Background Previous studies have shown that educational attainment(EA),intelligence and income are key factors associated with mental disorders.However,the direct effects of each factor on major mental disorders are u...Background Previous studies have shown that educational attainment(EA),intelligence and income are key factors associated with mental disorders.However,the direct effects of each factor on major mental disorders are unclear.Aims We aimed to evaluate the overall and independent causal effects of the three psychosocial factors on common mental disorders.Methods Using genome-wide association study summary datasets,we performed Mendelian randomisation(MR)and multivariable MR(MVMR)analyses to assess potential associations between the 3 factors(EA,N=766345;household income,N=392422;intelligence,N=146808)and 13 common mental disorders,with sample sizes ranging from 9907 to 807553.Inverse-variance weighting was employed as the main method in the MR analysis.Results Our MR analysis showed that(1)higher EA was a protective factor for eight mental disorders but contributed to anorexia nervosa,obsessive-compulsive disorder(OCD),bipolar disorder(BD)and autism spectrum disorder(ASD);(2)higher intelligence was a protective factor for five mental disorders but a risk factor for OCD and ASD;(3)higher household income protected against 10 mental disorders but confers risk for anorexia nervosa.Our MVMR analysis showed that(1)higher EA was a direct protective factor for attention-deficit/hyperactivity disorder(ADHD)and insomnia but a direct risk factor for schizophrenia,BD and ASD;(2)higher intelligence was a direct protective factor for schizophrenia but a direct risk factor for major depressive disorder(MDD)and ASD;(3)higher income was a direct protective factor for seven mental disorders,including schizophrenia,BD,MDD,ASD,post-traumatic stress disorder,ADHD and anxiety disorder.Conclusions Our study reveals that education,intelligence and income intertwine with each other.For each factor,its independent effects on mental disorders present a more complex picture than its overall effects.展开更多
AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career...AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.展开更多
Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this rel...Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .展开更多
Transportation accessibility has been treated as an important means of reducing the urban-rural income disparity.However,only a few studies have examined the effects of different types of transportation accessibility ...Transportation accessibility has been treated as an important means of reducing the urban-rural income disparity.However,only a few studies have examined the effects of different types of transportation accessibility on urban-rural income disparity and their spatial heterogeneity.Based on data from 285 prefecture-level(and above)Chinese cities in 2000,2005,2010,2015,and 2020,this study uses spatial econometric models to examine how highway accessibility and railway accessibility influence the urban-rural income disparity and to identify their spatial heterogeneity.The result reveals that highway accessibility and railway accessibility have‘coreperiphery’ring-like circle structures.The urban-rural income disparity exhibits strong spatial clustering effects.Both highway accessibility and railway accessibility are negatively associated with urban-rural income disparity,and the former having a greater effect size.Moreover,there is a substitution effect between highway accessibility and railway accessibility in the whole sample.Furthermore,these associations differ in geographic regions.In the central region,highway accessibility is more important in reducing the urban-rural income disparity,but its effect is weakened with the increase of railway accessibility.In the western region,railway accessibility has a larger effect on narrowing the urban-rural income disparity,and this effect is strengthened by the increase of highway accessibility.We conclude that improving transportation accessibility is conducive to reducing the urban-rural income disparity but its effect is spatial heterogenetic.Highways and railways should be developed in a coordinated manner to promote an integrated transport network system.展开更多
Using cross-sectional data from 853 counties in 11 western China provinces, we employ quantile regression (QR) and instrumental variable quantile regression (IVQR) to investigate the hierarchical effect of fiscal ...Using cross-sectional data from 853 counties in 11 western China provinces, we employ quantile regression (QR) and instrumental variable quantile regression (IVQR) to investigate the hierarchical effect of fiscal expenditure and agricultural loan on rural residents' income. We find: (1) the relationship between agricultural loan and income is consistent with the inverted U-shape (Kuznets curve); (2) the coefficient of quantile regression for rural residents' loan gradually decreases; particularly, the impact on the high-income group is insignificant (at 0.90 quantile); (3) for 0.10 and 0.50 quantile, the increase of fiscal expenditure would hinder rather than promote income growth; (4) the restraining effect becomes more pronounced for the lower groups; in contrast, there is a significant positive relationship between income and fiscal expenditure for 0.90 quantile's income group. Implications for government policy formulation are propounded accordingly.展开更多
