Priority Conditions Research Articles

Incidence of mental disorders and its predictors among air force personnel exposed to counter-insurgency operations in a West African country: a 6-month follow-up study

BackgroundDespite robust reports in the literature concerning the effect of exposure to combat on mental health, there is a paucity of studies in the Nigerian Air Force (NAF) using a...

Characteristics of longitudinal maternal health studies in sub-Saharan Africa: A systematic mapping of literature between 2012 and 2022.

High maternal mortality rates in sub-Saharan Africa necessitate the need for aligned research focusing on prevalent causes and neglected conditions in the region. This mapping review aimed to describe the characteristics of longitudinal maternal health studies between 2012 and 2022 in sub-Saharan Africa and identify gaps in priority conditions or geographical locations. We identified references through a Medline (PubMed) search covering September 2012 to June 2022. We included prospective cohort or clinical trials that enrolled at least 1000 pregnant women, with a study site in sub-Saharan Africa, and published in English or French. Screening and data extraction were done in duplicate using EPPI-reviewer software. Descriptive analysis was used to summarize the results, identifying patterns in studies across time, country, study design, topics, and funders. We identified 213 eligible studies, which were covered in 534 publications. We identified studies in 33 of the 48 sub-Saharan African countries, with the majority in east and southern Africa. The predominant study topics were HIV (36.4%), nutrition (20%), and malaria (16.3%), with very few publications on hypertensive disorders of pregnancy (6.4%), ante/postpartum hemorrhage (3.7%), and sexually transmitted infections (3.2%). More studies were cohorts (115/213; 54%) than clinical trials. The National Institutes of Health (31.5%), Bill and Melinda Gates Foundation (22.1%), and USAID (10.8%) were the largest research funders. Identifying research trends and mismatches between research topics and disease burden provides useful information for guiding future research prioritization. In particular, gaps exist for studies on hypertensive disorders of pregnancy and ante/postpartum hemorrhage, among the top causes of maternal mortality in sub-Saharan Africa.

Global Pathology: A Snapshot of the Problems, the Progress, and the Potential.

For equitable global health care, the United Nations has outlined Sustainable Development Goals for health in low-income and middle-income countries (LMICs) with the goal of reaching universal health care by 2030. Currently, 47% of the global population lacks access to basic diagnostics for many common diseases. The need for diagnostic access has never been more critical owing to the dramatic rise of noncommunicable diseases in LMICS. In a recent analysis, The Lancet Commission on Diagnostics estimated that 1.1 million deaths occurring on an annual basis could be avoided if the diagnostic gap were reduced to 10% for only 6 priority conditions. To provide a nonexhaustive summary of the progress made to overcome the barriers to adequate access and explore the potential solutions needed to achieve global diagnostic equity. Several experts in global pathology were interviewed in addition to pathologists working in low-resource settings outside of the United States. Published literature on the topic of global pathology work was analyzed and summarized to provide a cohesive snapshot of the status of global pathology. Working to increase access to diagnostics in low-resource settings will save millions of lives. The solution to the current inadequate availability of global pathology services will require a global commitment from the entire pathology and laboratory medicine community, government support, and collaboration between the public-private sectors to achieve equitable health care.

Identifying patterns of change in traffic flows’ parameters depending on the organization of public transport movement

This study examines the issue of traffic organization on sections of city streets, in which there are public transport stop zones of different configurations (with a drive-in pocket and along a traffic lane). Accordingly, the object of research is the parameters of traffic flows; the subject is the regularities in their change on such specific sections of the street-road network, taking into account the configuration of stops, the number of traffic lanes, and priority conditions for the movement of public transport. The task addressed in this work was the quantitative assessment of the efficiency of traffic management in public transport stop zones. It was also important to compare different configurations of street segments in terms of their impact on delays of private and public transport. As a result of the research, the speed and time characteristics of the traffic flow and their dependence on its composition and intensity for different number and specialization of traffic lanes, as well as the location of the public transport stop, were determined. The resulting quantitative indicators of delays of all types of transport for each modeling option made it possible to determine the best of them according to the criterion of minimal time loss. This applies to both private and public transport, as the values of delays may differ from each other by 10–50 %. An applied aspect related to using the scientific result is the possibility of justifying the number of traffic lanes, or their allocation for public transport, as well as determining the appropriate configuration of stops. This constitutes the prerequisites for the transfer of the scientific results to the relevant interested structures in the field of transport, which are responsible for the organization and safety of traffic under urban conditions

