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It is unclear whether the enhancing contact model (ECM) intervention is effective in reducing family caregiving burden and improving hope and quality of life (QOL) among family caregivers of persons with schizophrenia (FCPWS).
We conducted a cluster randomized controlled trial in FCPWS in eight rural townships in Xinjin, Chengdu, China. In total, 253 FCPWS were randomly allocated to the ECM, psychoeducational family intervention (PFI), or treatment as usual (TAU) group. FCPWS in three groups were assessed caregiving burden, QOL and state of hope at baseline (T0), post-intervention (T1), 3-month (T2), and 9-month (T3) follow-up, respectively.
Compared with participants in the TAU group, participants in the ECM group had statistically significantly lower caregiving burden scores both at T1 and T2 (p = 0.0059 and 0.0257, respectively). Compared with participants in the TAU group, participants in the PFI group had statistically significantly higher QOL scores in T1 (p = 0.0406), while participants in the ECM group had statistically significantly higher QOL scores in T3 (p = 0.0240). Participants in both ECM and PFI groups had statistically significantly higher hope scores than those in the TAU group at T1 (p = 0.0160 and 0.0486, respectively).
This is the first study to explore the effectiveness of ECM on reducing family caregiving burden and improving hope and QOL in rural China. The results indicate the ECM intervention, a comprehensive and multifaceted intervention, is more effective than the PFI in various aspects of mental wellbeing among FCPWS. Future research needs to confirm ECM's effectiveness in various population.
Children’s exposure to talk about conceptual categories plays a powerful role in shaping their conceptual development. However, it remains unclear when parents begin to talk about categories with young children and whether such talk relates to children’s language skills. This study examines relations between parents’ talk about conceptual categories and infants’ expressive language development. Forty-seven parent-infant dyads were videotaped playing together at child age 10, 12, 14, and 16 months. Transcripts of interactions were analyzed to identify parents’ talk about conceptual categories. Children’s expressive language development was assessed at 18 months. Findings indicate that parents indeed talked about conceptual categories with infants and that talk was stable across time, with college-educated parents producing more than non-college-educated parents. Further, parents’ talk about conceptual categories between 10 and 16 months predicted children’s 18-month expressive language. This study sheds new light on mechanisms through which early experiences may support children’s language development.
The association between executive dysfunction, brain dysconnectivity, and inflammation is a prominent feature across major psychiatric disorders (MPDs), schizophrenia, bipolar disorder, and major depressive disorder. A dimensional approach is warranted to delineate their mechanistic interplay across MPDs.
This single site study included a total of 1543 participants (1058 patients and 485 controls). In total, 1169 participants underwent diffusion tensor and resting-state functional magnetic resonance imaging (745 patients and 379 controls completed the Wisconsin Card Sorting Test). Fractional anisotropy (FA) and regional homogeneity (ReHo) assessed structural and functional connectivity, respectively. Pro-inflammatory cytokine levels [interleukin (IL)-1β, IL-6, and tumor necrosis factor-α] were obtained in 325 participants using blood samples collected with 24 h of scanning. Group differences were determined for main measures, and correlation and mediation analyses and machine learning prediction modeling were performed.
Executive deficits were associated with decreased FA, increased ReHo, and elevated IL-1β and IL-6 levels across MPDs, compared to controls. FA and ReHo alterations in fronto-limbic-striatal regions contributed to executive deficits. IL-1β mediated the association between FA and cognition, and IL-6 mediated the relationship between ReHo and cognition. Executive cognition was better predicted by both brain connectivity and cytokine measures than either one alone for FA-IL-1β and ReHo-IL-6.
Transdiagnostic associations among brain connectivity, inflammation, and executive cognition exist across MPDs, implicating common neurobiological substrates and mechanisms for executive deficits in MPDs. Further, inflammation-related brain dysconnectivity within fronto-limbic-striatal regions may represent a transdiagnostic dimension underlying executive dysfunction that could be leveraged to advance treatment.
