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.

Depressed Older Patients’ Need for and Expectations of Improved Health Services—An Evaluative Approach to the Chronic Care Model

Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implementation of the Chronic Care Model (CCM). A qualitative evaluative design was used. Data were collected through individual interviews with older persons living in Norway. The qualitative content analysis revealed two themes: The need to be safeguarded and Expectation of being considered valuable and capable. Evaluation of the improvement in care with focus on the CCM components showed that the most important components for improving the depressed older person’s daily life were: delivery system re-design, self-management support, productive interaction and a well-informed active patient. The findings highlight the need for a health services designed for persons suffering from chronic ill-health, where the CCM could serve as a framework for policy change and support the redesign of the existing healthcare system. We conclude that older persons with depression need attention, especially those who have been suffering for many years. The identified components may have implications for health professionals in the promotion of mental healthcare.

Youth’s Perspectives on a Sustainable Model for the Provision of Youth Friendly Sexual and Reproductive Health Services in Kenya: A Quantitative Approach

Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is;youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.

New Challenges for Occupational Health Services Facing Economic Reform in China

In China, which is facing economic reform and the rapid development of small-scale industries, various occupational hazards are reappearing. The problems are related to the ignorance of the managers and the workers, a lack of capital, the insufficiency of occupational health services, and the transfer of some hazardous work from large factories in the cities to small plants in the towns and villages. The change in life-style, especially in smoking habits, has aggravated occupational hazards. The problems may be solved by renewing the concept of health among the managers and workers, enforcing legislation related to occupational hazards, strengthening health personnel training, and reinforcing health education and self-help. 1989 Academic Press, Inc.

Innovative Services Models Based on ＂Four new＂ Economy

The propose of ＂four new＂ economy is to undertake innovation-driven transformation of Shanghai, promote the development of strategic emerging industries and transform and upgrade of manufacturing. In the following years, Shanghai will focus on the capture of key technologies, promoting the transformation of technology, expanding market demand, improving the development of the carrier, encouraging and supporting enterprises, financial institutions and social capital to increase the investment and use of＂four new＂ economy, to promote the ＂four new＂ economy gradually grow and develop. With the ＂four new＂ economy＇s development and growth, its service model should be changed too. On the basis of theory and practice, the text proposes three forms of innovative services models and relate recommendations to promote it.

On Rural Medical Care and Health Undertaking Development during New Medical Reform

Based on in-depth survey of township hospitals in Lushan County of Henan Province, this paper studies the development situations of rural medical care and health undertaking in the course of new medical reform. Results show that both rural medical institution and public health undertaking have considerable development in this course. Working capital situation gradually turns better. However, there are still problems and challenge of shortage of high quality medical care personnel, lack of employment mechanism, poor medical environment, and imperfect bidding and purchasing system of medicines. To further develop rural medical situation, it should improve medical environment, speed up informationization construction, and give prominence to functional orientation.

基于SERVQUAL模型的基层医疗卫生服务质量评价研究

目的:在县域医共体的建设背景下,评价社区卫生服务中心服务质量及影响因素,提出基层医疗卫生服务质量改善对策。方法:运用SERVQUAL模型,从社区卫生服务中心服务质量的有形性、可靠性、响应性、信任性、移情性方面,形成问卷条目;通过多因素二分类logistic回归探索筛查服务质量差距的影响因素;借助IPA象限图呈现居民对社区卫生服务中心的SERVQUAL模型各维度服务质量重要性的分布情况。结果:问卷各项条目的服务质量差距均为负值,服务保证性和移情性维度的服务质量差距得分最高,分别为-0.47±0.59分和-0.47±0.65分;服务有形性维度的服务质量差距得分最低,为-0.40±0.55分。年龄、收入情况和慢病年限是服务质量差距的影响因素。结论:当前基层医疗卫生服务质量与居民的期望之间存在一定差距,基层医疗卫生服务机构应重视对低年龄、高收入和慢病病程较长的居民的服务需求。

Exploration on New Campus Courier Service Models

Recently,e-commerce develops rapidly,advancing express delivery services,but the whole logistics are incomplete,especially for the issue of ＂the last one-kilometer ＂.For example,the research reviewed status quo and problems of Tianjin Agricultural University and made improvements on campus delivery services to explore the status quo and resolving ways,exploit the hint business opportunity in campus express model,improve efficiency and service attitude and get doublewin of both parties involved.

