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
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
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
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
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
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
According to Cisco’s Internet Report 2020 white paper,there will be 29.3 billion connected devices worldwide by 2023,up from 18.4 billion in 2018.5G connections will generate nearly three times more traffic than 4G c...According to Cisco’s Internet Report 2020 white paper,there will be 29.3 billion connected devices worldwide by 2023,up from 18.4 billion in 2018.5G connections will generate nearly three times more traffic than 4G connections.While bringing a boom to the network,it also presents unprecedented challenges in terms of flow forwarding decisions.The path assignment mechanism used in traditional traffic schedulingmethods tends to cause local network congestion caused by the concentration of elephant flows,resulting in unbalanced network load and degraded quality of service.Using the centralized control of software-defined networks,this study proposes a data center traffic scheduling strategy for minimization congestion and quality of service guaranteeing(MCQG).The ideal transmission path is selected for data flows while considering the network congestion rate and quality of service.Different traffic scheduling strategies are used according to the characteristics of different service types in data centers.Reroute scheduling for elephant flows that tend to cause local congestion.The path evaluation function is formed by the maximum link utilization on the path,the number of elephant flows and the time delay,and the fast merit-seeking capability of the sparrow search algorithm is used to find the path with the lowest actual link overhead as the rerouting path for the elephant flows.It is used to reduce the possibility of local network congestion occurrence.Equal cost multi-path(ECMP)protocols with faster response time are used to schedulemouse flows with shorter duration.Used to guarantee the quality of service of the network.To achieve isolated transmission of various types of data streams.The experimental results show that the proposed strategy has higher throughput,better network load balancing,and better robustness compared to ECMP under different traffic models.In addition,because it can fully utilize the resources in the network,MCQG also outperforms another traffic scheduling strategy that does rerouting for elephant flows(namely Hedera).Compared withECMPandHedera,MCQGimproves average throughput by 11.73%and 4.29%,and normalized total throughput by 6.74%and 2.64%,respectively;MCQG improves link utilization by 23.25%and 15.07%;in addition,the average round-trip delay and packet loss rate fluctuate significantly less than the two compared strategies.展开更多
To build an“ecological and livable city”,it is important to figure out the relationship between human activity and urban park space and create a high-quality urban park through the integration of“people”and“park...To build an“ecological and livable city”,it is important to figure out the relationship between human activity and urban park space and create a high-quality urban park through the integration of“people”and“park”.Taking Longhu Park in Huainan Province as an example,the study quantitatively analyzed and evaluated the characteristics and service quality of slow traffic space using importance-performance analysis(IPA)and space syntax,clarified the key indexes and areas to be optimized,and put forward corresponding design countermeasures and suggestions in combination with human activity demand.The results suggest that:①The mean performance of park recreation service quality is 3.63,less than the mean importance(3.95).Tourists pay special attention to the safety and convenience of slow traffic space,and the diversity and identiability of site functions is the focus“to be improved”.②The accessibility of Longhu Park shows a strong irregular shape in the southwest.The dead-end roads in the far lake area and the flora and fauna area on the northwest side have weak spatial perception,and the composite function carrying potential of slow traffic space is better reflected in a small range.Therefore,an optimization strategy for slow traffic space is proposed to enhance the continuity of road network,site identifiability,and functional diversification.The results will provide new thoughts of governance based on spatial humanism for the high-quality renewal of urban parks in the new era.展开更多
Objective:The purpose of this study is to conduct an in-depth investigation and analysis of the factors affecting the quality of community nursing services in Laishan District,Yantai City,and provide suggestions for i...Objective:The purpose of this study is to conduct an in-depth investigation and analysis of the factors affecting the quality of community nursing services in Laishan District,Yantai City,and provide suggestions for improving the quality of the services.Method:The community nursing services in Laishan District,Yantai City were investigated through questionnaires and on-site observations.Result:The content of nursing services was correlated with the professional titles of the staff.The guidance given to patients and caregivers was significantly correlated with the educational level of community nursing personnel.Therefore,this indicates that the professional titles and educational backgrounds of the community nursing personnel have a significant impact on the quality of service provided.Conclusion:The role of professional title evaluation can be optimized,further enhancing the educational level of nurses in surrounding communities,optimizing service content and methods,etc.,in order to improve the quality of community nursing services in the region.展开更多
Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of inform...Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.展开更多
Recent research and studies have shown that Information Technology(IT)has a significant impact on service quality,customer satisfaction,and customer relationship development.With the proliferation and penetration of t...Recent research and studies have shown that Information Technology(IT)has a significant impact on service quality,customer satisfaction,and customer relationship development.With the proliferation and penetration of technology in all aspects of life,organizations are responding to the implications and opportunities that IT creates in relation to customer services.The main objective of using information technology in organizations is to increase customer satisfaction,service quality,and customer relationship management,which the authors will focus on here.Enhancing service quality,improving customer satisfaction,and establishing close and sustainable customer relationships are key advantages of leveraging information technology in this field.This article examines the impact of information technology on service quality,customer satisfaction,and customer relationship development and provides strategies and models for organizations to improve customer satisfaction and establish closer connections with them through the use of information technology.Seventy individuals from the IT field were used to evaluate the proposed model.The proposed model was compared with three models:SEM,regression,and decision tree,and the results demonstrated better performance of this approach.展开更多
The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements relate...The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.展开更多
"High-level opening up"and"high-quality development"are important development goals and directions of China during the 14th Five-Year Plan period.Heilongjiang,as the largest and oldest province ope..."High-level opening up"and"high-quality development"are important development goals and directions of China during the 14th Five-Year Plan period.Heilongjiang,as the largest and oldest province open to Russia,has a long history of communication and plays a vanguard role.However,the province's geographical advantages are weakening under the impact of the COVID-19 pandemic and the rapid development of the internet industry.Facing the new era,maintaining and enhancing the regional advantages of the province has become an urgent issue that requires attention.This study takes the Russian language service in Heilongjiang Province as the subject,combines theory with practice through theoretical elaboration and historical analysis,as well as tries to provide reference for improving the language service system in Heilongjiang Province and enhancing its regional advantages.This study believes that a high-quality language service plays an important role in solving the issue.It is necessary to fully understand and apply the essential power of language,be more aware of the importance of Russian language services,build a sound ecosystem of language services,give full play to the traditional advantages of the"Russian"in this province,and finally assume "Russian language services"as the"golden banner"for the development of language services,economy,and culture in the province.展开更多
Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving p...Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P <han visitors to in-patient f 0.05). Patients of 60 years of age and above reported mor< 0.001) and reliability e positive perception th<an those between 40 and 49 on reliability(F = 3.311, P = 0.010), assurances(F = 2.751, P 0.05) and empathy(F = 4.009, P = 0.003). For the i ve dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.展开更多
An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, col- lecting well-established...An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, col- lecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessin~ medical services quality.展开更多
Cloud computing facilitates the great potentiality of storing and managing remote access to services in terms of software as a service(SaaS).Several organizations have moved towards outsourcing over the cloud to reduc...Cloud computing facilitates the great potentiality of storing and managing remote access to services in terms of software as a service(SaaS).Several organizations have moved towards outsourcing over the cloud to reduce the burden on local resources.In this context,the metaheuristic optimization method is determined to be highly suitable for selecting appropriate services that comply with the requirements of the client’s requests,as the services stored over the cloud are too complex and scalable.To achieve better service composition,the parameters of Quality of Service(QoS)related to each service considered to be the best resource need to be selected and optimized for attaining potential services over the cloud.Thus,the cloud service composition needs to concentrate on the selection and integration of services over the cloud to satisfy the client’s requests.In this paper,a Hybrid Chameleon and Honey Badger Optimization Algorithm(HCHBOA)-based cloud service composition scheme is presented for achieving efficient services with satisfying the requirements ofQoS over the cloud.This proposed HCHBOA integrated the merits of the Chameleon Search Algorithm(CSA)and Honey Badger Optimization Algorithm(HBOA)for balancing the tradeoff between the rate of exploration and exploitation.It specifically used HBOA for tuning the parameters of CSA automatically so that CSA could adapt its performance depending on its incorporated tuning factors.The experimental results of the proposed HCHBOA with experimental datasets exhibited its predominance by improving the response time by 21.38%,availability by 20.93%and reliability by 19.31%with a minimized execution time of 23.18%,compared to the baseline cloud service composition schemes used for investigation.展开更多
