ArchiveMental health is a vital component of overall health. Mental disorders, characterized by high prevalence and disability rates, impose a substantial burden on individuals, families, and society. Mental health rehabilitation services are essential for assisting individuals in regaining social functioning and reintegrating into societal activities, including work, education, and social engagement. In recent years, the Chinese government has increasingly prioritized mental health rehabilitation. This has been demonstrated through the introduction of numerous relevant policy documents and the implementation of key initiatives. These include the Management and Treatment Program for Severe Mental Disorders, self-help and mutual aid programs for persons with disabilities, and the Mental Health-Social Integration Initiative. These efforts have significantly advanced the development of mental health rehabilitation services, particularly in community-based settings. This article analyzes the development of major mental health rehabilitation policies and services in China, discusses future trends, and aims to provide insights to inform future policy-making and service prioritization.
To investigate the prevalence of anxiety symptoms and its influencing factors among young medical workers in Beijing, thus providing an evidence-based basis for caring for young medical workers.
From September to October 2023, an online survey was conducted among young medical workers aged 45 and below in Beijing health system. The 7-item Generalized Anxiety Disorder Scale (GAD-7) was used to assess anxiety symptoms. Chi-square test was conducted to compare the prevalence of anxiety symptoms across respondents with different characteristics, and binary logistic regression was employed to predict the influencing factors.
A total of 25 604 questionnaires were distributed, and 23 379 valid questionnaires were recovered. The prevalence of moderate and above anxiety symptoms among young medical workers was 15.30%. The occurrence of anxiety symptoms vaied among respondents with different genders, ages, working years, educational backgrounds, marital statuses, numbers of children, housing conditions, employment forms, administrative positions, annual incomes, and professional titles (P < 0.05). Binary logistic regression showed that age of 30–34 years (OR = 1.27, 95%CI: 1.16–1.39), age of 35–45 years (OR = 1.43, 95%CI: 1.27–1.61), working years of 10 to 14 (OR = 1.25, 95%CI: 1.15–1.37), working years ≥ 15 (OR = 1.47, 95%CI: 1.30–1.65), one child (OR = 0.89, 95%CI: 0.81–0.97), number of children ≥ 2 (OR = 0.90, 95%CI: 0.81–1.00), renting (OR = 1.33, 95%CI: 1.25–1.41), working in public health institutions (OR = 1.33, 95%CI: 1.03–1.71), and annual income of 100 000–200 000 CNY (OR=1.12, 95%CI: 1.05–1.19) were independent influencing factors for anxiety symptoms.
The risk of anxiety symptoms among young medical workers should not be ignored, and multiple measures should be taken to care for young medical workers.
To investigate the prevalence of occupational stress among ride-hailing drivers in a megacity and analyze its influencing factors.
From June 2024 to November 2024, a cross-sectional study and convenience sampling were conducted to investigate the occupational stress of ride-hailing drivers in a megacity. A total of 2 687 self-administered questionnaires were ultimately included in the statistical analysis. Binary logistic regression was adopted to analyze the factors influencing occupational stress.
The overall prevalence of occupational stress remained at 53.96% in the megacity, being higher in males (54.38%) than in females (44.04%) (χ2 = 4.51, P = 0.034). The comparison between different age groups showed that the prevalence of occupational stress in the group of 35–44 years old was the highest (59.09%). The factors associated with an increased risk of occupational stress among male participants included age of 35–44 years old (OR = 1.42, 95%CI: 1.06–1.90, P = 0.001), inadequate rest (OR = 1.52, 95%CI: 1.28–1.81, P < 0.001), not consuming fresh vegetables daily (OR=1.38, 95%CI: 1.09–1.75, P = 0.007), daily consumption of sugar-sweetened beverages (OR = 1.22, 95%CI: 1.03–1.45, P = 0.021), and daily consumption of milk or yogurt (OR = 1.31, 95%CI: 1.10–1.56, P = 0.002). The factor associated with a decreased risk of occupational stress among males was consuming ≥ 3 meals per day (OR = 0.61, 95%CI: 0.39–0.95, P = 0.002). The factors associated with an increased risk of occupational stress among female participants were daily tea consumption (OR = 2.29, 95%CI: 1.002–5.23, P = 0.049) and not consuming fresh vegetables daily (OR = 4.56, 95%CI: 1.41–14.72, P = 0.011).
