Assistive technology application in educational contexts: policy framework and core areas / 中国康复理论与实践

ObjectiveTo study domestic and international policies and core areas related to assistive technology services for children with disabilities, to explore the application of assistive technology for children with special needs in the educational context. MethodsBased on the relevant policies and theoretical frameworks of policies on assistive technology services of United Nations, World Health Organization (WHO) and China, the policy frameworks and core areas of assistive technology in the educational context were analyzed using the theories of the six elements of the WHO assistive technology service system and the 5P service model, as well as the international and domestic classifications and directory lists of assistive technologies. ResultsInternational Classification of Functioning, Disability and Health (ICF) gave the definition and classification of assistive technology in educational scenarios. With the Convention on the Rights of Persons with Disabilities (CRPD) as the core and the Assistive Technology for Children with Disabilities (ATD) strategy as the centerpiece of the international policy, the core areas of assistive technology application in educational settings were established with the 5P Model, consisting of five related areas, namely individuals, policies, products, practitioners and service delivery, based on the six elements of the WHO assistive technology service system, namely leadership and governance, financing, human resources for health, service delivery, medical technology and health information system. The ecosystem focused on people, policies, products, practitioners and services that promote access to and use of assistive technology. ConclusionThe policy and core areas for the application of assistive technology in educational contexts are formed on the basis of ICF, with the CRPD at the core, and the strategy of ATD, to define scientifically the definition; and promote assistive technology services for children with disabilities from the perspective of the right to comprehensive, efficient, and child-centered development, to provide usable, accessible, affordable, adaptable, acceptable and quality assistive technology services to ensure that children with disabilities enjoy equal and quality education, and to improve the quality of life and well-being. A human-centered assistive technology ecosystem can be established using 5P Model, to innovate and develop assistive technology services for children with disabilities.

Application of “Cloud Pharmaceutical Service System”in the medication therapy management for chronic airway diseases / 中国药房

OBJECTIVE To evaluate the effect of “Cloud Pharmacy Service System” electronic management platform in medication therapy management （MTM） of chronic airway diseases. METHODS MTM module setting of “Cloud Pharmaceutical Service System” was introduced. Totally 371 patients with chronic airway disease admitted to our hospital from January 2021 to March 2022 were selected for MTM based on the “Cloud Pharmacy Service System”. The standardization of inhalation device mastery and compliance of patients before and after intervention were compared with self-made inhalation device evaluation scale and Morisky medication adherence scale-8 （MMAS-8）. The satisfaction of patients with pharmacist after intervention was investigated. RESULTS “Cloud Pharmaceutical Service System” is mainly divided into 4 modules， such as medication therapy review， pharmacist intervention， personal medication record and the medication-related action plan， other functions. Among 371 patients， there were 237 outpatients （142 cases of asthma， 95 cases of chronic obstructive pulmonary disease） and 134 inpatients （19 cases of asthma and 115 cases of chronic obstructive pulmonary disease）. The score of the patients using inhalation device increased from 74.76±24.71 before intervention to 99.45±2.12 after intervention （P＜0.05）. MMAS-8 score increased from 7.14± 1.15 before intervention to 7.88±0.44 after intervention （P＜0.05）. The degree of patients’ satisfaction with pharmacists reached 100% after intervention. CONCLUSIONS “Cloud Pharmacy Service System” is helpful to improve the effects of pharmaceutical service for patients with chronic airway disease by providing whole-process， online， visual and immediate MTM.

Study on the Patient Satisfaction Evaluation System of Elderly-friendly Medical Institutions / 中国医学伦理学

【Objective:】 Evaluating the service quality and medical experience of elderly-friendly medical institutions from the perspective of elderly patients and their accompanying relatives and friends is a specific measure and work focus to promote the construction of elderly-friendly medical institutions, optimize the medical procedures for the elderly, solve the intelligent technology difficulties encountered in the medical process for the elderly, promote public hospitals to fully implement preferential policies for elderly medical services, and continuously improve the health and well-being of the elderly. 【Methods:】 Based on literature analysis and expert consultation, the satisfaction evaluation indicators for elderly-friendly medical institutions were formed. The Analytic Hierarchy Process was used to assign weights to the indicators. And then, the satisfaction evaluation index system for elderly-friendly medical institutions was formed. 【Results:】 After two rounds of Delphi method, and the scoring and demonstration of 15 experts, four primary indicators and 21 secondary indicators were finally formed, and then, assigned weight coefficients to them through analysis. 【Conclusion:】 After the expert demonstration, the satisfaction evaluation system for elderly-friendly medical institutions has good reliability and validity, providing the basis for the construction of elderly-friendly medical institutions and contributing to the formation of a sustainable, systematic, and diversified elderly-friendly service system.

Establishment and application of pediatric outpatient and emergency intelligent pharmacy service system in our hospital / 中国药房

OBJECTIVE To provide reference for the construction of intelligent pharmacy and quality control of each link in medical institutions. METHODS The problems， difficulties， and risk points in the links of prescription extraction， allocation， drug resource utilization， prescription and child information verification in pediatric outpatient and emergency pharmacy of our hospital were sorted out to put forward the solutions. The pediatric outpatient and emergency intelligent pharmacy service system of our hospital was established， and its effectiveness was analyzed. RESULTS & CONCLUSIONS In response to the risk points of drug accumulation， dispensing errors， being prone to complaints or disputes， safety hazards in dispensing， and pharmacist’s incorrect operation in various stages such as payment， taking medicine and dispensing， pediatric outpatient and emergency intelligent pharmacy service system was established in our hospital by adding intelligent queuing links， enabling “QR codes”， introducing devices such as rapid dispensing machines， intelligent drug racks， and intelligent dismantling machines. After using the system， the average outpatient dispensing speed increased from 37.55 s/piece to 16.97 s/piece （direct delivery prescriptions） and 27.10 s/piece （non-direct delivery prescriptions）， and the average emergency dispensing speed increased from 26.98 s/piece to 19.61 s/piece （P＜ 0.01）. The walking distance for pharmacists to dispense prescriptions had decreased from 4-16 m/piece to 2-5 m/piece， and the inventory rate had shortened from 2.0-2.2 h/time to 1.5-1.7 h/time. The rate of dispensing error decreased from 0.003% to 0 （P＜ 0.01）. At the same time， the improvement of pharmaceutical service quality has been demonstrated in terms of shortening the waiting time of family members of child， precise drug supplement and helping family members understand medication information. The application of the system can further promote pediatric outpatient and emergency pharmacy services in our hospital.

