Evolution Of Services Research Articles

MO851: Impact of COVID-19 on Dialysis Patients: Reported Experience in Qatar

Abstract BACKGROUND AND AIMS Patient-centred care is a concept focussing on meeting the specific health needs of patients as expressed by them. There is increasing evidence to show that patient centred care can help to achieve higher rates of patient satisfaction, clinical outcomes and overall better experience, particularly for patients with chronic disease. Patients Reported Experience Measures (PREM) is another concept associated with patient-cantered care. PREM surveys capture information about the healthcare experience as perceived by patients. Its importance lies in the incorporation of patient feedback into the clinical decisions and service evolution. Dialysis patients play an important role in their treatment and their voice matters to provide proper care. PREM was first conducted in 2019 in our dialysis unit including 200 patients. In 2020, COVID-19 impacted the dialysis services and resulted in many challenges including staff shortage and deployment. METHOD We used a validated questionnaire from the National Health Service in United Kingedm. It consisted of 7 questions covering demographics, dialysis options, patient portal, patient's relationship with the staff, teamwork and travelling abroad. The survey involved 317 randomly selected patients who have been at least 1 year on dialysis. We performed a comparison of the 2019 and 2020 results using Chi-squared test. RESULTS 257 patients on hemodialysis and 60 on peritoneal dialysis participated in the survey. Majority of the surveyed patients (65%) were on dialysis from 1–5 years and 32% with more than 5 years’ survival on dialysis. Sixty five % of patients responded that they were on follow up in nephrology or low clearance clinic before starting dialysis. Access to dialysis team, nurses and doctors from home declined in 2020 due to the shortage of staff in the dialysis services and deployment of many staff to COVID-19 facilities, 62% of surveyed patients were able to contact their care givers from home compared with 87% in 2019 (P < 0.0001). Regarding education, 78% of the patients responded that they received education before starting dialysis and it was in an understandable manner while patients' response to the same question was 85% in 2019 (P = 0.047). 44% received education on side effects, which is remarkably less compared with 74% in 2019 (P = 0.0001). CONCLUSION Patient reported experience helps in the evaluation of health services. Exploring patient experience in dialysis patients in Qatar, we found negative impact of COVID-19 from patients’ perspectives. Our PREM survey showed significant decline in many parameters likely attributed to COVID-19 consequences including the shortage of staff.

Emerging trends and evolutions for smart city healthcare systems

• This study examines the evolution of healthcare, identifying the reasons, methods, and effects. • The evolution of network services and historical events are provided. • Healthcare evolutions are presented in terms of social relevance and scientific significance. rapid development of the industry affected all its branches, led to evolution, and influenced people's worldview and desires. The revolutionary changes also affected the healthcare system, contributing to its development in technological, socio economic, scientific, and physical terms. Healthcare has gone through several stages called Healthcare 1.0, Healthcare 2.0, Healthcare 3.0, and Healthcare 4.0. Each of these stages is a logical chain of one whole progress, resulting in solving open challenges and previous problems. Each stage has its advantages, disadvantages, distinctive features, methods of providing medical care, scientific and technical innovations, where the research of which is mandatory for understanding the system as a whole, identifying trends, and developing future directions. This paper is devoted to a systematic analysis of the evolutionary development of healthcare, identifying the causes, means, and influence on subsequent processes. The chronology of the methods is revealed. Each stage of development is analyzed in terms of social significance, scientific and technological significance, communications, and application of information technologies, which makes this paper unique in this area. The studies were carried out with an emphasis on the technical component of the system, particularly the application of network technologies and services, the issues of the introduction of emerging technologies.

E-Commerce Revolution in the Insurance Industry Product Development

The insurance industry appears to be lagging in the rapid evolution of financial services and e-commerce. However, insurers are still hesitant to approve policies online and are adding these services slowly to their sites for product development. This paper discusses some of the fundamental issues surrounding the use of alternative Internet business models in insurance, benefits, barriers as well as the success factors. An Extensive experience within the insurance industry and ability to deliver cost effective e-commerce solutions which suit our needs, are involved in making the Insurance Products suitable for E-commerce. Above all a Bird's eye description can help us in competing in the increasingly competitive insurance sector.