基于KANO-QFD集成方法的健康网站信息服务质量优化研究

[目的/意义]健康网站作为新兴的健康信息服务方式,是用户获取健康信息和服务的重要平台。优化健康网站信息服务质量不仅可以保护用户的健康安全,还可以促进在线医疗行业的发展。[方法/过程]文章构建了基于KANO-QFD集成方法的健康网站信息服务质量优化模型,并以好大夫在线为例进行了实证研究。主要运用E-SERVQUAL和KANO模型设计调查问卷对健康网站进行用户需求获取与分析,采用Better-Worse系数分析法进行用户需求关键信息服务质量要素提取,最后使用QFD模型构建信息服务质量屋实现优化策略重要度排序。[结果/结论]可以为健康网站信息服务质量优化提供针对性对策与建议,细化分析用户需求和明确健康网站信息服务质量的重点改进方向。

A hypothesis study on a four-period prevention model for high altitude disease

Background:High altitude disease(HAD)can reduce combat effectiveness and damage the health of soldiers at high altitudes.The objective of this hypothesis study is to build a four-period prevention model for high altitude disease that can be applied at high altitudes of over 3000 m.Presentation of the hypothesis:We divided the time at high altitude into nine periods,with three stages from the ascent preparation to the descent to the plain,and applied a continuous dynamic and systematic four-period prevention model across the nine periods.Each period of three stages has its own different measures and targets high altitude health care services for the prevention of high altitude disease.A standard four-period prevention model for high altitude disease was constructed for the high altitude health services at the population level.Testing the hypothesis:Our hypothesized HAD prevention model represents a continuous dynamic and systematic four-period prevention model across the nine periods.This hypothesis can be tested from three aspects.The first one is assessment of soldiers’operating efficacies.The second is comparison of the long-term high altitude population health basic data and development and utilization of big data.The third is descent population health status comparative study and historical retrospective study on prevention.Implications:As we know,it is necessary to protect soldiers’health through the ascent and descent.Through the standard four-period model,we can protect soldiers’health by preventing high altitude diseases,screening the susceptible population,securely tracking their location and maintaining soldiers’health statuses;we also maintain their operational capabilities,eliminate their psychological fears and ease their family troubles.

Research on the New Mode of college students’mental Health Education under the Network environment

With the rapid development of science andtechnology, internet technology has become matureincreasingly. It has become an important part ofpeople’s work, life and study. At the same time, thenetwork environment has also brought an impact onthe physical and mental health of college students.Nowadays, the quality and level of college students’mental health education has become society topics.College psychological health education work shouldkeep pace with the network environment developmentand the students’ physical and mental development.It is the effective innovation of psychological healtheducation work. The new model of college students’psychological health education development isconstructed. It is improve the level of students’ physicaland mental health development, and the psychologicalquality of college students is strengthen. Based onthis, this paper analyzes the existing problems on thecollege students’ mental health development. Under thenetwork environment, it proposes an effective method toconstruct a new mode of college students’ mental healtheducation .

