Active Measures Research Articles

Real-World-Evidence of Digital Health Applications (DiGAs) in Rheumatology: Insights from the DiGAReal Registry.

Prescribable digital health applications (DiGAs) present scalable solutions to improve patient self-management in rheumatology, however real-world evidence is scarce. Therefore, we aimed to assess the effectiveness, usage, and usability of DiGAs prescribed by rheumatologists, as well as patient satisfaction. The DiGAReal registry includes adult patients with rheumatic conditions who received a DiGA prescription. Data at baseline (T0) and the 3-month follow-up (T1) were collected through electronic questionnaires. Study outcomes included DiGA-specific outcome assessments as well as generic outcome assessments, including the Patient Global Impression of Change (PGIC), Patient Activation Measure (PAM®), and the German Telehealth Usability and Utility Short Questionnaire (TUUSQ). Changes between T0 and T1 were analyzed using descriptive statistics and paired tests. A total of 191 patients were included between June 2022 and April 2023. Of these, 127 completed the 3-month follow-up, and 114 reported using the prescribed DiGA, with 66% reporting weekly use and 15% completing the full DiGA program. The most commonly prescribed DiGAs targeted pain management (53%). Symptom improvement was reported by 51% of patients using a DiGA, with significant reductions in exhaustion levels (p = 0.03). Significant DiGA-specific improvements were observed for DiGAs addressing back pain (p = 0.05) and insomnia (p = 0.006). However, no overall significant changes were detected in patient activation, health literacy, pain, overall health, or disease activity. Back pain and weight management DiGAs were the most effective, frequently used, and best-rated DiGAs, with symptom improvements reported by 50% to 82% of patients. The findings suggest that DiGAs can improve symptom management in rheumatic patients, especially for conditions like back pain and weight control. Further real-world evidence is needed and may support value-based digital health efforts and reimbursement frameworks.

Feelings of guilt among cancer patients and the usage of complementary or alternative medicine - A cross-sectional survey.

This study aimed to investigate the influence of feelings of guilt among cancer patients on their health behavior, with a specific focus on the use of complementary and alternative medicine (CAM). A multicentric cross-sectional study was conducted, involving 162 oncological patients, assessing sociodemographic variables, feelings of guilt, patient activation, self-efficacy, and CAM usage. The Shame-Guilt-Scale was employed to measure guilt, with subscales including punitive guilt, self-criticism (actions), moral perfectionism, and empathy-reparation. To assess patient activation and self-efficacy, we used the German Version of the Patient Activation Measure 13 and the Short Scale for Measuring General Safe-efficacy Beliefs, respectively. To evaluate CAM-usage, we used a standardized instrument from the working group Prevention and Integrative Oncology of the German Cancer Society. Statistical analyses, including regression models, were employed to examine potential associations. Female gender was associated with more frequent CAM usage. Regarding holistic and mind-body-methods, younger patients more often used these methods. No significant association was found between feelings of guilt and CAM usage. Patients experienced guilt most strongly related to empathy and reparation for their own actions. Our results do not support the hypothesis of a direct link between guilt and CAM usage. Guilt may be an important aspect in psychological support for cancer patients, yet, with respect to counselling on CAM, it does not play an important part to understand patients' motivations.

Emergence of West Nile virus infection in Kerala, South India: A case of concern.

West Nile virus (WNV) infection is emerging as a disease of public health concern in Kerala, India with recurring outbreaks since 2011. With its tropical climate, biodiversity hot spots of Western ghats, forest cover, plenty of water bodies and bird sanctuaries, Kerala provides an ideal ecological niche for vector breeding and transmission of WNV. In this article, we reflect on the peculiar features of the outbreaks of WNV fever in Kerala and highlight the knowledge gaps, the research priorities and the need for effective control measures. Information on transmission patterns of WNV, its circulating lineages and identification of vectors is needed to adopt appropriate control strategies in the state. In addition to the active measures on the part of the health system to ensure vector control and to curtail transmission pathways of the disease, inclusion of the community in preventing WNV infection through awareness campaigns and other participatory control measures should be initiated in the pre-monsoon months.

Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study

BackgroundHigh blood pressure is a prevalent condition in patients with chronic kidney disease on hemodialysis. Adequate control of high blood pressure is essential to reducing deaths in this group. The present study aimed to observe mortality prospectively in a group of patients in hemodialysis and hemodiafiltration programs in whom the use of antihypertensives was optimized with the point-of-care dry weight (POC-DW) technique.MethodsThe present observational, prospective study was carried out at the Pafram hemodiafiltration unit in Morona Santiago, Ecuador, and the hemodialysis unit of the Fundación Renal del Ecuador in Guayaquil, Ecuador, from August 2019 to December 2023. Patients who were receiving hemodiafiltration were included. Weight was optimized with POC-DW for eight weeks. In Group 1, patients whose use of antihypertensive drugs was not required to control systolic blood pressure with a value less than 150 mmHg predialysis, less than 130 mmHg postdialysis, and a peridialytic blood pressure (defined as post-HD minus pre-HD SBP) between 0 and − 20 mmHg were analyzed. In Group 2, patients who required antihypertensive drugs for not meeting the aims of systolic blood pressure were included. The variables included clinical, demographic, mortality, description of the treatment, and routine laboratory tests in dialysis programs. The sample was nonprobabilistic. Survival analysis was performed for the study groups. The log-rank test (Mantel-Cox) was used for survival comparisons.ResultsThe study included 106 patients. Optimal blood pressure control without antihypertensive treatment was achieved in 52 patients (49.1%) (Group 1). In 54 patients (50.9%), antihypertensive agents were required (Group 2). There was more significant mortality in the group that received antihypertensives: 11 patients in group 1 (21.2%) versus 25 patients in group 2 (46.3%) (P = 0.005). Survival was more significant in group 1, with an HR of 2.2163 (1.125–4.158) (P = 0.0243).ConclusionIn hemodiafiltration and hemodialysis programs, blood pressure control with active ultrafiltration measures and without using antihypertensives is essential for survival in patients with CKD.

Hemiparasitic plants facilitate ecological restoration of encroached European grasslands.

Species-rich grasslands of temperate Europe are threatened by the spread and increasing dominance of the rhizomatous grass Calamagrostis epigejos. Native hemiparasitic Rhinanthus species have been proposed as biocontrol to suppress C. epigejos, but experimental evidence is limited. We conducted a series of experiments at 21 grassland sites in Central Europe encroached by C. epigejos to test the effects of Rhinanthus on C. epigejos and on plant and arthropod communities and compare them to the effects of mowing applied once or twice a year. Rhinanthus suppressed Calamagrostis epigejos significantly more than mowing. Mowing frequency and Rhinanthus sowing had synergistic effects, leading to an average 75% reduction of C. epigejos biomass in Rhinanthus plots that were mown twice during the three-to four-year experimental period. The effect was more pronounced at sites in dry climates. Both Rhinanthus and mowing significantly increased plant diversity. Rhinanthus plots mown twice changed most rapidly towards the target grassland vegetation. The abundance and species richness of arachnids and Auchenorrhyncha were generally higher in abandoned plots than in plots with active management. Rhinanthus plots harboured fewer grass-feeding insects but more forb-associated herbivorous Auchenorrhyncha and Heteroptera species and several heliophilous spiders. Our experiment showed that Rhinanthus spp., in combination with mowing, is an efficient and widely applicable method to reverse the encroachment of C. epigejos into grasslands and restore the diversity of infested plant communities. Active management measures also trigger a species turnover of arthropod communities, reflecting changes in grassland vegetation and arthropod guild species pools.

