Restructuring Of System Research Articles

Implementing the pillars of value-based care: Leadership lessons from the CIUSSS Centre Ouest de l'Ile de Montreal.

The Canadian healthcare landscape is characterized by its ambitious pursuit of innovation in response to challenges such as resource limitations and system restructuring. However, meaningful innovations cannot be sustained without leadership that empowers a patient-first integrated model of care. This article will explore the transformative changes of CIUSSS Centre Ouest de l'Île de Montréal directed to implanting the pillars of a value-based health system. We showcase our "Hospital-at-Home" program as an example to highlight the critical role of leadership in setting our vision of "Care Everywhere," empowering our healthcare workforce, and in ensuring successful implementation and sustainment. Our manuscript aims to provide insights into the leadership strategies that have underpinned these achievements, focusing on how these innovations have anticipated emerging healthcare demands, and highlighting a sustainable model for health leaders and policy-makers who are addressing similar challenges.

An Overview of Early Psychosis Care in New Zealand-A Need for Culturally Adapted Service Models.

It has been over 20 years since a review of early psychosis services in New Zealand was completed, and it is unclear if services now meet international best practice. Furthermore, significant disparities in psychosis experiences exist in New Zealand, and it is unclear whether service structure might contribute to such disparities. Given the current restructuring of the health system in New Zealand, now is the optimal time to understand strengths and weaknesses in early psychosis care provision. All early psychosis services in New Zealand (n = 12) were surveyed. Leads from each service completed a survey on the general elements of their service, alongside the First-Episode Psychosis Services Fidelity Scale, which allows comparison with international early psychosis services. Specific services are provided across 11/20 districts, leaving 9 without any dedicated early psychosis care. Service strengths included short wait lists, comprehensive assessments, good provision of case managers, team managers and psychiatrists and good length of care. Relative weaknesses included provision of therapy, limited age ranges, high numbers of inpatient referrals, poor Clozapine usage and limited family participation. There was also a lack of services for people at risk for psychosis. Lack of cultural support staff, models and confidence in meeting cultural needs was also evident. While New Zealand early psychosis services are relatively comparable to international services, certain areas of weakness need to be addressed by decreasing variability in service eligibility, increasing care for those at-risk, wider availability of therapy and family involvement and improved cultural services.

Restructuring of distribution systems through clustering of voltage sensitivity to PV presence

Restructuring of distribution systems through clustering of voltage sensitivity to PV presence

The History of the Generational Evolution of the Labor Market: Indicators and Results (Based on the Materials of the Population Censuses in the Volgograd Region in 1979–2002)

Introduction. The relevance and purpose of this study are determined by the importance of the labor market in regional development. The choice of an object is determined by the formation of an able-bodied population in different social conditions over a relatively short historical period of time and the need for assessment for subsequent forecasting of the changes that have occurred due to this. Materials and methods. The open materials of the All-Union (1979) and All-Russian (1989 and 2002) population censuses were used. Historical-evolutionary, historical-comparative, and statistical approaches, as well as the method of groupings based on the theory of generations, are applied. Results. For generations silent, baby boomers, X, Y (millennials), and Z, such characteristics as the share in the population, the ratio by sex, place of residence, features of sources of livelihood, types of activities, groups of occupations, and others were revealed. Their differences in the conditions of centralized, transitional, market-based public relation and commonality due to the general biological and digital conditions of formation, as well as the influence of these factors on the nature and depth of processing of the recorded indicators, are shown. Conclusions. The increasing propensity of younger generations to perform skilled labor functions, low willingness to engage in unskilled labor, and interest in diversifying activities. This implies the need for further restructuring of the labor relations system and methods of forecasting the appropriate directions of its transformation. Funding. The article was prepared with the financial support of the Russian Science Foundation and the Committee for Economic Policy and Development of the Volgograd Region, grant No. 24-28-20066, https://rscf.ru/project/24-28-20066/

