Complex Set Of Conditions Research Articles

Factors and Processes Facilitating Recovery from Coercion in Mental Health Services-A Meta-Ethnography.

Being subjected to or witnessing coercive measures in mental health services can have a negative impact on service users, carers and professionals, as they most often are experienced as dehumanising and traumatic. Coercion should be avoided, but when it does happen, it is important to understand how the experience can be processed so that its consequences are managed. A systematic review and meta-ethnography was used to synthesise findings from qualitative studies that examined service users', staff's and relatives' experiences of recovery from being exposed to coercive measures in mental health care settings. We identified, extracted and synthesised, across 23 studies, the processes and factors that were interpreted as significant to process the experience. Recovery from coercion is dependent on a complex set of conditions that support a sense of dignity and respect, a feeling of safety and empowerment. Being in a facilitating environment, receiving appropriate information and having consistent reciprocal communication with staff are the means through which these conditions can be achieved. People employ strategies to achieve recovery, both during and after coercion, to minimise its impact and process the experience. The findings point to the importance of mental health care settings offering recovery-oriented environments and mental health professionals employing recovery-oriented practices, that would empower service users to develop strategies for managing their mental distress as well as their experiences in mental health care in a way that minimises traumatisation and fosters recovery.

ТЕХНОЛОГИИ И ФАКТОРЫ ФОРМИРОВАНИЯ ЭТНОКУЛЬТУРНОЙ ИДЕНТИЧНОСТИ МОЛОДЁЖИ

Introduction. In the context of the interpenetration of national cultures, the development and unification of mass culture, the issues of preserving the cultural uniqueness of ethnic communities directly depend on their cultural and ethnic identity. In this regard, the paper considers approaches to the concept of identity, highlights ethno-cultural identity, which, in the context of multicultural region, is one of the most significant in the structure of personal identities. Materials and research methods. The methodological basis of the study is a complex of pedagogical, philosophical, and cultural approaches to understanding identity, factors and ways of forming ethno-cultural identity. The empirical basis of the study is the findings of a sociological study conducted by the authors among the Buryat population of the Republic of Buryatia in 2020. The purpose of the study is to determine the factors for the formation of ethno-cultural identity and socio-cultural technologies used in working with the younger generation to facilitate this process. Results. The formation and development of ethno-cultural identity is influenced by a complex set of conditions and factors, as well as a variety of social institutions. The authors pay special attention to a number of indicators of ethno-cultural identity, which are formed as a consequence of traditional and acceptable social experience in the family, which is an integral part of the ethno-culture, which transmits ethnic characteristics gradually, in the course of everyday communication and interaction of the micro community members. On the basis of the author’s sociological research, the work demonstrates manifestations of various factors influencing ethnic identity. Particular attention is paid to technologies implemented in educational, cultural and leisure institutions aimed at maintaining the culture and traditions of the ethnic group, which, in turn, affects the ethno-cultural identity of its members.

Breast cancer screening during the COVID-19 pandemic: moving from disparities to health equity.

The COVID-19 pandemic created unprecedented disruptions to routine health care in the United States. Screening mammography, a cornerstone of breast cancer control and prevention, was completely halted in the spring of 2020, and screening programs have continued to face challenges with subsequent COVID-19 waves. Although screening mammography rates dropped for all women during the pandemic, a number of studies have now clearly documented that reductions in screening have been greater for some populations than others. Specifically, minoritized women have been screened at lower rates than White women across studies, although the specific patterns of disparity vary depending on the populations and communities studied. We posit that these disparities are likely due to a variety of structural and contextual factors, including the differential impact of COVID-19 on communities. We also outline key considerations for closing gaps in screening mammography. First, practices, health systems, and communities must measure screening mammography use to identify whether gaps exist, and which populations are most affected. Second, we propose that strategies to close disparities in breast cancer screening must be multifaceted, targeting the health system/practice, but also structural factors at the policy level. Health disparities arise from a complex set of conditions, and multimodal solutions that address the complex, multifactorial conditions that lead to disparities may be more likely to succeed and are necessary for promoting health equity.

