To develop and validate a questionnaire based on the Transtheoretical Model (TTM) for assessing the stages of behavior change in patients with Chronic Obstructive Pulmonary Disease (COPD) (COPD-TTM questionnaire), which can be used to evaluate patients’ behavioral stages and provide a basis for personalized interventions.

A preliminary COPD-TTM questionnaire was constructed through literature review and expert consultation, consisting of five primary dimensions and 15 secondary items. The structural validity was verified by measuring 171 COPD patients, while content validity was assessed through expert ratings. A retest was conducted two weeks later to validate the test-retest reliability.

Five factors were extracted from the 15 items, cumulatively explaining 68.5% of the total variance, with item loadings for each factor not less than 0.65, indicating alignment of the questionnaire items with the expected TTM stages. The CFA results showed a χ²/v value of 1.85, CFI of 0.98, RMSEA of 0.045, and SRMR of 0.05,demonstrating good structural validity of the questionnaire. The S-CVI was 0.93, with all I-CVI values above 0.80, indicating strong content validity. The Cronbach’s α coefficient for the COPD-TTM questionnaire was 0.980, and the test-retest reliability ICC was 0.961(95%CI: 0.935-0.977), suggesting good reliability and validity.

The COPD-TTM questionnaire can be used to assess the stages of behavior change in patients, providing a basis for further development of individualized intervention plans. Future research should focus on a broader range of factors influencing behavior change to optimize personalized interventions.

To assess the burden of stroke and its subtypes attributable to dietary factors in China from 1990 to 2021.

Utilizing the Global Burden of Disease (GBD) 2021 database, we analyzed the trends of stroke and its subtypes (ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage) caused by dietary factors in China using the Join point regression model and estimated annual percentage change (EAPC).

In 2021, the number of stroke deaths attributable to dietary factors in China was 1 077 762, with an age-standardized mortality rate (ASMR) of 21.59 per 100 000. From 1990 to 2021, both the ASMR and age-standardized disability-adjusted life years (DALYs) rate (ASDR) due to dietary factors showed a declining trend, with EAPCs of -2.69 and -2.74, respectively. Ischemic stroke presented the heaviest burden, with an ASMR of 11 per 100 000. Excess sodium intake was identified as the primary dietary risk factor, with an ASMR of 8.77 per 100 000 for ischemic stroke attributable to excess sodium and an ASMR of 10.6 per 100 000 for hemorrhagic stroke. The burden of disease was significantly higher in males and individuals aged 70 and above, with mortality rates more than twice that of other age groups.

Over the past 32 years, the burden of stroke attributable to dietary factors in China has decreased, yet the overall numbers remain substantial.Future public health policies should focus on controlling high-sodium diets and increasing the intake of grains and fruits, particularly targeting high-risk populations such as elderly males, to further reduce the burden of stroke.

To conduct a quantitative evaluation of China’s Huimin insurance policy texts, provide references for the formulation and improvement of future Huimin insurance policies, and promote the further improvement of the multi-level medical security system.

Based on the text mining method, 14 Huimin insurance policies issued at the national and provincial levels were processed. A PMC index model was constructed to conduct an overall and surface chart analysis of the 14 Huimin insurance policies, and a comparison was made between Policy P10 and Policy P7.

The results of the PMC index model showed that the average PMC index score of the 14 Huimin insurance policies was 6.98, all at an acceptable level or above. Among them, 6 policies were rated as excellent, and 8 policies were rated as acceptable. The policies scored relatively high in policy content (0.87) and policy nature (0.81), and relatively low in policy perspective (0.61), incentive and restraint (0.60), and policy timeliness (0.33).

China’s Huimin insurance policies are generally at an acceptable level. They can be improved by strengthening the top - level design of Huimin insurance policies, improving the incentive and restraint mechanism, and optimizing policy timeliness.

To investigate the care service needs of disabled elderly individuals in Weifang city and analyze the influencing factors on the willingness to utilize care services among elderly individuals with varying degrees of disability, aiming to provide better care services for this population.

A care service needs questionnaire was developed based on the Anderson model as a theoretical framework. A convenience sampling method was employed to select 1 322 disabled elderly individuals in Weifang city, and a questionnaire survey was conducted to assess their care service needs. Logistic regression models were utilized to analyze the influencing factors affecting the care service needs of elderly individuals with mild, moderate, and severe disabilities.

Among the disabled elderly in Weifang city, those with mild and moderate disabilities had the highest demand for general care services (59.2%), while those with severe disabilities had the highest demand for medical care services (45.0%). Comprehensive analysis using three models revealed that factors such as “gender” (OR=0.778, 95%CI: 0.604-0.961), “educational level” (OR=0.598, 95%CI:0.511-0.701), “economic status” (OR=0.789, 95%CI: 0.640-0.961), “source of income” (OR=1.251, 95%CI: 1.084-1.444), “type of health insurance” (OR=1.870, 95%CI: 1.291-2.710), “number of chronic disease medications” (OR=0.767, 95%CI: 0.692-0.852),and “hearing status” (OR=0.833, 95%CI: 0.699-0.994) were significant factors influencing the care service needs of disabled elderly individuals.

