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Abstract Background Work-family conflict among physicians has many adverse consequences, like reduced work engagement and impaired well-being. However, relatively little research has been conducted on the impact of work-family conflict on specific pathways of physician well-being. The aim of this study was to determine the relationship between work-family conflict and employee well-being among physicians and to explore the mediating role of job satisfaction and work engagement in this relationship. Methods Using data from a cross-sectional survey of 2,480 physicians in Jilin Province, China, partial least squares structural equation modeling (PLS-SEM) was applied in this study to examine the direct and indirect effects of work-family conflict on employee well-being and to assess the mediating roles of job satisfaction and work engagement therein. Results The employee well-being score of physicians in Jilin Province was 5.16 ± 1.20. The univariate analysis results indicated significant disparities in employee well-being scores across different age groups, marital statuses, and professional titles. Work-family conflict was significantly negatively associated with employee well-being, while job satisfaction and work engagement were significantly positively associated with employee well-being. In addition, job satisfaction and work engagement were found to mediate the association between work-family conflict and employee well-being, and work engagement was considered to mediate the association between job satisfaction and employee well-being. Conclusions Our study confirms that work-family conflict negatively affects physicians’ employee well-being. Moreover, our investigation revealed that the association between work-family conflict and employee well-being is influenced by both job satisfaction and work engagement and that work engagement plays a mediating role in the link between job satisfaction and employee well-being. Therefore, we propose that hospital administrators should rationally allocate organizational resources and develop manageable schedules to enhance physicians’ employee well-being.

Abstract Background Turnover problems among primary health care workers are a significant contributor to the shortage of health human resources. This study aims to determine the relationship between job stress and turnover intention among primary health care workers, as well as to examine the mediating effects of job satisfaction and presenteeism on this relationship. Methods Stratified random sampling and quota sampling were used to select 703 primary health care workers in Jilin Province, China in January 2020. Validated scales were used to measure turnover intention, job stress, job satisfaction, and presenteeism among primary health care workers. The study utilized a partial least squares structural equation modeling (PLS-SEM) approach to test the research hypotheses. Results The turnover intention score of primary health care workers in Jilin Province was 2.15 ± 1.03, and 19.5% of respondents reported a higher turnover intention. Significant sex and occupation differences were found, with a higher rate of turnover intention for male and doctor groups among primary health care workers. This study also revealed a positive correlation between job stress and turnover intention (β = 0.235, P

Objective Investigating the digital health literacy of university students can facilitate their effective acquisition of health information and adoption of appropriate protective behaviors. This study aims to explore the subtypes of digital health literacy among university students during the COVID-19 pandemic and their association with mental health outcomes. Methods From 17 November to 14 December 2022, a stratified random sampling approach was used to conduct an online questionnaire survey on digital health literacy, fear of COVID-19, and depression status among students at Jilin University, China. A total of 1060 valid responses were obtained in the survey. Latent profile analysis identified subtypes of digital health literacy and linear regression analyses were used to examine the association of digital health literacy to the mental health outcome. Results Three latent profiles were identified: Profile 1—low digital health literacy (n = 66, 6.23%), Profile 2—moderate digital health literacy (n = 706, 66.60%), and Profile 3—high digital health literacy (n = 288, 27.17%). Results from linear regression demonstrated a negative correlation between digital health literacy and fear of COVID-19 ( B = −2.954, P

Abstract Background The serious shortage of human resources for primary health care (PHC) is a common issue in health reforms worldwide. China has proposed that it is an effective way to encourage and guide qualified medical personnel to work in primary health care institutions (PHCIs). However, few studies have been conducted on the willingness and influencing factors of medical personnel to seek employment at PHCIs. Methods Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PHCIs from the perspective of guided objects. Through a three-phase investigation of 1160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors. Results A total of 6 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of PHCIs and SG. The values of the fit index indicated an acceptable-fitting model. Conclusion Family, remuneration, individual development, and job responsibility are closely related to the willingness of medical personnel to seek employment at PHCIs, and the internal and external environment of PHCIs is also an important factor. Therefore, the development of PHC providers can be promoted by paying attention to the family members of medical personnel, establishing a reasonable remuneration system, providing suitable development opportunities, arranging work rationally and improving the internal construction of PHCIs.

