bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural glymphatic system: Clinical implications and potential importance of melatonin
Authors: Bitar Ryan D , Torres-Garza Jorge L , Reiter Russel J , Phillips William T
Published: December 2021

The central nervous system was thought to lack a lymphatic drainage until the recent discovery of the neural glymphatic system.  This highly specialized waste disposal network includes classical lymphatic vessels in the dura that absorb fluid and metabolic by-products and debris from the underlying cerebrospinal fluid (CSF) in the subarachnoid space. The subarachnoid space is continuous with the Virchow-Robin peri-arterial and peri-vascular spaces which surround the arteries and veins that penetrate into the neural tissue, respectively.  The dural lymphatic vessels exit the cranial vault via an anterior and a posterior route and eventually drain into the deep cervical lymph nodes. Aided by the presence of aquaporin 4 on the perivascular endfeet of astrocytes, nutrients and other molecules enter the brain from peri-arterial spaces and form interstitial fluid (ISF) that baths neurons and glia before being released into peri-venous spaces.  Melatonin, a pineal-derived secretory product which is in much higher concentration in the CSF than in the blood, is believed to follow this route and to clear waste products such as amyloid-β from the interstitial space. The clearance of amyloid-β reportedly occurs especially during slow wave sleep which happens concurrently with highest CSF levels of melatonin.  Experimentally, exogenously-administered melatonin defers amyloid-β buildup in the brain of animals and causes its accumulation in the cervical lymph nodes. Clinically, with increased age CSF melatonin levels decrease markedly, co-incident with neurodegeneration and dementia.  Collectively, these findings suggest a potential association between the loss of melatonin, decreased glymphatic drainage and neurocognitive decline in the elderly.
Effect of extraction ph and temperature on the physicochemical properties and pectin yield from mango peel (Mangifera indica L.)
Authors: Ramiírez-Benítez José Efraín , Alcantara-Marte Yulisa Yanilka , Arias Lara Gerson Neftalí , Velázquez Vizcaíno Nelson Darling , Alcantara-Marte Yanilka Yulisa
Published: December 2021

Objective: To evaluate the effect of the pH and extraction temperature on the pectin yield from mango (Mangifera indica) peel, cultivar Banilejo, and its physicochemical properties.
Design/methodology/approach: Pectin extraction was done by acid hydrolysis, using hydrochloric acid and ethyl alcohol to precipitate and purify. A randomized design with a factorial arrangement was used, evaluating the effect of pH (1.5, 2.0, and 2.5) and temperature (70, 80, and 90 ºC) on the yield and quality of pectin. Quality was determined by measuring pH, viscosity and moisture content, ash, methoxyls, and esterification degree. Their means were compared using Tukey's test at 95 % confidence.
Results: The best results were obtained at pH 2.0 and 80 ºC, reporting an 18.159 % yield, 6.766 % moisture, 2.630 % ash, 0.085 Pa.s of viscosity, 26.307 % methoxyl, and 64.753 % esterification.
Study limitations/implications: The different treatment combinations demonstrate that pH, ash, methoxyl content, and esterification degree vary as a function of the assessed pH and extraction temperatures; while viscosity, moisture and yield were not influenced by these variables.
Findings/conclusions: It is concluded that mango peel is a viable source to obtain quality pectin.
Blockchain-Based Delivery Assurance
Authors: Demir Mehmet
Published: December 2021

Climate-related catastrophes and wars are leaving people in need of aid. The main obstacle
in providing help to people in need is the lack of trust in aid processes. Donors and charity
organizations want to make sure that funds and materials gathered reach the intended destinations.
The lack of proof leads to a general sentiment of waste, corruption and misuse, which undermines
aid efforts. Blockchain technology injects trust into the business transactions through impeccable
record keeping and fulfils the lack of trust problem in aid delivery. However, our review of relevant
literature indicates that a delivery assurance framework that covers major aspects of providing a
blockchain-based solution to aid delivery is absent.
In this thesis, we propose a novel blockchain-based transparent delivery framework for
creating solutions that record and share data on the interaction of business participants involved in
a delivery process. This framework is novel as it creates solutions that include handover and
monitoring aspects of the delivery business and adds several benefits that come with the
blockchain technology. This delivery assurance framework also provides complete guidance as it
answers several key questions such as “How can we use blockchain technology to solve
problems?” and “How can we make sure the solutions are financially viable and acceptable?”