Dynamics and Factors of Medical Service in European Russia at the Beginning of the 20th Century

The article examines the evolution of medical service in European Russia at the beginning of the 20th century. Based on the analysis of statistical data, it is displayed that by 1913 the number of medical care cases increased by half up to 550 services per 1000 people. The key factors determining the dispersion of medical service were health care funding level, doctor and paramedics availability and the zemstvo status of the province. Also, a statistically significant relationship was revealed between medical service and the level of well-being of the population. In urban area, the independent factors determine the variance of studied factor substantially worse than the one in rural areas; by 1913, the most significant factor changed from the zemstvo status of the province to the level of accessibility of medical care. The obtained data allow to infer that in the Russian Empire there were parallel and interdependent processes of developing practices of public health organization and healthcare seeking.

IMPROVEMENT OF SUBJECT-OBJECT RELATIONS IN THE CONTEXT OF FORMATION OF NEEDS IN ECOSYSTEM SERVICES OF URBAN PARKS

Topicality. Today in Ukraine there is no clear understanding of the mechanism of formation of demand for ecosystem services of urban parks and appropriate response measures. Cultural and ideological values of society are reflected in the formation of a culture of recreation in parks throughout the existence of mankind, which requires detailed study. In order to implement adequate decisions on the development of parks, it is necessary to determine the main factors influencing the formation of qualitative characteristics of parks, which best meet modern ideas and needs of society for comfortable urban parks. There are already positive examples in foreign experience of an integrated approach to the organization of parks based on an understanding of the basic needs of society and the factors that cause them to change. Therefore, it is necessary to refer to the existing world experience and identify the necessary changes in the field of park management at the institutional level of the organization. Aim and tasks. The aim of the article is to identify the main patterns of evolution of ecosystem services of urban parks, as well as to determine the factors shaping the needs for these services and, accordingly, institutional support for urban parks, taking into account the experience of economically developed countries. The objectives of the study are: analysis of the preconditions for the formation of needs for ecosystem services of urban parks; identification of modern factors that are most relevant in creating trends in the development of current qualities of parks; analysis of foreign experience of institutional support of city parks; identification of current improvements needed by subject-object relations in the park economy of Ukraine. Research results. All spheres of public life - from culture to scientific achievements, are reflected in the organization of parks, which reflects the formation of relations "man - nature". The study identified a number of factors that have the greatest impact on the formation of modern parks and determine current trends in their development. All the considered factors can be divided into steels, relative steels and variables. In each of the proposed groups of factors can be identified those that are most relevant today, on the basis of which we can propose the use of "filter factors" in decision-making in the system of park improvement. The analysis of foreign experience in the functioning of parks has shown a wide range of possibilities of subject-object relations in the field of park improvement, based on which a number of current changes in this area in Ukraine have been proposed. Conclusion. The study found that park development trends are closely linked to the values of various social institutions, which indicates the need to study current social, economic and cultural changes in the context of park development. It is also established that socio-economic development and the emergence of related problems encourage the emergence of new factors that may be a key factor influencing the development of parks (eg environmental problems, urbanization, sanitation, sanitary and epidemiological problems, organoleptic characteristics of urban comfort in the context of climate change ) and create relevant trends. In turn, the implementation of current changes in the field of park management requires the improvement of subject-object relations, relations between government, society and institutions.

Spatial-temporal evolution of ecosystem services and its potential drivers: A geospatial perspective from Bairin Left Banner, China

