Essential Priorities Research Articles

Consensus on innovations and future directions of community first responder schemes in United Kingdom: a national nominal group technique study

AimWe aimed to achieve consensus among NHS and community stakeholders to identify and prioritise innovations in Community First Responder (CFR) schemes.MethodsWe conducted a mixed-methods study, adopting a modified nominal group technique with participants from ambulance services, CFR schemes and community stakeholders. The 1-day consensus workshop consisted of four sessions: introduction of innovations derived from primary research; round-robin discussions to generate new ideas; discussion and ranking of innovations; feedback of ranking, re-ranking and concluding statements. Innovations were ranked on a 5-point Likert scale and descriptive statistics of median and interquartile range calculated. Discussions were recorded, transcribed, and analysed thematically.ResultsThe innovations found were classified into two categories: process innovations and technological innovations. The process innovations included six types of innovations: roles, governance, training, policies and protocols, recruitment, and awareness. The technological innovations included three aspects: information and communication; transport; and health technology. The descriptive statistics revealed that innovations such as counselling and support for CFRs (median: 5 IQR 5,5), peer support [5 (4,5)], and enhanced communication with control room [5 (4,5)] were essential priorities. Contrastingly, innovations such as the provision of dual CFR crew [1.5 (1,3)], CFR responsibilities in patient transport to hospital [1 (1,2)], and CFR access to emergency blue light [1 (1,1.5)] were deemed non-priorities.ConclusionsThis article established consensus on innovations in the CFR schemes and their ranking for improving the provision of care delivered by CFRs in communities. The consensus-building process also informed policy- and decision-makers on the potential future change agenda for CFR schemes.

Stability of Envelope Proteins of SARS-CoV-2 Variants Could Be a Choice of New Drug Target

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has emerged as one of the worst viral pandemics during the past few years. As reported by the World Health Organization, around 77,56 49 520 cases and 70 51 720 deaths were reported from all over the world, which includes approximately 3500 patients reported during the recent past only. Currently, circulating variants of SARS-CoV-2 are KP.3, JN.1, BA.2.86 and KP.2. Mass vaccinations have been provided since the end of December 2020, which led to 5.47 billion people vaccinated till date. However, the disease continues in small foci all over the world. Development of an effective drug target and mutation independent vaccine thus becomes essential research priorities. Owing to the unavailability of a specific drug molecule, the present study has focused on the development of an effective drug target to treat COVID-19. In-house primers were designed for four essential structural genes viz., Spike protein, ORF1ab, Nucleocapsid gene, and Envelope gene. Samples of different waves were amplified using these primers employing the Polymerase Chain Reaction (PCR) assay. A total number of 86 SARS-CoV-2 RT PCR positive samples were studied, and results showed the most frequent appearance (80.2%) of Envelope (E) protein in all the samples. This suggests that during transmission across numbers of human hosts, it is the Envelope protein that was the most stable one. The most severe Delta variant showed the presence of E proteins in all the samples assayed. Blocking E protein as a new drug target to intervene intracellular replication of virus could be an effective drug development strategy.

Key factors in the future of oral and dental health in Iran using scenario writing approach

BackgroundOral and dental health can significantly impact individuals’ quality of life. The World Health Organization introduces oral health as one of the essential priorities of public health worldwide. Given the lack of studies on the future of oral and dental health in Iran, this study used a futures studies approach to identify the factors in oral and dental health in Iran through scenario writing.MethodsThis study was conducted in three stages including the scenario writing approach, qualitative methods, and exploratory future research. First, potential variables affecting future oral and dental health systems were extracted through interviews. The focus group discussion determined the uncertainty and importance of the variables. Then, the cross-impact balance matrix was imported into the Scenario Wizard software to identify the different states of the scenario generator variables and compatible scenarios were extracted.ResultsSeventy variables were extracted as key variables affecting the future of oral and dental health. Regarding the importance and uncertainty, seventeen variables scored higher and fell into policy and governance, economy and financing, social, service delivery, and technology, serving as five categories of scenario generators. Fifteen scenarios with weak consistency and three with strong consistency were obtained using the Cross-Impact Balance matrix in Scenario Wizard software.ConclusionThe probability of a pessimistic scenario where all five categories of the scenarios were in the worst possible state was higher due to its consistency. The government’s support policies and commitment to oral and dental health were two key factors in the future. Achieving an optimistic and favorable scenario for the future of the country’s oral and dental health system depends on the government and policymakers in the health sector adopting a positive attitude towards the role of oral and dental health services in improving societal health. In this scenario, the five categories of the scenario generators were in the best condition.

