Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).T...Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).The United States Preventive Services Task Force(USPSTF) October 2015 draft recommendation for CRC screening included mt-s DNA as an "alternative" screening test that "may be useful in select clinical circumstances",despite its very high sensitivity for early stage CRC.The evidence supporting mt-s DNA for routine screening use is robust.The clinical efficacy of mt-s DNA as measured by sensitivity,specificity,life-years gained(LYG),and CRC deaths averted is similar to or exceeds that of the other more specifically recommended screening options included in the draft document,especially those requiring annual testing adherence.In a population with primarily irregular screening participation,tests with the highest point sensitivity and reasonable specificity are more likely to favorably impact CRC related morbidity and mortality than those depending on annual adherence.This paper reviews the evidence supporting mt-s DNA for routine screening and demonstrates,using USPSTF's modeling data,that mt-s DNA at three-year intervals provides significant clinical net benefits and fewer complications per LYG than annual fecal immunochemical testing,high sensitivity guaiac based fecal occult blood testing and 10-year colonoscopy screening.展开更多
The Jabodetabek Metropolitan Area(JMA),Indonesia’s largest urban agglomeration,faces severe challenges due to rapid population growth and environmental degradation.Expanding urban areas has led to a reduction in gree...The Jabodetabek Metropolitan Area(JMA),Indonesia’s largest urban agglomeration,faces severe challenges due to rapid population growth and environmental degradation.Expanding urban areas has led to a reduction in green spaces,damaging ecosystem services,and exacerbating urban heat island effect,soil erosion,and flood risk.Therefore,this study identified key ecosystem service indicators,including Urban Heat Mitigation(UHM),Sediment Retention(SR),and Flood Risk Mitigation(FRM),and defined the spatial pattern of ecosystem services and its management zones in the JMA in 2024.Spatial data and ecosystem service indicators were analyzed using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)and spatial clustering analysis tool(e.g.,Rustiadi’s Quantitative Zoning Method(RQZM)Ⅱ),and the results served as the basis for formulating strategic recommendations.This study highlighted significant regional disparities.Jakarta,Tangerang Regency,Bekasi Regency,Depok City,Tangerang City,South Tangerang City,and Bekasi City experienced the increase of urban heat effect and flood risk due to dense infrastructure and limited green spaces.Conversely,southern peri-urban areas of Bogor Regency demonstrated higher ecological capacities,particularly in water infiltration and temperature regulation,but remained vulnerable to soil erosion due to urban expansion.The results underscored the critical imbalance between growing urban demands and the diminishing capacity of peri-urban areas to supply ecosystem services,which is driven by the transformation of green spaces into built-up areas.To address these challenges,this study proposed the Nature-Based Solutions(NBS)by emphasizing forested area conservation in the southern region of the JMA,natural landscape restoration and rehabilitation in the central region,and a hybrid of natural and artificial ecosystem creation in the northern region.展开更多
This study explored beliefs and actual practices of young women on utilization of Prevention of Mother to Child Transmission (PMTCT) of HIV services in Balaka district of Southern Malawi. The study design wascross sec...This study explored beliefs and actual practices of young women on utilization of Prevention of Mother to Child Transmission (PMTCT) of HIV services in Balaka district of Southern Malawi. The study design wascross sectional which utilized qualitative data collection and analysis methods. In-depth interviews were conducted on 12 young mothers of 15 to 24 years old. The respondents were drawn from 6 health centres in the district during their visits to either the under-five clinic, HIV and AIDS support groups or HIV follow up clinics. Data were analyzed using thematic analysis approach. Overall the respondents had positive beliefs on utilization of PMTCT services. They believed that adherence to PMTCT guidelines such as condom use, taking of Nevirapine (NVP) and exclusive breastfeeding protected the baby from contracting the virus. Nevertheless, all respondents believed that HIV testing was mandatory and that early weaning caused malnutrition and death of babies. Actual practice was very low. Very few young mothers breastfed exclusively, weaned their babies abruptly and took NVP as recommended. Not all positive beliefs translated into positive behavior. Lack of male support, inability of the midwives to provide comprehensive care to HIV infected mothers and their infants, and fear of stigma and discrimination were other factors that hindered utilization of PMTCT services. Culture was also a major barrier because traditionally babies are expected to be breastfed and supplements are fed to babies too. Therefore, there is a need to mobilize communities on PMTCT of HIV. Education programmes in HIV should emphasize behavior change interventions and should focus on both men and women and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that beliefs translate into positive behavior.展开更多