Elderly individuals with varying degrees of disability have different demands for care service items, and these needs are influenced by factors such as gender, educational level, economic status, source of income, type of health insurance, number of chronic disease medications, and hearing status. Government, market, and societal sectors should play an active role in meeting the care service needs of disabled elderly individuals, aiming to ensure that high-quality care services genuinely benefit this population.

To explore the relationship between self-efficacy, belief perception, and pain coping strategies in community-dwelling elderly patients with chronic pain, providing a theoretical basis and guidance for targeted nursing interventions.

A stratified sampling method was used to select 363 community-dwelling elderly patients with chronic pain. The Chronic Pain Self-Efficacy Scale, Pain Beliefs and Perception Questionnaire, and Coping Strategies Questionnaire-Revised were employed for the survey. Pearson correlation analysis was conducted to analyze the correlations among variables, and multiple linear regression analysis was performed to identify factors influencing pain coping strategies.

The self-efficacy score among the 363 patients was 73.70±8.92, the belief perception score was -4.69±13.67, and the pain coping strategies score was 73.96±8.60. Univariate analysis indicated statistically significant differences in coping strategy scores based on age, marital status, educational level, payment method for medical expenses, previous occupation, monthly income level, religious belief, physical exercise, duration of pain, number of comorbid chronic diseases, and primary caregiver (P<0.05). Correlation analysis showed a positive correlation between coping strategy scores and self-efficacy scores (r=0.517, P<0.01), and a negative correlation between coping strategy scores and belief perception scores (r=-0.443, P<0.01). Multiple linear regression analysis revealed that religious belief, educational level, belief perception scores, and self-efficacy scores were influencing factors for community-dwelling elderly patients with chronic pain.

Healthcare professionals should develop rational intervention strategies based on the study results to help patients enhance their self-efficacy, establish correct belief perceptions, and guide them in adopting proactive pain coping strategies, ultimately improving their quality of life.

To investigate the ameliorative effects of ursolic acid on gut microbiota and inflammation in high-fat diet-induced obese mice.

Eighteen C57BL/6J mice were acclimatized for one week and then randomly divided into three groups: control group (CON), high-fat diet group (HFD), and unsolid acid group (UA). The CON group was fed standard diet, the HFD group was fed high-fat diet, and the UA group received high-fat diet along with daily gastric gavage of 100 mg/kg ursolic acid. The experiment lasted for 12 weeks, during which weekly measurements of body weight and food intake were recorded. At the end of the experiment, fecal samples were collected aseptically, and blood serum was obtained after anesthesia.The liver and epididymal fat were collected post-euthanasia. Pathological observations of the liver and fat tissues were conducted using hematoxylin-eosin staining. Biochemical indices and inflammatory factor levels in serum and liver were measured using kits. The microbial diversity in the feces of C57BL/6J mice was assessed using 16S rDNA sequencing.Comparisons between groups were performed using t-tests for pairwise comparisons and one-way ANOVA or Kruskal-Wallis tests for multiple comparisons. Spearman correlation analysis was used to assess the relationship between dominant bacterial genera and inflammatory factors.

During the experiment, the body weight of the HFD group significantly increased compared to the CON group (P<0.05), while the UA group showed a significant reduction in body weight compared to the HFD group (P<0.05), with no correlation between weight change and food intake (P>0.05). Compared to the CON group, the HFD group exhibited increased serum and liver biochemical indices, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) (P<0.05),along with decreased high-density lipoprotein (HDL) levels (P<0.05), all of which improved following UA intervention (P<0.05). Pathological observations revealed normal morphology of liver and fat tissues in the CON group, swelling of hepatocytes with numerous lipid vacuoles in the HFD group, and reduced hepatocyte size and lipid vacuoles in the UA group compared to the HFD group. The gut microbiota composition varied among groups at the phylum and genus levels, with higher relative abundances of Akkerman Sia and unclassified Muribaculaceae. Correlation analysis indicated that Akkerman Sia, unclassified Muribaculaceae, and Ligi lactobacillus were negatively correlated with serum and liver TNF-α and IL-1β (P<0.05), while Olsen Ella showed a positive correlation with TNF-α and IL-1β (P<0.05).

A high-fat diet promotes obesity by inducing dysbiosis and elevating inflammatory factor levels in mice. Ursolic acid intervention can regulate gut microbiota and inflammatory responses, thereby improving obesity.

To develop a Fertility-Friendly Perception Scale for reproductive-aged women and to test its reliability and validity.

Based on the social ecological system theory, a preliminary scale was created through literature review, semi-structured interviews, expert consultations, and a pilot survey. A convenience sampling method was employed to select 608 reproductive-aged women for the reliability and validity testing.

The Fertility-Friendly Perception Scale consisted of 6 dimensions and 40 items. The split-half reliability of the total scale was 0.885, and the Cronbach’s α coefficient was 0.912. The overall content validity index of the scale was 0.85, with item-level content validity indices ranging from 0.80 to 1.00. Exploratory factor analysis revealed a total of 6 common factors, with a cumulative variance contribution rate of 60.766%.Confirmatory factor analysis indicated χ²/v=1.921, a root means square error of approximation of 0.055, IFI of 0.909, CFI of 0.908, and TLI of 0.900.

