Integration Process Research Articles

НАРИСИ ІСТОРІЇ МІСТОБУДУВАННЯ В УКРАЇНІ І СВІТІ

Introduction. The article examines the nutritional dynamics and peculiarities of the development of the environment in Ukraine, which requires an integrated approach to address the challenges and problems of this problem. The foldability and rich profile of this galus poses system requirements that require support and legislative security at the edge. Also, we are talking about developing a strategy for the development of local development, which is based on the idea of ensuring harmony between the economic, social and environmental development of the place. The main essence lies in the creation of such a local environment that would satisfy the needs of the current generation, without reducing the ability of future generations to take control of their lives. It is important that the main aspects of the development of strategies for the development of local development include, first of all, economic stability, so that they are aimed directly at creating minds for economic growth and development, ensuring the stability of financial, economic and investment processes in localities. Social inclusion plays an important role, and development strategies are aimed at ensuring accessibility and equal access to infrastructure, housing, lighting, health care and other social services for all levels of the population. Problem statement. Urban planning is a complex, multi-level and multi-disciplinary process that has a systemic nature. The main task of urban planning is to create such a material environment in which human needs should be satisfied as best as possible. In contrast to previous years, the urban planning process has been streamlined and has become more integrated into public production. The specificity of this type involves a whole series of competencies affecting many fields of knowledge. Urban planning activity involves planning, development of territories, careful development and implementation of urban planning documentation regarding both the expansion of cities and the construction of new ones. At the same time, many questions arise regarding architectural solutions, harmonious placement of buildings in the surrounding landscape. The process of urban planning always heralds socio-economic development: infrastructure and architectural projects implemented within the framework of urban planning can contribute to economic growth, attracting investment and creating jobs, while the process of social integration is underway, creating conditions for communication and interaction between different social and cultural groups .

КРИТЕРІАЛЬНИЙ ВПЛИВ НА ВИБІР ВИДУ ТРАНСПОРТНОГО СПОЛУЧЕННЯ ПРИ ОРГАНІЗАЦІЇ ДОСТАВКИ ВАНТАЖІВ В УМОВАХ МІЖНАРОДНОЇ ІНТЕГРАЦІЇ

Introduction. The organisation of cargo delivery in various transport connection options requires the identification of the most optimal parameters of transportation by certain transport modes and the development of better transport connections. The systematisation of transport and logistics processes requires a comprehensive solution to the problems of organising the delivery of goods in international multimodal connections. The growing demands of the freight clientele are becoming a key factor in the competition between both carriers and logistics operators to serve more profitable cargo flows. Problem Statement. International integration processes involve interaction between all participants in international cargo delivery, and its reliability depends on the effectiveness of its organisation. Ensuring high-quality transport services for a particular cargo delivery is only possible if the criteria are correctly selected and adequately assessed. Purpose. To determine the criteria of influence on the choice of transport mode in the organisation of cargo delivery, taking into account the factor influence characterising the carrying capacity of each transport mode serving a particular order, as well as the synergy of their interaction.

Research on urban agglomeration spatial network structure in the middle reaches of the Yangtze River based on real-time traffic accessibility scenario analysis

ABSTRACT Investigating the spatial network structure of urban agglomerations based on traffic accessibility has an important practical significance in accelerating the process of regional integration. Taking urban agglomeration in the middle reaches of the Yangtze River (UAMRYR) as the case study, this study aims to examine the characteristics associated with the spatial network structure based on traffic accessibility and its changes under scenarios of different traffic accessibilities by adopting real-time traffic data, modified gravity model, and social network analysis (SNA). The main conclusions are as follows. Wuhan, Changsha, and Nanchang are the central cities in the spatial network; the spatial network structure of UAMRYR is imbalanced and in the agglomeration stage of regional economic development. With the development of traffic accessibility, resources first gather in the individual center cities and then spread to other cities, and the network tends toward equilibrium.

