ABSTRACT
Influenza causes a significant disease burden as an acute respiratory infection. Evidence suggests that meteorological factors can influence the spread of influenza; however, the association between these factors and influenza activity remains controversial. In this study, we investigated the impact of temperature on influenza across different regions of China based on the meteorological data and influenza data from 554 sentinel hospitals in 30 provinces and municipalities in China from 2010 to 2017. A distributed lag nonlinear model (DLNM) was used to analyze the exposure lag response of daily mean temperatures to the risk of influenza-like illness (ILI), influenza A (Flu A), and influenza B (Flu B). We found that in northern China, low temperatures increased the risk of ILI, Flu A, and Flu B, while in central and southern China, both low and high temperatures increased the risk of ILI and Flu A, and only low temperatures increased the risk of Flu B. This study suggests that temperature is closely associated with the influenza activity in China. Temperature should be integrated into the current public health surveillance system for highly accurate influenza warnings and the timely implementation of disease prevention and control measures.
Subject(s)
Influenza, Human , Humans , Influenza, Human/epidemiology , Temperature , Hot Temperature , Meteorological Concepts , China/epidemiologyABSTRACT
Objective @#To analyze the status and influencing factors of the intention of people aged 18 to 25 years to primary medical institutions and their satisfaction for health services in Zhejiang Province, so as to provide basis for the improvement of health services in primary medical institutions.@*Methods@#During November and December in 2019,the 18-25 year-old people in Zhejiang Province were recruited to investigate the general information, intention to seek medical advice and satisfaction for health services in primary medical institutions through WeChat. Logistic regression was performed to analyze the influencing factors of the intention and the satisfaction. Importance matrix was used to analyze the key drivers of the satisfaction. @*Results@#Among the 620 people surveyed, with a response rate of 93.37%, 142 (22.90%) chose primary medical institutions for advice. Actually 516 (83.23%) people went to primary medical institutions last year, and 384 ( 74.42% ) of them were satisfied with the health services. The results of multivariate logistic regression analysis showed that the people aged 18-25 years who were under the new rural cooperative medical care system ( OR=3.062, 95%CI: 1.745-5.373 ) and who had records in community health centers ( OR=0.547, 95%CI: 0.308-0.970 ) were more likely to go to primary medical institutions for medical advice; the ability of doctors ( OR=1.478, 95%CI:1.168-1.871 ) ,the drug notification by medical staff ( OR=1.308, 95%CI: 1.065-1.606 ) , routine examination items ( OR=1.523, 95%CI: 1.227-1.889 ) , the ways of payment ( OR=1.168, 95%CI: 1.017-1.340 ) , the comfort of environment ( OR=1.785, 95%CI: 1.437-2.219 ) and the bulletin boards of health knowledge ( OR=1.302, 95%CI: 1.086-1.561 ) were associated with the satisfaction. The results of importance matrix analysis showed that the ability of doctors and routine examination items were the priorities to improve, followed by the drug notification by medical staff; the comfort of environment had competitive advantages; the ways of payment and the bulletin boards of health knowledge needed to be further analyzed. @*Conclusions@#The 18-25-year-old people in Zhejiang Province were less intended to seek medical advice in primary medical institutions, which was associated with the type of medical insurance and records in community health centers. They were satisfied with the health services, the ability of doctors and routine examination items were the key drivers.
ABSTRACT
Objective@#To understand the satisfaction of the residents in Hangzhou with primary health care services and its influencing factors, so as to provide basis for improving the quality of primary health care services.@*Methods@#This study adopted multi-stage stratified random sampling method to recruit the residents aged 14 years or over in Hangzhou from July to September, 2019. A self-designed electronic questionnaire for primary health care services in Hangzhou was used to collect the demographic information, the utilization of primary health care institutions, the scores of the indicators of primary health care services and the satisfaction. The ordinal and multinomial logistic regression model was conducted to analyze the influencing factors for the satisfaction with primary health care services. @*Results@#Totally 1 600 questionnaires were issued, 1 454 valid ones were collected, and the response rate was 90.88%. Five ( 0.34% ) residents were very dissatisfied, 16 ( 1.10% ) residents were dissatisfied, 153 ( 10.52% ) residents were generally satisfied, 780 ( 53.65% ) residents were satisfied, and 500 ( 34.39% ) residents were very satisfied with primary health care services. The ordinal and multinomial logistic regression analysis showed that basic medical insurance for urban employees ( OR=0.514, 95%CI: 0.370-0.714 ) , no health records in primary health institutions ( OR=0.528, 95%CI: 0.331-0.844 ) or unknown ( OR=0.524, 95%CI: 0.331-0.829 ) , the queuing time spent for getting medicines ( OR=0.698, 95%CI: 0.531-0.917 ) , ways of getting medicines (OR=0.639, 95%CI: 0.452-0.903 ) and completeness of testing equipment ( OR=1.315, 95%CI: 1.012-1.710) were influencing factors for the satisfaction with primary health care services.@*Conclusions@#The residents in Hangzhou are generally satisfied with the primary health care services, which are associated with the type of medical insurance, the condition of health records in primary institutions, the queuing time spent for getting medicines, the ways of getting medicines and the completeness of inspection equipment.
ABSTRACT
When artists depict a mirror in a painting, it necessarily lacks the most obvious property of a mirror: as we move around the painting of the mirror, the reflections we see in it do not change. And yet representations of mirrors and other reflecting surfaces can be quite convincing in paintings. Here, we will examine the rules of reflection, the many ways that painters can break those rules without losing the impression of reflection and the rules that cannot be broken. The rules that govern the perception of reflection are a small subset of the physical rules of reflection.