ArchiveTo evaluate the reliability and validity of a national questionnaire on the intelligent maturity of infectious disease surveillance and early warning.
A questionnaire was developed based on the intelligent maturity index system for infectious disease surveillance and early warning. Expert consultation was used to assess the content, items, and content validity of the questionnaire. A random sampling method was taken to select 700 county (district) CDCs in the Chinese mainland for a one-month questionnaire survey in mid-October 2023. Item analysis was performed with the critical ratio method. Reliability was evaluated using Cronbach′s α coefficient and Spearman-Brown coefficient. Validity was analyzed using confirmatory factor analysis and content validity index.
In the item analysis, six items did not meet the standard: IT infrastructure construction, coverage of security measures such as cloud desktop and cloud terminal, adoption of national information standards for the informatization construction of infectious disease surveillance and early warning, ability to call national application programming interfaces (APIs) and use software development kits (SDKs) to achieve application integration, missed reporting rate of infectious diseases, and proportion of confirmed cases in the syndromic surveillance of infectious diseases. After comprehensive consideration, these items were retained. The reliability analysis showed that the total Cronbach′s α coefficient was 0.872. The Cronbach′s α coefficients for the three dimensions were 0.755 for intelligent strategy and foundation, 0.857 for intelligent business process and management, and 0.607 for intelligent effectiveness. The Spearman-Brown coefficient was 0.756. The validity analysis showed that the overall content validity index of the questionnaire was 0.985, and the content validity index of each item ranged from 0.820 to 1.000. The structural equation model constructed by confirmatory factor analysis fitted well after modification.
The national questionnaire on the intelligent maturity of infectious disease surveillance and early warning has good reliability and validity, and is suitable for evaluating the intelligent maturity of infectious disease surveillance and early warning on integrated regional platforms across provinces nationwide.
Public health emergency management is directly related to public health, social stability, and national security. Currently, public health emergency management in China faces challenges such as imperfect cross-departmental collaboration models, generally insufficient early identification capabilities for public health emergencies, and the ineffective role of information technology support. This article focuses on the needs of national public health emergency management, from the three perspectives of risk management, emergency management, and crisis management, and organically integrates information technology with key aspects such as early identification, early warning and prediction, risk assessment, emergency response, and decision-making management, to construct a smart public health emergency management platform for China. This platform aims to provide information technology support for multi-point monitoring, comprehensive early warning, decision-making management, as well as business collaboration and data sharing across multiple departments and agencies in public health emergency management.
Information management departments within Chinese Center for Disease Control and Prevention (CDC) agencies played a crucial role in the control of the novel coronavirus disease (COVID-19) pandemic, and their importance has become increasingly prominent. However, these departments still face challenges due to insufficient development and have considerable room for growth. This article provides an overview of the current status, functions, and responsibilities of information management departments within Chinese CDC agencies, and examines the work of similar departments in other countries. It also analyzes the developmental changes in information management departments of CDC agencies both domestically and internationally following the COVID-19 pandemic. Finally, by integrating the development of information management departments in CDC agencies worldwide, this article explores potential future directions for the development of information management departments within Chinese CDC agencies.
This paper aims to explore the application of Internet of Things (IoT) in healthcare under the rapid development of artificial intelligence technology, systematically analyze the resulting iatrogenic risks, and examine their conceptualization, classification, and governance pathways. Through a systematic review of relevant literature and based on Bogner's classification of medical failures, this study categorizes iatrogenic risks into active and latent types and identifies risk factors in the medical application of IoT technology. The research finds that algorithm limitations and cybersecurity issues are the main factors contributing to active iatrogenic risks, while human-machine integration challenges and loose regulatory environments are the primary factors leading to latent iatrogenic risks. While IoT medical technology improves healthcare service efficiency and quality, it also introduces iatrogenic risks. The study indicates that precise efforts in technical security regulatory standards and multi-stakeholder risk avoidance mechanisms are necessary to establish an IoT healthcare risk control system and reduce iatrogenic risks.