Establishment of an resilience evaluation index framework for blood service system under emergency support / 中国输血杂志

【Objective】 To construct an index framework for the evaluation of blood service system resilience under emergency support, and improve the ability of blood centers to deal with emergencies. 【Methods】 The contents of evaluation index system were preliminarily determined through the literature analysis. The Delphi method and analytic hierarchy process(AHP) were used. Experts in relevant fields were consulted to determine the resilience evaluation of indicator framework. Six experts were invited to score the weight of resilience index and finally determined the weight of the index. 【Results】 The resilience evaluation index framework of blood service was established with 5 first-level indicators and 22 second-level indicators. The weights of first-level indicators economic resilience, social resilience, infrastructure resilience, organizational resilience and process resilience were 0.140, 0.071, 0.156, 0.225 and 0.408, respectively. 【Conclusion】 The established evaluation index framework of blood service system resilience is scientific, which provides a reference basis for evaluating the resilience of blood service system.

The construction of public sports service guarantee system in a healthy community in the background of public health / A construção de um sistema de garantia de serviço desportivo público em uma comunidade saudável no contexto da saúde pública / Construcción de un sistema de garantía de servicios deportivos públicos en comunidades urbanas saludables en el contexto de la salud pública

ABSTRACT Community sports are a very important part of urban public service. It directly affects the quality of life of residents and plays an important role in improving the health level of the masses. However, there are still many problems in the current public sports service system, which hinders the provision of public health. In order to ensure the effectiveness of the indicators of community sports service guarantee system, this study uses the fuzzy analytic hierarchy process to construct the community public sports service guarantee system, and verifies the effectiveness of the system constructed by this method through an example application. The results show that the weight of each index from large to small is service effectiveness > residents' demand > service capacity > service content; the weight of service effectiveness is 48.46%, which is an important indicator of service guarantee system. In addition, the effectiveness of the community sports service system was verified, and the CR value of the evaluation index system was greater than 0.1, which showed that the consistency of the evaluation index system met the requirements. The public sports service guarantee system constructed by the research institute has good applicability and high practical value. I hope that the research results can provide some reference for the improvement of grass-roots sports service construction, and provide some theoretical support for the construction of grass-roots service evaluation system.

RESUMO O desporto comunitário é uma parte muito importante do serviço público urbano. Afeta diretamente a qualidade de vida da população e desempenha um papel importante na melhoria do nível de saúde das massas. No entanto, ainda há muitos problemas no atual sistema de serviço público de desporto comunitário, o que dificulta a prestação da saúde pública. A fim de garantir a eficácia dos indicadores do sistema de garantia do serviço desportivo, este estudo utiliza o processo hierárquico analítico difuso para construir o sistema de garantia do serviço desportivo público e verifica a eficácia do sistema construído por este método através de uma aplicação dada como exemplo. Os resultados mostram que o peso de cada índice, de alto para baixo, é a eficácia do serviço > demanda da população > capacidade de serviço > conteúdo de serviço; o peso da eficácia do serviço é 48.46%, que é um importante indicador do sistema de garantia do serviço. Além disso, a eficácia do sistema de serviços desportivos foi verificada, e o valor CR do índice de avaliação do sistema foi superior a 0.1, o que mostrou que a consistência do sistema de índice de avaliação satisfazia os requisitos. O sistema público de garantia do serviço desportivo construído pelo instituto de pesquisa tem boa aplicabilidade e elevado valor prático. Espero que os resultados da investigação possam servir de referência para a melhoria da construção de serviços desportivos de base e proporcionar algum apoio teórico à construção de um sistema de avaliação de serviços de base.

RESUMEN Los deportes comunitarios son una parte muy importante del servicio público urbano. Afecta directamente la calidad de vida de los residentes y juega un papel importante en la mejora del nivel de salud de las masas. Sin embargo, todavía existen muchos problemas en el actual sistema público de servicios deportivos, lo que dificulta la prestación de servicios de salud pública. Con el fin de asegurar la efectividad de los indicadores del sistema de garantía del servicio deportivo comunitario, este estudio utiliza el proceso de jerarquía analítica difusa para construir el sistema de garantía del servicio público deportivo comunitario, y verifica la efectividad del sistema construido por este método a través de una aplicación de ejemplo. Los resultados muestran que el peso de cada índice, de mayor a menor, es la eficacia del servicio> la demanda de los residentes> la capacidad del servicio> el contenido del servicio; el peso de la efectividad del servicio es del 48,46%, lo que es un indicador importante del sistema de garantía del servicio. Además, se verificó la efectividad del sistema de servicios deportivos comunitarios y el valor de RC del sistema de índice de evaluación fue mayor a 0.1, lo que mostró que la consistencia del sistema de índice de evaluación cumplió con los requisitos. El sistema de garantía del servicio público de deportes construido por el instituto de investigación tiene una buena aplicabilidad y un alto valor práctico. Espero que los resultados de la investigación puedan proporcionar alguna referencia para la mejora de la construcción de servicios deportivos de base y proporcionar algún apoyo teórico para la construcción de un sistema de evaluación de servicios de base.

