Assessment of Online Transgender Healthcare Teaching Modules for Internal Medicine Residents and Fellows

Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.

An Experimental Study on the Effectiveness of Individualized Online Intervention for Mental Health Literacy of Community Residents

Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily depend on traditional education and contact interventions,which have limitations with regard to pertinence and individualization.Artificial intelligence(AI)and big data technology have influenced mental health services to be more intellectual and digital,and they also provide greater technical convenience for individualized interventions for promoting mental health literacy.However,there is relatively little research on the effectiveness of individualized online intervention for mental health literacy in the literature.This study aims to fill this void.To verify whether individualized online intervention can improve the level of mental health literacy.Methods:We conducted a pretest–post-test control experiment.The participants were recruited from a large community located in central China.A total of 152 participants completed the research.We use mixed linear model estimation and paired t-tests to analyze the data.Results:Individualized online intervention can effectively improve the mental health literacy level of participants.Specifically,we found that compared with the control group,the mental health literacy in the experimental group was significantly improved after receiving individualized online intervention.Likewise,the mental health literacy of the control group has also improved after receiving individualized online intervention.In addition,we compared the mental health literacy level of the experimental group at Time 3 to those at Time 2 and found that the mental health literacy level at Time 3 had not decreased one month later.This shows that individualized online intervention was not only momentarily effective,but also had long-term efficacy.Conclusion:This study illustrates that the individualized online intervention has both great momentary and long-term effectiveness in improving community residents’mental health literacy.

Ophthalmic exam and ophthalmology residents’ subspecialty preference

AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.

Analysis of Influencing Factors on Fruit Consumption of Urban and Rural Residents in Beijing

In light of the rapid expansion of China s economy,there has been a notable shift in the consumption patterns of urban and rural residents.This is evident in the increased consumption of agricultural products,with fruit consumption representing a particularly pronounced trend.The 2023 Beijing Consumption Statistics indicate that demand for fruit is increasing,accompanied by heightened competition for quality and brands.The paper is based on research that examines the current situation of fruit consumption among urban and rural residents in Beijing.The results indicate that when urban and rural residents in Beijing purchase fruits,price is the most significant factor influencing fruit consumption.Taste,appearance,and variety are also considered to be important influencing factors,while the influence of factors such as fruit type,consumption pattern,and fruit brand is relatively minor.

Dynamic analysis of major public health emergency transmission considering the dual-layer coupling of community–resident complex networks

We construct a dual-layer coupled complex network of communities and residents to represent the interconnected risk transmission network between communities and the disease transmission network among residents. It characterizes the process of infectious disease transmission among residents between communities through the SE2IHR model considering two types of infectors. By depicting a more fine-grained social structure and combining further simulation experiments, the study validates the crucial role of various prevention and control measures implemented by communities as primary executors in controlling the epidemic. Research shows that the geographical boundaries of communities and the social interaction patterns of residents have a significant impact on the spread of the epidemic, where early detection, isolation and treatment strategies at community level are essential for controlling the spread of the epidemic. In addition, the study explores the collaborative governance model and institutional advantages of communities and residents in epidemic prevention and control.

The Impact of the Digital Economy on Rural Residents’Working Hours:Mechanisms and Empirical Evidence

The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018,this paper measured the development level of the digital economy in China from the perspectives of internet development and digital financial inclusion,and tested the mechanisms of how the digital economy affected rural residents’working hours.The results showed that the digital economy extended rural residents’working hours by expanding information channels and enhancing human capital,and this mechanism was affected by heterogeneity in rural residents’educational background,age,and social capital.Building on these findings,this paper holds that to increase rural residents’income by extending their working hours and achieving common prosperity for all,it is necessary to expand the opportunities for rural residents to participate in skills training and promote their accumulation of human capital.

The Prediction for the Consumer Price Index of Residents in Perspective of Time Series Method in Case of Chongqing

The consumer price index (CPI) measures the relative number of changes in the price level of consumer goods and services over time, reflecting the trend and degree of changes in the price level of goods and services purchased by residents. This article uses the ARMA model to analyze the fluctuation trend of the CPI (taking Chongqing as an example) and make short-term predictions. To test the predictive performance of the model, the observation values from January to December 2023 were retained as the reference object for evaluating the predictive accuracy of the model. Finally, through trial predictions of the data from May to August 2023, it was found that the constructed model had good fitting performance.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Application of BOPPPS + Mind Maps to Improve Clinical Competence of General Practitioner Residents: Taking Cough as an Example

Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.

Exploration of the Integration of Curriculum Ideology and Politics into the Educational Pathway of Standardized Training for General Practice Residents

In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.

全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

Flipped classroom approach to global outreach:cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents

AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018.Residents were instructed to watch a pre-class video lecture prior to the in-class-casebased activity.Content tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same content.RESULTS:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly improve.CONCLUSION:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting.The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge.Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings.Finally,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.