Masqueraders: how to identify atypical diabetes in primary care

Diabetes mellitus is a complex set of conditions that impacts 34 million Americans. While type 1 diabetes, type 2 diabetes, and gestational diabetes are most frequently encountered, there are many other types of diabetes with which healthcare providers are less familiar. These atypical forms of diabetes make up nearly 10% of diabetes cases and can masquerade as type 1 or 2 diabetes mellitus (T1DM or T2DM), and the treatment may not be optimized if the diagnosis is not accurate. Atypical forms include monogenic diabetes (formally known as maturity-onset diabetes of the young [MODY]), latent autoimmune diabetes of the adult (LADA), ketosis-prone diabetes, and secondary diabetes. This paper will detail the defining characteristics of each atypical form and demonstrate how they can masquerade astype 1 or 2 diabetes mellitus. Gestational diabetes mellituswill not be discussed in this article.

Contemporary zoo design and the historical treasure of garden art: Tiergarten Schönbrunn

Contemporary zoos are facing a complex set of conditions: they conduct scientific studies aimed at the conservation of species and their habitats on the one hand, and pursue the involvement of the audience in the protection and care of nature on the other. Looking around the world of zoos, only a few have been able to evolve into complex conservation centres. The development process takes decades, and the challenge is comparable to the transition of menageries into zoological gardens in the eighteenth and nineteenth centuries. This article conveys how landscape architecture can contribute to this metamorphosis by increasing the wellbeing of confined animals and discovering strategies to foster the transformation of even the oldest zoo into a modern scientific institution. While the survey concentrates on the spatial development of Tiergarten Schönbrunn and the environmental quality of animal enclosures (thus on animal welfare), the discussion explores the correlation between the changing operation strategies and the visitors’ experience in the light of landscape architecture.

Impact of Case Definitions on Efficacy Estimation in Clinical Trials-A Proof-of-Principle Based on Historical Examples.

Efficacy estimations in clinical trials are based on case definitions. Commonly, they are a more or less complex set of conditions that have to be fulfilled in order to define a clinical case. In the simplest variant, such a case is identical with a single positive diagnostic test result. Frequently, however, case definitions are more complex. Further, their conditions often ignore the inherent logical structure of symptoms and disease: A symptom or a set of symptoms may be necessary but not sufficient for the unambiguous identification of a case. After describing the structure of case definitions and its impact on efficacy estimations, we exemplify this impact using data from two clinical trials dealing with the effectiveness of the vaginal application of tenofovir gel for the prevention of HIV infections and with the therapeutic effects of fecal transplantation on recurrent Clostridium difficile infections. We demonstrate that the diagnostic performance of case definitions affects efficacy estimations for interventions in clinical trials. The potential risk of bias and uncertainty is high, irrespective of the complexity of the case definition. Accordingly, case definitions in clinical trials should focus on specificity in order to avoid the risk of bias.

Schema Therapy for psychosomatic disorders

Schema Therapy for psychosomatic disorders Abstract. Schema Therapy (ST) was developed as an advancement of Cognitive Behavioural Therapy (CBT) to form a comprehensive psychotherapeutic concept for patients with profound and chronic mental disorders. In this integrative psychotherapeutic treatment, cognitive, emotional, and behavioural interventions as well as the work with the therapeutic relationship are connected to establish a goal-oriented, flexible and transparent approach. The efficacy of schema therapy is particularly emphasised by studies investigating the treatment of different personality disorders. Moreover, pilot studies exist for different axis-I disorders, such as eating disorders or obsessive-compulsive disorders. Furthermore, schema therapy seems promising for patients with chronic psychosomatic symptoms. With this approach, symptoms, behavioural patterns, and central biographic events underlying the complex set of conditions, may be approached with the aid of the schema mode model, which can be conceptualised and processed in a way that is easily accessible for the patient.

A narrative review of data collection and analysis guidelines for comparative effectiveness research in chronic pain using patient-reported outcomes and electronic health records.

