Special Unit Research Articles

Features of selection of candidates for units of special operations forces of foreign countries by the criterion of physical preparedness

Features of selection of Military Special Operations Forces personnel of foreign countries by the criterion of physical preparedness are considered. Scientific, methodological literature on the research topic was studied, specialists were interviewed. Selection of candidates for special operations forces is consists of several stages. It has been established that the physical fitness of candidates is checked at all stages of selection. Determining the aerobic and strength endurance of candidates is a mandatory element of testing their physical preparedness. Tests are selected based on the requirements of the future professional activity of the fighters. Also take into account how these tests correlate to injury risk or professional tasks performance. The main tests for determining strength endurance choose exercises with local load distribution. Long-distance running is the main exercise for determining the level of aerobic endurance of military personnel. Swimming exercises is included in the selection programmes for most special operations units. The speed and coordination abilities of servicemen are tested with the help of various variants of the shuttle run. There is no gender or age differentiation when assessing candidates. The selection of candidates is made from several phases and involves complication of standards. The selection program also includes applied physical exercises that are performed in uniform, namely: swimming, marching, overcoming an obstacle course, etc. The system of selection is based on the motivation of servicemen. They tend to score more points than their competitors.

Investigating and Reducing the Architectural Impact of Transient Faults in Special Function Units for GPUs

Ensuring the reliability of GPUs and their internal components is paramount, especially in safety-critical domains like autonomous machines and self-driving cars. These cutting-edge applications heavily rely on GPUs to implement complex algorithms due to their implicit programming flexibility and parallelism, which is crucial for efficient operation. However, as integration technologies advance, there is a growing concern regarding the potential increase in fault sensitivity of the internal components of current GPU generations. In particular, Special Function Unit (SFU) cores inside GPUs are used in multimedia, High-Performance Computing, and neural network training. Despite their frequent usage and critical role in several domains, reliability evaluations on SFUs and the development of effective mitigation solutions have yet to be studied and remain unexplored. This work evaluates the impact of transient faults in the main hardware structures of SFUs in GPUs. In addition, we analyze the main overhead costs and benefits of developing selective-hardening mechanisms for SFUs. We focus on evaluating and analyzing two SFU architectures for GPUs (’fused’ and ’modular’) and their relations to energy, area, and reliability impact on parallel applications. The experiments resort to fine-grain fault injection campaigns on an RTL GPU model (FlexGripPlus) instrumented with both SFUs. The results on both SFU architectures indicate that fused SFUs (in commercial-grade devices) require lower area overhead (about 27%) for their integration in GPUs but are more vulnerable to transient faults (in up to 47% for the analyzed cases) and less power efficient (in up to 36.6%) than modular SFUs. Moreover, the reliability estimation shows that Modular SFUs are structurally more resilient than Fused ones in up to one order of magnitude. Similarly, selective-hardening mechanism based on Triple-Modular Redundancy (TMR) shows that coarse-grain strategies might increase the reliability of the overall SFUs under feasible overhead costs.

Research on the Legal Status of Urban Governments: from the Practice of Thu Duc City, Ho Chi Minh City, Vietnam