Our simulation study validates the applicability of our framework and the solution we
created using the framework. Further, the validation we received from an industry expert strongly
suggests that a solution developed with our framework is applicable in industry. This thesis
presents the development of the framework along with details on the design and execution of our
simulations, including the raw data, data enhancement processes, tools, data structures, smart
contract code, load testing methodology and the eventual analysis of the simulation results.
Transfer Learning Based Performance Modeling And Effective Storage Management In Big Data Ecosystems
Authors: Alsayoud Fatimah
Published: December 2021

Big data ecosystems contain a mix of sophisticated hardware storage components to support heterogeneous workloads. Storage components and the workloads interact and affect
each other; therefore, their relationship has to consider when modeling workloads or managing storage. Efficient workload modeling guides optimal storage management decisions,
and the right decisions help guarantee the workload’s needs. The first part of this thesis
focuses on workload modeling efficiency, and the second part focuses on cost-effective
storage management.
Workload performance modeling is an essential step in management decisions. The
standard modeling approach constructs the model based on a historical dataset collected
from one set of setups (scenario). The standard modeling approach requires the model to
be reconstructed from scratch with every time the setups changes. To address this issue,
we propose a cross-scenario modeling approach that improves the workload’s performance
classification accuracy by up to 78% through adopting the Transfer Learning (TL).

The storage system is the most crucial component of the big data ecosystem, where the
workload’s execution process starts by fetching data from it and ends by storing data into
it. Thus, the workload’s performance is directly affected by storage capability. To provide
a high I/O performance in the ecosystems, Solid State Drive (SSD) are utilized as a tier or as a cache on big data distributed ecosystems. SSDs have a short lifespan that is affected
by data size and the number of writing operations. Balancing performance requirements
and SSD’s lifespan consumption is never easy, and it’s even harder when interacting with
a huge amount of data and with heterogeneous I/O patterns. In this thesis, we analysis
big data workloads I/O pattern impacts on SSD’s lifespan when SSD is used as a tier or as
a cache. Then, we design a Hidden Markov Model (HMM) based I/O pattern controller
that manages workload placement and guarantees cost-effective storage that enhances the
workload performance by up to 60%, and improves SSD’s lifespan by up to 40%.

The designed transfer learning modeling approach and the storage management solutions improve workload modeling accuracy, and the quality of the storage management
policies while the testing setup changes.
Examining the Evolving Environmental Protection Policy Convergence in the Ontario Municipal Drinking Water, Wastewater and Stormwater Sectors: Analysis of State/Non-State Governance and the Value of an Environmental Management System Standard for the Wastewater and Stormwater Sectors
Authors: Tovilla Edgardo
Published: December 2021

The central question this dissertation attempts to answer is whether there is practical value in
Ontario legislatively mandating that municipalities implement an environmental management
system (EMS) standard for their wastewater and stormwater activities, to be added to the
drinking water quality management system standard (DWQMS) that is already statutorily
required. This research explores the evolving governance approaches of the municipal drinking,
wastewater and stormwater sectors in Ontario, examining theories of governance, a review of
the literature concerning policy convergence and standards as instruments of organizational
innovation and the legal and policy framework within which municipal water management
takes place.
The research method employed a combination of semi-structured interviews, case studies
and a focus group as data gathering techniques. The research finds evidence in support of and
wide recognition of the practical value of EMS by assisting municipalities in meeting their
environmental objectives, addressing environmental and property damage risks, providing an
additional mechanism of public accountability, transparency, and improving alignment with the
existing legal structure. It was also apparent that there is no political appetite in the provincial
government to embark on a mandated EMS, so the preferred option at this time is a
provincially-endorsed, voluntary sector-specific standard for wastewater and also for stormwater, which could constitute a catalyst to boost voluntary uptake of EMS by small to
medium municipalities (as it is already occurring with large municipalities). This standard could
be based on a customized variation of the ISO 14001, DWQMS and other standards to address
existing regulatory gaps.

The research also reveals that Ontario municipal water management governance is notable
because governments are drawing on independently developed and implementing non-state
forms of regulation (such as EMS standards), in which private sector, civil society and multistakeholder rule instruments, processes, institutions and actors all perform important roles in
support of conventional state-based regulation, showing both horizontal and vertical policy
convergence.

A limitation of the research is that it focuses on water governance of municipalities of one
jurisdiction. Future research could examine the practical utility of examining water governance
to other contexts (e.g., water governance for First Nations, and in non-Canadian jurisdictions)
The Benefits of Functioning as a Mentor for Nurse Students in the Republic of Kazakhstan - Discussion Paper Based on Current Literature
Authors:   JAMK University of Applied Sciences, Merasto Merja , Kangas-Niemi Annina ,   JAMK University of Applied Sciences, Kivinen Eveliina ,   JAMK University of Applied Sciences
Published: December 2021

