To analyze the distribution situation and turnover of primary health care (PHC) physicians and its impact on equity of distribution in China from 2011 to 2021, thereby providing empirical evidence for optimizing the allocation and workforce development of PHC physicians.

We used the basic information of health human resources collected by the National Health Commission Statistical Information Center. Individual-level data collected by April 2022 were longitudinally linked to construct a retrospective cohort for analysis of the turnover pattern of PHC physicians. The Gini coefficient and Theil index were calculated to measure the equity of distribution. We performed counterfactual analysis to evaluate the impact of turnover on distribution equity.

The number of PHC physicians and the number per thousand population in China increased from 644 858 and 0.48 in 2011 to 1 102 532 and 0.78 in 2021, respectively. Among the 3 696 434 PHC physicians enrolled in the cohort study from 2011 to 2021, a total of 384 364 turnover events were related to PHC institutions, primarily occurring between PHC institutions [173 051 (45.0%)]. The net turnover rate of PHC physicians increased from 0.22% to 0.46% with fluctuations. The factual Gini coefficient and Theil index decreased from 0.142 and 0.033 in 2011 to 0.123 and 0.025 in 2021, respectively, while the counterfactual Gini coefficient and Theil index declined from 0.146 and 0.035 in 2012 to 0.121 and 0.024 in 2021, respectively, which suggested improved equity in the distribution of PHC physicians. From 2012 to 2021, the annual "counterfactual minus factual" results were persistently negative with absolute values ranging from 0.000 2 to 0.004 4, suggesting that physician turnover had a minimal impact on the equity of physician distribution.

The development of PHC physicians in China shows a positive trend. Continuous efforts should be made to strengthen the dynamic monitoring and guide the rational turnover of PHC human resources.

To investigate the determinants of starting salaries among master of public health (MPH) graduates, thereby giving insights for enhancing career outcomes.

The data from the National Survey of Educational Satisfaction among Medical Graduates (June–July 2022) were used to analyze the starting salaries of 495 employed MPH graduates from 54 colleges and universities across China. Unpaired binary logistic regression was adopted to identify the factors influencing starting salaries, while Shapley value decomposition was employed to quantify the relative contribution of each variable.

Geographic location of employment, employer type, annual household income per capita, and gender were primary determinants of starting salaries. Compared with the graduates employed in eastern China, those in central China had 0.17 times the odds of securing higher starting salaries (95%CI: 0.09–0.33), while those in western China had 0.33 times the odds (95%CI: 0.21–0.52). Graduates employed at centers for disease control and prevention (CDCs) had 0.34 times the odds of securing higher starting salaries relative to those at comprehensive hospitals (95%CI: 0.21–0.55). Graduates from high-income households exhibited 1.68 times the odds of securing higher starting salaries than those from low-income households (95%CI: 1.12–2.54). Male graduates had 1.67 times the odds of securing higher starting salaries compared with female graduates (95%CI: 1.06–2.66). Shapley value decomposition revealed that structural factors of the labor market accounted for 83.50% of starting salary disparities. The contribution of employer type (42.75%) exceeded that of geographic location of employment (40.75%).

Structural factors of the labor market predominantly influence the starting salaries of MPH graduates, with employer type exerting a stronger effect than geographic location of employment. Annual household income per capita and gender also significantly impact starting salaries.

To understand the settings, staffing, and performance of public health management departments in Sichuan province, thus providing a basis for exploring the scope, evaluation criteria, and compensation mechanisms of the public health work in medical institutions.

In July 2024, according to the Sichuan Province Medical Institutions Public Health Responsibility List (2023 Edition), a survey form was designed by the Sichuan Preventive Medicine Association for the survey of 261 medical institutions and 648 full-time and part-time public health management practitioners across 21 cities and prefectures in Sichuan province.

