Healthcare Services Demand in Post-disaster Settings:The 2014 Earthquake in Ludian County,Yunnan Province,China

Healthcare relief teams dispatched to rural areas often face difficulties due to limited initial and ongoing health information in the affected community.The present study investigated patterns of healthcare service demand for a rural displaced population in a post-disaster situation.Three weeks after the 2014 Ludian County earthquake,the Institute for Disaster Management and Reconstruction(IDMR) at Sichuan University and Hong Kong Polytechnic University organized a disaster nursing team to support the rural community in Longtoushan,at the epicenter of the earthquake.A cross-sectional,records-based study of 2484 records obtained from a temporary hospital in Longtoushan(for the period of 14 September-1 October 2014) was conducted.The daily number of records by patients' sociodemographic characteristics and medical diagnoses were plotted on a time series graph to explore the temporal change during the study period.Findings indicate that healthcare service demand from younger age groups was higher than that of the older adult group.Three major health problems were observed:respiratory disease,skin problems,and ear,eye,and throat(EET) problems.All of these very real health problems are chronic issues that require long-term care.They are not health issues directly related to the disaster emergency itself.Yet disaster relief nursing teams were selected on the basis of their ability to cope primarily with traumatic disaster-related injuries.The existing practice of teaming up disaster relief professions might not be optimal.To better understand the healthcare needs of a displaced population,short- and long-term planning is needed.Planning will allow disaster response professionals to better organize and deploy healthcare personnel to manage the above-listed problems in a postdisaster situation.

Dynamic Analysis of Supply and Demand Coupling of Ecosystem Services in Loess Hilly Region:A Case Study of Lanzhou,China

The relationship between the supply and demand for ecosystem services(ESs)is a key issue for the rational allocation of natural resources and optimisation of sustainable development capacity.This paper investigateed the dynamic evolution features of supply and demand of four ESs in Lanzhou of China,namely,water supply,food supply,carbon fixation and soil retention services.The crosssectional data of 2005 and 2017 were used for calculating ESs value and its supply and demand through ArcGIS software,InVEST model,elastic coefficient model and coupling coordination model.Results showed that:1)from 2005 to 2017,the supply of water supply services increased,the demand of soil retention services decreased,and the supply and demand of food supply and carbon fixation services increased.The high-value areas of service supply were mainly distributed in the rocky mountain areas in the southeast and northwest with high vegetation coverage,while the high-value areas of demand were mainly distributed in the urban areas and surrounding areas with high population density.2)There were five different types of coupling relations.Water supply service was dominated by a negative coupling type D,which means that the decrease in demand for ESs has had a positive response on the supply of ESs.Negative coupling type C was the main type of food supply and carbon fixation services,which means that the increase in demand for ESs has had a negative response on the supply of ESs.All three services were supplemented by a positive coupling type A,which means that the increase in demand for ESs has had a positive response on the supply of ESs.Soil retention service generally exhibits a positive coupling type B,which means that the decrease in demand for ESs has had a negative response on the supply of ESs.3)Over the past 12 yr,the coordination degree of supply and demand of water supply,food supply and soil retention services decreased,and the coordination degree of carbon fixation service increased.Various types of ES had a low degree of coupling and coordination,showing different characteristics of temporal and spatial evolution.The areas with imbalanced ESs supply and demand were mainly distributed in urban areas dominated by construction land.The research results are valuable to the optimisation of urban and rural ecological environments and the sustainable development of territory space under the framework of ecological civilisation,including similar ecologically vulnerable areas in other developing countries.

Lewin Behavior Model-Based Study on Influence Factors of Individuals to Mobile Service Demand

How to fmd main influence factors of individuals to mobile service demand is investiga- ted. The empirical research is conducted in the sample of high-value customers in China mobile market. Based on Lewin behavior model, this pa- per establishes factors-matrix from personal and environmental dimensions. Relationships among multiple factors are tested in the structural equa- tion model and their impacts on customers＇ de- mands are elaborated. Findings indicate that opera- tional convenience and business brand image have significant effects on sample users＇ demands. Fur- thermore, annual income, gender, occupation, the needs of access to information and the needs of enriching and improving social relationships are al- so important factors for high-value users. The re- suits may provide further insights into mobile service demand and the model can be popularized to other behavior researches.