The continuous integration of artificial intelligence (AI) technologies, represented by machine learning, deep learning, and foundation models, with biotechnology has brought numerous benefits to human health, but it has also inevitably given rise to a series of risks that have attracted significant attention from governments, businesses, think tanks, and research institutions. This paper analyzes the potential risks of integrating AI and biotechnology, focusing on knowledge acquisition, toxin design, and pathogen modification. We review the current status of AI governance in the global biotechnology field from four perspectives: international frameworks, national legislation, industry guidelines, and scientist initiatives. To mitigate relevant risks in China, we propose a series of recommendations, including developing risk assessment methods and tools, strengthening legislation, and actively participating in global governance, aiming to contribute to the construction of a responsible governance framework with Chinese characteristics.
To investigate the prevalence of diabetes mellitus among middle-aged and elderly patients with chronic pain in Beijing city, Jiangxi province, and Chongqing city, China, and to provide a reference for the development and improvement of pain management strategies for this population.
From January to August 2023, a multi-stage stratified random sampling method combined with convenience sampling was used to recruit 4320 outpatients aged ≥45 years with self-reported pain duration >3 months from six tertiary and six secondary general hospitals in Beijing city, Jiangxi province, and Chongqing city. A questionnaire survey was conducted to analyze the prevalence of diabetes mellitus among middle-aged and elderly patients with chronic pain, the influencing factors of pain intensity, and the factors that alleviate or exacerbate pain, as well as treatment status.
Among the 4 151 middle-aged and elderly patients with chronic pain finally included in the analysis from the three provinces/cities, 736 had diabetes mellitus, with a prevalence of 17.7%. Among the 736 patients with chronic pain and diabetes mellitus, 163 (22.1%) had mild pain, 441 (59.9%) had moderate pain, and 132 (17.9%) had severe pain. Multivariable ordinal logistic regression analysis showed that living in rural areas, strenuous physical activity, having other medical histories, and having depressive symptoms were risk factors for increased pain intensity in patients with chronic pain and diabetes mellitus. Common pain-relieving factors for patients with diabetes mellitus were bed rest (60.9%), rest days (47.0%), and appropriate massage (38.3%), while aggravating factors were physical fatigue (59.8%), inappropriate exercise (44.8%), and prolonged sitting (35.2%). A total of 672 patients with chronic pain and diabetes mellitus received pain treatment, with a treatment rate of 91.3%. Common pain treatment methods included topical medications (61.9%), oral analgesics (55.1%), and moderate rest (48.7%).
The prevalence of diabetes mellitus among patients with chronic pain is high. Patients with diabetes mellitus living in rural areas, with other medical histories, engaging in strenuous physical activity, and experiencing depressive symptoms are more likely to experience increased pain. Moderate rest and appropriate exercise can effectively alleviate pain in patients with diabetes mellitus.
To investigate the detection rate of different subtypes of cardiovascular disease (CVD) high-risk populations in Shaanxi province and their influencing factors, so as to provide a scientific basis for the prevention and control of CVD.
From December 2015 to December 2022, a convenience sampling method was used to recruit 168 742 permanent residents aged ≥35 years from 12 project sites in 5 cities of Shaanxi province: Baoji city (Fengxiang county, Jintai district, Mei county), Hanzhong city (Chenggu county, Hantai district), Shangluo city (Shangzhou district, Zhen'an county), Weinan city (Chengcheng county, Tongguan county, Pucheng county), and Xianyang city (Sanyuan county, Jingyang county). Questionnaires, physical examinations, and laboratory tests were conducted. The detection rates of different subtypes of CVD high-risk populations in Shaanxi province were calculated, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors of the detection of different subtypes of CVD high-risk populations.
