BACKGROUND:Emergency medical service system(EMSS)is essential in providing acute care services for health conditions.However,trends of emergency and acute care in China haven’t been studied systematically.METHODS:Rel...BACKGROUND:Emergency medical service system(EMSS)is essential in providing acute care services for health conditions.However,trends of emergency and acute care in China haven’t been studied systematically.METHODS:Relevant literature was carefully reviewed,including original and review articles,letters,government reports,yearbooks,both in Chinese and in English.Data on the number of emergency visits,physicians and beds in emergency departments(EDs),and the workforce of prehospital emergency care were summarized and analyzed from China Health and Family Planning Statistical Yearbooks(2006–2018).RESULTS:Over the past decade,the number of ED visits tripled from 51.9 million to 166.5 million;and utilization of pre-hospital emergency care increased from 3.2 million to 6.8 million.In response to rapid increases in demand,the number of licensed emergency physicians raised from 20,058 to 59,409;the beds’number increased from 10,783 to 42,367.For pre-hospital emergency care,the volume of health workforce increased from 3,687 to 8,671,with a 109%increase in the number of physicians from 1,774 to 3,712.However,overcrowding,the long length of stay in EDs,poor work environment,and work exhaustion were still the critical challenges faced by China’s EMSS.CONCLUSIONS:The number of emergency visits has grown with continual capability enhancement during the past decade.However,overcrowding,the long length of stay in EDs,poor work environment,and work exhaustion still need to be solved by China’s EMSS.These fi ndings and comparison with the USA could offer experiences and lessons to EMSS development worldwide,especially for developing countries.展开更多
Objective To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis,which is a rare subject of research in the mainland of China.Methods A time-series analysis ...Objective To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis,which is a rare subject of research in the mainland of China.Methods A time-series analysis was conducted to examine the association of outdoor air pollutants with hospital outpatient visits in Shanghai by using two-year daily data（2010-2011）.Results Outdoor air pollution was found to be associated with an increased risk of outpatient visits for acute bronchitis in Shanghai.The effect estimates of air pollutants varied with the lag structures of the concentrations of the pollutants.For lag06,a 10 μg/m3 increase in the concentrations of PM10,SO2,and NO2 corresponded to 0.94%（95% CI：0.83%,1.05%）,11.12%（95% CI：10.76%,11.48%）,and 4.84%（95% CI：4.49%,5.18%） increases in hospital visits for acute bronchitis,respectively.These associations appeared to be stronger in females（P〈0.05）.Between-age differences were significant for SO2（P〈0.05）,and between-season differences were also significant for SO2（P〈0.05）.Conclusion Our analyses have provided the first evidence that the current air pollution level in China has an effect on acute bronchitis and that the rationale for further limiting air pollution levels in Shanghai should be strengthened.展开更多
Previous studies have reported associations of short-term exposure to different sources of ambient fine particulate matter(PM2.5)and increased mortality or hospitalizations for respiratory diseases.Few studies,however...Previous studies have reported associations of short-term exposure to different sources of ambient fine particulate matter(PM2.5)and increased mortality or hospitalizations for respiratory diseases.Few studies,however,have focused on the short-term effects of source-specific PM2.5 on emergency room visits(ERVs)of respiratory diseases.Source apportionment for PM2.5 was performed with Positive Matrix Factorization(PMF)and generalized additive model was applied to estimate associations between source-specific PM2.5 and respiratory disease ERVs.The association of PM2.5 and total respiratory ERVs was found on lag4(RR=1.011,95%CI:1.002,1.020)per interquartile range(76μg/m3)increase.We found PM2.5 to be significantly associated with asthma,bronchitis and chronic obstructive pulmonary disease(COPD)ERVs,with the strongest effects on lag5(RR=1.072,95%CI:1.024,1.119),lag4(RR=1.104,95%CI:1.032,1.176)and lag3(RR=1.091,95%CI:1.047,1.135),respectively.The estimated effects of PM2.5 changed little after adjusting for different air pollutants.Six primary PM2.5 sources were identified using PMF analysis,including dust/soil(6.7%),industry emission(4.5%),secondary aerosols(30.3%),metal processing(3.2%),coal combustion(37.5%)and traffic-related source(17.8%).Some of the sources were identified to have effects on ERVs of total respiratory diseases(dust/soil,secondary aerosols,metal processing,coal combustion and traffic-related source),bronchitis ERVs(dust/soil)and COPD ERVs(traffic-related source,industry emission and secondary aerosols).Different sources of PM2.5 contribute to increased risk of respiratory ERVs to different extents,which may provide potential implications for the decision making of air quality related policies,rational emission control and public health welfare.展开更多