Objective: The article studies the legal status of city government in centrally run cities through legal regulations as a basis for the organization, operation, and construction of city government in Centrally run cities: From the practice of Thu Duc City, Ho Chi Minh City, Vietnam. From there, the authors proposed to improve the system of legal regulations related to the organization and operations of the Thu Duc City government. Method: The article is conducted based on synthesizing and analyzing international documents, thereby drawing out achievements and shortcomings of laws related to the organization and operation of government. Thu Duc City's authority in the process of organizing and implementing regulations in practice. In addition, the authors also conducted a survey of 300 votes on three related subjects: managers of Ho Chi Minh City and Thu Duc City; department-level managers in Thu Duc City; Ward-level People's Committee; and people in Thu Duc City about the legal regulations as a basis for perfecting the legal status and organization, operation and construction of the government of Thu Duc city and Ho Chi Minh City. Results and Discussion: The city-within-a-city model has existed and developed in several countries around the world such as China, Korea, Japan, and the Philippines. However, the city government model in centrally run cities in Vietnam is completely new, so there are still many legal problems, as well as practical implementation. Therefore, this article summarizes the legal regulations as a basis for building the Thu Duc City government, based on analyzing the achievements and shortcomings of the law related to the organization. and activities of the Thu Duc City government in the process of organizing and implementing regulations in practice. From there, the authors proposed to improve the system of legal regulations related to the organization and operations of the Thu Duc City government. Discussion: The government organization model in a special administrative-economic unit like the Thu Duc City government comes from the special and unique features of the objects managed and served by the government apparatus, Therefore, it is necessary to have certain characteristics in terms of position, role, function, authority, organizational structure, and operating methods, which are not completely similar to the local government organization model at the same level of the whole country. country, according to the general provisions of current Vietnamese law.

Experiences of Burnout, Post-Traumatic Growth, and Organisational Support in Police Officers Working in Specialised Units: An Interpretative Phenomenological Analysis

Repeated exposure to traumatogenic material is a part of every working day for police officers in specialist units, such as forensic scene investigation and digital forensic analysis, with recent years marking an increase in its volume and intensity (Office for National Statistics (2018). While this may be considered a price paid for choosing to pursue careers in these areas, it is likely to have a significant impact on a professional and personal level, with psychological and physical effects extending beyond the individual’s working hours (Burns et al. in Traumatology 14:20–31, 2008). On the other hand, this important work may contribute to elements of growth and self-development, recognised in existing literature as post-traumatic growth (Tedschi and Calhoun in SAGE Publications, Inc, 1995). The present study adopted a qualitative approach to understanding the lived experiences of seven digital forensic analysts and two forensic scene investigators. Semi-structured interviews explored the impact of their work, as well as their coping strategies and perceived organisational support. Using interpretative phenomenological analysis (IPA), the study yielded rich personal accounts and identified three superordinate themes: “The effects are inevitable”, “Creating a safe environment”, and “Sense of responsibility and personal growth”. Participants described the inevitable effects of their work, along with their coping strategies developed in response to these. Furthermore, participants considered the safety of their work environment and relationships with their colleagues, while also reflecting on their experience of personal growth through their exposure to adversity. Findings are discussed in relation to theoretical and practical implications, as well as directions for future research.

Health-Related Quality of Life and Psychosocial Variables in Women with Colorectal Pelvic Floor Dysfunction: A Cross-Sectional Study.

Pelvic floor dysfunction comprises various disorders, including urinary incontinence, fecal incontinence, pelvic organ prolapse, and chronic pelvic pain. This study aimed to evaluate health-related quality of life (HRQoL), anxiety, depression, sleep disturbance, and sexual functioning in women with pelvic floor dysfunction of colorectal etiology compared with control women. Patients were recruited from a specialized colorectal unit and controls were selected from among the patients' friends and relatives. Sociodemographic and clinical data were collected. Pelvic floor dysfunction distress and impact, HRQoL, depression, anxiety, insomnia, and sexual functioning were assessed using the following validated questionnaires: Short-Form Pelvic Floor Distress Inventory (PFDI-20), Short Form Pelvic Floor Impact Questionnaire (PFIQ-7), 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), and Changes in Sexual Functioning Scale (CSFQ). Statistical analyses included Welch's t-test, Fisher's exact test, and Spearman's correlation coefficients. Eighty-four patients and 57 controls were included. Compared with controls, patients were more likely to be obese or overweight, have had higher numbers of deliveries, more vaginal deliveries, more frequent use of forceps, and have had more associated comorbidities, mainly in the urinary, neurological, and psychiatric domains. As expected, patients scored significantly higher than controls on both the PFDI-20 and PFIQ-7 and their respective sub-scales, with the highest mean values in the patient group on the sub-scales related to the colorectal-anal domain. QoL, depression, anxiety, insomnia, and sexual functioning were significantly worse in patients than in controls (p < 0.0001 in every case). In patients, PFIQ-7 scores correlated significantly with HRQoL (p < 0.001 for the physical component and p < 0.01 for the mental component), depression (p < 0.001), anxiety (p < 0.001), insomnia (p < 0.05), and sexual functioning scores (p < 0.05). Colorectal pelvic floor dysfunction had a markedly deleterious impact on the HRQoL, depression, anxiety, sleep disturbance, and sexual functioning of patients. It is concluded that colorectal pelvic floor dysfunction exerts a considerable burden on patients' lives. Addressing these issues in clinical settings could significantly improve patients' well-being.

