BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartu...BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.展开更多
Background:In the current social environment,scarcity,as a universally present objective state,profoundly impacts individuals’decision-making and health through the subjective feeling it induces,known as a“scarcity ...Background:In the current social environment,scarcity,as a universally present objective state,profoundly impacts individuals’decision-making and health through the subjective feeling it induces,known as a“scarcity mindset.”Particularly,the feeling of scarcity related to money and sleep time is not only widespread but also directly linked to an individual’s mental health.Purpose:This study aims to delve into the relationship between the feeling of scarcity and mental health,with a specific focus on the relationship between the feeling of money scarcity or sleep time scarcity and mental health,as well as the role of sleep quality or life satisfaction in this relationship.Procedure:We determined the sampling quotas based on the population and economic development levels of each province in the“China Statistical Yearbook(2021)”(National Bureau of Statistics,2021).Participants were selected using the Probability Proportional to Size(PPS)sampling method.Data was collected by distributing online questionnaires to participants,and the relationships between the main variables were explored using structural equation modeling.Results:1.In China,the feeling of sleep time scarcity is stronger than the feeling of money scarcity among the public.2.The feeling of money scarcity is positively correlated with depression and anxiety,whereas the feeling of sleep time scarcity is only positively correlated with depression.3.The feeling of scarcity mainly leads to depression and self-denial through reducing life satisfaction,and it leads to anxiety through reducing sleep quality.Conclusion:The feeling of scarcity in money and sleep time is related to different dimensions of mental health.Therefore,reasonably planning financial allocation and ensuring an adequate amount of sleep can reduce the sense of scarcity,thereby improving mental health.Additionally,improving sleep quality and increasing life satisfaction can alleviate the adverse effects of scarcity on mental health.展开更多
BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improv...BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.展开更多
Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Met...Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.展开更多
The paper selected Chinese Cruise Line as the case study. Having based on the survey data of Chinese cruise tourism consumers, the factor analysis method, one-way analysis of variances method, cluster analysis method,...The paper selected Chinese Cruise Line as the case study. Having based on the survey data of Chinese cruise tourism consumers, the factor analysis method, one-way analysis of variances method, cluster analysis method, and other quantitative and qualitative methods were taken to analyze Chinese consumers’ satisfaction differences of cruise tourism service quality with different segmentation markets and clusters markets, and the reasons of satisfaction differences were also explored. Then precision marketing strategy of Chinese cruise tourism with different segmentation markets and clusters markets from the supply-side reform perspective was discussed. The purpose of current research was to provide suggestions of precision management and precision marketing of Chinese cruise tourism for relevant enterprises and government departments.展开更多
Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and wa...Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and water quality parameters in Nairobi City, focusing on the impacts of rainfall and temperature on surface water quality. Data from multiple sources, including the Water Resources Authority, Nairobi Water and Sewerage Company, and the World Bank’s Climate Change Knowledge Portal, were analyzed to assess the relationships between meteorological variables (rainfall and temperature) and water quality parameters (such as electroconductivity, biochemical oxygen demand, chloride, and pH). The analysis reveals varying impacts of rainfall and temperature on different water quality parameters. While parameters like iron and pH show strong relationships with both rainfall and temperature, others such as ammonia and nitrate exhibit moderate relationships. Additionally, the study highlights the influence of runoff, urbanization, and industrial activities on water quality, emphasizing the need for holistic management approaches. Recommendations encompass the establishment of annual publications on Nairobi River water quality, online accessibility of water quality data, development of hydrological models, spatial analysis, and fostering cross-disciplinary research collaborations. Implementing these recommendations can enhance water quality management practices, mitigate risks, and safeguard environmental integrity in Nairobi City.展开更多
