1
|
Wang M, Qi X, Li Z, Li J, Dong S. Evaluation of the suitability of elderly care in prefecture-level cities in China based on GIS. Heliyon 2023; 9:e16539. [PMID: 37303514 PMCID: PMC10250761 DOI: 10.1016/j.heliyon.2023.e16539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023] Open
Abstract
The population of China is aging, and the demand for healthy elderly care is expanding. There is an urgent need to develop a market-oriented elderly care industry and cultivate a number of high-quality elderly care bases. The geographical environment is an important condition affecting the health of elderly individuals and the suitability of elderly care. Research on this topic has important guiding significance for the layout of elderly care bases and the choice of elderly care locations. In this study, a spatial fuzzy comprehensive evaluation was conducted to construct an evaluation index system based on the following standard layers: climatic conditions, topography, surface vegetation, atmospheric environment, traffic conditions, economy and population, elderly-friendly urban environments, elderly care service capabilities, and wellness and recreation resources. The index system analyzes the suitability of elderly care in 4 municipalities and 333 prefecture-level administrative regions in China, and development and layout suggestions are proposed. The results show the following: (1) The three concentrated areas with a highly suitable geographical environment for elderly care in China are the Yangtze River Delta, the Yunnan-Guizhou-Sichuan region and the Pearl River Delta. The areas with the most concentrated unsuitable areas are the southern Xinjiang and Qinghai-Tibet areas. (2) In areas with a geographical environment that is highly suitable for elderly care, high-end elderly care industries can be deployed, and national-level elderly care demonstration bases can be built. Areas with a highly suitable temperature in Central and Southwest China can develop characteristic elderly care bases for people with cardiovascular and cerebrovascular diseases. Scattered areas with a highly suitable temperature and humidity can develop characteristic elderly care bases for people with rheumatic and respiratory diseases.
Collapse
Affiliation(s)
- Mengyuan Wang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xiaoming Qi
- College of Geographical Science, Inner Mongolia Normal University, Hohhot, 010022, China
| | - Zehong Li
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jingnan Li
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Suocheng Dong
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| |
Collapse
|
2
|
Huang Y, Wang Y, Zhang T, Wang P, Huang L, Guo Y. Exploring Health Effects under Specific Causes of Mortality Based on 90 Definitions of PM 2.5 and Cold Spell Combined Exposure in Shanghai, China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:2423-2434. [PMID: 36724352 DOI: 10.1021/acs.est.2c06461] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In this study, a total of 90 definitions were set up based on six air pollution definitions, five cold spell definitions, and three combined exposure scenarios. The relative risks (RRs) on all-cause, circulatory, and respiratory mortality were explored by a model combining a distributed linear lag model with quasi-Poisson regression. The definition in which daily PM2.5 increases more than 75 μg/m3 for at least 2 days and the average temperature falls below the 10th percentile for at least 2 days produced the best model fit performance in all-cause mortality. The high peaks of the health effect were generally observed around the lag days 6-9. The cumulative relative risks (CRRs) were more significant in the simultaneous-exposure scenario and higher in respiratory mortality, where the highest CRR (12.15, 3.69-40.03) was observed in definition P1T5, in which daily PM2.5 increases more than 75 μg/m3, and the average temperature falls below the 2.5th percentile for at least two days. For relative risk due to interaction (RERI), we found positive additive interactions (RERI > 0) between PM2.5 pollution and cold spell, especially in respiratory mortality. Clarifying the definition of combined events can help policymakers to capture health risks and construct more effective risk warning systems.
Collapse
Affiliation(s)
- Yujia Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Yiyi Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Ting Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Peng Wang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Faculty of Civil Engineering and Mechanics, Jiangsu University, Zhenjiang 212013, China
| | - Lei Huang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public and Preventive Medicine, Monash University, Melbourne 3004, VIC, Australia
| |
Collapse
|
3
|
Waring J, Marshall F, Bishop S, Sahota O, Walker M, Currie G, Fisher R, Avery T. An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contributions to ‘safe’ hospital discharge. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02290] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundHospital discharge is a vulnerable stage in the patient pathway. Research highlights communication failures and the problems of co-ordination as resulting in delayed, poorly timed and unsafe discharges. The complexity of hospital discharge exemplifies the threats to patient safety found ‘between’ care processes and organisations. In developing this perspective, safe discharge is seen as relying upon enhanced knowledge sharing and collaboration between stakeholders, which can mitigate system complexity and promote safety.AimTo identify interventions and practices that support knowledge sharing and collaboration in the processes of discharge planning and care transition.SettingThe study was undertaken between 2011 and 2013 in two English health-care systems, each comprising an acute health-care provider, community and primary care providers, local authority social services and social care agencies. The study sites were selected to reflect known variations in local population demographics as well as in the size and composition of the care systems. The study compared the experiences of stroke and hip fracture patients as exemplars of acute care with complex discharge pathways.DesignThe study involved in-depth ethnographic research in the two sites. This combined (a) over 180 hours of observations of discharge processes and knowledge-sharing activities in various care settings; (b) focused ‘patient tracking’ to trace and understand discharge activities across the entire patient journey; and (c) qualitative interviews with 169 individuals working in health, social and voluntary care sectors.FindingsThe study reinforces the view of hospital discharge as a complex system involving dynamic and multidirectional patterns of knowledge sharing between multiple groups. The study shows that discharge planning and care transitions develop through a series of linked ‘situations’ or opportunities for knowledge sharing. It also shows variations in these situations, in terms of the range of actors, forms of knowledge shared, and media and resources