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Cancer is a significant global public health issue. With the continuous increase in cancer incidence rates and the prolonged survival time of cancer patients, the number of cancer survivors is also steadily rising. Cancer survivors face complex challenges in terms of physical, psychological, and social care, and their care services require effective coordination and integration across disciplines, sectors, and domains. Establishing integrated care model for cancer survivors has become an important strategy for addressing the challenges of survivorship care globally. However, the development of cancer survivorship care in China has been relatively lagging. This article synthesizes and summarizes the conceptual frameworks, characteristics and practical application of several representative integrated care models for survivorships. Based on China's healthcare service system, recommendations for designing and implementing integrated care strategies for cancer survivorships in China are proposed from five aspects: establishing consensus, pilot testing and exploration, workforce development, strengthening primary care, and policy support.

Background The trend of prevalence and severity of the overweight problem in young children, reduces the general quality of the future population to a certain extent, inducing a great risk to the sustainable development of health human capital stock in China. Objective To scientifically understand the spatio-temporal evolutionary patterns and future development trends of overweight rates among children under 5 in China, in order to provide support for controlling overweight in children, improve the efficiency of local governance and support for the implementation of precise interventions. Methods In April 2022, the 5 km×5 km gridded dataset in 105 middle-and low-income countries provided by the Institute for Health and Evaluation at the University of Washington (IHME) was used as the data source to extract the gridded data of overweight rates among children under 5 in China (excluding Hong Kong Special Administrative Region, Macao Special Administrative Region and Taiwan District) from 2000 to 2019 in this study. The average overweight rate of children under 5 from 2000 to 2019 was calculated pixel-to-pixel, the Theil-Sen estimator, Mann-Kendall test and Hurst index estimation method was used to characterize the spatio-temporal evolutionary patterns and future development trends among children under 5 pixel-to-pixel. Results Overweight among children under 5 is more prevalent in most regions of Shandong Province, Hunan Province and local regions of Fujian Province, Guangdong Province, Hainan Province, Beijing Municipality and Tianjin Municipality during the 20-year period from 2000 to 2019, with the average overweight rate of children under 5 in Hunan Province reaching 29.42%. The area of the regions with significant increase in overweight rates among children under 5 accounts for 60.59% of the total area of the regions in the study (excluding regions with missing data) . The area of the central and eastern regions with a significantly increasing trend in the overweight rates among children under 5 accounts for a higher proportion of the total area of central and eastern regions (excluding regions with missing data) than the proportion accounted by the area of the western regions with a significantly increasing trend in the overweight rates among children under 5 of the total area of western regions (excluding regions with missing data) . The area of the regions with no significant change in the evolution trend of overweight rates accounts for 25.33% of the total area of the regions in the study, which is scattered in patches in parts of provinces, such as cities cluster in the middle reaches of the Yangtze River urban agglomeration. The area of the regions with significant change in the evolution trend of overweight rates accounts for 14.08% of the total area of the regions in the study, concentrated in some regions in the Xinjiang Uygur Autonomous Region, Qinghai Province, Sichuan Province and Yunnan Province in the west of China, and local regions of Hebei Province, Liaoning Province and Shandong Province in the east of China. According to the Hurst index, the area of the regions with persistent or trend-enhancing characteristics of the time series of overweight rates of children under 5 accounts for 84.87% of the total area of the regions in the study. Conclusion The spatial heterogeneity of overweight rates among children under 5 in China is obvious. There is a synergistic "U"-shaped association between the overweight rates of children under 5 and the overall level of regional development, the association implies a multi-stage, cascading developmental process of "declining stage of stunting" "stabilization stage" "rising stage of overweight with overnutrition". Focusing on social problems derived from the coupling of multidimensional factors of overweight in young children, the results of the study provide scientific support and policy reference for the government to formulate region-specific policies, build a three-level governance network of "government policy regulation - social concept penetration - family health management", and scientifically and precisely solve the overweight problem among children under 5.

Purpose: This study aimed to determine the current turnover intention among workers at Centers for Disease Control and Prevention (CDCs) in Northeast China and to investigate the factors contributing to this phenomenon. Materials and methods: The cross-sectional study was conducted in May 2023 across four northeastern provinces of China. The study included a total of 11,912 valid participants who were CDC workers selected using a stratified cluster sampling method. The study assessed demographics, turnover intention, work resources, work perceptions, and psychological support through online questionnaires. The binary logistic regression analysis identified the factors associated with turnover intention for CDC workers, while the Interpretative Structural Modelling (ISM) revealed the hierarchical relationship between the influencing factors. Results: The study found that 28.8% of the respondents reported high turnover intention. The binary logistic regression suggested that the risk factors of turnover intention among employees included gender, age, education, and several work-related, organizational, and psychological factors. The work-related factors were daily working hours, job burnout, and role overload. The organizational factor was unit support for training, unit's infrastructure conditions, leadership style, remuneration package and performance appraisal and promotion system. The psychological support factors were family support, professional identity, and organizational commitment. The ISM analysis results showed that the primary factors influencing CDC workers' intention to leave were internally connected and grouped into four categories according to their level of impact: surface, transition, deep, and essential factors. Notably, the essential factors were professional identity and organizational commitment. Conclusion: Nearly one-third of the respondents expressed a strong desire to resign from their employment. Turnover intention among CDC workers was subject to diverse influences. Early identification, detection, and targeted multidisciplinary interventions should be introduced to address the array of factors that affect staff, with particular emphasis on boosting the professional identity and organizational commitment of CDC workers. [ABSTRACT FROM AUTHOR]

