bluuebunny/crossref_metadata_2025 huggingface dataset:
To study the effect of L-asparaginates and phytase on the content of actinomycetes and enterobacteria in the intestinal microbiome of broiler chickens
Authors: Zhilochkina T. I.
Published: January 2024

In 2021, in the vivarium of the FNC "VNITIP" of the Russian Academy of Sciences, on 4 groups of broiler chickens of the cross breeding of the SGC "Smena 8", an experiment was conducted with the use of a mineral additive in the form of Lasparaginates in feed, both in combination with phytase and without it. Group I chickens received complete mixed feeds with the addition of inorganic forms of microelements in the form of premixes in accordance with the guarantee standards. Group II chickens received a total diet without the inclusion of microelements of the premix, but with the addition of the phytase enzyme in the amount of 1 million units. per ton. The birds of the third experimental group received feed with the addition of a mineral premix (OMEK-broiler) in the form of Lasparaginates, with a content of 7.5% of microelements from the accepted norms. Group IV chickens consumed complete mixed feed with the inclusion of L-asparaginates, with a content of 7.5% of microelements from the accepted norms, with the addition of phytase in the amount of 1 million units / t. Based on the data obtained, it was found that the introduction of L-asparaginates into the diets in an amount of 7.5% of the guaranteed norms provided better assimilation of metals, contributing to a more complete assimilation of feed nutrients. The addition of phytase to Lasparaginates enhanced this process, which could indirectly affect the improvement of broilers' productive indicators, as well as the qualitative and quantitative characteristics of the microbial community of their intestines. Thus, the number of actinomycetes and enterobacteria in all experimental groups showed low indicators, which indicated not only good feed quality and its high conversion, but also increased activity of biochemical processes.
Dependence of the nutritional value of meat on the quality category
Authors: Kalyuzhnaya T. V. , Orlova D. A. , Karpenko L. Yu.
Published: January 2024

In the literature data, information about the nutritional value of meat of different quality categories is mainly represented by its assessment in the presence of PSE and DFD defects either in pork or beef. There are practically no studies on the nutritional value of meat with the quality category RSE, RFN, PFN. Therefore, the assessment of the nutritional value of meat, depending on the quality categories, is of both scientific and practical interest.The purpose of the research was to study the dependence of the nutritional value of meat on the quality category.The research was carried out in the conditions of the educational and research center for the examination of food and animal feed of the St. Petersburg State University of Veterinary Medicine in the period 2020-2022.The materials for the study were 107 samples of meat of various quality categories obtained from different types of slaughter animals.The nutritional value of meat samples was determined according to GOST 34567-2019 "Meat and meat products. Method for determination of moisture, fat, protein, sodium chloride and ash using near-infrared spectroscopy (with Correction)" using infrared analyzer "InfraLUM FT-12". Processing of the received data was carried out using the software "Spectrum/Pro".As a result of determining the nutritional value of meat of different quality categories, it was found that the content of protein, fat and moisture depended on the category. It should be noted that information about the nutritional value of meat of various quality categories should be taken into account when conducting input control and processing meat raw materials at processing enterprises.
The current ecological and ichthyotoxicological state of the Svir bay of Lake Ladoga
Authors: Romanov A. Yu. , Arshanitsa N. M. , Ekimova S. B.
Published: January 2024

A significant part of the water area of the bay is represented by a shallow littoral, which is characterized by the highest biodiversity and bioproductivity. Approximately 90% of benthic organisms known for Lake Ladoga are inhabitants of the littoral zone. The littoral and water areas gravitating towards it are a spawning and feeding place for all fish species living in the lake. The Svir Bay of Lake Ladoga is located in the southeastern part of the lake water area. Its area is 260 km2. The present study in the water area of the Svirskaya Bay with an assessment of the state of the ichthyofauna was carried out in the summer of 2022, and the previous one - in the eighties of the last century The article presents the materials of biological and chemical-analytical studies in the Svir bay of Lake Ladoga, which is of great fishery importance. The ecological and ichthyotoxicological state of the studied water area and the most important importance of the ichthyofauna in assessing the state of its individual sites are shown. Thus, the shallow littoral zone turned out to be more polluted compared to the more remote from the coast and more deepened southern part of the lake. A higher level of pollution of the littoral, which occupies a significant part of its water area, negatively affected the ichthyofauna of the reservoir and its reproduction, which led to an impact on fish stocks, especially valuable species, and the structure of the ichthyocenosis of the lake as a whole. The results of the research also showed that the condition of the lip as a whole has improved somewhat compared to the eighties of the last century, when the last ichthyotoxicological studies were conducted in this water area. Taking into account the state of the ichthyofauna and other indicators of the study, the pollution level of the Svir Bay of Lake Ladoga can be characterized as weakly expressed sublethal.
Micromorphometric parameters of the thyroid gland and antioxidant status in rats with acute radiation damage against the background of the use of DAFS-25 and MONCLAVIT-1
Authors: Brevnova S. A.
Published: January 2024

