Sexual and reproductive health service needs of university/ college students： updates from a survey in Shanghai, China

Aim： To promote the provision of reproductive health services to young people by exploring the attitudes and perceptions of university students in Shanghai, China, toward reproductive health. Methods： From July 2004 to May 2006, 5 243 students from 14 universities in Shanghai took part in our survey. Topics covered the demands of reproductive health-care services, attitudes towards and experience with sex, exposure to pornographic material, and knowledge on sexual health and sexually transmitted infections （STIs）/AIDS. Results： Of the 5 067 students who provided valid answer sheets, 50.05% were female and 49.95% were male, 14.86% were medical students, and 85.14% had non-medical backgrounds. A total of 38.4% of respondents had received reproductive health education previously. The majority of students supported school-based reproductive health education, and also acquired information about sex predominantly from books, schoolmates, and the Internet. Premarital sexual behavior was opposed by 17.7% of survey participants, and 37.5% could identify all the three types of STIs listed in the questionnaire. Although 83.7% knew how HIV is transmitted, only 55.7% knew when to use a condom and 57.8% knew that the use of condoms could reduce the risk of HIV infection. Conclusion： The reproductive health service is lagging behind current attitudes and demands of university students. Although students＇ attitudes towards sexual matters are liberal, their knowledge about reproductive health and STIs/AIDS is still limited. It is therefore necessary to provide effective and confidential reproductive health services to young people.

Preliminary construction of evaluation indicator system for inpatients'nursing service needs in tertiary general hospital

Objectives:To construct a comprehensive evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients'nursing services.Method:We used the Delphi method to conduct two rounds of expert consultations with 41 experts.Result:The indicator system consisting of 5 first-level indicators and 48 second-level indicators was preliminarily constructed.Conclusions:We formed an evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and classified it into five categories:hospital environment,nursing attitude,nursing skills,information exchange,and emotional support.The indicator system is scientific and reliable.It can provide a basis for nursing staffs to identify and meet the needs of inpatients'care services.

Identifying Service Needs from the Perspective of Service Providers—A Qualitative Study

The provision of high-quality medical care has become a key challenge in many countries. At the same time, there is a growing awareness that the early detection of chronic diseases can reduce mortality rates. Therefore, it is important to identify service needs which influence to participate in health screening. To date, little research has been conducted into the perspectives of service providers on this topic. In this preliminary study, we aimed to explore the perspectives of service providers who work in a community-based setting in order to identify perceived barriers to chronic disease screening and incentives which can increase participation rates. In-depth interviews were conducted with 10 experienced health service providers from October 2017 to December 2017. Interviewees included physicians and community health representatives who had been working in a community-based health screening service for at least 3 years. The study identified several aspects of health screening services for chronic diseases that are in need of improvement, including a shortage of appropriate health service providers, inadequate attendance promoting measures, a lack of continually accessible and affordable medical services, healthcare professionals who possess inadequate communication skills, and rural-urban health care disparities. Service providers believe that current services do not fulfill community needs. Older adults who live in rural areas experience especially significant screening-related health disparities, which are mainly affected by structural service barriers. To improve the quality of medical services, healthcare screening services should be evaluated according to the perspectives of both participants and service providers.

Research progress on the health status and community management service needs of mobile elderly people

The health status of the floating elderly population and the need of community management services are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile elderly people have more health and psy-chological problems compared to the rest of the elderly population.Therefore,the community should take a variety of measures to meet their needs and help them to better adapt to the new living environment,and maintain their physical and mental health.This paper aims to summarize recent studies on the physical and emotional health problems of mobile elderly people and related community management service needs.

Core competencies and perceived training needs of nurses in the background of Internet plus nursing service:a qualitative descriptive study

Background:The Internet plus nursing service program is being piloted in China,which has become a new home nursing service model led by nurses.To enable safe and effective homecare service delivery,nurses working in the program need a high level of competency.However,the content of these core competencies and the training needs of nurses for Internet plus nursing services are still unknown.Aim:To describe nurses’perceptions of core competencies and training needs to work in the Internet plus nursing service program,thereby providing a reference for the development of training programs.Methods:A qualitative descriptive study using semi-structured interviews was conducted on 15 nurses with experience of working in the Internet plus nursing service program.Interviews were audio-recorded and transcribed verbatim,and the data were analyzed using thematic analysis.Results:Core competencies involved comprehensive assessment competence,direct care practice competence,health education and consulting competence,risk estimation and response competence,and communication competence.Training needs involved complex operational items,knowledge of chronic disease management,professional communication,risk identification and response,nursing standards,norms,and procedures,and utilization of information technology.Conclusions:The training system may be developed based on nurses’core competencies and their training needs to promote professional development of the Internet plus nursing service.