Patient satisfaction is a crucial measure of healthcare quality and plays a vital role in ensuring effective healthcare systems. This study aims to assess the level of patient satisfaction with primary healthcare serv...Patient satisfaction is a crucial measure of healthcare quality and plays a vital role in ensuring effective healthcare systems. This study aims to assess the level of patient satisfaction with primary healthcare services in Riyadh, Saudi Arabia, identify social factors affecting satisfaction, and determine the reasons behind dissatisfaction and how to improve satisfaction. The study employed a cross-sectional observational design and included a random sample of 400 patients from primary healthcare centers in Riyadh. Data were collected using an electronic questionnaire and analyzed using SPSS software. The study found that patients were generally satisfied with the primary healthcare services provided in Riyadh, with high levels of satisfaction reported for booking appointments, triage services, and emergency care. However, some aspects of the healthcare experience, such as long waiting times and the physical design of healthcare centers, need improvement. These findings can be used to inform the development of policies and interventions aimed at enhancing healthcare quality in Saudi Arabia.展开更多
In a cloud manufacturing environment with abundant functionally equivalent cloud services,users naturally desire the highest-quality service(s).Thus,a comprehensive measurement of quality of service(QoS)is needed.Opti...In a cloud manufacturing environment with abundant functionally equivalent cloud services,users naturally desire the highest-quality service(s).Thus,a comprehensive measurement of quality of service(QoS)is needed.Opti-mizing the plethora of cloud services has thus become a top priority.Cloud ser-vice optimization is negatively affected by untrusted QoS data,which are inevitably provided by some users.To resolve these problems,this paper proposes a QoS-aware cloud service optimization model and establishes QoS-information awareness and quantification mechanisms.Untrusted data are assessed by an information correction method.The weights discovered by the variable precision Rough Set,which mined the evaluation indicators from historical data,providing a comprehensive performance ranking of service quality.The manufacturing cloud service optimization algorithm thus provides a quantitative reference for service selection.In experimental simulations,this method recommended the optimal services that met users’needs,and effectively reduced the impact of dis-honest users on the selection results.展开更多
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.
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.
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.
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.
基金This work is funded by the National Natural Science Foundation of China under Grant No.61772180the Key R&D plan of Hubei Province(2020BHB004,2020BAB012).
文摘According to Cisco’s Internet Report 2020 white paper,there will be 29.3 billion connected devices worldwide by 2023,up from 18.4 billion in 2018.5G connections will generate nearly three times more traffic than 4G connections.While bringing a boom to the network,it also presents unprecedented challenges in terms of flow forwarding decisions.The path assignment mechanism used in traditional traffic schedulingmethods tends to cause local network congestion caused by the concentration of elephant flows,resulting in unbalanced network load and degraded quality of service.Using the centralized control of software-defined networks,this study proposes a data center traffic scheduling strategy for minimization congestion and quality of service guaranteeing(MCQG).The ideal transmission path is selected for data flows while considering the network congestion rate and quality of service.Different traffic scheduling strategies are used according to the characteristics of different service types in data centers.Reroute scheduling for elephant flows that tend to cause local congestion.The path evaluation function is formed by the maximum link utilization on the path,the number of elephant flows and the time delay,and the fast merit-seeking capability of the sparrow search algorithm is used to find the path with the lowest actual link overhead as the rerouting path for the elephant flows.It is used to reduce the possibility of local network congestion occurrence.Equal cost multi-path(ECMP)protocols with faster response time are used to schedulemouse flows with shorter duration.Used to guarantee the quality of service of the network.To achieve isolated transmission of various types of data streams.The experimental results show that the proposed strategy has higher throughput,better network load balancing,and better robustness compared to ECMP under different traffic models.In addition,because it can fully utilize the resources in the network,MCQG also outperforms another traffic scheduling strategy that does rerouting for elephant flows(namely Hedera).Compared withECMPandHedera,MCQGimproves average throughput by 11.73%and 4.29%,and normalized total throughput by 6.74%and 2.64%,respectively;MCQG improves link utilization by 23.25%and 15.07%;in addition,the average round-trip delay and packet loss rate fluctuate significantly less than the two compared strategies.