Stretched sapwood, ultra-widening permeability, and ditching da Vinci: revising models of plant form and function.

The mechanisms leading to dieback and death of trees under drought remains unclear. For constructing an understanding of these mechanisms, addressing major empirical gaps regarding tree structure-function relations remains essential. We give reasons to think that a central factor shaping plant form and function is selection favoring both constant leaf specific conductance with height growth and isometric (1:1) scaling between leaf area and the volume of metabolically active sink tissues ("sapwood"). Sapwood volume-leaf area isometry implies that per-leaf area sapwood volumes become transversely narrower with height growth; we call this "stretching." Stretching means that selection must favor increases in permeability above and beyond that afforded by tip-to-base conduit widening (ultra-widening permeability), as via fewer and wider vessels or tracheids with larger pits or larger margo openings. Leaf area-metabolically active sink tissue isometry would mean that it is unlikely that larger trees die during drought because of carbon starvation due to greater sink-source relationships as compared to shorter plants. Instead, increase in permeability is most plausibly associated with greater risk of embolism, and this seems a likelier culprit of the preferential vulnerability of larger trees to climate change-induced drought. Other implications of selection favoring constant per-leaf area sapwood construction and maintenance costs are departure from the da Vinci rule expectation of similar sapwood areas across branching orders, and that extensive conduit furcation in the stem seems unlikely. Because all of these considerations impact the likelihood of vulnerability to hydraulic failure versus carbon starvation, both implicated as key suspects in forest mortality, we suggest that these predictions represent essential priorities for empirical testing.

The influence of ESG practices on domestic value-added to exports during the period of technological change.

Sustainable development and raising the domestic value-added rate of exports (DVARE) have become essential priorities in the pursuit of high-quality economic growth. An econometric spatial model is developed in this research using data on Chinese enterprises spanning 2008 to 2019. According to a study, exports' domestic value-added rate (DVAR) can be successfully increased using environmental, social, and governance (ESG) practices. Spatial spillover analysis demonstrates that adopting ESG practices boosts export DVAR both within and between regions. According to heterogeneity analysis, the sample's overall increase in DVARE as a result of ESG practices is mostly attributable to the mix and processing trade organizations, the eastern area, and large firms. An examination of the underlying mechanisms shows that businesses that implement advanced technologies are able to reinforce the favorable impact of ESG practices on DVARE. This article gives evidence from real-world studies that show how ESG practices help boost Chinese exports and advance sustainable development. The findings hold significant implications for other developing nations as they make the transition towards a pattern of economic growth.

Implementation, Challenges, Best Practices, and Innovation of Distance Education and Online Training in Vocational Education

This quantitative descriptive study investigated the landscape of online vocational education and training, focusing on applications, challenges, best practices, and strategic planning. Conducted in Yiwu City, Zhejiang Province, China with a specific emphasis on the Zhejiang Institute of Mechanical and Electrical Technicians. Using stratified random sampling to ensure a representative sample of 98 participants. In their research, the authors provide an in-depth look at the online vocational education and training platform, highlighting its strengths and areas for improvement. While the platform is praised for its user-friendliness, navigation, and alignment with learning objectives, it also faces challenges in overall usability and learner engagement. Users appreciate the platform's intuitive interface and visually appealing design, but they note a need for better language diversity support in accessibility features. Content organization is generally logical, and search functionalities receive positive feedback, although there's room for improvement in terms of clarifying explanations and content progression. Turning to vocational education institutions, the research reveals key insights. These institutions are recognized for their effective technological support and the importance of continuous investment in keeping up with evolving technologies. Quality assurance, accreditation, curriculum updates, and hiring qualified instructors are seen as essential priorities. Improving assessment methods is also crucial for enhancing the quality of online vocational education. While efforts to promote access and equity are commendable, proactive measures are needed to address potential barriers. The institutions' commitment to resource allocation and financial sustainability practices, guided by data and cost-effectiveness, garners strong support. The research findings emphasize the critical components of online vocational education and training courses. Users highly value interactive and engaging content, suggesting opportunities for enhancements in multimedia integration and gamification. A user-friendly interface is deemed crucial, with potential for improvements in intuitiveness and interactivity. Effective communication channels are highlighted as vital for fostering a sense of community among learners. Aligned with the research, the authors identify crucial focus areas and strategies for enhancing online vocational education and training. These encompass improving interface usability, strengthening communication channels, enriching multimedia engagement, ensuring accessibility, and introducing innovative collaboration features. These strategies serve as concrete commitments aimed at augmenting educational quality, accessibility, and inclusivity for all learners. In conclusion, the research offers a comprehensive view of the online vocational education and training landscape, recognizing its strengths while outlining opportunities for improvement. It calls for collaborative efforts to enhance user engagement, interface usability, and multimedia integration. Furthermore, the study's recommendations provide actionable strategies to shape a more inclusive, engaging, and accessible future for vocational education and training.

