Model Exploration of an Information-Based Healthcare Intervention Using Parallelization and Active Learning

A Study on Healthy Food Service Designing for Semi-disabled Elderly Based on SAPAD

Social Navigation for Adolescent Emergency Department Patients: A Randomized Clinical Trial

BackgroundThe prevalence of dependency personality disorder (DPD) is high among elderly people living in rural areas. This study aims to explore the association between dependency on community resources and social support among elderly individuals living in rural areas.MethodsA cross-sectional study was conducted in 26 locations in China. A total of 1160 participants aged ≥ 60 years were selected using a complex multistage sampling design. All data were obtained using questionnaires via face-to-face interviews. DPD was measured using the Minnesota Multiphasic Personality Inventory-II in the standardized Chinese version. Self-efficacy was assessed using the Chinese version of the General Self-Efficacy Scale. Social support was measured using the Chinese version of the questionnaires of the Older American Resources and Services scale. Community services and resources comprised 44 items. The association between DPD and levels of social support and self-efficacy was evaluated using a logistic regression model. The association between social support and self-efficacy was assessed using analysis of covariance.ResultsUnivariate analysis results showed that elderly people living in rural areas had higher DPD scores and lower levels of self-efficacy compared with those living in urban areas (P < 0.001). Logistic regression analysis showed that DPD was positively associated with the received frequencies of community health service, contracted family doctor services, and regular lectures on health knowledge among the elderly people with odd ratios of 1.58 (P < 0.001), 2.03 (P = 0.013), and 2.67 (P = 0.005), respectively. Logistic regression analysis showed significant interaction between social support and self-efficacy effect on DPD was found in the additive model (P < 0.001).ConclusionDPD was associated mainly with the community resources among elderly people living in rural areas. Social support and self-efficacy were commonly associated with DPD through a synergistic effect. These results suggest that DPD among elderly people may be reduced through effective social support to directly and indirectly promote the elderly’s use of community resources and improve their self-efficacy.

This study examined devolution which was introduced in Kenya at the beginning of 2013 with a view to establishing whether it was helping to reduce poverty as provided for in the Republic of Kenya Constitution (RoK, 2010). As is the case in other African countries, the majority of Kenyans are poor. We gathered data through desk reviews of relevant books, journal articles and reports and interviews with senior staff of Kakamega, Kisumu and Kajiado counties. It was evident that after abolishing Kenya's independence (1963) devolved constitution termed Majimbo and establishing a highly centralized governance system, Kenya implemented several deconcentration measures which included the District Focus for Rural Development, Rural Development Grants and Rural Works Program aimed at facilitating decision making and allocation and use of resources in communities. These various efforts did not lead to improvement in the country's poverty situation which stood at 56 per cent in the 1980s and 1990s. With the introduction of devolved funds such as the Constituency Development Fund (CDF) and the Local Authority Transfer Fund (LATIF) in 2003, the poverty situation had reduced gradually to 46 per cent at present. We have also shown that devolution which was introduced recently with more decision-making powers and resources had potential to ensure further reduction of poverty, especially at the county and household levels.

The aim of this research was to discover whether day case surgery for cataract is associated with an increased use of community resources in comparison with inpatient surgery. Retrospective postal questionnaires were sent to determine the use of resources in the community. More detailed information was gathered by interviews with a sub-sample. The response rate was high (86 per cent). Generally, the reported use of community resources was low. The most important formal care services appeared to be those provided by nurses, general practitioners and home helps/domestic assistance. Inpatients rather than day case patients made greater use of these services. Day case patients made greater use of some forms of informal care. It appears that, day case cataract surgery does not result in high levels of community health care. This might in part be as a result of more rigorous discharge protocols for inpatients.

Using a stress-coping framework, we designed a six-session educational support group offering family caretakers information about schizophrenia, training in problem-solving skills for managing patient behavior, and greater access to social support and community resources. Subjects were recruited though local community mental health centers; 24 subjects participated in one of five identically structured caretakers' groups and another 24 subjects served as matched controls. Results of the multivariate analysis of covariance indicated a significant difference between the experimental and control caretakers following the intervention. Caretakers of the educational support group reported significantly reduced anxiety and personal distress and significantly more active coping behaviors (increased use of community resources and better management of home life with their schizophrenic family member). However, no changes were reported in the frequency of their negative feelings toward their mentally ill family member or in their generalized sense of self-efficacy.

This article focuses on the use of community resources to enhance student learning. The article highlights rural educational settings and provides examples of one program and how resources are identified and utilized. Educational strategies for using community resources as teaching and learning tools are included as suggestions.

