BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
This study aimed to evaluate the association of a healthy lifestyle pattern with mortality risk among patients with type 2 diabetes mellitus(T2DM).Data were derived from a prospective cohort study enrolling 13776Chine...This study aimed to evaluate the association of a healthy lifestyle pattern with mortality risk among patients with type 2 diabetes mellitus(T2DM).Data were derived from a prospective cohort study enrolling 13776Chinese patients with T2DM.A healthy lifestyle pattern was constructed based on six lifestyle factors,including smoking status,alcohol consumption,dietary habits,physical activity,sedentary time,and sleep duration.Multivariate Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for all-cause and cause-specific mortality.During a median follow-up of 9.78 years,2497 deaths were recorded.Compared with T2DM patients with a lifestyle pattern scoring 0–2,those scoring 5–6 had a 40%lower risk for all-cause mortality(HR=0.60,95%CI:0.52–0.69),a 33%lower risk for cardiovascular disease mortality(HR=0.67,95%CI:0.52–0.86),and a 25%lower risk for cancer mortality(HR=0.75,95%CI:0.58–0.97).Additionally,we found that the association between the lifestyle pattern and all-cause mortality risk was stronger in females than in males(P for interaction<0.05).In conclusion,adherence to a healthy lifestyle pattern is associated with a decreased risk of all-cause,cardiovascular disease,and cancer mortality.These findings have important implications for reducing premature mortality among patients with T2DM.展开更多
In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing...In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.展开更多
Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabo...Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.展开更多
Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has b...Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has been associated with the onset of various conditions,including acute respiratory infections,asthma,atopic dermatitis,and food allergies^([2]).Multiple factors,including age,sun exposure,adiposity,and genetics,influence vitamin D levels^([2,3]).Increasing attention has been directed toward understanding the environmental determinants that may influence vitamin D status.Given the potential of metallic pollutants to disrupt endocrine function and their ubiquity in the environment,investigating the effects of metal exposure on human vitamin D status,particularly in vulnerable populations,is imperative.展开更多
Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of dru...Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.展开更多
Objective:Mental disorders of the elderly population in China deserve attention.Social health is significantly associated with depression.This study aimed to evaluate the rate of depressive symptoms and to test the re...Objective:Mental disorders of the elderly population in China deserve attention.Social health is significantly associated with depression.This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults.Methods:We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province,China.Face-to-face interviews were used to complete a structured questionnaire for all participants.We used the Social Health Scale for the Elderly(SHSE)to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms.Multivariate logistic regression was used to evaluate the asso?ciation between social health status and depressive symptoms.Results:Of the total of 3757 participants included,1887(50.23%)were female,and the mean±standard deviation(SD)age was(70.0±8.3)years.The rate of depressive symptoms was 25.92%.The social health score was higher in non?depressed participants than in depressed participants(raw score 50.7 vs.48.3,P<0.001).Participants with"moderate”or"good”social health had a significantly lower risk of depressive symptoms than those with“poor"social health(odds ratio(OR)=0.55,95%con fide nee interval(Cl):0.46-0.66 for moderate social health;OR=0.45,95%Cl:0.35-0.60 for good social health).The association between social health and depressive symptoms was con sistent across several subgroups.Con clusi ons:Social health is signify cantly inversely associated with depressive symptoms.The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits,but systematic assessment to guide intervention merits further investigation.展开更多
The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor populations bec...The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor populations became victims of the novel corona virus.Therefore,this study focuses on Africa’s readiness to integrate telemedicine into the weak health systems and its adoption may help alleviate poor healthcare and poverty after COVID-19.We conducted a narrative review through different search strategies in Scopus on January 20,2021,to identify available literature reporting implementation of various telemedicine modes in Africa from January 1,2011 to December 31,2020.We summarized 54 studies according to geographies,field,and implementation methods.The results show a willingness to adopt telemedicine in the resource-poor settings and hard-to-reach populations,which will bring relief to the inadequate healthcare systems and alleviate poverty of those who feel the burden of healthcare cost the most.With adequate government financing,telemedicine promises to enhance the treating of communicable and non-communicable diseases as well as support health infrastructure.It can also alleviate poverty among vulnerable groups and hard-to-reach communities in Africa with adequate government financing.However,given the lack of funding in Africa,the challenges in implementing telemedicine require global and national strategies before it can yield promising results.This is especially true in regards to alleviating the multidimensionality of poverty in post-COVID-19 Africa.展开更多
