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This study aimed to develop a measurement scale with good reliability and validity to assess the reasonableness of resident healthcare-seeking culture. Methods: This investigation utilized a cross-sectional research design, employing a multi-stage random sampling technique to select adult inhabitants aged eighteen and above who possess fundamental literacy abilities. An online survey was conducted from March to April 2021 across 27 provinces in China, encompassing 911 questionnaires for scale development. This study primarily applied discriminant coefficients and exploratory factor analysis to refine the scale items. Scale reliability was assessed using Cronbach's alpha, and split-half reliability. Scale validity was determined through content validity and structural validity. Data analysis was performed using SPSS 21.0, and structural equation modeling was executed with AMOS 23.0 software. Statistical significance was defined at P< 0.05. Results: The Resident Healthcare-seeking Culture Scale (RHCS) ultimately comprised 5 dimensions and 20 items. The cumulative explained variance of the five common factors within this scale amounts to 55.24%, satisfactorily adhering to the established criterion of social science research that the extracted factors should explain between 50% and 60% of the total variance. The Cronbach's alpha coefficient for the total scale was 0.83. Split-half reliability was 0.87. The Pearson correlation coefficients associating the scores from the five dimensions with the overall scale score were 0.78, 0.65, 0.65, 0.64, and 0.42, respectively, all statistically significant with P-values less than 0.001. The results of confirmatory factor analysis suggested that RMR=0.045, GFI=0.952, AGFI=0.936, PGFI=0.712, NFI=0.917, IFI=0.944, TLI=0.931, CFI = 0.943, and RMSEA = 0.046. Conclusion: The measurement scale for healthcare-seeking culture among Chinese residents exhibits superior reliability and validity, serving as an effective instrument for hospital administrators to evaluate the reasonableness of demand-side healthcare culture. Plain Language Summary: Known information: Healthcare culture encompasses both the facets of supply and demand. Existing research predominantly attends to the supply aspect, delving into the organizational culture within healthcare settings and crafting numerous evaluative instruments, including the Hospital and Safety Culture scales. Conversely, the realm of demand, specifically the healthcare-seeking culture among residents, remains underexplored, with a notable absence of tools to assess the reasonableness of this culture. Contribution of this study: This research quantitatively explores the resident healthcare-seeking culture for the first time, introducing a new theoretical framework to the domain of healthcare culture studies. By developing a scale with robust reliability and validity, this research offers a scientific instrument to evaluate the reasonableness of resident healthcare-seeking culture. Furthermore, this study addresses a previously unexplored void in the investigation of healthcare-seeking culture among residents. Implications of this study: By employing this scale, healthcare providers can gain a deeper insight into the characteristics of resident healthcare-seeking culture among residents across various demographic settings. This understanding enables them to tailor their services more closely to align with the cultural practices surrounding patients' access to healthcare, thereby enhancing patient satisfaction and collaboration in treatment. Moreover, this scale furnishes valuable data to health policymakers, facilitating the incorporation of patients' healthcare-seeking cultural traits into the formulation of health policies and the design of more effective and culturally resonant policy initiatives. [ABSTRACT FROM AUTHOR]

Abstract Introduction This study protocol specifies the primary research line and theoretical framework of the 2023 Survey of the Psychology and Behavior of the Chinese Population. It aims to establish a consistent database of Chinese residents' psychological and behavioral surveys through multi‐center and large‐sample cross‐sectional surveys to provide robust data support for developing research in related fields. It will track the public's physical and psychological health more comprehensively and systematically. Methods The study was conducted from June 20, 2023 to August 31, 2023, using stratified and quota sampling methods. A total of 150 cities across 800 communities/villages were surveyed, selected from China (Despite extensive coordination, we have been unable to contact our counterparts in the Taiwan region of China to obtain relevant statistical data). The questionnaires were distributed to the public one‐on‐one and face‐to‐face by trained surveyors. The questionnaires included basic information about the individual, personal health status, basic information about the family, the social environment in which the individual lives, psychological condition scales, behavioral level scales, other scales, and attitudes towards topical social issues. Supervisors conducted quality control during the distribution process and returned questionnaires, logically checked and cleaned for data analysis. Discussion Data collection has been finished, and scientific outputs based on this data will support the development of health promotion strategies in China and globally. In the aftermath of the pandemic, it will guide policymakers and healthcare organizations to improve their existing policies and services to maximize the physical and mental health of the Chinese population. Trial Registration This study was filed in the National Health Security Information Platform (Record No.: MR‐37‐23‐017876) and officially registered in the China Clinical Trials Registry (Registration No.: ChiCTR2300072573).

Suboptimal health status is a global public health concern of worldwide academic interest, which is an intermediate health status between health and illness. The purpose of the survey is to investigate the relationship between anxiety statuses and suboptimal health status and to identify the central symptoms and bridge symptoms. This study recruited 26,010 participants aged <60 from a cross-sectional study in China in 2022. General Anxiety Disorder-7 (GAD-7) and suboptimal health status short form (SHSQ-9) were used to quantify the levels of anxiety and suboptimal health symptoms, respectively. The network analysis method by the R program was used to judge the central and bridge symptoms. The Network Comparison Test (NCT) was used to investigate the network differences by gender, place of residence, and age in the population. In this survey, the prevalence of anxiety symptoms, SHS, and comorbidities was 50.7 %, 54.8 %, and 38.5 %, respectively. "Decreased responsiveness", "Shortness of breath", "Uncontrollable worry" were the nodes with the highest expected influence. "Irritable", "Exhausted" were the two symptom nodes with the highest expected bridge influence in the network. There were significant differences in network structure among different subgroup networks. Unable to study the causal relationship and dynamic changes among variables. Anxiety and sub-health were self-rated and may be limited by memory bias. Interventions targeting central symptoms and bridge nodes may be expected to improve suboptimal health status and anxiety in Chinese residents. Researchers can build symptom networks for different populations to capture symptom relationships. • This is the first study to examine the intrarelationships network of anxiety and suboptimal health among Chinese residents. • "Decreased responsiveness," "Shortness of breath," and "Uncontrollable worry" were the central symptoms in the network. • "Irritable" and "Exhausted" were the key bridge nodes connecting anxiety and suboptimal health states. • "Memory decline" - "Decreased responsiveness" was an edge of significant difference in all subgroups. [ABSTRACT FROM AUTHOR]

ObjectiveTo analyze the changing trends of the disease burden of viral hepatitis B (HB) and its risk factors among Chinese residents from 1990 to 2019, to provide a reference for HB prevention and control. MethodsData on the disease burden of HB and its risk factors among Chinese residents from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Descriptive statistics were performed using standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rate of HB. Joinpoint regression model was used to analyze the trends of disease burden of HB attributable to smoking, alcohol consumption, drug abuse, and high body mass index (BMI) among Chinese residents from 1990 to 2019. ResultsDuring the 30-year period among Chinese residents there were significant decreasing trends in the HB standardized rate (1/100 000) of incidence (2 725.98 to 1 397.31), prevalence (12 239. 53 to 6 566.12), mortality (24.67 to 8.07), and DALYs (793.38 to 247.71), with average annual percentage changes (AAPC) of – 2.29%, – 2.13%, – 3.82%, and – 3.98%, respectively (P < 0.001 for all), and although declining more rapidly in a global comparison, these standardized rates were still higher than those in the total world population. The values of APPC were significantly higher negatively in the female population than in the male population for HB standardized of incidence (– 2.49% vs. – 2.14%), prevalence (– 2.26% vs. – 2.04%), mortality (– 4.82% vs. – 3.48%), and DALYs (– 5.15% vs. – 3.63%) rates (all P < 0.001), indicating that there was still a higher disease burden of HB in the male Chinese population. During this period, the standardized mortality rate and DALYs rate of HB attributable to smoking, drinking alcohol, drug use, and high BMI showed a significant decreasing trend (both P < 0.01), with the AAPC of – 62.20%, – 62.01%, – 44.44%, and – 18.18% for the mortality rate and – 63.90%, – 63.54%, – 47.71%, and – 18.76% for the DALYs rate. ConclusionAlthough the disease burden of viral hepatitis B among Chinese residents has decreased from 1990 to 2019, it is still higher than that of the world population, and male residents who smoke, consume alcohol, take drugs and have high body mass index still need to pay more attention.

