Bootstrapping Data Envelopment Analysis of Efficiency and Productivity of County Public Hospitals in Eastern, Central, and Western China after the Public Hospital Reform

China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Possessions Ceded for the Benefit of the Hospitals and Churches From the Sighisoara County

Transilvania is a province of the actual state of Romania, geographically situated in the middle of the country, in the inner arch of the Carpathians. Starting with the 10th century, the territory of Transilvania became attractive for the neighboring Hungarian royalty and later on, in the 1 lth century it was annexed into Hungary. For a better control of the newly annexed territory and in order to convert the orthodox population to Catholicism, the Hungarian rulers brought the Szeklers to Transilvania and two centuries later, German originating populations, from Rhine, Luxemburg, and Saxony （the name of Sas people, or Saxon of Transilvania derives from ＂Saxony＂）. The aim of this paper is to focus on the Sighisoara County, namely on the easement of certain areas for temporary or permanent maintenance or use by the church and hospitals in the region. That was a common practice in Medieval Europe aimed at ensuring the survival means for these institutions. However, it was not the only one to serve this goal. There were also donations on behalf of various people or allocations of money by the county authorities. The documents attesting this are unpublished, unedited and are to be found in the archives of the Brasov County, Budapest, and Vienna. They are the stepping stone of this paper and hence, they grant its originality. The objectives of the paper are to bring arguments in favor of the thesis that community money was directed towards meeting the needs of the hospitals, as well as towards supporting the widows, the orphans, and the needy ones. Worth noting in this respect is the management of the funds ceded to the church and county hospitals and that actually benefitted the whole community. Moreover, the paper also emphasizes the role played by education, since the latter is an important landmark for a community＇s development level

Attributes of Specialized Households'Resilience and Its Impact on Rural Industrial Advancement:A Case Study of National Musical Instrument Production Specialized Households in Lankao County,Henan,China

Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.

Spatial Equity Evaluation of Rural Eldercare Service Resources Based on Accessibility: A Case Study of Huanxian County of Gansu Province, China

Safeguarding the elderly population in the countryside is an inherent requirement for alleviating social conflicts in rural areas and effectively carrying out China’s Rural Revitalization.The existing spatial mismatch between rural elderly service facilities and pop-ulation distribution in China aggravates the imbalance of facility resource space,how to improve the accuracy of demand and supply results and better measuring the spatial fairness of elderly service is significant to realize the optimal allocation of rural elderly service.Based on the above,this study pays attention to the refined needs of the elderly population,and focuses on the spatial equity of the rural elderly facilities,to make up for the short boards of the basic public services in the countryside and realize the all-round rural revitalization.This study takes Huanxian County in the hilly loess area of Longdong,China as an example and explores the spatial equity of rural elderly services by using the Urban Spatial Network Analysis(UNA)to measure the accessible quantity and supply capacity of elderly services.The results found that there were 553 rural eldercare service facilities in Huanxian County,including 285 eldercare facilities and 268 medical and health facilities,and the spatial distribution is characterized by a southward shift in the east and uneven regional distribution.Overall,the supply capacity of rural pension services was generally good,with the township center as the gathering point and spreading out in a faceted manner,with nearby townships forming a contiguous area;however,there were strong contrasts and obvious differences in the strength of supply capacity.However,the spatial equity of rural eldercare service was poor.In 42.05%of the eld-erly population grid cells,eldercare service spatial equity was extremely low.The spatial distribution also presented a northern preference over the southern,a western preference over the eastern,and a concentration along the highway.The study explored the realization of spatial equity in the optimal allocation of rural elderly services based on paying attention to the refined needs of the rural elderly pop-ulation,a vulnerable group,to provide a reference for solving the shortcomings of basic public services in rural areas.The fair allocation of rural elderly services demands that the spatial optimization of facility layout be organically coordinated with policy,management,and post-maintenance,and all elements in the rural territorial system be fully mobilized to achieve the basic guarantee of China’s rural elderly problems.

Development of Self-Rated Nursing Record Frequency for Delirium Care of Nurses in Acute Care Hospitals (NRDC-Acute)