The accelerated growth of the vehicular fleet, the modernization of large urban centers, and the few adjustments to the road network in Fortaleza have intensified the problems of traffic and emissions of atmospheric p...The accelerated growth of the vehicular fleet, the modernization of large urban centers, and the few adjustments to the road network in Fortaleza have intensified the problems of traffic and emissions of atmospheric pollutants, highlighting the necessity for strategic urban planning initiatives to address the escalating issues of traffic and pollution. With the objective of analyzing the indices of concentrations of atmospheric pollutants and estimating how these levels can affect human health, this work consists of a study of the analysis of air quality in the intense trade region of Fortaleza. For this, the analysis zone was divided into three perimeters (Major - Medium - Minor), where each perimeter was analyzed at 7 am, 12 noon and 5 pm. Concentrations of the type of O<sub>3</sub>, particulate matter (PM<sub>2.5</sub> and PM<sub>10</sub>), CO<sub>2</sub> and HCHO were collected. Our results demonstrate that most of the analyses are within the limits of current legislation;however, at certain times and perimeters, the analyses of CO<sub>2</sub> and HCHO exceeded the established limits. In view of the above, we conclude that public policies to control air quality are necessary to reduce the damage to human health and the environment caused by pollutants.展开更多
Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data...Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.展开更多
BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown...BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.展开更多
The Keriya River Basin is located in an extremely arid climate zone on the southern edge of the Tarim Basin of Northwest China,exhibiting typical mountain-oasis-desert distribution characteristics.In recent decades,cl...The Keriya River Basin is located in an extremely arid climate zone on the southern edge of the Tarim Basin of Northwest China,exhibiting typical mountain-oasis-desert distribution characteristics.In recent decades,climate change and human activities have exerted significant impacts on the service functions of watershed ecosystems.However,the trade-offs and synergies between ecosystem services(ESs)have not been thoroughly examined.This study aims to reveal the spatiotemporal changes in ESs within the Keriya River Basin from 1995 to 2020 as well as the trade-offs and synergies between ESs.Leveraging the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)and Revised Wind Erosion Equation(RWEQ)using land use/land cover(LULC),climate,vegetation,soil,and hydrological data,we quantified the spatiotemporal changes in the five principal ESs(carbon storage,water yield,food production,wind and sand prevention,and habitat quality)of the watershed from 1995 to 2020.Spearman correlation coefficients were used to analyze the trade-offs and synergies between ES pairs.The findings reveal that water yield,carbon storage,and habitat quality exhibited relatively high levels in the upstream,while food production and wind and sand prevention dominated the midstream and downstream,respectively.Furthermore,carbon storage,food production,wind and sand prevention,and habitat quality demonstrated an increase at the watershed scale while water yield exhibited a decline from 1995 to 2020.Specifically,carbon storage,wind and sand prevention,and habitat quality presented an upward trend in the upstream but downward trend in the midstream and downstream.Food production in the midstream showed a continuously increasing trend during the study period.Trade-off relationships were identified between water yield and wind and sand prevention,water yield and carbon storage,food production and water yield,and habitat quality and wind and sand prevention.Prominent temporal and spatial synergistic relationships were observed between different ESs,notably between carbon storage and habitat quality,carbon storage and food production,food production and wind and sand prevention,and food production and habitat quality.Water resources emerged as a decisive factor for the sustainable development of the basin,thus highlighting the intricate trade-offs and synergies between water yield and the other four services,particularly the relationship with food production,which warrants further attention.This research is of great significance for the protection and sustainable development of river basins in arid areas.展开更多
Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implicatio...Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implications for ecological protection and quality development of the Yellow River Basin.Therefore,in this study,we took Yan'an City,Shaanxi Province of China,as the study area,selected four typical ecosystem services,including soil conservation service,water yield service,carbon storage service,and habitat quality service,and quantitatively evaluated the spatiotemporal variation characteristics and trade-offs and synergies of ecosystem services from 2010 to 2018 using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.We also analysed the relationship between the GCLC project and regional ecosystem service changes in various regions(including 1 city,2 districts,and 10 counties)of Yan'an City and proposed a coordinated development strategy between the GCLC project and the ecological environment.The results showed that,from 2010 to 2018,soil conservation service decreased by 7.76%,while the other three ecosystem