The association between ambient temperature and acute exacerbation of chronic bronchitis （AECB） was still unknown. Therefore, we performed an epidemiological study in a large hospital of Shanghai to explore the rela...The association between ambient temperature and acute exacerbation of chronic bronchitis （AECB） was still unknown. Therefore, we performed an epidemiological study in a large hospital of Shanghai to explore the relationship about temperature and outpatient visit for AECB. We adopted a quasi-Poisson generalized additive models and distributed lag nonlinear models to estimate the accumulative effects of temperature on AECB across multiple days. We found significant non-linear effects of cold temperature on hospital visits for AECB, and the potential effect of cold temperature might last more than 2 weeks. The relative risks of extreme cold （first percentiles of temperature throughout the study period） and cold （10th percentile of temperature） temperature over lags 0-14 d were 2.98 [95% confidence intervals （CI）： 1.77, 5.04] and 1.63 （95% Ch 1.21, 2.19）, compared with the 25th percentile of temperature. However, we found no positive association between hospital visits and hot weather. This study showed that exposure to both extreme cold and cold temperatures were associated with increased outpatient visits for AECB in a large hospital of Shanghai.展开更多
Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air pa...Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,展开更多
The letters and visits system plays a vital role in government work, serving as a crucial tool for supervising law enforcement and administrative conduct, ensuring public officials’ integrity, and promoting governanc...The letters and visits system plays a vital role in government work, serving as a crucial tool for supervising law enforcement and administrative conduct, ensuring public officials’ integrity, and promoting governance by law. As Chinese citizens’ political awareness grows, the volume of letters and visits has increased steadily. This paper reviews the current state of letters and visits information construction, identifies challenges and problems in system integration, presents integration ideas for existing systems, and proposes an innovative approach to letters and visits system integration. This research aims to provide valuable insights and guidance for other units undertaking similar system integration efforts.展开更多
Background:Agarwood,primarily derived from the Aquilaria and Gyrinops genera,holds significant economic importance.However,there is a lack of comprehensive investigations providing guidance to importing nations regard...Background:Agarwood,primarily derived from the Aquilaria and Gyrinops genera,holds significant economic importance.However,there is a lack of comprehensive investigations providing guidance to importing nations regarding cultivation quantities and expected yields of Agarwood from distinct species.This study aims to address this gap by exploring the historical context and trade evolution of Agarwood,highlighting its global importance,and the challenges associated with securing accurate species information.Method:On-site visits to Agarwood cultivation sites were conducted to gain a nuanced understanding of Aquilaria species and their cultivation requirements.Additionally,a thorough analysis of global export and import data for Agarwood products over the last decade was undertaken.Results:China Mainland emerged as the leading exporter of Agarwood,averaging an annual export value of USD 1 million.India’s substantial exports challenge the prevailing notion of limited Agarwood production within its borders.Hong Kong and Singapore are pivotal distribution hubs,while Hong Kong and Taipei feature prominently as import destinations.Our analysis uncovers anomalies in the representation of Agarwood producers from 2001 to 2008,suggesting potential misclassification of Aquilaria Agarwood as Gyrinops in global export information.These findings underscore the urgency of investigating classification and reporting practices in the Agarwood trade.Furthermore,A.filaria emerges as a notable source,while A.malaccensis is decline in prominence.Conclusion:This study provides crucial insights for policymakers,stakeholders,and industry players seeking to make informed decisions in the Agarwood trade landscape.The results highlight the need for accurate species identification,classification,and reporting practices to ensure sustainable cultivation and trade of Agarwood.展开更多
Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the...Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the main reasons for emergency department (ED) overcrowding, which greatly affects healthcare workers’ wellbeing, health costs, patients’ satisfaction and treatment outcomes. Currently, there is no solid definition of non-urgent emergency visits, which is the first step towards dealing and potentially solving this issue. Having that, the aim of the current study is to define and validate the criteria for NU-ED visits in Israel. Methods: This qualitative study included twelve senior physicians and nurses working in Emergency Department and/or Health Maintenance Organizations (HMOs) across Israel. The study was performed using in-depth, semi-structured, open-ended interviews. Qualitative data analysis was performed by conventional content analysis. Results: The urgency of medical visits was defined based on these two questions: 1) Does the medical condition require an immediate treatment? 