Spatial-temporal changes and driving factors of eco-environmental quality in the Three-North region of China

Eco-environmental quality is a measure of the suitability of the ecological environment for human survival and socioeconomic development.Understanding the spatial-temporal distribution and variation trend of eco-environmental quality is essential for environmental protection and ecological balance.The remote sensing ecological index(RSEI)can quickly and objectively quantify eco-environmental quality and has been extensively utilized in regional ecological environment assessment.In this paper,Moderate Resolution Imaging Spectroradiometer(MODIS)images during the growing period(July-September)from 2000 to 2020 were obtained from the Google Earth Engine(GEE)platform to calculate the RSEI in the three northern regions of China(the Three-North region).The Theil-Sen median trend method combined with the Mann-Kendall test was used to analyze the spatial-temporal variation trend of eco-environmental quality,and the Hurst exponent and the Theil-Sen median trend were superimposed to predict the future evolution trend of eco-environmental quality.In addition,ten variables from two categories of natural and anthropogenic factors were analyzed to determine the drivers of the spatial differentiation of eco-environmental quality by the geographical detector.The results showed that from 2000 to 2020,the RSEI in the Three-North region exhibited obvious regional characteristics:the RSEI values in Northwest China were generally between 0.2 and 0.4;the RSEI values in North China gradually increased from north to south,ranging from 0.2 to 0.8;and the RSEI values in Northeast China were mostly above 0.6.The average RSEI value in the Three-North region increased at an average growth rate of 0.0016/a,showing the spatial distribution characteristics of overall improvement and local degradation in eco-environmental quality,of which the areas with improved,basically stable and degraded eco-environmental quality accounted for 65.39%,26.82%and 7.79%of the total study area,respectively.The Hurst exponent of the RSEI ranged from 0.20 to 0.76 and the future trend of eco-environmental quality was generally consistent with the trend over the past 21 years.However,the areas exhibiting an improvement trend in eco-environmental quality mainly had weak persistence,and there was a possibility of degradation in eco-environmental quality without strengthening ecological protection.Average relative humidity,accumulated precipitation and land use type were the dominant factors driving the spatial distribution of eco-environmental quality in the Three-North region,and two-factor interaction also had a greater influence on eco-environmental quality than single factors.The explanatory power of meteorological factors on the spatial distribution of eco-environmental quality was stronger than that of topographic factors.The effect of anthropogenic factors(such as population density and land use type)on eco-environmental quality gradually increased over time.This study can serve as a reference to protect the ecological environment in arid and semi-arid regions.

Land cover change and eco-environmental quality response of different geomorphic units on the Chinese Loess Plateau

Land cover in the Chinese Loess Plateau has undergone dramatic changes since the late 1980s.Revealing the trend in land cover change and eco-environmental quality response of different geomorphic units in this stage is a realistic requirement for promoting sustainable development of the Chinese Loess Plateau.Based on the data of geomorphic units and land cover in 1990,2000,2010 and 2018 of the Chinese Loess Plateau,we studied the trend of land cover change and eco-environmental quality response of different geomorphic units by using a significance index of land cover change,a proportion index of land cover change and an eco-environmental response model.The results indicated that from 1990 to 2018,the areas of forestland and construction land substantially increased,whereas those of cropland,grassland,wetland and unused land considerably decreased.Land cover change exhibited large geomorphic differences,and the main conversion of land cover was from cropland into other land types.Unstable trend of land cover change in the loess tablelands and sandy loess hills declined,whereas the unstable trends in the other geomorphic units enhanced.Eco-environmental quality varied among different geomorphic units.The expansion of construction land and degradation of forestland,grassland and wetland resulted in the deterioration of eco-environmental quality.The conversion of cropland and unused land into forestland and grassland,and the conversion of grassland into forestland were the main factors that drove the improvement of eco-environmental quality.The findings of this study may provide theoretical reference and support decision making for the optimization of land use structure and the improvement of eco-environmental quality on the Chinese Loess Plateau.

