Background: Child eating behaviors (CEBs) and parental feeding practices (PFPs) play critical roles in childhood obesity. However, the bidirectional relationships between CEBs and PFPs remain equivocal. This longitudinal study aimed to explore their bidirectional relationships. Methods: A convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships. Results: Eight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children’s unhealthy eating habits (β = −0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01). Conclusions: There were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents’ understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs.

ObjectiveTo evaluate whether the involvement of methodological experts improves the quality of clinical practice guidelines (CPGs) after adjusting for other factors.SettingThe quality of Japanese CPGs published in 2011–2019 was assessed using the Appraisal of Guidelines, Research, and Evaluation (AGREE) II instrument. A questionnaire survey targeting CPG development groups was conducted through postal mail.Participants405 CPGs were retrieved from a Japanese CPG clearinghouse. Questionnaires were distributed to the 405 CPG development groups. Of the 178 respondents, 22 were excluded because of missing values. Finally, 156 participants representing their CPG development groups were included in the analysis.Primary and secondary outcome measuresCPG quality was assessed using the AGREE II tool. The characteristics of CPGs, including publication year, development organisation, versions, number of members in the development group and involvement of methodological experts, were corrected from the description in the CPGs and the questionnaire survey. We performed multiple logistic regressions using the quality of CPGs as the dependent variable and the involvement of experts as the independent variable, adjusting for other possible factors.ResultsA total of 156 CPGs were included. Expert involvement was significantly associated with the AGREE II instrument scores in domains 1 (β=0.207), 2 (β=0.370), 3 (β=0.413), 4 (β=0.289), 5 (β=0.375), 6 (β=0.240) and overall (β=0.344).ConclusionThis study revealed that the involvement of methodological experts in the CPG development process improves the quality of CPGs. The results suggest the importance of establishing a training and certification programme for experts and constructing expert referral systems that meet CPG developers’ needs to improve the quality of CPGs.

Objective: To generate the Chinese Sleep Health Index (SHI-C) in Mandarin with cross-cultural adaptations and test its psychometric properties.Methods: This study used a cross-sectional design. Health science students were included (N = 271) and a sub-set (n = 74) was invited for the re-test. Cross-cultural adaptation of the SHI-C was performed prior to for-mal validation. The SHI-C, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Bedtime Pro-crastination Scale, and Sleep Hygiene Index were used to measure variables of interest. Exploratory factor analysis was used to evaluate the structure validity. Bivariate analyses were used to evaluate the construct validity.Results: Exploratory factor analysis identified 3 factors (ie, sleep quality, sleep duration, and disordered sleep) accounting for 55.6% of the total variance. The SHI-C total and sleep quality sub-index scores were signifi-cantly associated with both PSQI global score (r =-0.132, p < .05; r =-0.182, p < .01, respectively) and ISI score (r =-0.655, p < .05; r =-0.820, p < .05, respectively). SHI-C total, sleep quality sub-index, and sleep duration sub-index scores were significantly associated with Bedtime Procrastination Scale and Sleep Hygiene Index scores (r =-0.238 to-0.368, p < .05). Students with insomnia (ISI > 9) or poor sleep quality (PSQI > 5) had significantly lower SHI-C scores than those without (73.5 vs. 89.0, p < .01; 84.1 vs. 86.7, p < .05, respectively). SHI-C showed good internal consistency (Cronbach's alpha = 0.73) and test-retest reliabil-ity (intraclass correlation coefficient = 0.82).Conclusions: The SHI-C demonstrated good validity and adequate reliability in a Chinese sample of health sci-ence students. It could be used to measure sleep health in future research and practice. Psychometric proper-ties of the SHI-C among other Chinese populations remain to be confirmed.(c) 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

