To develop a knowledge, attitude, and behavior questionnaire on screen use among caregivers of children and to test its reliability and validity.

Based on the theory of “Knowledge-Attitude-Practice”, the initial questionnaire was formed through literature analysis, research group discussion, two rounds of Delphi expert consultation and pre-investigation. Through convenient sampling, 270 main caregivers of children aged 2 to 12 in Heilongjiang Province were selected for questionnaire investigation. Item analysis of the data was conducted, and internal consistency coefficient was used to analyze the reliability of the questionnaire. Exploratory factor analysis and content validity were used to evaluate the validity of the questionnaire.

The formal questionnaire consisted of 5 items on general information, 10 items on knowledge dimension, 7 items on attitude dimension, and 9 items on behavior dimension. The Item - Level Content Validity Index (I-CVI) ranged from 0.850 to 1.000. The Scale-Level Content Validity Index (S-CVI) was 0.808, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.982. The factor loadings for all items were greater than 0.4, and the contribution rate of cumulative variance was 63.346%, indicating good validity. The Cronbach’s α coefficient of the questionnaire overall was 0.892, and the Cronbach’s α coefficient of the three dimensions ranged between 0.738 and 0.886, with good reliability.

The questionnaire has good reliability and validity, and can be used as an evaluation tool for the level of knowledge, attitude, and behavior of caregivers of children.

To explore the mediating effect of self-compassion on social support and diabetes distress (DD) among community-dwelling elderly individuals with type 2 diabetes mellitus (T2DM).

From June to July 2024, a cross-sectional survey was conducted among elderly T2DM patients in communities in Nanjing. The survey used the general information questionnaire, DDS, SSRS, and SCS. A multiple linear regression model was employed to examine the factors influencing DD, and the mediating effect of self-compassion was analyzed by the Bootstrap method for validation.

The prevalence of DD among the respondents was 35.1%, and the scores for social support and self-compassion were (39.48±8.13) and (91.18±9.10), respectively. Social support and self-compassion were significantly positively correlated (r=0.344, P<0.001). Social support (β=-0.132, P<0.001) and self-compassion (β=-0.216, P<0.001) were the influencing factors of DD, and self-compassion exhibited a partial mediating effect in the relationship between social support and DD, accounting for 37.02% of the total effect.

Community healthcare workers should pay attention to the screening of DD among elderly T2DM patients, and actively explore comprehensive intervention strategies that integrate social support with self-compassion to enhance their psychological well-being.

To assess the public awareness of tuberculosis (TB) prevention and control knowledge in high-altitude Xizang during the 13th Five-Year Plan period (2016-2020) and provide evidence for optimizing regional TB health education strategies.

A multistage stratified cluster random sampling method was employed to select study participants aged 15 years and older who had resided in the Xizang region for over six months. Data ware managed using EpiData 3.1 and analyzed with IBM SPSS Statistics 24.0.

Among 1 191 participants, awareness rates of the five core TB prevention indicators were 32.58% (388/1 191), 78.51% (935/1 191), 77.25% (920/1 191), 62.05% (739/1 191), and 47.69% (568/1 191), respectively. The overall awareness rate was 59.61% (3550/5 955), while the full-awareness rate (all five messages) reached 11.50% (137/1 191).

Xizang’s overall TB core knowledge awareness rate (59.61%) falls below the 85% target set by the National TB Control Plan (2016-2020). Tailored interventions are recommended, including Tibetan-Chinese bilingual health campaigns targeting agricultural/pastoral workers, individuals with limited education, and employees of government agencies/enterprises. Concurrent efforts should enhance livelihood support and bilingual training for grassroots workers in high-altitude regions.

To investigate the prevalence and associated factors of chronic pain among community-dwelling older adults in Shanghai, China.

A multi-stage stratified cluster sampling method was employed to recruit residents aged ≥60 years from August to November 2023. A structured questionnaire was used to collect data on demographic characteristics, pain status, and indicators of pain severity. Multivariate logistic regression was applied to identify factors associated with moderate to severe chronic pain.

A total of 3 606 valid responses were obtained. The overall prevalence of chronic pain was 73.9%, with mild pain being the most common (60.4%). The mean age of participants was 73.2±9.4 years. The most frequently reported pain sites were the lumbosacral region, shoulders, and neck. Major pain relief approaches included traditional therapies (55.7%), topical medications (41.5%), and oral analgesics (40.1%). Pain intensity was significantly correlated with psychological distress (r=0.793) and impaired daily functioning (r=0.795). Female sex (OR=1.291), higher educational attainment (OR=1.620-1.679), poor spousal health (OR=1.777-3.112), and impaired ability of daily living (OR=0.481) were independently associated with increased risk of moderate to severe pain.