Relationship between the use of smart medical services and mental health status

In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.

Health service needs of women with reproductive tract infections in selected areas of China

OBJECTIVE: To provide insight into the psychosocial factors underlying the utilisation of health services by women with reproductive tract infection (RTI) symptoms. METHODS: A cross-sectional study, adopting Aday and Andersen' s Social Behaviour Model, was conducted between 1998 and 1999 in Chinese Hebei province and Beijing. A total of 864 eligible married women (age 21 to 60 years) were face to face interviewed. RESULTS: The percentage of self-reported symptoms of RTIs in urban and rural women was 35.6 and 46.8, respectively; the proportion of women with RTIs who utilised health services was 27.5% and 26.7%, respectively. Compared to urban women, rural women had less knowledge on RTIs and more traditional beliefs, and were more satisfied with local health services. The results of logistic regression analysis showed that the common factor influencing health service utilisation in women with RTIs was current experience of RTIs. Knowledge about self-medication, perceived social stigma attached to RTIs, prior experience of RTIs, family income and perceived severity of RTIs were also predictors of utilisation of health services in rural women with RTIs. Satisfaction with health providers, information received from health providers, prior experience of RTIs, occupation and medical care coverage were predictors of utilisation of health services in urban women with RTIs. CONCLUSION: The prevalence of RTIs is high, but the rate of seeking health services is low. There is a great need for emphasizing culturally acceptable reproductive health education in different places to improve women' s ability for self-care. Regular medical check-ups for women are also important. It is necessary to improve the quality of health service, complete the reform of health insurance and alleviate women' s social stigma related to RTIs, giving women social and moral support.

A study on the health service demands and influence factors among elderly people based on a community survey in Western China

Objective:To investigate the health service demands and to analyze influencing factors among elderly people based on a community survey in Guilin,China.Methods:A random sampling was used to investigate 366 elderly people in a community using a Health-Care-Needs questionnaire,which was designed by The Western Nursing Alliance research team in China.This survey was used to understand the basic situation,financial condition,health condition,self-care abilities,pension plan,and care services demands of the elderly residing at home.Additionally,this article analyzed the influencing factors contributing to the obtained results.Results:The top 3 nursing needs were security needs(1.61±0.45 points),health education needs(1.54±0.57 points),and respect and self-development needs(1.13±0.64 points).Logistic multifactor regression analysis showed that gender,monthly income,lack of exercise,activities of daily living(ADL)scores,methods of medical payment,and pension plan were independent factors affecting elderly nursing needs.Conclusions:The home-based health services supply for elders did not meet their needs.Therefore,a comprehensive approach considering multifactors such as gender,income,exercise,self-care ability,medical expense payments,and supporting preferences should be considered to address the complex needs of health care.

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years＇medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

How the Reproductive Health Needs of Unmarried Youth Be Concerned in Quality Services in Family Planning/Reproductive Health?

Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services. Method Data were drawn from a baseline questionnaire survey of provision of reproductive health information and services for unmarried youth aged 16-20 years in rural areas of Chengdu, Southwest China in 2001-2002. Results The study comprised of 1 895 valid subjects. More than 70% subjects felt that the knowledge, information and services in relation to sexual and reproductive health provided by the society were rather insufficient. Near 95% thought that unmarried young people seeking sexual and reproductive health counseling and services were quite normal, although some of them had different misgivings. Their preferred services in reproductive health included： counseling in relation to sexual and reproductive health, how to cope with unexpected sex and unwanted pregnancy, how to select the appropriate contraceptives for unmarried youth, etc. About 2/3 subjects agreed to provide contraceptive services to unmarried youth actively, by the society. A. nd they thought the difficulties and obstacles in provision of contraceptive services for un- married youth were in the following order.＂ restriction of the traditional conceptions, shyness of unmarried youth in accept of such services, disapproval of parents/school teachers, and so forth. Conclusion To improve reproductive health status of unmarried youth and meet their needs is a challenge to quality service of family planning/reproductive health program in China, The related departments and service providers should pay attention to this matter and take the strategies and measures to provide appropriate, specific, friendly and accessibly services for unmarried young people.

Health care service usage and costs for high-needs elderly patients with heart failure

Heart failure(HF)has been defined as global disease of pandemic proportions,since it affects around 26 million people worldwide.[1]According to a recent study,age is the most important factor influencing the prevalence of HF,as it is for most other chronic conditions.[2]This means that,with the predicted aging of the population(the proportion of the world’s population aged 60 years and over will nearly double from 2015 to 2050),[3]there will be a growth in the total burden of HF,and a rise in the number of comorbidities in HF patients.According to a recent study,almost 86%of adults with HF have two or more comorbid conditions.[4]Comorbidity,defined as the co-existence of one or more additional conditions in individuals with a specified index medical condition,[5]adds to the complexity of treating elderly patients with HF.