BackgroundThe prolonged COVID-19 pandemic has seriously impacted the mental health of healthcare workers. This study aimed to explore the mental health status of healthcare workers, compare the differences in mental health between physicians and nurses, and verify the impact of risk perception on mental health in the long-term COVID-19 pandemic in Jilin Province, China.MethodsA stratified random sample was used to conduct an on-site questionnaire survey in December 2020 to measure the mental health status, risk perceptions, and demographic characteristics of healthcare workers in Jilin Province, China. A total of 3,383 participants completed the questionnaire survey, of which 3,373 were valid questionnaires.ResultsA total of 23.6% (n = 795) of participants had symptoms of depression, 27.4% (n = 923) had symptoms of anxiety, and 16.3% (n = 551) had symptoms of stress. Physicians reported significantly higher rates of depression and anxiety than nurses (p = 0.023, p = 0.013, respectively). There was no significant difference in the proportion of participants with stress between physicians and nurses (p = 0.474). Multivariate logistic regression results showed that healthcare workers who had a high level of risk perception were more likely to have symptoms of depression (AOR = 4.12, p < 0.001), anxiety (AOR = 3.68, p < 0.001), and stress (AOR = 4.45, p < 0.001) after controlling for other variables.ConclusionAt least one in six healthcare workers experienced mental health problems, and physicians were more likely than nurses to suffer from depression during the prolonged COVID-19 epidemic. Risk perception was highly predictive of depression, anxiety, and stress symptoms in medical staff. Public health interventions are needed to mitigate the long-term psychological impact of the COVID-19 pandemic.

ObjectiveThis cross-sectional research aims to develop reliable predictive short-term prediction models to predict the number of RTIs in Northeast China through comparative studies.MethodologySeasonal auto-regressive integrated moving average (SARIMA), Long Short-Term Memory (LSTM), and Facebook Prophet (Prophet) models were used for time series prediction of the number of RTIs inpatients. The three models were trained using data from 2015 to 2019, and their prediction accuracy was compared using data from 2020 as a test set. The parameters of the SARIMA model were determined using the autocorrelation function (ACF) and the partial autocorrelation function (PACF). The LSTM uses linear as the activation function, the mean square error (MSE) as the loss function and the Adam optimizer to construct the model, while the Prophet model is built on the Python platform. The root mean squared error (RMSE), mean absolute error (MAE) and Mean Absolute Percentage Error (MAPE) are used to measure the predictive performance of the model.FindingsIn this research, the LSTM model had the highest prediction accuracy, followed by the Prophet model, and the SARIMA model had the lowest prediction accuracy. The trend in medical expenditure of RTIs inpatients overlapped highly with the number of RTIs inpatients.ConclusionBy adjusting the activation function and optimizer, the LSTM predicts the number of RTIs inpatients more accurately and robustly than other models. Compared with other models, LSTM models still show excellent prediction performance in the face of data with seasonal and drastic changes. The LSTM can provide a better basis for planning and management in healthcare administration.ImplicationThe results of this research show that it is feasible to accurately forecast the demand for healthcare resources with seasonal distribution using a suitable forecasting model. The prediction of specific medical service volumes will be an important basis for medical management to allocate medical and health resources.

Objective: This study aimed to investigate the cost-effectiveness of low-dose rivaroxaban plus aspirin versus aspirin alone for patients with stable cardiovascular diseases in the China.Methods: We used TreeAge 2019 to construct a Markov model to assess the direct healthcare costs and quality-adjusted life years for three therapies, namely low-does rivaroxaban plus aspirin, rivaroxaban alone, and aspirin alone. Transitional probabilities were derived from the COMPASS trial, and the costs and utilities were obtained from the Chinese Health Care Statistical Yearbook and published studies. Use the Incremental cost-effectiveness ratio to describe the results. The willingness-to-pay threshold is set at US$11,000 (China’s 2020 Gross National Product per capita).Result: In patients with stable cardiovascular disease, the increased cost per quality-adjusted life year gained in the low-dose rivaroxaban combined with aspirin group compared to the aspirin alone group was US$7937.30. The increased cost per quality-adjusted life year gained in the rivaroxaban alone group versus the aspirin alone group was US$15,045.78.Conclusion: A low-does rivaroxaban plus aspirin therapy may be cost-effective in the secondary prevention of stable cardiovascular disease in patients.

Abstract Background This study aims to explore the effect of public hospital managers’ risk and gain perception on their attitude towards physician dual practice (PDP). Methods A cross-sectional study enrolling 1513 managers from public hospitals in the East, Middle and West of China was conducted. Generalized linear mixed models (GLMM) were used to identify the determinants of managers’ support for PDP. Results The rate of managers’ support for allowing PDP or implementing PDP with restriction, was 94.3% (95% CI: 0.93, 0.95). The mean score of managers’ risk perception was 67.7 ± 14.46, and the mean score of managers’ gain perception was 24.0 ± 5.56. After controlling for individual and institutional characteristics, the GLMM presented the score for risk perception increased 1 score and the rate of managers’ support for PDP decreased by 5% (OR = 0.95, 95% CI: 0.93, 0.97); while the score for gain perception increased 1 score and the rate of managers’ support increased by 18% (OR = 1.18, 95% CI: 1.12, 1.24). Conclusions Our data demonstrate that the majority of Chinese public hospital managers are in favor of allowing or implementing PDP with restrictions. Although gain perception is comparatively weaker than risk perception, a stronger influence in determining public hospital managers’ support for PDP is demonstrated.

