目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上...目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上海交通大学医学院附属儿童医院呼吸科收治的67例0~6岁喘息性疾病患儿,按照随机数字表分为观察组33例和对照组34例,其中失访3例,最终每组32例。观察组采用基于EMS管理模式的延续性护理,对照组给予常规护理和出院电话随访。2组患儿出院后1、3、6个月随访评估儿童呼吸和哮喘测试(Test for Respiratory and Asthma Control in Kids,TRACK)结果、喘息复发情况;出院后6个月随访采用支气管哮喘用药依从性评分表(Medication Adherence Report Scale for Asthma,MARS-A)和护理工作满意度调查表评估用药依从性及护理工作满意度。结果·2组患儿人口学特征及临床基线特征差异无统计学意义。重复测量方差分析结果显示,时间、组别、组别×时间的交互作用对TRACK总分的影响均有统计学意义;出院后1、3、6个月,观察组TRACK总分均显著高于对照组(均P=0.000);2组患儿TRACK总分均随时间推移逐渐上升(P=0.000)。观察组1、3、6个月随访发现喘息复发率分别为25.0%、18.7%、9.4%,均显著低于对照组(分别为50.0%、43.7%、31.3%,均P<0.05);广义估计方程分析显示组间比较差异有统计学意义(P=0.013),观察组干预效果优于对照组(OR=0.292)。出院后6个月观察组MARS-A得分为(4.519±0.395)分,显著高于对照组[(3.994±0.739)分,P=0.001]。护理工作满意度调查结果显示,观察组显著高于对照组(P=0.000)。患儿MARS-A得分与护理工作满意度呈中度正相关(r=0.389,P=0.001)。结论·基于EMS管理模式的延续性护理可显著提高学龄前喘息性疾病儿童的用药依从性和喘息控制水平,明显降低喘息复发率,以及提高护理工作满意度。展开更多
Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial sca...Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial scale, biophysical and ecological structure, and functionality. This requires conducting studies at the local level to understand how, for example, the watershed ecosystem contributes to humanity locally and nationally. This study focuses on selected regulatory ecosystem services (RES) in Kenya’s catchment area ecosystems (Elgeyo and Nyambene). Field-based sampling and Landsat imagery with secondary information were used to generate biophysical and ecological data. The study used market price-based, cost-based, and unit transfer methods for RES valuation. The study estimates the total value of the six selected regulatory ecosystem services (RES) at KES 41.4 billion (US$386.7 million) and KES 14.73 billion (US$137.71 million) for Elgeyo and Nyambene, respectively. This equates to KES 1.64 million (US$15,331.19) and KES 2.72 million (US$25,375) per hectare per year. Extrapolating the study estimates to the national level, the country’s regulatory ecosystem services would range from US$18.4 billion to US$30.45 billion annually. This equates to between 16.7% and 27.7% of Kenya’s GDP in 2021, underscoring the importance of watersheds to the national economy.展开更多
Dear Editor,This letter deals with state estimation issues of discrete-time nonlinear systems subject to denial-of-service(DoS)attacks under the try-once-discard(TOD)protocol.More specifically,to reduce the communicat...Dear Editor,This letter deals with state estimation issues of discrete-time nonlinear systems subject to denial-of-service(DoS)attacks under the try-once-discard(TOD)protocol.More specifically,to reduce the communication burden,a TOD protocol with novel update rules on protocol weights is designed for scheduling measurement outputs.In addition,unknown nonlinear functions vulnerable to DoS attacks are considered due to the openness and vulnerability of the network.展开更多
In 2024,the China International Fair for Trade in Services (hereinafter referred to as CIFTIS) opened in the China National Convention Center and Shougang Park on September 12th.The theme of the CIFTIS this time was&q...In 2024,the China International Fair for Trade in Services (hereinafter referred to as CIFTIS) opened in the China National Convention Center and Shougang Park on September 12th.The theme of the CIFTIS this time was"global services,shared prosperity",which is not only a window for allowing the world to discover the development of China's service trade,but is also a bridge for promoting global cooperation with regards to the service trade.As one of the world-famous service trade events,the CIFTIS has become an important business card allowing China to open up.The CIFTIS has attracted the attention of the whole world and become a bridge for all parties to share development opportunities,promote industrial growth,and strengthen communication.展开更多
Understanding stakeholders’differences in perceptions of ecosystem services(ES)is crucial for guiding ecolog-ical conservation and planning.However,the variations of ES perception amongst different types of residents...Understanding stakeholders’differences in perceptions of ecosystem services(ES)is crucial for guiding ecolog-ical conservation and planning.However,the variations of ES perception amongst different types of residents in urbanizing areas along an urban-rural gradient are still poorly understood.Combining a questionnaire-based survey,redundancy analysis,and statistical tests,we delineated the urban-rural gradient according to local res-idents’socio-economic characteristics,and investigated the differences in local residents’perceptions of ES and