Background: Nursing records play an important role in multidisciplinary collaborations in delirium care. This study aims to develop a self-rated nursing record frequency scale for delirium care among nurses in acute care hospitals (NRDC-Acute). Methods: A draft of the scale was developed after a literature review and meeting with researchers with experience in delirium care, and a master’s or doctoral degree in nursing. We identified 25 items on a 5-point Likert scale. Subsequently, an anonymous self-administered questionnaire survey was administered to 520 nurses from 41 acute care hospitals in Japan, and the reliability and validity of the scale were examined. Results: There were 232 (44.6%) respondents and 218 (41.9%) valid responses. The mean duration of clinical experience was 15.2 years (SD = 8.8). Exploratory factor analysis extracted 4 factors and 13 items for this scale. The model fit indices were GFI = 0.991, AGFI = 0.986, and SRMR = 0.046. The Cronbach’s alpha coefficient for the entire scale was .888. The four factors were named “Record of Pharmacological Delirium Care on Pro Re Nata (PRN)”, “Record of Non-Pharmacological Delirium Care”, “Record of Pharmacological Delirium Care on Regular Medication”, and “Record of Collaboration for Delirium Care”. Conclusion: The scale was relatively reliable and valid. Nurses in acute care hospitals can use this scale to identify and address issues related to the documentation of nursing records for delirium care.

Mapping Air Quality Using Remote Sensing Technology: A Case Study of Nairobi County

Nairobi County experiences rapid industrialization and urbanization that contributes to the deteriorating state of air quality, posing a potential health risk to its growing population. Currently, in Nairobi County, most air quality monitoring stations use low-cost, inaccurate monitors prone to defects. The study’s objective was to map Nairobi County’s air quality using freely available remotely sensed imagery. The Air Pollution Index (API) formula was used to characterize the air quality from cloud-free Landsat satellite images i.e., Landsat 5 TM, Landsat 7 ETM+, and Landsat 8 OLI from Google Earth Engine. The API values were computed based on vegetation indices namely NDVI, TVI, DVI, and the SWIR1 and NIR bands on the QGIS platform. Qualitative accuracy assessment was done using sample points drawn from residential, industrial, green spaces, and traffic hotspot categories, based on a passive-random sampling technique. In this study, Landsat 5 API imagery for 2010 provided a reliable representation of local conditions but indicated significant pollution in green spaces, with recorded values ranging from -143 to 334. The study found that Landsat 7 API imagery in 2002 showed expected results with the range of values being -55 to 287, while Landsat 8 indicated high pollution levels in Nairobi. The results emphasized the importance of air quality factors in API calibration and the unmatched spatial coverage of satellite observations over ground-based monitoring techniques. The study recommends the recalibration of the API formula for characteristic regions, exploring newer satellite sensors like those onboard Landsat 9 and Sentinel 2, and involving key stakeholders in a discourse to develop a suitable Kenyan air quality index.

Automated machine learning for rainfall-induced landslide hazard mapping in Luhe County of Guangdong Province,China

Landslide hazard mapping is essential for regional landslide hazard management.The main objective of this study is to construct a rainfall-induced landslide hazard map of Luhe County,China based on an automated machine learning framework(AutoGluon).A total of 2241 landslides were identified from satellite images before and after the rainfall event,and 10 impact factors including elevation,slope,aspect,normalized difference vegetation index(NDVI),topographic wetness index(TWI),lithology,land cover,distance to roads,distance to rivers,and rainfall were selected as indicators.The WeightedEnsemble model,which is an ensemble of 13 basic machine learning models weighted together,was used to output the landslide hazard assessment results.The results indicate that landslides mainly occurred in the central part of the study area,especially in Hetian and Shanghu.Totally 102.44 s were spent to train all the models,and the ensemble model WeightedEnsemble has an Area Under the Curve(AUC)value of92.36%in the test set.In addition,14.95%of the study area was determined to be at very high hazard,with a landslide density of 12.02 per square kilometer.This study serves as a significant reference for the prevention and mitigation of geological hazards and land use planning in Luhe County.

Practical Research on Promoting the Reform of“One Field for One Household”in Guoyang County

In recent years,the problem of farmland fragmentation has become a major obstacle to the development of modern agriculture,and the reform of“one field for one household”can effectively sort out cultivated land resources,increase contracted land area,improve land utilization rate,and effectively solve the problems of contracted land dispersion and farmland fragmentation in rural areas.This paper systematically anatomized the practice and effects of“one household,one field”reform in Guoyang County,analyzed the problems existing in the implementation process,and put forward corresponding suggestions and countermeasures,in order to provide experience and reference for the reform of one field in other regions.

Allocation of Public Service Facilities in Villages and Towns from the Perspective of Smart Contraction: A Case Study of Zixi County, Jiangxi Province

The limitation of traditional layout system and the continuous contraction of villages and towns have brought challenges to the layout of public service facilities.It is an imperative task against this background to integrate space resources and allocate public service facilities scientifically and reasonably.This paper took the system and method of rural public service facility allocation from the perspective of smart contraction as the theoretic support,and Zixi County in Jiangxi Province for example,built the four-level life circle of“county-fundamental-basic-routine”based on the influence factors of facility allocation,village and town contraction strength,rural comprehensive assessment results,residents’trip willingness and demands on public service facilities,finally proposed the suggestions for optimizing the allocation of village and town public service facilities.

