Target Goals Research Articles

State of the science and recommendations for using wearable technology in sleep and circadian research.

Wearable sleep-tracking technology is of growing use in the sleep and circadian fields, including for applications across other disciplines, inclusive of a variety of disease states. Patients increasingly present sleep data derived from their wearable devices to their providers and the ever-increasing availability of commercial devices and new-generation research/clinical tools has led to the wide adoption of wearables in research, which has become even more relevant given the discontinuation of the Philips Respironics Actiwatch. Standards for evaluating the performance of wearable sleep-tracking devices have been introduced and the available evidence suggests that consumer-grade devices exceed the performance of traditional actigraphy in assessing sleep as defined by polysomnogram. However, clear limitations exist, for example, the misclassification of wakefulness during the sleep period, problems with sleep tracking outside of the main sleep bout or nighttime period, artifacts, and unclear translation of performance to individuals with certain characteristics or comorbidities. This is of particular relevance when person-specific factors (like skin color or obesity) negatively impact sensor performance with the potential downstream impact of augmenting already existing healthcare disparities. However, wearable sleep-tracking technology holds great promise for our field, given features distinct from traditional actigraphy such as measurement of autonomic parameters, estimation of circadian features, and the potential to integrate other self-reported, objective, and passively recorded health indicators. Scientists face numerous decision points and barriers when incorporating traditional actigraphy, consumer-grade multi-sensor devices, or contemporary research/clinical-grade sleep trackers into their research. Considerations include wearable device capabilities and performance, target population and goals of the study, wearable device outputs and availability of raw and aggregate data, and data extraction, processing, and analysis. Given the difficulties in the implementation and utilization of wearable sleep-tracking technology in real-world research and clinical settings, the following State of the Science review requested by the Sleep Research Society aims to address the following questions. What data can wearable sleep-tracking devices provide? How accurate are these data? What should be taken into account when incorporating wearable sleep-tracking devices into research? These outstanding questions and surrounding considerations motivated this work, outlining practical recommendations for using wearable technology in sleep and circadian research.

Trends in Hyperlipidemia Treatments: Summary of Recommendations for Statin and Non-Statin Options

Several treatment options and recommendations exist to guide a primary care provider to reduce overall cardiac morbidity and mortality risk through lipid control. The wealth of data from large studies, the choices of agents with varying mechanisms of action, and differing guidelines result in a challenge to keep abreast of this rapidly changing landscape. In this literature review the latest data regarding lipid management are reviewed and summarized. Current US and international cholesterol treatment guidelines recommend lifestyle modification followed by statin as first-line of therapy in management of hyperlipidemia. After optimizing statin dose if LDL remains above target goal, then the addition of ezetimibe provides added reductions in morbidity and mortality. Fibrates can be considered as an adjunct to statins therapy particularly in the diabetic population with persistent triglyceride elevations and provide modest reductions in coronary artery disease. PCSK9 inhibitors can reduce morbidity and mortality in a high-risk population when a statin or statin+ezetimibe does not bring LDL below the target goal. Some newer agents (ANGPTL3/ACL/MTP Inhibitors) are reserved for patients with a predisposition to ASCVD due to a familial genetic dyslipidemia. Cost for these adjunctive therapies is a concern for the patient and clinician and patient education along with a shared decision approach are warranted. To date, evidence for these agents is limited. Finally, there remains unclear guidance on the value between a “treat to dose” versus a “treat to target” approach to lipid management. Further research is needed to provide clarity on which strategy proves optimal for primary prevention of MACEs.

Impact of Guideline-Directed Management Strategies for Low-Density Lipoprotein Cholesterol Control in Patients Who Underwent Percutaneous Coronary Intervention