CUSMA, a capitalist adventurism? Marxist analysis of class inequities in the Canada-United States-Mexico agreement

This essay will serve as a theoretical intervention, highlighting the inherent contradictions within CUSMA's labor provisions. By critically analyzing the agreement through a Marxist lens, it will reveal how the agreement perpetuates capitalist exploitation even with its purported aims of improving labor conditions. The analysis will emphasize that meaningful advancements in labor rights under global trade agreements like CUSMA require a radical restructuring of economic systems. This theoretical critique aims to deepen the understanding of labor rights within the context of international trade and capitalist frameworks, rather than proposing policy changes.

Follow-up supportive policies and risk perception influence livelihood adaptation of anti-poverty relocated households in ethnic mountains of southwest China

The poverty alleviation relocation program (PAR) is a milestone project in breaking spatial poverty traps in ethnic mountainous regions and provides a key solution for eradicating global absolute poverty. As direct participants in the restructuring of environmental and livelihood systems, the livelihood adaptation of relocated households is fundamental to the sustainable development of human-land systems in resettlement sites and the consolidation of the success of poverty alleviation. This research constructs an adaptive integration analysis framework of “external disturbance-adaptation process-adaptation outcome”, by utilizing questionnaire data from relocated households in the Liangshan Yi minority area of Southwest China, and employing a formative structural equation model to investigate the transmission mechanisms and heterogeneous effects of PAR on livelihood adaptation across different resettlement characteristics. The results indicate that: (1) External disturbance of PAR facilitates positive adaptation outcomes, with follow-up supportive policy as the most significant determinant, which contributes directly to adaptation outcomes and indirectly through improved learning and self-organization capacity. Conversely, risk perception has a negative impact on adaptation outcomes and further exacerbates adverse impacts by reducing buffering capacity. (2) The pathways influencing subjective and objective adaptation outcomes demonstrate heterogeneity. PAR has a positive impact on subjective adaptation, but a non-significant effect on objective adaptation, self-organization capacity and buffering capacity are the most important direct drivers and mediating variables affecting both, respectively. (3) Resettlement characteristics exert a moderating effect on livelihood adaptation. The positive effect of follow-up supportive policy on learning capacity and the marginal contribution of learning capacity to adaptative strategies being greater in mid-to-long-term resettlements. Buffering capacity of village resettlements and subjective adaptation of town resettlements are more beneficial from follow-up supportive policy.

The life and death of Liberal Studies: explaining curriculum change in post-handover Hong Kong

ABSTRACT This article analyses the history of a secondary school subject in Hong Kong called ‘Liberal Studies’ which was introduced as a compulsory school subject in 2009 and replaced by ‘Citizenship and Social Development’ in 2021. Through an analysis of curriculum guidelines, government publications, media articles, and the extant literature we explain both why it was created and replaced. What emerges is that the subject was both a product and victim of the shifting political climate in post-handover Hong Kong. Its emergence was linked to the post-handover restructuring of the education system, the quest for educational reform and facilitated by a process of referencing global trends and overseas models. Its demise was the result of direct state intervention following the introduction of the National Security Law in 2020. The subject was seen to encourage anti-government protests, have failed to educate patriotic citizens and its replacement justified by reference to the need for national security and nation building. We discuss the relevance of LS with regards to models of curriculum change.

Value Objective, Game Analysis and Approach to Rule of Law for Comprehensive Supervision of Agricultural Natural Resource Assets in China

