Factors influencing parent satisfaction with preventive health services for the early detection of speech and language delay in preschool children

The aim of this study was to identify parent and child characteristics which could influence parent satisfaction with preventive health services designed to detect preschool children with speech and language (SL) delay. This study was conducted on 101 children aged 18 to 36 months who participated in an organized SL delay early detection program. Validated instruments were used to assess children’s and parents’ characteristics. Satisfaction was evaluated using the client satisfaction questionnaire for the three activities of the program: 1) a public information session about SL development, 2) parent training sessions for parents concerned by their child SL development, and 3) a child’s SL assessment. Multiple logistic regressions were used to identify all independent factors (p < 0.05) associated with satisfaction and to estimate the odds ratios (OR) for satisfaction. Economically disadvantaged parents were less prone to participate in the first two activities of the early detection program. Older parents were more satisfied with the public information session (OR = 1.33 for 1 year increment;p = 0.001). Distressed parents were less satisfied with both the parent training sessions (OR = 0.28;p = 0.009) and the SL assessment (OR = 0.43;p = 0.046). Parents whose child had health problems at birth were less satisfied with the public information session (OR = 0.14, p = 0.03) and the SL assessment (OR = 0.33, p = 0.036). There is a need to better adapt the delivery of preventive services for the early detection of SL delay, especially for disadvantaged and distressed parents and for those whose child had suffered from health problems at birth.

Enhancing diabetic retinopathy screening:Non-mydriatic fundus photography-assisted telemedicine for improved clinical management

The utilization of non-mydriatic fundus photography-assisted telemedicine to screen patients with diabetes mellitus for diabetic retinopathy provides an accurate,efficient,and cost-effective method to improve early detection of disease.It has also been shown to correlate with increased participation of patients in other aspects of diabetes care.In particular,patients who undergo teleretinal imaging are more likely to meet Comprehensive Diabetes Care Healthcare Effectiveness Data and Information Set metrics,which are linked to preservation of quality-adjusted life years and additional downstream healthcare savings.

Climate change indirectly enhances sandstorm prevention services by altering ecosystem patterns on the Qinghai-Tibet Plateau

Climate change influences both ecosystems and ecosystem services.The impacts of climate change on ecosystems and ecosystem services have been separately documented.However,it is less well known how ecosystem changes driven by climate change will influence ecosystem services,especially in climate-sensitive regions.Here,we analyzed future climate trends between 2040 and 2100 under four Shared Socioeconomic Pathway(SSP) scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0,and SSP5-8.5) from the Coupled Model Intercomparison Project 6(CMIP6).We quantified their impacts on ecosystems patterns and on the ecosystem service of sandstorm prevention on the Qinghai-Tibet Plateau(QTP),one of the most climate-sensitive regions in the world,using Random Forest model(RF) and Revised Wind Erosion Equation(RWEQ).Strong warming(0.04℃/yr) and wetting(0.65 mm/yr) trends were projected from 2015 to 2100.Under these trends,there will be increased interspersion in the pattern of grassland and sparse vegetation with meadow and swamp vegetation,although their overall area will remain similar,while the areas of shrub and needleleaved forest classes will increase and move toward higher altitudes.Driven by the changes in ecosystem patterns caused by climate change indirectly,grassland will play an irreplaceable role in providing sandstorm prevention services,and sandstorm prevention services will increase gradually from 2040 to 2100(1.059-1.070 billion tons) on the QTP.However,some areas show a risk of deterioration in the future and these should be the focus of ecological rehabilitation.Our research helps to understand the cascading relationship among climate change,ecosystem patterns and ecosystem services,which provides important spatio-temporal information for future ecosystem service management.