ObjectivesThis study aims to evaluate the direct effects of work stress, health status and presenteeism on task performance, and further explore the mediating effects of health status and presenteeism, hoping to provide theoretical basis for improving the performance of medical staff.MethodsA cross-sectional study was conducted among medical staff in Jilin Province, Northeast China. The Challenge and Hindrance-Related Self-Reported Stress scale, Short Form-8 Health Survey scale, Stanford Presenteeism Scale and Task Performance Scale were adopted to assess the work stress, health status, presenteeism and task performance of medical staff.ResultsA total of 4,347 questionnaires were distributed among medical staff, and 4261 were valid, for an effective rate of 98.02%. The mean scores for work stress, health status, presenteeism and task performance were 2.05 ± 0.84, 4.18 ± 0.68, 2.15 ± 0.79 and 4.49 ± 0.64, respectively. The ANOVA results showed that there were significant differences in the task performance scores between different genders, ages, marital statuses, professional titles, departments and work years (P < 0.05). Work stress (β = −0.136, P < 0.001) and presenteeism (β = −0.171, P < 0.001) were negative predictors of task performance. Health status (β = 0.10; P < 0.001) was positive predictor of task performance. Health status (β = −0.070; P < −0.001) and presenteeism (β = −0.064; P < 0.001) mediated the relationship between work stress and task performance (P < 0.001). Presenteeism mediated the relationship between health status and task performance (β = 0.07; P < 0.001).ConclusionWork stress and presenteeism had significant negative impact on the task performance of medical staff; health status had a significant positive effect on task performance. Meanwhile, health status and presenteeism played a mediating role in the relationship between work stress and task performance, and presenteeism played a mediating role in the relationship between health status and task performance. Reasonable assignment of tasks can reduce the work stress, but to improve the performance of medical staff, we should pay more attention on improving health, such as making health-related safeguard measures, raising awareness, building a platform, etc.

Objectives This study aimed to identify and study the associations and co-occurrence of multimorbidity, and assessed the associations of diseases with sex, age and hospitalisation duration.Design Cross-sectional.Setting 15 general hospitals in Jilin Province, China.Participants A total of 431 295 inpatients were enrolled through a cross-sectional study in Jilin Province, China.Primary outcome measures The complex relationships of multimorbidity were presented as weighted networks.Results The distributions of the numbers of diseases differed significantly by sex, age and hospitalisation duration (p

Background: The shortage of health care workforce is a common problem all over the world and one of the main reasons for the shortage is the high turnover rate. Based on the characteristics of medical work, this study explored the relationship among public service motivation (PSM), work stress, task performance and turnover intention. Methods: Medical personnel in public hospitals were selected by stratified random sampling in Jilin province of China and validated scales from previous studies were applied to measure the variables. Besides, a structural equation model of turnover intention was constructed to demonstrate the relationship. Results: A total of 3191 valid questionnaires were collected. The results showed that the score of turnover intention was 2.02 ± 1.13. There are significant differences in turnover intention among medical staff of different genders and departments. At the same time, PSM had direct and negative effects on the turnover intention (β = −0.292, P < 0.001), work stress had direct and positive effects on the turnover intention (β = 0.479, P < 0.001), whereas task performance had no significant effect on turnover intention (β = 0.044, P < 0.142). The results showed an acceptable fit model. Conclusion: The greater the PSM, the lower the turnover intention, and the higher the work stress, the higher the turnover intention. In addition, work stress and task performance play a mediating role between PSM and turnover intention. This paper provides theoretical support for the measures to reduce the turnover intention of medical staff.

In this study, La and Ce doped PbO2 electrodes were prepared and the characteristic of the electrodes were discussed with the help of structure analysis. The catalytic effects of the doped electrodes were explored through the degradation of para-aminophenol wastewater. The results showed that the para-aminophenol removal was 96.96%, 89.34%, and 77.55% after 180 min treatment with Ce-PbO2, La-PbO2, and PbO2, respectively. The para-aminophenol enhanced degradation mechanism was discussed with rare earth element doping electrodes and a kinetic model was established based on radical reactions mechanism with genetic algorithm (GA) calculation. The reaction constants of these electrodes were calculated and the results showed that the reaction constant of Ce-PbO2 electrode was the highest, which indicated that Ce-PbO2 electrode could have a better treatment effect. The EE/O was used as the index of energy consumption efficiency and the results were calculated and compared. This paper could provide basic data and technique reference of the prediction the oxidation reaction process of different electrodes for the electrochemical oxidation application in wastewater treatment.