A multi-objective physiological control system for continuous-flow left ventricular assist device with non-invasive physiological feedback

In order to enable continuous-flow left ventricular assist device (CFLVAD) to adjust pump speed adaptively in response to changes in ventricular load, we developed a multi-objective physiological control system for CFLVAD with non-invasive physiological feedback mechanism, and proposed a multi-objective hierarchical control (MOHC) strategy to coordinate three controllers. A model-based estimation method was utilized to gain the physiological feedback variables. Suction prevention controller, regurgitation prevention controller, and physiological pulsatility controller were developed and applied to achieve the objectives: preventing left ventricular suction, preventing pump regurgitation, pump flow adaptive adjustment, and enhancing vascular pulsatility. The constraint conditions of feedback variables and controller priority were used to implement multi-objective hierarchical control. The preload and afterload were increased or decreased to simulate the scenarios of the sharp increase in left ventricular flow, the sharp decrease in left ventricular flow, and the rest-exercise-rest. The performance of MOHC was evaluated by subjecting it to three scenarios and compared with that of constant speed control (CSC) and pulsatile varying speed control (PVSC). The simulation results show that the linear correlation between the filtered and actual feedback variables was as high as 99.9%. Compared with CSC and PVSC, MOHC can avoid ventricular suction and pump regurgitation when the left ventricular flow changed rapidly. During rest or exercise, MOHC provided more adequate physiological perfusion and enhances greater vascular pulsatility than CSC and PVSC. MOHC can adjust the CFLVAD pump speed in response to changes in ventricular load.

Optimization Model of Emergency Evacuation Network Based on Genetic Algorithm

Aggregation and dispersion are the normal states. In economic production and social life, the evacuation of people and materials deserves extensive attention. From the perspective of mathematics and economics, arranging a thoughtful evacuation is essential for the best balance between personal satisfaction and cost. In this paper, evacuation is deeply studied by a genetic algorithm; the balance, cost, and willingness (satisfaction) priority models, which consider both satisfaction and cost, are established. In this paper, based on the field investigation and questionnaire survey conducted by Oriental Sports Center, overall satisfaction is inferred by the satisfaction of each person in the tested sample, and the time cost from the evacuation point to different reception points is inferred through actual investigation. Based on these data, a balance model is established, and the calculation is performed. The ratio of the total willingness value of the evacuated individuals to the total cost is taken as the function of the optimization objective. When the optimization objective function is complex, the genetic algorithm is used to search for the optimal solution by simulating the process of natural evolution. At the same time, the cost priority and willingness priority models are established to compare the advantages and disadvantages of different evacuation schemes and their applicable situations. The evacuation of Oriental Sports Center is studied using a genetic algorithm. The objective function value of equilibrium model optimization is 0.2155 (optimal solution), significantly different from willingness priority model optimization (0.0300). After calculating the optimization objective function value and cost value under the conditions of cost priority and willingness priority, a “People-oriented and cost-balanced” suggestion is put forward for a large crowd evacuation scheme.

