Optimizing the pediatric patient centered care medical home through a trauma informed care lens

The need for mental health services in primary care settings to address trauma remains a pressing issue for pediatrics. The existing literature supports the compatibility of Trauma-Informed Care Principles in Patient-Centered settings to address trauma, yet despite professional guidelines highlighting these models, a specific example within a primary care setting remains unrealized. This paper will conceptualize a Trauma Informed Medical Home model with Integrated Behavioral Health utilizing some aligning concepts such as safety, accessibility and collaboration found within the Trauma Informed Care and a Medical Home guideline. The resulting conceptualized model will represent a strengthened primary care setting where the delivery of mental health services using a trauma-informed lens can optimize patient-centered primary care medical home services.

The effectiveness of self-care management in treating heart failure: A scoping review

Introduction: Heart failure is a common chronic disease associated with increased mortality and rehospitalization rates. Selfcare management provided in various ways is one approach to avoiding the need for rehospitalization by lowering recurrence rates. Therefore, this study aims to determine the most effective self-care management interventions for heart failure patients. Design and Methods: The databases Science Direct, Google Scholar, and PubMed were used to conduct literature reviews over ten years. In September 2021, a full-text article search was conducted using the keywords "Self-Care," "Self-Management," "Intervention," "Heart Failure Patients," and "Randomized Control Trial" in PubMed ScienceDirect and Google Scholar databases. The inclusion and exclusion criteria were determined using the PICOS technique. After the screening, 39 articles met the criteria. Results: Self-care management is provided through education programs, training programs, and the utilization of apps and websites to improve its self-care abilities. Conclusions: Therefore, one way to provide self-care management during the COVID-19 pandemic was through the program's website, which is viewed "remotely" and used to track patient progress.

Difficulties in the Implementation of International Academic Mobility Programs: Student's Stance. Russian-German Experience in Solving Problems in the Context of the COVID-19 Pandemic

Introduction. Academic mobility of students is an integral part of quality higher education in Russia. A frequent problem is a difficult adaption to a foreign country. The article looks into to the problem of offsetting negative consequences of cultural adaptation of Russian students in German universities during short-term stay. The aim of the article is to work out recommendations on preliminary preparation of short-term international academic mobility programs between Russian and foreign partner universities, taking into account cultural adaptation of students. Materials and Methods. The research draws on surveys of students participating in the 6-month (1 semester) international Russian-German academic mobility program. As a survey technique, a group continuous correspondence survey was employed. The questionnaire was compiled following the conditions of relevance and representativeness using empirical indicators and descriptive statistics. The method of statistical factor analysis served a tool to identify the main factors influencing the quality of adaptation;for a comparative analysis of the results of the survey, statistical methods of comparing averages and statistical visualization were used. Results. The article analyzes the results of surveys of students of the German-Russian Institute of Advanced Technologies about the main points of education in Germany that cause them difficulties. A comparative analysis of learning in the context of the COVID-19 pandemic (hybrid, almost completely remote learning) with the period before the pandemic (full face-to-face learning) was made. Conclusions are drawn about the prevailing factors that influenced the success of learning in both cases. Examples of practical recommendations are formulated as to the necessary preparation of Russian university students for studying at European universities in the years following the pandemic, taking into account the results of surveys of teachers from the host German university, as well as the observations of an expert from the Kazan National Research Technical University over the teaching process at the Technical University of Kaiserslautern. Based on the results of the analysis of factors most affecting the success of Russian students in a foreign university, we propose measures aimed at accelerating and mitigating the adaptation of Russian-speaking students to a long stay in a foreign environment. In the aftermath of the COVID-19 pandemic, the hybrid form of education looks most effective, as it increases the success of Russian students studying abroad. Discussion and Conclusion. The proposed approach to the assessment of influencing factors and the developed methods for their elimination will help prevent similar problems in the future. The conclusions made by the authors contribute to the practice of short-stay international academic mobility organization. The article materials are of interest to the scientific and pedagogical community, faculty and management of educational institutions. © 2023 National Research Ogarev Mordovia State University. All rights reserved.