Among the 168 379 permanent residents aged ≥35 years finally included in the analysis in Shaanxi province, 60 197 were identified as high-risk for CVD, with a detection rate of 35.75%. Among them, 8 611, 27 047, 28 995, 6 632, 3 310, and 5 737 individuals were identified as having a history of CVD, hypertension, diabetes, dyslipidemia, heavy smoking, and World Health Organization (WHO) assessed risk, respectively, with detection rates of 5.11%, 16.06%, 17.22%, 3.94%, 1.97%, and 3.41%, respectively. Multifactorial unconditional logistic regression analysis showed that age ≥45 years, smoking, alcohol consumption, snoring, daytime fatigue or sleepiness, overweight with normal waist circumference (WC), normal body mass index (BMI) with high WC, both high BMI and WC, and a family history of hypertension, diabetes, CVD, and hypercholesterolemia were risk factors for the detection of high-risk CVD populations, while female sex and middle and high socioeconomic status (SES) were protective factors. Age ≥45 years, snoring, fatigue and sleepiness, overweight with normal WC, normal BMI with high WC, both high BMI and WC, and a family history of hypertension, diabetes, CVD, and cancer were risk factors for the detection of high-risk CVD history populations, while female sex, smoking, alcohol consumption, and a family history of hypercholesterolemia were protective factors. Female sex, age ≥45 years, alcohol consumption, snoring, fatigue and sleepiness, overweight with normal WC, normal BMI with high WC, both high BMI and WC, and a family history of hypertension and hypercholesterolemia were risk factors for the detection of high-risk hypertension populations, while high SES, smoking, and a family history of diabetes were protective factors. Age ≥45 years, sleep snoring, fatigue and drowsiness, excessive BMI with normal WC, normal BMI with excessive WC, both excessive BMI and WC, family history of hypertension, family history of diabetes were risk factors for the diabetes subtype, and female, moderate and high SES and smoking were protective factors. Age ≥55 years, smoking, sleep snoring, excessive BMI with normal WC, normal BMI with excessive WC, both BMI and WC, family history of hypertension, family history of diabetes, and family history of hypercholesterolemia were risk factors for dyslipidemia subtype, and female, moderate and high SES, alcohol consumption, and family history of CVD were protective factors. Age 45 to 64 years, smoking, alcohol consumption, sleep snoring, fatigue and sleepiness, excessive BMI but normal WC, normal BMI but excessive WC, both BMI and WC and family history of diabetes were risk factors for heavy smoking subtype, and female and high SES were protective factors. Women, age ≥45 years, smoking, alcohol consumption, sleep snoring, fatigue and sleepiness, excessive BMI with normal WC, normal BMI with excessive WC, both BMI and WC with excessive BMI, and family history of hypertension, family history of diabetes, and family history of hypercholesterolemia were risk factors for WHO risk assessment subtype, and high SES was a protective factor.
In Shaanxi province, the detection rate of CVD in high-risk groups was high, and hypertension and diabetes were the main CVD high risk subtypes. Gender, age, SES, smoking status, alcohol consumption status, sleep snoring status, fatigue and sleepiness status, BMI and WC status, and family history of hypertension, diabetes, CVD, hypercholesterolemia, and cancer were the main influencing factors for the detection rate of CVD in high-risk groups in this area.
To investigate the current status of depression and anxiety and their influencing factors among adolescents with spinal curvature abnormalities.
From September 2021 to December 2022, a stratified cluster sampling method was used to select 2 855 adolescents with spinal curvature abnormalities from 28 middle schools in Shenzhen city to complete a questionnaire survey, explore the prevalence of depression and anxiety symptoms in this population, and establish logistic regression and mixed network models.
The number of adolescents with spinal curvature abnormalities who experienced depression and anxiety were 1 260 (44.1%) and 1 219 (42.7%), respectively, and the prevalence gradually increased with age (P<0.001). Among girls, 835 (48.6%) and 811 (47.2%) experienced depression and anxiety, respectively, while among boys, the numbers were 425 (37.4%) and 408 (35.9%), respectively. Girls (OR=1.40, 95%CI: 1.15–1.70), average peer relationships (OR=1.58, 95%CI: 1.19–2.09), average teacher-student relationships (OR=1.70, 95%CI: 1.36–2.11), moderate (OR=1.69, 95%CI: 1.30–2.19) or high (OR=4.61, 95%CI: 3.33–6.38) study pressure, acceptable (OR=1.50, 95%CI: 1.24–1.83) or poor (OR=1.77, 95%CI: 1.24–2.53) body image, sometimes (OR=1.40, 95%CI: 1.11–1.77) or often (OR=2.59, 95%CI: 1.69–3.98) experiencing