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 explore the relationship between parental emotional expression and depression symptoms in adolescents.

A random cluster sampling method was employed to select 13 240 adolescents from Pidu District, Chengdu. A general demographic questionnaire, the Chinese version of the Emotional Expression Scale, and the Chinese version of the Kutcher Adolescent Depression Scale were used for investigation and psychological assessment. Binary logistic regression analysis was conducted to examine the association between parental emotional expression and adolescent depression symptoms, with subgroup analysis based on factors such as gender, region, family economic status, only-child status, and primary caregiver.

The study found that 2 726 adolescents (20.6%) exhibited depression symptoms. Among the participants, 6 697 adolescents (50.6%) reported high levels of parental emotional expression. The incidence of depression symptoms was significantly higher in the group with high parental emotional expression compared to the group with low parental emotional expression (P < 0.001). Logistic regression analysis indicated that high parental emotional expression was a risk factor for depression symptoms in adolescents, even after controlling for multiple confounding factors (OR=2.08, 95%CI: 1.87-2.30). Subgroup analysis did not reveal any interaction between parental emotional expression and factors such as gender, region, or family economic status (P_interaction > 0.05).

Adolescent depression symptoms are closely associated with high parental emotional expression. Reducing negative emotional expression from parents may improve depression symptoms in adolescents and promote their psychological well-being.

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 investigate the childhood traumatic experiences, mental health symptoms, and well-being of middle school students, analyze the associations among the three, explore the mechanism by which childhood traumatic experiences and mental health symptoms affect well-being, and provide reference for improving the well-being of middle school students.

From September to November 2023, a total of 1 294 students were selected by convenience sampling and stratified sampling from two middle schools as the survey subjects. The Childhood Trauma Questionnaire, Symptom Checklist 90, and EPOCH Well-being Scale were used for the questionnaire survey. SPSS 25.0 was used for descriptive analysis, t-test, chi-square test, and Pearson correlation analysis. The plug-in process was used to explore the mediating role of mental health symptoms between childhood traumatic experiences and well-being.

There were significant differences in well-being scores among factors such as gender, school stage, household registration, parental education level, parental marital status, and“who to live with” (t=2.813, 7.11, 3.459, 9.723, 6.923, 2.515, and 20.253, P < 0.05). In this study, 90.2% of middle school students had one or more childhood traumatic experiences. The detection rates of physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse were 15.1%, 61%, 42.8%, 81.9%, and 10%, respectively. There were significant differences in childhood traumatic experiences among only-child status, school stage, parental education level, marital status, and family structure (t=-4.082, 5.415, 10.144, -3.032, 9.467, and -2.003, P < 0.05). All dimensions of childhood traumatic experiences and mental health symptoms were negatively correlated with well-being; except for sexual abuse, all dimensions of childhood traumatic experiences were positively correlated with mental health symptoms (r=0.301, P < 0.05). Mental health symptoms played a partial mediating role between childhood traumatic experiences and well-being, and the proportion of the mediating effect was 37.5%.

Childhood traumatic experiences and mental health symptoms negatively predict the well-being of middle school students, and mental health symptoms play a mediating role between childhood traumatic experiences and well-being. Against the background of a relatively high incidence of childhood traumatic experiences among middle school students, the well- being of middle school students can be improved by improving their mental health and reducing the impact of childhood traumatic experiences on well-being.

To clarify the causal relationship between body image comparison on social media and perinatal depression in pregnant women.

A convenience sampling method was employed to select pregnant women attending prenatal check-ups at a tertiary hospital in Hefei, Anhui Province, from September 2023 to April 2024. A longitudinal survey was conducted during late pregnancy (T1) and six weeks postpartum (T2) using a general information questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and a body image comparison scale for social media. Data analysis was performed using SPSS 23.0 and Mplus 8.3 statistical software. Pearson correlation analysis was conducted to examine the relationship between body image comparison on social media and depression scores at T1 and T2, while a cross-lagged model was constructed using Mplus 8.3 to explore the causal relationship between body image comparison and perinatal depression.

A total of 277 pregnant women were included in the study, with depression rates of 34.30% and 21.66% at T1 and T2, respectively. A positive correlation was found between body image comparison on social media and depression scores at both T1 and T2 (P < 0.010). Body image comparison at T1 positively predicted depression at T2 (β=0.237, P=0.001).

Pre-pregnancy body image comparison on social media can predict postpartum depression.

To explore the mediating role of depression symptoms in the relationship between bullying and suicide risk, and to analyze the moderating effect of emotional intelligence.

A stratified cluster sampling method was employed to select 16 388 students from 20 primary and secondary schools in the Pidu District of Chengdu, who completed self-administered questionnaires. Structural equation modeling was established to test the mediating and moderated mediating effects.