ObjectiveTo analyze the change trend of the disease burden of injuries among Chinese residents from 1990 to 2019, and to predict the age-standardized incidence, mortality, and disability-adjusted life-years (DALY) rates of injuries from 2020 to 2025, providing a reference for the prevention and control of injuries among the Chinese population. MethodsData on the disease burden of injury in populations in China, Asia, and the world from 1990 to 2019 were collected from the Global Burden of Disease Study – 2019 (GBD 2019). Crude and age-standardized rates of incidence, mortality, years lived with disability (YLD), years of life lost (YLL), and DALY of injury were used in the descriptive analysis. A joint-point regression model was constructed to analyze the average annual percentage change (AAPC) in these rates between 1990 and 2019. In addition, an autoregressive integrated moving average (ARIMA) model was constructed to predict the standardized rates of incidence, mortality, and DALY of injury from 2020 to 2025 in the Chinese population. ResultsFrom 1990 to 2019, increases in the crude and age-standardized rates (1/100 000) of injury incidence (5 976.31 to 6 328.60 and 5 863.81 to 6 138.73) and YLD (461.57 to 679.01 and 511.58 to 534.88) were observed in the Chinese population, with overall rate increases of 5. 89%, 4.69%, 47.11%, and 4.56%, respectively, and the rate increases were all higher than those in the Asian and global populations; however, decreases in the crude and age-standardized rates were observed for injury mortality (74. 34 to 49.67 and 83.03 to 44.20), YLL (4215.54 to 1825.22 and 4204.05 to 1787.50), and DALY (4677.11 to 2504.23 and 4715.63 to 2322.38), with overall decreases of – 33.19%, – 46.76%, – 56.70%, – 57.48%, – 46.46%, and – 50.75%, respectively, and the rate decreases were all greater than those in the Asian and global populations. The results of Joinpoint regression model analysis show that from 1990 to 2019, the age-standardized incidence and YLD rate of injuries in the Chinese population showed an overall increasing trend (AAPC = 0.15%, P = 0.006), while the age-standardized mortality, YLL, and DALY rate of injuries showed an overall decreasing trend (AAPC = – 2.28%, – 2.62%, and – 3.07%, all P < 0.01). The injury type that ranked first in terms of injury disease burden in the Chinese population in 1990 and 2019 was road traffic injuries, with DALYs of 13.73957 million person-years and 13.2577 million person-years, and the age-standardized DALY rates (1/100 000) of 12.327 2 and 8.595 8, respectively. For the Chinese population between 2020 and 2025, the predicted age-standardized injury incidence rate (1/100 000) ranges from 6 293.79 to 6 492.15; the predicted age-standardized mortality rate (1/100 000) ranges from 41.50 to 48.38; and the predicted age-standardized DALY rate (1/100 000) ranges from 1 850.11 to 2 234.510. The predicted age-standardized injury incidence rate for 2020 – 2025 is expected to continue to increase, while the predicted age-standardized mortality and DALY rates are expected to continue to decrease (all P < 0.05). ConclusionThe age-standardized incidence and YLD rates of injuries in the Chinese population showed an overall increasing trend from 1990 to 2019, while the age-standardized mortality, YLL, and DALY rates showed an overall decreasing trend. From 2020 to 2025, the age-standardized incidence rate of injuries will continue to increase, while the age-standardized mortality rate and DALY rate will continue to decrease.

ObjectiveTo analyze the change in the disease burden of cardiovascular disease (CVD) and chronic respiratory disease (CRD) among Chinese residents from 1990 to 2019, and to predict the incidence rate, mortality rate, and disability-adjusted life year (DALY) rate of CVD and CRD from 2020 to 2030, so as to provide a reference for formulating the prevention and control strategies of CVD and CRD in China. MethodsFrom the Global Burden of Disease 2019 (GBD 2019) study, we collected relevant data on the burden of CVD and CRD among Chinese residents from 1990 to 2019. Descriptive analysis was performed using the following indicators: incident cases (in million), incidence rate (1/100 000), standardized incidence rate (1/100 000), number of deaths (in million), mortality rate (1/100 000), standardized mortality rate (1/100 000), DALY (person-years), DALY rate (1/100 000), and standardized DALY rate (1/100 000). The Joinpoint regression model was used to analyze the changes in the disease burden of CVD and CRD among Chinese residents during the period, and the gray prediction model was used to predict the incidence rate, mortality rate, and DALY rate of CVD and CRD among Chinese residents from 2020 to 2030. ResultsComparison between 1990 and 2019 showed an increase in the number of CVD incident cases (5.3007 vs. 12.3411), incidence rate (447.81 vs. 867.65), standardized incidence rate (646.20 vs. 652.21), number of deaths (2.4240 vs. 4.5843), mortality rate (204. 78 vs. 322.30), DALYs (6026.16 × 104 vs. 9193.31 × 104), and DALY rate (5 091.03 vs. 6463.47) among Chinese residents, with overall percentage changes of 132.82%, 93.75%, 0.93%, 89.12%, 57.39%, 52.56%, and 26.96%, respectively, but the decreases in CVD standardized mortality rate (381.21 vs. 276.94) and standardized DALY rate (7 412.81 vs. 4 938.38), with overall percentage changes of – 27.35% and – 33.38%, respectively. The number of CRD incident cases and the incidence rate increased from 8.5808 and 724.92 in 1990 to 11.9075 and 837.17 in 2019, with the overall percentage changes of 38.77% and 15.48%; while there were decreases in standardized incidence rate (863.43 vs. 767.50), number of deaths (1.3010 vs. 1.0853), mortality rate (109.93 vs. 76.30), standardized mortality rate (226.43 vs. 67.98), DALYs (2 899.21 × 104 vs. 2 252.05 × 104), DALY rate (2 449.31 vs. 1 583.33), and standardized DALY rate (3 910.13 vs. 1 269.95) of CRD during the period, with the total percentage changes of – 11.11%, – 16.58%, – 30.59%, – 69.98%, – 22.32%, – 35.36%, and – 67.52%, respectively. The Joinpoint regression model showed an increasing trend in the overall standardized incidence rate of CVD among Chinese residents from 1990 to 2019 (average annual percentage change [AAPC] = 0.03%, P < 0.05), while the standardized mortality rate and standardized DALY rate of CVD and the standardized incidence rate, standardized mortality rate, and standardized DALY rate of CRD all showed a decreasing trend (all P < 0.05). The predicted CVD incidence rate of Chinese residents in 2020 – 2030 is 886.94 – 1 151.61, the predicted mortality rate is 329.00 – 392.92, and the predicted DALY rate is 6 525.22 – 7 260.53. The predicted CVD incidence rate, mortality rate, and DALY rate in 2020 – 2030 continue to increase (all P = 1.00); the predicted CRD incidence rate of Chinese residents in 2020 – 2030 will be 824.71 – 971.00, the predicted mortality rate will be 55.68 – 68.42, and the predicted DALY rate will be 1 145.20 – 1 420.31. The predicted CRD incidence rate will continue to increase, the predicted mortality rate and the predicted DALY rate will continue to decrease (P = 0.85, 1.00 and 1.00).ConclusionFrom 1990 to 2019, the standardized CVD incidence rate of Chinese residents showed an overall increasing trend, while the standardized CVD mortality rate, standardized DALY rate, and CRD standardized incidence rate, standardized mortality rate, and standardized DALY rate showed an overall decreasing trend; from 2020 to 2030, the predicted CVD incidence rate, mortality rate, DALY rate, and predicted CRD incidence rate all continued to increase, while the predicted CRD mortality rate and DALY rate both continued to decrease.

To deal with the challenges posed by generational differences in China's sustainable consumption transition, this study's pioneers using a mixed-methods approach with data mining and literature research to classify Chinese residents into four generations based on the sustainable consumption perspective. We developed a conceptual model of generational differences and conducted an empirical study using structured interviews with a multi-stage random sampling approach. The results highlight significant differences and distinct influencing mechanisms among the four generations regarding perceptions of sustainable consumption, lifestyle, and sustainable consumption behavior. Based on this, multi-generational differentiated green marketing strategies, green product development and green marketing practices, as well as consumer education systems and strategies for stakeholders including the government, enterprises, and society are proposed. The findings contribute to advancing theoretical perspectives in sustainable consumption research, serving as a valuable reference for sustainable consumption research worldwide. [ABSTRACT FROM AUTHOR]

