by Ying Li, Jing Jia, Runze Lu, Liyan Dong, Lizhu Fang, Litao Sun, Zongyi Zhang, Qing Duan, Lijie Zhang, Kunzheng Lv, Huilai Ma
BackgroundQingdao, a historically high-risk area for hemorrhagic fever with renal syndrome (HFRS) in China, is undergoing agricultural mechanization and urbanization. However, the specific risk factors for HFRS in this context remain unclear. This study sought to determine the risk factors for HFRS in Qingdao.
MethodsCommunity-based, 1:2 case-control study. Each case was matched with two healthy neighborhood controls based on biological sex, age, and the same neighborhood or village. Univariate and multivariate conditional logistic regression analyses were performed. Furthermore, stratified analyses were performed to explore risk factor heterogeneity between the peak season for Hantaan virus (HTNV) type HFRS (October-January) and other months.
Results93 cases (73.2%, 93/127) reported from January 2022 to September 2023 and 186 controls completed this questionnaire. Farmers accounted for the highest proportion (68.8%, 64/93). In multivariate logistic regression analysis, there were three significant risk factors for HFRS: piles of firewood and/or grain in residential yards (odds ratio [OR]=3.75, 95% CI: 2.14–6.55), mite and/or flea bites (OR=1.83, 95% CI: 1.06–3.18) and contacting with rats and/or their excreta (OR=1.73, 95% CI: 1.09–2.74); three variables represented significant protective factors for HFRS: frequency of sun exposure for quilts and bedding (OR=0.41, 95% CI: 0.19–0.90), rodent control measures at home (OR=0.50, 95% CI: 0.30–0.81) and knowing the main sources of HFRS transmission (OR=0.58, 95% CI: 0.36–0.90). Stratified analysis revealed that the influence of these factors varied by season, with rodent contact and control measures being particularly salient during the HTNV peak season.
ConclusionThis study provides the first comprehensive evidence of risk and protective factors for HFRS in Qingdao, highlighting the role of rodent control, promoting comprehensive health education, environmental management, and personal protection. However, the results should be interpreted considering the study’s limitations, including a 73.2% response rate and the potential for recall bias.
by Hua-Hong Wu, Ya-Qin Zhang, Cheng-Dong Yu, Fang-Fang Chen, Jun-Ting Liu, Shao-Li Li, Xin-Nan Zong
BackgroundBrachydactyly type A3 (BDA3), a common finger deformity, demonstrates an inverse epidemiological relationship with population height, suggesting a potential link with individual stature. We aimed to investigate the distribution of BDA3 and its association with shorter stature in Chinese children.
MethodsFrom 2022 to 2023, we conducted a cross-sectional survey in 10 randomly selected schools in Beijing with children aged 3–18. We measured height on-site, obtained left hand-wrist X-rays, calculated predicted adult height (PAH) based on height and bone age, and diagnosed BDA3 deformity based on the X-ray images. And we compared the height and PAH between the BDA3 and Non-BDA3 groups by t-test or chi-square test, examined the association of BDA3 with shorter stature and shorter PAH using binary logistic regression model.
ResultsA total of 5,567 children participated, with 573 diagnosed with BDA3 (a detection rate of 10.3%). Notably, girls exhibited a significantly higher detection rate than boys (14.5% vs. 6.3%). The detection rate in children 12 years(15.3% vs. 7.6%). The average height and PAH were 0.30 SD and 0.22 SD lower, and the risk of shorter stature and shorter PAH were 1.57 times and 1.47 times higher in the BDA3 group than in the Non-BDA3 group, respectively. And, children >12 years in the BDA3 group had a significantly lower PAH than those in the Non-BDA3 group (about 2.0 cm). Conclusion: Children with BDA3 are more likely to have shorter stature and shorter PAH than those with no BDA3 in Chinese children aged 3–18 years.
To estimate the longitudinal predictive relationships between anxiety, depression and post-traumatic stress disorder symptoms in nurses exposed to horizontal violence and identify the most influential symptom using cross-lagged panel network analysis.
A longitudinal cross-lagged panel network analysis study.
Data were obtained from a short longitudinal survey conducted at four tertiary hospitals in Shandong Province, China. Two follow-up surveys spaced 7 weeks apart were conducted on 298 nurses with horizontal violence exposure using the General Information Scale, the Negative Acts Questionnaire, the seven-item Generalised Anxiety Disorder scale, the nine-item Patient Health Questionnaire and the four-item SPAN. Unique longitudinal relationships between symptoms were estimated using cross-lagged panel network analysis.
The results showed that the out-expected influence of A2 (Uncontrollable worry) and P2 (Physiological arousal) was highest and they were the most predictive symptoms in the network. The bridge out-expected influence of A2 (Uncontrollable worry) was also highest and it was the key bridge symptom within the network.
A2 (Uncontrollable worry) and P2 (Physiological arousal) were the top risk factors contributing to mental health deterioration in nurses with horizontal violence exposure.
This study precisely identified the predictive mechanisms and core symptoms among psychological symptoms in nurses exposed to horizontal violence, which is expected to play a significant role in improving the mental health of this group. The results showed that “Uncontrollable worry” and “Physiological arousal” were the core symptoms with the strongest predictive effects on other symptoms. Additionally, “Uncontrollable worry” was also the bridge symptom driving the mutual transmission and development of anxiety, depression and post-traumatic stress disorder. Nursing managers should prioritise “Uncontrollable worry” and “Physiological arousal” as intervention targets, optimising mental health interventions to effectively enhance the psychological well-being of nurses exposed to horizontal violence.
No patient or public contribution.
This scoping review synthesises the application of patient journey mapping (PJM) in breast cancer care to provide insights for enhancing patient-centred services and improving the quality of life for patients with breast cancer.
Scoping review.
Web of Science, PubMed, Cochrane Library, CINAHL, Embase, CNKI, Wanfang and SinoMed were systematically searched for relevant studies published between 1 May 2005 and 1 May 2024.
Studies involving adults (≥18 years) with breast cancer that examined patient journeys were eligible, regardless of whether a formal PJM approach was used. All study designs in healthcare or community settings were considered. Exclusions included studies on other cancers, duplicates, inaccessible full texts, non-English/Chinese publications and non-original articles.
Two reviewers independently screened and extracted data, with a third resolving discrepancies. Information on study characteristics, methods and PJM applications was narratively synthesised and tabulated.
A total of 20 studies published from 2011 to 2024 were included. Four primary approaches to PJM in breast cancer care were identified, with cancer care stage mapping being the most prevalent. PJM illustrated patients’ trajectories, experiences and emotions, revealed critical interaction points such as diagnosis, decision-making and follow-up, and highlighted delays, coordination gaps and opportunities for service improvement. Most studies incorporated four core elements—patients, touchpoints, timelines and experiences—and emphasised patient perspectives across the care continuum, despite methodological heterogeneity.
This review shows that PJM has been applied to illustrate longitudinal healthcare experiences, identifies key touchpoints and supports the design and improvement of breast cancer care services. Most studies underscored patient perspectives and emotional needs, but current PJM applications remain fragmented, hospital-focused and weakly integrated across care settings and families. Future research should refine methodologies and apply digital technologies to develop personalised, dynamic maps that may enhance patient-centred care.