Health In China Research Articles

Social Support and Psychological Capital Mediate the Effect of Personalities on the Mental Health of Professional Staff in China During COVID-19 Pandemic.

COVID-19-related lockdown can lead to mental health problem, which displays heterogeneous between individuals. The aim of this study was to explore the association between mental health, social support and psychological capital state of professional staff with different personalities during the COVID-19 pandemic in China. A cross-section study was conducted via online survey using the questionnaires of General Health Questionnaire (GHQ-12), Multidimensional Scale of Perceived Social Support (MSPSS), Psychological Capital Questionnaire (PCQ), Eysenck Personality Questionnaire-Revision Short Scale of China (EPQ-RSC). A total of 626 employees were included. Multiple regression analysis was performed to investigate the association of psychological capital, perceived social support, EPQ-N and EPQ-E and their interactions in general mental health. About 2.7% of professionals had mental health. The married had a higher mental health score than the single (P<0.05). The regular exercising workers had the lowest mental health score (P<0.05), and higher psychological capital and social support scores than the non-exercising ones (P<0.01). Multivariate analysis showed that the interaction between social support, psychological capital and neuroticism was statistically significant (β=-0.161, P<0.001) in general mental health with neuroticism ranking the top (β=0.352, P<0.001). Mediation analysis showed that social support modified the effect of psychological capital on mental health, accounting for 25.5% of the total effect, and that both social support and psychological capital mediated the effect of neuroticism or extroversion differentially on mental health. Neuroticism is an influencing factor on mental health of professional staff. Social support and psychological capital played a partial mediating role in the effect of neuroticism or extroversion differentially on mental health in China. The findings suggest that during the COVID-19 pandemic, more social support and psychological capital are needed for the professional individuals with neuroticism to alleviate their stress and improve mental health.

Advancing digital health in China: Aligning challenges, opportunities, and solutions with the Global Initiative on Digital Health (GIDH).

We summarized the unique challenges that China faced in digital health due to its large population, regional disparities, and uneven distribution of medical resources. Under the guidance of the Global Initiative on Digital Health (GIDH) released by WHO, we proposed corresponding solutions that address infrastructure, data, terminology, technology and security.

Zoonotic outbreak risk prediction with long short-term memory models: a case study with schistosomiasis, echinococcosis, and leptospirosis

BackgroundZoonotic infections, characterized with huge pathogen diversity, wide affecting area and great society harm, have become a major global public health problem. Early and accurate prediction of their outbreaks is crucial for disease control. The aim of this study was to develop zoonotic diseases risk predictive models based on time-series incidence data and three zoonotic diseases in mainland China were employed as cases.MethodsThe incidence data for schistosomiasis, echinococcosis, and leptospirosis were downloaded from the Scientific Data Centre of the National Ministry of Health of China, and were processed by interpolation, dynamic curve reconstruction and time series decomposition. Data were decomposed into three distinct components: the trend component, the seasonal component, and the residual component. The trend component was used as input to construct the Long Short-Term Memory (LSTM) prediction model, while the seasonal component was used in the comparison of the periods and amplitudes. Finaly, the accuracy of the hybrid LSTM prediction model was comprehensive evaluated.ResultsThis study employed trend series of incidence numbers and incidence rates of three zoonotic diseases for modeling. The prediction results of the model showed that the predicted incidence number and incidence rate were very close to the real incidence data. Model evaluation revealed that the prediction error of the hybrid LSTM model was smaller than that of the single LSTM. Thus, these results demonstrate that using trending sequences as input sequences for the model leads to better-fitting predictive models.ConclusionsOur study successfully developed LSTM hybrid models for disease outbreak risk prediction using three zoonotic diseases as case studies. We demonstrate that the LSTM, when combined with time series decomposition, delivers more accurate results compared to conventional LSTM models using the raw data series. Disease outbreak trends can be predicted more accurately using hybrid models.

Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary

Since 1990, China has made considerable progress in resolving the problem of “treatment difficulty” of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors, and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China, CVD has persistently ranked first. In 2021, CVD accounted for 48.98% and 47.35% of deaths in rural and urban areas, respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy “focusing on the primary health institute and emphasizing prevention” and truly achieve a shift of CVD prevention and treatment from hospitals to communities, the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the “Report on Cardiovascular Health and Diseases in China” annually since 2005. The 2024 report is established based on representative, published, and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys, randomized controlled clinical trials, large sample registry studies, and typical community prevention and treatment cases, along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

In-vitro activities of essential antimicrobial agents including aztreonam/avibactam, eravacycline, colistin and other comparators against carbapenem-resistant bacteria with different carbapenemase genes: A multi-centre study in China, 2021

Carbapenem-resistant bacteria (CRB), including carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Enterobacterales (CRE), pose a considerable threat to public health in China. Eravacycline, aztreonam/avibactam and colistin are important antimicrobial agents for the treatment of serious infections caused by CRB. This study aimed to evaluate the prevalence of CRB strains, and the susceptibility of commonly used clinical antimicrobial agents against strains with different carbapenemase genes. In total, 7194 gram-negative bacteria strains were collected from different regions of China, and 924 carbapenem-resistant strains were identified. All strains were from confirmed infections. Antimicrobial susceptibility testing, covering 21 antimicrobial agents including aztreonam/avibactam, eravacycline, colistin and other comparators, was performed using the broth microdilution method. Carbapenemase genes (blaKPC, blaNDM, blaOXA, blaIMP and blaVIM) were screened using polymerase chain reaction amplification and sequence analysis. All statistical analyses were performed using Statistical Package for the Social Sciences Version 23.0. The isolation rates of CRE, CRAB and CRPA were 6.31% (332/5265), 62.95% (440/699) and 15.20% (152/1000), respectively. The predominant carbapenemase in carbapenem-resistant Escherichia coli (CRECO) was NDM, while in carbapenem-resistant Klebsiella pneumoniae (CRKP), it was KPC. All CRAB produced OXA-23, and 85.52% of CRPA did not produce any of the following carbapenemases: NDM, KPC, VIM, IMP and OXA. Aztreonam/avibactam, colistin and eravacycline exhibited high antimicrobial activity against different species producing various carbapenemases. Compared with ceftazidime/avibactam, aztreonam/avibactam demonstrated superior antimicrobial activity, particularly pronounced in CRECO and strains producing metallo-beta-lactamases. In comparisons between tigecycline and eravacycline, the latter maintained higher antimicrobial activity across different species. Antimicrobial agents exhibited varying levels of activity against strains with different resistance mechanisms. Using aztreonam/avibactam, eravacycline and colistin to treat infections caused by CRB offers significant advantages. These findings will guide clinical practice and optimize antimicrobial administration.

A study on the mediating-moderate effect of the types of illicit drugs on mental health in China.

In China, over 5 million people have been identified and registered by the public security institutions for using illicit drugs. The aim of this study is to compare the influence of different types of illicit drugs on the self-reported mental health of Chinese people. In particular, we want to assess the damage of Heroin, Methamphetamine and Ketamine to mental health in a social environment where drug use is strictly regulated. The study is based on survey with 6,906 people who use drugs in Guangdong province, China. Risk of mental health issue is measured using the Brief Symptoms Inventory 18 (BSI-18) Scale, and a higher BSI-18 score indicates more severe mental health problems. The data was analyzed through multilevel regression analysis, propensity score matching analysis and mediation analysis. The three major types of illicit drugs have both moderating and mediating effects on the length of drug-use history, that Heroin use leads to longer drug-use duration, while Ketamine use causes more damage on mental health per unit time of drug-use duration. Average duration of Methamphetamine use is 0.7 year shorter than average duration of Heroin use, and average duration of Ketamine use is 1.7 year shorter than average duration of Heroin use. For each year of increase of drug-use duration, Ketamine use leads to 1.2 times more of BSI score increase than Heroin use, and 2.3 times more of BSI score increase than Methamphetamine use. These three drugs are associated with severe mental health issue in a society with strict drug regulation. Attention should be paid to the mental health of people regardless of the type of drugs they use.