The development of public sports service system in central and western regions from the perspective of national health strategy / O desenvolvimento do sistema público de serviços desportivos nas regiões central e ocidental sob a perspectiva da estratégia nacional de saúde / Desarrollo del sistema de servicios públicos de deporte en la región centro - oeste desde la perspectiva de la estrategia nacional de salud

ABSTRACT National health is a new requirement for social development in the new era and in the current situation. At present, there is a problem of unbalanced development of public sports service system among various regions in China, especially the large gap between the East and the Midwest. In order to understand the development status of public sports service system in central and western regions from the perspective of national health strategy, this study constructed the evaluation index system of public sports service in central and western regions, and revised the indicators through two rounds of expert survey, and determined the index weight using AHP. On this basis, taking a city in the central and western region to represent public sports development, the validity and rationality of the evaluation model are verified. The research shows that the public sports service system of the city has a good level and the sports service system is relatively perfect, which can meet the diversified needs of residents participating in sports to a certain extent. Therefore, the development momentum of public sports service system in central and western regions is good, but it still needs to further promote the rational allocation of regional sports resources. It is hoped that this study can provide certain reference for the development of public sports service system in central and western regions from the perspective of national health strategy.

RESUMO A saúde nacional é uma nova exigência para o desenvolvimento social na nova era e na situação atual. Atualmente, existe um problema de desenvolvimento desequilibrado do sistema de serviço público de desporto entre várias regiões da China, com sobretudo uma grande lacuna entre as regiões leste e centro-oeste. A fim de compreender o estado de desenvolvimento do sistema de serviço público de desportos nas regiões central e ocidental a partir da Perspectiva da estratégia nacional de saúde, este estudo construiu o sistema de índice de avaliação do serviço público de desporto nas regiões central e ocidental, e revisou os indicadores através de duas rondas de inquéritos especializados, e determinou o peso do índice por meio do o processo hierárquico analítico (Analytic Hierarchy Process — AHP). Nesta base, verificou-se a validade e a racionalidade do modelo de avaliação, tomando uma cidade na região central e ocidental como representativa do desenvolvimento desportivo público. A pesquisa mostra que o sistema público de serviço esportivo da Cidade tem um bom nível e o sistema de serviço desportivo é relativamente perfeito, o que pode atender às necessidades diversificadas dos residentes que praticam esportes, em certa medida. Por conseguinte, o impulso para o desenvolvimento do sistema público de serviços desportivos nas regiões central e ocidental é positivo, mas ainda precisa de promover a alocação racional dos recursos desportivos regionais. Espera-se que este estudo possa fornecer certa referência para o desenvolvimento do sistema de serviço público de desporto nas regiões centrais e ocidentais, a partir da Perspectiva da estratégia nacional de saúde.

RESUMEN Resumen: La salud nacional es un nuevo requisito para el desarrollo social en la nueva era y en la situación actual. En la actualidad, existe un problema de desarrollo desequilibrado del sistema de servicios deportivos públicos entre varias regiones de China, especialmente la gran brecha entre el Este y el Medio Oeste. Con el fin de comprender el estado de desarrollo del sistema de servicios deportivos públicos en las regiones central y occidental desde la perspectiva de la estrategia nacional de salud, este estudio construyó el sistema de índices de evaluación del servicio deportivo público en las regiones central y occidental. Con ese sistema revisó los indicadores a través de dos rondas de encuestas entre expertos y determinó el peso del índice utilizando el proceso de jerarquía analítica (PJA). Sobre esta base, tomando una ciudad de la región central y una de la occidental para representar el desarrollo deportivo público, se verificó la vigencia y racionalidad del modelo de evaluación. La investigación muestra que el sistema público de servicios deportivos de la ciudad tiene un buen nivel y el sistema de servicios deportivos es relativamente perfecto, lo que puede satisfacer las diversas necesidades de los residentes que participan en deportes. Por lo tanto, el desarrollo del sistema de servicios deportivos públicos en las regiones central y occidental es bueno, pero aún debe promover más la asignación racional de los recursos deportivos regionales. Se espera que este estudio pueda proporcionar una referencia para el desarrollo del sistema público de servicios deportivos en las regiones central y occidental desde la perspectiva de la estrategia nacional de salud.

Dilemma and path selection of college sports resources into the public service system of national fitness in the new era / Dilema e seleção do caminho dos recursos desportivos universitários que integram o sistema nacional de serviços públicos de educação física na nova era / Dilemas y opciones para la integración de los recursos deportivos de la nueva era en el servicio público universal de gimnasia

ABSTRACT With the improvement of people's yearning for a healthy and beautiful life, national fitness has become a hot word in academic circles. Combining Data Envelopment Analysis (DEA) and the Tobit technology, this paper constructs the evaluation model of college sports resource efficiency based on the DEA Tobit model. Based on the establishment of the input-output index system of college sports resources, the model achieves the effect of accurate analysis on the allocation efficiency of university sports resources. Taking 10 universities in a city as experimental objects, the model is verified. The verification shows that the three efficiency indexes of STU University and IPE University in group M are all 1, which shows that the resource allocation is more reasonable; the comprehensive efficiency of Ju university is low, and the sports resources investment is excessive; in group n, except for the EU University, the efficiency of other colleges and universities is lower than the pass line. It can be concluded that there are problems such as excessive input of sports resources and low output rate in Colleges and universities of a city. Therefore, colleges and universities in a city should make full use of the existing resources, enhance their social sports guidance force, while improving the publicity of national fitness. This study has high reference significance for the path selection of national fitness integration in Colleges and Universities.

