Cities In Zhejiang Province Research Articles

Geographic and Perceived Healthcare Access Equity among Patients with Acute Cardiovascular Event in China

Introduction: In acute cardiovascular event (ACE) such as stroke and myocardial infarction, access to comprehensive, timely, and quality healthcare services was critical for receiving appropriate treatment and improving prognosis. However, due to significant disparities on distribution of healthcare resources, allocating the limited resources to regions and population in needs was a key challenge for China. This study aimed to evaluate both geographic and perceived healthcare access of ACE patients in China, find inconsistency and furtherly improve it. Methods: This study was conducted in Hangzhou (a capital city of Zhejiang Province in southeast China) city. We conducted a ground-truthed field census to locate and confirm all institutions based on their locations. Geographic Information System (GIS) was used to analyze the geographic healthcare access (e.g. distance to nearest institution, density of institutions in the area etc.) and potential distribution disparities. Meanwhile, we sampled 21 ACE patients from one typical hospital in Shangcheng District in a pilot study, and a questionnaire-based face-to-face survey was conducted to collect data on perceptions of healthcare access, including perceived presence of institutions, perceived distance to nearest institution, perceived affordability of healthcare etc. Results: A number of 2,763 healthcare institutions were recognized, confirmed and geocoded in the GIS. The geographic healthcare access was excellent for city residents and over 95% of the city areas were within 15-minute access-buffer. However, only 10.2% institutions could provide emergency services and among them only 7.8% institutions could provide emergency services for ACE patients. Based on patient survey, approximately 33.3% ACE patients reported healthcare access was not good in their living areas. Average perceived distance and time to the nearest healthcare institution were 6.9±4.7 km and 23.8±13.7 minutes, respectively. The majority of the patients reported that no emergency services were localized near their homes. When the ACEs happened, 85.7% of the patients were transported by the ambulance. Discussion: The knowledge generated from this study could form a basis for understanding of healthcare access in China. Access to emergency healthcare services was poor in some areas in the city. The mapping data showed an excellent healthcare access for residents, but the patients did not all perceive this. Compared to geographic data, patients perceived longer distance and duration of time to the nearest healthcare institution. The inconsistence might be due to the traffic condition in city area, urban planning, mode of transportation, and inconsistence of accessibility captured by GIS and perceptions. Lessons learned: The findings of this proposed study would guide policy deliberations and healthcare resources allocations. It would provide instrumental information for policy makers to target interventions to improve both geographic and perceived healthcare access. Limitations: The recruitment of patient survey was limited at the pilot stage. We planned to expand the sample size into more areas and linked healthcare access to ACE outcomes to further evaluate the impact of healthcare access on health, and thus find more potentials for policy intervention. Funding: This work was supported by the Open Competition grant from the China Medical Board (14-197).

Coupled LAI assimilation and BEPS model for analyzing the spatiotemporal pattern and heterogeneity of carbon fluxes of the bamboo forest in Zhejiang Province, China

Bamboo forests are widely distributed in the tropical and sub-tropical regions, and have a great carbon sequestration capacity. However, the carbon dynamics of bamboo forest are still poorly understood. This study developed an algorithm for assimilating LAI dynamics based on an integrated ensemble Kalman filter using MODIS LAI data, MODIS reflectance data, and canopy reflectance data modeled by PROSAIL for two typical bamboo forests. The assimilated LAI was highly consistent with the observed LAI, yielding correlation coefficient (r) of 0.84 and 0.94 for Moso bamboo forest and Lei bamboo forest, respectively. Then, the spatiotemporal pattern of the CO2 fluxes within bamboo forest were modeled for Zhejiang Province during 2011–2014 using the Boreal Ecosystem Productivity Simulator model driven by assimilated LAI. The modeled CO2 fluxes were in agreement with the CO2 fluxes measured by eddy covariance technology at two selected sites within the study region. Average r, absolute deviation, and root mean square error values were 0.77, 0.65gCm−2day−1, and 0.82gCm−2day−1, respectively. Bamboo stands with high Net Ecosystem Exchange (NEE) values were found to be distributed throughout mountainous areas in the northwest, southwest, and northeast of Zhejiang, while low NEE stands were located in the mountain basin areas, high altitude areas, and the majority of coastal areas. Among the eleven cities in Zhejiang Province, Hangzhou was the highest annual total NEE city (0.34±0.06TgCyr−1), and Huzhou was the highest NEE density city (7.65±1.02MgChm−2yr−1). The carbon sequestrated by bamboo forest was 1.74TgCyr−1, accounted 6.36Tg CO2 yr−1, which indicated the bamboo forested area in Zhejiang Province was a carbon sink. The spatial heterogeneity of CO2 fluxes of bamboo forest can be revealed by an exponential semivariance model. The analysis of the model structure indicated that the spatial heterogeneity of CO2 fluxes of bamboo forest was characterized by significant autocorrelation, with an average autocorrelation range of 3.00km, however the effect of random factors (management levels, management measures, etc.) cannot be ignored. This is the first time that the CO2 fluxes of bamboo forest in Zhejiang Province have been mapped and this study provides a new estimate of CO2 fluxes in this region.

