Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Public satisfaction with the quality of First Health Facility Services in Indonesia: Does sociodemographic matter?

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.

Ontological Model for Cohesive Smart Health Services Management

Health care has become an essential social-economic concern for all stakeholders(e.g.,patients,doctors,hospitals etc.),health needs,private care and the elderly class of society.The massive increase in the usage of health care Internet of things(IoT)applications has great technological evolvement in human life.There are various smart health care services like remote patient monitoring,diagnostic,disease-specific remote treatments and telemedicine.These applications are available in a split fashion and provide solutions for variant diseases,medical resources and remote service management.The main objective of this research is to provide a management platform where all these services work as a single unit to facilitate the users.The ontological model of integrated healthcare services is proposed by getting requirements from various existing healthcare services.There were 26 smart health care services and 26 smart health care services to classify the knowledge-based ontological model.The proposed ontological model is derived from different classes,relationships,and constraints to integrate health care services.This model is developed using Protégébased on each interrelated/correlated health care service having different values.Semantic querying SPARQL protocol and RDF query language(SPARQL)were used for knowledge acquisition.The Pellet Reasoner is used to check the validity and relations coherency of the proposed ontology model.Comparative to other smart health care services integration systems,the proposed ontological model provides more cohesiveness.

Assessment of reproductive health service utilization in urban slums: Evidence from Western Rajasthan

Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

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.

Client views,perception and satisfaction with immunisation services at Primary Health Care Facilities in Calabar,South-South Nigeria

Objective:To determine the degree of client satisfaction with immunisation services at Primary Health facilities in Calabar,Cross River State,Nigeria.Method:A semi-structured questionnaire was administered on 402 caregivers who were selected using systematic random sampling from four primary health centres.The four centres were randomly selected from the 19 health centres using the table of random numbers.Data obtained were analysed using Epi-Info s of tware version 2002.Results:The majority of clients were dissatisfied with most aspects of care given at the Health Care Centres including long waiting time,accessibility of immunisation services,poor respect for clients’ rights,especially to their dignity,health information and counseling on their medical needs.Conclusions:The study concludes that client satisfaction with immunization service in Calabar was low due to poor attitude of health care providers,long waiting time and lack of respect for clients’ rights.

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

Assessment and regulation of ocean health based on ecosystem services: Case study in the Laizhou Bay, China

The ecosystem-based management of nearshore waters requires integrated assessment of ocean health and scientific guidance on artificial regulations to promote sustainable development. Quantitative approaches were developed in this paper to assess present and near-term ocean health based on ecosystem services. Results of the case study in the Laizhou Bay of China showed that the index score of ocean health was 0.785 6 out of 1.0 at present and was expected to range from 0.555 1 to 0.804 1 in the near-term future depending on different intensities of artificial regulation of negative pressures. Specifically, the results of ocean health at present mainly indicated that cultural services and provisioning services performed essentially perfectly while supporting services and regulating services functioned less well. It can be concluded that this nearshore ecosystem would partially lose supporting and regulating services in the near-term future if the increasing pressures were not wellregulated but that all of these categories of ecosystem services could be slightly improved if the negative pressures were fully controlled. Additionally, it is recommended that publicity and education on ecosystem services especially on cultural services and regulating services should be further strengthened. The analytical process and resulting quantification provide flexible tools to guide future development of regulations so as to facilitate ecosystem-based management in the coastal zone.

The Management of Mental Health, and Service Networks in Italy

Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.