RESUMO Com a melhoria do desejo das pessoas por uma vida saudável e agradável, a atividade física nacional tornou-se a palavra de ordem nos círculos acadêmicos. Combinando a Análise por Envoltória de Dados (DEA, do inglês Data Envelopment Analysis) e a tecnologia Tobit, foi construído o modelo de avaliação da eficiência dos recursos desportivos universitários com base no modelo DEA Tobit. Com base no estabelecimento do sistema de índice de entradas-resultados dos recursos desportivos universitários, o modelo produz o efeito de uma análise precisa da eficiência de alocação dos recursos desportivos universitários. Tomando dez universidades de uma cidade como objetos experimentais, o modelo é verificado. Após verificação, os três índices de eficiência da Universidade de Stu e da Universidade de IPE no Grupo M são todos 1, o que indica que a alocação de recursos é mais razoável; a eficiência global da Universidade de Ju é inferior à da Universidade UE, e a eficiência de outras universidades do Grupo n é inferior à linha de aprovação, com excepção da Universidade UE. Os resultados mostram que há alguns problemas nos recursos esportivos de faculdades e universidades em uma cidade, como muita entrada de recursos esportivos e baixos resultados. Por conseguinte, as escolas e universidades urbanas devem utilizar plenamente os recursos existentes, reforçar a orientação dos esportes sociais e melhorar a divulgação da aptidão física nacional. Este estudo tem um alta relevância de referência para a seleção do caminho da integração da atividade física nacional em faculdades e universidades.

RESUMEN Con el aumento del deseo de las personas de tener una vida saludable y plena, la educación física nacional se ha convertido en un concepto imperativo en los círculos académicos. Combinando el Análisis Envolvente de Datos (DEA) y la tecnología Tobit, este documento construye el modelo de evaluación de la eficiencia de los recursos deportivos universitarios basándose en el modelo Tobit DEA. Con el uso del sistema de índice de insumo-resultado de los recursos deportivos universitarios, el modelo logra un análisis preciso de la eficiencia de asignación de dichos recursos. El modelo es verificado tomando 10 universidades de una ciudad como objetos experimentales. La verificación muestra que los tres índices de eficiencia de la Universidad STU y de la Universidad IPE en el grupo M son todos 1, lo que demuestra que la asignación de recursos es más eficaz. Por otra parte, la eficiencia integral de la universidad de Ju es baja y la inversión en recursos deportivos es excesiva. En el grupo n, a excepción de la Universidad EU, la eficiencia de otros colegios y universidades es menor que la línea de aprobación. Se puede concluir que existen problemas como la inversión excesiva en recursos deportivos y la baja tasa de resultados en los colegios y universidades de una ciudad. Por lo tanto, los colegios y universidades deben aprovechar al máximo los recursos existentes, reforzando la orientación respecto a los deportes sociales y, al mismo tiempo, mejorando la publicidad de la educación física nacional. Este estudio tiene una gran importancia como referencia para la selección del camino de integración nacional de la educación física en colegios y universidades.

The construction of urban public sports service from the perspective of public health / Construção de serviços desportivos públicos urbanos sob a perspectiva da saúde pública / Construcción de servicios deportivos públicos urbanos desde la perspectiva de la salud pública

ABSTRACT With the deepening of urban public sports service construction in China, the construction of public sports service system has become an important guarantee for mass sports rights in China. In view of this, this study takes City XX as an example, and analyzes the difference of public sports service construction in this city using the Theil index method, and determines the measurement index. It analyzes the equality degree of service resource allocation among and within the four regions of City XX, including A, B, C, D, and so on. The influencing factors of sports service efficiency are analyzed. The results show that there are significant differences in the allocation of public sports service resources among districts and counties of City XX. From the overall difference, the total Theil index of national fitness and sports clubs showed an upward trend, while others showed a downward trend. From the perspective of regional differences, there were 6 indicators with the highest equalization level in area C and 5 indicators in area A. The lowest level was found. Population density, per capita GDP, aging rate and urbanization rate of city XX have obvious positive correlations with public sports service efficiency. The aging rate is the most positive factor, while per capita GDP and population density have little influence. This study can provide some reference value for other cities in China in the construction of public sports services.

RESUMO Com o aprofundamento da construção de serviços públicos desportivos urbanos na China, a construção de um sistema público de serviço desportivo tornou-se uma importante garantia para o exercício dos direitos desportivos em massa na China. Em vista disso, este estudo toma a Cidade XX como exemplo, e analisa a diferença de construção de serviços públicos desportivo nessa Cidade pelo método índice de Theil, e determina o índice de medição. Analisa o grau de igualdade de alocação de recursos entre e dentro das quatro regiões da Cidade XX, incluindo as regiões A, B, C, D, e assim por diante. Os fatores que influenciam a eficiência do serviço esportivo são analisados. Os resultados mostram que há diferenças significativas na alocação de recursos públicos de serviços esportivos entre os distritos e condados da Cidade XX. A partir da diferença global, o índice total serviços de atividades físicas em âmbito nacional e clubes desportivos mostrou uma tendência ascendente, enquanto outros mostraram uma tendência descendente. Sob a perspectiva das diferenças regionais, havia seis indicadores com o mais alto nível de equalização na área C e 5 indicadores na área A. O nível mais baixo foi encontrado. A densidade populacional, o PIB per capita, a taxa de envelhecimento e taxa de urbanização da Cidade XX têm uma correlação positiva óbvia com a eficiência do serviço desportivo público. A taxa de envelhecimento é o fator mais positivo, enquanto o PIB per capita e a densidade populacional têm pouca influência. Este estudo pode fornecer algum valor de referência para outras cidades da China na construção de serviços desportivos públicos.