Cervical cancer is the second most common cancer among women and the leading cause of deaths among women worldwide. In Kenya, uptake of screening services is at 3.2% below the targeted of 70%. Therefore, there is need...Cervical cancer is the second most common cancer among women and the leading cause of deaths among women worldwide. In Kenya, uptake of screening services is at 3.2% below the targeted of 70%. Therefore, there is need to study the factors that lead to low uptake of the screening services. One way of increasing the uptake of the screening services is its integration with other routine services, thus leading to a reduction in morbidity and mortality rates associated with the disease. The objective of this study was to review and examine the importance of integrating cervical cancer screening services in the routine examinations offered in the Kenyan health facilities. A retrospective study design was adopted by this study. The review of articles, journals, strategic plans was done from the year 2012 to 2017. Data sources included Medline, PMC, Library, Pubmed, Google scholar, cancer prevention plans and strategies. About 28 data sources were reviewed with 78.5% indicating that increased knowledge and creation of awareness on cervical cancer would greatly improve the utilization of the screening services. More than 87% of the information collected among published work in Kenya demonstrated that knowledge on importance cervical cancer screening is inadequate. The primary results of this study suggest that all women of reproductive age (WRA) should undergo cervical cancer screening as a routine service. An integration approach should be adopted, to enhance knowledge on cervical cancer and the importance of screening, causes, preventive and treatment options. The study recommends that, the Government of Kenya through the Ministry of health should include cervical cancer screening as a routine procedure for all WRA.展开更多
In this study, accessibility and location-allocation models have been integrated into GIS to improve spatial planning and environmental sustainability of health services in Al-Madinah Al-Munawwarah. This integration p...In this study, accessibility and location-allocation models have been integrated into GIS to improve spatial planning and environmental sustainability of health services in Al-Madinah Al-Munawwarah. This integration provides a planning framework in order to check the efficiency of the spatial allocation of health services and to generate alternatives either by proposing an active service or to improve an existing one. To achieve these objectives, the accessibility to the service area was analyzed within the analysis of health services networks, which are divided into eight types: public hospitals, specialized hospitals, health units, healthcare centers, infirmaries, clinic complexes, the Red Crescent Center, and ambulance facilities, with time intervals of (5 minutes - 10 minutes - 15 minutes) to access coverage ranges, and the location-allocation model was used based on the maximum coverage model within a response time not exceeding 15 minutes, The results of the study revealed the poor distribution of health services Al-Madinah Al-Munawwarah suffers from weak accessibility to health services coverage areas and is unable to meet the needs of its population at present. The current need for health services reached twenty-four locations, including two public hospitals, three specialized hospitals, two health centers, three ambulance facilities, four infirmaries, three clinic complexes, four health units, and three Red Crescent centers.展开更多
The Amazonian economic occupation over the last forty years has been extremely harmful to the environment and to the traditional populations. One of the strategies to overcome this difficulty, dealing with sustainable...The Amazonian economic occupation over the last forty years has been extremely harmful to the environment and to the traditional populations. One of the strategies to overcome this difficulty, dealing with sustainable development, is the development of productive units—starting with non-timber forest products (NTFP)—and the Payment for Environmental Services (PES) for the residents and/or owners of forest areas. The main problem which the literature demonstrates is that the estimated values paid for the PES are rather high, because they use the opportunity cost as reference, not considering the family reproduction social cost. The main aim of this study is to provide an alternative forecast of the value to be paid for the environmental services (PES) for the Amazon forest, based on the real costs of the forest communities maintenance, as based on the real economic needs of rural family production in the “Chico Mendes” Extractive Reserve (RESEX), in Xapuri (Acre state), Brazil. It was used a specific methodology, developed regionally, which measured and provided indicators to evaluate and to analyze the economic evolution of those families over the last decade. Based on the needs of family reproduction, the calculations require that the minimum value for PES should be US$13 per hectare, a far lower and more appropriate value than the literature’s average propositions that is around US$50 per hectare. The present paper estimates that the costs of the PES in the Chico Mendes RESEX would be approximately US$5,767,000 per year—taking into account the average area per family.展开更多
