老年患者门诊预约挂号的影响因素:基于安德森健康行为模型的实证研究

目的基于安德森健康行为模型,研究老年患者门诊预约挂号的影响因素,为优化门诊预约挂号服务、推进老年患者预约挂号提供参考。方法以安德森健康行为模型为理论框架设计问卷,采用方便抽样法向上海某三级甲等综合医院门诊老年患者发放调查问卷。将各维度因素纳入二分类logistic回归模型,采用单因素分析和logistic回归分析探讨老年患者门诊预约挂号的影响因素。结果共回收282份有效问卷,预约挂号187人,占66.31%。曾使用过1~2种预约挂号服务、存在社会支持、距离医院路程80 min以上、收入为>5000~7500元、就诊科室预约率25.00%以上、有预约挂号使用意愿的老年患者更倾向于预约挂号。患慢性病数量在5种及以上的老年患者更不倾向于预约挂号。结论老年患者门诊预约需求较大且受多种因素影响。须关注老年人预约挂号“痛点”,关怀老年群体,共建支持网络,加强有效宣传,优化医疗资源配置,激发使用意愿。

Optimizing Vaccine Access: A Web-Based Scheduling System with Geo-Tagging Integration and Decision Support for Local Health Centers

The system created aims to produce an online vaccination appointment scheduling system with geo-tagging integration and a decision-support mechanism for neighborhood health clinics. With a decision support mechanism that suggests the essential vaccines based on their account details, it is made to meet the unique vaccination needs of each patient. The system includes immunizations that are accessible locally, and patients and midwives can manage their own corresponding information through personal accounts. Viewers of websites can visualize the distribution of vaccines by purok thanks to geotagging. The Agile Scrum Methodology was modified by the researchers for early delivery, change flexibility, and continual system improvement in order to accomplish the study’s main goal. In order to assess the system’s acceptability in terms of functional adequacy, performance efficiency, compatibility, usability, reliability, security, maintainability, and portability, it was designed in accordance with the ISO 25010 Product Software Quality Standards. Following the assessment, the system was given an average total weighted mean score of 4.62, which represents a verbal interpretation of “strongly agree”. This score demonstrates that the evaluators were in agreement that the system met the requirements of ISO 25010 for Product Software Quality Standards.

Fifth Definition for Strategic HRM:HRM Involvement

This study aims to contribute to development of SHRM field.Because personnel management and human resource management are in practice by firms,however,firms do not apply strategic HRM yet.There are four definitions of SHRM so far.This study presents a new approach for the development of the field.It is HRM involvement.HRM involvement is related to appointment of managers and board of directors.Because board of directors appoints managers in firms,HR must be member of board of directors.Because managers achieve firm performance(market share and profit),and Board of Directors appoints managers.Therefore,HRM manager must be involved with board of directors to affect appointments.This study uses semantic content analysis and systematic review methods as a research methodology.To conclude,organizations may apply strategic HRM through strategic HR Directors at top level,appointment of C-level Executives and HRM involvement.

Visual analysis of shared medical appointments based on CiteSpace

Objective:Analyze the research hotspots and frontiers of shared outpatient service,and provide a reference for researchers in this field to carry out follow-up research.Methods:Search the Web of Science core collection database until 2022 and visually analyzekeywords in this field through CiteSpace5.8.R3 software,Results:A total of 261 iteratures were included.The research focuses mainly on advanced care planning,diabetes care,andgroup prenatal care,The research trend tends to be telemedicine and nursing provided by specialized nurses.Conclusion:Scholars can learn from the research hotspots of foreign shared medical appointments,pay attention to the research trend,expand its application scope in combination with China's national conditions,and further promote thedevelopment of shared medical appointments in China.