Risk factors for avian influenza virus contamination of live poultry markets in Zhejiang, China during the 2015\u20132016 human influenza season

Live bird markets (LBMs), being a potential source of avian influenza virus, require effective environmental surveillance management. In our study, a total of 2865 environmental samples were collected from 292 LBMs during the 2015–2016 human influenza season from 10 cities in Zhejiang province, China. The samples were tested by real-time quantitative polymerase chain reaction (RT-PCR). Field investigations were carried out to investigate probable risk factors. Of the environmental samples, 1519 (53.0%) were contaminated by A subtype. The highest prevalence of the H9 subtype was 30.2%, and the frequencies of the H5 and H7 subtype were 9.3% and 17.3%, respectively. Hangzhou and Jinhua cities were contaminated more seriously than the others. The prevalence of H5/H7/H9 in drinking water samples was highest, at 50.9%, and chopping board swabs ranked second, at 49.3%. Duration of sales per day, types of live poultry, LBM location and the number of live poultry were the main risk factors for environmental contamination, according to logistic regression analysis. In conclusion, LBMs in Zhejiang were contaminated by avian influenza. Our study has provided clues for avian influenza prevention and control during the human influenza season, especially in areas where LBMs are not closed.

Prevalence of prior HIV testing and associated factors among MSM in Zhejiang Province, China: a cross-sectional study.

BackgroundMen who have sex with men (MSM) have become one of high-risk population for human immunodeficiency virus (HIV) infection, due to their multiple sex partners and unprotected anal intercourse. Promoting HIV testing is an effective strategy for the prevention and control of HIV infection. We assessed the factors associated with a prior HIV testing history, which could provide guidance for implementation of future HIV intervention programs.MethodsA cross-sectional study was conducted in three cities of Zhejiang Province, namely, Hangzhou, Ningbo and Wenzhou, using respondent-driven sampling, between December 2013 and June 2014. A face-to-face questionnaire survey was employed to collect relevant information about HIV testing. Univariate and multivariate logistic regression analyses were used to identify the factors associated with a prior HIV testing history.ResultsThe adjusted rate of prior HIV testing among MSM in Zhejiang Province was 55.9 %. The adjusted rates of HIV and syphilis infections among MSM in Zhejiang Province were 14.0 % and 11.4 %, respectively. A weighted multivariate analysis showed that MSM of older age were more likely to be tested, as were MSM with higher level of education, self-reported homosexuality and a higher frequency of receiving AIDS/sexually transmitted infections educational intervention in the past year. MSM with suicidal inclination and self-perceived lower possibility of HIV infection were less likely to report ever having undergone an HIV test.ConclusionsThe prevalence of prior HIV testing among MSM in Zhejiang Province, China is low. Effective and more frequent interventional measures should be adopted to improve risk awareness and psychosocial support for younger, less educated MSM, and to encourage more MSM to undergo HIV testing.

Dietary and physical activity of adult patients with type 2 diabetes in Zhejiang province of eastern China: Data from a cross-sectional study.