Changes in muscle performance among older adults with myeloid malignancies engaging in a mobile health (mHealth) exercise intervention: a single arm pilot study

BackgroundOlder adults with cancer are vulnerable to declines in muscle performance (e.g., strength, speed, duration of muscular contraction), which are associated with worse cancer-related outcomes. Exercise-based interventions can mitigate these declines, but evidence of their effect among older adults with myeloid malignancies receiving outpatient treatment is limited. We explore change in muscle performance among patients in a single arm pilot study of a mobile health (mHealth) exercise intervention.MethodsPatients ≥ 60 years old with myeloid malignancies receiving outpatient chemotherapy completed a home-based resistance band and walking exercise program [EXercise for Cancer Patients (EXCAP)©®] delivered via a mobile application with symptom monitoring [(Geriatric Oncology-EXCAP (GO-EXCAP)] lasting 2 cycles of chemotherapy (approximately 8–12 weeks). Clinical exercise physiologists provided instruction and ongoing support. Upper and lower extremity peak torque (maximum force, newton-meters, Nm), total work (force over entire movement, Nm), and average power (speed of force, watts, W) were assessed using the BIODEX System 4 isokinetic dynamometer. Muscle activation (motor recruitment, millivolts, mV) was captured using the BTS FREEEMG 1000. We report descriptive statistics and within-patient differences from baseline to post-intervention using Wilcoxon signed rank tests (α = 0.10) and effect size (ES, Cohen’s d, 0.20 ≤ small < 0.50, large ≥ 0.80), and explore differences by exercise level (resistance exercise, daily steps).ResultsA total of 25 patients completed baseline assessments, 23 with muscle performance data at baseline, 16 at post-intervention. Of these, most were male (n = 10, 62.5%) and had acute myeloid leukemia (n = 9, 56.3%). From baseline to post-intervention there were improvements in left shoulder peak torque [mean change = 2.45 (Standard Deviation = 2.41), p = 0.004] and average power [2.29 (3.05), p = 0.033]. Muscle activation increased for left rectus femoris [0.04 (0.04), p = 0.074], right and left biceps brachii [0.03 (0.04), p = 0.012; 0.03 (0.05), p = 0.098, respectively], and left pectoralis major [0.02 (0.03), p = 0.064]. Several measures of peak torque/total work and all measures of muscle activation showed ES ≥ 0.20 for improvement. There were no statistically significant decreases from baseline to post-intervention.ConclusionsOlder adults with myeloid malignancies participating in a mHealth exercise intervention had stable to improved muscle performance. Further research is needed to establish the preliminary efficacy of this intervention for improving physical performance in this population at high risk for decline.Trial registrationclinicaltrials.gov NCT04035499 (registered July 29th, 2019).

Supporting the Individualized Use of Digital Tools in Community Mental Health: The Technology Specialist Pilot Study.

This pilot study evaluated the feasibility of the technology specialist intervention, which assists clients in achieving mental health recovery and well-being goals via existing digital tools in a real-world community mental health setting. Thirteen adult clients with serious mental illness and their providers completed baseline, 3-, and 6-month assessments, including goal setting, self-efficacy, activation, and acceptability measures, along with weekly ecological momentary assessments. Clients selected goals and corresponding tools, used the tools steadily, and showed improvement in activation and self-efficacy. Most participating clients (82%, n = 9) and providers (80%, n = 8) found the intervention acceptable. These preliminary findings show that the technology specialist intervention is promising and warrants further testing.

Continuous Glucose Monitors and Programmed Shared Medical Appointments in Managing Type 2 Diabetes Mellitus Among First Nation Women in Australia: A Co-Designed Feasibility Study.

