Practice Characteristics Research Articles

The Practice Characteristics of Authorized Heritage Discourse in Tourism: Thematic and Spatial

Under the influence of tourism and globalization, heritage production presents a new landscape. As a crucial framework for interpreting heritage, Authorized Heritage Discourse (AHD) has profound significance in discussing its practice characteristics in this context. Taking cities along the Jiangsu–Zhejiang section of the Grand Canal as a case study and drawing upon policy text, this study explores the practice characteristics of AHD in the tourism context. Results indicate that the thematic practices of AHD encompass protection and management, ecological construction, cultural production and inheritance, touristification, infrastructure and services, and marketing and cooperation, forming a clustering pattern with touristification as the central theme. The spatial characteristics manifest as multi-scale practices ranging from global to regional to local, each corresponding to diverse thematic characteristics. This study deepens the understanding of AHD in tourism and advances the research progress of heritage tourism. It also provides practical references for the utilization of urban heritage and the management of heritage tourism.

Gender based disparities in Medicare physician reimbursement persist across years and specialty.

The gender pay gap is wide in medicine but the extent of this disparity across specialties and over time have not been elucidated. Here we evaluate differences in Medicare reimbursement between men and women physicians over time and by specialty, controlling for physician and practice characteristics. The Centers for Medicare & Medicaid Services Payment Data was used to determine total reimbursements and number of services submitted by physicians practicing in the US between 2013 and 2019. Data from the American Community Survey (ACS) were used to determine average income, unemployment rates, poverty rates, income, and educational attainment levels by zip code for each physician's practice location. Among the 3,831,504 physicians included in this analysis from 2013-2019, 2,712,545 (70.8%) were men and 1,118,859 (29.2%) were women. Overall, men received more in Medicare reimbursements ($58,815 ± $104,772 vs. $32,205 ± $60,556, p<0.001) and billed more services (864 ± 1,780 vs. 505 ± 1,007, p<0.001) compared to women. The median Medicare reimbursement for men decreased from 2013 to 2019 from $59,710 to $57,874, while the median Medicare reimbursement for women increased from $30,575 to $33,456. Men were reimbursed more than women across all specialties with the greatest disparity in procedure-heavy specialties. The specialties with the highest difference in median Medicare reimbursement between men and women were ophthalmology ($99,452), dermatology ($84,844), cardiology ($64,112), nephrology ($62,352), and pulmonary medicine ($47,399). In linear regression models controlling for calendar year, years of experience, total number of services, and ACS zip-code-level variables, men received a higher amount of Medicare reimbursement in all specialties, as compared to women (p<0.01 for all). The percentage of top earning men (range: 65.0%-99.5%) surpassed the proportion of men in each specialty (range: 46.1%-94.6%), except public health and preventive medicine. Women physicians continue to receive lower total Medicare reimbursements than men physicians, particularly in procedure-heavy specialties. Lower clinical volume and fewer procedural services among women physicians partially contribute to the disparities in reimbursement.

Characteristics of classroom composition and teaching practices and the social integration of students with and without special educational needs in inclusive education environments

ZusammenfassungAktuelle Studien weisen darauf hin, dass Schüler*innen mit sonderpädagogischem Förderbedarf, die an allgemeinen Schulen unterrichtet werden, weniger sozial eingebunden sind als diejenigen ohne sonderpädagogischen Förderbedarf. Theoretisch wird dieser Befund unter anderem auf soziale Vergleichsprozesse und Kontaktmöglichkeiten der Schüler*innen sowie auf den Einfluss der Lehrkräfte durch ihren persönlichen Umgang mit den Schüler*innen zurückgeführt. Eine Schlüsselfunktion wird hierbei dem Unterricht zugesprochen: Dieser kann als soziale Situation betrachtet werden, in der sich die Zusammensetzung und konkrete Unterrichtsgestaltung auch auf die Entstehung sozialer Kontakte und damit die soziale Integration der Schüler*innen auswirken. Mit Daten des IQB-Bildungstrends 2016 (N = 9417) wurde untersucht, ob verschiedene Merkmale der Klassenzusammensetzung und der Unterrichtsgestaltung mit der sozialen Integration der Schüler*innen zusammenhängen und inwiefern sich diese für Schüler*innen mit (n = 899) und ohne (n = 8488) sonderpädagogischen Förderbedarf der Schwerpunkte Lernen, Sprache und emotionale-soziale Entwicklung unterscheiden. Unter Verwendung von Mehrebenenstrukturgleichungsmodellen konnte gezeigt werden, dass sowohl die Klassenführung als auch die konstruktive Unterstützung positiv mit der sozialen Integration von Viertklässler*innen zusammenhängen und sich dies für die konstruktive Unterstützung zwischen Schüler*innen mit und ohne sonderpädagogischen Förderbedarf unterscheidet. Die Studie liefert Hinweise darauf, inwieweit Lehrkräfte durch die Gestaltung ihres Unterrichts neben Lernprozessen auch das soziale Miteinander unterstützen.