Spatiotemporal change of beneficiary area from wind erosion prevention service in the Ulan Buh Desert in 2008 and 2018

The Ulan Buh Desert is one of the eight deserts in China that provides wind erosion prevention service(i.e.,the ecosystem;vegetation,production,and construction activities that promote sand fixation).It is significant for the construction of the national ecological barrier,and the protection of the ecological security in the Yellow River and North China.In this study,we selected two representative years(2008 and 2018)and quantified wind erosion prevention service from the Ulan Buh Desert using the RWEQ model.Meanwhile,the HYSPLIT model was used to simulate the spatial flow process from the service supply area to the beneficiary area and to determine its scope.The specific dust reduction amount in the beneficiary area was then calculated.The energy and the time-space relation of wind erosion prevention service in the areas that receive benefits from Ulan Buh Desert were compared before and after implementing environmental restoration measures.The results showed that:(1)the total amount of wind erosion prevention in the Ulan Buh Desert in 2018 was 2.12×10^(10)kg,which was 5.17 times higher than that in 2008;(2)in 2018,the distribution density of the flow path of wind erosion prevention service was lower than that in 2008,and the flow paths in each year were concentrated in the beneficiary areas with the path distribution frequency of less than 10%;(3)the total dust reduction in the downwind area of the Ulan Buh Desert in 2018 was higher than that in 2008,totaling 15.54 million tons.Inner Mongolia Autonomous Region and Shanxi Province had the most significant amount of dust reduction.

An Evidence-Based Management Approach to HIV/AIDS in Nigeria

Objectives: This paper seeks to examine the history of HIV/AIDS in Nigeria while presenting a clear picture of some of the issues that exist in service delivery. Lastly, this paper explores how an evidence-based management approach offers an effective set of tools to HIV/AIDS organizations. Methods: Content analysis and a qualitative desk review of the literature. Results: Findings from this paper reveal that through the use of evidence-based management, preconceived notions can be challenged so as to yield a diversity of thought and a more people-centered approach to public health delivery. This paper also shows that in the Nigerian setting, an evidence-based management framework can be a transformative tool in ensuring that key populations can receive critical care and treatment in the long run despite the uncertainty that might exist when it comes to funding and resources. Conclusions: Evidence-based management is a rigorous framework that can be used for understanding how a multitude of factors can position an organization to achieve its theory of change, which in turn can lead to sustainable impact in the long run. Incorporating the use of evidence in everyday organizational behavior involves not only looking at the manner in which data is aggregated, but also how it is disseminated. In order to ensure that the evidence is not manipulated, nonprofit organizations are often viewed as being best suited for collecting evidence since they are not heavily plagued by systemic corruption and political tides, compared to their government counterparts.

Evaluation of Inner Mongolia Wind Erosion Prevention Service based on Land Use and the RWEQ Model

Inner Mongolia is the important ecological barrier zone in northern China,which plays an important role in the prevention and control of wind in the regional ecosystem.Based on the Revised Wind Erosion Equation(RWEQ)model and the cost-recovery method,this study simulated the wind erosion prevention service(WEPS)in Inner Mongolia in 2010 and 2015,investigated the spatial pattern of material and monetary value of WEPS,and analyzed the differences among various cities and various ecosystems.The results indicated that the total WEPS of Inner Mongolia was estimated to be 73.87×10^(8) t in 2015,which was 4.61×10^(8) t less than in 2010,while the monetary value of WEPS was calculated to be 738.66×10^(8) yuan in 2015,which was 46.16×10^(8) yuan less than in 2010.Among all the leagues and cities,Xilin Gol League supported the highest WEPS,reaching 18.65×10^(8) t in 2015,while Wuhai provided the lowest.The WEPS of Hulunbeier increased the most,by 4.37×10^(8) t from 2010 to 2015.The WEPS in the grassland ecosystem was the highest among the different ecosystems,accounting for more than55%of the total WEPS in Inner Mongolia,but it was reduced by 1.05×10^(8) t during the same period.The WEPS in the forest ecosystem increased the most,reaching 0.19×10^(8) t.This study found that the implementation of projects such as returning farmland to forests and grasses and sand control effectively increased the WEPS by increasing the forest area.However,unsuitable land use increased the desertification of ecosystems which resulted in a reduction of WEPS in Inner Mongolia.