Ecosystem services (ESs) declines have been widely recognized due to natural and human drivers and in turn negatively affected human well-beings, particularly in semi-arid regions. However, in which way and to what extent these drivers influence ESs spatially remains to be further demonstrated. This work aims to address this gap by capturing variations of geographic scales in this process. In this study, the CA-Markov and InVEST () model were combined to assess four key ESs and ecosystem service index (ESI) from 2000 to 2035, and spatial pattern of ESI were identified under different development scenarios. The Spearman correlation was conducted to analyze the tradeoffs and synergies of ESs changes among their historical associations. The multi-scale geographically weighted regression (MGWR) was adopted to explore the spatial heterogeneity of responses on ESI from various drivers. The results are as follows: (1) From 2000 to 2020, ESI decreased significantly in the north resulted from the deforestation, while there was a growing tendency of emergence for ESI hotspots in the south due to the implementation of ecological management measures. Compared to other scenarios, fewer cold spots of ESI variation were observed in the ecological preservation scenario from 2020 to 2035 especially in northern forests. (2) The significant positive correlations between habitat quality, soil conservation and carbon storage were strengthened while negative correlations between habitat quality, carbon storage and water yield had decreased over time. (3) The geographic scales at which different drivers interacted with ESI varied remarkably. The process of elevation and GDP were modeled at global scales, indicating their spatially homogeneous effects on ESI. However, effects of slope and vegetation on ESI were operated at local scales, with the spatial correlation coefficients varied greatly. (4) There existed apparent spatial heterogeneity of responses on ESI from natural and human drivers. The combined effects of vegetation and precipitation played a significant role in driving ESI among natural drivers. The effects of geomorphological drivers were closely related to vegetation types and anthropogenic drivers. A method was provided in this study to intuitively reveal the spatial relationships between ESI and various drivers in view of their different geographic scales. We suggest that ecological measures such as forestation shall be implemented prudently according to local water resources based on our results. These findings could provide more practical and feasible measures for the ecological sustainability in semi-arid regions and offer a reference for other similar regions in the world.

‘Roots in the soil’: the evolution of a countryside youth service in Westmorland, 1939–c.1950

ABSTRACT This article traces the evolution of the statutory Youth Service in rural Westmorland (now part of Cumbria), from its establishment in 1939 to the early post-war years. It focuses on how the county’s Youth Service innovated and developed new ways of working with young country people in their spare time, and the challenges of introducing urban-focused policy into rural practice. It argues that to be effective in work outside urban areas, the national Youth Service had to adapt to existing patterns of country life and leisure. Tensions between this external organising body and local communities are also considered. The article draws on official Youth Service records, including minute books, correspondence and annual reports, alongside local press accounts and oral history testimony. In doing so, it enhances our understanding of the professionalisation of informal education, and the leisure habits of rural youth, during and immediately after the Second World War.

Delivering specialised care to people ageing with HIV in the UK: experience and evolution of services from 2009 to 2019.

The introduction of antiretrovirals has resulted in a demographic shift with an increasing proportion of people living with HIV older than 50 years and a change in the spectrum of diseases affecting this population. A specialised clinical service dedicated to older people living with HIV was implemented at Chelsea and Westminster Hospital, London, UK in 2009, following training of health-care providers in HIV, ageing, comorbidity, and polypharmacy management. We report the results of a service evaluation reviewing 10 years of activity of this specialised clinic, including lessons to be applied in routine practice. We estimated the prevalence of multimorbidity and polypharmacy and described algorithms devised for use across our HIV outpatient services following implementation of the specialised clinical pathway. The service evaluation was approved by our local clinical governance system and data relative to the period 2009-19 were collected on a secured trust database. Dedicated time was created for senior and junior doctors, a nurse, and a pharmacy to create clinical appointments for older people living with HIV referred by all service care providers. The team would review different clinical scenarios, book follow-up appointments to review results, refer to different specialists or to complex multidisciplinary teams when necessary. 744 people with HIV aged 50 years and older attended our services (93% [691] male, 7·1% [53] female; mean age 56·5 years [SD 5·5]; 84·2% [622] White, 7·5% [56] Black, 0·9% [7] Asian, 7·5% [56] other race or ethnicity). The prevalence of multimorbidity was 69·3% and of polypharmacy was 46·6%. The most common comorbidities were vitamin D deficiency (428 of 690, 62%), dyslipidaemia (373, 50·1%), hypertension (157, 21·5%), depressive or anxious disorders (117, 15·8%), osteoporosis (91, 12·2%), obesity (98, 13·2%), chronic kidney disease (56, 7·5%), and diabetes (43, 5·7%). Patients with dyslipidaemia, osteoporosis, and metabolic disorders were referred to a live well pathway clinic focusing on targeted lifestyle interventions, including diet and physical exercise, under the supervision of a dietician and a physiotherapist. We have described how our HIV over-50 clinic was organised and implemented, and we reported data showing high rates of comorbidities and polypharmacy, which led to the establishment of a specialised care pathway for all HIV care providers and to the implementation of further joint HIV and specialty clinics (cardiology, metabolic, menopause, nephrology, neurology, and geriatric). None.

Pulmonary thromboendarterectomy-the Royal Papworth experience.

