Institutional Characteristics Research Articles

Follow-up computed tomography and unexpected hemostasis in non-operative management of pediatric blunt liver and spleen injury.

While follow-up CT and prophylactic embolization with angiography are often conducted during non-operative management (NOM) for BLSI, particularly in a high-grade injury, the utility of early repeated CT for preventing unexpected hemorrhage remains unclear. This study aimed to elucidate whether early follow-up computerized tomography (CT) within 7 days after admission would decrease unexpected hemostatic procedures on pediatric blunt liver and spleen injury (BLSI). A post-hoc analysis of a multicenter observational cohort study on pediatric patients with BLSI (2008-2019) was conducted on those who underwent NOM, in whom the timing of follow-up CT were decided by treating physicians. The incidence of unexpected hemostatic procedure (laparotomy and/or emergency angiography for ruptured pseudoaneurysm) and complications related to BLSI were compared between patients with and without early follow-up CT within 7 days. Inverse probability weighting with propensity scores adjusted patient demographics, comorbidities, mechanism and severity of injury, initial resuscitation, and institutional characteristics. Among 1320 included patients, 552 underwent early follow-up CT. Approximately 25% of patients underwent angiography on the day of admission. The incidence of unexpected hemostasis was similar between patients with and without early repeat CT (8 [1.4%] vs. 6 [0.8%]; adjusted OR, 1.44 [0.62-3.34]; p = 0.40). Patients with repeat CT scans more frequently underwent multiple angiographies (OR, 2.79 [1.32-5.88]) and had more complications related to BLSI, particularly bile leak (OR, 1.73 [1.04-2.87]). Follow-up CT scans within 7 days was not associated with reduced unexpected hemostasis in NOM for pediatric BLSI.

Advertising and Content Differentiation: Evidence from YouTube

Abstract Many media outlets depend on advertising revenue to finance their operations, but the effect of advertising on media outlets’ content choices is largely unexplored. This paper exploits two institutional features from YouTube to show that an exogenous increase in the feasible amount of advertising induces YouTubers to differentiate their video content from their competitors. A plausible mechanism is that YouTubers avoid competition: viewers typically perceive advertising as a nuisance and therefore as an implicit price they have to pay; thus, they could switch to a competitor if a YouTuber increased her advertising quantity. This is less likely, however, if the YouTuber differentiates her content from the mainstream and moves to a niche.

INSTITUTIONAL FACTORS OF THE TECHNOLOGIC ACADEMIC ENTREPRENEURSHIP DYNAMICS

The article deals with identifying the obstacles to the commercialization of academic research results generated by the differences in institutional environment for the production of scientific knowledge and the production of technological products by innovative start-ups. To do this, it gives the characteristics of the above-mentioned institutional environments, as well as patterns of behavior in them that do not have the character of formal or informal institutions. Particular attention is paid to psychological traits of entrepreneurs and their cognitive abilities, which may not be available to teachers and researchers at universities and research organizations. Comparison of the content of these environments gives grounds for distinguishing two types of institutional barriers: the first one is of a general economic nature and can generate significant costs for the work of innovative start-ups; the second one is intra-organizational in nature and can generate high risks of transition from science to commercial industry, preventing researchers and teachers from making decisions about creating innovative technology start-ups. The paper concludes with recommendations to reduce the level of barriers of the second type. In particular, to compensate for the risks associated with possible consequences of failure to create a startup and the difficulties of returning to the field of research activity, university management could legally guarantee a teacher or researcher a return to work in scientific or educational departments of faculties for at least five years after creating a startup.

Features of nursing practice organization in the geriatric center (boarding house)

In recent decades, interest in gerontology has increased significantly. This is explained by the fact that among the most pressing problems facing the world community is the problem of population aging. As in many developed countries of the world, in Russia the number of people aged 80 years and older is increasing. The sharp aging of the population is the most important problem in the life of any state — that is why there is an urgent need to expand gerontological research. Target. Assessment of the existing system for placing elderly and senile people in a geriatric center (boarding house).Results. The working time costs of nursing staff were studied by conducting photo-timing and interviewing; an analysis of existing problems in the organization of nursing practice was carried out; real ways to improve the quality of life of an elderly person living in a boarding house are outlined. Conclusion. As sociological studies show, small boarding houses are indispensable in rural areas, where they take on the character of temporary institutions (for the autumn-winter period), largely solving the problems of many villagers who do not want to permanently move to boarding houses.

