Introduction: Expanding evidence suggests beneficial impacts of greenspace on human health, yet the relationships between greenness and stillbirth remain unknown. This study aimed to quantify the risk and burden of stillbirth associated with maternal greenness exposure during pregnancy. Methods: A total of 3,982,304 eligible birth records across 31 provinces in Iran from 2013 to 2018 were included in this study. Greenness exposure during pregnancy was assessed using the satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) with multiple buffers. Stillbirth was defined as the birth of babies with no signs of life at >= 22 weeks of gestation. Multivariable-adjusted logistic regression models were employed to investigate greenness-stillbirth associations. To estimate the exposure-response functions, greenness exposures were fitted as smooth terms using restricted cubic splines. Avoidable burden of stillbirth under the predefined scenarios of improved greenness was estimated through a counterfactual analysis. Results: A total of 29,770 stillbirths occurred during 2013-2018, totaling to an overall annual rate of 748 cases per 100,000 births. Lower stillbirth risks were consistently seen in pregnant mothers being exposed to greater greenness within buffers of 500-3000 m. For instance, per 0.1-unit increase of NDVI and EVI within a 3000-m buffer was associated with the estimated odds of 0.971 (95 % confidence interval: 0.963-0.978) and 0.957 (0.947-0.968) for stillbirth, respectively. Evidently nonlinear relationships were identified between greenness exposure and stillbirth, exhibiting approximately an inverted L-shaped pattern with the steeper slope at high greenness levels. Assuming causality, 34-41 stillbirths per 100,000 births could be avoidable by achieving the 80th percentile of NDVI/EVI during 2013-2018, representing 4.6-5.4 % of nationwide registry-based stillbirths in Iran. Conclusions: Our findings provided robust national evidence on beneficial effects of surrounding greenness in alleviating risk and burden of stillbirth in Iran, suggesting a greener environment could potentially serve as a promising intervention strategy for reducing stillbirth risk in less developed countries.

Growing evidence has linked extreme temperature with neuropsychiatric disorders under climate warming with frequent extreme heat events over the past decades, while cognitive performance in relation to heat exposure remains largely unstudied, particularly in populations at high vulnerability to climate risks (e.g., China). Based on five survey waves of a nationwide dynamic cohort (2011–2020), we analyzed 47,825 cognitive test records from 14,729 respondents aged 45+ years across 126 Chinese cities. Global cognitive performance and its two dimensions (episodic memory and mental status) was measured using standardized questionnaires. Temperature exposure prior to cognitive tests was assessed using both average temperatures and heat days exceeding predefined temperature thresholds. Linear mixed-effects models were utilized to examine the relationship between high temperature exposure and cognitive function. This study revealed consistent evidence for heat-related declines in global cognitive performance and episodic memory across multiple exposure-window analyses, while robust associations were observed solely during prolonged exposure periods (more than 90 d) for mental status. For each 1-°C rise in annual mean temperature within 1 year prior to investigation, cognitive scores declined by 0.058 (95% CI: −0.079, −0.037) points for global performance, 0.033 (95% CI: −0.048, −0.018) points for episodic memory, and 0.025 (95% CI: −0.038, −0.013) points for mental status, respectively. Similar findings were seen in analyses using heat exposure days defined by multiple temperature percentiles, linking per 10-d increase in heat duration to reduced global cognitive scores ranging from −0.142 (95% CI: −0.214, −0.070) to −0.168 (95% CI: −0.254, −0.082). Despite varied evidence by heat exposure metrics and cognitive dimensions, stratified analyses suggested possibly higher susceptibility among females, less-educated, and urban-dwelling residents to heat-related cognitive impairment. These results provided suggestive evidence for the role of exposure to heat in triggering cognitive impairment in middle-aged and older individuals. This finding may be crucial in developing public health strategies for managing climate change risks of neurobehavioral disorders in a healthy aging society.

The impact of short-term exposure to air pollutants on the morbidity of schizophrenia, particularly in low- and middle-income countries, remains inadequately explored. The objective of this research was to investigate the relationship between short-term exposure to ambient air pollutants and the risk of schizophrenia hospitalization in Jingmen, China. We performed a time-stratified case-crossover study using daily records of hospital admissions due to schizophrenia in Jingmen Mental Health Center from 2015 to 2017. Environmental exposures to air pollutants and meteorological conditions on case and control days were estimated on the basis of measurements from ground monitoring stations. To investigate the relationship between short-term exposure to ambient air pollutants and the risk of hospitalization for schizophrenia, a conditional logistic regression model was employed. We performed subgroup analyses stratified according to sex, age groups, and season. In total, 4079 schizophrenia hospitalizations were recorded during the designated period. Increased risk of schizophrenia was merely associated with short-term exposure to SO2 and NO2. The estimated odds per interquartile range (IQR) increase in exposure was 1.112 (95% confidence interval (CI): 1.033, 1.196) for SO2 (IQR = 12 µg/m3) and 1.112 (95% CI: 1.033, 1.197) for NO2 (IQR = 18 µg/m3) on lag-0 day. Greater air pollution-schizophrenia associations were observed among middle-aged and older adults (over 45 years of age) and during the cold season. This study added case-crossover evidence indicating that short-term exposure to ambient air pollution, specifically SO2 and NO2, is linked to a higher risk of hospital admissions for schizophrenia. These findings contribute to a better understanding of the detrimental effects of air pollution on neuropsychiatric health conditions.

