Objective 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.Methods 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.Results 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.Conclusions 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.
Objectives 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.Methods 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 sociod-emographic index(SDI),GDP per capita,population aging,and national policies and data capacity.Results 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(βQ1=-3.13,95%CI:-5.75 to-0.50),and middle SDI status(βHigh SDI=-2.15,95%CI:-4.27 to-0.04)were more likely to address healthy ageing-related themes.Conclusions 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.
Objective 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.Methods 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.Results 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.Conclusions 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.
Objective 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.Methods 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.Results 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).Conclusions 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.
Objective 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.Methods 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.Results 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.Conclusions 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.
Objective 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.Methods 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.Results 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%).Conclusions 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.
Objective 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.Methods 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.Results 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).Conclusions 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.
Objective To comprehensively assess the establishment and service provision of weight management clinics in healthcare institutions in Shenzhen city,Guangdong province,thus providing robust evidence to support the standardized and scientific development of weight management services in China.Methods In June 2025,a census survey was conducted among 62 secondary-and tertiary-level medical institutions(STLMIs)and 734 community health service organizations(CHSOs)in Shenzhen.A structured questionnaire was employed to investigate the weight management clinics in terms of establishment,service capacity,equipment configuration,extended services,participation in professional skills training,and existing problems.Results The establishment rates of weight management clinics were 83.87%in STLMIs and 11.58%in CHSOs,being higher in STLMIs than in CHSOs(χ2=209.68,P<0.001).In terms of service capacity,STLMIs demonstrated generally strong capabilities in weight management clinics,except for bariatric and metabolic surgery.CHSOs exhibited satisfactory basic service capacity but limited specialized intervention capabilities,with significantly weaker overall capacity than STLMIs.For services targeting children and adolescents as well as pregnant and postpartum women,the proportion of CHSOs with corresponding service capacity was lower than that of STLMIs(all P<0.01).Regarding equipment configuration,both STLMIs and CHSOs reported over 80%availability of basic examination and assessment equipment(excluding body fat scales and body composition analyzers),with no statistically significant differences(P>0.05).However,STLMIs showed higher availability of body fat scales,body composition analyzers,and metabolic assessment equipment than CHSOs(all P<0.01).In terms of extended services,the proportions of STLMIs conducting weight management-related skills training and providing school-based health education and free medical consultations were 50.00%and 40.38%,respectively,both higher than those of CHSOs(17.65%and 21.18%,respectively;both P<0.05).With respect to professional skills training,the proportions of STLMIs receiving training in endocrine and metabolic diseases,nutrition guidance,exercise guidance,and psychological and behavioral interventions were 80.77%,76.92%,78.85%,and 59.62%,respectively,all higher than those of CHSOs(51.76%,48.24%,52.94%,and 32.94%,respectively;all P<0.01).The major problems reported by STLMIs included information systems failing to meet work demands,insufficient publicity coupled with low outpatient volume,and lack of effective incentive mechanisms.CHSOs mainly reported inadequate equipment and facilities,information systems failing to meet work demands,and limited professional skills among healthcare staff.Conclusions The overall establishment of weight management clinics in healthcare institutions in Shenzhen is relatively satisfactory,while substantial room for improvement remains in CHSOs.