First Nations women in Australia diagnosed with type 2 diabetes, co-designed and attended a programmed shared medical appointment that included continuous glucose monitors and culturally responsive food appreciation activities over 8 weekly sessions to improve glycaemic control. The project was a single site, longitudinal change from baseline, mixed methods, feasibility study using HbA1c as the primary outcome measure. Secondary outcome measures included, weight, metabolic health-related blood panels, CGM, Blood Glucose Levels (BGL) time-in-range percentage, Patient Activation Measure (PAM) and Problem Areas In Diabetes (PAID) tools and client satisfaction survey and semi focussed interviews. Forty participants commenced and twenty-five participants completed the program (62,5%). Of the completing participants the mean HbA1c had an absolute reduction of 0.7 percentage points ( from baseline to program completion, P = .013). Eighteen (75%) reduced HbA1c and maintained some reduction for 12 months. Seven (28%) achieved remission, HbA1c <6.4% (46mmol/l) maintained for 12 months. There were statistically significant improvements in weight, systolic blood pressure, liver enzymes, BGL time-in-range, PAM and PAID scores. It is feasible to use programmed shared medical appointments incorporating CGM aiming to improve glycaemic control and other metabolic measures of health among First Nations women in Australia. Trial Registration: The project was registered with the Australian and New Zealand Clinical Trial Registry ACTRN12622000650796. The trial web page = https://www.anzctr.org.au/ACTRN12622000650796.aspx.

A web-based decision support system to support occupational therapy services in promoting active ageing

Background: Dealing with the consequences of Thailand’s ageing population is a significant challenge. The growing usage of Information and Communication Technology (ICT) has the potential to support healthy and active ageing. Objective: This study aimed to develop a web-based Decision Support System (DSS) and evaluate its usability. Materials and methods: Research and Development (R&amp;D) was a study design. It was divided into two phases: the development of the web-based DSS and its usability. Results: The web-based DSS was designed under the requirements of the users and comprised seven components: 1) the login page; 2) the main page; 3) the register page; 4) active ageing measurement; 5) decision-making for older people; 6) the Occupational Therapy (OT) recommendations system; and 7) exporting information. A System Usability Score (SUS) of 80.41 in the usability test showed that the web-based DSS was very user-friendly and had excellent efficacy, efficiency, and satisfaction. Conclusion: The web-based DSS effectively enhanced ageing for older people.

Patient activation and support needs in patients after ICU discharge: A UK survey of critical illness survivors.

Understanding the degree to which patients are actively involved, confident and capable of engaging with self-management and rehabilitation could be an initial step in guiding individualised supportive strategies for people after critical illness. To assess the levels of active involvement with self management among ICU survivors using the Patient Activation Measure (PAM), explore associations between patient characteristics and PAM results, and investigate its relationship with patients' support needs at key transition points during the recovery process. Eligible participants received both the PAM and Support Needs After Critical care (SNAC) questionnaires by post. The return of the completed questionnaires was considered as consent to participate. Ethical approval was obtained (17/NI/0236). Descriptive statistics were used to summarise the data and Pearson's coefficient for correlations between variables. There were 200 completed PAM and SNAC questionnaires. PAM scores showed that levels of active involvement with self management fell into level 1 (n = 64; disengaged and overwhelmed, low confidence to self manage) and 2 (n = 70; still struggling), with considerably less participants achieving scores in level 3 (n = 51; taking action) and 4 (n = 15; pushing further). Lower patient activation levels were associated with higher support needs (r = -0.16, p = 0.02). We found that patient activation levels are low implying low knowledge, skills and confidence to self-manage after critical illness, and also that patients have support needs at various timepoints during recovery. Future research should focus on a longitudinal study to track changes in activation and support needs in the same patients over time and identify effective strategies to optimise recovery after critical illness.

Exploring Patient Activation and Compliance in Patients with Different Rheumatological Disorders.