Prevalence of dyslexia related to mental health problems and character strengths among primary school students in northwest China

ABSTRACT Objective This study aimed to examine the prevalence of dyslexia, mental health problems, and character strengths among primary school students in northwest China. Method Primary school students (N = 2,322) were assessed for dyslexia, strengths and difficulties, self-esteem, bullying, depression, anxiety, and character strengths. The Student’s t-test and χ2 test were used to compare continuous and categorical variables between students with and without dyslexia. Results The estimated prevalence of dyslexia ranged from 4.9% to 6.9% and was highly prevalent among boys. Students with dyslexia reported statistically higher mean scores for emotional symptoms, conduct behaviours, internalizing and externalising problems, as well as total difficulties. Conversely, they exhibited lower levels of prosocial behaviour, expressed lower self-esteem, and reported higher instances of being bullied. Additionally, the prevalences of depression and anxiety symptoms were 36.5% and 26.3%, respectively, among dyslexic students. Signature strengths among students with dyslexia included appreciation of beauty and excellence, love, hope, forgiveness, and judgement. Conclusions These findings underscore dyslexia’s impact on mental health and academic performance in China. Implementing character strength-focused interventions could enhance well-being and academic outcomes among dyslexic primary school students.

Analysis of the Changing Trend of the Burden of Rheumatic Heart Disease in China from 1990 to 2021

Objective: This study aims to provide an accurate quantitative analysis of the burden of rheumatic heart disease in China, and to provide a scientific basis for the formulation of effective prevention and control strategies. Methods: Based on the latest public database 2021 Global Burden of Diseases (GBD2021), the characteristics and trends of incidence, prevalence, mortality, and attributable risk factors of rheumatic heart disease in the Chinese population from 1990 to 2021 were quantitatively analyzed. Results: From 1990 to 2021, the incidence of rheumatic heart disease in China decreased from 620,195 to 445,472, with an average annual decrease rate of 1.07%. The incidence rate decreased from 52.72/100,000 to 31.31/100,000 with an average annual decrease rate of 1.65%, while the age-standardized incidence rate decreased from 48.92/100,000 to 39.86/100,000 with an average annual decrease rate of 0.46%. The number of cases increased slightly from 8,923,639 to 9,073,096, with an average annual growth rate of 0.28%, and the prevalence decreased from 758.75/100,000 to 637.72/100,000 with an average annual decrease rate of 0.31%. The age-standardized prevalence decreased from 708.27/100,000 to 619.85/100,000 with an average annual decrease rate of 0.21%. The number of deaths decreased from 134,208 to 78,910, with an average annual decrease rate of 1.98%, and the mortality rate decreased from 11.41/100,000 to 5.51/100,000 with an average annual decrease rate of 2.55%. The age-standardized mortality rate decreased significantly from 19.07/100,000 to 5.00/100,000 with an average annual decrease rate of 5.00%. These data show that although the number of cases increased slightly, the incidence rate, prevalence rate, mortality rate, and age-standardized rates all showed a downward trend. Conclusion: From 1990 to 2021, the burden of rheumatic heart disease in China has undergone significant changes. Although the number of cases increased slightly, the incidence rate, prevalence rate, mortality rate, and age-standardized rates all showed a downward trend. Specifically, the incidence rate decreased from 52.72/100,000 to 31.31/100,000, indicating a significant decrease in the number of new cases of rheumatic heart disease per 100,000 people. The decrease in prevalence rate, from 758.75/100,000 to 637.72/100,000, reflects a decrease in the proportion of the population with rheumatic heart disease. The most significant decrease is in the mortality rate, from 11.41/100,000 to 5.51/100,000, indicating a substantial reduction in the risk of death from rheumatic heart disease. These changes may be attributed to the continuous progress in healthcare services, implementation of public health policies, and increased population health awareness in China. In addition, advances in medical technology, improvements in emergency systems, and optimization of cardiovascular disease management have also played an important role in reducing mortality rates. However, the slight increase in the number of cases suggests that despite significant progress, rheumatic heart disease remains an important challenge in the field of public health in China, requiring continuous attention and intervention.

