Objective To establish a competency evaluation indicator system for school physicians. Methods A preliminary pool of competency indicators for school physicians was established through systematic literature review and policy document analysis. The Delphi method was used to conduct two rounds of expert consultations with 16 experts who involve in educational administration, clinical medicine, public health management, and school healthcare. Based on the opinions of the experts, the indicator system was screened, revised, and refined to establish the final competency evaluation indicator system for school physicians. Results The questionnaire recovery rates of the two rounds of expert consultations were both 100.0%. The expert authority coefficient were 0.93 and 0.94, and Kendall′s coefficients of concordance were 0.21 and 0.26, respectively (both P<0.01). The final competency evaluation indicator system for school physicians consisted of five primary indicators, including basic medical service capacity, school health service capacity, health education and communication capacity, professional ethics and competency, and self-improvement capacity, as well as 35 secondary indicators (items). All indicators received relatively high importance scores. The system demonstrated a reasonable structure, good scientific validity, and practical applicability. Conclusion The competency evaluation indicator system for school physicians developed in this study demonstrates high scientific validity and practicality. It can serve as an important tool for school physician management, competency development, and performance evaluation, providing references for improving school health service quality and strengthening the construction of school physician teams.

Objective To evaluate the efficiency of health resource allocation in 22 types of hospital institutions in Guangdong Province from 2018 to 2022,identify their strengths and shortcomings in resource utilization,and offer evidence-based recommendations for optimizing medical resource allocation and policymaking.Methods The efficiency of health resource allocation was assessed using the DEA-BCC model and the DEA-Malmquist index model across the 22 hospital categories.Results In 2022,the overall resource allocation efficiency of the 22 types of hospital institutions in Guangdong Province was suboptimal,with an average score of 0.657.From 2018 to 2022,the mean total factor productivity(TFP)change index for these hospitals was 0.968,with only 6 categories exhibiting a TFP index exceeding 1.Conclusion The efficiency of health resource allocation in Guangdong's hospitals remains inadequate.Government authorities should enhance macro-level planning for regional resource distribution,accelerate advancements in medical technology,and establish a real-time monitoring framework.Concurrently,policy interventions and incentive mechanisms should be reinforced to ensure both scientifically sound allocation and effective utilization of medical resources.

Objective To evaluate the efficiency of health resource allocation in 22 types of hospital institutions in Guangdong Province from 2018 to 2022,identify their strengths and shortcomings in resource utilization,and offer evidence-based recommendations for optimizing medical resource allocation and policymaking.Methods The efficiency of health resource allocation was assessed using the DEA-BCC model and the DEA-Malmquist index model across the 22 hospital categories.Results In 2022,the overall resource allocation efficiency of the 22 types of hospital institutions in Guangdong Province was suboptimal,with an average score of 0.657.From 2018 to 2022,the mean total factor productivity(TFP)change index for these hospitals was 0.968,with only 6 categories exhibiting a TFP index exceeding 1.Conclusion The efficiency of health resource allocation in Guangdong's hospitals remains inadequate.Government authorities should enhance macro-level planning for regional resource distribution,accelerate advancements in medical technology,and establish a real-time monitoring framework.Concurrently,policy interventions and incentive mechanisms should be reinforced to ensure both scientifically sound allocation and effective utilization of medical resources.

Objective:To analyze the regional differences in health resource allocation in Guangdong Province and provide references for optimizing health resource allocation in Guangdong Province. Methods:The health resource density index,entropy weight-TOPSIS method,and RSR method were used to comprehensively evaluate the allocation of health resources in Guangdong Province from 2018 to 2022. Results:The results of the entropy weight-TOPSIS analysis showed that the average levels of comprehensive evaluation in the Pearl River Delta,Western Wing (West Guangdong),Eastern Wing (East Guangdong),and mountainous areas (North Guangdong) from 2018 to 2022 were 0.4452,0.1338,0.2144 and 0.0566,respectively. The RSR grading results show that Zhuhai,Dongguan,Guangzhou and Shenzhen had better allocation of health resources,with a"good"grading result;Shaoguan,Yunfu and Heyuan are worse. Conclusion:There is an obvious regional difference in the allocation of health resources in Guangdong Province. The allocation level of health resources in the Pearl River Delta and the Eastern Wing (East Guangdong) is relatively high,while the allocation level of health resources in the western wing (West Guangdong) and the mountainous areas (North Guangdong) is relatively low. In the future,Guangdong Province should pay attention to the areas with poor allocation of health resources,develop regional characteristic economy,strengthen the training of health talents,optimize the allocation of health resources,and realize that all people in the province can enjoy high-quality,convenient and equal medical and health services. At the same time,it is also necessary to strengthen cooperation and exchanges among regions to jointly promote the comprehensive development of health undertakings in Guangdong Province.

