IMPORTANCE Few studies have reported the association of economic growth with trends of visual impairment in schoolchildren in China or elsewhere. OBJECTIVES To describe 30-year trends and patterns in visual impairment in China and to explore the association between visual impairment and economic development. DESIGN, SETTING, AND PARTICIPANTS In this time series analysis of 7 successive cross-sectional surveys from 1985 to 2014, a total of 1 951 084 schoolchildren aged 7 to 18 years from all provinces and autonomous regions of mainland China, excluding Tibet, were studied.

Background The prevalence of atopic dermatitis (AD) dramatically increased over these years and environmental factors were considered as potential contributors towards these trends. Objective This study aimed to explore several major environmental exposures, including air pollution, temperature and relative humidity, in order to identify potential modifiable risk factors and their interactive effects on AD. Methods We applied a bivariate response surface model and stratification model based on time‐series Poisson generalized additive models to examine the interactive effects of air pollution and meteorological factors on AD. Results A total of 64 987 outpatient visits for AD were recorded from 1 January 2013 to 31 December 2017. Interactive effects were found between air pollutants and meteorological factors. Enhanced positive associations between pollutants and outpatient visits for AD were found at the highest quartile temperature level. A 10 μg/m3 increase in PM2.5, PM10, NO2 and SO2 were associated with 0.42% (95% CI: 0.16–0.67%), 0.34% (95% CI: 0.15–0.54%), 1.11% (95% CI: 0.38–1.84%) and 1.06% (0.21–1.93%) increase in outpatient visits for AD at the highest quartile temperature level. Conclusion That effects of air pollutants on AD can be modified by meteorological factors, with enhanced effects on hot days.

One principal reason for ED crowding in Beijing lies in the large numbers of patients who persist in the expectation of receiving ongoing care in the ED for minor illnesses. However, as is true in many nations, one of the other most important root causes of ED crowding is "access block," the inability to promptly move patients deemed by emergency physicians to need inpatient care to an inpatient bed for that care. However, in our system, another challenge, not widely described as a contributor to crowding in other nations, is that doctors assigned to inpatient services have been empowered to refuse to admit patients perceived to have overly "complex" needs. Further, patients with multisystem illnesses or end-stage status, who need ongoing chronic care to manage activities of daily living, have begun to populate Beijing EDs in increasing numbers. This is an issue with various root causes.

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