In light of the rapid expansion of China s economy,there has been a notable shift in the consumption patterns of urban and rural residents.This is evident in the increased consumption of agricultural products,with fru...In light of the rapid expansion of China s economy,there has been a notable shift in the consumption patterns of urban and rural residents.This is evident in the increased consumption of agricultural products,with fruit consumption representing a particularly pronounced trend.The 2023 Beijing Consumption Statistics indicate that demand for fruit is increasing,accompanied by heightened competition for quality and brands.The paper is based on research that examines the current situation of fruit consumption among urban and rural residents in Beijing.The results indicate that when urban and rural residents in Beijing purchase fruits,price is the most significant factor influencing fruit consumption.Taste,appearance,and variety are also considered to be important influencing factors,while the influence of factors such as fruit type,consumption pattern,and fruit brand is relatively minor.展开更多
The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018...The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018,this paper measured the development level of the digital economy in China from the perspectives of internet development and digital financial inclusion,and tested the mechanisms of how the digital economy affected rural residents’working hours.The results showed that the digital economy extended rural residents’working hours by expanding information channels and enhancing human capital,and this mechanism was affected by heterogeneity in rural residents’educational background,age,and social capital.Building on these findings,this paper holds that to increase rural residents’income by extending their working hours and achieving common prosperity for all,it is necessary to expand the opportunities for rural residents to participate in skills training and promote their accumulation of human capital.展开更多
Using the CHDES database,we created the CIDI to comprehensively quantify digital adoption at the individual level and examine digitalization’s impact on individual income.Empirical analysis results indicate that incr...Using the CHDES database,we created the CIDI to comprehensively quantify digital adoption at the individual level and examine digitalization’s impact on individual income.Empirical analysis results indicate that increasing the CIDI by one standard deviation(0.13)improves individual income by 5.93 percentage points,which remains true after a series of endogeneity and robustness tests.In the heterogeneity analysis,we discovered that when digital adoption grows,residents in the countryside and county seats can earn more money through internet business operations and other channels.This helps to decrease the urban-rural income divide,but it has also pushed those digitally skilled into high-paying sectors,widening the income gaps between sectors.In the mechanism analysis,we developed an income function that takes into account the individual level of digitalization to show that digitalization can boost income by increasing working hours or labor participation and adjusting the portfolio of individual material,human,and social capital.In this paper,we have expanded the system for measuring the individual levels of digitalization by offering basic data,research methodology,and policy suggestions for the digital economy’s inclusive development.展开更多
Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transg...Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.展开更多
BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is b...BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.展开更多
BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low-or middle-income countries(LMICs).A better understanding of maternal general healthy nutrition knowledge,as well as misbeli...BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low-or middle-income countries(LMICs).A better understanding of maternal general healthy nutrition knowledge,as well as misbeliefs,is highly essential,especially in such settings.In the current era of infodemics,it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well.AIM To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC,and to determine the sources of such information and their assessment methods.METHODS This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old.The data were collected through online questionnaire forms:One was for the general nutrition knowledge assessment,and the other was for the nutritional myth score.Sources of information and ways of evaluating internet sources using the Currency,Relevance,Authority,Accuracy,and Purpose test were additionally analyzed.RESULTS The mean general nutrition knowledge score was 29±9,with a percent score of 70.8%±12.1%(total score:41).The median myth score was 9(interquartile range:6,12;total score:18).The primary sources of nutrition knowledge for the enrolled mothers were social media platforms(55%).Half of the mothers managed information for currency and authority,except for considering the author's contact information.More than 60%regularly checked information for accuracy and purpose.The mothers with significant nutrition knowledge checked periodically for the author's contact information(P=0.012).The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information(P=0.016).Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13%(P=0.044).However,using social media increased the likelihood of having myths among mothers by approximately 1.2(P=0.001).CONCLUSION Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics.However,healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.展开更多
