Difficult Time Research Articles

The Decision-making and Control Mechanism of the Sovietisation of Lithuania in 1944–1946: the Role of Moscow Emissaries

The article examines one of the constituent elements of the decision-making and control mechanism of Sovietisation: the role of Moscow’s agents (instructors, envoys, inspectors, emissaries) in making strategic policy decisions in the Sovietisation of Lithuania. The study attempts to uncover the environment in which and also how and why three significant resolutions of the Central Committee of All-Union Communist Party (the Bolsheviks) (AUCP[B] CC) sharply criticising the work of the Central Committee of the Communist Party of Lithuania (LCP[B] CC) and essentially adjusting the course and process of Sovietisation of Lithuania were issued: the resolution of 30 October 1944 ‘On shortcomings and objectives in the area of the political work of the Lithuanian SSR party organisation’, the resolution of 15 August 1945 ‘On shortcomings and errors of the LCP[B] CC work in managing the political work of the party’, and the resolution of 5 October 1946 ‘On the work of the LCP (B) CC’. These were some of the main programme-directive type resolutions of the government of the Soviet Union and strongly criticised the LCP (B) CC leadership and provided specific goals, objectives, methods and tools for the implementation of Sovietisation. The chronological limits of the article are summer 1944 (the beginning of re-occupation) and October 1946 (the date of the last resolution of the AUCP[B] CC on Lithuania). The author treats the Sovietisation of Lithuania conducted by the leadership of the Communist Party of the Soviet Union as the process of the country’s forced incorporation in the political, economic, cultural and social system of the USSR and the unification of internal affairs according to the standards of the totalitarian communist state. Top USSR party and government organisations, at all levels interrelated by the strict vertical line of the government, participated in the complex decision-making and control mechanism of the policy of Sovietisation in Lithuania. The following were the divisions of the central government and key acting figures who cooperated in making critical decisions regarding the Sovietisation of Lithuania and monitored the process of their implementation in 1944–1946: AUCP[B] CC Politburo (Andrey Zhdanov, Andrey Andreev), the Council of People’s Commissars of the USSR (Georgiy Malenkov, Lavrentiy Beria, Vsevolod Merkulov, Yakov Chadajev, Arseniy Zverev, Ivan Benediktov), AUCP[B] CC Organising Bureau (Malenkov, Zhdanov, Alexey Kuznetsov, Nikolay Patolichev, Georgiy Popov), AUCP[B] Personnel Board (Malenkov, Nikolay Shatalin, Evgeniy Andreev, Kuznetsov, Vladimir Shcherbakov, Kaloshin, Nikolay Mayorov), AUCP[B] CC Affairs Board (Dmitriy Krupina), AUCP[B] CC Propaganda and Agitation Board ( Georgiy Alexandrov, Mikhail Yovchyuk), AUCP[B] CC Party Bodies Inspection Board (Mikhail Shamberg, Patolichev, Vasiliy Zhavoronkov), AUCP[B] CC Lithuanian Bureau ( Mikhail Suslov, Ivan Tkachenka, Fyodor Kovalev), and AUCP[B] CC Bureau (Antanas Snieckus, Mečislovas Gedvilas, Justas Paleckis, Daniyil Shupikov, Alexander Isachenka, Vasiliy Pisarev). In stage one of Sovietisation (1944–1947 April), before the AUCP[B] CC Lithuanian Bureau was dissolved, the Kremlin leadership was not satisfied with and did not trust the competence or information provided by the LCP (B) CC leadership or how it proceeded with the integration of Lithuania into the political, social and economic system of the USSR. As a result, in order to assess the political situation in Lithuania more objectively and take decisions, AUCP[B] CC inspectors were used as management and control tools. The AUCP[B] CC Lithuanian Bureau carried out these functions only partially. For the LCP (B) CC leadership, this was the most difficult time of adjustment to Kremlin policy, a time of “learning” and balancing. When the AUCP[B] CC leaders set the general direction, objectives and goals of Sovietisation in Lithuania and controlled its progress, the role of emissaries and inspectors was important and often decisive. On the basis of their informational and analytical reports, all three of the most important directive-type resolutions (30 October 1944, 15 August 1945 and 5 October 1946) criticising activities of the LCP (B) CC leadership and adjusting the process of Sovietisation of Lithuania were issued.

