High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child H...High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child Health Hospital of Hubei Province.Each participant accepted hrHPV testing and completed a self^administered questionnaire about basic information and potential risk factors.The univariable and multivariable logistic regression model was used to explore the associations between variants and hrHPV infection.Our results showed that hrHPV prevalence was 16.09% in Hubei Province,among which,hrHPV was more likely to be positive in women aged 51 years or above (OR=1.65,95% CI:1.28-2.14),and in women who had symptoms of bleeding after intercourse (OR=1.32,95% CI:1.17-1.50),had first sexual intercourse at the age of 18 years or below (OR=1.33,95% CI:1.07-1.64),had at least three male sexual partners (OR=2.50,95% CI:2.07-3.03),and who had been diagnosed with sexually transmitted infections (OR=1.50,95% CI:1.12-2.03).Married women (OR=0.66,95% CI:0.55-0.78) and women who frequently used condoms (OR=0.75,95% CI:0.67-0.84) had a relatively lower hrHPV prevalence.This study confirms that hrHPV infection was associated with age,marital status,symptoms of intercourse bleeding,history of sexually transmitted infections,and sex-related behaviors.Above all,this study provides a baseline database prior to obtaining vaccinations for dynamic tracking of the changes in hrHPV prevalence.展开更多
Background The prevalence of prolonged grief disorder(PGD)and its symptoms among the bereaved population in China vary considerably.Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among...Background The prevalence of prolonged grief disorder(PGD)and its symptoms among the bereaved population in China vary considerably.Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China.Methods We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023,for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals.The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data(‘JBI checklist’)and the Grading of Recommendations,Assessment,Development and Evaluations(GRADE),respectively.The‘metaprop’package in R V.4.1.2 was used to synthesise the prevalence.Results A total of 28 studies involving 10994 bereaved individuals were included in the analysis,with JBI checklist scores between 3 and 7.The combined prevalence(95%confidence interval)of PGD and its symptoms was 8.9%(4.2%to 17.6%)and 32.4%(18.2%to 50.8%),respectively.PGD and its symptoms were most prevalent among those who had lost their only child(22.7%)and those bereaved by earthquakes(80.4%),respectively.The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms.Conclusions The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China.This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes.Further methodologically rigorous studies are needed to provide more accurate prevalence estimates.PROSPERO registration number CRD42023432553.展开更多
Background Post-stroke depression(PSD)is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life(QoL).To date,few studies have examined the network structure of depressive s...Background Post-stroke depression(PSD)is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life(QoL).To date,few studies have examined the network structure of depressive symptoms and their relationships with QoL in stroke survivors.Aims This study aimed to explore the network structure of depressive symptoms in PSD and investigate the interrelationships between specific depressive symptoms and QoL among older stroke survivors.Methods This study was based on the 2017–2018 collection of data from a large national survey in China.Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale(CESD),while QoL was measured with the World Health Organization Quality of Life-brief version.Network analysis was employed to explore the structure of PSD,using expected influence(EI)to identify the most central symptoms and the flow function to investigate the association between depressive symptoms and QoL.Results A total of 1123 stroke survivors were included,with an overall prevalence of depression of 34.3%(n=385;95%confidence interval 31.5%to 37.2%).In the network model of depression,the most central symptoms were CESD3(‘feeling blue/depressed’,EI:1.180),CESD6(‘feeling nervous/fearful’,EI:0.864)and CESD8(‘loneliness’,EI:0.843).In addition,CESD5(‘hopelessness’,EI:−0.195),CESD10(‘sleep disturbances’,EI:−0.169)and CESD4(‘everything was an effort’,EI:−0.150)had strong negative associations with QoL.Conclusion This study found that PSD was common among older Chinese stroke survivors.Given its negative impact on QoL,appropriate interventions targeting central symptoms and those associated with QoL should be developed and implemented for stroke survivors with PSD.展开更多
