Objective To evaluate the validity, reliability, and acceptability of the scale of knowledge, attitude, and behavior of lifestyle intervention in a diabetes high-risk population (HILKAB), and provide scientific evidence for its usage. Methods By convenient sampling, we selected 406 individuals at high risk for diabetes for survey using the HILKAB. Pearson correlation coefficient, factor analysis, independent sampling, and t-test for high-and low-score groups were used to evaluate the content validity, construct validity, and discriminant validity of the scale. Reliability of the scale was evaluated by internal consistency, which included Cronbach'sαcoefficient,θcoefficient,Ωcoefficient, and split-half reliability. Scale acceptability was evaluated by acceptance rate and completion time of the survey. Results In this study, 366 questionnaires (90.1%) was qnalified and the completion time was (8.62 ± 2.79) minutes. Scores for knowledge, attitude, and behavior were 10.60±3.73, 26.56±3.58, 17.09±9.74, respectively. The scale had good face validity and content validity. The correlation coefficient of items and the dimension to which they belong was between 0.25 and 0.97, and the correlation coefficient of three dimensions and the entire scale was between 0.64 and 0.91, all with P<0.001. Factor analysis of the scale extracted eight common factors. The cumulative variance contribution rate was 65.23%, thereby reaching the 50% approved standard. Of 30 items there were 29 items with factor loadings ≥0.40, indicating the scale had good construct validity. For the high-score group, scores for knowledge, attitude, and behavior dimensions were 13.89±2.55, 29.56± 2.46, 28.05 ± 2.93, respectively, which were higher than those for the low-score group (7.67 ± 2.78, 23.89 ± 3.35, 6.25 ± 3.13); t-values were 55.14, 119.40, 95.29, respectively, with P<0.001. The scale consisted of three dimensions: knowledge, attitude, and behavior. The Cronbach's α coefficient was between 0.84 and 0.92, the θ coefficient was between 0.85 and 0.96, the Ω coefficient was between 0.90 and 0.94, and the split-half reliability was between 0.77 and 0.95, reaching the 0.70 standard letter. Conclusion The validity, reliability, and acceptability of the HILKAB scale were satisfactory for use in a population at high risk of diabetes.

Objective:To explore the effects of mothers' exposure to polycyclic aromatic hydrocarbons during pregnancy on their children's neurobehavioral development.Methods:In November 2009 to April 2010, a total of 221 pairs of mother-newborn pairs were recruited from two cooperative hospitals in Taiyuan, and their children were followed up at age two. High performance liquid chromatography was used to determine the level of BPDE-DNA in cord blood leukocytes. The Neonatal behavioral neurological assessment (NBNA) was used to assess the neurodevelopment of newborns, and the Gesell Development Scale was used to measure neurodevelopmental indexes of 2-year-old children. NBNA includes behavior, active and passive tone, primitive reflexes and general assessment, with a total score of 40 points. The Gesell Developmental Schedules consisted of four sub-scales: motor development, adaptive behavior development, language development and personal-social behavior development. We used mean and standard deviation to describe continuous variables with normal distribution, median (interquartile range) to describe continuous variables with skewed distribution, and frequency and proportion to describe categorical variables. Restricted cubic spline models were applied to assess the dose-response relationships between maternal prenatal polycyclic aromatic hydrocarbons exposure and children's neurobehavioral development at two years old. Generalized linear models were applied to evaluate the effect of exposure to maternal prenatal polycyclic aromatic hydrocarbons exposure on children's neurobehavioral development at 0 and two years old.Results:The NBNA score was 38.0±0.8, and the scores of 2-year-old children's motor, adaptive, language and personal-social were 111.6±15.0, 110.5±14.6, 108.8±17.2 and 111.7±14.5, respectively. After adjusting for confounding factors, there is no dose-response association between the cord blood BPDE of pregnant women and neonatal NBNA scores, but there were dose-response associations between BPDE and scores of 2-year-old children's motor, adaptive, language and personal-social. A unit increase in cord blood ln (BPDE-DNA), the score of motor, adaptive, language and personal-social of 2-year-old children decreased on average by 4.54、6.29、8.41 and 7.02 points.Conclusion:Maternal exposure to polycyclic aromatic hydrocarbons during pregnancy is associated with decreased children's neurobehavioral development at two years old.