I married a Traveller: An Interpretative Phenomenological Analysis of the lived experiences of women marrying into the Travelling community and its impact to their identity

Policy developments associated with increased lifestyle-related regulations have compelled Travellers to re-assess their social worlds and adapt accordingly. Adopting a social constructionist epistemological stance, this qualitative study drew upon the Identity Process Theory, alongside Interpretative Phenomenological Analysis (IPA) as a broad framework to (1) explore the way in which non-Traveller women experience a sense of community integration upon marrying into the Traveller community, (2) to explicate the extent to which their experiences of integration impact upon their own identity, and (3) to develop an understanding of how these lived experiences inform the changes within Traveller culture through the process of integration. Semi-structured interviews were conducted with six women aged between 28–42 years living within the UK. Guided by the principles of IPA, three superordinate themes, each consisting of two subordinate themes emerged from the analysis: ‘Joining the culture’, ‘Cultural Clashes’, and ‘Changes to the self’. The findings highlighted that participant’s experienced interpersonal conflict and continuous negotiations between continuity and discontinuity, that had either positive or negative impacts to their individual identity. This paper has important implications for professionals who aim to provide support and enhance the overall wellbeing of individuals living between these two contrasting cultures.

A Comparative Study on the Painting Forms of Western Oil Painting and Chinese Ink Painting

Since modern international students introduced oil painting on a large scale to China, oil painting has been developing in China for over a hundred years. In citing the process of progress, learning, integration, and improvement, the change in titles from “Western painting” and “Western painting” to “oil painting” and then to “Chinese oil painting” indicates that oil painting, as an art form, has deeply embodied the characteristics and connotations of traditional Chinese culture. During this period, its development is closely related to the historical background of the entire China, reflecting the continuation and evolution of traditional Chinese freehand brushwork spirit in the complex and changing context of the times. This article compares oil paintings imported from abroad with domestic ink painting, taking the artistic realm of painting in both the East and the West as the starting point. The main axis that runs through them is Chinese ink painting and Western oil painting landscapes. Showcasing the similarities and differences between Chinese ink wash landscape painting and Western oil painting landscapes, Chinese landscape painting emphasizes the expression of emotions and a sense of awe and emotion towards nature, with the main idea of “learning from nature”; The Western oil painting landscape emphasizes the realism of the scenery, which is a re-creation of nature, allowing people to have a realistic feeling of being there when watching the painting. The main reason there are these differences between Chinese ink painting and Western oil painting landscapes is due to different social and cultural backgrounds and fields of consciousness.

Artificial intelligence and human integration: a conceptual exploration of its influence on work processes and workplace learning

ABSTRACT This paper examines the influence of Artificial Intelligence (AI) on job and organizational processes, drawing on sociotechnical systems (STS) theory. It discusses the emergence of AI and its implications for HRD on individual, group, and organizational learning. AI has changed the trajectory of work processes and outcomes, paving the way for the future of work. An AI-human integration process model is proposed to reinforce its influence on job design in response to AI applications in the workplace. Learning is experienced between humans and between humans and AI. AI’s cognitive intelligence is capable of learning from each other through a process of deep learning. Humans, too, can learn from AI to modify their response towards working with AI-enabled applications. The model illustrates the relationships between individuals, work processes, and sociotechnical systems through multilevel interactions. Of relevance to HRD are two critical processes, namely learning and innovating, that facilitate the continuation of AI-human integration, enabling employees to embrace AI as an integral part of their work life. The paper offers several implications for HRD research and practice, recognizing opportunities for workplace learning and the potential constraints and risks arising from AI adoption that are applicable globally and internationally.

Multilevel Analysis of the Neovascularization and Integration Process of a Nonvascularized Rectus Fascia Transplantation.

Failure to close the abdominal wall after intestinal transplantation (ITx) or multivisceral Tx remains a surgical challenge. An attractive method is the use of nonvascularized rectus fascia (NVRF) in which both layers of the donor abdominal rectus fascia are used as an inlay patch without vascular anastomosis. How this graft integrates over time remains unknown. The study aims to provide a multilevel analysis of the neovascularization and integration process of the NVRF. Three NVRF-Tx were performed after ITx. Clinical, radiological, histological, and immunological data were analyzed to get insights into the neovascularization and integration process of the NVRF. Moreover, cryogenic contrast-enhanced microfocus computed tomography (microCT) analysis was used for detailed reconstruction of the vasculature in and around the NVRF (3-dimensional histology). Two men (31- and 51-y-old) and 1 woman (49-y-old) underwent 2 multivisceral Tx and 1 combined liver-ITx, respectively. A CT scan showed contrast enhancement around the fascia graft at 5 days post-Tx. At 6 weeks, newly formed blood vessels were visualized around the graft with Doppler ultrasound. Biopsies at 2 weeks post-Tx revealed inflammation around the NVRF and early fibrosis. At 6 months, classical 2-dimensional histological analysis of a biopsy confirmed integration of the fascia graft with strong fibrotic reaction without signs of rejection. A cryogenic contrast-enhanced microCT scan of the same biopsy revealed the presence of microvasculature, enveloping and penetrating the donor fascia. We showed clinical, histological, and microCT evidence of the neovascularization and integration process of the NVRF after Tx.