The prevalence of occupational stress among ride-hailing drivers is high, and its influencing factor are age of 35–44 years, inadequate rest, and dietary habits. Preventive measures targeting occupational stress in this population should be implemented.
To analyze the depressive symptoms, anxiety symptoms, and comorbidities among the elderly in Jiangsu province and their influencing factors, thus providing data support for the prevention and control of depression and anxiety in the elderly.
The data from the Elderly Psychological Care Action Project that was carried out in Jiangsu province from 2022 to 2024 were used, a total of 67 817 elderly people aged 65 and above were included in the analysis. Binary logistic regression and unordered multinomial logistic regression models were used to analyze the influencing factors of depressive symptoms, anxiety symptoms, and comorbidities.
The detection rates of depressive symptoms, anxiety symptoms, and comorbid depressive and anxiety symptoms among elderly people aged 65 and above in Jiangsu province were 5.1%, 2.7%, and 2.1%, respectively. Binary logistic regression and unordered multinomial logistic regression analyses showed that the risks of depression, anxiety, and comorbidities in female elderly people were 1.206, 1.211, and 1.189 times that in male elderly people, respectively. The risks of depression, anxiety, and comorbidities in elderly people aged 85 and above were 1.313, 1.389, and 1.508 times that of those aged 65–69, respectively. The risks of depression, anxiety, and comorbidities in elderly people with chronic diseases were 2.217, 2.079, and 2.242 times that of those without chronic diseases, respectively. The risks of depression, anxiety, and comorbidities in elderly people with 1–5 years of education were 0.689, 0.594, and 0.528 times that of those with no education, respectively. The risks of depression, anxiety, and comorbidities in elderly people with 6–10 years of education were 0.856, 0.619, and 0.587 times that of those with no education, respectively. The risks of depression, anxiety, and comorbidities in elderly people satisfied with their relationship with their children were 0.742, 0.500, and 0.573 times that of those without children, respectively. The risks of depression and comorbidities in elderly people dissatisfied with their relationship with their children were 1.797 and 1.707 times that of those without children, respectively. The risks of anxiety and comorbidities in unmarried elderly people were 2.013 and 1.915 times that of married elderly people, respectively. The risks of anxiety and comorbidities in elderly people dissatisfied with their relationship with their spouse were 2.931 and 2.874 times that of those without a spouse, respectively. The risks of anxiety and comorbidities in elderly people with poor relationships with friends were 1.891 and 1.851 times that of those without friends, respectively. The risks of depression, anxiety, and comorbidities in elderly people who regularly participated in elderly activities were 0.649, 0.630, and 0.633 times that of those who did not participate, respectively. The risks of depression, anxiety, and comorbidities in elderly people with negative attitudes towards aging were 1.363, 1.277, and 1.365 times that of those who did not have a clear attitude, respectively. The risks of depression, anxiety, and comorbidities in elderly people with positive attitudes towards aging were 0.470, 0.408, and 0.349 times that of those who did not have a clear attitude, respectively. The risks of depression, anxiety, and comorbidities in elderly people with poor psychological resilience were 2.345, 2.138, and 2.482 times that of those with good psychological resilience, respectively. The risks of depression, anxiety, and comorbidities in elderly people satisfied with their overall life were 0.186, 0.154, and 0.119 times that of those dissatisfied, respectively. The risks of depression, anxiety, and comorbidities in elderly people engaged in various non-paid work in daily life were higher than those engaged in paid work (all P<0.05).
The detection rates of depressive and anxiety symptoms among elderly people aged 65 and above in Jiangsu province are relatively low. Gender, age, marital status, educational background, chronic diseases status, the relationships with relatives and friends, the main daily work, participation in elderly activities, attitude towards aging, psychological resilience, and overall satisfaction with current life are influencing factors for depressive symptoms, anxiety symptoms, and comorbidities in the elderly.
To investigate fertility anxiety and influencing factors among Chinese residents aged 18–25 years.
Data from 17 771 individuals in this age group were obtained from the 2023 Chinese Psychology and Behavior Investigation. The survey was administered in 800 communities and villages across 150 cities nationwide. Participants completed several questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Family Health Scale (FHS), the Body Image Acceptance and Action Questionnaire (BI-AAQ), and the Perceived Social Support Scale-Short Form (PSSS-SF).