How Healthcare Providers Decide on a Referral Location in Telephone Triage: A Cross-sectional Study.

Approximately 25% of patients that present to the emergency department (ED) do so after contact with a healthcare professional. Many of these patients could be effectively managed in non-ED ambulatory settings. Aligning patients with safe and appropriate outpatient care has the potential to improve ED overcrowding, patient experience, outcomes, and costs. Little is understood about how healthcare providers approach triage decision-making and what factors influence their choices. To evaluate how providers think about patient triage, and what factors influence their decision-making when triaging patient calls. Cross-sectional survey-based study in which participants make triage decisions for hypothetical clinical scenarios. Healthcare providers in the specialties of internal medicine, family medicine, or emergency medicine within a large integrated healthcare system in the Southeast. Differences in individual training and practice characteristics were used to compare observed differences in triage outcomes. Free-response data were evaluated to identify themes and factors affecting triage decisions. Out of 72 total participants, substantial variability in triage decision-making was observed among all patient cases. Attending physicians triaged 1.4 fewer cases to ED care compared with resident physicians (p < 0.001, 95% CI 0.62-2.1). Academic attendings demonstrated a trend toward fewer cases to ED care compared with community attendings (0.61, p = 0.188, 95% CI - 0.31-1.5). Qualitative data highlighted the complex considerations in provider triage and led to the development of a novel conceptual model to describe the cognitive triage process and the main influencing factors. Triage decision-making for healthcare providers is influenced by many factors related to clinical resources, care coordination, patient factors, and clinician factors. The complex considerations involved yield variability in triage decisions that is largely unexplained by descriptive physician factors.

The Artistic Characteristics of Modern Calligraphy After 1985: An Exploration Based on Grounded Theory

The current researches on modern calligraphy are mostly summaries of materials and contingency studies, lacking empirical studies. At the same time, the artistic characteristics of modern calligraphy require further clarification. Based on an analysis of the existing literature, this paper investigates the artistic characteristics of modern calligraphy practice through a qualitative research method, grounded theory, sorting out the constitutive dimensions of the artistic characteristics of modern calligraphy and establishing a theoretical model of the artistic characteristics of modern calligraphy. This study finds that the practice of modern calligraphy possesses six characteristics: diverse, cultural, social, expressive, design, and spiritual. The cross-media and multichannel artistic expression of modern calligraphy combine sociality and design, and the creative expression of modern calligraphy gives new connotations to the text, demonstrating the strong spiritual aspirations of contemporary people.

Prospects for Sustainable Corporate Governance in Russia Based on Integrated Communications

The article presents the author’s understanding of the terms “corporate governance”, “corporate management” and “communication management” in the context of the concept of sustainable development, the ESG agenda and sustainable corporate governance, as well as their relationship. The role of the stakeholder approach in bringing together the content of the concepts of “corporate governance” and “integrated communications” is shown. Some features of communications management in Russia, including in the context of ESG, are examined in detail. The relevance of the study is due to the fact that many Russian companies and organizations are extremely slow to implement the principles and methods of integrated communications and sustainable corporate governance, although they determine the effectiveness of theiractivities. The subject of the study is the system of sustainable corporate governance as part of the implementation of ESG principles in Russia. The purpose of the article is to show Russian stakeholders the role of integrated communications in the development of sustainable corporate governance and ESG policies using research methods such as analysis of scientific papers on the research topic, comparison, generalization, systemic and logical analysis. The scientific novelty of the publication is justified by the author’s interpretation of the variants of understanding the terms, for example, the authors of the article consider the organizational and/or functional division of communications into internal and external to be unproductive. In addition, in order to modernize the methodology for rating and auditing companies and organizations for compliance of their activities with ESG principles, the authors propose to increase the number of management criteria of block “G”, using metrics for assessing the effectiveness of integrated communications management, taken from the “corporate management” and “communications” systems management». The practical significance of the work lies in the possibility of its use in the development of integrated communications systems within the framework of sustainable corporate governance, as well as in the course of modernizing the methodology for rating and auditing ESG policies in Russian companies and organizations. A further direction of research may be related to the development of criteria and indicators of the quality of integrated communications systems and sustainable corporate governance, as well as consideration of the characteristics of Russian communications practices in the business environment.