neck and shoulder pain, sometimes (OR=1.58, 95%CI: 1.26–1.98) or often (OR=1.92, 95%CI: 1.25–2.95) experiencing lower back pain, poor sleep quality (OR=5.09, 95%CI: 4.19–6.18), and screen time ≥2 h/d (OR=1.25, 95%CI: 1.04–1.51) were associated with a higher risk of depression (all P<0.05). Girls (OR=1.37, 95%CI=1.13–1.64), average peer relationships (OR=1.62, 95%CI: 1.23–2.12), moderate (OR=2.14, 95%CI: 1.65–2.77) or high (OR=7.31, 95%CI: 5.30–10.08) study pressure, acceptable (OR=1.40, 95%CI: 1.15–1.69) or poor (OR=1.90, 95%CI: 1.35–2.68) body image, sometimes (OR=1.38, 95%CI: 1.10–1.74) or often (OR=2.20, 95%CI: 1.47–3.30) experiencing neck and shoulder pain, sometimes (OR=1.67, 95%CI: 1.34–2.08) or often (OR=1.76, 95%CI: 1.18–2.64) experiencing lower back pain, poor sleep quality (OR=3.11, 95%CI: 2.58–3.76), and screen time ≥2 h/d (OR=1.25, 95%CI: 1.04–1.50) were associated with a higher risk of anxiety (all P<0.05). In the network analysis, sleep quality (Weight=0.47) and peer relationships (Weight=0.25) had strong direct associations with depression, and study pressure (Weight=0.31) had a strong direct association with anxiety.
The prevalence of depression and anxiety symptoms is high among adolescents with spinal curvature abnormalities in Shenzhen city, and is influenced by factors such as sex, peer relationships, study pressure, body image, neck and shoulder pain, lower back pain, sleep quality, and screen time. Early attention to mental health issues in this population and the timely provision of reasonable and effective interventions are conducive to their physical and mental health development.
To understand the training needs of primary healthcare professionals with integrated medical, preventive, and managerial skills, and to propose suggestions for optimizing the training of such personnel in China, providing a reference for the implementation of the "14th Five-Year Plan" for National Health.
In January 2023, a multi-stage sampling method was used to conduct a questionnaire survey on the training needs of 1 641 primary healthcare professionals from community health service centers and township hospitals in 107 prefecture-level cities (autonomous prefectures, districts/counties) across 25 provinces (autonomous regions, municipalities) in China. The survey covered four main areas: basic skills, medical skills, preventive skills, and managerial skills.
Among basic skills, the highest training need was for practicing registration qualifications, at 48.08% (789/1 641). For medical skills, the highest training need was for emergency treatment and pre-hospital first aid, at 46.62% (765/1 641). For preventive skills, the highest training need was for community health service investigation, at 45.52% (747/1 641). For managerial skills, the highest training need was for personnel training and scientific research teaching, at 51.86% (851/1 641). The lowest training need was for the implementation and management of basic public health programs, at 33.88% (556/1 641). Primary healthcare professionals in western regions and township hospitals had higher needs in all areas.
There are regional, urban-rural, and skill-based differences in the training needs of primary healthcare professionals with integrated medical, preventive, and managerial skills in China. It is recommended to coordinate the training of these personnel with the development of village (community) public health committees, clarify their corresponding skill development requirements, and accelerate the standardization process.
To analyze the correlation between early or late natural menopausal age and muscle mass percentage and bone mass percentage in postmenopausal women, and to provide a reference for health care of postmenopausal women.
A total of 2 059 naturally menopausal women were selected from the Guangzhou Chronic Disease Prospective Cohort Study of Middle-aged and Elderly People. Baseline survey data were collected from November 2017 to January 2020, including general demographic characteristics, female physiological data, and body composition indicators such as muscle mass percentage and bone mass. Generalized linear models were used for data analysis.
The average age and average menopausal age of the participants were (59.1±5.1) years and (50.4±2.9) years, respectively. After adjusting for relevant confounding factors, compared with the normal menopausal age group, both the early menopausal age group (β=–1.02, 95%CI: –1.83 to –0.21) and the late menopausal age group (β=–0.75, 95% CI: –1.43 to –0.06) were associated with decreased muscle mass percentage (both P values <0.05). No association was found between early or late menopausal age and bone mass percentage.
Early or late natural menopause is associated with decreased muscle mass percentage in postmenopausal women, but not with bone mass percentage.