Background/ObjectiveThere are little direct comparative evidences of strategies between more than 50% and absolute target goal of LDL-C level less than 55mg/dL for the patients underwent percutaneous coronary intervention (PCI). The purpose of this study is to investigate the clinical impact of different strategies between two in patients underwent PCI. MethodsA total of 3,104 patients with prior PCI were retrospectively enrolled from 2014 to 2020 at Yeungnam University Medical Center. The study population was stratified into two groups based on whether LDL-C level were less than 55 mg/dL at one-year mark or not. Furthermore, the 50% reduction rate of LDL-C was also categorized based on whether it had decreased by 50% or more from the initial LDL-C level at the one-year mark. The primary endpoint was 3-year major adverse cardiovascular events (MACE) which was defined as a composite of cardiovascular death, nonfatal myocardial infarction, target-lesion revascularization, hospitalization for heart failure, or non-fatal stroke. ResultsThere was no significant difference between the LDL < 55 mg/dL group and the LDL ≥ 55 mg/dL group in the risk of MACE (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.81–1.38; P = 0.690) after propensity score matching. However, the group that achieved ≥ 50% reduction of LDL-C from baseline LDL-C level showed a significant reduction in the occurrence of MACE in the subgroup of LDL-C level ≥ 55 mg/dL (HR, 0.41; 95% CI, 0.19-0.89; P= 0.025), compared to the group with < 50% reduction of LDL-C. Among all patients, the achievement rate of target LDL-C < 55 mg/dL and more than 50% reduction from baseline was 17.2%. ConclusionGuideline directed management strategy of more than 50% reduction of LDL-C from the baseline will be needed to reduce the incidence of MACE in PCI treated patients with LDL-C ≥ 55 mg/dL and additional efforts to increase target-goal achievement rate of LDL-C are warranted.

Abstract #1608386: Retrospective Analysis of Patients With Type 2 Diabetes Achieving LDL-C Target Goals and the Rates of Utilization of Newer Lipid-Lowering Medications

Abstract #1608386: Retrospective Analysis of Patients With Type 2 Diabetes Achieving LDL-C Target Goals and the Rates of Utilization of Newer Lipid-Lowering Medications

Effects of corona virus on commercial farming in the kingdom of Eswatini

The aim of this study was to investigate the effects of the COVID-19 pandemic on commercial farming (particularly sugar cane, pineapples and citrus fruits) in the Kingdom of Eswatini. The study concentrated on how the pandemic has affected the workers, marketing of the final products as well as the strategies adopted in order to ensure that production was maximized and the target goals were met in the midst the COVID-19 pandemic. The study adopted the qualitative approach of data collection and analysis. Due to restrictions on movement and visitation imposed by the government in an effort to curb the spread of COVID-19, data was collected from only nine (9) respondents, comprising of supervisors and managers (four from Royal Swazi Sugar Cooperation, three from Illovo and two from Rhodes using a questionnaire. The study found that, since commercial farming (specifically sugar cane, pineapple and citrus fruits) form the back born of the country’s economy, production continued normally even though a few alterations had to be made to accommodate the COVID-19 regulations so as to ensure that the GDP is less affected. Despite that borders were formally closed and/or operating under strict rules and restrictions, (mainly on emergencies), it was not hard to export the products. This is solely because drivers were allowed to pass through, although at times the products would delay due to fumigation at the border post. Also, the COVID-19 pandemic has taught both the government and the commercial organizations that they need to be always prepared for unforeseen occurrences through ensuring that there is more than enough food or products available for local consumption and export. The study recommends that measures to increase production be put in place to fill up the production deficit, while the relaxation of more COVID-19 control measures is effected in order to ensure a full recovery of the agricultural commercial sector in Eswatini – a significant sector in the country’s economy.

Phase 1 Trial Results for Patients with Advanced Hematologic Malignancies Undergoing Reduced Intensity Allogeneic HCT with Orca-T Donor Cell Therapy Product and Single Agent Tacrolimus