Cholesterol is a nutrient commonly found in the human diet. The relationship between dietary cholesterol, its sources, and cardiovascular disease (CVD) is still a topic of debate. This study aimed to investigate the association between dietary cholesterol, its sources, and cardiovascular events in a Chinese population. The present study analyzed data from the China Health and Nutrition Survey (CHNS) cohort between 1991 and 2015. This study analyzed data from 3903 participants who were 40 years of age or older at baseline and had no history of cardiovascular disease, diabetes, or hypertension. During a median follow-up of 14 years, 503 cardiovascular disease events were identified through follow-up questionnaires administered every 2–3 years. The events included fatal and nonfatal coronary heart disease, stroke, heart failure, and other cardiovascular disease deaths. Cox regression was used to estimate risk ratios (HR) for CVD events after adjusting for demographic, socioeconomic, and behavioral factors. It was discovered that sources of dietary cholesterol varied among different subgroups of the population. The top three sources of cholesterol among all participants were eggs, red meat, and seafood, accounting for 57.4%, 28.2%, and 9.0% of total daily cholesterol intake, respectively. The present study found that there was a significant association between total dietary cholesterol intake, and the risk of developing cardiovascular disease (adjusted HR [95% CI]: total cholesterol (highest and lowest quartiles compared) 1.57 [1.17–2.11]). Cholesterol from poultry, seafood, and eggs was also significantly associated with a reduced risk of CVD (adjusted HR [95% CI]: poultry 0.18 [0.04–0.82], seafood 0.11 [0.02–0.54], and eggs 0.16 [0.03–0.73]). After adjusting for daily caloric intake, daily fat intake, and daily saturated fat intake, the previously observed association between red meat cholesterol and cardiovascular events (unadjusted HR [95% CI]: 0.44 [0.35–0.55]) was no longer statistically significant (adjusted HR [95% CI]: 0.21 [0.04–1.01]). [ABSTRACT FROM AUTHOR]

ObjectiveTo enhance individuals’ sustained intention to use health science popularization videos, this study investigated the path relationships and influencing mechanisms of health science popularization video factors on users’ perceived value, expectancy confirmation, enjoyment, satisfaction, trust, and continuous usage intention based on the cognitive-affective-conative and expectation-confirmation model theoretical framework.MethodsThis study adopted a cross-sectional design and collected data using self-administered questionnaires. The hypotheses were analyzed using the smart partial least squares (Smart-PLS) structural equation modeling method with a dataset containing 503 valid responses. Subsequently, comprehensive data analysis was conducted.ResultsBlogger and video quality factors present in health science popularization videos substantially influenced users’ perceived value (p

Space travel began in 2001 and became popular in 2021 because of commercial operations. With the development of space technology and commercialization, like re-launchable rockets used to travel to space in recent years, hawse have gradually entered the space era. However, the space industry causes massive emissions, inducing some opposition to its development. It is essential to investigate the attitude of residents toward space travel and balance the pros and cons of sustainability. A quantitative analysis was adopted to test two models based on duality theory. The data were obtained from 284 samples from various regions of China and analyzed using partial least squares structural equation modeling (PLS-SEM). The results show that the two-factor model of economic development conflicted with environmental protection. However, study two indicates that educational interventions can facilitate sustainable space travel because they mediate the relationship between economic and environmental factors. [ABSTRACT FROM AUTHOR]

Objective: To determine the appropriateness of three widely used formulas estimating 24-h urinary Na (24hUNa) from spot urine samples in the Chinese population. Design: Systematic review and meta-analysis. Setting: Literature review was conducted to identify studies for estimating 24hUNa using the Kawasaki, Tanaka and INTERSALT formulas simultaneously in PubMed, Embase and the Cochrane library databases. The mean difference (MD) and correlation coefficients (r) between measures and estimates from different formulas were assessed. Participants: Information extraction and quality assessment were performed in thirteen studies involving 8369 subjects. Results: Two studies which affected the overall robustness were excluded in the 'leave-one-out' sensitivity analyses. Within the final meta-analysis included eleven studies and 7197 participants, 36·07 mmol/d (95 %CI 16·89, 55·25) of MD was observed in the Kawasaki formula, and –19·62 mmol/d (95 %CI –37·37, –1·87) in the Tanaka formula and –35·78 mmol/d (95 %CI –50·76, –20·80) in the INTERSALT formula; a pooled r-Fisher's Z of 0·39 (95 %CI 0·32, 0·45) in the Kawasaki formula, 0·43 (95 %CI 0·37, 0·49) in the Tanaka formula and 0·36 (95 %CI 0·31, 0·42) in the INTERSALT formula. Subgroup analyses were conducted to explore the possible factors affecting the accuracy of the formula estimation from three mainly aspects: population types, Na intake levels and urine specimen types. Conclusions: The meta-analysis suggested that the Tanaka formula performed a more accurate estimate in Chinese population. Time of collecting spot urine specimens and Na intake level of the sample population might be the main factors affecting the accuracy of the formula estimation. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine incidence and mortality trends of ischemic stroke (IS) among Chinese residents from 1990 to 2019 and to provide a reference for the prevention and control of IS in China. MethodsThe data on IS incidence and mortality among Chinese residents from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Joinpoint regression model was used to analyze changing trend of IS incidence and mortality. The age-period-cohort (APC) model was used to assess the effects of age, period, and birth cohort on the risk of IS incidence and mortality. ResultsThe crude incidence rate (per 100 000 population) of IS increased from 74.26 in 1990 to 201.74 in 2019 for all Chinese residents; and the rate increased from 64.58 to 183.60 for the male residents and from 84.55 to 220.59 for the female residents. The standardized incidence rate (per 100 000 population) of IS also increased from 107.49 in 1990 to 144.78 in 2019 for all Chinese residents; for male and female residents, the standardized incidence rate increased from 101.14 and 113.72 to 141.10 and 149.44, respectively. During 30-year period, the average annual percentage change (AAPC) in standardized IS incidence rate for all, male and female Chinese residents were 1.04%, 1.16% and 0.94% (all P < 0.001). The crude IS mortality rate (per 100 000 population) for all, male and female Chinese residents increased from 32.08, 32.09 and 32.06 in 1990 to 72.37, 79.89 and 64.55 in 2019; the standardized IS mortality rate (per 100 000 population) for all and female Chinese residents decreased from 64.32 and 56.13 in 1990 to 62.18 and 48.26 in 2019; but the standardized IS mortality rate for male Chinese residents increased from 77.34 in1990 to 83.55 in 2019. During 30-year period, the AAPC in standardized IS mortality rate for all, male and female Chinese residents were – 0.12% (P = 0.463), 0.29% and – 0.50% (both P < 0.05). The results of the APC model analysis showed that the local drift values of IS incidence rate for male residents aged 35 – 89 years and female residents aged 45 – 89 years were greater than 0, and the local drift values of IS mortality rate for male residents aged 75 – 94 years were greater than 0. The longitudinal curve for age-specific IS incidence and mortality for both male and female residents in the same birth cohort showed an increasing trend. The IS risk of male residents remained stable in each period group from 1990 to 2004, then increased slowly from 2005 to 2009, and rapidly increased in each period group from 2010 to 2019. The IS risk of the female residents decreased in each period group from 1990 to 2004, and increased slowly from 2005 to 2009; from 2010 to 2014, the risk increased rapidly, and from 2015 to 2019, the increasing trend was very smooth and almost remained stable. From 1990 to 2019, the IS mortality risk of male and female Chinese residents showed a downward trend over the time period and the mortality risk reached the minimum from 2015 to 2019. From 1990 to 2019, the IS risk of male and female Chinese residents increased first and then decreased with the birth cohort. The peak of the birth cohort effect on IS in male residents occurred from 1973 to 1977, and that in female residents occurred from 1958 to 1962. The IS mortality risk in male and female Chinese residents from 1990 to 2019 showed an overall downward trend along with the birth cohort. ConclusionThe incidence of ischemic stroke in Chinese residents showed an increasing trend from 1990 to 2019. Age, period, and birth cohort effect have a certain influence on the risk of ischemic stroke with gender disparity. Although the period and cohort effect on IS mortality risk showed a decline trend, the continuous increasing age effect made the actual burden of IS mortality much heavier among Chinese residents, especially among elderly male residents.

ObjectiveTo investigate the situation and influencing factors of clinic visits at primary medical and health institutions among Chinese residents with two-week illness for providing evidence to the intervention on medication seeking behavior of the residents. MethodsWith multistage random sampling and a self-designed questionnaire, we conducted an online survey among 174 500 urban and rural residents in 31 provincial-level administrative divisions across China during March – April 2019; the data on 7 295 residents attending outpatient clinics within previous two weeks were analyzed. Multivariate logistic regression model was used to explore main influencing factors for the residents' medication seeking behavior. ResultsOf the 7 295 outpatient clinic attendees, 4 305 (59.0%) reported visiting a doctor in primary medical and health institutions. The results of multivariate logistic regression analysis showed that the outpatient clinic attendees with following characteristics were less likely to have clinic visits at primary medical and health institutions: being female, having the education of college and above, suffering from chronic disease, being not capable of reaching the nearest primary medical or health institution within 15 minutes by walking, and reporting a fair or better economic status; but those living in central China, with rural household registration, being migrants, participating in basic medical insurance for urban and rural residents, and having alcohol drinking were more likely to seek medication in primary medical and health institutions. ConclusionThe proportion of clinic visits at primary medical and health institutions was not high and mainly influenced by gender, education background, living region, household registration, migration status, type of medical insurance, self-reported economic status, alcohol consumption, chronic disease condition, and the time to reach the nearest primary medical and health institution by walking among Chinese residents with two-week illness.