2) Is the emergency department the only place that can provide the required treatment at a certain timepoint? We found that non-urgent visits mostly occur during the nights and weekends, when medical treatments are not available in the HMOs. Visitors for non-urgent cases mostly complained about minor injuries or chronic conditions, fever, abdominal or chest pain. Most visits occurred based on referral from the family physician or the nurse from the call center. Participants reported a lack of awareness and knowledge about the roles of the EDs and the available options in the HMOs, which seem unable to provide patients with appropriate treatments. The usage of triage scales seems to ensure that patients are being treated based on the clinical urgency of their condition. Medical cases that score above 3 can be defined as non-urgent visits. Therefore, implementation of these scales in the community and their use in deci展开更多
Eczema is a very common inflammatory skin disease characterized by patches of erythematous,itchy, cracked, and scaly skin.According to the 2010 Global Burden of Disease Study, the global prevalence of eczema is 3.33% ...Eczema is a very common inflammatory skin disease characterized by patches of erythematous,itchy, cracked, and scaly skin.According to the 2010 Global Burden of Disease Study, the global prevalence of eczema is 3.33% and the leading cause of skin condition-based disability-adjusted life years is eczema[1].The large health burden brought about by eczema suggests high direct medical costs and health care utilization[2].Thus, eczema prevention is of great importance in efforts to eliminate the public health burden of the disease.展开更多
基金supported by National Key R&D Program of China(2017YFC0908700,2017YFC0908703)Taishan Young Scholar Program of Shandong Province(tsqn20161065,tsqn201812129)+3 种基金Taishan Pandeng Scholar Program of Shandong Province(tspd20181220)National S&T Fundamental Resources Investigation Project(2018FY100600,2018FY100602)Key R&D Program of Shandong Province(2019GSF108075,2020SFXGFY03,2017G006013,2018GSF118003)Qilu Young Scholar Program.
文摘BACKGROUND:Emergency medical service system(EMSS)is essential in providing acute care services for health conditions.However,trends of emergency and acute care in China haven’t been studied systematically.METHODS:Relevant literature was carefully reviewed,including original and review articles,letters,government reports,yearbooks,both in Chinese and in English.Data on the number of emergency visits,physicians and beds in emergency departments(EDs),and the workforce of prehospital emergency care were summarized and analyzed from China Health and Family Planning Statistical Yearbooks(2006–2018).RESULTS:Over the past decade,the number of ED visits tripled from 51.9 million to 166.5 million;and utilization of pre-hospital emergency care increased from 3.2 million to 6.8 million.In response to rapid increases in demand,the number of licensed emergency physicians raised from 20,058 to 59,409;the beds’number increased from 10,783 to 42,367.For pre-hospital emergency care,the volume of health workforce increased from 3,687 to 8,671,with a 109%increase in the number of physicians from 1,774 to 3,712.However,overcrowding,the long length of stay in EDs,poor work environment,and work exhaustion were still the critical challenges faced by China’s EMSS.CONCLUSIONS:The number of emergency visits has grown with continual capability enhancement during the past decade.However,overcrowding,the long length of stay in EDs,poor work environment,and work exhaustion still need to be solved by China’s EMSS.These fi ndings and comparison with the USA could offer experiences and lessons to EMSS development worldwide,especially for developing countries.
基金supported by the National Clinical Key Subject Construction for founds(occupational disease Program),the National Basic Research Program(973 program)of China(2011CB503802)National Natural Science Foundation of China(81222036)Gong-Yi Program of China Ministry of Environmental Protection(201209008)
文摘Objective To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis,which is a rare subject of research in the mainland of China.Methods A time-series analysis was conducted to examine the association of outdoor air pollutants with hospital outpatient visits in Shanghai by using two-year daily data（2010-2011）.Results Outdoor air pollution was found to be associated with an increased risk of outpatient visits for acute bronchitis in Shanghai.The effect estimates of air pollutants varied with the lag structures of the concentrations of the pollutants.For lag06,a 10 μg/m3 increase in the concentrations of PM10,SO2,and NO2 corresponded to 0.94%（95% CI：0.83%,1.05%）,11.12%（95% CI：10.76%,11.48%）,and 4.84%（95% CI：4.49%,5.18%） increases in hospital visits for acute bronchitis,respectively.These associations appeared to be stronger in females（P〈0.05）.Between-age differences were significant for SO2（P〈0.05）,and between-season differences were also significant for SO2（P〈0.05）.Conclusion Our analyses have provided the first evidence that the current air pollution level in China has an effect on acute bronchitis and that the rationale for further limiting air pollution levels in Shanghai should be strengthened.