Purpose: This study aimed to assess patient activation using patient activation measure 13 (PAM-13) in systemic lupus erythematosus (SLE), psoriatic arthritis (PsA), and axial spondyloarthritis (axSPA). Patients and methods: A cross-sectional study was conducted involving patients with three rheumatological conditions (SLE, PsA, and axSPA). Patients were contacted either at the clinic or through social media platforms. Data, including demographics, PAM 13, Arabic compliance questionnaire for rheumatology (ACQR), and disease-related activity scores, were collected electronically. The analyses included Chi-squared tests, linear regression, and binary logistic regression. Results: Overall, 418 patients were recruited (SLE = 323, PsA = 65, and axSPA = 30), with a mean (±SD) age of 42 ± 11 years and a female predominance (88%). PAM-13 scores did not significantly differ between the rheumatological disorders. Patients with axSPA showed significantly higher compliance than those with SLE or PsA (p = 0.012). In regression models, patients with PsA were more likely to be in activation level 1, with an OR of 2.890 (95% CI: 1.044-8.000, p = 0.0041), whereas patients with axSPA were more likely to be in activation level 4, with an OR of 2.460 (95% CI: 1.122-5.393, p = 0.025). The SLEDAI score was inversely related to the PAM-13 score (Pearson's correlation coefficient = -0.221, p < 0.001). Conclusions: This study explored the levels of activation and medication compliance in different rheumatological conditions. Larger studies are needed to confirm these findings and explore the challenges and opportunities for improving compliance and activation.

Cognitive Hegemony: The True Objective of Russia’s New Active Measures

The traditional tactics of Soviet destabilization have evolved under Putin’s leadership, taking on new and more insidious forms. Russia’s ongoing commitment to the Soviet-era strategy of "active measures"—now employed in subtler ways—remains central to its foreign policy objectives. A destabilized West is less likely to focus on Moscow’s political and geopolitical transgressions, or on its military actions that openly challenge the liberal international order. This article examines the covert aspects of Russia’s political warfare aimed at undermining Western stability. The Kremlin’s priority of fracturing solidarity within the European Union and weakening transatlantic relations—especially in light of the unified economic sanctions imposed on Russia by the U.S. and EU over its aggressive war against sovereign Ukraine—compels Russian security agencies to adapt their "active measures" to new global realities. We explore key tactics and strategies employed by Russia in its covert confrontation with major Western institutions, such as the EU and NATO. Ultimately, we aim to deconstruct how the Soviet concept of "active measures" and the notion of "political warfare" have become nearly synonymous, fitting within the broader and evolving framework of "hybrid warfare."

Emotional pictures in the brain and their interaction with the task: A fine-grained fMRI coordinate-based meta-analysis study.

The impacting research on emotions of the last decades was carried out with different methods. The most popular was based on the use of a validated sample of slides, the International Affective Pictures System (IAPS), divided mainly into pleasant, neutral and unpleasant categories, and on fMRI as a measure of brain activation induced by these stimuli. With the present coordinate-based meta-analysis (CBMA) based on ALE approach, we aimed to unmask the main brain networks involved in the contrast of pleasant vs. neutral and unpleasant vs. neutral IAPS slide categories. Furthermore, we included studies employing both IAPS and non-IAPS (but analogously validated) pictures, a condition termed as IAPS EXTENDED. After selecting 97 papers published in the 2000-2023 interval, the planned contrasts were analyzed by also considering their interaction with the Load factor of the concomitant task, which comprised the conditions: No Load (passive viewing), Low-Load tasks and High-Load tasks. We analyzed a total of 152 experiments (106 focusing on the negative vs. neutral contrast; 46 reporting positive vs. neutral contrasts). We additionally performed conjunction and contrast analyses. Results confirmed outcomes of past meta-analyses on the involvement of a number of cortical and subcortical paralimbic and limbic regions during unpleasant picture processing, but the increase of the pubblications on this topic in last years, together with a more fine-grained analysis, allowed us to find also the involvement of additional areas, such as the right middle frontal gyrus, left inferior frontal gyrus (BA 9), posterior cingulate, and left inferior parietal lobule. Concerning passive viewing and low-load tasks, a clear frontal asymmetry emerged with greater right prefrontal activation (BA9) to unpleasant vs. pleasant pictures, whereas, during No Load tasks only, left frontal dominance to pleasant vs. unpleasant stimuli was found (BA13). The unpleasant vs. neutral comparison on High-Load tasks (the pleasant condition had an insufficient sample size) revealed a specific lateralization of several areas of the right hemisphere (STG-BA 38, MFG-BA 46, FG-BA 37), whereas, in the other load conditions, the inferior frontal gyrus was right lateralized, but the main activated regions were bilateral or left lateralized. Results are discussed considering the effects of both valence and task/load variables, and the involvement of hippocampus/amygdala, hemispheric asymmetries of emotions, the occipito-temporal areas, several sub-regions of the prefrontal/orbitofrontal cortex, and an extended motor network.