Objective To understand the death situation and changing trend of accidental poisoning among Chinese residents from 2004 to 2020, and to provide scientific basis for formulating prevention strategies of accidental poisoning. Methods The data of accidental poisoning deaths of Chinese residents in the national death cause surveillance system from 2004 to 2020 were collected. The annual percent change (APC) and average annual percent change (AAPC) were calculated by statistical software Joinpoint 4.9.0; and the change trend of standardized mortality was analyzed. Results There was no obvious turning point in the overall downward trend of the standardized mortality rate of accidental poisoning in Chinese residents (AAPC=- 3.1%, P < 0.05). The crude death rate of accidental poisoning in males was 2.15 to 2.61 times higher than that in females. The standardized mortality rate of urban residents decreased from 339/100 000 in 2004 to 1.37/100 000 in 2020 (AAPC=- 4.3%, P < 0.05), and that in rural areas decreased from 3.94/100 000 in 2004 to 2.84/100 000 in 2020 (AAPC=-2.6%!, P < 0.05). The standardized mortality rate of accidental poisoning in residents aged 4 years old decreased from 0,08/100 000 in 2004 to 0.02/100 000 in 2020 (AAPC二--1.7%, P < 0.05). The standardized mortality rate of accidental poisoning in residents aged 44 years old decreased from L40/100 000 in 2004 to 0.90/100 000 in 2020 (AAPC =-1.7%, P < 0.05). The standardized mortality rate of accidental poisoning among residents over 65 years old decreased from 1.47/100 000 in 2004 to 0.79/100 000 in 2020 (AAPC =-3,7%, P < 0.05). The standardized mortality rate of accidental poisoning in the eastern region decreased from 3,61/100 000 in 2004 to 2.01/100 000 in 2020 (AAPC=-5.6%, P < 0.05). The standardized mortality rate of accidental poisoning in the central region decreased from 4.25/100 000 in 2004 to 235/100 000 in 2020 (AAPC=-3.1%, P < 0.05). Although it decreased in the western region, it was not statistically significant. Condusion The standardized mortality rate of accidental poisoning among Chinese residents decreased slightly from 2004 to 2020, and there were differences among different genders, regions, places of residence and age groups, among which the elderly and residents in the western region were the high-risk groups of accidental poisoning deaths. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine the trend in intentional injury mortality during 2008 – 2020 among Chinese residents and to predict the mortality rate of years of 2021 – 2025 in the population for providing evidence to intentional injury prevention. MethodsThe data on gender-, age-, region-specific intentional injury mortality for years of 2008 – 2020 among the populations of surveillance sites across China were extracted from National Cause-of-Death Surveillance Dataset. Yearly crude and standardized rate were calculated to describe intentional injury mortality. Joinpoint regression analysis model was used to analyze changing trend in standardized mortality rates, and grey model was applied to predict intentional injury mortality rates for years of 2021 – 2025. ResultsFor the whole population surveyed, the standardized mortality rate (per 100 000) decreased significantly from 2008 to 2020 for intentional injury (from 11.10 to 5.76 ), suicide and sequelae (10.11 to 5.42), and homicide and sequelae (1.01 to 0.31) (average annual percent change [AAPC] = – 5.85%, – 5.62%, – 10.77%) (all P < 0.001), respectively. For the male population, the standardized mortality rate of intentional injury decreased significantly from 12.77 to 6.99 during the whole period (P < 0.001, APPC = – 5.50%); while, for the female population, there was a significant decrease from 2010 to 2018 (annual percent change [APC] = – 7.31%，P < 0.001) but a unsignificant increase from 2018 to 2020 (APC = 0.04%，P = 0.995) in the standardized mortality rate, though the rate decreased significantly from 9.70 to 4.58 for the whole period from 2008 to 2020 (P < 0.001, APPC = – 6.12%). The mortality rate of intentional injury decreased significantly from 2008 to 2020 for the populations aged 1 – 4 years (0.02 to 0.01, AAPC = – 6.01%), 15 – 44 years (0.59 to 0.31, AAPC = – 5.37), 45 – 64 years (0.86 to 0.46, AAPC = – 5.42%), and ≥ 65 years (0.77 to 0.39, AAPC = – 6.17%) (P < 0.01 for all). The standardized mortality rate of intentional injury decreased significantly from 2008 to 2020 for the populations in eastern region (9.08 to 4.77, AAPC = – 5.53%), central region (14.37 to 6.92, AAPC = – 6.07%), and western region (10.73 to 5.90, AAPC = – 5.42%) and also for the populations in urban regions (6.69 to 4.18, AAPC = – 4.56%) and rural regions (14.06 to 6.67, AAPC = – 6.71%) (P < 0.001 for all). The predicted annual mortality rate of intentional injury from 2021 to 2025 for the population surveyed were 6.07, 5.83, 5.60, 5.38, and 5.16 based on grey model analysis. ConclusionThe intentional injury mortality rate for Chinese residents from 2008 to 2020 and in the next five years shows a continuous downward trend.

The incidence of hyperuricemia is on the rise in China, primarily due to dietary habits. However, limited data exists regarding dietary purine intake in the country. This study aimed to estimate the daily dietary purine intake among Chinese residents from 2014 to 2021 and evaluate the temporal trend using joinpoint regression analysis. The analysis revealed an annual percentage change (APC) of 0.8% (95% CI: 0.1–1.5%) in dietary purine intake prior to the joinpoint (2014–2019). Following the joinpoint (2019–2021), the APC significantly increased to 6.5% (95% CI: 3.3–9.8%), indicating a noteworthy upward trend (p = 0.045). Furthermore, the average daily purine intake varied significantly among different regions of China, with the southern region showing the highest dietary intake of purines. Considering the diverse contributions of various food sources to dietary purine intake, it was observed that meat consumption had the greatest impact, accounting for 36.2% of purine intake, followed by cereals consumption (25.3%) and vegetables and edible fungi (24.2%). These findings hold significance for dietary intervention and management strategies aimed at reducing purine intake among the population.

COVID-19 has undergone several mutations and is still spreading in most countries now. PA has positive benefits in the prevention of COVID-19 infection and counteracting the negative physical and mental effects caused by COVID-19. However, relevant evidence has indicated a high prevalence of physical inactivity among the general population, which has worsened due to the outbreak of the pandemic, and there is a severe lack of exercise guidance and mitigation strategies to advance the knowledge and role of PA to improve physical and mental health in most countries during the epidemic. This study surveyed the effects of COVID-19 on PA in Chinese residents during the pandemic and provided important reference and evidence to inform policymakers and formulate policies and planning for health promotion and strengthening residents' PA during periods of public health emergencies. ANOVA, Kolmogorov–Smirnov, the chi-square test and Spearman correlation analysis were used for statistical analysis. A total of 14,715 participants were included. The results show that nearly 70% of Chinese residents had inadequate PA (95%CI 58.0%–82.19%) during the COVID-19 outbreak, which was more than double the global level (27.5%, 95%CI 25.0%–32.2%). The content, intensity, duration, and frequency of PA were all affected during the period of home isolation, and the types of PA may vary among different ages. The lack of physical facilities and cultural environment is the main factor affecting PA. However, there was no significant correlation between insufficient PA and the infection rate. During the period of home isolation and social distance of epidemic prevention, it is necessary to strengthen the scientific remote network monitoring and guidance for the process of PA in China. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine changing trend in disease burden of lung cancer and related risk factors among residents in China from 1990 to 2019 for developing targeted strategies on lung cancer prevention and treatment. MethodsThe open access data relevant to disease burden of lung cancer and its associates among Chinese residents in 1990, 2005 and 2019 were extracted from the Global Burden of Disease (GBD) Study 2019. We used years lived with disability (YLDs), years of life lost (YLLs), and disability adjusted life years (DALYs) to describe changes of lung cancer burden and population-attributable faction (PAF) to analyze the disease burden attributable to risk factors and epidemiological transition among the residents of various age groups from 1990 to 2019. ResultsIn 2019 among Chinese male residents, the rates (1/100 000) of YLDs, YLLs, and DALYs of lung cancer were 19.10, 1 632.03, and 1 651.13 and all the rates were higher than those of 8.73, 731.14, and 739.87 among Chinese female residents; the three rates increased with age, with the highest rates of 76.17, 5 243.52, and 5 319.70 in the residents aged 70 years and over. Compared to those in 1990, the rates of YLDs, YLLs, and DALYs increased by 3.61%, 2.49%, and 2.50%, respectively in 2019. Among the 16 known risk factors of lung cancer, the top five with highest contributions to DALYs (million person years), DALYs rate (1/10 000) and PAF were smoking (10.75, 755.91 and 62.06%), environmental particulate pollution (3.86, 271.20 and 22.47%), second-hand smoke (1.35, 94.81 and 7.86%), high fasting plasma glucose (1.11, 77.87 and 6.47%) and home air pollution due to solid fuel use (0.85, 59.72 and 4.94%). Of the PAF for the 16 known risk factors during the period of 1990 – 2019, the PAFs of 8 factors increased, with the highest increase of 110.12% for environmental particulate pollution and other 8 factors′ PAF decreased, with the lowest decrease of 77.74% for home air pollution due to solid fuel use. ConclusionDuring 1990 – 2019 among residents in China, the disease burden of lung cancer was heavy and the YLDs, YLLs and DALYs rate of lung cancer increased; smoking is still a main risk factor for disease burden of lung cancer.

