Background: China is a country with a high burden of pulmonary tuberculosis (PTB). Chongqing is in the southwest of China, where the notification rate of PTB ranks tenth in China. This study analyzed the temporal and spatial distribution characteristics of PTB in Chongqing in order to improve TB control measures. Methods: A spatial-temporal analysis has been performed based on the data of PTB from 2011 to 2018, which was extracted from the National Surveillance System. The effect of TB control was measured by variation trend of pathogenic positive PTB notification rate and total TB notification rate. Time series, spatial autonomic correlation and spatial-temporal scanning methods were used to identify the temporal trends and spatial patterns at county level. Results: A total of 188,528 cases were included in this study. A downward trend was observed in PTB between 2011 and 2018 in Chongqing. The peak of PTB notification occurred in late winter and early spring annually. By calculating the value of Global Moran’s I and Local Getis’s G_i^*, we found that PTB was spatially clustered and some significant hot spots were detected in the southeast and northeast of Chongqing. One most likely cluster and three secondary clusters were identified by Kulldorff’s scan spatial-temporal Statistic. Conclusions: This study identified seasonal patterns and spatial-temporal clusters of PTB cases in Chongqing. Priorities should be given to southeast and northeast of Chongqing for better TB control.

Background: Job burnout has become a widespread phenomenon in school settings. However, little is known about the mental health condition of the growing cohort of generalist teachers in rural primary schools. Drawing on the job demands–resource model and social exchange theory, this study examines the correlation between job burnout and job satisfaction through perceived organizational support and work engagement. Methods: We recruited 639 Chinese generalist teachers in rural primary schools as the study subjects and developed a serial mediation model to assess the hypothesized construct. The data acquired online via Wenjuanxing Software were confirmed as valid and analyzed with SPSS and SmartPLS. Results: The participants scored above the median in perceived organizational support, work engagement, and job satisfaction, and had scores close to the median for job burnout. Statistically significant differences among the investigated variables were found in gender, age, experience, and degree. Job burnout was negatively predictive of perceived organizational support, work engagement, and job satisfaction (each p = 0.000). Perceived organizational support mediated the association between job burnout and work engagement (p = 0.000) and the connection between job burnout and job satisfaction (p = 0.000), while work engagement mediated the association between job burnout and job satisfaction (p = 0.000) and the association between perceived organizational support and job satisfaction (p = 0.000). Conclusions: Perceived organizational support and work engagement as two sequential mediators buffered the detrimental impact of job burnout on job satisfaction among Chinese generalist teachers in rural primary schools. Targeted strategies should be implemented to diminish generalist teachers’ feelings of burnout, being unsupported by organizations, disengagement at work, and dissatisfaction with the job.

Background: Previous research pointed to a close relationship between the incidence of tuberculosis (TB) in aging populations and socio-economic conditions, however there has been lack of studies focused on a region of unbalanced socio-economic development. The aim of this paper is to explore the spatio-temporal variation in TB incidence and examine risk determinants of the disease among aging populations in a typical region. Methods: Data on TB-registered cases between 2009 and 2014, in addition to social-economic factors, were collected for each district/county in Beijing, Tianjin and Hebei, a region characterized by an aging population and disparities in social-economic development. A Bayesian space–time hierarchy model (BSTHM) was used to reveal spatio-temporal variation in the incidence of TB among the elderly in this region between 2009 to 2014. GeoDetector was applied to measure the determinant power (q statistic) of risk factors for TB among the elderly. Results: The incidence of TB among the elderly exhibited geographical spatial heterogeneity, with a higher incidence in underdeveloped rural areas compared with that in urban areas. Hotspots of TB incidence risk among the elderly were mostly located in north-eastern and southern areas in the study region, far from metropolitan areas. Areas with low risk were distributed mainly in the Beijing-Tianjin metropolitan areas. Social-economic factors had a non-linear influence on elderly TB incidence, with the dominant factors among rural populations being income (q = 0.20) and medical conditions (q = 0.17). These factors had a non-linear interactive effect on the incidence of TB among the elderly, with medical conditions and the level of economic development having the strongest effect (q = 0.54). Conclusions: The findings explain spatio-temporal variation in TB incidence and risk determinants of elderly TB in the presence of disparities in social-economic development. High-risk zones were located mainly in rural areas, far from metropolitan centres. Medical conditions and the economic development level were significantly associated with elderly TB incidence, and these factors had a non-linear interactive effect on elderly TB incidence. The findings can help to optimize the allocation of health resources and to control TB transmission in the aging population in this region.