Objective To explore the relationship between vegetable and fruit intake and sleep duration among Chinese adults aged over 80 years,thereby providing a scientific basis for improving sleep quality in this population.Methods Multistage stratified cluster random sampling was conducted for data from the China Nutrition and Health Surveillance(2015-2017).A total of 2 319 elderly participants from 31 provinces(autonomous regions,municipalities directly under the Central Government)in China were selected to complete a questionnaire survey,physical measurements,and laboratory tests.The average daily intake of vegetables,fruits,and total vegetable and fruit intake was investigated,and the population was divided into quintiles in ascending order.Those with the daily sleep duration of 7-9 h were defined as the healthy sleep duration group,and those with the daily sleep duration of<7 h or>9 h were defined as the unhealthy sleep duration group.Multivariate unconditional logistic regression was adopted to explore the association between the two.Restricted cubic spline(RCS)analysis was performed to explore the dose-response relationship between fruit and vegetable intake and unhealthy sleep duration.Results Among the 2 319 elderly participants in China,52.13%had unhealthy sleep duration.Different sleep duration groups varied in sex(χ2=6.672),place of residence(χ2=8.422),educational background(χ2=15.573),per capita annual household income(χ2=23.021),marital status(χ2=8.894),physical activity level(χ2=9.873),and sedentary behavior distribution(χ2=6.631)(all P<0.05).In addition,there were also differences in age(t=2.220),vegetable intake(t=3.420),fruit intake(t=3.470),and total vegetable and fruit intake(t=4.190)among different groups(all P<0.05).Multivariate unconditional logistic regression showed that after adjusting for age,sex,BMI,place of residence,educational background,per capita annual household income,marital status,number of cohabitants,current smoking,current alcohol consumption,physical activity level,sedentary behavior,participation in health checkups within the past year,and the prevalence of hypertension,diabetes,and dyslipidemia,vegetable intake,fruit intake,and total vegetable and fruit intake were negatively associated with the risk of unhealthy sleep duration.Compared with the lowest group,the highest group showed reductions of 26%(vegetable intake:OR=0.74,95%CI:0.56-0.97),28%(fruit intake:OR=0.72,95%CI:0.55-0.95),and 29%(total fruit and vegetable intake:OR=0.71,95%CI:0.54-0.94)in the risk of unhealthy sleep duration(all Ptrend<0.05).RCS analysis revealed that both fruit intake and total vegetable and fruit intake had significantly negatively linearly associations with unhealthy sleep duration(both Pnon-linearity≥0.05).Conclusions The vegetable intake,fruit intake,and total vegetable and fruit intake are negatively correlated with the risk of unhealthy sleep duration in Chinese adults aged 80 and above.The findings provide a potential intervention target to promote healthy sleep duration in this population.
Objective To analyze the long-term trends,growth rates,and population disparities of overweight and obesity among Chinese adults from 1982 to 2015,thereby providing evidence for targeted prevention and control.Methods This study used data from the national nutrition surveys and health monitoring conducted in 1982,1992,2002,2012,and 2015.The weighted prevalence of overweight and obesity was calculated.Long-term trends were analyzed by inverse variance-weighted linear regression for prediction,and the geometric growth model was employed to calculate the compound annual growth rates(CAGRs)in different periods.Results From 1982 to 2015,the prevalence of overweight among Chinese adults increased from 11.0%to 33.3%,while that of obesity rose from 1.9%to 14.1%.Projections indicated these figures would reach 43.2%and 17.3%,respectively,in 2030.The increasing trends in both overweight and obesity prevalence show significant temporal fluctuations and population disparities:The CAGRs for both overweight and obesity decelerated during 2002-2012(2.1%and 4.8%,respectively)but rebounded in 2012-2015(3.3%and 7.9%,respectively).During 1982-2015,the CAGRs for both overweight and obesity were consistently higher in men than in women,with the disparity being most pronounced during 2012-2015(the CAGR of obesity reached 10.5%in men versus 5.4%in women).The 45-59 age group consistently had the highest prevalence of overweight,and it surpassed the≥60 age group to become the group with the highest obesity prevalence(40.3%for overweight and 16.2%for obesity in 2015)after 2002.The 18-44 age group,despite its currently lower prevalence,exhibited the highest CAGRs for both overweight and obesity across most periods,particularly surging to the top during 2012-2015(CAGR:4.0%for overweight and 10.2%for obesity).The western region emerged as a new growth hotspot,with CAGRs for overweight and obesity soaring to 8.0%and 13.4%,respectively,during 2012-2015.Conclusions The epidemic of overweight and obesity among Chinese adults continues to worsen.The growth pattern has shifted from a generalized increase to a structural shift driven by gender,age,and geographical factors.