Overview of the seized and examined pharmaceutical in the state of Minas Gerais-Brazil by the Civil Police from 2017 to 2022: A fundamental analysis of the recent impact over the drugs market.

This work presents a data survey regarding the qualitative chemical analysis of drugs seized by the Police in the state of Minas Gerais between July 2017 and June 2022, including an evaluation of labeling of 265 samples of anabolic androgenic steroids (AAS) seized in 2020. The Active Pharmaceutical Ingredients (API) present in the samples were identified through chemical analysis and classified by system Anatomical Therapeutic Chemical (ATC) methods. Analysis of the labeling information for 265 samples of AAS followed the guidance of legislation RDC 71 (2009) from ANVISA. For this study 6355 seized pharmaceuticals underwent qualitative chemical analysis that corresponded to 7739 APIs successfully identified and classified. Among the components studied AAS, psychostimulants, anesthetics, and analgesics were the most commonly examined. AAS seized and tested increased by over 100% and for the majority of the samples analyzed were found to not match the labeling on the packaging. In the meantime, anti-obesity drugs presented a prominent increase of 400% from 2020/1 to 2021/2, during covid-19 quarantine. Seized pharmaceuticals and tests can support information in the planning of public health and safety policies.

Performance Review of Ensemble Learning Method Use in COVID-19 Case Detection

COVID-19 cases attract most computer science researchers. There are two popular learning approaches: Machine Learning (ML) and Deep Learning (DL). The approach was applied as a computer-based COVID-19 diagnosis. Most researchers prefer ensemble learning used to assist the process. The technique has various features and performance results. Based on the survey, there are several efforts to improve performance better. This review describes a brief of the ensemble approach. The ensemble applies to image classification. The application employs X-Ray and Computerized Tomography (CT) images. The technique should consider various ensemble strategies. As supportive evidence, a brief description of each method is presented in the table. This study shows all ensemble methods demonstrate to improve prediction results. The stacking ensemble becomes a method that achieves the highest performance. © 2022 IEEE.

Understanding the Power of Evolutionary Computation for GPU Code Optimization

Achieving high performance for GPU codes requires developers to have significant knowledge in parallel programming and GPU architectures, and in-depth understanding of the application. This combination makes it challenging to find performance optimizations for GPU-based applications, especially in scientific computing. This paper shows that significant speedups can be achieved on two quite different scientific workloads using the tool, GEVO, to improve performance over human-optimized GPU code. GEVO uses evolutionary computation to find code edits that improve the runtime of a multiple sequence alignment kernel and a SARS-CoV-2 simulation by 28.9% and 29% respectively. Further, when GEVO begins with an early, unoptimized version of the sequence alignment program, it finds an impressive 30 times speedup-a performance improvement similar to that of the hand-tuned version. This work presents an in-depth analysis of the discovered optimizations, revealing that the primary sources of improvement vary across applications;that most of the optimizations generalize across GPU architectures;and that several of the most important optimizations involve significant code interdependencies. The results showcase the potential of automated program optimization tools to help reduce the optimization burden for scientific computing developers and enhance performance portability for domain-specific accelerators. © 2022 IEEE.

A systematic review of resilience in the maritime transport

Maritime transport is the backbone of international trade and the global economy. Resilience is essential for business continuity and handling unforeseen disruptions such as the COVID-19 pandemic. Studies on resilience in maritime transport (i.e. maritime resilience in the study) have become popular due to disruptive events. To date, no research has exclusively reviewed resilience in maritime transport. This study conducts a systematic review of maritime resilience based on 110 papers in the Scopus database and Google Scholar from 2010 to July 2022. The analysis covers various topics, including the most published authors, the most cited articles, co-word analysis, research techniques, etc. The primary significance of this study is to assess the state of existing knowledge on maritime resilience and to unearth future research directions, which might help academics and practitioners decide what future studies to pursue. To our knowledge, this is the first systematic review study on marine resilience.