To investigate the relationship between depressive status and changes in depressive status and fertility intentions among Chinese people of childbearing age.
Using data from the China Family Panel Studies (CFPS), the depressive status of married individuals of childbearing age was assessed based on the CES-D 8 questionnaire, with a score of ≥7 considered indicative of depressive symptoms. First, using the 2020 CFPS data, χ2 tests and logistic regression were used to analyze the relationship between current depressive status and fertility intentions among married individuals of childbearing age. Second, combining the 2018 and 2020 CFPS data, logistic regression was used to analyze the impact of changes in depressive status from 2018 to 2020 on fertility intentions in 2020.
A total of 8 905 married individuals of childbearing age were included in the 2020 CFPS survey, with a mean age of (37.1±7.3) years, of whom 53.7% were female. Among the participants, 1 068 (12.0%) expressed an intention to have children in the next two years. No significant correlation was found between depressive status and fertility intentions among all participants (OR=0.84, 95%CI: 0.69–1.03). Depressive status had an impact on women′s fertility intentions, with women experiencing depressive symptoms showing weaker fertility intentions (OR=0.74, 95%CI: 0.55–0.99), but no significant correlation was observed in men. Combining the 2018 and 2020 data, compared to individuals whose CES-D 8 scores remained unchanged or decreased from 2018 to 2020, individuals whose CES-D 8 scores increased (i.e., worsening depressive symptoms) showed a significant decrease in fertility intentions (OR=0.15, 95%CI: 0.04–0.62).
There is a significant correlation between depressive symptoms and fertility intentions in women, with women experiencing depressive symptoms more likely to exhibit weaker fertility intentions. Furthermore, as the severity of depressive symptoms increases, individuals' fertility intentions gradually weaken.
To evaluate the vaccine effectiveness (VE) of influenza vaccine (InfV) in pregnant women on their infants in Gansu province.
A total of 1 229 978 infants born to pregnant women in Gansu province from January 1, 2018 to December 31, 2023 were included in this study. Data were collected from the electronic medical record system, birth registration system, and immunization program system of Gansu province. A retrospective cohort of pregnant women who received InfV during pregnancy was constructed by linking the databases of each system through ID number. Information on laboratory-confirmed influenza cases in infants was collected through the electronic medical record system. Robust Poisson regression analysis was used to compare the adjusted risk ratio (RR), VE, and 95%confidence interval (CI) of influenza in infants born to pregnant women who received InfV during pregnancy and those who did not from 2018 to 2023.
The incidence of influenza in infants born to 1 210 pregnant women who received InfV during pregnancy was 4.71% (57/1 210), which was significantly lower than 6.13% in infants born to 1 228 768 pregnant women who did not receive InfV during pregnancy (χ2=4, P<0.05). The adjusted RR was 0.78 (95%CI: 0.29–0.99), and the VE was 22.13% (95%CI: 0.79–40.30).
InfV vaccination during pregnancy provides some protection against influenza in infants under 6 months of age.
To investigate the current status of public health emergency response team building in disease prevention and control institutions in Shanghai city, analyze existing problems and their causes, and provide a reference for improving the construction of public health emergency response teams in these institutions.
From March 22, 2023 to April 15, 2023, a questionnaire survey was conducted to collect data on the current status of public health emergency response team building in Shanghai city′s disease prevention and control institutions, as well as the basic information, professional skills, and emergency handling experience of team members. Data were statistically analyzed using Excel 2003 and SPSS 20.0 software.
A total of 1 956 questionnaires were collected, of which 1 921 were valid, yielding an effective rate of 98.21%. Shanghai city′s disease prevention and control institutions have established 12 regular emergency response teams (Comprehensive Coordination, Acute Communicable Disease Control, Chronic Communicable Disease Control, Vaccine-Preventable Disease Control, Disinfection and Vector Control, Radiation Event Response, Environmental Event Response, Foodborne Disease Control, Occupational Poisoning Control, Chemical Toxicity Testing, Pathogen Detection, and Logistics Support) and 2 reserve emergency response teams (Acute Communicable Disease Control Reserve and Health-Related Hazard Control Reserve). The average age of emergency responders was (36.82±9.05) years, with a male-to-female ratio of 1:1.90. The majority of team members held bachelor′s degrees (59.66%) and intermediate professional titles (41.12%). 50.34% of the team members had ≤5 years of experience in public health emergency response work. A relatively large number of personnel were familiar with public health-related specialties such as acute communicable disease prevention and control, comprehensive coordination, chronic non-communicable disease prevention and control, emergency management, microbial detection, environmental health, and food hygiene. However, fewer than 10% of personnel were familiar with radiation hygiene, parasitic disease prevention and control, child and adolescent health, immunization planning, and occupational health. Except for the number of individuals who participated in the COVID-19 response (>90%), the number of participants in other public health emergency responses was less than 45%, and the frequency of participation was mostly 1–5 times.