Introduction: Reduced intensity conditioning hematopoietic bone marrow stem cell transplantation (HSCT-RIC) is the only curative option for many hematological malignancies in older/unfit patients. Strategies to minimize complications such as graft versus host disease (GVHD) in HSCT include donor graft engineering but this approach has not been widely tested to the RIC setting due to a potential trade-off between engraftment and reduced GVHD with T cell depletion strategies. Here we present the interim results of our single center Phase I trial evaluating the T cell reduced Orca-T cell therapy product and single agent tacrolimus in the RIC setting. Methods: The trial is a single-center open-label phase 1 feasibility and safety study for dose escalation of conventional T cell (Tcon) infusion. Primary objectives included measuring the incidence of grade III-IV acute GVHD, time of engraftment and donor T cell chimerism at day +30. Secondary objectives are measuring relapse free survival, severity of GVHD and incidence of serious infections. While the study has three independent trial arms depending on donor type (HLA matched related and unrelated, 9/10 HLA matched or haploidentical matched), accrual has focused on the HLA-matched cohort which is reported here. The first 11 patients on this arm were conditioned with fludarabine 40mg/m 2, melphalan 50 mg/m 2 and 4 Gy of total body irradiation (TBI), an additional 4 patients have been treated with thiotepa 10 mg/kg replacing the melphalan. All patients received single agent tacrolimus with a target goal of 6-8 ng/ml. Results: A total of 15 HLA-matched patients have been recruited thus far in this interim dose escalation analysis. The median patient age is 68.0 years (range 62 to 72), with 73% male (11/15) patient distribution. Pre transplant, 53% had acute myeloid leukemia (8/15), 20% had myelodysplastic syndrome (3/15), 13% had acute lymphoblastic leukemia (2/15) and 13% had a myeloproliferative neoplasm (2/15). Prior to transplant, all acute leukemia patients were in complete remission (CR) or CR with incomplete count recovery. Median follow up was 10.4 months for the entire cohort (range 2 to 20 months). 14/15 patients had engraftment by day 20 and 1/15 at day 39 post-transplant. Based on these findings, no dose escalation of Tcon infusion was needed. None of the patients had infusion reactions on day of transplant nor engraftment syndrome. Median percent donor chimerism for CD15 was high, with 100% at day 30 (15/15, range 94% to 100%) and 99% (13/15, patients with available data, range 98% to 100%) at day 90. Median CD3 chimerism at days 30 and 90 of transplant were also high at 99% (15/15, range 68% to 100%) and 99% (for 13/15 patients with available data, range 78% to 100%) respectively. No patients developed grade III-IV acute GVHD ( Fig.), defined &amp;lt;100 days post-transplant. One patient developed grade II aGVHD. In 12 months, the incidence for moderate to severe chronic GVHD was 7%. The 12-month relapse free survival (RFS) is thus far 79% ( Fig.). The cumulative incidence for grade 2 and 3 infections in the first 90 days was 26.7%, where 2 patients died. One patient died at day 180 from liver biopsy complications for late onset hepatic sinusoidal obstruction syndrome. No surviving patient has had disease relapse. Conclusions: These early results demonstrate that Orca-T is a safe and feasible transplant strategy in the RIC setting for patients with advanced hematological malignancies. Patients showed robust and early donor myeloid and eventual full donor T cell engraftment. The low incidence of acute and chronic GVHD with low rates of disease relapse, suggest retention of graft versus leukemia effect. Few studies of donor graft-engineered products have been successfully evaluated in the RIC setting and merits larger multicenter studies evaluatingGVHD-free and RFS post-transplant to validate these findings.

Efektifitas Pemanfaatan Repository Perguruan Tinggi: Studi pada Perpustakaan IPDN Kampus Jatinangor

IPDN library has been providing college repository services since 2017 through eprints.ipdn.ac.id, but there has been no measurement related to the effectiveness of the utilization of the IPDN repository service. The purpose of this study is to obtain a general overview of the effectiveness of the use of University repositories in the IPDN Library Jatinangor campus. The study used qualitative methods with data collection through interviews to 15 informants, observation and documentation. The results showed that the IPDN Repositori is provided with the aim to provide convenience for users, especially IPDN lecturers in the storage and assessment of scientific work, but there are still server and network constraints at the time of its utilization. In addition, the IPDN Library has conducted socialization and assistance for users. However, monitoring activities related to the utilization of IPDN repository services are still minimal. In conclusion, the effective utilization of University repositories, especially in the Institute of domestic government (IPDN) is included in the sufficient category. As for the 4 (four) dimensions that become a measure of effectiveness, there is 1 (one) dimension that is still lacking in its application, namely the monitoring dimension, 2 (two) dimensions that are sufficient, namely the dimension of targeting and program goals, 1 (one) dimension that is good, namely the dimension of socialization.

