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Kiepek, Wendy, and Patricia P. Sengstack. "An Evaluation of System End-User Support during Implementation of an Electronic Health Record Using the Model for Improvement Framework." Applied Clinical Informatics 10, no. 05 (October 2019): 964–71. http://dx.doi.org/10.1055/s-0039-3402450.
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Abstract Background Electronic health record (EHR) system implementation is complex. Strong support for clinicians and other end-users during the initial phase of implementation requires dedicated resources and commitment to ensure a smooth transition, reduce frustration, and assist in adoption. Objectives Evaluate end-user support processes and personnel employed during the initial phase of EHR implementation at an academic medical center and identify facilitators of success, challenges, and lessons learned. Methods Using the model for improvement framework, this case report describes the activities that follow the concepts of planning, doing, studying, and acting (PDSA) when providing on-site support to system end users during an EHR implementation in a complex health care system. Results Strengths included engaged and supportive leadership, use of internal support personnel, use of zone leaders, daily huddles for effective dissemination of information, and an evaluation survey tool to provide data supporting rapid changes in support personnel allocation. Challenges primarily surrounded the management of over 1,000 external support personnel which included limited EHR system knowledge, scheduling, and transportation logistics. Conclusion Implementation of EHR systems continues. Supporting end users is one aspect of these complex projects that require dedicated resources to manage effectively. Organizations taking a more proactive approach, based on learning from experiences, as well as from other health care organizations, can improve their ability to take on this challenge armed with best practices and lessons learned.
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Perederiy, Veronika A., and Anastasiya V. Getun. "Potential of Student Youth of HEIs as a Factor of Influence on the Economy of the Republic of Crimea." Теория и практика общественного развития, no. 8 (August 30, 2023): 60–66. http://dx.doi.org/10.24158/tipor.2023.8.6.
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Geographical location, natural resource potential, landscape and climatic conditions, health resort treatment, beach recreation, cultural and historical traditions define the Russian Crimea as one of the most popular do-mestic tourism destinations. Along with this, the peninsula is also an important regional center of education and science. The authors examined the state of the republic's higher education system and its impact on the eco-nomic sphere, emphasizing student youth as the main subject capable of making a significant contribution to the economic development of the region. In this regard, the task was set to investigate the potential of the stu-dent population studying in higher educational institutions of the Republic of Crimea, and their involvement in the socio-economic, labor and innovation spheres of the region. The article contains analytical data on the ac-tivities of higher educational institutions operating in the territory of the Republic, a brief review of educational programs, achievements in the field of scientific research. The authors point out the changes in the system of higher education of the peninsula, positively affecting its economic, social and cultural development.
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Ivanov, I., V. Gordienko, and E. Popova-Petrosyan. "THE CLINICAL COURSE OF SIMPLE AND PROLIFERATING UTERINE FIBRODS IN WOMEN OF REPRODUCTIVE AGE." Tavricheskiy Mediko-Biologicheskiy Vestnik 23, no. 3 (October 19, 2022): 21–27. http://dx.doi.org/10.29039/2070-8092-2020-23-3-21-27.
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Uterine fibroids are widespread among diseases of the female system. The significance of this problem has increased in recent years as a result of increased complications of pregnancy, childbirth and the postpartum period in women with uterine myoma. In such women, fetal retardation syndrome, premature birth, abnormal position of the fetus, anomalies of labor activity were more often observed. Therefore, medicine and the state have an urgent task to maintain reproductive health in women with a diagnosis of uterine fibroids.
The aim of our study was to compare the picture of the clinical course of simple and proliferating fibroids in women of reproductive age. Materials and methods. A study of 22 non-pregnant women of reproductive age with a diagnosis of uterine fibroids (intramural, subserous, submucous) was performed. Clinical studies were conducted on the basis of the Center for Women’s Health «LLC Company Ethel» in Simferopol during 2018-2019. All women included in the study underwent an ultrasound examination of the pelvic organs using three-dimensional energy dopplerometry of intratumoral blood flow. A sample was taken into groups depending on the clinical course of the disease. Group A n = 14 (women of reproductive age with proliferating myoma), group B n = 8 (women of reproductive age with simple myoma). Research results. When studying the clinical course of simple and proliferating fibroids in women of reproductive age, it was found that with proliferating uterine fibroids, menstrual irregularities of the type of hyperpolymenorrhea, rapid growth and development of complications of the disease, than with simple fibroids were much more common. Conclusions. It is proved that with proliferating uterine fibroids, the clinical course of the disease is much more aggressive and faster, compared with the clinic with simple myoma, therefore it is necessary to change treatment approaches depending on the form.
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Samardžić, Ljiljana. "Characteristics of Patients Treated Psychoterapeutically in the Outpatient Clinical Setting." Acta Facultatis Medicae Naissensis 30, no. 3 (September 1, 2013): 151–58. http://dx.doi.org/10.2478/afmnai-2013-0007.
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Summary The influence of social changes in transitional country and transitional times, among other things, have made changes in the structure of the patients seeking psychotherapeutic treatment. However, there has not been any research studying characteristics of patients in psychotherapeutic treatment. The aim of our study was to establish socio-demographic, clinical and psychodynamic characteristics of patients psychotherapeutically treated in the outpatient clinical setting. Our sample consisted of 61 non-psychotic patients, randomly selected by the method of consecutive admissions and treated with psychoanalytic psychotherapy in the outpatient clinical setting. The study was conducted from January 2009 to January 2012 at the Mental Health Clinic, Clinical Center Niš. Mini International Neuropsychiatric Interview, Global Assessment of Functioning Scale and a Semi-structured interview for the Operationalized Psychodynamic Diagnosis were used for collecting data. Our results have shown that patients treated with psychotherapy in the outpatient clinical setting have specific socio-demographic, clinical and psychodynamic characteristics. They are young, post-adolescent individuals, mainly with the diagnosis personality disorder and co-morbidity, with a moderate level of structural integration and individuation vs. dependency as the main psychological conflict. We suggest a long-term psychodynamic psychotherapy as the treatment of choice for patients with presented clinical and psychodynamic characteristics and operationalized psychodynamic diagnostic system as a valuable tool for establishing treatment focus and treatment planning.
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Manuel, Vladimir, Moira Inkelas, and Brandon Shelton. "563 Team Science to Assess Effectiveness and Impact in Public Healthcare Delivery System Contracting." Journal of Clinical and Translational Science 8, s1 (April 2024): 168. http://dx.doi.org/10.1017/cts.2024.479.
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OBJECTIVES/GOALS: Healthcare organizations and payers are moving from accountability to effectiveness frameworks. Static vendor contracts for full-scale implementation limit organizations' ability to evaluate impact before scale-up, or to iteratively improve. Our team science innovation employs science and learning methods as systems engage vendors. METHODS/STUDY POPULATION: Our team science innovation is a method to assess and model impact of interventions at scale in healthcare delivery systems. We are integrating expertise in learning processes of an academic medical center (UCLA CTSI) with the organizational knowledge and methodological expertise of the nation’s largest Medicaid managed care plan (LA Care Health Plan), which has over 2 million members. The LA Care Advanced Analytics Lab has unique capability in machine learning, while enables deep learning of variation. Our innovative product is a template to quickly mobilize evaluation and learning for a diverse population in a varied and distributed delivery system. The template design enables rapid learning for the full-scale policy implementation often imposed by government, and in the short timeframes involved. RESULTS/ANTICIPATED RESULTS: LA Care and the UCLA CTSI partnered to provide subject matter expertise and design effective pilots for interventions such as transitional care services, complex care management, and physician home visit strategies, accounting for confounding factors affecting the intervention and outcome. So far, collaborative modeling and design has produced a successful pilot of a physician home visit program intended to reduce avoidable emergency department visits. This pilot quickly revealed several major changes that would need to be incorporated for the contracted vendor to produce results if operated at scale, further informed by machine learning, in sufficient time to inform the contracting process. There are multiple evolving applications, including housing/homelessness. DISCUSSION/SIGNIFICANCE: Integrating the large data and analytics of a large healthcare organization with learning methods from the CTSI -- including learning from variation and designs for studying impact during scale-up -- fosters academic-community team science that could significantly improve the value of our largest delivery systems, public and commercial.
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Luo, Fang, Qiao Hu, and Caihong Sun. "Studying on the psychological contract of farmers behavior of transferring agricultural land in China." CNS Spectrums 28, S1 (March 2023): S16—S17. http://dx.doi.org/10.1017/s1092852923000846.