Knowledge and Service Demand of Reproductive Health among Migrant Population

Objective To understand the sexual and reproductive health knowledge among unmarried migrant population and their service demands as well as current services delivered by local family planning departments, so as to provide scientific evidences on conducting reproductive health education and appropriate service for migrant population in the district. Methods A questionnaire survey was conducted among a convenient sample of unmarried young migrant population between 15 and 25 years old in Dongshan District. All data were entered into database with the software Foxpro6.0 and analyzed with the statistics software SPSS10.0. Results Unmarried migrant population had some kinds＇ of sexual and reproductive health knowledge and was eager to access to reproductive health service. They hoped that relevant governmental departments could provide them more information, education and service on sexuality and reproductive health. Conclusion Relevant departments should work together to popularize reproductive health knowledge among unmarried migrant population and meet their demands on reproductive health service, so as to improve their current reproductive health situation.

上海市40~60岁社区妇女保健门诊患者骨质疏松症的认知状况及对预防服务需求的影响

目的了解上海市40~60岁社区妇女保健门诊患者骨质疏松症知识掌握情况、相关服务需求与利用状况,为进一步完善围绝经期妇女骨健康的预防策略提供依据。方法2022年10月—2023年4月,在上海市10家社区卫生服务中心妇女保健门诊就诊的40~60岁患者人群中开展骨质疏松症知识评价、服务需求与利用的问卷调查。结果1278名40~60岁社区妇女保健门诊患者骨质疏松症的知识问卷总知识得分的不及格率为73.00%。不同类别知识的不及格率从高到低排序,依次是危险因素(75.98%)、运动知识(71.83%)和钙知识(31.77%)。经卡方检验,三类知识的不及格率、及格率和良好率的差异有统计学意义(χ^(2)=655.83,P<0.001)。不同年龄组、文化程度、工作情况、月收入的妇女的骨质疏松症知识得分差异有统计学意义(P<0.05)。文化程度越低,月收入越低,知识得分越低;在岗妇女的知识得分更高,无业妇女的知识得分较低。排在前2位的骨质疏松症防治服务项目为“40岁以上妇女体检要增加骨密度检测项目”(81.14%)和“社区定期开展骨质疏松症的筛查”(77.70%)。logistic回归分析结果显示,与三类知识均及格的妇女相比至少一类(OR值为1.714,95%CI为1.068~2.751)或两类(OR值为1.603,95%CI为1.043~2.545)知识不及格的女性未做过骨密度检测的可能性更高。结论在上海市严峻的人口老龄化背景下,应关注骨健康知识薄弱环节,关注低学历、低收入、无职业的围绝经期妇女等重点人群,在围绝经期妇女保健服务中纳入骨质疏松症的健康教育、早期风险识别的预防措施,充分发挥基层妇女卫生保健服务的存量资源作用。

Traffic accessibility and the coupling degree of ecosystem services supply and demand in the middle reaches of the Yangtze River urban agglomeration,China

The spatial relationships between traffic accessibility and supply and demand(S&D)of ecosystem services(ESs)are essential for the formulation of ecological compensation policies and ESs regulation.In this study,an ESs matrix and coupling analysis method were used to assess ESs S&D based on land-use data for 2000,2010,and 2020,and spatial regression models were used to analyze the correlated impacts of traffic accessibility.The results showed that the ESs supply and balance index in the middle reaches of the Yangtze River urban agglomeration(MRYRUA)continuously decreased,while the demand index increased from 2000 to 2020.The Gini coefficients of these indices continued to increase but did not exceed the warning value(0.4).The coupling degree of ESs S&D continued to increase,and its spatial distribution patterns were similar to that of the ESs demand index,with significantly higher values in the plains than in the montane areas,contrasting with those of the ESs supply index.The results of global bivariate Moran’s I analysis showed a significant spatial dependence between traffic accessibility and the degree of coupling between ESs S&D;the spatial regression results showed that an increase in traffic accessibility promoted the coupling degree.The present results provide a new perspective on the relationship between traffic accessibility and the coupling degree of ESs S&D,representing a case study for similar future research in other regions,and a reference for policy creation based on the matching between ESs S&D in the MRYRUA.