The The Application of Artificial Intelligence and Machine Learning to Enhance Results-Based Management

Artificial Intelligence (AI) and Machine Learning (ML) technologies have revolutionized numerous industries and sectors, offering transformative potential for Results-Based Management (RBM). RBM is a management paradigm wherein organizations and government entities plan and assess the effectiveness of their projects, policies, or programs in achieving outcomes. Integrating AI and ML into RBM can significantly enhance outcomes, fostering data-driven and informed decision-making. AI and ML integration into RBM practices facilitates improved decision-making, resource optimization, accountability, and transparency. These technologies enhance RBM by enabling predictive analytics, real-time monitoring, task automation, customization, and scalability. The dynamic synergy of AI and ML extends beyond RBM into sectors like agriculture, public health, academia, and public administration. Despite their immense potential, AI and ML tools face challenges such as perpetuating inaccuracies and biases due to inherent biases or low data quality. Nevertheless, their application in RBM empowers organizations to plan better, monitor, evaluate, and refine projects and programs, optimizing resource allocation and performance. Ongoing research, ethical considerations, data quality, and accountability are essential priorities for harnessing the full benefits of AI and ML in RBM. Therefore, this research paper investigates the potential of AI and ML tools and technologies in improving results-based management. It comprehensively reviews existing literature, practical applications, and case studies to elucidate how AI and ML can enhance results-based management practices and contribute to better decision-making.

Essential problems and priorities of state regulation of migration approaches in the Republic of Kazakhstan

The article aims to determine the activities that include the management of migration processes, the impact on the increase or stabilization of the population, and the unity and security of the country. The impact of the migration policy on the country’s security was studied systematically, structurally, historically, behaviorally, on a comparative basis, based on social methods. The main task is to improve immigration and migration of foreigners to the country of Kazakhstan, openness of state borders, geopolitical location of the republic, stability of interethnic relations, as well as state regulation of migration and settlement processes. In this article, the problems of real socio-economic growth, development of the region, employing citizens in the country, and reaching the highest level of civilized development were considered. Kazakhstan faces a general spectrum of future development with modern conditions of economic prosperity: transformation into a civilized new state, where the negative impact of migration and landing is rooted in the economic system of a developing country, where migration and landing processes do not have any impact on the development of the country. The authors state the inability of the authorities regulating migration and landing to create an insurmountable barrier for unwanted immigrants to the state and support the acceptable entry of large ethnic groups into society, the need for new methods and tools for Migration Policy, as well as research on new initiatives. Based on statistical data on the migration process of Kazakhstan, forecast indicators for 2030–2050 have been developed.

Spatiotemporal analysis of CO2 emissions and emission reduction potential of Beijing buses using smart card data

Human activities, primarily carbon dioxide emissions, have undeniably caused global warming. The transportation sector contributes about a quarter of global CO2 emissions. While replacing traditional buses with electric ones has reduced emissions, it is crucial to consider the indirect emissions resulting from electricity consumption. This study proposes a framework for modeling bus emissions using smart card data, integrating spatiotemporal distribution characteristics and emission reduction potentials. Our analysis reveals that routes spanning 10–30 km contribute to 81% of total bus emissions, with an average emission rate of 56.2 gCO2/per-km for residents traveling by bus. Bus emissions also exhibit cyclical variations during holidays, weekdays, and weekends, indicating spatial clustering and trends. Although the area within Beijing's 4th Ring Road constitutes only 13% of the total area within the 6th Ring Road, it generates almost half of the CO2 emissions. With urban expansion, total bus emissions increase gradually, but emission intensity decreases. This study emphasizes the potential for reducing emissions through improved public transportation operations. It recommends fully electrifying the bus fleet and employing low grid emission factors, which could reduce emissions by up to 71% compared to diesel options. Electrification of buses and optimizing power generation on the grid are essential priorities for emission reduction.