BackgroundMaintenance of activities of daily living (ADL) during acute hospitalization is an important treatment goal, especially for elderly inpatients with diseases that often leave disabilities, such as cerebral infarction. However, studies assessing risk-adjusted ADL changes are limited. In this study, we developed and calculated a hospital standardized ADL ratio (HSAR) using Japanese administrative claims data to measure the quality of hospitalization care for patients with cerebral infarction.MethodsThis study was designed as a retrospective observational study using the Japanese administrative claim data from 2012 to 2019. The data of all hospital admissions with a primary diagnosis of cerebral infarction (ICD-10, I63) were used. The HSAR was defined as the ratio of the observed number of ADL maintenance patients to the expected number of ADL maintenance patients multiplied by 100, and ratio of ADL maintenance patients was risk-adjusted using multivariable logistic regression analyses. The c-statistic was used to evaluate the predictive accuracy of the logistic models. Changes in HSARs in each consecutive period were assessed using Spearman's correlation coefficient.ResultsA total of 36,401 patients from 22 hospitals were included in this study. All variables used in the analyses were associated with ADL maintenance, and evaluations using the HSAR model showed predictive ability with c-statistics (area under the curve, 0.89; 95% confidence interval, 0.88-0.89).ConclusionsThe findings indicated a need to support hospitals with a low HSAR because hospitals with high/low HSAR were likely to produce the same results in the subsequent periods. HSAR can be used as a new quality indicator of in-hospital care and may contribute to the assessment and improvement of the quality of care.

Objective Secondary hyperparathyroidism(SHPT)is a common complication in patients with chronic kidney disease receiving long-term dialysis,but instruments specific to SHPT and their psychometric properties remain unclear.This systematic review aimed to evaluate the psychometric properties of available symptom instruments for SHPT and to provide evidence-based recommendations for the selection of the most suitable patient-reported outcome measure(PROM).Methods This review was conducted following the PRISMA guidelines and the Consensus-based Standards for the Selection of Health Measurement Instruments(COSMIN)methodology.A systematic search of 5 electronic databases was performed.Two independent reviewers screened the studies,extracted the data,and appraised the quality.Quality of evidence was graded using the modified GRADE approach.Results Seven studies investigated four PROMs,including the Dialysis Symptom Index(DSI),Chronic Kidney Disease-Symptom Burden Index(CKD-SBI),Kidney Symptom Questionnaire(KSQ),and Health Questionnaire Specific for End-Stage Renal Disease(HQ-ESRD).All scales showed inconsistent content validity with moderate and very low quality of evidence.Hypothesis testing for construct validity was the most commonly evaluated measurement property and the quality of evidence ranged from moderate to high.Internal consistency showed high level of evidence for sufficient quality of the DSI and the CKD-SBI.Structural validity was insufficient with high-quality evidence for the DSI.Criterion validity and responsiveness had sufficient quality for the DSI and the HQ-ESRD respectively,and the level of evidence was high.Conclusion Current evidence on the methodological quality of existing PROMs is limited and needs further validation.Based on the results synthesized,no evidence was generated regarding which instrument was superior to the others.DSI validated the most psychometric properties among the four scales.High-quality symptom instruments specific to the SHPT developed following the COSMIN methodology are warranted.

高校的基层组织单位普遍存在重业务、轻党建的思想观念,党建与业务的互补性没有被充分认识,甚至出现党建与业务脱离,形成"两张皮"的局面.上海交通大学护理学院教师党支部在基层工作中"唱主角",深度融合党建和业务工作,为"打造'护新沙龙',助力学院学科建设"系列活动,从健全制度、搭建平台、注重考评等方面探索新时代高校教师党支部党建工作与业务工作深度融合的实现路径.