Are We Talking about the Same Thing? Modeling Semantic Similarity between Common and Specialized Lexica in WordNet

Specialized languages can activate different sets of semantic features when compared to general language or express concepts through different words according to the domain. The specialized lexicon, i.e., lexical units that denote more specific concepts and knowledge emerging from specific domains, however, co-exists with the common lexicon, i.e., the set of lexical units that denote concepts and knowledge shared by the average speakers, regardless of their specific training or expertise. Communication between specialists and non-specialists can show a big gap between language(s), and therefore lexical units, used by the two groups. However, quite often, semantic and conceptual overlapping between specialized and common lexical units occurs and, in many cases, the specialized and common units refer to close concepts or even point to the same reality. Considering the modeling of meaning in functional lexical resources, this paper puts forth a solution that links common and specialized lexica within the WordNet model framework. We propose a new relation expressing semantic proximity between common and specialized units and define the conditions for its establishment. Besides contributing to the observation and understanding of the process of knowledge specialization and its reflex on the lexicon, the proposed relation allows for the integration of specialized and non-specialized lexicons into a single database, contributing directly to improving communication in specialist/non-specialist contexts, such as teaching–learning situations or health professional-patient interactions, among many others, where code-switching is frequent and necessary.

Challenges faced by learners with multiple disabilities at a resource school in the Oshana region of Namibia

AbstractUpon attaining freedom from the South African regime in 1990, Namibia adopted a constitution according to which access to education is a fundamental right. Before the Salamanca Statement in 1994 and Namibia's consequent ratification thereof, education in Namibia was mainly divided into two distinct streams: general education and special education. Post‐Salamanca, there has been a slight shift in the provision of education for learners with special educational needs in that special education was, and mainly continues to be, offered in special schools, now called resource schools; in special classes and units attached to regular schools; and in mainstream classrooms with an inclusive education orientation. Learners with severe to profound special educational needs are mainly educated in resource schools, and this remains the preferred option for most parents and communities of children with severe to profound special needs. The resource schools are constructed for a specific set of disabilities, such as sensory, physical or intellectual disabilities. They are assumed to be well‐equipped with material and personnel resources that enable staff to respond effectively to the needs of their learners. Most, if not all, the resource schools in Namibia were built a long time ago, to serve a specific population of learners. However, some learners present with a range of disabilities and barriers to learning that could be beyond the original scope of the specific school. Consequently, more and more teachers in resource schools report that they observe daily how learners struggle to function in schools in which the infrastructure and resources can barely accommodate their complex needs. This is mainly because of the diversity and comorbid conditions of these learners. This research focused on the challenges encountered by learners with multiple disabilities in a resource school for learners with sensory disabilities. The study followed a qualitative approach, with an intrinsic case study design. Purposive, criterion sampling procedures were employed to select the participants. Data were collected through semi‐structured, face‐to‐face, in‐depth interviews, complemented by observation. The main findings of the study are that learners with multiple disabilities faced challenges associated with the physical infrastructure of the school (accessibility), the inability of staff to respond effectively to their needs, a lack of teaching and learning resources (leading to their exclusion from certain learning activities), as well as a poorly structured curriculum that undermines their multiple disabilities. The research reveals that there is limited agency and acknowledgement of the complex needs of children with multiple disabilities. The study concludes that learners with multiple disabilities need to access a curriculum that is cognisant of their needs and receive the quality education that they deserve, as set out in the Sector Policy on Inclusive Education. In addition to the curriculum, the school environment should be welcoming and stigma‐free, to enable learners to experience a sense of belonging, love and security. We recommend an audit of the needs of learners with multiple disabilities in order to create a conducive learning and socialisation environment for them. Furthermore, the government could invest in renovating old buildings, as well as adjusting infrastructure to the complex needs of learners, so that resource schools can become more inclusive by identifying and responding to the needs of all learners.