Aims/IntroductionLifestyle management helps improve the clinical outcome of patients with type 2 diabetes. The present study aimed to obtain lifestyle data on the dietary and physical activity of adult type 2 diabetes patients in Zhejiang province of eastern China for better patient education and improvement of clinical management.Materials and MethodsA cross‐sectional survey of 607 adult type 2 diabetes patients was carried out in 12 hospitals within eight cities of Zhejiang province. Data were collected for sex, age, basic physical measurement (blood pressure, height, weight, waist circumference and hip circumference), dietary favor and habit (vegetarian diets vs meat diets, preference of salty or light flavors), detailed dietary intake (24‐h recall method), as well as the weekly physical activity.ResultsThe mean age of the patients in the analysis was 56.39 ± 12.29 years, and 38.71% of the patients had higher levels of body mass index than recommended. The average daily total energy intake was 1887.71 ± 575.10 kcal. The percentage of calories from carbohydrate, protein and fat were 61.36 ± 11.59%, 13.29 ± 3.37% and 25.35 ± 11.16%, respectively. For physical activity, the patients generally spent most of their daily time sitting and sleeping, and the time for moderate vigorous activity was limited.ConclusionsAdult patients with type 2 diabetes in Zhejiang province have a relatively high carbohydrate and low protein diet, with very limited physical activity. Patient education to achieve a better lifestyle intervention needs to improve in this region.

A Hybrid Heuristic Algorithm for the Intelligent Transportation Scheduling Problem of the BRT System

AbstractThis work proposes a hybrid heuristic algorithm to solve the bus rapid transit (BRT) intelligent scheduling problem, which is a combination of the genetic algorithm, simulated annealing algorithm, and fitness scaling method. The simulated annealing algorithm can increase the local search ability of the genetic algorithm, so as to accelerate its convergence speed. Fitness scaling can reduce the differences between individuals in the early stage of the algorithm, to prevent the genetic algorithm from falling into a local optimum through increasing the diversity of the population. It can also increase the selection probability of outstanding individuals, and speed up the convergence at the late stage of the algorithm, by increasing the differences between individuals. Using real operational data of BRT Line 1 in a city of Zhejiang province, the new scheduling scheme can be obtained through algorithm simulation. The passengers’ total waiting time in a single way will be reduced by 40 h on average under the same operating cost compared with the original schedule scheme in a day.

The Effect of Agglomeration on Urban Productivity in Zhejiang, China

The urban productivity not only determine with the traditional inputs such as the physical capital, human capital and labour but also the density and agglomeration of output and labour could determine part of urban productivity. This study attempts to highlight the role of spatial agglomeration on urban productivity in Zhejiang, China. For measuring the effect of agglomeration on economic performance, we use the employment as a proxy of productivity and its effect of agglomeration. The data of 11 major cities of Zhejiang province from 1999 to 2008 were chosen to estimate regressions for the aim of this study. The results show that part of the growth of urban productivity in Zhejiang could be induced by the growth of output and labour density. Hence, agglomeration is an important type of externality mechanism in determining the urban economic performance.

Empirical Analysis of Technical Efficiency in Information Services

With the high development of knowledge-based economy, information service industry plays an important role in driving economic transition. We use stochastic frontier analysis (SFA) method to estimate the technical efficiency in seven cities of Zhejiang Province in China. We find that the average technical efficiency of information services industry is high and have different developed trends among the cities. The human capital、industrial concentration degree, openness and urbanization have significant impact on technical efficiency, while government behaviors do not show significant effect.

A Survey on Demodex Infections for Undergraduate Students in Some Universities in Ningbo City of Zhejiang Province of China

Objective: The purpose of this survey is to investigate the university students’ face infections with Demodex, and explore the possible factors of Demodex infections. Methods: On this survey, the following pressure method is adopted. The operator has used sterilized thumb against the client part of the facial skin, observing mites under microscopy. Results: The results of the survey for the total Demodex infection rate were 32.50%. Demodex folliculorum infection rate was 39.49%, Demodex brevis infection rate was 49.74%, and the mixed infection rate was 10.77%. Conclusions: This survey shows that college students’ Demodex infection rate is serious according to the corresponding social customs.

