To understand the relationship between masticatory function and diabetes mellitus in middle-aged and older adults, along with the mediating role of dietary factors therein, thus providing a basis for research into the mechanisms by which oral health influences metabolic diseases and for the early intervention of diabetes mellitus.

Data were collected from the China Development and Nutrition Health Impact Cohort Survey (2022–2023) and the China Health and Nutrition Survey across ten regions: Heilongjiang province, Liaoning province, Shandong province, Henan province, Hunan province, Hubei province, Jiangsu province, Shaanxi province, Guangxi Zhuang Autonomous Region, and Guizhou province. This study utilized comprehensive demographic and epidemiological data from 2 509 middle-aged and older adults aged ≥55 years, encompassing masticatory function, dietary intake, medical history, physical measurements, and blood biochemical test data. A multivariable unconditional logistic regression model was employed to analyze the relationship between masticatory function and the prevalence of diabetes mellitus. Mediating effect models were further employed to examine the mediating effects of different food categories.

Among the 2 509 middle-aged and older adults included in the analysis, 805 (32.08%) exhibited masticatory dysfunction, while 516 (20.57%) had diabetes mellitus. Among the entire cohort, middle-aged and older adults with normal masticatory function consumed higher amounts of other cereals and pulses, tubers, vegetables, fruits, eggs, beans and bean products, nuts, fish and shellfish, meat, and cooking oil than those with masticatory dysfunction. Male middle-aged and older adults with normal masticatory function consumed higher amounts of other cereals and pulses, tubers, fruits, meat, and cooking oil than those with masticatory dysfunction. Female middle-aged and older adults with normal masticatory function consumed higher amounts of fruits, eggs, legumes and their products, nuts, fish and shellfish, and meat than those with masticatory dysfunction (all P < 0.05). After adjusting for confounding factors including gender, age, educational attainment, place of residence, employment status, annual household income per capita, smoking status, alcohol consumption, total physical activity, presence of hypertension, presence of dyslipidaemia, body mass index, and intake of various food categories, the results from unconditional multivariable logistic regression analysis revealed that middle-aged and older adults with masticatory dysfunction exhibited a 28.8% higher likelihood of developing diabetes mellitus than those with normal masticatory function (OR = 1.288, 95%CI: 1.029–1.612). After stratification by gender, female middle-aged and older adults with masticatory dysfunction had a 39.8% higher likelihood of developing diabetes mellitus than those with normal masticatory function (OR = 1.398, 95%CI: 1.033–1.894). Mediating effect analysis revealed that fruit intake exerted a mediating effect on the relationship between masticatory function and diabetes mellitus prevalence in the entire cohort (ab = 0.005, P = 0.032) and among female middle-aged and older adults (ab = 0.006, P = 0.018). Legume and legume product intake also mediated the relationship between masticatory function and diabetes mellitus prevalence among female middle-aged and older adults (ab = 0.006, P = 0.045).

Masticatory dysfunction in middle-aged and older adults is associated with an increased likelihood of diabetes mellitus, with fruit intake serving as an important mediating factor.

To explore the impact of the family dinner index (FDI) on subjective well-being among the elderly and analyze the chain mediating role of intergenerational solidarity and loneliness.

A cross-sectional survey was conducted from September to December 2024 via multistage sampling, involving 1 165 elderly residents (≥60 years) in District D of Tianjin city. Data were collected by the Family Dinner Index Scale, Intergenerational Solidarity Scale, Loneliness Scale, and Subjective Well-being Scale. Structural equation modeling and the Bootstrap method (5 000 resamples) were employed to test the mediating role.

The scores of the Family Dinner Index, Intergenerational Solidarity, Loneliness, and Subjective Well-being Scales were (32.45±8.72), (68.34±15.23), (18.56±5.89), and (36.78±6.95), respectively. The structural equation model demonstrated a high degree of fitting (χ²/df = 1.98, CFI = 0.97, RMSEA = 0.036). Path analysis revealed that the FDI directly and positively predicted subjective well-being (β = 0.20, P < 0.001) and intergenerational solidarity (β = 0.39, P < 0.001), while directly and negatively predicting loneliness (β = –0.18, P < 0.001). Intergenerational solidarity negatively predicted loneliness (β = –0.50, P < 0.001) and positively predicted subjective well-being (β = 0.25, P < 0.001). Loneliness directly and negatively predicted subjective well-being (β = –0.43, P < 0.001). The FDI influenced subjective well-being through the chain path from intergenerational solidarity to loneliness.

