Environmental Efficiency Analysis of China＇s Vegetable Production

Objective To analyze and estimate the environmental efficiency of China‘s vegetable production. Methods The stochastic translog frontier model was used to estimate the technical efficiency of vegetable production. Based on the estimated frontier and technical inefficiency levels, we used the method developed by Reinhard, et al.to estimate the environmental efficiency. Pesticide and chemical fertilizer inputs were treated as environmentally detrimental inputs. Results Frome stimated results, the mean environmental efficiency for pesticide input was 69.7%, indicating a great potential for reducing pesticide use in China‘s vegetable production. In addition, substitution and output elasticities for vegetable farms were estimated to provide farmers with helpful information on how to reallocate input resources and improve efficiency.Conclusion There exists a great potential for reducing pesticide use in China‘s vegetable production.     

Water Quality Assessment of the River Nile System： An Overview

Objectives The main objective of the present article is to assess and evaluate the characteristics of the Nile water system, and identify the major sources of pollution and its environmental and health consequences. The article is also aimed to highlight the importance of water management via reuse and recycle of treated effluents for industrial purpose and for cultivation of desert land. Method An intensive effort was made by the authors to collect, assess and compile the available data about the River Nile. Physico-chemical analyses were conducted to check the validity of the collected data. For the determination of micropollutants, Gas Chromatography (GC) and High Performance Liquid Chromatography (HPLC) were used. Heavy metals were also determined to investigate the level of industrial pollution in the river system.Results The available data revealed that the river receives a large quantity of industrial, agriculture and domestic wastewater. It is worth mentioning that the river is still able to recover in virtually all the locations,with very little exception. This is due to the high dilution ratio. The collected data confirmed the presence of high concentrations of chromium and manganese in all sediment samples. The residues of organo-chlorine insecticides were detected in virtually all locations. However, the levels of such residues are usually below the limit set by the WHO for use as drinking water. The most polluted lakes are Lake Maryut and Lake Manzala.Groundwater pollution is closely related to adjacent (polluted) surface waters. High concentrations of nutrients, E.coli, sulfur, heavy metals, etc. have been observed in the shallow groundwater, largely surpassing WHO standards for drinking water use. Conclusion A regular and continuous monitoring scheme shall be developed for the River Nile system. The environmental law shall be enforced to prohibit the discharge of wastewater (agricultural, domestic or industrial) to River Nile system.     

Health and Economic Impacts of Air Pollution in China： A Comparison of the General Equilibrium Approach and Human Capital Approach

In China, combustion of fossil fuels and biomass has produced serious air pollution that does harm to human health. Based on dose-response relationships derived from epidemiological studies, the authors calculated the number of deaths and people with health problems which were thought to be attributable to China＇s air pollution in the year of 2000. In order to estimate the corresponding economic impacts from the national point of view, the general equilibrium approach was selected as an analysis tool for this study. A computable general equilibrium （CGE） model was constructed involving 39 sectors and 32 commodities. The human capital approach （HCA） was also used for comparison. The economic burden of disease for people estimated by HCA was equivalent to 1.26‰ （ranging from 0.44‰ to 1.84‰） of China＇s gross domestic product （GDP）. China＇s GDP loss estimated by the general equilibrium approach reached 0.38‰ （ranging from 0.16‰ to 0.51‰）. The difference between the two approaches and the implications of the results were discussed.     

Measuring health care efficiency with a tripartite configuration under the “National” Health Insurance system

Background The ＂National＂ Health Insurance （NHI） in Taiwan, China is a single-payer system that was introduced in 1995 to provide universal health care. It is worth noting that three stakeholders are involved in Taiwan＇s NHI, which can be seen as a triangular governance regime between the Bureau of ＂National＂ Health Insurance （BNHI）, the insured and providers. Accordingly, this study intended to assess the efficiency of various different production processes that occur among these stakeholders in Taiwan＇s NHI system. Methods A two-stage relational Data Envelopment Analysis （DEA） model is adopted to investigate the sub-process efficiencies of the health care resources held by 23 cities and counties through stages I or II, where the outputs of the first stage serve the inputs of the second. The dataset was collected from the annual reports published by the Department of Health, Taiwan, China. Results Under the proposed framework, the efficiency of the whole process can be obtained from the product of productivity and allocative efficiency. Ten DMUs are efficient either in stages I or II, with only two DMUs being efficient with regard to both sub-processes. Conclusion The relational DEA model not only demonstrates the physical relationship between the whole process and the sub-process components, but also produces reliable outcomes in efficiency measurement among different stakeholders in Taiwan＇s NHI system.     