The aim of the study: The aim of this discussion paper is to identify and provide an overview of the benefits of mentorship for the mentor of nurse students and describe the facilitators and barriers the nurse mentors encounter in their mentorship activities during nurse students' clinical practice. Methods: The databases CINAHL, Medline, Pub Med and Science Direct from 2016-2021 were searched. The studies were screened by title, abstract and full text. 25 studies met the inclusion criteria. Results: Eight key themes emerged from the included studies. These theme areas were as follows; 1) being a role model, 2) recognition of role value and esteem, 3) keeping up to date, 4) student attributes, 5) colleague attributes, 6) time challenges, 7) location challenges and 8) lack of financial remuneration. The findings revealed nurse mentors experiencing knowledge transfer and facilitating students’ learning as major benefits of mentoring. Being a role model was reported in many of the selected articles. The mentoring role promoted the overall clinical quality, patient safety, and additionally made nurse mentors feel valued. Overall “lack of time” was referred several times as a barrier and frustrating element in the mentor’s work. Conclusions: Mentors have an important role and should be acknowledged as one of the cornerstones of quality nursing education. The findings highlight the significant benefits of mentoring from the mentor’s perspective. In the Republic of Kazakhstan, the goal is to develop the mentoring of nurse students and to train more competent mentors in the coming years. It is important to point out that mentoring has multiple benefits for the mentor, the student, the work community, and the health care organization as well as for nursing education. Research in these areas is important when developing mentoring nationwide. Keywords: education, Kazakhstan, mentor, mentoring, nurses, students, nursing.
Evaluation of the effectiveness of research and innovative activities of medical universities and research organizations of the Republic of Kazakhstan
Authors:   Republican Center for Healthcare Development, Koikov Vitaliy , Akanov Amangali ,   Republican Center for Healthcare Development, Abduazhitova Assel ,   Republican Center for Healthcare Development, Aubakirova Alma ,   Republican Center for Healthcare Development, Otargalieva Dinara ,   Republican Center for Healthcare Development, Otargalieva Dinara ,   Republican Center for Healthcare Development
Published: December 2021

Despite the existing achievements of individual organizations, the effectiveness of the majority of Kazakhstani medical universities and research organizations continues to remain at a low level. By order of the Ministry of Health of the Republic of Kazakhstan dated December 23, 2020 №ҚР DSM-316/2020, the rules for assessing the effectiveness of research and innovative activities (RIA) were approved. As part of the implementation of the new Rules for assessing RIA, we assessed the performance of RIA of medical universities and reaearch organizations of the Republic of Kazakhstan for 2020, as well as an assessment of the dynamics of key indicators of RIA for the period from 2018 to 2020. When evaluating RIA of medical universities and resraerch organizations, the following key indicators were taken into account: The volume of profit from scientific research, The number of publications in the Web of Science (WoS), Scopus, Springer, Citation of scientific works, The number of patents and other titles of protection (in which, as a patent holder the organization itself is indicated), The level of commercialization of the RIA results, The level of participation in international conferences and forums. The assessment of the effectiveness of the RIA of Kazakhstani medical universities, research organizations over the past 3 years has revealed such positive aspects as an increase in the number of articles published annually in scientific journals indexed in authoritative databases by 44.4%, an increase in the share of publications of Kazakhstani authors in high-ranking journals (Q1-Q2) from 25.6% to 48.8%, an increase in the share of employees with the Hirsch index according to WoS / Scopus - from 7.7% to 10.2%, an increase in the average Hirsch index according to WoS / Scopus - from 0.15 to 0.18, an increase in the patent activity medical universities and research organizations - by 17.8%, an increase in the volume of profit received annually from the commercialization of research results - by 99.7%. On the other hand, there is a low activity of a fairly large share of domestic medical universities and research organizations in the field of science in terms of individual indicators. Taking into account the results of the study, further steps were proposed for the development of medical science in the Republic of Kazakhstan, as well as measures, the implementation of which is required at the level of medical universities and research organizations. Keywords: scientific and innovative activities, indicators of science, rating, medical science
Pharmacoeconomic Analysis of Influenza Vaccine Prophylaxis Using Trivalent Vaccine in the Conditions of Healthcare in Kazakhstan
Authors:   United Nations Development Programme, Gaitova Kamila , Tamabekov Yersultan ,   KazDream Technologies, Tabarov Adlet ,   Republican Center for Health Development, Zholdassоv Zaid ,   Republican Center for Health Development, Beisakhmetov Yerkanat ,   Republican Center for Health Development, Salpynov Zhandos ,   Republican Center for Health Development, Zhussupova Anara ,   Republican Center for Health Development
Published: December 2021

The primary purpose: To assess the clinical and economic effectiveness of influenza vaccination with population coverage of 40% compared with the absence of vaccination and at 10% current coverage in the health system of the Republic of Kazakhstan. The secondary purpose: To carry out an assessment of clinical and economic effectiveness of influenza vaccination in schoolaged children compared with the absence of vaccination Methods. A decision-making model was developed to assess the economic and clinical effectiveness of influenza vaccination in children and adults. Pharmacoeconomic analysis of influenza vaccine prophylaxis with the use of the trivalent vaccine Grippol® plus in the healthcare environment of Kazakhstan. The creation of the model was based on the description of the influenza progression in vaccinated and unvaccinated children and adults depending on the possible variants of its progression. In addition, to calculate QALY loss, the effect of disease on a patient’s quality of life was taken into account. Results. According to the budget impact analysis results, if school-aged children are vaccinated with coverage of 80%, the total cost stands at 7 140 383 360.87 tenges. In the case of refusal of vaccination among school – aged children, the total treatment costs for children with influenza will account for 8 589 133 135,95 tenges, with expenditures increased by 1 448 749 775,08 tenges. If adults (18 years of age and older) are vaccinated and 10% of the population is covered by immunization, the total cost will be 27 791 126 613.76 and 26 848 387 939.88 tenges, respectively. In the case of non-vaccination in adults, the total costs for the treatment of influenza will be 28 105 372 838,39 tenges, which is higher by 314 246 224,63 tenges than in the case of the population’s vaccination coverage of 10%, and by 1 256 984 898,51 tenges with vaccination coverage of 40%. Conclusion. In general, children and adults’ vaccination is not only a cost-effective but also a cost-saving method of preventing influenza in the health care system of Kazakhstan. Keywords: influenza vaccines, vaccination, clinical effectiveness, cost-effectiveness, cost-utility, children, adults
Risk Identification System Based on an Incident Report in a Healthcare Organization
Authors:   National Center for Neurosurgery JSC, Alzhaxina Gaukhar , Kurenkeyeva Gulnar ,   Business Almaty Management University
Published: December 2021