Family dinners significantly enhance subjective well-being of the elderly by strengthening intergenerational solidarity and alleviating loneliness. The findings provide a scientific basis for formulating family-oriented policies in response to aging.

To review and analyze the distribution, spatiotemporal trends, and influencing factors of healthy ageing-related themes at the World Health Assembly (WHA) during 2024–2025.

We collected the agendas, side events, and member state statements from WHA77 and WHA78, and combined them with national socioeconomic development levels, public data, and policy documents. Descriptive analysis and Tobit regression were employed to present the current status and spatiotemporal changes and to examine the influences of the sociodemographic index (SDI), GDP per capita, population aging, and national policies and data capacity.

Neither WHA77 nor WHA78 established an independent agenda item on healthy ageing, while relevant keywords were embedded within broader themes such as universal health coverage. Compared with WHA77, WHA78 demonstrated increased frequency and broader coverage of healthy ageing topics, particularly concentrated in Europe and the Asia-Pacific region. At WHA77, discussions were primarily linked to universal health coverage, whereas at WHA78 they were more frequently associated with chronic diseases and dementia. At WHA78, member states with available national data related to healthy ageing (β = 1.20, 95%CI: 0.21 to 2.18), higher GDP per capita (β_Q1 = –3.13, 95%CI: –5.75 to –0.50), and middle SDI status (β_{High SDI =} –2.15, 95%CI: –4.27 to –0.04) were more likely to address healthy ageing-related themes.

The frequency of healthy ageing-related themes at the WHA is influenced by factors such as national data capacity and socioeconomic development level. Although the WHA has not yet established an independent healthy ageing agenda item, healthy ageing-related themes are increasingly integrated into both formal agendas and side events, with expanding spatiotemporal coverage.

To systematically assess the impact of comprehensive medical reform on the supply of primary healthcare resources in China, providing evidence to inform the optimization of national healthcare reform policies.

Using data from sources such as the China Health and Family Planning Statistical Yearbook, China Health Statistical Yearbook, and China Fiscal Yearbook, we constructed a provincial panel data set of China from 2012 to 2020. Treating China′s pilot comprehensive reform as a quasi-natural experiment, we developed a multi-period difference-in-differences (DID) model to systematically evaluate the impact of the reform on primary healthcare resource supply across the dimensions of scale, structure, and accessibility. Additionally, we conducted thematic analysis of semi-structured interviews with 30 key informants from six provinces (Zhejiang, Guangdong, Hunan, Henan, Sichuan, and Yunnan) to validate and deepen the quantitative findings.

The multi-period DID model showed that the comprehensive medical reform increased the number of healthcare personnel per thousand population at the primary level (β = 0.079, P = 0.046) and the number of registered nurses per thousand population at the primary level (β = 0.045, P = 0.001). The structural proportions of healthcare personnel and registered nurses at the primary level (β = 0.006, P = 0.088; β = 0.009, P = 0.01) and the accessibility (β = 0.038, P = 0.014; β = 0.085, P = 0.001) were also significantly improved. The thematic analysis of semi-structured interviews revealed that comprehensive medical reform influenced the supply of primary healthcare resources through five mechanisms: allocation, resource distribution, governance structure, technology application, and institutional design, whereas policy coordination and systemic reform limitations constrained the overall effectiveness.

Comprehensive medical reform significantly improves the structure and accessibility of primary healthcare resources in China. However, shortages of primary-level physicians remain. Future efforts should focus on establishing a long-term governance mechanism for an integrated primary healthcare resource supply system, moving from pilot points to multiple simultaneous implementations and from fragmented initiatives to systematic integration, thereby supporting the high-quality development of the Healthy China initiative.

To systematically evaluate the public health knowledge awareness and training needs of members of the village (community) public health committees in Pudong New Area,Shanghai, thereby providing a basis for strengthening the capacity building of primary-level public health teams.