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BackgroundAt present, the social economy is in a period of fast-paced change in China, with various modes of production and life evolving and emerging. The transfer of agricultural land is the transformation of the utilization mode of the main factors of production in rural areas, and it is one of the contents of the social and economic reform in rural areas. In 2021, the area of rural land transfer is up to 3.7×1011 m2 in China, an increase of 4.3% over the previous year. 1,239 counties (cities, districts) and 18,731 townships have established agricultural land management rights transfer centers to provide services such as policy consultation, information release, and contract signing for both sides of the transfer. Farmers are the subjects of agricultural land management and transfer. Their behaviors are affected by their psychology to some extent. In the long-term, dynamic, and gradual process of agricultural land transfer, it is particularly important to respect farmers’ wishes, pay attention to farmers’ psychology, and guide farmers’ behavior. However, only a few written contracts were signed. Most are verbal agreements of spontaneous or collective land transfers. The verbal agreements auto-execute to some extent within certain limits. The goals of farmers in farmland transfer are diversified, and their cognition, willingness and psychological identity affect the performance of the contract and the effect of transfer.Subjects and MethodsThe psychological contract of agricultural land transfer can be defined as the transferor and transferee of agricultural land transfer. Through a certain psychological suggestion mode, through the subjective cognition and understanding of the rights and obligations of both parties, rather than the direct explicit expression, a contract relationship of rights and obligations is formed. The party awarding contract and the contractor are the subjects of agricultural land transfer. Therefore, the subjects of the psychological contract of agricultural land transfer include farmers, village collectives and enterprises, all of whom have equal status, forming their own psychological contracts. The forming process of the psychological contract of agricultural land transfer includes four steps. Step one is cognition and judgment. Both parties to the transfer are aware of and judge their own rights and obligations based on external environmental information and their own circumstances. Step two is psychological expectations. Before information is transmitted, both sides of the transmission transform cognition and judgment into psychological expectations. The third step is to convey psychological expectations. Both sides of transfer transmit psychological expectations by means of direct patterns, such as oral form and written form, and implicit ways, such as perception and comprehension. Step four is the formation of the psychological contract. Both sides of transfer reciprocally admit information of psychological expectations transmitted in implicit ways, forming psychological contracts. If they can’t come to an agreement on psychological contracts, a new four-step cycle is entered.ResultsThe forming of the psychological contract of agricultural land transfer is shown in Figure 1. First, farmers’ behavior background, such as the experiences of land lease and transfer, the targets of land transfer and education, has an effect on the building of psychological contracts and its type. On the one hand, the farmers who have the experience of land transfer and get high benefits from it are much more motivated than those who don’t have that experience or ever have dissension while transferring. On the other hand, the targets of transfer and the education level of farmers affect the type of psychological contracts. Second, Farmers’ subjective norms, mainly reflected in the difference in folk customs, will form various communication modes and take different measures to deal with breaching contracts while transferring. Third, farmers’ behavior cognition reflects in their comprehension of the capability of executing contracts, including bargaining power, decision-making level and managing modes of the rent. The ability of behavior cognition and control of farmers has a positive influence on their behavior intention and happened.ConclusionsAccording to the above results, in order to promote the reposeful transfer and orderly development of agricultural land, the following suggestions are proposed: The first is to improve the agricultural land transfer policy system, establish and improve the institutional environment for agricultural land transfer, create conditions for the establishment of farmers’ behavioral psychological contracts in the process of agricultural land transfers, and guide farmers to establish relationship psychological contracts. The second is to improve the market system, properly cultivate and develop agricultural land transfer intermediaries, reduce transaction costs, and reduce the probability of farmers’ psychological contracts being broken. The third is to guide farmers to establish a positive agricultural land transfer psychology based on their resource endowments such as labor force quality and cultural quality, and encourage farmers to make agricultural land transfer decisions such as subcontracting, leasing, reselling, and interchanging.Figure 1.Psychological contracts of agricultural land transfer forming
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Bogdanov, Dmitriy S., Dmitriy V. Cherkashin, Semen V. Efimov, and Alevtina I. Zakharova. "Associations of polymorphisms of the <i>ACE</i> and <i>ACE2</i> genes with clinical manifestations and cardiovascular complications of the coronavirus infection." Bulletin of the Russian Military Medical Academy 25, no. 1 (April 13, 2023): 145–54. http://dx.doi.org/10.17816/brmma114802.
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A problem of the novel coronavirus infection pandemic is the absence of specific biomarkers, the determination of which would make it possible to assess the likelihood of a severe disease course, development of complications, immediate and long-term consequences, and effective etiotropic (antiviral) therapy. The severity of the novel coronavirus infection depends on various factors such as the initial state of health, immune status, age, smoking status, concomitant cardiovascular diseases, and diabetes mellitus. However, a severe disease course is also observed in patients without the aforementioned risk factors. The development of the disease and its complications depends on sex and geographical identity. Angiotensin-converting enzyme 2 (ACE2), associated by gene-gene interaction with ACE, plays a main role in the pathogenesis of the penetration of severe acute respiratory syndrome-2 coronavirus into the cell. The main body of information on this problem is represented by systematic meta-analyses and results of single-center cohort studies, which offer insufficient information to unequivocally assert the associations of ACE and ACE2 gene polymorphisms with pathological changes in the circulatory system during and after a new coronavirus infection. Differences in the incidence of ACE and ACE2 alleles may explain the differences between susceptible populations and/or response to the severe coronavirus infection. The above studies were carried out on the effect of the coronavirus in the initial period of the pandemic. For a more complete molecular genetic picture of the influence of polymorphism, persons with different strains of the coronavirus must be considered. In addition, no data are available regarding the expressions of ACE and ACE2 genes in response to a coronavirus infection. Moreover, the identification of the polymorphic variants of the genes of the reninangiotensinaldosterone system and ACE2 associated with a high risk of developing and worsening cardiovascular diseases may be one of the promising areas for the early diagnosis and prevention of post-COVID-19 changes. Therefore, all scientific interest research is aimed at studying genetic factors, such as single nucleotide polymorphisms that affect susceptibility to infection, severity of the disease course, and development of circulatory system consequences. In general, polymorphic variants of ACE and ACE2 and their interaction will help us understand this problem and systematize knowledge for further research in this area.
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Lake, Johanna K., Paula Tablon Modica, Victoria Chan, and Jonathan A. Weiss. "Considering efficacy and effectiveness trials of cognitive behavioral therapy among youth with autism: A systematic review." Autism 24, no. 7 (May 18, 2020): 1590–606. http://dx.doi.org/10.1177/1362361320918754.
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Cognitive behavioral therapy is a widely studied and commonly used psychosocial intervention for treating emotional problems in individuals with autism. To date, most studies of cognitive behavioral therapy and autism have focused on efficacy. Effectiveness trials, by contrast, measure whether an intervention produces particular results under “real-world” clinical conditions. We conducted a systematic review of cognitive behavioral therapy interventions targeting affective disorders among youth with autism and (a) classified studies as either efficacy or effectiveness trials and (b) coded how the effectiveness trials reflect the implementation characteristics outlined in the Framework of Dissemination in Health Services Intervention Research. The systematic search yielded 2959 articles, with 33 studies meeting inclusion criteria. Thirteen studies were categorized as effectiveness and 20 as efficacy. We discuss how the effectiveness studies considered elements of the implementation framework and provide recommendations for future studies, including greater consideration and measurement of adoption and sustainability processes, as well as organizational- and system-level outcomes. Results shed light on our understanding of the effectiveness of cognitive behavioral therapy in routine clinical practice, how an implementation framework can be used to guide and improve effectiveness studies, and identify barriers, facilitators, and gaps in the implementation process. Lay abstract Cognitive behavioral therapy is a common treatment for emotional problems in people with autism. Most studies of cognitive behavioral therapy and autism have focused on efficacy, meaning whether a treatment produces results under “ideal” conditions, like a lab or research setting. Effectiveness trials, by contrast, investigate whether a treatment produces results under “real-world” conditions, like a community setting (e.g. hospital, community mental health center, school). There can be challenges in bringing a cognitive behavioral therapy treatment out of a lab or research setting into the community, and the field of implementation science uses frameworks to help guide researchers in this process. In this study, we reviewed efficacy and effectiveness studies of cognitive behavioral therapy treatments for emotional problems (e.g. anxiety, depression) in children and youth with autism. Our search found 2959 articles, with 33 studies meeting our criteria. In total, 13 studies were labelled as effectiveness and 20 as efficacy. We discuss how the effectiveness studies used characteristics of an implementation science framework, such as studying how individuals learn about the treatment, accept or reject it, how it is used in the community over time, and any changes that happened to the individual or the organization (e.g. hospital, school, community mental health center) because of it. Results help us better understand the use of cognitive behavioral therapy in the community, including how a framework can be used to improve effectiveness studies.
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Qiu, Annie, Sheila Shapouri, Esther N. Drill, Jake Schade, Arliene Ravelo, Ai Ni, Tu My To, Keith Lamont Dawson, and Matthew J. Matasar. "Real-world assessment of practice efficiency with the introduction of subcutaneous rituximab." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e18025-e18025. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18025.
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e18025 Background: Rituximab (R), available as an intravenous (IV; R-IV) infusion or subcutaneous (SC; R-SC) injection, is used in the treatment of follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and chronic lymphocytic leukemia (CLL). This study evaluated real-world practice efficiency changes associated with the adoption of R-SC by studying differences in chair time by route of administration. Methods: We conducted a retrospective analysis of practice care delivery measures before and after adoption of R-SC at Memorial Sloan Kettering Cancer Center (MSKCC). Data for patients (pts) with FL, DLBCL, or CLL receiving R-based therapy from September 2016 to September 2018 were extracted from the electronic medical record. A linear mixed effect multivariate model with random intercept was used to analyze the association between treatment type (R-IV vs R-SC) and chair time (defined as the difference in pt room-in and room-out times) in the year prior to and following R-SC adoption at MSKCC. Model covariates included treatment time and location, therapy type (monotherapy vs combination), and pt demographics. Given the prolonged infusion time, patients’ first dose of R-IV was excluded from the analysis. Results: Data were collected during 6744 visits (3018 visits prior to R-SC adoption and 3726 after) for 1503 pts receiving R. Pts receiving R-IV combination therapy had a mean chair time of 203 minutes (min); overall, R-SC injection reduced chair time by a mean of 92 min (p < 0.001 vs R-IV). Monotherapy, regardless of route, reduced chair time by a mean of 30 min (p < 0.001) compared with combination therapy, and mean chair time was further reduced by 39 min (p < 0.001) for R-SC pts receiving monotherapy. Reductions in chair time increased over time following initial adoption of R-SC (p = 0.042), and were greater at the lymphoma-specific site than multispecialty oncology infusion centers (p < 0.001). Conclusions: Adoption of R-SC results in substantial time savings for both the pt and health system as measured by reduced chair time and improved pt throughput. Given increasing constraints on infusion chair space, increased utilization of R-SC may improve practice efficiency and pt access to care.
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Balaev, Magomedbashir Kh, Andrey P. Fisenko, and Svetlana I. Aprosimova. "Influence of medical-social and socio-economic factors on infant mortality rate in the Republic of Ingushetia." Russian Medicine 30, no. 2 (May 17, 2024): 142–51. http://dx.doi.org/10.17816/medjrf625546.