Joining the dots? Special education and alternative provision

The English mass state education system, developing over 150 years, has created subsystems for children and young people who had difficulty in functioning at or beyond 'mainstream' schooling, or whose behaviour was deemed inappropriate. While many descriptions and labels proliferated in the education system, by 1981 children notionally had been categorised with 'special educational needs' (SEN) with disability added in 1995 (SEND) and/or were increasingly placed in what became alternative educational provisions (APs). By 2021, this dual subsystem was attempting to deal with around one and a half million children, a majority still in mainstream schooling in what was considered to be inclusion, others designated as 'high needs', mainly within (expensive) segregated special schools or units, and other children were subject to temporary or permanent exclusions from school. In March 2022, with a follow-up in 2023, the government, driven largely by financial considerations and a lack of oversight of existing provision, proposed that the expanding special educational needs and AP subsystems be formally linked. This article examines these emerging proposals through an historical lens, and considers what these may mean for teachers, associated professionals and the children.

Happy Images in Vietnamese Perception Through Idioms of Happiness: A Cultural Approach

Idioms illustrate special linguistic units since they reflect human wisdom in the perception of the world (Giang, 2023b). They have intertwined and transformed into archives of a community's culture in the past. Idioms also play a significant role in the linguistic ontologization of emotions such as happiness, sadness, anger, etc. Semantically, idioms in Vietnamese are all perceptively associated with typical images (Hanh, 2008), and idioms of happiness have their own happy images. The paper aims to investigate the happy images Vietnamese people perceive through idioms of happiness from a cultural perspective. This is a descriptive study that presents the theoretical background of Vietnamese idioms in general and the findings and discussion of happy images behind the idioms of happiness in particular. To gather the data, a hand search of Giang’s (2018) collection of Vietnamese idioms was conducted to provide a corpus of 32 entries, from which three groups of happy images were identified. Results from this study show that happy images in Vietnamese perception through idioms of happiness derive from (i) animals, (ii) human body parts, and (iii) events and festivals.

Русский музыкальный жаргон как предмет лингвистического изучения

e paper deals with Russian musical jargon treated as a professional sociolect of musicians. The material has been taken from the data presented in the Internet. Stylistically, musical jargon belongs to a colloquial register of the Russian language. A thematic classification of Russian musical jargon has been offered. This class of words and expressions may be subdivided into two unequal groups – specialized and non-specialized jargon units. The former comprises units reflecting the sphere of musical performance whereas the latter refer to various spheres of everyday life. Specialized musical jargon group is subdivided into three subgroups – nominations of subjects, objects and ways of musical performance. Nomination technique of the jargon described includes occasional affixal word formation, word composition, metaphorical transference, borrowings (mainly from the English language), dialectal and dated words, and onomatopoeia. Transference of musical notions into various sphere of reality is also a feature of the jargon described.

Impact of Intraoperative Decision-Making on Pathological Margin Status in Patients Undergoing Pelvic Exenteration for Locally Recurrent Rectal Cancer.