Prevention and Treatment of Pneumoconiosis in China

Silicosis is one of the most serious occupational iseases which affect many workers‘ health in China.Under the guidance of policies from the Chinese Government,the industries,health care instituteions,scientists and workers were organized and have made great efforts in prevention and treatment of sillicosis as well as pneumoconissis.Since the 1960s,the national health standards and chest X-ray diagnosis criteria for silicosis were established and have been revised recently.A nationwide epidemiological survey revealed that the cumulative pneumoconiosis cases were about 4800000(1949-1992).The high prevalence rate has been the motivation to search for anti-silicotic drugs.Several kinds of anti-silicotic drugs were studied and found to be able to retard progression of silicosis and cause changes in X-ray picture.The mechanism of drug efficiency and the development of silicosis have attracted the interest of scientists in this fields and fruitful results have been obtained.For prevention of dust havards,the systematic design for facilities of dust collection and the isolation of dust source appropriate to township industries have been worked out and used widely.Recently,under the supervision of the Ministry of Public Health,China,a pilot study on countermeasure for industrial hazards and health care service in township industries has been instituted.     

Current attitudes toward organ donation after cardiac death in northwest China

Background People＇s attitude toward organ donation after cardiac death （DCD） has not come to an agreement in different countries and regions.Influenced by the local culture in China for thousands of years,the general public has different ideas about this issue.The purpose of this study was to investigate the current attitudes trend and characteristics of transplantation with organs donated after cardiac death in northwest China.Methods This largest single-center cohort study was performed by an interview or by telephone using a questionnaire.The family members of potential DCD donors were recruited from the First Affiliated Hospital,medical college of Xi＇an Jiaotong University located in a metropolitan area of northwest China.The 12-item attitude questionnaire was specifically developed from the literature review with coordinator,physician,and donor＇s family feedback.The participants were asked to rate the queries on a 5-point Likert intensity scale.Results The 174 participants included 56 （32.2％） women and 118 （67.8％） men.Most people were aged between 41 and 50 years （n=63,36.2％）,31 and 40 years （n=59,33.9％）,and less than 30 years （n=36,20.7％）.The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization （RCO,n=160,92％）,donor is a hero （n=143,82.2％）,honor to be a donor＇s family member （n=136,78.2％）,improved relationship with colleagues （n=124,71.3％）,and with recipient after donation （n=123,70.7％）.The best person to suggest organ donation to a family was ranked as the coordinator of RCO （n=160,92％）,doctor unrelated to transplantation （n=104,59.8％）,social worker （n=36,20.7％）,and doctor related to transplantation （n=25,14.4％）.The top two reasons for non-consent to donation were that the family insisted on intact body after patient death and did not want to have surgery again （n=51,41.5％）,and feared that they would be misunderstood by neighbors,relatives,and friends about donation （n=28,22.8％）.Conclusions This study revealed initial attitudes toward DCD in China.Some data afford insight into the decision-making procedure.The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.     

Upgrading of Industrial Wastewater Treatment Units at Automobile Industry

Industrial wastewater is one of the major sources of water pollution in Egypt.The principal hazard to public health caused by industrial wastes is pollution with toxic materials,which may enter a municipal water supply or may be harmful to people using the stream for recreatinal puposes.These wastes can damage aquatic life,sewer fabric and interfere with the operation of treatment plants.Morevoer,persistent untreated pollutats passing through these systems may contaminate receving water bodies and incresae the cost and environmental risks of sludge treatment and disposal.     