potential factors affecting them in the Guanting Reservoir basin,a rapidly urbanizing basin in China.The results showed that residents living in urban-rural transitional areas attached great importance to provisioning services of providing food and domestic water,regulating services of carbon sequestration and air purification,and cul-tural services of providing education and training,which were 0.7%-13.1%,0.7%-9.1%and 2.5%-21.2%higher than that of residents in other areas,respectively.Age and occupation were major factors affecting residents’perceptions.In terms of land-use types that deliver ES,the difference in perceptions of ES delivered by grassland was the greatest amongst residents.Our results support recommendations for policymakers to take into account the stakeholders’diverse perceptions,thus promoting residents’sense of gain on ES.展开更多
In an attempt to assess the Kenyan healthcare system, this study looks at the current efforts that are already in place, what challenges they face, and what strategies can be put into practice to foster interoperabili...In an attempt to assess the Kenyan healthcare system, this study looks at the current efforts that are already in place, what challenges they face, and what strategies can be put into practice to foster interoperability. By reviewing a variety of literature and using statistics, the paper ascertains notable impediments such as the absence of standard protocols, lack of adequate technological infrastructure, and weak regulatory frameworks. Resultant effects from these challenges regarding health provision target enhanced data sharing and merging for better patient outcomes and allocation of resources. It also highlights several opportunities that include the adoption of emerging technologies, and the establishment of public-private partnerships to strengthen the healthcare framework among others. In this regard, the article provides recommendations based on stakeholder views and global best practices addressed to policymakers, medical practitioners, and IT specialists concerned with achieving effective interoperability within Kenya’s health system. This research is relevant because it adds knowledge to the existing literature on how healthcare quality can be improved to make it more patient-centered especially in Kenya.展开更多
文摘目的·探讨基于EMS[环境管理(environment management,E)、用药指导(medicine direction,M)与自我监测(self monitoring,S)]管理模式的延续性护理在学龄前喘息性疾病儿童中的应用效果。方法·选取2019年12月至2020年11月,在上海交通大学医学院附属儿童医院呼吸科收治的67例0~6岁喘息性疾病患儿,按照随机数字表分为观察组33例和对照组34例,其中失访3例,最终每组32例。观察组采用基于EMS管理模式的延续性护理,对照组给予常规护理和出院电话随访。2组患儿出院后1、3、6个月随访评估儿童呼吸和哮喘测试(Test for Respiratory and Asthma Control in Kids,TRACK)结果、喘息复发情况;出院后6个月随访采用支气管哮喘用药依从性评分表(Medication Adherence Report Scale for Asthma,MARS-A)和护理工作满意度调查表评估用药依从性及护理工作满意度。结果·2组患儿人口学特征及临床基线特征差异无统计学意义。重复测量方差分析结果显示,时间、组别、组别×时间的交互作用对TRACK总分的影响均有统计学意义;出院后1、3、6个月,观察组TRACK总分均显著高于对照组(均P=0.000);2组患儿TRACK总分均随时间推移逐渐上升(P=0.000)。观察组1、3、6个月随访发现喘息复发率分别为25.0%、18.7%、9.4%,均显著低于对照组(分别为50.0%、43.7%、31.3%,均P<0.05);广义估计方程分析显示组间比较差异有统计学意义(P=0.013),观察组干预效果优于对照组(OR=0.292)。出院后6个月观察组MARS-A得分为(4.519±0.395)分,显著高于对照组[(3.994±0.739)分,P=0.001]。护理工作满意度调查结果显示,观察组显著高于对照组(P=0.000)。患儿MARS-A得分与护理工作满意度呈中度正相关(r=0.389,P=0.001)。结论·基于EMS管理模式的延续性护理可显著提高学龄前喘息性疾病儿童的用药依从性和喘息控制水平,明显降低喘息复发率,以及提高护理工作满意度。
文摘Evidence of increased valuation of ecosystem services (ES) globally is significant. However, most of these studies focus on marketed subsets of ES at national and international levels. Ecosystems differ in spatial scale, biophysical and ecological structure, and functionality. This requires conducting studies at the local level to understand how, for example, the watershed ecosystem contributes to humanity locally and nationally. This study focuses on selected regulatory ecosystem services (RES) in Kenya’s catchment area ecosystems (Elgeyo and Nyambene). Field-based sampling and Landsat imagery with secondary information were used to generate biophysical and ecological data. The study used market price-based, cost-based, and unit transfer methods for RES valuation. The study estimates the total value of the six selected regulatory ecosystem services (RES) at KES 41.4 billion (US$386.7 million) and KES 14.73 billion (US$137.71 million) for Elgeyo and Nyambene, respectively. This equates to KES 1.64 million (US$15,331.19) and KES 2.72 million (US$25,375) per hectare per year. Extrapolating the study estimates to the national level, the country’s regulatory ecosystem services would range from US$18.4 billion to US$30.45 billion annually. This equates to between 16.7% and 27.7% of Kenya’s GDP in 2021, underscoring the importance of watersheds to the national economy.