In the surveyed medical institutions, there were 178 tertiary hospitals and 83 secondary hospitals. More than 80% of hospitals had independent public health department, while the proportion of hospitals where the public health department was co-located with the healthcare-asscoiated infection department exceeded 80%. The proportion of designated/sentinel settings in tertiary hospitals was 56.74%, which was higher than that (34.94%) in secondary hospitals (χ² = 10.762, P = 0.001). In addition, tertiary hospitals outperformed secondary hospitals in the establishment of public health departments (76.97% vs. 60.24%), emergency management departments (91.01% vs. 80.72%), allocation of public health administrators in clinical departments (80.90% vs. 61.45%), and infectious disease information level (92.70% vs. 83.13%). The staffing structure of public health management departments in hospitals was predominantly composed of nurses (56.02%), with a more severe imbalance in secondary hospitals. Although the overall implementation of public health management work was generally consistent between hospitals of different levels, tertiary hospitals had higher proportions in staff health care (47.19% vs. 31.33%), foodborne disease surveillance and reporting (83.71% vs. 69.88%), and myopia prevention and control (14.61% vs. 4.82%) than secondary hospitals. In contrast, secondary hospitals had a higher proportion in hospital infection prevention and control than tertiary hospitals (60.24% vs. 44.38%).

Although the public health management in Sichuan province has developed rapidly, there are insufficient resource allocation and uneven service levels. In the future, it is necessary to optimize the organizational framework, adjust the staffing structure, explore compensation mechanisms, and build an evaluation system to improve the overall quality and efficiency of hospital public health services.

To establish an evaluation index system for public health responsibilities in secondary and tertiary medical institutions, thus strengthening the public health functions of medical institutions and enhancing the collaboration between regional medical and public health institutions.

In 2023, in line with China's national and Jiangsu provincial policies and decisions on strengthening the implementation of public health responsibilities in medical institutions, a framework for the evaluation index system was initially developed through interviews, expert discussion, and policy-literature analysis. The Delphi method was then applied with 20 experts across relevant fields over two consultation rounds to establish the evaluation index system for the public health responsibilities in secondary and tertiary medical institutions. The analytic hierarchy process (AHP) was employed to determine the weight of each index.

The recovery rates of questionnaires reached 100% in both rounds, with an expert authority coefficient of 0.88 and the coefficient of concordance meeting the criteria (P<0.001). The evaluation index system consisted of 8 first-level indexes, 23 second-level indexes, and 72 third-level indexes. The mean importance scores, appropriateness scores, and total scores for all levels of indexes were not less than 4.00, with a coefficient of variation below 20%. The AHP results revealed that public health safety management (0.194), infectious disease prevention and control (0.147), and immunization services (0.136) are key areas of public health responsibilities for medical institutions.

The evaluation index system for public health responsibilities of secondary and tertiary hospitals helps medical institutions clarify key points of public health responsibilities, strengthen the public health responsibilities, optimize the integration paths of medical services and prevention, and enhance the systems and mechanisms for public health services and disease prevention and control.

To explore the association between self-efficacy and subjective well-being (SWB) among older adults, thus providing a scientific basis for developing measures to improve the SWB of older adults.

A questionnaire survey was conducted from December 2018 to December 2023 among 27 352 older adults aged 65 and above, selected via a two-stage sampling method from 146 communities in 10 cities across China. The Chinese version of the General Self-Efficacy Scale (GSES) was adopted to assess self-efficacy, and the Chinese version of the Personal Wellbeing Index for Adults (PWI-A) was used to assess SWB. A generalized linear regression model was employed to analyze the association between self-efficacy and SWB.

The 27 352 older adults showed the average SWB score of 52.76 ± 11.85 and the average self-efficacy score of 2.65 ± 0.72. The generalized linear regression model showed that without controlling for other factors, older adults with self-efficacy scores in the second (Q2), third (Q3), and fourth quartiles (Q4) had SWB scores 3.8 (95%CI: 3.4–4.2), 6.0 (95%CI: 5.6–6.3), and 11.0 (95%CI: 10.6–11.4) higher, respectively, than those with self-efficacy scores in the first quartile (Q1). After controlling for covariates, such as sex, age, and prevalence of chronic diseases, older adults with self-efficacy scores in Q2, Q3, and Q4 had SWB scores 2.5 (95%CI: 2.1–2.8), 4.0 (95%CI: 3.6–4.3), and 8.2 (95%CI: 7.8–8.6) higher than those with self-efficacy scores in Q1.