Shanghai city′s disease prevention and control institutions have established relatively well-developed emergency response teams. However, there are problems such as an unbalanced team structure, a shortage of high-level and interdisciplinary professionals, and insufficient experience in emergency response. These institutions should establish a unified planning, coordinated management, and unified command working mechanism for public health emergency response teams. They should further strengthen the recruitment of high-level personnel, enhance the reserve of public health emergency personnel, optimize the composition of emergency response teams, conduct targeted emergency training and drills, and improve the overall quality of emergency response teams to ensure high-quality and sustainable development of public health emergency work.
To understand the epidemiologic trends and factors influencing the prevention and control of pulmonary tuberculosis with diabetes mellitus (PTB-DM) in Chongqing city, and to provide a basis for reducing the risk of comorbidities and improving patient outcomes in the region.
Data on PTB-DM patients registered in Chongqing city from 2016 to 2022 were extracted from the National Tuberculosis Information Management System. Descriptive analysis was used to analyze disease trends and demographic characteristics. Chi-square test was used to compare between groups. Multivariate unconditional logistic regression was used to analyze factors influencing patient outcomes. Joinpoint regression model was used to analyze disease trends.
From 2016 to 2022, the average registration rate of PTB patients in Chongqing city was 49.38/100 000, with a decreasing trend (average annual percentage change [AAPC]= −10.70%, 95% confidence interval [95%CI]: 16.16%–5.63%). The average registration rate of PTB-DM patients was 2.9/100 000, with an increasing trend (AAPC=14.38%, 95%CI: 7.08%–23.73%). Enrolled PTB-DM were predominantly male, older, referred, had delayed medical visits, and had positive pathogen detection results. Among the outcomes of PTB-DM patients, successful treatment accounted for 80.85% and adverse outcomes accounted for 19.15%. The average annual treatment success rate was 82.01%. Joinpoint regression analysis showed a decreasing trend in the patients′ treatment success rate. Multivariate unconditional logistic regression analysis showed that ethnic minorities (odds ratio [OR]=0.744, 95%CI: 0.633–0.874), 0–24 years old (OR=0.217, 95%CI: 0.051–0.922), 25–39 years old (OR=0.540, 95%CI: 0.398–0.734), 40–54 years old (OR=0.488, 95%CI: 0.416–0.572), 55–64 years old (OR=0.709, 95%CI: 0.607–0.828), initial treatment (OR=0.648, 95%CI: 0.531–0.791), and with negative pathogen detection results (OR=0.576, 95%CI: 0.489–0.677) were protective factors against adverse outcomes in PTB-DM patients. Living in southeast Chongqing (OR=1.560, 95%CI: 1.218–1.999) and being referred for treatment (OR=1.289, 95%CI: 1.080–1.539) were risk factors for adverse outcomes in PTB-DM patients.
The co-morbidity trend of PTB-DM in Chongqing city is obvious. Treatment and management factors, such as diagnostic route, delayed medical visits and management methods, have an impact on the treatment outcomes of PTB-DM patients.
To understand the impact of extreme temperatures on the risk of stroke mortality among residents in Nanchang city, Jiangxi province, from 2018 to 2022, and to provide data support for the formulation of corresponding preventive measures and health policies.
Data on stroke mortality among Nanchang residents from January 1, 2018, to December 31, 2022, as well as data on air pollutants and meteorology in Nanchang during the same period, were collected from the Chinese Center for Disease Control and Prevention’s Population Mortality Registration Information System. A generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was used to analyze the cumulative lag effect of extreme temperatures on the risk of stroke mortality among residents. Subgroup analyses were conducted for different genders, ages, and stroke subtypes to identify sensitive populations.
