Exploring the mediating role of psychological resilience in the relationship between childhood trauma and the severity of depression among individuals with depressive disorder, and to identify subtypes of depressive disorder by latent profile analysis and analyze the related factors among subtypes.

General information questionnaire, Hamilton Depression Rating Scale (HAMD), Childhood Trauma Questionnaire (CTQ-SF) and Connor-Davidson Resilience Scale (CD-RISC) were used to investigate 360 patients with depressive disorder in outpatient department and ward of Traditional Chinese Medicine Department of Shanghai Mental Health Center.

HAMD was positively correlated with CTQ-SF and the scores of all dimensions (P<0.01), and negatively correlated with CD-RISC and the scores of all dimensions (P<0.01). There was a significant negative correlation between CTQ-SF and CD-RISC (P<0.01). The mediation effect test indicated that childhood trauma had a significant direct predictive effect on the severity of depressive disorder (β=0.079, t=12.984, P<0.001). After adding psychological resilience as a mediating variable, the direct predictive effect of childhood trauma on the severity of depressive disorder remained significant (β=0.050, t=2.636, P<0.01). Latent profile analysis showed that patients with depressive disorder could be classified into low-trauma-high-resilience depressive disorder (72.8%) and high-trauma-low-resilience depressive disorder (27.2%). Gender, age, marital status and educational background were the predictors of latent profile classification(P<0.05).

The severity of depression is correlated with childhood trauma and psychological resilience, and childhood trauma can effectively predict the severity of depression. Individuals with higher levels of childhood trauma and lower levels of psychological resilience are more prone to developing depressive disorder. It is recommended to enhance individual psychological resilience to reduce the occurrence of depressive disorder.

To understand the changing trend of drowning disease burden among Chinese children and adolescents from 1990 to 2021, and to provide a reference for formulating prevention and control strategies.

The standardized disability adjusted life years(DALYs) rate, standardized mortality and standardized incidence rate of drowning children and adolescents under 20 years of age in China from 1990 to 2021 were collected through the Global Burden of Disease (GBD) database in 2021. Average annual percentage change (AAPC)and the annual percentage change (APC) were used to analyze the trend of changes in drowning disease burden among children and adolescents of different ages and genders.

From 1990 to 2021, the standardized DALYs rate (AAPC=-6.30%) and the standardized mortality rate (AAPC= -6.15%) of children and adolescents drowning in China declined more than the standardized incidence rate (AAPC=-3.70%) (all P<0.001). The crude DALYs rates, crude mortality rates, and crude incidence rate in the <5, 5-<10, 10-<15, and 15-<20 age groups decreased (AAPC range was -8.53% to -2.38%, all P<0.001), and the <5 age group decreased the most rapidly (all P<0.001). The standardized DALYs rate, standardized mortality rate and standardized incidence rate of male and female drowning showed a downward trend(all P<0.001), and the decline rate of male drowning was higher than that of female drowning.

The overall disease burden of drowning among children and adolescents in China has shown a downward trend from 1990 to 2021. In the future, a multidimensional and immersive drowning prevention and emergency rescue education system should be constructed based on age and gender differences to enhance the safety literacy and self-rescue and mutual-rescue abilities of children and adolescents.

To investigate the associations between motoric cognitive risk syndrome(MCR) and its parameters with sarcopenia among elderly individuals in rural areas, and the moderating effect of lifestyle behaviors (physical activity, alcohol consumption, smoking) on the relationship between MCR and sarcopenia, to provide a scientific basis for developing targeted intervention strategies and preventive measures.

A convenience sampling method was employed, and 652 elderly participants were recruited from rural regions of Anhui Province for this study. MCR was assessed by a combination of subjective cognitive decline and slow gait, and sarcopenia was assessed by Sarcopenia Five(SARC-F). The regression method was used to analyze the correlation between MCR and its parameters and sarcopenia, and the moderating role of lifestyle behaviors in the above correlation was analyzed.

Older adults with MCR had higher SARC-F scores (β=0.819, P<0.05), and had a higher risk of developing sarcopenia (OR=1.794, P<0.05). Stratified analysis revealed that lifestyle behaviors significantly moderated the association between MCR and sarcopenia, with the effect of MCR on sarcopenia risk being more pronounced among individuals who did not exercise, did not consume alcohol, and did not smoke.

MCR is associated with a higher risk of sarcopenia, and exercise, alcohol consumption, and smoking have a moderating effect on the above associations.

To analyze the colorectal cancer(CRC) screening results and colonoscopy compliance among rural residents in Sichuan Province, providing evidence for optimizing CRC screening strategies.

From January to December 2023, through cluster sampling, residents aged 40 to 74 from rural areas of 8 districts/counties in Sichuan Province were selected to participate in CRC screening. The high-risk rate, colonoscopy compliance rate, and lesion detection rate were calculated. The χ² test and multivariable logistic regression model were used to analyze factors influencing colonoscopy compliance.