Updating the WHO Model Lists of Essential Medicines to promote global access to the most cost-effective and safe medicines for mental disorders

IntroductionSince its first publication in 1977, the World Health Organization’s (WHO) Model List of Essential Medicines (EML) has guided the national procurement of medicines deemed essential to inform public health policy worldwide. Aiming to include the most effective, safe, and cost-effective medicines for priority conditions, WHO updates the EML every two years. However, over the past 45 years, updates to the mental health section of the EML have been infrequent, mostly involving the addition of individual medicines. A comprehensive revision of the entire section was never attempted.ObjectivesThe aim of this project was to update the mental health section of the EML to identify the most effective and safest medicines for mental disorders in the light of the most up-to-date evidence base.MethodsA series of nine evidence-based applications were submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines in December 2022, recommending a substantial revision of the entire mental health section.ResultsAll of our applications were accepted by the WHO Expert Committee. For psychotic disorders, aripiprazole, olanzapine, paliperidone, and quetiapine were added as therapeutic alternatives to risperidone; short-acting intramuscular chlorpromazine was replaced by short-acting intramuscular olanzapine; first-generation antipsychotics were limited to oral haloperidol and chlorpromazine. For bipolar disorder, the list now includes second-generation antipsychotics such as quetiapine, aripiprazole, olanzapine, and paliperidone. Tricyclic antidepressants for depressive disorders were limited to amitriptyline alone. Treatment options for anxiety and obsessive-compulsive disorder are now expanded to include SSRIs. For anxiety disorders, diazepam and lorazepam became the only benzodiazepines recommended, with the specific caveat that they should only be used for short-term emergency treatment of acute and severe anxiety symptoms. Finally, chlorpromazine and haloperidol are no longer considered essential medications for psychotic disorders in children under 13 years of age.ConclusionsThe WHO released the 23rd EML in July 2023. After decades of minimal and inconsistent updates, groundbreaking changes have been made to its mental health section. The updated mental health section provides a compelling opportunity to improve the quality of medicine selection at the country level, with the goal of increasing the availability of the safest and most effective psychotropic medicines worldwide.Disclosure of InterestNone Declared

Estimation of ecosystem water consumption and the suitable scale of cultivated land in the Karamay region and Muzat River basin based on the optimized SEBAL energy balance model and water resource constraint model

Food security is closely related to the development of human society, and the root of food production lies in cultivated land, with water conservancy as its lifeline. This study estimates the ecological water consumption of located in the arid region of Northwest China (the Karamay region and Muzat River basin) from 1990 to 2020 based on the optimized Land Surface Energy Balance Algorithm. The verification accuracy of SEBAL energy balance model is greatly improved after optimization. It was showed an increasing trend in the Karamay region and Muzat River basin, increasing at the rates of 2.84 mm/year and 2.86 mm/year respectively. The suitability of cultivated land was evaluated by combining four periods of 30 m spatial resolution land use/land cover data from 1990, 2000, 2010, and 2020, as well as the Hydrological Statistical Yearbook and Xinjiang Statistical Yearbook. Through the analysis of spatial optimization for cultivated land, it can be inferred that the primary limiting factors affecting cultivated land suitability in the Karamay region are irrigation guarantee rate (54.03%) and soil salinity (11.98%). Muzat River region are irrigation guarantee rate (32.19%) and soil salinity (18.62%). By comparing the scenarios of setting ecological priority and cultivated land priority, it is concluded that under the conditions of water resource constraints and 50%, 75% and 90% design irrigation assurance rates, Karamay still has cultivated land expansion potential, which can be used as the main preparatory reclamation area. In addition to the traditional agriculture irrigation area, the Muzat River basin still has development potential under the condition of ecological priority and no more than 75% irrigation design assurance rate. The study on the cultivated land suitability under the condition of water resource constraints can provide new ideas for food security.