Impact of team-based health information technology to improve low-density lipoprotein cholesterol goal attainment after acute coronary syndrome hospital discharge: a single-center experience

Abstract Objectives The reduction in circulating low-density lipoprotein cholesterol (LDL-C) is the primary aim of lipid-lowering therapies as a method of atherosclerotic cardiovascular disease risk reduction. Although guidelines recommended strictly control of low-density lipoprotein cholesterol (LDL-C) below 70 mg/dL by high-intensity statin therapy in patients with acute coronary syndrome (ACS), the LDL-C target goal is not often attained. Health information technology (HIT) with information integration, decision making algorithm, is being applied on chronic illness care. Purpose We aimed to perform a qualitative review of the impact of HIT interventions on lipid management and LDL-C goal attainment in patients after ACS hospital discharge. Method Consecutive ACS patients with dyslipidemia (LDL-C &amp;gt;100 mg/dL) at discharge between January 2018 and December 2021 in a tertiary medical center were retrospectively reviewed. The LDL-C &amp;lt;70 mg/dL is defined as target. The team-based approach quality improvement program that consisted of patient education and high-intensity statin initiation before discharge, outpatient clinics with periodic laboratory follow-up, titration of lipid-lowering agents, and system-level interventions that involve database monitoring and outreach by centralized care teams, was introduced in October 2018. Electronical medical records including the medications, laboratory data at discharge and within 1 year were compared, before and after initiation of HIT system. Result A total 2248 ACS patients were included. The LDL-C &amp;lt;70 mg/dL attainment rate (36.52%, 53.57%, 59.22%, 62.18% in 2018, 2019, 2020, and 2021) and medium serum LDL-C level (80.5 mg/dL, 68 mg/dL, 65 mg/dL, 64 mg/dL in 2018, 2019, 2020, and 2021) significantly improved within 6 months after initiation of the team-based integrated intervention with assisted by HIT (2018 as the reference, all p&amp;lt;0.001). The LDL-C goal attainment rate at 12-month kept increasing gradually (53.80%, 61.82%, 64.21%, in 2019, 2020, 2021, p= 0.019). Most of the population initiated with moderate-intensity statin in 2018 (76.24%, 20.92%, 10.95%, 6.41% in 2018, 2019, 2020, and 2021), then switched to a high-intensity statin after initiation of the program (0.57%, 63.67%, 72.41%, 84.44% in 2018, 2019, 2020, and 2021) (2018 as the reference, all p&amp;lt;0.001), while the adverse event rates including hepatotoxicity and rhabdomyolysis remained similarly low. Conclusion Our results confirmed that multifaceted intervention with HIT assisted multidisciplinary approach could substantially improve LDL-C goal attainment in post-ACS patients. There was a direct relationship between high-intensity statins and LDL-C goal attainment, without significant increase of adverse events.LDL-C goal attainment rate and levelLower lipid treatment and adverse event

Abstract 16753: Effectiveness of Guideline-Endorsed Low-Density Lipoprotein Cholesterol Reduction Rates in Patients With Prior Percutaneous Coronary Intervention

Background/Objective: Low-density lipoprotein cholesterol (LCL-C) should be treated by guideline directed management which is more than 50% reduction of initial LDL-C and less than 55mg/dL LDL-C level in patients with prior percutaneous coronary intervention (PCI). However, there is no direct comparative evidence on target reduction rate and target goal LDL-C level. Therefore, we investigated the clinical influence of &gt;50% reduction from baseline LDL-C in patients with prior PCI. Methods: A total of 3,104 patients with prior PCI were retrospectively enrolled from 2014 to 2020 at Yeungnam University Medical Center. The primary endpoint was 3-year major adverse cardiovascular events (MACE which was defined as a composite of cardiovascular death, nonfatal myocardial infarction, target-lesion revascularization, hospitalization for heart failure, or non-fatal stroke. And the secondary endpoints were individual components of the primary endpoint. Results: Among all patients, the achievement rate of target LDL-C &lt; 55 mg/dL and more than 50% reduction from baseline was 17.2%. There was no significant difference between the LDL &lt; 55 mg/dL group and the LDL ≥ 55 mg/dL group in the risk for MACE (hazard ratio [HR], 1.09; 95% confidence interval [CI], 0.84-1.43; P = 0.502) after propensity score matching. However, the group that achieved ≥ 50% reduction of LDL-C from baseline LDL-C level showed a significant reduction in the occurrence of MACE in the subgroup of LDL-C level ≥ 55 mg/dL (HR, 0.34; 95% CI, 0.16-0.74; P= 0.004), compared to the group with &lt; 50% reduction of LDL-C. Conclusion: More than 50% reduction from the baseline LDL-C reduced the incidence of MACE in the LDL-C ≥ 55 mg/dL

Abstract 16725: Cost-Effectiveness Analysis of Intensive Treatment of Systolic Hypertension: Results From Sprint Patient-Level Data