基金supported by the National Natural Science Foundation of China (Nos. 81571130090, 91543112)the National Key Research and Development Program of China (Nos. 2016YFC0206506, 2017YFC0702700)+2 种基金the Ministry of Ecology and Environment: the research of national-level ecological and environmental planning (No. 14430019)the Peking University Health Science Center (No. BMU20160549)the National Young Thousand Talents Program of China
文摘Previous studies have reported associations of short-term exposure to different sources of ambient fine particulate matter(PM2.5)and increased mortality or hospitalizations for respiratory diseases.Few studies,however,have focused on the short-term effects of source-specific PM2.5 on emergency room visits(ERVs)of respiratory diseases.Source apportionment for PM2.5 was performed with Positive Matrix Factorization(PMF)and generalized additive model was applied to estimate associations between source-specific PM2.5 and respiratory disease ERVs.The association of PM2.5 and total respiratory ERVs was found on lag4(RR=1.011,95%CI:1.002,1.020)per interquartile range(76μg/m3)increase.We found PM2.5 to be significantly associated with asthma,bronchitis and chronic obstructive pulmonary disease(COPD)ERVs,with the strongest effects on lag5(RR=1.072,95%CI:1.024,1.119),lag4(RR=1.104,95%CI:1.032,1.176)and lag3(RR=1.091,95%CI:1.047,1.135),respectively.The estimated effects of PM2.5 changed little after adjusting for different air pollutants.Six primary PM2.5 sources were identified using PMF analysis,including dust/soil(6.7%),industry emission(4.5%),secondary aerosols(30.3%),metal processing(3.2%),coal combustion(37.5%)and traffic-related source(17.8%).Some of the sources were identified to have effects on ERVs of total respiratory diseases(dust/soil,secondary aerosols,metal processing,coal combustion and traffic-related source),bronchitis ERVs(dust/soil)and COPD ERVs(traffic-related source,industry emission and secondary aerosols).Different sources of PM2.5 contribute to increased risk of respiratory ERVs to different extents,which may provide potential implications for the decision making of air quality related policies,rational emission control and public health welfare.
基金supported by the National Clinical key subject construction funds(occupational disease program)the National Basic Research Program(973 program)of China(2011CB503802)+3 种基金Gong-Yi Program of China Ministry of Environmental Protection(201209008)China Medical Board Collaborating Program(13-152)Public Welfare Research Program of National HealthFamily Planning Commission of China(201402022)
文摘The association between ambient temperature and acute exacerbation of chronic bronchitis （AECB） was still unknown. Therefore, we performed an epidemiological study in a large hospital of Shanghai to explore the relationship about temperature and outpatient visit for AECB. We adopted a quasi-Poisson generalized additive models and distributed lag nonlinear models to estimate the accumulative effects of temperature on AECB across multiple days. We found significant non-linear effects of cold temperature on hospital visits for AECB, and the potential effect of cold temperature might last more than 2 weeks. The relative risks of extreme cold （first percentiles of temperature throughout the study period） and cold （10th percentile of temperature） temperature over lags 0-14 d were 2.98 [95% confidence intervals （CI）： 1.77, 5.04] and 1.63 （95% Ch 1.21, 2.19）, compared with the 25th percentile of temperature. However, we found no positive association between hospital visits and hot weather. This study showed that exposure to both extreme cold and cold temperatures were associated with increased outpatient visits for AECB in a large hospital of Shanghai.