The International Health Regulations(2005)aim to prevent,protect against,and control the international spread of diseases while avoiding unnecessary interference with international traffic and trade.The Pandemic Agreement is grounded in the principle of equity and establishes an institutional framework for pandemic prevention,preparedness,and response.Functionally complementary,the two instruments together establish a two-tiered legal framework for global health governance.However,their actual effectiveness is highly dependent on domestic implementation by States Parties.Currently,in fulfilling its relevant international obligations,China faces three main structural challenges:inadequate domestic legal articulation,insufficient supporting capacities for compliance,and the deficiency of a systematic mechanism for translating international norms into domestic practice.Looking ahead,efforts should take the revision of the International Health Regulations(2005)and the formulation of the Pandemic Agreement as an opportunity to coordinate domestic regulations,capacity-building,and international cooperation.While improving its domestic health governance system,China will actively participate in building a just,equitable,open,and inclusive global health governance order.
Objective To develop a weight management knowledge assessment scale for primary and secondary school students and evaluate its reliability and validity.Methods Literature review and Delphi expert consultation(2 rounds)were used to form the initial weight management knowledge assessment scale for primary and secondary school students.A total of 2 611 students from the third grade of primary school to the third grade of senior high school were selected through the convenient sampling method from primary and secondary schools in Tianjin city,Jiangsu province,Hebei province,Hubei province,Sichuan province,and Ningxia Hui Autonomous Region to conduct a formal survey of their weight management knowledge in April to May 2025.The critical ratio method,discrete trend method,factor analysis method,and correlation coefficient method were employed to screen the scale items.The Cronbach's α coefficient and intra-class correlation coefficient(ICC)were adopted to evaluate the reliability of the scale.The validity of the scale was evaluated based on the item-level content validity index(I-CVI),scale-level content validity index(S-CVI),exploratory factor analysis,intrinsic correlation test,average variance extracted(AVE),composite reliability(CR),factor AVE square root,and comparison of correlation coefficients between this factor and other factors.Results Through exploratory factor analysis,the weight management knowledge assessment scale for primary and secondary school students was determined to include 40 items in 8 dimensions:preventive cognition,lifelong management,monitoring and evaluation,dietary nutrition,reasonable exercise,sleep psychology,scientific weight loss,and family action,which showed a cumulative variance contribution rate of 76.342%.The Cronbach's α coefficient of the total scale was 0.825,and that of each subscale was within the range of 0.801-0.896.The ICC was 0.833,and the ICC correlation coefficients varied in the range of 0.811-0.882.The I-CVI of the scale items and the S-CVI were 0.851-1.000 and 0.872,respectively.The results of confirmatory factor analysis showed that the correlation coefficients of the eight common factors—prevention cognition,lifelong management,monitoring and evaluation,dietary nutrition,reasonable exercise,sleep psychology,scientific weight loss,and family action—with the scale were 0.804,0.811,0.768,0.702,0.811,0.739,0.714,and 0.775(all P<0.01),and the model fit well(χ2=2 681.847,CFI=0.901,TLI=0.891,GFI=0.869,IFI=0.903,NFI=0.882,RMSEA=0.071).The AVE and CR were in the ranges of 0.532-0.721 and 0.735-0.796,respectively.The dimensional correlation tests of the scale all met the standard and were less than the square root of AVE,and the scale had good validity.Conclusions The weight management knowledge assessment scale for primary and secondary school students encompasses preventive cognition,lifelong management,monitoring and evaluation,dietary nutrition,reasonable exercise,sleep psychology,scientific weight loss,and family action,demonstrating good reliability and validity.It can be used to measure the weight management knowledge of primary and secondary school students in China.