A total of 23 630 stroke deaths were reported in Nanchang city from 2018 to 2022, including 12 269 hemorrhagic strokes and 11 361 ischemic strokes. The distribution relationship between daily average temperature and stroke mortality in Nanchang city showed an approximate "J" shaped curve, with the minimum mortality temperature (MMT) being 8.5 °C. DLNM analysis showed that the effect of extreme high temperature on the risk of stroke mortality reached its peak on the same day (lag0 d), with a cumulative relative risk (cumRR) of 1.328 (95%CI: 1.136–1.553), and the difference was not statistically significant after lag2 d (P>0.05). The effect of extreme low temperature on the risk of stroke mortality had a lag effect, reaching its peak at lag6 d, with a cumRR of 1.031 (95%CI: 1.013–1.049). Subgroup analysis showed that the distribution trends of the effects of extreme high temperature on the risk of stroke mortality in each subgroup were similar, and all reached their peak at lag0 d. The cumRR for males [1.389 (95%CI: 1.149–1.679)] was higher than that for females [1.263 (95%CI: 1.027–1.553)], the cumRR for residents <60 years old [1.166 (95%CI: 0.844–1.611)] was lower than that for residents ≥60 years old [1.373 (95%CI: 1.158–1.630)], and the cumRR for hemorrhagic stroke [1.316 (95%CI: 1.090–1.589)] was higher than that for ischemic stroke [1.305 (95%CI: 1.059–1.601)]. Under extreme low temperature, the cumRR at lag5 d for males [1.033 (95%CI: 1.013–1.054)] was higher than that at lag7d for females [1.032 (95%CI: 1.004–1.060)], the cumRR at lag5 d for residents <60 years old [1.042 (95%CI: 1.005–1.079)] was higher than that at lag6 d for residents ≥60 years old [1.028 (95%CI: 1.010–1.046)], and the cumRR at lag6 d for hemorrhagic stroke [1.045 (95%CI: 1.015–1.076)] was higher than that at lag6 d for ischemic stroke [1.026 (95%CI: 1.003–1.049)].
Extreme temperatures can increase the risk of stroke mortality in Nanchang city residents. The effect of extreme high temperature is acute and short-lived, while the effect of extreme low temperature has a certain lag. Males and residents with hemorrhagic stroke have a higher risk of stroke mortality under both extreme high and low temperatures. Residents <60 years old and ≥60 years old have a higher risk of stroke mortality under extreme low and high temperatures, respectively.
To provide a reference for the scientific prevention and control of foodborne diarrhea among the 6–17 year-old population by analyzing the surveillance data of foodborne diarrhea cases in this age group from sentinel hospitals in Beijing from 2013 to 2022.
The clinical information of foodborne diarrhea cases aged 6–17 years who visited 36 sentinel hospitals in Beijing from 2013 to 2022 was collected, and stool samples or anal swabs were collected for pathogen detection. The χ2 test was used for rate comparisons, and multivariate logistic regression was applied to analyze the influencing factors of pathogen infection.
From 2013 to 2022, a total of 2 128 foodborne diarrhea cases aged 6–17 years were reported by Beijing sentinel hospitals, with males outnumbering females (1.95:1). The number of cases was highest in the outer suburbs, accounting for 36.75% (782/2 128). The peak period for pathogen detection was from July to September each year, while norovirus was mostly detected in winter and spring. Logistic regression results showed that compared with the 15–17 year-old group, the 12–14 year-old group (OR=0.512, 95%CI: 0.326–0.804) had a lower risk of pathogen infection. Compared with the outer suburbs, the risk of pathogen infection was higher in urban areas (OR=1.447, 95%CI: 1.029–2.034) and inner suburbs (OR=1.543, 95%CI: 1.119–2.129). Summer (OR=7.674, 95%CI: 3.688–15.968) was the season with the highest risk of pathogen infection, and the inner suburbs (OR=3.348, 95%CI: 1.690–6.634) had the highest risk of norovirus detection. Cases with fever (OR=1.806, 95%CI: 1.358–2.403) and diarrhea ≥10 times/24 h (OR=1.832, 95%CI: 1.300–2.581) had a higher risk of pathogen infection. Cases with abdominal pain (OR=2.109, 95%CI: 1.146–3.881) and dehydration (OR=2.327, 95%CI: 1.146–3.881) had a higher risk of norovirus detection.
