Developing a Subjective Evaluation Scale for Assessing the Built Environments of China’s Hygienic City Initiative

Objective To develop a preliminary subjective evaluation scale for assessing the built environments of China’s Hygienic City Initiative and to evaluate its reliability and validity.Methods The initial items of the scale were determined based on a review of policy documents and consultations with experts. The final items of the scale were confirmed through individual interviews with residents combined with the discretetrend method, critical ratio method, correlation coefficient method, and factor analysis method. Then, the dimensions of the scale were determined using exploratory factor analysis(EFA). The Cronbach’s α coefficient, split-half reliability coefficient, and confirmatory factor analysis(CFA) were used to assess the reliability and validity of the scale.Results A scale containing five dimensions with 22 items was established, including urban lifestyle,governance, basic functions, environmental sanitation, and amenities. The Cronbach’s α coefficient of the scale was 0.876, and the split-half reliability coefficient was 0.796. The CFA results indicate that each inspection level was within the standard limit.Conclusion The preliminarily subjective evaluation scale for assessing the built environments of China’s Hygienic City Initiative demonstrates a high level of reliability and validity. Additional empirical studies should be carried out to further verify the value of the scale in terms of practical application.

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

Objective To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health(SRH)status of residents,providing a basis for a better promotion on construction of health-supportive environments.Methods The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021.With SRH level as the dependent variable,two-category logistic regression analysis was conducted to analyze the impact of the built environment in hygienic cities on the SRH status of residents.Results A total of 1,357 respondents were enrolled in this study.After controlling confounding factors,four aspects in the built environment in hygienic cities were detected remarkable influences on the SRH level of residents,including enough green space in the living area[odds ratio(OR)=1.395,95%confidence interval(95%CI):1.055–1.845],clean and hygienic living environment(OR=1.472,95%CI:1.107–1.956),residents’confidence in drinking water safety in the living area(OR=1.856,95%CI:1.354–2.544)and residents’confidence in food safety in the living area(OR=1.405,95%CI:1.027–1.921).Conclusion Regarding city construction,the government should focus more on the subjective perception of residents on built environments to build a supportive environment benefiting the health of residents.

Synthetic Characteristics Associated with HIV Diagnosis through Voluntary HIV Testing among HIV-positive People with Non-marital and Non-commercial Heterosexual Transmission in China

The Joint United Nations program on HIV/AIDS reported that 53% of new infections globally in 2017 were beyond key populations and their sexual partners.In this report, although only 16% in Asia and the Pacific were people living with HIV (PLHIV) who did not report any HIV-risk behaviors (mainly including injective drug use, men who have sex with men, sexual workers, and their dients), increasing diag no sed cases who reported their own transmission as non-marital and non-commercial heterosexual con tact (non-M&C sex, defi ned as those heterosexuals who have unpaid sex with any other sexual partners whom they have never married) in China have indicated that the HIV epidemic is spreading to the general population by the bridge of key populations.

Epidemiological Characteristics of Varicella Outbreaks—China,2006–2022

Introduction:Varicella outbreaks significantly disrupt schools and other child-centered institutions.This study aimed to identify patterns and epidemiological features of varicella outbreaks in China from 2006 to 2022.Methods:Data were extracted from outbreak reports submitted to the Public Health Emergency Reporting Management Information System within the specified timeframe.Analytical methods included Spearman correlation tests and the Mann-Kendall trend tests,conducted using R software to analyze and summarize reported data.Additionally,statistical analyses of trends and epidemiological characteristics were performed using SPSS software.Results:Between 2006 and 2022,a total of 11,990 varicella outbreaks were reported in China,resulting in 354,082 cases.The attack rates showed a decreasing trend over the years(Z=−4.49,P<0.05).These outbreaks occurred in two peaks annually.The eastern region accounted for the highest number of outbreaks(31.53%),followed by the southwestern(24.22%)and southern(17.93%)regions.Varicella outbreaks were most common in elementary schools.Most of the outbreaks(60.43%)were classified as Grade IV(general)severity,with 86.41%of the outbreaks having 10–49 cases.The median and inter-quartile ranges(IQR)of the duration of outbreaks,response time,and case counts were 21(10,39)days,4(0,12)days,and 23(16,35)cases,respectively.These variables showed a positive correlation(P<0.001).Conclusions:Varicella outbreaks exhibited fluctuating trends,initially decreasing until 2012,followed by an increase,reaching the highest peak in 2018–2019.Continual monitoring of varicella epidemiology is necessary to assess the burden of the disease and formulate evidence-based strategies and policies for its prevention and control.