The aim of the review was to synthesise the best available evidence regarding attitude of health care providers towards adolescent sexual and reproductive health services in developing countries. The review was conduc...The aim of the review was to synthesise the best available evidence regarding attitude of health care providers towards adolescent sexual and reproductive health services in developing countries. The review was conducted following qualitative research method. An online search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), EMBASE and MEDLINE databases was conducted to identify relevant studies for the review. There were nine studies that met the inclusion criteria and these were critically assessed by two independent reviewers using the standardised Joanna Briggs Institute (JBI) critical appraisal forms. Data were extracted using the standardised JBI data extraction forms. A narrative synthesis was done on the findings. Key findings from the review indicate that unprofessional attitude of health care professionals and lack of youth friendly reproductive health services, inhibit adolescents from gaining access to sexual and reproductive health services in developing countries. It is recommended that youth friendly reproductive health services be provided to increase uptake of re-productive health services by adolescents.展开更多
This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are present...This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.展开更多
As the healthcare system advances and expands in its services,the challenges of remaining efficient become more important.Emergency medical services(EMS)are vital cornerstones of communities.In many countries,EMS is a...As the healthcare system advances and expands in its services,the challenges of remaining efficient become more important.Emergency medical services(EMS)are vital cornerstones of communities.In many countries,EMS is available for every individual,regardless of their social or insurance status,via a toll-free telephone number.Understanding the risk factors for busy days in EMSs might be helpful for improving the allocation of resources,which is the key to better care for all patients in the prehospital setting.[1]An important factor influencing ambulance call volume could be the interplay of public behavior and weather.展开更多
The Yangtze River is the third largest river in the world and the longest and largest river in China.China has adopted a national strategy to protect the Yangtze River.A better understanding of the ecosystem services ...The Yangtze River is the third largest river in the world and the longest and largest river in China.China has adopted a national strategy to protect the Yangtze River.A better understanding of the ecosystem services value along the Yangtze River would provide support for the Yangtze River protection strategy.Using Costanza’s method to estimate the ecosystem services value,the value of 10 ecosystem services was estimated within 1 km and 2 km from the Yangtze River in 2017.These 10 services were derived from the four established groupings of provisioning,regulating,supporting,and cultural services.This study compared and analyzed the changes in the ecosystem services value in the upper,middle,and lower reaches of the river,and in provinces,cities,and villages along the Yangtze River.The total ecosystem services value within 1 km and 2 km from the river was 37.208 and 43.769 billion yuan,respectively.Within 1 km,the ecosystem services value in the middle reaches was 12.93 billion yuan,while the next highest value was in the upper reaches at 12.45 billion yuan,and the downstream area had the smallest value of 11.855 billion yuan.Within 2 km,the value of upstream ecosystem services was the highest at 16.31 billion yuan,while the second highest value was in the middle reaches at 14.376 billion yuan,and the smallest value was in the downstream area at 13.083 billion yuan.In the Yangtze River Basin,regulating services played a leading role,accounting for 81.6%and 78.9%of the ecosystem services value within 1 km and 2 km from the river,respectively.Among the 10 ecosystem services,hydrological regulation was the most important,while the value of raw material production made the smallest contribution.Among the provinces and cities along the Yangtze River,the highest ecosystem services value was in Hubei Province,while the lowest values were in Shanghai and the Qinghai-Tibet Plateau.If villages within 1 km and 2 km from the river were to be relocated,the total regional ecological value would increase by 527 and 975 million yuan,respectively.展开更多
Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 par...Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.展开更多
Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high bur...Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high burden of sexual and reproductive health problems. Sixteen million girls aged 15 to 19 years give birth every year of which 95% occur in low- and middle-income countries. Twenty five percent of unsafe abortions are in 15 - 19 years in Sub-Saharan Africa. Contraceptive use is low as approximately 10% of adolescents are current users. These problems can be averted if different ranges of Sexual and Reproductive Health Services for adolescent (SRHSA) are available and utilized by adolescents. In Tanzania, there is limited information addressing the availability, types and utilization pattern of sexual and reproductive health services by adolescents. This study investigates the availability, range and utilization of sexual and reproductive health services for adolescents (ASRHS) at Kinondoni Municipality, Tanzania. Method: A cross-sectional study was carried out in April to May 2013. A checklist was used to collect information on the availability and range of services offered at selected health facilities. In depth interviews conducted with in-charges of Reproductive and Child Health (RCH) clinics to explore barriers for provision of Sexual and Reproductive Health Services (SRHS) for adolescents. Adolescents were questioned using a questionnaire on utilization of SRHS and perceived barriers. Descriptive statistics were used to summarize quantitative data and content analysis for qualitative data. Results: On availability and range of adolescents’ sexual and reproductive health services, a total of 25 health facilities were surveyed. Forty four percent of the surveyed facilities did not have the adolescent sexual and reproductive health services (ASRHS). The Adolescents Sexual and Reproductive Health (ASRH) services offered differed greatly between facilities. On utilization of adolescents’ sexual and reproductive health services in total, 204 adolescents from the community were involved in this study. A third of adolescents reported to have ever used ASRH. The adolescents perceived barriers for underutilization of the services were fear of being seen at the clinics (23.3%), lack of money (18.3%), lack of privacy & confidentiality (14.2%) and unfriendly health care providers. Three barriers were perceived by health care providers in the provision of ASRHS: integration of SRHS, lack of training in relation to adolescents SRHS and attitudes of health care providers towards young people. Conclusion: About half of the health facilities did not have the SRH-services to adolescent (44%) and different ranges of services were not offered at the facilities as it was shown in the records. The results from this study show services were underutilized by adolescents. Training, attitudes of health care providers towards young people, & cost influenced ASRHS provision and utilization. Strategies to increase training in ASRHS for health providers including communication skills and scaling ASRH services to all primary care facilities may help to improve availability and access of services to adolescents.展开更多
文摘Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).The United States Preventive Services Task Force(USPSTF) October 2015 draft recommendation for CRC screening included mt-s DNA as an "alternative" screening test that "may be useful in select clinical circumstances",despite its very high sensitivity for early stage CRC.The evidence supporting mt-s DNA for routine screening use is robust.The clinical efficacy of mt-s DNA as measured by sensitivity,specificity,life-years gained(LYG),and CRC deaths averted is similar to or exceeds that of the other more specifically recommended screening options included in the draft document,especially those requiring annual testing adherence.In a population with primarily irregular screening participation,tests with the highest point sensitivity and reasonable specificity are more likely to favorably impact CRC related morbidity and mortality than those depending on annual adherence.This paper reviews the evidence supporting mt-s DNA for routine screening and demonstrates,using USPSTF's modeling data,that mt-s DNA at three-year intervals provides significant clinical net benefits and fewer complications per LYG than annual fecal immunochemical testing,high sensitivity guaiac based fecal occult blood testing and 10-year colonoscopy screening.
基金funded by the Directorate General of Higher Education,Research,and Technology,Ministry of Education,Culture,Research,and Technology,Indonesia,under the Research Program Implementation Contract for the year 2024 under subcontract number 027/ES/PG.02.00.PL/2024.