A total of 26 134 residents participated in the initial screening, with 5 483 identified as high-risk individuals, yielding a high-risk rate of 20.98%. Among them, 3 901 individuals underwent colonoscopy, resulting in a compliance rate of 71.15%. Multivariable logistic regression analysis showed that the compliance was significantly lower in the 70-74 age group(OR=0.55, 95% CI: 0.41-0.74) compared to the 40-44 age group. Higher education levels were associated with increased compliance. Self-employed individuals (OR=2.28, 95% CI: 1.59-3.26), those with a history of intestinal polyps (OR=3.40, 95% CI: 2.55-4.53), and those who were double-positive in both the high-risk factor questionnaire (HRFQ) and the fecal occult blood test (FOBT) (OR=3.03, 95% CI: 2.52-3.65) had higher compliance rates. Colonoscopy detected 230 cases of lesions, with a detection rate of 5.90%. Males had a higher lesion detection rate than females across all age groups.

The CRC screening program in rural areas of Sichuan Province has achieved positive results, but the compliance with colonoscopy still needs improvement, particularly among males, the elderly, and those with lower education levels. Efforts should be intensified to deliver targeted health education to these key populations, with the aim of further improving the overall compliance with colonoscopy and early detection rates.

To analyze the specific paths of the resource allocation efficiency of community home care in China and provide strong support for the balanced development of the resource allocation of such services.

Based on the relevant data from China Civil Affairs Statistical Yearbook, China Statistical Yearbook, China Health Statistics Yearbook, and China Social Statistics Yearbook (2020—2023), this study used the Data Envelopment Analysis (DEA) method to measure the allocation efficiency of community-based home care resources in China. On this basis, the Fuzzy-set qualitative comparative analysis (fsQCA) was employed to explore the configurational paths for the efficient allocation of community-based home care resources.

The average values of the comprehensive efficiency, pure technical efficiency, and scale efficiency of community home care services in China were 0.533, 0.640, and 0.810, respectively. There were significant differences among different regions and provinces. There were three paths to improve the efficiency of community home care services, with an overall consistency of 0.925, indicating a strong explanatory power of the model.

The overall efficiency level of community home care services needs to be enhanced. It is recommended to optimize management processes and technological innovation, strengthen the radiation and driving force of advantageous regions, precisely expand the scale of the elderly care industry, effectively improve the resource allocation efficiency, adhere to the principle of development based on local conditions, and explore new differentiated elderly care paths.

To evaluate the policy effects of medical resource allocation and service utilization in the Beijing-Tianjin-Hebei region, identify regional disparities, analyze policy outcomes, and propose recommendations.

Based on panel data from 30 provinces (autonomous regions and municipalities) across China from 2010 to 2022, the synthetic control method was employed to assess the policy effects of coordinated medical and health development in the Beijing-Tianjin-Hebei region.

Under the influence of the policy, the growth of medical resources and service utilization in Beijing has continued to decline, with non-capital core functions effectively relocated. In Hebei, the growth of medical resources and service utilization has increased significantly, showing remarkable results in medical resource expansion. For Tianjin, the policy effects on some indicators were unstable, but it remained affected by the policy.

It is recommended to innovate service models,promote the balanced distribution of medical resources, improve the efficiency of service utilization, and enhance the level of homogenized services.

To construct the AIDS prevention behavior education program for elderly women based on the theory of planned behavior, and to provide reference for the development of AIDS prevention behavior education for elderly women.

Based on the theory of planned behavior, semi-structured interviews were conducted with 16 experts and 15 elderly women around the four dimensions of behavioral attitude, subjective norms, perceived behavioral control, and behavioral intention, and a preliminary plan was constructed. Using the Delphi method, two rounds of consultation were conducted with 20 specialists. Selection criteria for program components required all items to meet the following thresholds: mean scores more than 3.5 for both importance and feasibility, coefficient of variation less than 0.25, and full score percentage more than 20%. This process resulted in the final formulation of an AIDS prevention behavior education program targeting elderly women.

The response rates of experts in the two rounds were 100% and 90%, respectively. The authority coefficients of experts were 0.888 and 0.884, respectively. The Kendall’s coefficients of concordance were 0.193 and 0.218, respectively (both P<0.001).Finally, an AIDS prevention behavior education program for elderly women was established, including 4 first-level items, 10 second-level items, 19 third-level items, and 6 participatory teaching methods.

The AIDS prevention behavior education program for elderly women based on the theory of planned behavior is scientific and reliable, which provides new ideas and methods for AIDS prevention behavior education for elderly women.

To explore the effects of community-based self-management intervention on depression, anxiety, and quality of life in high-risk populations with chronic obstructive pulmonary disease(COPD), providing scientific evidence for the formulation of community-based COPD prevention and intervention policies.

Data on sociodemographic characteristics, lifestyle, health status, and lung function were collected from 464 participants through 8 community-based self-management sessions for COPD conducted in Suzhou. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7(GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9). Quality of life was assessed using the EQ-5D-3L scale (including the EQ-VAS).