Objective To evaluate the validity, reliability, and acceptability of the scale of knowledge, attitude, and behavior of lifestyle intervention in a diabetes high-risk population (HILKAB), and provide scientific evidence for its usage. Methods By convenient sampling, we selected 406 individuals at high risk for diabetes for survey using the HILKAB. Pearson correlation coefficient, factor analysis, independent sampling, and t-test for high-and low-score groups were used to evaluate the content validity, construct validity, and discriminant validity of the scale. Reliability of the scale was evaluated by internal consistency, which included Cronbach'sαcoefficient,θcoefficient,Ωcoefficient, and split-half reliability. Scale acceptability was evaluated by acceptance rate and completion time of the survey. Results In this study, 366 questionnaires (90.1%) was qnalified and the completion time was (8.62 ± 2.79) minutes. Scores for knowledge, attitude, and behavior were 10.60±3.73, 26.56±3.58, 17.09±9.74, respectively. The scale had good face validity and content validity. The correlation coefficient of items and the dimension to which they belong was between 0.25 and 0.97, and the correlation coefficient of three dimensions and the entire scale was between 0.64 and 0.91, all with P<0.001. Factor analysis of the scale extracted eight common factors. The cumulative variance contribution rate was 65.23%, thereby reaching the 50% approved standard. Of 30 items there were 29 items with factor loadings ≥0.40, indicating the scale had good construct validity. For the high-score group, scores for knowledge, attitude, and behavior dimensions were 13.89±2.55, 29.56± 2.46, 28.05 ± 2.93, respectively, which were higher than those for the low-score group (7.67 ± 2.78, 23.89 ± 3.35, 6.25 ± 3.13); t-values were 55.14, 119.40, 95.29, respectively, with P<0.001. The scale consisted of three dimensions: knowledge, attitude, and behavior. The Cronbach's α coefficient was between 0.84 and 0.92, the θ coefficient was between 0.85 and 0.96, the Ω coefficient was between 0.90 and 0.94, and the split-half reliability was between 0.77 and 0.95, reaching the 0.70 standard letter. Conclusion The validity, reliability, and acceptability of the HILKAB scale were satisfactory for use in a population at high risk of diabetes.

Objective:To explore the effects of mothers' exposure to polycyclic aromatic hydrocarbons during pregnancy on their children's neurobehavioral development.Methods:In November 2009 to April 2010, a total of 221 pairs of mother-newborn pairs were recruited from two cooperative hospitals in Taiyuan, and their children were followed up at age two. High performance liquid chromatography was used to determine the level of BPDE-DNA in cord blood leukocytes. The Neonatal behavioral neurological assessment (NBNA) was used to assess the neurodevelopment of newborns, and the Gesell Development Scale was used to measure neurodevelopmental indexes of 2-year-old children. NBNA includes behavior, active and passive tone, primitive reflexes and general assessment, with a total score of 40 points. The Gesell Developmental Schedules consisted of four sub-scales: motor development, adaptive behavior development, language development and personal-social behavior development. We used mean and standard deviation to describe continuous variables with normal distribution, median (interquartile range) to describe continuous variables with skewed distribution, and frequency and proportion to describe categorical variables. Restricted cubic spline models were applied to assess the dose-response relationships between maternal prenatal polycyclic aromatic hydrocarbons exposure and children's neurobehavioral development at two years old. Generalized linear models were applied to evaluate the effect of exposure to maternal prenatal polycyclic aromatic hydrocarbons exposure on children's neurobehavioral development at 0 and two years old.Results:The NBNA score was 38.0±0.8, and the scores of 2-year-old children's motor, adaptive, language and personal-social were 111.6±15.0, 110.5±14.6, 108.8±17.2 and 111.7±14.5, respectively. After adjusting for confounding factors, there is no dose-response association between the cord blood BPDE of pregnant women and neonatal NBNA scores, but there were dose-response associations between BPDE and scores of 2-year-old children's motor, adaptive, language and personal-social. A unit increase in cord blood ln (BPDE-DNA), the score of motor, adaptive, language and personal-social of 2-year-old children decreased on average by 4.54、6.29、8.41 and 7.02 points.Conclusion:Maternal exposure to polycyclic aromatic hydrocarbons during pregnancy is associated with decreased children's neurobehavioral development at two years old.

