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Article ; Online: Job preferences of medical and nursing students seeking employment in rural China

Meiling Bao / Cunrui Huang

BMC Medical Education, Vol 21, Iss 1, Pp 1-

a discrete choice experiment

2021 Volume 12

Abstract: Abstract Background China has a shortage of health workers in rural areas, but little research exists on policies that attract qualified medical and nursing students to rural locations. We conducted a discrete choice experiment to determine how specific ... ...

Abstract	Abstract Background China has a shortage of health workers in rural areas, but little research exists on policies that attract qualified medical and nursing students to rural locations. We conducted a discrete choice experiment to determine how specific incentives would be valued by final–year students in a medical university in Guizhou Province, China. Methods Attributes of potential jobs were developed through the literature review, semi–structured interviews, and a pilot survey. Forty choice sets were developed using a fractional factorial design. A mixed logit model was used to estimate the relative strength of the attributes. Willingness to pay and uptake rates for a defined job were also calculated based on the mixed logit estimates. Results The final sample comprised 787 medical and nursing students. The statistically significant results indicated “Bianzhi” (the number of personnel allocated to each employer by the government) and physical conflicts between doctors and patients were two of the most important non-monetary job characteristics that incentivized both medical and nursing students. Policy simulation suggested that respondents were most sensitive to a salary increase, and the effect of incentive packages was stronger for students with a rural family background. Conclusions Strategies for patient–doctor relationships, Bianzhi and salary should be considered to attract final–year medical and nursing students to work in rural China. In addition, specific recruitment policy designs tailored for students with different majors and backgrounds should be taken into account.
Keywords	Discrete choice experiment ; Job preferences ; Health workers ; Medical and nursing students ; Recruitment policy ; Special aspects of education ; LC8-6691 ; Medicine ; R
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Eliciting primary healthcare physicians’ preferences for job characteristics in rural China

Lei Wang / Gang Chen / Cunrui Huang / Meiling Bao / Gang Yan

BMJ Open, Vol 13, Iss

a discrete choice experiment

2023 Volume 3

Abstract: Introduction The outflow and scarcity of physicians in rural areas can adversely affect universal health coverage and population health outcomes, which are critical concerns in China. This study explored primary healthcare physicians’ job preferences ... ...

Abstract	Introduction The outflow and scarcity of physicians in rural areas can adversely affect universal health coverage and population health outcomes, which are critical concerns in China. This study explored primary healthcare physicians’ job preferences using a discrete choice experiment to identify appropriate incentives for retention.Methods Eight job characteristics were identified through a literature review and qualitative studies as the attributes relevant to designing the discrete choice experiment, with levels varying between two hypothetical jobs. The data were analysed using conditional logit model, mixed logit model and latent class model.Results A total of 1781 licensed physicians (including licensed assistant physicians) from township health centres in rural areas were surveyed. Policy simulation suggested that they were sensitive to both monetary and non-monetary policy incentives. As for non-monetary job characteristics, a highly intense doctor–patient relationship, bianzhi (the number of personnel allocated to each employer by the government) and educational opportunities were highly valued by the respondents. The latent class model could identify distinct groups with different job preferences according to their memberships.Conclusion Urban jobs were much preferred to rural ones. However, policy incentives can lend themselves to effective retention strategies. It is also important to tailor policy incentives to different subgroups.
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Strengthen mechanistic research on health impact of climate change and improve ability to address and adapt to climate change

Wenjun MA / Tao LIU / Cunrui HUANG

环境与职业医学, Vol 39, Iss 3, Pp 237-

2022 Volume 239

Abstract: The threats to human health caused by climate change have become a global public health issue. However, at present, most studies regarding the health-related mechanisms of climate change are limited to biological mechanisms, and most of these mechanisms ... ...