The establishment of the Ministry of Natural Resources and the Ministry of Agriculture and Rural Affairs of China marks the integrated installation of centralized and unified supervision of agricultural natural resource assets. It is of great practical significance to explore comprehensive systems of supervision of agricultural natural resource assets with the aim of super-ministry system restructuring; this could provide support for the development of new quality agricultural productivity. This paper mainly discusses the value objective and the approach of the rule of law concerning comprehensive supervision of agricultural natural resource assets in China with the aim of super-ministry system restructuring and codification. It combines a normative analysis of law with an economic analysis to address the current laws and regulations concerning the supervision of agricultural natural resource assets and summarize the existing problems of the supervision system. From the perspective of game equilibrium, the paper explores the reasonable expected utility of multiple entities under comprehensive supervision of agricultural natural resource assets. The results show the following: (1) The value objective of comprehensive supervision of agricultural natural resource assets should include process-oriented, multi-participation asset accretion and technological innovation. (2) Different supervision departments have different objectives and interests with respect to taking risks. (3) From the perspective of game equilibrium, an effective balance between development and use and comprehensive supervision of agricultural natural resource assets calls for a reconstruction of the structure of rights (powers) and for practical systematic selection. Therefore, this research recommends that efforts to improve the legal systems of comprehensive supervision of agricultural natural resource assets in China should take comprehensive supervision legislation as an approach to solving the issues and should also take comprehensive central and local cohesion as realization mechanisms, highly integrated and coordinated in legislation, while allocating to various institutions responsibility for the efficient use of agricultural natural resource assets, and the protection of rural green ecological environment, to promote the revitalization of rural ecology, and the security of agricultural resources.

Dynamic remodelling of the endoplasmic reticulum for mitosis.

The endoplasmic reticulum (ER) is a dynamic and continuous membrane network with roles in many cellular processes. The importance and maintenance of ER structure and function have been extensively studied in interphase cells, yet recent findings also indicate crucial roles of the ER in mitosis. During mitosis, the ER is remodelled significantly with respect to composition and morphology but persists as a continuous network. The ER interacts with microtubules, actin and intermediate filaments, and concomitant with the mitotic restructuring of all cytoskeletal systems, ER dynamics and distribution change. The ER is a metabolic hub and several examples of altered ER functions during mitosis have been described. However, we lack an overall understanding of the ER metabolic pathways and functions that are active during mitosis. In this Review, we will discuss mitotic changes to the ER at different organizational levels to explore how the mitotic ER, with its distinct properties, might support cell division.

Striving for Equity: Examining Health Disparities in Urologic Oncology.

Health disparities in urologic oncology, particularly in prostate, bladder, kidney, and testicular cancers, significantly impact patient outcomes across different demographic groups. This narrative review aims to investigate the extent and drivers of these disparities, focusing on the influence of race, socioeconomic status, and geographic location on diagnosis, treatment, and survival outcomes. We conducted a comprehensive review of the existing literature and analyzed data from national cancer databases to identify patterns of inequity. Our findings reveal that minority populations, individuals with lower socioeconomic status, and those residing in underserved areas are less likely to receive timely and guideline-based care, leading to worse outcomes. This review underscores the urgent need for targeted interventions, including policy reforms, health system restructuring, enhanced community outreach, and increased funding for disparity-focused research, to ensure equitable access to high-quality oncologic care. Addressing these disparities is crucial for improving cancer outcomes and achieving health equity in urologic oncology.

Comparative analysis of the parameters of the external diameter of the isthmus, ampulla and funnel of the fallopian tubes in women giving birth in the first and second periods of adulthood

