To provide a reference for the expansion and balanced distribution of quality medical resources, thereby promoting maternal and child health.

This study utilized panel data from 31 provinces, cities, and autonomous regions from 2012 to 2021. The Moran I index and Getas-Ord G* index were employed to analyze the spatiotemporal characteristics and hotspot distributions of quality medical resources. The Grossman health production function was used to explore the effects of quality medical resources on maternal and child health.

From 2012 to 2021, the overall quality of medical resources in China showed an upward trend, with the number of tertiary hospitals increasing from 1 624 to 3 275, increasing by 101.66%.The Moran I indices for the years 2012, 2017, and 2021 were 0.292, 0.286, and 0.264, respectively, indicating a declining trend in the spatial autocorrelation of quality medical resources. For every additional tertiary hospital per 10 000 square kilometers, the infant mortality rate decreased by approximately 2.73‰, and the maternal mortality rate decreased by about 0.25 per 100 000.

The overall trend of quality medical resources in China is upward, with the eastern region experiencing the highest increase in quality medical resources, while the western region shows the greatest percentage increase. A significant“East-Central-West” hierarchical differentiation pattern exists, characterized by a spatial clustering distribution, where the eastern region is high, the central region is relatively high, and the western region is low. The effects of quality medical resources on maternal and child health are significant, negatively impacting both infant and maternal mortality rates.

To analyze suspected adverse events following immunization (AEFI) of poliomyelitis vaccination (PV) in Anhui Province from 2020 to 2023.

Data on adverse events following immunization (AEFI) were collected through the AEFI monitoring module of the Chinese Disease Prevention and Control Information System. These included cases related to the bivalent oral poliovirus vaccine (bOPV), inactivated poliomyelitis vaccine made from Sabin strains (sIPV), inactivated poliovirus vaccine (IPV), and the combined diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and Haemophiles influenza type b vaccine (DTaP-IPV-Hib). The number of vaccine doses administered was obtained from the Anhui Immunization Program Information Management System. Descriptive epidemiological methods were used to analyze the incidence and characteristics of AEFI reports.

A total of 3 036 cases of AEFI related to poliomyelitis vaccination were reported in Anhui Province from 2020 to 2023, with an overall incidence rate of 38.37 per 100 000 doses. The incidence rates for bOPV, IPV-Sabin, IPV-Salk, and DTaP-IPV-Hib were 17.47, 47.86, 33.29, and 82.11 per 100 000 doses, respectively. General reactions accounted for 94.57% of cases, while abnormal reactions constituted 4.97%. The male-to-female ratio was 1.31:1. Among general reactions, the incidence rates for high fever (axillary temperature ≥ 38.6°C), local swelling (diameter > 2.5 cm), and local induration (diameter > 2.5 cm) were 8.67, 7.22, and 4.41 per 100 000 doses, respectively. For abnormal reactions, the incidence rates for allergic rashes and other diseases were 1.43 and 0.48 per 100 000 doses, respectively.

From 2020 to 2023,AEFI related to poliomyelitis vaccination in Anhui Province were predominantly general reactions, with abnormal reactions being rare.

To explore the association between mixed exposure to low concentrations of heavy metals (cadmium, lead, mercury) and bone density, as well as the mediating effects of alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BAP), parathyroid hormone (PT), calcium (Ca), and phosphorus (P).

A cross-sectional study was conducted based on NHANES survey data, including a total of 1 465 participants. Polynomial logistic regression was used to analyze related risk factors, and Bayesian Kernel Machine Regression (BKMR) was employed to assess the impact of mixed exposure to cadmium, lead, and mercury on bone density. The mediation effects of ALP, BAP, PT, Ca, and P in the relationship between exposure to cadmium (Cd), lead (Pb), mercury (Hg), and bone density were analyzed using the Mediation package in R software (Bootstrap method).

The results of polynomial logistic regression indicated that the risk of bone loss increased at the third quartile (T3) of Cd concentration (OR=1.56, 95%CI: 1.08-2.26); the risk also increased at the second quartile (T2) of Pb concentration (OR=1.49, 95%CI: 1.06-2.08). Conversely, the risk of osteoporosis decreased at T3 of Hg concentration (OR=0.38, 95%CI:0.15-0.94). BKMR model analysis revealed that increased concentrations of cadmium, lead, and mercury were associated with a decrease in bone density scores (T-score), with posterior inclusion probabilities for Cd, Pb, and Hg being 1, 1, and 0.47, respectively. Mediation analysis showed that Cd influenced bone density through the mediating effects of ALP and Ca, with mediation proportions of -32.3% and -64.9%, respectively. Hg affected bone density through the mediating effects of ALP and BAP, with mediation proportions of 7.3% and 61.8%. Pb influenced bone density through the mediating effects of ALP, BAP, and PT, with mediation proportions of 38.9%, 97.6%, and 1.5%, respectively.