A key component of preoperative preparation for pelvic exenteration surgery is the development of an operative plan in a multidisciplinary setting based on the extent of local tumor invasion on preoperative imaging. Changes to the extent of resection or operative plan may occur intraoperatively based on intraoperative findings. To report the frequency and extent of intraoperative deviation from the planned extent of resection during pelvic exenteration for locally recurrent rectal cancer and determine whether this resulted in a more or less radical resection. Retrospective observational study. A high-volume pelvic exenteration center. Patients who underwent pelvic exenteration for locally recurrent rectal cancer between January 2015 and December 2020. Frequency and extent of intraoperative deviation from the planned extent of resection, R0 resection rate. One hundred thirty-six patients underwent pelvic exenteration for locally recurrent rectal cancer, of whom 110 (81%) had R0 resection margins. Twelve patients were excluded because of missing information, and 49 patients (40%) had a change to the operative plan. Operative changes were major in 30 patients (61%), more radical in 40 patients (82%), and margin relevant in 24 patients (49%). In patients in whom there was a change to the operative plan and R0 resection was achieved, the median distance to a relevant margin was 2.5 mm (range, 0.1-10 mm). Of 8 patients with a change in operative plan and R1 resection, 3 were margin relevant, of whom all were considered major, and 2 were more radical and 1 was less radical. Generalizability outside of specialist units may be limited. Intraoperative changes to the planned extent of resection occur commonly and most often result in an unanticipated major or more radical resection. Such changes may contribute to high rates of R0 resection margins in specialist pelvic exenteration units that use an ultraradical approach in these patients. See Video Abstract . ANTECEDENTES:Un componente clave de la preparación preoperatoria para exenteración pélvica es el desarrollo de un plan quirúrgico en un entorno multidisciplinario, basado en el grado de invasión tumoral local en las imágenes preoperatorias. Es posible que se produzcan cambios intraoperatorios en la extensión de la resección o en el plan quirúrgico según los hallazgos intraoperatorios.OBJETIVO:Informar la frecuencia y la extensión de la desviación intraoperatoria de la extensión planificada de la resección durante la exenteración pélvica para el cáncer de recto localmente recurrente, y si esto resultó en una resección más o menos radical.DISEÑO:Estudio observacional retrospectivo.ESCENARIO:Un centro de exenteración pélvica de alto volumen.PACIENTES:Pacientes sometidos a exenteración pélvica por cáncer de recto localmente recurrente entre enero de 2015 y diciembre de 2020.PRINCIPALES MEDIDAS DE RESULTADO:Frecuencia y extensión de desviación intraoperatoria de la extensión planeada de resección, tasa de resección R0.RESULTADOS:136 pacientes fueron sometidos a exenteración pélvica por cáncer de recto localmente recurrente, de los cuales 110 (81%) tuvieron márgenes de resección R0. 12 pacientes fueron excluidos por falta de información y 49 pacientes (40%) tuvieron un cambio en el plan quirúrgico. Los cambios operatorios fueron mayores en 30 pacientes (61%), más radicales en 40 pacientes (82%) y con relevancia sobre márgenes en 24 pacientes (49%). En los pacientes en los que hubo un cambio en el plan quirúrgico y se logró la resección R0, la distancia mediana hasta un margen relevante fue de 2.5 mm (rango 0.1-10 mm). De ocho pacientes con un cambio en el plan quirúrgico y resección R1, tres tuvieron relevancia sobre márgenes de los cuales todos se consideraron mayores, dos fueron más radicales y uno fue menos radical.LIMITACIONES:La generalización fuera de las unidades especializadas puede ser limitada.CONCLUSIONES:Los cambios intraoperatorios en la extensión planificada de la resección ocurren comúnmente y con mayor frecuencia resultan en una resección mayor imprevista y más radical. Dichos cambios pueden contribuir a altas tasas de márgenes de resección R0 en unidades especializadas en EP que emplean un enfoque ultrarradical en estos pacientes. (Traducción-Dr. Jorge Silva Velazco ).

Infant Intensive Care Unit: Is it Time to Change?