НАПРЯМИ І ПЕРСПЕКТИВИ ЦИФРОВІЗАЦІЇ І КОМП’ЮТЕРИЗАЦІЇ ПРОЦЕСУ НАДАННЯ МЕДИЧНИХ ПОСЛУГ

Ensuring the development and further development of the electronic health care system are priority conditions for achieving the goals and objectives of improving the quality of the provision of medical services, improving the health of the population, improving the quality of communication processes between interested parties, reducing the number of medical errors, ensuring effective control over circulation and the use of medical technologies and medicines, the formation of a unified policy and medical space with the EU. The purpose of the article is to analyze the implementation of strategic plans for the development of the electronic health care system of Ukraine, to determine the most priority directions for its improvement and prospects for further development in the light of providing strategic planning for the development of the health care sector. The results of the study of the state of the e-Health system, conducted by specialists of the Agency for Local Economic Development of Yavoriv Oblast within the project "Synergy of electronic health and digital skills in Georgia, Moldova and Ukraine: a way to increase the resilience of civil societies of the Eastern Partnership in times of crisis" were analyzed; research by experts of the independent public association-coalition "Ukraine after Victory"; study "Primary medical care in Ukraine: progress achieved and next steps: data analysis for 2020-2021"; the study "Telemedicine in Ukraine: a situational analysis" conducted by the Charitable Fund "Patients of Ukraine" and the Ukrainian Center for Health Care within the framework of the "Sustainable Development of National Health Care Systems" (LHSS) and USAID "Integrated Health Systems IDIQ" projects, and as well as the content of the Law of Ukraine "On Amendments to Certain Legislative Acts of Ukraine Regarding the Functioning of Telemedicine", the explanatory note to it and "Strategy for the Development of Telemedicine in Ukraine". It was determined that 50% of the tasks of the "Concept for the Development of Electronic Healthcare" approved in 2020 have not been completed, 36% of the tasks have been partially completed, and only 24% of the tasks have been completed to a sufficient extent. The implementation of telemedicine as one of the most priority areas of development of the e-health system in Ukraine as of 2023 is unsatisfactory. The adoption of the Law "On Amendments to Certain Legislative Acts of Ukraine Regarding the Functioning of Telemedicine" and the approval of the "Strategy for the Development of Telemedicine in Ukraine" do not create prerequisites for solving the accumulated problems due to the determination of technical assistance funds from international institutions, organizations and foreign countries as the only source of funding , the absence of measures to minimize possible risks of strategy implementation, as well as a contradictory statement regarding the participation in the implementation of the tasks of the main stakeholders.

Region-Aware Portrait Retouching With Sparse Interactive Guidance

Portrait retouching aims to improve the aesthetic quality of input portrait photos and especially requires human-region priority. The deep learning-based methods largely elevate the retouching efficiency and provide promising retouched results. However, existing portrait retouching methods focus on automatic retouching, which treats all human-regions equally and ignores users' preferences for specific individuals, thus suffering from limited flexibility in interactive scenarios. In this work, we emphasize the importance of users' intents and explore the interactive portrait retouching task. Specifically, we propose a region-aware retouching framework with two branches: an automatic branch and an interactive branch. The automatic branch involves an encoding-decoding process, which searches region candidates and performs automatic region-aware retouching without user guidance. The interactive branch encodes sparse user guidance into a priority condition vector and modulates latent features with a region selection module to further emphasize the user-specified regions. Experimental results show that our interactive branch effectively captures users' intents and generalizes well to unseen scenes with sparse user guidance, while our automatic branch also outperforms the state-of-the-art retouching methods due to improved region-awareness.

Association between Priority Conditions and Access to Care, Treatment of an Ongoing Condition, and Ability to Obtain Prescription Medications among Medicare Beneficiaries during the COVID-19 Pandemic