2020—2025年广东省医疗机构床位需求预测

目的预测2020—2025年广东省医疗机构的床位需求总量。方法基于卫生服务需求法与Holt双参数指数平滑模型,结合年龄别人口数据预测床位需求。结果2025年,广东省住院人数为2425.11万人,床位需求数为70.04万张,每千常住人口床位需求数为5.63张、每千常住人口拥有床位数5.55张,供需比例为98.58%。预测模型的平均百分误差为1.63%(标准差=±1.90%,均方根误差=20.63)。结论结合人口的年龄结构进行预测结果更稳定、误差更小。2020年,广东省的床位配置量基本能满足床位需求,供需较为平衡。但2024年床位需求将超过床位配置总量。未来,广东省应加大床位资源的投入力度,提高基层卫生机构的床位利用率,全面落实分级诊疗制度。

Lived experiences with unmet supportive care needs in pediatric cancer:Perspective of Chinese children and their parents

Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through lived experiences.Methods:The data of this study was collected using face-to-face semi-structured interviews.The participants were recruited from the oncology units of three children’s hospitals in China’s cities(Shanghai,Guangzhou,and Hefei)from October 2020 to December 2021.Data were analyzed using Colaizzi’s sevenstep phenomenological analysis method.Results:Eight pediatric cancer patients and twenty-four parents were enrolled in the study.Four main themes and eight subthemes(both children’s and parent’s perspectives)were generated:1)meeting the ongoing needs along the cancer trajectory(can you tell me what comes next;our needs are growing);2)communicating with a family focus(they only talk to my parents;let each family member have a voice);3)providing care beyond the treatment(I am bigger than my body[the children’s needs for emotional consolidation and information about their prognosis];there are things beyond treatment);4)getting support from the community(I am not a monster[the children were unhappy about being treated differently];we want to connect with the resources near us).Conclusion:This study revealed multiple unmet SCNs from the perspective of Chinese children with cancer and their parents.The findings call for comprehensive and in-depth supportive care beyond treatment,integration of the family member voice in pediatric cancer care,and a coordinated pediatric cancer support mechanism in the Chinese healthcare system.

Nurses' lived experiences of professional autonomy in Iran

Objectives: Nurses' autonomy is a complex and multi-dimensional concept that has often been overlooked.Although many studies have addressed patients' autonomy,there has been no assessment of nurses' experience of professional autonomy.The present study aimed to assess nurses' lived experiences of professional autonomy in Shiraz,Iran.Methods: The present qualitative study was conducted in Shiraz (Iran) from January 2016 to February 2018.The target population was selected among nursing professionals employed by various hospitals affiliated to Shiraz University of Medical Sciences,Shiraz,Iran.The experiences of the participants were assessed through 14 in-depth semi-structured interviews.The response of the participants was analyzed using Van Manen's 6-step approach for interpretive phenomenology.Results: Based on the analysis of the interviews,4 themes,11 categories,and 13 sub-categories were extracted.The themes were: Advocacy for patients and nurses,independence in the workplace,Involvement in professional decision-making,and Professional accountability.Conclusion: Due to the intense interaction between nurses and patients,a better quality of care will be achieved if the professional autonomy of nurses is ensured.Healthcare authorities and hospital managers should provide the framework and permit the nurses to practically exercise full independence in the workplace.