AIM: To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. METHODS: This prosp...AIM: To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. METHODS: This prospective study was carried out in Imam Hospital, Tabriz University of medical sciences, Iran. Continuous patients with long lasting lower gastrointestinal tract symptoms who had the criteria of a colonoscopy were included. The endoscopist visualized the caecum documented by a photo and/or a specimen from terminal ileum. RESULTS: Four hundred and eighty consecutive symptomatic patients [mean age (SD): 42.73 (16.21)] were included. The prevalence of colorectal neoplasia was 15.3% (34 subjects) and 37.7% (181 subjects) had a completely normal colon. Adenomatous polyps were detected in 56 (11.7%) patients, in 12.3% of men and 10.9% of women. The mean age of the patients with a polyp was significantly higher than the others (49.53 ± 14.16 vs 41.85 ± 16.26, P = 0.001). Most of the adenomatous polyps were left sided and tubular; only 22.5% of polyps were more than 10 mm. Cancer was detected in 16 (3.6%) of our study population, which was mostly right sided (57.2%). The mean age of patients with cancer was significantly higher than the others (60.25 ± 8.26 vs 42.13 ± 16.08, P < 0.005) and higher than patients with polyps [60.25 (8.26) vs 49.53 (1.91) (P < 0.0005)]. None of the symptoms (diarrhea, abdominal pain, rectal bleeding, constipation, altering diarrhea and constipation, history of cancer, known irritable bowel disease, history of polyp and fissure or family history of cancer) were predictors for cancer or polyps, but the age of the patient and unexplainedanemia independently predicted cancer. CONCLUSION: Less advanced patterns and smaller sizes of adenomas in Iran is compatible with other data from Asia and the Middle East, but in contrast to western countries. Prevalence of colonic neoplasia in our community seems to be lower than that in western population. Colonic symptoms are not predictors for polyps or cancer but unexplained anemia and elder age can predict CRC.展开更多
Objective:To investigate the prevalence and severity of menopausal symptoms among Chinese women aged 40-60 years and provide evidence for developing personalized health management strategies.Methods:Using a multi-stag...Objective:To investigate the prevalence and severity of menopausal symptoms among Chinese women aged 40-60 years and provide evidence for developing personalized health management strategies.Methods:Using a multi-stage stratified cluster sampling approach,we conducted a nationwide crosssectional survey across representative provincial-level administrative divisions(PLADs)and prefecture-level cities,encompassing 26 district/county survey sites.The questionnaire collected information on demographic characteristics,menopausal status,and symptoms.Data analysis employed means and standard deviations(X±S)or rates and proportion ratios to describe menopausal symptom occurrence,with group differences analyzed using Mann-Whitney or Kruskal-Wallis tests.Results:The study included 42,304 women with a mean age of 49.9±5.7 years.The overall prevalence of menopausal symptoms was 46.3%[95%confidence interval(CI):45.8%,46.7%],predominantly mild to moderate in severity.The prevalence of mild to severe symptoms began increasing in women over age 44,peaking at age 52.Moderate to severe symptoms showed an uptick after age 46,also peaking at 52 years,while severe symptoms increased after age 48,reaching maximum prevalence at age 56.The most commonly reported symptoms were insomnia(50.0%,95%CI:49.5%,50.5%),fatigue(48.2%,95%CI:47.7%,48.7%),and nervousness(46.9%,95%CI:46.5%,47.4%).Significant differences in symptom severity between premenopausal and postmenopausal women were observed in the 45-49(P<0.001)and 50-54(P=0.019<0.05)age groups.Conclusions:The study revealed distinct patterns in the prevalence,severity,and manifestation of menopausal symptoms across different age groups in China.The age-related progression of symptoms provides a scientific foundation for developing targeted healthcare interventions for women at various stages of menopause.展开更多
Introduction:Depression among older adults has emerged as a critical public health concern in China.While previous studies have demonstrated spatial heterogeneity in the prevalence of depressive symptoms among elderly...Introduction:Depression among older adults has emerged as a critical public health concern in China.While previous studies have demonstrated spatial heterogeneity in the prevalence of depressive symptoms among elderly populations across China,the spatiotemporal evolution of this phenomenon remains inadequately explored.This study aimed to estimate city-level prevalence of depressive symptoms among elderly Chinese residents from 2013 to 2020 and analyze its spatial-temporal patterns.Methods:Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)surveys conducted in 2013,2015,2018,and 2020.The study employed sandwich estimation methodology to calculate prevalence rates,while global autocorrelation analysis was utilized to evaluate spatial patterns in the distribution of depressive symptoms.Results:The average prevalence of depressive symptoms among Chinese older adults demonstrated a consistent increase from 30.27%[95%confidence interval(CI):24.53%,36.02%]in 2013 to 37.79%(95%CI:31.01%,44.56%)in 2020.Higher prevalence rates were observed in cities across Southwest,Northwest,and Central China,although no significant spatial aggregation was detected.Conclusions:The prevalence of depressive symptoms among older adults in China showed a substantial increase between 2013 and 2020.Enhanced preventive measures and interventions are particularly needed to improve mental well-being among elderly populations in China’s western and central regions.展开更多