What drives China's healthcare expenditure? A theoretical and empirical study of determinants and trends.

As economic development advances, there is an increasing focus on improving health conditions, making healthcare expenditure a critical issue worldwide. In China, healthcare spending has shown a marked upward trend, highlighting the importance of understanding its underlying determinants to guide effective policy-making. This study introduces the application of an SV-TVP-FAVAR model to examine the drivers of healthcare expenditure in China from 2007 to 2022. The analysis reveals that economic factors, demographic composition, and policy interventions significantly influence healthcare spending dynamics. Economic growth is strongly linked to increased healthcare expenditure, with economic factors having a particularly pronounced impact during periods of prosperity. Although an aging population drives greater demand for healthcare, the growth rate of healthcare spending has not kept pace with demographic aging, especially following China's economic slowdown. Policy variables present a dual-edged impact: while increased fiscal outlays contribute to budget deficits, limiting the fiscal space for healthcare investment, government emphasis on scientific and technological progress tends to enhance healthcare spending, indicating a synergistic relationship between these areas. Furthermore, the study identifies a prolonged impact of the COVID-19 pandemic on healthcare expenditure, which continues to interact with other driving factors over an extended period. The empirical findings from this research provide crucial evidence to support the development of informed healthcare policies.

Valvular heart disease and cardiomyopathy in China: epidemiology and current treatments.

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. In connection with the previous section, this ninth section of the report offers a comprehensive analysis of valvular heart disease and cardiomyopathy. Although rheumatic valve disease is still the main cause of valvular heart disease in China, with the aging of the population and the improvement of living standards, the prevalence of degenerative valvular heart disease is on the rise. Because many patients with valvular heart disease have only mild to moderate valve stenosis or insufficiency, and no symptoms, the detection rate in the population is low and late, resulting in many patients been in the severe late stage of disease at visit, increasing the difficulty of treatment and affecting effectiveness and prognosis. Therefore, we should strengthen the examination and screening of valvular heart disease in order to find and prevent it as early as possible. In addition, compared with other diseases, the treatment of valvular heart disease needs more and higher technical support (surgery, intervention, etc). However, not all hospitals can provide relevant technologies. At present, the treatment of valvular heart disease is still mainly concentrated in the provincial hospitals. It is necessary to carry out more professional training so that more doctors and hospitals can participate in the treatment of valvular heart disease. Cardiomyopathy is a group of myocardial diseases with abnormal myocardial structure and/or function, but couldn't be explained by hypertension, coronary atherosclerosis, valvular heart disease and congenital heart disease. It includes hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic cardiomyopathy (also known as arrhythmogenic right ventricular cardiomyopathy), restrictive cardiomyopathy (RCM) and undifferentiated cardiomyopathy.

Evaluating the impacts of integrating health and social care systems on social care use among older adults with chronic diseases in China

Health and social care systems often operate in silos and cannot meet the complex needs of older adults with multiple chronic conditions. Since 2016, China has been implementing an integrated care initiative in some cities. This study aimed to evaluate the impacts of integrating health and social care in China on social care use among older adults with chronic conditions. Using panel data from the China Health and Retirement Longitudinal Study (N = 5,259), I employed a difference-in-differences analysis to evaluate the effects of the integrated care initiative. The initiative reduced social care use by 4.5 percentage points, primarily through a decreased receipt of informal care rather than formal care. The reduction in social care use was primarily due to a delayed increase in care levels, rather than a substitution with outpatient or inpatient services. The integration of health and social care was found to delay the progression of instrumental activities of daily living (IADL) by 8.8 percentage points but had no impact on activities of daily living (ADL). Heterogeneity analysis showed that the effects of the integrated care initiative on social care receipt and IADL limitation were weaker among those living in the Eastern region of China compared to other regions, indicating additional benefits of the initiative in mitigating geographical disparities. My findings suggest that integrating health and social care can effectively reduce the likelihood of older adults with chronic diseases receiving assistance for daily living tasks from family carers and delay the decline in their functional capabilities.