services changed relatively little,with water yield service increasing by 0.56% and carbon storage service and habitat quality service decreasing by 0.16% and 0.14%,respectively.The ecological environment of Yan'an City developed in a balanced way between 2010 and 2018,and the four ecosystem services showed synergistic relationships,among which the synergistic relationships between soil conservation service and water yield service and between carbon storage service and habitat quality service were significant.The GCLC project had a negative impact on the ecosystem services of Yan'an City,and the impact on carbon storage service was more significant.This study provides a theoretical basis for the scientific evaluation of the ecological benefits of the GCLC project and the realization of a win-win situation between food security and ecological security.展开更多
Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) ...Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.展开更多
BACKGROUND Systemic lupus erythematosus(SLE)is a heterogeneous autoimmune disorder with varied clinical courses and prognoses,not only did the patients suffer from physical impairment,but also various physical and psy...BACKGROUND Systemic lupus erythematosus(SLE)is a heterogeneous autoimmune disorder with varied clinical courses and prognoses,not only did the patients suffer from physical impairment,but also various physical and psychiatric comorbidities.Growing evidence have suggested that mental disorders in SLE patients,can lead to various adverse consequences.AIM To explored the features and influencing factors of mental health in patients with SLE and clarifying the correlations between mental health and personality characteristics and perceived social support.The results would provide a basis for psychological intervention in patients with SLE.METHODS The clinical data of 168 patients with SLE admitted at the First Affiliated Hospital of Hainan Medical University between June 2020 and June 2022 were collected.Psychological assessment and correlation analysis were conducted using the Symptom Checklist-90(SCL-90)and Perceived Social Support Scale,and the collected data were compared with the national norms in China.The relevant factors influencing mental health were identified by statistical analysis.A general information questionnaire,the Revised Life Orientation Test,and Short-Form 36-Item Health Survey were employed to assess optimism level and quality of life(QoL),respectively.RESULTS Patients with SLE obtained higher scores for the somatization,depression,anxiety,and phobic anxiety subscales than national norms(P<0.05).A correlation was identified between total social support and total SCL-90 score or each subscale(P<0.05).The factors significantly affecting patients’mental health were hormone dosage and disease activity index(DAI)(P<0.05).The average optimism score of patients with SLE was 14.36±4.42,and 30 cases were in the middle and lower levels.A positive correlation was found between optimism level and QoL scores.CONCLUSION Patients with SLE develop psychological disorders at varying degrees,which are significantly influenced by hormone dosage and DAI.Patients’mental health should be closely monitored during clinical diagnosis and treatment and provided adequate support in establishing positive,healthy thinking and behavior patterns and improving their optimism level and QoL.展开更多
BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality....BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality.This situation has garnered significant attention within the medical community.AIM To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients.METHODS One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)groups.Patients in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing model.Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models.RESULTS Patient satisfaction in the observation group was significantly higher than in the control group.The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group.After treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically significant.CONCLUSION Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.展开更多
Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhe...Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ<sup>2</sup>dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ<sup>2</sup>dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ<sup>2</sup>dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ<sup>2</sup>dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .展开更多
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
Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding s...Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.展开更多