The search for formulations of radioprotective agents with different mechanisms of action is one of the promising areas in radiobiology. One of the components of the body's antioxidant system are glutathione peroxidases, selenium-dependent proteins capable of neutralizing reactive oxygen species and inhibiting lipid peroxidation. In addition, selenium is involved in the metabolism of thyroid hormones and the maintenance of cellular homeostasis of thyrocytes. The thyroid gland is involved in the regulation of metabolism, and also affects the functioning of many body systems. Consequently, the course and outcome of radiation pathology will depend on the functional state of the thyroid gland. Iodine is required for the synthesis of thyroid hormones. DAFS-25 is a feed additive for farm animals containing diacetophenonyl selenide (mass fraction of selenium is 25%). Monclavit-1 is a veterinary drug containing iodine in the form of a polymer complex. The combined use of selenium and iodine as a radioprotective agent is currently poorly understood. Thus, the purpose of this work was to evaluate changes in the concentration of malondialdehyde and the functional state of the thyroid gland in acute radiation injury against the background of the use of DAPS-25 and Monclavit-1.In order to conduct the experiment on the principle of pairs of analogues, 5 groups of animals were formed, 10 individuals each. The determination of the concentration of malondialdehyde was carried out by the colorimetric method. The material selected for histological examination was fixed in a formalin solution, then dehydrated, paraffinized, and stained with hematoxylin-eosin.The use of DAFS-25 and Monclavit-1 contributes to a decrease in the concentration of malondialdehyde in the blood of irradiated animals and a relative restoration of the histological structure of the thyroid gland on the 30th day of the experiment.
The course and branching of the extraorgan veins of the organs of urination in the arctic fox
Authors: Shchipakin M. V. , Bylinskaya D. S. , Melnikov S. I.
Published: January 2024

When keeping fur-bearing animals, it is necessary to take into account that these animals have increased motor activity when they are in natural biogeocinosis. Due to the fact that these representatives of fur-bearing animals are kept in conditions of inactivity, this can inevitably lead to changes in the structure of the cardiovascular system. The purpose of the study is to study the features of the course and branching of extraorgan veins of the organs of urination in Arctic foxes, to determine the morphometric data of these vessels. The objects for this study were the corpses of female arctic foxes of two age groups: newborns and three to four months, five in each group. To achieve this task, a set of traditional anatomical research methods was used. According to the results of the study, it was found that the course and branching of the extraorgan vessels of the organs of urination in female arctic foxes is different. The main outflow of blood from the kidneys are the right and left renal veins; from the ureter – the cranial and caudal branches of the ureter; from the tip of the bladder – the cranial cystic vein; from the body and the bottom of the bladder is the caudal cystic vein. It is also necessary to note the close relationship of the organs of urination with the reproductive system, since the left renal vein communicates with the ovarian. In addition, we have established the presence of rare valves in the veins of the ureters and bladder, and the absence of such in the vessels of the kidneys. Thus, based on linear parameters, it can be concluded that the diameter of the veins gradually increases with the growth of the animal, especially by the period of maturation and intensification of organs.
The experience of using orthoses made of modern polymer materials in the rehabilitation of Shetland breed ponies after resection of the femoral head
Authors: Korobchuk M. V. , Karklin A. I. , Balashova O. V.
Published: January 2024

As a rule, due to the physiological characteristics of the functioning of the musculoskeletal system, amputation and prosthetics of the affected limbs of horses and ponies are not performed (for example, in case of fractures of the fetlock, metacarpal, metatarsal, radius or tibia). However, in some cases, modern achievements in the field of materials science make it possible not only to save the animal, but also to provide it with a completely comfortable existence. This is especially important when breeding animals are injured, the euthanasia of which is accompanied by significant economic losses and impoverishes the gene pool of the breeding stock of domestic stud farms. Dislocation of the hip joint in horses is quite rare, but it is a very common disease of the pelvic region. The disease is characterized by displacement of the femoral head from the articular cavity, as well as rupture of the ligaments of the joint and damage to its capsule.The article contains an information about the successful experience of using modern polymeric materials used in the manufacture of an orthosis designed to compensate the difference in in the lengths of the pelvic limbs of a pony that arose after surgical resection of the femoral head. The text of the work includes an epicrisis and a description of the implementation of the design of the orthosis due to it: the elements of the orthopedic structure, the materials used, the timing and cost of manufacturing. The conclusion of the work concludes that the use of orthosis allowed: to significantly improve the quality of veterinary measures carried out; to provide the injured limb with a position as close as possible to the natural physiological one; to reduce the discomfort of the animal caused by the need to forge the injured limb during postoperative recovery. The success of professional collaboration in the implementation of an integrated approach to solving problems arising in the treatment and rehabilitation of animals, as well as in the performance of various interdisciplinary studies, is noted.
COMPARISON OF LOGISTIC REGRESSION, MULTINOMIALNB, SVM, AND K-NN METHODS ON SENTIMENT ANALYSIS OF GOJEK APP REVIEWS ON THE GOOGLE PLAY STORE
Authors: Maulana Audenza , Inayah Khasnaputri Afifah  , Asghafi Mubarrak  , Kiagus Rachmat Fauzan  , Ardhan Dwintara  , Zen Bita Parga
Published: January 2024