BACKGROUND Recent reports of both heightened prevalence rates and limited clinical relevance of clinical high-risk(CHR)criteria and their relevant symptoms in children and adolescents indicate an important role of neu...BACKGROUND Recent reports of both heightened prevalence rates and limited clinical relevance of clinical high-risk(CHR)criteria and their relevant symptoms in children and adolescents indicate an important role of neurodevelopment in the early detection of psychoses.Furthermore,sex effects in CHR symptoms have been reported,though studies were inconclusive.As sex also impacts on neurodevelopment,we expected that sex might have an additional contribution to age in the prevalence and clinical relevance of CHR symptoms and criteria.AIM To investigate age and sex effects on CHR criteria and symptoms and their association with psychosocial impairment and mental disorder.METHODS In this cross-sectional cohort study,n=29168-to 40-year-olds,randomly drawn from the population register of the Swiss canton Bern,were assessed in semistructured interviews by phone or face-to-face for CHR symptoms and criteria using the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument in its child and youth,and adult version,respectively.Furthermore,social and occupational functioning and DSM-IV axis I disorders were assessed.Simple and interaction effects of age and sex on CHR symptoms and criteria,and interaction effects of age,sex,and CHR symptoms and criteria on presentation of functional impairment and of non-psychotic disorder were investigated using logistic regression analyses.RESULTS Altogether,542(18.6%)participants reported any CHR symptom;of these,261(9.0%)participants reported any one of the 11 criteria relevant cognitive and perceptual basic symptoms,and 381(13.1%)any one of the five attenuated or transient psychotic symptoms(attenuated psychotic symptoms/brief intermittent psychotic symptoms).Fewer participants met any one of the CHR criteria(n=82,2.8%)or any one of the three recently recommended CHR criteria(n=38,1.3%).Both age and sex were significantly(P<0.05)associated with CHR symptoms and criteria,mostly by younger age and female sex.Though slightly differing between symptom groups,age thresholds were detected around the turn from adolescence to adulthood;they were highest for cognitive basic symptoms and CHR criteria.With the exception of the infrequent speech disorganization attenuated psychotic symptom,the interaction of age with CHR symptoms and criteria predicted functional impairment;whereas,independent of each other,sex and CHR symptoms mostly predicted mental disorders.CONCLUSION Age and sex differentially impact on CHR symptoms and criteria;these differences may support better understanding of causal pathways.Thus,future CHR studies should consider effects of sex and age.展开更多
Objective To describe whether or not there are gender differences in lower urinary tract symptoms(LUTS)prevalence and risk factors in community-dwelling older Chinese Americans.Methods We performed a secondary analysi...Objective To describe whether or not there are gender differences in lower urinary tract symptoms(LUTS)prevalence and risk factors in community-dwelling older Chinese Americans.Methods We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English,Mandarin,Cantonese,Taishanese,or Teochew.A clinical review of systems was used to assess LUTS,which included urinary frequency,urgency,burning and/or pain,blood in urine,and urinary incontinence.Results Of the total 3157 people queried,42%were men and 58%were women.More men reported LUTS compared to women(32.9%vs.28.6%,p=0.01).In a multivariable analysis,female gender(adjusted odds ratio[aOR]0.60,95%confidence interval[CI]0.49-0.73),being married(aOR 0.79,95%CI 0.65-0.97),and smoking(aOR 0.66,95%CI 0.49-0.88)were found to be protective,while traditional Chinese medicine use(aOR 1.51,95%CI 1.28-1.78),heart disease(aOR 1.54,95%CI 1.24-1.91),and anxiety(aOR 1.69,95%CI 1.25-2.28)were most strongly associated with increased odds of LUTS.When examining genders separately,being married was found to be protective only in women.Meanwhile,unique factors found in men were hypertension,heart disease,and practice of Tai Chi.Conclusion In this large population-based study,LUTS were more prevalent in older Chinese American men than women.We also found gender-specific factors that influenced the odds of reporting LUTS;however,traditional Chinese medicine use was the only factor that was shared by both genders.Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.展开更多
Background:The human papillomavirus virus(HPV)is very common with over 150 strains and at least 42 acquired by sexual contact.It is a public health concern among women the world over,with an estimated prevalence of 11...Background:The human papillomavirus virus(HPV)is very common with over 150 strains and at least 42 acquired by sexual contact.It is a public health concern among women the world over,with an estimated prevalence of 11.7%globally,and 24%in Sub-Saharan Africa.There are five common HPV types;HPV16,HPV18,HPV52,HPV31,and HPV58.Cervical cancer affects women globally,with estimated 570,000 new cases in 2018.Nearly 90%of the 311,000 deaths worldwide in that year occurred in low-and middle-income countries.Objective:To estimate the prevalence of HPV among sexually active women in Lagos,Nigeria;and to determine the most common HPV type among that category.Methods:A descriptive cross-sectional study design was implemented,with 198 women in total enrolled for the study.Sexually active women from various health facilities in Lagos were screened by obtaining cervical tissue,stirred into PCR cell media,and assayed for HPV genotypes using the Roche COBAS®4800 System.Results:Age of the women ranged from 18 to 65 years(mean 34.6±6.4),with the majority(56.4%)between 25-34 years;65%were married and 63%had a secondary education.Age at first penile-vaginal contact ranged from 9 to 38 years(mean 20.4±3.9).Sixty-five percent of women stated total lifetime sexual partners of between 2 and 4(mean 2.9±2.5).The prevalence of high-risk HPV was 40.4%(95%CI:40.1 to 40.7)and breakdown of types obtained were;HPV16,2.5%(95%CI:2.22 to 2.78);HPV18,3.5%(95%CI:3.22 to 3.78);other high risk(OHR)HPV,28.3%(95%CI:28 to 28.6);HPV16&OHR HPV,1.5%(95%CI:1.22 to 1.78);HPV18&OHR HPV,4.1%(95%CI:3.82 to 4.38);HPV16,18&OHR HPV,0.5%(95%CI:0.221 to 0.779).HPV negative and inconclusive results were 58.1%and 1.5%respectively.Conclusion:Prevalence of OHR HPV is high among Nigerian women.This informs the pattern of HPV existing in the African region,and may aid future efforts at eradicating the virus.The findings are further contributive evidence to the initiative to eliminate cervical cancer as a public health challenge in Nigeria.展开更多