The coverage of work injury insurance and its affecting factors in Zhejiang province, China

In China, the coverage rate of work injury insurance was 23.2%in 2011, which was far lower than expected. The factors affecting the insurance's enrollment has very little known. This paper aims to study the existing coverage of work injury insurance scheme and its influencing factors. The data were collected from 2 836 workers who came from 9 industries in three cities of Zhejiang province using face-to-face questionnaire interview. Of these 2836 workers, the work injury insurance coverage was 50.1%, and 29.6% were not sure if they were covered or not. The results showed that the awareness of occupational disease and industrial injury insurance was helpful in increasing the coverage rate. Besides, the logistic regression analysis showed that in certain circumstances working population shared higher coverage of work injury insurance. For examples, male workers with local household registration and longer working years; people who had been informed about occupational risk factors, and thus gained more training on the issue; people who had exposed to occupational hazards or involved in administrative duties; and people who had already insured by a medical insurance scheme. In the contrary, the heavier family burden with longer working hours per week they needed, the lower possibility they joined the insurance scheme. The coverage of work injury insurance is higher than native average level but much lower than the average international level. The awareness of occupational disease and injury insurance was closely associated with the coverage of work injury insurance. Therefore, it is imperative to popularize the knowledge on OHS for migrant workers, as well as to reinforce the supervision and management of the issue would have been an effective way to elevate the coverage rate of work injury insurance.

The emission inventory of atmospheric industrial pollution sources of the five cities in Zhejiang Province

The amount of several air pollutants emitted in some cities including Hangzhou, Ningbo, Huzhou, Shaoxing and Jiaxing of Zhejiang Province is based on pollution source census data of Zhejiang Province in 2010. This paper focused on the release of air pollutants such as NOx, SO2, CO, PM2.5, PM10 and VOC, and calculated the total amount of those air pollutants. It analyzed air pollutant emission factors and found that the electricity and heat production industry released the largest amount of pollutants.

Identification the Status and Dominant Factor of Eutrophication in the Newly Built Reservoir during the Impoundment Period

In this paper, taking Laohutan reservoir in Huzhou city of Zhejiang province as an example, we systematically discussed the variation trends of trophic status in the early impoundment period of newly built reservoir and the dominant factor of eutrophication. It has been proved that the reservoir’s nutrition index in the early stage is on rise and the water body has a trend of eutrophication. According to actual situation, the outbreak of cyanobacteria and deterioration of water quality in September have showed the features of eutrophication. The dominant factors of eutrophication are total phosphorus, total nitrogen and dissolved oxygen, among which total phosphorus matters most to the trophic status. The results have laid great important foundation for people to explore evolution process of new reservoir ecosystem and the influences of hydraulic engineering construction to ecological environment, and they also provide reference for construction and management of other new reservoir.

Municipal Solid Waste Management Practice in China - A Case Study in Hangzhou

The management of municipal solid waste (MSW) in China is facing urgent problems with rapid industrialization and urbanization. This article focused on the status of Hangzhou, capital city of Zhejiang province, China. The regulations, policies, implementation, barriers and solutions about source separation, separate collection, clean & direct transportation, treatment and disposal were introduced. Source separation, separate collection and clean & direct transportation were seriously carried out from 2010. MSW was classified into four kinds, such as kitchen waste, hazardous waste, recyclable waste and other waste. Four kinds of wastes were collected, transported, treated and disposed, respectively. At the same time, a questionnaire survey was conducted in 2011 on 200 households in Xiasha and Gongshu Districts in Hangzhou. The results indicate that many citizens cannot effectively and correctly separated different kinds of solid wastes. Kitchen waste was directly disposed in landfill, because there is no composting plant in Hangzhou City. The collection of recoverable waste and hazardous waste was not in control of municipal solid waste management (MSWM) system. In order to optimize MSWM system in Hangzhou, the government and the citizen must make efforts in source separation, comprehensive treatment system, effective regulations and policies.

Fragmentation and Unity of Rural Public Governance: A Case Study on Lin’an City in China

The township, as the most basic political system in China, a head of which is connected to a city, and the another head connected with the countryside, is the foundation of national economic and social development. In the face of strong intervention of economic globalization, the gradually weakening of local township government, and the increasingly tense of national finance, agricultural and rural development policy, which is presently ubiquitous in the rural area of China, stressed from top to bottom, expert guidance, government-dominated promoting, will face the serious challenges of rural governance under the background of globalization. The rural governance is that the national institutions and other authorities based on the village government provides public service activities to the village society, in order to maintain rural order, promote rural development, according to the laws, regulations, customs and traditions. And rural governance is the process of multi subjects’ collaborative management of rural village. Rural governance quality reflects the ability of government’s rural social mobilization and management, and relates to the stable development and prosperity of rural society. The current problems of township governance, mainly are not the “township”problems of its own, but the “institutions and mechanisms of government”problem. This article takes the Lin’an city of Zhejiang province as the research object, through the development of villages and towns work rules in the process of tracking, puts forward a good example of rural governance in china.

