This study aims to provide a brief overview of the history and development of global health education(GHE)as academic degree programs worldwide,and to identify GHE’s development opportunities and obstacles in China.T...This study aims to provide a brief overview of the history and development of global health education(GHE)as academic degree programs worldwide,and to identify GHE’s development opportunities and obstacles in China.This is a state-of-the-art review of published and unpublished information that described and evaluated disciplinary development of global health degree programs worldwide,written in English,and published or shared between 1990 and 2020.Data were derived from official websites of leading global health institutions,like“Google Scholar”,“PubMed”,and unpublished information such as presentation files and unpublished manuscripts collected from knowledgeable leaders in the field.We retrieved and reviewed a total of 35 articles and a large amount of unpublished information or sources on the internet.Global Health emerged as a new discipline around the end of the last millennium and proliferated in the last two decades in developed nations,especially the United States and the United Kingdom.The development of China’s GHE programs was built on China’s increasing engagement in global health affairs and research.In 2012,Wuhan University established the first official global health department in China.Several universities such as Peking University and Duke Kunshan University subsequently set up departments or programs to offer undergraduate and postgraduate majors and degrees.The first school-level global health unit was established in Shanghai in 2019.The Consortium of Chinese Universities for Global Health(CCUGH)grew from 10 founding members in 2013 to 25 in 2020.Major desirable attributes“unique”to students majoring in global health include global-mindedness,health interests,compassion,intercultural sensitivity,and adventurous spirit.Graduates from GHE programs have a diverse set of career choices spanning research,government,not-for-profit,and private sector occupations.We identified a number of strengths,weaknesses,opportunities,and threats to the future development of GHE in China.To ensure sustainable future growth,we advocate addressing the following key aspects:(1)clearer disciplinary distinctions;(2)multidisciplinary collaborations;(3)public-sector investments;and(4)non-public sectors participation.Amidst China’s increasing engagement in health affairs globally and the proliferation of GHE programs in developed nations,China has experienced fast growth in GHE degree programs since 2012 while a number of challenges remain for its future development.展开更多
Emerging infectious diseases(EIDs),whether newly identified or re-emerging in human and animal populations,pose significant threats to global public health.China has experienced multiple EIDs outbreaks in recent years...Emerging infectious diseases(EIDs),whether newly identified or re-emerging in human and animal populations,pose significant threats to global public health.China has experienced multiple EIDs outbreaks in recent years,underscoring the need for robust surveillance and early warning systems.Although China has established surveillance systems for events affecting climate,wildlife,livestock and poultry,and humans,the current systems remain inadequate for the early detection,monitoring,and prevention of zoonotic spillover events.The“One Health”approach,which integrates human,animal,and environmental health,offers a comprehensive strategy for mitigating EIDs risks.This study reviews China's national-level surveillance and early warning systems from a“One Health”perspective,highlighting key limitations and proposing future directions to enhance preparedness and response capabilities.The findings are intended to inform policy improvements and strengthen interdisciplinary collaboration for effective EIDs management.展开更多
