Family socioeconomic status and mental health in Chinese adolescents: the multiple mediating role of social relationships

BACKGROUND

The purpose of this study is to explore whether social relationships of family and school contexts mediate the influence of socioeconomic status (SES) on Chinese adolescents' mental health.

METHODS

A school-based study was conducted among a sample aged 13-18 in East China (n = 6902). We used scales for measuring social relationships and self-rated mental health. Family SES was computed from subjective socioeconomic status, education and occupation of parents.The mediation model was tested by using Path Analysis in IBM SPSS-Amos.

RESULTS

The results showed that SES can significantly influence adolescent mental health through parent-child relationship, student-teacher relationship and student-student relationship. The total effect, direct effect and total indirect effect were -0.209 (95% CI = -0.299, -0.136), -0.090 (95% CI = -0.174, -0.007), -0.119 (95% CI = -0.187, -0.078) for boys, and -0.337 (95% CI = -0.478, -0.230), -0.132 (95% CI = -0.283, 0.010), -0.205 (95% CI = -0.351, -0.085) for girls.

CONCLUSION

The link between SES and adolescent mental health can be explained by social relationships. Focusing on the parent-child, student-student and student-teacher relationship interventions may contribute to improving the mental health of Chinese adolescents, especially in low socioeconomic groups, as well as female students.

Meaning of socioeconomic status for mental health of adolescents in East China

There is limited evidence on the association between different dimensions of socioeconomic status and mental health on adolescents in developing nations. The aim of this study was to examine this association among adolescents in East China. A school-based study that recruited 6902 adolescents aged 13 to 18 years was conducted in Suzhou, Hefei and Hangzhou. Multiple of indicators of socioeconomic status and mental health in adolescents were examined. Results revealed that girls showed significantly higher score of the global severity index, obsessive-compulsive, depression, anxiety, hostility, and phobic anxiety symptoms than boys. As expected, there was a slightly negative correlation between different dimensions of socioeconomic status to different domains of mental health problems (r ranged from -0.044 to 0.124). Furthermore, we found that maternal education and occupation were significantly associated with mental health for both boys and girls, while subjective socioeconomic status only was significantly associated with girls. In conclusion, adolescents in families with socioeconomic disadvantage, in the form of lower educational level and occupational prestige of mothers, had greater risk of mental health problem. Meanwhile, higher subjective socioeconomic status positively affects the mental health of female adolescents.

Risk factors for depressive symptoms among older Chinese adults: A meta-analysis

BACKGROUND

The study aims to explore the risk factors for depressive symptoms among older Chinese adults.

METHODS

PubMed, PsycINFO, Cochrane Library, EMbase, Google Scholar, Chinese National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database, and Wanfang data were searched for potentially relevant articles published before September 1^st, 2019. Stata/IC 15 was used to perform a meta-analysis and subgroup analysis to compute the pooled odds ratio.

RESULTS

The retrieve strategy yielded 11 studies that met the inclusion criteria. The total sample size was 31528 across seven districts, including Mainland China, Hong Kong, and Taiwan. Patients with depression were included in the sample size. Fourteen risk factors were extracted for at least having two or more relative studies. The combined odds ratio ranged from 0.70 to 4.75. Female, poor self-perceived financial condition, single, average and poor self-perceived health status, diabetes, adverse life events, poor social support, two or more numbers of cardiovascular diseases, and functional disability are risk factors of depressive symptoms among older Chinese adults. Fair or good social support is a protective factor.

LIMITATIONS

These findings may be somewhat limited by (i) quality of studies included, (ii) a finite number of studies met inclusion criteria.

CONCLUSIONS

Despite the methodological limitations of the studies and this meta-analysis, average or poor self-perceived health status, functional disability, poor social support, poor self-perceived financial condition, negative life events, and diabetes appear to be significant risk factors for depressive symptoms among the aged population in China. Social support can mitigate depressive symptoms.

Contributions of Modifiable Risk Factors to Dementia Incidence: A Bayesian Network Analysis

OBJECTIVE

To determine and compare the contributions of modifiable risk factors (RFs) with the prevention of dementia in older adults.

