To compare the characteristics and trends of disease burden of pressure ulcers in children in China and globally from 1990 to 2021.

Data from the Global Burden of Disease 2021 (GBD 2021) were retrieved, and the incidence, prevalence, and disability-adjusted life years (DALYs) of pressure ulcers in children aged 0-14 years in China and globally from 1990 to 2021 were analysed. Age-standardized rate (ASR) and estimated annual percentage change (EAPC) were calculated to assess temporal trends, and the joinpoint regression model was employed to identify any turning points.

From 1990 to 2021, in China, the age-standardized incidence and prevalence rates of pressure ulcers among children aged 0-14 years both declined, with estimated EAPCs of -1.92% and -1.97%, respectively, ranking second worldwide in speed of decline. The age-standardized DALY rate remained relatively stable. The age-standardized incidence, prevalence, and DALYs rates of pressure ulcers in children globally all showed a downward trend, with estimated annual percentage changes of -0.44%,-0.46%, and -2.41%, respectively. In China, the incidence, prevalence and DALYs rate of pressure ulcers in children aged 0-14 years increased with age. Globally, the incidence and prevalence rates of pressure ulcers in children aged 0-14 years increased with age, and the rate of DALYs was higher in children aged 5-9 years. The age-standardized incidence and prevalence rates were higher in high SDI regions. The age-standardized DALYs rate was higher in low and low-middle SDI regions.

From 1990 to 2021, the burden of pressure ulcers in children aged 0-14 years globally and in China was gradually decreasing. Targeted prevention and intervention strategies are needed for children of different ages and in areas of different economic levels. Children with chronic or critical illnesses that require long-term bed rest should be paid paticular attention.

To explore the relationship between four dimensions of father’s parenting involvement (emotional, rule-setting, academic, and daily life), peer relationships, and the depression status of rural children.

A total of 657 rural children were assessed using the Father Involvement Questionnaire, the Peer Relationships Scale, and the Child Depression Inventory. SPSS 27.0 software and the Process 4.1 plugin were used to analyze the relationship between paternal parenting involvement and the depression status of rural children, as well as the mediating effect of peer relationships.

All dimensions of father’s parenting involvement had a significant positive impact on peer relationships(β_emotional=0.394, β_rule-setting=0.227, β_academic=0.219, β_{daily life}=0.202). The emotional, rule-setting, and academic dimensions of paternal parenting involvement significantly negatively predicted children’s depression levels (β_emotional=-0.032, β_rule-setting=-0.025, β_academic=-0.028), while the daily life dimension showed no significant effect. Peer relationships significantly negatively influenced depression levels (β_emotional=-0.159, β_rule-setting=-0.162, β_academic=-0.162, β_{daily life}=-0.168).

Peer relationships play a bridging role between father’s parenting involvement and depression in rural children. Father’s involvement in emotional, rule-setting, and academic aspects can directly predict children’s depressive symptoms, or indirectly predict them through peer relationships. Parenting involvement in the daily life dimension indirectly influences children’s depression through peer relationships.

The aims of this study were to develop the Adolescents Self-injury Tendency Scale (ASITS) under peer influence, and test the reliability and validity of this scale.

A primary questionnaire was developed using a literature review, semi-structured interviews, and expert evaluation. Afterward, 1 938 middle and high school students were surveyed with the initial questionnaire, and ASITS was formulated through item analysis and exploratory factor analysis. Furthermore, we conducted confirmatory factor analysis in the second sample (n=3 160) and tested the scale’s reliability and validity.

ASITS comprised 4 factors and 15 items. The model showed good fit (RMSEA=0.04, SRMR=0.01, CFI=0.98, TLI=0.97). Cronbach’s α for the total scale and each factor ranged from 0.72 to 0.84. The criterion validity showed that ASITS was positively correlated with self-injurious behavior, depression-anxiety-stress symptoms, loneliness and peer pressure (r=0.38,0.31, 0.34, 0.22, P<0.001), and negatively correlated with core self-evaluation (r=-0.34, P<0.001).

ASITS has good reliability and validity, thus providing a reliable tool for evaluating adolescents’ tendency to inflict self-injury under peer influence.

To explore the influence of family sports behavior environment on adolescent internet addiction behavior, and to explore the role of parent-child and peer relationships at the interpersonal relationship level.

Convenience sampling was used to survey 909 junior high school students using the Family Sports Behavior Environment Scale, 10 item Internet Addiction Scale, Parent-Child Intimacy Scale, and Children and Adolescents Peer Relationship Scale.

The chain mediation effect analysis showed that parent-child relationship and peer relationship played a mediating role between family sports behavior environment and internet addiction, respectively. The mediating effects of the three paths in the father-child relationship accounted for 24.9%, 11.4%, and 9% of the total effect, respectively. The mediating effects of the three paths in the mother-child relationship accounted for 25%, 8.3%, and 8.3% of the total effect, respectively.

