Reexamining the Environmental Kuznets Curve in Chinese Cities: Does Intergovernmental Competition Matter?

Since China's central authority began enforcing the environmental target responsibility system and introduced environmental indicators to the official ranking tournament in 2007, an ecological transformation has emerged in the intergovernmental competition (IGC) among localities. Because the extant literature on the environmental Kuznets curve (EKC) remains unclear regarding how that ecological IGC transformation changes the EKC economy-pollution correlation, this research investigates the degree to which the transformed IGC changes the form of the EKC, and how that altered EKC varies for different pollutants (i.e., SO2 and CO2) and in different regions (i.e., the eastern, central, and western regions). The results demonstrate a consistently inverted U-shaped relationship between income and SO2 emissions in all three regions, whereas when CO2 emissions are taken as the pollution indicator, the EKC hypothesis holds only in the eastern and central cities, and a positive linear income-CO2 nexus is found in the western region. Spatial analysis reveals that whereas the IGC flattens the inverted U-shaped curves between income and SO2 emissions, it has led to a higher economic cost, corresponding to the turning point of the EKC for CO2 emissions. The findings indicate that the ecological transformation of the IGC has facilitated a positive up-down yardstick competition in the strategic interactions of sustainable development across local Chinese governments, which can lead to a kind of balance between centralization and decentralization by inspiring local officials' adaptability and activity in reducing pollutant emissions and strengthening the officials' responsiveness to performance rankings. This study elucidates the environmental impacts of IGC in China and provides an institutional explanation for the strategic interactions among local governments when they are tackling the environment-economy nexus under multitask conditions.

Construction sector joint health and safety committees: Can their effectiveness be assessed using the JHSC assessment eTool?

BACKGROUND: Joint health and safety committees (JHSCs) are a legal requirement for most Ontario workplaces. However, few evidence-based tools exist to assess JHSC effectiveness. The JHSC Assessment eTool has been developed and tested in the healthcare and education sectors with positive results. OBJECTIVE: The objective of this study is to test the usability and feasibility of the JHSC Assessment eTool in the construction sector. METHODS: Testing was carried out in two phases using a non-experimental study design. In the first phase, construction sector health and safety experts reviewed the content of the eTool to ensure that it had relevance for the sector. In phase two, a convenience sample of JHSCs from construction sector workplaces were recruited to pilot the eTool and provide feedback. RESULTS: Feedback from six constructor sector health and safety experts and six JHSC committees indicated that the eTool had value and relevance for use in the sector. Additionally, our study identified several minor areas for refinement including the addition of construction-specific resources in the final report. CONCLUSIONS: The results of our study suggest minor modifications to the eTool for use by construction sector workplaces.

How Must We Prepare in the Next Decades When Caring for Those With Developmental Disabilities: "Grown Up" (2018).

The Guarantee of Rights and Support for Persons with Developmental Disabilities Act was enacted and revised in 2014. However, national measures for persons with developmental disabilities remain insufficient. In the film, "Grown Up," director Hyeyoung Jang filmed the daily life of her sister, who has developmental disabilities. She raised not only the issue of institutionalization in people with developmental disabilities in Korea but also the issue of a lack of policies that would be essential to them and their family members. In the future, I hope that as experts, child and adolescent psychiatrists in Korea will pay more attention to the lives of people with developmental disabilities outside the clinic and propose policies to help them and their family members.

Influence of tutor responsibility system combined with CBL teaching method on the operating skills and teaching quality of hematology residents / 中华医学教育探索杂志