Chronic pain is a widespread and complex set of conditions that are often difficult and expensive to treat. Comparative effectiveness research (CER) is an evolving research method that is useful in determining which treatments are most effective for medical conditions such as chronic pain. An underutilized mechanism for conducting CER in pain medicine involves combining patient-reported outcomes (PROs) with electronic health records (EHRs). Patient-reported pain and mental and physical health outcomes are increasingly collected during clinic visits, and these data can be linked to EHR data that are relevant to the treatment of a patient’s pain, such as diagnoses, medications ordered, and medical comorbidities. When aggregated, this information forms a data repository that can be used for high-quality CER. This review provides a blueprint for conducting CER using PROs combined with EHRs. As an example, the University of Pittsburgh’s patient outcomes repository for treatment is described. This system includes PROs collected via the Collaborative Health Outcomes Information Registry software and cross-linked data from the University of Pittsburgh Medical Center EHR. The requirements, best practice guidelines, statistical considerations, and caveats for performing CER with this type of data repository are also discussed.

PRODUCTIVITY AND QUALITY OF WINTER WHEAT VARIETIES IN THE EASTERN PART OF THE ROSTOV REGION

Productivity of winter barley varieties is a main characteristic for their wide introduction into agricultural production. Yields and quality of grain are usually formed under influence of a complex set of conditions. Grain productivity depends on such factors as cultivation technology, hydrothermal regime, tolerance to unfavourable weather conditions. Plant moisture supply is the main factor for obtaining high yields of winter barley in the eastern part of the Rostov region. The study was conducted in the years of 2014-2016, which were characterized with different moisture supply. There were studied the varieties ‘Master’, ‘Tigr’, ‘Timofey’ and ‘Erema’ developed by the FSBSI ARC “Donskoy”. On average three varieties ‘Master’ (4.26 t/ha), ‘Timofey’ (4.18 t/ha) and ‘Erema’ 4.37 t/ha) gave the largest yields for three-year period of study. On average for three-year period of study the greatest quantity of protein was found in the variety ‘Tugr’ (11.7%), the greatest amount of starch was found in the variety ‘Timofey’ (59.2%).

Screen industry collaboration: The Knock – producing fiction with Creative England/BFI

Using a case study of independent film, this article explores the identity and working practices of the academic film producer, examining the relationship with both industry and academia. For the practitioner / academic, a complex set of conditions are to be negotiated in order to succeed in producing drama alongside academic duties as the two-way focus challenges the market demands of drama production. Non-commercial funding sources enable independent filmmakers authentic routes to finance and distribution deals with government agencies, however diminishing finance and regularly changing criteria results, at times in selective funding in a postcode lottery. Students benefit from the practitioner /academic by gaining valuable skills and knowledge through real industry experience in the age of employability. However, the paper examines whether this is at the expense of experimentation and sufficient study of critical thinking, in industry driven curricula.

Chronic obstructive pulmonary disease: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases.

Chronic obstructive pulmonary disease (COPD) is a complex set of conditions with multiple risk factors, disease mechanisms, and clinical manifestations. These characteristics make primary prevention of COPD challenging. Semantic issues related to prevalent and incident disease (e.g., the use of specific cut points on a continuous range) should not derail development of primary prevention initiatives. Potential targets for COPD prevention occur along the spectrum of disease development. Understanding risk factors early in life, whether specific to COPD or not, allows for study of interventions to optimize lung function at birth and to prolong the lung function plateau, potentially reducing the development of COPD. It is necessary to identify noninvasive ways to screen for early COPD in those at risk before progression to clinically significant disease. Identification of specific COPD subgroups, such as individuals with chronic bronchitis, those with α1-antitrypsin deficiency, or early radiographic changes with normal spirometry, may offer specific opportunities for primary prevention. A better understanding of why COPD progresses despite smoking cessation is needed. Future research initiatives should also focus on identifying the underlying mechanisms and relevant interventions for nonsmokers with COPD, a currently poorly studied group. Ultimately, preventing the development of COPD will serve to reduce the tremendous burden of this chronic disease worldwide.

