Health In China Research Articles

Uncovering the impact and mechanisms of air pollution on eye and ear health in China

Increasing air pollution could undermine human health, but the causal link between air pollution and eye and ear health has not been well-studied. Based on four-week-level records of eye and ear health over 1991-2015 provided by the China Health and Nutrition Survey, we estimate the causal effect of air pollution on eye and ear health. Using two-stage least squares estimation, we find that eye or ear disease possibility rises 1.48% for a 10μg/m3 increase in four-week average PM2.5 concentration. The impacts can last about 28weeks and will be insignificant afterward. Females, individuals aged 60 years and over, with high exposure environments, relatively poor economic foundations, and low knowledge levels are more vulnerable to such negative influences. Behavioral channels like more smoking activities and less sleeping activities could partly explain this detrimental effect. Our findings enlighten how to minimize the impact of air pollution and protect public health.

Short-Term Interaction Effects of PM2.5 and O3 on Daily Mortality: A Time-Series Study of Multiple Cities in China.

In recent years, PM2.5 and O3 have been the two main pollutants affecting public health in China, but the interaction of the two pollutants on human health remains unclear. A two-stage analytical approach was used to investigate the relationships of PM2.5-O3 co-pollution with nonaccidental, cardiovascular, and respiratory mortality levels across 14 cities in China. We first utilized a generalized additive model (GAM) to determine the city-specific associations of PM2.5 and O3 with daily mortality. The associations were then combined at the national and regional levels using meta-analysis. To investigate the potential interactions between the two pollutants and cause-specific mortality, we performed stratified analyses by co-pollutant exposure levels and the synergy index (SI) (SI > 1 indicates a synergistic interaction). The effect of changes in the two pollutants' concentrations (in 10 μg/m3 increases) on mortality was assessed. The stratification analysis results suggested that each 10 μg/m3 increase in PM2.5 at lag0-1 (lag01) in the low, moderate, and high strata of the O3 concentrations increased nonaccidental mortality by 0.07% (95% confidence interval: -0.03%, 0.17%), 0.33% (0.13%, 0.53%), and 0.68% (0.30%, 1.06%), respectively, with significant between-group differences (p < 0.001). Moreover, each 10 μg/m3 increase in O3 (lag01) in the low, moderate, and high strata of the PM2.5 concentrations increased nonaccidental mortality by 0.15% (-0.06%, 0.36%), 0.53% (0.19%, 0.87%), and 0.75% (0.14%, 1.36%), respectively, with significant between-group differences (p < 0.001). We also found substantial synergistic interactions between the two pollutants and nonaccidental, cardiovascular, and respiratory mortality levels, with SI values of 1.48, 1.51, and 1.33, respectively. Additionally, a subgroup analysis revealed that the interaction of these two pollutants on nonaccidental mortality were greater in South China compared to elsewhere, and during the warm season compared to during the cold season. Our findings suggested that the simultaneous control of PM2.5 and O3 within the context of combined air pollution could significantly decrease the disease risk, especially in southern China and during the warm season.

Public Healthcare System in China: Issues, challenges and survival strategies

Public Healthcare System in China faces numerous challenges due to the country's size, population, and socio-economic diversity. This paper intends to examine a modern management system for public hospitals to fulfil the needs of the society in the new era of China. It also explores the evolution of healthcare, growth of the healthcare sector, challenges, and survival strategies to the healthcare sector. With the strategic triangle as a base, the research will make attempts to translate the public value framework combined with the hospital context into a blueprint for solving some of the key challenges facing the healthcare service system.

Pulmonary embolism and deep venous thrombosis in China.