COVID-19 and Religious Practices: A Case Study of the Cham in Ninh Thuan

With the ups and downs of the COVID-19 pandemic, including waves of infections, the discussion and questioning of how to adapt traditional and religious activities in times of crisis became of upmost importance among the clerics of religious groups in Ninh Thuan. This article discusses the impact of the COVID-19 pandemic on the Cham in Ninh Thuan, the role of faith agents in responding to the unprecedented health crisis, and the way they maintained their faith and kept the spirit of traditions and religions alive during a difficult time. At the same time, this article looks into how the religious communities in Ninh Thuan engaged in dialogue about the COVID-19 pandemic, including potential racial or sectarian debates, to minimize misunderstandings and mobilize resources to help each other overcome challenges and possible discrimination. This is a case study of an ethnic minority and sheds light on the flexible and resilient approaches of the Cham to navigate the pandemic and maintain their traditions and practices. This research speaks to policy-makers and provides lessons for managing crises in the future.

Growing Up Amidst Active Warfare: Understanding the Experiences of Ukrainian Adolescents Through Chat Data

Armed conflicts violate young people’s rights by exposing them to violence and trauma, disrupting their sense of safety. This study examines how Russia’s war against Ukraine affects Ukrainian adolescents’ lives. The study utilizes data from Let’s Chat, a free, low-threshold support service for Ukrainian-speaking children and youths. We analyzed 185 chat conversations between chat workers and Ukrainian adolescents using data-driven thematic analysis. The war emerged roughly every fourth conversation, affecting discussions on forced relocation, school disruptions, and social relationships. Although youths rarely initiate war-related conversations, its effects are evident. This study highlights the complex impact of war on youth development, adding to other stressors in their lives. War often emerges as an added burden, complicating their already delicate development. Digital channels like Let’s Chat can help adolescents cope with these challenges and plan their futures in a culturally sensitive manner across borders, providing crucial support in difficult times.

Abortion access barriers shared in “r/abortion” after Roe: a qualitative analysis of Reddit community post-Dobbs decision leak in 2022

With drastic changes to abortion policy, the months following the Dobbs leak and subsequent decision in 2022 were a uniquely uncertain and difficult time for abortion access in the US. To understand experiences of challenges to abortion access during that time, we used a hybrid inductive and deductive thematic coding approach to analyse descriptions of barriers and their impacts shared in an abortion subreddit (r/abortion). A simple random sample of 10% of posts was obtained from those shared from 02 May 2022 through 23 December 2022; comments were purposively sampled during the coding process. In this sample of submissions (n = 523 posts, 88 comments), people described structural barriers identified in past research, including state abortion bans and gestational limits, high costs, limited appointment availability, and long travel required. Posters also commonly described known social barriers, including limited social support and abortion stigma. Several impactful barriers not well-described in past research emerged inductively, including wait time for receiving mail-ordered abortion medication, low credibility of online ordering platforms, and concerns about legal risks of accessing abortion or related medical care. The most common consequences of experiencing barriers were adverse mental health outcomes, delayed access to care, and being compelled to self-manage their abortion because of access barriers. This analysis provides timely insights into the experiences and impacts of abortion access barriers in a group of people with a range of engagement with clinical abortion care, lived experiences, and points in their abortion processes, with public health implications for mental health and abortion access.