Cross-sectional Study on Their Reproductive Health Status of 604 Fem ale Floating Residents in Beijing

This study on the reproductive health statusw asbased on the data from a survey and an exam ination of severalhundredsof fem ale floating residentsin Beijing. The results w ere compared w ith those from fem ale perm anent residents in Beijing. The study revealed thatm ostof theinvestigated fem alefloating residentshad lived in Bei- jing w ith their fam ily for threeyearson an average. They had a harderlifethan that of Beijing perm anentresidents. Also they did notreceiveadequateprenatalcaresdur- ing their pregnanciesin Beijing and a quarter of thesem othersdid notreceiveany pre- natal exam ination during their pregnancies at all. Again the fem ales had a great prevalence of reproductive tractinfections, reaching 29.3of thoseexam ined, high- er than the w om en perm anently residing in Beijing.

The status and influence factors of residents＇ health knowledge awarenessin Yizhou district of Hami city

[目的] 了解新疆哈密市伊州区居民健康知识知晓情况及其影响因素.[方法]采用分层整群随机抽样 的方法,抽取哈密市伊州区的丽园街道丽园社区、石油新城街道支油区社区、陶家宫乡和回城乡的居民（ 共 700名）进行问卷调查,利用二元Logistic回归方法分析影响因素.[结果]居民健康知识知晓率为23.5%.具 备健康理解知识知晓、科学健康观知识知晓、传染病知识知晓和职业病知识知晓的比例分别为 55. 0%、 33.4%、27.3%、33. 14%和 52.3%.居民获取健康知识的主要途径占比分别为医生80. 15%、电视38. 10%、 学校或单位22.33%、网络21.02%.居民文化程度与家庭平均月收入及健康知识知晓水平有关（P〈0. 05）. [结论]居民的健康知识知晓水平还有提升空间,影响健康知识知晓水平的主要因素为文化程度和家庭平均月 收入,应有针对性地制定健康教育和健康促进策略,以提高居民健康知识知晓水平.

How does the construction of China’s ecological civilization affect the health burden of urban and rural residents?

Accelerating the construction of ecological civilization and promoting the management of health environment problems is one of the core elements of the implementation of the“Beautiful China”and“Healthy China”strategies with Chinese characteristics in the new era.Based on the scientific connotation of ecological civilization,this paper systematically assesses the level of interprovincial ecological civilization construction in China using the combined CRITIC empowerment method and explores the impact of ecological civilization construction on the health burden of urban and rural residents using interprovincial panel data from 2003 to 2018 with the help of panel feasible generalized least squares,simultaneous equation estimation,and the extended regression model.It is found that there is a significant inverted U-shaped relationship between provincial ecological civilization construction and urban and rural residents’economic health burden,as well as a significant U-shaped relationship between ecological civilization construction and urban and rural residents’disease burden.Fiscal decentralization,urbanization,and industrialization are the three important indirect mechanisms through which ecological civilization affects the health burden of urban and rural residents,and fiscal decentralization plays a typical role in crowding out the health effect of ecological civilization.In the eastern and central regions,ecological civilization construction has effectively reduced the health burden of urban and rural residents,but it is more significant for improving the economic health burden of rural residents.While the“catching-up trend”of the progress of ecological civilization construction in the western region is obvious,ecological civilization plays an important role in alleviating the economic health burden of urban residents.After the robustness test,the conclusion still holds.This study provides an important empirical basis for local governments to improve the accuracy of their policies in promoting the“Beautiful China”and“Healthy China”strategies.

An Empirical Study on the Coupling and Coordination of Health Investment, Resident Health and Economic Growth in Sichuan Province —Based on a Modified Coupling Model

We should calculate the coupling degree of medical investment, resident health and economic growth in Sichuan Province, and make clear the coordinated development of the aforementioned three factors. In that, the government was able to formulate policies that feature the positive interaction and coordinated development of regional medical investment, health and economy. Methods on index system for the evaluation of health investment, resident health and economic growth were constructed, and the coupling and coordination degree of the three systems were empirically studied based on the entropy weight method, the coupling coordination model and the gray correlation method. From the perspective of time series, the overall coupling and coordination level of Sichuan Province is relatively low, and the comprehensive development level of health investment and economic growth system has lagged behind the resident health system;from the perspective of spatial distribution characteristics, in 2019, the coordinated development level of health investment resident health and economic growth coupling in western Sichuan, southern Sichuan, northern Sichuan, eastern Sichuan and northern Sichuan is in the primary coordination stage, but there is a lag in the development of the health investment system between western Sichuan and southern Sichuan, and there is a lag in the development of the economic growth system between northern Sichuan and eastern Sichuan. From the analysis of gray correlation degree, the main correlation factors are diverse. All in all, the overall coordination level of health investment, resident health and economic growth in Sichuan Province is relatively low, and in order to achieve its coordinated development, it is necessary to narrow regional differences, formulate coordinated development strategies according to local conditions, and improve the overall coordination level.