Burden of Disease Due to Cancer——China,2000-2019

Summary What is already known about this topic?Cancer is a major global public health problem and the leading cause of death in China.China has a large population,and therefore has a significant proportion of the global burden of cancer.What is added by this report?The age-standardized incidence of cancer has increased in China,while the cancer mortality rate has decreased.Compared with younger age groups,individuals over 70 have a greater burden of cancer.Digestive tract cancer and breast cancer should be targeted for prevention,treatment,and control.

Burden of Mental and Substance Use Disorders-China, 1990−2019

Summary What is already known about this topic?Mental and substance use disorders have notable contributions to the disease burden in China.What is added by this report?In China,mental disorders and substance use disorders accounted for 20.29 million and 5.76 million disability-adjusted life years(DALYs)in 2019,respectively;depressive disorders were the leading cause of DALYs.For mental disorders,the numbers of DALYs increased 12.06%from 2000 to 2019 while the standardized rates declined 5.24%;for substance use disorders,both the numbers and standardized rates of DALYs decreased 8.52%and 18.52%,respectively.

Effects of Varicella Vaccine Time of First Dose and Coverage of Second Dose--Beijing and Ningbo,China,2012-2018

What is already known about this topic?The effectiveness of the two-dose vaccination schedule of varicella is better than that of one dose,but the vaccination schedule and coverage of varicella varies based on provinces in the mainland of China and has differing effects.What is added by this report?Earlier vaccination of the first dose may reduce the varicella incidence,and improving the vaccination coverage rates of the second dose will further reduce the varicella incidence.What are the implications for public health practice?Taking the first dose of vaccination promptly at 12 months old and improving the coverage of second dose of vaccination may play an important role in varicella prevention and control in China.

Trends in Mortality of Low Birth Weight Infants-China,2004-2019

Summary What is already known about this topic?Low birth weight(LBW)significantly affects the health of children during the perinatal period,neonatal period,and infancy,and is an important risk factor for neonatal death.What is added by this report?The mortality rate of low birth weight infants(LBWI)decreased from 2004 to 2019 in China,while the proportion of overall infant deaths due to LBW increased.What are the implications for public health practices?A key way to reduce child mortality and improve children’s health is to reduce the occurrence of LBW and associated mortality.

Epidemiological Characteristics of Osteoarthritis in Yichang City—Hubei Province,China,2017–2018

Summary What is already known about this topic?OA has been listed as the fastest increasing major public health problem and ranked second as a cause of disability by World Health Organization(WHO).With population aging,osteoarthritis(OA)is causing an increased economic burden for individuals and society and is attracting an increasing amount of scientific attention.

The Health Demands of Designated Drivers-Four Cities,China,2019

Summary What is already known about this topic?The health status of designated drivers is largely associated with road safety,which is a major public health issue.However,few studies have focused on the health demands of designated drivers.What is added by this report?This study investigated the health consciousness,first aid knowledge learning,acceptable ways to acquire health knowledge,and willingness to have physical examinations for designated drivers to provide suggestions for improving their health status.What are the implications for public health practice?The industry and platform should provide scientific and reasonable guidance on healthy lifestyles for designated drivers and implement physical examinations to monitor their health status.

Burden of Acute Viral Hepatitis--China,1990−2019

What is already known about this topic?The World Health Organization’s(WHO)Global Health Estimates(GHE)reported that acute hepatitis caused 9,213 deaths and 307,720 person years of disability-adjusted life years(DALYs)in 2016,and acute hepatitis B accounted for 85.81%of all DALYs among acute hepatitis types A,B,C,and E in China.What is added by this report?In China,the percent changes in years lived with disability(YLDs)due to acute hepatitis A,B,and E in groups aged 50–69 years and 70 years or more and in all age groups for acute hepatitis C were increased from 2000 to 2019.What are the implications for public health practices?Effective vaccines,interventions,and treatments are key approaches to achieve the WHO’s goal of reducing new hepatitis infections by 90%and deaths by 65%between 2016 and 2030.