Objective To analyze and clarify the concept of “feeding styles”.Methods PubMed, Web of Science, Embase, CINAHL,PsycINFO,CNKI,VIP,and Wanfang were systematically searched, and the search time range was from the inception to January 2022.The Rodgers evolutionary model of concept analysis was applied to analyze the included literature.Results A total of 63 relevant articles were ultimately included.There were 5 attributes of feeding styles, namely: feeding process, parent-child interactions, demandingness and responsiveness, emotional climate, and trait-like propensities.The antecedents of feeding styles involved multifaceted factors related to society, family, caregivers, and children.Children’s dietary structure, eating behavior and weight gains were the consequences observed.Conclusions Feeding styles are closely related to socioeconomic status, cultural beliefs, and health perceptions.Future studies can focus on different connotations across specific cultural contexts of this concept, which is conducive to the further development of assessment tools and exploration of types of feeding styles.

In Japan, the crude mortality rate of colorectal cancer is the second highest among men and highest among women by site. We aimed to calculate the social burden of colorectal cancer using the cost of illness (COI) method and identify the main factors that drove changes in the COI. From 1996 to 2020, the COI was estimated by summing direct, morbidity, and mortality costs. In addition, the COI by 2035 was projected by fitting approximate curves obtained from historical data to health-related indicators by sex and age. Future projections of the number of patients by the stage of disease were also made to explore the factors that changed the COI. The number of deaths and incidence from colorectal cancer was expected to continue increasing due to population aging. However, the COI was projected to rise from 850.3 billion yen in 1996 to 1.451 trillion yen in 2020, and peaked at 1.478 trillion yen in 2023 before it declined. Although the increased number of deaths associated with population aging increased COI, it was expected that the COI would decrease around 2023 due to a decrease in the human capital value of the deceased. In addition, the mortality rate was expected to decrease in the future due to an increase in the percentage of early detection of colorectal cancer via widespread screening and advances in medical technology.

Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey (HSOPS 1.0), developed by the U.S. Agency for Healthcare Research and Quality in 2004, has been widely adopted in the United States and internationally. An updated version, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019, has not yet been applied in China. The aim of the present study was to translate HSOPS 2.0 into Chinese version with cross-cultural adaptations and test its psychometric properties.A convenience sample was used. Hospital nurses (N = 1013) and a sub-set (n = 200) was invited for the re-test. A three-stage study was conducted. Firstly, the HSOPS 2.0 was translated by a panel. Secondly, the content validity was tested using the two-round Delphi method and cognitive interview. Next, the construct validity was tested by the confirmatory factor analysis and further demonstrated by the convergent validity, discriminant validity, and correlations with the outcome of patient safety. Thirdly, the reliability was tested by internal consistency reliability and re-test reliability.The "float or PRN" and "manager" words were deleted as considered unfitted for the Chinese health care system. The content validity index provided evidence of strong content validity (I-CVI = 0.84 ~ 1.00, S-CVI = 0.98). Confirmatory factor analysis revealed a good model fit (χ2/df = 4.05, RMSEA = 0.06, CFI = 0.94) and acceptable factor loadings (0.41 ~ 0.97). Convergent validity, and discriminant validity supported the factorial structure of the Chinese version of HSOPS 2.0. Further evidence for the construct validity was derived from correlations with the outcome of patient safety (r = 0.10 ~ 0.41). A good internal consistency (Cronbach's α = 0.68 ~ 0.93, McDonald's omega = 0.84 ~ 0.96) and test-retest reliability (ICC = 0.78 ~ 0.95) showed acceptable reliability. Additionally, Chinese nurses reported markedly lower scores for three dimensions, including "Response to Error", "Communication Openness", and "Reporting Patient Safety Events", when comparing the findings of this study with those from U.S. research utilizing the HSOPS 2.0.The Chinese version of HSOPS 2.0 demonstrated good validity and reliability in a Chinese sample of hospital nurses, which suggests that it can be used to measure nurse-perceived patient safety culture in future research and practice. Psychometric properties of the Chinese version of HSOPS 2.0 among other Chinese healthcare professionals remain to be confirmed.