Assessing the impacts of ecological-living-productive land changes on eco-environmental quality in Xining City on Qinghai-Tibet Plateau, China

The Ecological-living-productive land(ELPL)classification system was proposed in an effort to steer China's land pattern to an ecological-centered path,with the development model shifting from a single function into more integrated multifunction land use.The focus is coordinating the man-land contradictions and developing an intensive,efficient and sustainable land use policy in an increasingly tense relationship between humans and nature.Driven by socioeconomic change and rapid population growth,many cities are undergoing urban sprawl,which involves the consumption of cropland and ecological land and threatens the ecological balance.This paper aims to quantitatively analyze the critical effects of ELPL changes on eco-environmental quality according to land use classification based on leading function of ecology,living and production from 1990 to 2015 with a case study of Xining City.Also,four future land use scenarios were simulated for 2030 using the Future Land Use Simulation(FLUS)model that couples human and natural effects.Our results show a decrease in productive land(PL)and an increase in ecological land(EL)and living land(LL)in Xining City.Forestry ecological land(FEL)covered the top largest proportion;agriculture productive land(APL)showed the greatest reduction and urban and rural living land(U-RLL)presented a dramatic increase.The eco-environmental quality improved in 1990-2010,mainly affected by the conversion of APL to FEL and GEL.However,the encroachment of U-RLL into APL,other ecological land(OEL)and FEL was the main contributor to the decline in eco-environmental quality in 2010-2015 as well as the primary reason for the increase area of lower-quality.The Harmonious Development(HD)-Scenario,characterized by a rational allocation of LL and PL and a better eco-environment,would have implications for planning and monitoring future management of ELPL,and may represent a valuable reference for local policy-makers.

Grey Clustering Evaluation on Regional Eco-environmental Quality Based on Normalized Index Value

[Objective] The aim was to assess regional eco-environmental quality by means of grey clustering method based on normalized index value. [Method] Eco-environmental quality in Chaohu basin was assessed by using grey clustering method based on normalized index value, and the evaluation results were compared with those of unascertained measure method to verify the feasibility of grey clustering method used to evaluate regional eco-environmental quality. [Result] In the grey clustering assessment method based on normalized index value, indices whose standard normalized values in the same grade were close to each other were classified into one class and had the same whitening function, which reduced the number of whitening functions. Grey clustering method based on normalized index value was used to assess eco-environmental quality in Chaohu basin, and the evaluation results were basically in accordance with those of unascertained measure method, namely eco-environmental quality in Hefei, Chaohu and Lu’an belonged to the third (pass), fourth (worse) and fifth grade (bad), except for one grade difference in overall basin, and the results showed that the method had practicality and could be applied to assess regional eco-environmental quality. [Conclusion] The study could provide theoretical foundation for the establishment of comprehensive management countermeasures of regional ecological environment.

Spatiotemporal changes of eco-environmental quality based on remote sensing-based ecological index in the Hotan Oasis,Xinjiang

The rapid economic development that the Hotan Oasis in Xinjiang Uygur Autonomous Region,China has undergone in recent years may face some challenges in its ecological environment.Therefore,an analysis of the spatiotemporal changes in ecological environment of the Hotan Oasis is important for its sustainable development.First,we constructed an improved remote sensing-based ecological index(RSEI)in 1990,1995,2000,2005,2010,2015 and 2020 on the Google Earth Engine(GEE)platform and implemented change detection for their spatial distribution.Second,we performed a spatial autocorrelation analysis on RSEI distribution map and used land-use and land-cover change(LUCC)data to analyze the reasons of RSEI changes.Finally,we investigated the applicability of improved RSEI to arid area.The results showed that mean of RSEI rose from 0.41 to 0.50,showing a slight upward trend.During the 30-a period,2.66% of the regions improved significantly,10.74% improved moderately and 32.21% improved slightly,respectively.The global Moran's I were 0.891,0.889,0.847 and 0.777 for 1990,2000,2010 and 2020,respectively,and the local indicators of spatial autocorrelation(LISA)distribution map showed that the high-high cluster was mainly distributed in the central part of the Hotan Oasis,and the low-low cluster was mainly distributed in the outer edge of the oasis.RSEI at the periphery of the oasis changes from low to high with time,with the fragmentation of RSEI distribution within the oasis increasing.Its distribution and changes are predominantly driven by anthropologic factors,including the expansion of artificial oasis into the desert,the replacement of desert ecosystems by farmland ecosystems,and the increase in the distribution of impervious surfaces.The improved RSEI can reflect the eco-environmental quality effectively of the oasis in arid area with relatively high applicability.The high efficiency exhibited with this approach makes it convenient for rapid,high frequency and macroscopic monitoring of eco-environmental quality in study area.