The aim: To assess the risk identification system based on the incident report, the existing incident reporting system, and factors affecting the structure of incidents in the healthcare organization. Methods. Within the framework of this study, personnel were questioned on the knowledge and use of the incident reporting system related to the provision of medical treatment and care. To collect primary information, a questionnaire was developed, statistical processing of the research results was carried out by the method of calculating the relative risk (RR) using the Stat Tech program, on the website "Medical statistics". Results. All employees (100%) are aware of the incident reporting system. Personnel were more likely to use the incident reporting system as a way to deal with business and organizational issues. The knowledge of events that must be reported were rated equally by the doctors and the nurse (70%; RR - 1.0; C1 0.83 - 1.19). The nurse was more afraid of criticism than doctors (56% versus 66%; RR - 1.18; CI 95%; C1 0.94 - 1.47). Doctors rated the priority of filling out a report lower than a nurse (52% versus 58%; RR - 0.89; CI 95%; C1 0.69 - 1.15). The value and convenience of filling out the report were assessed by the doctors and the nurse equally (64%; RR - 1.0; CI 95%; C1 0.82 - 1.23). Conclusion. Medical personnel have a positive view of the incident reporting system, however, lack of knowledge of specific reported events, poor safety culture, and lack of feedback are the main factors hindering the effectiveness of the system. Developing a list of specific health care events to be reported will enhance the effectiveness of incident reporting as a risk management tool. Keywords: healthcare system, risk management, patient safety, incident, incident report.
Analysis of the Current Situation after the Introduction of Compulsory Social Health Insurance System іn Kazakhstan
Authors:   Non-Profit Joint Stock Company ", Umertayev Azamat ,   Social Health Insurance Fund", Kurenkeyeva Gulnar ,   Business Almaty Management University
Published: December 2021

The aim of the study: To assess the current state, the balance of functions and development trends of Social Health Insurance Fund NJSC. Methods. In order to study the level of awareness of the population about the implementation of the compulsory social health insurance system (CSHI), a mass survey was conducted twice during 2019 (in May and September) with a total sample of 2,150 respondents, including all regions of Kazakhstan. Also, within the framework of the study, such indicators of the activity of the Social Health Insurance Fund as the availability of funding for 2019-2020, the amount of funding by service providers, and coverage of the population were analyzed. Results. There is a positive trend in the compulsory health insurance system: awareness of the population is growing; the population positively assesses the changes in the provision of health services; there is a twofold increase in PHC visits; the share of private spending on health is twice the ceiling recommended by WHO; the level of coverage of the population with the compulsory health insurance system is quite high - 84%. However, about 3 million of the country's citizens remain uncovered. Conclusions. It is necessary to create a system for monitoring the effectiveness of the implementation of compulsory health insurance on the basis of information systems with the further adoption of managerial decisions both at the regional level and at the republican level. The introduction of mechanisms for proactive monitoring of the quality of medical care will protect the rights of patients, as well as improve feedback with them. Key words: Compulsory social health insurance, Medical services, Health care financing, Kazakhstan
Optimization of the Provided Medical Services in а Medical Organization
Authors:   e Shymkent city multidisciplinary hospital, Zhakibaev Askhat , Beisbekova Arailym ,   Kazakh National medical University named after S.Zh. Asfendiyarov
Published: December 2021

The aim: To develop recommendations aimed at optimizing the work of the Shymkent city multidisciplinary hospital by studying the main performance indicators. Methods.The research was carried out according to the traditional scheme and included the classical stages: drawing up a plan and program, collecting material, processing and analyzing it. Results. To improve the quality of medical care, targeted measures are being implemented. Thus, the design capacity of Primary Healthcare: polyclinic – 500 people per shift, actual attendance – 703 people per shift. The hospital has 330 beds. However, the rate of bed coverage per 10 000 people is low at 28.4. The overall incidence has decreased, and in 2019 it was 75 652. It was found that the number of visits to doctors has increased, thus, this figure in 2019 reached 66.5%. It was found that the volume of provision of free medicines increased and reached 47 420. The indicator of provision with medical technical means as a whole also increased and amounted to 82%. Conclusions. A set of measures aimed at improving the hospital's activities using the existing organizational structure will allow us to respond in a timely manner to changes in all areas of the hospital's activities, and the KPI system will help assess the effectiveness of managerial actions in the field of quality management to improve the quality of medical care and improve the weaknesses of healthcare facilities. Keywords: medical organization, medical care, KPI system.
The Improvement of Approaches to the Creating of the National Health Accounts in Connection with the Spread of COVID-19
Authors:   Republican Center for Healthcare Development, Zabirova Elmira
Published: December 2021