Institutional arrangements of government and municipal response to the COVID-19 pandemic

This study proposes a research strategy that treats a government form as a specific arrangement of institutional features and conducts the study of government form at the institutional-feature level. Consistently, it examines how the three core features of a government – CEO (chief executive officer) selection by appointment based on managerial expertise, mayoral election by the council among themselves, and at-large council election – affect municipal COVID response, a highly politicized area. These features are theorized to reduce the intensity of politics and create space for the effective working of public administration, and hypothesized to be positively associated with active COVID response. The hypotheses are confirmed on the whole from the analysis of original survey data gathered during the pandemic from municipalities in eleven western U.S. states. The implications of the findings for the council-manager form of government are discussed.

Getting to the bottom of why children with spina bifida use the emergency department: A qualitative analysis of parent and stakeholder perspectives

Children with Spina Bifida (SB) have considerable healthcare utilization, including Emergency Department use (EDU). We aimed to elicit reasons for EDU using qualitative analysis of interviews with both patient-caregiver dyads and stakeholders. A cohort of children with SB followed at our institution between 2016 and 2020 was identified and patient and clinical characteristics abstracted. Purposeful sampling by age and degree of past EDU was performed. Semi-structured interviews of dyads were performed using iteratively revised interview guides. Spanish-language interviews were conducted by a native Spanish speaker and transcripts professionally translated. Supplemental interviews with stakeholders, namely knowledgeable healthcare professionals, were also conducted. A qualitative framework approach was used for analysis, including open followed by closed independent coding with calculation of inter-rater reliability. A final interpretation of coding reports assessing convergence, divergence, and variation in themes across participant characteristics. 116 families (4 Spanish-speaking) and 7 stakeholders were interviewed. Sampling yielded a heterogenous cohort for EDU (56% with 0-10, 44% with >10 visits) and age (25% 0-4, 44% 5-11, 31%>11 years). IRR was optimal (κ=0.9). Themes in perceived reasons for EDU were 1) desire for "one-stop-shop" care, 2) an emergent medical problem, 3) providers' instructions, 4) negative past healthcare experience, 5) intrinsic caregiver moderators, and 6) temporospatial influences. Themes 1, 2, and 5 predominated in dyads, whereas themes 6, 3, and 5 were most common in stakeholders. Stakeholders focused largely on negative institutional and patient characteristics. Among dyads only, theme #1 was disproportionately emphasized by Spanish-speaking patients. Families desired access to coordinated expert care, testing and imaging. The ED offers this for children with SB, regardless of clinical acuity. This may be especially valued by families with inherent challenges to navigating the healthcare system. Negative experiences in community clinical settings, healthcare provider recommendations and intrinsic parental factors were themes that seemed to contribute to seeking this "one-stop-shop" type of care. Care coordination may reduce ED reliance, but themes for the interviews suggest a systems-based efforts should weave in the community care setting. For both stakeholders and caregivers, the ED represented a valued form of immediate access to multispecialty, expert care and testing in the context of perceived lack of timely, coordinated outpatient care. This may be moderated by intrinsic caregiver factors and negative past experiences. Although stakeholders discussed ideas that fit into patient-caregiver themes, the also uniquely focused on systems-based and patient-caregiver limitations.