背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存...背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存者的长期用药行为、依从态度与行为,并识别与用药行为相关的因素。方法基于2017年在河北省南和县5个乡镇、60个村开展的农村地区脑卒中患者管理研究——中国农村地区脑卒中管理的系统整合技术辅助照护模式研究(SINEMA),本研究对象为曾参与过2017年SINEMA研究且同意参与2024年5—7月随访并完成调查的所有脑卒中幸存者。调查研究对象降压药、他汀类药、抗血小板药和降糖药的用药情况,并使用Maastricht Utrecht Adherence in Hypertension-16(MUAH-16)量表评估其用药依从态度(积极的医疗与药物态度维度)。采用Morisky Green Levine量表测量服用4类药物的患者的用药依从行为(得分为0分定义为依从性高)。使用描述性分析展示患者基本特征、用药依从性状况和多因素Logistic回归分析识别出的相关因素。结果本研究共纳入912名研究对象,平均年龄为(72.0±7.9)岁,其中女性占46.1%(420/912);在药物服用方面,有772例(84.6%)患者自报服用降压药,547例(59.9%)服用抗血小板药,427例(46.8%)服用他汀类药,以及203例(22.3%)服用降糖药。在正在服用4类药物的人群中,降糖药服用依从性为77.3%(157/203),降压药服用依从性为71.5%(552/772)、抗血小板药物服用依从性为71.2%(392/547),他汀类药服用依从性为71.2%(304/427)。调查结果显示49.2%(449/912)的患者具有积极的医疗与药物态度。多因素Logistic回归分析结果显示,在服用降压药的患者中,受教育程度较高(中学及以上:OR=1.87,95%CI=1.13~3.09)、具有积极的医疗与药物态度(OR=1.53,95%CI=1.08~2.17)的患者用药依从性高,可独立完成工作(OR=0.56,95%CI=0.32~0.99)、去村卫生所≥1次/月者(OR=0.68,95%CI=0.53~0.88)用药依从性较低(P<0.05)。在服用抗血小板药的患者中,受教育程度较高(中学及以上:OR=1.79,95%CI=1.09~2.96)的患者用药依从性较高,出血性脑卒中患者(OR=0.55,95%CI=0.31~0.98)用药依从性较低(P<0.05)。在服用他汀类药的患者中,去村卫生所≥1次/月者(OR=0.67,95%CI=0.46~0.98)用药依从性较低(P<0.05)。在服用降糖药的患者中,男性(OR=0.21,95%CI=0.06~0.73)、注册慢性疾病重大疾病保险(OR=0.34,95%CI=0.15~0.79)、去村卫生所≥1次/月者(OR=0.34,95%CI=0.13~0.89)用药依从性较低(P<0.05)。结论本研究结果显示,农村地区具有较长疾病史的脑卒中幸存者具有相对较高的用药依从性,但仍有近三成患者未能规律依从诊疗建议,不同药物类型依从行为的影响因素存在差异,应开展个性化的用药依从干预,增加患者的用药依从性及二级预防行为。展开更多
Implementing national to community-based 'One Health' strategy for human,animal and environmental challenges and migrating-led consequences offer great opportunities,and its value of sustained development and ...Implementing national to community-based 'One Health' strategy for human,animal and environmental challenges and migrating-led consequences offer great opportunities,and its value of sustained development and wellbeing is an imperative.'One Health' strategy in policy commitment,partnership and financial investment are much needed in advocacy,contextual health human-animal and environmental development.Therefore,appropriate and evidence-based handling and management strategies in moving forward universal health coverage and sustainable development goals (SDGs) are essential components to the China-Africa health development initiatives.It is necessary to understand how to strengthen robust and sustainable 'One Health' approach implementation in national and regional public health and disaster risk reduction programs.Understanding the foundation of'One Health' strategy in China-Africa public health cooperation is crucial in fostering health systems preparedness and smart response against emerging and re-emerging threats and epidemics.Building the value of China-Africa 'One Health' strategy partnerships,frameworks and capacity development and implementation through leveraging on current and innovative China-Africa health initiatives,but also,mobilizing efforts on climatic changes and disasters mitigation and lifestyle adaptations strategies against emerging and current infectious diseases threats are essential to establish epidemic surveillance-response system under the concept of global collaborative coordination and lasting financing mechanisms.Further strengthen local infrastructure and workforce capacity,participatory accountability and transparency on 'One Health' approach will benefit to set up infectious diseases of poverty projects,and effective monitoring and evaluation systems in achieving African Union 2063 Agenda and SDGs targets both in Africa and China.展开更多