基于ARIMA模型的广州市中医药卫生资源配置预测分析

本文收集了广州地区2003年至2022年的中医药卫生技术人员和医院床位数等数据,采用R语言构建自回归整合移动平均模型(Autoregressive Integrated Moving Average Model,ARIMA)进行中医药卫生资源配置预测研究,分析了广州市中医药卫生资源的情况以及发展趋势,为广州市相关中医药卫生政策制定提供参考依据。

互联网平台下的Teach-back健康教育模式在胸外科优质护理中的应用效果

目的分析Teach-back健康教育和互联网平台模式在胸外科优质护理中的应用效果。方法选择2022年5月—2023年4月临沂市中心医院收治的60例胸外科手术患者为研究对象,以抽签法按序分为研究组和对照组,每组30例。对照组提供优质护理,研究组联合Teach-back健康教育和互联网平台模式。比较两组患者护理后的自护能力和生活质量、心理状态和治疗依从。结果研究组自护能力和生活质量均明显高于对照组,差异具有统计学意义(P<0.05);研究组抑郁和焦虑自评得分均明显低于对照组,差异具有统计学意义(P<0.05);研究组治疗依从明显高于对照组,差异具有统计学意义(P<0.05)。结论新型健康教育模式在胸外科优质护理中,利于提高患者自护能力和生活质量,缓解心理压力,提高治疗依从,值得临床应用。

Impact of the New Cooperative Medical Scheme on Health Care Service Utilization in Rural China

Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods （random-effect probit regression model and DID methods）, this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization （outpatient and inpatient） of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization （both outpatient and inpatient） between the NCMS enrollment group and the non-enrollment group in both working age group （15-59） and the elderly group （60 and over）. Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior （visiting the hospital to receive a health examination） in the working age group, but the effect did not appear in the elderly group.

Context-Aware Technology of Disabled Health Service for Intelligent Community

With the rapid development of Ubiquitous computing,context-aware technology as one of the core contents of the former has made a series of research progress and achievements.Context-aware technology can automatically provide the corresponding services according to the strategy given by the inference engine through sensing the related context of the environment and tasks.It is because context-aware technology can significantly improve the intelligence of computer interaction,the application of this technology to“Intelligent community”which is a new concept built on the highly developed Internet and sensor networks has become more promising and meaningful.As an important part of the intelligent community,the technology is also of great use for the disabled health service.Based on the research of the theory of context-aware technology and the examples of international development applications,this paper designs an ontology based context-aware system framework named CADHS for disabled health service.The hierarchy based framework uses ontology to standardize and formalize context information and complete context modeling.This framework includes the collection and encapsulation of the original context information and constructs a formal reasoning model.Moreover,the framework provides query and subscription services as the external interface of the system.On the basis of this framework,the DHS-Protosystem(Disabled Health Service Protosystem)is designed and implemented.This paper introduces implementation of query and subscription service module.

移动医疗服务用户健康信息披露意愿研究——基于fsQCA和NCA的实证分析

[目的/意义]移动医疗服务的健康信息具有隐私和敏感等特征,用户健康信息披露行为日益受到学界和公众的关注。[方法/过程]本研究基于精细加工可能性模型,利用必要条件分析和模糊集定性比较分析的方法对问卷数据进行实证研究,探究影响健康信息披露意愿的必要条件及不同因素组合产生的组态路径。[结果/结论]研究发现,信任是影响用户健康信息披露意愿的必要条件,存在3条影响用户健康信息披露意愿的路径:路径一为风险消解型,当用户感知风险被消解时,即使需要披露的信息敏感性高,用户也会具有很高的披露意愿;路径二为权衡利弊型,当用户预期收益大于预期风险时,其信息披露意愿会随之增强;路径三为利益驱动型,当用户隐私关注水平较低时,其健康信息披露意愿主要受感知收益驱动。

Dynamic behavior of new cutting subgrade structure of expensive soil under train loads coupling with service environment