Objective To compare the disease burden of gastric cancer among Chinese residents in 1990 and 2017 for providing references to decision making on gastric cancer prevention and health management. Methods Using the data of 1990 and 2017 from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we analyzed the changes in years of life lost (YLL), years living with disability (YLD) and disability-adjusted life years (DALY) due to gastric cancer in Chinese population between 1990 and 2017. Results In contrast with those in 1990, higher gastric cancer-related YLL (7 648 000 person-years [PYs] vs. 7 340 000 PYs), YLD ( 167 000 PYs vs. 74 000 PYs), standardized YLD rate (8.5/100 000 vs. 8.4/100 000) and DALY (7 815 000 PYs vs. 7 415000 PYs) were observed in 2017 in Chinese population, with the increasing percentage of 4.2%, 125.7%, 1.2%, and 5.4%; but the standardized YLL rate declined from 779/100 000 to 383.2/100 000 and the standardized DALY rate declined from 787.3/100 000 to 391.7/100 000. There were gender, age, and region differences in the changes between 1990 and 2017 for disease burden due to gastric cancer in the population; in the males, the YLD increased by 152.1%, higher than 76.9% in the females; while the standardized YLL and DALY rate decreased by 46.4% and 45.8% in the males, both lower than in female population (58.5% and 58.0%); the YLL, standardized YLD rate, and DALY of the males increased by 13.7%, 11.6%, and 15.1% but those of the females decreased by 12.7%, 19.0%, and 11.9%, respectively; the DALY decreased in people aged < 50 and 55 – 59 years but increased in the people of other age groups, with the highest increase of 133.5% in the people ≥ 80 years; the standardized DALY rate decreased among all age groups and the decrease percentage (75.7%) was the highest for the people aged 20 – 24 years; the highest increase of DALY (86.2%) was observed in the population of Shaanxi province whereas the greatest decrease of DALY (25.1%) was in the population of Tibet Autonomous Region; the standardized DALY rate decreased in all 33 provincial-level administrative divisions, with the greatest decrease (66.7%) in Beijing and the least decrease (14.7%) in Shaanxi province. Conclusion The disease burden of gastric cancer in Chinese population decreased in 2017 compared to that in 1990 but the decrease differed by gender and region and the disease burden is still at a relatively high level.

ObjectiveTo analyze changing trend in the burden of skin and subcutaneous diseases among Chinese residents during 1990 – 2019 for providing evidences to the development of health policy. MethodsData on incidence and prevalence of skin and subcutaneous diseases among Chinese residents in 1990, 2000, 2010, and 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Indicators including incidence and prevalence number, crude and standardized incidence and prevalence, disability-adjusted life years (DALY) and estimated annual percentage change (EAPC) of the indicators were adopted to assess changing trend in disease burden of skin and subcutaneous diseases. ResultsCompared to that in 1990, an upward trend in the burden of skin and subcutaneous diseases was observed among Chinese residents in 2019, with the increases of 29.33% for incidence number, 27.20% for age-standardized incidence rate, 27.23% for prevalence number, 5.52% for age-standardized prevalence rate, and 14.75% for DALY, respectively; but the age-standardized DALY rate decreased by 0.29%. During the period, the age-standardized prevalence rate and DALY rate of skin and subcutaneous diseases in female residents were higher than those in the male residents; while the age-standardized incidence rate for female residents was lower than that for male residents. In terms of different skin and subcutaneous diseases in Chinese residents during the 30-year period, decubitus ulcer showed the highest increase in age-standardized incidence rate (with an EAPC of 1.078, 95% uncertainty interval [95% UI]: 0.826 – 1.317) and in DALY rate (EAPC = 2.202, 95% UI: 0.905 – 3.451); in contrast, cellulitis manifested the highest decrease in age-standardized incidence rate (EAPC = – 1.210, 95% UI: – 1.416 – – 1.019) and in DALY rate (EAPC = – 7.304, 95% UI: – 8.081 – – 7.087); the increase of age-standardized prevalence rate was the highest for acne vulgaris (EAPC = 1.087, 95% UI = 1.052 – 1.110) but the decrease was the highest for cellulitis (EAPC = – 1.097, 95% UI: – 1.289 – – 0.917). ConclusionAmong Chinese residents during 1990 – 2019, the burden of skin and subcutaneous diseases was under control but still remained at a high level due to increased incidence rate and prevalence rate of the diseases; special concern should be paid to decubitus ulcer to attenuate the burden of skin and subcutaneous diseases.

ObjectiveTo examine the mortality of accidental falls and its variation trend among Chinese residents during 2004 – 2018 for providing evidences to the development of prevention strategies on accidental falls. MethodsFrom National Information System for Mortality Surveillance, we extracted the data on reported deaths due to accidental falls among Chinese residents during 2004 – 2018. Annual mortality rate and standardized mortality rate of accidental falls were calculated; annual percentage change (APC) and average annual percentage change (AAPC) were calculated with Joinpoint 4.8.0.1 statistical software. ResultsIn Chinese residents from 2004 to 2018, the annual standardized mortality rates (per 100 000 people) of accidental falls were 8.69, 9.34, 8.48, 8.46, 8.28, 9.25, 9.21, 8.62, 7.68, 7.39, 7.86, 8.43, 8.56, 9.00, and 9.04, respectively, with a non-significant increasing trend on the whole (AAPC = 0.4, P > 0.05). For the female residents, the standardized mortality rate of accidental falls decreased from 6.54/100 000 in 2004 to 5.11/100 000 in 2014 (APC = – 2.5%, P < 0.05); while from 2014 to 2018, the standardized mortality rate increased non-significantly (P > 0.05). For the infants less than one year old, the mortality rate of accidental falls increased non-significantly from 2004 to 2006 (P > 0.05), but the mortality rate decreased significantly from 0.05/100 000 in 2006 to 0.02/100 000 in 2018 (APC = – 8.2%, P < 0.05). The standardized mortality rate of accidental falls decreased significantly from 1.48/100 000 in 2004 to 1.24/100 000 in 2018 among the residents aged 15 to 44 years (AAPC = – 1.6%, P < 0.05) but among the residents aged 45 be 64 yeas and those aged ≥ 65 years, the rate increased significantly from 1.83/100 000 and 4.63/100 000 in 2004 to 2.17/100 000 and 5.69/100 000 in 2018 (AAPC = 1.0% and 1.3%, both P < 0.05). For the residents in central China, the standardized mortality rate of accidental falls decreased significantly from 8.34/100 000 in 2004 to 6.68/100 000 in 2015 (APC = – 2.3%, P < 0.05), the rate then increased from 2015 to 2018 non-significantly (P > 0.05); for the residents in western China, the standardized mortality rate of accidental falls increased significantly from 9.97/100 000 in 2004 to 12.33/100 000 in 2018 (AAPC = 1.6%, P < 0.05). Among urban residents, significant decrease in standardized mortality rate of accidental falls (from 8.28/100 000 to 6.39/100 000) was observed during the period from 2004 to 2013 (APC = – 2.2%, P < 0.05) but after then, a significant increase in the rate was found with a significantly increased rate of 8.02% in 2018 (APC = 4.5%, P < 0.05). Conclusion Among residents in China, the standardized mortality rate of accidental falls increased non-significantly from 2004 to 2018 and the residents at elder age and living in western China were populations with higher mortality of accidental falls; in addition, the standardized death rate of accidental falls showed an increasing trend from 2014 to 2018 among urban residents.