Currently, National Health Accounts specialists are facing the problem of attributing new cost items related to the treatment and prevention of the spread of SARS-CoV-2 coronavirus infection. The current international methodology developed in 2011 by OECD, WHO, and EuroStat specialists "A System of Health Accounts 2011" does not provide approaches to the attribution of health care costs aimed at preventing the pandemic. In this regard, there is an urgent need to review the basic approaches to the formation of costs in the Methodology and the construction of the National Health Accounts for 2021 already taking into account these costs. This article provides ways to address this problem and suggestions for including costs associated with treating and preventing the spread of coronavirus in the structure tables of the National Health Accounts. Keywords: National Health Accounts, pandemic, COVID-19
Overview of factors affecting the psychoemotional status of medical workers in the context of COVID-19
Authors:   Astana Medical University, Akhmediyarova Nargiz , Orazova Galiya ,   Astana Medical University, Suleymenova Roza , Amirseitova Farida , Gudym Yelena
Published: December 2021

During the COVID-19 pandemic, the main blow fell on medical institutions and medical workers working in them. Medical institutions (Healthcare facilities) are being rapidly restructured, and industry specialists are working in conditions that practically correspond to emergency situations. The manuscript examines the results of a study of the psychoemotional state of medical workers during the covid-19 pandemic and analyzes the socio-demographic, professional, organizational, psychological and psychosocial factors affecting their psychoemotional health. In general, the high intensity of symptoms of psychoemotional stress in medical workers working in conditions of a serious epidemic was more often observed in women compared to men, and in nurses compared to other categories of medical workers. It is noteworthy that there are few studies to assess the psychoemotional state of junior medical workers.
Pharmacoeconomic Analysis of Use of Parenteral Nutrition Medications in Kazakhstan's Health System’s Conditions
Authors: Zagidullina Galina , Zhussupova Anar , Zholdassоv Zaid , Tabarov Adlet , Salpynov Zhandos
Published: December 2021

Objective: To study the clinical effectiveness, safety, and cost-effectiveness of parenteral nutrition medications. Methods. A modelling and a cost-effectiveness assessment were applied concerning the use of the NuTRIflex Lipid group medications. A comparative analysis of the parenteral nutrition medications’ effectiveness was performed, using cost-minimization, missed opportunities and budget impact analyses. The analysis was carried out by modelling in MS Excel Software. Results. The cost-minimization analysis demonstrated that NuTRIflex medications (NuTRIflex Lipid plus, NuTRIflex Lipid Special) were the least expensive options of parenteral nutrition for a minimum level of a daily dose’s cost as well as for a minimum level of costs for side-effects elimination. Based on the results of the missed opportunities analysis, the use of NuTRIflex Lipid peri medication will provide 55.8% (without side effects consideration) and 85.4% (with side effects consideration) more patients with parenteral nutrition, than that of Oliclinomel N4-550 E. From a payer’s perspective in the healthcare system, the budget impact analysis showed that the use of NuTRIflex Lipid peri will save costs equaling to 2.1 billion tenge versus Oliclinomel N4-550 E (on the assumption that side effects take place). Conclusion. It is impossible to make a definite conclusion on the superiority of NuTRIflex Lipid’s clinical effectiveness and safety over Oliclinomel and vice versa, since there are no direct comparative studies, assessing clinical effectiveness and safety in evidence-based medicine databases. More patients will receive parenteral nutrition if the NuTRIflex Lipid medication is used compared with the use of Oliclinomel, and it would be cost-saving from a payer’s perspective in Kazakhstan’s health system.
Analysis of Service Maintenance of Medical Equipment in State Organizations of the Republic of Kazakhstan. Policy Brief
Authors: Tuleubayeva Ainara , Kabykenova Assem
Published: December 2021

This paper presents results of overestimation of service work of medical equipment at the state organizations of the Republic of Kazakhstan. It is typical that official representatives overprice the cost of service work of medical devices, so the service of expensive equipment is carried out by unauthorized suppliers who do not have the necessary knowledge and skills. There is also deficit of financial resources between the actual need and the planned expenditures of budgetary funds for the maintenance of medical devices. There is insufficiently developed practice of training medical personnel on the basis of equipment manufacturers or an institution providing professional training in servicing relevant types of equipment. Due to this reason, there is a lack of engineers servicing medical equipment. The authors proposed recommendations for making changes to the current regulatory legal acts of the Republic of Kazakhstan regarding the scope of service maintenance of medical devices. It is recommended to create a competent center for centrally dealing with the issues of medical equipment breakdowns, as well as Implementation of a computerized maintenance management system (CMMS) for medical equipment
Applicability of the Clinical Care Classification in the Electronic Document Management of Nursing Staff to Improve the Efficiency of Medical Services in the Health System of the Republic of Kazakhstan: Policy Brief
Authors:   Republican Center for health development, Sarsembaikyzy Gulbanu , Tyulyubayeva Zhanar ,   Republican Center for health development
Published: December 2021