A Blockchain and CP-ABE Based Access Control Scheme with Fine-Grained Revocation of Attributes in Cloud Health

The Access control scheme is an effective method to protect user data privacy.The access control scheme based on blockchain and ciphertext policy attribute encryption(CP–ABE)can solve the problems of single—point of failure and lack of trust in the centralized system.However,it also brings new problems to the health information in the cloud storage environment,such as attribute leakage,low consensus efficiency,complex permission updates,and so on.This paper proposes an access control scheme with fine-grained attribute revocation,keyword search,and traceability of the attribute private key distribution process.Blockchain technology tracks the authorization of attribute private keys.The credit scoring method improves the Raft protocol in consensus efficiency.Besides,the interplanetary file system(IPFS)addresses the capacity deficit of blockchain.Under the premise of hiding policy,the research proposes a fine-grained access control method based on users,user attributes,and file structure.It optimizes the data-sharing mode.At the same time,Proxy Re-Encryption(PRE)technology is used to update the access rights.The proposed scheme proved to be secure.Comparative analysis and experimental results show that the proposed scheme has higher efficiency and more functions.It can meet the needs of medical institutions.

Alexa,let's train now!——A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

Background:There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging.Consequently,the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions.In this context,digital and home-based physical training interventions might be a promising alternative to center-based intervention programs.Thus,this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.Methods:In this pre-registered systematic review(PROSPERO;ID:CRD42022320031),5 electronic databases(PubMed,Web of Science,Psyclnfo,SPORTDiscus,and Cochrane Library)were searched by 2 independent researchers(FH and PT)to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults.The systematic literature search yielded 8258 records(extra17 records from other sources),of which 27 controlled trials were considered relevant.Two reviewers(FH and PT)independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale).Results:Of the 27 reviewed studies,15 reported positive effects on cognitive and motor-cognitive outcomes(i.e.,performance improvements in measures of executive functions,working memory,and choice stepping reaction test),and a considerable heterogeneity concerning study-related,population-related,and intervention-related characteristics was noticed.A more detailed analysis suggests that,in particular,interventions using online classes and technology-based exercise devices(i.e.,step-based exergames)can improve cognitive performance in healthy older adults.Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence(≤85%)and monitoring of the level of regular physical activity in the control group.Conclusion:The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall,though there is limited evidence that specific types of digital and home-based physical training interventions(e.g.,online classes and step-based exergames)can be an effective strategy for improving cognitive performance in older adults.However,due to the limited number of available studies,future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Age- and Sex-Specific Impact of Health Literacy on Healthy Lifestyle Characteristics among Japanese Residents in a Rural Community

The study aimed to examine age- and sex-specific associations between health literacy (HL) and healthy lifestyle characteristics. The cross-sectional study was conducted to examine a total 1348 Japanese participants (613 male and 735 female) who took the health check-up program in April 2013, at Tsumagoi Village, Japan. Information was collected by self-administered questionnaire on three communicative and two critical HL items, and healthy lifestyle characteristics listed in Bres-low’s seven health practices. In multivariate logistic analysis, high HL (≥18) was significantly asso-ciated with healthy lifestyle characteristics in both non-elderly (<65 years old) and elderly (≥65 years old) [Odds ratio (OR) = 1.40, 95% Confidence interval (CI) = 1.13 - 1.75 for non-elderly, OR = 1.34, 95% CI = 1.02 - 1.76 for elderly], as well as female participants (OR = 1.43, 95% CI = 1.06 - 1.94), while the significance was borderline in male participants (OR = 1.34, 95% CI = 0.96 - 1.88). Among 5 HL items, the ability to extract health-related information was significantly associated with healthy lifestyle characteristics (OR = 1.52, 95% CI = 1.11 - 2.07 for non-elderly, OR = 1.55, 95% CI = 1.04 - 2.30 for elderly, OR = 1.95, 95% CI = 1.28 - 2.97 for female participants. HDL-C concentration in the high HL group was significantly higher than that in the low HL group. Among healthy lifestyle characteristics, proportions of smoking behavior (non-smoker), exercise frequency (twice or more per week), and sleep duration (7 - 8 hours) were significantly higher in the high HL group than in the low HL group. The present study revealed a positive association between HL and healthy lifestyle characteristics, which suggests that people are likely to engage in health-promoting behaviours based on access and ability to understand medical information for both age groups and female participants. Significant findings among female participants may be emphasized since it’s important from the entire family's perspective as women are the caretakers of the family. These findings may indicate the importance of comprehensive assessment, including HL, for health promotion in the community.