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. In connection with the previous section, this eighth section of the report offers a comprehensive analysis of pulmonary embolism and deep venous thrombosis. In recent years, research in the field of pulmonary vessel in China has made great progress. A number of nationwide multi-center registry research results have filled the gaps in the epidemiology, diagnosis and treatment of pulmonary hypertension and venous thromboembolism. Different types of pulmonary hypertension still need attention to the identification of risk factors and/or risk stratification, and venous thromboembolism needs attention in the prevention and the overall management inside and outside hospital. In the future, we look forward to the publication of more high-quality research in China, which could be able to improve relevant guidelines for pulmonary vascular diseases both domestically and internationally.

Community Health Centers' Responsiveness and Its Associated Factors Among Outpatients in Southeast China: A Cross-Sectional Study.

The responsiveness of community health centers can reflect the soft capacity of medical institutions and is related to the improvement of health outcome indicators. This study is aimed at assessing the level and distribution of community health centers' responsiveness and its associated factors among outpatients under the health-oriented integrated healthcare system in China. A total of 634 outpatients were recruited from six community health centers in Zhejiang Province, China, in July 2022. SPSS software was used to conduct the analysis (version 23.0). Health system responsiveness was used as a measure of outpatient responsiveness to health care services through a self-administered questionnaire. Determinants of community health centers' responsiveness were determined by using a multiple linear regression model at a p-value <0.05. The total score of community health centers responsiveness was 8.25±1.01, and the Gini coefficient is 0.027. Within these domains, social support and dignity received the highest scores, while choice of providers and autonomy scored the lowest. Age group between 60-74 years (β: 0.129; 95% CI: 0.042-0.529), ≥75 years (β: 0.095; 95% CI: 0.006-0.707), monthly income with 8000 RMB and above (β: 0.098; 95% CI: 0.035-0.653), having a family doctor (β: 0.124; 95% CI: 0.096-0.410), and satisficing with community health service (β: 0.298; 95% CI: 0.848-1.428) were significant predictors of community health centers' responsiveness. The Chinese community health centers show high responsiveness, indicating that the construction of a health-oriented integrated healthcare system has been effective. The family doctor contract service is important and should continually enhance both technical proficiency and health promotion capabilities. Encourage residents to actively participate in their treatment process is also essential.

Potential distribution prediction of Pomacea canaliculata in China based on the Biomod2.

Pomacea canaliculata is a globally significant invasive species that poses substantial threats to agricultural production, ecosystems, and human health in China. To evaluate its habitat suitability in China, we collected and collated 741 county-level occurrence points of P. canaliculata in China through database query, literature search and news reports, and obtained the five most important climatic factors by variance inflation factor and Pearson correlation coefficient from 19 bioclimatic factors. We investigated the potential suitable distribution areas of P. canaliculata under current and future climate scenarios using the Biomod2 ensemble model, and identified the primary environmental variables influencing their distributions. The results showed that under the current climate, the suitable habitat areas were concentrated in southern provinces or municipalities, such as Zhejiang, Shanghai, Fujian, Jiangxi, Guangdong, Guangxi, Hainan, and Yunnan. Under different climate scenarios in the future, the suitable habitat area would show large-scale expansion in the southern provinces or municipalities, and spread to the northern region. The most two important environmental factors affecting the distribution of suitable habitat areas were precipitation of wettest month and mean temperature of wettest quarter. A combination model to predict the potential distribution of P. canaliculata under current and future climate conditions would help manage the risk of its invasion and spread, and provide a reference for relevant regions and departments to take active measures in advance to prevent the spread, monitor and mitigate its invasion.

Blue paper on Alzheimer's disease in China(simplified version)