Among the participants, 28.5% were involved in bullying, and 29.2% exhibited a high risk of suicide. The direct effect between bullying and suicide risk was 0.154 (95%CI: 0.136-0.173, P < 0.001), while the mediating effect of depression symptoms was 0.164 (95%CI: 0.153-0.175, P < 0.001). Emotional intelligence negatively moderated the mediating pathway: at low levels of emotional intelligence, the mediating effect (bullying → depression symptoms → suicide risk) was 0.157 (95%CI: 0.144-0.169),whereas at high levels of emotional intelligence, the mediating effect was 0.114 (95%CI: 0.103-0.126).

There is a positive association between bullying and suicide risk among children and adolescents, with bullying indirectly influencing suicide risk through depression symptoms. Additionally, emotional intelligence negatively moderates the mediating effect of depression symptoms. Interventions aimed at alleviating depression symptoms and enhancing emotional intelligence may be effective strategies to mitigate the adverse effects of bullying on the psychological and behavioral health of children and adolescents.

To explore the relationship between the cumulative effect of overweight and obesity in children and the occurrence of elevated blood pressure, providing a basis for better prevention of hypertension in children.

Data were derived from the “Zigong School-Based Cardiovascular Metabolic Risk Cohort Study” conducted from 2012 to 2018. The survey included a questionnaire and physical examinations. The “overweight and obesity years” metric was calculated to assess the cumulative effect of overweight and obesity in children. Multivariable-adjusted linear regression and logistic regression models were employed to analyze the relationship between the cumulative effect of overweight and obesity, blood pressure levels and their changes, and the occurrence of elevated blood pressure.

The study included 1 637 children who were not hypertensive at baseline and had undergone at least four surveys, with an average age of 6.43 years, of which 50.00% were male. After an average follow-up of 4.57 years, 447 children developed elevated blood pressure, resulting in a cumulative incidence rate of 27.31%. During the follow-up, 381 children exhibited a cumulative effect of overweight and obesity (non-zero cumulative overweight and obesity years). The cumulative overweight and obesity years were positively correlated with endpoint systolic blood pressure, endpoint diastolic blood pressure, the difference between endpoint and baseline systolic blood pressure, and the difference between endpoint and baseline diastolic blood pressure (β₁=0.25, β₂=0.19, β₃=0.19, β₄=0.11, all P<0.05). Additionally, cumulative overweight and obesity years (OR=1.05, P<0.001),the degree of cumulative overweight and obesity (OR=1.04, P<0.001), and the duration of cumulative overweight and obesity (OR=1.14, P=0.014) were all positively correlated with the occurrence of elevated blood pressure in children.

The cumulative effect of overweight and obesity in children increases the risk of developing elevated blood pressure. Dynamic monitoring and timely intervention for overweight and obese children are crucial for preventing hypertension.

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 mortality trend and years of life lost due to bladder cancer among residents in Pudong New Area, Shanghai from 2002 to 2022.

The data were derived from the cause-of-death monitoring database of registered residents in Pudong New Area, and the demographic data were provided by the Public Security Bureau of Pudong New Area.The crude mortality rate (CMR), age-standardized mortality rate (ASMR), potential years of life lost (PYLL), potential years of life lost rate (PYLLR), average years of life lost (AYLL), standardized potential years of life lost (SPYLL), standardized potential years of life lost rate (SPYLLR) and probability of premature death were calculated. The Join point software was used to analyze the annual percent change (APC), and the differential analysis method was used to evaluate the influence of population age-structure factors on bladder cancer mortality.

From 2002 to 2022, there were 2 244 deaths from bladder cancer among residents in Pudong New Area, Shanghai. The average annual CMR was 3.81 per 100 000, showing an upward trend (APC=2.24%, Z=4.607, P < 0.001). The average annual Chinese-standardized mortality rate was 1.77 per 100 000, showing an overall downward trend (APC=-1.54%, Z=-3.236, P=0.002). The mortality rate of bladder cancer in men was higher than that in women (Z_CMR=24.370, P < 0.001; χ²=1 143.000, P < 0.001). The mortality rate increased with age (χ²=9 324.374, P < 0.001),and the mortality rates in the 60 to >70-year-old group (APC=-3.36%, Z=-3.263, P=0.002) and the 70 to >80-year-old group (APC=-1.99%, Z=-3.229, P=0.015) decreased significantly. The PYLL due to bladder cancer death among residents in Pudong New Area was 9 120 person-years, and the AYLL was 4.06 years per person. The PYLL and AYLL in men were higher than those in women. The population age-structure factor was a risk factor for promoting bladder cancer mortality.

The mortality rate of bladder cancer increases with age, and the death burden of bladder cancer in men is heavier than that in women. Men over 60 years old should be regarded as a high-risk group. The population age-structure factor is the main reason affecting the bladder cancer mortality rate, and active measures should be taken to cope with the impact of aging. The probability of premature death in women shows an upward trend, and the prevention and control of bladder cancer in women need to be strengthened.

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.