Bridging the Gap in Genomic Implementation: Identifying User Needs for Precision Nephrology

Genomic medicine holds transformative potential for personalized nephrology care; however, its clinical integration poses challenges. Automated clinical decision support (CDS) systems in the electronic health record (EHR) offer a promising solution but have shown limited impact. This study aims to glean practical insights into nephrologists' challenges using genomic resources, informing precision nephrology decision support tools. We conducted an anonymous electronic survey among US nephrologists from January 19, 2021 to May 19, 2021, guided by the Consolidated Framework for Implementation Research. It assessed practice characteristics, genomic resource utilization, attitudes, perceived knowledge, self-efficacy, and factors influencing genetic testing decisions. Survey links were primarily shared with National Kidney Foundation members. We analyzed 319 surveys, with most respondents specializing in adult nephrology. Although respondents generally acknowledged the clinical use of genomic resources, varying levels of perceived knowledge and self-efficacy were evident regarding precision nephrology workflows. Barriers to genetic testing included cost/insurance coverage and limited genomics experience. The study illuminates specific hurdles nephrologists face using genomic resources. The findings are a valuable contribution to genomic implementation research, highlighting the significance of developing tailored interventions to support clinicians in using genomic resources effectively. These findings can guide the future development of CDS systems in the EHR. Addressing unmet informational and workflow support needs can enhance the integration of genomics into clinical practice, advancing personalized nephrology care and improving kidney disease outcomes. Further research should focus on interventions promoting seamless precision nephrology care integration.

Characteristics of Wise Leadership Practices in an Educational Setting: A Content Analysis

Leadership practices encompass a range of behaviours, actions, and attitudes that leaders utilise to effectively steer and guide their teams towards a shared objective. Nevertheless, there is a scarcity of research that clearly delineates the attributes of smart leadership, despite its significance in educational contexts. This study aims to investigate the diverse characteristics of wise leadership practice in an educational setting. This study employs a content analysis technique to scrutinise the current literature and identify the fundamental themes and strategies that have successfully fostered wise leadership in educational settings. The completed content analysis yielded seven (7) distinct characteristics of wise leadership practices in an educational setting, specifically: (a) lifelong learners for self-reflection; (b) emotional and cultural competence; (c) ability to manage emotional conflicts; (d) self-discipline and self-control; (e) innovative and encouraging creativity; (f) supportive and collaborative in relationships; and (g) effective interpersonal communication skills. In conclusion, this study has provided useful insights into effective leadership strategies in educational environments by conducting a thorough analysis of numerous studies. Future studies should prioritise the thorough investigation of sensible leadership techniques in education.

Team climate, job satsfaction and burnout: results from a national survey of staff in general practice in England.

Measures are needed to address recruitment and retention problems in general practice. A good team climate (relational processes of team working) can mitigate the effects of pressured work environments, but little is known about it in British general practice. To assess team climate, explore practice characteristics and workforce combinations associated with favourable team climates, and analyse associations between practice team climate and job satisfaction, intention to remain in post, burnout and measures of practice performance. An online questionnaire distributed to practices (for all their staff) via Clinical Research Networks, mid 2022, comprising validated measures: 14 item Team Climate Inventory (TCI) and single items on job satisfaction and emotional exhaustion/burnout; a question on intention to remain in post; participant role, age group, gender. Anonymous completion; submission through the Oxford RCGP RSC. Responses received from 4.8% of national staff headcount, n = 9835, (21.6% GP, 22.9% nurse/direct patient care, 55.5% non-clinical). Mean TCI score, 3.73 (scale 1-5 best); 78.3% were satisfied in their jobs; 26.1% reported high burnout. GPs perceived significantly better team climate, and reported lower job satisfaction, higher burnout (especially male GPs) and lower intention to quit than other groups. After adjusting for practice and workforce characteristics, team climate was better in smaller practices and associated with more job satisfaction, less burnout, increased intention to remain and improved patient-reported experiences; climate was unrelated to QOF performance. Team climate could be used to improve morale and patient experience. Micro teams might be beneficial in larger practices.