Universal Index Formula of Parameterized Combination Operator for Eco-environmental Quality Evaluation

[Objective] The aim was to evaluate the regional eco-environmental quality by using the universal index formula of parameterization combination operator based normalized index values.[Method] Through setting reference values and normalized transformation formulae for typical ecological environmental indexes appropriately,the difference among the standard normalized values would become very small after normalized transformation,and the ecological environmental indices expressed by normalized values can be equivalent to normalized indices.Under certain optimization conditions,shuffled frog leaping based on immune evolutionary particle swarm optimization algorithm was applied to optimize the parameters in parameterization combination operator formula,and the universal index formula suited to eco-environmental quality assessment was established finally.[Result] The universal index formula of parameterization combination operator,appropriate for any m(1≤m≤23) ecological environmental indices,was used to assess the eco-environmental quality of towns surrounding Headland Reservoir,and the results were in full accordance with those of unascertained measure method,that is,the eco-environmental quality of five towns around Headland Reservoir was the fourth grade.[Conclusion]The universal index formula of parameterization combination operator,suited to eco-environmental quality evaluation,is simple and intuitive in form,easy in computation and universal in application.

我国三级公立医院绩效考核结果分析与思考

目的 对我国三级公立医院绩效考核结果进行分析,为推进三级公立医院高质量发展提供依据。方法 运用描述性分析法和对比分析法对2019年—2021年三级公立医院绩效考核结果及发展趋势进行分析。结果 出院患者手术占比、微创手术占比、四级手术比例和日间手术占择期手术比例均有所增长;Ⅰ类切口感染率下降,DRG组数中位数逐渐增加;抗菌药物使用强度逐步降低,且明显低于40 DDDs的国家上限要求;门诊预约诊疗率大幅度提升,门诊患者预约后平均等候时间稳中有降;人员支出占业务支出比例稳中有升;副高级以上职称的比例、接收对口支援医院和医联体内医院进修半年以上人员的比例逐步提升。存在的主要问题为三级公立医院发展不均衡,跨省异地就医现象仍然存在,医院管理水平有待进一步提高,患者就医感受和医务人员获得感仍需进一步改善。结论 为推进三级公立医院高质量发展,还需进一步提升医疗服务水平;加强医院科学管理,推进管理出效益;激活医务人员积极性,推动以人为本的全面发展。

JBI循证卫生保健中心文本证据的质量评价清单

在缺乏高质量研究证据的情况下,经过严格地质量评价后的文本证据可作为医疗卫生保健决策依据的有效补充。本文旨在详细介绍JBI循证卫生保健中心3类文本证据(政策、专家意见及记叙)的质量评价清单,并通过实例分析对其核心内容进行详细解读,为国内研究人员评价文本证据的质量提供工具和支持。

基于三级公立医院绩效考核方式的精神专科医院内部质量评价指标体系的构建研究

目的分析基于三级公立医院绩效考核方式的精神专科医院内部质量评价指标体系的构建研究。方法选取2022年1月—2023年12月29名相关领域专家作为研究对象,医护人员以三级公立医院绩效考核指标体系为指导,通过查找文献,根据组内讨论,构建精神专科医院内部质量评价指标体系。选择15年及以上工作经验、从事医疗质量管理等领域的专家,通过问卷调查的方式,采用德尔菲法进行咨询,最后分数≥7分,变异系数≤0.25,方可进入纳入标准。结果本研究以三级公立医院绩效考核为导向,结合Donabedian质量理论,初步构建精神专科医院内部质量评价指标体系。结论通过构建精神专科医院内部质量评价指标体系,可为医院内部管理和服务质量的提升提供依据。