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) showed that treating patients at high risk for cardiovascular events but without diabetes or a history of stroke to a systolic blood pressure (SBP) target goal of &lt;120 mm Hg (Intensive Care, IC), compared with &lt;140 mm Hg (Standard Care, SC), resulted in lower rates of fatal and nonfatal major cardiovascular events and death. We examined the cost-effectiveness of IC vs SC over a life-time horizon, based on patient-level data, from a health-sector perspective. Methods: Patient-level data from SPRINT were used to calculate and estimate cost, effectiveness, quality adjusted life years (QALY), and the incremental cost-effectiveness ratio (ICER). For participants who died during the trial, life years and QALYs were estimated from in-trial analysis; for who survived to the end of the trial, pooled, harmonized data from six epidemiologic cohorts included in the National Heart, Lung, and Blood Institute Pooled Cohorts Study was used to estimate risk of lifetime primary fatal and non-fatal events and calculate life-years. Published utilities estimates were used to calculate QALYs. For participants without SPRINT lifetime primary event estimates, we applied multiple imputation method via machine learning to impute the life-years and QALYs. The ICER was expressed as cost per QALY gained. Results: IC participants were estimated to gain an average of 0.51 QALY (95% CI: 0.21, 0.81) relative to SC participants. Estimated total lifetime costs were $17,449 higher with IC (95% CI: $10,697, $24,201) than SC. The ICER for IC vs SC was $34,214 per QALY gained, with 68.5% of bootstrap-derived estimates &lt;$50,000/QALY. The results from multiple imputation chained equations for addressing missing data showed that IC is cost effectiveness at $50,000/QALY. Across various scenario analyses, we consistently found a more than 60% probability that IC is cost-effective over a lifetime when the willingness-to-pay value exceeds $100,000 per QALY. Conclusions: Based on participant-level trial and epidemiologic cohort data, IC is cost-effective, with significant clinical benefit at acceptable higher lifetime cost. Recommending intensive SBP targets in patients at high CVD risk is an effective, high-value therapy.

Nurse management of noradrenaline infusions in intensive care units: An observational study

BackgroundIntensive care nurse management of noradrenaline (norepinephrine) infusions is a common and essential clinical competency for patient haemodynamic support. Nurses titrate and wean noradrenaline infusions to a target blood pressure in a dynamic, high-risk, and unpredictable environment. Titration and weaning are complex interventions, and blood pressure goals are often variable. ObjectivesThe aim was to examine how nurses used blood pressure targets when escalating, weaning, and titrating noradrenaline in intensive care patients admitted for haemodynamic management and explore patient blood pressure responses to changes in noradrenaline doses. MethodsIn this naturalistic observational study, noradrenaline dose changes were classified as escalation, weaning, and titration changes and analysed to explore nursing practice. The study was undertaken in two adult medical/surgical intensive care units in Melbourne, Australia. Participants included intensive care nurses and patients who received noradrenaline infusions for haemodynamic support. ResultsObservations of 14 nurse–patient dyads provided 25 h of blood pressure and noradrenaline dose data. Patient participants received weight-adjusted maximum noradrenaline doses of between 0.06 mcg/kg/min and 0.87 mcg/kg/minute, with those in the escalation group receiving dose increases of up to 5 mcg to achieve blood pressure goals. During weaning, patients maintained or increased their blood pressure as noradrenaline doses were decreased. Nurses consistently maintained blood pressures at higher than target goals, and despite constant fluctuations, they only documented blood pressure readings hourly. ConclusionsIntensive care nurses managed noradrenaline to achieve mean arterial pressure targets that were variable and not evidence based. The disconnection between observed blood pressure fluctuations and nurse documentation of patient blood pressures was reflected in titration practices. Discrepancies between documented and actual blood pressures raised issues about data used by nurses and doctors to inform clinical practice on noradrenaline management.

Every Tube Counts: reducing extra tubes drawn in the emergency department

A common practice exists in hospitals where extra tubes of blood are collected for possible add-on testing, this practice contributes to wastage of consumables. Baseline estimates from a 5-month local...

Assessing Nutrition Status in an Outpatient Wound Center: A Feasibility Study.