The consumer price index (CPI) measures the relative number of changes in the price level of consumer goods and services over time, reflecting the trend and degree of changes in the price level of goods and services p...The consumer price index (CPI) measures the relative number of changes in the price level of consumer goods and services over time, reflecting the trend and degree of changes in the price level of goods and services purchased by residents. This article uses the ARMA model to analyze the fluctuation trend of the CPI (taking Chongqing as an example) and make short-term predictions. To test the predictive performance of the model, the observation values from January to December 2023 were retained as the reference object for evaluating the predictive accuracy of the model. Finally, through trial predictions of the data from May to August 2023, it was found that the constructed model had good fitting performance.展开更多
Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group particip...Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.展开更多
As an innovative economic model,the sharing economy has seen rapid growth globally in recent years.It has not only brought a profound impact on traditional economies but also injected new vitality and momentum into th...As an innovative economic model,the sharing economy has seen rapid growth globally in recent years.It has not only brought a profound impact on traditional economies but also injected new vitality and momentum into the sustainable development of the social economy.However,for the sharing economy,the process of collecting personal income tax is facing several issues,such as the ambiguity of tax policies regarding personal income,challenges in identifying taxpayers,and difficulties in defining income.To achieve the fairness and efficiency of personal income tax collection in the sharing economy,this study proposes optimized regulatory mechanisms and conducts in-depth discussions on the adjustment of personal income tax policies,innovation in tax management technology,and improvement in the quality of personal income tax services.展开更多
In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice re...In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.展开更多
Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centr...Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.展开更多
Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing ...Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.展开更多
By using the data concerning China's urban-rural residents' income gap from 1978 to 2010,this paper mainly researches the application of several kinds of models in predicting China's urban-rural residents&...By using the data concerning China's urban-rural residents' income gap from 1978 to 2010,this paper mainly researches the application of several kinds of models in predicting China's urban-rural residents' income gap.By conducting empirical analysis,we establish ARIMA prediction model,grey prediction model and quadratic-polynomial prediction model and conduct accuracy comparison.The results show that quadratic-polynomial prediction model has excellent fitting effect.By using quadratic-polynomial prediction model,this paper conducts prediction on trend of China's urban-rural residents' income gap from 2011 to 2013,and the prediction value of income gap of urban-rural residents in China from 2011 to 2013 is 14 173.20,15 212.92 and 16 289.67 yuan respectively.Finally,on the basis of analysis,corresponding countermeasures are put forward,in order to provide scientific basis for energy planning and policy formulation:first,strengthen government's function of public service,coordinate resources,and strive to provide an equal opportunity of development for social members,so as to promote people's welfare and promote social equality;second,breach industrial monopoly and bridge income gap between employees in monopoly industry and general industry;last but not the least,support,encourage and call for government to establish social relief fund,adjust residents' income distribution from the non-governmental perspective,and endeavor to promote the income level of low-income class.展开更多
By conducting meta-analysis on the researches of relationship between income level and happiness at home and abroad,this paper researches the relationship between income level and happiness.The results show that the r...By conducting meta-analysis on the researches of relationship between income level and happiness at home and abroad,this paper researches the relationship between income level and happiness.The results show that the relationship between income level and happiness takes on U-shape curve,and it can be explained from adaptation,social comparison and psychological expectation.Finally,in order to promote rural residents' income level and strengthen rural residents' happiness in China,corresponding policy suggestions are put forward as follows:bridge gap of urban-rural residents' income distribution;dilute the competitions for money and status among people;perfect rural social security system;endeavor to create a situation in which all rural residents do their best.展开更多
This paper measures the Chinese regional income distribution gap based on the Theil index with data of 31 provinces in China from 1998 to 2011. The results showed that overall the income gap between China's rural ...This paper measures the Chinese regional income distribution gap based on the Theil index with data of 31 provinces in China from 1998 to 2011. The results showed that overall the income gap between China's rural areas was on the rise from 1998 to 2006,and the income gap was mainly caused by the gap between the East China,Central China and West China. After 2006,it showed a slow decline. The dynamic panel data model established for consumer demand,spending habits,income,regional income disparities showed that income and regional income disparities significantly influence consumer demand of rural residents. Before 2006 regional income gap inhibited the consumption of rural residents,but it promoted consumption after 2006.展开更多
基金Nanjing Medical Science and Technology Development Project(ZKX20027).