Today's community activities cannot be separated from the name of transportation because it makes it very easy for people's daily activities. With the existence of transportation, people can more quickly reach their destination. With the Gojek application on the Google Play Store, it will help people travel or deliver goods. To determine service quality, sentiment analysis can be used to classify reviews. The purpose of this study is to compare which method has the best accuracy, so that it can classify reviews into positive or negative sentiments. The methods tested in this study are Logistic Regression, MultinomialNB, SVM, and K-NN. Performance assessment methods include score accuracy, recall, and precision, classification reports, and confusion matrix to determine the appropriate method for classifying reviews into positive or negative categories. Of the four methods tested, the one with the highest performance is the Logistic Regression method. Accuracy, recall and precision scores of the Logistic Regression method were 82.45%, 82.49%, 82.45% and 82.43%, respectively. Classification report also shows good results. In the confusion matrix, there are 111 and 124 True positives and True negatives. There are only 22 and 28 False positive and False negative results respectively. The method that has the lowest score is K-NN, with score accuracy, recall, and precision respectively were 52.28%, 59.43%, 93, 52%, and 65.65%. Classification report shows quite bad results. In the connection matrix, it produces True positives and True negatives 130 and 19. There are only 127 and 9 False positive and False negative results respectively. The results of this study state that using the Logistic Regression method is suitable for use in classifying positive and negative reviews in the review dataset on the Gojek application on the Google Play Store.
Voces y sentidos del profesorado. Opiniones de egresados normalistas
Authors: Berlín Ortiz Claudia , Cornejo Veloz Rafael , Díaz Azuara Eduardo , Edel Navarro Rubén , Ferra Torres Gerson Edgar , Herrera Meza Grecia , Hoyos Ramírez Merced Guadalupe , Juárez Pérez Julio César , Marín Enríquez Martín , Parra Salas Emma Guadalupe , Pérez Martagón Dulce María
Published: January 2024

La presente obra es producto del esfuerzo conjunto y el trabajo colaborativo de la Academia Interinstitucional de Seguimiento a Egresados del estado de Veracruz, coordinada e integrada por profesores y profesoras de las cinco escuelas normales públicas, de la Dirección de Educación Normal (DEN) y con el apoyo metodológico de la Universidad Veracruzana (UV). Este estudio evaluativo indaga las percepciones y opiniones de cinco generaciones de egresados de licenciatura y de posgrado a través del diseño, validación y aplicación de una encuesta elaborada en el grupo de investigación, la cual explora las dimensiones sociales, profesionales y de formación continua de los profesores en servicio. Este libro representa el fruto de tres años de trabajo, iniciados en el año 2020, en medio de la pandemia, lo que resalta la importancia del esfuerzo sostenido por el grupo de investigación. Además, esta publicación contribuye a la generación de conocimiento sobre la formación inicial de profesores en México, así como a definir políticas y estrategias que dibujen rutas para la mejora de los servicios educativos de las escuelas normales como instituciones de educación superior, especialistas en la formación de profesores de educación básica.
КЫРГЫЗСТАНДА КАЙРА ИШТЕТҮҮ ӨНӨР ЖАЙЛАРЫН ӨНҮКТҮРҮҮ ҮЧҮН ЧЕТ ӨЛКӨЛҮК ТАЖРЫЙБАЛАРДЫ КОЛДОНУУ
Authors: Аттокурова Гулумкан , Исманалиев Курманбек , Эсенали кызы Гүлзина , Алманбетова Адель
Published: January 2024

Бул макалада кайра иштетүү өнөр жай өндүрүшү боюнча чет өлкөлүк тажрыйбаларды окуп үйрөнүп изилдөө менен өнүккөн өлкөлөрдөгүдөй бир катар кайра иштетүү, сактоо, сатуу, жеткирүү сыяктуу маселелерге көңүл бөлүндү. Экономикалык эффективдүүлүктү жогорулатуу менен экспорттук мүмкүнчүлүктү жогорулатууга багыт алууга болот. Андыктан экономикалык эффективдүүлүктү жогорулатуу үчүн бир катар ишканалардын ортосундагы байланыштарды күчөтүү менен алардын өз ара кызматташуусун арттыруу керек.
A Study on the Human Agency of Ma-eul Education Community Activists
Authors:   The Korean Society for Lifelong Education, Park Gwi Ja , Park Sangok
Published: January 2024