Objective: There is strong evidence supporting the impact of health care provider advice on patients’ smoking behavior. This paper examines adult smoker reports of health care provider smoking cessation interventions...Objective: There is strong evidence supporting the impact of health care provider advice on patients’ smoking behavior. This paper examines adult smoker reports of health care provider smoking cessation interventions. Design: The 2010 Minnesota Adult Tobacco Survey (MATS) is a random digit dial telephone survey with 7057 Minnesota adults. Both landline and mobile telephone samples were included. These samples were combined and weighted to represent the population of adults in Minnesota. Results: Among adult Minnesotans, 16.1% were current smokers, 80.9% reported seeing a health care provider in the past 12 months and 80.2% of those adults were asked if they smoke. Among smokers who saw any provider in the past 12 months, 94.4% reported they were asked about smoking and 71.8% were advised not to smoke. In contrast, 43.9% of smokers received referrals from a health care provider and among those, 37.5% were recommended medications and 24.8% were referred to a quit smoking program. Conclusion: Given the large body of evidence supporting cessation interventions by health care providers, the increase in use of electronic medical records and the availability and success of evidence-based cessation programs, efforts to improve rates of identifying and treating each tobacco user are needed. Further research is needed to explore how cessation intervention responsibilities can be shared among the clinical team and integrated into ongoing clinical care.展开更多
Statistics Norway has been engaged in the development of official statistics on accidents at work for the last ten years and represents Norway in international bodies like Eurostat working groups. Some of the work was...Statistics Norway has been engaged in the development of official statistics on accidents at work for the last ten years and represents Norway in international bodies like Eurostat working groups. Some of the work was documented and presented back in 2011 at the ISI Dublin convention and a review of further developments the last four years could shed even more light over the efforts made. There has been implemented a new data collection system at the national level that involves data and files based on forms for reporting accidents at work being sent from the Norwegian Labour and Welfare Administration （NLW） to Statistics Norway. Nevertheless there are still some challenges to be met. These include the use of different versions of the NLW forms, the scanning and extraction of data in the NLW, the implementation of a secure electronic solution for transmitting data between the NLW and Statistics Norway, the reading and interpretation of tiff-files and the lessons to be learned from other countries. The ambition is that Statistics Norway produces methodological sound official statistics on accidents at work within the first half of 2015 and transmits data and files to Eurostat that are necessary and sufficient to fulfil EU regulations within the first half of 2016.展开更多
Background:The“two-week visiting rate in those needing to visit”has been examined extensively as an important indicator of healthcare seeking behavior in China.Nevertheless,its relationship with health behaviors,suc...Background:The“two-week visiting rate in those needing to visit”has been examined extensively as an important indicator of healthcare seeking behavior in China.Nevertheless,its relationship with health behaviors,such as physical activity,remains unknown.In addition,a significant difference exists between urban and rural Chinese people in terms of physical activity and healthcare seeking behavior.This study sought to investigate the relationship between physical activity and the two-week visiting rate by conducting a stratified analysis.Methods:The analysis included 5,801 participants aged above 15 years old.Multivariable logistic regression was applied to analyze the association after adjusting for possible confounding variables.Urban and rural differences were investigated using stratified analysis.Results:Adjusted estimates showed that those who were physically active were more likely to visit a healthcare facility,but only among the whole sample(adjusted odds ratio(AOR)=1.45,95%confidence interval(CI):1.26.1.66)and the rural sample(AOR=1.56,95%CI:1.21.2.01),and not among the urban sample.Conclusions:Educating people on physical activity may help in improving healthcare seeking behavior and vice versa.Additionally,health interventions may be tailored based on different settings.展开更多
BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are...BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.展开更多
Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2...Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2 days. However,untreated AMS can progress to life-threatening conditions such as high-altitude cerebral and pulmonary edema(HACE and HAPE, respectively)^([1]).展开更多
BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patie...BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.展开更多
BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dyn...BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio(APR)in hepatitis B progression to HCC.METHODS Data from 4843 patients with hepatitis B(January 2015 to January 2024)were analyzed.HCC incidence rates in males and females were compared using the log-rank test.Data were evaluated using Kaplan–Meier analysis.The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time.Furthermore,Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.RESULTS The incidence of HCC was higher in males.To ensure the model’s normality assumption,this study applied a logarithmic transformation to APR,yielding ratio.Ratio levels were higher in females(t=5.26,P<0.01).A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males(95%CI:1.653-2.431)and a 2.273-fold higher risk in females(95%CI:1.620-3.190).CONCLUSION Males are more prone to HCC,while females have higher APR levels.Despite no baseline APR link,rising APR indicates a higher HCC risk.展开更多
Preterm birth(PTB),defined as a live birth occurring before 37 weeks of gestation,is associated with numerous adverse outcomes.These include poor growth,respiratory disorders,heightened susceptibility to infections be...Preterm birth(PTB),defined as a live birth occurring before 37 weeks of gestation,is associated with numerous adverse outcomes.These include poor growth,respiratory disorders,heightened susceptibility to infections because of low body weights,underdeveloped body functions,and low immunity.Such complications considerably affect infant health,pose life-threatening risks,and impose substantial social and economic burdens.展开更多
BACKGROUND Few studies have specifically modeled the risk of venous thromboembolism(VTE)for postoperative hepatocellular carcinoma(HCC)patients,although HCC is the third leading cause of cancer death worldwide.This st...BACKGROUND Few studies have specifically modeled the risk of venous thromboembolism(VTE)for postoperative hepatocellular carcinoma(HCC)patients,although HCC is the third leading cause of cancer death worldwide.This study aimed to develop and validate a nomogram that accurately predicts the risk of VTE in patients after HCC surgery.AIM To develop and validate a nomogram to accurately predict the risk of VTE in postoperative HCC patients by integrating clinical and laboratory risk factors.The model seeks to provide a user-friendly tool for identifying high-risk individuals who may benefit from targeted anticoagulation therapy,thereby improving clinical decision-making and patient outcomes.METHODS Data from patients who underwent HCC surgery at Chongqing University Cancer Hospital in China were analyzed.Through univariate and multivariate logistic regression analyses,independent risk factors for VTE were identified and integrated into a nomogram.The predictive performance of the nomogram was assessed via receiver operating characteristic curves,calibration curves,decision curve analysis and other relevant metrics.RESULTS Of 905 postoperative HCC patients were included in the study.The nomogram incorporated eight independent risk factors for VTE:Karnofsky Performance Scale,base disease,cancer stage(tumor-node-metastasis),chemotherapy,D-dimer concentration,white blood cell count,hemoglobin,and fibrinogen.The C-index for the nomogram model was 0.825 in the training cohort and 0.820 in the validation cohort,indicating good discriminative ability.Calibration plots of the model revealed high concordance between the predicted probabilities and observed outcomes.CONCLUSION We developed and validated a novel nomogram that can accurately estimate the risk of VTE in individual postoperative HCC patients.This model can identify high-risk patients who may benefit from targeted anticoagulation therapy.展开更多
BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehen...BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehensive analysis of demographic,clinicopathological,haematological,and follow-up data to identify independent prognostic factors.METHODS We conducted a prospective cohort study in China involving rectal cancer patients and applied Cox regression and least absolute shrinkage and selection operator regression to assess the significance of various variables as independent prognostic factors for OS.The identified factors were integrated into a nomogram model,which was evaluated for predictive accuracy via the C-index,area under the curve(AUC),calibration curve,and decision curve analysis(DCA).RESULTS Multivariate analysis revealed independent predictors of OS,including the Karnofsky performance status,age,sex,TNM stage,chemotherapy,surgery,targeted therapy,β2-microglobulin,lactate dehydrogenase,and the neutrophil-to-lymphocyte ratio.The nomogram demonstrated a C-index of 0.80 for the training and validation cohorts,with AUC values indicating high predictive accuracy for 1-year,3-year,and 5-year OS.The calibration curves confirmed the model's excellent agreement with the observed survival rates,and DCA revealed the superior clinical utility of the nomogram over the TNM staging system.CONCLUSION In this study,a novel prognostic model that accurately predicts the OS of rectal cancer patients was developed.The model exhibited excellent discriminatory and calibration capabilities,thus offering a reliable tool for health care professionals to estimate patient survival.展开更多
Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfa...Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.展开更多
Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants fr...Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted.A standardized questionnaire was used to collect data on fish consumption.Participants were stratified into low-and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores.Hazard ratios(HRs)and 95%confidence intervals(CIs)were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(SI).Results During 703,869 person-years of follow-up,2,773 incident stroke events were identified.Higher fish consumption was associated with a lower risk of stroke,particularly among moderate-to-high-risk individuals(HR=0.53,95%CI:0.47-0.60)than among low-risk individuals(HR=0.64,95%CI:0.49-0.85).A significant additive interaction between fish consumption and predicted stroke risk was observed(RERI=4.08,95%CI:2.80-5.36;SI=1.64,95%CI:1.42-1.89;AP=0.36,95%CI:0.28-0.43).Conclusion Higher fish consumption was associated with a lower risk of stroke,and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.展开更多
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
基金supported by the Jiangsu Provincial Health Commission Medical Research Project(Grant Nos.M2020085 to J.S.and H2023022 to X.F.)the Outstanding Youth Fund of Jiangsu Natural Science Foundation(Grant No.BK20230005 to D.H.)Suzhou Science and Technology Bureau Livelihood Technology-Technology Demonstration Project(Grant No.SS202010 to Y.L.)。
文摘This study aimed to evaluate the association of a healthy lifestyle pattern with mortality risk among patients with type 2 diabetes mellitus(T2DM).Data were derived from a prospective cohort study enrolling 13776Chinese patients with T2DM.A healthy lifestyle pattern was constructed based on six lifestyle factors,including smoking status,alcohol consumption,dietary habits,physical activity,sedentary time,and sleep duration.Multivariate Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)for all-cause and cause-specific mortality.During a median follow-up of 9.78 years,2497 deaths were recorded.Compared with T2DM patients with a lifestyle pattern scoring 0–2,those scoring 5–6 had a 40%lower risk for all-cause mortality(HR=0.60,95%CI:0.52–0.69),a 33%lower risk for cardiovascular disease mortality(HR=0.67,95%CI:0.52–0.86),and a 25%lower risk for cancer mortality(HR=0.75,95%CI:0.58–0.97).Additionally,we found that the association between the lifestyle pattern and all-cause mortality risk was stronger in females than in males(P for interaction<0.05).In conclusion,adherence to a healthy lifestyle pattern is associated with a decreased risk of all-cause,cardiovascular disease,and cancer mortality.These findings have important implications for reducing premature mortality among patients with T2DM.
基金supported by the Research Funds of the Center for Big Data and Population Health of IHM(grant number JKS2022015)the Key Scientific Research Fund of the Anhui Provincial Education Department(grant number2023AH050610)the Anhui Natural Science Foundation(grant number 1808085QH252)。
文摘In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.
基金supported by the National Science and Technology Major Program for Noncommunicable Chronic Diseases(2023ZD0503500)the National Natural Science Foundation of China(82030102,12126602,91857118)+1 种基金the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003)the National High Level Hospital Clinical Research Funding(2022-GSP-GG-1,2022-GSP-GG-2)。
文摘Objective Evidence suggests that depleted gut microbialα-diversity is associated with hypertension;however,whether metabolic markers affect this relationship remains unknown.We aimed to determine the potential metabolites mediating the associations ofα-diversity with blood pressure(BP)and BP variability(BPV).Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study.The 24-hour,daytime,and nighttime BP and BPV were calculated based on ambulatory BP measurements.Linear mixed models were used to characterize the relationships betweenα-diversity(Shannon and Chao1 index)and BP indices.Mediation analyses were performed to assess the contribution of metabolites to the observed associations.The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants.Results Gut microbial richness(Chao1)was negatively associated with 24-hour systolic BP,daytime systolic BP,daytime diastolic BP,24-hour systolic BPV,and nighttime systolic BPV(P<0.05).Moreover,26 metabolites were strongly associated with richness(Bonferroni P<0.05).Among them,four key metabolites(imidazole propionate,2-hydroxy-3-methylbutyric acid,homovanillic acid,and hydrocinnamic acid)mediated the associations between richness and BP indices(proportions of mediating effects:14.1%–67.4%).These key metabolites were also associated with hypertension in the prospective cohort.For example,each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent(OR[95%CI]=0.90[0.82,0.99];P=0.03)and incident hypertension(HR[95%CI]=0.83[0.71,0.96];P=0.01).Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV,and that certain metabolites mediate these associations.These findings provide novel insights into the pathogenesis and prevention of hypertension.