Pulmonary thromboendarterectomy (PTE) was first introduced to the UK 25 years ago, and the UK national service is provided by a single hospital. The aim of this work is to summarize our experience and review activity and outcomes by era at a high-volume PTE center. During this period the understanding of chronic thromboembolic pulmonary hypertension (CTEPH) increased and drug treatments and balloon angioplasty were developed. We also review our contribution to the better understanding of this surgery and CTEPH. We retrospectively reviewed all patients undergoing PTE for CTEPH at our center between Jan 1997 and Sept 2019, dividing them into four equal cohorts. Pre-operative characteristics and post-operative outcomes are described by era. A MEDLINE search was performed and original scientific clinical publications from this unit were reviewed. Their contemporary relevance and influence to the evolution of the clinical service are discussed. Over this 23-year period from the commencement of our program, 2,116 consecutive PTE were performed. The mean patient age was 57.8 years (range, 11-89 years). The first 25% of our PTE were performed over 12 years whilst the most recent 25% were performed in less than three years. Over time, the average pre-operative mean pulmonary artery pressure has not changed significantly. The 30-day mortality by era quartile has progressively fallen from 12.3% to 1.9% most recently (P<0.001). Overall, one year survival exceeded 90%. 17 publications influenced our practice development during this period. There was a consistent increase in activity and significant improvement in outcomes between the first and last quartiles of activity studied.

EVOLUTION AND ADVANCEMENTS IN THE DEVELOPMENT OF PHARMACEUTICAL CARE SERVICES

The evolution of pharmaceutical care services has undergone a significant transformation, shifting from a product-focused approach to a patient-centered model. This article explores the historical development, patient-centered approach, Medication Therapy Management (MTM) programs, collaborative care, technological integration, challenges, and future directions in pharmaceutical care services. Pharmacists now play a pivotal role in optimizing medication therapy, conducting comprehensive assessments, and working collaboratively with healthcare providers. Advancements in technology, such as electronic health records and automated systems, have further enhanced the quality of care provided. Despite challenges related to reimbursement and scope of practice, the trajectory of pharmaceutical care services is moving toward greater recognition and integration within healthcare systems.

Co-producing an urban mobility service? The role of actors, policies, and technology in the boom and bust of dockless bike-sharing programmes

ABSTRACT This paper examines the role of actors, policies and technology in the evolution of a basic urban transport service by investigating a complex range of factors shaping the inception and adaptation of the bike-sharing programme. Media data were analysed in relation to two major programmes, supplemented by further investigation into the broader discourse of the programmes. The findings reveal that an array of actors in the categories of government, citizen, business maker and investor, together with evolving policies and technology, collectively determine the sustainability of the programme. The operator-investor centred unorthodox co-production and delivery of dockless bike-sharing provides an alternative model to urban basic service provision which is currently dominated by the centralised and government-citizen centred co-production models.

Evolution of labour supply in ridesourcing

Contrary to traditional transit services, supply in ridesourcing systems emerges from individual labour decisions of gig workers. The effect of decentralisation in supply on the evolution of on-demand transit services is largely unknown. To this end, we propose a dynamic model comprising of the subsequent supply-side processes: (i) initial exposure to information about the platform, (ii) a long-term registration decision, and (iii) daily participation decisions, subject to day-to-day learning based on within-day matching outcomes. We construct a series of experiments to study the effect of supply market properties and pricing strategies. We find that labour supply in ridesourcing may be non-linear and undergo several transitions, inducing significant variations in income levels and level of service over time. Our results provide indications that the ridesourcing market may benefit from a cap in supply and regulation of the commission fee.