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BACKGROUND: The infant mortality rate, as one of the indicators of the health and quality of life of the population, is an important factor that determines the country’s healthcare priorities. Despite the steadily decreasing infant mortality rates in the Russian Federation, the value of this indicator varies by region; thus, studying the factors influencing its value is relevant. If the leading medical, social, and socioeconomic factors that influence the level of infant mortality could be determined using data from a representative region (Republic of Ingushetia), the main directions for organizing measures aimed at reducing mortality among children in the first year of life will be identified. AIM: To determine the main medical, social and socio-economic factors that influence the infant mortality rate in the Republic of Ingushetia. MATERIALS AND METHODS: An observational single-center retrospective study was performed to examine the influence of medical, social, and socioeconomic factors on the mortality rate of children aged 1 year in the Republic of Ingushetia. The obtained data were compared with similar indicators for the Russian Federation as a whole and the North Caucasus Federal District. RESULTS: During the study period (2011–2019), significant changes were observed in infant mortality rates in the Republic of Ingushetia: infant mortality has decreased because of the age components, leading to the normal ratio of neonatal and post neonatal mortality. Rates of infant mortality from certain conditions arising in the perinatal period, congenital anomalies, and nervous system and circulatory system diseases have significantly decreased. The proportion of women admitted under the supervision of antenatal clinics in the early pregnancy (up to 12 weeks) has increased, the incidence of morbidity among pregnant women has decreased, and the proportion of normal births has been increasing. Although many medical organizations have employed a sufficient number of medical personnel, the coverage for biochemical screening has decreased, detection of malformations and biochemical abnormalities during prenatal diagnostics was low, medical personnel have low qualifications, and the shortage of obstetric and pediatric beds and pathology beds for newborns and premature infants was significant. A statistically significant dependence of the frequency of deaths of children aged 1 year on socioeconomic indicators−unemployment level, monetary income of the population, and housing conditions−was revealed. CONCLUSION: The main medical, social, and socioeconomic factors that influence infant mortality were analyzed using data from the Republic of Ingushetia. Positive and negative trends in the current state of the healthcare system of this republic have been identified.
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Golding, M., F. Nishat, K. Merrill, R. Kaur, J. Stinson, J. Protudjer, R. Woodgate, et al. "POS1401-HPR LIVED EDUCATIONAL EXPERIENCE OF YOUNG ADULTS WITH CHILDHOOD- AND ADULT-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-CENTER CANADIAN QUALITATIVE STUDY." Annals of the Rheumatic Diseases 82, Suppl 1 (May 30, 2023): 1053.1–1053. http://dx.doi.org/10.1136/annrheumdis-2023-eular.3294.
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BackgroundEducation and employment established in young adulthood predict future lifetime socioeconomic achievements. Young adults with Systemic Lupus Erythematosus (SLE) have physical, cognitive and mental health issues and other comorbidities that may impact employment.ObjectivesTo understand the lived experiences of young adults with SLE (YASLE), as students, and to assess their perceived barriers from SLE.MethodsYASLE were recruited from two Lupus clinics in Toronto and Winnipeg. Semi-structured qualitative interviews were conducted individually via secure video conferencing. As this study was conducted during the coronavirus pandemic, participants were also asked about the pandemic impacts on their education experiences. All interviews were transcribed verbatim, double-coded and analysed using a reflexive thematic approach.ResultsTwelve participants (2 males), 9 of childhood- and 3 adult-onset SLE (cSLE, aSLE) were interviewed. Nine participants (82%) were <25 years old. Five also worked while studying. Five were Asians, 5 were White, 2 of other ethnicities. Half have severe disease (central nervous system or renal involvement). Median duration of disease was 4.0 (25th-75thpercentile, 1.8- 5.3) years. The impacts of SLE on their education experience emerged in 5 themes:1)Challenges imposed by SLE:Difficulties adjusting to the diagnosis, physical and cognitive symptoms of SLE. While most participants disclosed their diagnosis to their schools, some expressed hesitation.2)Changes in aspirations:Education/career goals were modified by reducing course load or shifting to more sedentary or less cognitively demanding careers.3)Coping and acceptance: More adaptive than maladaptive coping strategies were used to manage their SLE, including self-acceptance, pacing, planning and avoidance. All strived to do well in their studies despite SLE and were hopeful for their futures.4)Facilitating factors for education success:Family and friends’ social support, individualized accommodations from school and parental financial support were identified.5)Pandemic impacts: Virtual learning and flexible schedules enabled participants to adapt their schedules according to their physical conditions (e.g. pain, fatigue). However, fewer opportunities to interact in-person were viewed as challenges. Participants want hybrid options to continue even after the pandemic.ConclusionSLE affected students’ performance through physical symptoms, fatigue and cognitive dysfunction. Ongoing social and school supports help to support them. Maintaining the remote learning options may increase accessibility for them. These results identified opportunities for developing future supportive interventions for YASLE patients in their schooling which then better prepare them for future employment.References[1]Jetha A, Badley E, Beaton D, Fortin PR, Shiff NJ, Gignac MA. Unpacking early work experiences of young adults with rheumatic disease: an examination of absenteeism, job disruptions, and productivity loss. Arthritis care & research. 2015;67:1246-54.[2]E. F Lawson, A. O. Hersh, L. Trupin, E. von Scheven, M. J. Okumura, J. Yazdany, et al. Educational and vocational outcomes of adults with childhood and adult onset systemic lupus erythematosus: nine years of follow-up. Arthritis Care Res 2014; 66: 717-24.Acknowledgements:NIL.Disclosure of InterestsMike Golding: None declared, Fareha Nishat: None declared, Kaitlyn Merrill: None declared, Ramandeep Kaur: None declared, Jennifer Stinson: None declared, Jennifer Protudjer Speakers bureau: Nutricia (Food allergy university, Nov 2022), Consultant of: Novartis 2021, allergy products, Roberta Woodgate: None declared, Christine Peschken: None declared, Diane Lacaille: None declared, Umut Oguzoglo: None declared, Zahi Touma: None declared, Lily Lim Speakers bureau: Pfizer Feb 2023. Not drug related and not related to this abstract.
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Krugman, Richard D., Stephanie Stronks-Knapp, Mischa Haroutunian, and Jessica M. Yeatermeyer. "A Health-Based Child Protection System: Studying a Change in Paradigm." Journal of Clinical Ethics 19, no. 4 (December 1, 2008): 346–49. http://dx.doi.org/10.1086/jce200819406.
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Bobyleva, E. S., A. Yu Gorbunov, O. I. Starodubtsevа, and Ya M. Vakhrushev. "THE MEDIC-STATISTICAL CHARACTERISTIC INCIDENCE OF PNEUMONIA IN THE UDMURT REPUBLIC." Russian Archives of Internal Medicine 8, no. 6 (December 3, 2018): 438–43. http://dx.doi.org/10.20514/2226-67042018-8-6-438-443.
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The Community-acquired Pneumonia (CAP) is an urgent problem of modern medicine owing to its high prevalence, gravity of a current, the increasing resistance of a microflora to antibacterial therapy, a large number of complications and a high lethality. Udmurt republic is one of leaders among the regions of Russian Federation on morbidity by diseases of the respiratory system, include CAP. It is therefore necessary to take analysis and prognosis incidence for the future improving quality administer. Research objective. The analysis of incidence and mortality from diseases of respiratory organs in the Udmurt Republic for 2009-2016. Materials and methods. The retrospective and prospection clinical-epidemiological research of prevalence and primary incidence of diseases of respiratory organs among the adult population of the Udmurt Republic living in 4 cities is conducted (Izhevsk, Sarapul, Glazov, Votkinsk) and 25 rural areas for the 8-summer period (2009-2016). The analysis is carried out on the basis of data of the state statistical registration and reporting documentation of Budgetary institution of health care of the Udmurt Republic «Republican medical information and analysis center of the Ministry of Health of the Udmurt Republic». Results of a research. The prevalence of diseases of respiratory organs in the Udmurt Republic was 49871,39±1,33 on 100 thousand population. The average growth rate was 2,3%, and the average rate o f a gain was — 0,25%. In comparison with data for the same period to the Russian Federation, average growth rate the average rate of a gain — 5,48% was 1,7%, and that demonstrates some decrease in incidence. In the analysis of structure of incidence of diseases of respiratory organs of the population of the Udmurt Republic it is established that she throughout the entire period of observation significantly hasn’t changed. At the same time annually, leading places are taken by pneumonia and the chronic obstructive pulmonary disease (COPD). Estimating the level of primary incidence of diseases of respiratory organs, it is noted that on UR the average growth rate is 105,42%, the average rate of a gain of 5,42%, in comparison across the Russian Federation average growth rate of 87,07%, and the average rate of a gain — 12,93%. Conclusion. Thus, to UR, as well as in general across the Russian Federation steadily high incidence of pneumonia is noted. At the same time the tendency to increase in incidence and this pathology mortality is noted. This circumstance demands further studying of a problem of pneumonia, including improvement of methods of medical correction.
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Han, Xiaofei, Yi Li, Xiyue Wu, and Wei Chen. "Big Data and Tourism Competitiveness Evaluation in the New Media Environment." Mobile Information Systems 2022 (April 1, 2022): 1–15. http://dx.doi.org/10.1155/2022/2703945.