IntroductionDisseminating health science information via the internet has become an essential means for improving Chinese residents' health literacy, which has received constant attention from the Chinese government. Therefore, it is important to explore Chinese residents' perceived value and emotional response to mobile health science information for determining Chinese residents' satisfaction and use intention.MethodsThis study applied the cognition–affect–conation model to evaluate the perceived value, arousal, pleasure, trust, satisfaction, and continuous use intention. A mobile device was used to obtain health science information from 236 Chinese residents via an online survey and the data were analyzed using partial least squares (PLS)-structural equation modeling.ResultsThe results showed that Chinese residents' perceived value of health science information obtained using the mobile device directly affect the degree of arousal (β = 0.412, P < 0.001), pleasure (β = 0.215, P < 0.01), and trust (β = 0.339, P < 0.001). The degree of arousal (β = 0.121, P < 0.01), pleasure (β = 0.188, P < 0.01), and trust (β = 0.619, P < 0.001) directly affected Chinese residents' satisfaction, which further affected their continuous use intention (β = 0.513, P < 0.001). Similarly, trust directly affected Chinese residents' continuous use intention (β = 0.323, P < 0.001). The degree of arousal directly affected their degree of pleasure (β = 0.304, P < 0.001), and pleasure also imposed a direct effect on trust (β = 0.293, P < 0.001).DiscussionThe result of this study provided an academic and practical reference to improve mobile health science popularization information. Affective changes have imposed an important effect on Chinese residents' continuous use intention. High-quality, diversified and frequent use of health science information can significantly increase residents' continuous use intention, improving their health literacy as a consequence.

Real estate has always been a key industry associated with China's economic and social development, and the real estate market has fluctuated violently in recent years. An objective and accurate evaluation of Chinese residents' willingness to purchase housing provides a foundation for the sustainable development of the real estate industry. Accordingly, an evaluation index system and an evaluation model of Chinese residents' willingness to buy housing were established in this study. First, the influencing factors of Chinese residents' willingness to buy housing were systematically analyzed using Perceived Value Theory. Subsequently, the Continuous Ordered Weighted Averaging was used to assign weights to the selected index system, with smaller expert weights assigned to extreme expert opinions to reduce the subjectivity of the weight calculation results. Ultimately, an evaluation model based on the Extension Cloud Model was constructed. Residents of Nanyang City, Henan Province, China, were selected to find some distinctive conclusions. The empirical study showed that Nanyang residents were hesitant about the purchase intention of the case in April 2021, but quickly became resolute in not buying. Owing to the abrupt change in the real estate industry in China, perceived risk has become the most important risk factor. Several methods have been suggested to improve Chinese residents' willingness to buy housing. Compared with the Analytic Hierarchy Process, the Entropy Weight Method, the fuzzy mathematics, and the grey cluster analysis, it was proved that the proposed model was more effective and advanced. [ABSTRACT FROM AUTHOR]

Abstract Background A growing number of researches supported that dietary fructose was associated with most of the key features of metabolic syndrome (MetS). However, there was no related epidemiological studies among Chinese population, despite the sharp increase in MetS cases. This study explores the relationship between dietary fructose and MetS among Chinese residents aged 45 and above. Methods A total of 25,528 participants (11,574 males and 13,954 females) were included in this nationwide representative cross-sectional study of China National Nutrition and Health Survey. Dietary fructose intake was assessed by 3-day 24-h dietary records. MetS was defined by the International Diabetes Federation and Chinese Diabetes Society criteria. Results The consumption of dietary fructose was 11.6 g/day for urban residents and 7.6 g/day for rural residents. Fruits and vegetables as well as their products were the main sources of fructose intake. There was no association between dietary fructose intake and the odds of having MetS in both urban (P = 0.315) and rural residents (P = 0.230) after adjustment for confounding factors. Moreover, for urban residents participating physical activities, the odds of having MetS in the fourth quartiles (OR: 0.67; 95%CI: 0.52-0.87) was lower than that in the first quartile. In the sensitivity analysis, a significant reduction in the odds of having MetS was also found in the fourth quartiles (OR, 95%CI: 0.68, 0.51-0.90; 0.67, 0.49-0.91; 0.74, 0.56-0.99) compared with the first quartile when excluding smokers, alcohol users, and underweight/obesity, respectively. And there was no association between dietary fructose intake and the odds of having MetS after multivariate adjustment stratified by gender, smoking and alcohol use. Conclusions Under the current dietary fructose intake status, there was no association between dietary fructose intake and the odds of having MetS among Chinese residents aged 45 and above. Physical activity and relatively low fructose intake may have a beneficial synergistic effect on MetS.

As cyberspace has become an important factor in modern-day life, the impact of the Internet on residents has also attracted more attention. Based on the data of China Family Panel Studies (CFPS), this study empirically examines the impact of Internet use on Chinese residents' subjective well-being (SWB) from a multi-dimensional perspective. The research found that Internet use had a significant impact on residents' SWB, which was mainly reflected in job satisfaction, happiness, social ties, and future confidence. The impacts of the Internet's different application fields are not consistent. Applying its use more in studying, working, socialize and commercial activities has a stronger effect, but has no significant impact on entertainment. Further heterogeneity tests also found that the marginal effect of Internet use increases with age, male and low-income groups can obtain greater benefit from the Internet, and there is almost no difference between urban and rural areas. This research provides micro evidence of the social effects of Internet use and provides enlightenment for how to further promote the quality of Internet use to better benefit people. [ABSTRACT FROM AUTHOR]

The United States (US) is a well-known international tourism destination. However, some states, such as Michigan, remain unfamiliar to international tourists. The current study reflects the rapid increase of Chinese residents in the US, targeting this group as potential international tourists to Michigan. This quantitative study seeks to identify factors that determine the visit intentions of this tourist segment. To this end, it examines the relationship between destination image, factors pertaining to the theory of planned behavior (TPB), acculturation, and visit intention. An online survey is conducted, and the collected data are analyzed using partial-least-square structural equation modeling. The results validate the destination image as strongly related to attitudes. Among the TPB factors, perceived behavioral control is most strongly related to visit intention, followed by subjective norms and attitudes. Acculturation partially mediates the relationship between perceived behavioral control and visit intention. The result can be utilized in destinations not renowned as popular international tourism destinations and that need a new business opportunity to revitalize the local economy. [ABSTRACT FROM AUTHOR]

Background: Home quarantine is an important strategy to contain the mass spread of the coronavirus disease 2019 (COVID-19) pandemic. However, there are a dearth of studies on the prevalence and risk factors of home quarantine strategy implementation among residents. This study aims to assess the state of home quarantine strategy implementation among Chinese residents, which could provide a reference for quarantine policymakers around the world during the pandemic.Method: We conducted a cross-sectional survey of 3,398 residents in China by adopting a convenience sampling strategy. We measured the prevalence and risk factors of home quarantine strategy implementation with the Center for Epidemiological Studies-Depression Scale (CES-D), 10-item Connor-Davidson Resilience Scale (CD-RISC 10), and Perceived Social Support Scale (PSSS). A multivariable model was used to determine the factors associated with home quarantine strategy implementation.Results: A total of 2,936 (86.4%) respondents carried out home quarantine. There were some factors significantly associated with home quarantine strategy implementation among Chinese residents during the COVID-19 outbreak. Respondents who were male, lived in western and central China, were aware of the primary symptoms of COVID-19, were willing to accept recommendations on relevant protective measures, understood local quarantine measures, had better resilience, and had better social support were more likely to engage in home quarantine. Respondents who were married, were employed, were healthy, and had high depression scores were more likely to refuse to follow home quarantine guidance.Conclusions: Gender, region, marital status, employment status, health status, awareness of the primary symptoms of COVID-19, willingness to accept recommendations on relevant protective measures, understanding of local quarantine measures, depression, psychological resilience, and perceived social support were the main factors affecting the implementation of residents' home quarantine strategy. Health service policymakers should adopt relevant measures to improve the prevalence of home quarantine strategy implementation among residents during the pandemic.