From 2013 to 2022, foodborne diarrhea cases among the 6–17 year-old population in Beijing were predominantly male, with suburban areas being the key regions for prevention and control. The epidemiological and clinical characteristics of cases infected with different pathogens can be used to provide a basis for food safety and health education and clinical diagnosis.
Brucellosis incidence has been rising in China in recent years, and its geographical distribution has been expanding, making it a pressing public health issue. Understanding the epidemiological characteristics of brucellosis and establishing reliable prediction models are crucial for effective early warning and forecasting. This review summarizes recent research findings on the spatiotemporal distribution of brucellosis in China and commonly used prediction models, aiming to provide data and technical support for improving the scientific prevention and control of brucellosis.
Quality of life (QOL) among older adults is a comprehensive evaluation of their physical, mental, and familial well-being, as well as their overall experience of later life. Research on QOL in older adults is crucial in the context of rapid aging, coupled with the challenges of aging before becoming wealthy and prepared. This study systematically reviewed QOL evaluation tools and summarized the current status of QOL among older adults in China. Many widely used QOL scales were developed in the previous century and may not fully reflect the comprehensive aspects and dynamic changes in the QOL of older adults today. While the QOL of older adults in China is relatively high compared to other developing countries, disparities exist. Older adults residing in rural areas, the central and western regions, those of advanced age, women, and those with lower socioeconomic status experience poorer QOL. We recommend developing or revising QOL evaluation tools that meet the needs of contemporary older adults and conducting nationally representative surveys to comprehensively evaluate the current status of QOL among this population.
Health behavior is not only the cornerstone of the physical and mental development of adolescents, but also the key to shaping the character and happiness of future life. This study employed literature review, content analysis, and logical analysis to examine authoritative research results on adolescent health behaviors in China and abroad, reviewing the literature on adolescent health behaviors, including concept classifications, theories, research methods, tools, and research content dimensions, to provide a basis for domestic research and practice, and to improve adolescent health behavior levels to leverage its leading role in health. The study found that the concept of adolescent health behavior is often used confusingly and lacks uniform classification. The application of health behavior theories in adolescent behavior research in China is relatively scarce. Research methods on adolescent health behaviors are primarily quantitative and cross-sectional, with research tools mainly relying on self-reported questionnaires. There is currently no unified standard for the specific content categories of adolescent health behaviors.
Constructing a novel training model for innovative talent in public health and preventive medicine that integrates theory and practice has become a crucial aspect of medical education in China. Currently, public health and preventive medicine education in China faces challenges such as the difficulty of multidisciplinary integration across subjects and curricula, the struggle to reconcile teaching and research, and the lack of an optimized talent cultivation model. Therefore, this article outlines the current challenges and desired goals of cultivating innovative public health and preventive medicine talent while exploring potential breakthroughs under the "New Medical Science" initiative. The article discusses strategies including integrated development of disciplines and specialties, leading overall disciplinary development with first-class disciplines, balancing localized and internationalized approaches to education, and reconstructing the educational ecosystem under autonomous school management.
Public health, as a highly practical discipline, has gained increasing attention following the novel coronavirus disease (COVID-19) pandemic. Professional practice is a crucial component in the training of Master of Public Health (MPH) postgraduates, who represent high-level public health professionals. High-quality practical training is essential for ensuring the quality of MPH education. Currently, there are several challenges in the professional practice-based teaching of MPH students in China, including a singular type of practice bases and a lack of standards and norms for base construction; the absence of detailed practical teaching manuals and authoritative teaching materials; a lack of training for base instructors; unclear, vague, and monotonous practical teaching requirements and content; unclear responsibilities and an ineffective coordination mechanism between university and field instructors; and low student enthusiasm for field practice coupled with an imperfect assessment and evaluation system. This article summarizes the existing problems in professional practice-based teaching for MPH students in China and proposes corresponding suggestions, aiming to provide a reference for improving the quality of practical teaching for MPH professionals in the country.
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