The study aimed at assessing the physiochemical characteristics of rainwater in Warri and it environ was investigated. Pb, Zn, Cd, Cu and Cr concentrations in rainwater from roof and non-roof sources were determined u...The study aimed at assessing the physiochemical characteristics of rainwater in Warri and it environ was investigated. Pb, Zn, Cd, Cu and Cr concentrations in rainwater from roof and non-roof sources were determined using Atomic Absorption Spectrophotometry. Three geospatial locations comprising Jakpa, Udu, and Ubeji were selected based on prevailing anthropogenic activities. The rainwater samples were systematically collected from (aluminum) roof and non-roof sources for the months of April, June, and August and October 2022, treated and analyzed in the laboratory for sixteen physicochemical parameters. Results were statistically analyzed using ANOVA, and T-test for the determination of the level of relationships and variations across geospatial locations. Significant correlations (r = 0.72) exist between Cr in rainwater from roof and non-roof sources. Implying point-source contaminations and may be emanating from the influence of roof materials. Furthermore, high concentrations of Cd and Pb in roof source above WHO standards were mostly in Jakpa and Ubeji. Calculated Health Risk Index (HRI) for children and adult is greater than 1. The results showed that most samples from the locations are considered not safe (HRI > 1) especially for Cd, which means that there are potential health risks consuming rainwater from Jakpa, Udu and Ubeji. Therefore, there is need for prompt sensitization program to dissuade people from directly drinking rainwater from these locations.展开更多
Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 marri...Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.展开更多
On-demand availability and resource elasticity features of Cloud computing have attracted the focus of various research domains.Mobile cloud computing is one of these domains where complex computation tasks are offloa...On-demand availability and resource elasticity features of Cloud computing have attracted the focus of various research domains.Mobile cloud computing is one of these domains where complex computation tasks are offloaded to the cloud resources to augment mobile devices’cognitive capacity.However,the flexible provisioning of cloud resources is hindered by uncertain offloading workloads and significant setup time of cloud virtual machines(VMs).Furthermore,any delays at the cloud end would further aggravate the miseries of real-time tasks.To resolve these issues,this paper proposes an auto-scaling framework(ACF)that strives to maintain the quality of service(QoS)for the end users as per the service level agreement(SLA)negotiated assurance level for service availability.In addition,it also provides an innovative solution for dealing with the VM startup overheads without truncating the running tasks.Unlike the waiting cost and service cost tradeoff-based systems or threshold-rule-based systems,it does not require strict tuning in the waiting costs or in the threshold rules for enhancing the QoS.We explored the design space of the ACF system with the CloudSim simulator.The extensive sets of experiments demonstrate the effectiveness of the ACF system in terms of good reduction in energy dissipation at the mobile devices and improvement in the QoS.At the same time,the proposed ACF system also reduces the monetary costs of the service providers.展开更多
基金Supported by Department of Science and Technology of Liaoning Province,No.2021JH2/10300095.
文摘BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.
基金the Key Projects of Philosophy and Social Sciences Research,Ministry of Education(Grant Number 21JZD038).
文摘Background:In the current social environment,scarcity,as a universally present objective state,profoundly impacts individuals’decision-making and health through the subjective feeling it induces,known as a“scarcity mindset.”Particularly,the feeling of scarcity related to money and sleep time is not only widespread but also directly linked to an individual’s mental health.Purpose:This study aims to delve into the relationship between the feeling of scarcity and mental health,with a specific focus on the relationship between the feeling of money scarcity or sleep time scarcity and mental health,as well as the role of sleep quality or life satisfaction in this relationship.Procedure:We determined the sampling quotas based on the population and economic development levels of each province in the“China Statistical Yearbook(2021)”(National Bureau of Statistics,2021).Participants were selected using the Probability Proportional to Size(PPS)sampling method.Data was collected by distributing online questionnaires to participants,and the relationships between the main variables were explored using structural equation modeling.Results:1.In China,the feeling of sleep time scarcity is stronger than the feeling of money scarcity among the public.2.The feeling of money scarcity is positively correlated with depression and anxiety,whereas the feeling of sleep time scarcity is only positively correlated with depression.3.The feeling of scarcity mainly leads to depression and self-denial through reducing life satisfaction,and it leads to anxiety through reducing sleep quality.Conclusion:The feeling of scarcity in money and sleep time is related to different dimensions of mental health.Therefore,reasonably planning financial allocation and ensuring an adequate amount of sleep can reduce the sense of scarcity,thereby improving mental health.Additionally,improving sleep quality and increasing life satisfaction can alleviate the adverse effects of scarcity on mental health.
文摘BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.
文摘Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.
基金National Natural Science Foundation of China(72074053).