急性肾损伤临床指南和共识的方法学质量评价

目的对急性肾损伤临床指南和共识进行方法学质量评价和推荐意见汇总分析,为临床指南和共识制订提供理论依据。方法系统检索国内外指南相关数据库,检索时限为建库至2023年9月4日,采用指南研究与评价(AGREE)Ⅱ工具进行方法学质量评价,并对急性肾损伤治疗相关推荐意见进行汇总分析。结果本研究共纳入9篇指南和共识。AGREEⅡ六个领域的平均标准化得分依次为:范围和目的50.93%,参与人员43.83%,制订的严谨性40.39%,清晰性73.46%,应用性41.90%,编辑独立性49.07%。指南推荐评价结果为1篇“强推荐”,8篇“修订后推荐”。相关推荐意见主要包括内科药物治疗、辅助支持治疗和肾脏替代治疗。结论本研究所进行的方法学质量评价和推荐意见汇总分析可帮助临床医生快速全面掌握领域内的诊疗情况,为临床实践提供参考。相关人员在今后指南制订过程中,应注意在证据检索阶段明确证据筛选标准与证据评级;在形成推荐意见时提高证据与推荐意见的联系性,在制订推荐意见时应多考虑现实可行性和指南实施过程中可能遇到的促进或阻碍因素,以制订出全面、科学的临床指南。

国有企业负责人经营业绩考核:制度特征分析与指标维度优化

业绩考核制度是落实企业责任、激发企业活力,并由此推动经济社会运行的重要机制。在对比股东主导和市场主导两种业绩考核逻辑,分析、认知国有企业负责人经营业绩考核制度的基础上,探究了业绩考核制度的本质特征,即国有企业负责人经营业绩考核制度是一项以考核为抓手的产权管理体系,是以目标设定与过程管理为核心的“自驱式”机制设计。强调应唯经营(而非考核)出业绩,并且正向激励与风险容错是业绩考核赋能企业发展的重要属性。现行业绩考核指标体系还难以引导国有企业高质量发展,建议围绕“产业布局、经营生态、创新驱动、风险管理、财务收益”五个维度进一步优化国有企业负责人经营业绩考核指标,且以年度考核为核心,形成导向明确、相对稳定、可预期的考核指标体系,并赋予企业负责人一定的自由裁量权,以提高考核制度效果,助力中国经济高质量发展。

2021年中国基层卫生和全科医学研究方法学质量评价报告:定性研究和混合方法研究部分

背景全科医学具有显著的跨学科领域特征,定性研究和混合方法研究均适用于该领域的科研工作,近年来我国基层卫生和全科医学相关学术论文发表数量稳步增长,但整体文献质量尚未经过系统评估。目的探明我国基层卫生与全科医学领域发表的定性研究和混合方法研究的方法学质量。方法于2022年8月—2023年4月,由4名研究人员采用质量评估项目(CASP)中的定性研究评价工具和混合方法研究评价工具(MMAT)分别对我国2021年全科医学与基层卫生领域发表的定性研究和混合方法研究进行分析和方法学质量评价。研究人员两两分组,独立进行信息提取和方法学质量评价。结果共纳入35篇定性研究文献及9篇混合方法研究文献。定性研究的主要问题包括:65.71%(23/35)的研究未充分考虑伦理学问题;94.29%(33/35)的研究未讨论招募参与者的问题;82.86%(29/35)的研究未充分考虑研究者和参与者之间的关系;42.86%(15/35)的研究样本量<20人,且25.71%(9/35)的研究未讨论资料饱和问题。混合方法研究的主要问题包括:8/9的研究未明确报告混合方法研究设计类型,且8/9的研究未能有效整合研究的不同组成部分以共同回答研究问题。结论我国2021年发表的基层卫生及全科医学领域的定性研究和混合方法研究的方法学质量仍存在部分限制,尤其是在定性研究的伦理性、可靠性及信息饱和程度等方面和混合方法研究的整合方面受限严重,应进一步加强科研方法学的培训,并严格遵循科研设计和报告规范,以改善科研工作和所得证据的质量。