With the population aging in China, the prevalence and mortality rate of Alzheimer's disease (AD) have been rising in China. AD has become one of the major threats to people's health and social sustainable development. In order to support the Healthy China Initiative and promote health in China, "Chinese Alzheimer's Disease Blue Book (Simplified Edition)"(refer to as the Blue Book) was compiled by experts and scholars from the National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University; the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention; the National Health Commission Capacity Building and Continuing Education Center; and the China Population and Development Research Center. The epidemiological characteristics, diagnosis and treatment status, prevention and treatment management of AD and related cognitive disorders in China were systematically reviewed in the Blue Paper, aiming to provide references for the prevention of AD, provide support for the standardized diagnosis and treatment of the disease, and provide a reference for the government to formulate relevant health policies. Specifically, the Blue Book covers the following topics of AD and related cognitive disorders: (1)epidemiology characteristics; (2)economic burden; (3)influencing factors; (4)China Brain Cognitive Health Index; (5) diagnosis status; (6)treatment status; (7)construction of national center for cognitive disorders;(8)community-based prevention and control; (9) AD patients care; (10)public health resources for prevention and control.

Online digital health and informatics education for undergraduate nursing students in China: impacts and recommendations

BackgroundDigital health plays a vital role in healthcare services. Governments in many countries, including China, are increasingly advocating for the appropriate use of digital technologies to address significant health system challenges. It is crucial to incorporate digital health education into the curriculum for future nurses to adapt to the changes in the digital medical system. This study aimed to evaluate the impact of an online Digital Health and Informatics Course in China on the knowledge and comprehension of key digital health and informatics topics, self-assessment of nursing informatics competencies, and satisfaction among undergraduate nursing students. The findings of this study provide recommendations for the design and implementation of future digital health education.MethodsThis study employed a one-group, quasi-experimental mixed-methods design with pre- and post-assessments. The participants received digital health and informatics education through six three-hour online sessions in six interactive days, with online self-learning materials in between. An online quiz and focus group discussions pre- and post the course were designed to evaluate the knowledge and comprehension of key digital health and informatics topics. Also, a validated Chinese version of the Self-assessment of Nursing Informatics Competencies Scale was conducted pre- and post-course to assess self-assessment of nursing informatics competencies. Additionally, all students were invited to participate in an online survey with a performance-focused course evaluation form as well as focus group discussions to gather their feedback on the learning experience and their evaluations of the course.ResultsA total of 24 undergraduate nursing students were enrolled in the course. All students completed all sessions of this course, resulting in an attendance rate of 100%. Additionally, all students completed both pre- and post-assessments. In terms of the knowledge and comprehension of key digital health and informatics topics, scores of the quiz on knowledge assessment improved from the pre-test [mean pretest score: 78.33 (SD 6.005)] to the post-test [mean post-test score: 83.17 (SD 4.86)] upon completion of the course (P < 0.001). Also, students acknowledged that the course enhanced their knowledge and comprehension of informatics and digital health, the benefits of (nursing) informatics in clinical practice, and the role of health care professionals in informatics and digital health. In terms of self-assessment of nursing informatics competencies, scores on nursing informatics attitudes demonstrated significant improvement (P < 0.001). Furthermore, students reported high satisfaction with various aspects of this course, including the opportunity to explore broad horizons in informatics for future careers, engaging in group discussions, and analyzing case studies on the use of informatics and digital health in clinical practice.ConclusionsThis Online Digital Health and Informatics education effectively improved undergraduate nursing students’ knowledge and comprehension of the key digital health and informatics topics, nursing informatics attitudes in the self-assessment of nursing informatics competency with high levels of satisfaction. In order to ensure that future education in digital health and informatics for nursing students is in line with the technological advancements in clinical settings, it is necessary to foster collaboration between medical school training and clinical practice. This collaboration should involve the use of clinical examples to illustrate advanced digital health applications and the inclusion of practical exercises on the use of digital health technology in clinical settings.