文摘The paper selected Chinese Cruise Line as the case study. Having based on the survey data of Chinese cruise tourism consumers, the factor analysis method, one-way analysis of variances method, cluster analysis method, and other quantitative and qualitative methods were taken to analyze Chinese consumers’ satisfaction differences of cruise tourism service quality with different segmentation markets and clusters markets, and the reasons of satisfaction differences were also explored. Then precision marketing strategy of Chinese cruise tourism with different segmentation markets and clusters markets from the supply-side reform perspective was discussed. The purpose of current research was to provide suggestions of precision management and precision marketing of Chinese cruise tourism for relevant enterprises and government departments.
文摘Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and water quality parameters in Nairobi City, focusing on the impacts of rainfall and temperature on surface water quality. Data from multiple sources, including the Water Resources Authority, Nairobi Water and Sewerage Company, and the World Bank’s Climate Change Knowledge Portal, were analyzed to assess the relationships between meteorological variables (rainfall and temperature) and water quality parameters (such as electroconductivity, biochemical oxygen demand, chloride, and pH). The analysis reveals varying impacts of rainfall and temperature on different water quality parameters. While parameters like iron and pH show strong relationships with both rainfall and temperature, others such as ammonia and nitrate exhibit moderate relationships. Additionally, the study highlights the influence of runoff, urbanization, and industrial activities on water quality, emphasizing the need for holistic management approaches. Recommendations encompass the establishment of annual publications on Nairobi River water quality, online accessibility of water quality data, development of hydrological models, spatial analysis, and fostering cross-disciplinary research collaborations. Implementing these recommendations can enhance water quality management practices, mitigate risks, and safeguard environmental integrity in Nairobi City.
文摘The accelerated growth of the vehicular fleet, the modernization of large urban centers, and the few adjustments to the road network in Fortaleza have intensified the problems of traffic and emissions of atmospheric pollutants, highlighting the necessity for strategic urban planning initiatives to address the escalating issues of traffic and pollution. With the objective of analyzing the indices of concentrations of atmospheric pollutants and estimating how these levels can affect human health, this work consists of a study of the analysis of air quality in the intense trade region of Fortaleza. For this, the analysis zone was divided into three perimeters (Major - Medium - Minor), where each perimeter was analyzed at 7 am, 12 noon and 5 pm. Concentrations of the type of O<sub>3</sub>, particulate matter (PM<sub>2.5</sub> and PM<sub>10</sub>), CO<sub>2</sub> and HCHO were collected. Our results demonstrate that most of the analyses are within the limits of current legislation;however, at certain times and perimeters, the analyses of CO<sub>2</sub> and HCHO exceeded the established limits. In view of the above, we conclude that public policies to control air quality are necessary to reduce the damage to human health and the environment caused by pollutants.
文摘Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.
文摘BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.
基金financially supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region(2022D01C77)the PhD Programs Foundation of Xinjiang University(BS202105).
文摘The Keriya River Basin is located in an extremely arid climate zone on the southern edge of the Tarim Basin of Northwest China,exhibiting typical mountain-oasis-desert distribution characteristics.In recent decades,climate change and human activities have exerted significant impacts on the service functions of watershed ecosystems.However,the trade-offs and synergies between ecosystem services(ESs)have not been thoroughly examined.This study aims to reveal the spatiotemporal changes in ESs within the Keriya River Basin from 1995 to 2020 as well as the trade-offs and synergies between ESs.Leveraging the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)and Revised Wind Erosion Equation(RWEQ)using land use/land cover(LULC),climate,vegetation,soil,and hydrological data,we quantified the spatiotemporal changes in the five principal ESs(carbon storage,water yield,food production,wind and sand prevention,and habitat quality)of the watershed from 1995 to 2020.Spearman correlation coefficients were used to analyze the trade-offs and synergies between ES pairs.The findings reveal that water yield,carbon storage,and habitat quality exhibited relatively high levels in the upstream,while food production and wind and sand prevention dominated the midstream and downstream,respectively.Furthermore,carbon storage,food production,wind and sand prevention,and habitat quality demonstrated an increase at the watershed scale while water yield exhibited a decline from 1995 to 2020.Specifically,carbon storage,wind and sand prevention,and habitat quality presented an upward trend in the upstream but downward trend in the midstream and downstream.Food production in the midstream showed a continuously increasing trend during the study period.Trade-off relationships were identified between water yield and wind and sand prevention,water yield and carbon storage,food production and water yield,and habitat quality and wind and sand prevention.Prominent temporal and spatial synergistic relationships were observed between different ESs,notably between carbon storage and habitat quality,carbon storage and food production,food production and wind and sand prevention,and food production and habitat quality.Water resources emerged as a decisive factor for the sustainable development of the basin,thus highlighting the intricate trade-offs and synergies between water yield and the other four services,particularly the relationship with food production,which warrants further attention.This research is of great significance for the protection and sustainable development of river basins in arid areas.