During an in-depth analysis of the management of patients of older age groups, another equally important category of the population is overlooked - patients of the second period of adulthood. In no case should this period of life be missed, especially in relation to women. It is in this age period that the menopause process occurs, which determines the further involutive restructuring of the reproductive system in particular and the entire body as a whole. It is advisable to study the morphological dynamics of the fallopian tubes, which are a key link in the female reproductive system. Objective: in a comparative aspect, to analyze the parameters of the outer diameter of the isthmus, ampoule and funnel of the fallopian tubes in women who gave birth in the first and second periods of adulthood according to the sectional study and calculate the correlation relationship. The study was performed on autopsy material in the period 2018-2022, the analysis of the results of morphometry of both fallopian tubes of 49 deceased women who gave birth at the age of 22-56 years was carried out. Group I included 26 women of the first period of adulthood (22-35 years old), group II included 23 women of the second period of adulthood (36-56 years old). The outer diameter of the fallopian tube funnel was determined using a micrometer after their isolation from the pelvic cavity. Having determined the size of the semicircle of the pipe, their diameter was calculated. The tendency to the predominance of the parameters of the outer diameter of the fallopian tubes in the second period of adulthood in comparison with the representatives of the first period of adulthood (p > 0.05) has been established. Thus, the outer diameter from the first period of adulthood to the second period at the isthmus site increases by 4.5 % in the right fallopian tube and by 6.25 % in the left fallopian tube, at the ampoule site - by 1 and 0.7 %, respectively, and at the funnel site - by 3.1 and 4.2 %, respectively. The tendency to the prevalence of parameters in each studied section of the right fallopian tube over similar ones in the left (p > 0.05) is determined. The results obtained during the sectional examination of the autopsy material can form the basis for studying the age-related anatomy of the fallopian tubes. The data form the basis for further clinical and morphological studies, as well as provide an understanding of the age characteristics of various sections of the fallopian tubes for the application of this information in practical medicine, for example, in the differential diagnosis of pathological conditions.

Efficient methane fermentation from the waste of a novel straw alkali-heat pretreatment-butyric acid fermentation process

ABSTRACT The butyric acid biorefinery technology for straw is highly significant for environmental protection and the restructuring of the energy system. However, this process produces waste from alkali-heat pretreatment (PW) and butyric acid fermentation (FW). In this study, the feasibility of methane fermentation from the wastes was confirmed, with the methane production from PW and FW of 351.1 ± 11.8 and 741.5 ± 14.2 mLCH4/gVS, respectively. The initial pH and V FW/V PW of methane fermentation using the mixed waste of PW and FW were optimized at 7.5 and 1.8, respectively. The methane fermentation using the mixed waste was also verified by operating two anaerobic digesters in sequencing batch mode. At the V FW/V PW of 0.25 (actual ratio), methane production was 301.20 mLCH4/gVS with the waste load of 0.64 kgVS/m³/d. When the V FW/V PW was 1.8 (optimal ratio), methane production reached 396.45 mLCH4/gVS at the waste load of 1.20 kgVS/m3/d. This study facilitates the comprehensive utilization of all components within rice straw.

New Turkey, social policy, and a daytime talk show as a remedy: Müge Anlı as a modern Çalıkuşu

ABSTRACT ‘Müge Anlı ile Tatlı Sert’, which investigates unresolved criminal cases with interactive audience support, is one the most popular daytime television shows in contemporary Turkey. The neoliberal restructuring of the welfare system in New Turkey posits that providing protection and security against social risks is the sole responsibility of individuals and families. In line with this approach, the show individualizes social problems ready to be resolved by ‘Müge Abla’ (Sister Müge) and her audience. Müge Anlı's image, which conforms to the ideal modern and modest Republican woman, allows her to gain authority, trust, respect, and popularity. The show’s discourses, structure, and communicative strategies are the product of the New Turkey where ‘the sacred family’ is the central political unit and the nation is an extended, happy family reproduced through this show.

Livestock production systems in wetlands of Argentina: assessing transition toward sustainable agroecological systems-

ABSTRACT The magnitude of the current environmental degradation requires an urgent restructuring of food production systems. In this sense, agroecology is considered a sustainable approach, because it provides tools to guide transition toward sustainable production systems and to meet the Sustainable Development Goals (SDG). Nevertheless, it is imperative to possess evidence regarding the implementation of agroecology and current extent. The goals of this study are to compare two instruments for assessing agroecological transitions, to measure the agroecological performance of extensive livestock systems in slightly disturbed wetlands, identify agroecological elements that differentiate farm categories, and identify relationships among these elements. We evaluated 19 representative extensive livestock production ranches from central-western Argentina. We used the Characterization of Agroecological Transition (CAET) from the Tool for Agroecology Performance Evaluation (TAPE). Moreover, CAET was modified through interaction with ranchers and technicians (Adapted CAET). The results obtained with both tools revealed that the agroecological performance of extensive livestock systems is currently in transition, with an overall average of 56.9%. This suggests that there is a group of farmers implementing agroecological strategies which have the potential to drive the transition to achieve the SDGs. This research provides valuable knowledge for applying agroecology principles in minimally impacted wetlands.