Characteristics of youth's health keeping practices under the digitalization

The article discusses the problems of health keeping of modern Russian youth under the digitalization. Paying attention to the negative dynamics in the health of young Russians, the authors point out to form and promote a culture of health keeping among the younger generation. However, in order for the implemented measures to be effective, the authors propose to differentiate them taking into account the specifics of the perception of health and practices of caring for it among young people, which is associated with their distinction into two age groups within the framework of generational theory: zoomers and millennials. In this regard, the article presents the results of an empirical study conducted by the authors on the health conservation of Russian youth, which are depicted the characteristics of consumption and practices in the field of health among these age groups. As it states, both categories are quite conscious of their health status. The most common ways to stay healthy are proper nutrition, sleep patterns, and regular exercise. However, certain differences have been identified in the basic practices of caring for it as compared to the traditional model of a healthy lifestyle. Thus, self-tracking based on mobile applications, as well as digital consumption of health information in new media, is popular among zoomers. Millennials appear to be more committed to the primary source of health information, the medical community, which is also reflected in the need for regular health checkups. Based on the findings, a number of practical recommendations are proposed.

Equity in the Setting of Heart Failure Diagnosis: An Analysis of Differences Between and Within Clinician Practices.

Timely heart failure (HF) diagnosis can lead to earlier intervention and reduced morbidity. Among historically marginalized patients, new-onset HF diagnosis is more likely to occur in acute care settings (emergency department or inpatient hospitalization) than outpatient settings. Whether inequity within outpatient clinician practices affects diagnosis settings is unknown. We determined the setting of incident HF diagnosis among Medicare fee-for-service beneficiaries between 2013 and 2017. We identified sociodemographic and medical characteristics associated with HF diagnosis in the acute care setting. Within each outpatient clinician practice, we compared acute care diagnosis rates across sociodemographic characteristics: female versus male sex, non-Hispanic White versus other racial and ethnic groups, and dual Medicare-Medicaid eligible (a surrogate for low income) versus nondual-eligible patients. Based on within-practice differences in acute diagnosis rates, we stratified clinician practices by equity (high, intermediate, and low) and compared clinician practice characteristics. Among 315 439 Medicare patients with incident HF, 173 121 (54.9%) were first diagnosed in acute care settings. Higher adjusted acute care diagnosis rates were associated with female sex (6.4% [95% CI, 6.1%-6.8%]), American Indian (3.6% [95% CI, 1.1%-6.1%]) race, and dual eligibility (4.1% [95% CI, 3.7%-4.5%]). These differences persisted within clinician practices. With clinician practice adjustment, dual-eligible patients had a 4.9% (95% CI, 4.5%-5.4%) greater acute care diagnosis rate than nondual-eligible patients. Clinician practices with greater equity across dual eligibility also had greater equity across sex and race and ethnicity and were more likely to be composed of predominantly primary care clinicians. Differences in HF diagnosis rates in the acute care setting between and within clinician practices highlight an opportunity to improve equity in diagnosing historically marginalized patients.

MIDWIFERY CARE FOR W O M E N PLANNING VAGINAL BIRTH AFTER CAESAREAN: A SURVEY OF O N TA R I O MIDWIFERY PRACTICES

Due to new evidence, the safety of vaginal birth after Caesarean (VBAC) si again generating controversy ni maternity care. Asurvey of midwifery practices was undertaken ot determine midwifery practice patterns and the factors that influence their care of women with aprior Caesarean birth. Atwo-part questionnaire, pertaining to practice characteristics and VBAC care, was mailed to al 40 Ontario midwifery practices. Data from closed-ended questions were analysed using SPSS, while open-ended responses were examined for common themes. A survey response rate of 92.5% was obtained. While 73% of practices that responded reported that they wil not accept women with more than one lower segment Caesarean birth into care, 65% indicated that they wil attend home births for women with one prior Caesarean birth. For practices that do not atend women with aprior Caesarean birth at home, prohibitive hospital policies (64%) and lack of obstetrical support (86%) were the most frequently reported reasons. Concern about increased risk and lack of experience were also identified. Variations ni practice patterns do not appear ot be related to geographic practice characteristics. The survey has identified some of the factors that influence how Ontario midwives care for women with a prior Caesarean birth. Hospital policies and support from consultant obstetricians appear to have a greater impact on midwifery care for women with prior Cacsarean birth than midwives' perception of increased risk or lack of experience.