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The rapid development of science and technology has prompted human beings to continuously update the technical means of disseminating information. Nowadays, new media based on the Internet and mobile terminals have become an indispensable tool for the public to receive and disseminate information. Tourism informatization is an important means to promote the development of tourism and an important way to enhance tourism competitiveness. With the support of new media technology, the “audience” is gradually changing from the passive and silent “recipient of information” under the traditional media to the active intervener, which independently receives and feeds back information, and the flow of information is more free. New media has promoted the development of a “user-centered” communication model, presenting a situation in which “information receivers have the right to choose media, and channels have become the center of communication.” Studying the effect of regional tourism image dissemination under the background of new media and finding out the factors that affect the effect of tourism image dissemination under the background of new media are the magic weapon for the further development of the current tourism industry. These have completely overturned the traditional communication format. In the era of new media, what kind of changes the tourism image will bring in the process of shaping, dissemination, and promotion is a question worthy of our deep consideration. With the rapid development of information technology and the widespread use of modern communication equipment, human beings have entered the era of big data with the core value of mining data. At present, people no longer only use intuition and experience as the basis for making decisions, but more importantly, based on big data technology to analyze the relationship between data and then make scientific decisions. The advent of the era of big data has caused a corresponding change in the evaluation criteria for informatization of tourist destinations. Therefore, for tourism destinations, reexamining the evaluation criteria of informatization and establishing a reasonable evaluation index system have become a realistic problem in the development process of tourism destination information. Under this circumstance, strengthening the research on the evaluation of tourism destination information is of great significance to the healthy and rapid development of tourism destination informationization. This study proposes the background and significance of the research and discusses the relevant theoretical basis. The paper establishes three levels of indicators from the three aspects of core competitiveness, basic competitiveness, and environmental competitiveness and selects nonquantitative processing methods for data processing. After comparison, it comprehensively analyzes the tourism situation under big data. In connection with the actual situation under big data, it puts forward targeted countermeasures and safeguard measures for the improvement of tourism competitiveness under big data and provides reference for relevant departments to formulate relevant policies. Only government departments and relatives and friends have an average credibility of more than 3, and the average credibility of relatives and friends has reached 3.71.
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Schwartz, Theodore H. "MR Imaging and Epilepsy—3T or not 3T? that is the Question." Epilepsy Currents 6, no. 3 (May 2006): 70–72. http://dx.doi.org/10.1111/j.1535-7511.2006.00101.x.
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3T-Phased Array MRI Improves the Presurgical Evaluation in Focal Epilepsies: A Prospective Study Knake S, Triantafyllou C, Wald LL, Wiggins G, Kirk GP, Larsson PG, Stufflebeam SM, Foley MT, Shiraishi H, Dale AM, Halgren E, Grant PE Neurology 2005;65(7):1026–1031 Background Although detection of concordant lesions on MRI significantly improves postsurgical outcomes in focal epilepsy (FE), many conventional MR studies remain negative. The authors evaluated the role of phased array surface coil studies performed at 3 Tesla (3T PA-MRI). Methods Forty patients with medically intractable focal epilepsies were prospectively imaged with 3T PA-MRI, including high matrix TSE T2, fluid attenuated inversion recovery, and magnetization prepared rapid gradient echo. All patients were considered candidates for epilepsy surgery. 3T PA-MRIs were reviewed by a neuroradiologist experienced in epilepsy imaging with access to clinical information. Findings were compared to reports of prior standard 1.5T MRI epilepsy studies performed at tertiary care centers. Results Experienced, unblinded review of 3T PA-MRI studies yielded additional diagnostic information in 48% (19/40) compared to routine clinical reads at 1.5T. In 37.5% (15/40), this additional information motivated a change in clinical management. In the subgroup of patients with prior 1.5T MRIs interpreted as normal, 3T PA-MRI resulted in the detection of a new lesion in 65% (15/23). In the subgroup of 15 patients with known lesions, 3T PA-MRI better defined the lesion in 33% (5/15). Conclusion Phased array surface coil studies performed at 3 Tesla read by an experienced unblinded neuroradiologist can improve the presurgical evaluation of patients with focal epilepsy when compared to routine clinical 1.5T studies read at tertiary care centers. MR Imaging of Patients with Localization-Related Seizures: Initial Experience at 3.0T and Relevance to the NICE Guidelines Griffiths PD, Coley SC, Connolly DJ, Hodgson T, Romanowski CA, Widjaja E, Darwent G, Wilkinson ID Clin Radiol 2005;60(10):1090–1099 The purpose of this study is to describe our initial experience of imaging adults with localization-related epilepsy using MR imaging at 3.0T. We discuss the findings in the context of the recently released NICE guidelines that provide detailed advice on imaging people with epilepsy in the UK. One hundred twenty consecutive people over the age of 16 years with localization-related epilepsy were referred for clinical MR examinations from a regional neuroscience center in England. None of the people had had MR examinations prior to the present study. Highresolution MR imaging was performed taking advantage of the high field strength and high performance gradients of the system. Two experienced neuroradiologists reported on the examinations independently and the presence and type of pathology was recorded. There was complete agreement between the two reporters in all 120 cases. The overall frequency of abnormalities shown by MR was 31 of 120 (26%) and the commonest abnormality shown was mesial temporal sclerosis found in 10 of 120 (8%). Tumors were shown in 4 of 120, all of which appeared low grade as judged by imaging criteria. Epilepsy is the commonest neurological condition and demands a significant resource in order to provide good care for sufferers. Recent guidelines published in the UK have suggested that the majority of people with epilepsy should receive brain MR as part of their routine assessment. Our work shows that using the most sophisticated MR imaging in a highly selected population there is a modest pick-up rate of brain abnormalities. If a widespread epilepsy-imaging programme is started the detection rate is likely to be much lower. Although MR is acknowledged to be a reliable way of detecting pathology in people with epilepsy there is a dearth of information studying the health economics of imaging epilepsy in relation to patient management and outcomes.
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Kalel, Zhan S., Gabriel Gulis, and Altyn M. Aringazina. "Implementation of Health Impact Assessment in the Healthcare System of the Republic of Kazakhstan." International Journal of Environmental Research and Public Health 20, no. 3 (January 28, 2023): 2335. http://dx.doi.org/10.3390/ijerph20032335.
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The Health Impact Assessment (hereinafter referred to as HIA) is an effective method for predicting potential health impacts from decisions. Little is known about the implementation of the HIA in the Republic of Kazakhstan (further, RK). In addition, the Russian language literature has not yet been reviewed in terms of HIA-related knowledge. By conducting a literature review of enabling factors, including Russian language literature, on the implementation of the HIA and studying governance systems in RK, we aim to suggest an implementation process to implement the HIA in RK. After careful analysis of the governance system, we suggest set up of a HIA support unit under the National Scientific Center for Health Development and discuss the possible benefits. The proposed center should guide the implementation of the HIA in RK.
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Cevik, Celalettin, and Bulent Kilic. "Change from health center to family physician period in the Turkish health system: A qualitative study." International Journal of Health Planning and Management 33, no. 4 (August 3, 2018): e1022-e1036. http://dx.doi.org/10.1002/hpm.2580.
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Hu, Jin, and Gen Bao Zhang. "Experiments and Study of the Static Rigidity of Workpiece Spindle of Direct-Drive Gear Hobbing Machine." Applied Mechanics and Materials 233 (November 2012): 355–60. http://dx.doi.org/10.4028/www.scientific.net/amm.233.355.
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Static rigidity of workpeice spindle component is a very important index of the rigidity of derict-drive gear hobbing spindle unit. In this study, the static rigidity of workpiece spindle system were analyzed through a finite element method (EFM) by building geometric models and studying the deformation when radial cutting force was imposed. Experiments on workpiece were carried out with and without the assistance of tailstock center separately to measure the changes of the static rigidity of spindle. The results prove a less change of the static rigidity of spindle when with the assistance of tailstock center, which helps to ensure the accuracy and surface roughness of a workpiece.
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Bảy, Vu Khac, Duong Van Tai, Hoang Son, Luong Anh Tuan, and Hoang Nhan. "Studying the road grip of firefighting and rescue motorcycles when moving straight." Engineering Solid Mechanics 10, no. 3 (2022): 227–40. http://dx.doi.org/10.5267/j.esm.2022.4.004.
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A fire fighting and rescue motorcycle fitted with a fire fighting and rescue vehicle cluster on the vehicle's suspension will change the vehicle's center of gravity, affecting the vehicle's stability during travel. By modeling the kinematics in the planar motion of a two-wheeled motorcycle with 4 degrees of freedom, the paper has built a system of differential equations for the planar motion of the vehicle. Investigate the influence of the installation position of the vehicle cluster, the road surface collision, and the vehicle's speed on the loading and unloading of the vehicle in the process of moving in a straight line. The test results evaluate the reliability of the theoretical model.
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Lu, Chun, Hui Hui Zhang, and Chi Ma. "The Analysis on Dynamic Changes of Land Desertification and Salinization Based on RS and GIS." Advanced Materials Research 726-731 (August 2013): 4668–73. http://dx.doi.org/10.4028/www.scientific.net/amr.726-731.4668.
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Abstract:For studying the characters of dynamic changes of land Desertification in Songnen Plain, this paper makes use of remote sensing data and geography information system technology and introduces some characteristic parameters, such as the degree of desertification change, to get the numerical value of these characters. The research result shows that: in 1975-1988, the land area of desertification increases rapidly; the deterioration in the border region of land desertification is stronger than that in the center; and in 1988-2001, the area of desertification decreases slowly, the reversion in the border of desertification is stronger than that in the center, then the tendency of expansion of land desertification been initially contained.
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Kravchuk, Oksana, and Hennadiy Shelepko. "ARRANGEMENT OF INCLUSIVE STUDYING IN THE MANAGEMENT SYSTEM OF THE EDUCATIONAL INSITUTIONS." Psychological and Pedagogical Problems of Modern School, no. 1(7) (May 25, 2022): 165–71. http://dx.doi.org/10.31499/2706-6258.1(7).2022.261222.
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Nowadays the training of future teachers working in the conditions of inclusive education belongs to the important components of the educational process at universities. However, a great number of teachers graduated from universities when the issue of inclusive studying was not paid proper attention, teachers’ training was aimed at the formation of professional competence to teach and educate children with common development. Along with the changes connected with an outside technological support of the architectural availability and the creation of appropriate infrastructure, the arrangement of a working process sets a goal to develop a high level of an inclusive culture in a teachers’ and students’ staff. In this regard, a manager of a contemporary institution faces the task to direct the managerial activity toward the efficient meeting of the requirements of inclusive studying.The purpose of the research is to suggest a management model for inclusive studying at educational institutions.The introduction of the inclusive studying implies a modification of a managerial system and a change of the configuration in the directions of a school’s working process which will provide the formation of a high-level inclusive culture in teachers’ and students’ staff.The creation of consultation centers in the general secondary institutions focused on several directions is suggested in this paper.An appropriate sector will be responsible for the working process of each direction. It is suggested to single out the following sectors based on a consultative center: the sector which is responsible for studying the inclusive learning practices; the sector of psychological assistance for inclusive studying; the sector of methodological support in organizing inclusive studying.To a certain extent, the division into sectors and directions is conditional; their configuration has a flexible nature and can be modified, and restructured due to the requirements which are relevant for each institution taken separately.