BACKGROUND:Increased professional commitment is essential for relieving the nursing workforce shortage, which is exacerbated by the COVID-19 pandemic. The professional commitment of graduating nursing students is a powerful predictor of their work commitment. However, limited information is available regarding graduating nursing students' professional commitment. Existing studies investigating nursing students' professional commitment are limited by their lack of theoretical foundation. OBJECTIVES:To investigate the level of graduating nursing students' professional commitment and its multilevel influencing factors from the perspective of the Ecological Systems Theory in the early days following the COVID-19 outbreak. DESIGN:A descriptive cross-sectional study. SETTING:Three educational institutions in Shanghai, China. PARTICIPANTS:513 nursing students who were graduating with an associate or bachelor's degree. METHODS:The independent variables were measured by a self-designed questionnaire. The dependent variable professional commitment was measured by the Nursing Professional Commitment Scale. Hierarchical regression analyses, which allowed the independent variables entered in order, were performed to identify the significant predictor variables of the professional commitment and its dimensions. RESULTS:The level of professional commitment was 100.15 ± 20.35 (score ranged between 34 and 136). The individual factors (degree, whether had received a scholarship during the past academic years, ΔR2 = 0.142), family factors (parents and siblings' attitudes towards one's majoring in nursing, ΔR2 = 0.153), educational factors (academic faculty's belief in nursing profession, leaders' emphasis on nursing profession, satisfaction with clinical instructors' role modeling, ΔR2 = 0.097), and social factors (reason for majoring in nursing, perceived nurse-patient relationship, ΔR2 = 0.153) were significant predictors of the graduating nursing students' professional commitment (R2 = 47.6 %, F = 32.277, p < 0.001). CONCLUSIONS:The graduating nursing students had a moderate level of professional commitment, which needed to be improved. Nursing educators should comprehensively consider various factors to understand the relationship between individuals and environmental systems, and implement targeted interventions to shape the positive professional values of nursing students.

Objective:To examine the influence of professional commitment and significant others on occupation choices in graduating nurse students.Methods:From February to April 2020, 477 graduating nursing students from four medical colleges or universities located in Shanghai were involved in the survey. The questionnaire items included general personal information, nursing professional commitment scale, significant others and occupation choices. Multinomial logistic regression analysis was used to identify influencing factors of nursing students' occupation choices.Results:The significant others for nursing students' employment choices were their parents [70.6% (337/477)], teachers [12.2% (58/477)], peers [9.4% (45/477)] and others [7.8% (37/477)], respectively. The results showed that the score of professional commitment of nursing students was (100.53±20.71); the most significant others influencing nursing students' occupation choice were their parents and school teachers. The proportion of nursing students choosing "hospital nurse" as their occupation choice is 67.9%(324/477); the graduating nursing students with higher score of professional commitment are less likely to choose continuing their education as graduate students( OR=0.961, 95% CI=0.938~0.984) or other unrelated occupations( OR=0.916, 95% CI=0.886~0.948). The graduating nursing students who has higher satisfaction with their clinical teachers during the internship ( OR=0.164, 95% CI=0.030~0.894; OR=0.371, 95% CI=0.144~0.959) were less likely to choose other unrelated occupations. Academic teachers ( OR=2.896, 95% CI=1.212~6.920) may be significant others to graduating nursing students who prefer to continue their education as graduates. Conclusions:Professional commitment is a key factor affecting occupation choices of graduating nursing students, and teachers have a significant influence on nursing students' choosing occupation.