Modern medical schools curricula: Necessary innovations and priorities for change.

Medical schools' curricula have expanded over the decades to incorporate important new medical breakthroughs and discoveries. Their current focus and overall structures remain, however, stubbornly captive of early 20th-century thinking, with changes having been undertaken in a piecemeal fashion. Indeed, since the notable Flexner reform in 1910, medical schools' study plans have suffered successive and typically always partial adjustments which have failed to keep up with scientific, technological and sociological change. This difficulty may be attributable to the well-known conservatism of medical schools, where updating study plans is a process that invariably encounters numerous barriers to change. These observations were afforded detailed attention some 15 years ago when de Oliveira wrote: 'it is now perfectly demonstrated that public medical schools have not been able to adapt their operation in depth and in due time to the new demands of teaching dictated by an explosive scientific and technological development'. Recent advances in communication and information technologies, as well as the introduction of new pedagogical techniques, have the potential to bring significant benefits to medical practice and healthcare systems, but these have not in the main become properly taught and utilized. The proposition that healthcare is evolving from reactive disease care to care that is predictive, preventive, personalized and participatory was initially regarded as highly speculative, yet systems approaches to biology and medicine are now beginning to provide experience of both health and disease at the molecular, cellular and organ levels. Medicine is a broad scientific field. In contrast to the 19th century, current medical 'sectarianism' is a positive by-product of rapid and gratifying medical progress, and the multiplicity of new models means that the lines of evidence legitimately bearing on practice and health policymaking are already highly diverse and likely to become ever more variegated over time. Put simply, most sound decisions, by definition, will be evidence-informed and not evidence-based, where divergence may be as informative as convergence. Here, the most enduring lesson of history is, perhaps, that clinical medicine is constantly rediscovering its humanistic core. Complexities create opportunities for innovation. In innovative environments, high-performing organizations are finding ways to create a culture that supports a diverse workforce preparing to deliver different models of care, with direct implications for excellence of patient experience and strong repercussions for medical education. The COVID-19 crisis saw major increases in the use of telemedicine, virtual office visits and other forms of online contact, and these are likely to increase considerably. This particular transformation will not be easy or comfortable to make. But reconfiguration of medical education seems inevitable, fuelled by online educational technology and the need to transform clinical training to more outpatient settings with promotion based on competency and person-centeredness, not simply time. As we prepare to enter 2024, this is an exciting time to be working in healthcare. We have more evidence than ever about how to provide high quality, person-centered care, and to keep patients safe. Shame on us if there is any hesitation about applying this knowledge to make the healthcare experience better for patients and providers. Embracing change and making continuous improvements are essential and urgent priorities for medicine and healthcare and, as we describe in the current article, will become more and more indispensably important in our rapidly changing world.

Somut Olmayan Kültürel Miras Unsurlarından Türk Lokumu ve Afyon Kaymağının Afyonkarahisar İçin Önemi

With its rich flavors and traditional practices, Turkish cuisine is integral to our Intangible Cultural Heritage (ICH). Our rich culinary culture, developed over centuries, has been passed down from generation to generation through regional flavors, different cooking techniques, and shared table manners. Turkish culinary culture represents a social experience along with the use of rich and diverse ingredients. This research aims to thoroughly examine Turkish delight and Afyon cream, which are ICH elements in Afyonkarahisar province, and to determine the sustainability and significance of traditional food and beverage production and social practices derived from these cultural elements in Turkish culinary culture. The study sample was selected as the gastronomy elements of Afyonkarahisar province. Secondary data sources and document archive scanning techniques were used in the research, and Tableau and Power BI programs were used for data visualization. In addition to the research, semi-structured interviews were conducted with 5 traditional Turkish delight and Afyon cream producers. According to the results of the study, it was found that there are a total of 56 elements of Turkish culinary culture/traditional food and beverage production and social practices in Turkish and 3 of these elements are found in Afyonkarahisar. By comparing the registered ICH elements in different provinces, it was found that the quantitative difference between Afyonkarahisar and other provinces is relatively small, but it still needs to be improved despite being a gastronomy city, and the average number of elements in Turkey is three. As a result of the interviews conducted with the producers of Turkish delight and Afyon cream, it was found that sustainability and the transfer of production stages to future generations are essential priorities. At the same time, it was concluded that Afyonkarahisar, one of the gastronomy cities, needs more ICH elements related to Turkish culinary culture. Suggestions were made to diversify and develop Afyonkarahisar's ICH elements related to Turkish culinary culture. These suggestions include encouraging more traditional food and beverage producers, creating training and support programs for these producers, and emphasizing and increasing promotional activities for Afyonkarahisar's gastronomy potential in the tourism sector.