目的系统评价我国儿童青少年抑郁症状的流行现状。方法检索PubMed、Embase、Cochrane Library、Web of Science、万方数据、中国生物医学文献数据库、中国知网和维普数据库,收集2015年1月—2024年5月发表的有关我国儿童青少年抑郁症状...目的系统评价我国儿童青少年抑郁症状的流行现状。方法检索PubMed、Embase、Cochrane Library、Web of Science、万方数据、中国生物医学文献数据库、中国知网和维普数据库,收集2015年1月—2024年5月发表的有关我国儿童青少年抑郁症状患病率的文献。使用Stata 16.0软件进行Meta分析,对纳入研究进行Egger's检验和漏斗图分析评估发表偏倚。结果共纳入53篇文献,包含314867例儿童青少年,其中有抑郁症状者65324例,抑郁症状患病率为23.3%(95%CI:21.4%~25.1%)。亚组分析结果显示,女生、学校所在地为农村、学段为职高、东部地区、使用儿童抑郁障碍自评量表评估、新型冠状病毒感染疫情期间的儿童青少年抑郁症状患病率较高,分别为24.9%、29.5%、28.1%、25.6%、27.2%、27.7%。所纳入研究在漏斗图中的分布大致对称,但Egger's检验提示可能存在发表偏倚(P<0.001)。结论我国儿童青少年抑郁症状的患病率较高,特别是女生、农村地区的儿童青少年、职高学段的学生及东部地区的儿童青少年表现出更高的患病率。此外,新型冠状病毒感染疫情可能对儿童青少年抑郁症状的发生具有影响。展开更多
Background:Nonmotor symptoms are common among patients with Parkinson’s disease(PD)and some may precede disease diagnosis.Methods:We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before an...Background:Nonmotor symptoms are common among patients with Parkinson’s disease(PD)and some may precede disease diagnosis.Methods:We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before and after PD diagnosis,using random-effect models.We searched PubMed(1965 through October/November 2012)for the following symptoms:hyposmia,constipation,rapid eye movement sleep behavior disorder,excessive daytime sleepiness,depression,and anxiety.Eligible studies were publications in English with original data on one or more of these symptoms.Results:The search generated 2,373 non-duplicated publications and 332 met the inclusion criteria,mostly(n=320)on symptoms after PD diagnosis.For all symptoms,the prevalence was substantially higher in PD cases than in controls,each affecting over a third of the patients.Hyposmia was the most prevalent(75.5%in cases vs.19.1%in controls),followed by constipation(50%vs.17.7%),anxiety(39.9%vs.19.1%),rapid eye movement sleep behavior disorder(37.0%vs.7.0%),depression(36.6%vs.14.9%),and excessive daytime sleepiness(33.9%vs.10.5%).We observed substantial heterogeneities across studies and meta-regression analyses suggested that several factors might have contributed to this.However,the prevalence estimates were fairly robust in several sensitivity analyses.Only 20 studies had data on any symptoms prior to PD diagnosis,but still the analyses revealed higher prevalence in future PD cases than in controls.Conclusion:These symptoms are common among PD patients both before and after diagnosis.Further studies are needed to understand the natural history of nonmotor symptoms in PD and their etiological and clinical implications.展开更多
Objectives Anxiety and depression(A&D)are common mental disorders with high economical and health burdens.This study aimed to investigate the prevalence and the incidence rate of A&D symptoms and their relatio...Objectives Anxiety and depression(A&D)are common mental disorders with high economical and health burdens.This study aimed to investigate the prevalence and the incidence rate of A&D symptoms and their relationship with sociodemographic and other risk factors and comorbidities in adults living in southeastern Iran.Design A population-based cohort study with random cluster household survey sampling method.Setting Second round of Kerman Coronary Artery Disease Risk Factors Study(KERCADRS)(2014-2018)performed in Southeastern,Iran.Participants We recruited 9997 participants(15-80 years)in the second round of the study,from whom 2820 persons were the people who also participated in the first round of KERCADRS in 2009-2012.The age-standardised A&D prevalence was measured among all participants,and the 5-year A&D incidence rate was measured in those who were free from A&D in the first round in 2009-2012 and were at risk of A&D in the follow-up.The relationship between A&D and demographic characteristics,smoking,opium use,obesity and physical activity was assessed by logistic regression models.Results Overall,the prevalence of anxiety(48.1%to 16.4%,p<0.001)and depression(5.9%to 1.3%,p<0.001)decreased between the two rounds.The highest prevalence of anxiety was among widowed(31.4%),unemployed(21.3%),obese(19.4%),and opium users(17.4%).Young adults,women,those divorced or widowed,and those with obesity and low physical activity had a higher chance of developing anxiety.The 5-year incidence rate(person/1000 person-years)was 15.0 for anxiety and 3.9 for depression.Conclusion Despite the overall decrease in the prevalence of A&D symptoms in last 5 years in the area,young adults,women,unemployed,opium users,people with low physical activity and those with obesity had a higher chance of developing anxiety and are in need of more targeted interventions.展开更多
基金This work was supported by the Natural Science Foundation of Hubei Province, China (No.2017CKC891).