Several longitudinal studies have associated ambient air pollution exposure with lung function, while cohort evidence was extremely sparse in low- and middle-income countries (LMICs) experiencing heavy air pollution. In this study, we sought to establish the concentration-response association between long-term exposures to fine particulate matter (PM2.5) and gaseous air pollutants (e.g., nitrogen dioxide [NO2] and ozone [O-3]) and lung function in Chinese middle-aged and older adults. We conceived a nationwide longitudinal study from 2011 through 2015, by enrolling 13,614 participants aged 45 and above from 28 provincial regions across mainland of China. Lung function in each survey wave was measured as peak expiratory flow (PEF) repeatedly by welltrained interviewers using standardized devices. We assigned the exposures to ambient air pollutants (PM2.5, NO2 and O-3) of participants according to their residential cities at baseline, via deriving monthly estimates from well-validated spatiotemporal datasets developed by machine learning methods. Possible exposure biases were examined through Monte Carlo simulation approach with 1000 random simulations of the residential addresses for each participant. The associations of long-term air pollution exposure with PEF and PEF z-score were assessed using mixed-effects linear models. We compared estimated effects of each pollutant with the effect of aging on lung function to elevate interpretability of the association magnitude. Subgroup analyses were conducted to identify potential effect modifiers. We evaluated totally 34,196 repeated measurements of lung function from 13,614 adults. Mean of age at survey was 60.8 years (standard deviation 9.4 years). An increase of 10-mu g/m(3) in annual PM2.5, NO2 and O-3 exposure was respectively associated with a decline in PEF of 14.6 (95% confidence interval: 13.1-16.2) L/min, 21.7 (19.6-23.8) L/min, and 25.5 (20.6-30.4) L/min, which were equivalent to the effects of aging by 3.9-7.3 years and percent declines of 4.9-8.5%. We observed approximately linear relationships between PEF and PM2.5 and O-3, while a reversely J-shaped NO2-PEF relation was identified with steeper drops below 30 mu g/m(3). Stratified analyses suggested significantly greater lung function impairment associated with ambient air pollutants in men, younger (<65), and less-educated adults. Our primary findings were robust to the sensitivity analyses based on Monte Carlo simulation approach with 1000 simulations, as well as adjustments for co-pollutant analyses. This study provided national evidence that long-term exposure to ambient PM2.5, NO2 and O-3 may be independently associated with reduced lung function in Chinese middle-aged and older adults. Improvement of air quality may substantially offset the deterioration of lung function due to ageing in LMICs.

目的 探讨"基于问题学习"在徒手心肺复苏现场急救技术课堂教学中的应用效果.方法 对徒手心肺复苏现场急救技术课堂教学进行改革.选择本院2016级预防医学专业66名学生、2017级预防医学专业43名学生为研究对象,2016级为对照组,采用传统教学法;2017级为实验组,采用"基于问题学习"教学法.课堂教学结束后比较两组易错知识点考核成绩、情景实操成绩和总成绩.结果 实验组的易错知识点考核成绩、情景实操成绩和总成绩均高于对照组(P＜0.05).结论 "基于问题学习"的教学方法可提高学生的学习主动性和动手能力,教学效果好.

毕业论文是培养"应用型人才"的重要环节,针对以往毕业论文教学工作中存在的问题,湘南学院公共卫生学院开展了系列改革.通过调整人才培养方案,改革课程设置,以项目为载体,与社会实践相结合,完善"产学研"校企合作机制,实施毕业论文"双导师制",合理安排进度,加强过程管理,分批次答辩等,探索提升毕业论文质量的有效举措.

新冠肺炎疫情防控期间,开展线上教学是应急之举,也是利用信息化技术开展教学改革的探索.该文以"流行病学"第二章内容"疾病分布"教学为例,阐述通过腾讯会议视频直播讲解、QQ群视频讨论、文献评阅、组间互评、教师答疑总结、思政教育等多种方式,对2016级预防医学专业学生开展的流行病学实验课程的教学工作,以期为其他教育界同仁提供参考.