Keywords: educational institution management; innovations; inclusion; inclusive studying; inclusive culture; specific educational needs; management model for inclusive studying.
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Sherbakov, S. S. "Measurement and Real Time Analysis of Local Damage in Wear-and-Fatigue Tests." Devices and Methods of Measurements 10, no. 2 (June 24, 2019): 207–14. http://dx.doi.org/10.21122/2220-9506-2019-10-2-207-214.
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In rolling fatigue tests the approach of the axes is usually measured once per cycle or for several loading cycles because of the difficulties of processing a large amount of data in multi-cycle testing. The aim of this work was the development and tests of smoothing model for measured by the SZ-01 center time series experimental data using wavelet transform.With the help of the SZ center, the frictional moment in the roller/shaft system was measured allowing for studying the change in the coefficient of rolling resistance as a function of the level of the contact and non-contact bending load during wear-fatigue tests. Also the axes approach of the contacting bodies (roller and shaft) was measured at eight points on the raceway circumference in one cycle. This allowed studying the heterogeneity of local damages under conditions of rolling and mechano-rolling fatigue. When developing a software module for smoothing a large amount of experimental data from the test center, various methods of time series smoothing were used: moving average; exponential moving average; wavelet transform and moving average applied to the differences of the wavelet coefficients; wavelet transform and exponential moving average applied to the difference of the wavelet coefficients.The results of numerical simulation showed that the best approximation to the original series was provided by the wavelet transform using an exponential moving average to smooth the differences between the coefficients of the wavelet transform.The use of a software module based on this model in SZ-01 center allowed smoothing the time series characterizing the change of roller and shaft axes approach and torque.
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Espinoza-Cordero, Tula, Katherin Ortiz-Cotrina, Carlos Carranza-Llanos, and Juan Carlos Cotrina-Aliaga. "Implementation of Electronic Medical Records System EQUALI to Improve Patient Care." Bulletin of Computer Science and Electrical Engineering 2, no. 1 (June 14, 2021): 9–16. http://dx.doi.org/10.25008/bcsee.v2i1.1144.
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In the present, where we live a pandemic because of Covid-19, it presents a challenge and change in the way we live for all, in which a different way of being able to receive health care must be created. in this research aimed to implement the electronic medical records system to improve patient care, such research is descriptive-explanatory in which a population of 67 patients from a health center is sampled. In conclusion, the implementation of the Electronic Medical Records System improved patient administrative care at the Health Center.
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McDonald Diouf, Colleen. "Standing Tall: Leadership Reflections from the Community Health Center Frontlines." Creative Nursing 27, no. 2 (May 1, 2021): 83–87. http://dx.doi.org/10.1891/crnr-d-21-00008.
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Community health centers have withstood adversity for several decades. As health-care systems seek to reverse health inequities experienced by Black, Indigenous, and People of Color (BIPOC), learnings from community health centers demonstrate tangible ways to improve access and health for all. During the COVID-19 pandemic many community health centers have engaged in innovations in services to build on trust and to reach community members with testing and other needed services. Lessons around leading these efforts could support systemic change in the health-care system.
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Cherkasov, P. "“Platform for Change” (Part Three)." World Economy and International Relations 67, no. 7 (2023): 127–38. http://dx.doi.org/10.20542/0131-2227-2023-67-7-127-138.
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The article presents the professional “profiles” of the leading employees of IMEMO, whom Academician Alexander Dynkin considered to be his like-minded people, on whom he relied as the director of the Institute (2006–2016), and who he calls the “IMEMO patriots”. It is referred to the heads of the main centers, departments and sectors of IMEMO. Among those named by academician Dynkin is Nadezhda Arbatova, the Head of the Department of European Political Studies. She has long been widely recognized in the international scientific and expert community as one of the most authoritative experts on the problems of Russia’s relations with the European Union. The well-known Ella Kirichenko has been heading the Center for North American Studies at IMEMO for a long time. Victoria Zhuravleva is a recognized expert on the domestic political life of the United States. She has replaced Ella Kirichenko as the Head of the Center for North American Studies. Lyudmila Khudyakova is the Head of the Department of Global Economic Problems and Foreign Economic Policy. Under her guidance, a number of important projects on the role of financial markets in the development of the world economy with regard to Russia’s economic interests were implemented. Stanislav Zhukov is an authoritative Russian orientalist whose works have received international recognition. He had headed the Center for Energy Research at IMEMO, and later moved to the position of Deputy Director of the Institute. Vitaly Shvydko and Sergey Lukonin are among Russia’s best experts on Japan and China. Both of them are also studying the problems of the Asia-Pacific region. Irina Krobrinskakya is the Director of the IMEMO Center for Situational Analysis. Givi Machavariani is a unique specialist who has made a significant contribution to the development of forecasting research methodology, to the creation of a database and an integral system for the world economy forecasting. Eduard Solov’ev is the Head of the Center for Post-Soviet Studies. His professional interests include the analysis of contemporary parties and ideologies, the political life of Russia and the United States, as well as the theory and practice of international relations. Tatyana Karlova is the Scientific Secretary of IMEMO, the organizer and coordinator of all the current work of the Institute. Nataliya Kirsanova is the Deputy Director of the Institute, who has been regulating the financial activities of IMEMO for many years. Evgeniya Klyueva is the Head of the Department of Information Support for Scientific Research at IMEMO. She manages the work of the Institute’s website, which has become a source of up-to-date information reflecting all aspects of IMEMO’s activities. All these highly qualified specialists continue to play an important role at IMEMO.
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D’Antonio, Patricia. "CHANGING THE NARRATIVE ON NURSING HOME CARE." Innovation in Aging 6, Supplement_1 (November 1, 2022): 84. http://dx.doi.org/10.1093/geroni/igac059.335.
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Abstract Redesigning our nursing home care system will require substantial policy change, and we know that policy change needs an effective framing strategy. This panel will include speakers who have been studying public mindsets and opinions about nursing home care and its implications for advocacy communications. We will also talk about the implications of this research for the larger reframing aging initiative.
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Mihova, Polina, and Margarita Stankova. "Application of an Electronic Health Record System for Studying the Influence of the Daylight-Saving Time Change on Health Needs." Procedia Computer Science 192 (2021): 3815–21. http://dx.doi.org/10.1016/j.procs.2021.09.156.
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Makhmudova, Dildora, and Hurshid Makhmudov. "Analysis and assasment method of the Chirchik river flow for water supply and water use." E3S Web of Conferences 264 (2021): 01045. http://dx.doi.org/10.1051/e3sconf/202126401045.
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The scientific work is devoted to studying hydroecological problems and methods for assessing the transformation of river water on the example of the Chirchik River, which flows through large industrial centers of the Republic of Uzbekistan and the territory of its capital, Tashkent. Investigations of quantitative and qualitative transformation of river water runoff were carried out using the interpolation method. The main task is to describe the method of interpolation of hydrometeorological data of the territories; For such system, the center in this work adopted a material point that characterizes the movement of the whole system; for this research, such as the hydrometeorological parameters of the territory. The data of the hydrometeorological service of the Republic of Uzbekistan were used when interpolating climatic parameters, which are the main determining factors in the formation and transformation of the river flow of Chirchik. In the proposed interpolation method, a combined system is created, consisting of a landscape-natural component, a system representing a moving mass with a single center. The meteorological parameters of the territory are taken as elements of the mass system, which have their centers of change-movement. The performed test calculations showed that the difference in meteorological parameters affects the position of their centers; each parameter: atmospheric pressure, precipitation, humidity, and temperature, etc., has its center.
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Whiteford, Michael, Martha Stewart, and Sue Bell. "Health Care Practices and Dietary Habits Among Tai Dam Refugee Women in Iowa." Practicing Anthropology 9, no. 4 (September 1, 1987): 5–16. http://dx.doi.org/10.17730/praa.9.4.54m58341250m2200.
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Following the changes of governments in South Vietnam, Laos and Cambodia a decade ago, the state of Iowa, like much of the rest of the United States, became home to a number of Asian refugees. In September, 1975, the Governor's task force for Indochinese resettlement was created; over the next couple of years, thousands of displaced citizens from Southeast Asia settled in this midwestern state. Unlike the west coast of the United States, Iowa has never had a very large Asian population. As anthropologists, we were interested in studying the process of culture change and adjustment facing these new residents. During the summer of 1982, we visited the Iowa Refugee Service Center to explain who we were and what we were interested in doing.
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Kabatska, O. "Students’ entrepreneurial competence formation approaches in the human health background Studying." Scientific Journal of National Pedagogical Dragomanov University. Series 15. Scientific and pedagogical problems of physical culture (physical culture and sports), no. 3(123) (July 28, 2020): 71–74. http://dx.doi.org/10.31392/npu-nc.series15.2020.3(123).14.
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The article presents the students‘ entrepreneurial competence formation approaches of higher education. The importance of students acquiring health-preserving competence in the process of education at V. N. Karazin Kharkiv National University. Educational and professional programs –―Secondary education (Biology and human health)‖ and ―Secondary education (Human health)‖ were analyzed in order to identify the specifics of the formation of health competence.
The value of the foundations of the students‘ entrepreneurial competence formation who master the knowledge, skills and abilities in the basics of health for their implementation in professional activities, taking into account the requirements of Ukraine as a European state.
According to the results of the study of scientific research, it has been revealed that the students‘ entrepreneurial competence formation is paid attention only in the process of education of future specialists in international economic relations, business, etc. It has been established that the study of the basics of entrepreneurial activity of students is aimed at the formation of their competencies for work in positions of managers, employees in government agencies and institutions, and so on.