There is a negative correlation between low concentrations of mixed exposure of cadmium, lead, and mercury and T-score, and the mediating effects of ALP, BAP, PT, and Ca are statistically significant.

To explore the factors related to cognitive impairment in elderly individuals aged 60 and above in China from the perspective of social determinants of health, providing a reference for the prevention and treatment of cognitive impairment in the elderly.

Utilizing data from the fourth wave of the 2018 China Health and Retirement Longitudinal Study, we conducted a statistical description of the cognitive status of 5 721 elderly individuals aged ≥60. A multifactor logistic regression model was employed to analyze factors affecting cognitive status in the elderly, investigating the impact of the interaction between depression symptoms and disability on cognitive impairment.

Among the participants, 2 277 individuals (39.80%) were identified with cognitive impairment. Risk factors for cognitive impairment included being female (OR=1.702, 95%CI: 1.491 to 1.943), aged ≥80 years (OR=1.862, 95%CI: 1.467 to 2.364), experiencing depression (OR=1.333,95%CI: 1.173 to 1.514), having a disability (OR=2.082, 95%CI: 1.687 to 2.569), sleeping more than 8 hours (OR=1.582,95%CI: 1.288 to 1.944), and residing in central and western regions (OR=1.275, 1.538; 95%CI: 1.109-1.467, 1.337-1.771). There was a multiplicative interaction between depression and disability affecting cognitive status in the elderly (P _interaction=0.005), with no additive interaction observed (RERI=-1.217, 95%CI: -2.480 to 0.046; AP=-0.522, 95%CI: -1.112 to 0.069;S = 0.523, 95%CI: 0.291 to 0.938).

The detection rate of cognitive impairment among elderly individuals in China is concerning. The multiplicative interaction of depression and disability on cognitive status suggests that the government should intervene from the perspective of social determinants of health, implementing multidimensional strategies to achieve an integrated approach to prevention and treatment.

To analyze the financing and utilization of preventive service costs in Guizhou Province from 2016 to 2022, providing reference for improving the resilience and sustainability of preventive funding structures and optimizing the functional structure of preventive services.

Based on the System of Health Accounts 2011 (SHA2011), this study analyzes the preventive service costs in Guizhou Province from the dimensions of total preventive service costs, financing schemes, service functions, and institutional flows.

The preventive service costs in Guizhou Province were 3.72 billion yuan in 2016, increasing to 10.056 billion yuan by 2022, with the proportion of these costs in recurrent health expenditures rising from 5.07% to 8.49%. In 2020, the proportion of expenditures on infectious disease prevention and control increased to 14.71%,while the shares for chronic disease management, child health services, and maternal health care decreased. Over the seven years, government programs and household health expenditures declined, while corporate financing significantly increased. The proportion of preventive service costs attributed to hospitals and grassroots medical institutions rose annually from 48.59% to 67.29%.

From 2016 to 2022, the preventive service costs and their share of recurrent health expenditures in Guizhou Province increased; however, the phenomenon of “less attention on prevention and much attention on treatment” remains evident. Hospitals, grassroots medical institutions, and public health agencies are the primary providers of various preventive services, reflecting a trend of “medical care supporting prevention”. The proportion of personal cash expenditures in preventive service costs gradually decreased, but government and social health funding remains insufficient, and the financing structure is vulnerable to short-term and long-term external factors.

To analyze the pilot policies for long-term care insurance and provide recommendations for optimizing these policies.

Utilizing the PMC index model, we constructed nine primary variable indicators and 45 secondary variable indicators to evaluate long-term care insurance policies.

Common issues across various regions included insufficient policy levels, unclear policy timelines, and inadequate incentive and constraint mechanisms.

It is necessary to elevate policy levels and further enhance the government’s coordination and collaboration, clarify policy timelines to achieve an organic integration of short, medium, and long-term planning, and improve incentive and constraint measures to effectively increase participation in insurance.

To analyze the coupling coordination relationship between the construction achievements of the 39 tight-knit county medical community pilot counties in Guangxi and the regional economic development levels in 2022.

The coupling coordination degree model was used to analyze the coupling coordination degree of the two systems. Moran I index was employed to conduct spatial correlation analysis of the coupling coordination degree.

Among the pilot counties, five counties (12.82%) exhibited a moderate coordination type between the construction achievements and regional economic development levels; 21 counties (53.85%) were in a barely coordinated state; and 13 counties (33.33%) showed moderate disorder.The global Moran I index was 0.542.