Background: A growing number of researches supported that dietary fructose was associated with most of the key features of metabolic syndrome (MetS). However, there was no related epidemiological studies among Chinese population, despite the sharp increase in MetS cases. This study explores the relationship between dietary fructose and MetS among Chinese residents aged 45 and above.Methods: A total of 25,528 participants (11,574 males and 13,954 females) were included in this nationwide representative cross-sectional study of China National Nutrition and Health Survey. Dietary fructose intake was assessed by 3-day 24-h dietary records. MetS was defined by the International Diabetes Federation and Chinese Diabetes Society criteria.Results: The consumption of dietary fructose was 11.6 g/day for urban residents and 7.6 g/day for rural residents. Fruits and vegetables as well as their products were the main sources of fructose intake. There was no association between dietary fructose intake and the odds of having MetS in both urban (P = 0.315) and rural residents (P = 0.230) after adjustment for confounding factors. Moreover, for urban residents participating physical activities, the odds of having MetS in the fourth quartiles (OR: 0.67; 95%CI: 0.52-0.87) was lower than that in the first quartile. In the sensitivity analysis, a significant reduction in the odds of having MetS was also found in the fourth quartiles (OR, 95%CI: 0.68, 0.51-0.90; 0.67, 0.49-0.91; 0.74, 0.56-0.99) compared with the first quartile when excluding smokers, alcohol users, and underweight/obesity, respectively. And there was no association between dietary fructose intake and the odds of having MetS after multivariate adjustment stratified by gender, smoking and alcohol use.Conclusions: Under the current dietary fructose intake status, there was no association between dietary fructose intake and the odds of having MetS among Chinese residents aged 45 and above. Physical activity and relatively low fructose intake may have a beneficial synergistic effect on MetS. [ABSTRACT FROM AUTHOR]

Social stratum differences lay behind the winter sports body-building activities of Chinese residents. Guided by social stratification theory this paper takes heterogeneity research as the paradigm, and carries out in-depth interviews to explore the winter sports body-building behaviors and concepts of Chinese citizens in three classes, namely, middle class (white collar), working class (blue collar), and unemployed (jobless) class. In addition, the authors explored the correlation of participation and experience of each class with economy, education, and society dimensions of snow sports culture. This paper holds that: a. Difference in economic conditions determine the level, scope, and degree of the participation of winter sports; b. The improvement of education level accelerates the socialization progress of participants, but it also increases the differentiation of individual participation and intensifies social stratification; c. The bidding and holding of Beijing Winter Olympics greatly promotes the development of winter sports in China, and forms a feature of "middle-class consumers", while the consumption of the working class and unemployed (jobless) residents is more "rational". The paradigm of social stratification and heterogeneity research helps relevant researchers to break away from the narrow perspective of finding the individual-level causality behind winter sports body-building, laying the basis for social, and sports researchers to recognize and understand the unequal social structure of winter sports participation. [ABSTRACT FROM AUTHOR]

Background: Home quarantine is an important strategy to contain the mass spread of the coronavirus disease 2019 (COVID-19) pandemic. However, there are a dearth of studies on the prevalence and risk factors of home quarantine strategy implementation among residents. This study aims to assess the state of home quarantine strategy implementation among Chinese residents, which could provide a reference for quarantine policymakers around the world during the pandemic. Method: We conducted a cross-sectional survey of 3,398 residents in China by adopting a convenience sampling strategy. We measured the prevalence and risk factors of home quarantine strategy implementation with the Center for Epidemiological Studies-Depression Scale (CES-D), 10-item Connor-Davidson Resilience Scale (CD-RISC 10), and Perceived Social Support Scale (PSSS). A multivariable model was used to determine the factors associated with home quarantine strategy implementation. Results: A total of 2,936 (86.4%) respondents carried out home quarantine. There were some factors significantly associated with home quarantine strategy implementation among Chinese residents during the COVID-19 outbreak. Respondents who were male, lived in western and central China, were aware of the primary symptoms of COVID-19, were willing to accept recommendations on relevant protective measures, understood local quarantine measures, had better resilience, and had better social support were more likely to engage in home quarantine. Respondents who were married, were employed, were healthy, and had high depression scores were more likely to refuse to follow home quarantine guidance. Conclusions: Gender, region, marital status, employment status, health status, awareness of the primary symptoms of COVID-19, willingness to accept recommendations on relevant protective measures, understanding of local quarantine measures, depression, psychological resilience, and perceived social support were the main factors affecting the implementation of residents' home quarantine strategy. Health service policymakers should adopt relevant measures to improve the prevalence of home quarantine strategy implementation among residents during the pandemic. [ABSTRACT FROM AUTHOR]

Real estate has always been a key industry associated with China’s economic and social development, and the real estate market has fluctuated violently in recent years. An objective and accurate evaluation of Chinese residents’ willingness to purchase housing provides a foundation for the sustainable development of the real estate industry. Accordingly, an evaluation index system and an evaluation model of Chinese residents’ willingness to buy housing were established in this study. First, the influencing factors of Chinese residents’ willingness to buy housing were systematically analyzed using Perceived Value Theory. Subsequently, the Continuous Ordered Weighted Averaging was used to assign weights to the selected index system, with smaller expert weights assigned to extreme expert opinions to reduce the subjectivity of the weight calculation results. Ultimately, an evaluation model based on the Extension Cloud Model was constructed. Residents of Nanyang City, Henan Province, China, were selected to find some distinctive conclusions. The empirical study showed that Nanyang residents were hesitant about the purchase intention of the case in April 2021, but quickly became resolute in not buying. Owing to the abrupt change in the real estate industry in China, perceived risk has become the most important risk factor. Several methods have been suggested to improve Chinese residents’ willingness to buy housing. Compared with the Analytic Hierarchy Process, the Entropy Weight Method, the fuzzy mathematics, and the grey cluster analysis, it was proved that the proposed model was more effective and advanced.

The COVID-19 has undergone several mutations, and caused deleterious effects on physical and mental health of people worldwide. Whilst physical exercise is known for its positive effect on enhancing immunity and reducing the negative consequences of unhealthy emotional states caused by the pandemic; there is a severe lack of psychological exercise intervention measures and mitigation strategies to advance the knowledge and role of physical exercise to improve mental health in most countries. This study surveyed the association between physical exercise and mental health burden during the COVID-19 outbreak in China to better understand the influence of different physical exercise types on reducing mental health burden during the pandemic. ANOVA, binary logistic regression, the chi-square test, and Spearman's correlation analysis were used for statistical analysis. 14,715 participants were included. The results showed that Chinese residents had several poor mental health conditions during the COVID-19 outbreak. And there was a significant positive correlation between the extent of adverse effects on mental health and provincial proportions of confirmed COVID-19 cases (r = 0.365, p < 0.05). Some main factors caused an unhealthy psychological status, including epidemic severity (62.77%, 95% CI 58.62-65.64%), prolonged home quarantine (60.84%, 95% CI 58.15-63.25%), spread of large amounts of negative information about COVID-19 in the media (50.78%, 95% CI 47.46-53.15%), limitations in daily life and social interaction (45.93%, 95%CI 42.46-47.55%), concerns about students' learning (43.13%, 95% CI 40.26-45.48%), and worries about being infected (41.13%, 95% CI 39.16-45.23%). There was a significant association between physical exercise and mental health. The largest associations were seen for home-based group entertainment exercise (i.e., family games, rope skipping, and badminton), Chinese traditional sports (i.e., Chinese martial arts, Taijiquan and Qigong), and popular sports (i.e., yoga, video dancing, sensory-motor games, and whole-body vibration), as well as durations of 30-60 min per session, frequencies of three to five times per week and a total of 120-270 min of moderate-intensity exercise weekly during the COVID-19 outbreak (p < 0.05).