文摘Background Previous studies have shown that educational attainment(EA),intelligence and income are key factors associated with mental disorders.However,the direct effects of each factor on major mental disorders are unclear.Aims We aimed to evaluate the overall and independent causal effects of the three psychosocial factors on common mental disorders.Methods Using genome-wide association study summary datasets,we performed Mendelian randomisation(MR)and multivariable MR(MVMR)analyses to assess potential associations between the 3 factors(EA,N=766345;household income,N=392422;intelligence,N=146808)and 13 common mental disorders,with sample sizes ranging from 9907 to 807553.Inverse-variance weighting was employed as the main method in the MR analysis.Results Our MR analysis showed that(1)higher EA was a protective factor for eight mental disorders but contributed to anorexia nervosa,obsessive-compulsive disorder(OCD),bipolar disorder(BD)and autism spectrum disorder(ASD);(2)higher intelligence was a protective factor for five mental disorders but a risk factor for OCD and ASD;(3)higher household income protected against 10 mental disorders but confers risk for anorexia nervosa.Our MVMR analysis showed that(1)higher EA was a direct protective factor for attention-deficit/hyperactivity disorder(ADHD)and insomnia but a direct risk factor for schizophrenia,BD and ASD;(2)higher intelligence was a direct protective factor for schizophrenia but a direct risk factor for major depressive disorder(MDD)and ASD;(3)higher income was a direct protective factor for seven mental disorders,including schizophrenia,BD,MDD,ASD,post-traumatic stress disorder,ADHD and anxiety disorder.Conclusions Our study reveals that education,intelligence and income intertwine with each other.For each factor,its independent effects on mental disorders present a more complex picture than its overall effects.
文摘AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.
文摘Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .
基金Under the auspices of National Natural Science Foundation of China(No.42371214,42101184)Chenguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission(No.22CGA27)Funded Projects for the Academic Leaders and Academic Backbone,Shaanxi Normal University(No.18QNGG013)。
文摘Transportation accessibility has been treated as an important means of reducing the urban-rural income disparity.However,only a few studies have examined the effects of different types of transportation accessibility on urban-rural income disparity and their spatial heterogeneity.Based on data from 285 prefecture-level(and above)Chinese cities in 2000,2005,2010,2015,and 2020,this study uses spatial econometric models to examine how highway accessibility and railway accessibility influence the urban-rural income disparity and to identify their spatial heterogeneity.The result reveals that highway accessibility and railway accessibility have‘coreperiphery’ring-like circle structures.The urban-rural income disparity exhibits strong spatial clustering effects.Both highway accessibility and railway accessibility are negatively associated with urban-rural income disparity,and the former having a greater effect size.Moreover,there is a substitution effect between highway accessibility and railway accessibility in the whole sample.Furthermore,these associations differ in geographic regions.In the central region,highway accessibility is more important in reducing the urban-rural income disparity,but its effect is weakened with the increase of railway accessibility.In the western region,railway accessibility has a larger effect on narrowing the urban-rural income disparity,and this effect is strengthened by the increase of highway accessibility.We conclude that improving transportation accessibility is conducive to reducing the urban-rural income disparity but its effect is spatial heterogenetic.Highways and railways should be developed in a coordinated manner to promote an integrated transport network system.
文摘Using cross-sectional data from 853 counties in 11 western China provinces, we employ quantile regression (QR) and instrumental variable quantile regression (IVQR) to investigate the hierarchical effect of fiscal expenditure and agricultural loan on rural residents' income. We find: (1) the relationship between agricultural loan and income is consistent with the inverted U-shape (Kuznets curve); (2) the coefficient of quantile regression for rural residents' loan gradually decreases; particularly, the impact on the high-income group is insignificant (at 0.90 quantile); (3) for 0.10 and 0.50 quantile, the increase of fiscal expenditure would hinder rather than promote income growth; (4) the restraining effect becomes more pronounced for the lower groups; in contrast, there is a significant positive relationship between income and fiscal expenditure for 0.90 quantile's income group. Implications for government policy formulation are propounded accordingly.
文摘In light of the rapid expansion of China s economy,there has been a notable shift in the consumption patterns of urban and rural residents.This is evident in the increased consumption of agricultural products,with fruit consumption representing a particularly pronounced trend.The 2023 Beijing Consumption Statistics indicate that demand for fruit is increasing,accompanied by heightened competition for quality and brands.The paper is based on research that examines the current situation of fruit consumption among urban and rural residents in Beijing.The results indicate that when urban and rural residents in Beijing purchase fruits,price is the most significant factor influencing fruit consumption.Taste,appearance,and variety are also considered to be important influencing factors,while the influence of factors such as fruit type,consumption pattern,and fruit brand is relatively minor.
基金This paper is part of the Youth Program of Science and Technology Research of Chongqing Municipal Education Commission(KJQN202300545)Youth Program of National Social Science Fund of China(21CJY001)Science and Technology Research Program of Chongqing Municipal Education Commission(KJQN202300567).
