Search

BackgroundThe elderly residents in the mountainous area of northern Beijing have a high incidence of chronic diseases, a weak economic foundation, limited access to health knowledge, and a long distance from community health service institutions. At present, the team of family doctors in the mountainous area of northern Beijing is composed of community doctors and rural doctors. Both of them play an important role in contracting services for elderly residents in mountainous areas.ObjectiveTo explore the current status of family doctor contracted services in the northern mountain areas of Beijing and put forward appropriate suggestions on family doctor contracted services with the elderly residents in mountain areas.MethodsA combination of qualitative research and quantitative research was adopted. From September to October 2019, eight townships were selected in the northern mountain areas of Huairou District in Beijing. A total of 141 community doctors, 133 rural doctors and 345 elderly residents were selected proportionally from each township for questionnaire research. The elderly resident's questionnaires included basic information of the elderly, the way and the content of services which they want family doctor team to provide, the channels to obtain health consultation, and the satisfaction evaluation of the contracted services; the rural doctors and the community doctors' questionnaires included basic information, the use of internet in the contracted services, and the content of services provided to the elderly residents. During the same period, 16 cases of elderly residents, 24 cases of community doctors, and 24 cases of rural doctors were selected by using the purposive sampling method for personal in-depth interviews, in order to understand the level of awareness of the responsibilities of community doctors and rural doctors in the linkage contracted services, their views on the contracted services and the application of the internet in this service model, their suggestions on the development of the contracted services, etc. A content analysis method was used to analyse qualitative data.ResultsAccording to the quantitative research results, the top three services that elderly residents in the northern mountain areas of Beijing want the family doctor team to provide are ranked as follows: carrying out the health education in countryside〔199 (57.7%) 〕, physical examination in countryside〔197 (57.1%) 〕, the delivery of medical service and medicine in the countryside〔169 (49.0%) 〕; the top three ways or channels of services that elderly residents want the family doctor team to provide are ranked as follows: outpatient clinicservice, in-home medical services, organizing health education lectures in the community; the top three channels that elderly residents consider most effective to obtain health information are ranked as follows: publicity by rural doctors or loudspeaker in the village〔253 (73.33%) 〕, face-to-face publicity by community doctors during consultation〔134 (38.84%) 〕, posting and distribution of publicity materials〔126 (36.52%) 〕. The results of multiple linear regression analysis showed that service attitude, service effectiveness, service items, and communication ability were the influencing factors of elderly residents' satisfaction with community doctors and rural doctors' linkage contracted services (P0.05) . The qualitative research results showed that the elderly residents had low demand for online services and high dependence on rural doctors, but the technical level of rural doctors were limited, community doctors had little communication with elderly residents, and they mainly focused on the coordination of medical resources.ConclusionThe development of contracted services for elderly residents in the northern mountain areas of Beijing cannot be carried out without the joint efforts of community doctors and rural doctors. Currently, the elderly residents highly depend on rural doctors because of close-up services and show a great demand on community doctors for high-level technology and medical resources platform. It's recommended to take the needs of elderly residents as the guide, give full play to the advantages of rural doctors in terms of location and people, and the advantages of community doctors' technology and platform, and optimize the effectiveness of community doctors and rural doctors' linkage contracted services.

Person-centered primary care measures (PCPCM) facilitate high-quality and culturally appropriate primary care. Access to PCPCM remains unequal between rural and urban areas, and the available evidence on rural PCPCM is still lacking. A cross-sectional survey was conducted with stratified sampling by regions, and four districts (Xicheng, Fengtai, Huairou, and Daxing) in Beijing were selected to test the performance of PCPCM in both urban and rural areas. Descriptive statistical methods were used to compare the urban–rural differences in the demographic characteristics of PCPCM. Correlation and regression analyses were performed to determine the associations between PCPCM in demographics and utilization of primary care. The PCPCM showed good reliability and validity in both urban and rural areas (P  <.001), slightly lower in rural areas, but scores of rural PCPCM (R-PCPCM) in all items were lower than urban PCPCM (U-PCPCM). Patients in either the preferred urban or rural health centers all showed the highest PCPCM scores, with U-PCPCM= 3.31 for CHCs and R-PCPCM= 3.10 for RHCs, respectively. Patients in urban areas were more likely to receive higher-quality primary care than in rural areas (P  < .001). Patients who preferred hospitals (β = 2.61, P  < .001) or CHCs (β = 0.71, P  = .003) as providers was a significant positive predictor of U-PCPCM but it was the preference for hospitals (β = 2.95, P  < .001) for R-PCPCM. Urban–rural differences existed in the performance of PCPCM, with rural areas typically more difficult to access better PCPCM. To promote health equity in rural areas, healthcare providers should strive to minimize urban–rural differences in the quality and utilization of primary care services as much as feasible. [ABSTRACT FROM AUTHOR]

