The paper demonstrates why it is necessary to take the restoration of marine coastal ecosystem health as a new goal for integrated catchment management, in coastal area of the Tolo Harbour. The present goal of integra...The paper demonstrates why it is necessary to take the restoration of marine coastal ecosystem health as a new goal for integrated catchment management, in coastal area of the Tolo Harbour. The present goal of integrated catchment management (ICM) in the Tolo Harbour is to meet with Water Quality Objectives. The performance of an ICM plan, Tolo Harbour Action Plan (THAP), is evaluated by using marine coastal ecosystem health indicators including stress indicators and responses indicators. Since the implementation of THAP in 1988, some significant reduction in pollution loading has been observed - reduction of 83 % of BOD load and 82 % of TN between 1988 and 1999. There has been an improvement in the health state of Tolo Harbour marine coastal ecosystem as evidenced in the trends of the physical, chemical and biological indicators, although some reverse fluctuations in some periods exist. However, this can only be considered as the first sign of the ecosystem health restoration, since ecosystem health展开更多
Integrated medicine is not only a new methodology,but also a new view of medicine.In the face of the growing needs of the people for skin health management,modern dermatology should establish the concept of integrated...Integrated medicine is not only a new methodology,but also a new view of medicine.In the face of the growing needs of the people for skin health management,modern dermatology should establish the concept of integrated medicine.The existing skin health management in China is still based on the medical concept of"professional refinement and specialist differentiation",and still fails to solve many negative effects caused by the fragmentation of medical knowledge and the mechanization of clinical medical practice.Therefore,based on the concept of integrated medicine,this paper puts forward a new concept of skin health management integrated medicine.However,in order to establish this brand-new integrated medical view of skin health management,we should focus on the medicine for the diagnosis and treatment of skin diseases,the physical and mental health management of skin patients,the integration of traditional Chinese medicine and western medicine for the diagnosis and treatment of skin diseases,the combination of prevention and treatment of skin diseases,the cooperation of medical and nursing care for the health management of skin diseases,and the development of skin health care industry,speed up the skin disease health management integration of medical practice and other aspects.展开更多
Traditionally the global management system of an organization is frequently split into a number of individual management systems that are defined and implemented according to specific management systems standards (MSS...Traditionally the global management system of an organization is frequently split into a number of individual management systems that are defined and implemented according to specific management systems standards (MSSs) as well as managed independently. The individual implementation of MSSs is an option that leads to several inefficiencies and sub-optimization of the global management system of an organization. As referred by ISO [1] the interested parties’ requirements increase. A more effective and efficient option for an organization is to integrate, into an integrated management system (IMS), the implementation and management of requirements of multiple MSSs. Certain difficulties are associated to the structuring process, implementation, verification, evaluation, improvement and progressive development of an IMS in the organizations. Several scholars have proposed various theoretical approaches regarding the integration of individual management systems (MSs) leading to the conclusion that there is not a common practice for all organizations as they encompass different characteristics. This paper aims to present and justify a designed methodology to be used by organizations to support the integration of various MSs. Among them are highlighted: the Environmental Management System (EMS) according ISO 14001 [2], the Quality Management System (QMS) according ISO 9001 [3], and the Occupational Health and Safety Management System (OH & SMS) according OHSAS 18001 [4]. The methodology was designed in the context of a Portuguese company, on sequence of an organizational diagnosis and a research that was performed through a questionnaire. The strategy and the research methods took into consideration the case study.展开更多