基金supported in part by the Shandong Provincial Natural Science Foundation(ZR2021QF057)Taishan Scholars Program(tsqn202211203)+3 种基金Shandong Provincial Higher Education Youth Innovation Team Development Project(2022KJ 290)“20 New Universities”Project of Jinan City(202228077)QLU/SDAS Computer Science and Technology Fundamental Research Enhancement Program(2021JC02023)QLU/SDAS Pilot Project for Integrated Innovation of Science,Education,and Industry(2022JBZ01-01).
文摘Dear Editor,This letter deals with state estimation issues of discrete-time nonlinear systems subject to denial-of-service(DoS)attacks under the try-once-discard(TOD)protocol.More specifically,to reduce the communication burden,a TOD protocol with novel update rules on protocol weights is designed for scheduling measurement outputs.In addition,unknown nonlinear functions vulnerable to DoS attacks are considered due to the openness and vulnerability of the network.
文摘In 2024,the China International Fair for Trade in Services (hereinafter referred to as CIFTIS) opened in the China National Convention Center and Shougang Park on September 12th.The theme of the CIFTIS this time was"global services,shared prosperity",which is not only a window for allowing the world to discover the development of China's service trade,but is also a bridge for promoting global cooperation with regards to the service trade.As one of the world-famous service trade events,the CIFTIS has become an important business card allowing China to open up.The CIFTIS has attracted the attention of the whole world and become a bridge for all parties to share development opportunities,promote industrial growth,and strengthen communication.
基金supported by the National Natural Science Foundation of China(Grant No.42361144859)Beijing Nova Pro-gram(Grant No.20220484163)Beijing Normal University Tang Scholar.
文摘Understanding stakeholders’differences in perceptions of ecosystem services(ES)is crucial for guiding ecolog-ical conservation and planning.However,the variations of ES perception amongst different types of residents in urbanizing areas along an urban-rural gradient are still poorly understood.Combining a questionnaire-based survey,redundancy analysis,and statistical tests,we delineated the urban-rural gradient according to local res-idents’socio-economic characteristics,and investigated the differences in local residents’perceptions of ES and potential factors affecting them in the Guanting Reservoir basin,a rapidly urbanizing basin in China.The results showed that residents living in urban-rural transitional areas attached great importance to provisioning services of providing food and domestic water,regulating services of carbon sequestration and air purification,and cul-tural services of providing education and training,which were 0.7%-13.1%,0.7%-9.1%and 2.5%-21.2%higher than that of residents in other areas,respectively.Age and occupation were major factors affecting residents’perceptions.In terms of land-use types that deliver ES,the difference in perceptions of ES delivered by grassland was the greatest amongst residents.Our results support recommendations for policymakers to take into account the stakeholders’diverse perceptions,thus promoting residents’sense of gain on ES.
文摘In an attempt to assess the Kenyan healthcare system, this study looks at the current efforts that are already in place, what challenges they face, and what strategies can be put into practice to foster interoperability. By reviewing a variety of literature and using statistics, the paper ascertains notable impediments such as the absence of standard protocols, lack of adequate technological infrastructure, and weak regulatory frameworks. Resultant effects from these challenges regarding health provision target enhanced data sharing and merging for better patient outcomes and allocation of resources. It also highlights several opportunities that include the adoption of emerging technologies, and the establishment of public-private partnerships to strengthen the healthcare framework among others. In this regard, the article provides recommendations based on stakeholder views and global best practices addressed to policymakers, medical practitioners, and IT specialists concerned with achieving effective interoperability within Kenya’s health system. This research is relevant because it adds knowledge to the existing literature on how healthcare quality can be improved to make it more patient-centered especially in Kenya.