Investigating the ascendancy of brand experience on brand equity: A Literature review

This literature review aims to analyze the correlations amid brand experience and brand equity. The whole range of sensory, emotional, cognitive, and behavioral reactions that customers exhibit towards a brand is encompassed by brand experience. It highlights the significance of establishing memorable and meaningful engagements that surpass the practical characteristics of a product or service. The evaluation examines an extensive array of academic articles, research papers, and industry reports to get a thorough comprehension of the current body of knowledge about this correlation. The assessment additionally highlights certain deficiencies in the current body of knowledge. Additional investigation is necessary to understand the specific ways in which brand experience impacts brand equity. In summary, this literature study offers a thorough examination of the associating between brand experience and brand equity. The upshots indicate that brand experience is indispensable in constructing and improving brand equity. This statement emphasizes the importance of brand experiences in developing a strong brand value, and it advocates for additional research to enhance our comprehension of this connection in different circumstances. This review offers significant insights for marketing practitioners seeking to effectively maintain and enhance brand equity through strategic brand experiences.

Enabling patient-physician continuity in Swedish primary care: the importance of a named GP. A registry-based observational study.

Continuity of care is important for patients with chronic conditions. Assigning patients to a named GP may increase continuity. To examine whether patients who were registered with a named GP at the onset of their first chronic disease had higher continuity of care at subsequent visits than patients who were only registered at a practice. Registry-based observational study in Skåne County, Sweden. The study population included 66 063 patients registered at the same practice at least 1 year before the onset of their first chronic condition between 2009 and 2015. We compared patients registered with a named GP with patients only registered at a practice over a 4-year follow-up period. The primary outcome was the usual provider of care (UPC) index for all visits and for visits related to the chronic disease. Secondary outcomes were the number of GP, nurse, and out-of-hours visits; emergency department visits; hospital admissions; and mortality. We used linear regression models, adjusted for patient characteristics (using entropy balancing weights) and for practice-level fixed effects, to compare the UPC between those registered with a named GP and those who were not. Patients with a named GP at onset of their condition had a UPC that was 3-4 percentage points higher than patients who did not have a named GP, but the difference decreased and was not statistically significant after adjusting for patient and practice characteristics. Patients with a named GP made more visits, although not specifically for the chronic condition. There were no statistically significant differences for the other outcomes. Patient registration with a GP at diagnosis of their first chronic condition does not demonstrate higher continuity of care at subsequent GP visits and is not linked to other relevant outcomes for patients.

Family physicians provide maternity care in and around the maternity care shortage areas, particularly rural.

This study examined demographic, practice, and area-level characteristics associated with family physicians' (FP) provision of maternity care. Using the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs' maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county-level factors (percentage of reproductive-age women, the number of obstetrician-gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive-age women). We performed summary statistics and multivariate logistic regression analyses. Of the 59,903 FPs in the sample, 7.5% provided maternity care. FPs practicing in rural were 2.5 times more likely to provide maternity care than those practicing in urban areas. FPs in academic (odds ratio [OR] 4.6, 95% confidence interval [CI] 4.1-5.1) and safety-net settings (OR 1.9, 1.7-2.1) had greater odds of providing maternity care. FPs in the bottom quintile with no or fewer OBGYNs and CNMs had a higher likelihood of maternity care provision (OR 2.1, 1.8-2.3) than those in the top quintile, with more OBGYNs and CNMs. FPs in high-needs areas, such as rural and safety net settings, and areas with fewer CNMs or OBGYNs are more likely to provide maternity care, demonstrating the importance of FPs in meeting the needs of women with limited maternity care access. Our study findings highlight the importance of considering the contributions of FPs to maternity care as the organizations prioritize resource allocation to areas of highest need.