Nowadays, there exist various standards for individual management systems （MSs）, at least, one for each stakeholder. New ones will be published. An integrated management system （IMS） aims to integrate some or all ...Nowadays, there exist various standards for individual management systems （MSs）, at least, one for each stakeholder. New ones will be published. An integrated management system （IMS） aims to integrate some or all components of the business into one coherent and efficient MS. Maximizing integration is more and more a strategic priority in that it constitutes an opportunity to eliminate and/or reduce potential factors of destruction of value for the organizations and also to be more competitive and consequently promote its sustainable success. A preliminary investigation was conducted on a Portuguese industrial company which, over the years, has been adopting gradually, in whole or in part, individualized management system standards （MSSs）. A research, through a questionnaire, was performed with the objective to develop, in a real business environment, an adequate and efficient IMS-QES （quality, environment, and safety） model and to potentiate for the future a generic IMS model to integrate other MSSs. The strategy and research methods have taken into consideration the case study. It was obtained a set of relevant conclusions resulting from the statistical analyses of the responses to the survey. Globally, the investigation results, by themselves, justified and prioritized the conception of a model of development of the IMS-QES and consequent definition and validation of a structure of an IMS-QES model, to be implemented at the small- and medium-sized enterprise （SME） where the investigation was conducted.展开更多
The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. T...The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. The focus is application of the SCT domains to self-management programs. The exploration of the current chronic disease self-management research provides an understanding of the Social Cognitive Theory concepts studied in interventional self-management research. The integrative review explicated two areas related to the theory in need of further research. First, social support has not been thoroughly explored as a mechanism for enhancing self-management interventions. Second, moral disengagement was not identified as a focus within chronic disease research raising the question about the impact of moral disengagement on long-term adherence and behavior change.展开更多
Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the ta...Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.展开更多
目的基于健康行为改变整合理论(integrated theory of health behavior change,ITHBC)构建非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者自我管理干预方案,并评价其在NAFLD患者中的应用效果。方法以ITHBC为理论框架...目的基于健康行为改变整合理论(integrated theory of health behavior change,ITHBC)构建非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者自我管理干预方案,并评价其在NAFLD患者中的应用效果。方法以ITHBC为理论框架,通过文献分析法初步拟定干预方案初稿。采用专家函询法修改及完善自我管理方案。采用立意抽样法纳入2023年4-5月在乌鲁木齐市某社区卫生服务中心体检的符合NAFLD诊断标准的患者80例,采用随机数字表法分为对照组和观察组各40例。对照组行社区常规护理,观察组行基于ITHBC的自我管理干预;随访4个月,比较2组患者的自我管理能力及临床特征变化。结果(1)3轮专家函询问卷有效回收率分别为100%、85%、85%,专家权威系数为0.833,协调系数分别为0.191、0.254、0.272,均P<0.01。最终干预方案包括一级指标5项,二级指标11项,三级指标17项。(2)随访4个月后,观察组患者干预后自我管理总分、疾病防治管理、日常生活管理、心理认知管理及不良生活方式管理评分均显著高于对照组(P<0.05);而临床指标(腰围、BMI、总胆固醇、三酰甘油及低密度脂蛋白)均低于对照组(P<0.05)。结论基于ITHBC构建的NAFLD患者自我管理干预方案可提高患者自我管理能力,进而改善患者病情,提升NAFLD的预后。展开更多
文摘The paper demonstrates why it is necessary to take the restoration of marine coastal ecosystem health as a new goal for integrated catchment management, in coastal area of the Tolo Harbour. The present goal of integrated catchment management (ICM) in the Tolo Harbour is to meet with Water Quality Objectives. The performance of an ICM plan, Tolo Harbour Action Plan (THAP), is evaluated by using marine coastal ecosystem health indicators including stress indicators and responses indicators. Since the implementation of THAP in 1988, some significant reduction in pollution loading has been observed - reduction of 83 % of BOD load and 82 % of TN between 1988 and 1999. There has been an improvement in the health state of Tolo Harbour marine coastal ecosystem as evidenced in the trends of the physical, chemical and biological indicators, although some reverse fluctuations in some periods exist. However, this can only be considered as the first sign of the ecosystem health restoration, since ecosystem health
基金The 2019 Project of Sichuan Sexual Sociology and Sex Education Research Center(SXJYZ1912)The first batch of doctoral special scientific research funds of Sichuan University of Arts and Sciences(2019BS003R)。
文摘Integrated medicine is not only a new methodology,but also a new view of medicine.In the face of the growing needs of the people for skin health management,modern dermatology should establish the concept of integrated medicine.The existing skin health management in China is still based on the medical concept of"professional refinement and specialist differentiation",and still fails to solve many negative effects caused by the fragmentation of medical knowledge and the mechanization of clinical medical practice.Therefore,based on the concept of integrated medicine,this paper puts forward a new concept of skin health management integrated medicine.However,in order to establish this brand-new integrated medical view of skin health management,we should focus on the medicine for the diagnosis and treatment of skin diseases,the physical and mental health management of skin patients,the integration of traditional Chinese medicine and western medicine for the diagnosis and treatment of skin diseases,the combination of prevention and treatment of skin diseases,the cooperation of medical and nursing care for the health management of skin diseases,and the development of skin health care industry,speed up the skin disease health management integration of medical practice and other aspects.