胃肠道手术ERAS指南/共识质量评价及内容分析

目的 通过评价和分析胃肠道手术加速术后康复(ERAS)指南/共识,遴选推荐使用的高质量指南/共识,为ERAS临床实践提供决策依据。方法 计算机检索PubMed、Embase、万方、中国知识基础设施工程等数据库及指南相关网站,纳入自数据库建库至2023年7月的胃肠道手术ERAS指南/共识。应用指南研究与评估系统Ⅱ和国际实践指南报告规范对纳入研究的指南/共识进行质量评价。分析整理推荐使用的高质量指南,汇总推荐意见。结果 最终纳入8部指南、13部共识。基于应用指南研究与评估系统Ⅱ,各领域平均标准化得分:范围和目的 64.22%±14.47%、参与人员29.68%±15.43%、制定的严谨性30.26%±18.76%、表达的明晰性73.68%±19.06%、应用性10.05%±11.39%、编辑独立性54.46%±36.58%,其中3部指南推荐使用。基于国际实践指南报告规范,指南背景、证据和推荐意见领域存在严重报告缺失(报告率<10%)。基于3部推荐使用的指南,汇总提出术前、术中和术后三部分24条推荐意见。结论 胃肠道手术ERAS指南/共识质量参差不齐,3部推荐使用。

Dynamics of the eco-environmental quality in response to land use changes in rapidly urbanizing areas: A case study of Wuhan, China from 2000 to 2018

The dramatic land use changes that occur in rapidly urbanized areas are important inducement to changes in the eco-environmental quality.Investigating urban land use changes and their eco-environmental quality responses can provide theoretical support and a decision-making basis for sustainable and high-quality development in rapidly urbanizing areas.Taking Wuhan,China,as the study area,this paper extracts land use information using Landsat satellite remote sensing images and a support vector machine classification.Based on this,a remote sensing-based ecological index evaluation model including humidity,greenness,dryness and heat is constructed to explore the changes in land use and their eco-environmental quality responses from 2000 to 2018.The results show that(1)the structure,extent and spatial layout of land use in Wuhan from 2000 to 2018 have undergone tremendous changes under rapid urbanization,and the change of construction land is the greatest among all land use types;(2)the overall quality of eco-environment in Wuhan continues to improve as the scale of the improved eco-environment areas is greater than that of the deteriorated areas.The direction and magnitude of the impact of each indicator on the eco-environmental quality are different;(3)the improvement or deterioration of eco-environmental quality is closely related to the changes of different land use types within the study area.The eco-environmental quality shows significant spatial heterogeneity,especially between the main urban areas and the suburban areas.This paper argues that reasonably adjusting the land use structure can serve to maintain or even improve the quality of the regional eco-environment.Finally,this study puts forward suggestions for the coordinated development of land use and the eco-environment in rapidly urbanizing areas.

驱动型绩效管理在公立医院“接诉即办”考核中的应用

以政府热线“12345”为载体的“接诉即办”工作机制,为提升医院对患者诉求的解决力度提出了新要求。医疗机构肩负着民生“七有”中至关重要的“病有所医”职责。为系统解决“接诉即办”中的难点、痛点问题,医院探索将驱动型绩效管理理念应用到“接诉即办”管理中。通过驱动型绩效管理在“接诉即办”考核中的实践应用,建立医院内部“接诉即办”绩效考核管理体系和工作机制,对医院各部门高质高效响应患者诉求、努力提高医疗质量、优化工作流程、强化医务人员人文关怀意识以及沟通能力等方面起到促进作用,以“接诉即办”绩效管理改革驱动医院主动治理能力的提升,实现接诉即办向未诉先办转变。