RESUMEN La profundización de la construcción de servicios deportivos públicos urbanos en China se ha convertido en una garantía importante para los derechos deportivos de masas en China. Ante esto, este estudio toma como ejemplo la Ciudad XX y analiza la diferencia de construcción de servicios públicos deportivos en esta ciudad utilizando el método del índice de Theil y determina el índice de medición. Verifica el grado de igualdad en la asignación de recursos de servicios entre y dentro de las cuatro regiones de la Ciudad XX incluyendo A, B, C, D, etc. También analiza los factores que influyen en la eficiencia del servicio deportivo. Los resultados muestran que existen diferencias significativas en la asignación de los recursos de los servicios deportivos públicos entre los distritos y condados de la Ciudad XX. A partir de la diferencia general, el índice de Theil total de los clubes deportivos y de educación física nacionales mostró una tendencia al alza, mientras que otros mostraron una tendencia a la baja. Desde la perspectiva de las diferencias regionales, se encontraron 6 indicadores con el nivel más alto de igualación en el área C y 5 indicadores en el área A. Se encontró también el nivel más bajo. La densidad de población, el PIB per cápita, la tasa de envejecimiento y la tasa de urbanización de la ciudad XX tienen evidentes correlaciones positivas con la eficiencia de los servicios deportivos públicos. La tasa de envejecimiento es el factor más positivo, mientras que el PIB per cápita y la densidad de población tienen poca influencia. Este estudio puede aportar algún valor de referencia para otras ciudades de China en la construcción de servicios deportivos públicos.

Current situation of emergency medical service system for patients with acute myocardial infarction in Hebei Province and its influence on treatment and prognosis / 中华急诊医学杂志

Objective:To investigate the current situation of emergency medical service (EMS) system and its effect on treatment of the acute stage and short- and long-term prognosis in patients with acute myocardial infarction in Hebei province.Methods:Totally 2 961 patients with acute myocardial infarction who were admitted to major tertiary and some representative secondary hospitals in Hebei province from January 2016 to December 2016 were collected. According to the pattern of arriving hospital, all the patients were divided into the EMS group and self-transport group. The general conditions, time from onset to treatment, treatment methods, in-hospital mortality rate and 3-year mortality rate were compared between the two groups.Results:Of the included 2 961 patients, 33.13% of them were transported through EMS and 66.87% of them by private transport. Patients with a history of hypertension and ST-segment elevation myocardial infarction were more likely to choose EMS, and the difference was statistically significant ( P<0.05). Moreover, patients in the EMS group were more likely to go to tertiary hospitals for treatment (88.58% vs 85.76%, P=0.033). The time from onset to treatment of the EMS group was significantly shorter than that of the self-transport group (160 min vs 185 min, P<0.01), and the proportion of patients in the EMS group from onset-to-door time in <3 h and 3-6 h was higher than that of the self-transport group (55.76% vs 49.14%, 21.41% vs 19.09%, P<0.01). Compared with the self-transport group, the EMS group has a higher rate of reperfusion therapy (67.48% vs 61.67%, P=0.002). Patients in the EMS group had a higher in-hospital mortality rate in the acute stage (7.03% vs 4.44%, P=0.003), but its 3-year mortality rate was lower than that of the self-transport group (17.31% vs 20.77%, P<0.05). Conclusions:EMS can shorten symptom-onset-to-arrival time, increase the rate of reperfusion therapy and improve long-term prognosis of patients with acute myocardial infarction.

Policy Framework and Methodological System of Inclusive Development of Health Service System and Physical Activity / 中国康复理论与实践

Objective:To explore the theory and methods of integrating sports into modern health service systems. Methods:Based on the theory of World Health Organization modern health service systems and the policy guideline Rehabilitation in Health Service Systems, we analyzed how to promote the integration of sports into modern health service systems in six areas: leadership and governance capacity, financing, health human resources, service delivery, medical technology and health information systems, systematically analyzed the key elements and requirements for integrating physical education and sports into the health service system in the four segments of the health service continuum: prevention, intervention, rehabilitation and health promotion. Results:The goal of building a human-centered, cross-sectoral and multidisciplinary health service system was proposed, requiring the promotion of the integration of medicine and sports, the use of sports intervention as a method of health intervention, the development of service technologies and standards for the integration of sports and health; the training of professionals who master sports intervention and sports rehabilitation, and the development of information systems to promote the development of the integration of sports and health services. Conclusion:Sports is an important mean of health and an important part of modern health services. Starting from the components of the health service system, we can build a theoretical and methodological system for integrating sports into the modern health service system, so as to promote the realization of a health service system covering the whole population and the whole life cycle, achieve the United Nations 2030 Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages; and realize the goals related to "Healthy China".

Theoretical Framework and Key Elements of International Rehabilitation Policy: Contents Analysis of WHO Rehabilitation Policy Documents / 中国康复理论与实践

