Safety and Quality of Care Evaluation in Japanese Long-Term Facilities Focused on the Activity Condition and Cognitive Function of Residents

Objective: Currently, standards for evaluating long-term care facilities do not exist in Japan. This study aimed to evaluate the quality of healthcare services in Japan’s long-term care facilities and identify the structural and process indicators associated with the facilities’ outcome indicators. Methods: This retrospective study assessed changes in residents’ abilities to participate in physical activities, their cognitive function, and their vulnerability to injuries. From 2012 to 2013, we collected information on the healthcare services at 1067 long-term care facilities registered with Japan’s Welfare, Health and Medical Care Information Network in the Welfare and Medical Service Agency. We examined 12 structural indicators, 26 process indicators, and 7 outcome indicators. We used multivariate linear regression models adjusted to analyze relationships between outcome indicators and structural or process indicators. Results: Residents’ activity and cognitive function indicators either improved by 80% - 90% or were maintained for one year. The Geriatric Functional Independence Measures, the Barthel Index, and holding conferences related to care were all considered activities of daily living. Three adverse events—tumbles and falls, behavioral problems, and aimless wandering or leaving the facility without permission—were factors that restricted residents’ behavior and number of residents per care staff member. Conclusions: Maintaining or improving levels of independence and cognition in daily living requires a care process system that enables ongoing monitoring of residents’ activities of daily living and cognitive functioning. Ensuring the safety of residents and improving the quality of care in long-term care facilities without securing adequate care staff are not possible.

Evaluation of Care Quality Related to Dietary Intake and Swallowing Functions of Residents at Long-Term Facilities in Japan

This study aimed to evaluate the quality of healthcare services pertaining to the dietary intake and swallowing functions of residents, nutrition management practices, and performance of residents at long-term care facilities. We investigated outcome indicators, such as changes in dietary intake and swallowing function levels of residents, and clarified which structural and process indicators were associated with the outcome indicators. This was a retrospective study, analyzing information on healthcare services from 1067 long-term care facilities during the fiscal year 2012, sampled from among those registered with the Welfare, Health and Medical Care Information Network of the Welfare and Medical Service Agency in Japan. Five outcome indicators were identified. Next, we examined the relationships between the outcome indicators and structural or process indicators using a multivariate linear regression model, adjusting for facility type. The findings showed how the five outcome indicators were used in long-term care facilities over a period of one year and determined the independent predictors of these outcome indicators. The amplification of dietary function 1 was associated with “assessment of oral functions using a feeding and swallowing assessment checklist every three months”, “holding care conferences related to ingestion and swallowing every three months”, and “maintaining a 1:2 ratio for meal-time assistants to residents”. To improve the quality of care, it is necessary to increase the number of staff (e.g., to provide meal assistance to residents) and to understand changes in the residents’ status through accurate assessment and monitoring.

Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Accessibility and Fairness of Public Service Facilities from the Perspective of Supply and Demand Coordination: A Case Study of Old Urban Area of Guangzhou City

The accessibility and fairness of public service facilities are important manifestations of the convenience and equality of urban public service resource allocation.Optimizing the layout of urban public service facilities is an inevitable requirement for promoting the construction of people centered cities.This paper takes the old urban area of Guangzhou as the research area,measures the accessibility of multiple types of public service facilities based on an improved two-step floating catchment method,and combines Palma Ratio and location quotient methods to explore the fairness of urban public service facilities from two dimensions:social equity and spatial equity,with supply and demand relationship analysis as the main line.Research has shown that:①there is a significant spatial difference in the accessibility of public service facilities in the old urban areas of Guangzhou,and the comprehensive accessibility is generally higher in the central and southeastern regions of the old urban areas with fewer residential populations;②from the perspective of social equity,the resource allocation of public service facilities in the old urban areas of Guangzhou is in a seriously unfair state(with a fairness index of 2.99),and there are also varying degrees of unfairness within the streets;③from the perspective of spatial equity,the location quotient of public service facilities in the old urban areas of Guangzhou shows a pattern of multil center circles decreasing,indicating a significant spatial mismatch between the accessibility supply side of public service facilities and the demand side of the residential population.The research conclusion will provide scientific basis for optimizing the allocation of urban public service facilities and ensuring the equalization of public services.