It was also investigated that the students‘ entrepreneurial competence formation who study the basics of health is possible if they study interdisciplinary disciplines on relevant topics, due to their own choice in this area and even in a distance format. It has been noted that the Center for e-learning of V. N. Karazin Kharkiv National University provides distance education for students and anyone wishing to gain knowledge in various fields. It was also revealed that teachers under the guidance of employees of this center create distance e-courses in the Moodle system, pass the appropriate certification of their intellectual work and manage the student education via the Internet in a comfortable environment for all participants in the educational process.
As a result, it is noted that the preparation of highly qualified specialists, possessing the health and entrepreneurial competencies will ensure the preservation and strengthening the health of the population of Ukraine, promote the best realization of acquired knowledge, skills and abilities of students even in difficult conditions of future professional self-realization.
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Sakamoto, Masahide. "Comprehensive study on system design for revision of asbestos health damage relief system." Impact 2022, no. 4 (August 2, 2022): 6–8. http://dx.doi.org/10.21820/23987073.2022.4.6.
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Once it was found that long-term exposure to asbestos can cause lung and other diseases, its use in buildings was largely stopped and people who experienced health problems caused by its use began to be compensated. Environmental economist Professor Masahide Sakamoto, Faculty of Commerce, Senshu University, Japan, is working to identify the structural problems of this health damage compensation system and ultimately change the system to ensure people receive the compensation they deserve. Sakamoto's study presents a methodology for designing the system in stages to improve the level of benefits and, in the long-term, will reduce the economic, physical and mental burden on the victims and their families. In addition to eliminating disparity in benefits for asbestos victims Sakamoto wants to put forward a new analytical framework for pollution research. Indeed, environmental economics is behind much of Sakamoto's work. He is also studying the cost-sharing principle for different qualities of pollution and global environmental problems, with reference to the cost-burden principle based on social cost theory by K W Kapp. Furthermore, he is conducting research on institutional design to promote the spread of renewable energy as a way to establish a sustainable socioeconomic system and analysing the structural causes of environmental destruction from the perspective of the history of economic theory.
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Kronick, Rachel, G. Eric Jarvis, and Laurence J. Kirmayer. "Refugee mental health and human rights: A challenge for global mental health." Transcultural Psychiatry 58, no. 2 (March 31, 2021): 147–56. http://dx.doi.org/10.1177/13634615211002690.
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This article introduces a thematic issue of Transcultural Psychiatry that presents recent work that deepens our understanding of the refugee experience—from the forces of displacement, through the trajectory of migration, to the challenges of resettlement. Mental health research on refugees and asylum seekers has burgeoned over the past two decades with epidemiological studies, accounts of the lived experience, new conceptual frameworks, and advances in understanding of effective treatment and intervention. However, there are substantial gaps in available research, and important ethical and methodological challenges. These include: the need to adopt decolonizing, participatory methods that amplify refugee voices; the further development of frameworks for studying the broad impacts of forced migration that go beyond posttraumatic stress disorder; and more translational research informed by longitudinal studies of the course of refugee adaptation. Keeping a human rights advocacy perspective front and center will allow researchers to work in collaborative ways with both refugee communities and receiving societies to develop innovative mental health policy and practice to meet the urgent need for a global response to the challenge of forced migration, which is likely to grow dramatically in the coming years as a result of the impacts of climate change.
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Kurnosov, V. B., Yu I. Konovalov, O. I. Okina, and K. R. Galin. "Change of solution composition during it migration through the sedimentary cover in the center of the modern hydrothermal system (Juan de Fuca Ridge, Pacific Ocean, Hole ODP 858B)." Литология и полезные ископаемые, no. 2 (July 6, 2024): 163–79. http://dx.doi.org/10.31857/s0024497x24020021.
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The article presents the results of studying the change of the composition of the hydrothermal solution during its migration through the Pleistocene sediments from the Hole ODP 858B 38.6 m deep, which was drilled in the northern segment of the Middle Valley of the Juan de Fuca Ridge, in the Dead Dog hydrothermal field, in 20 m from the hydrothermal source with temperature 276°C. The influence of sediments of the Units I, IIB, IID from this hole on the change in the composition of the solution during the solution-sediment interaction has been established. The greatest influence on the composition of the solution occurred during its interaction with the sediments of the Units IIB and IID under high-temperature conditions (200–350°C), which is expressed in the enrichment of the solution with a large amount of chemical elements. A possible change in the composition of the solution is shown in the process of solution-sediment interaction during its migration through the entire sedimentary cover with a thickness of 250–300 m.
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Hedgecoe, Adam. "Scandals, Ethics, and Regulatory Change in Biomedical Research." Science, Technology, & Human Values 42, no. 4 (November 7, 2016): 577–99. http://dx.doi.org/10.1177/0162243916677834.
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This paper explores how a particular form of regulation—prior ethical review of research—developed over time in a specific context, testing the claims of standard explanations for such change (which center on the role of exogenous shocks in the form of research scandals) against more recent theoretical approaches to institutional changes, which emphasize the role of gradual change. To makes its case, this paper draws on archival and interview material focusing on the research ethics review system in the UK National Health Service. Key insights center on the minimal role scandals play in shaping changes in this regulatory setting and how these depend upon the absence of a single coherent profession (and accompanying social contract) associated with biomedical research.
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Joshi, Anjali S. "Single-System Design: An Effective Strategy for Evaluating Clinical Change." British Journal of Occupational Therapy 63, no. 6 (June 2000): 283–87. http://dx.doi.org/10.1177/030802260006300607.
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Documentation and research are two essential factors for the growth of any profession and, therefore, have priority in occupational therapy. Documentation is the key to the communication of the clinical services rendered by the occupational therapist to clients and to other members of the professional team (Gillette 1982, Ottenbacher and York 1984). Single-system research, sometimes referred to as single-subject research, is a quantitative research method. In single-system research, the efficacy of a certain intervention can be evaluated in a systematic way by studying one subject in a single setting (Ottenbacher 1984). A therapist can make use of any therapeutic technique to work in a single-system design. Gillette (1982, p499) stated: ‘Each occupational therapy clinic is a virtually untouched laboratory, a storehouse of evidence that, properly recorded, analysed and published, would serve to confirm the value of occupational therapy as a health care service.’ This article describes the application of single-system design in a clinical setting. The client discussed was treated using sensory integrative therapy. The purpose of this article is to show how a selected behaviour can be recorded and measured effectively using a single-system design.
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Duan, Wei, Xuelin Li, Desheng Xu, Hui Ma, Fu Sai, and Xi Lian. "ECONOMIC PSYCHOLOGY ANALYSIS OF RECYCLERS' EMOTIONAL STABILITY IN CLOSED-LOOP SUPPLY CHAIN UNDER UNCERTAINTY." International Journal of Neuropsychopharmacology 25, Supplement_1 (July 1, 2022): A55—A56. http://dx.doi.org/10.1093/ijnp/pyac032.077.
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Abstract Background In today's society, with the sustainable development of economy, material products are rich and diverse. The production speed of products has far exceeded people's needs. Emission reduction and environmental protection have become people's new pursuit. Closed loop supply chain should consider not only product life cycle and recycling, but also economic and environmental benefits. It has become the focus of scholars all over the world. Closed loop supply chain refers to the complete supply chain cycle from procurement to final sales, including product recovery and reverse logistics supported by life cycle. It is a highly complex process. In the closed-loop supply chain, the simplest form is composed of manufacturers, retailers and recyclers. Recycler is the most critical link in the new closed-loop supply chain system, which is not available in the traditional supply chain. Therefore, this paper mainly studies the change of recyclers when exogenous variables fluctuate from the perspective of economic psychology. Research Objects and Methods Most scholars use short-term static methods when studying the uncertainty of recyclers in closed-loop supply chain. It is particularly important to analyze the uncertain factors in the closed-loop supply chain. In order to analyze this problem, this paper first improves the closed-loop supply chain model of capital flow and logistics coupling, so as to better simulate the real closed-loop supply chain. Secondly, the sensitivity analysis function of Vensim software is used to simulate the impact of exogenous variables on the inventory value and capital value of recyclers in the closed-loop supply chain model. At the same time, in order to verify the impact of recyclers' emotional stability, this study adopts the following scale. The communication anxiety scale adopts 15 questions of the Interaction Anxiety Scale (IAS) compiled by Leary, with a single dimension and a 5-level score, from 1 to 5 to “very inconsistent”. The higher the score, the greater the degree of social anxiety. The emotion regulation self-efficacy scale adopts the emotion regulation self-efficacy scale (RES) revised by Caprara. The 12 questions are divided into three dimensions: expressing positive emotions, managing depression / pain and self-efficacy of managing anger / anger, with 4 questions in each dimension. A 5-level score is adopted, from 1 to 5, which means “very inconsistent” to “very consistent”. The higher the score, the higher the degree of self-confidence in regulating their emotions. In the study, Cronbach's α The coefficient is 0.80. The aggression scale adopts the aggression scale (bpaq) compiled by Buss and Perry The scale has 29 questions and is divided into four dimensions: physical aggression, verbal aggression, anger and hostility. The higher the score, the stronger the attack. In this study, Cronbach's α The coefficient is 0.85. The depression questionnaire adopts Beck's revised depression Inventory-II (BDI-II). The questionnaire has 21 questions, with a single dimension. The higher the total score, the heavier the degree of depression. The data were obtained by spss19 0 and amos17 0 for analysis. Results the 19 exogenous variables were divided into four categories: Manufacturer related parameters, retailer related parameters, recycler related parameters and other related parameters. The sensitivity of these 19 parameters to recycler inventory and capital in closed-loop supply chain is simulated and analyzed. Through the comparative analysis of sensitivity chart, it can be seen that the manufacturer's inventory adjustment time, the retailer's safety inventory coefficient, the retailer's smoothing time, the retailer's inventory adjustment time, the collector's fixed expenditure and the collector's initial inventory value are positively correlated. And have a significant impact on collectors' inventory and emotional stability. The reason is that appropriate time adjustment helps to reduce work pressure and naturally improve job satisfaction. Conclusion in the closed-loop supply chain, the fluctuation of the same exogenous variable in the same range has a more significant impact on the recycler's inventory than on the recycler's capital. For recyclers, the decline of inventory value has a positive impact on the capital of recyclers, while the decline of capital value has a negative impact on the capital of recyclers. The impact of retailer order smoothing time on recycler inventory and capital is uncertain. Therefore, recyclers should strengthen fund management, establish insurance mechanism and prepare reserves to prevent the impact of external variable fluctuations on recyclers' funds. At the same time, in view of the uncertainty caused by exogenous variables related to manufacturers and retailers on recyclers' funds and inventory, recyclers need to deal with it through information sharing, compensation mechanism, incentive and other ways. Acknowledgements Supported by a project grant from National Natural Science Foundation of China (Grant No.71764019), the National Social Science Foundation of China (Grant No.19BGL187), the Planning Project of Philosophy and Social Science of Inner Mongolia (Grant No.2021NDB082), Inner Mongolia Natural Science Foundation (Grant No.2021MS07016 and 2020MS07020) and Research Center for Resources, Environment and Energy Development Strategic.