Little is known about how sociodemographic and clinical factors affect the caregiving burden of persons with schizophrenia (PwSs) with transition in primary caregivers.
This study aimed to examine the predictive effects of sociodemographic and clinical factors on the caregiving burden of PwSs with and without caregiver transition from 1994 to 2015 in rural China.
Using panel data, 206 dyads of PwSs and their primary caregivers were investigated in both 1994 and 2015. The generalised linear model approach was used to examine the predictive effects of sociodemographic factors, severity of symptoms and changes in social functioning on the caregiving burden with and without caregiver transition.
The percentages of families with and without caregiver transition were 38.8% and 61.2%, respectively. Among families without caregiver transition, a heavier burden was significantly related to a larger family size and more severe symptoms in PwSs. Deteriorated functioning of ‘social activities outside the household’ and improved functioning of ‘activity in the household’ were protective factors against a heavy caregiving burden. Among families with caregiver transition, younger age, improved marital functioning, deteriorated self-care functioning, and better functioning of ‘social interest or concern’ were significant risk factors for caregiving burden.
The effects of sociodemographic and clinical correlates on the caregiving burden were different among families with and without caregiver transition. It is crucial to explore the caregiver arrangement of PwSs and the risk factors for burden over time, which will facilitate culture-specific family interventions, community-based mental health services and recovery.
As part of a long-term experiment to determine the impacts of composted manure and straw amendments (replacing 50% of chemical fertilizer with composted pig manure, wheat straw return combined with chemical fertilizer, and setting no fertilizer and chemical fertilizer-only as controls) on rice-associated weeds in a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system, species richness, abundance, density, and biomass of weeds were assessed during years 8 and 9. Fertilization decreased the species richness and total density of rice-associated weeds but increased their total biomass. The species richness and densities of broadleaf and sedge weeds decreased with fertilization, while species richness of grass weeds increased only with straw return and density was not significantly affected. The shoot biomass per square meter of grass and broadleaf weeds was significantly higher with fertilization treatments than with the no-fertilizer control, while that of sedge weeds declined with fertilizer application. With fertilization, the densities of monarch redstem (Ammannia baccifera L.) and smallflower umbrella sedge (Cyperus difformis L.) decreased, that of Chinese sprangletop [Leptochloa chinensis (L.) Nees] increased, and those of barnyardgrass [Echinochloa crus-galli (L.) P. Beauv.] and monochoria [Monochoria vaginalis (Burm. f.) C. Presl ex Kunth] were not significantly affected. Ammannia baccifera was the most abundant weed species in all treatments. Whereas composted pig manure plus fertilizer resulted in higher density of A. baccifera and lower shoot biomass per plant than chemical fertilizer only, wheat straw return plus chemical fertilizer caused lower density and shoot biomass of A. baccifera. Therefore, it may be possible that fertilization strategies that suppress specific weeds could be used as improved weed management program components in rice production systems.
The looking-while-listening (LWL) paradigm is frequently used to measure toddlers’ lexical processing efficiency (LPE). Children's LPE is associated with vocabulary size, yet other linguistic, cognitive, or social skills contributing to LPE are not well understood. It also remains unclear whether LPE measures from two types of LWL trials (target-initial versus distractor-initial trials) are differentially associated with the abovementioned potential correlates of LPE. We tested 18- to 24-month-olds and found that children's word learning on a fast-mapping task was associated with LPE measures from all trials and distractor-initial trials but not target-initial trials. Children's vocabulary and pragmatic skills were both associated with their fast-mapping performance. Executive functions and pragmatic skills were associated with LPE measures from distractor-initial but not target-initial trials. Hence, LPE as measured by the LWL paradigm may reflect a constellation of skills important to language development. Methodological implications for future studies using the LWL paradigm are discussed.
Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China.
Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions.
The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty.
This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.