基金supported by grants from the National Natural Science Foundation of China(G.F.Wang,grant number 82204071)(P.Y.Su,grant numbers 81874268 and 82473655)the Research Funds of the Center for Big Data and Population Health of IHM(P.Y.Su,No.JKS2023016)Anhui Provincial Health Commission Scientific Research Project(Y.Zhou,No.AHWJ2023A30027)。
文摘Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has been associated with the onset of various conditions,including acute respiratory infections,asthma,atopic dermatitis,and food allergies^([2]).Multiple factors,including age,sun exposure,adiposity,and genetics,influence vitamin D levels^([2,3]).Increasing attention has been directed toward understanding the environmental determinants that may influence vitamin D status.Given the potential of metallic pollutants to disrupt endocrine function and their ubiquity in the environment,investigating the effects of metal exposure on human vitamin D status,particularly in vulnerable populations,is imperative.
基金a grant from the National Natural Science Foundation (No.30271140, 2002)
文摘Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.
基金Project supported by the Ministry of Science and Technology of the People’s Republic of China(No.2015FY111600)
文摘Objective:Mental disorders of the elderly population in China deserve attention.Social health is significantly associated with depression.This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults.Methods:We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province,China.Face-to-face interviews were used to complete a structured questionnaire for all participants.We used the Social Health Scale for the Elderly(SHSE)to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms.Multivariate logistic regression was used to evaluate the asso?ciation between social health status and depressive symptoms.Results:Of the total of 3757 participants included,1887(50.23%)were female,and the mean±standard deviation(SD)age was(70.0±8.3)years.The rate of depressive symptoms was 25.92%.The social health score was higher in non?depressed participants than in depressed participants(raw score 50.7 vs.48.3,P<0.001).Participants with"moderate”or"good”social health had a significantly lower risk of depressive symptoms than those with“poor"social health(odds ratio(OR)=0.55,95%con fide nee interval(Cl):0.46-0.66 for moderate social health;OR=0.45,95%Cl:0.35-0.60 for good social health).The association between social health and depressive symptoms was con sistent across several subgroups.Con clusi ons:Social health is signify cantly inversely associated with depressive symptoms.The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits,but systematic assessment to guide intervention merits further investigation.
文摘The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor populations became victims of the novel corona virus.Therefore,this study focuses on Africa’s readiness to integrate telemedicine into the weak health systems and its adoption may help alleviate poor healthcare and poverty after COVID-19.We conducted a narrative review through different search strategies in Scopus on January 20,2021,to identify available literature reporting implementation of various telemedicine modes in Africa from January 1,2011 to December 31,2020.We summarized 54 studies according to geographies,field,and implementation methods.The results show a willingness to adopt telemedicine in the resource-poor settings and hard-to-reach populations,which will bring relief to the inadequate healthcare systems and alleviate poverty of those who feel the burden of healthcare cost the most.With adequate government financing,telemedicine promises to enhance the treating of communicable and non-communicable diseases as well as support health infrastructure.It can also alleviate poverty among vulnerable groups and hard-to-reach communities in Africa with adequate government financing.However,given the lack of funding in Africa,the challenges in implementing telemedicine require global and national strategies before it can yield promising results.This is especially true in regards to alleviating the multidimensionality of poverty in post-COVID-19 Africa.
文摘Objective: There is strong evidence supporting the impact of health care provider advice on patients’ smoking behavior. This paper examines adult smoker reports of health care provider smoking cessation interventions. Design: The 2010 Minnesota Adult Tobacco Survey (MATS) is a random digit dial telephone survey with 7057 Minnesota adults. Both landline and mobile telephone samples were included. These samples were combined and weighted to represent the population of adults in Minnesota. Results: Among adult Minnesotans, 16.1% were current smokers, 80.9% reported seeing a health care provider in the past 12 months and 80.2% of those adults were asked if they smoke. Among smokers who saw any provider in the past 12 months, 94.4% reported they were asked about smoking and 71.8% were advised not to smoke. In contrast, 43.9% of smokers received referrals from a health care provider and among those, 37.5% were recommended medications and 24.8% were referred to a quit smoking program. Conclusion: Given the large body of evidence supporting cessation interventions by health care providers, the increase in use of electronic medical records and the availability and success of evidence-based cessation programs, efforts to improve rates of identifying and treating each tobacco user are needed. Further research is needed to explore how cessation intervention responsibilities can be shared among the clinical team and integrated into ongoing clinical care.