Background Ischemic heart disease (IHD) is one of the leading causes of mortality worldwide and imposes a heavy burden on patients. Previous studies have indicated that the optimal care for IHD during hospitalisation may reduce the risk of in-hospital mortality. The standardised mortality ratio (SMR) is an indicator for assessing the risk-adjusted in-hospital mortality ratio based on case-mix. This indicator can crucially identify hospitals that can be changed to improve patient safety and the quality of care. This study aimed to determine the hospital-level characteristics of the SMR for IHD in Japan. Methods This study was designed as a retrospective observational study using the Japanese administrative claim data from 2012 to 2019. The data of all hospital admissions with a primary diagnosis of IHD (ICD-10, I20-I25) were used. Patients with complete variables data were included in this study. Hospitals with less than 200 IHD inpatients in each 2-year period were excluded. The SMR was defined as the ratio of the observed number of in-hospital deaths to the expected number of in-hospital deaths multiplied by 100.The observed number of in-hospital deaths was the sum of the actual number of in-hospital deaths at that hospital, and the expected number of in-hospital deaths was the sum of the probabilities of in-hospital deaths. Ratios of in-hospital mortality was risk-adjusted using multivariable logistic regression analyses. The c-statistic and Hosmer-Lemeshow test were used to evaluate the predictive accuracy of the logistic models. Changes in SMRs in each consecutive period were assessed using Spearman’s correlation coefficient. Results A total of 64,831 were admitted patients with IHD in 27 hospitals as complete submission data. The SMRs showed wide variation among hospitals, ranging from 35.4 to 197.6, and analysis models indicated good predictive ability with a c-statistic of 0.93 (95% CI [0.92–0.94]) and Hosmer-Lemeshow test of 0.30. The results of chi-square tests and t -tests for all variables to assess the association with in-hospital mortality were P < 0.001. In the analysis of trends in each consecutive period, the SMRs showed positive correlations. Conclusions This study denoted that the SMRs for IHD could be calculated using Japanese administrative claim data. The SMR for IHD might contribute to the development of more appropriate benchmarking systems for hospitals to improve quality of care.

大众对传染病的认知有限,故疾病相关污名在疾病流行期间剧增,(疑似)患者、患者家属、相关医护人员等常被贴上"标签".不仅影响就医,而且相关人员常受到歧视,增加了疾病防控难度和疾病负担[1].为了解疾病相关污名,常需要专门评价工具从不同涉事人员的视角测量.目前,有关疾病污名研究主要集中在艾滋病、精神病等领域[2],对呼吸道传染病的污名研究相对较少.本研究对现有呼吸道传染病相关污名评价工具系统梳理,为相关研究在评价工具选择、发展与应用等提供借鉴.

Background: Aging increases the disease burden because of an increase in disease prevalence and mortality among older individuals. This could influence the perception of the social burden of different diseases and treatment prioritization within national healthcare services. Cancer is a disease with a high disease burden in Japan; however, the age-specific frequency and age-specific mortality rates differ according to site. In this study, we evaluated the relationship between the aging of the Japanese society and the disease burden by comparing the features of three cancers with different age-specific frequency rates in Japan. Furthermore, we made projections for the future to determine how the social burden of these cancers will change. Methods: We calculated the social burden of breast, lung, and prostate cancers by adding the direct, morbidity, and mortality costs. Estimates were made using the cost of illness (COI) method. For future projections, approximate curves were fitted for mortality rate, number of hospital admissions per population, number of outpatient visits per population, and average length of hospital stay according to sex and age. Results: The COI of breast, lung, and prostate cancers in 2017 was 903.7, 1,547.6, and 390.8 billion yen, respectively. Although the COI of breast and prostate cancers was projected to increase, that of lung cancer COI was expected to decrease. In 2017, the average age at death was 68.8, 76.8, and 80.7 years for breast, lung, and prostate cancers, respectively. Conclusions: Patients with breast cancer die earlier than those with other types of cancer. The COI of breast cancer ( "young cancer ") was projected to increase slightly because of an increase in mortality costs, whereas that of prostate cancer ( "aged cancer ") was projected to increase because of an increase in direct costs. The COI of lung cancer ( "aging cancer ") was expected to decrease in 2020, despite the increase in deaths, as the impact of the decrease in human capital value outweighed that of the increase in deaths. Our findings will help prioritize future policymaking, such as cancer control research grants.