Harnessing AI for Enhanced Searching in Digital Libraries: Transforming Research Practices

The application of Artificial Intelligence (AI) technologies in digital libraries is changing the paradigm in which users search and interact with digital content. This article is focused on how the use of AI technologies improves the search in digital libraries, demonstrating the benefits of such technologies in overcoming the challenges associated with formulation of query, information retrieval, and end user usage. Most search engine systems face the problems of user queries, which are inherent in online searches. Many user queries are vague, imprecise or ambiguous with regards to the context and as a result lead to less than satisfactory search results. AI technologies such as Natural Language Processing (NLP) and Machine Learning (ML) solve this challenge effectively as they enhance comprehension of queries, contextual understanding, and relevance of the results returned. With the capabilities of NLP incorporated in search engines, search queries which are in the form of natural language can be understood and executed which leads to efficiency in targeting the information needed. Comprehensive restructuring of standard information systems is used by computer learning algorithms for searches by inference and instills usage in users. This study also examines the place of AI in query formulation and the different ways it can be employed; fully automated, semi-automated and/or manually so that the users are less faced with the challenges that are usually present during the query formulation process. Such increases in the level of difficulty and scope of information retrieval suggest that search AI improved the scenario.

Assessing the conditions to implement innovative activity of technoparks in the field of high technologies

During the restructuring of national technological system, the development of innovations is of particular importance. In this regard, it is important to analyze how economic entities and innovative infrastructure cope with changing internal and external conditions, such as the need for import substitution of high-tech products and replenishment of specialists’ outflow from the information technology sector. The key element of the innovation infrastructure is scientific and industrial technology parks. The article examines the features of the Russian model of technoparks, as well as the factors of their success and lag. The purpose of the study is to identify the factors contributing to and hindering the innovation activity of technopark residents. Using statistical data analysis and spatial network analysis, the paper studies the structure and features of the activities of 12 participants in the state program «Creation of high-tech technoparks in the Russian Federation». The study examines such aspects of technoparks’ activity as the specifics of management companies functioning, ownership structure and geographical localization of resident enterprises, the level of integration of scientific and educational organizations. It determines the results of technoparks activity in the context of long-term effects for the innovation development at regional level. The findings indicate insufficient elaboration of approaches to support collaborative activities between residents, which is an important condition for effective innovation exchange. The results of the study can be used in the development and adjustment of government programs to support the innovation sector.

The Turkish Government’s Ambivalent Policy Response to the New Influx of Afghan Migrants through the Public Policy Tools

Turkey has been a hub for migrants since the Syrian crisis and has been home to 3.7 million refugees. The literature on migration focusses largely on Turkey’s response to refugees from Syria, host country citizens’ attitudes towards Syrians and their integration challenges, the EU–Turkey refugee deal, and its political implications for the EU and Turkey. Nonetheless, there has been a sharp rise in the number of Afghan migrants to Turkey since the complete withdrawal of US military forces from Afghanistan in 2020. Both scholarly and grey literature highlights that Turkey has recently been an attractive hub for Afghan migrants and other ethnic minorities, following Pakistan and Iran. Nonetheless, this literature has not substantially explored the Turkish government’s attitude towards the new influx of migrants. For this purpose, the article draws upon qualitative research based on secondary and grey literature (including semi-structured interviews with representatives from migration-related NGOs in Turkey). The article underpins its findings from the public policy framework of NATO (nodality, authority, treasure, organisation) by demonstrating how Turkey’s ambivalent response to the refugee inflow is shaped by limited information (nodality), weak legal mechanisms (authority), exploitation of new inflow as cheap labour (treasure), and migration system restructuring (organisation, treasure) after the withdrawal of external actors like the EU and UNHCR.