Currently, the nursing process is at the core of nursing education and practice, creating a scientific base for nursing care. The nursing process is one of the basic and integral concepts of the modern model of nursing service. This concept was given birth in the United States in the mid-50s and over the years of testing in clinical settings has proved its feasibility. In the health system, the professional group of secondary medical personnel is the most numerous and has a significant impact on ensuring the quality, availability of medical care, and efficiency of the entire system. Over the years, nurses from different countries have sought to gain recognition for their profession. The main goal was to establish the boundaries of their professional activities, the differences between medical and nursing duties, to create a terminological and conceptual apparatus of the profession and to determine the scientific method of providing nursing care to patients (clients). One of the most relevant areas of healthcare reforms in Kazakhstan is the development and expansion of the functions of nursing staff, including the maintenance of nursing documentation, the establishment of a nursing diagnosis, monitoring and management of patients, etc. What is the problem? 1. Lack of a single terminological and conceptual apparatus for all nurses; 2. Workload of general practitioners; 3. Implementation of patient attendance by nurses under the doctor's login; 4. Lack of payment to nurses for services rendered; 5. In appreciation of the role of the average medical worker in the treatment process; 6. Low potential in the nursing service. Policy options Scenario 1. Institutionalization of CCC in the health system of the Republic of Kazakhstan through the gradual introduction into information systems of the international classification of nursing diagnoses and nursing interventions in the practice of secondary medical workers. Scenario 2. Interaction of vertical links in the implementation of the CCC by making appropriate changes to regulatory legal acts. Scenario 3. Financing of nursing services by including nursing services in the medical services tariff. The vision for the implementation of the scenarios/policy options. Each of these policy options can contribute to improving the efficiency of providing medical care to the population, the status of secondary medical personnel, and the development of their critical thinking. However, given the different options in the direction of actions, resources and methods used, these policy options can provide a more significant achievement of the goal in improving the quality and effectiveness of introduction when they are implemented in association.
BİYOTEKNOLOJİK BULUŞLARIN PATENTLENMESİ
Authors: ZORLUOĞLU YILMAZ Ayça
Published: December 2021

Teknolojinin hızlı ilerlemesi sonucu biyoteknoloji alanındaki baş döndürücü gelişmeler yaşanmaktadır. Bu gelişmeler, pek çok hukuki düzenlemeyi gerektirdiği gibi aynı zamanda da kamu düzeni ve ahlak kuralları ile ilgili tartışmalara da yol açmaktadır. Uzun yıllardır süren biyoteknolojik buluşun patentlenebilirliği sorunu, COVID 19 pandemisi ile birlikte daha da hararetli bir hale gelmiştir. COVID 19 pandemisinin dünya genelinde yarattığı yıkıcı sonuçlar üzerine acil aşı ve ilaç geliştirme çalışmalarına başlanmıştır. Yeni teknikler kullanılarak geliştirilen bu modern aşılar, biyoteknolojik buluşların bir sonucudur ve patent koruması altındadır. Gelişmekte olan veya az gelişmiş ülkelere aşının yeterli seviyede ulaştırılamaması, bu buluşa ilişkin patent korumasının kaldırılması talebine yol açmıştır. Fakat güvenilir bir aşının geliştirilmesi ve üretimi süreci son derece masraflıdır. Biyoteknolojik buluşlar yalnızca aşılar ile de sınırlı değildir, başlıca kullanım alanları; sağlık sektörü, tarım, hayvancılık ve gıda sanayidir. Biyoteknolojik buluşlar, canlı organizmaların oluşumu ve gelişimi ile ilgili olduğundan beraberinde pek çok etik endişeyi de taşımaktadır. Tüm bu tartışmalar, biyoteknolojik buluşların patentlenmesi şartlarının ve patentlenebilirliğin istisnalarının değerlendirilmesi gerekliliğini ortaya koymaktadır.
Mediated Communication and Customer Service Experiences
Authors: Mays Kate K. , Katz James E. , Groshek Jacob
Published: December 2021

People around the world who seek to interact with large organisations increasingly find they must do so via mediated and automated communication. Organisations often deploy both mediated and automated platforms, such as instant messaging and interactive voice response systems (IVRs), for efficiency and cost-savings. Customer and client responses to these systems range from delight to frustration. To better understand the factors affecting people's satisfaction with these systems, we conducted a representative U.S. national survey (N = 1321). We found that people overwhelmingly like and trust in-person customer service compared to mediated and automated modalities. As to demographic attitude predictors, age was important (older respondents liked mediated systems less), but income and education were not strong attitude predictors. For personality variables, innovativeness was positively associated with mediated system satisfaction. However, communication apprehensiveness, which we expected to be related to satisfaction, was not. We conclude by discussing implications for the burgeoning field of human-machine communication, as well as social policy, equity, and the pullulating digital services divide.
An introduction to the International Psychotherapy Institute’s adult psychotherapy programme in China
Authors: Seim Kelly
Published: December 2021