To assess the effect of the Infant intensive care unit (InICU), a specialized unit for critically ill infants established in 2016 in authors' hospital, on infant mortality and compare the outcome with the current Pediatric intensive care units (PICU). In this retrospective cross-sectional study, two groups were defined; the first included expired patients aged 1 moto 2 yadmitted to PICU before the establishment of the InICU (the PICU group). The second included age-matched expired patients admitted to the InICU (the InICU group). Data were recorded using a questionnaire. The authors found that the age, sex, underlying diseases, the leading cause of admission to the ICU, time of death, hospital and ICU length of stay, and the pediatric index of mortality 2 (PIM 2) score were same between the two groups. The incidence of mortality in the PICU group was 10.66 in 1000 person-month. This value was 6.37 for the InICU group (P-value <0.001). The relative risk of mortality of patients admitted to the PICU group compared to the InICU group was 1.67 (P-value <0.001). Establishment of age specific InICU for infants may be beneficial in reducing infant mortality.

DAMPAK PENGEMBANGAN BIMBINGAN PRIBADI BAGI ANGGOTA UNIT KEGIATAN KHUSUS KORPS SUKARELA PALANG MERAH INDONESIA UNIVERSITAS ISLAM NEGERI SULTHAN THAHA SAIFUDDIN JAMBI

This research is motivated by several problems, namely: the level of independence of members decreases, the reduced attitude of self-discipline in members, leadership attitude has not been embedded, members are less enthusiastic to participate in routine activities and exercises. The type of research used is field research using a qualitative descriptive approach. By emphasizing field data sources as primary data and literature as secondary data. In taking the subject of research the researcher used the Purposive Sampling method. Data collection techniques using observation, interviews and documentation, with data reduction data analysis techniques, data presentation and verification. The researcher stated in this study that the process of developing personal guidance applied in the Special Activity Unit of the Indonesian Red Cross Voluntary Corps of UIN STS Jambi was very good in developing a potential that exists in each of their personalities. Supporting factors in the development of personal guidance for members of the Indonesian Red Cross Volunteer Corps Special Activity Unit of the Sulthan Thaha Saifuddin Jambi State Islamic University have been very good. The inhibiting factors faced by Members of the Indonesian Red Cross Volunteer Corps Special Activity Unit Unit Sulthan Thaha Saifuddin Jambi State Islamic University are few and can still be handled well by the members themselves. The impact of developing personal guidance for members of the Red Cross Voluntary Corps Special Activity Unit Indonesia Sulthan Thaha Saifuddin Jambi State Islamic University, namely positive and negative impacts.

К ВОПРОСУ О НАДЕЛЕНИИ СПЕЦИАЛИЗИРОВАННЫХ ПОДРАЗДЕЛЕНИЙ ПО ОБЕСПЕЧЕНИЮ ОБЩЕСТВЕННОГО ПОРЯДКА (в перевозочном и технологическом секторах объектов транспортной инфраструктуры) ОРГАНОВ ВНУТРЕННИХ ДЕЛ РОССИЙСКОЙ ФЕДЕРАЦИИ НА ТРАНСПОРТЕ ДОПОЛНИТЕЛЬНЫМИ ФУНКЦИЯМИ, ЗАДАЧАМИ И ПОЛНОМОЧИЯМИ

The article discusses issues of legal support for transport security at transport infrastructure facilities. Taking into account the forecast indicators for the development of transport facilities, a reasonable conclusion is given about the need to improve legislation in the field of transport security. It is noted that the system of counteracting acts of illegal interference in transport activities will be most effective with close interaction between the internal affairs bodies of the Russian Federation in transport and the forces ensuring transport security at transport infrastructure facilities. Based on the analysis, proposals have been devel-oped to provide specialized units of the internal affairs bodies of the Russian Federation in transport with additional functions, tasks and powers.

Manchester Intermittent Diet in Gestational Diabetes Acceptability Study (MIDDAS-GDM): a two-arm randomised feasibility protocol trial of an intermittent low-energy diet (ILED) in women with gestational diabetes and obesity in Greater Manchester

IntroductionThe prevalence of gestational diabetes mellitus (GDM) is rising in the UK and is associated with maternal and neonatal complications. National Institute for Health and Care Excellence guidance advises first-line...