文摘The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018,this paper measured the development level of the digital economy in China from the perspectives of internet development and digital financial inclusion,and tested the mechanisms of how the digital economy affected rural residents’working hours.The results showed that the digital economy extended rural residents’working hours by expanding information channels and enhancing human capital,and this mechanism was affected by heterogeneity in rural residents’educational background,age,and social capital.Building on these findings,this paper holds that to increase rural residents’income by extending their working hours and achieving common prosperity for all,it is necessary to expand the opportunities for rural residents to participate in skills training and promote their accumulation of human capital.
基金supported by the Scientific Research Fund of Renmin University of China(Special Funding Support of the Basic Scientific Research Fund for Central Universities)“Digital Economy Advancing High-Quality Development:Practice and Theoretical Perspectives”(Grant No.22XNA040)Major Task Project of the Theoretical and Social Science Research of the Ministry of Education“Study on the Industrial Subsidies and Industrial Policies of Major World Economies”(Grant No.22J2D013).
文摘Using the CHDES database,we created the CIDI to comprehensively quantify digital adoption at the individual level and examine digitalization’s impact on individual income.Empirical analysis results indicate that increasing the CIDI by one standard deviation(0.13)improves individual income by 5.93 percentage points,which remains true after a series of endogeneity and robustness tests.In the heterogeneity analysis,we discovered that when digital adoption grows,residents in the countryside and county seats can earn more money through internet business operations and other channels.This helps to decrease the urban-rural income divide,but it has also pushed those digitally skilled into high-paying sectors,widening the income gaps between sectors.In the mechanism analysis,we developed an income function that takes into account the individual level of digitalization to show that digitalization can boost income by increasing working hours or labor participation and adjusting the portfolio of individual material,human,and social capital.In this paper,we have expanded the system for measuring the individual levels of digitalization by offering basic data,research methodology,and policy suggestions for the digital economy’s inclusive development.
文摘Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.
文摘BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.
文摘BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low-or middle-income countries(LMICs).A better understanding of maternal general healthy nutrition knowledge,as well as misbeliefs,is highly essential,especially in such settings.In the current era of infodemics,it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well.AIM To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC,and to determine the sources of such information and their assessment methods.METHODS This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old.The data were collected through online questionnaire forms:One was for the general nutrition knowledge assessment,and the other was for the nutritional myth score.Sources of information and ways of evaluating internet sources using the Currency,Relevance,Authority,Accuracy,and Purpose test were additionally analyzed.RESULTS The mean general nutrition knowledge score was 29±9,with a percent score of 70.8%±12.1%(total score:41).The median myth score was 9(interquartile range:6,12;total score:18).The primary sources of nutrition knowledge for the enrolled mothers were social media platforms(55%).Half of the mothers managed information for currency and authority,except for considering the author's contact information.More than 60%regularly checked information for accuracy and purpose.The mothers with significant nutrition knowledge checked periodically for the author's contact information(P=0.012).The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information(P=0.016).Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13%(P=0.044).However,using social media increased the likelihood of having myths among mothers by approximately 1.2(P=0.001).CONCLUSION Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics.However,healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.
文摘The consumer price index (CPI) measures the relative number of changes in the price level of consumer goods and services over time, reflecting the trend and degree of changes in the price level of goods and services purchased by residents. This article uses the ARMA model to analyze the fluctuation trend of the CPI (taking Chongqing as an example) and make short-term predictions. To test the predictive performance of the model, the observation values from January to December 2023 were retained as the reference object for evaluating the predictive accuracy of the model. Finally, through trial predictions of the data from May to August 2023, it was found that the constructed model had good fitting performance.
文摘Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.
文摘As an innovative economic model,the sharing economy has seen rapid growth globally in recent years.It has not only brought a profound impact on traditional economies but also injected new vitality and momentum into the sustainable development of the social economy.However,for the sharing economy,the process of collecting personal income tax is facing several issues,such as the ambiguity of tax policies regarding personal income,challenges in identifying taxpayers,and difficulties in defining income.To achieve the fairness and efficiency of personal income tax collection in the sharing economy,this study proposes optimized regulatory mechanisms and conducts in-depth discussions on the adjustment of personal income tax policies,innovation in tax management technology,and improvement in the quality of personal income tax services.
文摘In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.
文摘Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.