Burden of Skin Disease—China,1990−2019

Summary What is already known about this topic?Skin diseases are common,affect society and individuals,and have high incidences to relapse,which reduces the quality of life.In 2019,skin diseases were the seventh leading global causes of years lived with disability(YLDs).What is added by this report?All-age disability-adjusted life years(DALYs)and YLDs from skin diseases have been steadily increasing in China from 1990 through 2019,although with a decline in the standardized rate of years of life lost(YLLs).In 2019,dermatitis was the leading cause of YLLs among people over the age of 15 years,while viral skin diseases had the greatest burden among people under 15 years.Acne vulgaris increased significantly among people aged 15–49 years,and psoriasis increased among people over 50 years.The male∶female ratio of DALYs lost due to skin disease did not change between 1990 and 2019.

Economic Burden of Malignant Tumors——Yichang City,Hubei Province,China,2019

Summary What is already known about this topic?Malignant tumors are common chronic noncommunicable disease and have caused serious health hazards to residents and heavy economic burden of disease to the society.What is added by this report?This is the first report on the economic burden of multiple types of malignant tumors in Yichang City.In 2019,the direct medical burden of lung cancer in Yichang was the highest,reaching 561.67 million CNY,and the indirect economic burden of lung cancer in Yichang was higher than that of other malignant tumors,costing 326.49 million CNY.

Disease Burden of Pancreatic Cancer--China,1990−2019

Summary What is already known about this topic?Pancreatic cancer is one of the most malignant tumors of the digestive tract,and the etiology is not clear.Pancreatic cancer has a poor prognosis and high mortality.What is added by this report?Compared with 1990,the burden of pancreatic cancer in China increased significantly in 2019.In 1990 and 2019,the disease burden indicator of male pancreatic cancer was higher than that of females,and pancreatic cancer became more common as age increased,especially above 50 years old.What are the implications for public health practices?This study mainly provided scientific data and references for the prevention and control of pancreatic cancer in people aged 50 and above.

Different Percentile Regression of Blood Glucose Among Adolescents Aged 12−20-United States,1999−2018

What is already known on this topic?The incidence of diabetes is on the rise in the world,and it is increasingly affecting young people.The American Diabetes Association(ADA)has published the 2020 Diabetes Medical Standard,but there is no blood glucose standard for teenagers by age and sex.What is added by this report?In this study,quantile regression was used to analyze the data of National Health and Nutrition Examination Survey(NHANES)and found that blood glucose varied significantly based on demographics.What are the implications for public health practice?This study provides reference for formulating the normal ranges of adolescent blood glucose and helping to screen out high-risk groups at an early stage for key interventions.The quantile regression method can give a set of curves,which could better describe the situation.

An Autoregressive Integrated Moving Average Model for Predicting Varicella Outbreaks — China, 2019

Introduction:Varicella,a prevalent respiratory infection among children,has become an escalating public health issue in China.The potential to considerably mitigate and control these outbreaks lies in surveillance-based early warning systems.This research employed an autoregressive integrated moving average(ARIMA)model with the objective of predicting future varicella outbreaks in the country.Methods:An ARIMA model was developed and fine-tuned using historical data on the monthly instances of varicella outbreaks reported in China from 2005 to 2018.To determine statistically significant models,parameter and Ljung-Box tests were employed.The coefficients of determination(R2)and the normalized Bayesian Information Criterion(BIC)were compared to selecting an optimal model.This chosen model was subsequently utilized to forecast varicella outbreak cases for the year 2019.Results:Four models passed parameter(all P<0.05)and Ljung-Box tests(all P>0.05).ARIMA(1,1,1)×(0,1,1)12 was determined to be the optimal model based on its coefficient of determination R2(0.271)and standardized BIC(14.970).Fitted values made by the ARIMA(1,1,1)×(0,1,1)12 model closely followed the values observed in 2019,the average relative error between the actual value and the predicted value is 15.2%.Conclusion:The ARIMA model can be employed to predict impending trends in varicella outbreaks.This serves to offer a scientific benchmark for strategies concerning varicella prevention and control.