Information Hiding and Digital Transformation: Strategies for First Information Reports (FIR) and Police Records

Throughout the last few years, it has become increasingly obvious that everything is moving from a traditional world to a digital one. In order for police organizations to remain competitive, they need to keep up with the rapid technological advancements that are taking place in order to stay ahead of the competition. The First Information Report (FIR) in South Asian and Southeast Asian countries is a legal document which provides police with information about an apparent crime which has been reported to them by the victims of crimes. It is part of the police's investigation process. The police still have a difficult time getting accurate information from victims in terms of what exactly occurred during the incident, which makes getting accurate information from them very difficult. The filing of a police report presents a wide range of challenges as far as police organizations are concerned. There is a major challenge in the investigation of crimes involving victims concealing information about critical knowledge subsets and the complexity of these sets from the police authorities. For police records to be managed effectively it requires an organisational transformation that is driven by well-established digital strategies that offer an overall view and full transparency of both the knowledge about FIRs as well as the access to them. There is no doubt that an organization such as a police force cannot underestimate the importance of adopting the right technologies and frameworks as part of its digital transformation strategy in order to be able to meet the needs of its customers. The challenge of solving the long-standing problem of police organizations with limited resources concealing knowledge is going to be a long-term task that can be quite challenging. This paper presents several strategies and best practices which can be adopted by law enforcement organizations so that they can successfully transform digitally and achieve their goals through the implementation of these strategies and best practices.

Effect of Multidisciplinary structure of New Education Policy on Achievement Motivation among Undergraduate Students in India

The New Education Policy 2020 was finally implemented after a 34-year delay. This study work is fascinated by the New Education Policy 2020, Multidisciplinary aspect has brought many changes in the curriculum of the Undergraduates and especially how it influences their Achievement Motivation and how much they have adopted the new education policy over time. The researcher used two variables: NEP Multidisciplinary Structure as the Independent Variable and Achievement Motivation as the Dependent Variable. The sample included 142 undergraduates. After applying the AMS scale to measure the students' achievement motivation, interview questions were arranged to support the results, and it was discovered that there were no significant differences in the achievement motivation of first- and second-year students. Overall, the results are supported by the interview responses, as they show that, while students appreciate the Multidisciplinary aspect of NEP and prefer undergraduate degrees with multiple exit options, they are having a difficult time adapting, it also indicated that the institutions are unable of offering the appropriate atmosphere and facilities that students require in order to adapt to the interdisciplinary nature of NEP. This might be because the NEP multidisciplinary feature is new for the institutions as well, and they, too, need some time to polish it in their curriculum. As this is a very new approach in the educational field, additional observations and research are needed to assess the amount of growth and adaptability over time.

Affiliation in times of pandemics: Determinants and consequences.

Affiliation is a basic human need, especially during difficult times. To what extent did the need to affiliate limit our capacity to abide by health guidelines, in particular regarding social distancing, during the COVID-19 pandemic? We investigated this issue using questionnaire data from two samples of the French population collected during the first French lockdown (April-May 2020). We found that in men, higher social comparison orientation (sensitivity to the needs of others and inclination to help) and higher perceived threat increased the frequency of reported affiliative activities. At the same time, men's reported affiliative activities were associated with a lower reported intention to abide by lockdown and protective measures and lower levels of reported compliance. This pattern was not found in women. The women in our samples, as has been observed elsewhere, were largely compliant, potentially precluding any effects of affiliative needs. Basic though they may seem, affiliative needs and reported affiliative activities may have played a significant role in the implementation of sanitary guidelines during the COVID-19 pandemic.

MENEMUKAN IMAN DALAM KETIDAKPASTIAN: REFLEKSI TEOLOGIS BERDASARKAN KITAB HABAKUK

This paper is organized to find faith in uncertainty through theological reflection based on the book of Habakkuk. Habakkuk is a prophet of God in the Old Testament who experienced a difficult time amid King Jehoiakim's reign. The difficulties of life and injustice that occurred during the time of King Jehoiakim made the prophet Habakkuk constantly pray and put his faith in God. This steadfastness of faith needs to be emulated by believers. The modern age in which believers live often brings various challenges, such as the relativism of absolute truth and identity crisis. As a believer living in modern times, I believe that imitating Habakkuk can be done to achieve faith resilience. By having faith resilience as a result of imitating Habakkuk, believers can get through difficult times through their faith. Believers' faith will be trained amid life's uncertainties. Through descriptive qualitative research methods, the author tries to narrate the discovery of faith amid uncertain conditions through theological reflection based on the book of Habakkuk. The author states that the theological reflection of the book of Habakkuk brings believers to have faith that even amid uncertainty, God still answers prayer.