上海市预防接种网约服务发展历程、现状、问题与策略

回顾上海市预防接种网络预约接种服务(以下简称“网约服务”)的发展历程,成绩斐然,网约服务方便接种门诊规划工作,方便受种者,特定疫苗预约功能方便紧缺疫苗管理和接种、助力完成新型冠状病毒疫苗接种。针对已建成的上海市预防接种网约服务系统的局限性提出改进建议方案,旨在未来进一步优化上海市预防接种网约服务,提高疫苗接种可及性及用户服务满意度。

Appointment scheduling with customer impatience based on operating cost model

An appointment scheduling problem is studied with the consideration of customer impatience.On the assumption that both the time of leaving queue and the time of service are exponentially distributed,in order to minimize the joint cost,the optimal appointment schedule of the fixed number of customers is studied.The joint cost function is composed of customers expected delay time and service availability time.The expected delay time of each customer in the queue is recursively computed in terms of customer interarrival time.Furthermore,the effect of impatience on the optimal schedule as well as the total operating cost is studied.The results show that as the impatience rate increases,the optimal interarrival time becomes shorter and the interarrival time of the last few customers gradually approaches that of the customers in the middle.In addition,impatient behaviors can increase the joint cost.

Appointment of Dr. Xue-Long JIANG as the Associate Editor-in-Chief of Zoological Research

We are very pleased to announce that we have invited Dr. Xue-Long JIANG to serve as the Associate Editor-in-Chief for Zoological Research （ZR）, effective from 1 March, 2016. Dr. JIANG, Professor and principle investigator from the Laboratory of Mammal Ecology and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, has worked with ZR since 2006 as a member of the editorial board and has played an active and important role in maintaining ZR as a respected academic publishing platform. Currently, he also works as the Associate Editor-in-Chief of Acta Thefiologica Sinica, Mammal Research and as a senior editorial board member of Biodiversity Science.

Appointment of Dr. Wai-Yee Chan as the Associate Editor-in-Chief of Zoological Research

We are very pleased to announce that we have invited Dr. Wai-Yee Chan, Professor and Director of School of Biomedical Sciences, The Chinese University of Hong Kong, to serve as the Associate Editor- in-Chief for Zoological Research （ZR）, effective 1 September, 2016.

Quantum Algorithm for Appointment Scheduling

Suppose a practical scene that when two or more parties want to schedule anappointment, they need to share their calendars with each other in order to make itpossible. According to the present result the whole communication cost to solve thisproblem should be their calendars’ length by using a classical algorithm. In this work, weinvestigate the appointment schedule issue made by N users and try to accomplish it inquantum information case. Our study shows that the total communication cost will bequadratic times smaller than the conventional case if we apply a quantum algorithm in theappointment-scheduling problem.

Design and Implementation of Clinic Appointment Registration System

Clinic Appointment Registration System is an important way to see a doctor, and it’s also a preliminary tool for storage and management of clinic medical records. This new system was developed using Visual Studio 2008 and C#.NET as the development environment and tools and Microsoft Access 2003 as the database to store the medical data based on Browse/Server (B/S) model. The system consists of several data operation functions including appointment registration, data management (e.g. addition, deletion and searching), data backup and recovery, etc., thus, achieve key research ob-jectives.

An Extended Bailey-welch Rule with No-show and Walk-in For Outpatient Appointment Scheduling

In clinic＇s appointment scheduling system no-shows have been a significant and confirmed issue with a bad influence on patient accessibility and clinic efficiency. The problem of walk-in has often been seen as the opposite of no-show problem. In this work we revisit a walk-in admitting based approach to mitigate the bad influence of no-show without overbooking. First we establish a model which utilizes marginal benefit objective function to balance the interests of the clinic, the patient and the doctor, we prove that no-show and walk-in cancels out each other straightly has a bad property. Then we propose a new rule which is an extension of the well-known Bailey - Welch rule, the simulation results show that our rule has an improvement comparing with the common rule that cancels them out straightly.