基金supported by the Innovation Capability Support Program of Shaanxi Province,China(2023-CX-RKX-102)the Key Research and Development Program of Shaanxi Province,China(2022FP-34)+1 种基金the Open Foundation of the Key Laboratory of Natural Resource Coupling Process and Effects(2023KFKTB008)the Open Fund of Shaanxi Key Laboratory of Land Consolidation,China(300102352502).
文摘Studying the spatiotemporal variations in ecosystem services and their interrelationships on the Loess Plateau against the background of the gully control and land consolidation(GCLC)project has significant implications for ecological protection and quality development of the Yellow River Basin.Therefore,in this study,we took Yan'an City,Shaanxi Province of China,as the study area,selected four typical ecosystem services,including soil conservation service,water yield service,carbon storage service,and habitat quality service,and quantitatively evaluated the spatiotemporal variation characteristics and trade-offs and synergies of ecosystem services from 2010 to 2018 using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)model.We also analysed the relationship between the GCLC project and regional ecosystem service changes in various regions(including 1 city,2 districts,and 10 counties)of Yan'an City and proposed a coordinated development strategy between the GCLC project and the ecological environment.The results showed that,from 2010 to 2018,soil conservation service decreased by 7.76%,while the other three ecosystem services changed relatively little,with water yield service increasing by 0.56% and carbon storage service and habitat quality service decreasing by 0.16% and 0.14%,respectively.The ecological environment of Yan'an City developed in a balanced way between 2010 and 2018,and the four ecosystem services showed synergistic relationships,among which the synergistic relationships between soil conservation service and water yield service and between carbon storage service and habitat quality service were significant.The GCLC project had a negative impact on the ecosystem services of Yan'an City,and the impact on carbon storage service was more significant.This study provides a theoretical basis for the scientific evaluation of the ecological benefits of the GCLC project and the realization of a win-win situation between food security and ecological security.
文摘Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
基金Supported by National Natural Science Foundation of China,No.81760840 and No.82160874Natural Science Foundation of Hainan Province,No.2019RC206.
文摘BACKGROUND Systemic lupus erythematosus(SLE)is a heterogeneous autoimmune disorder with varied clinical courses and prognoses,not only did the patients suffer from physical impairment,but also various physical and psychiatric comorbidities.Growing evidence have suggested that mental disorders in SLE patients,can lead to various adverse consequences.AIM To explored the features and influencing factors of mental health in patients with SLE and clarifying the correlations between mental health and personality characteristics and perceived social support.The results would provide a basis for psychological intervention in patients with SLE.METHODS The clinical data of 168 patients with SLE admitted at the First Affiliated Hospital of Hainan Medical University between June 2020 and June 2022 were collected.Psychological assessment and correlation analysis were conducted using the Symptom Checklist-90(SCL-90)and Perceived Social Support Scale,and the collected data were compared with the national norms in China.The relevant factors influencing mental health were identified by statistical analysis.A general information questionnaire,the Revised Life Orientation Test,and Short-Form 36-Item Health Survey were employed to assess optimism level and quality of life(QoL),respectively.RESULTS Patients with SLE obtained higher scores for the somatization,depression,anxiety,and phobic anxiety subscales than national norms(P<0.05).A correlation was identified between total social support and total SCL-90 score or each subscale(P<0.05).The factors significantly affecting patients’mental health were hormone dosage and disease activity index(DAI)(P<0.05).The average optimism score of patients with SLE was 14.36±4.42,and 30 cases were in the middle and lower levels.A positive correlation was found between optimism level and QoL scores.CONCLUSION Patients with SLE develop psychological disorders at varying degrees,which are significantly influenced by hormone dosage and DAI.Patients’mental health should be closely monitored during clinical diagnosis and treatment and provided adequate support in establishing positive,healthy thinking and behavior patterns and improving their optimism level and QoL.