Lived experiences of the disease journey among patients with idiopathic pulmonary fibrosis

Objective:This study aimed to explore the lived experiences of the disease journey and patients'care needs with idiopathic pulmonary fibrosis(IPF).Methods:Face-to-face semi-structured interviews were conducted with a purposive sampling of IPF patients admitted to the department of respiratory medicine in a tertiary hospital in Beijing.Interview data were analyzed using the thematic analysis method.In the end,16 patients were interviewed.Results:Four themes emerged from the qualitative data included the long and confusing journey to reach a diagnosis,living with the disease,understanding the disease and treatment and desire for continuity of care.A series of subthemes were also identified,including uncertainty of diagnosis,delaying the process,living with physical symptoms,living with emotional distress,loss of independence,uncertainty with the prognosis,questioning the cause of the disease,concerning the side effects of treatments,lacking continuity of care,and wanting a better quality ofhealthcare in community hospitals.Conclusions:Based on the findings,there is an urgent need to improve the care delivery to this vulnerable population in China.To meet their health needs,it is of paramount importance to develop effective education programs for health professionals and IPF patients and improve care models of healthcare systems,especially in remote areas,to enhance care continuity in the communities.

Service-Oriented Semantic Interoperability Technologies and Standards

Service-Oriented Software Engineering （SOSE） presents new challenges; in particular, how to promote interoperability and cooperation among loosely-coupled service resources. This is critical for service resource sharing and for implementing on-demand services. This paper discusses key technologies of service virtualization, including encapsulation of service interoperability （for available resources）; ontology-based Role, Goal, Process, and Service （RGPS） metamodeling （for interoperable aggregation and organization of virtualization services）; registration and repository management of Metamodel Framework for Interoperability （MFI） （for virtualization service management）; and virtualization service ontology and its represented association with RGP＆ Latest progress of the MFI and ISQ standards is also discussed.

Prescription of Cancer Treatment Modalities in Developing Countries:Results from a Multi-Centre Observational Study

Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer spe-cific treatment planned and written in the patients’ medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.

Brokers as Catalysts for the E-Health Market

In this study we use the experiences from the service industry and explore pre-requisites of the e-health market which will need to achieve to stimulate both sides of the market (vendors, healthcare organizations, government, institutions, corporations and services organizations) to interact with each other and develop demand driven services and social innovations. The results presented in this paper may be of interest for decision makers, industries (e.g. software or technology designers), small and medium enterprises (SME) and entrepreneurs with an interest in becoming a part of the e-health market, and for consumers (e.g. healthcare personnel and patients) that are willing to influence the market through their choices. The outcomes of the study shown that the role of virtual brokers is essential to the further development of a sustainable e-health market globally because its role as catalyst for interaction between the two-sides of the markets, its effects on the reduction of competitive constrains, its effects on the accessibility to broader network of actors and its effects on the support of public-private exchanges of knowledge and experience.

The current status of community mental health services in three northern areas of China

Objective:This study investigated and discussed the current status of community mental health service in three northern areas of China(Beijing,Harbin,and Karamay)in an effort to improve the community mental health services in China.Methods:In this study 176 residents from communities of the three northern areas of China were involved and divided into 18 groups.The study was conducted according to a self-prepared structured interview outline.Results:The analysis was conducted based on the following four perspectives:1.commu-nity residents’understanding of the mental health problems and how they treated psychiatric patients;2.community residents’access to and application of mental health information;3.com-munity residents’attitude to accept mental health services and the factors influencing community residents to seek help from mental health services;and 4.community residents’attitude and will-ingness to participate in the activities of community mental health services.Conclusion:Based on the investigation and analysis regarding the current status of the com-munity mental health services in three northern areas of China,it is concluded that the residents do not have s clear and complete understanding of mental health.The characteristics of mental health services had a regional correlation.Currently,the mental health services do not work effectively,and the residents are somewhat passive in obtaining information about mental health.Community mental health services should be offered according to different individual needs of the residents and the actual situations of each region.

Traffic Source Characterization：Considering Real Demands of Communication Attempts

in order to project a reliable telecommunication network ,we have to measure the call lossrate of present traffic and to predzct the traffic of hajective network. In this paper we point out that afactor of real communication needs for subscrihas should be added in studying the traffic source char-acterization. Generally, the predicted traffic does not equal to the real demends, Considered asubscriber's psychological facter for attempts in busy-hour, a mathematical medel of probable dertva-tive calls from each real communication demand is given,with which the calling-up probabity, andthe repeating attempt probability of original subscribers on line occupation are calculated and the rela-tionship between the traffic and the real cammunication need is predicted.