COVID-19 in Western Australia: 'The last straw' and hopes for a 'new normal' for parents of children with long-term conditions.

Children with long-term conditions are vulnerable due to the treatments required for their conditions. Since the start of the coronavirus disease 2019 (COVID-19) pandemic, Western Australians experienced restrictions that changed daily life activities but were able to return to some of their previous routines due to the restrictions. The study explored the stress experiences of parents caring for children with long-term conditions during COVID-19 in Western Australia. The study was codesigned with a parent representative caring for children with long-term conditions to ensure essential questions were targeted. Twelve parents of children with various long-term conditions were recruited. Ten parents completed the qualitative proforma, and two parents were interviewed in November 2020. Interviews were audio-recorded and transcribed verbatim. Data were anonymised and analysed using reflexive thematic analysis. Two themes were produced: (1) 'Keep my child safe' describes the children's vulnerabilities due to their long-term conditions, the adjustments parents' made to keep their children safeand the various consequences faced. (2) 'COVID-19's silver lining' covers the positives of the COVID-19 pandemic, including their children having fewer infections, the availability of telehealth appointments, relationship improvements and the parent's hopes for a new normal where behaviours prevent transmission of infectious (e.g., hand sanitising). Western Australia provided a unique context for the COVID-19 pandemic due to no transmission of the virus severe acute respiratory syndrome coronavirus 2 at the time of the study. The tend and befriend theory aids in explaining the parents' stress experiences, and the application highlights a unique aspect of this theory. Parents tended to their children during COVID-19, but many could no longer rely on others for connection, support and respite, and became further isolated in attempting to protect their children due to COVID-19 consequences. The findings highlight that some parents of children with long-term conditions need specific attention during times of pandemics. Further review is recommended to support parents through the impact of COVID-19 and similar crises. This study was codesigned with an experienced parent representative who was part of the research team and involved throughout the research process to ensure meaningful end-user engagement and ensure essential questions and priorities were addressed.

Developing consensus-based recommendations for the delivery of dementia services for the LGBTQIA+ community in the Republic of Ireland.

The number of older LGBTQIA+ adults is set to rise significantly in the coming years. The rising numbers sit together with the rise in the number of people in Ireland diagnosed with dementia. In Ireland, no dementia-specific services exist for people from the LGBTQIA+ community. The aim of this research was to 1) identify the future needs that older LGBTQIA+ people and their care partners living in Ireland have in relation to dementia care service delivery; and 2) develop consensus-based recommendations for dementia service provision in Ireland. A six-phase consensus process was used to develop the lists of needs and recommendations: 1) development; 2) national survey; 3) interviews with key stakeholders; 4) international review of best practice; 5) consensus meeting; 6) final member checking. Participants, aged over 50, were based in Ireland, identified as a member of the LGBTQIA+ community, or supported someone who is/was. Results are reported from the survey (n=49), individual interviews (n=8), and the consensus meeting (n=10). Participants have concerns related to identity management and suppression, creating an LGBTQIA+ affirmative ethos and workforce, and respect and safety. From the results and consensus process, a full list of ten prioritised needs and recommendations have been developed that focus specifically on dementia care in Ireland for the LGBTQIA+ community. The older LGBTQIA+ community has identified essential priorities for improving healthcare access and safety. These priorities need to be urgently implemented into clinical and dementia care services.