Objective:To explore the teaching effect of standardized training physicians in department of hematology through the tutor responsibility system combined with case-based learning (CBL teaching method), and to provide new ideas for the formulation of the teaching plan of standardized training physicians in the future.Methods:A total of 52 residents trained in the Department of Hematology, The First Affiliated Hospital of Army Medical University from January to December 2017 were selected in the study. And they were randomly divided into observation group and control group, with 26 cases in each group. The control group received the CBL teaching method, and the observation group received the tutor responsibility system combined with the CBL teaching method, both of which were taught for 3 years. Our hospital's self-made assessment form was used to assess the operating skills, theoretical knowledge and teaching quality of the two groups' residents before and after 3 years of teaching. SPSS 24.0 was used for t test and chi-square test. Results:After 3 years of teaching, the scores of bone marrow aspiration, bone marrow biopsy, lumbar puncture, and intrathecal injection, the basic theories of specialists, standardized diagnosis and treatment of common diseases, analysis of difficult cases, and rescue scores of critically ill patients, the scores of medical knowledge, clinical thinking, professional ethics, doctor-patient communication, theoretical connection with practice of both groups were all increased than before teaching ( P<0.05), and the above scores of the observation group were higher than those of the control group, with statistical differences ( P<0.05). Conclusion:The tutor responsibility system combined with CBL teaching method is conducive to improving the training effect and teaching quality of hematology.

Practical research on goal-oriented hierarchical responsibility system in emergency standardized training and teaching / 中华医学教育探索杂志

Objective:To explore the practical effect of goal-oriented hierarchical responsibility system in the teaching of emergency standardized training.Methods:A total of 43 residents who rotated in the Emergency Department of Huashan Hospital Affiliated to Fudan University from March 2019 to August 2019 were selected as the control group, and traditional teaching was implemented. Another 41 residents who rotated from September 2019 to March 2020 were selected as the research group, and the goal-oriented hierarchical responsibility system of teaching was implemented. They were all taught for 3 months, and the scores of theoretical and clinical skills, clinical comprehensive ability and teaching recognition before and after teaching were compared between the two groups. SPSS 24.0 was used for t-test and Chi-square test. Results:After teaching, the scores of theoretical knowledge questions, question and answer questions and case analysis in the two groups were higher than those before teaching ( P<0.05), and the scores of the research group were higher than those in the control group ( P<0.05). After teaching, the scores of 8 items in the study group on understanding of skill indications, anatomy and operation, preparation before operation, aseptic operation, operation ability, post-operation treatment, communication ability, humanistic care and overall performance were higher than those in the control group ( P<0.05). The recognition rates of teaching management, teaching methods, teaching content and teaching effect in the research group were higher than those in the control group ( P<0.05). Conclusion:The application of goal-oriented hierarchical responsibility system in the teaching of standardized training of emergency residents is helpful to improve their theoretical and clinical skill examination results and clinical ability, with high degree of teaching recognition.

Effects of cooperative nursing and patient education on postoperative infection and self-efficacy in gastrointestinal tumors.

BACKGROUND: Gastrointestinal tumors have a high incidence rate. The application value of the cooperative nursing care system of medical care has received widespread attention in recent years. However, there are few studies on the value of the joint application of collaborative nursing care and self-efficacy education. AIM: To explore the effect of cooperative nursing care management/self-efficacy education on postoperative infection and self-efficacy in gastrointestinal tumor surgery patients. METHODS: A total of 102 patients with gastrointestinal tumors treated in our hospital from October 2018 to February 2020 were selected and divided into a conventional group (n = 51) and a combined group (n = 51) according to the nursing plan. The routine group adopted routine nursing, and the joint group adopted the medical care cooperative responsibility system nursing management combined with self-efficacy education. The self-efficacy scores, coping style scores, self-experience burden scores, and postoperative complication rates of the two groups before and after intervention were counted. RESULTS: After intervention, the daily life behavior management, cognitive symptom management, and disease management scores of the two groups were higher than those before the intervention, and those of the combined group were higher than those of the conventional group (all P = 0.000). After the intervention, the positive response scores of the two groups were higher than those before the intervention, the negative response scores were lower than those before the intervention, and the combined group was better than the conventional group (all P = 0.000). After the intervention, the two groups' emotional, economic, and physical factor scores were lower than those before the intervention, and the combined group was lower than the conventional group (all P = 0.000). The incidence of infection in the combined group (1.96%) was lower than that in the conventional group (15.69%) (P = 0.036). CONCLUSION: Cooperative nursing care management and self-efficacy education improved the physical and mental states of gastrointestinal cancer surgery patients, change the response to disease, and reduce the risk of postoperative infection.

[Study on Technical Risks and Primary Responsibility of Medical Artificial Intelligence Diagnosis Products under Strategy of "Healthy China"].