文摘Statistics Norway has been engaged in the development of official statistics on accidents at work for the last ten years and represents Norway in international bodies like Eurostat working groups. Some of the work was documented and presented back in 2011 at the ISI Dublin convention and a review of further developments the last four years could shed even more light over the efforts made. There has been implemented a new data collection system at the national level that involves data and files based on forms for reporting accidents at work being sent from the Norwegian Labour and Welfare Administration （NLW） to Statistics Norway. Nevertheless there are still some challenges to be met. These include the use of different versions of the NLW forms, the scanning and extraction of data in the NLW, the implementation of a secure electronic solution for transmitting data between the NLW and Statistics Norway, the reading and interpretation of tiff-files and the lessons to be learned from other countries. The ambition is that Statistics Norway produces methodological sound official statistics on accidents at work within the first half of 2015 and transmits data and files to Eurostat that are necessary and sufficient to fulfil EU regulations within the first half of 2016.
基金This work was supported by the National Natural Science Foundation of China(Grant No.71904135)the Sichuan Science and Technology Program(2019YFS0274).The funding bodies played no role in the design of the study and collection,analysis,and interpretation of data and in writing the manuscript.
文摘Background:The“two-week visiting rate in those needing to visit”has been examined extensively as an important indicator of healthcare seeking behavior in China.Nevertheless,its relationship with health behaviors,such as physical activity,remains unknown.In addition,a significant difference exists between urban and rural Chinese people in terms of physical activity and healthcare seeking behavior.This study sought to investigate the relationship between physical activity and the two-week visiting rate by conducting a stratified analysis.Methods:The analysis included 5,801 participants aged above 15 years old.Multivariable logistic regression was applied to analyze the association after adjusting for possible confounding variables.Urban and rural differences were investigated using stratified analysis.Results:Adjusted estimates showed that those who were physically active were more likely to visit a healthcare facility,but only among the whole sample(adjusted odds ratio(AOR)=1.45,95%confidence interval(CI):1.26.1.66)and the rural sample(AOR=1.56,95%CI:1.21.2.01),and not among the urban sample.Conclusions:Educating people on physical activity may help in improving healthcare seeking behavior and vice versa.Additionally,health interventions may be tailored based on different settings.
基金supported by the National Key Research and Development Program of China(2017YFC1307705).
文摘BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.
文摘Acute mountain sickness(AMS) is an illness caused by hypoxia due to rapid ascent to altitudes above 2,500 m. Symptoms include headache,nausea, vomiting, and loss of appetite, all of which usually improve within 1 to 2 days. However,untreated AMS can progress to life-threatening conditions such as high-altitude cerebral and pulmonary edema(HACE and HAPE, respectively)^([1]).
文摘BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.
文摘BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio(APR)in hepatitis B progression to HCC.METHODS Data from 4843 patients with hepatitis B(January 2015 to January 2024)were analyzed.HCC incidence rates in males and females were compared using the log-rank test.Data were evaluated using Kaplan–Meier analysis.The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time.Furthermore,Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.RESULTS The incidence of HCC was higher in males.To ensure the model’s normality assumption,this study applied a logarithmic transformation to APR,yielding ratio.Ratio levels were higher in females(t=5.26,P<0.01).A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males(95%CI:1.653-2.431)and a 2.273-fold higher risk in females(95%CI:1.620-3.190).CONCLUSION Males are more prone to HCC,while females have higher APR levels.Despite no baseline APR link,rising APR indicates a higher HCC risk.
文摘Preterm birth(PTB),defined as a live birth occurring before 37 weeks of gestation,is associated with numerous adverse outcomes.These include poor growth,respiratory disorders,heightened susceptibility to infections because of low body weights,underdeveloped body functions,and low immunity.Such complications considerably affect infant health,pose life-threatening risks,and impose substantial social and economic burdens.