Primary care physicians play an important role in care coordination, including initiating referrals to community resources. Yet, it is unclear how awareness and use of community resources vary between physicians practising with and without an extended healthcare team. We conducted a cross-sectional survey of primary care physicians practising in Toronto, Canada, to compare awareness and use of community services between physicians practising in team- and non-team-based practice models. Team-based models included Community Health Centres and Family Health Teams - settings in which the government provides funding for the practice to hire non-physician health professionals, such as social workers, pharmacists, nurse practitioners, registered nurses and others. The survey was mailed to physicians, and reminders were done by phone, fax and e-mail. We used logistic regression to compare awareness between physicians in team-based (N = 89) and non-team-based (N = 138) models after controlling for confounders. We found that fewer than half of the physicians were aware of five of eight centralized intake services (e.g., ConnexOntario, Telehomecare). For most services, team-based physicians had at least twice the odds of being aware of the service compared to non-team-based physicians. Our findings suggest that patients in team-based practices may be doubly advantaged, with access to non-physician health professionals within the practice as well as to physicians who are more aware of community resources.

ObjectivesCoronavirus disease 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the concept of flexible surge capacity to reduce the burden on hospitals by focussing on community resources to develop home isolation centres in Bangkok, Thailand. Study designA qualitative study consisted of observational and semi-structured interview data. MethodsThe development and activities of home isolation centres were observed, and interviews were conducted with leaders and operational workforces. Data were deductively analysed and categorised based on the practical elements necessary in disaster and emergency management. ResultsData were categorised into the seven collaborative elements of the major incident medical management and support model. The command-and-control category demonstrated four subcategories: (1) coordination and collaboration; (2) staff engagement; (3) responsibility clarification; and (4) sustainability. Safety presented two subcategories: (1) patients' information privacy and treatment; and (2) personnel safety and privacy. Communication showed internal and external communications subcategories. Assessment, triage, treatment and transport followed the processes of the COVID-19 treatment protocols according to the World Health Organisation (WHO) guidelines and hospital operations. Several supply- and patient-related challenges were identified and managed during centre development. ConclusionsThe use of community resources, based on the flexible surge capacity concept, is feasible under restricted circumstances and reduced the burden on hospitals during the COVID-19 pandemic. Continuous education among multidisciplinary volunteer teams facilitated their full participation and engagement. The concept of flexible surge capacity may promote an alternative community-based care opportunity, irrespective of emergencies' aetiology.

Biological surveys starting in the 1950s provided clear evidence that the Itombwe Massif, located in eastern Democratic Republic of Congo, is one of the most important areas for conservation in Africa. Further surveys in the mid 1990s and early 2000s showed key species were still present and could be conserved. Following a report on these surveys the Ministry of Environment established the Itombwe Reserve in 2006 without consulting local communities who have legitimate customary rights to reside within the area and use the region's natural resources. Although creating the Reserve was within the government's legal authority, its establishment violated the rights of the people there. Here we report over a decade of work by a consortium of international and national human rights and conservation NGOs, the local communities and the protected areas authority (Institut Congolais pour la Conservation de la Nature), to remediate this taking of customary rights. Starting in 2008 these partners began a participatory process with all 550 villages within and around the boundary of the Reserve. Using a community resource use mapping approach, developed from best practices, the team helped communities determine the boundary of the Reserve, and then pilot participatory zoning to identify zones for settlements, agriculture, hunting, gathering of non-timber forest products, and conservation. This process secured the customary rights of long-term residents in the Reserve and protected their lands from being taken by non-rights holders. As a result of this work the use rights of communities were largely restored and the communities agreed on 23 June 2016 to formalize the boundaries of the renamed Itombwe Nature Reserve.

The purpose of this study was to describe adherence to recommended preventive health practices among middle-aged and older male and female family caregivers of individuals receiving home health services. Perceptions of the burden and benefit of caregiving, wellness orientation, social participation, and community resource use by the caregiving dyad (caregiver and carereceiver) were also explored using the t test and the chi2 test to detect gender differences. A sample of 319 participants 50 and older was recruited from a home health agency in southwestern Pennsylvania to participate in a telephone survey. Results revealed that caregivers had performed 86% of age- and gender-appropriate preventive health practices, but they currently adhered to guidelines for 63% of such behaviors, regardless of gender. Men experienced less burden than women, and were more likely to acknowledge that caregiving made them feel useful and appreciated and gave more meaning to their lives. The study suggests that family caregivers may be as vigilant in their preventive health behavior as the general population, despite their responsibilities. Nurses in contact with middle-aged and older family caregivers are well positioned to encourage health promotion and disease prevention behaviors in this accessible population.

