ObjectiveThis study examined the impact of an Integrated Care Delivery intervention on health care seeking and outcomes for chronically-ill patients in Henan province, China.MethodsA case-control study was carried out in six health care organizations from two counties in Henan province, China. 371 patients aged 50 years or over with hypertension or diabetes who visited either community health centers or hospitals in the Intervention or Control Counties were systematically selected and surveyed on health care seeking behavior, quality of care, and pathway of care for their major chronic condition. Bivariate analyses were performed to compare quality and value of care indicators between patients from the Intervention and Control Counties. Multivariate analyses were used to confirm these associations after controlling for patients’ demographic and health characteristics.ResultsPatients in both the Intervention and Control Counties chose their current health care providers primarily out of concern for quality of care (provider expertise and adequate medical equipment) and patient-centered care. Compared with the patients from the Control County, those from the Intervention County performed significantly better on almost all the quality and value of care indicators even after controlling for patients’ demographic and health characteristics. Significant associations between types of health care facilities and quality as well as value of care were also observed.ConclusionThe study showed that the Integrated Care Delivery Model was critical in guiding patients’ health care seeking behavior and associated with improved accessibility, continuity, coordination and comprehensiveness of care, as well as reducing health inequities and mitigating disparities for older patients with chronic conditions.

BACKGROUND: In this study, five microalgal species (Chlorella vulgaris, Chlorococcum sp. GD, Parachlorella kessleri TY, Scenedesmus quadricauda, and Scenedesmus obliquus) were cultivated in batch mode to evaluate their respective potential for the treatment of real aquaculture wastewater from a fishery. Subsequently, the microalga with the best performance was cultivated with different initial inoculation concentrations to evaluate the effect of initial inoculation on pollutant removal efficiency. RESULTS: When real aquaculture wastewater was inoculated with exogenous microalgae, the growth of both indigenous microalgae and bacteria was significantly inhibited. Pollutant removal was closely related to exogenous inoculationof microalgae. Parachlorella kessleri TY had high growth potential and pollutant removal capability in aquaculture wastewater, compared with the other four microalgae. When the wastewater was inoculated with low biomass concentrations of P. kessleri TY (50-100 mg L −1 ), it grew well and degraded most of the encountered pollutant. In particular, P. kessleri TY with 100 mg L −1 of inoculation concentration removed 94.4% of COD, 96.2% of ammonium, 99% of nitrite, 94.3% of nitrate, and 95.6% of phosphorus after 3 days of cultivation. CONCLUSIONS: Both the screening for microalgal species and the regulation of initial inoculation concentrations are promising approaches to enhance pollutant removal efficiency from real aquaculture wastewater. Determination of water qualityTo determine the water quality, the microalgal suspension was centrifuged at 5000 rpm for 5 min and the supernatant J Chem Technol Biotechnol 2019; 94: 900-910 /jctb up to 94.4%, 96.2%, 99%, 94.3%, and 95.6% for COD, ammonium, nitrite, nitrate, and total phosphorus, respectively. In the remaining tested inoculation concentrations (25, 50, 200, and 400 mg L −1 ), 77.8-88.9% of COD, 54.2-86.1% of ammonium, 64.1-91.7% of nitrite, 57.1-85.7% of nitrate, and 53-81.4% of total phosphorus were removed from the aquaculture wastewater J Chem Technol Biotechnol 2019; 94: 900-910

No abstract

Freshwater representatives of Rhodophyta were sampled and the complete chloroplast and mitochondrial genomes were determined. Characteristics of the chloroplast and mitochondrial genomes were analyzed and phylogenetic relationship of marine and freshwater Rhodophyta were reconstructed based on the organelle genomes. The freshwater member Compsopogon caeruleus was determined for the largest chloroplast genome among multicellular Rhodophyta up to now. Expansion and subsequent reduction of both the genome size and GC content were observed in the Rhodophyta except for the freshwater Compsopogon caeruleus. It was inferred that the freshwater members of Rhodophyta occurred through diverse origins based on evidence of genome size, GC-content, phylogenomic analysis and divergence time estimation. The freshwater species Compsopogon caeruleus and Hildenbrandia rivularis originated and evolved independently at the inland water, whereas the Bangia atropurpurea, Batrachospermum arcuatum and Thorea hispida are derived from the marine relatives. The typical freshwater representatives Thoreales and Batrachospermales are probably derived from the marine relative Palmaria palmata at approximately 415–484 MYA. The origin and evolutionary history of freshwater Rhodophyta needs to be testified with more organelle genome sequences and wider global sampling.

Macroalgae have received much attention for heavy metal removal in treatment of domestic wastewater. In this report, the uptake capacity of a common freshwater green alga, Cladophora fracta, for heavy metal ions (copper, zinc, cadmium, and mercury) was evaluated. The equilibrium adsorption capacities were 2.388 mg Cu 2+ , 1.623 mg Zn 2+ , 0.240 mg Cd 2+ , and 0.228 mg Hg 2+ per gram of living algae at 18°C and pH 5.0. The removal efficiency for Cu 2+ , Zn 2+ , Cd 2+ , and Hg 2+ were 99, 85, 97, and 98%, respectively. Greater removal efficiency was achieved when the concentrations of metal ions were at very low level. The results indicated that living algae are suitable for removal and recovery of heavy metal ions from aqueous solutions and can be a potential tool to treat industrial wastewater.