Improvement in Patient Mobility Following Short-Term Rehabilitation in Skilled Nursing Facilities

Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.

Pediatric and adult liver transplantation in Bahrain: The experiences in a country with no available liver transplant facilities

BACKGROUND Liver transplantation(LT)is a life-saving procedure for patients with end-stage liver disease and has become the standard and most effective treatment method for these patients.There are many indications for LT that vary between countries and settings.The outcome of LT depends on the available facilities and surgical expertise,as well as the types of liver graft donors available.AIM To assess the clinical characteristics of patients from Bahrain who underwent LT overseas,and analyze factors affecting their survival.METHODS In this retrospective cohort study,we reviewed the medical records and overseas committee registry information of all pediatric and adult patients who were sent overseas to undergo LT by the Pediatric and Medical Departments of Salmaniya Medical Complex and Bahrain Defence Force Hospital via the Overseas Treatment Office,Ministry of Health,Kingdom of Bahrain,between 1997 and 2023.Demographic data,LT indication,donor-recipient relationship,overseas LT center,graft type,post-LT medications,and LT complications,were collected.Outcomes measured included the overall and 5-year LT survival rate.Fisher’s exact,Pearsonχ2,and Mann-Whitney U tests were used to compare the pediatric and the adults’group in terms of clinical characteristics,donor-recipient relationship,medication,complications,and outcome.Survival analysis was estimated via the Kaplan-Meier’s method.Univariate and multivariate analyses were used to detect predictors of survival.RESULTS Of the 208 eligible patients,170(81.7%)were sent overseas to undergo LT while 38(18.3%)remained on the waiting list.Of the 170 patients,167(80.3%)underwent LT and were included in the study.The majority of the patients were Bahraini(91.0%),and most were males(57.5%).One-hundred-and-twenty(71.8%)were adults and 47(28.3%)were children.The median age at transplant was 50.0[interquartile range(IQR):14.9–58.4]years.The main indication for pediatric LT was biliary atresia(31.9%),while that of adult LT was hepatitis C-related cirrhosis(35.0%).Six(3.6%)patients required re-transplantation.Most patients received a living-related liver graft(82%).Pediatric patients received more living and related grafts than adults(P=0.038 and P=0.041,respectively),while adult patients received more cadaveric and unrelated grafts.Most patients required long-term immunosuppressive therapy after LT(94.7%),of which tacrolimus was the most prescribed(84.0%),followed by prednisolone(50.7%),which was prescribed more frequently for pediatric patients(P=0.001).Most patients developed complications(62.4%)with infectious episodes being the most common(38.9%),followed by biliary stricture(19.5%).Tonsilitis and sepsis(n=12,8.1%for each)were the most frequent infections.Pediatric patients experienced higher rates of infection,rejection,and early poor graft function than adult patients(P<0.001,P=0.003,and P=0.025,respectively).The median follow-up time was 6.5(IQR:2.6–10.6)years.The overall survival rate was 84.4%,the 5-year survival rate,86.2%,and the mortality rate,15.6%.Younger patients had significantly better odds of survival(P=0.019)and patients who survived had significantly longer follow-up periods(P<0.001).CONCLUSION Patients with end-stage liver disease in Bahrain shared characteristics with those from other countries.Since LT facilities are not available,an overseas LT has offered them great hope.

Improvement of Activities of Daily Living (ADL) for Patients Treated in Skilled Nursing Facilities (SNFs)

Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.

Reflection on the Integrated Development of Marine Fisheries and Tourism Based on the Transformation of Fishery Facilities: A Case Study of Ningde City of Fujian Province, China

Based on the analysis on the current situation of marine fishery resources and development in Ningde City,this paper plans a spatial pattern for the integration of marine fishery and tourism of the“one belt,three zones,and multiple points”,designs key projects,analyzes the existing problems in the integrated development of fishery and tourism,and proposes relevant countermeasures and suggestions.