OBJECTIVE: It provides reference for accurate and efficient supervision of medical artificial intelligence industry. METHODS: By summarizing the main responsibility dilemma of medical artificial intelligence diagnosis products, sorting out relevant researches at home and abroad, the primary responsibility system of medical artificial intelligence diagnosis products is constructed. RESULTS: A medical artificial intelligence diagnosis products primary responsibility system with the marketing authorization holder as the "first responsible person" is established, and three safeguard measures are proposed, namely, algorithm transparency and interpretability, classification supervision mode and social co-governance supervision mode. CONCLUSIONS: The medical artificial intelligence diagnosis products primary responsibility system is helpful to implement the primary responsibility, to build "responsible and beneficial" artificial intelligence, and to realize "self-discipline", "good governance" and "in good order".

Study on Technical Risks and Primary Responsibility of Medical Artificial Intelligence Diagnosis Products under Strategy of "Healthy China" / 中国医疗器械杂志

OBJECTIVE@#It provides reference for accurate and efficient supervision of medical artificial intelligence industry.@*METHODS@#By summarizing the main responsibility dilemma of medical artificial intelligence diagnosis products, sorting out relevant researches at home and abroad, the primary responsibility system of medical artificial intelligence diagnosis products is constructed.@*RESULTS@#A medical artificial intelligence diagnosis products primary responsibility system with the marketing authorization holder as the "first responsible person" is established, and three safeguard measures are proposed, namely, algorithm transparency and interpretability, classification supervision mode and social co-governance supervision mode.@*CONCLUSIONS@#The medical artificial intelligence diagnosis products primary responsibility system is helpful to implement the primary responsibility, to build "responsible and beneficial" artificial intelligence, and to realize "self-discipline", "good governance" and "in good order".

Exploration and practice of attending physician responsibility system under the background of China′s medical reform / 中华医院管理杂志

As an advanced medical management mode, attending physician responsibility system is an important means for public hospitals to promote refined management. The authors analyzed the characteristics and problems of the three-level rounds system, sorted out the concept and feasibility of attending physician responsibility system, summarized the exploration and practice of the attending physician in China, and put forward some suggestions on the implementation path of attending physician in China by strengthening medical quality management, making fully reasonable use of hospital resources, carrying out " two permits" and improving the supporting management system of the attending physician.

Testing the joint health and safety committee assessment tool in the education sector.

Joint Health and Safety Committee (JHSC) effectiveness has been identified as an area of concern for Ontario's education sector. The JHSC Assessment Tool has been previously tested in hospitals with positive results. This study assessed the feasibility and usability of the JHSC Assessment Tool in the education sector. Members of multi-workplace JHSCs from Ontario school boards used the tool to assess their committees' effectiveness before, during and after a committee meeting with usability testing conducted pre and post meeting. Results suggested that the JHSC Assessment Tool was feasible to use during a regular JHSC meeting, groups were able to come to consensus on the majority of items, and usability scores were high overall. Participant feedback provided insight that informed the development of a version relevant to multi-workplace committees.

The Principle of Government Accounting Reform was Applied in the Accounting Practice of Public Hospitals / 中国卫生经济

It analyzed the differences between hospital accounting system and government accounting system and focused on the possible problems of public hospitals in the implementation of government accounting. It made a thorough consideration on the formulation of the sup-plementary provisions of the hospital government accounting system suitable for the characteristics of the industry, fully demonstrated the ad-vancement and feasibility of the system achievements in the field of management accounting such as total cost accounting in the accounting of system of public hospitals, and put forwards that public hospitals should give full play to their practice in the field of the government account-ing. The role of the information platform through the integration of integration and construction, leading the government accounting reform to create a new station.

The Application of Performance Budget in Public Hospital Management / 中国卫生经济

Performance budgeting has been the direction of public budget reform in recent years.It is based on the performance,the target responsibility system,comprehensive budget management and performance evaluation of organic integration,broaden the management of new ideas.The application of performance budget in public hospital management has great significance to optimize the allocation of resources and improve management performance.