This study was conducted to understand the proactive and active behaviors of Ma-eul education community activists not merely at a personal level, but within a dimension that includes social structures and cultural characteristics. To achieve this, in-depth interviews were conducted with seven research participants to capture and analyze the manifestation of activists' agency traits using the relational agency conceptual model. The results revealed that the practice of activist agency characteristics emerged in the formation of social intimacy, intentional value sharing, relationship building that supports empowerment, harmonizing practices with convictions, and problem-solving through relationships. These were further facilitated through personal and relational reflection and learning. Based on these findings, the activists' agency was defined as the power of solidarity for forming 'our' relationships. The study discussed and organized the practice of activist agency into relationship-centered practice, forms of agency practice, the cyclical nature of agency manifestation, the characteristics of learning that mediate the manifestation of agency, and the implications of agency practice. This research offers a new perspective for understanding the practice experiences of activists through the concept of agency and attempts to define the concept of activist agency, distinguishing it from previous studies. Additionally, it proposes strategies for the revitalization of village education communities and suggestions for future research.
PROGRAM PEMBIASAAN MEMBACA HADITS PENDEK DALAM MENINGKATKAN BUDI PEKERTI ANAK USIA DINI
Authors: Hana Sarifah
Published: January 2024

Tujuan dari penelitian ini adalah untuk menyajikan gambaran secara lengkap mengenai suatu kejadian atau dimaksudkan untuk mengekspos dan mengklarifikasi suatu fenomena yang terjadi. Anak saat bermain dengan teman yang lebih dewasa akan terbiasa mencontoh apa yang teman lain kerjakan.  Penelitian kualitatif deskriptif adalah salah satu dari jenis penelitian yang termasuk dalam jenis penelitian kualitatif. Penelitian deskriptif merupakan strategi penelitian Dimana di dalamnya peneliti menyelidiki kejadian, fenomena kehidupan individu-individu dan meminta seorang atau sekelompok individu untuk menceritakan kehidupan mereka. Subjek penelitian ini tentang program pembiasaan membaca hadist pendek dalam meningkatkan budi pekerti di TK Muslimat NU Diponegoro 129 Randegan. Pembiasaan dalam pembelajaran dapat membentuk karakter anak usia dini. Dengan pembiasaan anak-anak usia dini sangat efektif diterapkan di fase fondasi. Pembiasaan merupakan proses pembentukan sikap dan perilaku yang relative menetap dan bersifat otomatis melalui proses pembelajaran yang berulang-ulang. Hal ini karena pada fase fondasi memiliki rekaman ingatan yang kuat dan kondisi kepribadian yang belum matang, sehingga mereka mudah dibentuk dan diatur dengan berbagai kebiasaan yang mereka lakukan sehari-hari. Itulah sebabnya pembiasaan menjadi cara yang efektif dalam mengoptimalkan perkembangan agama dan budi pekerti pada anak usia dini. Pada pembiasaan tersebut ditanamkan nilai-nilai moral yang sesuai dengan ajaran agama anak. Tujuan dengan pembiasaan membaca hadist pendek mempermudah anak untuk menghafal dan memahami makna hadis yang dibaca dan tanpa disadari anak melakukan perilaku sesuai dengan hadist yang dibaca dan meningkatkan budi pekerti anak
Complex tidal flow interactions in stellar and planetary convective envelopes
Authors: Astoul Aurélie
Published: January 2024

In close star/star or star/planet systems, tidal interactions are known to shape the orbital architecture of the system, and modify the star and planet spins. Most stars around which planets have been discovered are low-mass solar-type stars, and thus feature a magnetised and often differentially-rotating convective envelope, as is also expected in giant gaseous planets. The dissipation of tidal flows, and more specifically the dissipation of inertial waves (restored by the Coriolis acceleration) is of particular importance in the convective envelopes, especially in the early stages of the life of an exoplanetary system. In parallel, the non-linear self-interactions of inertial waves are able to trigger differential rotation in convective shells in the form of axisymmetric zonal flows. In turn, linear numerical studies have shown that differential rotation can strongly affect the properties of inertial waves, namely their propagation and the dissipation of their kinetic energy.