The average self-rated fertility anxiety score for all participants was 51.65 ± 33.65. Multiple linear regression analyses, stratified by gender and marital status, revealed that fertility anxiety was influenced by the following factors among subgroups: average monthly family income (β = 0.031), smoking (β = –0.027), overall family health (β = –0.046), and anxiety (β = 0.063) for males and ethnicity (β = –0.022), education (β = 0.028), and depression (β = 0.064) for females. For unmarried individuals, the influencing factors were gender (β = 0.124), education (β = 0.022), body mass index (BMI) (β = –0.027), overall family health (β = –0.023), and social support (β = –0.018). For unmarried individuals, the influencing factors were gender (β = 0.124), education (β = 0.022), BMI (β = –0.027), overall family health (β = –0.023), social support (β = –0.018), depression level (β = 0.047), health status (β = 0.030), and smoking (β = –0.016). For married individuals, the influencing factors were ethnicity (β = 0.113) and total body flexibility score (β = –0.225). All factors were statistically significant (P < 0.05).
Fertility anxiety among individuals aged 18–25 is influenced by demographic, psychological, and social factors. Key determinants include family income (males), depression (females), education/social support (unmarried), and ethnicity/body image flexibility (married).
To investigate the influence of different dimensions of health literacy on different stages of suicidal behavior among junior high school students and the gender differences, so as to provide a reference for the prevention and control of suicidal behavior.
From May to June 2023, a multi-stage stratified cluster sampling method was used to select 7 360 junior high school students from three districts and counties in Chongqing city to conduct a survey on health literacy and suicidal behavior. Chi-square test, t-test, F-test, binary logistic regression, and multiple logistic regression were used for statistical analysis.
The reported rate of suicidal behavior among junior high school students in Chongqing city was 15.48%, with girls (18.66%) higher than boys (12.19%) (P < 0.01). The functional (154.19 ± 20.25), interactive (53.75 ± 9.22), and critical (42.00 ± 6.93) health literacy scores of students with positive suicidal behavior were all lower than those of students with negative suicidal behavior (156.60 ± 21.41), (56.26 ± 9.75), and (42.63 ± 7.10), respectively (all P < 0.01). Binary logistic regression analysis showed that interactive health literacy (OR = 0.98, 95%CI: 0.97–0.99) and critical health literacy (OR = 1.02, 95%CI: 1.00–1.03) were associated with suicidal behavior. Multiple logistic regression analysis showed that interactive health literacy was associated with suicidal ideation (OR = 0.98, 95%CI: 0.97–0.99) and suicide plan (OR = 0.96, 95%CI: 0.95–0.98), while critical health literacy was only associated with suicide plan (OR = 1.03, 95%CI: 1.00–1.06). Stratified analysis showed that interactive health literacy was significantly associated with suicidal ideation only in males (OR = 0.97, 95%CI: 0.95–0.98).
Interactive health literacy is a influencing factor for suicidal ideation and suicide plan among junior high school students in Chongqing city, and there are gender differences.
To evaluate the effects of different interventions on the mental health of Chinese college students.
We searched the China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases for randomized controlled trials (RCTs) of mental health interventions among Chinese college students from inception until July 1, 2024. We assessed the quality of the studies using the Cochrane Risk of Bias Tool 2 (RoB 2) and analyzed the data using Stata 17.0.
Sixty-three RCTs (n = 7 240 participants) were included. The pooled Hedges′g was –0.718 (95%confidence interval [CI]: –0.960 to –0.476), indicating a significant improvement. Subgroup analyses revealed significant effects for group counseling (standardized mean difference [SMD] = –0.907, 95%CI: –1.571 to –0.243), exercise (SMD = –0.937, 95%CI: –1.246 to –0.628), and comprehensive interventions (SMD = –0.850, 95%CI: –1.019 to –0.682). Significant improvements in depression were observed with art interventions (SMD = –2.320, 95%CI: –4.317 to –0.323) and comprehensive interventions (SMD = –1.042, 95%CI: –1.461 to –0.624). Significant effects on anxiety were found with group counseling (SMD = –1.216, 95%CI: –1.656 to –0.777) and art interventions (SMD = –2.874, 95%CI: –5.624 to –0.124).