基金Sponsored by National Key Research and Development Project(2018YFD1100203)Research Topics of Huainan Municipal People’s Government Development Research Center,Innovation Topics of Huainan Urban Renewal Strategy Research(K2110098).
文摘To build an“ecological and livable city”,it is important to figure out the relationship between human activity and urban park space and create a high-quality urban park through the integration of“people”and“park”.Taking Longhu Park in Huainan Province as an example,the study quantitatively analyzed and evaluated the characteristics and service quality of slow traffic space using importance-performance analysis(IPA)and space syntax,clarified the key indexes and areas to be optimized,and put forward corresponding design countermeasures and suggestions in combination with human activity demand.The results suggest that:①The mean performance of park recreation service quality is 3.63,less than the mean importance(3.95).Tourists pay special attention to the safety and convenience of slow traffic space,and the diversity and identiability of site functions is the focus“to be improved”.②The accessibility of Longhu Park shows a strong irregular shape in the southwest.The dead-end roads in the far lake area and the flora and fauna area on the northwest side have weak spatial perception,and the composite function carrying potential of slow traffic space is better reflected in a small range.Therefore,an optimization strategy for slow traffic space is proposed to enhance the continuity of road network,site identifiability,and functional diversification.The results will provide new thoughts of governance based on spatial humanism for the high-quality renewal of urban parks in the new era.
文摘Objective:The purpose of this study is to conduct an in-depth investigation and analysis of the factors affecting the quality of community nursing services in Laishan District,Yantai City,and provide suggestions for improving the quality of the services.Method:The community nursing services in Laishan District,Yantai City were investigated through questionnaires and on-site observations.Result:The content of nursing services was correlated with the professional titles of the staff.The guidance given to patients and caregivers was significantly correlated with the educational level of community nursing personnel.Therefore,this indicates that the professional titles and educational backgrounds of the community nursing personnel have a significant impact on the quality of service provided.Conclusion:The role of professional title evaluation can be optimized,further enhancing the educational level of nurses in surrounding communities,optimizing service content and methods,etc.,in order to improve the quality of community nursing services in the region.
文摘Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.
文摘Recent research and studies have shown that Information Technology(IT)has a significant impact on service quality,customer satisfaction,and customer relationship development.With the proliferation and penetration of technology in all aspects of life,organizations are responding to the implications and opportunities that IT creates in relation to customer services.The main objective of using information technology in organizations is to increase customer satisfaction,service quality,and customer relationship management,which the authors will focus on here.Enhancing service quality,improving customer satisfaction,and establishing close and sustainable customer relationships are key advantages of leveraging information technology in this field.This article examines the impact of information technology on service quality,customer satisfaction,and customer relationship development and provides strategies and models for organizations to improve customer satisfaction and establish closer connections with them through the use of information technology.Seventy individuals from the IT field were used to evaluate the proposed model.The proposed model was compared with three models:SEM,regression,and decision tree,and the results demonstrated better performance of this approach.
文摘The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.
基金The "3th Five-Year Plan"of Education Science Key Project of Heilongjiang Province in 2020(Project Number:GJB1320294).
文摘"High-level opening up"and"high-quality development"are important development goals and directions of China during the 14th Five-Year Plan period.Heilongjiang,as the largest and oldest province open to Russia,has a long history of communication and plays a vanguard role.However,the province's geographical advantages are weakening under the impact of the COVID-19 pandemic and the rapid development of the internet industry.Facing the new era,maintaining and enhancing the regional advantages of the province has become an urgent issue that requires attention.This study takes the Russian language service in Heilongjiang Province as the subject,combines theory with practice through theoretical elaboration and historical analysis,as well as tries to provide reference for improving the language service system in Heilongjiang Province and enhancing its regional advantages.This study believes that a high-quality language service plays an important role in solving the issue.It is necessary to fully understand and apply the essential power of language,be more aware of the importance of Russian language services,build a sound ecosystem of language services,give full play to the traditional advantages of the"Russian"in this province,and finally assume "Russian language services"as the"golden banner"for the development of language services,economy,and culture in the province.