Nutritional and microbiological evaluations of chocolate-coated Chinese chestnut （Castanea mollissima） fruit for commercial use

In recent years, China has become an increasingly important and the largest chestnut producer in the world. This study aimed to evaluate the nutritional value and microbiological quality of the roasted freeze-dried Chinese chestnut （Castanea mollissima） （RFDC） coated with dark chocolate （DCC） and milk chocolate （MCC） for industrial use and commercial consumption. Chocolate coating significantly improved the nutritional value of chestnut. RFDC had high levels of starch （66.23%） and fibers （3.85%） while DCC and MCC contained significantly high amounts of sucrose, protein, fat and minerals. Furthermore, the protein content doubled in MCC rather than in DCC. This could be attributed to the different formulations in the two products. Milk powder and whey protein constituted the source of protein in MCC while cocoa powder added to MCC formulation constituted an additional source of minerals. The amino acid profile showed differences in amino acid composition related to the sample＇s protein content, indicating their good nutritional quality. The moisture contents in all RFDC, DCC and MCC were suitable for industrial processing. These results provide information about the additional nutrients of chocolate-coated chestnut and confirm that the product is an interesting nutritional food. The combination of freeze-drying and chocolate-coating generally results in greater reductions on microbiological loads, extending shelf life of harvested chestnut for commercial application, This is an alternative strategy to add value to chestnut, minimizing the significant losses in harvested fruits and providing a wider range of choices of new products to the consumer disposal.     

Overview of HIV drug resistance and its implications for China

Since the initiation of China＇s nationwide free antiretroviral therapy （ART） in 2002, the availability of highly active antiretroviral therapy （HAART） in China has increased dramatically. HAART has been proven to prolong survival and control HIV disease progression. At the same time, experience in developed countries indicates that the high mutation rate of the virus in the presence of HAART is associated with drug resistance and diminished efficacy. The increase in HAART availability and use in China therefore also comes with the potential for increased resistance. Transmission of drug-resistant strains to individuals who have never been exposed to ART is on the rise. Moreover, studies have shown that new infections by drug-resistant virus result in suboptimal response to ART. With the rapid scale up of ART in China in recent years, the prevalence of HIV drug resistance will likely increase, posing a major public health concern in China. This review article provides an overview of ART resistance, the current worldwide trends in HIV drug resistance, the effect of HIV drug resistance in clinical management, and the implications for China＇s HIV treatment and care.     

Improving Access to Quality Care in Family Planning:WHO’s Four Cornerstones of Evidence-based Guidance

The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policy-makers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines- Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grassroot providers.     

Severe Acute Respiratory Syndrome——Retrospect and Lessons of 2004 Outbreak in China

Objective To summarize lessons learned from an outbreak of severe acute respiratory syndrome （SARS） in China during the spring of 2004. Methods Data of SARS cases were officially reported by Beijing Municipal Center for Disease Control and Prevention （BCDC） and Anhui Provincial Center for Disease Control and Prevention （APCDC） and results of epidemiological investigations were collected and analyzed. Results Three generations of 11 cases of SARS were identified during the outbreak, Initial two cases were most likely to be infected in Diarrhea Virus Laboratory of National Institute of Virology, China Centers for Disease Control and Prevention and main mode of transmission was direct contact with SARS patients, Delay in detecting initial case resulted in spread of the illness at hospitals and communities with two generations of secondary cases, Conclusions SARS outbreak in 2004 has yielded following lessons for public health globally. （1） Lab bio-safety programs should be made and should be strictly abided by, Studies in highly pathogenic viruses such as SARS coronavirus should be utmost cautious, （2） Management systems of occupational exposure to virus and disease surveillance need to be strengthened to take all risk factors into account so as to detect potential patients with infectious disease as early as possible.     

Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population

Background Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years. Methods A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management. Results A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas （43.61%） was higher than that in rural （31.88%）. And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups （83.96%） and regular vaccination （nearly 99%）. Overall, geographic location and education level were the determinants of people access to essential public health services. Conclusions Implementation of the health reform since 2009 has headed China＇s public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China＇s public health system needs to be greatly improved in terms of its quality and accessibility.     