Analysis of the Impact of Road Traffic Safety Facilities on Traffic Safety

The development of the national economy is closely tied to infrastructure construction.In recent years,China has seen a significant increase in the number and scale of road construction projects,aimed at facilitating the flow of goods and enabling convenient travel for the masses.However,this surge in road construction also raises concerns about road traffic safety.Road traffic safety facilities play a crucial role in warning and protecting against traffic accidents.To ensure their effective implementation,this paper analyzes the essence of road traffic facilities and their impact on traffic safety.By identifying challenges in the application of traffic safety facilities and adhering to safety facility application principles,suggestions are proposed to enhance traffic safety management.

Investigating adverse events in long-term care facilities:a systematized review

Objective:This systematized review aimed to synthesize the results of empirical studies focused on the types and factors of adverse events(AEs)that contribute to them in long-term care(LTC)settings.Methods:The search was conducted in Pro Quest,Scopus,and Pub Med in January 2021 and resulted in 1057 records.The content analysis method was used in the data analysis.Results:In all,35 studies were identified as relevant for the review.The analysis revealed 133 different types of AEs and 60 factors that contributed to them.Conclusions:In LTC,various AEs occur,most of which are preventable,while many factors that influence their occurrence could be significantly modifiable.Through an effective analysis of AEs in LTC,it is possible to minimize their occurrence and,at the same time,minimize their negative impact on all par ties concerned.

Dignity and its related factors among older adults in long-term care facilities:A cross-sectional study

Objectives:This study aimed to explore the dignity and related factors among older adults in long-term care facilities.Methods:Cross-sectional data were obtained from a sample of 253 Chinese older adults dwelling in long-term care facilities.Dignity among older adults was measured using the Dignity Scale,and its potential correlates were explored using multiple linear regressions.Results:Results showed that the total score of the Dignity Scale is 151.95±11.75.From high to low,the different factors of dignity among older adults in long-term care facilities were as follows:caring factors(4.83±0.33),social factors(4.73±0.41),psychological factors(4.66±0.71),value factors(4.56±0.53),autonomous factors(4.50±0.57),and physical factors(4.38±0.55).A higher score of the Dignity Scale was associated with higher economic status,fewer chronic diseases,less medication,better daily living ability and long-time lived in cities.Conclusion:Older adults with low economic status,more chronic diseases,and poor daily living ability,taking more medications,or the previous residence in rural areas seem to be most at low-level dignity in long-term care facilities and thus require more attention than their peers.

Survey of <i>C. difficile</i>-Specific Infection Control Policies in Local Long-Term Care Facilities

Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.

Patients’ Perception and Satisfaction with Waiting Time, and Facilities Available in a State Teaching Hospital Eye Clinic, Southeast, Nigeria

Patients’ satisfaction with waiting time and the facilities in eye clinics is an important indication of the patients’ assessment of the quality of service in the eye clinic. In this study, waiting time was defined as time spent from arrival to time when the patient is seen by a doctor. Some factors that affect patients’ waiting time in health clinics include: healthcare setting, availability of adequate resources and personnel, efficient deployment of available resources and competence of healthcare workers, and punctuality of healthcare workers. The physical environment, comfort of patients, and level of infrastructure in the hospital also influence patients’ satisfaction. This observational, descriptive, cross-sectional study was conducted among patients that attended an eye care clinic, in a tertiary hospital, and 348 respondents were interviewed. Most of the respondents were aged 40 years and above (64.4%), females (63.5%), Igbos by tribe (94.8%), married (63.2%), Christians (96.6%), and had at least a secondary level of education (78.4%). Most perceived waiting time as being very long or long (60.1%), and only 48.8 were satisfied or very satisfied with the waiting time. Most also perceived the cleanliness of the eye clinic as being clean or very clean (85.0%), and 70.7% perceived the ventilation as being adequate or very adequate. The majority reported that a health talk was given (71.6%), and 62.7% were satisfied or very satisfied with the talk. More respondents (46.8%) perceived the waiting space as very inadequate or inadequate, as against 43.4% that perceived it as adequate or very adequate. More reported that prescribed drugs were completely unavailable or few available (48.0%), while 42.3% reported drugs as being reasonably or completely available. It is important that management of health facilities that offer eye care services, work towards improving patients’ perception and satisfaction with services provided in the eye clinics.