Thoughts on Children's Education from the Perspective of Ibn Hajar Al-Haitami

According to Ibn Hajar al-Haitami, the purpose of children's education involves efforts to care, develop, and exploit the potential of students so that they are able to understand kitabulloh, have noble morals, and have the skills to lead an independent life. In order to achieve these educational goals, Ibn Hajar al-Haitami wrote a book that specifically discusses various aspects, including educational objectives, educational flow, educator competencies, children's educational techniques, education costs, and characteristics of children's educational institutions. All these components are analyzed and described in his work entitled Tahrīru al-Maqōl Fī Adābi Wa Ahkāmi Wa Fawā'idu Yahtāju Ilaihā Muˋaddibū al-Aṭfāl. The study focused on six aspects of education discussed in the book, using. Descriptive Content Analysis Method, Types of Literature Research, and Descriptive Qualitative Approach. The main data are obtained from Tahrīru al-Maqōl Fī Adābi Wa Ahkāmi Wa Fawā'idu Yahtāju Ilaihā Muˋaddibū al-Aṭfāl, while the secondary data comes from various books discussing the biography of Ibn Hajar al-Haitami. The research process involves three stages: data collection, data processing, and data reporting. The results showed that the focus of children's educational goals emphasizes the development of material and non-material potential of learners. A religious-conservative approach is used in the flow of children's education, with the dominant educational technique being takzir. The competence of educators that is prioritized includes personal and social dimensions, while education financing can be obtained through salaries, endowments, and grants. Ibn Hajar al-Haitami recommended educational institutions in the form of maktab and madrasa.

Assessment of Dar es Salaam's resilience to climate change disasters using the Climate Disaster Resilience Index (CDRI)

Climate change is becoming an increasingly significant issue in Africa, and the need for climate resilience assessment has intensified. Dar es Salam is one of Africa's emerging megacities. With a population of over seven million, which continues to grow, there is an urgent need to understand the city's ability to deal with natural disasters. The Climate Disaster Resilience Index (CDRI) was used in this study to assess the city's ability to withstand and cope with climatic hazards. The Index was quantified using sets of dimensions (social, physical, economic, natural, and institutional), with various parameters indicating the city's abilities, strengths, and vulnerabilities to potential climate‐related disasters. Despite being moderately resilient to climate change disasters, the results of our study indicate that the city's economic and institutional features obtained the lowest scores and the least resilience level. The study's findings provide a perspective on aspects of the city management sectors in terms of resilience and which should be given greater consideration in order to strengthen the city's current and future resilience.

Exploring carbon emission accounting methods for typical public institutions: a case study of hospitals

Typical public institutions such as government offices, hospitals, and schools play important leading and exemplary roles in the green and low-carbon development of the whole society. This paper analyzes the business and energy consumption characteristics of public institutions, as well as the characteristics of personnel travel, and constructs a carbon accounting model for public institutions. It innovatively proposes a methodology for carbon accounting of personnel travel related to public institutions and validates and analyzes it using a comprehensive hospital as an example. The paper analyzes the carbon emission characteristics of various energy types, systems, and types of travelers in hospitals, provides schemes for the transformation of main energy systems, and corresponding emission reduction effects, thereby providing technical support for the full-chain carbon accounting of public institutions. Additionally, this paper explores the carbon reduction pathways for hospitals to support the peak carbon and carbon neutrality goals of public institutions, and promote the high-quality development of public institutions in China.

Improving Women’s Representation in Politics through Gender Quotas

Gender quotas for women in local government bodies can improve women’s representation in politics, increase provision of public services, and improve perceptions of women as leaders. Gender quotas are one policy tool designed to increase women’s representation in politics. Women hold fewer than 25 percent of parliamentary seats worldwide, and just 12 percent of the world’s heads of state and government are women. In many countries this imbalance extends to local governments. Countries are taking action In 2013, 118 countries were implementing a form of gender quotas for an elected office. Women's empowerment and their full participation on the basis of equality in all spheres of society, including participation in the decision making process and access to power ,are fund a mental for the achievement to fequality , development and peace. One way to implement gender quotas is by reserving a certain number of leadership positions for women. A review of eleven randomized evaluations in India, Lesotho, and across 28 states in India found that reservation quotas influenced women’s political participation and policy outcomes and increased the provision of public goods aligned with female voters’ preferences. Further, quotas improved men’s perceptions of women as leaders, increased the aspirations of girls, and helped women get elected even after quotas were removed. Most of the rigorous research drawn on in this insight comes from India comparative conclusions should be drawn cautiously. This evidence largely suggests that governments seeking to improve women’s representation in politics should consider reservation quotas for local leadership positions. overview of the three main types of quota policies reserved seats, party quotas, and legislative quotas. These are found in all major world regions in countries with a broad range of institutional, social, economic, and cultural characteristics. At the same time, the mere advent of gender quotas has not resulted in uniform increases in the percentage of women in parliament worldwide some countries have witnessed dramatic increases, while others have seen more modest changes or even setbacks in the number of women elected to national assemblies. Despite the rapid international diffusion of these measures, most research has focused on single countries or, at most, the presence of quotas within one world region. Consequently, explanations for the adoption and impact of gender quotas derived from one study often contradict .