深入探究医院患者安全文化(PSC)对护理信息系统(NIS)相关的患者安全管理实践的影响.采用方便抽样,对上海市4所三甲医院的648名护士进行横断面调查,采用医院患者安全文化问卷2.0版、健康IT患者安全评价问卷分别测量PSC和NIS相关的患者安全管理实践.PSC总分为(132.98±12.29)分,积极回答率为83.06％;NIS患者安全管理实践总分为(56.47±6.90)分,积极回答率为79.20％;PSC所有维度与NIS患者安全管理实践呈正相关(r=0.543,P<0.05).多元分层回归分析结果显示,PSC的6个维度可以独立影响NIS患者安全管理实践(F=21.962,P<0.001),可解释NIS患者安全管理实践31.0％的方差变异.患者安全文化与NIS患者安全管理实践关系密切.医院管理者应重视持续支持患者安全和组织学习改进,切实推进开放性沟通和非惩罚性上报文化建设,在改善护士配置及工作节奏的同时注重其培训与教育,关注交接班与转运时信息的精准交换,科学、有效地提高NIS患者安全管理实践水平.

Abstract Background Epilepsy is one of the most common chronic neurological diseases that adversely impact the quality of life of patients and their families. The “Quality of Life of Childhood Epilepsy Questionnaire” (hereinafter referred to as “QOLCE-16”) is a 16-item measure that was designed to assess health-related quality of life (HRQOL) among children with epilepsy. The purpose of the study was to translate and evaluate the psychometric properties of the QOLCE-16. Methods The 10 steps of Principles of Good Practices for translation and cultural adaptation of measures were adopted to translate the QOLCE-16 into Chinese. After that, item analysis, floor effect and ceiling effect, internal consistency, test–retest reliabilities, content validity and construct validity were conducted to test its applicability in children with epilepsy in China. A total of 435 native Chinese-speaking parents with children who had epilepsy from one children’s hospital were invited to take part in the study, including a cognitive interview sample of 5 and a validation sample of 430. Results A total of 414 objects were enrolled in our study for psychometric testing. The results of the item analysis revealed QOLCE-16-C to have good discrimination, the floor effect and ceiling effect were 0.2% and 1.0% respectively, and each item was significantly related to the total scale (P < 0.001). The Cronbach’s α value was 0.938 and the test–retest reliability was 0.724. For validity, results showed that the QOLCE-16-C had good content validity. Exploratory factor analysis indicated it was reasonable that the QOLCE-16-C consists of four dimensions after rotation. Confirmatory factor analysis demonstrated good construct validity (χ2/df = 1.698, GFI = 0.913, CFI = 0.974, RMSEA = 0.058). Conclusion The Chinese version of QOLCE-16-C appears to be a culturally appropriate, valid and reliable tool to assess the health-related quality of life of children with epilepsy in China.

目的:探讨患者安全追踪日志在患者安全关键环节的应用效果.方法:根据患者安全的五大关键点,包括手术患者转运交接、查对落实、出入院流程、输血管理、特殊检查.每月组织专人负责进行追踪督查,并按照追踪的时间点形成追踪日志,通过逐项查找追踪日志中存在的薄弱点,对现有的护理流程进行改进和完善,以确保患者安全.结果:通过患者安全追踪日志,共总结出患者安全管理的薄弱点82个,各类患者安全关联环节执行的规范率(手术患者转运交接规范率、查对落实规范率、出入院流程规范率、输血管理规范率、特殊检查规范率)均显著提升,追踪实施前后两组有统计学差异,患者的满意度实施前后显著提升,实施前后有统计学差异,关键患者不良事件的发生率显著降低,实施前后违反查对和特殊检查有统计学差异.结论:患者安全追踪日志能够以患者为中心实现整个关键流程的还原,是追踪方法学在护理管理中的应用效果的体现,能够便于管理者查找出薄弱点,逐项完善,同时对追踪者个人也是全方面的提升,起到相互促进的作用.

