The degree of equity and coupling coordination of staff in primary medical and health care institutions in China 2013-2019.

BACKGROUND: Primary medical and health care facilities are the first lines of defense for the health of population. This study aims to evaluate the current state and trend of equity and coupling coordination degree (CCD) of staff in primary medical and health care institutions (SPMHCI) based on the quantity and living standards of citizens in China 2013-2019. The research findings are expected to serve as a guideline for the allocation of SPMHCI. METHODS: The data used in this study including the quantity and living standards of citizens, as well as the number of SPMHCI in 31 provincial administrative regions of China, were obtained from the China Statistical Yearbook and the China Health Statistics Yearbook. The equity and CCD for SPMHCI were analyzed by using the Gini coefficient and the CCD model, and the Grey forecasting model GM (1, 1) (GM) was used to predict the equity and CCD from 2020 to 2022. RESULTS: Between 2013 and 2019, the number of SPMHCI increased from 3.17 million to 3.50 million, and the population-based Gini coefficient declined from 0.0704 to 0.0513. In urban and rural areas, the Gini coefficients decreased from 0.1185 and 0.0737 to 0.1025 and 0.0611, respectively. The CCD between SPMHCI and citizens' living standards (CLS) changed from 0.5691, 0.5813, 0.5818 to 0.5650, 0.5634, 0.6088 at national, urban, and rural levels, respectively. The forecasting results of GM revealed that at the national, urban and rural levels from 2020 to 2022, the Gini coefficient would rise at a rate of - 13.53, - 5.77%, and - 6.10%, respectively, while the CCD would grow at a rate of - 0.89, 1.06, and 0.87%, respectively. CONCLUSIONS: In China, the number of SPMHCI has increased significantly, with an equitable allocation based on the population. The interaction between SPMHCI and CLS is sufficient, but the degree of mutual promotion is moderate. The government could optimize SPMHCI and improve the chronic disease management services to improve CLS and to ensure the continued operation of primary medical and health care institutions in urban areas.

Cause analysis of unsafe acts of pilots in general aviation accidents in China with a focus on management and organizational factors.

Objectives. General aviation (GA) safety has become a key issue worldwide and pilot errors have grown to be the primary cause of GA accidents. However, fewer empirical studies have examined the contribution of management and organizational factors for these unsafe acts. Flawed decisions at the organizational level have played key roles in the performance of pilots. This study provides an in-depth understanding of the management and organizational factors involved in GA accident reports. Methods. A total of 109 GA accidents in China between 1996 and 2021 were analysed. Among these reports, pilot-related accidents were analysed using the human factors analysis and classification system (HFACS) framework. Results. The significant effects of managerial and organizational factors and the failure pathways on GA accidents have been identified. Furthermore, unlike traditional HFACS-based analyses, the statistically significant relationships between failures at the organizational level and the sub-standard acts of the pilots in GA accidents were revealed. Conclusions. Such findings support that the GA accident prevention strategy that attempts to reduce the number of unsafe acts of pilots should be directed to the crucial causal categories at HFACS organizational levels: resource management, organizational process, failure to correct a known problem, inadequate supervision and supervisory violations.

Protective role of statins in patients with acute coronary syndrome aged ≥ 75 years with low LDL-C who underwent percutaneous coronary intervention.

The effect of statins in patients with acute coronary syndrome (ACS) at advanced age with lower low-density lipoprotein cholesterol (LDL-C) levels undergoing percutaneous coronary intervention (PCI) remains unknown. We evaluated the effect of statins in 220 Chinese patients with ACS aged ≥ 75 years with low LDL-C undergoing PCI. Biomarkers were measured before and 6 hours after PCI, and patients were followed up for 1 year. Biomarkers in the statin group at 6 hours post-PCI were lower than controls (creatine kinase-myocardial band 14.2 ± 5.78 vs 47.3 ± 16.4 IU/L, P = .03; cardiac troponin I 0.36 ± 0.12 vs 1.33 ± 0.47 ng/mL, P = .01; and high-sensitivity C-reactive protein 7.6 ± 4.3 vs 13.6 ± 4.5 mg/L, P = .001, respectively). Significant differences were found in major adverse cardiac events at 1 year (P = .02-.01), while target lesion revascularization alone was less at 3 months between the 2 groups (P = .03). This study demonstrates that elderly patients with ACS having low LDL-C benefit from statins regardless of type, dosage, and duration of statin administration prior to PCI.

[Comparative study of N, P output and eutrophication risk in runoff water in cross ridge and longitudinal ridge].

Field in-situ rainfall simulation tests with two rainfall intensities (40 mm x h(-1) and 70 mm x h(-1)), which were conducted at typical sloping cropland in Yimeng mountainous area, were designed to analyze the output characteristics of dissolved inorganic nitrogen, Inorganic-N (NO3(-)-N, NH4(+) -N) and dissolved phosphorus (DP) in runoff water, as well as to compare the eutrophication risk in this water by calculating three ratios of Inorganic-N/DP, NO3(-) -N/DP, and NH4(+)-N/DP, respectively, in cross ridge and longitudinal ridge tillage methods. Results showed that, under the same rainfall intensity, the DP level in runoff water was higher in cross ridge than longitudinal ridge, while the change of different Inorganic-N level between the two tillage methods were not consistent. Cross ridge could effectively reduce runoff and the output rate of Inorganic-N and DP when compared to the longitudinal ridge tillage, which would be more outstanding with the increases of rainfall intensities. The losses of Inorganic-N and DP in runoff water were 43% and 5% less, respectively, in cross ridge than longitudinal ridge at the 40 mm x h(-1) rainfall intensity, and were 68% and 55%, respectively, at 70 mm x h(-1). The higher Inorganic-N/DP and NO3(-) -N/DP ratios suggest that runoff water from either cross ridge or longitudinal ridge tillage have a certain eutrophication risk, which present an increasing trend during the precipitation-runoff process. Compared with longitudinal ridge, cross ridge can not only hinder the increasing trend of eutrophication risk, but also can significantly lower it, and thus effectively reduce the effect of sloping cropland runoff on the eutrophication processes of receiving waters.