Impact of COVID-19 on dialysis patients: Reported experience in Qatar

Background: Patient-centered care is a concept focussing on meeting the specific health needs of patients as expressed by them. Patients Reported Experience Measures (PREM) is another concept associated with patient-centered care. PREM surveys capture information about the healthcare experience as perceived by patients.1 Its importance lies in the incorporation of patient feedback into the clinical decisions and service evolution.2 Dialysis patients play an important role in their treatment and their voice matters to provide proper care. PREM was first conducted in 2019 in our dialysis unit. In 2020, the COVID-19 impacted dialysis services and resulted in many challenges including staff shortage and deployment. Yet, the patients’ feedback was evaluated continuously and compared with previous years before the pandemic. Methods: A validated questionnaire from the National Health Service in London was used.3 It consisted of 7 questions covering demographics, dialysis options, patient portal, patient&apos;s relationship with the staff, teamwork, and traveling abroad. The survey involved 317 randomly selected patients who have been at least one year on dialysis. A comparison between 2019 and 2020 results was conducted using the chi-square test. Results: A drop in patients’ experience was observed in many survey components like education on dialysis, medication side effects, access to the patient portal, access to physicians and nurses from home (Figure 2). However, in other areas, some positive experiences remained unchanged like communication and knowledge among the staff.:Conclusion: Patients’ reported experience helps in the evaluation of health services. After exploring dialysis patients’ experiences, it was possible to identify what is going well and how COVID-19 impacted the patients’ perspectives. The PREM survey conducted in this work showed a significant decline in many parameters likely attributed to COVID-19 consequences including the staff shortages.

The Evolution of a Mediated Systematic Review Search Service

ABSTRACT Librarian contribution to systematic reviews and other evidence summaries is well-documented. Many libraries offer sophisticated support, including mediated search services. Tiered services are beginning to emerge, but few libraries offer fee-for-service models. This paper updates an earlier mediated search pilot delivered by the Health team at Deakin University library. The service has evolved to an expanded multi-tier model with a fee-for-service top tier. The tiers consist of online self-help and consultations through to proof-reading of searches, mediated search design and search translation. This new model was trialled and operationalised during the COVID-19 pandemic in 2020, a time with greater researcher focus on reviews than on field or lab-based research due to lockdown restrictions. This increased demand contributed to service development. The multi-tier model provided opportunity for librarian skill development including peer upskilling and co-authorship. Recognition of librarian contribution is important in mediated searching. The multi-tier service will continue to evolve. There is currently appetite amongst researchers for fee-for-service mediated search. Deakin librarians have also been working with researchers in emerging automation and living reviews and these technologies are likely to impact future directions of the services. Growth in other disciplines may also influence service expansion.