Parental perceptions and experiences of kangaroo care for preterm infants in neonatal intensive care units in China: a qualitative study

Backgroundkangaroo care (KC), endorsed by the World Health Organization, is an evidence-based intervention that plays a pivotal role in mitigating preterm infant mortality and morbidity. However, this intervention has not been fully integrated into healthcare systems in China. This study aimed to gain insight into parents’ perceptions and experiences of KC for preterm infants to contribute to the KC implementation on a larger scale.MethodsThis study employed a descriptive qualitative design, using face-to-face, semi-structured, in-depth interviews. Fifteen parents participating in KC for preterm infants in the neonatal intensive care units (NICUs) were purposively sampled from four hospitals across four cities in Zhejiang Province, China. Thematic analysis was employed to analyze the data.ResultsFour themes and twelve subthemes regarding the parents’ perceptions and experiences about KC were identified. The four themes included: (1) Low motivation upon initial engagement with KC, (2) Dynamic fluctuations of emotional states during KC, (3) Unexpected gains, and (4) Barriers to participation.ConclusionsParents’ perceptions and experiences of KC was a staged process, with parents exhibiting distinct cognitive patterns and unique experiences at each stage. Overall, as KC progresses, parents’ experiences tended to become increasingly positive, despite potential obstacles encountered along the way. To enhance the implementation of KC, healthcare providers could utilize prenatal and postnatal education programs. These programs aim to enhance the understanding of KC among parents of preterm infants, fostering sustained engagement in KC practices.

Clinical feature of omicron infection in children with inborn errors of immunity in China.

SARS-CoV-2 infection is hypothesized to be more severe in immunocompromised patients; however, clinical outcomes in children with inborn errors of immunity (IEI) during the Omicron pandemic in China have not been reported. This cohort study retrospectively reviewed 71 SARS-CoV-2-infected children with IEI using nationwide data from the National Center for Children's Health of China. COVID-19 was diagnosed by a positive rapid antigen or nucleic acid test result. Among 71 SARS-CoV-2-infected children with IEI, male preponderance (male: female ratio of ~1.8:1), a median age of 8 years (IQR 3-11), and a predominance of antibody deficiency (19/71, 26.8%) were detected. Most of the patients got infected through household transmission, while a small proportion of them did so during hospital visits. The mean time periods were 3.3 days (n=44) for incubation, 8.4 days for symptoms (n=69), and 8.8 days for viral shedding (n=37). The time to viral shedding was proportional to the symptomatic period (R2 = 0.1243, p=0.0323) and prolonged in children with X- linked agammaglobulinemia. The most common symptoms of COVID-19 were fever, and some children showed only aggravation of the underlying disease. 15% of IEI children progress to pneumonia, 85% require medication, 17% are admitted to hospital, and 4.1% are classified as critical. Previously application of anti- infective medications was associated with an increased risk of hospitalization after COVID-19 infection. Of the 71 children with IEI, all recovered from COVID- 19. Overall, Omicron variant did not cause significant life-threatening infections among children with IEI in China, and most of them had a good clinical outcome. Nevertheless, these children exhibit an increased vulnerability to higher hospitalization rates, pneumonia, and severe illness compared to the general pediatric population.

It Takes a Village: Health and Old-Age Support in China.

How do older individuals cope with health impairments and the potential economic losses that ensue? Exploiting longitudinal data on a nationally representative sample of Chinese seniors, we investigate whether and how familial economic support responds to sudden and sizable changes in health. We find that both financial and instrumental support from children go up following a health shock. Furthermore, financial transfers coming from siblings, other relatives and friends increase by a larger percentage than those from children. We also find evidence that instrumental care received from a spouse responds strongly to health shocks. Finally, we find that although labor supply and earned income drop considerably, there is no significant change in non-health expenditure. Our results suggest that households are able to cope with some of the adverse economic impacts of health shocks by relying on support networks that extend beyond their children and grand-children. This is particularly relevant in the context of shrinking family sizes resulting from stringent family planning policies.

Distribution of scoliosis in 2.22 million adolescents in mainland China: A population-wide analysis.