Several comorbid conditions have been observed to be associated with an increased risk of poor outcomes following a diagnosis of COVID-19. The purpose of this investigation was to assess associations between Centers for Medicare and Medicaid Services (CMS) designated priority conditions and an inability to access care, treat ongoing conditions, and obtain prescription medications among Medicare beneficiaries in the United States during the COVID-19 pandemic. Nationally representative CMS Medicare Current Beneficiary Survey (MCBS) COVID-19 Supplement Public Use Files (PUF) were analyzed via bivariable, binomial generalized linear models across three time periods: (1) Summer 2020; (2) Fall 2020; and (3) Winter 2021. Across an estimated 55.3–57.4 million Medicare beneficiaries, approximately one-fifth reported an inability to access at least one type of care at the onset of the pandemic. Significantly worse odds of an ability to get care across various time periods was observed among several priority conditions including immune disorders, cancer, depression, osteoporosis, diabetes, arthritis, and numerous cardiovascular and pulmonary conditions. Among those reporting an inability to access care, approximately one-third involved treatment of an ongoing condition, and under one-tenth involved prescription medications. To identify modifiable risk factors and to develop active interventions, future work should continue to assess the complex associations between outcomes, access to care, comorbidities, evolving healthcare infrastructures, computerization, and various public health initiatives.

Quality Control of Hidden Construction Work Using Photographs Attached to Inspection Reports

Introduction. In construction production the problem of increasing the reliability of information contained in the certificates of inspection of concealed works is more and more often solved with the help of their photofixation. Based on the results of earlier studies, the authors prove that using the diagnostic informativeness of photographs it is possible not only to confirm the fact of execution of concealed works in the required volume, but also to obtain additional information about their quality. For effective extraction of this information it is necessary to develop a method of quality control of hidden construction works on the basis of photographs attached to the inspection certificates, taking into account modern scientific achievements in the field of photogrammetry and color-texture analysis of photographic images.Materials and Methods. The developed method of quality control of hidden construction work is based on the use of contour, pixel, macro- and micro-texture analysis of photographic images. When developing the method, the results of numerous visual inspections of building structures (including the opening of their internal elements) and comparison of these results with the information contained in the certificates of certification of concealed works were used.Results. The article presents the results of a study carried out at the Don State Technical University on the development of a method for quality control of hidden construction work using photographs attached to inspection reports. The algorithms developed by the authors for analyzing photographs of building structures to control their quality are presented. The article contains proposals for the systematization and storage of typical textures of surfaces of building structures.Discussion and Conclusion. The priority condition for successful application of the new method of quality control of concealed construction works is its methodological support, which establishes a unified procedure for their photo fixation, additional requirements for the composition and parameters of photographs, rules of registration, storage and use of them as annexes to certificates of inspection of concealed construction works, as well as the regulations for comprehensive analysis of photographs with the use of appropriate software.

Hierarchical optimization control strategy for intelligent fuel cell hybrid electric vehicles platoon in complex operation conditions

Encountering complex traffic conditions such as the dynamic interference of preceding and rear vehicles and gradients, a control strategy that simultaneously considers inter-vehicle cooperative control and energy economy is one of the key technologies, that improves traffic efficiency and exploits the energy-saving potential of platoon vehicles. In this paper, a hierarchical optimization control strategy is proposed for the intelligent fuel cell hybrid electric vehicles (FCHEV) platoon in a network-connected environment. The hierarchical control framework consists of upper speed control and lower power distribution. In the upper layer, the improved particle swarm optimization (PSO) algorithm is applied to calculate the global optimal speed trajectory, and then the model predictive control (MPC) is adopted for global speed trajectory tracking and self-adaptation, which can ensure the ego vehicle tracks the pre-calculated speed trajectory, and can re-plan the vehicle speed under the condition of safety priority when sudden disturbances occur in the foreground. The lower layer utilizes Q-learning (QL) to achieve power distribution between hybrid power sources, reducing the number of fuel cell starts and stops, slowing battery degradation and improving vehicle economy. Simulation results based on complex road conditions show that the proposed controller has good energy economy and tracking performance. Under the condition of the slope, the total platoon cost of the proposed strategy is reduced by 3.99% compared with the constant speed cruise strategy, and under the interference condition, the total platoon consumption cost of the proposed strategy decreased by 6.79% compared with adaptive cruise control (ACC).