Clinical manifestations,diagnosis and long-term prognosis of adult autoimmune enteropathy:Experience from Peking Union Medical College Hospital

BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.

Phenotypic Characterization and Prevalence of Carbapenemase-Producing Acinetobacter baumanii Isolates in Four Health Facilities in Cameroon

Background and Objective: Nowadays, the clinical utility of carbapenems is threatened by the emergence of resistant bacteria, favored by its increasing use. According to the WHO, Acinetobacter baumannii: nosocomial infection agent, tops the list of priority antibiotic-resistant pathogens, considered to be the riskiest for humans. This study sought to determine the prevalence of carbapenemase-producing Acinetobacter baumannii strains in four health facilities in the Center and Littoral regions of Cameroon and the associated risk factors. Materials and Method: An analytical cross-sectional study was conducted over a six-month period from January to June 2022. All suspicious A. baumanii isolates obtained from pathological samples at the bacteriology laboratory of the different health facilities were systematically collected and re-identified. Re-identification and antimicrobial susceptibility Testing (AST) were performed using the VITEK 2 System and the Kirby-Bauer method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection and phenotypic characterization of carbapenemases was performed according to adequate standard procedures. Results: A total of 168/226 clinical isolates of Acinetobacter baumannii were confirmed after re-identification, among which 52.69% derived from male patients, 55.09% from participants aged between 10 - 39 years old, and 46.71% from pus samples. A very high resistance rates to all families of antibiotics was noted, except to colistin (10.2%). 40.12% of these isolates produced carbapenemase, represented by 62.69% of class B and 37.31% of class A. Carbapenemase production was observed only at HMR1, Centre region and at Laquintinie hospital, Littoral region with 53.33% and 50% respectively, even if there is no significant difference (P = 0.81). In addition, frequent hospitalisation was significantly associated to the production of carbapenemase among A. baumanii (Adjusted-OR = 16.53, P-value 0.0001). Conclusion: This study highlighted the emergence of carbapenemase-producing Acinetobacter baumannii which is increasingly growing. Continuous drug-resistant monitoring and preventive measures could help to prevent and curb the dissemination of A. baumanii resistance genes, especially in health settings.

Assessing the Impact of Fugitive Dust Emissions from Cement Silos at Cluster of Concrete Batching Facilities Using Air Dispersion Modeling

This research assessed the environmental impact of cement silos emission on the existing concrete batching facilities in M35-Mussafah, Abu Dhabi, United Arab Emirates. These assessments were conducted using an air quality dispersion model (AERMOD) to predict the ambient concentration of Portland Cement particulate matter less than 10 microns (PM10) emitted to the atmosphere during loading and unloading activities from 176 silos located in 25 concrete batching facilities. AERMOD was applied to simulate and describe the dispersion of PM10 released from the cement silos into the air. Simulations were carried out for PM10 emissions on controlled and uncontrolled cement silos scenarios. Results showed an incremental negative impact on air quality and public health from uncontrolled silos emissions and estimated that the uncontrolled PM10 emission sources contribute to air pollution by 528958.32 kg/Year. The modeling comparison between the controlled and uncontrolled silos shows that the highest annual average concentration from controlled cement silos is 0.065 μg/m3, and the highest daily emission value is 0.6 μg/m3;both values are negligible and will not lead to significant air quality impact in the entire study domain. However, the uncontrolled cement silos’ highest annual average concentration value is 328.08 μg/m3. The highest daily emission average value was 1250.09 μg/m3;this might cause a significant air pollution quality impact and health effects on the public and workers. The short-term and long-term average PM10 pollutant concentrations at these receptors predicted by the air dispersion model are discussed for both scenarios and compared with local and international air quality standards and guidelines.