文摘BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality.This situation has garnered significant attention within the medical community.AIM To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients.METHODS One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)groups.Patients in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing model.Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models.RESULTS Patient satisfaction in the observation group was significantly higher than in the control group.The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group.After treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically significant.CONCLUSION Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.
文摘Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ<sup>2</sup>dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ<sup>2</sup>dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ<sup>2</sup>dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ<sup>2</sup>dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .
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.
基金Under the auspices of the National Social Science Found of China(No.21XGL019)Hainan Provincial Natural Science Foundation of China(No.421RC1034)Professor/Doctor Research Foundation of Huizhou University(No.2022JB080)。
文摘Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.
文摘The study aimed at assessing the physiochemical characteristics of rainwater in Warri and it environ was investigated. Pb, Zn, Cd, Cu and Cr concentrations in rainwater from roof and non-roof sources were determined using Atomic Absorption Spectrophotometry. Three geospatial locations comprising Jakpa, Udu, and Ubeji were selected based on prevailing anthropogenic activities. The rainwater samples were systematically collected from (aluminum) roof and non-roof sources for the months of April, June, and August and October 2022, treated and analyzed in the laboratory for sixteen physicochemical parameters. Results were statistically analyzed using ANOVA, and T-test for the determination of the level of relationships and variations across geospatial locations. Significant correlations (r = 0.72) exist between Cr in rainwater from roof and non-roof sources. Implying point-source contaminations and may be emanating from the influence of roof materials. Furthermore, high concentrations of Cd and Pb in roof source above WHO standards were mostly in Jakpa and Ubeji. Calculated Health Risk Index (HRI) for children and adult is greater than 1. The results showed that most samples from the locations are considered not safe (HRI > 1) especially for Cd, which means that there are potential health risks consuming rainwater from Jakpa, Udu and Ubeji. Therefore, there is need for prompt sensitization program to dissuade people from directly drinking rainwater from these locations.
文摘Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.
基金This research work is funded by TEQIP-III under Assistantship Head:1.3.2.2 in PFMS dated 29.06.2021.
文摘On-demand availability and resource elasticity features of Cloud computing have attracted the focus of various research domains.Mobile cloud computing is one of these domains where complex computation tasks are offloaded to the cloud resources to augment mobile devices’cognitive capacity.However,the flexible provisioning of cloud resources is hindered by uncertain offloading workloads and significant setup time of cloud virtual machines(VMs).Furthermore,any delays at the cloud end would further aggravate the miseries of real-time tasks.To resolve these issues,this paper proposes an auto-scaling framework(ACF)that strives to maintain the quality of service(QoS)for the end users as per the service level agreement(SLA)negotiated assurance level for service availability.In addition,it also provides an innovative solution for dealing with the VM startup overheads without truncating the running tasks.Unlike the waiting cost and service cost tradeoff-based systems or threshold-rule-based systems,it does not require strict tuning in the waiting costs or in the threshold rules for enhancing the QoS.We explored the design space of the ACF system with the CloudSim simulator.The extensive sets of experiments demonstrate the effectiveness of the ACF system in terms of good reduction in energy dissipation at the mobile devices and improvement in the QoS.At the same time,the proposed ACF system also reduces the monetary costs of the service providers.