In this context, I will present our recent results of (magneto-)hydrodynamical non-linear numerical simulations of tidally-forced inertial waves, in 3D spherical convective shells. The emerging zonal flow strength and structure largely depend on the viscosity, tidal forcing amplitude and frequency. When strong, these flows deeply modify tidal dissipation rates from prior linear predictions. Moreover, we also find evidences of strong wave/wave and wave/zonal flow interactions leading to parametric and shear flow instabilities due to correlation resonances (when the Doppler-shifted frequency vanishes). Therefore, I will discuss to what extent these various non-linear effects disrupt the linear predictions for tides along the permissible forcing frequency range and for various viscosities, tidal amplitudes and size of the convective shells which are representative of the convective envelopes of low-mass stars and giant gaseous planets.
Revitalising millets in Northeast India: A healthy choice - Policy Brief
Authors:   International Centre for Integrated Mountain Development (ICIMOD), JHA Anil
Published: January 2024

Millets have long been a staple of the regional diet in Northeast India because of their durability and high nutritional value. However, the rise in consumption of fine cereals, along with a subpar production system and inadequate compensation for millet farmers, have led to the decline of millet consumption and production. The low volume output is exacerbated by the lack of access to good-quality traditional seeds, fertilisers, and effective farming methods, coupled with changing patterns of climate. Furthermore, poor market demand and a lack of pro-poor policies of the government make millet growing even more difficult. Farming communities have few options for generating revenue since limited efforts have been made to market and link millet-based products to markets. Thus, there is a need to support existing farming practices that generate agrobiodiverse landraces, develop climate-resilient cultivars, and facilitate platforms for the value addition of the product. The existing primary processing of millets is labour-intensive and the lack of proper storage facilities results in poor-quality grains fetching low market prices. Thus, there is a need to develop infrastructure and build the capacity of farmers and other stakeholders along the millet value chain.
Revitalising millets for rural transformation in Nepal - Policy Brief
Authors:   International Centre for Integrated Mountain Development (ICIMOD), JHA Anil
Published: January 2024

Nepalese agriculture is facing a number of challenges, including a shrinking cropped area, principally due to land use changes, low competitiveness, and increasing impacts of climate change, leading to a volatile food security situation. Likewise, changing dietary patterns – characterised by less diverse foods and more consumption of energy-dense ultraprocessed and packaged foods – has been the leading cause of malnutrition, especially among children and adolescents. Promoting a millet-based food system has the potential to improve food security and nutrition in the country. However, there has been a declining trend in the production and consumption of millets owing to a number of reasons.
Usher syndrome: Genetic diagnosis and current therapeutic approaches
Authors: Cuzzuol Beatriz Rocha , Apolonio Jonathan Santos , da Silva Júnior Ronaldo Teixeira , de Carvalho Lorena Sousa , Santos Luana Kauany de Sá , Malheiro Luciano Hasimoto , Silva Luz Marcel , Calmon Mariana Santos , Crivellaro Henrique de Lima , Lemos Fabian Fellipe Bueno , Freire de Melo Fabrício
Published: January 2024

Usher Syndrome (USH) is the most common deaf-blind syndrome, affecting approximately 1 in 6000 people in the deaf population. This genetic condition is characterized by a combination of hearing loss (HL), retinitis pigmentosa, and, in some cases, vestibular areflexia. Among the subtypes of USH, USH type 1 is considered the most severe form, presenting profound bilateral congenital deafness, vestibular areflexia, and early onset RP. USH type 2 is the most common form, exhibiting congenital moderate to severe HL for low frequencies and severe to profound HL for high frequencies. Conversely, type 3 is the rarest, initially manifesting mild symptoms during childhood that become more prominent in the first decades of life. The dual impact of USH on both visual and auditory senses significantly impairs patients’ quality of life, restricting their daily activities and interactions with society. To date, 9 genes have been confirmed so far for USH: MYO7A , USH1C , CDH23 , PCDH15 , USH1G , USH2A , ADGRV1 , WHRN and CLRN1 . These genes are inherited in an autosomal recessive manner and encode proteins expressed in the inner ear and retina, leading to functional loss. Although non-genetic methods can assist in patient triage and disease extension evaluation, genetic and molecular tests play a pivotal role in providing genetic counseling, enabling appropriate gene therapy, and facilitating timely cochlear implantation (CI). The CRISPR/Cas9 system and viral-based gene replacement therapy have recently emerged as highly promising techniques for treating USH. Regarding drug therapy, PTC-124 and Nb54 have been identified as promising drug interventions for genetic HL in USH. Simultaneously, CI has proven to be critical in the restoration of hearing. This review aims to summarize the genetic and molecular diagnosis of USH and highlight the importance of early diagnosis in guiding appropriate treatment strategies and improving patient prognosis.
From qualitative reflection to reflexive quality: an intersectoral approach to quality of care
Authors: Boxstaens Johan
Published: January 2024

Background: All over the continent, organizations in healthcare and welfare are increasingly being challenged to be transparent about what they are doing and to provide evidence regarding the results they achieve. Some organizations choose to develop policy and practice based on a variety of indicators and strictly scientifically based criteria. In this perspective, quality of care is measured against the background of those standardized indicators. Other organizations consider care as a craft or even an art which is impossible to capture in strictly standardized norms and indicators. In such organizations, scientific knowledge is often seen as subordinate to the experiential knowledge of service users and practical knowledge of staff members. Hence, quality of care is measured by – amongst other things – proximity and involvement with service users.