Research on the status and reform direction of community nursing personnel education in Zhejiang province

Objective To analyze the status of community nursing personnel training and explore its reform direction.Methods Totals of 160 community health service institutions in 11 cities in Zhejiang province were investigated by convenience sampling.The content validity of the modified questionnaire was 0.9,and the reliability Cronbach's α coefficient was 0.87.Results One hundred and sixty questionnaires were issued and 150 questionnaires were responsive with an effective response rate of 93.8％,including 119 community health service centers and 31 community health service station.Most community organizations (57.1％) thought that current personnel training program of nursing could not satisfy the requirements of practical community nursing.The shortcomings were as follows:1) insufficient health and recovery knowledge (54.7％) ; 2) insufficient humanity knowledge,such as psychology and law (45.2％) ; 3) insufficient knowledge about epidemic disease and preventive medicine (42.6％) ; 4) insufficient class hour on community nursing (40.0％) ; 5) insufficient knowledge on nursing research (18.7％).Most community organizations thought it was necessary for the college to set up community nursing class (54.8％).The courses they suggested were:preventive medicine,recovery medicine,health education,psychology,epidemic medicine,medicine and society.The core skills of the community nurses should include the skill to communicate with patients,the ability of disease systematic nursing,independent analysis and problem solving.Conclnsions Current college education can not fully meet the requirements of community nursing personnel training.College should set up special class on community nursing,revise the courses oriented towards community nursing,and emphasize the core skills of community nursing. Key words: Community nursing ; Personnel training ; Status ; Reform

Risk factors for multidrug resistance among previously treated patients with tuberculosis in eastern China: a case–control study

Previous treatment has been documented as a major risk factor for multidrug-resistant tuberculosis (MDR-TB). However, risk factors for MDR-TB among previously treated patients in China are unclear. This study aimed to ascertain the risk factors for MDR-TB in this particular population in China. A case-control study was conducted from July through August 2011 in five cities of Zhejiang Province. Cases were previously treated TB patients who had disease resistant to at least isoniazid and rifampin, whereas controls were previously treated TB patients who had disease sensitive to isoniazid and rifampin. Ninety-eight cases and 83 controls were identified. Multivariate analysis showed that a duration of first treatment of more than 8 months (odds ratio (OR) 2.18, 95% confidence interval (CI) 1.05-4.52), more than three prior episodes of anti-TB treatment (more than 2 months of continuous treatment as one episode) (OR 5.57, 95% CI 2.38-13.00), adverse effects of anti-TB medication (OR 3.63, 95% CI 1.79-7.36), and more than three TB foci in the lung (OR 2.17, 95% CI 1.08-4.37) were associated with MDR-TB in previously treated TB patients. Low family income (p=0.056) was marginally significant in the univariate analysis. Particular clinical diagnostic results, such as more than three TB foci in the lung, non-standard or irregular therapy, and adverse effects of anti-TB medication, were found to be associated with MDR-TB in previously treated TB patients. High quality directly observed treatment should be strengthened to ensure that the previously treated patients can receive standard and regular regimens.

Moso bamboo forest extraction and aboveground carbon storage estimation based on multi-source remotely sensed images

Using a combination of moso bamboo forest thematic maps derived from Landsat Thematic Mapper (TM) images, field inventory data, and Moderate Resolution Imaging Spectroradiometer (MODIS) normalized difference vegetation index (NDVI) images, moso bamboo forest was extracted using the matched filtering (MF) technique and its aboveground carbon storage (AGC) was then estimated. This study presents a feasible method for extracting large-scale moso bamboo forests and for estimating moso bamboo forest AGC based on low-spatial resolution MODIS images. The results showed that moso bamboo forests in the majority of counties can be accurately estimated between actual area and estimates, with an R 2 of 0.8453. The fitted accuracy of the AGC model was high (R 2 = 0.491). The prediction accuracy of the AGC model was also evaluated using validation samples collected from Lin'an City, with an R 2 and root mean square error prediction of 0.4778 and 3.06 Mg C ha−1, respectively. The AGC in the majority of counties or cities in Zhejiang Province was between 0 and 15 Mg C ha−1, and to a certain extent the predicted AGC estimates were close to observed ground truth data and representative of the study area.