The aim of this study was to assess the current status of disease-related knowledge and to analyze the relationship among the general condition, illness perception, and psychological status of patients with coronavirus disease 2019 (COVID-19).
A hospital-based cross-sectional study was conducted on 118 patients using convenience sampling. The general questionnaire, disease-related knowledge questionnaire of COVID-19, Illness Perception Questionnaire (IPQ), and Profile of Mood States (POMS) were used to measure the current status of participants.
The overall average score of the disease-related knowledge of patients with COVID-19 was (79.19 ± 14.25), the self-care situation was positively correlated with knowledge of prevention and control (r = 0.265; P = 0.004) and total score of disease-related knowledge (r = 0.206; P = 0.025); the degree of anxiety was negatively correlated with the knowledge of diagnosis and treatment (r = −0.182; P = 0.049). The score of disease-related knowledge was negatively correlated with negative cognition (volatility, consequences, emotional statements) and negative emotions (tension, fatigue, depression) (P < 0.05); positively correlated with positive cognition (disease coherence) and positive emotion (self-esteem) (P < 0.05).
It was recommended that we should pay more attention to the elderly and low-income groups, and increase the knowledge about diagnosis and treatment of COVID-19 and self-care in the future health education for patients.
A study was conducted to identify whether composted manure and straw amendments (replacement of a portion of chemical fertilizer [50% of the total nitrogen application] with composted pig manure, and straw return [all straw from the previous rice crop] combined with chemical fertilizer) compared with no fertilization and chemical fertilizer only would change the dominant species of wheat-associated weeds as well as influence their growth and seed yield in a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system. The study was initiated in 2010, and the treatment effects on the species, density, plant height, shoot biomass, seed yield of dominant weeds, and wheat yields were assessed in 2017 and 2018. Fertilization significantly increased the height, density, and yield of wheat, as well as the shoot biomass of wheat-associated weeds, but decreased the weed species number. A total of 17 and 14 weed species were recorded in the experimental wheat fields in 2017 and 2018, respectively. The most dominant weed species were American sloughgrass [Beckmannia syzigachne (Steud.) Fernald] and catchweed bedstraw (Galium aparine L.), which made up more than 64% of the weed community in all treatments. When the chemical fertilizer application was amended with pig manure compost and straw return, the relative abundance of B. syzigachne significantly decreased, while the relative abundance of G. aparine significantly increased. The application of the chemical fertilizer-only treatment resulted in increases in the density, shoot biomass, and seed yield of B. syzigachne, while the composted manure and straw amendments applied together with chemical fertilizer led to significant increases in the density, shoot biomass, and seed yield of G. aparine. Consequently, further research on ways to promote greater cropping system diversity will be needed to prevent the selection of weed species that are adapted to a limited suite of crop management practices.
Both experiments and direct numerical simulations have been used to demonstrate that riblets can reduce turbulent drag by as much as $10\,\%$, but their systematic design remains an open challenge. In this paper we develop a model-based framework to quantify the effect of streamwise-aligned spanwise-periodic riblets on kinetic energy and skin-friction drag in turbulent channel flow. We model the effect of riblets as a volume penalization in the Navier–Stokes equations and use the statistical response of the eddy-viscosity-enhanced linearized equations to quantify the effect of background turbulence on the mean velocity and skin-friction drag. For triangular riblets, our simulation-free approach reliably predicts drag-reducing trends as well as mechanisms that lead to performance deterioration for large riblets. We investigate the effect of height and spacing on drag reduction and demonstrate a correlation between energy suppression and drag reduction for appropriately sized riblets. We also analyse the effect of riblets on drag-reduction mechanisms and turbulent flow structures including very large-scale motions. Our results demonstrate the utility of our approach in capturing the effect of riblets on turbulent flows using models that are tractable for analysis and optimization.
The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.
Little is known about the trend and predictors of 21-year mortality and suicide patterns in persons with schizophrenia.
To explore the trend and predictors of 21-year mortality and suicide in persons with schizophrenia in rural China.
