两层级公共医疗资源空间均衡性及其影响机制——以分级诊疗改革为背景

中国公共医疗资源在层级间和地区间配置不合理的问题较为突出。分级诊疗改革对优化医疗资源配置、实现供需均衡具有重要意义。运用探索性空间分析法和地理探测器分别从全国地级市域和四川县域两个尺度分析了2015年两层级医疗资源的空间配置特征与影响机制。结果表明：基层和上层医疗资源均呈显著空间聚集特征,而层级间空间配置格局具有差异性。不同尺度和区域两层级医疗资源配置的决定力及其影响强度不同,上层医疗资源对外部影响因素响应强度大于基层。对上层级医疗资源配置而言,城镇化率、人口密度、经济发展水平是全局性因素,老龄化、地形条件和发病率为地方性因素;对基层医疗资源配置而言,人口密度是较为显著的全局性影响因素,城镇化率是重要的地方性影响因素,地形、经济发展水平、人口老龄化和发病率在部分尺度和区域有局部影响。为实现分级诊疗改革的目标,各级决策部门需以“全局性和地域性因素相结合,统一性和地方性政策相结合,自上而下与自下而上决策机制相结合”为思路,统筹不同区域和层级医疗资源配置,以提高医疗卫生服务体系的整体功能,促进其均衡、协同发展。     

Paleolimnological investigations of anthropogenic environmental change in Lake Tanganyika: I. An introduction to the project

We investigated paleolimnological records from a series of river deltas around the northeastern rim of Lake Tanganyika, East Africa (Tanzania and Burundi) in order to understand the history of anthropogenic activity in the lakes catchment over the last several centuries, and to determine the impact of these activities on the biodiversity of littoral and sublittoral lake communities. Sediment pollution caused by increased rates of soil erosion in deforested watersheds has caused significant changes in aquatic communities along much of the lakes shoreline. We analyzed the effects of sediment discharge on biodiversity around six deltas or delta complexes on the east coast of Lake Tanganyika: the Lubulungu River delta, Kabesi River delta, Nyasanga/Kahama River deltas, and Mwamgongo River delta in Tanzania; and the Nyamuseni River delta and Karonge/Kirasa River deltas in Burundi. Collectively, these deltas and their associated rivers were chosen to represent a spectrum of drainage-basin sizes and disturbance levels. By comparing deltas that are similar in watershed attributes (other than disturbance levels), our goal was to explore a series of historical experiments at the watershed scale, with which we could more clearly evaluate hypotheses of land use or other effects on nearshore ecosystems. Here we discuss these deltas, their geologic and physiographic characteristics, and the field procedures used for coring and sampling the deltas, and various indicators of anthropogenic impact.     

Measuring spatial accessibility to primary care in rural areas: Improving the effectiveness of the two-step floating catchment area method

Quantifying spatial accessibility in relation to the provision of rural health services has proven difficult. This article critically appraises the two-step floating catchment area (2SFCA) method, a recent solution for measuring primary care service accessibility across rural areas of Victoria, Australia. The 2SFCA method is demonstrated to have two fundamental shortcomings – specifically the use of only one catchment size for all populations, and secondly the assumption that proximity is undifferentiated within a catchment (especially problematic when the catchment is large). Despite its advantages over simple population-to-provider ratios, the 2SFCA method needs to be used with caution.     

Preliminary mapping of high-resolution rural population distribution based on imagery from Google Earth: A case study in the Lake Tai basin, eastern China

There is a large rural population in China. Throughout the country, sewage from rural households is mostly discharged with minimal treatment. Knowledge of rural population distribution is essential to study the rural households’ impacts on their surrounding environment. However, high-resolution spatial datasets on rural population distribution are rarely available in China. This study explores the feasibility of using the image from Google Earth to derive a high-resolution map on rural population distribution for a town in the Lake Tai basin of eastern China. Study results show that texture analysis in conjunction with other processing procedures can extract man-made building features from the image reasonably, which can then serve as the basis for the preliminary mapping of rural population distribution in the study region. This may prove to be a promising alternative for deriving spatial datasets on rural population distribution in many parts of the world.     