Research on the Reform of"Separation of Three Rights"for Rural Homesteads in Juancheng County,Shandong Province

In order to realize rural revitalization in an all-round way and promote the sustainable and healthy development of the economy and society,China is committed to deepening the pace of building a new countryside with Chinese characteristics.The reform of the"Separation of Three Rights"of rural homesteads is a key measure,which aims to activate rural resources,enhance the vitality of rural economic development,and then promote the overall process of rural revitalization.This study selects Juancheng County,Heze City,Shandong Province as a typical case.Through an in-depth analysis of the relevant policy orientation of the national homestead reform and the specific practice of local promotion work,it systematically sorts out the registration of homestead rights,transfer of use rights and relevant policy measures adopted in paid use,qualification conversion,policy publicity and system establishment.After in-depth research on the system reform practice of the"Separation of Three Rights"of homesteads in Juancheng County,this paper reveals the main problems existing in the current reform,including the lack of clear policy support for the mechanism of paid use of homesteads,difficulties in the process of identifying qualification rights and challenges,the imperfection of the transfer mechanism of use rights,and the lack or lag of relevant policies.A series of problem-oriented policy suggestions are put forward,including establishing and improving the system of paid use of rural homesteads,improving the income distribution mechanism,promoting the innovation of the mortgage guarantee system for the right to use homesteads,and optimizing the homestead qualification certification procedures.These suggestions aim to provide a useful reference for the Juancheng County Government in promoting the reform of"Separation of Three Rights"of homesteads,and then promote the rational allocation and efficient utilization of rural homestead resources.

Ethnic Customs and Rural Tourism Development in Xinbin Manchu Autonomous County of Fushun City

The development of ethnic minority tourism is currently a hot topic in domestic tourism development.As an important component of Chinese civilization,the Manchu people have created brilliant culture in the long river of historical development.As the hometown of the Manchu people,Fushun has unique folk cultural tourism resources and a strong ethnic flavor.Nowadays,under the promotion of the rural revitalization strategy,the construction of new rural areas is constantly developing,and rural tourism is gradually becoming a new industry.Therefore,in the context of the increasingly prosperous rural tourism industry,it has become increasingly important to combine the ethnic customs of Manchu culture with rural tourism.Taking the ethnic customs and integrated development of rural tourism in Xinbin Manchu Autonomous County of Fushun City,Liaoning Province as the research object,this paper mainly sorts out the current situation and characteristics of rural tourism development in the region,systematically explores the problems in development and how to further optimize development,and proposes new models suitable for the development of folk tourism in Xinbin of Fushun,in order to achieve maximum economic and social benefits and provide a reference for promoting the development of tourism in the region.

Machine Learning and Statistical Analysis in Groundwater Monitoring for Total Dissolved Solids Assessment in Winkler County, Texas

This research aims to develop reliable models using machine learning algorithms to precisely predict Total Dissolved Solids (TDS) in wells of the Permian basin, Winkler County, Texas. The data for this contribution was obtained from the Texas Water Development Board website (TWDB). Five hundred and ninety-three samples were obtained from two hundred and ninety-eight wells in the study area. The wells were drilled at different county locations into five aquifers, including Pecos Valley, Dockum, Capitan Reef, Edward Trinity, and Rustler aquifers. A total of fourteen different water quality parameters were used, and they include Potential hydrogen (pH), Sodium, Chloride, Magnesium, Fluoride, TDS, Specific Conductance, Nitrate, Total Hardness, Calcium, Temperature, Well Depth, Sulphate, and Bicarbonates. Four machine learning regression algorithms were developed to get a good model to help predict TDS in this area: Decision Tree regression, Linear regression, Support Vector Regression, and K-nearest neighbor. The study showed that the Decision Tree produced the best model with attributes like the coefficient of determination R2 = 1.00 and 0.96 for the training and testing, respectively. It also produced the lowest score of mean absolute error MAE = 0.00 and 0.04 for training and testing, respectively. This study will reduce the cost of obtaining different water quality parameters in TDS determination by leveraging machine learning to use only the parameters contributing to TDS, thereby helping researchers obtain only the parameters necessary for TDS prediction. It will also help the authorities enact policies that will improve the water quality in areas where drinking water availability is a challenge by providing important information for monitoring and assessing groundwater quality.