The Application of Performance Budget in Public Hospital Management / 中国卫生经济

Performance budgeting has been the direction of public budget reform in recent years.It is based on the performance,the target responsibility system,comprehensive budget management and performance evaluation of organic integration,broaden the management of new ideas.The application of performance budget in public hospital management has great significance to optimize the allocation of resources and improve management performance.

The clinical application of the nursing management model of doctor-nurse same group responsibility system in treating patients receiving TIPS / 介入放射学杂志

Objective To discuss the clinical application of the nursing management mode of doctornurse same group responsibility system in treating patieuts who are receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods A total of 70 TIPS patieots,who were admitted to a certain level Ⅲ hospital during the period from January 2016 to December 2016,were enrolled in this study.Using the table of random number,the patients were equally divided into the control group and the study group with 35 patients in each group.Traditional nursing group management mode was adopted in the control group,while doctor-nurse same group responsibility system was carried out in the study group (including the hospitalization period and the follow-up visit after discharge).Complications during hospitalization,postdischarge incidence of hepatic encephalopathy,readmission rate,and patient's satisfaction with medical staff were calculated,and the results were compared between the two groups.Results After the implementation of doctor-nurse same group responsibility system,the post-TIPS complications,the post-discharge incidence of hepatic encephalopathy and the readmission rate were significantly decreased and the patient's satisfaction with medical staff was remarkably improved,the differences were statistically significant (P＜0.05).Conclusion The implementation of doctor-nurse same group responsibility management mode for TIPS patients in the interventional ward can effectively reduce postoperative complications,post-discharge incidence of hepatic encephalopathy and the readmission rate,meanwhile,the patient's satisfaction with medical staff are obviously improved.Therefore,the implementation of doctor-nurse same group responsibility management mode for TIPS patients is of great value in clinical practice.

Discussions on management of director 's target responsibility system of scientific research institutions, taking China academy of Chinese medical sciences as an example / 国际中医中药杂志

Based on the analysis of the management of Director 's target responsibility system in China Academy of Chinese Medical Sciences these years, the methods and experience were introduced in this paper. How to further improve the management was also discussed, providing a certain reference for the target responsibility system management of scientific research institutes.

Application and exploration of master teacher responsibility system in neurology curriculum reform / 中华医学教育探索杂志

Objective To discuss the effect and application value of applying the master teacher responsibility system in neurology teaching. Methods 100 five-year medical students were randomly di-vided into the experimental group and the control group with computer. Master teacher and teaching team were set in the experimental group to use a variety of teaching methods for course-teaching. At the same time, the traditional teaching method was used in the control group. After the course, theory test was arranged for the two groups blindly. Statistic tool SPSS 13.0 of t test was used to evaluate the teaching effect of these two groups. And capability-oriented questionnaire survey for experimental group was conducted to survey students' subjective assessment of their own learning. Results The experimental group students' average score of the theory examination was (73.87±7.12), while control group students' average score was (73.18± 9.94), and the difference was not statistically significant (t=0.265, P=0.792). Besides, there was no signifi- cant difference in the scores of male and female students in the experimental group either (t=0.068, P=0.947). Teaching satisfaction survey results showed that 100% (16/16) of the experimental group students believed that their ability of autonomous learning, problem analysis and team cooperation was improved significantly. Conclusion Setting up master teacher responsibility system is beneficial to strengthening teacher team and cultivating students' autonomous learning ability, and it also ensures the fairness of the exam. But it still need to be improved in the quality of teachers, quantity of students, process supervision and so on to ensure the teaching effect.

Effect of responsibility system of family doctors for patients with diabetic retinopathy / 中国基层医药