Socio-spatial dynamics in the use of wild natural resources: Evidence from six rapidly growing medium-sized cities in Africa

Increasing urbanisation in sub-Saharan Africa transforms spatial configurations in and around towns and cities. At the same time wild natural resources play an important role in African livelihoods. Yet, little is known about the impact of urbanisation on the socio-spatial dynamics of the use of wild natural resources. Here we examined the importance of these resources for livelihoods, differences in their use between different locations along the urban-rural continuum, and the respective temporal dynamics. A total of 1158 households were interviewed in six medium-sized cities distributed across five African countries using a standardised questionnaire supplemented by expert interviews and spatial analyses employing Geographic Information Systems. Overall, even though periurban and rural households were more likely to use wild natural resources than those in the urban areas, the use of these resources was generally high along the entire urban-rural continuum. Despite the increasing urban pressure on these resources, they remain an integral part for most households, not only for those lacking access to productive resources, but also for those with a higher standard of living. This trend was found across all study towns, despite the marked differences in their respective socio-spatial as well as environmental settings.     

干旱区水资源约束下的生态退耕空间优化及权衡分析——以奇台县为例

干旱区耕地大规模扩张导致水资源超载、生态问题频发,亟须退地还水。因此,探索水资源约束下的生态退耕空间优化方案,不仅有助于解决干旱区面临的问题,还可为土地利用规划和决策提供参考。目前对退耕方案多效益矛盾的研究尚量化不足,有鉴于此,本文建立生态退耕空间优化配置及权衡分析模型,以新疆奇台县为研究区进行模型应用,构建了水资源约束下的生态退耕方案群,并设计保有耕地优先和保护生态优先等两种情景,利用蚁群优化算法实现了生态退耕的空间配置模拟与优化。结果表明:耕地面积在保有耕地优先情景将减至9.94万hm2,保护生态优先情景则为6.96万hm2;在此退耕过程中,河道内生态用水占水资源总量的比例从10%增加到30%,防固沙量由713.22万t增加至816.59万t,经济效益则由34.86亿元下降至24.75亿元。通过比较单位经济效益的减少比例可产生的生态效益增加比例,确定耕地面积退至8.35万hm2时是权衡生态和经济效益下的生态退耕最优方案。退耕还草主要发生在奇台县耕地集中区的东北、西北及西南部边缘,将有利于北部的沙漠化防控和南部的水源保护。本研究实现了干旱区水资源约束下生态退耕方案空间模拟和优化,对农...     

Changes in the residential segregation of immigrants in Sweden from 1990 to 2012: Using a multi-scalar segregation measure that accounts for the modifiable areal unit problem

In this paper, the levels of residential segregation of immigrants in Sweden during the years 1990, 1997, 2005, and 2012 are calculated. This paper applies a novel method for calculating segregation that is multi-scalar and addresses the modifiable areal unit problem (MAUP). The level of segregation is evaluated for each populated location by identifying the population that includes the k-nearest neighbours. The share of immigrants in this assessment population is then compared to the share in the reference population that comprises the K-nearest neighbours. One of the strengths of this method is the possibility to modify the reference population, thus making it possible to measure the difference in the results due to the size of the reference population. This study demonstrates that the results can considerably differ depending on which reference population is used. Furthermore, this study indicates that using different reference areas can produce completely different trends over time, such as decreasing or increasing segregation. The results demonstrate a general increase in segregation between 1990 and 1997, followed by a more complex pattern from 1997 to 2012. The segregation values are presented for all populated locations in Sweden, and population-weighted means are calculated for the whole of Sweden, in addition to the Stockholm, Malmö, and Gothenburg metropolitan areas.     

环印度洋区域国家地缘经济格局分析

环印度洋区域不仅关乎中国贸易与能源安全,同时也涵盖“一带一路”倡议合作的部分区域.为便于中国更好地开展与环印度洋区域国家之间的贸易合作,需要定量考察环印度洋区域的地缘经济格局,掌握域内外大国在该区域的地缘经济竞争情况.首先基于有序聚类方法将1992-2017年环印度洋区域国家的商品贸易数据划分为4个阶段,然后探究环印度...     

中国区域经济协同网络演变及成因分析——以2003—2017年中国40470组两两城市对为样本

以2003—2017年中国285个地级及以上城市构成的40470组两两城市对为样本,采用效率增值模型、社会网络分析法以及动态面板模型分析了中国区域经济协同网络演变及成因。结果表明：① 中国区域经济协同网络密度呈现三周期、双缺口变化特征,高强度协同作用偏向东部地区的东向性特征凸显;② 协同网络经历了星型覆盖格局-双区扇形发散格局-单区扇形发散格局-多层嵌套新格局的转变,表现为跨越东中西部地区的远距离协同,跨域性特征突出;③ 东部城市比较优势、经济联系和产业分工的良性循环决定了协同作用的东向性,而远距离协同作用利于整合区域差异化比较优势,降低资源争夺和重复建设风险,促进全域高效产业分工体系和跨域性协同网络的形成。