How Does Low-Carbon Financial Policy Affect Corporate Green Innovation?—Re-Examination of Institutional Characteristics, Influence Mechanisms, and Local Government Behavior

This paper employs a propensity score matching approach to construct a control group and estimate the impact of the CETS pilot policy, a low-carbon financial policy, on corporate green innovation and its impact mechanism in a difference-in-difference manner. The results show that the CETS pilot policy has a significantly positive effect on corporate green innovation. The higher the penalty degree and the carbon price, the more obvious the promotion of the green innovation of pilot enterprises. The mechanism test shows that the improvement of corporate green innovation is mainly due to the incentive effect rather than the anti-driving effect of the CETS pilot policy, that is, the policy promotes corporate green innovation by providing innovation resources and enhancing the willingness to innovate. Further analysis shows that only in regions where local governments have less competitive pressure can the CETS pilot policy effectively promote enterprise innovation resources and that a close and clean government–business relationship can help strengthen the promotion effect of the CETS pilot policy on the willingness of enterprises to innovate. Furthermore, this paper introduces its theoretical framework as a strategic tripod to explore the friction in the process of the CETS pilot policy affecting corporate green innovation from the perspective of the industry environment and corporate resources. This research shows that a lack of industry green technology and corporate human capital may hinder the positive impact of the CETS pilot policy on corporate green innovation. Finally, this study found that the CETS pilot policy has no significant impact on the quality of corporate green innovation, and the lack of industry green technology and corporate human capital may hinder the CETS pilot policy from improving the quality of corporate green innovation.

STRESS AND HEALTH BEHAVIOR OF HEALTH PROFESSIONS STUDENTS IN BULGARIA

The purpose of this study is to determine the prevalence of stress among students of various health specialties in Bulgaria and to examine its relationship with the individual and institutional characteristics of the students and with their health behavior. Methods: A survey was conducted among students from all 26 Bachelor and Master of health sciences programmes at a Medical University in Bulgaria. Information on self-assessed levels of health and stress, aspects of the health behavior (physical activity, smoking, alcohol intake, diet and sleep duration), personal (age, gender) and institutional factors (specialty and year of study) was collected with a structured questionnaire. Multinomial logistic regression was performed to evaluate the determinants of the perceived high level of stress. Results: A total of 570 (10% sample) of all students from the university with a mean age of 24 (SD 7.6) years took part in the study. The majority of students (61.7%) experienced a moderate level of stress. Self-reported high level of stress (25.4%) was significantly independently associated with three factors - female gender (OR=2.92, 95% CI=1.09-7.81), low level of self-rated health (OR=6.95, 95% CI=2.17-22.25) and higher (fourth or fifth) year of study compared to first (OR=5.49, 95% CI=1.72-17.59; OR=4.06, 95% CI=1.36-12.16). Conclusions: Stress is an important problem affecting the health of this group of the population. Active actions for building environments conducive to and supporting students' mental health are necessary, for which medical universities are in a very favourable position.

Development of an assessment tool for designated medical institutions in China--Based on the application of an online assessment system.