Current Status and Challenges of the Water and Soil Conservation in Hotan County, Xinjiang

In order to thoroughly analyze the current status and challenges faced by the water and water conservation in Hotan County of Xinjiang,the use situation of water resources,the effectiveness and shortcomings of water and soil conservation work in the region are reviewed.Hotan County has achieved several remarkable achievements in the soil and water conservation project,daily management and maintenance,and ecological restoration projects.Some measures,such as terrace construction,slope protection engineering,and the construction of windproof and sandwood belts,have also had a positive impact on improving the quality of surface water resources while effectively curbing soil erosion.But there are also lack of operating policy detailed rules and implementation plans,and planning and design of some water and soil conservation projects lack of integrity and systematicness,application and promotion of new technologies,and soil loss management and ecological recovery effect assessment lack of comprehensive assessment indicators and methods.It has caused some water and soil conservation works to fail to be effectively implemented.In this regard,countermeasures and suggestions are put forward,such as strengthening the planning and management of water and soil conservation,promoting the technology and measures of water and soil conservation,increasing investment and funding support,and strengthening publicity education and personnel training.

Current Situation and Countermeasures of Household Waste Classification in Feixi County, Hefei City

Feixi County has made significant progress in promoting waste classification,such as establishing a comprehensive classification system,and effectively reducing environmental pollution and waste volume.However,with the increase in waste generation,the county faces multiple challenges especially in the disposal of kitchen waste and improvement of residents environmental awareness.To address these issues,Feixi County has implemented various measures,such as strengthening the construction of infrastructure for waste classification,improving regulations and clearly defining responsibilities,enhancing residents environmental awareness to encourage their participation in waste classification through education and promotion,and increasing supervision to ensure effective implementation of the work.It emphasizes community governance,encourage all parties to participate in it,and strengthen publicity,education and training to enhance residents participation.Feixi County has achieved positive results,but efforts are needed to further improve facilities,raise awareness,enhance supervision,and ensure the continuous effectiveness of waste classification work to promote urban green sustainable development.

Theoretical Analysis and Practical Reflection on the Role Conflict of Double-Qualified Teachers in University-Affiliated Hospitals

Taking role conflict as the starting point,this article examines and reflects on the development of clinical teachers.In the process of the occurrence,development,and resolution of role conflicts among clinical teachers,there are many hidden issues related to the development of clinical teachers.The development of clinical teacher teaching and role conflict management contain similar educational philosophies and practical issues.This study draws on classic theories and research achievements in the development of university teachers and conducts theoretical analysis and practical reflection on the development of clinical teachers in medical colleges from the perspective of role conflict in social psychology.Policy recommendations are proposed,including strengthening the construction of teaching systems at the hospital organizational environment level,enhancing the role identity and teacher beliefs of clinical teachers,promoting their teaching development and academic learning,and ensuring their normal teaching investment;promoting leadership support at the level of interpersonal interaction and leveraging the role of colleague support in alleviating role conflicts;enhancing individual teacher beliefs,teacher role learning,and role skills.

Exploration of Teaching Development Strategies for Double-Qualified Teachers in University- Affiliated Hospitals Based on Role Conflict Theory

This study draws on the classic theories and research achievements of university teacher development,and from the perspective of role conflict in social psychology,proposes policy recommendations for the development of clinical teachers in medical colleges,including following different stages of teacher development and designing teaching development strategies at different levels;designing the content and form of teaching development activities to meet the temporal and spatial needs of clinical teachers;and building an academic community for clinical teachers to promote the creation of teaching development behaviors.

Study on the Changes of Medical Income Structure in Governmentrun Hospitals of Traditional Chinese Medicine from 2012 to 2021

Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.

Eco county construction in China

The county is recognized as a basic unit for implementation of the strategy for sustainable development. A campaign for construction of eco county has been developed all over China since the 1990s. It is aimed to enhance sustainable development capacity of the county by establishing ecologically sound production system and management mechanism through eco engineering, eco planning and eco management. It is a complicated systems engineering and a combination of multi disciplinary and needs the most extensive participation of decision makers, technicians, and farmers. Construction of eco county consists of many important works such as survey, systems diagnosis, planning, demonstration, implementation and assessment. In this paper, we will try to summarize the current status, main models in different regions, procedure of construction, and introduce the eco agriculture county construction in detail by taking Dazu County of Sichuan Province as an example.

Study on salary level of medical doctors in county-level public hospitals and related influencing factors

This study aimed to investigate the salary status of medical doctors who work in county-level hospitals, and analyze the existing problems. We collected the data from questionnaires and applied both EXCEL and SPSS to conduct analysis. Doctors working in county level-hospitals received relatively lower salaries, with 78.5% of the doctors making lower than 5000 RMB per month. Influencing factors for the salary levels included personal factors, attributes of the hospitals, workload and performance appraisal. Reasonable adjustment for the salary levels is needed to refine important elements of salary distribution, and to construct a rational performance appraisal system.