Bioremediation of Hexavalent Chromium Pollution by Sporosarcina saromensis M52 Isolated from Offshore Sediments in Xiamen,China

Objective Cr(VI)removal from industrial effluents and sediments has attracted the attention of environmental researchers.In the present study,we aimed to isolate bacteria for Cr(VI)bioremediation from sediment samples and to optimize parameters of biodegradation.Methods Strains with the ability to tolerate Cr(VI)were obtained by serial dilution and spread plate methods and characterized by morphology,16S r DNA identification,and phylogenetic analysis.Cr(VI)was determined using the 1,5-diphenylcarbazide method,and the optimum p H and temperature for degradation were studied using a multiple-factor mixed experimental design.Statistical analysis methods were used to analyze the results.Results Fifty-five strains were obtained,and one strain(Sporosarcina saromensis M52;patent application number:201410819443.3)having the ability to tolerate 500 mg Cr(VI)/L was selected to optimize the degradation conditions.M52 was found be able to efficiently remove 50-200 mg Cr(VI)/L in24 h,achieving the highest removal efficiency at p H 7.0-8.5 and 35°C.Moreover,M52 could completely degrade 100 mg Cr(VI)/L at p H 8.0 and 35°C in 24 h.The mechanism involved in the reduction of Cr(VI)was considered to be bioreduction rather than absorption.Conclusion The strong degradation ability of S.saromensis M52 and its advantageous functional characteristics support the potential use of this organism for bioremediation of heavy metal pollution.     

Heavy metals and PAHs in sewage sludge from twelve wastewater treatment plants in Zhejiang province

Objective To investigate the heavy metals （HMs） and polycyclic aromatic hydrocarbons （PAHs） in sludge of twelve wastewater treatment plants （WWTPs） in Zhejiang province of China, and to assess their potential for land application. Methods Sludge was collected from 12 WWTPs within the province. GC-MS and AAS were used to measure PAHs and HMs contents in sludge. Results Concentrations of HMs in most of the sludge samples were below the regulatory limits for the sludge to be used in agriculture in China with the exception of Zn in 2 sludge samples and Cd in 1 sample. All 16 PAHs, targeted by the USEPA agency, were found in the sludge from the twelve plants with a total concentration ranging from 33.73 mg kg^-1 to 82.58 mg kg^-1 （dry weight, d.w.）. The levels of Σ9 PAHs varied from 13.87 mg kg^-1 to 61.86 mg kg^-1 （d.w.） in the sludge, far exceeding the limitation value recommended by the Europe Union. The concentration and composition of PAHs in sewage sludge varied and depended mainly on the quantity and type of industrial wastewater accepted by the WWTPs. A significant relationship between the proportion of industrial wastewater received by WWTPs and the total content of 16 PAHs in the sludge was observed. Conclusion PAHs have become one of the primary pollutants in sludge of Zhejiang WWTPs instead of HMs. It is, therefore, essential to reduce the contents of PAHs before the sludge can be used in agriculture through proper treatment.     

Development and evaluation of the heroin abstainers’ cue-sensitization questionnaire

In order to develop the heroin abstainers＇ cue-sensitization questionnaire （HACSQ）, and evaluate its reliability and validity, during March and April in 2006, the cross-sectional sample survey and cluster sampling were adopted among 939 volunteer participants who were heroin abstainers from 5 compulsive detoxification centers in China. The data were collected by the self-report questionnaires. The reliability analysis included Cronbach＇s a coefficient, split reliability and test-retest reliability, while construction validity was analyzed in the light of exploratory and confirmatory factor analysis. Based upon the exploratory factor analysis, 4 factors were extracted, which were social emotion cue （SEC）, direct implement cue （DIC）, personnel cue （PC） and indirect implement cue （IIC） and they together explained 64.52% variance. According to the data, test-retest reliability coefficient ranged from 0.57 to 0.63, and Cronbach＇s α coefficient ranged from 0.86 to 0.95 across the 4 factors and HACSQ. The adjusted goodness of fit index was 0.75. It was suggested that the HACSQ demonstrated good validities and reliabilities, and may be used as a reliable assessment tool for the cue-sensitization among the heroin abstainers.     