Due to the expanding coverage of medical insurance and the growth of medical expenses, the ability to assess the performance of designated medical institutions (DMIs) in supporting the delivery of high-quality patient care and the standardized use of funds represents a priority in China. Despite such interest, there has yet to be an operable standard and labor-saving method for assessing DMIs in China. The main objectives include two aspects: (1) establishing an evaluation index system for DMIs based on contracts; (2) designing and developing an online evaluation platform. A group of 20 experts with theoretical and practical expertise in medical insurance regulation and performance evaluation were invited to select available indicators. A combination weighting method based on analytic hierarchy process and entropy method was used to determine the weight coefficient. Shanghai was taken as the sample area, and 760 DMIs were included in the empirical research. The test-retest reliability method and criterion-related validity method was used to test the reliability and the validity of the evaluation result. An assessment index system that included 6 domains and 56 indicators was established in this study. Furthermore, we developed an online platform to assist in the implementation of the assessment. The results showed that the average score of assessment was 94.39, the median was 96.92. The test-retest reliability value was 0.96 (P ≤ 0.01), which indicated high stability of the assessment. In addition, there was a significant negative relationship between assessment score and the penalty amount of DMIs (R = -0.133, P < 0.001). After adjusting for the basic characteristics of medical institutions, the number of visits and revenue, the negative relationship was still significant (B = -0.080, P < 0.05). These results are consistent with expectations, indicating that the assessment had good criterion-related validity. This study established an operable assessment measure and developed an online platform to assess the performance of DMIs. The results showed good feasibility and reliability in empirical research. Our research findings provided an operable Chinese solution for DMI assessment that saves manpower and time, which would have good enlightening significance in other regions of China and in low-income and middle-income countries internationally.

Policy Implementation in Management of Anchor Harbors Kepulauan Riau Province

Research discusses the implementation of anchor anchor management policies in the Kepulauan Riau Province which involves various actors with different interests. Research objectives are to implement anchor anchor management policies in the Kepulauan Riau Province. Research method used is a post-positivism approach by analyzing the types of benefits obtained, the scale of change desired, the decision-making framework, institutional and regime characteristics, as well as policy implementation and responsiveness. Results and discussion show that implementing this policy has significant economic, social, environmental and security benefits but still requires improvements to infrastructure and supporting facilities. There is also a need for good cooperation and coordination, increasing institutional capacity, increasing the capabilities of relevant officials, as well as developing technology and innovation to support more effective policy implementation. In conclusion, the anchor anchor management policy in the Kepulauan Riau Province must be improved so that it can have a positive impact on the community and the surrounding environment and improve the welfare of the local community. Apart from that, this research also highlights the importance of involving various actors in decision making regarding anchor anchor management policies. In this way, the resulting policies can be more effective and efficient, and can meet the needs and interests of all parties involved. Implication of this research is the need for synergy and collaboration between various actors regarding anchor anchor management policies. Apart from that, it is also important to pay attention to the decision-making framework, characteristics of institutions and regimes, as well as policy implementation.

Enacted institutions, participatory sense-making and social norms

This paper argues that institutions are higher-level autonomous systems enacted by patterns of participatory sense-making. Therefore, unlike in the standard equilibrium theory, institutions are not themselves thought of as behavioural patterns. Instead, they are problem domains that these patterns have brought forth. Moreover, these are not merely any patterns, but only those devoted to maintaining a specific strategy of problem solving, called the strategy of ‘letting be’. The latter refers to, following Hanne de Jaegher, a balance between underdetermination and overdetermination of individual behaviour by a collective. Such an understanding of institutions becomes an option once a hybrid ‘equilibrium + rules’ theory of institutions, such as the one proposed by Frank Hindriks, is supplemented with insights from enactivism. In this light, drawing a connection between these two areas is the additional, meta-theoretical goal of this paper. This connection is beneficial, I argue, in particular since it allows for a satisfactory, in-depth account of the normative character of institutions as well as their local character.

Exploring COVID-19 census burdens by US hospital characteristics: Implications of quality reporting at rural and critical access hospitals.