Spatial Accessibility of Emergency Facilities to Road Accident Victims in Federal Capital City

This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in servicing accident victims. This is useful for developing means of saving the lives of accident victims in the Federal Fapital City (FCC). The data used comprised of Nigerian Sat II 2013 multispectral imagery (5 m multispectral and 2.5 m Panchromatic) of FCC obtained from the National Space Research and Development Agency (NARSDA), coordinates of seventy (70) accident black spots, five (5) zebra points and sixteen (16) emergency health care facilities obtained from Federal Road Safety Commission (FRSC). ArcGIS 10.0 software was used to display, visualize, identify and extract features from the imagery, and create maps from different layers of the spatial data, choose colors and symbols, create buffer zones, analyze spatial relationships, and design map layouts. Purposeful sampling method was adopted to administer 99 questionnaires to accident victims in the hospitals within the FCC. The spatial data were used to determine the time of rescue, type of rescue and coverage time of rescue operation. The statistical data were used to assess the spatio-temporal distribution of accidents and determine the level of response by the rescue teams. The results show that accident victims have adequate access to health facilities but inadequate access to zebra points, and passers-by have more effective accident response than the government action agencies. Specific points for the creation of additional zebra points were identified through buffering, and the creation of sustainable Good Samaritan programs and training for community persons in first aid were suggested. Meanwhile, further research to determine the impact of time of rescue, type of rescue and category of hospital on the accident victims was suggested.

Evolution of the Quality of the Partogram in 96 Health Care Facilities of 3 Provincial Health Divisions in the Democratic Republic of the Congo

The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.

Study on Urban Resilience Based on the Analysis of Supply Guarantee Facilities during Epidemic Closure—A Case Study of Shanghai in 2022

In the case of major public emergencies, the ability of cities to resist shocks becomes very important and reflects urban resilience. This paper selected the supply guarantee facilities during the city-wide lockdown of Shanghai during March-May 2022 due to COVID-19 pandemic as the research object. In this research, the per capita supply guarantee capacity and supply guarantee overlay intensity were analyzed based on the official list of facilities, and the actual role of the supply guarantee facilities was investigated through a public research questionnaire. The thermodynamic diagram map that was generated based on phone visits reflected the actual distribution of the population. Then the level of “supply guarantee resilience” was evaluated and graded for each district of Shanghai. It was concluded that the overall level of supply guarantee resilience was high in the central city, divergence in the near suburban districts, and generally low in the remote suburban districts. Based on this, the paper summarized the problems of supply guarantee revealed in Shanghai during the epidemic lockdown as well as proposed strategies to improve the resilience of similar scenarios in the future. With the help of big data and public research tools, this paper aimed to provide ways and methods to evaluate the resilience of cities under major public emergencies.

Current Situation and Development Proposals of Agricultural Facilities(Planting)Application in Beijing

Facility agriculture is an essential carrier for promoting stable production and supply.In2020,the planting area of facility agriculture in Beijing(290098000 m2)accounted for 29.06%of the total planting area of crops(998078000 m2),and the output value accounted for 46.56%.In2022,Beijing Agricultural Technology Extension Station organized relevant departments to summarize and evaluate the agricultural facilities in Beijing through consultation materials,interviews,questionnaires,and field trips,combining survey data and statistical data to draw the following conclusions.Facilities play a major supporting role in stabilizing production and ensuring supply.The number of traditional greenhouses is extensive and covers a large area,so special planning and classification upgrades are urgently needed.Facilities are rich in scientific and technological resources,but the mode of production is out of date.It is of great significance to improve the comprehensive production capacity of facility agriculture and promote the healthy and stable development of facility industry in Beijing to increase the utilization rate of facility agriculture land,strengthen the support of facility science and technology,and cultivate the socialized service organization of facility.