The results from the PHQ-9 and GAD-7 scales indicated that, after the intervention,the proportion of participants in the mild depression (anxiety) group and moderate or severe depression (anxiety) group significantly decreased, while the proportion of participants in the normal group increased significantly (P<0.05). A significant change was also observed in the PHQ-9 scale for the group with FEV1/FVC≥70% (P=0.018). In terms of quality of life,significant differences were found in the distribution of self-care, pain/discomfort, and anxiety/depression dimensions between pre- and post-intervention in both the overall population and the FEV1/FVC≥70% group (P<0.05). Except for the FEV1/FVC<70% group in EQ-VAS analysis, significant improvements were observed in the EQ-5D-3L utility index and EQ-VAS scores in all groups (P<0.001).

Community self-management interventions can improve the psychological health and quality of life of high-risk COPD populations, with more pronounced effects in the FEV1/FVC≥70% group. This study provides support for community-based COPD intervention strategies in Suzhou.

To explore the mediating effect of empowerment on the relationship between social support and health literacy in patients with type 2 diabetes mellitus.

A cross-sectional survey was conducted with 243 patients with type 2 diabetes mellitus recruited by convenience sampling from a Grade III Class A hospital in Guiyang. Data were collected using a general information questionnaire, the Diabetes Health Literacy Scale (DHLS), the Diabetes Empowerment Scale-Short Form(DES-SF), and the MOS Social Support Survey (MOS-SSS). Statistical analyses in SPSS 26.0 included the Wilcoxon rank-sum test, Kruskal-Wallis H test, Spearman correlation analysis, and multiple linear regression analysis. A structural equation model was constructed using AMOS 24.0, and the mediating effect was tested through the bootstrap method.

The health literacy score was 53.00 (40.00, 61.00), the empowerment score was 31.00 (27.00, 36.00), and the social support score was 72.00 (61.00, 81.00) among the 243 patients with type 2 diabetes mellitus. Social support was positively correlated with health literacy (r=0.539, P<0.01), social support was positively correlated with empowerment (r=0.613, P<0.01), and empowerment was positively correlated with health literacy (r=0.597, P<0.01). Social support could directly and positively predict health literacy, and also indirectly predict health literacy through empowerment. The mediating effect value of empowerment was 1.036, accounting for 32.1% of the total effect.

Empowerment plays a partial mediating role between social support and health literacy in patients with type 2 diabetes mellitus. Therefore, by improving social support and strengthening empowerment, health literacy can be enhanced in patients with type 2 diabetes mellitus.

To explore the association between the number of living children and dementia among older adults, as well as the influence of social support and lifestyle on this association.

This study included 6 232 participants aged ≥65 years from the Hubei Memory and Aging Cohort, categorized by number of living children (0, 1-2, ≥3). Multivariable logistic regression was used to analyze the associations with dementia, stratified by residence, sex, education level, and personal monthly income, while also examining the modifying effects of social support and lifestyle habits.

Compared to older adults with 1-2 living children, those with no living children (OR=1.705, 95% CI: 1.205-2.412) and ≥3 living children (OR=1.344, 95% CI:1.030-1.753) had an increased risk of dementia. Stratified analysis revealed that compared with elderly people with 1-2 living children, those without living children in rural areas (OR=2.392, 95% CI: 1.544-3.707), males (OR=2.013, 95% CI: 1.190-3.404), females (OR=1.854, 95% CI: 1.094-3.144), those with low education levels (OR=1.859, 95% CI: 1.278-2.702), and those with low personal monthly income (OR=1.802, 95% CI: 1.211-2.682) had significantly higher risks of dementia. Among older adults with ≥3 living children, urban residents (OR=2.677, 95% CI: 1.557-4.603), males (OR=2.058, 95% CI: 1.259-3.363), those with higher education levels (OR=2.550, 95% CI: 1.298-5.009), and those with higher personal monthly income(OR=2.424, 95% CI: 1.096-5.361) all showed significantly elevated risks of dementia. Compared to older adults with poor social support and unhealthy lifestyles, the overall population with good social support (OR=0.569, 95% CI: 0.453-0.716) and healthy lifestyles (OR=0.485, 95% CI: 0.381-0.618) showed significantly lower dementia risk. Among childless older adults, those maintaining healthy lifestyles demonstrated even greater risk reduction (OR=0.515, 95% CI: 0.276-0.960). Among those with ≥3 living children, both good social support (OR=0.410, 95% CI: 0.306-0.549) and healthy lifestyles (OR=0.419, 95% CI: 0.307-0.573) were associated with the most substantial protective effects against dementia.

Older adults with no living children or ≥3 living children had significantly higher dementia risk compared to those with 1-2 living children. Compared with the elderly with 1-2 living children, the elderly in rural areas, males, females, with low education levels and low monthly personal income without living children, and urban elderly with ≥3 living children, males, and those with higher education levels and high monthly personal income had a higher risk of developing dementia. Good social support and healthy living habits were associated with a lower risk of dementia in the ungrouped population and elderly people with multiple children. Moreover,healthy living habits were also associated with a lower risk of dementia in the elderly without living children. No significant association was observed among those with 1-2 living children.