By assessing longitudinal associations between COVID-19 census burdens and hospital characteristics, such as bed size and critical access status, we can explore whether pandemic-era hospital quality benchmarking requires risk-adjustment or stratification for hospital-level characteristics. We used hospital-level data from the US Department of Health and Human Services including weekly total hospital and COVID-19 censuses from August 2020 to August 2023 and the 2021 American Hospital Association survey. We calculated weekly percentages of total adult hospital beds containing COVID-19 patients. We then calculated the number of weeks each hospital spent at Extreme (≥20% of beds occupied by COVID-19 patients), High (10%-19%), Moderate (5%-9%), and Low (<5%) COVID-19 stress. We assessed longitudinal hospital-level COVID-19 stress, stratified by 15 hospital characteristics including joint commission accreditation, bed size, teaching status, critical access hospital status, and core-based statistical area (CBSA) rurality. Among n = 2582 US hospitals, the median(IQR) weekly percentage of hospital capacity occupied by COVID-19 patients was 6.7%(3.6%-13.0%). 80,268/213,383 (38%) hospital-weeks experienced Low COVID-19 census stress, 28% Moderate stress, 22% High stress, and 12% Extreme stress. COVID-19 census burdens were similar across most hospital characteristics, but were significantly greater for critical access hospitals. US hospitals experienced similar COVID-19 census burdens across multiple institutional characteristics. Evidence-based inclusion of pandemic-era outcomes in hospital quality reporting may not require significant hospital-level risk-adjustment or stratification, with the exception of rural or critical access hospitals, which experienced differentially greater COVID-19 census burdens and may merit hospital-level risk-adjustment considerations.

Neighborhood-Level Disadvantage and Delayed Adjuvant Therapy in Head and Neck Cancer

For patients with head and neck squamous cell carcinoma (HNSCC), initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is recommended by the National Comprehensive Cancer Network Guidelines and the Commission on Cancer. Although individual-level measures of socioeconomic status are associated with receipt of timely, guideline-adherent PORT, the role of neighborhood-level disadvantage has not been examined. To characterize the association of neighborhood-level disadvantage with delays in receiving PORT. This retrospective cohort study included 681 adult patients with HNSCC undergoing curative-intent surgery and PORT from 2018 to 2020 at 4 US academic medical centers. The data were analyzed between June 21, 2023, and March 5, 2024. The primary outcome was delay in initiating guideline-adherent PORT (ie, >6 weeks after surgery). Time-to-PORT (TTP) was a secondary outcome. Census block-level Area Deprivation Index (ADI) scores were calculated and reported as national percentiles (0-100); higher scores indicate greater deprivation. The association of ADI scores with PORT delay was assessed using multivariable logistic regression adjusted for demographic, clinical, and institutional characteristics. PORT initiation across ADI score population quartiles was evaluated with cumulative incidence plots and Cox models. Among 681 patients with HNSCC undergoing surgery and PORT (mean [SD] age, 61.5 [11.2] years; 487 [71.5%] men, 194 [29.5%] women) the PORT delay rate was 60.8% (414/681) and median (IQR) TTP was 46 (40-56) days. The median (IQR) ADI score was 62.0 (44.0-83.0). Each 25-point increase in ADI score was associated with a corresponding 32% increase in the adjusted odds ratio (aOR) of PORT delay (aOR, 1.32; 95% CI, 1.07-1.63) on multivariable regression adjusted for institution, age, race and ethnicity, insurance, comorbidity, cancer subsite, stage, postoperative complications, care fragmentation, travel distance, and rurality. Increasing ADI score population quartiles were associated with increasing TTP (hazard ratio of PORT initiation, 0.71; 95% CI, 0.53-0.96; 0.59; 95% CI, 0.44-0.77; and 0.54; 95% CI, 0.41-0.72; for ADI quartiles 2, 3, and 4 vs ADI quartile 1, respectively). Increasing neighborhood-level disadvantage was independently associated with a greater likelihood of PORT delay and longer TTP in a dose-dependent manner. These findings indicate a critical need for the development of multilevel strategies to improve the equitable delivery of timely, guideline-adherent PORT.