Association between Ambient Air Pollution and Outpatient Visits for Acute Bronchitis in a Chinese City

Objective To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis,which is a rare subject of research in the mainland of China.Methods A time-series analysis was conducted to examine the association of outdoor air pollutants with hospital outpatient visits in Shanghai by using two-year daily data(2010-2011).Results Outdoor air pollution was found to be associated with an increased risk of outpatient visits for acute bronchitis in Shanghai.The effect estimates of air pollutants varied with the lag structures of the concentrations of the pollutants.For lag06,a 10 μg/m3 increase in the concentrations of PM10,SO2,and NO2 corresponded to 0.94%(95% CI:0.83%,1.05%),11.12%(95% CI:10.76%,11.48%),and 4.84%(95% CI:4.49%,5.18%) increases in hospital visits for acute bronchitis,respectively.These associations appeared to be stronger in females(P0.05).Between-age differences were significant for SO2(P0.05),and between-season differences were also significant for SO2(P0.05).Conclusion Our analyses have provided the first evidence that the current air pollution level in China has an effect on acute bronchitis and that the rationale for further limiting air pollution levels in Shanghai should be strengthened.     

Using Support Vector Machine to Predict Eco-environment Burden： A Case Study of Wuhan, Hubei Province, China

Objective The human socio-economic development depends on the planet＇s natural capital. Humans have had a considerable impact on the earth, such as resources depression and environment deterioration. The objective of this study was to assess the impact of socio-economic development on the ecological environment of Wuhan, Hubei Province, China, during the general planning period 2006-2020. Methods Support vector machine （SVM） model was constructed to simulate the process of eco-economic system of Wuhan. Socio-economic factors of urban total ecological footprint （TEF） were selected by partial least squares （PLS） and leave-one-out cross validation （LOOCV）. Historical data of socio-economic factors as inputs, and corresponding historical data of TEF as target outputs, were presented to identify and validate the SVM model. When predicted input data after 2005 were presented to trained model as generalization sets, TEFs of 2005, 2006,…, till 2020 were simulated as output in succession. Results Up to 2020, the district would have suffered an accumulative TEF of 28.374 million gha, which was over 1.5 times that of 2004 and nearly 3 times that of 1988. The per capita EF would be up to 3.019 gha in 2020. Contusions The simulation indicated that although the increase rate of GDP would be restricted in a lower level during the general planning period, urban ecological environment burden could not respond to the socio-economic circumstances promptly. SVM provides tools for dynamic assessment of regional eco-environment. However, there still exist limitations and disadvantages in the model. We believe that the next logical step in deriving better dynamic models of ecosystem is to integrate SVM and other algorithms or technologies.     

An Analysis of China’s Physician Salary Payment System

Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician’s average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician’s profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians’ basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.     

FINAL REPORT ABOUT STAGE Ⅱ COLLABORATION PROJECT ON LEPROSY REHABILITATION

Objective. To undertake the pilot experiments of prevention of disability (POD) in 14 different geographical areas to serve as examples for future development of rehabilitation work in China and in Asia. Mahods. According to the principles mid national criterion, 27 000 people affected by leprosy were selected and assessed using disability record forms at beginning and followed up regularly for observing changes of different indica-tors. Results. A total of 197 neuritis cases were detected and treated with prednisolone out of 1 407 new or active cas-es. Serf-care training of eyes, hands and feet were conducted for 10 500 disabled people affected by leprosy. Compre-hensive therapy was given to 1 804 cases having comphcated ulcers of which 1 055 cases have got their ulcers healed. Out of 706 prostheses, 613 were given to patients with satisfactory results. Surgical treatment was given to 269 cases and 251 have shown good progress. Conclusion. Most of patients have got benefit from the project in function or appearance which is very helpful for their going back to the society and agreed by foreign experts during the final evaluation. The experiences from the pro-ject can be implemented in the whole country.