Objectives We examined the level of agreement between biomedical and self-reported measurements of hypertension and diabetes in a Chinese national community sample, and explored associations of the agreement and possible contextual effects among provinces and geographic regions in China. Design Secondary analysis of a cohort sample. Setting and participants Community samples were drawn from the national baseline survey of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2012) through multistage probability sampling, which included households with members 45 years of age or above with a total sample size of 17 708 individuals. Outcome measures Sensitivity, specificity and κ were used as measurements of agreements or validity; variance of validity measures among provinces and communities was estimated using random-effects models. Results Self-reports for hypertension and diabetes showed high specificity (96.3% and 98.3%, respectively) but low sensitivity (56.3% and 61.5%, respectively). Agreement between self-reported data and biomedical measurements was moderate for both hypertension (κ 0.57) and diabetes (κ 0.65), with respondents who were older, of higher socioeconomic status, better educated and who had hospital admissions in the past 12 months showing stronger agreements than their counterparts. Large and significant variations in the sensitivity among provinces for hypertension, and among communities for both hypertension and diabetes, could neither be attributed to the effects of respondents’ characteristics nor to the contextual effects of city–village differences. Conclusions As a considerable number of people in the overall sample were unaware of their conditions, self-reports will lead to an underestimation of the prevalence of hypertension and diabetes. However, in more developed communities or provinces, self-reported data can be a reliable estimate of the prevalence of the two conditions. Further investigations of contextual effects at provincial and community levels could highlight public health strategies to improve awareness of the two conditions.

To examine a 16-year trend in cognitive impairment (CI) incidence and associated factors among older Chinese people. aged 60 and above whose cognitive function were normal at their first test. a secondary analysis that identified subjects from the database of Chinese Longitudinal Healthy Longevity Survey (CLHLS). The database contained mixed longitudinal cohorts of older Chinese people surveyed in 1998, 2000, 2002, 2005, 2008–09, 2011–12 and 2014. The cognitive function of subjects was tested using the Chinese Mini-Mental State Examination (CMMSE) in each wave. The unique individual code identified a mixed cohort of 17,896 subjects who had multiple CMMSE measures over a 16-year period and available covariates for the analysis. CI was defined as the CMMSE score below 18 points. Crude and age-standardised incidence of CI by gender were calculated by year of survey. Risk factor adjusted time trends in the incidence were examined using multilevel regression models. age-standardised CI incidence decreased from 58.77‰ to 10.09‰ (P < 0.001) from 1998 to 2014, and this decrease remained after adjusting for covariates. About 15.8% in the observed decline was explained by higher education, and 7.9% was due to health practice (regular exercise, physical activity and cognitive activity), beyond age and gender effects. the CI incidence among older Chinese people decreased from 1998 to 2014. Lower education level and less frequent health practices mentioned above were important risk factors in CI prevention.

Coercive measures is a topic that has long been discussed in the field of psychiatry. Despite global reports of reductions in the use of restraint episodes due to new regulations, it is still questionable if practices have really changed over time. For this study, we examined the rates of coercive measures in the inpatient population of psychiatric care providers across Finland to identify changing trends as well as variations in such trends by region. In this nationwide registry analysis, we extracted patient data from the national database (The Finnish National Care Register for Health Care) over a 20-year period. We included adult patients admitted to psychiatric units (care providers) and focused on patients who had faced coercive measures (seclusion, limb restraints, forced injection and physical restraints) during their hospital stay. Multilevel logistical models (a polynomial model of quadratic form) were used to examine trends in prevalence of any coercive measures as well as the other four specified coercive measures over time, and to investigate variation in such trends among care providers and regions. Between 1995 and 2014, the dataset contained 226,948 inpatients who had been admitted during the 20-year time frame (505,169 treatment periods). The overall prevalence of coercive treatment on inpatients was 9.8%, with a small decrease during 2011–2014. The overall prevalence of seclusion, limb restraints, forced injection and physical restraints on inpatients was 6.9, 3.8, 2.6 and 0.8%, respectively. Only the use of limb restraints showed a downward trend over time. Geographic and care provider variations in specific coercive measures used were also observed. Despite the decreasing national level of coercive measures used in Finnish psychiatric hospitals, the overall reduction has been small during the last two decades. These results have implications on the future development of structured guidelines and interventions for preventing and more effectively managing challenging situations. Clinical guidelines and staff education related to the use of coercive measures should be critically assessed to ensure that the staff members working with vulnerable patient populations in psychiatric hospitals are ethically competent.