In order to predict the global potential distribution range of Ixodes pacificus (I. pacificus) under different climate scenario models in the future, analyze the major climate factors affecting its distribution, and provide references for the transformation of passive vector surveillance into active vector surveillance, the maximum entropy model (MaxEnt) was used in this study to estimate the global potential distribution range of I. pacificus under historical climate scenarios and different future climate scenarios. The global distribution data of I. pacificus were screened by ENMtools and ArcGIS 10.8 software, and a total of 563 distribution data of I. pacificus were obtained. Maxent 3.4.1 and R 4.0.3 were used to screen climate variables according to the contribution rate of environmental variables, knife cutting method and correlation analysis of variables. R 4.0.3 was used to calculate model regulation frequency doubling and feature combination to adjust MaxEnt parameters. The model results showed that the training omission rate was in good agreement with the theoretical omission rate, and the area under ROC curve (AUC) value of the model was 0.978. Among the included environmental variables, the Tmin2 (minimum temperature in February) and Prec1 (precipitation in January) contributed the most to the model, providing more effective information for the distribution of I. pacificus. MaxEnt model revealed that the distribution range of I. pacificus was dynamically changing. The main potential suitable areas are distributed in North America, South America, Europe, Oceania and Asia. Under the future climate scenario model, the potential suitable areas show a downward trend, but the countries and regions ieeeeeeenvolved in the suitable areas do not change much. Therefore, the invasion risk of the potential suitable area of I. pacificus should be paid attention to. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to investigate the factors influencing the occurrence of medical insurance opportunistic behavior among the public in Northeast China and its importance ranking. Methods: Data are from a self-administered anonymous questionnaire survey of participants in Northeast China conducted from January to December 2019. Using a stratified sampling method, a sample of 895 residents aged 18 years or older was selected for the study and analysis. We used a stepwise logistic regression model to analyze the factors influencing the opportunistic behavior of the public within the medical insurance domain and standardized the coefficients of the independent variables in the model to further determine the degree of importance of the relevant influencing factors. Results: Opportunistic behavior was found in 34.2% of the participants. The order of importance of the factors influencing participants' opportunistic behavior were the frequency of occurrence of overmedication by medical practitioners, age, participants' evaluation of the harm of opportunistic behavior in medical insurance, marital status, participants' evaluation of the nature of opportunistic behavior in medical insurance, and participants' evaluation of the prevalence of opportunistic behavior in medical insurance. Conclusion: One-third of the participants in northeastern China engage in medical insurance opportunistic behavior. Among them, the frequency of occurrence of overmedication by medical practitioners is the most important factor influencing whether opportunistic behavior occurs. [ABSTRACT FROM AUTHOR]

The visceral adiposity index (VAI) and handgrip strength (HGS) are identified as important objectives for the prevention of illness. Nevertheless, there is limited understanding regarding the impact of the VAI and HGS on cardiometabolic multimorbidity (CMM). We aimed to ascertain the impact of the VAI and HGS on CMM among middle-aged and older people. Data spanning from 2011 to 2020 were derived from the China Health and Retirement Longitudinal Study (CHARLS). In total, 7909 individuals aged 45 years and older were included. Cox proportional hazard regression was utilized to examine the correlation among the VAI, HGS, and CMM. Throughout the 10-year follow-up, we determined that both the VAI (HR = 1.330; 95%CI = 1.179–1.500) and HGS (HR = 0.745, 95%CI = 0.645–0.861) exhibited significant associations with CMM risk. Individuals exposed to both a high VAI and low HGS were found to have higher hazards of CMM (HR = 1.377, 95%CI = 1.120–1.694) in contrast to participants exposed to one or none of these conditions. The older (HR = 1.414; 95%CI = 1.053–1.899) and male (HR = 1.586; 95%CI = 1.114–2.256) groups are more likely to experience CMM risk. Our findings suggest that both the VAI and HGS have significant effects on CMM risk. Appropriate interventions focused on vulnerable groups are recommended to prevent the incidence of CMM. [ABSTRACT FROM AUTHOR]