Group counseling, exercise, art, and comprehensive interventions can significantly improve mental health outcomes in college students, including conditions such as depression and anxiety. Universities should adopt targeted interventions based on students′ needs to provide timely and effective mental health support.
To analyze the policy texts of vaccine clinical trials in China and identify the characteristics, issues, and directions for improvement in the quality management.
Seventeen policy documents issued at the central level between January 2001 and December 2024 were obtained through a systematic search of the official websites of the State Council and relevant ministries. A three-dimensional analytical framework consisting of tools, elements, and strength was developed, integrating content analysis and the Latent Dirichlet Allocation (LDA) topic model to uncover the latent thematic structures within these policy texts.
The findings indicated a significant imbalance in the deployment of policy tools for vaccine clinical trials. The utilization of inducements (1.23%, 2 codes), symbolic and hortatory tools (3.09%, 5 codes), capacity-building tools (7.41%, 12 codes), and system-changing tools (9.89%, 16 codes) remained insufficient. Furthermore, the distribution of policy elements was uneven, with limited emphases on clinical trial design (4.94%, 8 codes), trial participants (3.09%, 5 codes), and trial contents (6.17%, 10 codes). Policy intensity also exhibited substantial disparities, lacking synergy and alignment among policy elements, tools, and intensity. The overall thematic coordination of the policies was effective, jointly contributing to the improvement of the vaccine trial regulatory system.
In the future, efforts should be made to enhance the balanced utilization of policy tools, optimize policy structures, prioritize vaccine clinical trial design, and adopt diverse and flexible design methodologies, thus improving the scientific rigor and practical applicability of vaccine trials.
The standard Specification for Safety Follow-up of Vaccine Clinical Trials (T/JPMA 023—2024) was published by Jiangsu Preventive Medicine Association on September 2, 2024 and officially implemented on September 9, 2024. This standard specifies the main procedures and key contents for safety follow-up after vaccination in vaccine clinical trials, and it is applicable to the follow-up of adverse events after vaccination in such trials. The safety of prophylactic vaccines is a critical focus in clinical trials and an important aspect of the vaccine registration review process. The quality of safety follow-up directly impacts the scientific validity of vaccine evaluations. This article interprets the key points of the standard and provides guidance for vaccine clinical trial institutions, trial sites, and professionals to enhance their understanding and promote the effective application of this standard.
To investigate the willingness to participate in vaccine clinical trials among permanent residents aged 18 years and older in Zhoushan city, Zhejiang province, and to analyze its influencing factors, so as to provide a reference for further improving residents' willingness to participate in vaccine clinical trials.
From August to November 2024, 623 permanent residents aged 18 years and older were selected from two counties (districts) in Zhoushan city using a convenience sampling method. A questionnaire survey was conducted to collect information on socio-demographics, awareness of vaccine clinical trials, willingness to participate, and motivations. The willingness rate was calculated with the direct standardization method. Non-parametric tests were taken to analyze data between groups, and ordered logistic regression models were used to analyze the influencing factors of willingness to participate in vaccine clinical trials.
A total of 623 valid questionnaires were included. Eighty-one participants (13.00%) were willing to participate, 336 (53.93%) were conditionally willing to participate, and 206 (33.07%) were unwilling to participate. The standardized rate of willingness or conditional willingness to participate was 64.56%. Statistical differences were found between groups based on gender (Z = –2.883), occupation (Z = –2.282), awareness of vaccine clinical trials (Z = –5.731), and previous experience as a clinical trial participant (Z = –3.683) (all P < 0.05). Age group was correlated with willingness to participate (Rs = 0.092, P < 0.05). Ordered logistic regression analysis showed that gender, age, awareness, and previous experience as a clinical trial participant were influencing factors for willingness to participate in vaccine clinical trials.
Male gender, age ≥ 60 years, low awareness, and lack of experience in clinical trials were associated with lower willingness to participate. It is recommended to objectively guide potential participants while improving their awareness, strengthen and improve the participant protection mechanism, and appropriately highlight altruistic motives to increase the actual enrollment rate.