Association of Healthy Eating Index-2015 Total and Component Scores with Measures of Inflammation and Immune Activation in Healthy Adults.

The Healthy Eating Index (HEI)-2015 measures diet quality and is associated with a lower risk of death from chronic disease. Dietary components may affect health via multiple mechanisms, including decreasing inflammation and affecting immune activation. We hypothesized that the overall HEI-2015 score, or individual component scores, would be associated with altered inflammation and immune activation in healthy adults. The association of HEI-2015 scores with 88 inflammation and immune activation markers was examined in 346 adults without diagnosed disease using general linear models to adjust for covariates, including visceral fat mass index (VFMI). The overall HEI-2015 score was inversely associated with plasma C-reactive protein (CRP) and leukocyte concentrations, which are markers of inflammation, but these associations lost statistical significance with adjustment for VFMI. However, even with VFMI adjustment, the total vegetable score was inversely associated with total lymphocyte concentration (β = -0.157 ± 0.052, P = 0.019) and with monocyte and neutrophil activation (e.g., classic monocyte CD11b β = -0.153 ± 0.055, P = 0.030; neutrophil CD11b β = -0.122 ± 0.051, P = 0.049). The refined grain score was inversely associated with percent NK-T cells (β =-0.171 ± 0.058, P = 0.037), IL-10 production by T cells (β = -0.204 ± 0.057, P = 0.0039), and positively associated with plasma soluble CD14 (β = 0.220 ± 0.059, P = 0.0041). The total dairy score was positively associated with production of multiple cytokines by lipopolysaccharide-stimulated peripheral blood mononuclear cells [e.g., interleukin (IL)-1β β = 0.182 ± 0.054, P = 0.0066]. Adjustment for VFMI decreased the association of HEI-2015 with inflammation, consistent with the known role of adiposity in mediating effects of poor diet on inflammation. This study also identified component scores associated with various aspects of immune activation that bear further study to clarify possible health benefits. This trial was registered at clinicaltrials.gov as NCT02367287.

Higher patient activation is associated with lower odds of functional limitation in older adults with chronic diseases

ObjectivesTo investigate the association between patient activation and functional limitation among older adults living with multiple chronic conditions. MethodsWe performed a secondary analysis of a parent study, which examined the relationship between self-efficacy and both inflammatory biomarkers and frailty. We conducted multivariate logistic regression while controlling for the patients’ sociodemographic variables and comorbidities to examine the association between self-reported functional limitation and patient activation as measured by the Patient Activation Measure (PAM-10). ResultsWe included 159 participants with a mean age of 82.00 ± 6.27 years. While controlling for the patients’ demographic, socioeconomic status, and comorbidities, we found that functional limitation decreases by 16 % (OR 0.84, 95 % CI: 0.75, 0.94, p = 0.002) for every one unit increase in patient activation score. ConclusionHigher patient activation scores were associated with decreased odds of functional limitation. Providers may consider the potential value of using behavioral activation strategies to address functional decline.