There is a positive correlation between self-efficacy and SWB scores in older adults. Providing learning environments, psychological interventions, and improving physical health conditions can enhance the self-efficacy and SWB of older adults.

To investigate the prevalence of depressive symptoms in pregnant couples in Anhui province and analyze the dose-response relationships of insufficient sleep and late bedtime with depressive symptoms, thus providing evidence for family-centered perinatal health interventions.

This multicenter cross-sectional study was conducted from November 2023 to June 2024. Through convenience sampling, 2 460 pregnant couples were recruited from five regions across southern, central, and northern Anhui province. Depressive symptoms in both partners were assessed via the Edinburgh Postnatal Depression Scale (EPDS). A self-designed questionnaire was employed to collect sociodemographic information, sleep duration, and bedtime. Generalized additive models (GAMs) were adopted to explore the associations between sleep and depression, while multivariable logistic regression was performed to examine the independent and interactive effects of sleep duration and bedtime on depression risk.

Depressive symptoms were detected in 16.4% of pregnant women and 14.6% of husbands, with a 3.3% co-occurrence rate. The symptom prevalence followed a U-shaped trend across trimesters, peaking at 19.4% in women during the third trimester. GAMs revealed nonlinear dose-response relationships of sleep duration and bedtime with depression. Insufficient sleep (<7 h) and late bedtime (>23:00) were independent risk factors for both wives (OR = 1.72, 95%CI: 1.35–2.16; OR = 2.46, 95%CI: 1.75–3.46) and husbands (OR = 1.69, 95%CI: 1.33–2.14; OR = 1.41, 95%CI: 1.27–2.24). Combined insufficient sleep and late bedtime further increased the risk (wives: OR = 3.75, 95%CI: 2.29–6.14; husbands: OR = 1.63, 95%CI: 1.09–2.43). A statistically significant interactive effect between partners′ sleep duration was observed on maternal depressive symptoms (OR = 1.38, 95%CI: 1.10–1.77).

Pregnant women exhibit higher depression prevalence than spouses, particularly during late pregnancy. Insufficient sleep and late bedtime are critical risk factors. Family-centered interventions targeting couple-based sleep health are recommended for perinatal depression prevention.

To design a local negative pressure isolation protection system on sickbed for infectious patients and conduct experimental research on its performance to analyze and evaluate the reliability and safety of its isolation protection against biological aerosol.

A local negative pressure isolation protection system on sickbed was designed with consideration to the structural type and materials. Then, the system was tested in terms of subjects′ experience, static and dynamic pressure difference, and noise. Particularly, the isolation protection performance of this system against biological aerosol in micro-circumstance airtight cabin was tested.

The local negative pressure isolation protection system on sickbed quickly established a stable local negative pressure difference within 1 min, with a maximum fluctuation error of 4.6%. The average noise under the maximum air volume was 64.2 dB(A). When Serratia marcescens aerosol with a maximum concentration of 1.4 × 10¹¹ CFU/mL was atomized inside the isolation hood, the aerosol leakage rate outside the hood was 0, which showed that the local negative pressure isolation protection system on sickbed could effectively cut off the transmission of pathogenic microorganisms in the air. Moreover, the subjects had a good subjective experience.

The designed local negative pressure isolation protection system on sickbed is comfortable, lightweight, and portable, which can be used to reduce the risk of microbial spread among respiratory patients.

To understand the use and its influencing factors of secondary prevention drugs among patients with cardiovascular and cerebrovascular diseases (CVDs) in East China from 2014 to 2019, thus providing a basis for the improving medication adherence of secondary prevention drugs among these patients.