Objective: To explore the association between dietary pattern which benefit for normal kidney function and the risk of cognitive decline or impairment in the elderly. Methods: In 2015, subjects aged 60 and over from four counties in the Nutrition and Chronic Disease Family Cohort project, were followed up in 2017. Cognitive function was repeatedly assessed, using the Mini Mental State Evaluation (MMSE) scale. Dietary pattern that benefit for normal kidney function was extracted, using the reduced rank regression method and followed by logistic regression models to explore the associations between scores that showing the kidney function on dietary patterns and the risk of cognitive deterioration and impairment in two years among those who were with normal cognition in 2015. Results: Dietary pattern that benefit for normal kidney function, was characterized by high consumption of cereal, vegetables, legume and fruits but with less meat and soy products. Comparing with the group with lowest score quartile on this dietary pattern, the risk of cognitive deterioration in the highest quartile group was significantly low (P<0.01) in two years, with an odds ratio as 0.57 (95%CI: 0.37-0.85). Linear trend was also obviously visible (P=0.007) in this group. The ones at the highest quartile group among the normal cognition ones in 2015, the risk of cognitive impairment also significantly reduced (P<0.05) in two years time, with an odds ratio as 0.52 (95%CI: 0.29-0.93). Also, linear trend could obviously be seen (P=0.01). Conclusion Dietary pattern that benefit for normal kidney function was both inversely associated with cognitive deterioration and impairment, in two years.

Objective: To assess the relationship between body mass index (BMI) and mortality in adults of Shanxi, China. Methods: Baseline data were from the '2002 China Nutrition and Health Survey’ in Shanxi province. All the death-related investigation and follow-up visits were carried out from December 2015 to March 2016. The follow-up program covered 5 360 people from all the 7 007 participants aged 18 years and over that having complete core information, with a rate as 76.5%. Participants of this study were divided into eight groups, according to the appearance of BMI. Taking the group with the lowest mortality density as the reference group, Cox regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of deaths by the whole population, gender and age groups (≥60 years, <60 years). Results were then adjusted by age, gender, smoking, alcohol use and education level from the baseline survey. Sensitivity analysis was also conducted. Results: Results from the study showed that among the total number of 67 129 person- years from the average period of 12.5 years, there were 615 deaths occurred, with the mortality density as 916 per 100 000 person-years. Taking the BMI range of 26.0-27.9 kg/m² as the reference, the aHRs of death increased to 1.90 (95%CI: 1.26-2.86), 1.68 (95%CI: 1.15-2.45), 1.49 (95%CI: 1.08-2.06) and 1.72 (95%CI: 1.07-2.76) after the multivariate adjustment, in these four groups (BMI<18.5, 18.5-19.9, 22.0-23.9 and ≥30.0 kg/m²), respectively. Low body weight (BMI<18.5 kg/m²) was associated with higher risks of death in the elderly of ≥60 years, with the aHR of death as 1.94 (95%CI: 1.20-3.15). Conclusions When BMI appeared as ≤19.9 kg/m², 22.0-23.9 kg/m² and ≥30.0 kg/m², the risks of death would increase. In addition to programs that focusing on obesity, special attention should be paid to the high risk of mortality which was caused by low-weight and malnutrition in the elderly.