目的分析整合式慢性病社区健康管理模式实施的促进和障碍因素,区分模式服务量高覆盖率组和低覆盖率组在实施性研究的整合性理论框架(consolidated framework for implementation research,CFIR)上的结构差异,为政府部门提供政策建议。...目的分析整合式慢性病社区健康管理模式实施的促进和障碍因素,区分模式服务量高覆盖率组和低覆盖率组在实施性研究的整合性理论框架(consolidated framework for implementation research,CFIR)上的结构差异,为政府部门提供政策建议。方法结合CFIR对22名专家进行半结构化访谈,采用定性结构评级法对13家社区卫生服务中心受访者评分,利用NVivo 12软件编码。结果高覆盖率组和低覆盖率组的相对优势、外部政策与激励、实施准备度、反思和评价、领导个人特质5个CFIR结构有差异。促进因素包括:测量数据更加精准,提高了高血压和糖尿病患者的异常检出率和控制率;模式实现了服务、技术、数据“三整合”,优化管理流程,提供管理抓手;基础性和个性化服务结合吸引患者到基层就诊;模式与我国政策背景,初级卫生保健工作和以患者为中心理念兼容;数字化工具的应用减轻医护人员工作负担;领导重视是基础,利益方间的通力合作是重要保障。障碍因素包括:宏观层面缺少卫生行政机构的支持性政策,组织架构和运行机制尚未建立,建设、投入主体以及具体工作规范和流程有待明确;缺乏监督管理机制和质量评估小组;模式推广目标模糊;缺乏规范化系统性的培训计划;为不同群体提供服务存在挑战,缺乏有效的社会面宣传;模式仍须提高需方获得感;社区布局限制了模式的服务提供。结论卫生行政部门应明确模式的建设、运行、投入主体,完善组织架构并明确各利益方的功能定位和职责分工,进一步制定工作规范和工作流程;建立信息反馈机制和质量控制小组并进行定期评估;制定清晰的目标;加大宣传教育,扩大宣传面;利用数字化工具形成良性医患互动机制。展开更多
本文用CORE-IAF(Coordinated Ocean-ice Reference Experiments–Interannual Forcing)外强迫场分别强迫LICOM3(LASG/IAP Climate System Ocean Model Version 3)和POP2(Parallel Ocean Program version 2)两个海洋模式,并分析了这两个...本文用CORE-IAF(Coordinated Ocean-ice Reference Experiments–Interannual Forcing)外强迫场分别强迫LICOM3(LASG/IAP Climate System Ocean Model Version 3)和POP2(Parallel Ocean Program version 2)两个海洋模式,并分析了这两个模式中太平洋北赤道逆流(NECC)的模拟结果。我们发现LICOM3和POP2模拟的NECC强度均弱于实测,这和Sun et al.(2019)的研究结果一致,也进一步证明了海洋模式中NECC偏弱是CORE-IAF外强迫场造成的,海表风应力及对应的风应力旋度是海洋模式准确模拟NECC的最主要因子。同时,我们也分析了NECC的模拟在动力机制上的差别,这里的动力强迫项包括风应力项、平流项和余项。我们发现模式的外强迫场虽然相同,但是两个模式中各动力强迫项(风应力项、平流项和余项)对NECC模拟的影响并不完全相同。展开更多
本文基于AREM（Advanced Regional Eta Model）模式，结合中国气象局成都高原气象研究所西南低涡加密观测科学试验得到的探空观测第一手资料，通过对2012年7月3～4日四川区域性暴雨天气过程（20120703过程）进行数值模拟分析，结果表明...本文基于AREM（Advanced Regional Eta Model）模式，结合中国气象局成都高原气象研究所西南低涡加密观测科学试验得到的探空观测第一手资料，通过对2012年7月3～4日四川区域性暴雨天气过程（20120703过程）进行数值模拟分析，结果表明：（1）降水雨带的分布主要取决于西南低涡移动路径，不同初值会使得低涡路径在磨合协调期产生强摆动，稳定后则在此基础上，随着环境流场继续移动发展。（2）引入4个加密探空站点资料会对整个大气物理量场造成一定影响，最大差值分布在这些站点附近，热力和动力物理量场最大偏差中心并不重合。时间演变直观地说明了初值对局地大气状态的影响时段有限，主要集中在前期，与模式自身调整期相重叠。（3）初始的大气状态必然会随着模式的磨合过程进行调整，不同初值在调整期能对中小尺度低涡系统的位置及强度产生影响，形成各自稳定的低涡系统初态。（4）低涡中心所对应的散度、涡度、垂直速度关系非常密切，但三者强度和发展高度的演变并非完全一致。展开更多
[Objective] The paper was to analyze the quality of flux observation data of rubber plantation.[Method]Based on the FSAM model,footprint and flux source area were analyzed according to the continuous flux measurement ...[Objective] The paper was to analyze the quality of flux observation data of rubber plantation.[Method]Based on the FSAM model,footprint and flux source area were analyzed according to the continuous flux measurement with the open-path eddy covariance system on the 50 m tower of Danzhou Key Field Station of Observation and Research for Tropical Agricultural Resources and Environments,Ministry of Agriculture from Jan 1 to Jun 30,2010.