Patient Safety Culture: Nurses’ Perspective in the Hospital Setting

Patient Safety Culture: Nurses’ Perspective in the Hospital Setting

MODELS OF INTERCULTURAL COMPETENCE: COMPARATIVE ANALYSIS

MODELS OF INTERCULTURAL COMPETENCE: COMPARATIVE ANALYSIS

Low-Temperature Nanosecond Laser Process of HZO-IGZO FeFETs toward Monolithic 3D System on Chip Integration.

Ferroelectric field-effect transistors (FeFETs) are increasingly important for in-memory computing and monolithic 3D (M3D) integration in system-on-chip (SoC) applications. However, the high-temperature processing required by most ferroelectric memories can lead to thermal damage to the underlying device layers, which poses significant physical limitations for 3D integration processes. To solve this problem, the study proposes using a nanosecond pulsed laser for selective annealing of hafnia-based FeFETs, enabling precise control of heat penetration depth within thin films. Sufficient thermal energy is delivered to the IGZO oxide channel and HZO ferroelectric gate oxide without causing thermal damage to the bottom layer, which has a low transition temperature (<250 °C). Using optimized laser conditions, a fast response time (<1 µs) and excellent stability (cycle >106, retention >106 s) are achieved in the ferroelectric HZO film. The resulting FeFET exhibited a wide memory window (>1.7V) with a high on/off ratio (>105). In addition, moderate ferroelectric properties (2·Pr of 14.7 µCcm-2) and pattern recognition rate-based linearity (potentiation: 1.13, depression: 1.6) are obtained. These results demonstrate compatibility in HZO FeFETs by specific laser annealing control and thin-film layer design for various structures (3D integrated, flexible) with neuromorphic applications.

Electrochemical characterization of localized corrosion mechanism of ALD Al2O3-coated copper for microelectronic application

To achieve performance and reliability in microelectronics devices, copper interconnections must be protected from aggressive environment during the manufacturing process and throughout the life of the devices. Atomic Layer Deposition Al2O3 thin films has been used as a compatible layer with key integration process steps, as well as being corrosion-resistant in neutral media. However, electrochemical tests in aggressive environment have revealed that the alumina prematurely failed to protect copper from localized corrosion. In this study, local and global electrochemical techniques have been employed to evaluate the reactivity of copper at multiple scales and to elucidate the underlying corrosion mechanisms.

European Integration, Opportunities and Risks of Business and Agriculture in Albania

The Integration Process of Albania in the European Union started in 1993 and is considered a long road with many challenges. The signing of the Stabilization-Association Agreement in 2006 is the most important moment of this process, including the harmonization of legislation, to prepare the final EU membership process. This article analyses business opportunities and risks, mainly those of the agri-food sector on its way to the EU. In this framework, trade agreements with the EU and Free Trade Agreements (CEFTA) have influenced the liberalization of trade for agri-food products, intensifying and increasing the level of trade with Europe and the countries of the region. This article also deals with the identification of comparative advantages for the agri-industry sector, where facing the regulated European market, not only challenges are analyzed, but also serious limitations, increasing the need for a structural change in trade relations. In the focus of this paper, are the economic and regional strategies, as well as the progress of the business and agri-food processes, also addressing the trade flows of Albania with the countries of the region and the EU. The analysis of this paper consists of three main premises: 1) in the framework of European integration, costs and benefits in terms of economy and business are more visible in the medium and long term; 2) the integration in the medium term brings a higher economic growth for the countries that aspire to join the EU; and 3) the European integration makes the economy more efficient, bringing about an increase in the ratio of investments, in relation to income, through the reduction of risk with a tendency to increase capital and income per capita (European Commission Report, 2023). The analysis of empirical data shows that the results are not as convincing as expected, thus confirming other previous studies by experts in the field. The main conclusion of this paper is that the integration process has influenced reforms and economic policies in terms of formal and content, both in terms of costs and benefits. In substantive terms, the data analysis shows that the process of European integration has served as a strong impetus for the development of institutions in the country, inter-institutional coordination, the establishment of new institutions, the improvement of human resources, local markets, and the increase of absorptive capacities of funds from the EU. On the other hand, it is concluded that in specific areas of domestic business, such as agri-industry, the effects of EU integration are either not felt yet or are minimal.