자원봉사 활동 참여가 노인의 자아통합감과 생활만족도에 미치는 영향

Objectives This study is meaningful in providing data for activating volunteer activities in the future by analyzing the relationship between self-integration and life satisfaction according to volunteer activities of the elderly and deriving the results that participation in volunteer activities has a positive effect on self-integration and life satisfaction. Methods To this end, 130 elderly people (73 women and 57 men) aged 60 or older living in area k were surveyed. SPSS 25.0 was used for analysis of the collected data, and frequency analysis, t-test, and one-way ANOVA were performed for analysis. Results The main results shown in the analysis were that first, the motivation to participate in volunteer activities was helpful, so the type of volunteer work was the most vulnerable group, the frequency of participation was 1-2 times a month, the participation time per session was 1-3 hours, and the total duration of activity was 1-5 years. Second, the sense of self-integration was higher in higher education, religion, spouse, and health. Third, life satisfaction was higher for women than men, higher education, religion, spouse, and health. Conclusions Participation in volunteer activities in old age has been shown to have a positive effect on the elderly's self-integration and life satisfaction, so active and diverse volunteer support measures should be taken at the government level for successful retirement.

A new performance based measure of activities of daily living: Pilot study of the Night Out Task Czech version

A new performance based measure of activities of daily living: Pilot study of the Night Out Task Czech version

Post-Treatment Cancer Survivors' Experience of Social Reintegration: A Systematic Review and Meta-Synthesis.

Synthesize qualitative research to explore post-treatment cancer survivors' social reintegration experience. We conducted a meta-synthesis that included studies on all types of cancer. There were no restrictions on article age or location of the studies, provided they met the inclusion criteria. A search of the Cochrane Library, PubMed/MEDLINE, Web of Science, Embase (Ovid), and CINAHL (EBSCO) was conducted for studies published in English in February 2024. The PRISMA guidelines were followed. The Joanna Briggs Institute Reviewer's Manual was used to assess the quality of studies. Meta-aggregation was performed to synthesize the findings of the included studies. A total of 1031 articles were identified in the initial search. Sixteen articles met the inclusion criteria and were included in this review. The total number of cancer survivors included in this systematic review was 395. Five synthesized findings were identified: the impact of cancer and treatments on survivors' physical, psychological, and social interactions was the cause of social withdrawal; cancer survivors encountered internal and external obstacles in the process of social reintegration; cancer survivors took action to promote social reintegration; support from others encouraged cancer survivors' social reintegration, but they also had unmet needs; social reintegration promoted cancer survivors to view cancer positively and achieve self-transcendence. This study synthesized qualitative evidence related to social reintegration among post-treatment cancer survivors. Cancer survivors took active measures for social reintegration. In turn, social reintegration also had a positive consequence on cancer survivors. Survivors had internal and external obstacles and needs in the process of social reintegration. Therefore, practitioners should identify obstacles and needs for social reintegration and develop targeted intervention programs to facilitate the social reintegration of survivors.

Employment of persons with disabilities: opportunities, priorities and outcomes of active policies in welfare states. Part one

This two-part article examines the active employment policies of welfare states and their impact on the situation of persons with disabilities of working age. On the basis of research materials and data from population surveys in the EU and OECD countries, the article analyzes the trends of active employment policies for persons with moderate and severe disabilities in welfare states of different models for the period from 2010 to 2020. The first part of the article reveals the approaches of active policy to retention on the labor market, to provision of employment assistance services, to reduction of unemployment risks, to employment of persons with disabilities. The principles of transformation of allowances for disability, temporary disability, unemployment, income maintenance and application of personal measures – incentives and sanctions, which are based on increasing the responsibility of citizens for their own well-being, are considered. The role of the factor of de-regulation of the employment sphere in the approaches of active policy to the expansion of labor supply and maintenance of demand on the part of employers is shown. The priorities of active measures to promote employment, based on cost reduction and increasing returns on investment, and their impact on the employment of citizens with different degrees of impairment are revealed. The results of active policies (employment gap and unemployment rate) and their sustainability in relation to persons with moderate and severe impairments are revealed.

Radiation Shielding and Activation Analyses for Neutron Activation Measurement Facility at Advanced Radiation Technology Institute, Jeongup

Radiation Shielding and Activation Analyses for Neutron Activation Measurement Facility at Advanced Radiation Technology Institute, Jeongup