The shock tester based on a three-body, single-level velocity amplifier is especially suitable for high-g shock tests of lightweight and compact pieces. This study focuses on disclosing some key technologies that affect whether the velocity amplifier could achieve a high-g level shock experimental environment. Equations describing the first collision are deduced and some key design criteria are proposed. The key conditions for formation of the opposite collision are proposed for the second collision, which is the most important point, to obtain a high-g shock environment. A test platform was constructed, and experiments were conducted with different shock rods, pulse shapers, and initial velocities. The test results fully demonstrated the powerful ability of the single-level velocity amplifier for high-g shock experiments and tell us that a duralumin alloy or carbon fiber is suitable to design shock rods. [ABSTRACT FROM AUTHOR]

n-InGaN/p-Cu2O core-shell nanowire (NW) p–n junctions enable efficient self-powered photoelectrochemical photodetectors (PEC PDs) in the visible. The photocurrent density under one-sun illumination is enhanced by 8 times compared to that of bare InGaN NW PEC PDs due to maximized photocarrier separation in the built-in electric field of the p–n junction. The responsivity reaches 173 μA/W under one-sun illumination. The response times of 30–40 ms are among the shortest achieved for PEC PDs. Together with the long-time stability and reusability, a robust, easy to fabricate, and easy to operate self-powered PEC PD is introduced. [ABSTRACT FROM AUTHOR]

Abstract Background Migrant workers are a unique phenomenon in the process of China's economic transformation. The household registration system classifies them as temporary residents in cities, putting them in a vulnerable state with an unfair share of urban infrastructure and social public welfare. The amount of pressure inflicted by migrant workers in Beijing, as one of the major migration destinations, is currently at a threshold. This study was designed to assess the factors associated with health-seeking behavior and to explore feasible solutions to the obstacles migrant workers in China faced with when accessing health-care. Methods A sample of 2,478 migrant workers in Beijing was chosen by the multi-stage stratified cluster sampling method. A structured questionnaire survey was conducted via face-to-face interviews between investigators and subjects. The multilevel methodology (MLM) was used to demonstrate the independent effects of the explanatory variables on health seeking behavior in migrant workers. Results The medical visitation rate of migrant workers within the past two weeks was 4.8%, which only accounted for 36.4% of those who were ill. Nearly one-third of the migrant workers chose self-medication (33.3%) or no measures (30.3%) while ill within the past two weeks. 19.7% of the sick migrants who should have been hospitalized failed to receive medical treatment within the past year. According to self-reported reasons, the high cost of health service was a significant obstacle to health-care access for 40.5% of the migrant workers who became sick. However, 94.0% of the migrant workers didn't have any insurance coverage in Beijing. The multilevel model analysis indicates that health-seeking behavior among migrants is significantly associated with their insurance coverage. Meanwhile, such factors as household monthly income per capita and working hours per day also affect the medical visitation rate of the migrant workers in Beijing. Conclusion This study assesses the influence of socio-demographic characteristics on the migrant workers' decision to seek health care services when they fall ill, and it also indicates that the current health service system discourages migrant workers from seeking appropriate care of good quality. Relevant policies of public medical insurance and assistance program should be vigorously implemented for providing affordable health care services to the migrants. Feasible measures need to be taken to reduce the health risks associated with current hygiene practices and equity should be assured in access to health care services among migrant workers.