Features of Applying Judicial Precedent in the Ukrainian judicial system

The article explores the possibility of future application of judicial precedent in the Ukrainian judicial system and the necessity of normative consolidation of its status as a source of law. Additionally, it is necessary to determine the criteria according to which judicial acts will be classified as sources of law. It is important to consider that the legal force of judicial precedent cannot be equivalent to the legal force of legislation; however, it can play a supplementary role and significantly enhance the quality and effectiveness of justice delivery. It analyzes specific works of scholars on the issue of recognizing judicial precedent as a source of law in Ukraine and its application in modern judicial practice. It is argued that the main questions arising during the investigation of the potential application of judicial precedent in Ukraine as a legal phenomenon should be analyzed through comparative analysis with legal systems where precedent is the primary source of law. It is substantiated that comprehensive and thorough research on precedent as a source of law is necessary for further improvement of the judicial system in Ukraine, driven by several reasons. Firstly, the increasing scientific interest in atypical sources of law for our country is associated with the intensive processes of Ukraine's integration into the European and global communities, as well as military actions in the country. Secondly, at the present stage, there is a significant influence of political, geographical, historical, and other factors on the legal space. The third reason for conducting research on judicial precedent is that both precedent and judicial practice are exclusively applied and legally applicable institutions directly related to the practical activities of the judicial system. It is established that unlike judicial practice, a judicial precedent, which is created by individually adopted court decisions of higher judicial instances, is a type of legal provisions developed as a result of judicial practice and one of its forms aimed at overcoming gaps in legislative regulation.

Revolutionizing Supply Chain Management: Real-time Data Processing and Concurrency

In the contemporary business landscape, effective supply chain management (SCM) is paramount for organizations seeking to thrive amidst evolving market dynamics and heightened customer expectations. This research paper presents a pioneering approach to SCM that harnesses cutting-edge technologies, namely Kafka and Akka, to revolutionize data integration and decision-making processes. By leveraging Kafka as a robust distributed event streaming platform and Akka as a versatile toolkit for developing concurrent and distributed applications, our system facilitates seamless communication and coordination across diverse nodes within the supply chain network. This paper elucidates the intricacies of the proposed architecture, detailing the implementation methodology and performance evaluation metrics. Through a comprehensive examination, we demonstrate how our solution enhances supply chain visibility, fosters operational agility, and enables real-time responsiveness to market fluctuations and customer demands. Moreover, practical use cases exemplify the transformative impact of our approach on inventory management optimization, order fulfillment efficiency, and logistics optimization. Furthermore, we delve into the challenges encountered during implementation and deployment, offering insights into potential mitigative strategies. Finally, we outline avenues for future research, exploring emerging trends and opportunities in the realm of SCM empowered by Kafka and Akka technologies.

Multi-Sensor Satellite Remote-Sensing Data for Exploring Carbonate-Hosted Pb-Zn Mineralization: Akhlamad Area, Razavi Khorasan, North East Iran

The exploration of Pb-Zn mineralization in carbonate complexes during field campaign is a challenging process that consumes high expenses and time to discover high prospective zones for a detailed exploration stage. In this study, multi-sensor remote-sensing imagery from Landsat-8, Sentinel-2, and ASTER were utilized for Pb-Zn mineralization prospectivity mapping in the Akhlamad carbonate complex area, Razavi Khorasan, NE Iran. Due to the presence of carbonate formations and various evidence of Pb-Zn mineralization, this area was selected. Band composition, band ratio, principal component analysis (PCA), and SAM techniques for mapping alteration minerals as well as lineament analysis were implemented. Subsequently, a fuzzy logic model for identifying the prospective zones of Pb-Zn mineralization using multi-sensor remote-sensing satellite images was designed. The weight of each exploratory layer was determined using the fuzzy hierarchical method and the integration process of the information layers was performed using fuzzy operators. Finally, the existing mineral indications were used to evaluate and validate the obtained mineral potential map. The outcome of this investigation suggested several high-potential zones for Pb-Zn exploration in the study area.