The characteristics of scoliosis afflicting school children and adolescents in mainland China are still unclear. Therefore, we conducted a systematic review to estimate scoliosis's prevalence and characterise its distribution in China. We screened PubMed, Scopus, WanFang, China National Knowledge Infrastructure, National Science and Technology Library, and WeiPu databases for mainland China articles published between 1 January 1980 and 31 October 2022. Among them, we identified population-wide scoliosis studies in school children and adolescents. The main outcomes were the positive rate of primary screening and the prevalence of final screening. Primary screening mainly included general examination with/without the forward bending test in school. The final screening entailed clinical diagnosis by Röntgen radiation in a hospital (based on primary screening). A meta-analysis of scoliosis distribution by gender was performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Further, we analysed the distributions of scoliosis by age, region, aetiological type, and severity of curvature, in addition to the correlation between its prevalence and altitude or latitude. 77 studies with 2 224 320 participants were included. The positive rate through primary screening was 3.97%, whereas the prevalence of scoliosis at final screening was 1.20%. Analysing the data revealed a higher prevalence of scoliosis in girls (OR = 1.57; 95% CI = 1.38-1.81). The age-wise peak rate of scoliosis was 15-16 years (1.07%) in boys and 13-14 years (1.42%) in girls. The mean prevalence of scoliosis was 1.07% in the western region, 1.54% in the central, and 1.35% in the eastern. Scoliosis prevalence was not correlated with either altitude or latitude. The prevalence of idiopathic and congenital scoliosis was 1.18 and 0.03%. Among all subjects with scoliosis, 79.10 and 16.80% had mild and medium disease severity. According to this comprehensive study using data sets of scoliosis in adolescents across mainland China, the mean prevalence of scoliosis is 1.20%, yet 1.57 times higher in girls than boys, and is most prevalent in the middle region. Overall, scoliosis in adolescents could pose a burden to public health in mainland China. PROSPERO CRD42021231987.

Educational mismatch and mental health: Evidence from China

Education is one of the most important social determinants of mental health. Many studies have shown that overeducation has different and complex correlations with mental health status under different circumstances. However, few studies have compared overeducation and undereducation in the Chinese context to illustrate their different associations with mental health. Our study attempts to evaluate the potential association between educational mismatch and workers' mental health in China by subdividing educational mismatch into overeducation and undereducation. By using the 2020 Chinese Family Panel Survey (CFPS) data, we screened out 7225 valid cross-sectional samples and used an ordered logit model to identify the association between educational mismatch and mental health. The findings show that overeducation is strongly associated with better psychological status, while undereducation is significantly associated with worsening psychological status. The mediating effect test shows that income satisfaction has penalty and premium effects respectively in different contexts. In addition, we found that undereducation was not significantly associated with worse psychological status in the lower job satisfaction and stable employment groups, whereas overeducation was not significantly associated with better psychological status only in precarious employment. Our research provides evidence that developing policies and interventions to improve national education can help improve national health.

Perception and Acceptance of Telemedicine Use in Health Care Among the General Public in China: Web-Based Cross-Sectional Survey.

The COVID-19 pandemic is bringing about substantial changes in health care systems, leading to a significant shift toward telemedicine for the delivery of health care services. This study aims to examine the relationship between perceived usefulness and ease of use of telemedicine services and their association with the behavioral intention to use telemedicine. An anonymous cross-sectional survey was conducted in China. Partial least squares structural equation modeling was used to determine significant predictors of intention to use telemedicine consultation. Types of illnesses that favored seeking telemedicine consultation, as well as the most preferred platform for conducting telemedicine consultations, were also investigated. In total, 1006 participants completed the survey. A total of 44.3% (n=446) reported being very likely and 49.3% (n=496) reported being likely to seek telemedicine consultation. Overall, the majority of participants expressed strong agreement or agreement regarding the perceived usefulness of telemedicine. Likewise, the majority indicated strong agreement or agreement when it came to their perception of the ease of using telemedicine. In the partial least squares structural equation modeling, perceived usefulness (β=0.322; P<.001) and perceived ease of use (β=0.118; P=.01) were significantly associated with a higher likelihood of seeking telemedicine consultation. A considerable number of participants expressed willingness to use telemedicine services for various medical conditions, particularly respiratory (n=340, 33.8%), skin (n=316, 31.4%), and musculoskeletal issues (n=316, 31.4%) while showing less interest in seeking telemedicine consultations for reproductive health (n=44, 4.4%) and cancer (n=64, 6.4%). The majority preferred video chat (n=443, 44%) and text chat (n=317, 31.5%) as their most preferred platforms for telemedicine consultation, while a smaller proportion preferred telephone (n=193, 19.2%) and email (n=53, 5.3%). Telemedicine has the potential to play a larger role in China's health care system. The preferences for certain platforms over others may influence service design and implementation.