文摘High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child Health Hospital of Hubei Province.Each participant accepted hrHPV testing and completed a self^administered questionnaire about basic information and potential risk factors.The univariable and multivariable logistic regression model was used to explore the associations between variants and hrHPV infection.Our results showed that hrHPV prevalence was 16.09% in Hubei Province,among which,hrHPV was more likely to be positive in women aged 51 years or above (OR=1.65,95% CI:1.28-2.14),and in women who had symptoms of bleeding after intercourse (OR=1.32,95% CI:1.17-1.50),had first sexual intercourse at the age of 18 years or below (OR=1.33,95% CI:1.07-1.64),had at least three male sexual partners (OR=2.50,95% CI:2.07-3.03),and who had been diagnosed with sexually transmitted infections (OR=1.50,95% CI:1.12-2.03).Married women (OR=0.66,95% CI:0.55-0.78) and women who frequently used condoms (OR=0.75,95% CI:0.67-0.84) had a relatively lower hrHPV prevalence.This study confirms that hrHPV infection was associated with age,marital status,symptoms of intercourse bleeding,history of sexually transmitted infections,and sex-related behaviors.Above all,this study provides a baseline database prior to obtaining vaccinations for dynamic tracking of the changes in hrHPV prevalence.
基金This work was supported by National Natural Science Foundation of China(grant number:71774060)2015 Irma and Paul Milstein Program for Senior Health Awards from the Milstein Medical Asian American Partnership Foundation,the Young Top Talent Program in Public Health from Health Commission of Hubei Province(grant number:EWEITONG[2021]74,PI:B-LZ)Wuhan Health and Family Planning Commission(grant numbers:WX17Q30,WG16A02,WG14C24).The funding sources listed had no role in the study design,the collection,analysis and interpretation of data,the writing of the report,and the decision to submit the paper for publication.
文摘Background The prevalence of prolonged grief disorder(PGD)and its symptoms among the bereaved population in China vary considerably.Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China.Methods We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023,for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals.The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data(‘JBI checklist’)and the Grading of Recommendations,Assessment,Development and Evaluations(GRADE),respectively.The‘metaprop’package in R V.4.1.2 was used to synthesise the prevalence.Results A total of 28 studies involving 10994 bereaved individuals were included in the analysis,with JBI checklist scores between 3 and 7.The combined prevalence(95%confidence interval)of PGD and its symptoms was 8.9%(4.2%to 17.6%)and 32.4%(18.2%to 50.8%),respectively.PGD and its symptoms were most prevalent among those who had lost their only child(22.7%)and those bereaved by earthquakes(80.4%),respectively.The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms.Conclusions The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China.This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes.Further methodologically rigorous studies are needed to provide more accurate prevalence estimates.PROSPERO registration number CRD42023432553.
基金supported by Beijing High Level Public Health Technology Talent Construction Project(Discipline Backbone-01-028)the Beijing Municipal Science&Technology Commission(No.Z181100001518005)+2 种基金the Capital's Funds for Health Improvement and Research(CFH 2024-2-1174)the University of Macao(MYRG-GRG2023-00141-FHS,CPG2025-00021-FHS)the Science and Technology Plan Foundation of Guangzhou(No.202201011663).
文摘Background Post-stroke depression(PSD)is a common neuropsychiatric problem associated with a high disease burden and reduced quality of life(QoL).To date,few studies have examined the network structure of depressive symptoms and their relationships with QoL in stroke survivors.Aims This study aimed to explore the network structure of depressive symptoms in PSD and investigate the interrelationships between specific depressive symptoms and QoL among older stroke survivors.Methods This study was based on the 2017–2018 collection of data from a large national survey in China.Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale(CESD),while QoL was measured with the World Health Organization Quality of Life-brief version.Network analysis was employed to explore the structure of PSD,using expected influence(EI)to identify the most central symptoms and the flow function to investigate the association between depressive symptoms and QoL.Results A total of 1123 stroke survivors were included,with an overall prevalence of depression of 34.3%(n=385;95%confidence interval 31.5%to 37.2%).In the network model of depression,the most central symptoms were CESD3(‘feeling blue/depressed’,EI:1.180),CESD6(‘feeling nervous/fearful’,EI:0.864)and CESD8(‘loneliness’,EI:0.843).In addition,CESD5(‘hopelessness’,EI:−0.195),CESD10(‘sleep disturbances’,EI:−0.169)and CESD4(‘everything was an effort’,EI:−0.150)had strong negative associations with QoL.Conclusion This study found that PSD was common among older Chinese stroke survivors.Given its negative impact on QoL,appropriate interventions targeting central symptoms and those associated with QoL should be developed and implemented for stroke survivors with PSD.