Impact of Confinement on the Reduction of Pollution and Particulate Matter Concentrations. Reflections for Public Transport Policies

Different initiatives have been implemented to improve air quality in large cities, such as encouraging travel by sustainable modes of transport, promoting electro-mobility, or the car-free day. However, to date, we have not found statistics that indicate to what extent the concentration levels of particulate matter PM2.5, PM10 and nitrogen oxides (NOx) pollutants decrease as a result of public policy. We used official data from the Chilean Government's national air quality information system (SINCA) for the Santiago metropolitan region and estimated the impact of the confinement by COVID-19 on the ambient concentration average values of NOx gases and particulate matter PM2.5 and PM10, which are the main air pollutants produced by the transport sector after CO2. We found that in general there are significant differences between the average levels of gas emissions for 2020 compared to 2019. In particular, we found that, for the months of total confinement May-July, the monthly average levels decreased between 7% and 19% for particulate matter PM2.5, between 18% and 50% for PM10 and between 34% and 48% for NOx. With the return to the new normality, these improvements in ambient concentration levels may be affected by the increase in private transport trips, due to the reluctance of citizens to return to mass public transport. Our results, therefore, represent the maximum impact that can be expected in reducing ambient concentration levels in the city of Santiago of Chile when a mobility reduction of gasoline vehicles is implemented. Article Highlights The reduction of PM2.5, PM10 and NOx was no more than 7%, 18% and 34%, respectively. The average concentration of PM2.5 decreased by 7-19% compared to previous years. The average concentration of PM10 decreased by 18% and 50% compared to previous years. Concentrating commuting on public transport would help reduce levels of PM(10 )and PM2.5.

Preparing for the next pandemic: adopt, adapt or improve?

This article offers the risky proposition of forecasting the future. The often paraphrased quote of Peter Drucker, famous European management guru, applies here. He was fond of pointing out how predicting the future can be likened to driving backwards down a dark and isolated country road at night with no lights, while looking out the back window via the rear view mirror. Instead, his wisdom suggested inventing the very future we want. We had best start now. Despite COVID-19 persisting in many countries, this article shares tactics from several strategic approaches to preparing for the next pandemic: accept the current practices (adopt), modify to suit new conditions (adapt), or find a different and better way (improve). The author favours improve.

Changing trends in remote teaching among instructors in higher education in the shadow of the coronavirus crisis

Purpose The purpose of the study is to examine whether the remote teaching experience of instructors in higher education during the COVID-19 pandemic has improved after one year. Design/methodology/approach The study involved 75 instructors teaching at an institution of higher education in Israel, who answered twice (once in 2020 and again in 2021) a quantitative questionnaire that examined their remote teaching experience. Findings The hypotheses about greater use of digital tools and about more positive attitudes of instructors toward remote teaching and learning at the second measurement than at the first one were confirmed. This hypothesis about lower levels of technical difficulties in remote teaching at the second measurement was not confirmed, but the level of reported difficulty was already low at the first measurement. Practical implications It is recommended that academic institutions continue the trend of deploying innovation in teaching with confidence in the ability of instructors to adapt to change. At the same time, instructors should be provided with mental and technical support. Originality/value Few studies have examined the change in attitudes of instructors toward remote teaching over time. In the present study, we used a repeated measures design, which made it possible to monitor the instructors' adaptation to remote teaching. Adaptation to the new teaching method can contribute to innovation in teaching in academic institutions and to improvement in its quality.

Meeting the challenge of gender inequality through gender transformative research: lessons from research in Africa, Asia, and Latin America

While the global development agenda has prioritized gender equality, many challenges remain, and the COVID-19 crisis has exacerbated inequalities. Gender transformative approaches to social change have the potential to address the underlying causes of inequality. This paper draws insights from studies funded by Canada's International Development Research Centre to understand how integrating gender transformative approaches to research can support social change. The findings suggest that gender transformative research is most successful in supporting change when it analyzes and addresses the multiple causes of inequality, takes an intersectional and structural approach, embeds the research in local contexts, and engages power holders and perpetrators of inequality.