Abstract	The threats to human health caused by climate change have become a global public health issue. However, at present, most studies regarding the health-related mechanisms of climate change are limited to biological mechanisms, and most of these mechanisms are not totally clear. In this special column: Mechanisms underlying human health effects of climate change, we offered several papers which investigated the effects of different meteorological factors (temperature and rainfall) on various health outcomes (preterm birth, death, diarrhea, infectious diseases, etc.), and also elaborated associated potential biological mechanisms, vulnerability mechanisms, social driving process and transmission dynamics mechanisms. These studies can deepen our understanding of the health effects of climate change, provide references to make targeted adaptative measures, and also provide scientific and technological supports for improving ability to address the health risks of climate change in China.
Keywords	climate change ; extreme weather ; mechanistic research ; health impact ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	300
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Editorial Committee of Journal of Environmental and Occupational Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Research progress on potential mechanisms of preterm birth after maternal heat exposure

Liyun WANG / Qiong WANG / Cunrui HUANG

环境与职业医学, Vol 39, Iss 3, Pp 275-

2022 Volume 280

Abstract: Preterm birth and its complications are the leading cause of neonatal death, and also a perinatal problem that contributes to the global burden of disease. Recently, the association between maternal heat exposure and elevated risk of preterm birth has ... ...

Abstract	Preterm birth and its complications are the leading cause of neonatal death, and also a perinatal problem that contributes to the global burden of disease. Recently, the association between maternal heat exposure and elevated risk of preterm birth has been found in lots of studies. But the potential mechanisms of how heat exposure increase the incidence of preterm birth are still unclear. Thus, we reviewed maternal vulnerability factors and territorial moderators associated with preterm birth due to heat exposure during pregnancy, and summarized potential mechanisms between heat exposure and risk of preterm birth based on previous studies. We found that heat exposure during pregnancy may involve various mechanisms to increase the risk of preterm birth, such as oxidative stress, inflammation, reproductive and urinary infections, neuroendocrine changes, and complications during pregnancy. Prospective cohort studies and animal experiments should be conducted to clarify the adverse health effects of heat exposure on different types of preterm birth from three facets of "exposure-mechanism-effect", aiming to provide a scientific basis for the protection of maternal and infant health through conducing clinical preventive interventions against preterm birth in scorching weather.
Keywords	pregnancy ; high temperature ; preterm birth ; risk ; mechanism ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	610
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Editorial Committee of Journal of Environmental and Occupational Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing the health effects of extreme temperature and development of adaptation strategies to climate change in selected countries in the Asia-Pacific region

Liangliang Cheng / Cunrui Huang

APN Science Bulletin, Vol 9, Iss

2019 Volume 1

Keywords	Science (General) ; Q1-390 ; Environmental sciences ; GE1-350
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Asia-Pacific Network for Global Change Research
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Understanding small Chinese cities as COVID-19 hotspots with an urban epidemic hazard index

Tianyi Li / Jiawen Luo / Cunrui Huang

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 10

Abstract: Abstract Multiple small- to middle-scale cities, mostly located in northern China, became epidemic hotspots during the second wave of the spread of COVID-19 in early 2021. Despite qualitative discussions of potential social-economic causes, it remains ... ...

Abstract	Abstract Multiple small- to middle-scale cities, mostly located in northern China, became epidemic hotspots during the second wave of the spread of COVID-19 in early 2021. Despite qualitative discussions of potential social-economic causes, it remains unclear how this unordinary pattern could be substantiated with quantitative explanations. Through the development of an urban epidemic hazard index (EpiRank) for Chinese prefectural districts, we came up with a mathematical explanation for this phenomenon. The index is constructed via epidemic simulations on a multi-layer transportation network interconnecting local SEIR transmission dynamics, which characterizes intra- and inter-city population flow with a granular mathematical description. Essentially, we argue that these highlighted small towns possess greater epidemic hazards due to the combined effect of large local population and small inter-city transportation. The ratio of total population to population outflow could serve as an alternative city-specific indicator of such hazards, but its effectiveness is not as good as EpiRank, where contributions from other cities in determining a specific city’s epidemic hazard are captured via the network approach. Population alone and city GDP are not valid signals for this indication. The proposed index is applicable to different epidemic settings and can be useful for the risk assessment and response planning of urban epidemic hazards in China. The model framework is modularized and the analysis can be extended to other nations.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Increasing heat risk in China’s urban agglomerations

Guwei Zhang / Gang Zeng / Xin-Zhong Liang / Cunrui Huang

Environmental Research Letters, Vol 16, Iss 6, p

2021 Volume 064073

Abstract: A heat danger day is defined as an extreme when the heat stress index (a combined temperature and humidity measure) exceeding 41 °C, warranting public heat alerts. This study assesses future heat risk (i.e. heat danger days times the population at risk) ... ...