文摘BACKGROUND Few studies have specifically modeled the risk of venous thromboembolism(VTE)for postoperative hepatocellular carcinoma(HCC)patients,although HCC is the third leading cause of cancer death worldwide.This study aimed to develop and validate a nomogram that accurately predicts the risk of VTE in patients after HCC surgery.AIM To develop and validate a nomogram to accurately predict the risk of VTE in postoperative HCC patients by integrating clinical and laboratory risk factors.The model seeks to provide a user-friendly tool for identifying high-risk individuals who may benefit from targeted anticoagulation therapy,thereby improving clinical decision-making and patient outcomes.METHODS Data from patients who underwent HCC surgery at Chongqing University Cancer Hospital in China were analyzed.Through univariate and multivariate logistic regression analyses,independent risk factors for VTE were identified and integrated into a nomogram.The predictive performance of the nomogram was assessed via receiver operating characteristic curves,calibration curves,decision curve analysis and other relevant metrics.RESULTS Of 905 postoperative HCC patients were included in the study.The nomogram incorporated eight independent risk factors for VTE:Karnofsky Performance Scale,base disease,cancer stage(tumor-node-metastasis),chemotherapy,D-dimer concentration,white blood cell count,hemoglobin,and fibrinogen.The C-index for the nomogram model was 0.825 in the training cohort and 0.820 in the validation cohort,indicating good discriminative ability.Calibration plots of the model revealed high concordance between the predicted probabilities and observed outcomes.CONCLUSION We developed and validated a novel nomogram that can accurately estimate the risk of VTE in individual postoperative HCC patients.This model can identify high-risk patients who may benefit from targeted anticoagulation therapy.
文摘BACKGROUND Rectal cancer is prevalent and associated with substantial morbidity and mortality.AIM To develop a nomogram prediction model for overall survival(OS)in patients with rectal cancer by leveraging a comprehensive analysis of demographic,clinicopathological,haematological,and follow-up data to identify independent prognostic factors.METHODS We conducted a prospective cohort study in China involving rectal cancer patients and applied Cox regression and least absolute shrinkage and selection operator regression to assess the significance of various variables as independent prognostic factors for OS.The identified factors were integrated into a nomogram model,which was evaluated for predictive accuracy via the C-index,area under the curve(AUC),calibration curve,and decision curve analysis(DCA).RESULTS Multivariate analysis revealed independent predictors of OS,including the Karnofsky performance status,age,sex,TNM stage,chemotherapy,surgery,targeted therapy,β2-microglobulin,lactate dehydrogenase,and the neutrophil-to-lymphocyte ratio.The nomogram demonstrated a C-index of 0.80 for the training and validation cohorts,with AUC values indicating high predictive accuracy for 1-year,3-year,and 5-year OS.The calibration curves confirmed the model's excellent agreement with the observed survival rates,and DCA revealed the superior clinical utility of the nomogram over the TNM staging system.CONCLUSION In this study,a novel prognostic model that accurately predicts the OS of rectal cancer patients was developed.The model exhibited excellent discriminatory and calibration capabilities,thus offering a reliable tool for health care professionals to estimate patient survival.
基金supported by the Basic Medical Research Foundation of Naval Medical University(2022SK029 and 2023QN035).
文摘Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-010,2019-I2M-2-003,and 2017-I2M-1-004)the National High Level Hospital Clinical Research Funding(2022-GSPGG-1,2022-GSP-GG-2)+2 种基金the Research Unit of Prospective Cohort of Cardiovascular Diseases and Cancers,CAMS(2019RU038)the National Key Research and Development Program of China(2018YFE0115300 and 2017YFC0211700)the National Natural Science Foundation of China(82030102,12126602).
文摘Objective The relationship between fish consumption and stroke is inconsistent,and it is uncertain whether this association varies across predicted stroke risks.Methods A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted.A standardized questionnaire was used to collect data on fish consumption.Participants were stratified into low-and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores.Hazard ratios(HRs)and 95%confidence intervals(CIs)were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(SI).Results During 703,869 person-years of follow-up,2,773 incident stroke events were identified.Higher fish consumption was associated with a lower risk of stroke,particularly among moderate-to-high-risk individuals(HR=0.53,95%CI:0.47-0.60)than among low-risk individuals(HR=0.64,95%CI:0.49-0.85).A significant additive interaction between fish consumption and predicted stroke risk was observed(RERI=4.08,95%CI:2.80-5.36;SI=1.64,95%CI:1.42-1.89;AP=0.36,95%CI:0.28-0.43).Conclusion Higher fish consumption was associated with a lower risk of stroke,and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.