Background: China has one of the highest tuberculosis (TB) burdens in the world. However, the unbalanced spatial and temporal trends of TB risk at a fine level remain unclear. Objective: We aimed to investigate the unbalanced risks of pulmonary tuberculosis (PTB) at different levels and how they evolved from both temporal and spatial aspects using PTB notification data from 2851 counties over a decade in China. Methods: County-level notified PTB case data were collected from 2009 to 2018 in mainland China. A Bayesian hierarchical model was constructed to analyze the unbalanced spatiotemporal patterns of PTB notification rates during this period at subnational scales. The Gini coefficient was calculated to assess the inequality of the relative risk (RR) of PTB across counties. Results: From 2009 to 2018, the number of notified PTB cases in mainland China decreased from 946,086 to 747,700. The average number of PTB cases in counties was 301 (SD 26) and the overall average notification rate was 60 (SD 6) per 100,000 people. There were obvious regional differences in the RRs for PTB (Gini coefficient 0.32, 95% CI 0.31-0.33). Xinjiang had the highest PTB notification rate, with a multiyear average of 155/100,000 (RR 2.3, 95% CI 1.6-2.8; P<.001), followed by Guizhou (117/100,000; RR 1.8, 95% CI 1.3-1.9; P<.001) and Tibet (108/100,000; RR 1.7, 95% CI 1.3-2.1; P<.001). The RR for PTB showed a steady downward trend. Gansu (local trend [LT] 0.95, 95% CI 0.93-0.96; P<.001) and Shanxi (LT 0.94, 95% CI 0.92-0.96; P<.001) experienced the fastest declines. However, the RRs for PTB in the western region (such as counties in Xinjiang, Guizhou, and Tibet) were significantly higher than those in the eastern and central regions (P<.001), and the decline rate of the RR for PTB was lower than the overall level (P<.001). Conclusions: PTB risk showed significant regional inequality among counties in China, and western China presented a high plateau of disease burden. Improvements in economic and medical service levels are required to boost PTB case detection and eventually reduce PTB risk in the whole country.

Background: University students with a vocational pathway face greater cultural, psychological, cognitive, and behavioral challenges during the transition process than their counterparts with an academic route. Method: This study examined the predictive effect of bicultural identity integration, self-esteem, academic resilience, and interaction anxiousness on school belonging using a quantitative approach with 326 Chinese vocational pathway university student participants. Result: The participants had high levels of cultural adaptability, self-esteem, academic resilience, and school belonging, but they also displayed moderate interaction anxiousness. Bicultural identity integration (B = 0.24; p < 0.001), self-esteem (B = 0.35; p < 0.001), and academic resilience (B = 0.25; p < 0.001) significantly positively predicted school belonging, while interaction anxiousness (B = −0.17; p < 0.01) negatively predicted school belonging. Conclusions: Bicultural identity integration, self-esteem, academic resilience, and interaction anxiousness were crucial determinants of school belonging among Chinese university students with vocational qualifications. Effective measures should be initiated to boost their feelings of being recognized, respected, and connected to the university community.

Grounded on the social exchange theory (SET), social cognitive theory (SCT), and self-determination theory (SDT), this study aims to explore the mediating role of self-efficacy (SE) and work engagement (WE) on the effect of social support (SS) on job satisfaction (JS) among Chinese ethnic minority kindergarten teachers (KTs). The results show that: (1) SS has a directly significant effect on JS; (2) WE mediates the relationship between SS and JS; and (3) SE mediates the relationship between SS and WE. Although the mediation of SE on the relationship between SS and JS is not found, the posited multiple mediations of SE and WE on the relationship between SS and JS are totally accepted. The results reveal that SS mainland Chinese ethnic minority KTs received can not only have a direct effect on JS but also have an indirect impact through the one-path mediating role of WE and the chain mediating role of SE and WE. The results suggest that governments, supervisors, and sponsors should work together to provide ethnic minority KTs with more prioritized SS from both cultural psychology and financial material and opportunities for facilitating professional knowledge and skills in order to enhance their SE, inspire their WE, and eventually accumulate their JS.