A cross-sectional survey was conducted online via the Questionnaire Star platform from July to August 2024, covering 5 365 committee members from 1 525 villages (communities) in Pudong New Area. The questionnaire included basic information and public health knowledge in three dimensions: prevention and control of common diseases, healthy lifestyles and behaviors, and knowledge and skills of disinfection and protection. Data were analyzed by χ² tests and multivariate logistic regression.

The overall awareness rate of public health knowledge among the participants was 54.71%, and the awareness rate in the dimension of disinfection and personal protection was the lowest (45.41%). Different genders, ages, educational backgrounds, job categories, regions, number of participation times in epidemiological investigations during the COVID-19 pandemic, and training needs all affected public health knowledge scores (all P < 0.05). Multivariate analysis showed that females (OR = 1.215, 95%CI: 1.078–1.369), those with a bachelor′s degree or above (OR = 1.305, 95%CI: 1.063–1.603), family doctors (OR = 2.022, 95%CI: 1.698–2.407), residents in urban fringe areas (OR = 1.202, 95%CI: 1.034–1.398), and those who underwent more than 10 epidemiological investigations (OR = 1.469, 95%CI: 1.238–1.743) had significantly better knowledge awareness. The awareness rates of those over 55 years old (OR = 0.674, 95%CI: 0.524–0.868), those in remote rural areas (OR = 0.82, 95%CI: 0.675–0.996), and those without training willingness (OR=0.682, 95%CI: 0.572–0.814) were lower. Training needs analysis revealed that the most demanded topics were infectious disease prevention and control (70.89%) and disinfection and protection skills (70.61%), with preferred training methods being on-site lectures (60.09%) and practical operations (54.63%).

Currently, the public health committees in Pudong New Area have established a multi-collaborative organizational framework. However, the committee members still need improvements in overall public health knowledge awareness, particularly in practical skills such as disinfection and protection.

To understand the cognition, attitudes, and suggestions of managers in primary medical institutions towards the prescription rights of public health physicians, thus providing references for improving the policy on public health physicians′ prescription rights and promoting the integration of medical and prevention services.

In December 2024, through the convenience sampling method combined with the snowball sampling method, 85 managers from primary medical institutions in Jiangsu province were selected as the subjects. An online questionnaire was used for the survey, and SPSS 27.0 and Nvivo software were used for data analysis.

Among the surveyed managers in primary medical institutions, 91.76% (78/85) had learned about the relevant information on public health physicians′ prescription rights; 95.29% (81/85) recognized the "physician" identity of public health physicians; and 92.94% (79/85) supported public health physicians having corresponding prescription rights after training. Among them, 92.94% (79/85) believed that granting prescription rights could provide integrated medical and prevention services, and 92.94% (79/85) believed that the ambiguity of practice scope and unclear regulations were the main obstacles to the implementation of granting public health physicians′ prescription rights. It was suggested that the scope of practice of prescription rights should be expanded in directions such as chronic disease management. Among the surveyed managers with positive attitude and providing suggestions, 98.25% (56/57) believed that the training and assessment of public health physicians′ prescription rights should include corresponding clinical knowledge and skills, and preventive medicine education should increase clinical practice hours and gradually align with clinical medicine. The cognition of the drawbacks of the absence of prescription rights (χ² = 6.740, P < 0.05) and the selection of training and assessment methods (χ² = 7.577, P < 0.05) were related to whether the original profession was preventive medicine, and the suggestion for the admission of public health physicians′ prescription rights was related to whether they were public health (assistant) physicians (χ² = 6.518, P < 0.05).

Managers in primary medical institutions generally hold a positive attitude towards public health physicians′ prescription rights but are constrained by factors such as unclear regulations, insufficient training, and low patient trust. It is suggested that the system norms, training assessment, and cognitive guidance should be improved to promote the implementation of prescription rights and the integration of medical and prevention services.

To understand the equilibrium status of public health security in different regions at the county (county-level city, district) level in Zhejiang province, thus providing a basis for targeted policy implementation across the entire province.