基金Liver and Gastrointestinal Diseases Research Center, Tabriz University of medical sciences, East Azerbaijan, Iran
文摘AIM: To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. METHODS: This prospective study was carried out in Imam Hospital, Tabriz University of medical sciences, Iran. Continuous patients with long lasting lower gastrointestinal tract symptoms who had the criteria of a colonoscopy were included. The endoscopist visualized the caecum documented by a photo and/or a specimen from terminal ileum. RESULTS: Four hundred and eighty consecutive symptomatic patients [mean age (SD): 42.73 (16.21)] were included. The prevalence of colorectal neoplasia was 15.3% (34 subjects) and 37.7% (181 subjects) had a completely normal colon. Adenomatous polyps were detected in 56 (11.7%) patients, in 12.3% of men and 10.9% of women. The mean age of the patients with a polyp was significantly higher than the others (49.53 ± 14.16 vs 41.85 ± 16.26, P = 0.001). Most of the adenomatous polyps were left sided and tubular; only 22.5% of polyps were more than 10 mm. Cancer was detected in 16 (3.6%) of our study population, which was mostly right sided (57.2%). The mean age of patients with cancer was significantly higher than the others (60.25 ± 8.26 vs 42.13 ± 16.08, P < 0.005) and higher than patients with polyps [60.25 (8.26) vs 49.53 (1.91) (P < 0.0005)]. None of the symptoms (diarrhea, abdominal pain, rectal bleeding, constipation, altering diarrhea and constipation, history of cancer, known irritable bowel disease, history of polyp and fissure or family history of cancer) were predictors for cancer or polyps, but the age of the patient and unexplainedanemia independently predicted cancer. CONCLUSION: Less advanced patterns and smaller sizes of adenomas in Iran is compatible with other data from Asia and the Middle East, but in contrast to western countries. Prevalence of colonic neoplasia in our community seems to be lower than that in western population. Colonic symptoms are not predictors for polyps or cancer but unexplained anemia and elder age can predict CRC.
基金Supported by the National Key R&D Program of China(2022YFC2703801).
文摘Objective:To investigate the prevalence and severity of menopausal symptoms among Chinese women aged 40-60 years and provide evidence for developing personalized health management strategies.Methods:Using a multi-stage stratified cluster sampling approach,we conducted a nationwide crosssectional survey across representative provincial-level administrative divisions(PLADs)and prefecture-level cities,encompassing 26 district/county survey sites.The questionnaire collected information on demographic characteristics,menopausal status,and symptoms.Data analysis employed means and standard deviations(X±S)or rates and proportion ratios to describe menopausal symptom occurrence,with group differences analyzed using Mann-Whitney or Kruskal-Wallis tests.Results:The study included 42,304 women with a mean age of 49.9±5.7 years.The overall prevalence of menopausal symptoms was 46.3%[95%confidence interval(CI):45.8%,46.7%],predominantly mild to moderate in severity.The prevalence of mild to severe symptoms began increasing in women over age 44,peaking at age 52.Moderate to severe symptoms showed an uptick after age 46,also peaking at 52 years,while severe symptoms increased after age 48,reaching maximum prevalence at age 56.The most commonly reported symptoms were insomnia(50.0%,95%CI:49.5%,50.5%),fatigue(48.2%,95%CI:47.7%,48.7%),and nervousness(46.9%,95%CI:46.5%,47.4%).Significant differences in symptom severity between premenopausal and postmenopausal women were observed in the 45-49(P<0.001)and 50-54(P=0.019<0.05)age groups.Conclusions:The study revealed distinct patterns in the prevalence,severity,and manifestation of menopausal symptoms across different age groups in China.The age-related progression of symptoms provides a scientific foundation for developing targeted healthcare interventions for women at various stages of menopause.
基金Supported by the National Natural Science Foundation of China(No.42130713)the Innovation Project of LREIS(No.O88RA205YA)the National Natural Science Foundation of China(No.42407621).
文摘Introduction:Depression among older adults has emerged as a critical public health concern in China.While previous studies have demonstrated spatial heterogeneity in the prevalence of depressive symptoms among elderly populations across China,the spatiotemporal evolution of this phenomenon remains inadequately explored.This study aimed to estimate city-level prevalence of depressive symptoms among elderly Chinese residents from 2013 to 2020 and analyze its spatial-temporal patterns.Methods:Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)surveys conducted in 2013,2015,2018,and 2020.The study employed sandwich estimation methodology to calculate prevalence rates,while global autocorrelation analysis was utilized to evaluate spatial patterns in the distribution of depressive symptoms.Results:The average prevalence of depressive symptoms among Chinese older adults demonstrated a consistent increase from 30.27%[95%confidence interval(CI):24.53%,36.02%]in 2013 to 37.79%(95%CI:31.01%,44.56%)in 2020.Higher prevalence rates were observed in cities across Southwest,Northwest,and Central China,although no significant spatial aggregation was detected.Conclusions:The prevalence of depressive symptoms among older adults in China showed a substantial increase between 2013 and 2020.Enhanced preventive measures and interventions are particularly needed to improve mental well-being among elderly populations in China’s western and central regions.
基金Supported by the Swiss National Science Foundation,No.135381 and No.144100.