Objective To investigate the association between dietary patterns and obesity among adult residents in rural Hebei province,providing a theoretical foundation for formulating dietary interventions tailored to reducing the obesity rate in this population.Methods The data were obtained from the Nutrition and Health Status Surveillance of Chinese Residents in 2022,including food frequency,personal information,health records,and physical examination results of permanent rural residents aged≥18 years in Hebei province.Dietary patterns were identified through factor analysis.Multivariate logistic regression models were employed to examine the relationship between dietary patterns and the risk of obesity in rural adults.Results Among the 2 479 rural residents aged≥18 years included in the study,the prevalence rate of obesity was 25.78%.The obesity rate was higher in non-smokers(26.74%)than in smokers(22.20%).Additionally,the obesity rate was higher in the populations with hypertension(34.16%),diabetes(38.60%),and dyslipidemia(32.74%)than in non-diseased populations.Four distinct dietary patterns were extracted via factor analysis as the animal protein-snack pattern,vegetable-fruit pattern,staple food pattern,and pasta-alcohol pattern,with a cumulative variance contribution rate of 38.77%.Logistic regression analysis indicated that after adjusting for confounding factors,individuals in the high-intake group of animal protein-snack pattern had higher risk of obesity than those in the low-intake group(Q3 high group OR=1.491,95%CI:1.177-1.889,P=0.001).Conclusions Dietary patterns are associated with obesity among rural adult residents in Hebei province,and a diet rich in animal protein-snack may elevate the risk of obesity.
Objective To evaluate the current diagnosis and treatment capacity of primary healthcare institutions in Beijing for weight management in patients with multimorbidity and identify key problems,thus providing evidence for improving primary care services.Methods From October to November 2025,a multi-stage random sampling method was employed to select 60 primary healthcare institutions in Beijing,from which 71 general practitioners,69 pharmacists,and 131 patients with multimorbidity were surveyed.Four self-developed questionnaires were administered to institutions,general practitioners,pharmacists,and patients.Descriptive analysis,content analysis,and subject framework analysis were conducted.Results Only 36.67%of the institutions had established weight management clinics,and specialized equipment and multidisciplinary teams were generally insufficient.The availability rate of weight-loss drugs was 71.67%.Less than 40%of general practitioners were proficient in exercise/diet planning,and only 9.86%could independently develop weight-loss plans.A total of 34.35%of patients reported insufficient follow-up on weight management.Family doctor contract rates were low,and referral procedures and criteria remained unclear.Conclusions The capacity of primary healthcare institutions in Beijing for weight management in patients with multimorbidity remains notably weak.It is recommended that comprehensive measures should be implemented in domains such as guideline development,resource allocation,and capacity training to enhance weight management and chronic disease prevention and control at primary healthcare institutions.
Objective To investigate body mass index(BMI)level of older adults aged 80 years and above in China under the new BMI recommendation standard and analyze the distribution characteristics of people with different BMI levels.Methods A total of 3 262 older adults of advanced ages from the China Nutrition and Health Surveillance(2015-2017)were included.The appropriate BMI level of them was determined by the latest The Appropriate Range of Body Mass Index and Body Weight Management Standards for the Oldest Old published in 2025.The results were weighted and adjusted by the sixth census data of the National Bureau of Statistics.The Rao-Scott chi-square test based on complex sampling design correction was performed to analyze the distribution characteristics of BMI among the older adults of advanced ages.Results The weighted mean BMI of the older adults aged 80 years and above in China was(23.5±0.2)kg/m2 in urban areas and(22.4±0.2)kg/m2 in rural areas in 2015-2017.The overall distribution trends of BMI among the older adults of advanced ages were similar in urban and rural areas in China,while the BMI level in rural areas was slightly lower than that in urban areas(F=20.94,P<0.01).Under the new standard,44.6%of the older adults of advanced ages had a BMI in the appropriate range,and 43.0%had a BMI below the appropriate range.The proportions of the older adults of advanced ages living in rural areas(65.3%)or in the central and western China(34.4%and 25.0%),with primary school education or below(89.8%),and with lower per capita annual dietary expenditure(23.0%)who had BMI below the appropriate range were higher(P<0.01).Conclusions Under the new appropriate BMI range standard,the BMI of older adults aged 80 or above in China is at a medium to low level,suggesting that the current nutritional problems of this population in China are still dominated by undernutrition.Understanding the BMI level and distribution characteristics of this population under the new standard can provide new data support for the health management of key populations.