The association between physical fitness and mental health among college students: a cross-sectional study.

Physical inactivity and mental health disorders are emerging threats to public health in China. Previous research on links between exercise and mental wellbeing have focused on clinical populations, with little evidence from the general population, particularly younger adults. We aimed to investigate associations between physical fitness and mental health in Chinese college students. In this series, of cross-sectional observational studies, we enrolled 7,468 Chinese college students aged 16-24 years in 199 classes at Changzhou Vocational Institute of Engineering between Sept 1, 2017, and Jun 30, 2018. Exposures of interest were the students' physical fitness level, measured by the Chinese University Students Physique Test. The primary outcomes were mental health situations, measured by the University Personality Inventory (UPI). The multivariable linear regression models were used to assess the relationship between the levels of physical fitness and mental disorders symptoms. Completed mental health and physical fitness data were available for 6,724 participants aged 16-24 years. Compared with the failed group, the corresponding levels of difference in overall UPI scores were - 1.45 scores (95% CI: -2.45, -0.46; p < 0.01) for the passed group and - 2.95 scores (95% CI: -4.13, -1.77; p < 0.01) for the good group. Similar results were observed in the four different aspects of psychotic disorder symptoms. There was a significantly negative correlation between the level of physical fitness and phycological situations among Chinese college students. Our findings highlight the psychological situations of students with low physical fitness levels should be concerned.

Housing wealth, fertility and children's health in China: A regression discontinuity design

This paper examines the influence of housing wealth on fertility outcomes through a regression discontinuity design based on a 2006 Chinese housing-market policy. Our analysis reveals that the positive impact of this policy on housing wealth significantly enhances the likelihood of fertility by 7.3 %. Our result implies that a 1 % increase in housing wealth can raise the fertility rate by 0.18 %. Furthermore, we observe that children born subsequent to the positive housing wealth shock exhibit improved health, not only at birth but also over the long term. Lastly, we present suggestive evidence suggesting that both parental pre-birth time allocation and parental health may help explain the documented positive effects of housing wealth on fertility rates.

Efficiency evaluation and promoter identification of primary health care system in China: an enhanced DEA-Tobit approach

BackgroundWith Primary Health Care (PHC) being a cornerstone of accessible, affordable, and effective healthcare worldwide, its efficiency, especially in developing countries like China, is crucial for achieving Universal Health Coverage (UHC). This study evaluates the efficiency of PHC systems in a southwest China municipality post-healthcare reform, identifying factors influencing efficiency and proposing strategies for improvement.MethodsUtilising a 10-year provincial panel dataset, this study employs an enhanced Data Envelopment Analysis (DEA) model integrating Slack-Based Measure (SBM) and Directional Distance Function (DDF) with the Global Malmquist-Luenberger (GML) index for efficiency evaluation. Tobit regression analysis identifies efficiency determinants within the context of China’s healthcare reforms, focusing on horizontal integration, fiscal spending, urbanisation rates, and workforce optimisation.ResultsThe study reveals a slight decline in PHC system efficiency across the municipality from 2009 to 2018. However, the highest-performing county achieved a 2.36% increase in Total Factor Productivity (TFP), demonstrating the potential of horizontal integration reforms and strategic fiscal investments in enhancing PHC efficiency. However, an increase in nurse density per 1,000 population negatively correlated with efficiency, indicating the need for a balanced approach to workforce expansion.ConclusionsHorizontal integration reforms, along with targeted fiscal inputs and urbanisation, are key to improving PHC efficiency in underdeveloped regions. The study underscores the importance of optimising workforce allocation and skillsets over mere expansion, providing valuable insights for policymakers aiming to strengthen PHC systems toward achieving UHC in China and similar contexts.