An Audit of Mortality Pattern in the Neonatology Unit of the University of Uyo Teaching Hospital, Uyo, Nigeria: A Seven-Year Review.

Most neonatal deaths occur in low and middle-income countries (LMICs). These deaths can be prevented through universal access to basic high-quality in-patient health services. Prematurity, neonatal sepsis, and perinatal asphyxia have been reported as the leading causes of in-patient neonatal deaths. This study aimed to assess the trend of neonatal mortality in our hospital, determine the pattern and causes of neonatal mortality, and evaluate the factors associated with neonatal mortality in our facility. This was a retrospective cross-sectional descriptive study conducted in the Special Care Babies Unit (SCBU) and Sick Babies Unit (SBU) of the University of Uyo Teaching Hospital, over seven years (2015-2021). Demographic, clinical, and mortality data was extracted from the case record files of patients into a structured proforma and analysed. There was a total of 228 deaths comprising 130 males (57.02%) and 98 (42.98%) females. The median age at demise was 4.00 (IQR = 1.00 - 12.00) days for both genders. The majority (71.50%) of deaths occurred in the Sick Babies Unit. More males died than females (57% vs 43%). The three leading causes of death were: prematurity (38.60%), neonatal sepsis (38.16%), and birth asphyxia (13.60%). The leading causes of neonatal mortality in our environment are prematurity and neonatal sepsis. There is a need for increased community education on antenatal care, training of traditional birth attendants, improved newborn transportation facilities, and provision of neonatal intensive care facilities.

Home care models dedicated to COVID-19 patients: the experience of a Local Health District of Veneto Region (Italy).

During COVID-19 pandemic, health professionals have been working in an extreme uncertainty context. Affected patients needed to be cared at home as long as possible to avoid virus spreading and hospital resources saturation. The Veneto Regional Administration (North-east of Italy) released Regional guidelines about it. The Western Healthcare District of the Local Health Authority of the city of Vicenza (180,000 inhabitants) implemented a healthcare pathway following them. Aim of the study is to describe the results and outcomes of such implementation. In the implemented health care pathway, a new service called "Special Unit of continuity of care" (USCA) with physicians and nurses has been dedicated to the prise en charge at home of patients suffering from Sars-CoV-2. They were referred to the USCA by general practitioners or by hospital specialists, and managed through a daily clinical monitoring by regular home visits and phone calls, specialist consultations and therapy management. In order to prevent hospital admission, an oxygen concentrator when possible has been employed and managed at home by the members of the USCA when the oxygen saturation was below 93%. An observational retrospective study has been conducted using anonymized data from different databases: the USCA activity database (from 12/01/20 to 21/31/21), the hospital and Emergency Department discharge databases, and the "healthcare co-payments exemptions database". The latter database refers to the people excluded - because of their chronicity - from the co-payment of a list of medical exams and services. Descriptive and multivariate logistic regression analyses have been implemented. 1,419 patients suffering from Sars-CoV-2 have been cared and managed by the USCA in the considered period of time (mean 11.4 days), of whom 787 (55.5%) with at least one chronic condition (described in the above quoted "healthcare co-payments exemption database") and 261 provided with oxygen concentrator. 275 (19.4%) needed a hospital admission, 39 (2.8%) in intensive unit; 53 died during hospitalization (3.8%). Out of the 261 patients utilizing oxygen concentrator, 103 have been admitted to hospital (39.5%), 7.3% in intensive unit and 8.0% died. In implemented multivariate analyses, the use of oxygen concentrator, proxy measure of the severity of the condition, is the major determinant for the risk of hospital admission (adj OR: 3.2, CI 2.3-4.3) and of dying within 30 days (adj OR: 2.8 CI 1.5-5.1). Among the 261 patients provided with oxygen concentrator, 158 (60,5%) have been managed at home without any admission to emergency department and/or hospitalization. In an uncertain context such as COVID-19 pandemic, the already-implemented home care model has been modified by integrating the USCA physicians and nurses and specialist care networks to prevent hospitalization and the sense of isolation and abandonment of people as much as possible. Almost 1,500 patients suffering from COVID-19 have been cared for at home over 13 months by such new service with complex and multidisciplinary activities. The risk of hospitalization and death appears determined by the severity of the pathology with high and significant OR 60% of patients with oxygen concentrators who, despite an initial high hyposaturation were not hospitalized, represent, partly, the group of patients who would have been requiring hospital care in the absence of a home care pathway in a standard situation.