Objective 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.Methods 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.Results 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.Conclusions 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.
Objective To analyze the associations of early-pregnancy body mass index(BMI),body fat percentage,and comprehensive indexes with the risk of macrosomia under the updated international obesity definition.Methods The study was part of the Peking University-Weifang Birth Cohort.Between March 2024 and February 2025,650 pregnant women who had registered,undergone physical examinations during early pregnancy(6 weeks to 13 weeks and 6 days of gestation),and subsequently delivered before August 1,2025 at Weifang Maternal and Child Health Hospital were recruited.Researchers collected basic demographic information and calculated BMI based on on-site measurements of body height and body weight during early pregnancy.Body fat percentage was assessed via bioelectrical impedance analysis(BIA)and delivery data,including gestational age,fetal sex,and birth weight,were obtained during childbirth.The obesity of mothers in early pregnancy was determined by three methods:BMI,body fat percentage,and new international definition of obesity,and the association between obesity in early pregnancy and macrosomia was analyzed by multivariate logistic regression and trend test.Results Among the 650 participants,26.31%were overweight and 14.00%were obese according to BMI criteria,and 66.46%had excessive body fat.The incidence of macrosomia was 8.62%.Compared with normal BMI,overweight did not have a significant association with macrosomia(P=0.079),whereas obese pregnant women had a 4.155-fold increased risk of delivering macrosomic infants(OR=5.155,95%CI:2.451-10.843).Compared with women with normal body fat percentage,those with excessive body fat had a 1.546-fold increased risk of delivering macrosomic infants(OR=2.546,95%CI:1.243-5.215).Compared with the pregnant women with both normal BMI and normal body fat,those with BMI indicating overweight combined with excessive body fat had a 1.318-fold increased risk(OR=2.318,95%CI:1.006-5.338),and those with BMI indicating obesity combined with excessive body fat had a 5.437-fold increased risk(OR=6.437,95%CI:2.670-15.516).An increasing trend in the risk of macrosomia with increases in early-pregnancy BMI and body fat percentage was identified(P<0.05).Conclusions According to the new international definition of obesity that combines BMI and body fat percentage,our analysis shows a strong association between obesity in early pregnancy and macrosomia.This finding supports early prevention strategies targeting pregnant women with BMI indicating normal weight or overweight and excessive body fat.
Objective To explore the associations between insulin resistance surrogate indices and hyperuricemia among Chinese older adults aged over 80 years and evaluate the predictive performance of different indices for hyperuricemia,thus providing a scientific basis for the prevention and control of hyperuricemia in this population.Methods On the basis of the data from the China Nutrition and Health Surveillance(2015-2017),multistage stratified cluster random sampling was employed to select 2 667 participants aged over 80 years from 31 provinces(autonomous regions,municipalities)in China.A questionnaire survey,physical measurements,and laboratory tests were conducted.The triglyceride-glucose(TyG)index was combined with body mass index(BMI),waist circumference(WC),and waist-to-height ratio(WHtR)to derive the TyG-BMI,TyG-WC,and TyG-WHtR indices,which,together with the triglyceride/high-density lipoprotein cholesterol(TG/HDL-C)ratio,metabolic score for insulin resistance(METS-IR),were used as insulin resistance surrogate indices.The participants were categorized by ascending quartiles.Hyperuricemia was defined as a serum uric acid concentration≥420 μmol/L in men and≥360 μmol/L in women.Multivariable unconditional logistic regression was adopted to explore the associations between insulin resistance surrogate indices and hyperuricemia.Receiver operating characteristic(ROC)curves were established to compare the predictive performance of different indices for hyperuricemia.Results Among the 2 667 Chinese older adults,23.24%had hyperuricemia,and the prevalence of hyperuricemia was statistically different among different groups of body mass index(BMI)(χ2=38.167),marital status(χ2=4.012),sleep duration(χ2=6.452),hypertension(χ2=12.320),diabetes(χ2=4.922),and