The Spectrum and Age-Sex Patterns Among Outpatients with Allergic Diseases—Yichang City,Hubei Province,China,2018–2021

What is already known about this topic?Allergic diseases have affected an estimated 40%of the population in China.However,our understanding of the full spectrum of these diseases remains insufficient.What is added by this report?Between 2018 and 2021,Yichang City documented 625,929 outpatient visits mainly related to skin and mucous membrane allergies(77.90%)and allergic respiratory conditions(19.64%).In 2021,the occurrence of outpatient visits for conditions such as allergic rhinitis,acute atopic conjunctivitis,and atopic dermatitis increased.The demographic analysis revealed that male patients comprised the majority of the under 18 age bracket(56.05%),while female patients were predominantly represented in the 18 to 65 age bracket(61.79%).What are the implications for public health practice?This constitutes the first analysis of the spectrum of allergic diseases,utilizing regional outpatient data,which has substantial implications for understanding the disease burden.

Clinical and radiographic predictors in diagnosing sputum smear- negative pulmonary tuberculosis in HIV-negative patients： a cross- sectional study in China

Background In county-level tuberculosis （TB） dispensaries in China,the accurate diagnosis of sputum smear-negative pulmonary tuberculosis （SNPT） needs to be improved by developing and validating clinical and radiographic predictors.Methods The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006.A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were recruited.Their sputum samples were collected for culture before anti-TB treatment,and the treatment outcomes （changes of X-rays） were followed up at the end of the 6th month.Results Of the 432 SNPT patients,sputum culture positive （9.7%） or culture negative with good changes of X-rays at the end of the 6th month （73.6%） was validated as SNPT.Four predictive variables were associated with validated SNPT in the multivariate logistic regression model：age ≤55 years old （odds ratio （OR） 5.66; 95% CI 2.69-11.91）,〉60 days of cough （OR 3.73; 95% CI 1.10-12.65）,≥10% of pulmonary consolidation in the lungs （OR 5.40; 95% CI 2.90-10.06）,and pulmonary consolidation in the upper lobe anterior segment （OR 3.00; 95% CI 1.57-5.72）.The area under the receiver operating characteristic curve of the model was 0.77 （95% CI 0.71-0.83）.Conclusion Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.

Identifying the Optimal Age for Herpes Zoster Vaccination—Yichang City,Hubei Province,China,2017–2019

Summary What is already known about this topic?Herpes zoster(shingles)is a common skin condition in older adults,which usually presents as a painful rash with blisters.Vaccination is the most effective method to prevent shingles.However,there is not sufficient population-based epidemiological data in China to optimize the timing of zoster vaccination.What is added by this report?Clustering analyses of population-wide epidemiological data from the Healthcare Big Data Platform in Yichang,China showed that the average annual zoster incidence is the highest among people 55 years or older,at 10 cases per thousand persons per year,making this age group the optimal target population for vaccination.Incidence was lower but increased with age among younger adults,28–54 years old.What are the implications for public health practice?With limited vaccination resources,zoster vaccinations should be targeted at adults 55 years or older who are at the greatest risk for shingles.Research should be conducted to understand the risk of shingles among young and middle-aged adults and identify triggers of shingles:potentially leading to preventive measures.

The Incidence,Mortality,and DALYs Trends Associated with Esophageal Cancer-China,1990-2019

What is already known about this topic?Esophageal cancer(EC)is one of the most common malignant tumors in China.The new cases and deaths in China account for more than half of the world,and the disease burden of esophageal cancer is serious.What is added by this report?From 1990 to 2019,the disease burden of EC in China showed a decrease overall;it first increased between 1990 and 2004,but then decreased between 2004 and 2019.The burden of EC in men was much higher than that in women.Age was an important factor affecting the burden of EC,with disease burden rising rapidly after 40 years old.What are the implications for public health practices?The screening,early diagnosis,and treatment for EC should continue to be strengthened in China.Middleaged and elderly men are high-risk groups of EC and should be a key population for EC prevention and control.