Expansive soil is sensitive to dry and wet environment change. And the volume deformation and inflation pressure of expansive soil may induce to cause the deformation failure of roadbed or many other adverse effects. Aimed at a high-speed railway engineering practice in the newly built Yun-Gui high-speed railway expansive soil section in China, indoor vibration test on a full-scaled new cutting subgrade model is carried out. Based on the established track-subgrade-foundation of expansive soil system dynamic model test platform, dynamic behavior of new cutting subgrade structure under train loads coupling with extreme service environment(dry, raining, and groundwater level rising) is analyzed comparatively. The results show that the subgrade dynamic response is significantly influenced by service conditions and the dynamic response of subgrade gradually becomes stable with the increasing vibration times under various service environment conditions. The vertical dynamic soil stress is related with the depth in an approximate exponential function, and the curves of vertical dynamic soil stress present a "Z" shape distribution along transverse distance. The peak value of dynamic soil stress appears below the rail, and it increases more obviously near the roadbed surface. However, the peak value of dynamic soil stress is little affected outside 5.0 m of center line. The vibration velocity and acceleration are in a quadratic curve with an increase in depth, and the raining and groundwater level rising increase both the vibration velocity and the acceleration. The vertical deformations at different depths are differently affected by service environment in roadbed. The deformation of roadbed increases sharply when the water gets in the foundation of expansive soil, and more than 60% of the total deformation of roadbed occurs in expansive soil foundation. The laid waterproofing and drainage structure layer, which weakens the dynamic stress and improves the track regularity, presents a positive effect on the control deformation of roadbed surface. An improved empirical formula is then proposed to predict the dynamic stress of ballasted tracks subgrade of expansive soil.

Physical restraint in mental health nursing: A concept analysis

Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related literature,this study aims to clarify the concept of physical restraint in mental health nursing.Method: Three databases (PubMed,PsyclNFO and CINAHL) were retrieved,and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.Results: Physical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement.It should be the last option used by qualified personnel.Antecedents of physical restraint are improper behavior (violence and disturbance) of patients,medical assessment prior to implementation and legislation governing clinical usage.Consequences of physical restraint are alleviation of conflict,physical injury,mental trauma and invisible impact on the institution.Discussion: This study defined the characteristics of physical restraint in mental health nursing.The proposed concept analysis provided theoretical foundation for future studies.

基于SERVQUAL模型与IPA分析的武汉市社区卫生服务中心服务质量评价

目的调查社区卫生服务中心服务质量,为提升社区卫生服务中心服务能力提供参考。方法使用基于SERVQUAL模型设计的社区卫生服务中心服务质量实际感知和期望问卷,对武汉市7个区社区卫生服务中心的411名就诊患者进行调查,计算患者实际感知值和期望值的差距,通过IPA分析绘制矩阵图。结果就诊患者对社区卫生服务中心服务质量实际感知平均得分为3.8分,期望平均得分为4.3分,差值为-0.5分。5个维度实际感知平均得分均低于期望得分,差值均为负值。22个条目中:5个条目分布在第一象限,为保持优势区;2个条目分布在第二象限,为可能过度关注区;9个条目分布在第三象限,为低优先顺序区;6个条目分布在第四象限,为集中关注区。结论患者对社区卫生服务中心服务质量的感知与期望存在差距。需完善医疗设备配置和基础设施建设,合理配备卫生技术人员,积极提升医疗服务能力。

基于三阶段DEA的基层医疗卫生服务效率分析

[目的]基于三阶段DEA模型,对我国城乡基层医疗卫生服务效率进行测算,进一步探究效率提高的阻碍因素及实现途径措施。[方法]选取城乡基层医疗卫生服务投入与产出相关数据,运用三阶段数据包络分析模型剔除环境变量与随机噪声,对全国28个省份进行效率测算。[结果]在外部因素的影响下,城镇基层医疗卫生服务DEA有效的省份有3个,无效25个;乡村基层医疗卫生服务DEA有效的省份有7个,无效21个。第二阶段似SFA分析结果显示外部因素对城乡基层医疗卫生资源的投入冗余产生影响,剔除后各省份的城乡基层卫生服务综合技术效率均有所下降。[结论]①基层医疗卫生服务资源配置和服务效率目前存在地区不平衡、城乡不平衡的问题;②基层医疗卫生事业发展面临经济社会的发展、人口老龄化等趋势带来的新挑战;③城镇基层卫生服务效率不高,诊疗服务功能被弱化。