Within Emmaüs vzw, an organization that overarches a variety of facilities in the fields of healthcare and welfare in Belgium, forces were joined to develop a new framework for quality of care in which an effort is made to transcend the contradiction that is outlined above. In order to do so, the experiential knowledge of service users, the practical knowledge of staff and research based knowledge were combined and considered to be equally valuable in tackling issues regarding quality of care.

The project: Building on participatory action research with service users, their social context, staff members, policy makers and academics, we co-constructed a value-driven and intersectoral framework for quality of care that is underpinned by rhizome theory (Guattari & Deleuze, 2014). The ecological approach to quality of care entails an effort to capture and do right by the complexity that characterizes the fields of care and welfare. Furthermore, we connected the concepts of quality and reflexivity in a meta-model that can be used to fuel quality improvement across healthcare en welfare organizations. In our project, service users and staff were involved as respondents and as co-researchers. We use the CAIMeR theory (Blom & Morèn, 2010) as an analytical framework to describe processes of change and to capture effective practice. Although the project is still ongoing, our research shows that the intersectoral framework is widely accepted across organizations in youth care, mental healthcare, elderly care and support of people with disability. Recently also a general hospital expressed their interest in our intersectoral framework and reflexive meta-model.

Presentation: We will present the highlights of our co-constructed framework for quality of care and the reflexive meta-model that is currently piloted in different organizations.

Learning objectives: After this session, participants will be able to:

Understand how participatory action research can help further policy and practice on quality of care across healthcare and welfare organizations.

Understand how the reflexive meta-model we developed can be used in practice.
Barriers and facilitators of the built environment towards social participation, mental and physical health outcomes among seniors residing in a low-income urban community in Singapore: A qualitative study.
Authors: Chua Alyssa Marion
Published: January 2024

Background and Introduction: Health is complex and multifaceted, comprising domains including but not limited to physical, mental, and psychological health. While the built environment has proven to influence these domains, literature is still lacking in studying the effect of the built environment on social participation, as well as its influence on health outcomes in Singapore’s local context. Given the nation’s rapidly ageing population, rising chronic conditions and increased load in the provision of care, there is an urgent need for effective solutions to improve health. In particular, the built environment holds great potential, offering an opportunity for simple, tangible, and long-lasting interventions.

Objective: This study aims to identify the barriers and facilitators of the built environment, both tangible and non-tangible, that limited or facilitated social participation in communal activities among seniors residing in a low-income urban community in Singapore.

Methods: Photovoice go-along interviews were conducted in addition to semi-structured sit-down interviews with 25 seniors aged 65 and above residing in a low-income urbanised community, Marine Parade. Participants took the interviewer on a journey through their neighbourhood with polaroid cameras, then using the instant photographs, spoke of their thoughts and shared stories related to the aim of study. These interviews focused on elucidating the aspects of the built environment, both tangible and non-tangible, that limited or facilitated social participation and ultimately mental well-being, and physical health outcomes. All in-depth interviews were audiotaped, transcribed, and uploaded into the qualitative software NVivo, and responses were coded with theoretical and emergent themes regarding participants’ perceptions of the built environment. Key conceptual categories were constantly refined until a saturation of categories informed a framework outlining the aspects of the built environment that impacted health outcomes.

Findings: Collectively, 106 categories and 18 broader themes emerged. These preliminary themes reflected concerns of mobility as well as convenience, circulation, visibility, recognisability, and peacefulness of the space. Ideas were shared about how to improve the safety of pathways and routes, linkages to transportation as well as how to leverage on existing unused space to encourage social interaction. 

Implications on Ageing and Gerontology: Understanding how the built environment influences social participation could be key to changing health outcomes. As we grow into a Super-Aged Society, we hope to harness the full potential of the built environment towards independent and joyful ageing.
Cocreative care quality management in community mental health care centers.
Authors: Deloof. John
Published: January 2024

De MaRe en De Bolster innovated the view on care quality management by rethinking their framework starting from a client-centered perspective. In order to be succesfull in the Qualicor external care audit proces these organisations made the organisational shift to cocreative practice in quality care management. Clients and those involved in their lives are a fundamental partners in this proces. These organisations created numerous examples of good practice, such as cocreative quality panels, client-councils, advisory boards, involvement of clients in recruitment and selection of staffmembers, etc.
Attentive visitors: developing a training program to support community-based volunteers in their palliative care signposting role
Authors: Van Steenbergen Sabet , Vanderstichelen Steven , Statema Else Given , Deliens Luc , Dury Sarah , Chambaere Kenneth
Published: January 2024

Background: Community volunteers often notice palliative care (PC) needs that healthcare professionals (HCP) and family caregivers miss, potentially playing an important signposting role. In order to fulfill this role, volunteers need knowledge about PC needs and community resources; and they should have good relational, communication and observation skills. These skills and knowledge can be enhanced through training.

