Sex Differences and Psychological Stress: Responses to the COVID-19 Pandemic in China
Shiyan YanRui XuTerry D. StrattonVoyko KavcicDan LuoFengsu HouFengying BiRong JiaoKangxing SongYang Jiang
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Abstract Background About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic. Results 3,088 questionnaires were returned: 1,749 females (56.6%) and 1,339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (<45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19，completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.Keywords:
Snowball sampling
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Pandemic
Cross-sectional study
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Snowball sampling is a commonly employed sampling method in qualitative research; however, the diversity of samples generated via this method has repeatedly been questioned. Scholars have posited several anecdotally based recommendations for enhancing the diversity of snowball samples. In this study, we performed the first quantitative, medium-N analysis of snowball sampling to identify pathways to sample diversity, analysing 211 reach-outs conducted via snowball sampling, resulting in 81 interviews; these interviews were administered between April and August 2015 for a research project on anti-dam movements in Southeast Asia. Based upon this analysis, we were able to refine and enhance the previous recommendations (e.g., showcasing novel evidence on the value of multiple seeds or face-to-face interviews). This paper may thus be of particular interest to scholars employing or intending to employ snowball sampling.
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Snowball sampling is generally seen as a highly effective sampling technique that allows for the study of difficult to reach or 'hidden' populations. It is also seen as a valuable tool for the study of particularly sensitive or private matters. As a result, it was chosen as the sampling method for a research study into illegal drug users over the age of 40 who are not in contact with the criminal justice authorities or treatment agencies regarding their use. However, there proved to be great difficulty in locating and interviewing potential participants using snowball sampling. Four reasons for this are proposed, and it is suggested that snowball sampling is prone to failure in particular circumstances. Thus, caution should be exercised when considering its adoption as a sample-building technique.
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Surveillance of general outbreaks of infectious gastroenteritis was introduced in 1998 by the Food Safety Authority of Ireland (FSAI), in co-operation with the eight health boards. A total of 67 general outbreaks of gastroenteritis in Ireland were reported to the FSAI in 1998 and 1999. Over 1900 people were ill as a result of these outbreaks. Four percent required hospitalisation and there were two deaths. The duration of the outbreaks varied between one day and 38 days. Salmonellae (44%) and small round structured viruses (SRSV) (12%) were the most commonly reported pathogens. In 25% of the outbreaks the aetiology was unknown. The commonest settings were restaurants, hotels and take-aways, which accounted for 45% (30/67) of all outbreaks. Sixteen percent of all outbreaks occurred in hospitals and residential institutions. Over half of the outbreaks were reported to be foodborne, 63% of which were due to various serotypes of Salmonella enterica. Eggs were implicated as the vehicle of infection in 13% of all outbreaks. An infected food handler was identified in almost one third of outbreaks, although it could not be established if this had contributed directly to the outbreak.
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This paper explores snowball sampling, a recruitment method that employs research into participants' social networks to access specific populations. Beginning with the premise that research is ‘formed’, the paper offers one account of snowball sampling and using social networks to ‘make’ research. Snowball sampling is often used because the population under investigation is ‘hidden’ either due to low numbers of potential participants or the sensitivity of the topic, for example, research with women who do not fit within the hegemonic heterosexual norm. This paper considers how the recruitment technique of snowball sampling, which uses interpersonal relations and connections between people, both includes and excludes individuals. Following this, the paper contends that due to the use of social networks and interpersonal relations, snowball sampling (in)forms how individuals act and interact in focus groups, couple interviews and interviews. Consequently, snowball sampling not only results in the recruitment of particular samples, use of this technique produces participants' accounts of their lives. Doctoral research with (rather than on or for) 28 non‐heterosexual women is used to examine the inclusions and exclusions of snowball sampling and how interpersonal relations form research accounts.
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Objective To understand the characteristics of influenza-like illness(ILI) outbreaks in Yunnan province and provide evidence for the development of scientific and effective control measures.Methods The data of ILI outbreaks in Yunnan in 2009 were collected and analyzed Results Totally 72 ILI outbreaks occurred in Yunnan,resulting in 7 628 ILI cases.The attack rate ranged from 1.79% to 49.45%.The disease occurred all the year round with peak in Autumn.Twenty six outbreaks occurred in Zhaotong,Sixty eight outbreaks occurred in schools.The influenza viruses were isolated from the cases in 37 out of 54 outbreaks,including influenza H3N2 virus(in 12 outbreaks),influenza B virus(in 11 outbreaks),2009 pandemic influenza A(H1N1) virus(in 9 outbreaks) and influenza A(H1N1) virus(in 5 outbreaks).The interval between the finding of the first case and the response and the duration of epidemic was positive correlated.(r=0.896,P0.05).Conclusion More ILI outbreaks occurred in Yunnan in 2009 than in 2008,and 94% of the outbreaks occurred in schools.It is necessary to strengthen the ILI outbreak surveillance and reporting in schools and improve the sample collection and laboratory detection.
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All outbreaks of infectious intestinal disease reported to the authorities were entered on a computer database with outbreak control teams being established to investigate larger or more significant incidents. The outbreak database and, when set up, the notes of outbreak team meetings were examined for the 279 outbreaks reported in a three-year period (2003-2005). Faeces specimens submitted as part of an outbreak were examined for microbial pathogens and the results cross-matched to the outbreak number. Almost half of the general outbreaks reported (137) occurred in long-term care facilities for the elderly, 51 outbreaks were recorded in hospitals and 31 occurred in the wider community. In 76 outbreaks no specimen was logged. A microbial cause was confirmed in about one-third of outbreaks, with noroviruses being the most common (19%). Salmonellas accounted for 12 of the 21 community outbreaks linked to social events and all were foodborne. Suggestions for improving notification and surveillance are discussed.
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Womanist and feminist qualitative researchers continue to identify research methods and techniques that harness the power of social networking and personal connections while engaging with marginalized populations. Many have found that the use of snowball sampling allows increased access to individuals and groups that may otherwise remain inaccessible. The purpose of this article is to discuss the use of snowball sampling techniques within womanist and feminist research. The authors offer critical reflections of the use of this sampling technique as a tool that allows researchers access to “hidden” and marginalized populations. An example of the use of snowball sampling in a doctoral research project, which looks at the experiences of Black women faculty in New Mexico’s institutions of higher education, is provided. The article concludes with recommended strategies and key considerations about the use of snowball sampling in womanist research.
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