In response to an invitation from the Chinese mental health platform, Jiandanxinli, and its CEO Li Zhen, the International Psychotherapy Institute developed and implemented a two-year training programme, “Object relations psychoanalytic psychotherapy” to be held on-site in Beijing, and online weekly. This contribution begins with an example of the teaching intrinsic to the programme, and then describes the programme itself.
Design and implementation of the child and adolescent psychoanalytic psychotherapy training programme by the International Psychotherapy Institute for Jiandanxinli
Authors: Savege Scharff Jill
Published: December 2021

The author describes how her interest in China and Chinese families led her to direct an online two-year programme for training Chinese therapists in child and adolescent psychoanalytic psychotherapy. She sets her work in its social and professional context. She outlines the design and discusses modification in teaching technique to suit this educational setting, in which time must be allowed for translation from English to Chinese, and from conscious to unconscious. She illustrates a clinical case consultation group to show the group mind at work, and concludes with oral and written evaluation from participants.
ORGANIZATIONAL IDENTITY AND EFFECTIVENESS OF PUBLIC AND PRIVATE SENIOR SECONDARY SCHOOLS IN SOUTH WEST NIGERIA
Authors: Abari Ayodeji Olasunkanmi , Babatunde Mohammed Mubashir Olayiwola , Oyetola Idowu Olufunke
Published: December 2021

The study investigated the relationship between Organizational Identity and Public and Private Senior Secondary School Effectiveness in South West Nigeria. To put the study on course, three hypotheses were formulated. In the same vein, three separate instruments were designed and constructed to collect pertinent data namely the School Identity Questionnaire (SIQ), the School Effectiveness Questionnaire (SEQ) and Performance Records of Students in West African Senior Secondary Certificate Examination (WASSCE). While the first instrument measured identity, the other two simultaneously measured effectiveness. There was a total sample of 2,400 students from 120 sample schools at 20 students per 20 schools in each of the six South West States – Ekiti, Lagos, Ogun, Ondo, Osun and Oyo. Also, a total of 120 principals participated in the study. The Questionnaires were subjected to content and construct validity as well as split-half reliability test. The reliability coefficient for the SIQ was found to be 0.86 and for the SEQ was 0.90. The data were subjected to descriptive and inferential statistical analysis employing the Pearson’s Product-Moment Correlation Coefficient Analysis to test Hypotheses 1and 2, and the Analysis of Variance to test Hypothesis 3. Results of the analysis indicate that there is no significant relationship between organizational identity and school effectiveness in the two categories of schools separately, public and private. However, a significant relationship was found to exist between organizational identity and school effectiveness in private schools only when WASSCE Results were used as a measure of effectiveness. Results also show that a significant difference exists in organizational identity and school effectiveness between public and private senior secondary schools irrespective of the instrument used in measuring effectiveness. Recommendations were then made, in the light of the results, among which are that some degree of autonomy should be given to senior secondary schools for them to grow and develop their identity and effectiveness and, that the identity and effectiveness should regularly be monitored and measured for school improvement purposes.
Key words: organizational identity, secondary school, school effectiveness.
Importance of Differential Diagnosis of a Possible Brain Tumor in Patients with Cervical Radiculopathy
Authors: So Jin-Shup , Kim Young-Jin , Lee Sang-Koo , Cho Chun-Sung
Published: December 2021

Lesions occurring simultaneously in the somatosensory or motor cortex of the brain and the cervical spine are rare. Brain tumors can cause similar symptoms to cervical lesions which can lead to confusion in treatment priorities. Moreover, if cervical disease is noticeably observed in radiologic findings of a patient complaining of cervical radiculopathy with non-specific electromyography results, it is common to no longer perform further evaluation. Here we introduce two cases where the cause of cervical radiculopathy was first considered to be the result of a degenerative cervical disease but was later discovered to be a result of a brain tumor.
Motivation Factors for Elementary School Students
Authors: Pongračić Luka , Lazić Hasanagić Dea , Tadić Komadina Ljiljana
Published: December 2021

It is not hard to recognise motivated student. He is interested, curious, active, enthusiastic and does not give up when encounters difficulties, but thinks for further education. Motivation during schooling is highly related to a student’s later academic achievement and it is therefore very important to encourage it. This paper discusses the motivation factors and affective component for elementary school students. The empirical research has been carried out through a questionnaire based on the instrument Motivated Strategies for Learning Questionnaire (MSLQ) designed and adjusted for researching intrinsic goal orientation, extrinsic goal orientation and anxiety of Croatian elementary school students (1st – 4th grade). The sample of this research consisted of 311 primary school students from rural (N = 103) and urban (N = 208) primary schools. The research was conducted during 2019 in several Croatian counties. The aim of the paper is to determine levels of three motivation factors: intrinsic goal orientation, extrinsic goal orientation and anxiety as an important predictor of future academic success. Secondary goal is to determine differences according to gender, age and the living environment of students. The results had shown that the overall level of motivation of the participants is high from which it is evident that students are highly motivated to work, especially female students. The results also show high level of intrinsic goal orientation, higher level of extrinsic goal orientation and test anxiety comparing to Duncan et. al. (2015) results.
Iodine Deficiency and Pregnancy
Authors:   Postgraduate Institute for Public Health Workers under Health Ministry of Khabarovsk Krai, Vitko L.G. , Vitko N.Yu.
Published: December 2021