Gambaran Sedentary Behavior Mahasiswa Universitas Negeri Padang

College can be a difficult time for many students because during this time they face a lot of pressure and challenges that can cause various threats to the physical, social and emotional. Such times make them more susceptible to stress and health problems due to unhealthy lifestyles, one of which is sedentary behavior. This study aims to determine the description of the sedentary behavior of Padang State University students. This study uses a quantitative method using descriptive statistical analysis. The population in this study were Padang State University students in the 2018-2020 intake with a total of 4,166 people. Sampling in the study used the consecutive sampling technique using the Slovin formula with a 10% error tolerance so that a total of 98 respondents were obtained. This study used the Sedentary behavior questionnaire scale by Rosenberg et al (2010) which was adapted into Indonesian and distributed via gform. Based on the results, the mean was 37.3 and SD 23.5. This means that the sedentary behavior of Padang State University students tends to be high.

Lived experiences of bias in compensation and reintegration associated with false admissions of guilt.

Some exonerees receive compensation and aid after being exonerated of their wrongful convictions, and some do not. Looking beyond differences in state statutes, we examined possible reasons for biases in receiving compensation (via statutes or civil claims) and other reintegration services. More specifically, we examined how two unique types of false admission of guilt (i.e., false confessions and false guilty pleas) could be associated with biased outcomes in compensation procurement and reintegration outcomes. Although we did not have formal hypotheses for this qualitative study, based on the cumulative disadvantage framework (Scherr, Redlich, & Kassin, 2020), we anticipated that both types of false admission of guilt would negatively bias exonerees' experience post-exoneration. More specifically, we expected that exonerees whose cases involved at least one type of false admission of guilt would have a more difficult time obtaining compensation and would experience more negative post-exoneration outcomes, compared with exonerees in general. We conducted in-depth interviews with three samples: (a) exonerees (n = 19), (b) attorneys who had assisted exonerees with post-exoneration compensation claims (n = 15), and (c) innocence advocates who had worked with exonerees (n = 9). Across all samples, interviewees indicated that both forms of false admission of guilt are associated with biases that may influence exonerees' compensation and reintegration efforts. Specifically, interviews revealed that (a) false admissions are associated with disadvantages to exonerees' compensation and reintegration efforts, as predicted by the cumulative disadvantage framework; (b) under specific circumstances, false admissions are associated with advantages benefiting compensation attempts; and (c) false admissions can be nonapplicable (i.e., irrelevant) to reintegration efforts. Together, our findings provide a more nuanced understanding of the role false confessions and false guilty pleas may play post-exoneration. This understanding, derived from those individuals directly involved in the compensation and reintegration processes, is an important step in beginning to right the injustices experienced by those wrongfully convicted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Palm Oil Crisis in India's FMCG Sector – A Sustainability Dilemma

The FMCG companies in India and world over relies heavily on Palm oil as one of the core ingredients is going through difficult times. Oil Palm plantations have resulted in phenomenal ecological damage and biodiversity in southeast Asian countries which played a significant role in socio-economic development of the local community earlier. The supply chain disruptions along with pressing environmental or social concerns have negatively affected the balance sheets of Indian FMCG companies who was already under the strain of foreign currency fluctuations due to high import dependency. The government has initiated multiple programs under National Mission on Edible Oil to develop prospective solutions to resolve the crisis through sustainable palm oil agricultural practices as supporting environmental norms yet profitable outlook for self-consumption, leveraging government subsidies, inputs and technology through research and knowledge transfer. The study suggests the best competitive strategic measures which can be adopted.