基金Supported by the 12th Five-Year Infectious Disease Research Project:the Use and Optimization of the Standard Regimen for Diagnosis and Treatment of Tuberculosis in HIV/AIDS Patients in China(No.2012ZX10001-003)the 12th Five-Year Major Science and Technology Project on Discovery of Major New Drugs:Construction of a Technology Platform for Clinical Evaluation of AntiHIV Drugs(No.2012ZX09303013)+2 种基金the National 863 Project"Study the Key Technology of Personnel Protection and Lab Tracking of pathogenic microorganism"(2014AA021403)the year 2014 Key research project of the party of the education and health of Shanghai(201420)Scientific research in hospital construction project of Chinese Medical Doctor Assoclation
文摘Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P <han visitors to in-patient f 0.05). Patients of 60 years of age and above reported mor< 0.001) and reliability e positive perception th<an those between 40 and 49 on reliability(F = 3.311, P = 0.010), assurances(F = 2.751, P 0.05) and empathy(F = 4.009, P = 0.003). For the i ve dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.
文摘An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, col- lecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessin~ medical services quality.
文摘Cloud computing facilitates the great potentiality of storing and managing remote access to services in terms of software as a service(SaaS).Several organizations have moved towards outsourcing over the cloud to reduce the burden on local resources.In this context,the metaheuristic optimization method is determined to be highly suitable for selecting appropriate services that comply with the requirements of the client’s requests,as the services stored over the cloud are too complex and scalable.To achieve better service composition,the parameters of Quality of Service(QoS)related to each service considered to be the best resource need to be selected and optimized for attaining potential services over the cloud.Thus,the cloud service composition needs to concentrate on the selection and integration of services over the cloud to satisfy the client’s requests.In this paper,a Hybrid Chameleon and Honey Badger Optimization Algorithm(HCHBOA)-based cloud service composition scheme is presented for achieving efficient services with satisfying the requirements ofQoS over the cloud.This proposed HCHBOA integrated the merits of the Chameleon Search Algorithm(CSA)and Honey Badger Optimization Algorithm(HBOA)for balancing the tradeoff between the rate of exploration and exploitation.It specifically used HBOA for tuning the parameters of CSA automatically so that CSA could adapt its performance depending on its incorporated tuning factors.The experimental results of the proposed HCHBOA with experimental datasets exhibited its predominance by improving the response time by 21.38%,availability by 20.93%and reliability by 19.31%with a minimized execution time of 23.18%,compared to the baseline cloud service composition schemes used for investigation.
文摘Patient satisfaction is a crucial measure of healthcare quality and plays a vital role in ensuring effective healthcare systems. This study aims to assess the level of patient satisfaction with primary healthcare services in Riyadh, Saudi Arabia, identify social factors affecting satisfaction, and determine the reasons behind dissatisfaction and how to improve satisfaction. The study employed a cross-sectional observational design and included a random sample of 400 patients from primary healthcare centers in Riyadh. Data were collected using an electronic questionnaire and analyzed using SPSS software. The study found that patients were generally satisfied with the primary healthcare services provided in Riyadh, with high levels of satisfaction reported for booking appointments, triage services, and emergency care. However, some aspects of the healthcare experience, such as long waiting times and the physical design of healthcare centers, need improvement. These findings can be used to inform the development of policies and interventions aimed at enhancing healthcare quality in Saudi Arabia.
基金supported by the National Natural Science Foundation,China (Grant No:61602413,Jianwei Zheng,https://www.nsfc.gov.cn)the Natural Science Foundation of Zhejiang Province (Grant No:LY15E050007,Wenlong Ma,http://zjnsf.kjt.zj.gov.cn/portal/index.html).
文摘In a cloud manufacturing environment with abundant functionally equivalent cloud services,users naturally desire the highest-quality service(s).Thus,a comprehensive measurement of quality of service(QoS)is needed.Opti-mizing the plethora of cloud services has thus become a top priority.Cloud ser-vice optimization is negatively affected by untrusted QoS data,which are inevitably provided by some users.To resolve these problems,this paper proposes a QoS-aware cloud service optimization model and establishes QoS-information awareness and quantification mechanisms.Untrusted data are assessed by an information correction method.The weights discovered by the variable precision Rough Set,which mined the evaluation indicators from historical data,providing a comprehensive performance ranking of service quality.The manufacturing cloud service optimization algorithm thus provides a quantitative reference for service selection.In experimental simulations,this method recommended the optimal services that met users’needs,and effectively reduced the impact of dis-honest users on the selection results.