The coupling coordination degree of the two systems needs improvement; the achievements of the medical community construction are generally ahead of the regional economic development levels; there are regional disparities in coupling coordination degree, and mutual cooperation among the pilot counties in advancing the medical community construction is weak. It is recommended to strengthen cooperation and communication, promote high-quality regional economic development, and facilitate the rational allocation of quality medical and health resources.

To investigate the potential categories of health literacy in elderly patients with type 2 diabetes and their relationship with glycemic control.

A convenience sampling method was employed to select 1 113 elderly patients with type 2 diabetes from the Affiliated Hospital of North China University of Science and Technology between September 2021 and August 2022. General demographic data and diabetes health literacy were assessed using questionnaires, including a diabetes health literacy scale. A latent profile analysis was conducted on the health literacy of elderly patients with type 2 diabetes, and glycated hemoglobin levels were measured. The relationship between the latent categories of health literacy and glycemic control was analyzed using χ² tests and binary logistic regression.

The health literacy levels of patients could be categorized into three latent categories: low willingness to improve (31.72%), moderate balanced type (31.35%), and high confidence coping type (36.93%). Propensity score matching successfully matched 283 pairs of subjects. Low willingness to improve health literacy was identified as a risk factor for poor glycemic control in elderly patients with type 2 diabetes (OR=2.238, 95%CI:1.355-3.696), while high confidence coping health literacy served as a promoting factor for glycemic control (OR=0.318,95%CI: 0.196-0.516).

High health literacy can facilitate glycemic control in elderly patients with type 2 diabetes, suggesting that targeted interventions should be developed for different health literacy populations.

To analyze the multiple mediating effects of different types of social activities on the relationship between health status and cognitive function, providing insights for mitigating cognitive impairment in older adults.

Using data from the 2018 China Health and Retirement Longitudinal Study, 7 991 individuals aged 65 and older were selected to construct a multiple mediation model examining the mediating effects of physical exercise, cultural and recreational activities, interpersonal interactions, and family life on the relationship between self-rated health and cognitive function.

Self-rated health and the four types of social activities were significantly correlated with cognitive function (P < 0.01). Physical exercise, cultural and recreational activities, interpersonal interactions, and family life exhibited partial mediating effects between self-rated health and cognitive function. Specifically, self-rated health directly influenced cognitive function with an effect size of 0.591 (95%CI: 0.471-0.710). Furthermore, self-rated health mediated cognitive function through the four types of social activities. The mediating effect size was 0.010 (95%CI: 0.002-0.018) for physical exercise, 0.083 (95%CI: 0.055-0.113) for recreational activities, 0.061 (95%CI: 0.042-0.080) for interpersonal interactions, and 0.078 (95%CI: 0.054-0.104) for family life.

Self-rated health can delay cognitive decline in older adults by promoting their participation in social activities.

To understand the epidemiological characteristics of chickenpox-related absenteeism among primary and secondary school students in Huai’an city, providing reference for further improving chickenpox prevention and control in schools.

Descriptive epidemiological methods were employed to analyze data on chickenpox-related absenteeism collected from the Jiangsu Provincial Student Health Monitoring System for the 2018 to 2022 academic years. The circular distribution method was used to analyze the seasonal characteristics of absenteeism due to chickenpox.

The average annual rate of chickenpox-related absenteeism among primary and secondary school students in Huai’an city from 2018 to 2022 was 26.23 per 100 000. The absenteeism rates varied between 11.96 (2021 academic year) and 70.84 (2020 academic year) (χ²=101 240.39, P < 0.01), with an average of 3.98 days absent per student. The absenteeism rate for boys was higher than that for girls (27.06 vs. 25.26, χ²=166.19, P < 0.01). Among different school types, the average absenteeism rate ranged from 4.30 (vocational high schools) to 39.97 (primary schools), with urban students exhibiting a higher average absenteeism rate compared to those in suburban areas (30.84 vs. 17.10, χ²=9 519.78, P < 0.01). A primary peak in absenteeism occurred from October to December in the first semester, while a secondary peak was observed from April to June in the second semester. Circular distribution method analysis revealed a significant seasonal concentration trend, with peak days occurring on November 26 and May 18, and peak periods spanning from October 29 to December 25 and from April 9 to June 26, respectively (Z values of 48 673.79 and 217.29, with P values < 0.01).

The rate of chickenpox-related absenteeism among primary and secondary school students in Huai’an city is relatively high. Monitoring should focus on boys, primary schools, urban areas, and the two peak periods (October-December and April-June). The circular distribution method for analyzing seasonal characteristics of absenteeism due to chickenpox demonstrates good practicality and can provide data support for chickenpox prevention and control in schools.