Nature reserves play a significant role in providing ecosystem services and are key sites for biodiversity conservation.The Tianchi Bogda Peak Natural Reserve(TBPNR),located in Xinjiang Uygur Autonomous Region,China,i...Nature reserves play a significant role in providing ecosystem services and are key sites for biodiversity conservation.The Tianchi Bogda Peak Natural Reserve(TBPNR),located in Xinjiang Uygur Autonomous Region,China,is an important ecological barrier area in the temperate arid zone.The evaluation of its important ecosystem services is of great significance to improve the management level and ecological protection efficiency of the reserve.In the present study,we assessed the spatiotemporal variations of four ecosystem services(including net primary productivity(NPP),water yield,soil conservation,and habitat quality)in the TBPNR from 2000 to 2020 based on the environmental and social data using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.In addition,the coldspot and hotspot areas of ecosystem services were identified by hotspot analysis,and the trade-off and synergistic relationships between ecosystem services were analyzed using factor analysis in a geographic detector.During the study period,NPP and soil conservation values in the reserve increased by 48.20%and 25.56%,respectively;conversely,water yield decreased by 16.56%,and there was no significant change in habitat quality.Spatially,both NPP and habitat quality values were higher in the northern part and lower in the southern part,whereas water yield showed an opposite trend.Correlation analysis revealed that NPP showed a synergistic relationship with habitat quality and soil conservation,and exhibited a trade-off relationship with water yield.Water yield and habitat quality also had a trade-off relationship.NPP and habitat quality were affected by annual average temperature and Normalized Difference Vegetation Index(NDVI),respectively,while water yield and soil conservation were more affected by digital elevation model(DEM).Therefore,attention should be paid to the spatial distribution and dynamics of trade-off and synergistic relationships between ecosystem services in future ecological management.The findings of the present study provide a reference that could facilitate the sustainable utilization of ecosystem services in the typical fragile areas of Northwest China.展开更多
Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to est...Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served;they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.展开更多
目的:基于需方角度对纵向整合模式下的基层医疗卫生机构服务质量进行评价。方法:以北京市大兴区仁和医院和礼贤中心卫生院组成的纵向整合模式为典型案例,利用初级卫生保健质量评价工具PCAT-中文版(Primary Care Assessment Tool)对基层...目的:基于需方角度对纵向整合模式下的基层医疗卫生机构服务质量进行评价。方法:以北京市大兴区仁和医院和礼贤中心卫生院组成的纵向整合模式为典型案例,利用初级卫生保健质量评价工具PCAT-中文版(Primary Care Assessment Tool)对基层医疗卫生机构就诊病人采取出口调查。定量数据采用描述性统计和多元线性回归分析方法,定性数据采用主题框架分析法。结果:纵向整合模式下,该基层医疗卫生机构PCAT总得分为20.09,"首诊性"为6.59,"连续性"为3.27,"协调性"为4.58,"综合性"为5.62;三个延伸维度"以家庭为中心"为3.07,"面向社区"为1.86,"就医文化"为2.67;PCAT得分在患者就医次数和就医时间长短两个变量具有统计学意义。结论:纵向整合模式下基层医疗卫生机构的首诊性较好,连续性和三个延伸维度仍需进一步加强。未来应借助纵向整合模式的深入开展继续加强基层医疗卫生机构的服务连续性和向下转诊能力,并继续跟踪其效果。展开更多
The reciprocal relationship between mental and physical health is well established.Undiagnosed,untreated,and poorly managed mental health conditions are associated with numerous physical health complications,poor trea...The reciprocal relationship between mental and physical health is well established.Undiagnosed,untreated,and poorly managed mental health conditions are associated with numerous physical health complications,poor treatment adherence,and decreased quality of life.Despite growing evidence regarding the importance of effectively addressing these conditions in primary care,the rates of identification remain low and follow-up and management by primary care providers has been criticized.The objective of this review was to demonstrate the role of Patient-Centered Medical Home(PCMH)and mental health integration in addressing comprehensive health care needs in primary care patients,and to describe common barriers and facilitators to the implementation of these types of programs.展开更多
基金This research was funded by the Key Laboratory for Sustainable Development of Xinjiang's Historical and Cultural Tourism,Xinjiang University,China(LY2022-06)the Tianchi Talent Project.
文摘Nature reserves play a significant role in providing ecosystem services and are key sites for biodiversity conservation.The Tianchi Bogda Peak Natural Reserve(TBPNR),located in Xinjiang Uygur Autonomous Region,China,is an important ecological barrier area in the temperate arid zone.The evaluation of its important ecosystem services is of great significance to improve the management level and ecological protection efficiency of the reserve.In the present study,we assessed the spatiotemporal variations of four ecosystem services(including net primary productivity(NPP),water yield,soil conservation,and habitat quality)in the TBPNR from 2000 to 2020 based on the environmental and social data using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.In addition,the coldspot and hotspot areas of ecosystem services were identified by hotspot analysis,and the trade-off and synergistic relationships between ecosystem services were analyzed using factor analysis in a geographic detector.During the study period,NPP and soil conservation values in the reserve increased by 48.20%and 25.56%,respectively;conversely,water yield decreased by 16.56%,and there was no significant change in habitat quality.Spatially,both NPP and habitat quality values were higher in the northern part and lower in the southern part,whereas water yield showed an opposite trend.Correlation analysis revealed that NPP showed a synergistic relationship with habitat quality and soil conservation,and exhibited a trade-off relationship with water yield.Water yield and habitat quality also had a trade-off relationship.NPP and habitat quality were affected by annual average temperature and Normalized Difference Vegetation Index(NDVI),respectively,while water yield and soil conservation were more affected by digital elevation model(DEM).Therefore,attention should be paid to the spatial distribution and dynamics of trade-off and synergistic relationships between ecosystem services in future ecological management.The findings of the present study provide a reference that could facilitate the sustainable utilization of ecosystem services in the typical fragile areas of Northwest China.
文摘Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served;they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.
文摘目的:基于需方角度对纵向整合模式下的基层医疗卫生机构服务质量进行评价。方法:以北京市大兴区仁和医院和礼贤中心卫生院组成的纵向整合模式为典型案例,利用初级卫生保健质量评价工具PCAT-中文版(Primary Care Assessment Tool)对基层医疗卫生机构就诊病人采取出口调查。定量数据采用描述性统计和多元线性回归分析方法,定性数据采用主题框架分析法。结果:纵向整合模式下,该基层医疗卫生机构PCAT总得分为20.09,"首诊性"为6.59,"连续性"为3.27,"协调性"为4.58,"综合性"为5.62;三个延伸维度"以家庭为中心"为3.07,"面向社区"为1.86,"就医文化"为2.67;PCAT得分在患者就医次数和就医时间长短两个变量具有统计学意义。结论:纵向整合模式下基层医疗卫生机构的首诊性较好,连续性和三个延伸维度仍需进一步加强。未来应借助纵向整合模式的深入开展继续加强基层医疗卫生机构的服务连续性和向下转诊能力,并继续跟踪其效果。
文摘The reciprocal relationship between mental and physical health is well established.Undiagnosed,untreated,and poorly managed mental health conditions are associated with numerous physical health complications,poor treatment adherence,and decreased quality of life.Despite growing evidence regarding the importance of effectively addressing these conditions in primary care,the rates of identification remain low and follow-up and management by primary care providers has been criticized.The objective of this review was to demonstrate the role of Patient-Centered Medical Home(PCMH)and mental health integration in addressing comprehensive health care needs in primary care patients,and to describe common barriers and facilitators to the implementation of these types of programs.