Addressing the needs and rights of sex workers for HIV healthcare services in the Philippines

The right to health for all people means that healthcare services and programs are available,accessible,and acceptable for everyone in need.However,certain groups in the society may be marginalized from their needed healthcare services.In this regard,this paper discusses the challenges in providing HIV-related services to sex workers,a group that remains marginalized in Philippine society.

The Need and Its Influence Factors for Community-based Rehabilitation Services for Disabled Persons in One District in Beijing

Purpose To explore the needs for basic community-based rehabilitation services for disabled persons in Xuanwu District, Beijing, China, and to identify factors which influence disabled persons to accept rehabilitation services. Method One hundred and eight disabled persons were selected by systematic sampling and simple random sampling to assess their needs for community-based rehabilitation services. Results Of the interviewees, 57A% needed the community-based rehabilitation services, but only 13.9% took advantage of it. The main factors influencing the interviewees to accept these services were cost （P〈0.05）, knowledge about rehabilitation medicine （P〈0.05）; and the belief in the therapeutic benefit of the community-based rehabilitation service （P〈0.05）. Conclusion A considerable gap exists between the supply of community-based rehabilitation services in Beijing and the needs for these services by disabled residents underscoring the need for improved availability, and for additional research.

Unmet needs for mental care services for older people in Bangladesh during the COVID-19 pandemic

Dear Editor We read with interest the editorial by Qiu et at about the psychological distress among the general population in China during the COVID-19 pandemic and policy recommendations.The elderly are more vulnerable to increased mental health problems during COVID-19,which has raised significant challenges for community mental health services.12 Older people with comorbid conditions,including cardiovascular diseases,lung diseases,diabetes and hypertension are more likely to be severely affected and die because of COVID-19,which is caused by SARS-CoV-2.^(3).

Assessment of International GNSS Service Global Ionosphere Map products over China region based on measurements from the Crustal Movement Observation Network of China

The global ionosphere maps(GIM)provided by the International GNSS Service(IGS)are extensively utilized for ionospheric morphology monitoring,scientific research,and practical application.Assessing the credibility of GIM products in data-sparse regions is of paramount importance.In this study,measurements from the Crustal Movement Observation Network of China(CMONOC)are leveraged to evaluate the suitability of IGS-GIM products over China region in 2013-2014.The indices of mean error(ME),root mean square error(RMSE),and normalized RMSE(NRMSE)are then utilized to quantify the accuracy of IGS-GIM products.Results revealed distinct local time and latitudinal dependencies in IGS-GIM errors,with substantially high errors at nighttime(NRMSE:39%)and above 40°latitude(NRMSE:49%).Seasonal differences also emerged,with larger equinoctial deviations(NRMSE:33.5%)compared with summer(20%).A preliminary analysis implied that the irregular assimilation of sparse IGS observations,compounded by China’s distinct geomagnetic topology,may manifest as error variations.These results suggest that modeling based solely on IGS-GIM observations engenders inadequate representations across China and that a thorough examination would proffer the necessary foundation for advancing regional total electron content(TEC)constructions.

Identifying bereaved grievers with greatest medical or social service needs in Japan

Objective Severe grief adversely affects the health of bereaved families,potentially burdening medical and community health services.Interventions for effective community health maintenance must identify the people likely to face severe effects of bereavement.The present study identified characteristics of mourners who experience severe grief within a year of bereavement to confirm whether this grief increased their reliance on Japanese medical and social services.Design We conducted a nationwide postal survey of Japanese bereaved within the previous year,to compare those reporting daily or overwhelming‘heavy’grief to those with less heavy grief,in terms of demographic and socioeconomic details,daily work and non-work activity,frequency of medical and social service use.Setting/participants In 2019,with the support of the Ministry of Education and the All Japan Funeral Co-Operation,we distributed approximately 5500 questionnaires to Japanese who had presided at funerals within the past year for anonymous return.By January of 2020,we received 1078 complete voluntary responses from bereaved Japanese.Results Half of the‘heavy grief’group(n=143)reported adverse effects on health and daily life,including needs for pharmacological,medical or welfare support.Losses of husbands or children were particularly connected to severe grief;‘unexpected’death from cancer caused the greatest shock.Employment(even part-time)buffered against severe grief;grief was greater for the unemployed and substantially worse for those who lost significant income at the same time as they lost loved ones.Conclusion These findings suggest that prior counselling should reduce the shock of bereavement and economic loss,which increases subsequent medical dependence.Medical professionals and community health workers can use the above factors to target in advance the family members in greatest danger of heavy grief,to intervene lest grief adversely affect their physical and psychological health after bereavement.