Depression is one of the most common mental disorders. It refers to a kind of mood disorder with significant and lasting depression as the main clinical symptoms caused by various reasons. Its core symptoms are depression, loss of interest, lack of energy, often accompanied by physical symptoms, cognitive symptoms and so on. Serious patients have the risk of self injury and suicide. Most drug treatments focus on changing neurotransmitter activity in the brain, and Probiotics are a kind of active microorganisms which are beneficial to the host. They are colonized in the human intestinal tract and reproductive system and can produce exact health effects, thus improving the balance of the host's microecology and playing a beneficial role. Ingestion of certain probiotics seems to be a potential treatment for depression.

Jiaozhou Bay (JZB), located at Qingdao City, north China, is a semi-enclosed shallow bay that has undergone large-scale land reclamation and is suffering from a deteriorated water environment. Long-term evolution of JZB with respect of coastline, tidal prism, tidal dynamics, water-exchange capacity, and pollutant transport from 1863 to 2020 was investigated in this paper, using remote sensing images, historical charts, and a numerical model. The JZB was predominated by natural evolution from 1863 to 1935, during which the coastline barely changed. Thereafter, human intervention became intense and more and more natural tidal flats were replaced by salt ponds, aquaculture area, and reclamation very quickly. As a result, tidal prism, area of tidal flats, and area of JZB decreased sharply by 0.290 km3, 182 km2, and 223 km2, respectively, from 1935 to 2020, corresponding to annual decreasing rates being of 123 times, 10 times, 12 times, respectively, as that of before 1935. A numerical model showed that the residual current in JZB tended to be weaker due to the change of coastline and bathymetry, which is not favoring the water-exchange and pollutant transport, especially in the northeast of JZB. The basin residence time increased from 15.5 days in 1935 to 17.6 days in 2020, because of weaker residual tidal current and smaller tidal prism. Local residence time increased significantly near the area with large land reclamation, especially in the northeast and west of JZB. Distribution of dissolved inorganic nitrogen (DIN), in each year, which is the dominant pollutant in JZB, indicated higher DIN concentration and weaker transport along with reclamation. The research on JZB evolution over the last 150 years can provide useful suggestions for the decision-makers of the local government to improve the marine ecosystem. The systematic method to investigate long-term water environment evolution of JZB can be used to study other semi-closed bays.

Abstract Continuous tow investigations have shown that the present vent field inventory along fast to intermediate spreading ridges may be underestimated by at least 3–6 times, while the limited towed line investigations of venting sites along slow to ultra-slow spreading ridges make it impossible to determine their distribution. The Chinese Dayang cruise has conducted detailed towed line surveys of hydrothermal activity on segment 27 of the ultra-slow spreading southwest Indian ridge in 2015. The results have identified as many as 9 hydrothermal fields along 85-km-long segment, including one confirmed hydrothermal field, three inferred hydrothermal fields and five suspected fields. Hydrothermal activities are not only limited along-axis but also found approximately 10 km away from the axis. These vent fields are likely powered by a seismically identified axial magma chamber, including melt migration along normal faults to flank areas. The calculated hydrothermal activity frequency on segment 27 is approximately 3.6–8 times higher than that calculated from the Interridge database, suggesting that careful system exploration can reveal more hydrothermal activities even on ultra-slow spreading ridges effected by hotspot.

Abstract  A new chainlike polymer, Na[Ce(dipic)(H2O)3]2 [CrMo6H6O24] · 13H2O (H2dipic = pyridine-2,6-dicarboxylic acid) (1), has been synthesized and characterized by elemental analysis; IR and XPS spectroscopy, TG analysis, and single-crystal X-ray diffraction. Compound (1) is built up of Anderon-type polyoxoanions as structural motifs and cerium–dipic coordination fragments as linkers to yield an unprecedented one-dimensional chain. Such chains are further in close contact forming a three-dimensional supramolecular framework with channels via extensive hydrogen-bonding interactions among polyoxoanions, dipic ligands and water molecules. Furthermore, the magnetic properties of compound (1) have been studied by measuring their magnetic susceptibility in the temperature range 2–300 K. [ABSTRACT FROM AUTHOR]