Objectives:To systematically analyze the framework and contents of World Health Organization (WHO) policy and action strategies on rehabilitation using the theory of WHO health service components, to explore the theoretical bases, methodology, framework and core elements of WHO's international rehabilitation policy. Methods:WHO has launched rehabilitation-related policy documents, mainly including Rehabilitation in Health Systems, Rehabilitation in Health Systems: Guide for Action, Rehabilitation Indicator Menu: a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation (FRAME), Template for Rehabilitation Information Collection (TRIC): a tool accompanying the Systematic Assessment of Rehabilitation Situation (STARS), and established systems of international rehabilitation policy architecture system. Using content analysis, this study analyzed in detail the theoretical basis and methodology of international rehabilitation policy, the policy framework, and the core elements of the action strategy and priority areas of rehabilitation service development in perspective of WHO six building blocks of health system, namely leadership and governance, financing, human resources for health, service delivery, medical technology, and health information systems. Results:WHO rehabilitation policy is developed based on WHO's theories of person-centered health services, social determinants of health, and functioning, disability and health of International Classification of Functioning, Disability and Health. WHO rehabilitation policy recognized that the development of rehabilitation was an important pathway achieving United Nations 2030 Sustainable Development Goals 3, ensure healthy lives and promote well-being for all at all ages, i.e. Unlversal Health Coverage. This paper systematically analyzed WHO's international policy framework, action strategies, and development areas, content and priorities in six major areas: leadership and governance, financing, human resources for health, service delivery, medicine and technology, and health information systems. WHO rehabilitation policies advocates to develop national rehabilitation plans, to establish and improve rehabilitation leaderships and the development of mechanism and capacity of rehabilitation governance, to develop multiple approaches of rehabilitation financing, to integrate rehabilitation into health service system, provides different levels of rehabilitation services in the health service continuum, and to build networks of service delivery, to train professionals, to foster rehabilitation information system within health system, to enhance service quality and service coverage, to focus on key areas and priority programs to meet the diverse needs of different populations, and achieve universal health coverage; to include assistive technology into the rehabilitation service system as a field of medicine and technology; and to collect information on functioning and rehabilitation needs, outcomes and impacts of rehabilitation services in the health information system, and conduct evidence-based researches on rehabilitation systems. Conclusion:The framework and contents of WHO's international rehabilitation policies have systematically reviewed at the macro, meso, and micro levels with the perspective of WHO six building blocks of the health system. The goal of rehabilitation development is to achieve universal rehabilitation coverage. The conceptual theories of rehabilitation are based on the theories of people-centered health services and social determinants of health. Rehabilitation is an important initiative to achieve the United Nations 2030 Sustainable Development Goals. The international rehabilitation health policy system is built on six major areas of rehabilitation: leadership and governance, rehabilitation financing, rehabilitation human resources, rehabilitation service delivery, rehabilitation-related medicine and technology, and rehabilitation and health information system. The policy and action strategies for rehabilitation development, as well as specific implementation paths and methods, at macro, meso and micro levels: theory and policy, policy action, and implementation methods and tools have been reviewed and discussed. The implementation of the WHO rehabilitation policies advocates to take the following actions: strengthening the leadership, governance, planning and coordination capacity of rehabilitation services; constructing a reasonable rehabilitation financing mechanism and raising necessary funds for rehabilitation; improving the training and guarantee mechanism of rehabilitation human resources; enhancing the professional capacity of rehabilitation personnel, improving the capacity of rehabilitation service delivery and improving service quality; improving the quality and accessibility of assistive products and assistive technology services; establishing health information system covering functioning, disability and rehabilitation, and conducting scientific researches on rehabilitation.

Trends and challenges of emergency and acute care in Chinese mainland: 2005-2017 / 世界急诊医学杂志（英文）

@#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 pre-hospital 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 findings and comparison with the USA could offer experiences and lessons to EMSS development worldwide, especially for developing countries.

Framework and Core Content of World Health Organization Policy and Guidelines of Physical Activity / 中国康复理论与实践

Objective To study and analyze the theory, policy framework, and core content of physical activity policies and physical activity guidelines. Methods Using a policy research and content analysis approach and the theory of the six components of World Health Organization (WHO) health service system, we specifically analyze the theory, framework, and core content of WHO Global Action Plan on Physical Activity and WHO Physical Activity Guidelines. Results The Global Plan of Action for Physical Activity 2018-2030 (Action Plan) is an international policy document on physical activity issued by WHO that incorporates physical activity within the context of the seven principles of human rights, the life span, evidence-based practice, proportional universality, policy coherence and integration of health into all policies, participation and empowerment, and multisectoral partnerships into health services and social development. The Action Plan consists of four strategic objectives and 20 policy actions, covering six areas of WHO health service system, and the integration of physical activity policies into health services is of great importance in promoting the achievement of the United Nations Sustainable Development Goal 3 of universal health coverage. As a technical document for the implementation of the Action Plan, 2020 WHO Guidelines on Physical Activity and Sedentary Behavior (Guidelines) adopted the PI/ECO approach to analyze the physical activity needs of various groups of people, and provide guidelines to increase physical activity and reduce sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic diseases and people with disabilities. The guidelines cover duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations. The Guidelines implement the relevant guiding principles of the Action Plan and aim to improve overall population participation in physical activity at the micro level and improve critical and important health outcomes for the overall population. Conclusion As a health and development strategy, the Action Plan promotes the integration of physical activity into the health delivery system to facilitate the achievement of the United Nations 2030 Sustainable Development Goal 3 of universal health coverage.The four strategic objectives and 20 policy actions of the Action Plan can be integrated into these six areas based on the six components of WHO Health Service Delivery System: leadership and governance, financing, human resources, service delivery, medical technology, and health information. As a technical document to implement the Action Plan, the Guidelines are based on the PI/ECO approach framework and provide guidance on increasing physical activity and reducing sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, chronic patients, and persons with disabilities. The core content addresses the target populations, duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations.

Integrating Physical Activity into School-based Eye Health Services: A Policy and Development Study / 中国康复理论与实践

Objective To explore the theories, content and approaches of integrating physical activity in children's eye health service system in the context of health services. Methods From the perspectives of six building blocks of WHO health system, namely, leadership and governance, financing, human resources for health, service delivery, medical technology, and health information system, we analyzed the policy framework and key contents related to school-based eye health and physical activity, and explored how to promote the implementation of physical activity into the school-based eye health service system, and the integration of physical activity into the eye health continuum: prevention, intervention, rehabilitation, and health promotion. Results In perspective of health system, the integration of physical activity into school-based eye health services should be in accordance with the five principles of cross-cutting health services, namely, universal accessibility and equity, human rights, evidence-based, life-span, and empowerment. According to the World Vision Report, WHO advocates to build a person-centered eye health service system, and person-centeredness is the core concept of the new model of school-based eye health services and physical activity integration. WHO advocates a school-based approach to education and physical activity in health-promoting schools to promote student health, physical activity as a preventive, interventional, rehabilitation and health promotive measure related to children's eye health, and vigorously train professionals within schools who have knowledge and skills related to physical activity and eye health, build an information system on physical activity and children's eye health, and promote the integration of physical activity into the school-based eye health service system. Conclusion Physical activity is an important measure to promote children's eye health and an important component to achieve a person-centered eye health service system. Based on the six building blocks of the WHO health service system, a school-based eye health service that integrates a theoretical and methodological system of physical activity is constructed, requiring the provision of health promotion methods such as education and physical activity in the school setting, to enhance leadership and governance of eye health services based on educational and physical activity approaches in the school setting, establish new funding mechanisms, provide financial security, develop human resources related to physical activity for eye health, improve related service delivery systems, develop high-quality physical activity intervention eye health techniques and equipment, and integrate information on children's physical activity and eye health into school health information systems to achieve children's eye health and promote their physical and mental development.