Factors affecting depression among married adults: a gender-based household cross-sectional study

BackgroundDepression is a common mental health problem all over the world including Bangladesh. World Health Organization included it in the Mental Health Gap Action Programme as one of its priority conditions. Research on this issue is scanty in Bangladesh. Therefore, we designed to a gender-based household study on associated factors of depression among married adults in Rajshahi City of Bangladesh.MethodsWe conducted this household cross-sectional study from August 01 to October 31, 2019. A total of 708 married adults currently living together in Rajshahi City were recruited for this study. We applied a multi-stage random sampling technique for selecting samples and used a semi-structured questionnaire to collect necessary information from them. The Patient Health Questionnaire-9 was used for measuring depression and frequency distribution and binary logistic regression model were used for data analysis.ResultsThe prevalence of depression (moderate to severe) was 14.4% (95% CI: 11.9–16.9) among married adults, and females (21.2%, 95% CI: 17.2–25.4) suffered more than males (7.6%, 95% CI: 4.8–10.5). A multiple binary logistic regression model established four main factors of depression among married females: (i) multiple marriage [AOR = 19.982; 95% CI: 10.081–39.610; p < 0.01]; (ii) poor relationship with spouse [AOR = 2.175; 95%CI: 1.068–4.428; p < 0.05]; (iii) chronic medical comorbidity [AOR = 1.876; 95%CI: 1.009–2.626; p < 0.05]; and (iv) 7–12 years duration of conjugal life [AOR = 2.091, 1.009–4.334; p < 0.05]. Two main factors of depression among married males were (i) multiple marriage [AOR = 24.605; 95% CI: 20.228–40.402; p < 0.01] and hard work [AOR = 4.358; 95%CI: 1.109–7.132; p < 0.05].ConclusionThe prevalence of depression was significantly high among the study population, and females were the most vulnerable group. The concerned authorities and stakeholders should take appropriate measures to manage the problem with special focus on the risk factors and the vulnerable groups.

Marketing of BRICS innovation clusters in the context of geopolitical instability

The modern stage of society development is characterized by an increased attention to the issues of formation and development of national innovation systems (NIS), which would ensure the integration of various elements of the innovation process, thereby contributing to the build-up of the country's competitive advantages in the global market. Independent development of countries in modern economic conditions is not possible due to the complexity and turbulence of the external economic circuit. In the new geopolitical realities, the fact that past globalization paradigms are no longer having an impact on the viability of the NIS of many countries is becoming evident. At the same time, due to the changing geopolitical landscape, the role of international associations, such as BRICS, is being significantly transformed and they are becoming new centers of influence, including in matters of scientific and technological cooperation. One of the priority conditions for the effective functioning of international S&amp;T cooperation networks and the NIS of each individual country is the creation and maintenance of innovation infrastructure. Already functioning innovation clusters with technology parks, business incubators, accelerators, etc. can become such an infrastructure. Cluster structures are the most effective form of development of international scientific and technological cooperation, which allows to fully realize the potential of countries and structures involved in the interaction, as well as to obtain a significant synergistic and multiplicative effect. The issues of marketing support of innovative cluster associations, which contribute to the successful promotion of clusters in the professional community and target markets, are of particular relevance in this issue.

A Drone Scheduling Method for Emergency Power Material Transportation Based on Deep Reinforcement Learning Optimized PSO Algorithm

Stable material transportation is essential for quickly restoring the power system following a disaster. Drone-based material transportation can bypass ground transportation’s limitations and reduce transit times. However, the current drone flight trajectory distribution optimization model cannot meet the need for mountainous emergency relief material distribution following a disaster. A power emergency material distribution model with priority conditions is proposed in this paper, along with a two-layer dynamic task-solving framework that takes task dynamics into account. This research proposes an algorithm (TD3PSO) that combines the particle swarm algorithm (PSO) updating technique with the double-delay depth deterministic policy gradient algorithm (TD3) algorithm’s capacity to dynamically parameterize. The final task allocation experiment demonstrates that the modified TD3PSO significantly outperforms the conventional algorithm on the Solomon data set, with an improvement of 26.3% on average over the RLPSO algorithm and a 11.0% reduction in the volatility of the solving impact. When solving under realistic circumstances, the solution effect increases by 1.6% to 13.4%, and the redistribution experiment confirms the framework’s efficacy. As a result, the algorithm and architecture suggested in this paper may successfully address the issue of scheduling drones for power emergencies while enhancing transportation efficiency.