Aims: To develop a training program to support community homecare volunteers in their signposting function.

Methods: Learning objectives were formulated based on the results of a qualitative study in which 7 focus groups (15 community volunteers, 20 HCP’s) and 10 in-depth interviews (6 community residents with PC needs, 4 informal caregivers) were conducted. The content and structure of the training were developed in collaboration with a psychologist trainer, stakeholder organizations and community volunteers.

Results: The training program consists of a didactic workshop (5-6 hours) and a follow-up session (2-3 hours) in which reflection, exchange of knowledge/experiences are central. The workshop aims to achieve learning objectives related to increasing awareness and knowledge of the volunteer role and signposting function, PC needs and signals, community resources, communication with the community resident and communication with HCPs. Case discussions, reflection exercises and role plays are used to enhance volunteers' insights and skills related to recognizing, describing, responding to and communicating patient needs to HCPs. During the follow-up session, participants will be invited to share experiences and reflect on what the didactic workshop has meant for their volunteer work since.

Conclusion: The training responds to existing needs in community homecare and tries to strengthen community volunteers in taking up their signposting function. The training program will be piloted and evaluated Fall 2022-Spring 2023.

Funding: Flemish Cancer Fund
Integrated health and social care with a CALD focus: a service mapping study in Sydney Metropolitan
Authors: Uribe Gabriela , Dronavalli Mithilesh , Katz Ilan , Page Andrew , Wolfenden Susan , Gillespie James , Eastwood John , Huckel Schneider Carmen
Published: January 2024

Background: Underrepresented and underserved communities such as culturally and linguistically diverse (CALD) groups experience higher reported prevalence and severity of multimorbidity along with unmet social needs and disadvantages in accessing services. Minority populations report higher rates of emergency department presentations globally and nationally and it is understood that services are more frequently accessed on consumer initiative when problems become acute and critical, demonstrating significant barriers for early intervention. In Australia, most of the efforts to reduce over-utilisation of emergency care have focused on developing integrated health and social care approaches for the general population. There is little evidence available on how CALD populations are involved in the design and implementation of integrated care health and social care initiatives and how their needs are identified and addressed.

Methods: A service mapping study informing the development of a framework for comparative analysis of integrated health and social care services targeting CALD populations will be sought. Semi-structured interviews, with key stakeholders and decision-makers representing health and social services, as well as document review, will inform the development of a map of integrated health and social care services available for individuals from culturally and linguistically diverse backgrounds. Core defining elements of the mapped services comprise the basis for the framework that enables comparison of level of integration with a CALD focus, including governance and partnerships, health and social care staff, financing and payment systems, and data sharing and use.

Implications: This study will advance the understanding of how integrated health and social care policies (policy learning) and services are conceptualised, developed, and implemented at a local level (policy implementation) to address the needs of CALD populations. and how they can better respond to the health and social needs of CALD consumers.
Engaging and Empowering Young Carers: Shifting the Focus for Public Awareness and Intervention in Canada
Authors: Saragosa Marianne , Okrainec Karen , Hahn-Goldberg Shoshana , Caven Isabelle , Zheng Yuanjie (Bill) , Ramkishun Amanda , Pomozova-Mann Georgia
Published: January 2024

Over 8 million Canadians provide care to chronically ill or disabled family members. While most caregivers are between the ages of 45 and 54 (24%) and 55 and 64 years (20%), the third largest group is young carers. Carers between the ages of 15 and 24 account for 15% of all caregivers in Canada. This group of carers are those under the age of 25 that provide significant and ongoing unpaid care to a family member or friend. However, despite these known figures, very little attention has been paid to the existence of young carers in Canada except for scant emerging research. Our two-phased study aimed to first gain a better understanding of how young carers interact with the health system [how they are included in discussions and how is information shared with young carers]. The second phase focused on building on this body of knowledge by engaging young people and partnering with caregiver organizations in a more participatory, active manner to identify potential solutions to improve their involvement in supporting their family member’s healthcare use. In phase one, we applied a deductive analytical approach to identify touch points and pain points as perceived by participants. Our findings demonstrated that young carers interacted with the healthcare system at touch points spanning the home and community sectors, hospital and rehabilitation care, and primary and palliative care services. We also identified five types of pain paints that the young carer participants experienced in their caregiving roles: 1) desiring acknowledgement; 2) seeking information and communication; 3) managing system navigation; 4) engaging in balancing acts; and 5) performing point-of-care tasks. Phase two consisted of a virtual co-design event with the young carer participants, members of the partnering support organizations, and the research team. During the meeting, the group engaged in a brainstorming activity to identify priorities for our proposed project. The two priorities identified by our event were to 1) Build awareness of young carers for both healthcare organizations and healthcare practitioners and identify challenges in their recognition and support at point-of-care. And 2) Support the co-design of a prototype program that recognizes the needs of both young carers and healthcare workers during their healthcare interactions and that addresses the identified pain points. These results will inform the next steps that intend to explore to what extent are health care professionals aware of young carers and their support needs. Our program of research is adding to the national literature on Canadian young carers and provides more evidence to develop support provisions and interventions for young carers.
The role of Hospice Care at the end of life: perspectives from formal and informal caregivers  
Authors: Hermans Kirsten , Dierckx Eva , Wagner Ken , Langenaekens Paula , Verbert Lucretia , Cockx Judith , Vandommele Nele , Declercq Anja
Published: January 2024