Evaluating state-based network dynamics in anhedonia

Anhedonia is a transdiagnostic clinical syndrome associated with significant clinical impairment. In spite of this, a clear network-level characterization of anhedonia does not yet exist. The present study addressed this gap in the literature by taking a graph theoretical approach to characterizing state-based (i.e., reward anticipation, rest) network dynamics in a transdiagnostic sample of adults with clinically significant anhedonia (n = 77). Analyses focused on three canonical brain networks: the Salience Network (SN), the Default Mode Network (DMN) and the Central Executive Network (CEN), with hypotheses focusing on the role of saliency-mapping in anhedonia. Contrary to hypotheses, no significant relation was found between the SN and anhedonia symptom severity. Exploratory results revealed a significant association between anhedonia severity and DMN reorganization from rest to reward anticipation. Specifically, greater anhedonia severity was associated with less reward-related reorganization. This finding suggests that anhedonia severity may be associated with DMN hyposensitivity, such that individuals with more severe anhedonia may have a difficult time disengaging from their internal world in the context of potentially rewarding experiences. Although preliminary, this finding challenges the centrality of the SN in anhedonia severity and suggests the importance of the DMN. Clinical implications and future directions are explored.

The Role of Interventional Radiology in Patients Management during Sudan War 2023-2024: A Western Sudan Experience

Background: The purpose of this study is to evaluate the availability of interventional radiology services in Western Sudan from 2023 to 2024, during the Sudan War. This study aimed to evaluate the role of interventional radiology in the country's ongoing conflict. Methodology: This is a retrospective descriptive study with a prospective component that was conducted at El-Obeid International Hospital in North Kordofan State, Sudan, in August and September 2024. All information on patients who had interventional radiology operations between August 15th, 2023 and August 15th, 2024 was obtained from the hospital. Results: The findings revealed that 41% of the 131 patients received operations in the Interventional Radiology Clinic and 59% in the Catheterization Laboratory department. Among the 131 patients, 55% were men and 45% were women. The most common age group for undergoing IR treatments was 46-65 years, followed by ≥65 and 18-45 years, with incidence rates of 40%, 34%, and 25%, respectively. 41% of the procedures were performed in the interventional radiology clinic, with 59% performed in the catheterization laboratory. The most common technique was permacath implantation (36%). Conclusion: The ongoing conflict between 2023 and 2024 aggravated the situation. As a result, our study discovered that the only IR facility in Western Sudan during this difficult time is based in El-Obeid and serves seven states. This was exemplified by a severe breakdown in the healthcare system, the loss of basic needs, great poverty, and the plight of the refugees.