Framework and Contents of International Policies of Inclusive Physical Activity to School Health / 中国康复理论与实践

Objective To systematically analyze the framework and core content of physical activity inclusive school health policies. Methods This study conducted systematic content analysis of key messages of WHO key documents related to physical activity and school health services, and constructed policy and research framework. WHO's key policy documents in the field of school health included: Making Every School a Health-Promoting School Implementation Guidelines, WHO Guidelines on School Health Services, and the Global Criteria and Indicators for Making Every School a Health-Promoting School, and the key documents in the field of physical activity mainly include Global Action Plan for Physical Activity Promotion 2018-2030: Strengthening Physical Activity for a Healthy World, and WHO Guidelines on Physical Activity and Sedentary Behavior (Children and adolescents). Results Physical activity, as a health strategy and development strategy, is one of the most important tools for achieving health-promoting schools. In the area of health and education, the key to building health-promoting schools is to focus on child functioning and development, with the goal of promoting healthy inclusion and equity in schools. In the school setting, physical activity for children and adolescents is integrated into the school health service continuum with a focus on health promotion. At the macro level, the state and relevant authorities should establish a strategic structure and strategic planning for the integration of physical activity into the school health service system. At the meso level, educational institutions should develop and improve school health service policies and programs, and improve school health service tools based on the requirements of WHO school health service guidelines. Child health services are achieved through the provision of high-quality physical education programs and after-school physical activities. At the micro level, guided by global standards for building health-promoting schools, physical activity is promoted in the form of lessons and activities for healthy child development. Integrating physical activity into the school health service system can be done in six areas: school health leadership and governance, school infrastructure funding, school health service delivery that supports physical activity, human resources for school health, school health-related medicine and technology, and school health information system. We need to implement health-promoting school policies, strengthen multi-level school leadership and governance, raise the necessary funds to develop human resources adapted to the construction of health-promoting schools and build programs to support physical activity. Conclusion School health service is an important area for promoting children's health and achieving the UN 2030 Sustainable Development Goals, and physical activity is an important strategy of school health services. Policy documents issued by WHO construct the integration of physical activity into the policy framework of the school health service system, of which the core component is to integrate physical activity into the health-promoting school with educational and physical activity approaches. According to the WHO six building blocks of health service system, the integration of physical activity into the school health requires strengthening school health leadership and governance, improving school infrastructure financing, developing school health human resources, developing school-based health-related medical technologies, and establishing a health information system for sharing student health data.

Framework and Core Content of World Health Organization Policy and Guidelines of Physical Activity / 中国康复理论与实践

Objective To study and analyze the theory, policy framework, and core content of physical activity policies and physical activity guidelines. Methods Using a policy research and content analysis approach and the theory of the six components of World Health Organization (WHO) health service system, we specifically analyze the theory, framework, and core content of WHO Global Action Plan on Physical Activity and WHO Physical Activity Guidelines. Results The Global Plan of Action for Physical Activity 2018-2030 (Action Plan) is an international policy document on physical activity issued by WHO that incorporates physical activity within the context of the seven principles of human rights, the life span, evidence-based practice, proportional universality, policy coherence and integration of health into all policies, participation and empowerment, and multisectoral partnerships into health services and social development. The Action Plan consists of four strategic objectives and 20 policy actions, covering six areas of WHO health service system, and the integration of physical activity policies into health services is of great importance in promoting the achievement of the United Nations Sustainable Development Goal 3 of universal health coverage. As a technical document for the implementation of the Action Plan, 2020 WHO Guidelines on Physical Activity and Sedentary Behavior (Guidelines) adopted the PI/ECO approach to analyze the physical activity needs of various groups of people, and provide guidelines to increase physical activity and reduce sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic diseases and people with disabilities. The guidelines cover duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations. The Guidelines implement the relevant guiding principles of the Action Plan and aim to improve overall population participation in physical activity at the micro level and improve critical and important health outcomes for the overall population. Conclusion As a health and development strategy, the Action Plan promotes the integration of physical activity into the health delivery system to facilitate the achievement of the United Nations 2030 Sustainable Development Goal 3 of universal health coverage.The four strategic objectives and 20 policy actions of the Action Plan can be integrated into these six areas based on the six components of WHO Health Service Delivery System: leadership and governance, financing, human resources, service delivery, medical technology, and health information. As a technical document to implement the Action Plan, the Guidelines are based on the PI/ECO approach framework and provide guidance on increasing physical activity and reducing sedentary behavior for children and adolescents, adults, older adults, pregnant and postpartum women, chronic patients, and persons with disabilities. The core content addresses the target populations, duration, frequency, and intensity of physical activity, types of physical activity, critical and important health outcomes of physical activity, and health risk prevention and related considerations.

Integrating Physical Activity into School-based Eye Health Services: A Policy and Development Study / 中国康复理论与实践