Video Encryption Technique Based on Hybrid Chaotic Maps and Multi-Operation keys

During these critical times of the pandemic, a reliable and fast encryption technique for encrypting medical data for patients is a critical topic to consider. This epidemic forced governments and health care organizations to observe patients of COVID-19. The idea of encryption video is gaining in popularity, because of the growing use of communication technology like video conferencing to conclude corporate meetings and presentations. Video data sent back and forth between sender and recipient must also use the unsecured communication medium available, the internet. This paper proposed a way to encrypt video by using hybrid schemes, which used the advantage of both henon, elliptic curve, and logistic. The proposed method achieved significantly improved results. Simulations results are performed to gauge the efficacy of the presented method. © 2022 NSP.

How selected title I Essa designated priority & focus districts and schools utilized and applied the tenets of culturally responsive-sustaining education (CR-S) framework to improve learning outcomes for marginalized students

Given the historical trend in segregation across New York State that is profoundly and systematically rooted within the fabric of the state's education system, it is no surprise the education system had been viewed as having two separate systems, for example, Title I versus non-Title I. For non-Title I districts/schools, the average graduation outcome was 84% in SY 2017-18 compared to 69% for the study's selected Title I priority and focus districts/schools. In fact, the New York State Board of Regents had cited and charged its own education system as having a history of structural and institutional racism. What has become more evident is that most students attending low-performing Title I priority and focus districts/schools are non-whites.This qualitative grounded theory study investigated how educational administrators in the Northeast Region of the United States, in selected Title I priority and focus districts and schools utilize culturally responsive pedagogical practices to improve learning outcomes for marginalized students. Participants in the study consisted of eleven educational administrators comprising Superintendents, Assistant Superintendents, Principals, and Assistant Principals across NYSED identified districts/schools participating in the pilot integration grant.The researcher used semi-structured interviews conducted virtually on the secure Zoom platform to capture participants' perceptions, beliefs, decisions, and processes as described for addressing "within" and "between" segregation within their educational settings. The researcher considered and used grounded theory as the method of choice to "inductively build" a theory grounded from the perspectives of participants through their "space and world" (Lin, 2003;Merriam, 1998).The result of the study revealed that: 1) Educational administrators apply the CR-S framework to modify and assess curriculum development and instruction to improve the learning outcomes for Title I students. 2) Educational administrators utilize tenets of the CR-S framework to engage in progress monitoring and shared accountability to create learning outcomes for marginalized students. 3) Educational administrators engage in professional development using the CR-S framework to empower and promote adult and student-centered actions to build a path toward a culturally responsive learning environment. This study provides implications to district and school-level administrators, including researchers and policymakers, regarding the implementation of the CR-S framework to reinforce academic and social/emotional practices.Additionally, it provides possible suggestions for a post-COVID-19 pandemic environment where marginalized students could thrive. As a policy recommendation, school districts should embed the Culturally Responsive-Sustaining Education (CR-S) Framework as an evaluative metric within the New York State Education Department's (NYSED) annual performance and accountability report beginning in 2023-2024. Further research, utilizing a longitudinal study of K-12 could help to determine the impact of CR-S framework on specific academic learning outcomes in literacy and numeracy skills across three grade bands, K-5 (elementary school), 6-8 (middle school), and 9-12 (high school). (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Current management of children with COVID-19 in hospitals in India;Pilot study and findings