Family sports behavior environment can directly predict the degree of internet addiction among junior high school students, and at the same time, family sports behavior environment can indirectly influence the internet addiction behavior of junior high school students through the chain mediation effect of parent-child and peer relationships.

To explore the relationship between tooth loss and cognitive level in the elderly, and to verify the mediating roles of dietary diversity and social participation.

This paper used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018, and screened out 5 774 eligible research subjects. Spearman correlation analysis was used to explore the correlations among tooth loss, dietary diversity, social participation and cognitive level in the elderly.The chain mediating effects of dietary diversity and social participation between tooth loss and cognitive level in the elderly were analyzed using Model 6 of the Process 4.1 add-in in SPSS.

The direct effect of tooth loss on cognitive level in the elderly was significant (β=-0.298, P<0.01). Dietary diversity and social participation significantly influenced the cognitive level of the elderly (β=0.059, P<0.05; β=0.063, P<0.01). The mediating effects of dietary diversity and social participation between tooth loss and cognitive level in the elderly were -0.016 (95% CI: -0.005~-0.030) and -0.04 (95% CI: -0.016~-0.065), respectively, and the chain mediating effect was -0.011 (95% CI: -0.006~-0.017).

Tooth loss in older adults can directly affect their cognitive level, and can also influence cognitive function through the independent or chain mediating effects of dietary diversity and social participation. In the future, attention should be paid to the tooth loss situation of older adults, and their nutritional intake and social participation should be ensured to reduce the risk of cognitive impairment and achieve healthy aging.

To assess the economic burden of multimorbidity and complex multimorbidity, focusing on cost variations across medical insurance system, synergistic cost effects of multimorbidity clusters, and expenditure patterns among older versus non-older adults, thereby providing evidence to optimize disease management, health resource allocation, and targeted interventions for high-risk populations.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, CNKI, WanFang Data, SinoMed, PubMed, Embase, Web of Science,Scopus, and Cochrane Library were systematically searched for studies on the economic burden of multimorbidity until July 2024. Two reviewers independently screened studies and extracted data. Meta-analysis was performed using Review Manager 5.4 and Stata 18.0.

A total of 27 studies with 13 266 248 participants were included. Patients with multimorbidity had significantly higher annual per capita costs across all categories compared to those with a single condition. Healthcare costs (Total: SMD=0.34, 95% CI: 0.08-0.60; Out-of-pocket: SMD=0.36, 95% CI: 0.11-0.60), hospitalization costs (Total: SMD=0.36, 95% CI: 0.20-0.51; Out-of-pocket SMD=0.20, 95% CI: 0.02-0.39), and outpatient costs (Total: SMD=0.34, 95% CI:-0.02-0.70; Out-of-pocket: SMD=0.20, 95% CI: 0.04-0.36). Costs were also higher for ≥4 conditions than for ≥2.Geographically, total costs were higher in the US and the Eurozone than in mainland China and Singapore. The cost increase effect was highest in the US (SMD=0.38, 95% CI: 0.36-0.40), followed by Eurozone (SMD=0.26, 95% CI: 0.21-0.30) and China (SMD=0.26, 95% CI: 0.12-0.40), with significant subgroup differences (P<0.001). Costs varied by multimorbidity patterns (e.g., higher for diabetes/hypertension), severity (positively correlated with cumulative illness scores and CCI), and age (higher in adults ≥65 years).

Multimorbidity imposes a significant economic burden with regional and group variations. Optimized disease management, improved health insurance coverage, and targeted health policies to reduce the burden are urgently needed. Future studies should focus on economic impacts of specific multimorbidity patterns to develop precise interventions.

To investigate the contracting status and satisfaction levels of community residents with family doctor contract services in Zhejiang Province, and to analyze the associated influencing factors.

A multi-stage stratified sampling method was used to randomly select seven community health service centers in Hangzhou, Wenzhou, and Zhoushan,Zhejiang Province. A cross-sectional questionnaire survey was conducted among individuals visiting these centers from January to March 2024. Analysis of factors influencing satisfaction levels with family doctor contract services was performed using an ordered logistic regression model.

A total of 713 questionnaires were distributed, with 643 valid responses, yielding a response rate of 90.18%. Among the respondents, 373 had contracted family doctor contract services, resulting in a contracting rate of 58.01%. The main reasons for not contracting were having never heard of the family doctor contract service (40.00%) and considering it unnecessary (26.67%). The overall satisfaction score with family doctor services among the contracted population was 4.11 ± 1.16. Satisfaction was assessed across five dimensions showing statistically significant differences (H=20.182, P<0.001). Ordered logistic regression analysis revealed that individuals living with a spouse and/or children (OR=2.316, 95% CI:1.040-5.160) reported higher satisfaction levels with family doctor contract services. Conversely, lower satisfaction levels were observed among individuals with an annual household income of 200 000-<500 000 yuan (OR=0.242, 95% CI: 0.102-0.573), those with an annual household income of ≥500 000 yuan (OR=0.212, 95% CI: 0.074-0.605), those reporting moderate awareness of family doctor contract services (OR=0.282, 95% CI: 0.163-0.486), and those reporting good awareness (OR=0.011, 95% CI: 0.004-0.028).