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Golden, Robyn, Diane Mariani, Leslie Pelton, Teresa Moro, and Ellen Carbonell. "FACILITATING CAREGIVER HEALTH AND WELLNESS: AGE-FRIENDLY HEALTH SYSTEM CARING FOR CAREGIVERS (AFHS-C4C)." Innovation in Aging 6, Supplement_1 (November 1, 2022): 138. http://dx.doi.org/10.1093/geroni/igac059.549.
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Abstract Family caregivers of older adults are vital partners in health care. The health care system is uniquely positioned to connect with caregivers and help address their own needs. The Age-Friendly Health System Caring for Caregivers (AFHS-C4C) model focuses on achieving health system change by identifying and incorporating caregivers into standard health care practices while assisting caregivers with their own health and well-being. Created at Rush University Medical Center, this model was tested in six AFHS. At Rush, caregivers (n=322) were mostly female (74%) and African American (38%) or white (37%). Between baseline and follow-up, statistically significant (p<.05) decreases were observed in caregiver burden (BSFC: 18.51 to 13.82), depression (PHQ-9: 8.40 to 4.09), and anxiety (GAD-7: 7.73 to 5.15). Application of this program at additional sites has yielded important lessons learned about engagement, training needs, and sustainability. These lessons will be discussed in the context of scaling and spreading interventions nationally.
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Klatt, Maryanna D., Rani Bawa, Olivia Gabram, Amanda Blake, Beth Steinberg, Alexis Westrick, and Scott Holliday. "Embracing Change: A Mindful Medical Center Meets COVID-19." Global Advances in Health and Medicine 9 (January 2020): 216495612097536. http://dx.doi.org/10.1177/2164956120975369.
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Background Healthcare professional (HCP) burnout transcends clinician job title and role, thus creating a need for interprofessional strategies to address burnout. The organizational framework of offering employer-sponsored mindfulness programming to HCPs sets the stage for an orchestrated, mindful response to COVID-19. Objective This single arm pre-post interventional research tested changes in measures of burnout, resilience, perceived stress and work engagement for interprofessional HCP faculty and students participating in Mindfulness in Motion (MIM), a novel eight-week multimodal evidenced–based onsite intervention. Methods A Graduate Medical Education (GME) pilot of MIM was expanded to target inter-professional resiliency within an academic health center. MIM is the core offering of the Gabbe Health and Wellness program for students, staff, faculty, and residents and is embedded across the entire medical center. Results The faculty/student role demographic categories (n = 267) included resident physicians, resident chaplains, attending physicians, medical center faculty, and hospital administrative/managerial clinical staff. These cohorts demonstrated significant 27% reduction in participants meeting burnout criteria. Total burnout was determined by scores on subscales of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) of the Maslach Burnout Inventory (MBI). There was a highly significant pre/post decrease in the in the emotional exhaustion (p < 0.00001) and depersonalization scores (p < 0.001), with highly significant increase in the personal accomplishment (p < 0.00001) scores. Resilience, as measured by the Connor Davidson Resiliency Scale (CDRS), significantly increased (p < 0.00001), alongside a significant increase (p < 0.00001) in the total Utrecht Work Engagement Score (UWES) and a significant decrease in scores on the Perceived Stress Scale (PSS) (p < 0.00001). Conclusion MIM significantly reduced burnout and perceived stress, for interprofessional (HCP) faculty and staff, while increasing resilience and work engagement in a large healthcare system. These results paved the way for an organizational response that utilized mindfulness to empower HCPs to navigate through the novel challenges presented by COVID-19.
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Ridde, Valéry, Tarik Benmarhnia, Emmanuel Bonnet, Carol Bottger, Patrick Cloos, Christian Dagenais, Manuela De Allegri, Ariadna Nebot, Ludovic Queuille, and Malabika Sarker. "Climate change, migration and health systems resilience: Need for interdisciplinary research." F1000Research 8 (January 7, 2019): 22. http://dx.doi.org/10.12688/f1000research.17559.1.
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Climate change is one of today's major challenges, among the causes of population movements and international migration. Climate migrants impact health systems and how they respond and adapt to their needs and patterns. But to date, the resilience of health systems in the context of climate change has been little explored. The purpose of this article is to show the importance of studying, from an interdisciplinary perspective, the relationships between climate change, migration, and the resilience of health systems. Resilience is an old concept, notably in the field of psychology, and is increasingly applied to the study of health systems. Yet, no research has analysed the resilience of health systems in the context of climate change. While universal health coverage is a major international goal, little research has to date focused on the existing links between climate, migration, health systems and resilience. We propose an interdisciplinary approach relying on the concept of health system resilience to study adaptive and transformative strategies to articulate climate change, migration and health systems.
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Ridde, Valéry, Tarik Benmarhnia, Emmanuel Bonnet, Carol Bottger, Patrick Cloos, Christian Dagenais, Manuela De Allegri, Ariadna Nebot, Ludovic Queuille, and Malabika Sarker. "Climate change, migration and health systems resilience: Need for interdisciplinary research." F1000Research 8 (April 1, 2019): 22. http://dx.doi.org/10.12688/f1000research.17559.2.
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Climate change is one of today's major challenges, and among the causes of population movement and international migration. Climate migrants impact health systems and how their ability to respond and adapt to their needs and patterns. To date, the resilience of health systems in the context of climate change has barely been explored. The purpose of this article is to show the importance of studying the relationship between climate change, migration, and the resilience of health systems from an interdisciplinary perspective. Resilience is an old concept, notably in the field of psychology, and is increasingly applied to the study of health systems. Yet, no research has analysed the resilience of health systems in the context of climate change. While universal health coverage is a major international goal, little research to date focused on the existing links between climate, migration, health systems and resilience. We propose an interdisciplinary approach relying on the concept of health system resilience to study adaptive and transformative strategies to articulate climate change, migration and health systems.
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Sun, Qi-Bin, Sheng-Bang Qian, Li-Ying Zhu, Wen-Ping Liao, Er-Gang Zhao, Fu-Xing Li, Xiang-Dong Shi, and Min-Yu Li. "A New Window for Studying Intermediate Polars and Tilted Accretion Disk Precession." Astrophysical Journal 966, no. 1 (April 26, 2024): 83. http://dx.doi.org/10.3847/1538-4357/ad2fc2.
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Abstract TV Col is a long-period eclipsing intermediate polar (IP) prototype star for the negative superhump (NSH) system. We investigate the eclipse minima, eclipse depth, and NSH amplitude based on TESS photometry. Using the same analytical method as for SDSS J081256.85+191157.8, we find periodic variations of O − C for eclipse minima and NSH amplitudes with periods of 3.939(25) days and 3.907(30) days, respectively. The periodic variation of the NSH amplitude of TV Col confirms that periodic changes in NSH amplitude in response to the tilted disk precession may be universal, which is further evidence that the origin of the NSHs is related to the tilted disk precession. We suggest that the variation in NSH amplitude may be similar to the superorbital signal, coming from the periodic change in visual brightness of the energy released by streams touching the tilted disk with tilted disk precession. Finally, we find for the first time that the eclipse depth exhibits biperiodic variations with periods of P 1 = 3.905(11) days and P 2 = 1.953(4) days, respectively. P 2 is about half of P 1 and the disk precession period (P 1 ≈ P prec ≈ 2 × P 2). We suggest that P 1 may come from the periodic change in the brightness of the eclipse center due to tilted disk precession, while P 2 may come from two accretion curtains precessing together with the tilted disk, but more verification and discussion are necessary. The discovery of biperiodic variations in eclipse depth provides a new window for studying IPs and tilted disk precession.
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Hollander, Eric, Ann Phillips, Bryan H. King, Donald Guthrie, Michael G. Aman, Paul Law, Thomas Owley, and Ricki Robinson. "Impact of Recent Findings on Study Design of Future Autism Clinical Trials." CNS Spectrums 9, no. 1 (January 2004): 49–56. http://dx.doi.org/10.1017/s109285290000835x.
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ABSTRACTThere are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.
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Rotenstein, Lisa, Katherine Perez, Diana Wohler, Samantha Sanders, Dana Im, Alexander Kazberouk, and Russell S. Phillips. "Preparing health professions students to lead change." Leadership in Health Services 32, no. 2 (May 7, 2019): 182–94. http://dx.doi.org/10.1108/lhs-02-2018-0011.