Introduction: To date, the focus on COVID-19 among children, especially in low- and middle-income countries, has been to address key issues including poor vaccination rates. However, the focus is changing with new variants and concerns regarding the development of hyperinflammatory syndromes. There have also been concerns with the overuse of antibiotics to treat patients with COVID-19, with the Indian Government developing guidelines, including those for children, to improve patient care. Consequently, a need to document the current management of children with COVID-19 in India and use the findings for future guidance. Materials and Methods: Pilot study assessing the management of children with COVID-19 among five hospitals in India using purposely developed case report forms, which had been piloted in Bangladesh. Results: Low numbers of children in hospital with COVID-19 (11.9% of in-patient beds). The majority were boys (58.3%) and between 11 and 18 years (55.5%). Reasons for admission were in line with previous studies and included respiratory distress/breathing difficulties. 69.4% of children with COVID-19 were prescribed antibiotics empirically, typically those on the Watch list, and administered parenterally, with only limited switching to oral therapy. A minority were prescribed antimalarials, antivirals and anti-parasitic medicines. There was appreciable prescribing of immune boosters and steroids. Conclusion: It was encouraging to see low hospitalisation rates. However, concerns with high empiric use of antibiotics and limited switching to oral formulations need to be addressed potentially, by instigating antimicrobial stewardship programmes. Similarly, other antimicrobials where these are not recommended.

Effect of Game-based Learning using Live Streaming on Learners' Interest, Immersion, Satisfaction, and Instructors' Perception

Many people have preconceived notions about games and distrust the effects of game-based learning and show negative attitudes. In fact, there are limitations and disadvantages of game-based learning, and it is difficult to overcome them. More than half of the inconveniences or problems of teachers who want to try game-based learning revealed by the 2009 survey have not been solved yet. Due to the sudden spread of COVID-19, the Ministry of Education has issued a policy to convert classes at schools and academies into non-face-to-face. Non-face-to-face classes have the characteristics that instructors and learners will be spatially separated, spatially simultaneous, interactive, and teaching and learning behavior will be mediated by the screen. And these features are common to live streaming. Taking advantage of this, this study aims to approach improving the perception of game-based learning as an advantage of "watching games" beyond "playing games" by using live streaming for game-based learning. This study conducted game-based learning and game streaming learning for 210 third-year middle school students, compared the effects of game-based learning on learning interest, immersion, and satisfaction with the results of previous studies to verify the design and prove the combined effect of live streaming and game-based learning. In addition, in-depth interviews with instructors who conducted game-based learning confirmed that awareness of the introduction, value, and finance of game-based learning improved.

Valuing Diversity and Inclusion in Health Care to Equip the Workforce: Survey Study and Pathway Analysis.

BACKGROUND: The COVID-19 pandemic, with all its virus variants, remains a serious situation. Health systems across the United States are trying their best to respond. On average, the health care workforce is relatively homogenous, even though it cares for a highly diverse array of patients. This perennial problem in the US health care workforce has only been accentuated during the COVID-19 pandemic. Medical workers should reflect on the variety of patients they care for and strive to understand their mindsets within the larger contexts of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities. Along with talent and skills, diversity and inclusion (D&I) are essential for maintaining a workforce that can treat the myriad needs and populations that health systems serve. Developing hiring strategies that will help achieve greater workforce diversity remains a challenge for health system leaders. OBJECTIVE: The primary aims of this study were to: (1) explore the characteristics of US health systems and their associations with D&I practices and benefits, (2) examine the associations between D&I practices and three pathways to equip workforces, and (3) examine the associations between the three pathways to better equip workforces and business and service benefits. The three pathways are: (1) improving D&I among existing employees (IMPROVE), (2) using multiple channels to find and recruit the workforce (RECRUIT), and (3) collaborating with universities to find new talent and establish plans to train students (COLLABORATE). METHODS: During February to March 2021, 625 health systems in the United States were surveyed with the help of a consultant, 135 (21.6%) of whom responded. We assessed workforce talent- and diversity-relevant factors. We collected secondary data from the Agency for Healthcare Research and Quality Compendium of the US Health Systems, leading to a matched data set of 124 health systems for analysis. We first explored differences in diversity practices and benefits across the health systems. We then examined the relationships among diversity practices, pathways, and benefits. RESULTS: Health system characteristics such as size, location, ownership, teaching, and revenue have varying associations with diversity practices and outcomes. D&I and talent strategies exhibited different associations with the three workforce pathways. Regarding the mediating effects, the IMPROVE pathway seems to be more effective than the RECRUIT and COLLABORATE pathways, enabling the diversity strategy to prompt business or service benefits. Moreover, these pathway effects go hand-in-hand with a talent strategy, indicating that both talent and diversity strategies need to be aligned to achieve the best results for a health system. CONCLUSIONS: Diversity and talent plans can be aligned to realize multiple desired benefits for health systems. However, a one-size-fits-all approach is not a viable strategy for improving D&I. Health systems need to follow a multipronged approach based on their characteristics. To get D&I right, proactive plans and genuine efforts are essential.