To evaluate the protective effectiveness (VE) of acellular pertussis vaccine (aPV) in children ≤10 years of age in Nanshan district, Shenzhen city, Guangdong province, and to provide a reference for optimizing pertussis immunization strategies.
A 1:1 matched case-control study was conducted. A total of 442 clinically diagnosed or confirmed pertussis cases aged 4 months to 10 years reported in Nanshan district, Shenzhen city, from January 1, 2023, to March 25, 2024, were selected as the case group from the Chinese Center for Disease Control and Prevention Information System. A total of 442 healthy children with no history of pertussis infection, matched by residential community, sex, and birth date (±1 month), were selected as the control group from the Shenzhen Immunization Program Information Management System. Data on aPV immunization history were collected for both groups. A binary conditional logistic regression model was used to analyze the VE of aPV.
The aPV vaccination rates in the case and control groups of children ≤10 years of age in Nanshan district, Shenzhen city were 94.3% (417/442) and 99.1% (438/442), respectively. The overall VE of aPV against pertussis was 84.8% (95%CI: 55.9%–94.7%). The VE of 1–2, 3, and 4 doses of aPV against pertussis was 82.5% (95%CI: 33.6%–95.4%), 88.6% (95%CI: 64.6%–96.3%), and 84.3% (95%CI: 54.3%–94.6%), respectively. The VE of 4 doses of whole-cell aPV, 1–3 doses of component pertussis vaccine plus 1–3 doses of whole-cell aPV, and 4 doses of component pertussis vaccine against pertussis was 80.5% (95%CI: 43.1%–93.3%), 91.3% (95%CI: 71.0%–97.4%), and 89.6% (95%CI: 68.8%–96.5%), respectively. The VE of aPV 0–2, 3–6, and 7–9 years after completion of the full vaccination schedule was 87.0% (95%CI: 60.6%–95.7%), 83.8% (95%CI: 52.8%–94.4%), and 82.5% (95%CI: 46.7%–94.3%), respectively. The VE of component pertussis vaccine 0–2, 3–6, and 7–9 years after completion of the full vaccination schedule was 87.7% (95%CI: 61.3%–96.1%), 89.9% (95%CI: 68.5%–96.8%), and 92.9% (95%CI: 72.7%–98.1%), respectively. The VE of whole-cell aPV 0–2, 3–6, and 7–9 years after completion of the full vaccination schedule was 85.3% (95%CI: 51.2%–95.6%), 80.1% (95%CI: 41.7%–93.2%), and 78.8% (95%CI: 33.8%–93.2%), respectively.
Timely and full aPV immunization can effectively prevent pertussis in children ≤10 years of age. It is recommended to develop component pertussis-containing combination vaccines for basic immunization.
To investigate the impacts of different vaccination doses and intervals on the age of onset in mumps-containing vaccine (MuCV) breakthrough cases, providing evidence for optimizing MuCV immunization strategies.
Data were matched from the China Disease Prevention and Control Information System and the Chongqing Immunization Planning Information Management System. MuCV breakthrough cases in children born in Shapingba district between January 1, 2008 and December 31, 2023, who received MuCV and were diagnosed with mumps by December 31, 2023, were included. A multivariate linear regression model was employed to analyze the effects of vaccination doses and intervals on the age of onset in breakthrough cases.
From 2008 to 2023, 1 204 MuCV breakthrough cases were identified in Shapingba district, with disease onset primarily occurring in children aged 1–9 years (5–9 years: 639 cases, 53.07%). Breakthrough cases occurred in 782 (64.95%), 418 (34.72%), and 4 (0.33%) children who had received 1, 2, and 3 doses of MuCV, respectively, with mean onset ages of (5.25 ± 2.12), (6.52 ± 2.07), and (7.81 ± 2.51) years. Among children receiving 2 doses, those with intervals of < 2 years (97 cases, 23.21%), 2–4 years (193 cases, 46.17%), and > 4 years (128 cases, 30.62%) between doses had mean onset ages of (4.92 ± 2.08), (6.27 ± 1.53), and (8.10 ± 1.64) years, respectively. Significant differences in mean age of onset were observed across different vaccination doses and intervals (all P < 0.001). After adjusting for gender, residence, and household registration, multivariate regression showed that 2-dose (β = 1.275, 95%CI: 1.024–1.525) and 3-dose (β = 2.581, 95%CI: 0.510–4.652) recipients had delayed ages of onset compared with 1-dose recipients, with a linear trend between increasing doses and delayed onset (β = 1.275, P < 0.001). For the second dose, intervals of 2–4 years (β = 1.324, 95%CI: 0.909–1.738) and > 4 years (β = 3.175, 95%CI: 2.726–3.624) delayed onset compared with intervals < 2 years, with a linear trend between prolonged intervals and delayed onset (β = 1.605, P < 0.001).