The effect of minimum wages on self-reported physical and mental health in China

We exploit provincial variation in minimum wages allowed by the 2004 Chinese regulation to study the impact of minimum wages on the health of workers. We use data from Wave 1 of the World Health Organization's Study on Global Aging and Adult Health (SAGE) conducted in 2007–2010. We consider measures of self-reported health in ten domains and a measure of general health obtained from a factor analysis as dependent variables when estimating ordered probit models and linear models, respectively. We find that real minimum wages have a small, but not negligible, negative effect on most of the health outcomes and general health. The result is robust to several controls, including reporting heterogeneity. The negative effect on health is driven by the deterioration of working conditions, due to the increase in the number of days worked per week for public and private employees.

The impact of family urban integration on migrant worker mental health in China.

As China has undergone the processes of urbanization and economic development, a large migrant population has emerged, creating new family migration trends. Family migration brings about changes in urban integration costs and benefits, affecting health investment. The primary objective of this research is to investigate the influence of urban integration of migrant workers' families on their mental wellbeing, with the aim of offering policy recommendations conducive to the realization of a comprehensive public health strategy in China. This paper uses multi-dimensional indexes to measure family urban integration, covering economic, social and psychological dimensions, which may consider the complexity of integration. Utilizing a machine learning clustering algorithm, the research endeavors to assess the level of urban integration experienced by migrant workers and their respective families. The analysis discerns three distinct clusters denoting varying degrees of urban integration within these familial units, namely high-level, medium-level, and low-level urban integration. We applied binary logit regression models to analyze the influence of family urban integration on the mental health among migrant workers. Then we conducted a series of robustness tests. The results show that family urban integration decreases the probability of depressive symptoms by 14.6 percentage points. Further mechanism tests show that family economic integration enhances the psychological wellbeing of migrant workers by elevating their income status. Family social integration decreases depressive symptoms by increasing social status. Family psychological integration increases the psychological health of migrant workers by making them more satisfied with their lives. The heterogeneity test shows that family urban integration and its different dimensions have a strong impact on the depressive symptoms of women, first-generation, and less-educated groups. This study finds that family urban integration and its economic, social, and psychological dimensions significantly reduced the depressive symptoms of migrant workers. The results of this study lead the authors to recommend formulating a family-centered policy for migrant workers to reside in urban areas, optimizing the allocation of medical resources and public services, and improving family urban integration among migrant workers in order to avoid mental health problems in the process of urban integration.

The coordinated development among economy, society, energy, and environment and their impacts on public health in China's cities

As China's urban areas rapidly developed, prefecture-level cities faced challenges in the coordinated development of the economy, society, energy, and environment (ESEE), which could impact public health. Previous research had examined the interactions between the various ESEE systems and their effects on public health. However, relatively few studies had conducted comprehensive analyses across different systems and regions. This paper aimed to conduct an in-depth analysis in this field. First, it calculated the ESEE development levels using principal component analysis, the entropy method, and data from 278 Chinese cities between 2012 and 2021. Next, it employed a coupling coordination degree model, which reflects the degree of coordinated development between different systems, to explore the coordinated development levels and trends of the four ESEE systems in each prefecture-level city. Furthermore, this paper innovatively used a spatial Durbin model, incorporating ESEE coordination levels to investigate their impact on public health in local and surrounding areas. The results indicated that the positive impact of ESEE coordinated development on local public health was 0.5082, while the impact on surrounding areas was 2.0240. This influence was more pronounced in smaller cities, suggesting the need to enhance regional cooperation, balance developmental disparities, and promote ESEE coordinated development to improve public health.