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Purpose Health care systems increasingly demand health professionals who can lead interdisciplinary teams. While physicians recognize the importance of leadership skills, few receive formal instruction in this area. This paper aims to describe how the Student Leadership Committee (SLC) at the Harvard Medical School Center for Primary Care responded to this need by creating a leadership curriculum for health professions students. Design/methodology/approach The SLC designed an applied longitudinal leadership curriculum and taught it to medical, dentistry, nursing, public health and business students during monthly meetings over two academic years. The perceptions of the curriculum were assessed via a retrospective survey and an assessment of team functioning. Findings Most teams met their project goals and students felt that their teams were effective. The participants reported increased confidence that they could create change in healthcare and an enhanced desire to hold leadership positions. The sessions that focused on operational skills were especially valued by the students. Practical implications This case study presents an effective approach to delivering leadership training to health professions students, which can be replicated by other institutions. Social implications Applied leadership training empowers health professions students to improve the health-care system and prepares them to be more effective leaders of the future health-care teams. The potential benefits of improved health-care leadership are numerous, including better patient care and improved job satisfaction among health-care workers. Originality/value Leadership skills are often taught as abstract didactics. In contrast, the approach described here is applied to ongoing projects in an interdisciplinary setting, thereby preparing students for real-world leadership positions.
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Lindholm, Cassie, and Cheryl Modica. "A SYSTEMS APPROACH TO PRACTICE TRANSFORMATION FOR BRAIN HEALTH INTEGRATION INTO COMMUNITY HEALTH CENTER SERVICES." Innovation in Aging 7, Supplement_1 (December 1, 2023): 982. http://dx.doi.org/10.1093/geroni/igad104.3155.
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Abstract Community Health Centers are America’s largest and most successful primary care system, providing access to quality healthcare services to more than 30 million Americans through more than 14,000 service delivery locations regardless of patients’ ability to pay. The National Association of Community Health Centers (NACHC) provides the training and education that health centers need to advance practice transformation and improve care delivery models to succeed in value-based care and meet the needs of patient populations. Through the Value Transformation Framework (VTF), NACHC provides an approach to support health center systems change, organizes and distills evidence-based interventions, provides knowledge, tools and resources, and links performance to the Quintuple Aim – improved health outcomes, patient and staff experience, reduced costs, and equity. NACHC guides health centers in the application of the VTF through a nation-wide learning community, Elevate. Health center participation in Elevate is linked to improved performance on clinical quality measures, improved patient and staff experiences, and reduced costs. Within the Elevate, NACHC successfully implemented a learning track focused on brain health, offering health center-specific guidance on a clinical introduction to Dementia early detection/risk reduction; incorporating Dementia early detection/risk reduction into care management workflows and leveraging reimbursement opportunities; and strengthening community linkages and partnerships to support Dementia early detection/risk reduction. Evaluation data from this learning track indicates health center interest in continuing education related to brain health integration into health center services. This topic is especially relevant considering the increasing population segment of older adult patients that health centers serve.
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Satarkulova, A. "Change of Heart Rate Variability at Foreign Students in the Midlands." Bulletin of Science and Practice 6, no. 4 (April 15, 2020): 118–23. http://dx.doi.org/10.33619/2414-2948/53/14.
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Prenosological assessment of the functional state of students studying in different climatic and geographical conditions is a very important task, since it allows timely detection of conditions that precede pathologies in students and contributes to the preservation of health. Goal. Study of the state of the regulatory mechanisms of the cardiovascular system in foreign students living and studying in the midlands. Materials and methods. The study involved 342 first- and third-year students aged 20.0±1.9 years from India. The survey was carried out in the conditions of the low mountains (760 m above sea level, control group) and the midlands (1650 m above sea level). The main time and spectral parameters of HRV were recorded within 5 minutes using the hardware and software complex Psychophysiologist. Results. The comparative assessment showed that students living in the conditions of the midlands had low values of SDNN, TP, VLF, LF and HF and high indicators of AMo, HR, SI, which indicates the predominance of central regulatory mechanisms and the shift of the vegetative balance towards the sympathetic link in this group. Conclusion. The revealed changes in the spectral and temporal parameters of HRV in midlands students characterize the idea of a regulatory and adaptive state of the body, in which energy and metabolic resources are activated, primarily the circulatory system, aimed at maintaining homeostasis in changing environmental conditions.
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Tseligorov, Nikolay, Anatoly Ozersky, Anatoly Chubykin, Galina Galka, and Alexander Zhukov. "Study of robust stability of indoor temperature control system." E3S Web of Conferences 363 (2022): 03006. http://dx.doi.org/10.1051/e3sconf/202236303006.
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The stages of design and study of the indoor temperature control system have been considered. An assessment of the possibilities of the indoor temperature control of a discrete model of the control system has been carried out. The transfer function of the control object with interval coefficients of the numerator and denominator polynomials taking into account possible ranges of change of the greatest time constant responsible for the enclosing structures has been obtained. The applied graphical method of studying the obtained system has provided an output of the family of root trajectories on a complex plane and visually demonstrated absolute and robust absolute stability of the automatic temperature control system. The simulation carried out in the MATLAB system has confirmed the correctness of the results obtained.
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Mekhovych, A. "CONCEPTUAL SYSTEM OF MODERN HEALTH AND MEDICAL TOURISM." Energy saving. Power engineering. Energy audit., no. 5-6(159-160) (December 28, 2021): 30–36. http://dx.doi.org/10.20998/2313-8890.2021.05.04.
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The relevance of the statistic is amazed by the economic problems of the galusies themselves, due to the coronavirus infection COVID 19, which put on the order of the day the need for a glance at the traditional forms of organizing high prices and for tourism before tourism. It is stated in the statute that there is no fate at the link with the pandemic of travel to mass mandates, which has changed by an order of magnitude, but the task of not only developing new tourist routes, but preserving the health of tourists has become urgent. In connection with the cim, the market of health tourism has become aware of global changes, and the traditional sanatorium-and-spa mortgages and resorts are ceasing to be a miracle of health and wellness in the minds of the kidnapped health tourism center. Such a transformation of resort centers is zoomed in by the changing character of drinking and health services and the challenge of the need for a healthy way of life. More and more people will try to avoid adopting a physical form and may be required by anti-stress programs that have suffered from a disease caused by a pandemic. It is important that people of the middle age, as they make an active change, and are often surrounded by an hour.
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EDWARDS, GRIFFITH, EDNA OPPENHEIMER, and COLIN TAYLOR. "Hearing the noise in the system. Exploration of textual analysis as a method for studying change in drinking behaviour." Addiction 87, no. 1 (January 1992): 73–81. http://dx.doi.org/10.1111/j.1360-0443.1992.tb01902.x.
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McMullen, Heather, Victoria Boydell, Joanna Paula Cordero, Petrus S. Steyn, James Kiarie, Patrick Kinemo, Alice Monyo, Mary Awelana Addah, Jacob Tetteh Ahuno, and Osei-Bonsu Gyamfi. "Accounting for complexity – Intervention design in the context of studying social accountability for reproductive health." Gates Open Research 5 (May 23, 2022): 107. http://dx.doi.org/10.12688/gatesopenres.13260.2.
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Background: Social accountability interventions aim to propel change by raising community voices and holding duty bearers accountable for delivering on rights and entitlements. Evidence on the role of such interventions for improving community health outcomes is steadily emerging, including for sexual and reproductive health and rights (SRHR). However, these interventions are complex social processes with numerous actors, multiple components, and a highly influential local context. Unsurprisingly, determining the mechanisms of change and what outcomes may be transferable to other similar settings can be a challenge. We report our methodological considerations to account for complexity in a social accountability intervention exploring contraceptive uptake and use in Ghana and Tanzania. Main Body: The Community and Provider driven Social Accountability Intervention (CaPSAI) study explores the relationship between a health facility-focused social accountability intervention and contraceptive service provision in two countries. This 24-month mixed-method quasi-experimental study, using an interrupted time series with a parallel control group, is being undertaken in 16 sites across Ghana and Tanzania in collaboration with local research and implementation partners. The primary outcomes include changes in contraceptive uptake and use. We also measure outcomes related to current social accountability theories of change and undertake a process evaluation. We present three design components: aspects of co-design, ‘conceptual’ fidelity, and how we aim to track the intervention as ‘intended vs. implemented’ to explore how the intervention could be responsive to the embedded routines, local contextual realities, and the processual nature of the social accountability intervention. Conclusions: Through a discussion of these design components and their rationale, we conclude by suggesting approaches to intervention design that may go some way in responding to recent challenges in accounting for social accountability interventions, bearing relevance for evaluating health system interventions.
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McMullen, Heather, Victoria Boydell, Joanna Paula Cordero, Petrus S. Steyn, James Kiarie, Patrick Kinemo, Alice Monyo, Mary Awelana Addah, Jacob Tetteh Ahuno, and Osei-Bonsu Gyamfi. "Accounting for complexity – Intervention design in the context of studying social accountability for reproductive health." Gates Open Research 5 (July 22, 2021): 107. http://dx.doi.org/10.12688/gatesopenres.13260.1.
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Background: Social accountability interventions aim to propel change by raising community voices and holding duty bearers accountable for delivering on rights and entitlements. Evidence on the role of such interventions for improving community health outcomes is steadily emerging, including for sexual and reproductive health and rights (SRHR). However, these interventions are complex social processes with numerous actors, multiple components, and a highly influential local context. Unsurprisingly, determining the mechanisms of change and what outcomes may be transferable to other similar settings can be a challenge. We report our methodological considerations to account for complexity in a social accountability intervention exploring contraceptive uptake and use in Ghana and Tanzania. Main Body: The Community and Provider driven Social Accountability Intervention (CaPSAI) study explores the relationship between a health facility-focused social accountability intervention and contraceptive service provision in two countries. This 24-month mixed-method quasi-experimental study, using an interrupted time series with a parallel control group, is being undertaken in 16 sites across Ghana and Tanzania in collaboration with local research and implementation partners. The primary outcomes include changes in contraceptive uptake and use. We also measure outcomes related to current social accountability theories of change and undertake a process evaluation. We present three design features: co-design, ‘conceptual’ fidelity, and how we aim to track the intervention as ‘intended vs. implemented’ to explore how the intervention could be responsive to the embedded routines, local contextual realities, and the processual nature of the social accountability intervention. Conclusions: Through a discussion of these design features and their rationale, we conclude by suggesting approaches to intervention design that may go some way in responding to recent challenges in accounting for social accountability interventions, bearing relevance for evaluating health system interventions.