Background: Information technology and video gaming have potential advantages in the treatment of schizophrenia. However, information regarding the habits and attitudes related to internet use and video gaming in people with schizophrenia is limited. Objective: The aim of this study was to explore the habits and attitudes regarding video gaming and information technology usage and their associated factors in people with schizophrenia in Hong Kong. Methods: In this cross-sectional survey, service users with schizophrenia were recruited from 6 halfway hostels and 7 integrated centers for mental wellness in Hong Kong. A 79-item self-report questionnaire was utilized to explore the habits of internet use and video gaming in these people with schizophrenia. The attitude toward video gaming was assessed using the Gaming Attitudes, Motivations, and Experiences Scales. Of the 148 individuals in a convenience sample who were invited to participate in this study, 110 willingly participated (a response rate of 74.3%). The data were analyzed using descriptive statistics, a two-tailed independent t test, Pearson correlation, and principal analysis with 3 methods of rotation (varimax, equimax, and promax). Results: Most participants (100/110, 90.9%) had access to the internet and half of them (54/110, 49.1%) used the internet daily mostly to watch videos (66/110, 60.0%) or read news or books, etc (42/110, 38.2%). One-third of the participants (36/110, 32.7%) used the internet to play web-based games, and most of them (88/110, 80.0%) had played a video game in the past year. The most favorable gaming platforms were cellular phones (43/88, 49%) followed by computers (19/88, 22%) and arcade cabinets (6/88, 7%). The most favorable game genre was action games (34/145, 23.4%). Those who had a bachelor’s degree or higher scored lower in social interaction than those with a lower education level (P=.03). Those who played video games daily scored higher in the category of story than those who did not play daily (t86=2.03, P=.05). The most popular gaming category was autonomy and the least popular categories were violent catharsis and violent reward. Two motives, “social playing” and “evasive playing,” were formed to describe the characteristics of playing video games. Conclusions: Our data showed a high internet utilization rate among people with schizophrenia in Hong Kong. Only a few of them used the internet to search for health-related information. Our study also exemplified the unique habits of gaming among the participants. Health care professionals could utilize video games to engage people with schizophrenia and promote coping with stress and provide social skills training to such people with schizophrenia. Identification of the gaming attitudes can contribute to the development of serious games for the schizophrenic population. Further investigation is vital for the promotion of mental health through web-based platforms.

Objective: To identify the prevalence of posttraumatic stress disorder (PTSD) and its determinants among adolescents more than 4 years after the 2008 Wenchuan earthquake.Method: Adolescents (1,125 total) from 2 junior high schools in areas affected by the catastrophic earthquake were followed up for 3 years. The self-rating PTSD scale based on the Manual of Mental Disorders, 4th Edition (DSM-IV) and the Chinese Classification and Diagnostic Criteria of Mental Disorders, 2nd Edition, Revised (CCMD-2-R) was collected at 53 months, and determinant data were collected repeatedly. Logistic regression was used for a determinants analysis.Results: The prevalence of overall PTSD was 23.4% among the sample. The risk factors for PTSD were older age (OR=1.52, 95% CI: 1.20~1.92), and death or injury of a family member in the earthquake (OR=1.61, 95% CI: 1.09~2.37). Adolescents who had moderate-to-severe common mental health problems were more likely to have PTSD symptoms, with ORs from 3.98 to 17.67 (All P<0.05). Self-esteem remained a protective factor for PTSD regardless of age, whereas positive coping was a protective factor for PTSD when adolescents were older.Conclusion: PTSD symptoms among adolescent survivors of a catastrophic earthquake seemed to persist over time. Long-term interventions are needed to alleviate PTSD symptoms among adolescent survivors. (Disaster Med Public Health Preparedness. 2019;13:414-418)