Data were collected from 19 992 patients with CVDs who aged 35–75 years and used secondary prevention drugs in the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project (China PEACE MPP) from September 2014 to November 2019 across 57 counties/districts in seven provincial-level administrative regions (Shanghai, Jiangsu, Zhejiang, Anhui, Fujian, Jiangxi, and Shandong) in East China. Multivariate mixed models were employed with community-specific random intercepts to analyze the associations of individual characteristics with the reported use of secondary prevention drugs.

Among the 19 992 patients with CVDs reported in East China from 2014 to 2019, 4 435 (22.18%) patients used antiplatelets or statins. Among them, 3 671 (18.36%) and 2 181 (10.91%) patients used antiplatelets and statins, respectively, and 1 417 cases (7.09%) used both types of drugs. The results of the multivariate mixed model analysis showed that the patients with CVDs who had educational background of junior high school or above, hypertension history, dyslipidemia history, overweight or obesity were more likely to report taking secondary prevention drugs. Female patients, current smokers, and those diagnosed with CVDs for more than 7 years were less likely to report taking secondary prevention drugs.

The use of secondary prevention drugs among the patients with CVDs was suboptimal in East China from 2014 to 2019. Gender, educational background, history of hypertension and dyslipidemia, current smoking status, body mass index, and time from diagnosis of CVDs are the main influencing factors for the use of secondary prevention drugs among the patients in East China.

To understand the epidemic trend of SARS-CoV-2 and explore the practical significance of sewage monitoring in the assessment and prevention of COVID-19 epidemic by analyzing the monitoring data of SARS-CoV-2 in sewage in Shandong province.

In 2024, a total of 9 464 sewage samples from the main urban sewage treatment plants in 16 cities of Shandong province were collected weekly. The positive rate and the weighted average concentration of SARS-CoV-2 in the samples were continuously monitored. Correlation analysis was conducted between the weekly positive rates and weighted average concentrations across the province. On the basis of the data such as the weighted average concentration, the weekly number of SARS-CoV-2 infections was estimated. Correlation analysis was then performed between the estimated infection number and the reported cases of SARS-CoV-2 infection in Shandong province.

In 2024, a total of 9 464 sewage samples were monitored in Shandong province. The average positive rate of SARS-CoV-2 in the wastewater throughout the year was 46.91%, and the average weighted average concentration was 11.69 copies/mL. The positive rate and weighted average concentration of SARS-CoV-2 in the sewage samples in Shandong province showed two peaks. The first peak occurred from the 1st week to the 24th week (January to June), with the highest positive rate of 77.72% and the highest weighted average concentration of 42.27 copies/mL. The second peak occurred from the 29th week to the 46th week (July to November), with the highest positive rate of 67.36% and the highest weighted average concentration of 19.7 copies/mL. The positive rate and weighted average concentration throughout the province had a high correlation (r = 0.888 7, P < 0.001, 95%CI: 0.812 9–0.934 9). The positive rates varied among different cities (χ² = 2 233, P < 0.001), ranging from 14.58% to 89.58%. The weighted average concentrations ranged from 0.81 to 46.76 copies/mL. The number of reported SARS-CoV-2 infection cases in Shandong province ranged from 117 to 5 864, and the trend of increase or decrease in the number of reported cases over time was consistent with the changes in positive rate and weighted average concentration of SARS-CoV-2 in sewage. The estimated number of infections throughout the year ranged from 52 to 2 277, and there was a correlation between the estimated infection number and the number of reported cases (r = 0.769 9, P < 0.001, 95%CI: 0.629 2–0.861 8).

The positive rate and concentration changes of SARS-CoV-2 in sewage in Shandong province, 2024 are basically consistent with the variations in the number of reported cases. There is a certain correlation between the estimated infection number and the number of reported cases. The monitoring results of sewage can to some extent reflect the infection situation of the population.