[Result] Under unstable stratification,source areas were smaller than those under stable conditions,and source areas in the dormant season were larger than those in the growing season at the same level.In the main wind direction 130°-270°,the upwind range of source areas was in the magnitude of 100-758 m and vertical upwind range was-251-251 m at 80% level under unstable stratification in the growing season,and they were some large than those under the unstable stratification in the dormant season.The source areas of the upwind and vertical upwind ranges were 173-1 858,-534-534 m especially under stable stratification in the growing season,and they were smaller than those under stable stratification in the dormant season.In the other wind directions of 0°-130° and 270°-360°,the ranges were similar to those of the growing season in the prevailing wind direction under the same atmospheric conditions.[Conclusion] The study would lay a foundation for the future flux calculation and analysis.展开更多
文摘本文用CORE-IAF(Coordinated Ocean-ice Reference Experiments–Interannual Forcing)外强迫场分别强迫LICOM3(LASG/IAP Climate System Ocean Model Version 3)和POP2(Parallel Ocean Program version 2)两个海洋模式,并分析了这两个模式中太平洋北赤道逆流(NECC)的模拟结果。我们发现LICOM3和POP2模拟的NECC强度均弱于实测,这和Sun et al.(2019)的研究结果一致,也进一步证明了海洋模式中NECC偏弱是CORE-IAF外强迫场造成的,海表风应力及对应的风应力旋度是海洋模式准确模拟NECC的最主要因子。同时,我们也分析了NECC的模拟在动力机制上的差别,这里的动力强迫项包括风应力项、平流项和余项。我们发现模式的外强迫场虽然相同,但是两个模式中各动力强迫项(风应力项、平流项和余项)对NECC模拟的影响并不完全相同。
文摘本文基于AREM（Advanced Regional Eta Model）模式，结合中国气象局成都高原气象研究所西南低涡加密观测科学试验得到的探空观测第一手资料，通过对2012年7月3～4日四川区域性暴雨天气过程（20120703过程）进行数值模拟分析，结果表明：（1）降水雨带的分布主要取决于西南低涡移动路径，不同初值会使得低涡路径在磨合协调期产生强摆动，稳定后则在此基础上，随着环境流场继续移动发展。（2）引入4个加密探空站点资料会对整个大气物理量场造成一定影响，最大差值分布在这些站点附近，热力和动力物理量场最大偏差中心并不重合。时间演变直观地说明了初值对局地大气状态的影响时段有限，主要集中在前期，与模式自身调整期相重叠。（3）初始的大气状态必然会随着模式的磨合过程进行调整，不同初值在调整期能对中小尺度低涡系统的位置及强度产生影响，形成各自稳定的低涡系统初态。（4）低涡中心所对应的散度、涡度、垂直速度关系非常密切，但三者强度和发展高度的演变并非完全一致。
基金Supported by the Fundamental Research Funds for Rubber Research Institute,CATAS (1630022011013 )Hainan Natural Science Foundation (807045)Running Costs of Danzhou Key Field Station of Observation and Research for Tropical Agricultural Resources and Environments,Ministry of Agriculture~~
文摘[Objective] The paper was to analyze the quality of flux observation data of rubber plantation.[Method]Based on the FSAM model,footprint and flux source area were analyzed according to the continuous flux measurement with the open-path eddy covariance system on the 50 m tower of Danzhou Key Field Station of Observation and Research for Tropical Agricultural Resources and Environments,Ministry of Agriculture from Jan 1 to Jun 30,2010.[Result] Under unstable stratification,source areas were smaller than those under stable conditions,and source areas in the dormant season were larger than those in the growing season at the same level.In the main wind direction 130°-270°,the upwind range of source areas was in the magnitude of 100-758 m and vertical upwind range was-251-251 m at 80% level under unstable stratification in the growing season,and they were some large than those under the unstable stratification in the dormant season.The source areas of the upwind and vertical upwind ranges were 173-1 858,-534-534 m especially under stable stratification in the growing season,and they were smaller than those under stable stratification in the dormant season.In the other wind directions of 0°-130° and 270°-360°,the ranges were similar to those of the growing season in the prevailing wind direction under the same atmospheric conditions.[Conclusion] The study would lay a foundation for the future flux calculation and analysis.