Reducing privacy risks of China's healthcare big data through the policy framework.

While healthcare big data brings great opportunities and convenience to the healthcare industry, it also inevitably raises the issue of privacy leakage. Nowadays, the whole world is facing the security threat of healthcare big data, for which a sound policy framework can help reduce privacy risks of healthcare big data. In recent years, the Chinese government and industry self-regulatory organizations have issued a series of policy documents to reduce privacy risks of healthcare big data. However, China's policy framework suffers from the drawbacks of the mismatched operational model, the inappropriate operational method, and the poorly actionable operational content. Based on the experiences of the European Union, Australia, the United States, and other extra-territorial regions, strategies are proposed for China to amend the operational model of the policy framework, improve the operational method of the policy framework, and enhance the operability of the operational content of the policy framework. This study enriches the research on China's policy framework to reduce privacy risks of healthcare big data and provides some inspiration for other countries.

Discussion of the classification of pediatric drug clinical trials in children's hospitals in China.

This study aimed to gain insights into pediatric clinical trials conducted in children's hospitals in China and provide valuable references for the development of children's hospitals and the research and development of pediatric drugs. A comprehensive search was performed on the Chinese Clinical Trial Registry (Chi CTR) and ChinaDrugTrials.org.cn to collect information on all clinical trials involving subjects under 18 years, including those conducted in children's hospitals. The retrieval period was extended until 31 December 2022. A total of 459 pediatric clinical trials were collected, comprising 299 from Chi CTR and 160 from the Drug Clinical Trial Registration and Information Publicity Platform (Information Platform). Post-marketing drug studies and phase III clinical trials accounted for the majority of research stages. These trials covered a wide range of diseases/systems, with a particular focus on respiratory system disorders, tumors, endocrine disorders, and nutritional or metabolic diseases. Chemical drugs constituted the most extensively studied category, while traditional Chinese medicine/natural drugs received comparatively less attention. Clinical trial activities were primarily geographically focused on the eastern coastal regions of China, with multicenter trials being the most predominant. Ethics committee approval was obtained for 427 studies. The pediatric clinical trials conducted by children's hospitals in China have shown an overall upward trend; however, there is limited research focusing on traditional Chinese medicine, along with significant regional and institutional imbalances. Furthermore, there is still room for improvement regarding ethical review processes. It is recommended that children's hospitals enhance their scientific research capabilities while optimizing resource allocation to meet medical service demands effectively. Additionally, fostering more research-focused children's hospitals will contribute to the high-quality development of children's health in China.

Social support and travel: Enhancing relationships, communication, and understanding for travel companions

AbstractThis study explores the multifaceted relationship between travel patterns and mental health (MH) in China, offering a novel integrative approach that synthesizes various factors such as mode of transportation, cultural distance, financial implications, and trip planning. Utilizing a descriptive research design, 622 tourists were surveyed using a pen‐and‐paper questionnaire at designated tourist destinations in China. Findings reveal that travel positively influences MH by providing new experiences, socialization, and relaxation, leading to reduced stress and improved well‐being. Duration, frequency, and active travel modes are associated with better MH outcomes. Solo travel fosters personal growth, while group travel enhances social support. Natural environments offer greater MH benefits than urban settings, and leisure travel surpasses work‐related trips in promoting MH. Greater cultural distance, poor trip planning, and financial burdens negatively impact MH. This comprehensive framework offers insights into public health and tourism policies, advancing the understanding of how travel elements collectively influence MH.