Evidence to support cultivated fruiting body of Ophiocordyceps sinensis (Ascomycota)'s role in relaxing airway smooth muscle

Ethnopharmacological relevanceOphiocordyceps sinensis (O. sinensis) is a genus of Ascomycete fungus that is endemic to the alpine meadows of the Tibetan Plateau and adjoining Himalayas. It has been used traditionally as a tonic to improve respiratory health in ancient China as well as to promote vitality and longevity. Bioactive components found in O. sinensis such as adenosine, cordycepin, 3-deoxyadenosine, L-arginine and polysaccharides have gained increasing interest in recent years due to their antioxidative and other properties, which include anti-asthmatic, antiviral, immunomodulation and improvement of general health. Aim of the studyThis study's primary aim was to investigate the effect of a cultivated fruiting body of O. sinensis strain (OCS02®) on airways patency and the secondary focus was to investigate its effect on the lifespan of Caenorhabditis elegans. Materials and methodsA cultivated strain, OCS02®, was employed and the metabolic profile of its cold-water extract (CWE) was analysed through liquid chromatography-mass spectrometry (LC-MS). Organ bath approach was used to investigate the pharmacological properties of OCS02® CWE when applied on airway tissues obtained from adult male Sprague-Dawley rats. The airway relaxation mechanisms of OCS02® CWE were explored using pharmacological tools, where the key regulators in airway relaxation and constriction were investigated. For the longevity study, age-synchronised, pos-1 RNAi-treated wild-type type Caenorhabditis elegans at the L4 stage were utilised for a lifespan assay. ResultsVarious glycopeptides and amino acids, particularly a high concentration of L-arginine, were identified from the LC-MS analysis. In airway tissues, OCS02® CWE induced a significantly greater concentration-dependent relaxation when compared to salbutamol. The relaxation response was significantly attenuated in the presence of NG-Nitro-L-arginine methyl ester (L-NAME), 1H-[1,2,4]oxadiazolo [4,3-a]quinoxalin-1-one (ODQ) and several K+ channel blockers. The longevity effect induced by OCS02® CWE (5 mg/mL and above) was observed in C. elegans by at least 17%. ConclusionsThese findings suggest that the airway relaxation mechanisms of OCS02® CWE involved cGMP-dependent and cGMP-independent nitric oxide signalling pathways. This study provides evidence that the cultivated strain of OCS02® exhibits airway relaxation effects which supports the traditional use of its wild O. sinensis in strengthening respiratory health.

Gender stereotypes and mental health among Chinese people: the moderating role of marital status

ABSTRACT This study explores how marital status moderates the relationship between gender stereotypes and mental health in China. The findings reveal distinct impacts across different marital statuses, highlighting significant modulation by marital context: for cohabiting individuals, the negative effects are mitigated (coefficient = 0.143, p = 0.003), those in their first marriage experience diminished negative impacts (coefficient = 0.088, p < 0.001), and the effects are most pronounced for separated but not divorced individuals (coefficient = 0.223, p < 0.001). Significant sex-based differences include positive effects for women in first marriages (coefficient = 0.112, p < 0.05) and when separated but not divorced (coefficient = 0.234, p < 0.05), and for men post-divorce (coefficient = 0.167, p < 0.05). Gender stereotypes show a positive correlation with mental health for separated but not divorced individuals (coefficient = 0.445, p < 0.01), indicating that stereotypes paradoxically act as stabilisers in certain marital contexts.

Demand Forecasting of Nurse Talents in China Based on the Gray GM (1,1) Model: Model Development Study.

In a global context, the shortage of nursing personnel has emerged as a significant challenge, particularly in countries such as China experiencing population aging. The inadequacy of nursing human resources has become one of the primary threats affecting the quality of health services available to Chinese residents. Therefore, forecasting the demand for nursing personnel has become an important issue. This study presents a Gray GM (1,1) forecasting model for predicting the future 10-year demand for nursing workforce and the number of specialized geriatric nurses, aiming to provide a scientific basis for the development of policies in health care institutions in China. Based on data from the China Statistical Yearbook 2022, the Gray GM (1,1) model was used to predict the demand for nursing jobs and geriatric nurses over the next 10 years (2024-2033). The results indicate that from 2024 to 2033, amidst a continuous growth in the overall population and an increasingly pronounced trend of population aging, the demand for nursing workforce in China, especially for specialized geriatric nurses, is projected to steadily increase. The paper provides a reference basis for the establishment of China's health care workforce system and the involvement of government departments in health care workforce planning.