文摘The Jabodetabek Metropolitan Area(JMA),Indonesia’s largest urban agglomeration,faces severe challenges due to rapid population growth and environmental degradation.Expanding urban areas has led to a reduction in green spaces,damaging ecosystem services,and exacerbating urban heat island effect,soil erosion,and flood risk.Therefore,this study identified key ecosystem service indicators,including Urban Heat Mitigation(UHM),Sediment Retention(SR),and Flood Risk Mitigation(FRM),and defined the spatial pattern of ecosystem services and its management zones in the JMA in 2024.Spatial data and ecosystem service indicators were analyzed using the Integrated Valuation of Ecosystem Services and Trade-offs(InVEST)and spatial clustering analysis tool(e.g.,Rustiadi’s Quantitative Zoning Method(RQZM)Ⅱ),and the results served as the basis for formulating strategic recommendations.This study highlighted significant regional disparities.Jakarta,Tangerang Regency,Bekasi Regency,Depok City,Tangerang City,South Tangerang City,and Bekasi City experienced the increase of urban heat effect and flood risk due to dense infrastructure and limited green spaces.Conversely,southern peri-urban areas of Bogor Regency demonstrated higher ecological capacities,particularly in water infiltration and temperature regulation,but remained vulnerable to soil erosion due to urban expansion.The results underscored the critical imbalance between growing urban demands and the diminishing capacity of peri-urban areas to supply ecosystem services,which is driven by the transformation of green spaces into built-up areas.To address these challenges,this study proposed the Nature-Based Solutions(NBS)by emphasizing forested area conservation in the southern region of the JMA,natural landscape restoration and rehabilitation in the central region,and a hybrid of natural and artificial ecosystem creation in the northern region.
文摘This study explored beliefs and actual practices of young women on utilization of Prevention of Mother to Child Transmission (PMTCT) of HIV services in Balaka district of Southern Malawi. The study design wascross sectional which utilized qualitative data collection and analysis methods. In-depth interviews were conducted on 12 young mothers of 15 to 24 years old. The respondents were drawn from 6 health centres in the district during their visits to either the under-five clinic, HIV and AIDS support groups or HIV follow up clinics. Data were analyzed using thematic analysis approach. Overall the respondents had positive beliefs on utilization of PMTCT services. They believed that adherence to PMTCT guidelines such as condom use, taking of Nevirapine (NVP) and exclusive breastfeeding protected the baby from contracting the virus. Nevertheless, all respondents believed that HIV testing was mandatory and that early weaning caused malnutrition and death of babies. Actual practice was very low. Very few young mothers breastfed exclusively, weaned their babies abruptly and took NVP as recommended. Not all positive beliefs translated into positive behavior. Lack of male support, inability of the midwives to provide comprehensive care to HIV infected mothers and their infants, and fear of stigma and discrimination were other factors that hindered utilization of PMTCT services. Culture was also a major barrier because traditionally babies are expected to be breastfed and supplements are fed to babies too. Therefore, there is a need to mobilize communities on PMTCT of HIV. Education programmes in HIV should emphasize behavior change interventions and should focus on both men and women and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that beliefs translate into positive behavior.
文摘Cervical cancer is the second most common cancer among women and the leading cause of deaths among women worldwide. In Kenya, uptake of screening services is at 3.2% below the targeted of 70%. Therefore, there is need to study the factors that lead to low uptake of the screening services. One way of increasing the uptake of the screening services is its integration with other routine services, thus leading to a reduction in morbidity and mortality rates associated with the disease. The objective of this study was to review and examine the importance of integrating cervical cancer screening services in the routine examinations offered in the Kenyan health facilities. A retrospective study design was adopted by this study. The review of articles, journals, strategic plans was done from the year 2012 to 2017. Data sources included Medline, PMC, Library, Pubmed, Google scholar, cancer prevention plans and strategies. About 28 data sources were reviewed with 78.5% indicating that increased knowledge and creation of awareness on cervical cancer would greatly improve the utilization of the screening services. More than 87% of the information collected among published work in Kenya demonstrated that knowledge on importance cervical cancer screening is inadequate. The primary results of this study suggest that all women of reproductive age (WRA) should undergo cervical cancer screening as a routine service. An integration approach should be adopted, to enhance knowledge on cervical cancer and the importance of screening, causes, preventive and treatment options. The study recommends that, the Government of Kenya through the Ministry of health should include cervical cancer screening as a routine procedure for all WRA.