Currently, the family doctor contracting rate and satisfaction among community residents in Zhejiang Province are relatively high, but there is still room for improvement. Further efforts are needed to enhance publicity, improve service quality, and increase both the contracting rate and satisfaction of residents.

To explore the chain mediating role of activities of daily living and physical pain between chronic diseases and depressive symptoms in the elderly, and to provide new perspectives and intervention strategies for the prevention and alleviation of depressive symptoms in the elderly.

Based on the data of the 2020 China Health and Retirement Longitudinal Survey (CHARLS), the chain mediation model was constructed with the help of the PROCESS 4.1 program, and 5 000 repeated samplings were conducted using the Bootstrap method to verify the mediation variables.

A total of 7 505 elderly people aged 60 and above were included. Chronic diseases in the elderly were positively correlated with depressive symptoms (r=0.284, P<0.01), activities of daily living (r=0.265, P<0.01), and physical pain (r=0.379, P<0.01). The mediation test showed that chronic diseases in the elderly had a direct effect on depressive symptoms (β=0.451, 95% CI: 0.384-0.520), and activities of daily living (β=0.302, 95% CI: 0.280-0.324) and pain (β=0.522, 95% CI: 0.486-0.558) had significant individual mediating effects between the two. The chain mediating effect of activities of daily living and physical pain between the number of chronic diseases and depressive symptoms was significant (β=0.036, 95% CI: 0.029-0.044), and the total mediating effect and chain mediating effect accounted for 48.46% and 4.10% of the total effect, respectively.

Chronic diseases are significantly associated with depressive symptoms in the elderly. Activities of daily living and physical pain have a chain mediating effect between chronic diseases and depressive symptoms in the elderly. Emphasis should be placed on the synergistic effect of pain management and functional rehabilitation in the elderly. Early prevention should be carried out to reduce depressive symptoms in patients with chronic diseases and improve the quality of life of the elderly.

To investigate the impact of sleep deprivation on the physical and mental health of adolescents, and to provide theoretical references for improving the health level of adolescents.

Using data from the 2022 China Family Panel Studies (CFPS), participants aged 9-18 years were included. Observations aged >18 years, beyond the senior-high schooling stage, or with missing values on key variables were excluded. Multiple linear regression and propensity score matching were employed to estimate the effects of sleep deprivation on self-rated health and depressive symptoms among adolescents.

The final analytical sample comprised 2 600 valid observations, 61.96% of whom were classified as sleep-deprived. Insufficient sleep had significant negative impacts on adolescents’ self-rated health (β=-0.118, P=0.004) and depression (β=0.607, P<0.001). The results of propensity score matching through nearest neighbor matching, radius matching, and kernel matching showed that the average treatment effect of sleep status on adolescents’ self-rated health was -0.160 to-0.110, and on depression was 0.742 to 0.763.

Insufficient sleep leads to a decline in adolescents’ self-rated health and an increase in depressive symptoms. It is essential to ensure that adolescents get adequate sleep to promote healthy physical and brain development, alleviate anxiety and depression, and support their overall physical and mental well-being.

To analyze the current status of the provision of intergenerational support and depression among people aged 45-60 in China, and evaluate its impact on depression, providing a theoretical basis for further improving their health status.

Based on the 2018 China Health and Retirement Longitudinal Study Database (CHARLS), 7 861 middle-aged individuals aged 45-60 were included as the research subjects for analysis. The demographic characteristics, intergenerational support status, and depression status were described. The stepwise regression method was used to explore the influence of intergenerational support on depression status.

In the past year, among respondents providing emotional, economic, and life care support, 2 046 (63.8%) frequently met their parents, 2 646 (59.4%) cases met their children frequently, and 3 634(88.0%) cases often contacted their children. The number of respondents of providing financial support to the parents and to their children were 1 439 (18.3%) and 2 781 (35.4%), respectively. There were 1 679 (52.4%) cases who took care of their parents, 1 851 (94.6%) cases who took care their children, and 1 965 (64.1%) cases who took care of their grandchildren. The detection rate of depressive symptoms was 35.1%. In binary logistic regression adjusting for other factors, the results showed that the risk of depression detection was 0.571 (0.385-0.848) lower in those with frequent contact with their children than in those with infrequent contact.

Regular contact with children significantly reduced the risk of depression, whereas financial support or caregiving alone did not have a significant effect on depression.