A Mobile Clinical Decision Support System for High-Risk Pregnant Women in Rural India (SMARThealth Pregnancy): Pilot Cluster Randomized Controlled Trial.

Cardiovascular disease (CVD) is the leading cause of death in women in India. Early identification is crucial to reducing deaths. Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) carry independent risks for future CVD, and antenatal care is a window to screen and counsel high-risk women. In rural India, community health workers (CHWs) deliver antenatal and postnatal care. We developed a complex intervention (SMARThealth Pregnancy) involving mobile clinical decision support for CHWs and evaluated it in a pilot cluster randomized controlled trial (cRCT). The aim of the study is to co-design a theory-informed intervention for CHWs to screen, refer, and counsel pregnant women at high risk of future CVD in rural India and evaluate its feasibility and acceptability. In phase 1, we used qualitative methods to explore community priorities for high-risk pregnant women in rural areas of 2 diverse states in India. In phase 2, informed by behavior change theory and human-centered design, we used these qualitative data to develop the intervention components and implementation strategies for SMARThealth Pregnancy in an iterative process with end users. In phase 3, using mixed methods, we evaluated the intervention in a cRCT with an embedded qualitative substudy across 4 primary health centres: 2 in Jhajjar district, Haryana, and 2 in Guntur district, Andhra Pradesh. SMARThealth Pregnancy embedded a total of 15 behavior change techniques and included (1) community awareness programs; (2) targeted training, including point-of-care blood pressure and hemoglobin measurement; and (3) mobile clinical decision support for CHWs to screen women in their homes. The intervention focused on 3 priority conditions: anemia, HDP, and GDM. The evaluation involved a total of 200 pregnant women, equally randomized to intervention or enhanced standard care (control). Recruitment was completed within 5 months, with minimal loss to follow-up (4/200, 2%) at 6 weeks postpartum. A total of 4 primary care doctors and 54 CHWs in the intervention clusters took part in the study. Fidelity to intervention practices was 100% prepandemic. Over half the study population was affected by moderate to severe anemia at baseline. The prevalence of HDP (2.5%) and GDM (2%) was low in our study population. Results suggest a possible improvement in mean hemoglobin (anemia) in the intervention group, although an adequately powered trial is needed. The model of home-based care was feasible and acceptable for pregnant or postpartum women and CHWs, who perceived improvements in quality of care, self-efficacy, and professional recognition. SMARThealth Pregnancy is an innovative model of home-based care for high-risk pregnant women during the transitions between antenatal and postnatal care and adult health services. The use of theory and co-design during intervention development facilitated acceptability of the intervention and implementation strategies. Our experience has informed the decision to initiate a larger-scale cRCT. ClinicalTrials.gov NCT03968952; https://clinicaltrials.gov/ct2/show/NCT03968952. RR2-10.3389/fgwh.2021.620759.