This longitudinal follow-up study included 510 persons with schizophrenia who were identified in a mental health survey of individuals (≥15 years old) in 1994 in six townships of Xinjin County, Chengdu, China, and followed up in three waves until 2015. Kaplan–Meier survival analysis and Cox hazard regressions were conducted.
Of the 510 participants, 196 died (38.4% mortality) between 1994 and 2015; 13.8% of the deaths (n = 27) were due to suicide. Life expectancy was lower for men than for women (50.6 v. 58.5 years). Males consistently showed higher rates of mortality and suicide than females. Older participants had higher mortality (hazard ratio HR = 1.03, 95% CI 1.01–1.05) but lower suicide rates (HR = 0.95, 95% CI 0.93–0.98) than their younger counterparts. Poor family attitudes were associated with all-cause mortality and death due to other causes; no previous hospital admission and a history of suicide attempts independently predicted death by suicide.
Our findings suggest there is a high mortality and suicide rate in persons with schizophrenia in rural China, with different predictive factors for mortality and suicide. It is important to develop culture-specific, demographically tailored and community-based mental healthcare and to strengthen family intervention to improve the long-term outcome of persons with schizophrenia.
Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development.
This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China.
Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses.
The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015.
This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.
The prefrontal cortex (PFC) is enormously important in suicide and major depressive disorder (MDD). However, little is known about the structural alterations in the brains of people with MDD and suicidal ideation. We examined the gray matter volume (GMV) of the PFC of individuals with MDD and suicidal ideation to determine if PFC volumetric differences contribute to suicidal ideation in patients with MDD. Thirty-five subjects with MDD and suicidal ideation, 38 subjects with MDD but without suicidal ideation, and 43 age- and gender-matched healthy control (HC) subjects underwent T1-weighted imaging. A voxel-based morphometric analysis was conducted to compare the PFC GMVs of the three groups. Further GMV reductions in the left and right dorsolateral PFC (DLPFC) and right ventrolateral PFC (VLPFC) were detected in the MDD with suicidal ideation group compared with those in the HC group and the MDD without suicidal ideation group, whereas the MDD without suicidal ideation group only exhibited significant differences in the left DLPFC relative to the HC group. Our findings demonstrated that left DLPFC reductions were associated with MDD and suicidal ideation, and diminished GMV reductions in the right DLPFC and right VLPFC were only associated with suicidal ideation. These results help us better understand the neuropathological changes in MDD with suicidal ideation.
Immiscible displacement in porous media is common in many practical applications. Under quasi-static conditions, the process is significantly affected by disorder of the porous media and the wettability of the pore surface. Previous studies have focused on wettability effects, but the impact of the interplay between disorder and contact angle is not well understood. Here, we combine microfluidic experiments and pore-scale simulations with theoretical analysis to study the impact of disorder on the quasi-static displacement from weak imbibition to strong drainage. We define the probability of overlap to link the menisci advancements to displacement patterns, and derive a theoretical model to describe the lower and upper bounds of the cross-over zone between compact displacement and capillary fingering for porous media with arbitrary flow geometry at a given disorder. The phase diagram predicted by the theoretical model shows that the cross-over zone, in terms of contact angle range, expands as the disorder increases. The diagram further identifies four zones to elucidate that the impact of disorder depends on wettability. In zone I, increasing disorder destabilizes the patterns, and in zone II, a stabilizing effect plays a role, which is less significant than that in zone I. In the other two zones, invasion morphologies are compact and fingering, respectively, independent of both contact angle and disorder. We evaluate the proposed diagram using pore-scale simulations, experiments in this work and in the literature, confirming that the diagram can capture the effect of disorder on displacement under different wetting conditions. Our work extends the classical phase diagrams and is also of practical significance for engineering applications.
Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.
To explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI.
Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China.
Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status.
Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.