Climate policy integration as a process: from shallow to embedded integration

ABSTRACT Across many policy areas, policymakers try to integrate new policy issues into old policy processes. This is challenging. Getting to net-zero greenhouse gas emissions requires radical change across a broad range of societal sectors; thus, climate policy integration is essential. This article develops a new processual perspective on climate policy integration, allowing assessment, classification, and comparison of various stages of integration across policy processes, and over time. The integration process can be shaped by differing institutional logics. In a study of Norwegian agricultural policy, we identify three logics: multifunctional, market failure, and socio-technological transition. These portray differing frames, objectives, instruments, and sector involvement as appropriate ways of linking climate concerns to agricultural policy. We suggest that a shallow integration process is characterized by a sector-specific logic that facilitates discussions of policy frames and goals. In an embedded integration process, multiple logics are mobilized, and a broader range of policy elements are discussed: frames, goals, instruments, and sector involvement in the process. Consistent and contested integration processes are intermediate categories. Climate integration in Norwegian agricultural policy had the hallmarks of a shallow process in 2006–2009 but changed to a contested process in 2016–2021.

The typical and atypical developing mind: a common model.

We present a theory of atypical development based on a developmental theory of the typical mind integrating developmental, cognitive, and psychometric theory and research. The paper comprises three parts. First, it outlines the theory of typical development. The theory postulates central cognitive mechanisms, such as relational integration, executive and inferential processes, and domain-specific processes underlying different environmental relations, such as visuospatial or quantitative relations. Cognitive development advances in cycles satisfying developmental priorities in mastering these systems, such as executive control from 2-6 years, inferential control from 7-11 years, and truth control from 12-18 years. Second, we discuss atypical development, showing how each neurodevelopmental disorder emerges from deficiencies in one or more of the processes comprising the architecture of the mind. Deficiencies in relational integration mechanisms, together with deficiencies in social understanding, yield autism spectrum disorder. Deficiencies in executive processes yield attention-deficit and hyperactivity disorder. Deficiencies in symbolic representation yield specialized learning difficulties, such as dyslexia and dyscalculia. Finally, we discuss clinical and educational implications, suggesting the importance of early diagnosis of malfunctioning in each of these dimensions and specific programs for their remediation.

Modern Challenges of Adjusting the Effectiveness of the Application of Laws (on the Example of Tax and Legal Regulation)

The relevance of the research topic is determined by the current state of social relations. It is notedthat the analysis of modern social relations cannot be carried out outside the boundaries of significantchallenges that require not only their understanding, but also consideration in the relevant reform measures.The most important challenges today are the following: Russia&amp;#39;s war with Ukraine; European integrationprocesses that characterize modern trends in Ukrainian development; digitization of all aspects of public life.Given the problems associated with this, the article defines both objective reasons that affect tax relations, aswell as requirements that are subjective in nature.The purpose of the article is to highlight problematic aspects of the state of modern legal regulation.Attention is focused on the fact that war, European integration and digitalization are among the mostinfluential factors in this aspect. It is clear that they cannot fail to influence the traditional legal means thatguarantee the effectiveness of tax legislation. These aspects are the subject of analysis.Traditional methods of scientific knowledge are used in the research, thanks to which a systematicidea is formed about the reasons for adjusting legal means of influence on tax relations. The characteristicsof the influence of martial law on tax regulation are carried out depending on the stages. The beginning ofthe first is associated with 2014, while the second - with 2022. Despite common features (narrowing of theterritories where Ukrainian jurisdiction exists, reduction of the tax base and tax-paying taxpayers, etc.),differences in the content of these stages have been singled out. European integration processes, whichreflect the movement of Ukraine towards the European community, provide for the adjustment of the natureand content of tax legislation in the following directions: a) adaptation of the current tax legislation ofUkraine to European requirements; b) consideration of European prescriptions at the stage of developmentof zocono projects; c) achieving a balance of acts of the national legislation system.Three areas of relations, which most fundamentally affect the legal status of tax regulation, havebeen studied. The prospects of tax changes depending on the state of war, the prospects of the impact ofharmonization of EU legislation and national legislation, the need to take into account the processes ofdigitalization of tax relations are considered.On the basis of the conducted research, conclusions were made and recommendations were maderegarding the harmonization of the prescriptions of both exclusively tax norms and tax norms on the borderwith other industry regulations. Adjustment of the current set of legislative norms determines the importanceof a systematic approach to the turnover of virtual assets. The formation of a generalized, systematicapproach to these relations is fundamentally important. In order to achieve such a state, it is very importantto supplement the private law means of regulating the circulation of virtual assets with effective tools ofpublic and legal influence (taxation, supervision, public control). The study analyzes the substantive factorsof the regulation of such relations proposed by the two draft laws.