基于COSMIN指南的护士关怀行为评估工具质量评价

目的对护士关怀行为评估工具进行质量评价,为护理管理者选择高质量的评估工具提供参考。方法检索PubMed、Embase、the Cochrane Library、Web of Science、Medline、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中护士关怀行为评估工具相关研究,检索时限为建库至2023年3月。采用健康测量工具选择的共识标准(COSMIN)对纳入评估工具的方法学质量和测量属性质量进行评价,采用改良版证据质量评价及推荐强度评级指南(GRADE)对评估工具进行证据分级和分类推荐。结果共纳入9个护士关怀行为评估工具,均未报告效标效度、测量误差、反应度。4个评估工具为A级推荐,5个评估工具为B级推荐。结论护士关怀行为评估工具的方法学质量有待提高,测量属性有待进一步验证。未来应对现有评估工具进行完善和验证,开发本土化评估工具。

基于德尔菲法的临床科室运营评价指标体系构建

公立医院高质量发展要求、国考导向以及DIP医保支付改革均对公立医院精细化管理提出了巨大挑战,加强公立医院运营管理势在必行。本文以德尔菲法为理论基础,探索构建临床科室运营评价指标体系,旨在多维度评价各临床科室资源投入产出效率,进而为医院资源投入决策、精细化管理转型、加强科室运营指导提供科学依据。

基于传感技术的水质监测与评估方法研究

水质监测对于评估水生生态系统的健康状况和确保饮用水安全至关重要,传感器技术在这一过程中发挥着关键作用。本文概述了传感器技术,包括物理、化学和生物传感器,讨论了水质监测中评估的常见参数,如温度、pH值、溶解氧、浊度、电导率和营养物水平,重点探讨了水质监测和评估的各种方法,包括采样技术、实验室分析方法和在线监测系统,并借助这些技术实现实时数据收集和持续监测,增强保护水资源的能力。

Methodological quality(risk of bias) assessment tools for primary and secondary medical studies: What are they and which is better?

Methodological quality(risk of bias)assessment is an important step before study initiation usage.Therefore,accurately judging study type is the first priority,and the choosing proper tool is also important.In this review,we introduced methodological quality assessment tools for randomized controlled trial(including individual and cluster),animal study,non-randomized interventional studies(including follow-up study,controlled before-and-after study,before-after/pre-post study,uncontrolled longitudinal study,interrupted time series study),cohort study,case-control study,cross-sectional study(including analytical and descriptive),observational case series and case reports,comparative effectiveness research,diagnostic study,health economic evaluation,prediction study(including predictor finding study,prediction model impact study,prognostic prediction model study),qualitative study,outcome measurement instruments(including patient-reported outcome measure development,content validity,structural validity,internal consistency,cross-cultural validity/measurement invariance,reliability,measurement error,criterion validity,hypotheses testing for construct validity,and responsiveness),systematic review and meta-analysis,and clinical practice guideline.The readers of our review can distinguish the types of medical studies and choose appropriate tools.In one word,comprehensively mastering relevant knowledge and implementing more practices are basic requirements for correctly assessing the methodological quality.

Quality evaluation and content analysis of non-drug guidelines on risk factors of secondary prevention of myocardial infarction

Purpose: To strictly evaluate the quality of guidelines on risk factors related to secondaryprevention of myocardial infarction (MI), and to summarize and analyze the relevantrecommendations, and to provide evidence-based support for medical staff to developinterventions related risk factors for MI patients. Methods: The professional guideline websitesand databases in English and Chinese were retrieved, and the references related guidelines weretraced to get the published guidelines. Appraisal of Guidelines for Research and Evaluation IIwas used to evaluate the methodological quality of the guidelines. Then the relevantrecommendations for MI were summarized and analyzed. Results: A total of 8 guidelines,including evidence-based guidelines and expert consensus were included in the initial review of2,099 articles, among which 2 from the UK, 1 from the US and 5 from China. The overallquality of the included guidelines is moderate. However, some guidelines score relatively lowin the dimensions of rigor of development, clarity of presentations and editorial independence.A total of 24 items were extracted, including three risk factors: blood pressure, blood sugar andblood lipid. The recommendations mainly cover the relevant target values of risk factors,providing evidence-based support for medical staff to control and guide the risk factors ofpatients with MI in three aspects, such as blood pressure, blood sugar and blood lipid, whichproviding the theory basis for self-monitoring. Conclusions: It is recommended that clinicalpractice on risk factors of MI should be based on best evidence and fully put the individualfactors into account.