Making an Appointment

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Keeping an Appointment With Death The Final Contribution of a Woman Doct

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Sources appointment and health risks of PM_(2.5)-bound trace elements in a coastal city of southeastern China

To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As,Sn,Ba,Pb)in PM_(2.5)were monitored from December 2020 to November 2021 in a representative city,Xiamen.The concentrations of trace elements in Xiamen displayed an obvious seasonal variation and were dominated by K,Fe,Al,Ca and Zn.Based on Positive Matrix Factorization analysis,source appointment revealed that the major sources of trace elements in Xiamen were traffic,dust,biomass and firework combustion,industrial manufacture and shipping emission.According to health risk assessment combined with the source appointment results,it indicated that the average noncarcinogenic risk was below the threshold and cancer risk of four hazardous metals(Cr,Ni,As,Pb)exceeded the threshold(10^(-6)).Traffic-related source had almost half amount of contribution to the health risk induced by PM_(2.5)-bound trace elements.During the dust transport period or Spring Festival period,the health risks exceeded an acceptable threshold even an order of magnitude higher,suggesting that the serious health risks still existed in low PM_(2.5)environment at certain times.Health risk assessment reminded that the health risk reduction in PM_(2.5)at southeastern China should prioritize traffic-related hazardous trace elements and highlighted the importance of controlling vehicles emissions in the future.

Abundance and sources of particulate polycyclic aromatic hydrocarbons and aromatic acids at an urban site in central China

We conducted a simultaneous field study of PM_(2.5)-bound particulate polycyclic aromatic hydrocarbons(PAHs)and aromatic acids(AAs)in a polluted city Zhengzhou to explore the concentration,sources and potential conversion pathways between PAHs and AAs in different seasons.The average concentrations of PM_(2.5),28PAHs and 8AAs during the sampling period were 77μg/m^(3),75 ng/m^(3),and 283 ng/m^(3),respectively.The concentration of both28PAHs and 8AAs were highest in winter and lowest in summer with ratios of 6.3 and 2.3,respectively.PAHs with 5-7 rings were the main components of PAHs(52%),followed by 4rings PAHs(30%)and 2-3 rings PAHs(18%).According to the source appointment results obtained by positive matrix factorization,the main sources of PAHs were combustion and vehicle emissions,which account for 37%and 34%,respectively.8AAs were divided into three groups,including four benzene dicarboxylic acids(B2CAs),three benzene tricarboxylic acids(B3CAs)and one benzene tetracarboxylic acid(B4CA).And interspecies correlation analysis with PM_(2.5)source markers were used to investigate potential sources.Phthalic acid(o-Ph)was the most abundant specie of 8AAs(157 ng/m^(3),55%of 8AAs),which was well correlated with sulfate.Meanwhile,B3CAs and B4CA were highly correlated with sulfate and weakly correlated with levoglucosan,suggesting that secondary formation was their main source.As logical oxidation products of PAHs,o-Ph and B3CAs showed good correlations with a number of PAHs,indicating possible photochemical oxidation pathway by PAHs.In addition,O_(3),NO_(2),temperature and relative humidity have positive effects on the secondary formation of B3CAs.

Impact of adjustment measures on reducing outpatient waiting time in a community hospital： application of a computer simulation

Background As an important determinant of patient satisfaction, waiting time, has gained increasing attention in the field of health care services. The present study aimed to illustrate the distribution characteristics of waiting time in a community hospital and explore the impact of potential measures to reduce outpatient waiting time based on a computer simulation approach. Methods Dudng a one-month study period in 2006, a cross-sectional study was conducted in a community hospital located in Shanghai, China. Baseline data of outpatient waiting time were calculated according to the records of registration time and payment time. A simulation technique was adopted to investigate the impact of perspective reform methods on reducing waiting time. Results Data from a total of 10 092 patients and 26 816 medical consultations were collected in the study and 19 947 medical consultations were included. The average of the total visit time for outpatients in this hospital was 43.6 minutes in the morning, 19.1 minutes in the afternoon, and 34.3 minutes for the whole day studied period. The simulation results suggested that waiting time for outpatients could be greatly reduced through the introduction of appointment system and flexible demand-orientated doctor scheduling according to the numbers of patients waiting at different time of the workday. Conclusion Adoption of an appointment system and flexible management of doctor scheduling may be effective way to achieve decreased waiting time.