Asymmetry of the economic development of the Eurasian Economic Union: analysis and recommendations

The article analyses the asymmetry of the development of the Eurasian Economic Union countries (hereinafter referred to as the EAEU). The objective of the work is to analyse the symmetrical development of countries within the framework of the EAEU and to formulate measures and recommendations for increase of the economic potential of the countries. In order to achieve the purpose, the objective of comparative assessment on the basis of three indicators was set and overcome. The three indicators include gross domestic product per capita, investments per capita and average accrued salary. The corresponding calculations were done for each indicator, and graphs were constructed showing the general state of the economic development. During the study, the methods of factor and system analysis were applied. The initial data for the study were the official sources of the statistical authorities of the EAEU countries, the Interstate Statistical Committee of the Commonwealth of Independent States as well as publications and scientific articles related to this topic. The main problem is the uneven economic development of the EAEU member states which leads to negative consequences for strengthening the integration process. As a result of the study, some measures were proposed to achieve the symmetrical development of the countries within the framework of the EAEU, and recommendations were prepared for the effective development of interaction between the member countries of the integration association. Following the results of this work, a conclusion was formulated on strengthening ties between the countries by focusing on a mixed economy with government regulation, infrastructure development and increased investment activity.

General practitioners’ management of mastitis in breastfeeding women: a mixed method study in Australia

BackgroundMastitis is a common reason new mothers visit their general practitioner (GP). In Australia, the Therapeutic Guidelines: Antibiotic provides practical advice to GPs managing a range of infections, including mastitis. It is not known if Australian GPs prescribe antibiotics and order investigations as recommended for the management of mastitis.MethodsA convergent mixed methods design integrated quantitative analysis of a general practice dataset with analysis of interviews with GPs. Using the large-scale primary care dataset, MedicineInsight, (2021–2022), antibiotics prescribed and investigations ordered for mastitis encounters were extracted. Mastitis encounters were identified by searching ‘Encounter reason’, ‘Test reason’ and ‘Prescription reason’ free text field for the term ‘mastitis’; ‘granulomatous mastitis’ was excluded. Clinical encounters for mastitis occurring within 14 days of a previous mastitis encounter were defined as belonging to the same treatment episode. Semi-structured interviews were conducted with 14 Australian GPs using Zoom or telephone in 2021–2022, and analysed thematically. The Pillar Integration Process was used to develop a joint display table; qualitative codes and themes were matched with the quantitative items to illustrate similarities/contrasts in findings.ResultsDuring an encounter for mastitis, 3122 (91.7%) women received a prescription for an oral antibiotic; most commonly di/flucloxacillin ([59.4%]) or cefalexin (937 [27.5%]). Investigations recorded ultrasound in 303 (8.9%), blood tests (full blood examination [FBE]: 170 [5.0%]; C-reactive protein [CRP]: 71 [2.1%]; erythrocyte sedimentation rate [ESR]: 34 [1.0%]) and breast milk or nipple swab cultures in approximately 1% of encounters. Analysis using pillar integration showed consistency between quantitative and qualitative data regarding mastitis management. The following themes were identified:- GPs support continued breastfeeding.- Antibiotics are central to GPs' management.- Antibiotics are mostly prescribed according to Therapeutic Guidelines.- Analgesia is a gap in the Therapeutic Guidelines.- Low use of breast milk culture.ConclusionsPrescribing antibiotics for mastitis remains central to Australian GPs’ management of mastitis. Interview data clarified that GPs were aware that antibiotics might not be needed in all cases of mastitis and that delayed prescribing was not uncommon. Overall, GPs followed principles of antibiotic stewardship, however there is a need to train GPs about when to consider ordering investigations.