DESIGN

A systematic review and Bayesian network meta-analysis (NMA). The observational group was set as a reference to collect all existing RFs and compare them with each other.

SETTING AND PARTICIPANTS

An exhaustive and comprehensive literature search strategy was used to identify relevant prospective cohort studies from several online databases from their inception to May 1, 2019. Participants without dementia were adults aged greater than 50 years.

MEASURES

The required data were extracted from the eligible studies to facilitate the Bayesian NMA.

RESULTS

Forty-three cohort studies with 277,294 participants were included in this NMA. Using the observation group as the reference, all defined RFs, except for antioxidants, were associated with lower risks of all-cause dementia [no sleep disturbances (odds ratio, OR 0.43, 95% credible interval, CrI 0.24-0.62), a high level of education (OR 0.50, 95% CrI 0.34-0.66), no history of diabetes (OR 0.57, 95% CrI 0.36-0.78), nonobese patients (OR 0.61, 95% CrI 0.39-0.83), no smoking history (OR 0.62, 95% CrI 0.45-0.79), living with family members (OR 0.67, 95% CrI 0.45-0.89), participation in physical exercise (OR 0.73, 95% CrI 0.46-0.94), abstinence from drinking (OR 0.78, 95% CrI 0.56-0.99), and no history of hypertension (OR 0.80, 95% CrI 0.65-0.96)].

CONCLUSIONS/RELEVANCE

The findings provide reliable support for the hypothesis that modifiable somatic and lifestyle factors are strong predictors of all-cause dementia.

How do socioeconomic status relate to social relationships among adolescents: a school-based study in East China

Background

A great number of studies have concentrated on the influence of socioeconomic status with health outcomes, but little on how socioeconomic status affects social relationship in adolescents’ families, peers and schools. This study aimed to clarify more detailed information on the connection between social relationships and different dimensions of socioeconomic status.

Methods

A school-based cross-sectional study was performed by 13–18 adolescents enrolled in East China from September, 2018 to May, 2019, which recruited 6902 students from junior and senior high schools and used the stratified random sampling method. Parent-child relationship (cohesion, expressiveness, conflict), peer relationship (interpersonal relationship, communication and interaction, social emotion) and student-teacher relationship (intimacy, support, satisfaction, conflict) were investigated. Besides, objective socioeconomic status (parental education and occupation, assessed by the adolescent) and subjective socioeconomic status (self-evaluation of family social class) were measured. More detailed information was used to clarify the link between social relationships and different dimensions of socioeconomic status.

Results

All five indicators of socioeconomic status were slightly positively correlated with the quality of social relationships (r ranged from 0.036 to 0.189, all p < 0.001), except that maternal education was not correlated with the conflict dimension of parent-child relationship. Standardized regression coefficients indicated that paternal education (β = 0.08) and occupation (β = 0.07) were the predictors of parent-child relationship. And peer relationship model revealed that the corresponding effect size was slightly stronger for subjective socioeconomic status (β = 0.10), whereas the maternal education had a slightly stronger correlation with student-teacher relationship (β = 0.07) relative to other indicators.

Conclusions

Adolescents with lower socioeconomic status had poorer social relationships compared to those with higher socioeconomic status. These findings have important public health implications for health policy makers to make sound decisions on resources allocation and services planning in improving adolescents’ social relationships and promoting health outcomes.

Effects of non-pharmacological therapies for people with mild cognitive impairment. A Bayesian network meta-analysis

OBJECTIVE

To compare the effects of non-pharmacological therapies (NPTs) on improving the cognition of people with mild cognitive impairment (MCI) by performing a Bayesian network meta-analysis (NMA).

METHODS

We searched eight databases for potentially eligible studies. Physical exercise (PE), cognitive stimulation (CS), cognitive training (CT), cognitive rehabilitation (CR), musical therapy (MT) and multi-domain interventions (MI). Pairwise meta-analyses were performed by estimating the weighted mean differences with 95% confidence interval (CI) for mini-mental state examination. The NMA was undertaken to compare different interventions.