Revitalisasi Bank Sampah Gesit Desa Rumah Gerat melalui Edukasi dan Penataan Sistem Operasional Bank Sampah

This community service activity aims to enhance the effectiveness of the "Bank Sampah Gesit" in Rumah Gerat Village through educational initiatives and operational system restructuring. The program includes educating participants on waste management concepts, types of recyclable materials, and effective operational management, followed by a Focus Group Discussion (FGD) to design improved operational systems. Using a one-shot case study approach with pretest-posttest assessments, this initiative successfully increased participants' knowledge and understanding of waste management principles and established a functional waste management system. This system includes the types of waste managed, waste deposit recording systems, and the roles of waste collectors and sponsors in sustaining the bank. Fully supported by the Research and Community Service Institute (LPPM) of Universitas Negeri Medan and in collaboration with Roda Hijau Kota Medan, this community service program encourages active community participation in environmental conservation efforts. The goal is for this initiative to inspire the residents of Rumah Gerat Village to manage waste more efficiently, positively impacting the local environment, and creating a cleaner and sustainable environment for future generations.

System Restructuring, Value Expansion, and New Challenges: AI Era Journalism Practice Transformation and Challenges

System Restructuring, Value Expansion, and New Challenges: AI Era Journalism Practice Transformation and Challenges

Riverscape genomics of the endangered freshwater mussel Lampsilis rafinesqueana

Abstract Historical periods of rapid climate change and associated direct and indirect impacts such as glaciation and restructuring of drainage systems are important in shaping biodiversity, lineage divergence, and contemporary genetic variation amongst many aquatic taxa. Through an understanding of the impacts of these ancient changes in land‐ and waterscapes on current diversity, practitioners can account for a species' unique evolutionary history when developing conservation strategies. We investigated intraspecific genetic diversity of the critically endangered freshwater mussel, Lampsilis rafinesqueana, endemic to the interior region of the U.S.A. Our study (1) characterises genetic variation within and amongst populations to infer biogeographic history and (2) applies genetic information to potential conservation strategies. We applied restriction‐site associated DNA sequencing and mitochondrial DNA sequencing to investigate genetic diversity within and amongst populations of L. rafinesqueana from across the species' distribution. We then considered this information in the context of historical riverscape processes and applicability to conservation. Variation within rivers was similar, but we found different genetic populations associated with two major ecoregions, the Central Interior Highlands and Osage Plains. The plains population displayed an Ne value approximately 10‐fold lower than the highlands population. Historical demographic modelling suggests the two populations diverged approximately 1.2 million years ago and then both populations underwent a substantial decrease in population size around 19,700 years ago. These two major events are each correlated with known periods of historic rapid climate change. We identified two distinct populations of a federally endangered mussel, L. rafinesqueana. Contemporary genetic diversity of this species was strongly influenced by direct and indirect impacts of rapid historic shifts in climate. The highlands population has undergone a recent expansion, typical of post‐Pleistocene climate change, while also having a much larger Ne value than the plains population. Our results suggest low levels of gene flow amongst the two distinct populations across generations. We recommend that conservation managers for this species take into account relative difference in diversity between populations when developing management strategies. In many species, assisted gene flow amongst genetically unique populations should only be considered in extreme circumstances; however, in L. rafinesqueana, low levels of assisted migration amongst populations may be a valuable tactic to maintain natural levels of genetic variation. Our study shows that biogeographical frameworks can be useful for developing conservation strategies that serve to retain important genomic variation that represents the evolutionary potential of target freshwater species.