环京津城市群生态系统服务的时空演变与驱动因素

PDF HTML阅读 XML下载 导出引用 引用提醒 环京津城市群生态系统服务的时空演变与驱动因素 DOI: 10.5846/stxb202111203270 作者: 作者单位: 作者简介: 通讯作者: 中图分类号: 基金项目: 中央高校基本科研业务费专项资金资助（2021ZY33）；国家林草局重点项目（2019132703，2020132109） Spatial and temporal evolution and drivers of ecosystem services in Beijing, Tianjin and the Beijing-Tianjin Ring urban agglomeration Author: Affiliation: Fund Project: The National Natural Science Foundation of China（NO.51908034） 摘要 | 图/表 | 访问统计 | 参考文献 | 相似文献 | 引证文献 | 资源附件 | 文章评论 摘要:城市群已成为全球经济竞争的新空间单元，在促进城镇化建设，实现资源优质配置和发挥辐射带动作用等方面发挥着重要的功能。但剧烈的社会经济活动必然会对城市群生态系统服务造成破坏，因此开展城市群生态系统服务的时空演变研究，进而探索不同驱动因子对其的作用机制具有重要意义。目前，在已有的研究中缺少对城市群尺度和长时间跨度下的生态系统服务水平演变与驱动因素探究。为此，选取京津及环京津地区为研究区域，通过总结区域生态问题，构建起研究区域生态系统服务评价体系，并对2000-2018年生态系统服务进行计算，分析时空演变特征。然后，通过最小二乘法模型（Ordinary Least Squares，OLS）筛选出潜在的驱动因子，并导入地理加权回归模型（Geographically Weighted Regression，GWR）进行地理加权回归计算。最后，通过对结果分析，探讨自然和社会因子对生态系统服务的作用机制。研究结果表明：1）2000-2018年，研究区域生态系统服务呈现出先上升后下降，在2015年达到最高值的发展特征。2）在空间上，研究区域生态系统服务内总体上呈现燕山山脉及太行山山脉北部区域为生态系统服务的高值区域，坝上区域为低值区的空间分异特征。同时，生态系统服务演变在空间上呈现以燕山和太行山为界，燕山和太行山区域呈现先减弱后提升的趋势，西北区域整体呈现减弱趋势，东南区域从2015年起逐渐降低的空间演化特征。3）在驱动因素方面，自然环境和社会经济因素对生态系统服务的驱动作用从强到弱排列依次是：降雨量 > 土壤含沙 > 人口密度 > 温度 > 基础设施密度。4）其中，人口密度、土壤含沙量、基础设施呈较为明显的负相关驱动特征，降雨量呈较为明显的正相关驱动特征，温度则呈南部负相关，北部正相关，由东南向西北影响增强的趋势。本研究通过评估环京津城市群生态系统服务，分析区域生态系统服务的分析演变特征，并探索区域自然、社会因子对生态系统服务的驱动作用，为环京津城市群未来的生态环境保护和规划策略制定提供了科学指导和决策依据。 Abstract:Urban agglomerations have become a new spatial unit for global economic competition and had important functions in promoting urbanization, achieving high-quality allocation of resources and driving economic development. Intense socio-economic activities, however, are bound to cause damage to the ecosystem services of urban agglomerations. It is important to conduct studies on the spatio-temporal evolution of the ecosystem services of urban agglomerations and explore its driving factors. In this study, Beijing, Tianjin and the Beijing-Tianjin Ring were selected as the study area. The experiments constructed an ecosystem service evaluation system for the study area by summarizing regional issues, calculated ecosystem services from 2000-2018, and also analyzed their spatial and temporal evolution characteristics. Then, the potential drivers were screened out by the ordinary least squares model of the experimental data and imported into the geographically weighted regression model for regression. Finally, the driving role of natural and social factors on ecosystem services is explored, through an analysis of geographically weighted regression results. Firstly, the ecosystem services of the Beijing-Tianjin-Hebei urban agglomeration showed an upward and then downward trend from 2000 to 2018, reaching the highest value in 2015. Secondly, Spatially, the ecosystem services in the study area generally show the spatial differentiation characteristics of high value areas in the northern regions of Yanshan Mountains and Taihang Mountains, and low value areas in the dam area. At the same time, the evolution of ecosystem services spatially shows the boundary between Yanshan and Taihang Mountains, with the Yanshan and Taihang Mountains regions showing a trend of first weakening and then improving, while the northwest region shows an overall weakening trend and the southeast region gradually decreases from 2015 onward. Thirdly, Natural environment and socio-economic factors drive ecosystem services in descending order of strength:rainfall > soil sand content > population density > temperature > infrastructure density. Fourth, the population density, soil sediment concentration and infrastructure showed significantly negative correlation driving characteristics, while the rainfall showed significantly positive correlation driving characteristics, while the temperature showed negative correlation in the south and positive correlation in the north, with an increasing trend from southeast to northwest. Overall, by assessing the ecosystem services of the Beijing-Tianjin urban agglomeration, analyzing the analytical evolution characteristics of regional ecosystem services, and exploring the driving roles of regional natural and social factors on ecosystem services, this study provides scientific guidance and decision basis for the future ecological environmental protection and planning strategy formulation of the Beijing-Tianjin urban agglomeration. 参考文献 相似文献 引证文献

FINTECH НІМЕЧЧИНИ ТА УКРАЇНИ: ТЕНДЕНЦІЇ, ПЕРСПЕКТИВИ ТА ІНВЕСТИЦІЇ

The purpose of the article is to study the potential for the development of partnership relations between Ukraine and Germany when investing in the financial services market at the expense of FinTech. The study of the role and trends in the development of the Internet in modern conditions made it possible to determine that the Internet is not only an ideal source of information, an excellent way of communication and a platform for the activities of companies selling goods and providing services, there is also an increase in the number of users in all directions (smartphone users, Internet users, social network users). It is substantiated that the financial market is undergoing a significant transformation due to the development of the Internet and FinTech, which contributes to the formation of a new round of the evolution of the financial services market both in Ukraine and in various countries of the world and the development of mutual relations between countries in the provision of financial services. The work explores the potential of the relationship between Ukraine and Germany in the provision of financial services due to the development of FinTech, which contributes to the increase in the number and volume of financial services and the development of digital finance. FinTech development trends and Internet penetration rate in Ukraine and Germany, distribution of Ukrainian and German FinTech companies by field of activity for 2019–2021 were studied. It is substantiated that FinTech startups are effectively developing in Germany, which is due to strong funding from domestic and international investors, active support of the federal government and the country's position as a leading financial center of continental Europe, while in Ukraine a large number of FinTech companies operate without attracting funds from outside investors. Partnership relations between Ukraine and Germany when investing in the financial services market at the expense of FinTech are possible at the expense of investments, which is substantiated by correlation-regression analysis. Thus, the conducted research on forecasting an increase in the level of investments in FinTech within five years by 5% will allow to increase the level of GDP annually by 2%, increasing the total over five years by 16.5% in 2026 compared to 2021. Thus, this indicates the prospects of conducting investment activities by FinTech companies of Ukraine.