RESULTS

CS, PE, MI, MT and CT may all be effective in improving the cognition of patients with MCI. CR was unable to show a significant efficacy. Our NMA ranking results suggest the effectiveness of the six NPTs to be ranked from best to worst as follows: CS, PE, MI, MT, CT and CR.

CONCLUSIONS

NPT has great potential to improve the cognition of the elderly with MCI. CS has the highest probability of being the optimal NPT. However, the result should be interpreted with cautions given the limited number and small samples of included randomized controlled trials (RCTs) in this field, large diversity existing in different study designs and potential risk of bias. Future RCTs with high quality and large sample sizes are required to confirm our results.

SUMMARY

NPT, as a whole definition, has great potential to improve the cognition of the elderly with MCI. Our NMA ranking results suggest the effectiveness of the six NPTs to be ranked from best to worst as follows: CS, PE, MI, MT, CT and CR.

Depressive Symptoms Among Children and Adolescents in China: A Systematic Review and Meta-Analysis

Background

Depressive symptoms are a pervasive mental health problem in Chinese adolescents. The aim of this article was to systematically assess the trend of depressive symptoms in China among adolescents (1988 to 2018).

Material/Methods

A systematic and comprehensive literature search was conducted in both English and Chinese databases, including PubMed, EMBASE, Cochrane CENTRAL, CNKI, and Wan Fang Database, to identify relevant studies published between 1988 and 2018. Batteries of analyses in this meta-analysis were undertaken using Stata version 12.0 statistical software.

Results

Sixty-two related reports involving 232 586 participants finally met our inclusion and exclusion criteria. The results suggest the prevalence of depressive symptoms has generally increased over time. The prevalence estimates before 2000 were 18.4% (95% CI, 14.5–22.3%), and were 26.3% (95% CI, 21.9–30.8%) after 2016. The pooled prevalence of depressive symptoms among children and adolescents was 22.2% (95% CI: 19.9–24.6%, I²=99.6%, p<0.001). More subgroup analyses classified by screening instrument, gender, and region were carried out in this meta-analysis.

Conclusions

Results of our meta-analysis suggest that depressive symptoms have become more prevalent among Chinese adolescents. This trend emphasizes the need for effective prevention strategies and greater availability of screening tools for this vulnerable population.

Comparison of Cognitive Intervention Strategies for Older Adults With Mild to Moderate Alzheimer's Disease: A Bayesian Meta-analytic Review

OBJECTIVES

We aimed to identify the best form of cognitive therapy among 3 main cognitive interventions of Alzheimer's disease (AD) including cognitive training (CT), cognitive stimulation (CS), and cognitive rehabilitation (CR).

DESIGN

Systematic review and Bayesian network meta-analysis.

SETTING AND PARTICIPANTS

An exhaustive literature search was conducted based on PubMed, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, the China National Knowledge Infrastructure database, the Chinese Biomedical Literature database, the Wan Fang database, and Web of Science and other database and randomized controlled trials were identified from their inception to May 1, 2018. Older adult participants diagnosed with AD were recruited.

MEASURES

We conducted a Bayesian network meta-analysis (NMA) to rank the included treatments. Cognitive functions were measured based on the Mini-Mental State Examination (MMSE). A series of analyses and assessments, such as the Pairwise meta-analysis and the risk of bias, were performed concurrently.

RESULTS

Only 22 studies were included in our analysis based on a series of rigorous screenings, which comprised 1368 participants. No obvious heterogeneities were found in NMA (I² = 32.7%, P = .07) after the data were pooled. The mean difference (MD) of CT [MD = 2.1, confidence interval [CI]: 1.0, 3.2), CS (MD = 0.92, CI: -0.20, 2.0), and CR (MD = 2.0, CI: 0.73, 3.4) showed that CT and CR could significantly improve cognitive function as measured by MMSE in the treatment group whereas the CS was less effective. CT had the highest probability among the 3 cognitive interventions [the surface under the cumulative ranking curve (SUCRA) = 84.7%], followed by CR (SUCRA = 50.0%) and CS (SUCRA = 47.4%).