The Fertility-Friendly Perception Scale for reproductive-aged women demonstrates good reliability and validity, making it an effective tool for measuring the fertility-friendly perceptions of this population.

To analyze the causal association between glucosamine and the risk of fracture using the two-sample Mendelian randomization (MR) method.

This study was based on the summary data of genome-wide association studies of glucosamine and fracture in the European population. First, univariate MR analysis was performed using the inverse-variance weighted method,MR-Egger regression method, weighted median method, and MR-PRESSO. Sensitivity analysis was conducted by excluding palindromic instrumental variables, leave-one-out analysis, and reverse MR to verify the robustness of the results. Finally, multivariate MR analysis was used to evaluate the independent effect of glucosamine on fracture occurrence.

The results of the univariate inverse-variance weighted method showed that genetically predicted glucosamine was associated with a reduced risk of fracture (OR=0.94, 95%CI: 0.90-0.99, P=0.015). In addition, the results obtained by the MR-Egger regression method, weighted median method, and MR-PRESSO were consistent with those of the inverse-variance weighted method. Sensitivity analysis further verified the stability of the results. In the multivariate MR analysis, after adjusting for the potential effects of chondroitin, vitamin supplements, and osteoarthritis, the results still supported a negative causal relationship between glucosamine and the risk of fracture (adjusted for chondroitin: OR=0.61, 95%CI: 0.46-0.80, P=4.1×10^-4; adjusted for vitamins: OR=0.87, 95%CI: 0.81-0.93, P=1.1×10^-4;adjusted for osteoarthritis: OR=0.46, 95%CI: 0.29-0.73, P=9.7×10^-4).

Glucosamine can reduce the risk of fracture.

To investigate the status of aggressive behavior in first-episode schizophrenia patients and further explore the related influencing factors and their gender differences.

A total of 224 first-episode schizophrenia patients admitted to Beijing Anding Hospital from December 2019 to September 2022 were consecutively selected as study subjects.The Revised Hostility Scale was used to assess the occurrence of aggressive behavior in patients. Univariate analysis and binary logistic regression analysis were employed to explore the influencing factors of aggressive behavior in first-episode schizophrenia patients of different genders.

The detection rate of aggressive behavior in first-episode schizophrenia patients was 34.13%, with detection rates of 24.49% for male patients and 27.27% for female patients. For female first-episode schizophrenia patients, independent predictors of aggressive behavior included ethnicity (OR=0.009, 95%CI: 0.001-0.154),history of suicide attempts (OR=57.347, 95%CI: 5.152-638.353), lack of crisis coping (OR=1.113, 95%CI: 1.001-1.238),temperament (OR=3.059, 95%CI: 1.373-6.813), and hopelessness (OR=0.891, 95%CI: 0.796-0.998). For male patients, independent predictors included age (OR=0.951, 95%CI: 0.908-0.996), living alone (OR=6.130, 95%CI: 1.935-19.420), value conflict (OR=0.912, 95%CI: 0.843-0.987), disparity between desires and reality (OR=1.108, 95%CI: 1.044-1.177),temperament (OR=1.599, 95%CI: 1.062-2.408), and hopelessness (OR=1.101, 95%CI: 1.032-1.175).

The detection rate of aggressive behavior in first-episode schizophrenia patients is relatively high, and the influencing factors exhibit gender differences. During clinical screening and treatment, personalized intervention measures should be developed based on the characteristics of the patients to more effectively prevent and manage the occurrence of aggressive behavior.

To investigate whether there are differences in anxiety status and influencing factors between health examination populations undergoing first-time and non-first-time low-dose spiral computed tomography (LDCT).

This retrospective study involved individuals who underwent health examinations at a tertiary health management center from January to December 2023 (including LDCT and anxiety self-assessment scales). Participants were divided into first-time LDCT examination group and non-first-time LDCT examination group based on whether it was their first examination at this hospital. Univariate analysis utilized independent two-sample t-tests or χ² tests. Four models were established for the overall population: Model 1 did not adjust for confounding factors; Model 2 adjusted for age, gender, examination type, occupation, education level, and alcohol history; Model 3 further adjusted for previous history of pulmonary nodules, diabetes, and hypertension; Model 4 included Body Mass Index (BMI) adjustments based on the same variables in Model 3.

A total of 19 892 participants were included in this study, with an overall anxiety detection rate of 12.31%. The anxiety detection rate in the non-first-time LDCT examination group (14.27%) was higher than that in the first-time LDCT examination group (8.9%), with a statistically significant difference (χ²=122.878, P<0.05). After adjusting for the aforementioned confounding factors, the anxiety risk for those undergoing non-first-time LDCT was 1.519 times that of those undergoing first-time LDCT (OR=1.519, 95%CI: 1.374-1.68, P<0.001).

The non-first-time LDCT examination is an independent risk factor for anxiety in health examination populations.