Help received from relatives and services to satisfy needs of adults with severe mental disorders

Background: Few studies have considered the impact of demographic and clinical variables on help received respectively from services and relatives to satisfy needs of adults with severe mental disorders (SMD). Purposes: To identify major needs receiving help and, using the Andersen’s Behavioural Model of Health Service Use, to identify and compare predisposing, enabling and need factors associated with help given respectively by services and relatives. Methods: 352 adults with SMD from Montreal (Canada) were interviewed using six standardized instruments. Clinical records were consulted. Multiple linear regression analyses were processed to measure level of help received from relatives and services. Results: Factors significantly associated with help from relatives were: higher number of perceived needs;fewer diagnoses;better community functioning;being younger, and in a conjugal relationship;living autonomously;having social support and better quality of life;and, marginally, being an immigrant. Factors significantly associated with help from services were: higher number of perceived needs, better quality of life, supervised housing, adjustment disorder and schizophrenia. Conclusions: Help overall is insufficient to meet users’ needs. Services are more helpful than relatives, in particular regarding health needs. Comparatively to help from services, help from relatives is associated with predisposing factors like age, marital status and nationality.

The coordinated evolution of ecological environment,public service,and tourism economy along the Silk Road Economic Belt,using the Dual-Carbon Targets

Carbon peak and carbon neutrality(dual-carbon)are important targets for the international response to climate change.The Silk Road Economic Belt is a strategic resource region and is important for future ecological environment and tourism development.Based on the“dual-carbon”targets,the Single index quantification,Multiple index synthesis,and Poly-criteria integration evaluation model were used in this study to measure the coordinated development index of the ecological environment,public service,and tourism economy along the Silk Road Economic Belt and to analyze its spatial and temporal evolution.Further,it explores the dynamic evolution and development trend of the three systems using the Kernel Density and Grey Markov Prediction Model.The results show that the coordinated development index along this region needs to be improved during the study period.Furthermore,the coordinated development index of the Southwest region is relatively higher than that of the Northwest region.From the development trend of the three systems,all of them develop in a stable manner;however,the tourism economy system is easily affected by external disturbances.The coordinated development index of the three systems changes dynamically and tends to be in a good state of coordination.There is a certain spatial and temporal heterogeneity.The gravity center of the coordinated development index has been in the Southwest region.During the forecast period,the coordinated development index along this region will improve significantly,while insufficient and unbalanced development will continue.

Translational Science for Climate Services: Mapping and Understanding Users' Climate Service Needs in CSSP China

The Climate Science for Service Partnership China(CSSP China) is a joint program between China and the United Kingdom to build the basis for climate services to support the weather and climate resilient economic development and welfare in China. Work Package 5(WP5) provides the translational science on identification of: different users and providers, and their mandates;factors contributing to communication gaps and capacities between various users and providers;and mechanisms to work through such issues to develop and/or evolve a range of climate services.Key findings to emerge include that users from different sectors have varying capacities, requirements, and needs for information in their decision contexts, with a current strong preference for weather information. Separating climate and weather services when engaging users is often not constructive. Furthermore, there is a need to move to a service delivery model that is more user-driven and science informed;having sound climate science is not enough to develop services that are credible, salient, reliable, or timely for diverse user groups. Greater investment in building the capacity of the research community supporting and providing climate services to conduct translational sciences and develop regular user engagement processes is much needed. Such a move would help support the China Meteorological Administration's(CMA) ongoing efforts to improve climate services. It would also assist in potentially linking a broader group of "super" users who currently act as providers and purveyors of climate services because they find the existing offerings are not relevant to their needs or cannot access CMA's services.

Measuring the Needs for Medical Service in the Retirement Residential Community in Korea

Medical facilities in retirement residential areas provide diverse medical and health-related services to retirees, and they are equipped and programed with various medical services for enhancing retirees’ daily activities. To find out the current status of using medical facilities by retirees, this study surveyed retirees in their fifties, sixties, and seventies, who live in Eunpyeong-gu, Seoul. The survey data was sorted by the types of medical facilities they visit, reasons for their visit, and the types of medical facilities in a retirement residential area they would prefer to visit. The pros and cons of using private and general hospitals can be evaluated further to set up the right strategy to reconcile them;and each type of hospital can be improved by adding those missing elements that the interviewees mentioned. In the broad perspective, this indicates the need to suggest the direction of preparing residential areas that are technically planned for retirees on the basis of the analysis of Korean retirees’ needs.