To explore the feasibility of using the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutrition status of patients with chronic wounds receiving care in an outpatient wound clinic. The PG-SGA was administered to a single cohort convenience sample of adults with chronic wounds who presented to an outpatient wound clinic. The authors performed univariate descriptive analyses and calculated interrater reliability. Nutrition assessments were completed with 15 clinic patients. Patients required an average of 6.5 minutes (range, 3.5-10 minutes) to complete their component of the PG-SGA, exceeding the target goal of 5 minutes or fewer. Dietitians required an average of 2 minutes per patient to complete the professional component of the PG-SGA (physical examination). The nutrition assessment process was rated highly favorable. Resources to conduct the study at the site were available 100% of the time. The PG-SGA demonstrates promise for use in the chronic wound population and could be incorporated into clinical care in settings equipped with appropriate and adequate resources. The complexities of workforce stability and resource availability, in addition to the ongoing need to be responsive to patient challenges, must be acknowledged in the planning of future studies.

Methodological foundations of information security of students at school

The article presents the experience of researching information security issues in modern educational organizations (preschool, general education, professional), which made it possible to conclude that the search for the methodological foundations of this activity in a modern school is relevant. As a methodological basis, the study considers a systematic approach applied to the analysis of objects that have many interrelated elements, united by common functions and goals, management and functioning, and which involves structural and functional modeling of the process of building the information security of school students. The model of organization of this activity is considered, including the target (goal, objectives, principles), content (pedagogical conditions, components of information security behavior as the basis of information security of school students), organizational and technological (the logic of constructing technology stages), control and evaluation (monitoring, evaluation) components. The presented structural and functional model is characterized by reproducibility, provided that the described components and their content are implemented in the presented sequence.

Retrospective review of intermittent and continuous infusion vancomycin for methicillin-resistant Staphylococcus aureus bacteremia.

Vancomycin is commonly administered as an intermittent infusion (IIV), although vancomycin's stability at room temperature permits administration continuously over 24h (CIV). At our institution, CIV has been the preferred infusion method for over 20years due to ease of administration and simplicity of therapeutic drug monitoring. The purpose of this study was to examine the outcomes associated with IIV compared to CIV. This was a retrospective study of patients who received vancomycin for MRSA bacteremia. The primary outcomes were the time to therapeutic goal and frequency of adverse drug reactions on IIV compared to CIV. Secondary outcomes evaluated all-cause readmission, relapse, and mortality 30days after completion of therapy. Sixty-three patients were included. Significantly fewer patients were able to achieve a therapeutic goal on IIV compared to CIV (52.4% vs. 82.5%, p < 0.01). Patients on IIV took 3.6days, on average, to reach the target goal, compared to 1.9days when patients were switched to CIV (95% confidence interval, 0.48-3.04, p < 0.01). Six patients experienced adverse events on IIV, and 15 patients experienced adverse events on CIV (IIV 9.5%, CIV 23.8%, p = 0.035). One patient experienced relapse of infection, and six patients (9.5%) were readmitted 30days after completion of therapy. There were no deaths in the cohort. For MRSA bacteremia, CIV enabled patients to achieve the AUC/MIC goal significantly faster than when patients received IIV. Furthermore, patients who were unable to achieve a therapeutic trough on IIV became therapeutic once switched to CIV.

Evaluation of the Effectiveness of Paris Agreement - An Angle from the Determining of Normative Framework

The previous studies on Paris Agreement almost only analyzed the single field related to it, such as international cooperation and low-carbon economy. Therefore, this study will make an overall consideration of the Paris Agreement. In the sixth year after the implementation of the Paris Agreement, this study evaluates the effectiveness of the Paris Agreement under the circumstance that various scholars and academic circles attach great importance to climate change. In accordance with the chronological and systematic archival research methods, this study clearly sorted out information related to climate change and global governance in the context of the signing of the Paris Agreement by citing empirical literature and analytical theoretical knowledge. This study analyzed the scholars views on climate change, for example, in international cooperation in the field of climate change is compare difficult, the Paris agreement itself, namely, the main goal of target, NDC and some related regulations, the implementation of the Paris agreement triple dilemma, such as the global inventory for further analysis, assess the effectiveness of the Paris Agreement. According to the above analysis, the Paris agreement can only be said to be relatively effective. At the end of the paper, the author also evaluates this research.