文摘BACKGROUND Recent reports of both heightened prevalence rates and limited clinical relevance of clinical high-risk(CHR)criteria and their relevant symptoms in children and adolescents indicate an important role of neurodevelopment in the early detection of psychoses.Furthermore,sex effects in CHR symptoms have been reported,though studies were inconclusive.As sex also impacts on neurodevelopment,we expected that sex might have an additional contribution to age in the prevalence and clinical relevance of CHR symptoms and criteria.AIM To investigate age and sex effects on CHR criteria and symptoms and their association with psychosocial impairment and mental disorder.METHODS In this cross-sectional cohort study,n=29168-to 40-year-olds,randomly drawn from the population register of the Swiss canton Bern,were assessed in semistructured interviews by phone or face-to-face for CHR symptoms and criteria using the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument in its child and youth,and adult version,respectively.Furthermore,social and occupational functioning and DSM-IV axis I disorders were assessed.Simple and interaction effects of age and sex on CHR symptoms and criteria,and interaction effects of age,sex,and CHR symptoms and criteria on presentation of functional impairment and of non-psychotic disorder were investigated using logistic regression analyses.RESULTS Altogether,542(18.6%)participants reported any CHR symptom;of these,261(9.0%)participants reported any one of the 11 criteria relevant cognitive and perceptual basic symptoms,and 381(13.1%)any one of the five attenuated or transient psychotic symptoms(attenuated psychotic symptoms/brief intermittent psychotic symptoms).Fewer participants met any one of the CHR criteria(n=82,2.8%)or any one of the three recently recommended CHR criteria(n=38,1.3%).Both age and sex were significantly(P<0.05)associated with CHR symptoms and criteria,mostly by younger age and female sex.Though slightly differing between symptom groups,age thresholds were detected around the turn from adolescence to adulthood;they were highest for cognitive basic symptoms and CHR criteria.With the exception of the infrequent speech disorganization attenuated psychotic symptom,the interaction of age with CHR symptoms and criteria predicted functional impairment;whereas,independent of each other,sex and CHR symptoms mostly predicted mental disorders.CONCLUSION Age and sex differentially impact on CHR symptoms and criteria;these differences may support better understanding of causal pathways.Thus,future CHR studies should consider effects of sex and age.
基金Data collection for the Population Study of Chinese Elderly(PINE,R01AG042318,PI:XinQi Dong)was supported by the National Institute on Aging.The funding agent had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Objective To describe whether or not there are gender differences in lower urinary tract symptoms(LUTS)prevalence and risk factors in community-dwelling older Chinese Americans.Methods We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English,Mandarin,Cantonese,Taishanese,or Teochew.A clinical review of systems was used to assess LUTS,which included urinary frequency,urgency,burning and/or pain,blood in urine,and urinary incontinence.Results Of the total 3157 people queried,42%were men and 58%were women.More men reported LUTS compared to women(32.9%vs.28.6%,p=0.01).In a multivariable analysis,female gender(adjusted odds ratio[aOR]0.60,95%confidence interval[CI]0.49-0.73),being married(aOR 0.79,95%CI 0.65-0.97),and smoking(aOR 0.66,95%CI 0.49-0.88)were found to be protective,while traditional Chinese medicine use(aOR 1.51,95%CI 1.28-1.78),heart disease(aOR 1.54,95%CI 1.24-1.91),and anxiety(aOR 1.69,95%CI 1.25-2.28)were most strongly associated with increased odds of LUTS.When examining genders separately,being married was found to be protective only in women.Meanwhile,unique factors found in men were hypertension,heart disease,and practice of Tai Chi.Conclusion In this large population-based study,LUTS were more prevalent in older Chinese American men than women.We also found gender-specific factors that influenced the odds of reporting LUTS;however,traditional Chinese medicine use was the only factor that was shared by both genders.Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.
文摘Background:The human papillomavirus virus(HPV)is very common with over 150 strains and at least 42 acquired by sexual contact.It is a public health concern among women the world over,with an estimated prevalence of 11.7%globally,and 24%in Sub-Saharan Africa.There are five common HPV types;HPV16,HPV18,HPV52,HPV31,and HPV58.Cervical cancer affects women globally,with estimated 570,000 new cases in 2018.Nearly 90%of the 311,000 deaths worldwide in that year occurred in low-and middle-income countries.Objective:To estimate the prevalence of HPV among sexually active women in Lagos,Nigeria;and to determine the most common HPV type among that category.Methods:A descriptive cross-sectional study design was implemented,with 198 women in total enrolled for the study.Sexually active women from various health facilities in Lagos were screened by obtaining cervical tissue,stirred into PCR cell media,and assayed for HPV genotypes using the Roche COBAS®4800 System.Results:Age of the women ranged from 18 to 65 years(mean 34.6±6.4),with the majority(56.4%)between 25-34 years;65%were married and 63%had a secondary education.Age at first penile-vaginal contact ranged from 9 to 38 years(mean 20.4±3.9).Sixty-five percent of women stated total lifetime sexual partners of between 2 and 4(mean 2.9±2.5).The prevalence of high-risk HPV was 40.4%(95%CI:40.1 to 40.7)and breakdown of types obtained were;HPV16,2.5%(95%CI:2.22 to 2.78);HPV18,3.5%(95%CI:3.22 to 3.78);other high risk(OHR)HPV,28.3%(95%CI:28 to 28.6);HPV16&OHR HPV,1.5%(95%CI:1.22 to 1.78);HPV18&OHR HPV,4.1%(95%CI:3.82 to 4.38);HPV16,18&OHR HPV,0.5%(95%CI:0.221 to 0.779).HPV negative and inconclusive results were 58.1%and 1.5%respectively.Conclusion:Prevalence of OHR HPV is high among Nigerian women.This informs the pattern of HPV existing in the African region,and may aid future efforts at eradicating the virus.The findings are further contributive evidence to the initiative to eliminate cervical cancer as a public health challenge in Nigeria.