The COVID-19 has undergone several mutations, and caused deleterious effects on physical and mental health of people worldwide. Whilst physical exercise is known for its positive effect on enhancing immunity and reducing the negative consequences of unhealthy emotional states caused by the pandemic; there is a severe lack of psychological exercise intervention measures and mitigation strategies to advance the knowledge and role of physical exercise to improve mental health in most countries. This study surveyed the association between physical exercise and mental health burden during the COVID-19 outbreak in China to better understand the influence of different physical exercise types on reducing mental health burden during the pandemic. ANOVA, binary logistic regression, the chi-square test, and Spearman's correlation analysis were used for statistical analysis. 14,715 participants were included. The results showed that Chinese residents had several poor mental health conditions during the COVID-19 outbreak. And there was a significant positive correlation between the extent of adverse effects on mental health and provincial proportions of confirmed COVID-19 cases (r = 0.365, p < 0.05). Some main factors caused an unhealthy psychological status, including epidemic severity (62.77%, 95% CI 58.62-65.64%), prolonged home quarantine (60.84%, 95% CI 58.15-63.25%), spread of large amounts of negative information about COVID-19 in the media (50.78%, 95% CI 47.46-53.15%), limitations in daily life and social interaction (45.93%, 95%CI 42.46-47.55%), concerns about students' learning (43.13%, 95% CI 40.26-45.48%), and worries about being infected (41.13%, 95% CI 39.16-45.23%). There was a significant association between physical exercise and mental health. The largest associations were seen for home-based group entertainment exercise (i.e., family games, rope skipping, and badminton), Chinese traditional sports (i.e., Chinese martial arts, Taijiquan and Qigong), and popular sports (i.e., yoga, video dancing, sensory-motor games, and whole-body vibration), as well as durations of 30-60 min per session, frequencies of three to five times per week and a total of 120-270 min of moderate-intensity exercise weekly during the COVID-19 outbreak (p < 0.05). [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the current status of depression self-management (DSM), and to identify influencing factors of DSM among Chinese community residents.Methods: Stratified random sampling methodology was adopted in this cross-sectional survey. Respondents completed a collection of self-administered questionnairesResults: The majority of participants were female (72.2%), having a mean age of 39 years (SD = 17.3). The total mean score on the DSSM was low (31.63 ± 4.69). Using multiple linear regression analysis, age ranging from 25 to 64 years old (Beta = −0.176, p = 0.008), having personal stigma (Beta = −0.143, p = 0.020) and perceived stigma (Beta = 0.127, p = 0.037), and having a nuclear family structure (Beta = −0.313, p = 0.046), good family function (Beta = 0.278, p < 0.001) and good help-seeking attitude (Beta = 0.159, p = 0.008) were associated with DSSM-knowledge. Older age (≥65 years) (Beta = −0.152, p = 0.034), higher CES-D scores (Beta = −0.162, p = 0.005), having a father with a bachelor's degree or higher level of education (Beta = −0.134, p = 0.047), being female (Beta = 0.147, p = 0.012), indicating a religious preference (Beta = 0.145, p = 0.017) and having good family function (Beta = 0.247, p = 0.001) were significantly associated with DSSM-activities.Conclusions: Reducing stigma related to depression and enhancing help-seeking attitudes may be potential strategies for managing depressive symptoms among Chinese community residents.

Objective: This study aimed to investigate the current status of depression self-management (DSM), and to identify influencing factors of DSM among Chinese community residents. Methods: Stratified random sampling methodology was adopted in this cross-sectional survey. Respondents completed a collection of self-administered questionnaires Results: The majority of participants were female (72.2%), having a mean age of 39 years (SD = 17.3). The total mean score on the DSSM was low (31.63 ± 4.69). Using multiple linear regression analysis, age ranging from 25 to 64 years old (Beta = −0.176, p = 0.008), having personal stigma (Beta = −0.143, p = 0.020) and perceived stigma (Beta = 0.127, p = 0.037), and having a nuclear family structure (Beta = −0.313, p = 0.046), good family function (Beta = 0.278, p < 0.001) and good help-seeking attitude (Beta = 0.159, p = 0.008) were associated with DSSM-knowledge. Older age (≥65 years) (Beta = −0.152, p = 0.034), higher CES-D scores (Beta = −0.162, p = 0.005), having a father with a bachelor's degree or higher level of education (Beta = −0.134, p = 0.047), being female (Beta = 0.147, p = 0.012), indicating a religious preference (Beta = 0.145, p = 0.017) and having good family function (Beta = 0.247, p = 0.001) were significantly associated with DSSM-activities. Conclusions: Reducing stigma related to depression and enhancing help-seeking attitudes may be potential strategies for managing depressive symptoms among Chinese community residents. [ABSTRACT FROM AUTHOR]

Although environmental issues have attracted public attention, there are still many people unwilling to make behavioral changes to solve the problem, which makes promoting pro-environmental behavior become an interesting research topic. This study discusses the influence of air quality on the pro-environmental behavior of Chinese residents from the perspective of spatial distance, providing a theoretical basis and practical application for improving pro-environmental behavior. Through three experiments, this study reveals that air pollution within the local spatial distance could make residents more willing to conduct pro-environmental behavior. In addition, we also find that air pollution within local spatial distance would stimulate residents’ environmental affection and promote them to conduct pro-environmental behavior. That is, environmental affection plays a mediating role in the interactive effect of air quality and spatial distance on pro-environmental behavior.

Urban violence and threats to personal safety are everyday issues of shared concern for Chinese migrants in France. They push Chinese migrants to act as local residents and to interact with the host country in various and unexpected ways, whether openly or inconspicuously, in order to improve their living environment and negotiate their place in the host society. Drawing on an ethnography of Chinese immigrants living in the banlieues of Paris and their everyday social practices in relation to the issues of violence and insecurity, this article documents the strategies of everyday resistance used by Chinese immigrants, grounded in their local knowledge. In a shift toward further local participation, they perform these actions as local residents, resulting in a de facto citizenship. 摘要: 城市暴力与不安全是与在法华人密切相关的议题。出乎意料的是，这一让华人深受其扰的问题却推动了他们以在地居民的角色与移居国进行各种或公开的或隐蔽的互动，旨在改善移民自己所处的居住环境，并以此为契机对自己在移居国的位置进行讨价还价。本文基于对一处位于巴黎郊区的中国移民聚居区及其华人居民围绕着与暴力和不安全问题所做的日常社会实践的民族志调查，分析了中国移民基于他们积累的当地知识而发展出来的日常抗争策略。在此基础上，这些作为在地居民的实践推动中国移民更深入地参与到当地的社会生活之中，并最终产生了事实公民身份。 [ABSTRACT FROM AUTHOR]

This article compares various collective actions carried out by ethnic Chinese residents against violence in their communities, and the negotiations these residents initiated with local authorities on this issue, in two suburbs of Paris, Aubervilliers and La Courneuve. Although French national policy toward immigrant minorities has been guided by the principle of "color-blindness," some municipalities in the Paris region have gradually recognized the increasing diversity of their populations, and have incorporated the vocabulary of multiculturalism in their local governance. Consequently, the municipalities' different approaches to identifying and coping with violence against Chinese residents vary according to how they perceive the diversity of local residents, and according to inter-ethnic relations in those areas. We consider that the different degrees of recognition with regard to Chinese communities within the two municipalities have affected the consequences of the Chinese residents' collective actions, and their sense of inclusion in the cities where they live. Beyond the appearance of inter-ethnic conflicts, our comparative study demonstrates the intersectional cause of violence against the Chinese population—especially with regard to the disparities, both social and spatial, among Chinese residents themselves. 提要: 本文比较巴黎两个郊区的华人居民针对街区暴力抢劫所采取的集体行动。这些集体行动一方面抗议暴力抢劫，另一方面寻求与当地政府的合作。随着移民群体的增加和多样化，部分城市逐渐将多元文化政策纳入本地的治理之中。两个城市对待华裔族群的不同政策影响了华人居民的动员方式和结果，并影响了他们对所居地的融入感。通过对两个郊区的比较研究，本文凸显了在族群纷争的表象下，社会经济与空间的不平等如何塑造了暴力抢劫现象及可能的回应。 [ABSTRACT FROM AUTHOR]

Objectives: Sleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors.Methods: This research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8151 respondents, 6437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents' sleep quality.Results: During the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95% CI: 1.1-2.64), 1.35 (95% CI: 1.16-1.59), 5.59 (95% CI: 4.32-7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95% CI: 1.43-2.09), 1.57 (95% CI: 1.29-1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR = 0.77 (95% CI: 0.63-0.93).Conclusions: During the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents' rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality. [ABSTRACT FROM AUTHOR]

The study of subjective well-being (SWB) has attracted considerable attention from scholars globally. This has stimulated numerous studies that have identified regional and individual factors associated with SWB, but the extant research lacks multi-level studies that simultaneously examine their influence on SWB. Environmental pollution is one of such factors, but few studies have investigated its effect on SWB in China particularly. The current study addressed these problems by conducting hierarchical linear regressions to explore the effects of regional and individual factors on Chinese people's SWB. Three major environmental pollutions (wastewater pollution, domestic waste pollution, and air pollution) were studied using data from the Chinese General Social Survey 2013 and China Statistical Yearbook 2014. The results indicated that wastewater pollution and domestic waste pollution had significant negative influence on SWB. Moreover, gross domestic product (GDP) per capita might contribute more to the improvement of SWB than income inequality. This implies that individuals' SWB might be enhanced by improving absolute income, which is consistent with the micro-level proposition of the Easterlin paradox. Overall, these findings signal that effective management of environmental pollution is essential for promoting the SWB of the people in China. [ABSTRACT FROM AUTHOR]

Community health screenings provide both health care services and social networking opportunities among Chinese elders, and thus, affect their health-related quality of life. Older Chinese participants at a free monthly health screening hosted by Health Protection and Education Services were asked to explain why they visit health screenings and how do health screenings affect their health and social needs. Results show that free community health screenings are likely to lead to better quality of life in older Chinese attendees by reducing healthcare barriers, helping attendees to monitor their chronic conditions, and allowing them to strengthen their social connections. [ABSTRACT FROM AUTHOR]