An improved methodology for evaluating energy service demand for China's passenger transport sector

China's energy service demand statistics for the passenger transport sector only cover travel activities for business purpose.The incomplete data have made it very difficult to conduct long-term scenario analysis for this sector.Thus,this study develops a methodology by refining and combining vehicle activity and travel behavior methods.By taking advantage of the two methods,the extent of uncertainty in estimates can be reduced.A detailed description of China's energy service demand in the passenger transport sector for the years 2013,2015,and 2017 are produced.Results show that there is a significant underestimation of total passenger transport turnover in governmental statistics.After reevaluation,the total passenger turnover doubled and increased by 146%,167%,and 187%,resulting in national total passenger turnover of 6783,8031,and 9406 billion passenger kilometers in 2013,2015,and 2017,respectively.The majority of missing statistics are caused by not accounting for non-operational road transport,which is dominated by private vehicles.After adjustment,the road sector share in total passenger turnover grew substantially from 30%to 40%to approximately 75%,with the proportion of urban travel continuing to increase.We found that without complete data on China's passenger turnover,it may result in more than three-fold overestimation for future travel demand,leading to inaccurate projections with much higher energy consumption and CO_(2) emissions.It is therefore very important to have a detailed and precise calculation of energy service demand in the passenger transport sector.The estimation framework and step-by-step process can also be applied to other developing countries which are confronting similar statistical issues.

Health service needs of women with reproductive tract infections in selected areas of China

OBJECTIVE: To provide insight into the psychosocial factors underlying the utilisation of health services by women with reproductive tract infection (RTI) symptoms. METHODS: A cross-sectional study, adopting Aday and Andersen' s Social Behaviour Model, was conducted between 1998 and 1999 in Chinese Hebei province and Beijing. A total of 864 eligible married women (age 21 to 60 years) were face to face interviewed. RESULTS: The percentage of self-reported symptoms of RTIs in urban and rural women was 35.6 and 46.8, respectively; the proportion of women with RTIs who utilised health services was 27.5% and 26.7%, respectively. Compared to urban women, rural women had less knowledge on RTIs and more traditional beliefs, and were more satisfied with local health services. The results of logistic regression analysis showed that the common factor influencing health service utilisation in women with RTIs was current experience of RTIs. Knowledge about self-medication, perceived social stigma attached to RTIs, prior experience of RTIs, family income and perceived severity of RTIs were also predictors of utilisation of health services in rural women with RTIs. Satisfaction with health providers, information received from health providers, prior experience of RTIs, occupation and medical care coverage were predictors of utilisation of health services in urban women with RTIs. CONCLUSION: The prevalence of RTIs is high, but the rate of seeking health services is low. There is a great need for emphasizing culturally acceptable reproductive health education in different places to improve women' s ability for self-care. Regular medical check-ups for women are also important. It is necessary to improve the quality of health service, complete the reform of health insurance and alleviate women' s social stigma related to RTIs, giving women social and moral support.

Research strategy for constructing a green infrastructure network based on spatial prioritization

The destruction of the ecological system caused by urban expansion has led to the environmental deterioration,cities have become increasingly vulnerable.In this study,six districts and counties along the Yellow River in Zhengzhou were selected as the study area.First,green infrastructure elements were extracted by morphological spatial pattern analysis.Then,outside the urban areas,we used connectivity analysis to evaluate the importance of core areas,adopted minimum cumulative resistance model to extract potential corridors,and identified the important corridors by using the gravity model.Finally,in the urban areas,we set up an evaluation system to assess the demands for ecosystem services.The results showed that:(1)Seven landscape types of green infrastructure be identified in study area.(2)There are 17 vital cores,136 potential corridors,and 24 vital corridors outside the urban areas.(3)The blocks with high demand for ecosystem services are mostly concentrated in the old blocks with dense populations and poor infrastructure,and there are 5 blocks with comprehensive high-demand.Based on identified importance for green infrastructure land space,and high-demand level for ecosystem services areas in this study,a green infrastructure net plan was proposed based on spatial conservation prioritisation.