Immigration, Wealth and the 'Mortality Plateau' in Emergent Urban-Industrial Towns of Nineteenth-Century Massachusetts.

The mortality transition in Western Europe and the U.S. encompassed a much more complex set of conditions and experiences than earlier thought. Our research addresses the complex set of relationships among growing urban communities, family wealth, immigration and mortality in New England by examining individual-level, socio-demographic mortality correlates during the nineteenth-century mortality plateau and its early twentieth-century decline. In contrast to earlier theories that proposed a more uniform mortality transition, we offer an alternative hypothesis that focuses on the impact of family wealth and immigration on individual-level mortality during the early stages of the mortality transition in Northampton and Holyoke, Massachusetts.

Eating on the run. A qualitative study of health agency and eating behaviors among fast food employees

Understanding the relationship between obesity and fast food consumption encompasses a broad range of individual level and environmental factors. One theoretical approach, the health capability framework, focuses on the complex set of conditions allowing individuals to be healthy. This qualitative study aimed to identify factors that influence individual level health agency with respect to healthy eating choices in uniformly constrained environments (e.g., fast food restaurants). We used an inductive qualitative research design to develop an interview guide, conduct open-ended interviews with a purposive sample of 14 student fast food workers (aged 18–25), and analyze the data. Data analysis was conducted iteratively during the study with multiple coders to identify themes. Emergent themes included environmental influences on eating behaviors (time, cost, restaurant policies, social networks) and internal psychological factors (feelings associated with hunger, food knowledge versus food preparation know-how, reaction to physical experiences, perceptions of food options, delayed gratification, and radical subjectivity). A localized, embedded approach to analyzing the factors driving the obesity epidemic is needed. Addressing contextual interactions between internal psychological and external environmental factors responds to social justice and public health concerns, and may yield more relevant and effective interventions for vulnerable communities.

Multiple sclerosis and sexual dysfunction

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction (SD) is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciplinary teamwork and cooperation among specialists, individual patients, partners and the society.

Indicators of Conformance With Guidelines of Schizophrenia Treatment in Mental Health Services

The aim of this study was to develop indicators of conformance in clinical practice with guidelines for care in schizophrenia. Recommended guidelines rarely apply to all patients and need to allow for social ability, family context, and phase of the disorder. These indicators were therefore devised for tailoring to patient characteristics and allowing for factors that may justify the lack of adherence to clinical guidelines. A team of senior clinicians and methodologists reviewed three clinical guidelines (from the Schizophrenia Patient Outcomes Research Team, McEvoy and colleagues, and the National Institute for Health and Clinical Excellence) and defined criteria for their operationalization into clinical indicators. For each indicator, the team defined criteria for eligibility (requirements to be met to qualify for evaluation), conformance (criteria to be satisfied to comply with each recommendation), and moderators (factors that could justify the lack of application of a given recommendation). These indicators were tested with a random sample of 807 patients with schizophrenia or schizoaffective disorders in outpatient facilities, long-term residential facilities, and hospital units for acute care in the Piedmont region of Italy. A set of 15 indicators was derived, nine concerning pharmacological treatment and six for general care and psychosocial rehabilitation. Moderators such as patient or family refusal of antipsychotic treatment and the patient's level of disability helped to justify a considerable proportion of nonconformant care. The indicators developed are a simple and useful tool to monitor the conformance of care with recommended practices and to identify areas needing improvement.