Objective To explore the effect of responsibility system of family doctors( RSFD) for community management of the patients with diabetic retinopathy ( DR ) .Methods Fifty -two cases with non -proliferative diabetic retinopathy( NPDR) found in annual health examination in community health care centers were selected and randomly divided into intervention group(30 cases) and control group(22 cases).The intervention group received RSFD service mode and the control group received conventional management mode for 1 year.Patients'visual acuity, fundus,fasting blood-glucose(FBG),glycosylated haemoglobin(HbA1c) were observed and compared before and after intervention.Results In this study,the efficacy in improving patients'visual acuity and retinopathy was 73.3%in the intervention group and 45.5%in the control group,there was statistically significant difference between the two groups(χ2 =4.168,P=0.041).Before intervention,the control rates of patients'FBG were 36.4% and 30.0%respectively,and HbA1c was 27.3%and 33.3%.There were no statistically significant differences between the two groups(P>0.05).After intervention,the control rates of patients'FBG and HbA1c were 86.6% and 80.0% in intervention group,and 59.1%and 54.5%in the control group,there were statistically significant differences between the two groups (χ2 =5.147,P=0.023;χ2 =3.861,P=0.049).Conclusion RSFD service mode was conductive to control patients'blood sugar and improve visual acuity and retinopathy,we could disseminate and apply it to manage-ment of DR in community.

The application of medical coordination and hierarchical responsibility system in interventional ward nursing / 介入放射学杂志

Objective To discuss the clinical application of medical coordination and hierarchical responsibility system in interventional nursing care which is carried out based on the “Henan Province Model”. Methods From November 2003 to April 2014 at authors’ hospital, medical coordination and hierarchical responsibility system was executed through setting up a ranking system of nursing position , optimizing shift process , dividing physician-nurse medical liability groups , strengthening medical training , implementing medical coordination service mode, etc. The clinical results were compared with those of conventional nursing care that were recorded during the period from May to Oct. of 2013. Results After implementation of medical coordination and hierarchical responsibility system, the quality of medical care, the patent’s satisfaction, the cooperation satisfaction of physicians and nurses were significantly improved. Compared with those before implementation of medical coordination and hierarchical responsibility system , the differences in the above indexes were statistically significant(P<0.01 or P<0.05). Conclusion Based on multidisciplinary joint diagnosis and treatment, and combined with coordination physician-nurse service mode, the enthusiasm of nursing staff can be motivated and the tacit understanding between physicians and nurses as well as the quality of nursing service can be improved. All of the above will promote the development of nursing discipline.

The effect of attending physician responsibility system in the department teaching management / 中华医学教育探索杂志

Objective To evaluate the effect of the department teaching management by using attending physician responsibility system. Methods Eight teachers were scored using the teaching management quantitative scoring standard before and after the implementation ofattending physician responsibility system. Score data of 12 months before the implementation ofattending physician respon-sibility system was defined as the control group, while the score data of 12 months after the implemen-tation ofattending physician responsibility system was defined as the study group. Groups were compared by using the paired t-test and P0.05). Compared with the control group, there was significant statistical difference between the two groups in the senior grade and intermediate grade (P<0.05). Conclusion The attending physician responsibility systemfor teaching management is an effective way to improve the teaching management level.

Influence of the management of family-doctor responsibility system on drug utilization and compliance of hypertensive patients / 中国实用护理杂志

Objective To discuss the influence of the management of family-doctor responsibility system on drug utilization and compliance of hypertensive patients.Methods 1039 primary hypertension patients in Zhenhai Lianhua Community who were under the management of the residents electronic health files in June 2012,were implemented with the latest family-doctor responsibility system for eight months.The on-site questionnaire survey and electronic health management platform were carried out to analyze the drug utilization and treatment compliance of hypertensive patients.Results The proportion of taking medicine treatment among 1039 patients with essential hypertension reached 85.2％,including 56.3％ patients who took one kind of drug,35.4％ patients who took two kinds of drugs and 8.3％ patients who took at least three kinds of drugs.The most commonly used drugs were Amlodipine Besylate,Felodipine,Irbesartan and Hydrochlorothiazide tablets,Irbesartan,Levamlodipine Besylate tablets,Metoprolol Tartrate tablets and etc.The rate of patient compliance was 65.5％.After comparing the compliance of any two among three kinds of drug groups,the comparison of compliance between patients who took one kind,two or three kinds of drugs showed statistical significance.The comparison of drug types and compliance showed that compliance with compound preparation was statistically different from compliance with ARB,calcium antagonists,sympatholytic agent,diuretics.The educational level was also related to the compliance.Conclusions After the implementation of the family-doctor responsible management,the treatment rate and compliance rate are high,and the patients with hypertension in community still give priority to long-acting drugs.