Investigation of PM_(2.5) pollution during COVID-19 pandemic in Guangzhou,China

The COVID-19 pandemic has raised awareness about various environmental issues,includ-ing PM_(2.5) pollution.Here,PM_(2.5) pollution during the COVID-19 lockdown was traced and an-alyzed to clarify the sources and factors influencing PM_(2.5) in Guangzhou,with an emphasis on heavy pollution.The lockdown led to large reductions in industrial and traffic emissions,which significantly reduced PM_(2.5) concentrations in Guangzhou.Interestingly,the trend of PM_(2.5) concentrations was not consistent with traffic and industrial emissions,as minimum concentrations were observed in the fourth period(3/01-3/31,22.45 μg/m^(3))of the lockdown.However,the concentrations of other gaseous pollutants,e.g.,SO_(2),NO_(2) and CO,were corre-lated with industrial and traffic emissions,and the lowest values were noticed in the sec-ond period(1/24-2/0_(3))of the lockdown.Meteorological correlation analysis revealed that the decreased PM_(2.5) concentrations during COVID-19 can be mainly attributed to decreased in-dustrial and traffic emissions rather than meteorological conditions.When meteorological factors were included in the PM_(2.5) composition and backward trajectory analyses,we found that long-distance transportation and secondary pollution offset the reduction of primary emissions in the second and third stages of the pandemic.Notably,industrial PM_(2.5) emis-sions from western,southern and southeastern Guangzhou play an important role in the formation of heavy pollution events.Our results not only verify the importance of control-ling traffic and industrial emissions,but also provide targets for further improvements in PM_(2.5) pollution.

Particle-bound polycyclic aromatic hydrocarbons in typical urban of Yunnan-Guizhou Plateau:Characterization,sources and risk assessment

Monthly particle-phase ambient samples collected at six sampling locations in Yuxi,a high-altitude city on the edge of Southeast Asia,were measured for particle-associated PAHs.As trace substances,polycyclic aromatic hydrocarbons(PAHs)are susceptible to the influences of meteorological conditions,emissions,and gas-particulate partitioning and it is challenging job to precise quantify the source and define the transmission path.The daily concentrations of total PM_(2.5)-bound PAHs ranged from 0.65 to 80.76 ng/m^(3),with an annual mean of 11.94 ng/m^(3).Here,we found that the concentration of PM_(2.5)-bound PAHs in winter was significantly higher than that in summer,which was mainly due to source and meteorology influence.The increase of fossil combustion and biomass burning in cold season became the main contributors of PAHs,while precipitation and low temperature exacerbated this difference.According to the concentration variation trend of PM_(2.5)-bound PAHs and their relationship with meteorological conditions,a new grouping of PAHs is applied,which suggested that PAHs have different environmental fates and migration paths.A combination of source analysis and trajectory model supported local sources from combustion of fossil fuel and vehicle exhaust contributed to the major portion on PAHs in particle,but on the Indochina Peninsula the large number of pollutants emitted by biomass burning during the fire season would affect the composition of PAHs through long-range transporting.Risk assessment in spatial and temporal variability suggested that citizens living in industrial areas were higher health risk caused by exposure the PM_(2.5)-bound PAHs than that in other regions,and the risk in winter was three times than in summer.

Optimal appointment scheduling with no-shows and exponential service time considering overtime work

Appointment systems are used by health clinics to manage access to service providers.In such systems,a specified number of patients are scheduled in advance,but certain patients may not arrive or‘show up’to their appointments.The existence of no-show behaviour influences both the operational cost of the clinics and the waiting time of the patients.In this paper,we determine an optimal schedule that takes no-show behaviour into account to determine the time intervals between patients under the framework of the individual-block/variableinterval rule for minimising the overall cost of the patient waiting time,the practitioner idle time and overtime.Under the condition that the service time of each patient is exponentially distributed,we compare the results with a schedule designed for the same expected number of patients in the absence of no-shows and analyse the effect on the system performance from the perspectives of day-length,expected workload,no-show probability,ratio of overtime costs and no-golf policy.We extend our results to an equally-spaced appointment system,which is commonly used in practice.Our results show that not only do no-shows greatly affect the system performance compared with an appointment system with the same expected workload without no-shows,but they also affect the optimal scheduling behaviours in the dome-shaped distribution.In addition,overtime cannot be eliminated completely even if the day length is adequate for all patients because of the stochastic characteristic of service time.