Abstract	A heat danger day is defined as an extreme when the heat stress index (a combined temperature and humidity measure) exceeding 41 °C, warranting public heat alerts. This study assesses future heat risk (i.e. heat danger days times the population at risk) based on the latest Coupled Model Intercomparison Project phase 6 projections. In recent decades (1995–2014) China’s urban agglomerations (Beijing-Tianjin-Hebei, Yangtze River Delta, Middle Yangtze River, Chongqing-Chengdu, and Pearl River Delta (PRD)) experienced no more than three heat danger days per year, but this number is projected to increase to 3–13 days during the population explosion period (2041–2060) under the high-emission shared socioeconomic pathways (SSP3-7.0 and SSP5-8.5). This increase will result in approximately 260 million people in these agglomerations facing more than three heat danger days annually, accounting for 19% of the total population of China, and will double the current level of overall heat risk. During the period 2081–2100, there will be 8–67 heat danger days per year, 60%–90% of the urban agglomerations will exceed the current baseline number, and nearly 310 million people (39% of the total China population) will be exposed to the danger, with the overall heat risk exceeding 18 times the present level. The greatest risk is projected in the PRD region with 67 heat danger days to occur annually under SSP5-8.5. With 65 million people (68% of the total population) experiencing increased heat danger days, the overall heat risk in the region will swell by a factor of 50. Conversely, under the low-emission pathways (SSP1-2.6 and SSP2-4.5), the annual heat danger days will remain similar to the present level or increase slightly. The result indicates the need to develop strategic plans to avoid the increased heat risk of urban agglomerations under high emission-population pathways.
Keywords	urban agglomeration ; heat stress ; risk projection ; climate change ; Environmental technology. Sanitary engineering ; TD1-1066 ; Environmental sciences ; GE1-350 ; Science ; Q ; Physics ; QC1-999
Subject code	910
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	IOP Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Review on environmental-social factors and social driving process model construction of infectious diarrhea affected by rainstorm and flood

Lianping YANG / Li LIU / Yuchen LIU / Shiyu WANG / Weibin LI / Wenjun MA / Cunrui HUANG

环境与职业医学, Vol 39, Iss 3, Pp 296-

2022 Volume 303

Abstract: Infectious diarrhea is an important public health problem, which has a significant impact on global disease burden. Under the background of climate change, rainstorms increase and floods occur frequently. Most studies show that the incidences of ... ...

Abstract	Infectious diarrhea is an important public health problem, which has a significant impact on global disease burden. Under the background of climate change, rainstorms increase and floods occur frequently. Most studies show that the incidences of infectious diarrhea disease increase significantly after rainstorm and flood events. However, there is a lack of systematic summary on the path of rainstorm and flood events affecting the incidence of infectious diarrhea, including the key links and mechanisms underlying environmental-social interaction. This study comprehensively combed the literature from environmental factors, socio-economic and cultural factors, and population and individual susceptibility factors. The potential mechanisms of infectious diarrhea caused by rainstorm and flood events were discussed from the aspects of spreading of pathogens, affecting sanitation facilities and (or) drinking water treatment infrastructure, the regulatory role of individual and behavioral factors, and long-term effects. Based on the "pressure-state-response" model, a social driving process model of rainstorm and flood leading to incidence of infectious diarrhea was constructed. This model could provide reference for future quantitative modeling and other research directions. It is helpful to guide the public health departments to accurately identify factors affecting the incidence of infectious diarrhea after rainstorm and flood, so as to take targeted intervention measures.
Keywords	rainstorm and flood ; infectious diarrhea ; environmental factor ; social factor ; process mechanism ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	910
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Editorial Committee of Journal of Environmental and Occupational Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Identifying the critical windows and joint effects of temperature and PM2.5 exposure on small for gestational age

Xin Chen / Sidi Chen / Zhenghong Zhu / Jiajun Luo / Huailin Wang / Maimaitiminjiang Wulayin / Cunrui Huang / Wei Zhao / Qiong Wang

Environment International, Vol 173, Iss , Pp 107832- (2023)

2023

Abstract: The potential critical windows for extreme ambient temperature, air pollution exposure and small for gestational age (SGA) are still unclear, and no study has explored their joint effects on SGA. In a national multi-center prospective cohort, we included ...