基金supported by the Development Foundation of Shanghai Meteorological and Health Key Laboratory [QXJK201606]the Investigation of Science&Technology Basic Resources Program of China [2017FY101206]the General Program Foundation of Hebei Meteorological Bureau [17KY10]
文摘Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,
文摘The letters and visits system plays a vital role in government work, serving as a crucial tool for supervising law enforcement and administrative conduct, ensuring public officials’ integrity, and promoting governance by law. As Chinese citizens’ political awareness grows, the volume of letters and visits has increased steadily. This paper reviews the current state of letters and visits information construction, identifies challenges and problems in system integration, presents integration ideas for existing systems, and proposes an innovative approach to letters and visits system integration. This research aims to provide valuable insights and guidance for other units undertaking similar system integration efforts.
基金Jiangxi Province Double Thousand Talent-Leader of Natural Science Project(jxsq2023101038)Jiangxi Province Urgently Overseas Talent Project(2022BCJ25027)+1 种基金The Key Research Projects in Jiangxi Province(20223BBH8007&20232BBG70014)Innovation Team Project in Key Areas of Jiujiang City Base and Talent Plan(S2022TDJS029).
文摘Background:Agarwood,primarily derived from the Aquilaria and Gyrinops genera,holds significant economic importance.However,there is a lack of comprehensive investigations providing guidance to importing nations regarding cultivation quantities and expected yields of Agarwood from distinct species.This study aims to address this gap by exploring the historical context and trade evolution of Agarwood,highlighting its global importance,and the challenges associated with securing accurate species information.Method:On-site visits to Agarwood cultivation sites were conducted to gain a nuanced understanding of Aquilaria species and their cultivation requirements.Additionally,a thorough analysis of global export and import data for Agarwood products over the last decade was undertaken.Results:China Mainland emerged as the leading exporter of Agarwood,averaging an annual export value of USD 1 million.India’s substantial exports challenge the prevailing notion of limited Agarwood production within its borders.Hong Kong and Singapore are pivotal distribution hubs,while Hong Kong and Taipei feature prominently as import destinations.Our analysis uncovers anomalies in the representation of Agarwood producers from 2001 to 2008,suggesting potential misclassification of Aquilaria Agarwood as Gyrinops in global export information.These findings underscore the urgency of investigating classification and reporting practices in the Agarwood trade.Furthermore,A.filaria emerges as a notable source,while A.malaccensis is decline in prominence.Conclusion:This study provides crucial insights for policymakers,stakeholders,and industry players seeking to make informed decisions in the Agarwood trade landscape.The results highlight the need for accurate species identification,classification,and reporting practices to ensure sustainable cultivation and trade of Agarwood.
文摘Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the main reasons for emergency department (ED) overcrowding, which greatly affects healthcare workers’ wellbeing, health costs, patients’ satisfaction and treatment outcomes. Currently, there is no solid definition of non-urgent emergency visits, which is the first step towards dealing and potentially solving this issue. Having that, the aim of the current study is to define and validate the criteria for NU-ED visits in Israel. Methods: This qualitative study included twelve senior physicians and nurses working in Emergency Department and/or Health Maintenance Organizations (HMOs) across Israel. The study was performed using in-depth, semi-structured, open-ended interviews. Qualitative data analysis was performed by conventional content analysis. Results: The urgency of medical visits was defined based on these two questions: 1) Does the medical condition require an immediate treatment? 2) Is the emergency department the only place that can provide the required treatment at a certain timepoint? We found that non-urgent visits mostly occur during the nights and weekends, when medical treatments are not available in the HMOs. Visitors for non-urgent cases mostly complained about minor injuries or chronic conditions, fever, abdominal or chest pain. Most visits occurred based on referral from the family physician or the nurse from the call center. Participants reported a lack of awareness and knowledge about the roles of the EDs and the available options in the HMOs, which seem unable to provide patients with appropriate treatments. The usage of triage scales seems to ensure that patients are being treated based on the clinical urgency of their condition. Medical cases that score above 3 can be defined as non-urgent visits. Therefore, implementation of these scales in the community and their use in deci
基金supported by the Key Project of Natural Science Funds of China [No.81230066]the National Natural Science Fund Projects of China [No.81473043]
文摘Eczema is a very common inflammatory skin disease characterized by patches of erythematous,itchy, cracked, and scaly skin.According to the 2010 Global Burden of Disease Study, the global prevalence of eczema is 3.33% and the leading cause of skin condition-based disability-adjusted life years is eczema[1].The large health burden brought about by eczema suggests high direct medical costs and health care utilization[2].Thus, eczema prevention is of great importance in efforts to eliminate the public health burden of the disease.