Objective To explore the theories, content and approaches of integrating physical activity in children's eye health service system in the context of health services. Methods From the perspectives of six building blocks of WHO health system, namely, leadership and governance, financing, human resources for health, service delivery, medical technology, and health information system, we analyzed the policy framework and key contents related to school-based eye health and physical activity, and explored how to promote the implementation of physical activity into the school-based eye health service system, and the integration of physical activity into the eye health continuum: prevention, intervention, rehabilitation, and health promotion. Results In perspective of health system, the integration of physical activity into school-based eye health services should be in accordance with the five principles of cross-cutting health services, namely, universal accessibility and equity, human rights, evidence-based, life-span, and empowerment. According to the World Vision Report, WHO advocates to build a person-centered eye health service system, and person-centeredness is the core concept of the new model of school-based eye health services and physical activity integration. WHO advocates a school-based approach to education and physical activity in health-promoting schools to promote student health, physical activity as a preventive, interventional, rehabilitation and health promotive measure related to children's eye health, and vigorously train professionals within schools who have knowledge and skills related to physical activity and eye health, build an information system on physical activity and children's eye health, and promote the integration of physical activity into the school-based eye health service system. Conclusion Physical activity is an important measure to promote children's eye health and an important component to achieve a person-centered eye health service system. Based on the six building blocks of the WHO health service system, a school-based eye health service that integrates a theoretical and methodological system of physical activity is constructed, requiring the provision of health promotion methods such as education and physical activity in the school setting, to enhance leadership and governance of eye health services based on educational and physical activity approaches in the school setting, establish new funding mechanisms, provide financial security, develop human resources related to physical activity for eye health, improve related service delivery systems, develop high-quality physical activity intervention eye health techniques and equipment, and integrate information on children's physical activity and eye health into school health information systems to achieve children's eye health and promote their physical and mental development.

Framework and Contents of International Policies of Inclusive Physical Activity to School Health / 中国康复理论与实践

Objective To systematically analyze the framework and core content of physical activity inclusive school health policies. Methods This study conducted systematic content analysis of key messages of WHO key documents related to physical activity and school health services, and constructed policy and research framework. WHO's key policy documents in the field of school health included: Making Every School a Health-Promoting School Implementation Guidelines, WHO Guidelines on School Health Services, and the Global Criteria and Indicators for Making Every School a Health-Promoting School, and the key documents in the field of physical activity mainly include Global Action Plan for Physical Activity Promotion 2018-2030: Strengthening Physical Activity for a Healthy World, and WHO Guidelines on Physical Activity and Sedentary Behavior (Children and adolescents). Results Physical activity, as a health strategy and development strategy, is one of the most important tools for achieving health-promoting schools. In the area of health and education, the key to building health-promoting schools is to focus on child functioning and development, with the goal of promoting healthy inclusion and equity in schools. In the school setting, physical activity for children and adolescents is integrated into the school health service continuum with a focus on health promotion. At the macro level, the state and relevant authorities should establish a strategic structure and strategic planning for the integration of physical activity into the school health service system. At the meso level, educational institutions should develop and improve school health service policies and programs, and improve school health service tools based on the requirements of WHO school health service guidelines. Child health services are achieved through the provision of high-quality physical education programs and after-school physical activities. At the micro level, guided by global standards for building health-promoting schools, physical activity is promoted in the form of lessons and activities for healthy child development. Integrating physical activity into the school health service system can be done in six areas: school health leadership and governance, school infrastructure funding, school health service delivery that supports physical activity, human resources for school health, school health-related medicine and technology, and school health information system. We need to implement health-promoting school policies, strengthen multi-level school leadership and governance, raise the necessary funds to develop human resources adapted to the construction of health-promoting schools and build programs to support physical activity. Conclusion School health service is an important area for promoting children's health and achieving the UN 2030 Sustainable Development Goals, and physical activity is an important strategy of school health services. Policy documents issued by WHO construct the integration of physical activity into the policy framework of the school health service system, of which the core component is to integrate physical activity into the health-promoting school with educational and physical activity approaches. According to the WHO six building blocks of health service system, the integration of physical activity into the school health requires strengthening school health leadership and governance, improving school infrastructure financing, developing school health human resources, developing school-based health-related medical technologies, and establishing a health information system for sharing student health data.

Establishment of Education System of Professionals in the Fields of Sports and Exercises Rehabilitation in China / 中国康复理论与实践

Objective:To analyze the policy development background of personnel education in the fields of sports and exercises rehabilitation, discuss the educational objectives, disciplinary knowledge system and curricula principles, and specialties in China, to construct the education system of sports and exercises rehabilitation specialty in China. Methods:In light of policy recommendations of the World Report on Disability and the documents of Rehabilitation in Health Service System by World Health Orgnization (WHO), the theoretical framework of International Classification of Functioning, Disability and Health (ICF) had been adopted in the policy analysis and development of education system of speciality of sports and exercises rehabilitation in China at undergraduate level. Results:Rehabilitation is an important part of the national health service system and one of the important approaches to achieve the United Nations 2030 Sustainable Development Goal III: Universal Health Coverage. The education of professionals in the fields of sports and exercises rehabilitation is an important guarantee for the development and improvement of the rehabilitation service system. The educational goals of professionas tailored to the needs of health system for the coverage of total population and life-span experiences. Professionals in the fields of sports and exercises rehabilitation should learn knowledge and skills of rehabilitation sciences, which is integration of sport sciences and health sciences. They will work in a "sports and medicine integration" model in the health service system. The speciality of sports and exercises rehabilitation should be established on the basis of a comprehensive interdisciplinary and cross sectors principles guided by ICF theory, such as physical education, biology, psychology, sociology and environment sciences. The specialized knowledge system of sports and exercises rehabilitation can be divided into three levels: fundamental courses for liberal education, specific courses for professional education, and specialized training for speciality. The professional education tailored to the applied disciplines; rehabilitation skills and practices tailored to rehabilitation specialties. In the way of ICF, the principles of courses had been developed in the fields of sports and exercises rehabilitation: developing the health-related general education courses that matched with the international standards; strengthening and developing the professional foundation courses of sports and exercises rehabilitation in the view of health sciences and rehabilitation sciences, according to the laws of rehabilitation science and sport sciences; developing career-related skills based on the requirements of the rehabilitation service industry. Conclusion:In light of the ICF theory, according to the requirements of WHO Rehabilitation of Health Service System and the action suggestions of WHO World Report on Disability, the educational goals, theoretical frameworks, approaches, disciplinary knowledges and courses of sports and exercises rehabilitation had been developed. In order to further promote the professional development of sports and exercises rehabilitation, this paper provided a theoretical foundation and scientific basis for improving the scientific and standardized level of sports and exercises rehabilitation.