文摘目的系统评价我国儿童青少年抑郁症状的流行现状。方法检索PubMed、Embase、Cochrane Library、Web of Science、万方数据、中国生物医学文献数据库、中国知网和维普数据库,收集2015年1月—2024年5月发表的有关我国儿童青少年抑郁症状患病率的文献。使用Stata 16.0软件进行Meta分析,对纳入研究进行Egger's检验和漏斗图分析评估发表偏倚。结果共纳入53篇文献,包含314867例儿童青少年,其中有抑郁症状者65324例,抑郁症状患病率为23.3%(95%CI:21.4%~25.1%)。亚组分析结果显示,女生、学校所在地为农村、学段为职高、东部地区、使用儿童抑郁障碍自评量表评估、新型冠状病毒感染疫情期间的儿童青少年抑郁症状患病率较高,分别为24.9%、29.5%、28.1%、25.6%、27.2%、27.7%。所纳入研究在漏斗图中的分布大致对称,但Egger's检验提示可能存在发表偏倚(P<0.001)。结论我国儿童青少年抑郁症状的患病率较高,特别是女生、农村地区的儿童青少年、职高学段的学生及东部地区的儿童青少年表现出更高的患病率。此外,新型冠状病毒感染疫情可能对儿童青少年抑郁症状的发生具有影响。
基金by the intramural research program of the NIH,the National Institute of Environmental Health Sciences(Z01-ES-101986).
文摘Background:Nonmotor symptoms are common among patients with Parkinson’s disease(PD)and some may precede disease diagnosis.Methods:We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before and after PD diagnosis,using random-effect models.We searched PubMed(1965 through October/November 2012)for the following symptoms:hyposmia,constipation,rapid eye movement sleep behavior disorder,excessive daytime sleepiness,depression,and anxiety.Eligible studies were publications in English with original data on one or more of these symptoms.Results:The search generated 2,373 non-duplicated publications and 332 met the inclusion criteria,mostly(n=320)on symptoms after PD diagnosis.For all symptoms,the prevalence was substantially higher in PD cases than in controls,each affecting over a third of the patients.Hyposmia was the most prevalent(75.5%in cases vs.19.1%in controls),followed by constipation(50%vs.17.7%),anxiety(39.9%vs.19.1%),rapid eye movement sleep behavior disorder(37.0%vs.7.0%),depression(36.6%vs.14.9%),and excessive daytime sleepiness(33.9%vs.10.5%).We observed substantial heterogeneities across studies and meta-regression analyses suggested that several factors might have contributed to this.However,the prevalence estimates were fairly robust in several sensitivity analyses.Only 20 studies had data on any symptoms prior to PD diagnosis,but still the analyses revealed higher prevalence in future PD cases than in controls.Conclusion:These symptoms are common among PD patients both before and after diagnosis.Further studies are needed to understand the natural history of nonmotor symptoms in PD and their etiological and clinical implications.
基金The Kerman Coronary Artery Disease Risk Factors Study,phase II,was funded by the Deputy of Research and Technology at Kerman University of Medical Sciences(grant number KMU.REC.1393/310).
文摘Objectives Anxiety and depression(A&D)are common mental disorders with high economical and health burdens.This study aimed to investigate the prevalence and the incidence rate of A&D symptoms and their relationship with sociodemographic and other risk factors and comorbidities in adults living in southeastern Iran.Design A population-based cohort study with random cluster household survey sampling method.Setting Second round of Kerman Coronary Artery Disease Risk Factors Study(KERCADRS)(2014-2018)performed in Southeastern,Iran.Participants We recruited 9997 participants(15-80 years)in the second round of the study,from whom 2820 persons were the people who also participated in the first round of KERCADRS in 2009-2012.The age-standardised A&D prevalence was measured among all participants,and the 5-year A&D incidence rate was measured in those who were free from A&D in the first round in 2009-2012 and were at risk of A&D in the follow-up.The relationship between A&D and demographic characteristics,smoking,opium use,obesity and physical activity was assessed by logistic regression models.Results Overall,the prevalence of anxiety(48.1%to 16.4%,p<0.001)and depression(5.9%to 1.3%,p<0.001)decreased between the two rounds.The highest prevalence of anxiety was among widowed(31.4%),unemployed(21.3%),obese(19.4%),and opium users(17.4%).Young adults,women,those divorced or widowed,and those with obesity and low physical activity had a higher chance of developing anxiety.The 5-year incidence rate(person/1000 person-years)was 15.0 for anxiety and 3.9 for depression.Conclusion Despite the overall decrease in the prevalence of A&D symptoms in last 5 years in the area,young adults,women,unemployed,opium users,people with low physical activity and those with obesity had a higher chance of developing anxiety and are in need of more targeted interventions.