Prioritising Cochrane reviews to be updated with health equity focus

BackgroundThe prioritisation of updating published systematic reviews of interventions is vital to prevent research waste and ensure relevance to stakeholders. The consideration of health equity in reviews is also important to ensure interventions will not exacerbate the existing inequities of the disadvantaged if universally implemented. This study aimed to pilot a priority setting exercise based on systematic reviews of interventions published in the Cochrane Library, to identify and prioritise reviews to be updated with a focus on health equity.MethodsWe conducted a priority setting exercise with a group of 13 international stakeholders. We identified Cochrane reviews of interventions that showed a reduction in mortality, had at least one Summary of Findings table and that focused on one of 42 conditions with a high global burden of disease from the 2019 WHO Global Burden of Disease report. This included 21 conditions used as indicators of success of the United Nations Universal Health Coverage in attaining the Sustainable Development Goals. Stakeholders prioritised reviews that were relevant to disadvantaged populations, or to characteristics of potential disadvantage within the general population.ResultsAfter searching for Cochrane reviews of interventions within 42 conditions, we identified 359 reviews that assessed mortality and included at least one Summary of Findings table. These pertained to 29 of the 42 conditions; 13 priority conditions had no reviews with the outcome mortality. Reducing the list to only reviews showing a clinically important reduction in mortality left 33 reviews. Stakeholders ranked these reviews in order of priority to be updated with a focus on health equity.ConclusionsThis project developed and implemented a methodology to set priorities for updating systematic reviews spanning multiple health topics with a health equity focus. It prioritised reviews that reduce overall mortality, are relevant to disadvantaged populations, and focus on conditions with a high global burden of disease. This approach to the prioritisation of systematic reviews of interventions that reduce mortality provides a template that can be extended to reducing morbidity, and the combination of mortality and morbidity as represented in Disability-Adjusted Life Years and Quality-Adjusted Life Years.

MODEL DECISION ANALYSIS IN DETERMINING BUILDING QUALITY BASED ON THE ANALYTICAL HIERARCHY PROCESS

Building infrastructure consisting of several types of alternatives that provide the need for selection of various kinds of assessments for ranking in carrying out repairs. The purpose of this study is to determine the priority order and condition of building quality, which is useful as a reference in improvement activities related to seeing the satisfaction of policy makers. Problems with building quality can result from various factors, one of which is related to facilities, building repairs and their handling which are feared to affect productivity in assessments and influence policy making. Primary data can be used as research data to be included in the decision model and direct observations can be made at the research location for each building in Dilhokseumawe. This study uses the Analytical Hierarchy Process (AHP) model, to determine the weight of the components obtained from the results of the interest assessment of building components which include the level of building damage, building age, ease of access, building structure, roof structure, building safety level. The results of the analysis show that factors the main consideration is improving the level of building security with a value of 0.297858847, the second ranking is the Building Structure factor with a priority value of 0.257685234%, the third ranking is the Ease of Access factor with a priority value of 0.128154963 and the Fourth is Building Age with a value of 0.076683671%. Finally the Roof Structure with a priority value of 0.072065172%. The results of this study can be used as recommendations for decision making in view of the quality of buildings and buildings.&#x0D; &#x0D;

Application of information and communication technologies for the formation of health-saving competence as a component of physical training of youth

The importance of information and communication technologies as an element of the formation of health-saving competence of education seekers is considered. The purpose of the study is to substantiate and experimentally verify the pedagogical conditions for the formation of health-preserving competence of future biology teachers by means of information and communication technologies in the educational environment of a higher education institution, based on a theoretical analysis of the researched problem and educational practice. Methodology. The methodological basis of the research is a systematic and person-oriented approach to the analysis of psychological-pedagogical literature and pedagogical experience on issues of social-pedagogical activity. The work uses a multi-level systematic analysis of scientific sources, which is based on philosophical, general scientific and partly scientific and specific scientific levels of knowledge.&#x0D; Scientific novelty. It was determined that information and communication technologies are one of the priority conditions for health-saving use of hardware and software in the educational process. The importance of information and communication technologies for the development of health-preserving competence of education seekers, the organization of training, upbringing and development of youth has been established. On the basis of the conducted analysis, the importance of using information and communication technologies in the organization of the educational process in the educational institution was clarified. The possibilities of information and communication technologies for the formation of health-preserving competence of young people are highlighted. The role of information and communication technologies in the organization of the information and educational environment of the educational institution is defined. Conclusions. Creating a healthy informational educational environment, increasing the level of professional skills of teachers, activating the cognitive activity of young people and, as a result, increasing the efficiency of the educational process.