Objective:To analyze the regional differences in health resource allocation in Guangdong Province and provide references for optimizing health resource allocation in Guangdong Province. Methods:The health resource density index,entropy weight-TOPSIS method,and RSR method were used to comprehensively evaluate the allocation of health resources in Guangdong Province from 2018 to 2022. Results:The results of the entropy weight-TOPSIS analysis showed that the average levels of comprehensive evaluation in the Pearl River Delta,Western Wing (West Guangdong),Eastern Wing (East Guangdong),and mountainous areas (North Guangdong) from 2018 to 2022 were 0.4452,0.1338,0.2144 and 0.0566,respectively. The RSR grading results show that Zhuhai,Dongguan,Guangzhou and Shenzhen had better allocation of health resources,with a"good"grading result;Shaoguan,Yunfu and Heyuan are worse. Conclusion:There is an obvious regional difference in the allocation of health resources in Guangdong Province. The allocation level of health resources in the Pearl River Delta and the Eastern Wing (East Guangdong) is relatively high,while the allocation level of health resources in the western wing (West Guangdong) and the mountainous areas (North Guangdong) is relatively low. In the future,Guangdong Province should pay attention to the areas with poor allocation of health resources,develop regional characteristic economy,strengthen the training of health talents,optimize the allocation of health resources,and realize that all people in the province can enjoy high-quality,convenient and equal medical and health services. At the same time,it is also necessary to strengthen cooperation and exchanges among regions to jointly promote the comprehensive development of health undertakings in Guangdong Province.

Objective To explore the potential impact pathways of self-management behavior based on COM-B model,in maintenance hemodialysis(MHD)patients,and provide reference for the intervention of self-manage-ment behavior.Methods Judgment sampling was used to select 350 MHD patients undergoing dialysis at the hospital in a certain district of Guangzhou,and a questionnaire survey was conducted among them.Smart PLS software was used to construct a partial least squares structural equation model and perform path analysis.Results Self-manage-ment behavior score of MHD patients was(57.06±13.28).Univariate analysis showed that age,education back-ground,employment status,occupational classification,per capita monthly income of families,and the number of comorbidities could directly affect self-management behavior of MHD patients(P<0.05).PLS-SEM model showed that self-efficacy(β = 0.246),family care level(β = 0.124)and social support(β = 0.140)positively impacted patients' self-management behavior,while disease perception negatively affected self-management behavior(β =-0.097).Self-efficacy can mediate the impact of disease perception and social support on self-management behavior of MHD patients(P<0.05).Conclusions Self-management behavior of MHD patients is currently at a low level.Therefore,when devising intervention plans for these patients,it is crucial to consider the combined effects of disease knowledge education,disease perception reconstruction,opportunity provision,and motivation.The primary focus should be on enhancing patients' self-efficacy,which will ultimately elevate their overall level of self-management.