目的以整合技术接受与使用模型(unified theory of acceptance and use of technology,UTAUT)作为理论基础,探讨2型糖尿病患者运动手环的实际佩戴行为及其影响因素。方法2019年在北京市通州区、顺义区22个社区卫生服务中心,采用纵向追...目的以整合技术接受与使用模型(unified theory of acceptance and use of technology,UTAUT)作为理论基础,探讨2型糖尿病患者运动手环的实际佩戴行为及其影响因素。方法2019年在北京市通州区、顺义区22个社区卫生服务中心,采用纵向追踪设计,通过面对面问卷调查收集2型糖尿病患者的社会人口学特征、糖尿病病史及基于UTAUT理论的行为意向数据,并利用运动手环后台持续监测90 d佩戴行为。数据分析采用轨迹分析动态分组患者佩戴行为模式,并通过结构方程模型结合稳健最小二乘法解析影响因素。结果共纳入725名2型糖尿病患者,其中男性342名,女性383名,平均年龄为(60.3±7.6)岁。患者病程为(5.8±3.5)年,66.9%的研究对象无糖尿病相关并发症。轨迹分析依据研究对象90 d内佩戴手环的实际情况,将研究对象分为5组:从未使用组(37.1%,从未佩戴过手环)、快速放弃组(23.2%,仅在初始15 d内佩戴过)、逐步放弃组(10.2%,每15 d内佩戴天数由最初的8 d左右逐步降为0)、中等坚持组(11.7%,始终佩戴,每15 d内的累计佩戴天数约为5 d左右)、高度坚持组(17.9%,始终佩戴,每15 d中2/3以上的时间都在佩戴)。结构方程模型结果显示,模型拟合良好;比较拟合指数=0.933,塔克-刘易斯指数=0.910,近似误差均方根=0.031,加权均方根残差=0.941。在2型糖尿病患者中,使用意向越高,长期佩戴行为越好(直接效应值=0.266,P=0.003)。佩戴行为的主要影响因素为可观察性(间接效应=0.252,P<0.001),其次为努力期望(间接效应=0.198,P<0.001)和绩效期望(间接效应=0.122,P<0.001),感知风险影响虽有统计学意义(间接效应=-0.037,P<0.001),但效应值较小。此外,男性佩戴天数高于女性(直接效应值=-0.104,P=0.019)。结论社区2型糖尿病患者的运动佩戴行为尚可。运动手环的可观察性、努力期望和绩效期望会影响其佩戴意向和实际佩戴行为。在未来可穿戴设备的干预中,优先选择操作简便的设备,方便患者感知和观察其效用,降低风险疑虑,达到长期佩戴的目的。展开更多
基金partially funded by the National Natural Science Foundation of China(Grant No.NSFC 71774075).
文摘This study aims to provide a brief overview of the history and development of global health education(GHE)as academic degree programs worldwide,and to identify GHE’s development opportunities and obstacles in China.This is a state-of-the-art review of published and unpublished information that described and evaluated disciplinary development of global health degree programs worldwide,written in English,and published or shared between 1990 and 2020.Data were derived from official websites of leading global health institutions,like“Google Scholar”,“PubMed”,and unpublished information such as presentation files and unpublished manuscripts collected from knowledgeable leaders in the field.We retrieved and reviewed a total of 35 articles and a large amount of unpublished information or sources on the internet.Global Health emerged as a new discipline around the end of the last millennium and proliferated in the last two decades in developed nations,especially the United States and the United Kingdom.The development of China’s GHE programs was built on China’s increasing engagement in global health affairs and research.In 2012,Wuhan University established the first official global health department in China.Several universities such as Peking University and Duke Kunshan University subsequently set up departments or programs to offer undergraduate and postgraduate majors and degrees.The first school-level global health unit was established in Shanghai in 2019.The Consortium of Chinese Universities for Global Health(CCUGH)grew from 10 founding members in 2013 to 25 in 2020.Major desirable attributes“unique”to students majoring in global health include global-mindedness,health interests,compassion,intercultural sensitivity,and adventurous spirit.Graduates from GHE programs have a diverse set of career choices spanning research,government,not-for-profit,and private sector occupations.We identified a number of strengths,weaknesses,opportunities,and threats to the future development of GHE in China.To ensure sustainable future growth,we advocate addressing the following key aspects:(1)clearer disciplinary distinctions;(2)multidisciplinary collaborations;(3)public-sector investments;and(4)non-public sectors participation.Amidst China’s increasing engagement in health affairs globally and the proliferation of GHE programs in developed nations,China has experienced fast growth in GHE degree programs since 2012 while a number of challenges remain for its future development.