To determine the community resources most often used, most needed, and most difficult to use for immigrants. A naturalistic study using principles of community-based participatory research. A group of 106 abused immigrant women were interviewed in person with the Community Agency Use, Frequency, Helpfulness, and Difficulty form as part of a 7-year prospective study. The most frequently noted service needed most was counseling (n = 34, 33.0%) followed by legal services (n = 23, 22.3%) and social services (n = 13, 12.6%). Law enforcement was the most commonly used service (n = 63, 59.4%) and the most difficult to receive (n = 16, 48.5%). Counseling (n = 6, 18.2%) and legal services (n = 5, 15.2%) were also reported as difficult. Law enforcement is often called on to help in partner violence, but immigrant women report difficulty in using this service. Abused immigrant women have risk factors for abuse, and they face barriers in accessing the services they need. It is important for service providers in the community to be aware of the unique challenges of abused immigrant women and to address their needs accordingly.

Limited experimental data remains a key challenge in applying machine learning to drug discovery, particularly for cancer-related targets. In this study, we present a data-efficient active meta-deep learning framework to predict mitogen-activated protein kinase 1 (MAPK1) inhibitors, which are promising candidates for cancer-related therapies. Our approach integrates active learning (AL) with a meta-model that combines four deep architectures: a convolutional neural network, an attention, a graph convolutional network, and a graph neural network-attention, trained on molecular descriptors and graph-based representations. These models generate four probability-based features that feed into an attention-based meta-learner, improving predictive performance by 5.12% in the area under the precision-recall curve (AUPRC) and 5.48% in the Matthews correlation coefficient (MCC) using only 10% of the training data. Among the AL sampling strategies evaluated, entropy sampling showed competitive performance in selecting informative molecules for model improvement. Overall, our framework achieves an AUPRC of 0.835 ± 0.017 and MCC of 0.817 ± 0.017, on par with a traditional training method despite using only 26.7% of the training data. Compared to a conventional random forest model trained on brute-force, a 100% full training set, our approach shows a 10.6% improvement in AUPRC and modest gains in MCC, confirming the effectiveness of the proposed framework. Under severe class imbalance, balanced accuracy steadily increased across AL iterations, reaching values greater than 0.85 at the final iteration for all uncertainty-driven strategies. Molecular docking confirmed successful prioritization of the top four predicted compounds. Evaluation on an external MAPK1 data set demonstrated generalizability, with our approach achieving an AUPRC of 0.818 and an MCC of 0.403, comparable to the independent test set. These results highlight the potential of combining intelligent data selection with deep learning architectures through the meta-model to accelerate predictive performance in data-scarce drug discovery. Scientific contribution: This study contributes a novel, data-efficient active meta-deep learning framework for predicting MAPK1 inhibitors, addressing the challenge of limited experimental data in a cancer-specific target. By integrating AL with a meta-model composed of four deep architectures, the approach significantly enhances the predictive performance using only a fraction of the training data. The framework achieves superior metrics compared to traditional training methods, highlighting its potential to accelerate drug discovery in data-scarce settings.

When resource scarcity threatens customer value: Conceptualizing adaptation capabilities from a resource-scarce emerging market context Chapter 3 Market knowledge as a driver of adaptation capabilities in managing scarcity of natural resources Chapter 4 When natural resources break down, market knowledge steps in: A panel study in the extreme context of Ethiopian pastoralists Chapter 5 Market knowledge as a driver of sustainable use of common-pool resources in communities that are integrated with the global market system Chapter 6

The problem in this study will reveal the application of active and creative learning methods at Madrasah Aliyah Darul Ulum Banyuanyar Palengaan Pamekasan, this research aims to be able to describe the learning methods applied at SMP MUHAMMADIYAH 57 MEDAN. The type of data from observations is in the form of in-depth field notes and documentation in the form of archived notes. The research data source is the primary data source in the form of interviews and field observations with informants, while the secondary data source is in the form of document study results obtained in the research. The data collection procedure uses three data collection techniques, namely: participant observation techniques, in-depth interviews, and study of documents and using a qualitative descriptive method with primary data collection through interviews and observation while secondary data obtained through documentation. The research results show that the application of learning methods in Madrasahs is not yet effective because they still use conventional methods such as the lecture method, the discussion method, and the demonstration method. It is necessary to develop a variety of learning methods so that the learning process becomes active and creative.