Research on the Application of Operation Characteristic Curve in the Sampling Inspection for Foods in Prepackages with Fixed Content

New enterprises for products in prepackages with fixed content always use sampling inspection to make sure the accuracy of the net quantity of their products according to JJF 1070-2005 “Rules of Metrological Testing for Net Quantity of Products in Prepackages with Fixed Content”, but this sampling inspection plan is expensive. The theoretical basis of the variable sampling plan in JJF 1070 was analyzed first. Then based on ISO 3951-1, the variable acceptance standard, a new sampling plan for products in prepackages with fixed content was developed, and it’s operation characteristic curve was drawn. Taking one company in Jinhua city of Zhejiang province of China as an example, a comparative analysis for the practical application of these two sampling plans was carried out. Under the premise that the sampling plan’s discrimination power was unchanged, the results showed that the acceptance effects of two sampling plans waere almost the same, while the reduction of sample size for the new one was 44%, the inspection time and cost were all reduced.

Risk Factors for Severe Cases of 2009 Influenza A (H1N1): A Case Control Study in Zhejiang Province, China

Few case control studies were conducted to explore risk factors for severe cases of 2009 influenza A (H1N1) with the mild cases as controls. Mild and severe cases of 2009 influenza A (H1N1), 230 cases each, were randomly selected from nine cities in Zhejiang Province, China, and unmatched case control study was conducted. This study found that it averagely took 5 days for the severe cases of 2009 influenza A (H1N1) to start antiviral therapy away from onset, 2 days later than mild cases. Having chronic underlying diseases and bad psychological health combined with chronic underlying diseases were two important risk factors for severe cases, and their OR values were 2.39 and 5.85 respectively. Timely anti-viral therapy was a protective factor for severe cases (OR = 0.35, 95% CI: [0.18–0.67]). In conclusion, psychological health education and intervention, as well as timely anti-viral therapy, could not be ignored in the prevention, control and treatment of 2009 influenza A (H1N1).

A ten years (2000–2009) surveillance of resistantEnterobacteriaceaein Zhejiang Province, China

ObjectiveIn Zhejiang Province, there are several highly developed cities near the coast and several relatively under-developed mountain areas. Analysis of the composition of bacteria isolated from patients as well as their antibiotic resistance profile from various areas of this province, and tracing of such data year-by-year, will help to delineate the bacterial resistance profile of these areas and to understand how the stage of socio-economical development impacts on the composition of clinical micro-flora and their resistance profile.MethodsIn order to investigate variation in resistance rates and isolation rates of Enterobacteriaceae, from 2000 to 2009 in Zhejiang Province, China, Enterobacteriaceae isolated from 15 hospitals located in different regions of the province were surveyed.ResultsThe total numbers of the Enterobacteriaceae isolated increased more than 20-fold from 2000 to 2009. Among the Enterobacteriaceae, Escherichia coli and Klebsiella pneumoniae were the dominant isolates. The percentage of E. coli and K. pneumoniae that produced detectable extended-spectrum β-lactamases (ESBLs) increased from 2000 to 2007, and then declined slightly in 2008 and 2009. The percentages of K. pneumoniae and E. coli that were resistant to ceftazidime increased sharply from 2000 to 2009. There were remarkable increases in the carbapenem resistant rates during the decade, but they were much higher for the isolates from the developed cities than from the rural areas. In 2002, carbapenem-resistant E. coli was first found in Hangzhou, one of the highly developed cities in Zhejiang Province. By 2009, carbapenem-resistant bacteria were found for all species of Enterobacteriaceae surveyed in almost all areas of the province, although they were more frequently identified in developed areas than in rural areas.ConclusionMuch restrictive actions have to be taken in terms of rational use of antibiotics and nosocomial control to prevent the further spread of the drug-resistant pathogens.