Public Support for Migrant Entrepreneurship: The Case of North Koreans in the Republic of Korea

Migrant entrepreneurship is viewed as a pathway to substantive social integration, one that makes host countries more prosperous in the process. Accordingly, scholars have studied the social context in which migrant entrepreneurs operate, and considered at length the range of policy options that governments can use to support their activities. Conversely, the issue of public attitudes to policies that support migrant entrepreneurship has been largely neglected. Leveraging the case of North Korean migrant entrepreneurs in South Korea, this article fills this gap in the literature by examining how the structure of government support within a broader “policy mix” for migrant entrepreneurship policies acts on public attitudes. Overall, it finds South Koreans are most supportive of migrant entrepreneurship policies endorsed and paid for by large companies through corporate taxation or loans to the individual, rather than the state, and which have a target goal of employment support for profitable migrant-run firms or joint ventures run by teams of natives and migrants. Notably, policies explicitly justified as tools to address discrimination actively discourage support. The specifics of the Korean case show that determinants of native hostility toward migrants apply to migrant entrepreneurship even when ethnic differences and many of the institutional barriers that apply in other cases do not exist, suggesting that ethnicity is not a major motivating factor; economic rationality and what is “good for South Korea” are.

FRI594 Results Of A New Transition Of Care Process From Pediatric To Adult Diabetes Services

Abstract Disclosure: F.I. Cooper: None. N. Vyas: None. J. Pierce: None. A. Kulasingham: None. Adolescence is a challenging time in a child’s life and can be even more stressful for those living with diabetes. It has been shown that glycemic levels worsen in young adulthood due to factors such as increasing insulin resistance and gaps in care during the transitioning from pediatric to adult diabetes care. Data suggest that beginning transition preparation in early adolescence is associated with better outcomes. Our aim was to create a transition of care program for youth in our diabetes clinic following the Got Transition Core Elements and assess its effectiveness. First, we established a clinic transition policy and corresponding informational letter, which we distributed to youth ages 12-16. Then, we adopted a Diabetes Summary Form to track and monitor transition progress. Next, we implemented transition readiness screening to youth ages 14-16 using the Readiness Assessment of Emerging Adults with Diabetes Diagnosed in Youth (READDY) tool. Last, we distributed GotTransition.org surveys to youth and their caregivers to assess satisfaction with our clinic’s transition process and perceived readiness to move to an adult provider. The transition letter distribution rate had a mean of 56% and the READDY completion rate had a mean of 40%. Although we did not achieve our distribution target goal of 80%, 90% of those who did complete the READDY indicated they were somewhat or very ready to transition to adult care. The satisfaction survey revealed that many youths still need assistance with insurance (32%) and finding an adult provider (45%). Overall, our initial efforts to establish a healthcare transition program were successful. We will continue our work on 1) improving letter distribution and readiness screening rates, 2) designing a curriculum centered around adolescent-specific issues, including insurance needs and 3) increasing our connections with adult endocrinologists to facilitate seamless transitions. We hope other pediatric diabetes clinics can learn from our experience, as well expanding to other subspecialty clinics in our children’s hospital. Presentation: Friday, June 16, 2023

Engaging and assessing students via a museum educational program

Many museums offer educational programs encouraging visitors to “interact” with the subjects in a meaningful way. Students’ visit to a museum can be an effective means of introducing them to important science concepts through contact with actual specimens. As part of a properly designed educational program, students’ contact with realia can be an invaluable aid to engaging their interest and achieving corresponding learning goals. The present paper details a research project relating to the concept of evolutionary adaption. A worksheet was developed requiring students to work collaboratively during a museum visit to complete activities progressively leading them to the target goals of correlating: (i) the structure of certain physical features of birds with their function and (ii) the structure and function of those features with their respective habitats. The final worksheet activity was an open-ended assessment task aiming to identify the level of learning students had achieved from participating in the program. The results were statistically analyzed and indicated that students had grasped the concept of structure and function of specific traits and their importance to basic survival, but they had not been able to correlate the adaptation with other challenges presented by the habitat.

Қостілді оқыту ғылыми зерттеудің пәні ретінде

The authors of the given article being confident in the high degree of bilingual education development problems in modern science, however make no question of research relevance in the given area, necessity of searching research decisions. Consequently, authors did bibliographic analysis of publications aiming to find out the study degree of bilingual educational problem in science. For solving target goal VOSviewer program was used. Bibliographic analysis was done on the base of Scopus and Web of Science. As a result, based on clustering, the authors of the article defined publication activity of scholars according to the issues of bilingual education. Moreover, calculating indexes of scientific approximation allows authors to provide evidence assumptions of further scientific research advances in the presented area.