Barriers and future improvements of workplace-based learning in Korean medicine clinical clerkship: perspectives of graduates

BackgroundWorkplace-based learning (WPBL) has emerged as an essential practice in healthcare education. However, WPBL is rarely implemented in Korean medicine (KM) due to the passive attitude of teachers and possible violation of medical laws that limit the participation of trainees in medical treatment. In this study, we implemented WPBL in the clinical clerkship of Acupuncture and Moxibustion Medicine at a single College of KM and explored the barriers and future improvements of WPBL.MethodsThe WPBL was implemented from January to July 2019. During the clerkship, each senior student was assigned an inpatient at the university hospital. WPBL was conducted as follows: patient presentation by the supervisor, interaction with the patient at the bedside, preparation of medical records, oral case presentation, and discussion with feedback. The student performed a physical examination and review of systems as a clinical task. In addition, six doctors of KM who are currently practicing after three years of WPBL were interviewed in September 2022 to investigate the real-world effects and unmet needs of WPBL in their workplaces.ResultsTwo major themes identified from the interview were: “the experience of novice doctors of KM with KM practice” and “Current state of KM clinical education.” The five subcategories were: “Clinical competency priorities vary according to the KM workplace,” “Difficulties faced by doctors of KM immediately after graduation,” “WPBL experience of the interviewees,” “Necessary but difficult to implement real patient learning,” and “Unmet needs for clinical clerkship in KM.”ConclusionIt is essential to consider the unique characteristics of KM practice and the duties required in various workplaces for successful WPBL. We anticipate our study to be a starting point for improving the WPBL and addressing the unmet needs in KM clinical education.

Optimizing Variational Quantum Neural Networks Based on Collective Intelligence

Quantum machine learning stands out as one of the most promising applications of quantum computing, widely believed to possess potential quantum advantages. In the era of noisy intermediate-scale quantum, the scale and quality of quantum computers are limited, and quantum algorithms based on fault-tolerant quantum computing paradigms cannot be experimentally verified in the short term. The variational quantum algorithm design paradigm can better adapt to the practical characteristics of noisy quantum hardware and is currently one of the most promising solutions. However, variational quantum algorithms, due to their highly entangled nature, encounter the phenomenon known as the “barren plateau” during the optimization and training processes, making effective optimization challenging. This paper addresses this challenging issue by researching a variational quantum neural network optimization method based on collective intelligence algorithms. The aim is to overcome optimization difficulties encountered by traditional methods such as gradient descent. We study two typical applications of using quantum neural networks: random 2D Hamiltonian ground state solving and quantum phase recognition. We find that the collective intelligence algorithm shows a better optimization compared to gradient descent. The solution accuracy of ground energy and phase classification is enhanced, and the optimization iterations are also reduced. We highlight that the collective intelligence algorithm has great potential in tackling the optimization of variational quantum algorithms.

DESG У ПРОЦЕСІ ПРИЙНЯТТЯ ІНВЕСТИЦІЙНИХ РІШЕНЬ

Introduction. Nowadays, there is a growing need to supplement the qualitative criteria of investment attractiveness, both on the part of businesses and investors. This has led to the actualization of ESG principles, which are becoming strategic national and international norms. In this context, European companies are required to submit non-financial reporting, which is becoming mandatory along with financial statements. Such trends facilitate global digitalization which is aimed at achieving sustainable development goals. The introduction of a new category - DESG (Digital, environmental, social and governmental) - reflects the need to combine digitalization and sustainable development principles to achieve synergy at all levels of society and business. Problem Statement. Assessment of the role of DESG in the investment decision-making process. The purpose is to substantiate the essential characteristics of each of the DESG components, to evaluate scenarios for integrating the digital component into the ESG principles system, to substantiate and develop recommendations for integrating DESG into the investment decision-making process, taking into account international experience in the investment process. Methods. General scientific and special methods were used, in particular: scientific abstraction and epistemological (content) analysis, synthesis, induction and deduction, analogies and systematization, system-structural analysis, expert evaluation method, index method and grouping method. Results. The article examines the typology of DESG application in the investment decision-making process, considers a number of approaches to the definition and differentiation of key terms of sustainable finance. Rating agencies and methods for determining the practical characteristics of ESG are considered. An algorithm for applying DESG in the investment decision-making process is proposed. In the context of substantiating the stages of the algorithm, the essential characteristics of each of the DESG components are studied, trends in changing their priority on a global scale are analyzed. As an analytical basis for the study, the author analyzes the dynamics of changes in the number of asset owners acting in accordance with the PRI principles; the structure of asset owners acting in accordance with the PRI principles in 2022; and the industry structure of companies that provide information in accordance with the SABS criteria. Conclusions. Thus, in modern conditions, DESG is an important factor in making investment decisions. Therefore, our study allows us to draw a conclusion about the structural components of DESG and their role in the investment decision-making process. In the structure of the algorithm for applying DESG we propose to distinguish the following stages, namely: determining the structural components of DESG and their essential characteristics, the relationship between DESG components, justifying the direction of DESG application (scenarios for integrating digital components into the ESG system). The primary allocation of each component will allow to correctly determine the priorities when making an investment decision for each individual project. This will strengthen the targeted nature of investments, which will have a positive impact on the effectiveness of the investment process and the compliance of results with expectations.