"Sounds like a Cheesy Radio Ad": Using User Perspectives for Enhancing Digital COVID Vaccine Communication Strategies for Public Health Agencies

The World Health Organization (WHO) and other public health agencies have identified vaccine hesitancy as a critical challenge in reducing future cases and deaths from COVID-19. The current study has investigated ways to improve a widely circulated vaccine infographic video by Centers for Disease Control and Prevention. After gathering qualitative feedback on properties of the message that could be improved (from online crowdworkers), we conducted a randomized experiment to investigate different combinations of these attributes. Our results suggest participants were more likely to share the video which was: (1) played more slowly;(2) had a female speaker;(3) did not have background music. The study demonstrates potential of user studies for improving existing communication strategies for encouraging vaccinations and alleviating vaccine hesitancy on social media platforms. Our contribution also includes a repository of messages to encourage vaccination, generated by online crowdworkers, which could be utilized by future studies. © 2022 ACM.

Determining the Student-Teacher Perspective of Home Schooling as “New Normal” Education Trend in Jordan

Homeschooling has acquired global attention due to the Covid-19 pandemic lockdown, and its success will require the regulators' attention and the focus of new researchers. Thus, the current paper examines the effect of students' willingness to embrace a new educational system and teachers' capacity to adopt a new educational system on the success of the Jordanian homeschooling system. Additionally, this study explores the mediating function of improved learning ability in the relationship between students' desire to accept a new education system, instructors' ability to adopt a new education system, and the success of Jordan's homeschooling system. Primary data were collected by surveys and analysed using smart-PLS. The findings revealed a favourable correlation between students' desire to embrace a new education system and teachers' capacity to adopt a new education system and the success of the homeschooling system. Additionally, the data revealed that enhanced learning capacity plays a key role in mediating the relationship between students' desire to accept a new education system, teachers' ability to adopt a new education system, and the effectiveness of Jordan's homeschooling system. © 2021 Ani Publishing Ltd. All rights reserved.

Face Recognition Method of Mask Occlusion

Under the influence of the COVID-19, people can effectively prevent New Coronavirus infection by wearing masks in public places. However, the mask obscuration causes some face recognition systems to fail to recognize properly. Therefore, in this paper, we propose Multi-Residual Attention Network(MRANet) based on deep convolutional neural network for recognizing faces obscured by masks and improve a loss function. In our model, an attention mechanism and multiple residual layers skip connections are introduced, which allow the model to focus more on the unobscured facial information and contribute to increase the efficiency of information flow and gradient flow between each network layers. A dynamic addictive angular margin loss function, a more reasonable decision boundary function, is also proposed to improve the model’s discriminative power and convergence speed. Our algorithm can effectively identify and verify not only normal unobstructed faces, but also faces obscured by masks. We achieved a accuracy rate of 96.7% on the widely used Labeled Faces in the Wild dataset (LFW), a accuracy rate of 84.837% on the Real-world Masked Face Recognition Dataset (RMFRD), and the false accepted rate in the simulated face recognition system is as low as 0.944%. © 2021 IEEE.