Spatial Pattern Evolution and Influencing Factors on Industrial Agglomeration: Evidence from Pearl River Delta Urban Agglomeration.

In order to clarify the spatial pattern and influencing factors on industrial agglomeration in urban agglomerations, based on the data of prefecture-level cities from 2006 to 2018, this paper uses spatial standard deviation ellipse to analyze the spatial pattern evolution of manufacturing, producer services, consumer services, and foreign-invested industries and takes a dynamic spatial Durbin model to empirically test the influencing factors of industrial agglomeration in Pearl River Delta (PRD) urban agglomeration. The main conclusions are as follows: 1) the degree of industrial agglomeration is at a low level and the difference in the industrial agglomeration level between cities is mainly manifested in the service industries; 2) manufacturing and foreign-invested industries have entered the stage of industrial diffusion, and all types of industries show an east (by south)-to-west (by north) pattern, with a trend of expansion to the south and north; 3) the agglomeration level of service industries and foreign-invested industries on the east bank of the Pearl River is higher than that on the west; and 4) from the empirical results, there is a general inertia effect in the industrial agglomeration and a siphon effect in the manufacturing agglomeration. Economic scale, transportation infrastructure, government intervention, opening up, and urban environment can all positively influence the agglomeration in some industries, with the apparent spatial spillover effects of each influencing factor. In addition, from the long-term factors of industrial agglomeration, the coordinated development of urban agglomeration is beneficial to the agglomeration of manufacturing and producer services. The research significance of this paper is that it can practically provide a more comprehensive reference for the impact mechanism of industrial agglomeration in urban agglomerations of China.

From Aftermath Psychiatry to Lattermath Psychiatry, or from Deinstitutionalisation to Community-Centric Mental Health Services, and now to Mental Health Care Ecosystems: Beyond Symbols, Stereotypes, and Stigma of Home Visiting and Assertive Community Teams

From Aftermath Psychiatry to Lattermath Psychiatry, or from Deinstitutionalisation to Community-Centric Mental Health Services, and now to Mental Health Care Ecosystems: Beyond Symbols, Stereotypes, and Stigma of Home Visiting and Assertive Community Teams1 Alan Rosen (bio) What does the evolution of architecture have to do with the deinstitutionalisation of psychiatry and the evolution of community mental health services? And how do these trajectories relate to the quest to destigmatise mental health services so they will be more approachable earlier by individuals and families in need of them? The arguments advanced by Terry Smith in The Architecture of Aftermath suggests that a) worldwide, there is not only an economy but an icon-omy, and b) global architecture has been reeling from the destruction of global icons such as the World Trade Centre in New York on 11 September 2001.2 There should be a growing discomfort among entrepreneurs, developers, and architects that their construction of iconic buildings to promote national or global perpetual brands, symbols, or empires has been transformed in the public mind into building impermanent ‘soft targets’, vulnerable to terrorism. Smith argues that architecture has lost its way from its roots in creating homes and communities for all.3 Similarly, psychiatry may also have lost its way in the eyes of the public, the face of the market, and from the loss of its iconic massive institutions. Meanwhile, it had been long in retreat from engaging with whole communities to improve their wellbeing and mental health, and by neglecting to promote full membership of the community and full human rights while controlling the lives of people contending with severe mental disabilities. Instead, psychiatry has continued to build clinical edifices, fortress hospitals, and academic empires, with overreliance on medications, long-acting injections, ECT (electro-convulsive therapy), indefinite incarcerations, involuntary control, (arguably) captive fodder for research of variable worth, alienation, abuse, and neglect. These have become its dominant, stigmatising, and ultimately dysfunctional public symbols and icons. More recently, Terry Smith has also invoked a related concept: the ‘lattermath’, a late fifteenth-century term for new shoots of grass growing after [End Page 161] a harvest, or mowing, so we are not perpetually entrapped in the leftovers of aftermath, as it can lead to new life, new growth and new hope.4 That this may help us to make the case that a renewal of hope for psychiatry, especially via shifting its balance towards a familiar home context or a community centre of gravity, is imaginable.5 I have described the progression from deinstitutionalisation to ‘aftermath’ psychiatry consisting of clinical edifices, fortress hospitals, and academic empires with only occasional outreach, to a more hopeful ‘lattermath’ of new shoots of growth for a more hopeful, community-centric rights-based psychiatry with ‘in-reach’ to hospitals if, and when, necessary. Our mental health professions do not have to be left perpetually trapped in the rubble and debris of our old practices and approaches. Instead, it can be demonstrated that, if examined closely, there is ‘lattermath’ growth occurring in psychiatry leading to new life, new growth, and new hope for the profession. The public and wider community has usually welcomed most phases of development of community psychiatry, from pastoral home visits to crisis intervention and service delivery systems of evidence-based complex integrated community mental health care like assertive community treatment (see Table 1). These approaches, if properly applied, can confer much more respect and may diminish the power differential considerably. Communities have been disappointed when they have been withdrawn due to backlash from more institutionalised professionals or politicians.6 Can psychiatry revive itself through a new growth of practice innovation and evidence-based community mental health services for all, situated in the complexities and contexts of their own lives, and ‘on their own turf and terms’, often in their own homes, on their own streets? Can community psychiatry encompass both the necessary technical interventions and service delivery systems, while also facilitating human rights, humane relationships, more benign meanings, and purposes fostering healing, recovery, and communal wellbeing? If we do not learn better to integrate these needs, our future in psychiatry will continue to be like trying to tie together architectural gestures and...