Uncovering the impact and mechanisms of air pollution on eye and ear health in China

Increasing air pollution could undermine human health, but the causal link between air pollution and eye and ear health has not been well-studied. Based on four-week-level records of eye and ear health over 1991-2015 provided by the China Health and Nutrition Survey, we estimate the causal effect of air pollution on eye and ear health. Using two-stage least squares estimation, we find that eye or ear disease possibility rises 1.48% for a 10μg/m3 increase in four-week average PM2.5 concentration. The impacts can last about 28weeks and will be insignificant afterward. Females, individuals aged 60 years and over, with high exposure environments, relatively poor economic foundations, and low knowledge levels are more vulnerable to such negative influences. Behavioral channels like more smoking activities and less sleeping activities could partly explain this detrimental effect. Our findings enlighten how to minimize the impact of air pollution and protect public health.

Short-Term Interaction Effects of PM2.5 and O3 on Daily Mortality: A Time-Series Study of Multiple Cities in China.

In recent years, PM2.5 and O3 have been the two main pollutants affecting public health in China, but the interaction of the two pollutants on human health remains unclear. A two-stage analytical approach was used to investigate the relationships of PM2.5-O3 co-pollution with nonaccidental, cardiovascular, and respiratory mortality levels across 14 cities in China. We first utilized a generalized additive model (GAM) to determine the city-specific associations of PM2.5 and O3 with daily mortality. The associations were then combined at the national and regional levels using meta-analysis. To investigate the potential interactions between the two pollutants and cause-specific mortality, we performed stratified analyses by co-pollutant exposure levels and the synergy index (SI) (SI > 1 indicates a synergistic interaction). The effect of changes in the two pollutants' concentrations (in 10 μg/m3 increases) on mortality was assessed. The stratification analysis results suggested that each 10 μg/m3 increase in PM2.5 at lag0-1 (lag01) in the low, moderate, and high strata of the O3 concentrations increased nonaccidental mortality by 0.07% (95% confidence interval: -0.03%, 0.17%), 0.33% (0.13%, 0.53%), and 0.68% (0.30%, 1.06%), respectively, with significant between-group differences (p < 0.001). Moreover, each 10 μg/m3 increase in O3 (lag01) in the low, moderate, and high strata of the PM2.5 concentrations increased nonaccidental mortality by 0.15% (-0.06%, 0.36%), 0.53% (0.19%, 0.87%), and 0.75% (0.14%, 1.36%), respectively, with significant between-group differences (p < 0.001). We also found substantial synergistic interactions between the two pollutants and nonaccidental, cardiovascular, and respiratory mortality levels, with SI values of 1.48, 1.51, and 1.33, respectively. Additionally, a subgroup analysis revealed that the interaction of these two pollutants on nonaccidental mortality were greater in South China compared to elsewhere, and during the warm season compared to during the cold season. Our findings suggested that the simultaneous control of PM2.5 and O3 within the context of combined air pollution could significantly decrease the disease risk, especially in southern China and during the warm season.

Public Healthcare System in China: Issues, challenges and survival strategies

Public Healthcare System in China faces numerous challenges due to the country's size, population, and socio-economic diversity. This paper intends to examine a modern management system for public hospitals to fulfil the needs of the society in the new era of China. It also explores the evolution of healthcare, growth of the healthcare sector, challenges, and survival strategies to the healthcare sector. With the strategic triangle as a base, the research will make attempts to translate the public value framework combined with the hospital context into a blueprint for solving some of the key challenges facing the healthcare service system.