Developing consensus-based recommendations for the delivery of dementia services for the LGBTQIA+ community in the Republic of Ireland

Background: The number of older LGBTQIA+ adults is set to rise significantly in the coming years. The rising numbers sit together with the rise in the number of people in Ireland diagnosed with dementia. In Ireland, no dementia-specific services exist for people from the LGBTQIA+ community. The aim of this research was to 1) identify the future needs that older LGBTQIA+ people and their care partners living in Ireland have in relation to dementia care service delivery; and to 2) develop consensus-based recommendations for dementia service provision in Ireland. Methods: A six-phase consensus process was used to develop the lists of needs and recommendations: 1) development; 2) national survey; 3) interviews with key stakeholders; 4) international review of best practice; 5) consensus meeting; 6) final member checking. Participants, aged over 50, were based in Ireland, identified as a member of the LGBTQIA+ community or supported someone who is/was. Results: Results are reported from the survey (n=49), individual interviews (n=8), and the consensus meeting (n=10). Participants have concerns related to identity management and suppression, creating an LGBTQIA+ affirmative ethos and workforce, and respect and safety. From the results and consensus process, a full list of ten prioritised needs and recommendations have been developed that focus specifically on dementia care in Ireland for the LGBTQIA+ community. Conclusion: The older LGBTQIA+ community has identified essential priorities for improving healthcare access and safety. These priorities now need to be urgently implemented into clinical and dementia care services.

Effectiveness of an Intervention Program on Nurses’ Practices toward Neonatal Intubation Suctioning Procedure at Neonatal Intensive Care Unit

Intubation secretion suctioning is a scientific technique carried out by intensive care nurses to keep the airway open and hence the blood oxygen saturation level within normal range. The fluid suctioning process is one of the essential procedures and priorities for nursing performance in care. Objectives: This study aimed to determine the effectiveness of an intervention program on Nurses’ practices toward neonatal intubation suctioning procedure at neonatal intensive care unit. Methodology: This is a pre-experiment design conducted on nurses working in the Intensive Care Unit at Pediatric Teaching Hospital. It started from September 30, 2021 to March 15, 2022. An observational method was adopted to collect a sample of 24 nurses to analyze the effectiveness of an intervention program on nurses' practices. A two-part checklist was developed. The validity of the instrument was determined by a committee consisting of (10) specialists from different areas. SPSS version 24.0 was used to analyze the data. Results: The results of the study showed that the neonatal intensive care unit nurses who participated in the sample numbered (24), the practices towards suctioning intubation fluids were within a low and insufficient level in the pre-test, while the post-test for all three procedures domain were within the acceptable average level. Conclusions: The study showed that there are significant differences in the impact of the program on nurses’ practices before and after implementing the program on nurses, and this indicates an improvement in the work and practices of intensive care nurses towards implementing the procedure of suctioning intubation secretion for the neonatal. Recommendation: Implementation of the interventional program for nurses’ practices and circulating to nurses in all intensive care units Designing a guidebook for the program’s steps and the steps of the procedure for withdrawing fluid from the respiratory tract of the neonatal. Keywords: Intervention Program, Nurses’ Practices, Suctioning Procedure.

Developing consensus-based recommendations for the delivery of dementia services for the LGBTQIA+ community in the Republic of Ireland

Background: The number of older LGBTQIA+ adults is set to rise significantly in the coming years. The rising numbers sit together with the rise in the number of people in Ireland diagnosed with dementia. In Ireland, no dementia-specific services exist for people from the LGBTQIA+ community. The aim of this research was to 1) identify the future needs that older LGTBQIA+ people and their care partners living in Ireland have in relation to dementia care service delivery; and to 2) develop consensus-based recommendations for dementia service provision in Ireland. Methods: A six-phase consensus process was used to develop the lists of needs and recommendations: 1) development; 2) national survey; 3) interviews with key stakeholders; 4) international review of best practice; 5) consensus meeting; 6) final member checking. Participants, aged over 50, were based in Ireland, identified as a member of the LGBTQIA+ community or supported someone who is/was. Results: Results are reported from the survey (n=49), individual interviews (n=8), and the consensus meeting (n=10). Participants have concerns related to identity management and suppression, creating an LGBTQIA+ affirmative ethos and workforce, and respect and safety. From the results and consensus process, a full list of ten prioritised needs and recommendations have been developed that focus specifically on dementia care in Ireland for the LGBTQIA+ community. Conclusion: The older LGBTQIA+ community has identified essential priorities for improving healthcare access and safety. These priorities now need to be urgently implemented into clinical and dementia care services.

Cervical cancer situation in Malaysia: A systematic literature review

Cervix cancer is one of Malaysia’s most significant cancers for women (around 12.9%, with an age-standardised incidence rate of 19.7 per 100,000). It was higher than other Asian, West, and even worldwide nations. The National Strategic Plan for Cancer Control Program 2016–2020 (Health Ministry) was presented to minimize cancer and mortality. The high incidence of cervical cancer in Malaysia is mainly due to women’s insufficient knowledge about its prevention and importance. Compared with traditional literature reviews, the systemic analysis provides many advantages. A clearer review process, a more prominent field of study, and essential priorities that can manage research bias can all help to enhance these reviews. However, better integration, cooperation, and coordination between government and private sector as well as NGOs and professional organisations are essential for optimal cancer control and treatment across the country.