Establishing a Graduate Certificate in Health Informatics: Need Assessment and Competency-Based Framework.

Background:Health Informatics is an indispensable science in light of the massive reform healthcare has undertaken recently.Objective:Health Informatics is an indispensable science in light of the massive reform healthcare has undertaken recently.Methods:This descriptive multiphase study used a questionnaire to assess the need and applied a competency-based postgraduate curriculum to collect the required competencies as well as their proficiency levels.Results:Eighty percent of the respondents agreed that the current training should be advanced. 73.7% of the respondents agreed that this certificate would improve the level of knowledge, and it would impact on the delivery of healthcare positively (78.9%). For the required competencies, 10 competencies scored 1.75 and above, 22 scored between 1.5 and 1.75 and 22 scored below 1.50. The expert panel came to an agreement that the competencies with 1.5 and above should be included.Discussion:The findings emphasize the need to establish PG diploma in comply with previous studies that unveiled the need to provide education and training in Health Informatics. Only the required competencies were included as the program is one-year long. The selected competencies were validated and presented by the panel.Conclusion:A PG diploma in Health Informatics is a key element in the evolution of healthcare services, therefore, a competency-based framework was provided and validated by experts.

Decentralized Nation: Solving the Web’s Identity Crisis

The web of today whether you prefer to call it web 2.0, web 3.0, web 5.0 or even the metaverse is at a critical stage of evolution and challenge, largely centered around its crisis of identity. Like teenagers who cannot assess properly their reason for being and do not seem ready to take responsibility for their actions, we are constantly blaming the very system we are trying to get away from. To truly realize the benefits from innovation and technology, this crisis has to be resolved, not just through tactical solutions but through developments that enhance the sustainability of the web and its benefits. Significant strides are being made in the evolution of digital services enabled by technology, regulation, and the sheer pace of societal change. The journey to the decentralized web is mirroring the convergence of the physical and digital worlds across all economies and is increasingly embracing the digital native world. Technology has provided the foundational platform for individuals and entities to create and manage wealth, potentially without the need for big institutions. Ironically, despite all of the advancements, we are still facing an unprecedented and increasing wealth gap. Clearly, the system is broken, not just around the edges but at the very core of the democratic underpinning of our society. In this whitepaper, we propose how artificial intelligence on blockchain can be used to generate a new class of identity through direct human computer interaction. We demonstrate how this, combined with new perspectives for sustaining community and governance embedded within the use of blockchain technology, will underpin a sustainable solution to protect identity, authorship and privacy at the same time while contributing to restore trust amongst members of a future decentralized nation and hence contribute to solving the web most significant identity crisis.