文摘Traditionally the global management system of an organization is frequently split into a number of individual management systems that are defined and implemented according to specific management systems standards (MSSs) as well as managed independently. The individual implementation of MSSs is an option that leads to several inefficiencies and sub-optimization of the global management system of an organization. As referred by ISO [1] the interested parties’ requirements increase. A more effective and efficient option for an organization is to integrate, into an integrated management system (IMS), the implementation and management of requirements of multiple MSSs. Certain difficulties are associated to the structuring process, implementation, verification, evaluation, improvement and progressive development of an IMS in the organizations. Several scholars have proposed various theoretical approaches regarding the integration of individual management systems (MSs) leading to the conclusion that there is not a common practice for all organizations as they encompass different characteristics. This paper aims to present and justify a designed methodology to be used by organizations to support the integration of various MSs. Among them are highlighted: the Environmental Management System (EMS) according ISO 14001 [2], the Quality Management System (QMS) according ISO 9001 [3], and the Occupational Health and Safety Management System (OH & SMS) according OHSAS 18001 [4]. The methodology was designed in the context of a Portuguese company, on sequence of an organizational diagnosis and a research that was performed through a questionnaire. The strategy and the research methods took into consideration the case study.
基金Acknowledgements： This work had the financial support of the Portuguese National Science Foundation （FCT） through the Research Unit, UI 4005, Project Reference PEst-OE/EME/UI4005/2011.
文摘Nowadays, there exist various standards for individual management systems （MSs）, at least, one for each stakeholder. New ones will be published. An integrated management system （IMS） aims to integrate some or all components of the business into one coherent and efficient MS. Maximizing integration is more and more a strategic priority in that it constitutes an opportunity to eliminate and/or reduce potential factors of destruction of value for the organizations and also to be more competitive and consequently promote its sustainable success. A preliminary investigation was conducted on a Portuguese industrial company which, over the years, has been adopting gradually, in whole or in part, individualized management system standards （MSSs）. A research, through a questionnaire, was performed with the objective to develop, in a real business environment, an adequate and efficient IMS-QES （quality, environment, and safety） model and to potentiate for the future a generic IMS model to integrate other MSSs. The strategy and research methods have taken into consideration the case study. It was obtained a set of relevant conclusions resulting from the statistical analyses of the responses to the survey. Globally, the investigation results, by themselves, justified and prioritized the conception of a model of development of the IMS-QES and consequent definition and validation of a structure of an IMS-QES model, to be implemented at the small- and medium-sized enterprise （SME） where the investigation was conducted.
文摘The purpose of this integrative review is to evaluate research pertaining to self-management programs for older adults with chronic diseases using Albert Bandura’s Social Cognitive Theory (SCT) for behavior change. The focus is application of the SCT domains to self-management programs. The exploration of the current chronic disease self-management research provides an understanding of the Social Cognitive Theory concepts studied in interventional self-management research. The integrative review explicated two areas related to the theory in need of further research. First, social support has not been thoroughly explored as a mechanism for enhancing self-management interventions. Second, moral disengagement was not identified as a focus within chronic disease research raising the question about the impact of moral disengagement on long-term adherence and behavior change.
基金supported by the National Natural Science Foundation of China(No.71273097)
文摘Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.
文摘目的基于健康行为改变整合理论(integrated theory of health behavior change,ITHBC)构建非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者自我管理干预方案,并评价其在NAFLD患者中的应用效果。方法以ITHBC为理论框架,通过文献分析法初步拟定干预方案初稿。采用专家函询法修改及完善自我管理方案。采用立意抽样法纳入2023年4-5月在乌鲁木齐市某社区卫生服务中心体检的符合NAFLD诊断标准的患者80例,采用随机数字表法分为对照组和观察组各40例。对照组行社区常规护理,观察组行基于ITHBC的自我管理干预;随访4个月,比较2组患者的自我管理能力及临床特征变化。结果(1)3轮专家函询问卷有效回收率分别为100%、85%、85%,专家权威系数为0.833,协调系数分别为0.191、0.254、0.272,均P<0.01。最终干预方案包括一级指标5项,二级指标11项,三级指标17项。(2)随访4个月后,观察组患者干预后自我管理总分、疾病防治管理、日常生活管理、心理认知管理及不良生活方式管理评分均显著高于对照组(P<0.05);而临床指标(腰围、BMI、总胆固醇、三酰甘油及低密度脂蛋白)均低于对照组(P<0.05)。结论基于ITHBC构建的NAFLD患者自我管理干预方案可提高患者自我管理能力,进而改善患者病情,提升NAFLD的预后。