基金funded by the National Key Research and Development Program of China(grant number 2022YFF0802400)the Science and Technology Innovation Action Plan of Shanghai(grant number 24J22800900).
文摘Emerging infectious diseases(EIDs),whether newly identified or re-emerging in human and animal populations,pose significant threats to global public health.China has experienced multiple EIDs outbreaks in recent years,underscoring the need for robust surveillance and early warning systems.Although China has established surveillance systems for events affecting climate,wildlife,livestock and poultry,and humans,the current systems remain inadequate for the early detection,monitoring,and prevention of zoonotic spillover events.The“One Health”approach,which integrates human,animal,and environmental health,offers a comprehensive strategy for mitigating EIDs risks.This study reviews China's national-level surveillance and early warning systems from a“One Health”perspective,highlighting key limitations and proposing future directions to enhance preparedness and response capabilities.The findings are intended to inform policy improvements and strengthen interdisciplinary collaboration for effective EIDs management.
文摘背景良好用药依从性可显著降低脑卒中患者复发风险,是脑卒中患者二级预防的关键。然而,现有研究多针对农村脑卒中患者的短期用药及依从行为,而对同类患者的长期用药依从行为的研究较为有限。目的本研究旨在分析中国农村地区脑卒中幸存者的长期用药行为、依从态度与行为,并识别与用药行为相关的因素。方法基于2017年在河北省南和县5个乡镇、60个村开展的农村地区脑卒中患者管理研究——中国农村地区脑卒中管理的系统整合技术辅助照护模式研究(SINEMA),本研究对象为曾参与过2017年SINEMA研究且同意参与2024年5—7月随访并完成调查的所有脑卒中幸存者。调查研究对象降压药、他汀类药、抗血小板药和降糖药的用药情况,并使用Maastricht Utrecht Adherence in Hypertension-16(MUAH-16)量表评估其用药依从态度(积极的医疗与药物态度维度)。采用Morisky Green Levine量表测量服用4类药物的患者的用药依从行为(得分为0分定义为依从性高)。使用描述性分析展示患者基本特征、用药依从性状况和多因素Logistic回归分析识别出的相关因素。结果本研究共纳入912名研究对象,平均年龄为(72.0±7.9)岁,其中女性占46.1%(420/912);在药物服用方面,有772例(84.6%)患者自报服用降压药,547例(59.9%)服用抗血小板药,427例(46.8%)服用他汀类药,以及203例(22.3%)服用降糖药。在正在服用4类药物的人群中,降糖药服用依从性为77.3%(157/203),降压药服用依从性为71.5%(552/772)、抗血小板药物服用依从性为71.2%(392/547),他汀类药服用依从性为71.2%(304/427)。调查结果显示49.2%(449/912)的患者具有积极的医疗与药物态度。多因素Logistic回归分析结果显示,在服用降压药的患者中,受教育程度较高(中学及以上:OR=1.87,95%CI=1.13~3.09)、具有积极的医疗与药物态度(OR=1.53,95%CI=1.08~2.17)的患者用药依从性高,可独立完成工作(OR=0.56,95%CI=0.32~0.99)、去村卫生所≥1次/月者(OR=0.68,95%CI=0.53~0.88)用药依从性较低(P<0.05)。在服用抗血小板药的患者中,受教育程度较高(中学及以上:OR=1.79,95%CI=1.09~2.96)的患者用药依从性较高,出血性脑卒中患者(OR=0.55,95%CI=0.31~0.98)用药依从性较低(P<0.05)。在服用他汀类药的患者中,去村卫生所≥1次/月者(OR=0.67,95%CI=0.46~0.98)用药依从性较低(P<0.05)。在服用降糖药的患者中,男性(OR=0.21,95%CI=0.06~0.73)、注册慢性疾病重大疾病保险(OR=0.34,95%CI=0.15~0.79)、去村卫生所≥1次/月者(OR=0.34,95%CI=0.13~0.89)用药依从性较低(P<0.05)。结论本研究结果显示,农村地区具有较长疾病史的脑卒中幸存者具有相对较高的用药依从性,但仍有近三成患者未能规律依从诊疗建议,不同药物类型依从行为的影响因素存在差异,应开展个性化的用药依从干预,增加患者的用药依从性及二级预防行为。