CONCLUSIONS/RELEVANCE

Our study indicated that the CT might be the best method for improving the cognitive function of AD patients. The findings from our study may be useful for policy makers and service commissioners when they make choices among different alternatives.

Analysis of imprinted messenger RNA expression in deceased transgenic cloned goats

Genomic imprinting is an important epigenetic mechanism that has vital effects on fetal growth and development. We observed the differences in four tissues (heart, spleen, liver, and kidney) from dead transgenic cloned goats using hematoxylin and eosin (H&E) staining. Eight imprinted genes in the tissues of dead transgenic cloned and normal goats were analyzed using reverse transcription polymerase chain reaction. H&E staining results from the abortion group indicated the lack of obvious morphological changes in heart and spleen tissues, while inflammatory cell infiltration and glomerular nephritis characteristics were observed in liver and kidney tissues, respectively. Compared to the control group, CDKN1C, H19, IGF2R, and SNRPN were significantly (P < 0.05) overexpressed in the heart tissue of the abortion group, while XIST was significantly reduced. In the liver tissues, CDKN1C and DLK1 expression decreased, while GNAS, H19, IGF2R, PEG3, and XIST expression increased significantly. In the spleen tissues, DLK1 expression increased, while GNAS, H19, IGF2R, PEG3, SNRPN, and XIST expression decreased. In the kidney tissues, CDKN1C, DLK1, GNAS, IGF2R, and PEG3 expression increased, while H19 and XIST expression decreased. The overall expression of imprinted genes was abnormal in different tissues of transgenic cloned goats, and the degree of abnormal genomic imprinting was more severe in the abortion group compared to the death and control groups. These results suggest that abnormal expression of imprinted genes may cause developmental defects in transgenic cloned goats. Moreover, abnormal epigenetic modifications may affect the reprogramming of transgenic donor cells.

Identification of transgenic cloned dairy goats harboring human lactoferrin and methylation status of the imprinted gene IGF2R in their lungs

Dairy goat is a good model for production of transgenic proteins in milk using somatic cell nuclear transfer (SCNT). However, animals produced from SCNT are often associated with lung deficiencies. We recently produced six transgenic cloned dairy goats harboring the human lactoferrin gene, including three live transgenic clones and three deceased transgenic clones that died from respiratory failure during the perinatal period. Imprinted genes are important regulators of lung growth, and may be subjected to faulty reprogramming. In the present study, first, microsatellite analysis, PCR, and DNA sequence identification were conducted to confirm that these three dead kids were genetically identical to the transgenic donor cells. Second, the CpG island methylation profile of the imprinted insulin-like growth factor receptor (IGF2R) gene was assessed in the lungs of the three dead transgenic kids and the normally produced kids using bisulfite sequencing PCR. In addition, the relative mRNA level of IGF2R was also determined by real-time PCR. Results showed that the IGF2R gene in the lungs of the dead cloned kids showed abnormal hypermethylation and higher mRNA expression levels than the control, indicating that aberrant DNA methylation reprogramming is one of the important factors in the death of transgenic cloned animals.

Oct4 and Sox2 overexpression improves the proliferation and differentiation of bone mesenchymal stem cells in Xiaomeishan porcine

Mesenchymal stem cells derived from bone marrow (BMSCs) are a population of self-renewing multipotent cells that are capable of differentiating into various cellular lineages, and are widely employed in tissue engineering and cell therapy. Recently, clinical research involving BMSCs has become increasingly popular. In order to conduct appropriate research, it is first necessary to amplify large amounts of functional BMSCs in vitro. However, after several passages of expanding in vitro, the proliferation and differentiation potential of BMSCs gradually decline. To determine whether overexpression of Oct4 or Sox2 might prevent this decline, we transfected Oct4 or Sox2, which are essential for the pluripotency and self-renewal of embryonic stem cells, into BMSCs of Xiaomeishan porcine by a lentivirus. The results showed that overexpression of Sox2 or Oct4 BMSCs in culture media containing a basic fibroblast growth factor resulted in higher proliferation and differentiation compared to controls, suggesting that genetic modification of stemness-related genes is an efficient way to maintain the proliferation and differentiation potential of BMSCs.