Youth friendly health services and role of outreach activities to improve access to services

An attempt has been made to assess the Youth Friendly Health Services (YFHS) from the clients’ perspectives and the role of outreach community-based approach (Youth Information Center, YIC) in improving access to services. A cross- sectional study was undertaken in Arajiline and Hoskote blocks in Varanasi and Bangalore districts respectively using primarily a quantitative technique. A consecutive sample of 120 clients from 4 selected clinics was interviewed after seeking services from YFHS. Additionally, facility assessment of clinics and 8 FGDs were conducted among community members and the young people in the community. Majority of the clients (90.8%) are aware that YFHS provide services to young males and females separately on specific day and time. Nearly 66% clients visited YFHS to sought treatment for three key health problems i.e. menstruation problems (25.4%) followed by general illness (22.8%) and swelling/itching of private parts (21.1%). In Hos- akote privacy was maintained during the con- sultation with the doctor, however, situation was relatively not better in Arajiline. Out of those clients who had visited YIC atleast once, 49 out of 53 in Arajiline and 51 out of 60 in Hasokote reported that the YIC staff/activities had motivated them to sought services at YFHS. Study concludes that while majority of the clients were satisfied with the services at YFHS, there is a need for strengthening the existing “package” of the services. At facility level, reassurance about the privacy and confidentially and alternative ways to promote access and utilization of services by active involvement of young people is recommended. On the other hand, at outreach level, new technologies should be introduced to generate demand, intensive focus on adults in the community and integration of YIC with local governance and school environment is suggested so as to protect young people against poor health outcomes.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Integration of Location-Allocation and Accessibility Models in GIS to Improve Urban Planning for Health Services in Al-Madinah Al-Munawwarah, Saudi Arabia

In this study, accessibility and location-allocation models have been integrated into GIS to improve spatial planning and environmental sustainability of health services in Al-Madinah Al-Munawwarah. This integration provides a planning framework in order to check the efficiency of the spatial allocation of health services and to generate alternatives either by proposing an active service or to improve an existing one. To achieve these objectives, the accessibility to the service area was analyzed within the analysis of health services networks, which are divided into eight types: public hospitals, specialized hospitals, health units, healthcare centers, infirmaries, clinic complexes, the Red Crescent Center, and ambulance facilities, with time intervals of (5 minutes - 10 minutes - 15 minutes) to access coverage ranges, and the location-allocation model was used based on the maximum coverage model within a response time not exceeding 15 minutes, The results of the study revealed the poor distribution of health services Al-Madinah Al-Munawwarah suffers from weak accessibility to health services coverage areas and is unable to meet the needs of its population at present. The current need for health services reached twenty-four locations, including two public hospitals, three specialized hospitals, two health centers, three ambulance facilities, four infirmaries, three clinic complexes, four health units, and three Red Crescent centers.

Attitude of Health Care Providers towards Adolescent Sexual and Reproductive Health Services in Developing Countries: A Systematic Review

The aim of the review was to synthesise the best available evidence regarding attitude of health care providers towards adolescent sexual and reproductive health services in developing countries. The review was conducted following qualitative research method. An online search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), EMBASE and MEDLINE databases was conducted to identify relevant studies for the review. There were nine studies that met the inclusion criteria and these were critically assessed by two independent reviewers using the standardised Joanna Briggs Institute (JBI) critical appraisal forms. Data were extracted using the standardised JBI data extraction forms. A narrative synthesis was done on the findings. Key findings from the review indicate that unprofessional attitude of health care professionals and lack of youth friendly reproductive health services, inhibit adolescents from gaining access to sexual and reproductive health services in developing countries. It is recommended that youth friendly reproductive health services be provided to increase uptake of re-productive health services by adolescents.

Health-seeking behaviour and student perception of health care services in a university community in Nigeria