Abstract	The potential critical windows for extreme ambient temperature, air pollution exposure and small for gestational age (SGA) are still unclear, and no study has explored their joint effects on SGA. In a national multi-center prospective cohort, we included 179,761 pairs of mother-infant from 16 counties of 8 provinces in China during 2014–2018. Daily averaged temperature and PM2.5 concentration were matched to the maternal residential address to estimate personal exposure. Extreme temperature exposures were categorized by a series of percentile in each meteorological and geographic division for the entire pregnancy, each trimester and gestational week (GA-week). Generalized linear mixed models (GLMMs) and distributed lag nonlinear models (DLNMs) were used to estimate the whole pregnancy-, trimester-specific, and weekly-specific associations of extreme temperature and PM2.5 exposures with SGA. Combined effects were evaluated with the relative excess risk due to interaction (RERI) and proportion attributable to interaction (AP). We observed that by referring to temperature at the 41st − 50th percentile, heat (>90th percentile) exposure during 13th − 29th GA-weeks was associated with SGA; odds ratio (OR) and 95 % confidence intervals (CI) was 1.16 (1.06, 1.28). For cold (<=10th percentile), inverse associations were observed during the 1st − 8th GA-weeks. PM2.5 exposure during the 2nd − 5th and 19th − 27th GA-weeks was associated with SGA, with the strongest association in the 2nd GA-week (OR = 1.0017, 95 %CI: 1.0001, 1.0034, for a 10 μg/m3 increase). No interactive effects between ambient temperature and PM2.5 on SGA were observed. Our findings suggest the weekly susceptibility windows for heat and PM2.5 exposure were primarily the gestational weeks within the 2nd trimester, therefore, corresponding protective measures should be conveyed to pregnant women during routine prenatal visits to reduce exposures.
Keywords	Heat ; Cold ; Climate change ; Air pollution ; Interactive effect ; Small for gestational age ; Environmental sciences ; GE1-350
Subject code	333
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Rapid attribution of the record-breaking heatwave event in North China in June 2023 and future risks

Cheng Qian / Yangbo Ye / Jiacheng Jiang / Yangyang Zhong / Yuting Zhang / Izidine Pinto / Cunrui Huang / Sihan Li / Ke Wei

Environmental Research Letters, Vol 19, Iss 1, p

2023 Volume 014028

Abstract: A record-breaking heatwave event occurred in North China from 22 to 24 June 2023, with temperatures >40 °C at many meteorological stations. This marked the first time that Beijing had reached or exceeded 40 °C for three consecutive days. However, the ... ...

Abstract	A record-breaking heatwave event occurred in North China from 22 to 24 June 2023, with temperatures >40 °C at many meteorological stations. This marked the first time that Beijing had reached or exceeded 40 °C for three consecutive days. However, the extent to which such exceptional heatwave events are related to anthropogenic climate change remains unclear. It is also unclear how frequent and intense such strong heatwave events will be in the future. We carried out a rapid attribution analysis to address these questions. Our findings show that the return period of this three-day heatwave event in North China is about 111 years (24.3, +∞) at the 2023 climate state. Both the empirical and coupled model approaches consistently showed that the intensity of 2023-like three-day heatwave events has significantly increased by at least 1.0 °C (range 0.8 °C–1.3 °C) due to anthropogenic climate change. Future projections indicate that 2023-like events in North China are likely to occur at least 1.6 (range 1.3–2.1) times throughout the remainder of this century and be 0.5 °C (range 0.2 °C–0.8 °C) more intense than those under the 2023 climate even if carbon neutrality is achieved based on the very low CO _2 emissions scenario simulations. For the intermediate emissions scenario, the occurrence probability of 2023-like events in the North China region by the end of this century will be 5.5 (range 4.9–6.3) times those under the 2023 climate, with an intensity 2.9 °C (range 2.4 °C–3.1 °C) higher than those under the 2023 climate. These findings highlight the need for adaptation measures to address the occurrence of 2023-like three-day heatwaves in North China in June even if carbon neutrality is achieved.
Keywords	heatwaves ; event attribution ; anthropogenic climate change ; human influences ; empirical approach ; coupled model approach ; Environmental technology. Sanitary engineering ; TD1-1066 ; Environmental sciences ; GE1-350 ; Science ; Q ; Physics ; QC1-999
Subject code	950
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	IOP Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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