MuCV breakthrough cases in Shapingba district from 2008 to 2023 predominantly occurred in children aged 5–9 years. Increasing vaccination doses and extending the interval to the second dose significantly delayed the age of onset.
To explore the mediating roles of job content plateau and centralization plateau in the relationship between hierarchical plateau and turnover intention among Chinese family doctor team members.
A cross-sectional study was conducted based on a network questionnaire survey from September to November 2021 among 1 474 family doctor team members in eastern, central, and western China. The Turnover Intention Scale and Career Plateau Scale were adopted for measurement. The mediating effects of job content plateau and centralization plateau on the relationship between hierarchical plateau and turnover intention were analyzed.
Chinese family doctor team members exhibited low turnover intention (2.33 ± 0.763) and moderately low perceived career plateau (2.80 ± 0.83). The hierarchical plateau (3.58 ± 0.64) demonstrated greater severity than the job content plateau (2.46 ± 0.93) and centralization plateau (2.82 ± 1.04). Hierarchical plateau, job content plateau, and centralization plateau had significantly positive correlations with turnover intention. Job content plateau (indirect effect = 0.08, 95%CI: 0.05–0.09, P < 0.001) and centralization plateau (indirect effect = 0.05, 95%CI: 0.02–0.06, P < 0.001) both partially mediated the effect of hierarchical plateau on turnover intention.
Targeted interventions focusing on reducing job content and centralization plateaus may partially mitigate the transmission path from hierarchical plateau to turnover intention. However, the three dimensions may constitute a nonlinear compensatory system, highlighting the need for considering population-specific adaptability in intervention designs.
To understand the satisfaction and suggestions of center for disease control and prevention (CDC) personnel at the provincial, city, and county levels in China regarding current talent cultivation, evaluation, and incentive mechanisms, and to provide a basis for optimizing existing policies and strengthening personnel development in a targeted manner.
In November 2024, a convenient sampling and snowball sampling method was adopted to conduct an online survey of 3 626 in-service personnel from provincial, city, and county CDCs in 28 provinces (autonomous regions and municipalities) in China via Questionnaire Star. A 5-point Likert scale was used to score satisfaction.
Of the 3 626 participants, 46.9%, 64.5%, and 35.9% reported that their units had established talent cultivation, evaluation, and incentive mechanisms, respectively. The satisfaction scores for the current talent cultivation, evaluation, and incentive mechanisms were 69.8%, 67.9%, and 71.0%, respectively. Higher satisfaction scores were observed in county (district) level CDCs (70.1%, 68.7%, 71.5%), those with a college degree or below (70.8%, 69.4%, 72.4%), those with less than 10 years of work experience (70.5%, 68.6%, 71.5%), and junior or awaiting appointment personnel (71.3%, 69.8%, 72.6%). Lower satisfaction scores were found in provincial CDCs (68.3%, 64.9%, 67.5%), those with postgraduate degrees (69.0%, 66.2%, 69.1%), and those with 30 or more years of work experience (66.9%, 66.0%, 69.6%). The central region had the highest satisfaction scores for talent cultivation (70.1%) and evaluation mechanisms (68.2%), while the western region had the highest satisfaction score for incentive mechanisms (71.2%). 35.9%, 22.8%, and 26.6% of the participants provided suggestions on talent cultivation, evaluation, and incentives, respectively.
Some CDCs urgently need to establish talent cultivation, evaluation, and incentive mechanisms, while those that have already established such mechanisms need to optimize and improve them based on the needs and suggestions of their employees.
To analyze the impact of diagnosis-intervention packet (DIP) payment method on the medical service structure and outpatient-inpatient structure.