Objectives: Examining consumers’ healthcare behavior can help in the design of ways to ensure better access to health and the quality of care. Health-seeking behavior is viewed as the varied response of individuals to states of ill-health, depending on their knowledge and perceptions of health, socioeconomic constraints, adequacy of available health services and attitude of healthcare providers. This study examines health-seeking behavior of university students, their use of healthcare services in the community and barriers to seeking help at the university health centre. Method: Structured questionnaires were validated and administered on a random sample of university students spread over different academic disciplines in a large institution. The sample consisted of 1608 undergraduate students attending the public university in southwesternNigeria. The demographic profile reflects the national university student population. Relevant information was collected on preferred health services consulted by the undergraduates such as barriers to seeking adequate medical attention and their experiences with salient aspects of service delivery. Responses were weighted and the average was taken to be representative. Results: Students consulted their peers (37.5%) in health related academic disciplines rather than seek treatment at the university health centre. Some students (24.7%) preferred community pharmacies while others took personal responsibilities for their health or abstained from medical care for religious reasons (16.8%). Significant barriers to seeking medical attention at the health centre were cost of care, protracted waiting time, inadequate health information, unfriendly attitude of healthcare workers and drug shortage. Conclusions: Students sought help from community pharmacies (ease of access) and from peers in health related academic programmes rather than from physicians at the health centre. Health-seeking behavior of the students was influenced, essentially, by the nature of ailment, waiting time in the health facility and attitude of healthcare professionals. Implications for policy, practice or delivery: The findings of this research identified the relative use of available health services within the university. Initiatives to improve student access to the university health centre should address significant barriers of patient delays, the need for attitudinal change and continuing professional development of relevant workers in the health facility. Promotional activities may be necessary to inform and educate students on rational use of medicines and access to treatment at the health centre.

Violence at work and its relationship with burnout, depression and anxiety in healthcare professionals of the emergency services

The aim of this study was to examine the possible relationship between physical and psychological aggression suffered in the workplace and professional burnout, depression and anxiety suffered by healthcare professionals of the emergency services. Methods: 315 physicians, nurses, orderlies and ambulance drivers of Critical Care and Emergency Devices (CCED) in the Andalusian Public Health System, in the province of Granada (Spain) participated. They were interviewed about the exposure to violence at work and answered a battery of questions that measured burnout, depression and anxiety. Results: Physical aggression was significantly related to emotional exhaustion, personal accomplishment at work, depression and anxiety. Psychological aggression was associated with personal accomplishment. Logistic regression showed that the CCED professionals who have suffered physical aggression were 4.2 and 2.6 times more likely to have suffered anxiety and reduced personal accomplishment, respectively, than those who did not suffer physical aggression. On the other hand, feelings of anxiety and reduced personal accomplishment increase the professionals’ risk (3.4 and 2.1 times more likely, respectively) of suffering from physical aggression. Conclusion: The results suggest that exposure to violence is related to the other psychological problems tested: emotional exhaustion and personal accomplishment (two components of burnout), depression and anxiety. In addition, physical violence is a risk factor for anxiety and diminished personal accomplishment of the CCED professionals.

Availability, Range and Utilization of Sexual and Reproductive Health (SRH) Services for Adolescents at Kinondoni Municipality, Dar es Salaam—Tanzania

Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high burden of sexual and reproductive health problems. Sixteen million girls aged 15 to 19 years give birth every year of which 95% occur in low- and middle-income countries. Twenty five percent of unsafe abortions are in 15 - 19 years in Sub-Saharan Africa. Contraceptive use is low as approximately 10% of adolescents are current users. These problems can be averted if different ranges of Sexual and Reproductive Health Services for adolescent (SRHSA) are available and utilized by adolescents. In Tanzania, there is limited information addressing the availability, types and utilization pattern of sexual and reproductive health services by adolescents. This study investigates the availability, range and utilization of sexual and reproductive health services for adolescents (ASRHS) at Kinondoni Municipality, Tanzania. Method: A cross-sectional study was carried out in April to May 2013. A checklist was used to collect information on the availability and range of services offered at selected health facilities. In depth interviews conducted with in-charges of Reproductive and Child Health (RCH) clinics to explore barriers for provision of Sexual and Reproductive Health Services (SRHS) for adolescents. Adolescents were questioned using a questionnaire on utilization of SRHS and perceived barriers. Descriptive statistics were used to summarize quantitative data and content analysis for qualitative data. Results: On availability and range of adolescents’ sexual and reproductive health services, a total of 25 health facilities were surveyed. Forty four percent of the surveyed facilities did not have the adolescent sexual and reproductive health services (ASRHS). The Adolescents Sexual and Reproductive Health (ASRH) services offered differed greatly between facilities. On utilization of adolescents’ sexual and reproductive health services in total, 204 adolescents from the community were involved in this study. A third of adolescents reported to have ever used ASRH. The adolescents perceived barriers for underutilization of the services were fear of being seen at the clinics (23.3%), lack of money (18.3%), lack of privacy & confidentiality (14.2%) and unfriendly health care providers. Three barriers were perceived by health care providers in the provision of ASRHS: integration of SRHS, lack of training in relation to adolescents SRHS and attitudes of health care providers towards young people. Conclusion: About half of the health facilities did not have the SRH-services to adolescent (44%) and different ranges of services were not offered at the facilities as it was shown in the records. The results from this study show services were underutilized by adolescents. Training, attitudes of health care providers towards young people, & cost influenced ASRHS provision and utilization. Strategies to increase training in ASRHS for health providers including communication skills and scaling ASRH services to all primary care facilities may help to improve availability and access of services to adolescents.

Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

Professional Behaviors of Nurses in Geriatric Health Services Facility in Japan

Background: The characteristics of geriatric health services facilities (GHSFs) in Japan include provision of care focused on the life of the residents, and there is a need for cooperation between care workers and physical therapists responsible for the care. Our goal is to create an organizational system that allows nurses to succeed professionally. To do this, we must first discuss the professional behavior of nurses in GHSFs. Objectives: The aim of the present study was to clarify the professional behavior of nurses in GHSFs using a questionnaire survey. Method: We used a descriptive, cross-sectional design. The study was conducted in 1000 GHSFs all over Japan. The instrument used for data collection was a questionnaire. The questionnaires consisted of 24 items for determining the professional behavior of nurses, the background information of respondents. The professional behavior of nurses was analyzed using principal factor analysis (Promax rotation). Results: A total of 1189 nurses participated. Of those, 91% (n = 1084) were women, and mean age was 48.2 years. Most participants were staff nurses (n = 791;66%). We extracted 16 items by factor analysis, which were classified into four factors (professional development, autonomy, positive assertiveness to colleagues, and advocating for patient). Conclusion: The professional behaviors as identified in this study are similar to those reported in previous studies of clinical nurses in hospital. However, some subscale results are specific to the characteristics of GHSFs. The ability to understand professional behaviors has significant implications in terms of affirming and identifying sources of quality of care and creating a professional practice environment within GHSFs.

Examining Health of Wetlands with Multiple Ecosystem Services as Targets in China’s Coastal Regions

Coastal zones are key interconnectors of terrestrial and marine ecosystems.Due to the degradation and fragmentation of coastal wetlands,there is an urgent need to develop assessment methodology to compare the health of wetland ecosystems at different spatial scales.This will help efficiently develop and implement protections using easy-to-access ecosystem health data.This study aims to understand the spatial distribution of coastal and inland wetland health for China’s coastal regions.A Wetland Health Index(WHI)was developed to provide a basis for policy and decision making.Four utilization models—Long Term Model,Open Model,Nature Reserve Model,and Protected and Economic Model—were defined in the context of China’s coastal regions to specifically examine wetland health.Results show that the average WHI score was 63.6 with the range of 44.8–84.3 for 35 National Nature Reserves(NNRs),and the southern NNRs generally performed better than the northern NNRs.The wetlands in the southern provinces/municipalities are relatively healthier than their northern counterparts.The competent authority has slight influence on WHI scores but duration of conservation establishment does not show a clear correlation.With increasing economic activity,the differences in health conditions(WHI scores)of China’s coastal regions also increase.Gross Domestic Product(GDP)or economic intensification does not relate to WHI scores.Appropriate trade-offs between wetland management and economic development could contribute to improve health conditions,conservation and utilization of coastal and inland wetlands.

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.