文摘Introduction: Infertilityaffects one in six couples, and it is an important public health issue largely due to thepervasive effects on the emotional and psychological wellbeing of affected couples. In many developing nations emphasis is placed on childbirth and inability to fulfill this role can be very distressing. There is an unmet need for assisted reproductive technology (ART) in many developing countries and where facilities exist, they are mostly privately owned, expensive and concentrated in urban areas. To bridge this gap, public fertility clinics have been established to provide subsidized care. Evaluating the characteristics and peculiarities of clientele presenting at these public facilities will aid planning and prioritization of care. Methodology: A descriptive retrospective study of 116 infertile patients presenting to the fertility clinic of the University College Hospital, Ibadan, Nigeria from inception on the 14<sup>th</sup> of February 2019 and 31<sup>st</sup> of December 2022.Data was analyzed using the Statical Package for Social Sciences (IBM, SPSS, New York) version 23. Descriptive statistics were used to summarize the results which were presented with the aid of bar charts and frequency tables. Result: The mean age of the patients was 40.70 ± 6.62 years. Post-menopausal patients accounted for about one-fifth of the study population while 80.2% (93 women) were older than 35 years. The mean duration of infertility was 9.39 ± 6.11years and nine patients (7.8%) had a duration greater than 2 decades. Secondary infertility occurred in 67.2% of the women. Twenty-nine women (25%) had undergone myomectomy prior to presentation. Hypertension (11.2%) was the most prevalent comorbidity. Nineteen patients (16.4%) had used contraceptives in the past with the male condom (36.8%)being the most preponderant. Sixty-seven patients had experienced pregnancy losses before 28 weeks of gestation while just 16 patients (13.8%) had undergone ART, and none was successful. Conclusion: Secondary infertility was the prevalent type of infertility and may not be unconnected with the low contraceptive usage and high risk of sexually transmitted infection. Late presentation coupled with a large proportion of post-menopausal clientele suggests delayed health-seeking behavior most probably due to the prohibitive cost of ART. The need to streamline services offered in public fertility clinics is paramount in low-income countries grappling with scarce resources. A pragmatic approach will involve the provision of low-cost ART, while enhancing gamete donation programs through the implementation of gamete sharing policies. This will invariably bridge the unmet need and skewed access to ART in developing countries.
文摘By using the data concerning China's urban-rural residents' income gap from 1978 to 2010,this paper mainly researches the application of several kinds of models in predicting China's urban-rural residents' income gap.By conducting empirical analysis,we establish ARIMA prediction model,grey prediction model and quadratic-polynomial prediction model and conduct accuracy comparison.The results show that quadratic-polynomial prediction model has excellent fitting effect.By using quadratic-polynomial prediction model,this paper conducts prediction on trend of China's urban-rural residents' income gap from 2011 to 2013,and the prediction value of income gap of urban-rural residents in China from 2011 to 2013 is 14 173.20,15 212.92 and 16 289.67 yuan respectively.Finally,on the basis of analysis,corresponding countermeasures are put forward,in order to provide scientific basis for energy planning and policy formulation:first,strengthen government's function of public service,coordinate resources,and strive to provide an equal opportunity of development for social members,so as to promote people's welfare and promote social equality;second,breach industrial monopoly and bridge income gap between employees in monopoly industry and general industry;last but not the least,support,encourage and call for government to establish social relief fund,adjust residents' income distribution from the non-governmental perspective,and endeavor to promote the income level of low-income class.
文摘By conducting meta-analysis on the researches of relationship between income level and happiness at home and abroad,this paper researches the relationship between income level and happiness.The results show that the relationship between income level and happiness takes on U-shape curve,and it can be explained from adaptation,social comparison and psychological expectation.Finally,in order to promote rural residents' income level and strengthen rural residents' happiness in China,corresponding policy suggestions are put forward as follows:bridge gap of urban-rural residents' income distribution;dilute the competitions for money and status among people;perfect rural social security system;endeavor to create a situation in which all rural residents do their best.
基金Humanities and Social Science Fund Project of the Ministry of Education(13YJA790069)Fundamental Research Funds for Central Universities(2013RW004)
文摘This paper measures the Chinese regional income distribution gap based on the Theil index with data of 31 provinces in China from 1998 to 2011. The results showed that overall the income gap between China's rural areas was on the rise from 1998 to 2006,and the income gap was mainly caused by the gap between the East China,Central China and West China. After 2006,it showed a slow decline. The dynamic panel data model established for consumer demand,spending habits,income,regional income disparities showed that income and regional income disparities significantly influence consumer demand of rural residents. Before 2006 regional income gap inhibited the consumption of rural residents,but it promoted consumption after 2006.