In a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system, a study was conducted to determine the effects of different fertilization regimens (no fertilization, replacement of a portion of chemical fertilizer with composted pig manure, chemical fertilizer only, and straw return combined with chemical fertilizer) on the weed communities and wheat yields after 4 and 5 yr. The impact of the long-term recurrent fertilization regimen initiated in 2010 on the composition and diversity of weed communities and the impact of the components and total amount of fertilizer on wheat yields were assessed in 2014 and 2015. Totals of 19 and 16 weed species were identified in experimental wheat fields in 2014 and 2015, respectively, but the occurrence of weed species varied according to the fertilization regimen. American sloughgrass [Beckmannia syzigachne (Steud.) Fernald], water starwort [Myosoton aquaticum (L.) Moench], and lyrate hemistepta (Hemistepta lyrata Bunge.) were adapted to all fertilization treatments and were the dominant weed species in the experimental wheat fields. The greatest number of weed species were observed under the no-fertilization treatment, in which 40% of the weed community was composed of broadleaf weeds and the lowest wheat yields were obtained. With fertilizer application, the number of weed species was reduced, the height of weeds increased significantly, the density of broadleaf weeds was significantly reduced, the biodiversity indices of weed communities decreased significantly, and higher wheat yields were obtained. Only the chemical fertilizer plus composted pig manure treatment and the chemical fertilizer–only treatment increased the density of grassy weeds and the total weed community density. The treatment with chemical fertilizer only also resulted in the highest density of B. syzigachne. Rice straw return combined with chemical fertilizer yielded the lowest total weed density, which suggests that it inhibited occurrence of weeds. The different fertilizer regimens not only affected the weed species composition, distribution, and diversity, but also the weed density. Our study provides new information from a rice–wheat rotation system on the relationship between soil amendments and agricultural weed infestation.
Northeastern China is a region of high tick abundance, multiple tick-borne pathogens and likely human infections. The spectrum of diseases caused by tick-borne pathogens has not been objectively evaluated in this region for clinical management and for comparison with other regions globally where tick-transmitted diseases are common. Based on clinical symptoms, PCR, indirect immunofluorescent assay and (or) blood smear, we identified and described tick-borne diseases from patients with recent tick bite seen at Mudanjiang Forestry Central Hospital. From May 2010 to September 2011, 42% (75/180) of patients were diagnosed with a specific tick-borne disease, including Lyme borreliosis, tick-borne encephalitis, human granulocytic anaplasmosis, human babesiosis and spotted fever group rickettsiosis. When we compared clinical and laboratory features to identify factors that might discriminate tick-transmitted infections from those lacking that evidence, we revealed that erythema migrans and neurological manifestations were statistically significantly differently presented between those with and without documented aetiologies (P < 0.001, P = 0.003). Twelve patients (6.7%, 12/180) were co-infected with two tick-borne pathogens. We demonstrated the poor ability of clinicians to identify the specific tick-borne disease. In addition, it is necessary to develop specific laboratory assays for optimal diagnosis of tick-borne diseases.
Crystallized FeB and Fe2B powders were synthesized by a molten salt method with elemental Fe and B powders as starting materials. The results indicated that the presence of molten NaCl/KCl salts and the excess of Fe or B powders were essential to obtain pure FeB or Fe2B powders. The formation mechanism of iron borides was investigated by examining the phase compositions of the obtained products with different molar ratio of Fe/B. It was found that Fe powders firstly reacted with B powders to form Fe2B phase, and FeB phase formed from the reaction between Fe2B and excessive B. The as-synthesized FeB and Fe2B powders had a uniform short-rod and plate like morphology, respectively. Both FeB and Fe2B exhibited typical soft magnetic behavior. The saturation magnetization and the coercivity were 36.4 emu/g and 15.5 kA/m for FeB, 126.9 emu/g and 6.1 kA/m for Fe2B, respectively. The electrochemical performances of the as-synthesized FeB powders were evaluated by cyclic voltammetry, galvanostatic charge–discharge and electrochemical impedance test.