文摘In this study, accessibility and location-allocation models have been integrated into GIS to improve spatial planning and environmental sustainability of health services in Al-Madinah Al-Munawwarah. This integration provides a planning framework in order to check the efficiency of the spatial allocation of health services and to generate alternatives either by proposing an active service or to improve an existing one. To achieve these objectives, the accessibility to the service area was analyzed within the analysis of health services networks, which are divided into eight types: public hospitals, specialized hospitals, health units, healthcare centers, infirmaries, clinic complexes, the Red Crescent Center, and ambulance facilities, with time intervals of (5 minutes - 10 minutes - 15 minutes) to access coverage ranges, and the location-allocation model was used based on the maximum coverage model within a response time not exceeding 15 minutes, The results of the study revealed the poor distribution of health services Al-Madinah Al-Munawwarah suffers from weak accessibility to health services coverage areas and is unable to meet the needs of its population at present. The current need for health services reached twenty-four locations, including two public hospitals, three specialized hospitals, two health centers, three ambulance facilities, four infirmaries, three clinic complexes, four health units, and three Red Crescent centers.
文摘The Amazonian economic occupation over the last forty years has been extremely harmful to the environment and to the traditional populations. One of the strategies to overcome this difficulty, dealing with sustainable development, is the development of productive units—starting with non-timber forest products (NTFP)—and the Payment for Environmental Services (PES) for the residents and/or owners of forest areas. The main problem which the literature demonstrates is that the estimated values paid for the PES are rather high, because they use the opportunity cost as reference, not considering the family reproduction social cost. The main aim of this study is to provide an alternative forecast of the value to be paid for the environmental services (PES) for the Amazon forest, based on the real costs of the forest communities maintenance, as based on the real economic needs of rural family production in the “Chico Mendes” Extractive Reserve (RESEX), in Xapuri (Acre state), Brazil. It was used a specific methodology, developed regionally, which measured and provided indicators to evaluate and to analyze the economic evolution of those families over the last decade. Based on the needs of family reproduction, the calculations require that the minimum value for PES should be US$13 per hectare, a far lower and more appropriate value than the literature’s average propositions that is around US$50 per hectare. The present paper estimates that the costs of the PES in the Chico Mendes RESEX would be approximately US$5,767,000 per year—taking into account the average area per family.
文摘The aim of the review was to synthesise the best available evidence regarding attitude of health care providers towards adolescent sexual and reproductive health services in developing countries. The review was conducted following qualitative research method. An online search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), EMBASE and MEDLINE databases was conducted to identify relevant studies for the review. There were nine studies that met the inclusion criteria and these were critically assessed by two independent reviewers using the standardised Joanna Briggs Institute (JBI) critical appraisal forms. Data were extracted using the standardised JBI data extraction forms. A narrative synthesis was done on the findings. Key findings from the review indicate that unprofessional attitude of health care professionals and lack of youth friendly reproductive health services, inhibit adolescents from gaining access to sexual and reproductive health services in developing countries. It is recommended that youth friendly reproductive health services be provided to increase uptake of re-productive health services by adolescents.
文摘This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.
文摘As the healthcare system advances and expands in its services,the challenges of remaining efficient become more important.Emergency medical services(EMS)are vital cornerstones of communities.In many countries,EMS is available for every individual,regardless of their social or insurance status,via a toll-free telephone number.Understanding the risk factors for busy days in EMSs might be helpful for improving the allocation of resources,which is the key to better care for all patients in the prehospital setting.[1]An important factor influencing ambulance call volume could be the interplay of public behavior and weather.
