Guangdong Li, Wei Qi, Siao Sun, Xiaoping Liu, Zhenbo Wang
Within-facility increases in RN staffing intensity and a more RN-intensive skill mix were consistently associated with lower hospitalization and outpatient ED visit rates among long-stay nursing home residents. Although these observational findings do not support causal inference, they suggest that staffing composition should be considered alongside total nursing hours in quality improvement and workforce policy.
Armed conflict is an escalating threat to global food security yet its impact on cropland dynamics is poorly understood at global scale. Here we combine annual high-resolution cropland maps (2000-2020) with more than 460,000 conflict events across 155 countries to assess how armed conflicts affect cropland loss and food security. By 2020, conflict-exposed areas within 5 km of conflict events covered only 3% of global land but contained 6% of global cropland, indicating disproportionate exposure of agricultural land to conflict. Difference-in-differences estimates show that conflict exposure caused an average annual cropland loss of 14.46 ha per buffer-year and a 3% decline in cropland area. Losses were greatest in West Africa, Eastern Africa and Southeast Asia. Spatial matching analyses further indicate 23.7% greater cropland loss in conflict-affected areas than in comparable non-conflict areas. Preventing these losses could have supplied dietary energy sufficient for 255.54 million people annually.