目的 探讨父母喂养行为对学龄前儿童挑食的影响,检验儿童气质在其中的调节作用.方法 2020年6月采取方便抽样对上海市浦东新区6所幼儿园442名3～6岁学龄前儿童家长进行问卷调查.调查内容包括家长喂养行为、儿童挑食及儿童气质(生气沮丧、抑制控制).结果 父母鼓励健康饮食负向预测儿童挑食(β=-0.270,P＜0.001),父母以食物为奖励正向预测儿童挑食(β=0.210,P＜0.001);儿童生气沮丧特质分别调节父母鼓励健康饮食(β=0.125,t=2.207,P＜0.05)、以食物为奖励(β=0.141,t=3.465,P＜0.001)与儿童挑食之间的关系;儿童抑制控制在其中的调节作用不显著.结论 父母某些喂养行为与儿童挑食关系密切,且这种关系会因儿童气质中的情绪倾向性而有所不同.对于容易生气沮丧的学龄前儿童,家长多采用鼓励健康饮食,少用以食物为奖励的行为,可能有助于减少这类儿童的挑食问题.

目的 探讨祖辈、父辈喂养行为差异及其与学龄前儿童进食行为的关系,进一步明晰喂养人身份、喂养行为对进食行为的可能影响.方法 2020年5月-2021年1月,选择上海市浦东新区8所幼儿园和2处社区卫生服务中心的学龄前儿童的主要喂养人进行问卷调查.根据主要喂养人身份,采用1∶2倾向性评分匹配,形成祖辈组(72例)和父辈组(144例).结果 祖辈组和父辈组在饮食内容限制(t=4.72,P＜0.001)和饮食行为限制(t=2.13,P=0.036)维度得分的差异有统计学意义,其对应儿童在主动进食能力(t=-4.76,P＜0.001)、外因性进食(t=-5.07,P＜0.001)和情绪性进食(t=1.99,P=0.050)维度得分的差异有统计学意义.多变量方差分析发现,喂养人的饮食行为限制(F=1.82,P=0.086)、鼓励健康饮食(F=2.46,P=0.019)和饮食内容限制(F=3.69,P=0.001)对学龄前儿童进食行为有显著预测作用,喂养人身份与儿童进食行为之间无统计学关联(P＞0.10).结论 与祖辈相比,父辈喂养人更频繁地使用饮食行为限制和饮食内容限制,喂养行为而非喂养人身份与学龄前儿童的进食行为显著相关.

Abstract Background Primary liver cancer (PLC) is the fifth and second leading cause of death in Japan and Taiwan, respectively. The aim of this study was to compare the economic burden of PLC between the two countries using the cost of illness (COI) method and identify the key factors causing the different trends in the economic burdens of PLC. Materials and methods We calculated the COI every 3 years using governmental statistics of both countries (1996–2014 data for Japan and 2002–2014 data for Taiwan). The COI was calculated by summing the direct costs, morbidity costs, and mortality costs. We compared the COIs of PLC in both countries at the USD-based cost. The average exchange rate during the targeted years was used to remove the impact of foreign exchange volatility. Results From 1996 to 2014, the COI exhibited downward and upward trends in Japan and Taiwan, respectively. In Japan, the COI in 2014 was 0.70 times the value in 1996, and in Taiwan, the COI in 2014 was 1.16 times greater than that in 1996. The mortality cost was the greatest contributor in both countries and had the largest contribution ratio to the COI increase in Japan. However, the direct cost in Taiwan had the largest contribution ratio to the COI decrease. Conclusions To date, the COI of PLC in Japan has continuously decreased, whereas that in Taiwan has increased. Previous health policies and technological developments are thought to have accelerated the COI decrease in Japan and are expected to change the trend of COI of PLC, even in Taiwan.