Abstract TP65: Mastering the Art of Herding Cats: Unraveling the Methods of Effective Communication in a Growing Stroke Program

Background: Since becoming a Comprehensive Stroke Center in 2008, our annual stroke patient volume doubled, and intervention volume grew nearly 6-fold. The program achieved multiple milestones over this time, transitioning from a combined ICU-progressive care unit to separate specialized units, and later relocating to a new facility with a dedicated Neuro ICU and two progressive care units. As the program expanded, innovative communication techniques and processes were adopted to accommodate the growing staff and infrastructure. Methods: The development and dissemination of intervention reports to stakeholders from each stroke case heightened awareness of time goals and fostered collaboration. Effective communication was further facilitated through the development of a SharePoint site, newsletter, and electronic handbook. Strategically designed dashboards provided crucial data on volumes, diversion, and treatment times. QR codes were introduced for convenient data and research request access. Moreover, detailed electronic follow-up reports facilitated external collaboration with referring facilities. Results: Embracing electronic communication enhanced information sharing, improving our team’s grasp of program data, outcomes, launches, and outreach initiatives. The monthly newsletter achieved a 60% open rate, contributing to nearly 5,000 SharePoint site visits. Monthly intervention reports to stroke team responders heightened time goal awareness, fostering collaboration, improving documentation, and reducing the need for case delay documentation clarification. Sending an average of 71 follow-up reports monthly to referring hospitals and EMS agencies strengthened external partnerships. Moreover, leveraging social media amplified community outreach for stroke education. Conclusion: We have found electronic communication to be successful for our growing program. To enhance engagement and accommodate diverse learners, we recommend utilizing a range of methods, including visuals, quizzes, and interactive content. Future plans involve expanding communication strategies with emerging techniques and conducting a formal analysis to assess stakeholders' comprehension of shared information in stroke care.

Abdominal wall surgery units accreditation. The Spanish model

The Spanish Association of Surgeons (AEC) deems it essential to define and regulate the acquisition of high-specialization competencies within General Surgery and Gastrointestinal Surgery and proposes the Regulation for the accreditation of specialized surgical units. The AEC aims to define specialized surgical units as those functional elements of the health system that meet the defined requirements regarding their provision, solvency, and specialization in care, teaching, and research. In this paper we present the proposed accreditation model for Abdominal Wall Surgery Units, as well as the results of a survey conducted to assess the status of such units in our country. The model presented represents one of the pioneering initiatives worldwide concerning the accreditation of Abdominal Wall Surgery Units.

Implementasi Kebijakan Pengawasan Sungai Oleh Dinas Lingkungan Hidup Kabupaten Minahasa

This research aims to learn to analyze and describe the Implementation of Surveillance Policy by the Environmental Services of Minahasa District. The research method used is descriptive dermatative. The number of informants in this study is five. Data collection using observation, interview and documentation techniques. Data analysis through Data Reduction, Data Presentation and Conclusion Drawing. The results of the research show that the Programme of Action: the program of cleaning up the toubeke river is only carried out by the plumage and depletion. Here DLH contributes to the transportation of garbage. DLH provides fleet/facilitating vehicles and involves several officers. In 2023, he's already done twice a garbage cleaning program on the toubeke river. Executives: No special units have been assigned from the Environmental Services, adding that this lack of skilled personnel clearly constitutes an obstacle to enforcing supervisory functions. Results: From surveillance seen by DLH the toubeke river is still dirty These problems arise, among other things, because the laws made by the government are less stringent so that the people do not obey or do not perform as they ought to be as already laid down in the law.