International cross-cultural development and field testing of the primary care practice questionnaire for the PaRIS survey (PaRIS-PCPQ)

BackgroundThe PaRIS survey, an initiative of the Organisation for Economic Co-operation and Development (OECD), aims to assess health systems performance in delivering primary care by measuring the care experiences and outcomes of people over 45 who used primary care services in the past six months. In addition, linked data from primary care practices are collected to analyse how the organisation of primary care practices and their care processes impact care experiences and outcomes. This article describes the development and validation of the primary care practice questionnaire for the PaRIS survey, the PaRIS-PCPQ.MethodThe PaRIS-PCPQ was developed based on domains of primary care practice and professional characteristics included in the PaRIS conceptual framework. Questionnaire development was conducted in four phases: (1) a multi-step consensus-based development of the source questionnaire, (2) translation of the English source questionnaire into 17 languages, (3) cross-national cognitive testing with primary care professionals in participating countries, and (4) cross-national field-testing.Results70 items were selected from 7 existing questionnaires on primary care characteristics, of which 49 were included in a first draft. Feedback from stakeholders resulted in a modified 34-item version (practice profile, care coordination, chronic care management, patient follow-up, and respondent characteristics) designed to be completed online by medical or non-medical staff working in a primary care practice. Cognitive testing led to changes in the source questionnaire as well as to country specific localisations. The resulting 32-item questionnaire was piloted in an online survey and field test. Data from 540 primary care practices from 17 countries were collected and analysed. Final revision resulted in a 34-item questionnaire.ConclusionsThe cross-national development of a primary care practice questionnaire is challenging due to the differences in care delivery systems. Rigorous translation and cognitive testing as well as stakeholder engagement helped to overcome most challenges. The PaRIS-PCPQ will be used to assess how key characteristics of primary care practices relate to the care experiences and outcomes of people living with chronic conditions. As such, policymakers and care providers will be informed about the performance of primary care from the patient’s perspective.

Pediatric Urology Providers' Perceptions and Attitudes on Transitional Urologic Care in a Single-Payer Health Care System.

Advances in health care have improved outcomes for pediatric patients with congenital neurourological conditions, highlighting the need for an effective transition from pediatric to adult care. This study investigates Canada's transitional urologic care within its single-payer health care system, focusing on the active members of Pediatric Urologists of Canada and their practices, perceptions, and attitudes toward transitional urologic care. A survey was distributed to 35 Pediatric Urologists of Canada members from July 2023 to January 2024, which collected data on transitional care practices and available transitional urology clinics. It also focused on a service overview, covering aspects such as the responder's geographic and institutional affiliations, clinical practice characteristics involving transitional care, perceived challenges, and strategies for care enhancement. Nationwide engagement emphasized a commitment to improving transitional care, with a significant proportion of respondents (64%) having over 10 years of practice, reflecting substantial experience in addressing transitional care challenges. The survey identified 4 dedicated transitional care clinics, 3 of which are active, pointing to concerted efforts toward specialized service provision. The major challenges identified include the lack of adult transitional care initiatives and governmental support. Recommendations for improvement should focus on standardizing transition protocols and boosting patient education. The survey also underscored the necessity of protocolized care for spina bifida-neurogenic bladder and complex urogenital conditions. This study highlights the active efforts and existing challenges within Canada's transitional urologic care system, particularly emphasizing operational transitional care clinics as a crucial step forward in catering to transitioning patients' needs.