МАКРОРЕГІОНАЛЬНЕ СПІВРОБІТНИЦТВО ТА ІННОВАЦІЙНИЙ РОЗВИТОК ЄС

One of the critical problems of the global economic space is the issue of ensuring innovative sustainable development both for individual countries and for international integration associations. The article aims to identify drivers of innovative development of Member States based on the research of modern macro-regional strategies of the European Union. The research methodology involved extensive tools for analysis and synthesis, comparison, generalisation and foresight forecasting. The results revealed the positive effect of macro-regional strategies. There is a higher level of integration of macro-regions compared to the EU average. The practical significance of research results. It is concluded that the implementation of macroregional strategies of the spatial development of EU Member States achieves positive effects in the form of equalisation of innovation potential of regions and their levels of development. It increases their competitiveness through regional cooperation, business support, business and science development. Foresight analysis replaces the "short-sightedness" of planning, conditioned by time (rather than achieving strategic goals), existing resources and the need to achieve financial results. This allows identifying essential innovation priorities for regional development (including the "smart" specialisation). Moreover, foresight methods as prognostic components of EU innovation policy are gradually displacing traditional ideologically oriented neoconservative and neoliberal theories of individual EU Member States. Systemic and institutional approaches replace them with pragmatic content. Today's most effective macro-regional strategy is the EU Strategy for the Baltic Sea Region (EUSBSR), which brings together 8 EU Member States at different stages of economic development. Still, it has excellent potential to build knowledge that supports innovations.

Designing an App for Immunosuppression Adherence and Communication: A Qualitative Approach.

Background:Immunosuppression nonadherence may be the most important factor limiting long-term allograft survival.Objective:Following user-centered design, we explored the essential priorities and preferences of kidney transplant recipients and healthcare providers (HCP) to inform development of a smartphone app to improve immunosuppression adherence and communication.Design:A qualitative descriptive research design was used.Setting:The University of Alberta Hospital adult kidney transplant program in Edmonton, Canada.Participants:Participants were recruited by convenience sampling and included 32 kidney transplant recipients and 11 HCPs.Methods:Seven focus groups (5 with recipients and 2 with HCPs) were conducted to inform app development. Sessions were recorded, and transcripts were coded to elucidate themes.Results:App development to improve adherence was not a priority for HCP. Recipients prioritized choice: that all features be optional. Recipients preferred support while traveling; access to laboratory results; and use by younger or newly transplanted recipients. Both recipients and HCP preferred linkage to pharmacy; and self-management and accountability.For the app to improve communication, HCPs believed the priorities to be addressed included: clarity on scope of app; legal, ethical, and professional obligations; and charting. Both recipients and HCP prioritized HCP workload, and broader medication and health concerns. Healthcare providers preferred tech support; both recipients and HCPs preferred app access for nontransplant HCP.Limitations:Limitations include underrepresentation of physicians, recipients with racial/ethnic diversity, and potential selection bias of transplant recipients who perceived themselves to be adhering to immunosuppression medications.Conclusion:Future research is needed for the app to become a comprehensive, secure platform for broader communication between recipients and HCP, pharmacies, and nontransplant clinicians while streamlining HCP workload.

Energy inequality and clientelism in the wake of disasters: From colorblind to affirmative power restoration

Do social vulnerabilities and ruling party support shape government responsiveness in times of disasters? The 2017 hurricane María territory-wide power outage, the second longest in world history, is a tragic natural experiment that provides a unique opportunity to examine the determinants of government responsiveness during disaster recovery processes. We use data on power restoration crew deployments (N = 18,614 deployments), a novel measure of government responsiveness, and a new social vulnerability index to assess the determinants of government responsiveness in the wake of disasters. We find that communities with ties to the ruling party elicit greater government responsiveness while socially vulnerable communities are less likely to be prioritized during the disaster relief efforts, controlling for disaster damage as well as logistical, economic, and essential service recovery priorities. Existing power restoration policies place larger burdens on marginalized communities, motivating the need for including power restoration to vulnerable communities among restoration priorities.