Chronic pain is highly prevalent among older adults in Shanghai communities, predominantly manifesting as mild pain. Female gender, higher education level, poor spousal health, and limited self-care ability are significant risk factors for moderate to severe pain. Early identification of high-risk individuals and multidimensional interventions are essential to improve pain management and reduce the burden of chronic pain in this population.

To explore the operational efficiency of primary care organizations in the pilot counties of close-knit county medical communities in Sichuan Province, and to provide a reference for continuing to promote the high-quality development of close-knit county medical communities across the country and help build a more synergistic and efficient county medical service network.

Primary care organizations in 37 pilot counties in Sichuan Province were used for the study, and data envelopment analysis and Malmquist index model were used for static and dynamic measurement of operational efficiency, respectively.

The mean values of comprehensive efficiency, pure technical efficiency, and scale efficiency of primary care organizations in pilot counties in Sichuan Province in 2022 were 0.806, 0.936, and 0.863, respectively. Among them, the operational efficiencies of Wenchuan (0.314), Jiuzhaigou (0.226), Seda (0.116), and Ganzi (0.061) were located below 0.400. Compared with 2018, their comprehensive efficiency and pure technical efficiency have improved, while scale efficiency was flat. The mean value of the total factor productivity index of primary care organizations in the pilot counties from 2018 to 2022 was 0.975. Further decomposing the total factor productivity index, the mean values of the technical efficiency index, the technical progress index, the pure technical efficiency index, and the scale efficiency index were 1.014, 0.962, 1.022, and 0.992, respectively.

After the implementation of the policy, the operational efficiency of primary care organizations in the pilot counties of Sichuan Province showed significant improvement, but there is still much room for improvement, and the differences between counties are more obvious. In the future, we should focus on the technical progress and scale efficiency, strengthen the continuing medical education of primary medical personnel, innovate and carry out the new technology of primary characteristics, and reasonably balance and effectively allocate the medical resources in the counties.

To analyze the mortality rate and trend of non-melanoma skin cancer (NMSC) in China from 2005 to 2018 and predict its future trend, providing a basis for effective prevention and control.

NMSC mortality data from 2005 to 2018 were collected from the Chinese Cancer Registry Annual Report. The Joinpoint regression model was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC) to reflect temporal trends. An age-period-cohort model with intrinsic estimator algorithm was applied to analyze age, period, and cohort effects. The Bayesian age-period-cohort (BAPC) analysis with integrated nested Laplace approximation was employed to predict NMSC mortality trends in China from 2019 to 2035.

From 2005 to 2018, the age-standardized mortality rate (ASMR) of NMSC in China was 0.34 per 100 000, showing an upward trend with an AAPC of 5.6% (95%CI: 3.8%-7.4%). The ASMR was higher in males (0.41 per 100 000) than in females (0.26 per 100 000),but the increase was slightly faster in females (AAPC=6.2%). Rural areas had a higher ASMR (0.40 per 100 000) than urban areas (0.30 per 100 000), but the AAPC was only half that of urban areas. The mortality risk of NMSC increased with age. The cohort effect showed a declining trend in ASMR. The predicted ASMR of NMSC in China is expected to continue rising to 0.78 per 100 000(95%CI: 0.10-1.46 per 100 000) during 2019 and 2035.

The ASMR of NMSC in China exhibited an upward trend from 2005 to 2018, with variations by age, sex, and region. NMSC remains a public health concern requiring sustained attention.

To investigate the prevalence and influencing factors of scoliosis among middle school students in Anhui Province, providing a reference for scoliosis prevention and control.

From September to November 2022, a stratified cluster random sampling method was used to select 104 022 middle school students in Anhui Province for spinal curvature abnormality screening and questionnaire surveys. Logistic regression models were employed to analyze the influencing factors of scoliosis.

The detection rate of scoliosis among middle school students in Anhui was 2.46%, with thoracolumbar, lumbar, and thoracic scoliosis detection rates of 1.74%, 1.56%, and 1.45%, respectively. The detection rate of scoliosis generally increased with grade (χ²_trend=28.535, P_trend < 0.001), and high school students had a higher detection rate than junior high school students (2.76% vs. 2.21%, P < 0.001). Multivariate logistic regression analysis showed that among junior high school students, suburban residence (OR=0.65, 95%CI: 0.58-0.72) and overweight/obesity (OR=0.66, 95%CI: 0.58-0.75) were protective factors, while underweight (OR=1.30, 95%CI: 1.01-1.66) was a risk factor. Among high school students, suburban residence (OR=0.67, 95%CI: 0.59-0.76), overweight/obesity (OR=0.73, 95%CI: 0.65-0.83), correct reading/writing posture (OR=0.68, 95%CI: 0.52-0.89), moderate-to-vigorous physical activity ≥3 days/week (OR=0.85, 95%CI: 0.74-0.96), daytime outdoor activity ≥1 h/day (OR=0.88, 95%CI: 0.78-0.99), and adequate sleep (OR=0.80, 95%CI: 0.68-0.93) were protective factors, whereas underweight (OR=1.37, 95%CI: 1.08-1.75) was a risk factor.