基金National Key Research and Development Program of China,No.2018YFC 1506500,National Natural Science Foundation of China,No.71974070,No.41501593,No.41971402Social Sciences Foundation of the Ministry of Education of China,No.19YJCZH068Open Research Fund of Hubei Provincial Key Laboratory of Regional Development and Environmental Response(2018B(003))。
文摘The Yangtze River is the third largest river in the world and the longest and largest river in China.China has adopted a national strategy to protect the Yangtze River.A better understanding of the ecosystem services value along the Yangtze River would provide support for the Yangtze River protection strategy.Using Costanza’s method to estimate the ecosystem services value,the value of 10 ecosystem services was estimated within 1 km and 2 km from the Yangtze River in 2017.These 10 services were derived from the four established groupings of provisioning,regulating,supporting,and cultural services.This study compared and analyzed the changes in the ecosystem services value in the upper,middle,and lower reaches of the river,and in provinces,cities,and villages along the Yangtze River.The total ecosystem services value within 1 km and 2 km from the river was 37.208 and 43.769 billion yuan,respectively.Within 1 km,the ecosystem services value in the middle reaches was 12.93 billion yuan,while the next highest value was in the upper reaches at 12.45 billion yuan,and the downstream area had the smallest value of 11.855 billion yuan.Within 2 km,the value of upstream ecosystem services was the highest at 16.31 billion yuan,while the second highest value was in the middle reaches at 14.376 billion yuan,and the smallest value was in the downstream area at 13.083 billion yuan.In the Yangtze River Basin,regulating services played a leading role,accounting for 81.6%and 78.9%of the ecosystem services value within 1 km and 2 km from the river,respectively.Among the 10 ecosystem services,hydrological regulation was the most important,while the value of raw material production made the smallest contribution.Among the provinces and cities along the Yangtze River,the highest ecosystem services value was in Hubei Province,while the lowest values were in Shanghai and the Qinghai-Tibet Plateau.If villages within 1 km and 2 km from the river were to be relocated,the total regional ecological value would increase by 527 and 975 million yuan,respectively.
文摘Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.
文摘Background: It is estimated 1.2 billion of world’s population are adolescents aged 10 - 19 years;80% live in developing countries. Adolescents in developing countries especially Sub-Saharan Africa (SSA) face high burden of sexual and reproductive health problems. Sixteen million girls aged 15 to 19 years give birth every year of which 95% occur in low- and middle-income countries. Twenty five percent of unsafe abortions are in 15 - 19 years in Sub-Saharan Africa. Contraceptive use is low as approximately 10% of adolescents are current users. These problems can be averted if different ranges of Sexual and Reproductive Health Services for adolescent (SRHSA) are available and utilized by adolescents. In Tanzania, there is limited information addressing the availability, types and utilization pattern of sexual and reproductive health services by adolescents. This study investigates the availability, range and utilization of sexual and reproductive health services for adolescents (ASRHS) at Kinondoni Municipality, Tanzania. Method: A cross-sectional study was carried out in April to May 2013. A checklist was used to collect information on the availability and range of services offered at selected health facilities. In depth interviews conducted with in-charges of Reproductive and Child Health (RCH) clinics to explore barriers for provision of Sexual and Reproductive Health Services (SRHS) for adolescents. Adolescents were questioned using a questionnaire on utilization of SRHS and perceived barriers. Descriptive statistics were used to summarize quantitative data and content analysis for qualitative data. Results: On availability and range of adolescents’ sexual and reproductive health services, a total of 25 health facilities were surveyed. Forty four percent of the surveyed facilities did not have the adolescent sexual and reproductive health services (ASRHS). The Adolescents Sexual and Reproductive Health (ASRH) services offered differed greatly between facilities. On utilization of adolescents’ sexual and reproductive health services in total, 204 adolescents from the community were involved in this study. A third of adolescents reported to have ever used ASRH. The adolescents perceived barriers for underutilization of the services were fear of being seen at the clinics (23.3%), lack of money (18.3%), lack of privacy & confidentiality (14.2%) and unfriendly health care providers. Three barriers were perceived by health care providers in the provision of ASRHS: integration of SRHS, lack of training in relation to adolescents SRHS and attitudes of health care providers towards young people. Conclusion: About half of the health facilities did not have the SRH-services to adolescent (44%) and different ranges of services were not offered at the facilities as it was shown in the records. The results from this study show services were underutilized by adolescents. Training, attitudes of health care providers towards young people, & cost influenced ASRHS provision and utilization. Strategies to increase training in ASRHS for health providers including communication skills and scaling ASRH services to all primary care facilities may help to improve availability and access of services to adolescents.