Streaming movies, series and shows: attitudes and beliefs among Gen Zers

Purpose Faster internet and online streaming have changed the way young consumers enjoy their favorite movies, series and shows, and business models must adapt to these changes. This study aims to examine the streaming behaviors, beliefs and piracy intentions of Generation Z, the youngest and largest generation of online entertainment consumers. Research in the area of young consumer behavior and streaming piracy is limited, and for a good reason: current laws and regulations focus on punishing the distributors of pirated content rather than consumers. Design/methodology/approach This study used a self-reported questionnaire administered to 750 Generation Z college students aged 17–25 years. The authors used the scenario-based method to examine the factors explaining the intentions to commit movies, series and shows streaming (MS) piracy. This method has been extensively applied when analyzing digital piracy because sharing streaming account passwords and using illegal streaming websites among consumers is still not unlawful in the U.S. Therefore, an adequate approach to evaluate young consumers’ intentions is through a scenario-based model. All information was coded, and a statistical and econometric analysis was completed. Findings From the statistical analysis, the authors found that only 14% of the young participants indicated their intention to stop sharing account information and using illegal websites to watch their favorite movies and shows if streaming piracy were punishable by law. The key motivations are related to the denial of injury to others and the belief that governments would have a difficult time enforcing the law in online environments. Approximately 80% of the participants who indicated their intention to continue MS piracy expressed a low perception of any type of risk associated with MS piracy. Research limitations/implications The results were obtained using a scenario-based model. A scenario provides the opportunity for the participants to reflect on a specific conflict, but they can recognize that there is little at “stake” when addressing the conflict, potentially producing the bias of “over positive responses.” Nonetheless, the analysis is still reliable, as the number of observations is large (750 responses), and the conflict is expressed as a degree of conformity rather than a yes/no answer. Practical implications The authors believe that future generations’ attitudes and beliefs about streaming entertainment will pose significant economic hardships to the entertainment industry. Similar to other forms of entertainment, streamed movies, series and shows are highly susceptible to digital piracy and it is the most common risky behavior among adolescents. The economic impact of streaming piracy could extend to revenue losses, job losses and national domestic production. Social implications Peer influence, personal or through social media, is a strong predictor of streaming piracy. In fact, social media influencers play an important role in teenagers’ behavior, including the usage of illegal streaming apps or websites and other deviant behavior in the digital world. It is expected that social media influencers will continue to be a relevant explanatory factor of streaming piracy among young Gen Zers. Originality/value This study contributes to the literature on digital piracy in several ways. First, it adds to the understanding of streaming piracy and the views and perceptions of young consumers about entertainment streaming. Second, the authors extend the analysis of digital piracy to streamed movies, shows and series. Third, the authors complete a statistical analysis on the relationships between Gen Zers’ consumption behavior, beliefs and intentions of streaming entertainment piracy. Understanding Gen Zers’ behavior and attitudes toward paid versus unpaid consumption of streaming content will allow the entertainment industry to respond effectively to future changes in copyright laws and technology usage.

Nursing care for women with perinatal depression

The perinatal period can be a challenging and difficult time for many women, during which they experience a shift in their social roles and a gradual transition to motherhood. Perinatal depression (PND) is one of the most common perinatal mental health conditions that jeopardizes mental health. health. Electronic database searches were conducted to find suitable papers; these publications included risk factors for perinatal depression, interventions, limitations and perspectives of interventions, and finally the information was extracted for narrative synthesis. Personal psychiatric history and addictive behaviors, mother-infant and husband conflicts in the family, economic and employment in the society and teenage pregnancy were associated with the risk of developing the disease. Medication and psychotherapy, providing professional help and family-centered care, improving the health care system and psychological screening and education, and providing social support were effective solutions. Perinatal depression is an important global public health problem that deserves some attention from individuals, families, and societies.

Public Theology as a Theology of Resilience in Sub-Saharan Africa: A Public Pastoral Care Contribution

The negative impacts of COVID-19, the ongoing war between Russia and Ukraine, political unrest, and natural disasters in sub-Saharan Africa have caused widespread suffering. In light of these crises, many have questioned the relevance of theology in addressing such complex challenges. This article tackles critical questions such as: How can public theology effectively engage with the socio-political and economic issues facing sub-Saharan Africa? What role does public pastoral care play in fostering resilience within these communities? Can theology provide tangible support in the face of widespread suffering, and if so, how? The article argues that public theology offers a resilient framework to guide communities through these difficult times, particularly when integrated with public pastoral care. Public theology can provide hope, support, and a sense of purpose to those affected by engaging both spiritual and social dimensions. The article further explores how public pastoral care, as a practical expression of public theology, can address individuals’ and communities’ emotional, psychological, and spiritual needs. Ultimately, it demonstrates that public theology is relevant and essential in fostering resilience and promoting human flourishing in the face of adversity.

The Role of Curiosity in Virtual Environments: A Conceptual Integration.

Brands need to have a digital strategy. Yet, it is difficult to grab consumers' attention in virtual environments. We present the Curiosity in Virtual Environment (CVE) model, which integrates empirical and conceptual work on virtual environments, goal content, and curiosity. The model seeks to serve as a guiding framework and tool for research scholars and practitioners working in virtual environments who want to communicate with consumers. To elaborate and present the CVE, we first discuss the main characteristics of virtual environments and types of goal contents, followed by a brief introduction to the theoretical developments of curiosity. The model is then introduced, showing four quadrants in which practitioners should have an easier (more difficult) time grabbing consumers' attention. We then conduct a selective review of experimental studies on curiosity and consumption, identifying three voids in the field. We finish the article by suggesting directions for future research and acknowledging the limitations of the CVE model.