Data were collected from public medical institutions in DIP pilot city A and non-DIP reform city B in China from 2019 to 2022. Descriptive and difference-in differences-analyses were conducted on the medical service structure (medical service costs, drug costs, material costs, and examination and testing costs) and outpatient-inpatient structure (outpatient and inpatient costs, outpatient visits, and number of inpatient discharges).
In terms of medical service structure, the examination and testing costs in city A decreased by 19.0% compared with those in city B (P < 0.05). In terms of the outpatient-inpatient structure, compared with city B, city A saw a 14.1% decrease in inpatient costs (P < 0.05), a 15.8% decrease in the number of inpatient discharges (P < 0.05), and an 8.3% increase in outpatient visits (P < 0.05).
The DIP payment method promotes optimization of the medical service structure. It effectively suppresses the behavior of "rushing points" and helps to promote the diversion of mild patients to outpatient clinics, while it is still necessary to prevent unreasonable outpatient transfer.
To construct a scientific and effective evaluation indicator system applicable to institutions at all levels involved in health communication in China, including but not limited to medical and health departments, science popularization departments, media, and universities, to promote the standardization and effectiveness of health communication.
Based on the "input-process-output" model and Lasswell′s "5W" communication model, an initial indicator framework was established. The Delphi method was used to invite 14 experts to screen and optimize the evaluation indicators, and the analytic hierarchy process was used to determine the indicator weights.
The questionnaire recovery rate for both rounds was 100%. The expert familiarity was 0.89, the judgment coefficient was 0.94, and the expert authority coefficient was 0.91. The coefficients of variation for both rounds of consultation were < 0.3, and the overall coordination coefficients were 0.222 and 0.268, respectively (both P < 0.001). The final indicator system includes three first-level indicators, covering input, process, and output; 12 second-level indicators, covering communication subjects, communication objects, communication channels, and other elements; and 38 third-level indicators, covering annual budget, work plan, characteristic intellectual property (IP), awards, and other aspects. The weights of the first-level indicators ranged from 0.063 to 0.562, the second-level indicators from 0.043 to 0.600, and the third-level indicators from 0.001 to 0.171.
This indicator system covers the core elements of health communication work and can more reasonably evaluate the health communication work of institutions, improving the pertinence and effectiveness of health communication.
This study aims to systematically review and compare the funding structures, research themes, and developmental trends of health-related implementation science projects funded by the National Natural Science Foundation of China (NSFC) and the United States National Institutes of Health (NIH). The findings will offer valuable insights for optimizing the strategic planning and funding policies of health-related scientific research in China.
With "implementation science" and "implementation research" as core keywords, relevant data on health-related implementation science funding projects from both NSFC and NIH were retrieved and screened from their official websites and various commercial databases, covering the period from January 1, 2000 to December 1, 2024. CiteSpace 6.1.2 R6 was then employed to conduct visualized analyses of theme clustering and temporal trends, enabling a comparative analysis of the funding structures, research themes, and developmental trends of these projects between China and the United States.
A total of 39 NSFC-funded projects and 487 NIH-funded projects were included in the final analysis. Both China and the United States demonstrated a strong commitment to the strategic value of implementation science in transforming public health policies and healthcare delivery systems, consistently increasing financial investment in this area. However, significant differences were observed in their funding priorities. China primarily focused on mental health and psychological well-being, whereas the United States emphasized addressing major national or international multi-center public health challenges and supporting large-scale collaborative network research. Regarding research collaboration networks, the implementation science projects funded by NSFC were concentrated at Sun Yat-sen University and Peking University, while in the United States, the University of Washington, Johns Hopkins University, and Yale University ranked highest. High-frequency keyword analysis of implementation science funding projects revealed that China′s research themes concentrated on "implementation science," "multiphase optimization strategy," "implementation research," "empirical research," "effect evaluation," "community," "elderly," and "children." The United States focused on "implementation science," "research personnel," "public health," "evidence base," "scale up," "implementation strategy," and "AIDS prevention," with denser distribution of keyword hotspots. Analysis of developmental trends indicated that China′s research hotspots were relatively dispersed across the time dimension, exhibiting short-term and discontinuous characteristics. Conversely, the United States′ research hotspots showed significant centrality, with greater continuity and regularity in their thematic evolution.
Substantial disparities exist between China and the United States concerning the funding priorities, scale, and developmental trajectories of implementation science. China still needs to further strengthen its research mechanisms, inter-institutional collaboration, and methodological innovation in this domain.