DESIGN OF CORPORATE CLOTHING: AESTHETIC AND ERGONOMIC ASPECTS

The article is devoted to the process of designing corporate clothing for employees and students of higher education of the Khmelnytskyi National University, which is considered as a system of "corporate style → corporate image → corporate clothing and its identity", including logos, colors, graphic elements and graphic standards of visual identification of the KhNU and their structure. Scientific novelty. The most characteristic artistic and compositional solutions and the typology of graphic elements used in the corporate style of KhNU as a means of communication for the creation of the image and brand of the higher education institution were analyzed and highlighted. Practical meaning. The developed systematization of the graphic elements of the corporate style of KhNU made it possible to generalize their artistic and compositional features and use them in the design of men's and women's corporate clothing for employees and students of higher education of the Khmelnytskyi National University for visual representation and broadcasting of the values and main characteristics of the educational institution. The process of creating a sketch and harmonizing the project image of corporate clothing with the help of an information model, which allows to present it as a single symbolic system with the help of modern practices of visual presentation of fashion innovations, is demonstrated. The design stages of corporate clothing samples are presented with the help of computer technologies, which provide clothing designers with wide visual and artistic opportunities in the context of modern communication practices. Artistic and design, constructive and technological solutions for men's and women's corporate clothing models were developed, which were produced under the conditions of the Ukrainian fashion brand ARTY Sport using a calender thermopress for sublimation. Testing of experimental samples of products took place at the exhibition dedicated to the Day of Science (Khmelnytskyi, KhNU, 2022). Research materials can be used in the development of corporate style and design of modern corporate clothing. The results of the study can be used in further scientific research on the design of other types of corporate clothing for employees and students of higher education of the Khmelnytskyi National University.

The effect of institutional characteristics and social norms on corruption in healthcare

AbstractCorruption in healthcare is widespread and consequential. Informal payments (IPs) are a common form of petty corruption, especially in low‐ and middle‐income countries. Using data from the Life in Transition Survey encompassing 33 countries across Europe and Central Asia, I analyze the prevalence and reasons behind IPs made to public health providers. In addition to individual‐ and system‐level factors often used in literature, I also introduce a latent measure of social norms related to high levels of corruption. These are associated with a significantly higher prevalence of paying informally. This paper also bridges a gap between the corruption literature and health‐related research by introducing a typology of IPs based on why they were made. I find that the association between health system characteristics and IPs prevalence differs based on the reason for payment. This difference is further exacerbated by the existence of corruption‐related social norms. The results of this analysis highlight the need to revisit existing anti‐corruption policies and align them to the underlying social norms.

The two-spirit, lesbian, gay, bisexual, transgender, queer, and other sexual and gender identity curriculum in Canadian Dental Schools: What are the gaps and proposed next steps?

This study aimed to investigate gaps in the delivery of two-spirit, lesbian, gay, bisexual, transgender, queer, and other sexual and gender identity (2SLGBTQ+) curricula and identify curricular challenges within Canadian dental schools. A 21-item closed-ended questionnaire was distributed to curriculum experts across 10 dental schools in Canada. The survey questions were organized into three sections: institution characteristics, current 2SLGBTQ+ content and delivery, and opinions on the improvement of the 2SLGBTQ+ curriculum. Microsoft Excel (2020) was used to perform a descriptive analysis of the survey responses. Nine dental schools participated in the survey. All participating schools reported the offering of undergraduate, graduate, and degree completion programs. The most reported methods of teaching 2SLGBTQ+ content were 'lecture-based teaching' (n=5), 'small-group teaching' (n=4), and 'case-based discussions' (n=4). The most common topics taught were 'gender identity' (n=7) and '2SLGBTQ+ discrimination in healthcare care settings' (n=7). The topics of 'sex reassignment surgery,' 'alcohol, tobacco, or other substance use by 2SLGBTQ+ people,' '2SLGBTQ+ pediatric and adolescent oral health issues,' 'coming out,' and 'sex reassignment surgery' were not included or were unknown by the majority of dental schools (n=8). Overall, participants were unsatisfied with the level of 2SLGBTQ+-specific content covered at their institution and reported a 'lack of space within the curriculum and time constraints' as a barrier to implementation (n=8). Community-based research is needed to identify the unmet oral health needs of the 2SLGBTQ+ population, which can be translated into the development of a risk-based oral health curriculum within Canada and beyond.