Iodine deficiency is a topical health problem in many countries, including Russia. Iodine deficiency is especially adverse during intrauterine development and the first years of life. This necessitates adequate replenishment of iodine deficiency during planning and during pregnancy and breastfeeding
Local antibiotic therapy for endoprosthesis site infection (Literature review)
Authors:   Kazan State Medical University of the Ministry of Health of the Russian Federation, Kilmetov T.A. , Akhtyamov I.F. ,   Kazan State Medical University of the Ministry of Health of the Russian Federation
Published: December 2021

Endoprosthetics of joints has firmly taken its place in a number of orthopedic interventions in the treatment of diseases of the musculoskeletal system. Unfortu-nately, with an increase in the number of operations, the number of complications that develop at various stages of treatment does not decrease. Deep infections in the area of the endoprosthesis (paraprosthetic infection) are especially difficult in treatment, since only 20% of patients, and mainly in early forms of complications, manage to save the implant. The incidence of infectious complications at the stationary stage in specialized endoprosthetics centers does not exceed 1% during primary operations, but their number, as a rule, multiplies several years after the intervention. The most common treatment option for paraprosthetic infection is staged revision arthroplasty. The authors of the review conduct a comparative analysis of the effectiveness of one- and two-stage treatment options. The latter is based on the use of bone cement spacers impregnated with antibiotics.
Risk Factors and Prevention Measures for Postoperative Sternomediastinitis (Literature Review)
Authors:   Postgraduate Institute for Public Health Workers under Health Ministry of Khabarovsk Krai, Shevchenko A.A. , Zhila N.G. ,   St. Petersburg State Pediatric Medical University of the Ministry of Health of Russia, Kashkarov E.A. ,   Khabarovsk Krai Clinical Hospital  No.1 named after professor S.I. Sergeev under Health Ministry of Khabarovsk Krai, Shevchenko K.S. ,   The Tuberculosis Hospital under Health Ministry of Khabarovsk Krai, Kashkarova A.E. ,   Khabarovsk Krai Clinical Hospital named after A.K. Piotrovich under Health Ministry of Khabarovsk Krai
Published: December 2021

Median sternotomy remains the most common access in cardiac surgery, while postoperative sternomediastinitis is one of the most severe complications of the transsternal approach. The article analyzes the preoperative risk factors for the development of this complication, including concomitant pathology, constitutional features, bad habits, length of hospital stay, and the urgency of the operation. It was also noted that intraoperative risk factors consist of technical errors in the performance of the operation, intraoperative features of the course of surgery, the nature of the choice of the shunt during myocardial vascularization and the final stage of the operation. Postoperative risk factors include the specific management of the postoperative period in cardiac surgery patients, which can lead to the development of sternomediastinitis. The analysis of measures taken by cardiac surgeons to prevent the development of this complication was carried out
Effect of drying temperature on physical properties of fermented dried locust bean flour
Authors:   Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria., D. O Idowu , J. A. Olaniran ,   Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria., T. B. Onifade ,   Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
Published: December 2021

Drying plays a major role in food processing as it reduces the activities of micro-organisms and hence preserve food from deterioration. It has been reported that drying imposes new changes to the physical properties of the product which may in turn affect its handling, packaging and usability. The present research work, therefore aimed to evaluate the effect different drying temperature on physical properties of fermented dried locust bean flour. The local fermented locust bean was dried at different temperature of 50, 60, 70, 80 and 90°C at airflow rate of 1.8 kg/min. then milled and Investigated on final moisture content, bulk density, water retention ratio, flour wetting time, and swelling capacity of the fermented dried locust bean flour. The effect of drying temperature was found to be significant (p ≤ 0.05) on all the physical properties investigated except bulky density (0.638 g/ml). As the drying temperature increased from 50 to 90°C, final moisture content decreased significantly from 5.62 to 3.52%. Whereas, water retention ratio, wetting time, swelling capacity, porosity ratio and water retention ratio increase from 1.96 to 2.5 m/g, 153 to 299 s, 2.26 to 2.44, 0.81 to 0.91 and 1.96 to 2.5 m/g respectively. These findings could prove useful in the modeling of locust bean drying and to flour millers and pelletizer who may want to use locust bean flour as a sole or composite flour for different production and application. Keywords: Fermented locust bean flour, physical properties, modeling, pelletizer, miller, drying temperature, final moisture content.