Impact of a mortality prediction tool on end-of-life (EOL) quality measures.

404 Background: Determining treatment options for patients with cancer can be difficult for providers, especially when it comes to deciding the appropriate time to stop therapy. Many factors come into play when making important treatment and quality of life decisions including cancer responsiveness to treatment, patient preferences, labs, and diagnostic studies. Providers use their experience, instinct, and patient input in making these decisions, and can still have a difficult time knowing the best option for the patient. To support providers in identifying patients at high risk for poor outcomes, we developed a 90-day mortality risk machine-learning model (MRM) for patients with metastatic cancer. The tool was designed to facilitate earlier advance care planning (ACP) discussions and prognostic awareness leading to alignment of treatment with patient goals and values. The US Oncology Network (The Network) implemented the MRM beginning in early 2021 through late 2022. We assessed the impact of the MRM using performance on 5 EOL Quality Measures included in Medicare’s Merit-based Incentive Payment System (MIPS) Program. Methods: MRM predictions were made every two weeks and provided to practices through a secure web-based dashboard. Practices customized their use of the MRM based on their unique workflow. MRM utilization was collected July – December 2023 and determined how frequently practices accessed the dashboard. Practices were separated into two groups based on MRM utilization: High Utilizers (HU) used the tool more than once a week and Low Utilizers (LU) did not use the tool or used it less than or equal to once a week. EOL MIPS measure performance was collected and evaluated from the 2023 calendar year. For each of the EOL MIPS measures, we compared the average score between the two practice groups. A 2-sample unequal variance t-test with 1-tailed distribution was used to determine if there was a significant difference between the two practice groups for each EOL MIPS measure. Results: A total of 25 practices had available EOL MIPS scores. Five practices were classified as a HU group and 20 were in the LU group. EOL MIPS measure scores were higher among HU. All results trended towards improvement with a statistically significant difference observed for PIMSH 1 and MIPS 457 for HU compared to LU. The table shows the average MIPS scores across the two practice groups. Conclusions: Practices with the highest reported utilization of the MRM also reported improved MIPS EOL quality scores for the 2023 calendar year. While each practice implemented MRM independently, those using the tool more than once per week had improved performance in their MIPS EOL quality scores. EOL MIPS Measure HU LU Delta P MIPS 047 ACP 80.7 59.8 20.9 0.066 PIMSH 1 ACP Stage 4 disease 67.7 40.2 27.5 0.002 MIPS 453 Chemo Last 14 days (inv) 10.7 11.7 -1.0 0.279 MIPS 457 Hospice <3 days (inv) 11.7 14.8 -3.1 0.038 PIMSH 9 Supportive RX last 14 days (inv) 5.3 6.6 -1.3 0.119

The experience of being diagnosed with type 2 diabetes in primary care

The announcement of diabetes can be an ordeal for the person learning about it, and a difficult time for the doctor notifying them. By setting up a multi-professional team, we can offer personalized nursing support. This meets patients' expectations. These include reassurance, sufficient time to obtain answers to their questions, the ability to plan ahead, and the understanding that they have a say in their own health.

АНАЛИЗ ЦЕННОСТЕЙ И КУЛЬТУРЫ СОВРЕМЕННОЙ КАЗАХСТАНСКОЙ МОЛОДЕЖИ

This article comprehensively examines that the value system is an important category in human life in difficult and turbulent times. It is human nature to adapt to values. Without the values of the phenomena of existence, neither the activity nor the life of man as a social being has any meaning. Education through universal values is the main way out of spiritual immorality. Today, the system of higher education is based on the search for new benchmarks. In this regard, it is necessary to define the main goal of current education in higher education institutions and to set its direction.