{L-End}Objective To analyze the current status of e-health literacy (e-HL) among college students and its influencing factors based on the Anderson model. {L-End}Methods A total of 7 230 college students from Guangdong Province, Hebei Province, Jiangsu Province and other places were selected as the study subjects using the convenient sampling method based on the theoretical framework of the Anderson model. The e-HL level, anxiety symptoms and depression symptoms were investigated using the e-Health Literacy Scale, the 7-item Generalized Anxiety Scale and the Patient Health Questionnaire-9 items. {L-End}Results The score of e-HL was (29.2±6.7), with the pass rate of 42.8%. The result of multiple linear regression analysis showed that college students with lower class rank, higher average monthly family income, better online health information judgment ability, and lower degree of depression symptoms had higher e-HL level (all P<0.01). College students living in urban areas had higher e-HL levels than those living in rural areas (P<0.01). College students who engaged in regular physical exercise had higher e-HL levels than those who did not (P<0.01). College students with mild anxiety symptoms had lower e-HL levels than those without anxiety symptoms (P<0.01). {L-End}Conclusion The e-HL level of college students needs to be improved. From the perspective of the Anderson model, predisposing characteristics (class grade ranking), resources (place of residence, online health information judgment ability, regular physical exercise), demand factors (anxiety symptoms, depression symptoms) affect the level of e-HL of college students.

OBJECTIVETo elucidate the current diagnosis and treatment status of gastric cancer in the Chinese population based on three high volume databases.

METHODSClinical and pathological data of patients who underwent gastric cancer resection with complete follow-up information between January 2000 and December 2012 from Sun Yat-sen University Cancer Center, The First Affiliated Hospital of China Medical University and Tianjin Medical University Cancer Hospital were retrospectively analyzed. The overall survival rate was calculated by Kaplan-Meier method. The prognostic risk factors were analyzed by using Cox proportional hazards model.

RESULTSA total of 8 338 cases were enrolled into the study, including 2 977 cases (35.7%) from Sun Yat-sen University Cancer Center, 3 043 cases (36.5%) from The First Affiliated Hospital of China Medical University and 2 318 cases (27.8%) from Tianjin Medical University Cancer Hospital. There were 5 852 male cases and 2 486 female cases with a ratio of 2.4 to 1.0. The age of patients was from 15 to 89 years old (median 59 years old). The ratio of early gastric cancer (T1NanyM0) was 11.5% (956/8 338). There were 2 226 gastric cancer cases (26.7%) originating from the fundus and cardiac region, 1 637 cases (19.6%) from the body, 3739 (44.9%) cases from the antrum, and 736 cases (8.8%) from the whole stomach. The median maximal tumor diameter was (4.5 ± 2.8) cm. Based on the Lauren classification, 3 448 cases (41.4%) were intestinal type and 4 890 cases (58.6%) diffuse type. A total of 1 975 cases (23.7%) and 6 363 cases (76.3%) underwent complete and subtotal gastrectomy respectively. The majority of patients (7 707 cases, 92.4%) underwent radical gastric resection, while 631 cases (7.6%) palliative resection. According to AJCC/UICC seventh edition of gastric cancer TNM staging system, 802 patients (9.6%) were stage I(A, 735 patients (8.8%) stage I(B, 695 patients (8.3%) stage II(A, 1 507 patients (18.1%) stage II(B, 1 247 patients (15.0%) stage III(A, 1 342 patients (16.1%) stage III(B, 1 583 patients (19.0%) stage III (C and 427 patients (5.1%) stage IIII(. The average number of retrieved lymph node was 21.0 ± 13.1, in which 5 761 patients (69.1%) had more than 15 retrieved lymph nodes. The overall 1-, 3-, 5- and 10-year survival rates were 83.0%, 56.8%, 49.1% and 43.0% respectively. For patients receiving radical resection, the 1-, 3-, 5- and 10-year survival rates were 84.9%, 59.5%, 51.7% and 45.3% respectively. The overall 5-year survival rates for different stages were as follows: stage I(A 93.8%, stage I(B 80.8%, stage II(A 70.8%, stage II(B 59.6%, stage III(A 44.4%, stage III(B 32.9%, stage III(C 18.9% and stage IIII( 10.2%. Cox regression model showed that age, tumor site, tumor size, Lauren type, T staging, N staging, M staging and number of retrieved lymph nodes were independent factors affecting the prognosis of gastric cancer patients (P=0.000).

CONCLUSIONRetrospective study on these domestic three high volume databases demonstrates the clinical and pathological characteristics of gastric cancer based on Chinese population, which is expected to stand as a ground of basic data for future clinical research.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Databases, Factual ; Female ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; diagnosis ; surgery ; Survival Rate ; Young Adult