Residential area, nutritional status, reading/writing posture, physical activity, and sleep are influencing factors of scoliosis among middle school students. Targeted interventions based on these factors should be implemented across different school stages to reduce the occurrence of scoliosis.

To investigate the association between alpha-1-acid glycoprotein (AGP) and prediabetes prevalence in US adults.

We analyzed data from 2 926 participants (age ≥18 years) in the National Health and Nutrition Examination Survey (2017-2023). Participants were classified into prediabetes and non-prediabetes groups. AGP levels were measured and analyzed both as continuous and quartile-categorized variables. Weighted logistic regression models were employed to assess this relationship after adjusting for covariates.

The prediabetes group showed significantly higher AGP levels (0.79±0.02) versus controls (0.78±0.01; P<0.001). In fully adjusted models, each unit increase in AGP was associated with 7.8% higher prediabetes risk (OR=1.08, 95%CI:1.453-1.842). Quartile analysis revealed progressively increasing risks from Q2 to Q4 versus Q1 (all P<0.05). Subgroup analyses showed stronger associations in females (OR=1.01,95%CI:1.095-2.778, P=0.043) and younger adults (18-39 years; OR=1.22, 95%CI:1.182-7.965, P=0.008).

Elevated AGP levels are consistently associated with increased prediabetes risk, suggesting its potential as a novel biomarker for early risk identification.

To establish a comprehensive evaluation index system for multidrug-resistant organism (MDRO) infection prevention and control in hospitals, and conduct empirical research to analyze current management status and propose improvement strategies.

The evaluation system was developed through literature review, Delphi expert consultation, and analytic hierarchy process (AHP). A questionnaire survey was conducted to assess current MDRO prevention and control practices.

Both Delphi rounds achieved 100% response rates, with expert authority coefficients (Cr) of 0.9736 and 0.9794 respectively. Kendall’s W values were 0.520 (χ²=645.23, P<0.01) and 0.537 (χ²=593.525, P<0.01) for successive rounds. The system demonstrated good reliability (Cronbach’s α=0.757) and validity (I-CVI=0.833-1.000, S-CVI/UA=0.938,S-CVI/Ave=0.990), comprising 3 first-level, 15 second-level, and 48 third-level indicators. Empirical data revealed suboptimal implementation: MDRO patient reporting rate (23.71%), isolation rate (59.79%), PPE utilization (14.95%), and hand hygiene compliance (53.09%). ICUs showed significantly higher MDRO infection rates (1.88‰, χ²=39.130, P<0.01), detection rates (25.58%, χ²=103.308, P<0.01), and identification rates (16.76%, χ²=1629.737, P<0.01) than other departments.

The developed evaluation system is scientifically sound and practical. Current MDRO prevention measures require substantial improvement, necessitating targeted interventions and precision management strategies.

To investigate dietary intake and explore the association between dietary patterns and overweight/obesity among children and adolescents aged 6 to 17 years in Hebei Province, providing evidence for early prevention and control.

Using multistage stratified random sampling, 3 228 children and adolescents aged 6-17 years from 12 monitoring sites in Hebei Province were selected. Data on basic characteristics, food intake, and physical examination were collected. Factor analysis was used to extract dietary patterns, and unconditional logistic regression was employed to analyze the association between dietary patterns and overweight/obesity risk.

The prevalence of overweight/obesity was 28.78% during 2016 and 2017, with significant differences by gender, region, education level, parental education, and boarding status (all P<0.05). After adjusting for gender, region, and boarding status, the high-carbohydrate dietary pattern was identified as a risk factor for overweight/obesity (P<0.05). The high-protein dietary pattern showed a protective effect, with decreasing risk as factor scores increased (Q2 medium group: OR=0.803, 95%CI: 0.665-0.985, P=0.034; Q3 high group: OR=0.742, 95%CI: 0.584-0.942, P=0.014).

The prevalence of overweight/obesity is high among children and adolescents in Hebei Province. Dietary interventions focusing on increasing protein intake and reducing high-carbohydrate foods may help control overweight/obesity.