Background: Persons nearing the end of life often prefer to die in their familiar surroundings. Dying at home is, however, not always possible, even when the person is supported by a mobile palliative home care team. As the (complex) care needs increase, informal caregivers are required to be available 24 hours a day and take on a significant portion of clinical care. In some cases, no informal caregiver is available or the informal caregiver(s) are overburdened, leading to hospital admission. As it is often not possible to refer these persons to a palliative unit because of the limited number of places available there, forty percent of deaths occur in acute wards in hospitals. These wards are less specialized in palliative care delivery, resulting in an end-of-life care which is not optimally tailored to the needs of the person and his/her caregiver(s). In order to relieve the burden on informal care, to reduce the high mortality rate in acute hospital wards, and to offer better quality palliative care, hospitals and nursing homes started to collaborate in Flanders (Belgium). Two hospices within nursing homes were created: Hospice “Aulighem” and Hospice “De Klaproos”.

We studied the experiences of (1) health care professionals and (2) relatives/informal caregivers of persons nearing the end of life who reside in these 2 hospices.

Methods: A qualitative study was conducted: (1) two focus groups with a total of 17 care professionals of the respective hospices; and (2) ten individual interviews with relatives of persons who stayed in one of the respective hospices during the past year. Information concerning the experienced hospice care in terms of (1) added value and  (2) bottlenecks was gathered.

Results: In terms of added value, the following points emerged: the peaceful atmosphere, the "near-home feeling", the continuous proximity of care professionals and/or volunteers, the strong bond of trust between care professionals, residents and loved ones, the interdisciplinarity of the care (psychological, medical, spiritual and social) and the strong focus on the quality of dying and on aftercare.

The main bottleneck is that these types of hospices currently are not officially recognized nor subsidized by government. As a result, hospices sometimes face staff shortages and a lack of resources, and their future is uncertain.  Moreover, the cost for the resident is higher than in case of hospitalization.

Conclusion: This study very clearly shows the added value of hospice care, from the perspective of both formal and informal caregivers. However, structural financing is necessary for the continued existence of these types of hospices, and in order to reduce the cost for residents, to recruit the necessary staff and to provide them with the necessary training.

In future research, also the resident’s perspective should be included.
Towards local health system development in Wallonia: experiences with the HSO toolkit for integrated people centred health systems.
Authors: Scholtes Beatrice , Lambert Anne-Sophie , Macq Jean , Herbaux Denis
Published: January 2024

Since 2008 Belgium has been developing a more integrated care system. Today, the Belgian healthcare system is undergoing significant reform at national and sub-national levels. In primary care, at the federal level, the New Deal for general practice aims to improve the organisation of general practice and a new inter-federal plan for integrated care is currently under development. At the regional level, there are many initiatives. In Wallonia several projects are working towards greater inter-professional collaboration and clear territorial delimitations in order to cater for the needs of local populations in a more integrated fashion. 

The project Proxisanté has been exploring the needs of professionals and patients by conducting consultations and workshops with actors within primary care to feed into a decree which will be presented at the end of 2022. Based on the outcome of this process, actions will be undertaken, starting in 2023, to implement this vision and develop a territorial network of local health systems. Our team is responsible for following and supporting this process of implementation by developing a transdisciplinary and innovative bottom-up methodological approach. For this we intend to rely, among other things, on the Integrated People-Centred Health Systems (IPCHS) Standard developed by the Health Standards Organisation (HSO), as well as the various tools created to facilitate the implementation of this standard. 

The presentation will describe the preliminary work done to prepare for concrete support for the creation of local networks starting in 2023. Specifically, we will detail the methodology used to identify the priorities that need to be focused on to ensure successful implementation, Finally, we will present the key messages from meetings with different existing subsystems concerning their strengths and weaknesses, and the inspiring practices identified that will allow us to build a regional learning system dynamic.