On the basis of the public health security evaluation index system, relevant public health security data in 2023 were collected from seven counties (county-level cities, districts) in Zhejiang province. The entropy weight technique for order preference by similarity to ideal solution (TOPSIS) was used to calculate the index values for each county (county-level city, district). The comprehensive closeness degrees for six dimensions including policy guarantee, resource support, healthy environment, surveillance and early warning, emergency response, and vulnerable population were calculated upon the grouping by different socioeconomic levels, different terrains, and different county-level administrative categories. The coefficients of variation were calculated to assess the level of balance in public health security development.

The comprehensive closeness degree of public health security in moderately developed areas in Zhejiang was the highest (0.644 0), significantly higher than that in developed areas (0.399 3) and underdeveloped areas (0.344 6). The coefficient of variation for the health environment dimension among the three areas with different socioeconomic levels reached 91.25%. The comprehensive closeness degree of public health security levels in plains was the highest (0.525 0), followed by those in islands (0.353 9) and mountainous areas (0.333 3). The closeness degrees for the emergency response dimension in the latter two areas were both close to the ideal value of 1.000 0. County-level cities had the highest comprehensive closeness degree of public health security (0.666 0), followed by districts (0.435 9) and counties (0.382 2). The coefficients of variation for the health environment and emergency response dimensions among the three areas with different county-level administrative categories were high, reaching 68.77% and 51.93%, respectively.

The public health security levels in different counties (county-level cities, districts) of Zhejiang province exhibit a certain degree of non-equilibrium. In moderately developed areas, the overall public health security level is relatively high, with a particular emphasis on the healthy environment. The islands and mountainous areas have significant advantages in emergency response, while their healthy environment and surveillance and early warning capabilities are not as strong as those in plains. In county-level cities, the overall public health security level is relatively high.

To analyze the comprehensive feedback of supervised subjects on health supervision work and their experiential perceptions in the new era and explore the key influencing factors, thereby providing a scientific basis for optimizing health supervision practices and enhancing regulatory efficacy.

In November 2024, a convenience sampling method was employed to survey 3 156 supervised subjects across four types of institutions (public venues, medical institutions, schools/childcare facilities, and enterprises) in economically developed eastern regions of China. The survey covered basic demographics, awareness levels, supervision and re-inspection experiences, training and guidance received, regulatory compliance and enforcement intensity, satisfaction levels, and cooperation. Satisfaction was used as the core indicator to assess experiential perceptions. On the basis of an overall analysis of feedback and experiential perceptions, univariate analysis and multivariate linear regression were employed to identify key influencing factors.

Among the 3 156 supervised subjects, 955 (30.3%), 1 085 (34.4%), and 1 116 (35.3%) were in central urban areas, suburban areas, and outer suburban areas, respectively. Regarding institutional types, the 3 156 supervised subjects included 1 335 (42.3%) in public venues, 617 (19.6%) in enterprises, 611 (19.4%) in schools/childcare facilities, and 593 (18.8%) in medical institutions. Overall, 51.1% of the total supervised subjects, 58.4% in central urban areas, and 54.5% in public venues stated that they completely understood the laws and regulations of their industry, and 48.1% of the total supervised subjects, 51.9% in central urban areas, and 51.3% in medical institutions believed that it was very easy to obtain the relevant information. Additionally, 81.5% of respondents perceived the enforcement process as highly standardized. The overall satisfaction score for health supervision work was (4.73 ± 0.51), with the supervised subjects in schools/childcare facilities scoring highest (4.77 ± 0.47) and those in enterprises lower (4.71 ± 0.51). The supervised subjects in central urban areas (4.79 ± 0.46) had higher satisfaction scores than those in suburban areas (4.70 ± 0.54) and outer suburban areas (4.70 ± 0.51) (both P < 0.05). Multivariate regression analysis revealed that key factors influencing experiential perceptions included enforcement standardization (β = 0.580, P < 0.001), awareness of laws and regulations (β = 0.039, P = 0.004), ease of information access (β = 0.062, P < 0.001), and understanding of responsibilities (β = 0.095, P < 0.001), all showing significant positive effects, while penalty history (β = −0.100, P = 0.007) had a negative effect.

In the new era, supervised subjects generally exhibit favorable awareness and feedback of health supervision work, with positive experiential perceptions. However, significant disparities exist across different areas and institution types, with higher evaluations from central urban areas and schools/childcare facilities and lower evaluations from suburban areas and enterprises.