Indicators of Conformance With Guidelines of Schizophrenia Treatment in Mental Health Services

Indicators of Conformance With Guidelines of Schizophrenia Treatment in Mental Health Services

Reliability of the Autism Spectrum Disorders-Comorbid for Children (ASD-CC)

Autism spectrum disorders (ASD) in children are a serious and complex set of conditions that researchers have been attempting to quantify for many decades. In addition to the core symptoms of ASD, comorbid psychopathology is often present as well. Despite this fact and despite the many attempts to develop scaling methods for ASD, little has been done to develop tests specific to childhood psychopathology in ASD children. In this study we describe the initial psychometric properties of a new scale designed specifically to fill this assessment need, the Autism Spectrum Disorders-Comorbid for Children (ASD-CC). One-hundred and thirteen children with ASD between the ages of 2 and 16 years were assessed in order to determine interrater, test–retest, and internal reliabilities of this new scale. Implications of these promising findings with respect to further development of the ASD-DC are discussed.

The frequency, trajectories and predictors of adolescent recurrent pain: A population-based approach

Recurrent pains are a complex set of conditions that cause great discomfort and impairment in children and adults. The objectives of this study were to (a) describe the frequency of headache, stomachache, and backache in a representative Canadian adolescent sample and (b) determine whether a set of psychosocial factors, including background factors (i.e., sex, pubertal status, parent chronic pain), external events (i.e., injury, illness/hospitalization, stressful-life events), and emotional factors (i.e., anxiety/depression, self-esteem) were predictive of these types of recurrent pain. Statistics Canada’s National Longitudinal Survey of Children and Youth was used to assess a cohort of 2488 10- to 11-year-old adolescents up to five times, every 2 years. Results showed that, across 12–19 years of age, weekly or more frequent rates ranged from 26.1%–31.8% for headache, 13.5–22.2% for stomachache, and 17.6–25.8% for backache. Chi-square tests indicated that girls had higher rates of pain than boys for all types of pain, at all time points. Structural equation modeling using latent growth curves showed that sex and anxiety/depression at age 10–11 years was predictive of the start- and end-point intercepts (i.e., trajectories that indicated high levels of pain across time) and/or slopes (i.e., trajectories of pain that increased over time) for all three types of pain. Although there were also other factors that predicted only certain pain types or certain trajectory types, overall the results of this study suggest that adolescent recurrent pain is very common and that psychosocial factors can predict trajectories of recurrent pain over time across adolescence.

Regime change and nation building: can donors restore governance in post‐conflict states?

AbstractForeign aid agencies and international assistance organisations are now heavily involved in nation building in post‐conflict states. Their record of strengthening democratic governance in countries where civil war or military force replaced unpopular regimes is mixed. Experience suggests that a complex set of conditions must be created quickly in order to rebuild indigenous governance. Ensuring security, providing assistance through a transparent and coherent plan of action, coordinating donors' activities, establishing strong and legitimate national authority, strengthening democratic political processes, transferring responsibility and resources for development to a new government, stabilising the economy and strengthening social capital and human assets must all be done in quick succession. Achieving these goals requires a cadre of civilian and, sometimes, military personnel with expertise in post‐conflict nation building. The frequency with which government aid programmes and international assistance organisations engage in post‐conflict reconstruction also suggests the need for more explicit national and international policies and the creation of specialised nation‐building agencies to undertake these difficult tasks. Copyright © 2005 John Wiley & Sons, Ltd.

The stability of rapidly deforming rods and jets

When a uniform rod is deformed in tension under conditions of pure axial stress it will undergo indefinite uniform deformation. In practice these conditions are not achievable because neither perfect uniformity nor perfect uniaxial stress can be attained. In slow to moderately fast tension, instability (necking) starts at relatively small strains and is governed by the boundary conditions (uniformity and end effects) and the deformation model. If the strain rate is very high, however, then strains of several thousand per cent can be achieved before instability develops as is observed in shaped charge jets. It is shown in the present paper that, at very high strain rates, very large stable strains can be achieved either through certain deformation models (this is uncommon) or, more generally, through the effects of inertia on stability. A quantitative theory is developed which shows the important role of both radial and axial inertia. These inertial effects are intimately linked to the deformation model in such a way that, for any perturbation or other effect to initiate instability, a complex set of conditions involving the axial and radial inertia and the deformation model must be satisfied. These define the geometrical, inertial and material characteristics required for large stable extensions.