To conduct a visual analysis of the research dynamics, hotspots, and frontiers in field epidemiology in China from 2014 to 2024, providing a reference for research planning in this domain.
The literature on field epidemiology in China that was published in Chinese and English between January 1, 2014 and December 31, 2024 was retrieved from the China National Knowledge Infrastructure (CNKI), SinoMed, Web of Science Core Collection, and PubMed. CiteSpace 6.3.R1 was employed to visualize the annual publication trend, author and institution collaboration networks, and keywords. Research hotspots and frontiers were systematically reviewed.
A total of 8 475 articles (7 845 in Chinese and 630 in English) were included. The annual number of publications in Chinese and English increased from 638 and 25 in 2014 to 728 and 66 in 2024, respectively. From 2014 to 2024, the annual number of publications in English that were published by Chinese authors showed an overall upward trend (β = 6.000, t = 4.861, P < 0.001), while that in Chinese rose with large fluctuations (β = 14.564, t = 1.456, P = 0.179). The most frequent category was infectious diseases (4 013 articles). Academic journals were the primary publication format (6 891 articles). Regarding methodological applications, descriptive studies (3 260 articles) were mainly used for spatiotemporal distribution analysis of infectious diseases and characterization of chemical poisoning incidents. Case-control studies (2 481 articles) were primarily applied in tracing foodborne illnesses and analyzing occupational exposure associations. Cohort studies (1 160 articles) were commonly conducted to investigate the impact of vaccination history on disease incidence. Cross-sectional surveys (398 articles) were frequently employed in nutritional status censuses. Molecular source-tracing techniques (127 articles) were predominantly utilized in studies of foodborne pathogens. In author and institution collaboration networks, high-yield authors of publications in Chinese were Wang H, Ye Y, Huang X, etc., and those in English were Zhang Y, Wang L, Wang Y, etc. The Chinese Center for Disease Control and Prevention occupied a central position in both Chinese and English publication networks. Keyword co-occurrence analysis revealed large nodes for "epidemiological characteristics," "outbreak," and "food poisoning" in Chinese publications and for "disease outbreaks," "public health surveillance," "risk factors," etc. in English publications. Keyword clustering analysis showed that in Chinese publications, Clusters #11 (outbreak), #14 (outbreak epidemic), and #5 (investigation analysis) formed a methodological loop from event identification to field response and source attribution. Clusters #10 (clustering) and #9 (family clusters) highlighted households and communities as key transmission settings. Co-occurrence of #6 (tuberculosis) and #3 (pulmonary tuberculosis) indicated continued focus on classical respiratory diseases, emphasizing pathogen control. In English publications, Clusters #1 (betacoronavirus), #4 (communicable diseases), and #8 (pulmonary tuberculosis) formed a triangular co-occurrence cluster. Clusters #3 (disease outbreaks), #6 (disease outbreaks), #0 (case control studies), and #2 (risk factors) systematically mapped the emergency response pathway from outbreak detection and case-control studies to risk factor identification, reflecting the systematization of public health emergency response. Clusters #12 (occupational disease) and #10 (noise) indicated occupational noise exposure as a current research focus. Keyword burst detection identified COVID-19, mpox, and mpox virus as emerging hotspots in Chinese publications, and spatio-temporal analysis and disease outbreaks in English publications.
The studies of field epidemiology in China exhibits an upward trend and is gradually extending towards practical applications.
As an emerging disinfection technology, 222-nm ultraviolet C light (222-nm UVC) has attracted considerable research interest due to its potent broad-spectrum antimicrobial properties and potentially favorable biosafety profile. This review provides a systematic examination of the photochemical mechanisms mediating the germicidal effects of 222-nm UVC and comprehensively evaluates the biosafety of this technology, with a particular emphasis on potential impacts on cutaneous barrier integrity and ocular surface tissue. Furthermore, we discuss the risk of ozone generation during 222-nm UVC application and critically analyze recent advances in disinfection protocols and device development. By synthesizing current evidence, this review aims to establish a scientific foundation for the precise clinical implementation of this technology and optimize the balance between antimicrobial efficacy and human safety to facilitate the translational applications of this technology in healthcare-associated infection control and public health emergency management.