文摘Implementing national to community-based 'One Health' strategy for human,animal and environmental challenges and migrating-led consequences offer great opportunities,and its value of sustained development and wellbeing is an imperative.'One Health' strategy in policy commitment,partnership and financial investment are much needed in advocacy,contextual health human-animal and environmental development.Therefore,appropriate and evidence-based handling and management strategies in moving forward universal health coverage and sustainable development goals (SDGs) are essential components to the China-Africa health development initiatives.It is necessary to understand how to strengthen robust and sustainable 'One Health' approach implementation in national and regional public health and disaster risk reduction programs.Understanding the foundation of'One Health' strategy in China-Africa public health cooperation is crucial in fostering health systems preparedness and smart response against emerging and re-emerging threats and epidemics.Building the value of China-Africa 'One Health' strategy partnerships,frameworks and capacity development and implementation through leveraging on current and innovative China-Africa health initiatives,but also,mobilizing efforts on climatic changes and disasters mitigation and lifestyle adaptations strategies against emerging and current infectious diseases threats are essential to establish epidemic surveillance-response system under the concept of global collaborative coordination and lasting financing mechanisms.Further strengthen local infrastructure and workforce capacity,participatory accountability and transparency on 'One Health' approach will benefit to set up infectious diseases of poverty projects,and effective monitoring and evaluation systems in achieving African Union 2063 Agenda and SDGs targets both in Africa and China.
文摘目的以整合技术接受与使用模型(unified theory of acceptance and use of technology,UTAUT)作为理论基础,探讨2型糖尿病患者运动手环的实际佩戴行为及其影响因素。方法2019年在北京市通州区、顺义区22个社区卫生服务中心,采用纵向追踪设计,通过面对面问卷调查收集2型糖尿病患者的社会人口学特征、糖尿病病史及基于UTAUT理论的行为意向数据,并利用运动手环后台持续监测90 d佩戴行为。数据分析采用轨迹分析动态分组患者佩戴行为模式,并通过结构方程模型结合稳健最小二乘法解析影响因素。结果共纳入725名2型糖尿病患者,其中男性342名,女性383名,平均年龄为(60.3±7.6)岁。患者病程为(5.8±3.5)年,66.9%的研究对象无糖尿病相关并发症。轨迹分析依据研究对象90 d内佩戴手环的实际情况,将研究对象分为5组:从未使用组(37.1%,从未佩戴过手环)、快速放弃组(23.2%,仅在初始15 d内佩戴过)、逐步放弃组(10.2%,每15 d内佩戴天数由最初的8 d左右逐步降为0)、中等坚持组(11.7%,始终佩戴,每15 d内的累计佩戴天数约为5 d左右)、高度坚持组(17.9%,始终佩戴,每15 d中2/3以上的时间都在佩戴)。结构方程模型结果显示,模型拟合良好;比较拟合指数=0.933,塔克-刘易斯指数=0.910,近似误差均方根=0.031,加权均方根残差=0.941。在2型糖尿病患者中,使用意向越高,长期佩戴行为越好(直接效应值=0.266,P=0.003)。佩戴行为的主要影响因素为可观察性(间接效应=0.252,P<0.001),其次为努力期望(间接效应=0.198,P<0.001)和绩效期望(间接效应=0.122,P<0.001),感知风险影响虽有统计学意义(间接效应=-0.037,P<0.001),但效应值较小。此外,男性佩戴天数高于女性(直接效应值=-0.104,P=0.019)。结论社区2型糖尿病患者的运动佩戴行为尚可。运动手环的可观察性、努力期望和绩效期望会影响其佩戴意向和实际佩戴行为。在未来可穿戴设备的干预中,优先选择操作简便的设备,方便患者感知和观察其效用,降低风险疑虑,达到长期佩戴的目的。