used, and the wider culture and organisation of discharge. The study also describes the threats to patient safety associated with hospital discharge, as perceived by participants and stakeholders. These related to falls, medicines, infection, clinical procedures, equipment, timing and scheduling of discharge, and communication. Each of these identified risks are analysed and explained with reference to the observed patterns of knowledge sharing to elaborate how variations in knowledge sharing can hinder or promote safe discharge.ConclusionsThe study supports the view of hospital discharge as a complex system involving tightly coupled and interdependent patterns of interaction between multiple health and social care agencies. Knowledge sharing can help to mitigate system complexity through supporting collaboration and co-ordination. The study suggests four areas of change that might enhance knowledge sharing, reduce system complexity and promote safety. First, knowledge brokers in the form of discharge co-ordinators can facilitate knowledge sharing and co-ordination; second, colocation and functional proximity of stakeholders can support knowledge sharing and mutual appreciation and alignment of divergent practices; third, local cultures should prioritise and value collaboration; and finally, organisational resources, procedures and leadership should be aligned to fostering knowledge sharing and collaborative working. These learning points provide insight for future interventions to enhance discharge planning and care transition. Future research might consider the implementation of interviews to mediate system complexity through fostering enhanced knowledge sharing across occupational and organisational boundaries. Research might also consider in more detail the underlying complexity of both health and social care systems and how opportunities for knowledge sharing might be engendered to promote patient safety in other areas.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
- Justin Waring
- Centre for Heath Innovation, Leadership and Learning, Nottingham University Business School, Nottingham, UK
| | - Fiona Marshall
- Centre for Heath Innovation, Leadership and Learning, Nottingham University Business School, Nottingham, UK
| | - Simon Bishop
- Centre for Heath Innovation, Leadership and Learning, Nottingham University Business School, Nottingham, UK
| | - Opinder Sahota
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Marion Walker
- Community Health Sciences, University of Nottingham, Nottingham, UK
| | - Graeme Currie
- Warwick Business School, University of Warwick, Coventry, UK
| | - Rebecca Fisher
- Community Health Sciences, University of Nottingham, Nottingham, UK
| | - Tony Avery
- Community Health Sciences, University of Nottingham, Nottingham, UK
| |
Collapse
|
4
|
Egondi T, Kyobutungi C, Kovats S, Muindi K, Ettarh R, Rocklöv J. Time-series analysis of weather and mortality patterns in Nairobi's informal settlements. Glob Health Action 2012; 5:23-32. [PMID: 23195509 PMCID: PMC3509073 DOI: 10.3402/gha.v5i0.19065] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 08/23/2012] [Accepted: 08/23/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Many studies have established a link between weather (primarily temperature) and daily mortality in developed countries. However, little is known about this relationship in urban populations in sub-Saharan Africa. OBJECTIVES The objective of this study was to describe the relationship between daily weather and mortality in Nairobi, Kenya, and to evaluate this relationship with regard to cause of death, age, and sex. METHODS We utilized mortality data from the Nairobi Urban Health and Demographic Surveillance System and applied time-series models to study the relationship between daily weather and mortality for a population of approximately 60,000 during the period 2003-2008. We used a distributed lag approach to model the delayed effect of weather on mortality, stratified by cause of death, age, and sex. RESULTS Increasing temperatures (above 75th percentile) were significantly associated with mortality in children and non-communicable disease (NCD) deaths. We found all-cause mortality of shorter lag of same day and previous day to increase by 3.0% for a 1 degree decrease from the 25th percentile of 18°C (not statistically significant). Mortality among people aged 50+ and children aged below 5 years appeared most susceptible to cold compared to other age groups. Rainfall, in the lag period of 0-29 days, increased all-cause mortality in general, but was found strongest related to mortality among females. Low temperatures were associated with deaths due to acute infections, whereas rainfall was associated with all-cause pneumonia and NCD deaths. CONCLUSIONS Increases in mortality were associated with both hot and cold weather as well as rainfall in Nairobi, but the relationship differed with regard to age, sex, and cause of death. Our findings indicate that weather-related mortality is a public health concern for the population in the informal settlements of Nairobi, Kenya, especially if current trends in climate change continue.
Collapse
|
5
|
Conlon KC, Rajkovich NB, White-Newsome JL, Larsen L, O'Neill MS. Preventing cold-related morbidity and mortality in a changing climate. Maturitas 2011; 69:197-202. [PMID: 21592693 DOI: 10.1016/j.maturitas.2011.04.004] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 04/02/2011] [Indexed: 11/27/2022]
Abstract
Winter weather patterns are anticipated to become more variable with increasing average global temperatures. Research shows that excess morbidity and mortality occurs during cold weather periods. We critically reviewed evidence relating temperature variability, health outcomes, and adaptation strategies to cold weather. Health outcomes included cardiovascular-, respiratory-, cerebrovascular-, and all-cause morbidity and mortality. Individual and contextual risk factors were assessed to highlight associations between individual- and neighborhood-level characteristics that contribute to a person's vulnerability to variability in cold weather events. Epidemiologic studies indicate that the populations most vulnerable to variations in cold winter weather are the elderly, rural and, generally, populations living in moderate winter climates. Fortunately, cold-related morbidity and mortality are preventable and strategies exist for protecting populations from these adverse health outcomes. We present a range of adaptation strategies that can be implemented at the individual, building, and neighborhood level to protect vulnerable populations from cold-related morbidity and mortality. The existing research justifies the need for increased outreach to individuals and communities for education on protective adaptations in cold weather. We propose that future climate change adaptation research couple building energy and thermal comfort models with epidemiological data to evaluate and quantify the impacts of adaptation strategies.
Collapse
Affiliation(s)
- Kathryn C Conlon
- University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | | | | | | | | |
Collapse
|