Optimization path of primary public health service talent team construction: a largescale survey in Huaihai Economic Zone, China.

Background: The primary public health service system is indispensable for the implementation of the "Healthy China 2030" strategy, and primary healthcare workers, as the key drivers of this system, play a pivotal role in its development and establishment to ensure population well-being. In developing countries, such as China, primary public health systems are still weak, and in order to address this phenomenon, health system reform is needed, and primary public health personnel are crucial to health system reform. The current situation of primary public health workers in low-income and developing countries is characterized by varying degrees of problems that need improvement. Objectives: The purpose of this study is to understand the current situation of primary public health service workforce building, analyze the existing problems of the workforce, put forward suggestions for improvement and explore countermeasures, and provide Chinese wisdom and a reference basis for primary public health workforce building in the world, especially in developing countries. Methods: Combining the Work-Family Conflict Scale, Copenhagen Burnout Inventory, Minnesota Satisfaction Questionnaire, and Turnover Intention Scale, a relevant survey questionnaire was designed to quantitatively investigate the baseline characteristics of primary public health service institutions and their staff in four representative cities in the Huaihai Economic Zone: Xuzhou in Jiangsu Province, Linyi in Shandong Province, Shangqiu in Henan Province, and Huaibei in Anhui Province. The collected data were analyzed and processed using SPSS 25.0 statistical analysis software through univariate analysis and logistic regression analyses. Methods such as one-way ANOVA, Logistic regression analysis, and independent samples t-test were used to analyze the influencing factors of primary public health workforce development. Results: The current work intensity at the primary public health level is currently high, the salary and benefits cannot meet the needs of most primary public health personnel, and the competition between work and family in terms of time and resources is pronounced, and the majority of primary public health personnel are dissatisfied with the status quo of "doing more work for less reward" and the poor social security. Emotional exhaustion, depersonalization, and a sense of personal accomplishment were positively correlated with the tendency to leave (all p < 0.01), and the burnout and emotional exhaustion of primary public health workers were intense. Conclusion: Primary public health personnel play an important role in providing primary public health services. However, the current working conditions of junior public health personnel in the Huaihai Economic Zone are influenced by factors such as workload, income level, and employment situation improvement, leading to low job satisfaction, significant work-family conflicts, and high turnover intention. In this context, based on the opinions of grassroots administrative departments and internationally relevant experiences, a series of suggestions have been proposed to improve the professional service level, job satisfaction, and occupational identity of staff members. These suggestions make valuable contributions to both the Huaihai Economic Zone and countries worldwide in safeguarding individual health and promoting national primary healthcare reform.

Effects of work-family conflict, social support and burnout on job satisfaction among primary care physicians in Huaihai economic zone.

Background: Primary care physicians (PCPs) are doctors in primary health care institutions, namely village clinics, township health centers and community health service centers (stations) who are the main providers of primary health care services in primary health care settings. Improving the overall health status of the population requires the support of a large number of primary care physicians; however, the job satisfaction of this group has not been sufficiently emphasized and recognized. Objective: The purpose of this study was to examine the effects of primary care physicians' work-family conflict on their job satisfaction, as well as the mediating role of burnout and the moderating role of social support. Methods: This cross-sectional study was conducted from February 2023 to March 2023. Participants were 749 primary care physicians from four cities of Xuzhou, Linyi, Huaibei, and Shangqiu in the Huaihai Economic Zone of China. SPSS statistical analysis was used to evaluate the relationship between work-family conflict, social support, burnout and job satisfaction among medical workers. Results: Work-family conflict had a significant negative effect on job satisfaction (ß = -0.36, p< 0.001), after adding burnout in the model, work-family conflict also negatively predicted job satisfaction (ß = -0.32, p< 0.001). Social support had a moderating effect on the direct effect of burnout on job satisfaction (ß = 0.00, t = 2.66, p< 0.01, 95%CI [0.001, 0.007]), the predictive effect of burnout on job satisfaction at high level of social support (ß = -0.45, p< 0.001) was higher than a low level of social support (ß = -0.33, p< 0.001). Conclusions: This study demonstrated the negative impact of work-family conflict on primary care physicians' job satisfaction, as well as the mediating role of burnout and the moderating role of social support on burnout and job satisfaction, which are important for improving primary care physicians' job satisfaction and enhancing the quality of primary care in the future.

Association of serum vitamin D with anxiety in US adults: a cross-sectional study.

Objective: There have been proposals that vitamin D may be associated with a reduction in the incidence of anxiety disorders. However, the findings thus far have been inconsistent, warranting further investigation. The purpose of this paper is to explore the link between serum vitamin D and anxiety. Methods: Data are from the National Health and Nutrition Examination Survey (NHANES) in the United States from 2007 to 2012. Study included a total of 12,232 participants, and through the multivariate logistic regression to study the relationship between serum vitamin D and anxiety, smooth curve fitting is used to study the nonlinear relationship between serum vitamin D levels and anxiety. Results: Serum vitamin D levels demonstrated a negative correlation with anxiety (p < 0.001). Vitamin D exhibited a significant impact on anxiety (Q4:OR = 0.774, 95% CI: 0.663-0.903, p < 0.01), and this effect remained significant even after adjusting for confounding variables (Q4:OR = 0.781, 95% CI: 0.669-0.912, p < 0.01). Smoothed curve fitting revealed a negative association between serum vitamin D levels and the risk of anxiety, and these findings persisted after accounting for confounding variables. Conclusion: Serum vitamin D levels were inversely associated with anxiety risk in US adults. In the future, more accurate prospective studies are needed to confirm this result.