dyslipidemia(χ2=38.541)(all P<0.05).The results of multivariable unconditional logistic regression showed that after adjusting for age,sex,BMI,place of residence,educational background,marital status,annual household income per capita,current smoking,current drinking,physical activity level,sleep duration,and the prevalence of hypertension,diabetes,and dyslipidemia,each insulin resistance surrogate index was positively associated with the risk of hyperuricemia.Compared with the lowest group,the highest group of TyG(OR=1.79,95%CI:1.30-2.45),TyG-BMI(OR=2.41,95%CI:1.41-4.13),TyG-WC(OR=1.84,95%CI:1.27-2.67),TyG-WHtR(OR=1.99,95%CI:1.39-2.86),TG/HDL-C(OR=1.81,95%CI:1.31-2.50),and MET-IR(OR=2.20,95%CI:1.32-3.69)had a significantly higher risk of hyperuricemia.ROC analysis suggested that the TyG-WC index had the best predictive performance for the prevalence of hyperuricemia in this population.Conclusions TyG,TyG-BMI,TyG-WC,TyG-WHtR,TG/HDL-C,and METS-IR are independent risk factors for hyperuricemia in the Chinese older adults aged over 80 years.The TyG-WC index could be used as an elite predictor of hyperuricemia risk,providing a new target for the prevention and treatment of hyperuricemia in this population.
The strategic planning of the U.S.National Institute of Mental Health(NIMH)has undergone a systematic transformation from a neuroscience-centered focus to a balanced emphasis on both basic research and clinical application.It has gradually developed into a research framework characterized by scientific evidence,a life-course perspective,and interdisciplinary collaboration.The NIMH experience demonstrates that forward-looking planning,policy support,and social collaboration are key to advancing research innovation,improving service systems,and enhancing the quality of public services.China's mental health research funding system remains fragmented and exploratory,lacking systematic strategic guidance and sustained support mechanisms.Drawing on the U.S.experience,China should establish a scientific,systematic,and sustainable national strategic framework that strengthens basic research while emphasizing clinical translation,digital interventions,and social participation mechanisms,thereby promoting the organic integration of research achievements,service systems,and public health goals.
Objective To systematically analyze the factors influencing the leadership competency of primary-level health emergency administrators in the field of infectious disease prevention and control,as well as their underlying mechanisms,thereby providing evidence-based references for enhancing the leadership competency of primary-level health emergency administrators.Methods From November 2019 to March 2021,this study adopted a multi-stage stratified random sampling method to randomly select 152 primary-level health emergency administrators from Jiangsu province,Hubei province,Hunan province,Guangdong province,Anhui province,and Inner Mongolia Autonomous Region,as the research subjects.Structural equation modeling(SEM)combined with the bootstrap method was utilized to analyze and validate the paths and mediating effects of these influencing factors.Results Through the survey of 152 primary-level health emergency administrators,this study found that human resource support had a positive impact on organizational climate(β=0.461,P<0.001).Organizational climate(β=0.712,P<0.001)and material resources support(β=0.248,P=0.004)had positive impacts on external social support.External social support had a positive impact on leadership competency(β=0.519,P<0.001).Through the mediating effect test,two mediating paths were identified.Mediating path 1 was material resources support → external social support → leadership competency(with an effect value of 0.129;95%CI:0.005-0.258),and mediating path 2 was human resource support → organizational climate → external social support → leadership competency(with an effect value of 0.170;95%CI:0.094-0.303).Conclusions The characteristics of infectious disease prevention and control reinforce the inevitability of the indirect transmission of the mechanisms influencing health emergency leadership competency.Leadership competency is formed through complex interactions between individuals and their environment.The sustainable improvement of leadership competency among primary-level health emergency administrators needs to be achieved by optimizing resource allocation and organizational climate,as well as improving the social support network.
