bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urban–sub-urban–rural variation in the supply and demand of emergency medical services
Authors: Li Yue , Li Ji , Geng Jiayu , Liu Tao , Liu Xin , Fan Haojun , Cao Chunxia 
Published: January 2023

BackgroundEmergency medical services (EMSs) are a critical component of health systems, often serving as the first point of contact for patients. Understanding EMS supply and demand is necessary to meet growing demand and improve service quality. Nevertheless, it remains unclear whether the EMS supply matches the demand after the 2016 healthcare reform in China. Our objective was to comprehensively investigate EMS supply–demand matching, particularly among urban vs. sub-urban vs. rural areas.MethodsData were extracted from the Tianjin Medical Priority Dispatch System (2017–2021). From supply and demand perspectives, EMS resources and patient characteristics were analyzed. First, we performed a descriptive analysis of characteristics, used Moran's I to explore the spatial layout, and used the Gini coefficient to evaluate the equity of EMS supply and demand. Second, we analyzed urban–sub-urban–rural variation in the characteristics of EMS supply and demand by using the chi-square test. Finally, we examined the association between the EMS health resource density index and the number of patients by using the Spearman correlation and divided supply–demand matching types into four types.ResultsIn 2021, the numbers of medical emergency stations and ambulances were 1.602 and 3.270 per 100,000 population in Tianjin, respectively. There were gradients in the health resource density index of the number of emergency stations (0.260 vs. 0.059 vs. 0.036; P = 0.000) in urban, sub-urban, and rural areas. There was no spatial autocorrelation among medical emergency stations, of which the G values by population, geographical distribution, and the health resource density index were 0.132, 0.649, and 0.473, respectively. EMS demand was the highest in urban areas, followed by sub-urban and rural areas (24.671 vs. 15.081 vs. 3.210 per 1,000 population and per year; P = 0.000). The EMS supply met the demand in most districts (r = 0.701, P = 0.003). The high supply–high demand types with stationary demand trends were distributed in urban areas; the low supply–high demand types with significant demand growth trends were distributed in sub-urban areas; and the low supply–low demand types with the highest speed of demand growth were distributed in rural areas.ConclusionEMS supply quantity and quality were promoted, and the supply met the demand after the 2016 healthcare reform in Tianjin. There was urban–sub-urban–rural variation in EMS supply and demand patterns.
The association of park use and park perception with quality of life using structural equation modeling
Authors: Kodali Hanish P. , Ferris Emily B. , Wyka Katarzyna , Evenson Kelly R. , Dorn Joan M. , Thorpe Lorna E. , Huang Terry T.-K. 
Published: January 2023

IntroductionThe literature is limited on the impact of neighborhood parks on quality of life (QoL) and the mechanism linking them.MethodsIn this paper, we applied the structural equation model to data from a cross-sectional sample of 650 participants in low-income communities of New York City, we examined the associations of neighborhood park use vs. park perception and QoL, and whether these associations were mediated through self-reported perceived stress. We also examined whether park use mediated the relationship between park perception and QoL.ResultsWe found that park use had a significant but weak association with QoL (standardized β = 0.08, 95% confidence interval (CI): 0.02, 0.15, p = 0.02), but this relationship was not mediated by self-reported stress. Park perception was more strongly associated with QoL than park use (standardized β = 0.23, 95% CI: 0.16, 0.30, p &lt; 0.01), and this was partly mediated by self-reported stress (indirect effect- standardized β = 0.08, 95% CI: 0.03, 0.13, p &lt; 0.01) and, to a lesser extent, by park use (indirect effect- standardized β = 0.01, 95% CI: 0.00, 0.02, p = 0.01).DiscussionHaving well-perceived parks appears to be an important factor for QoL independent of park use, suggesting that quality parks may benefit everyone in a community beyond park users. This strengthens the argument in favor of increasing park investment as a strategy to improve population wellbeing.
Building back better children's surgical services toward universal health coverage: Perspectives from Bangladesh and Zimbabwe
Authors: Mazingi Dennis , Chowdhury Tanvir Kabir , Aziz Tasmiah Tahera , Tamanna Nowrin , Lakhoo Kokila , Banu Tahmina , Mustafa Saqif 
Published: January 2023

IntroductionThis article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’. Children's surgical services are crucial, yet underappreciated, for children's health and must be sufficiently addressed to make and sustain progress toward universal health coverage (UHC). Despite their considerable burden and socioeconomic cost, surgical diseases have been relatively neglected in favor of communicable diseases living up to their inauspicious moniker: ‘the neglected stepchild of global health'. This article aims to raise awareness around children's surgical diseases and offers perspectives from two prototypical LMICs on strengthening surgical services in the context of health systems recovery following the COVID-19 experience to make and sustain progress toward UHC.ApproachWe used a focused literature review supplemented by the perspectives of local experts and the 6-components framework for surgical systems planning to present two case studies of Bangladesh and Zimbabwe. The lived experiences of the authors are used to describe the impact of COVID-19 on respective surgical systems and offer perspectives on building back the health system and recovering essential health services for sustainability and resilience.FindingsWe found that limited high-level policy and planning instruments, an overburdened and under-resourced health and allied workforce, underdeveloped surgical infrastructure (from key utilities to essential medical products), lack of locally generated research, and the specter of prohibitively high out-of-pocket costs for children's surgery are common challenges in both countries that have been exacerbated by the COVID-19 pandemic.DiscussionContinued chronic underinvestment and inattention to children's surgical diseases coupled with the devastating effect of the COVID-19 pandemic threaten progress toward key global health objectives. Urgent attention and investment in the context of health systems recovery is needed from policy to practice levels to improve infrastructure; attract, retain and train the surgical and allied health workforce; and improve service delivery access with equity considerations to meet the 2030 Lancet Commission goals, and make and sustain progress toward UHC and the SDGs.
Transmission of tuberculosis in an incarcerated population during the subclinical period: A cross-sectional study in Qingdao, China
Authors: Wang Zhongdong , Li Haoran , Song Song , Sun Haiyan , Dai Xiaoqi , Chen Meng , Xu Honghong , Zhang Huaqiang , Pang Yu 
Published: January 2023

ObjectivesAs a closed gathering place, prison is the cradle of tuberculosis (TB) outbreak. Therefore, the analysis of the prevalence rate and risk factors of latent tuberculosis infection (LTBI) in prison will be a necessary measure to intervene in the spread of tuberculosis.MethodsIn this study, we consecutively recruited 506 adult prisoners in Qingdao to carry out this cross-sectional study. TB and LTBI were screened by IGRA, X-ray, X-pert, sputum smear and culture.ResultsA total of 17 TB, 101 LTBI and 388 HC were identified, with an infection rate of 23.32% (118/506) and a TB incidence rate of 3282/100,000 population. Age, malnutrition and inmates living with TB prisoners were risk factors for LTBI. Additionally, most TB cases (70.59%, 12/17) were subclinical tuberculosis (STB), contributing significantly to TB transmission.ConclusionOur results demonstrate that the transmission efficiency of asymptomatic patients is not essentially different from that of symptomatic patients, indicating that TB transmission occurs during the subclinical period. Our findings highlight the need to strengthen active case-finding strategies to increase TB case detection in this population.
Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia
Authors: Nemcikova Marta , Katreniakova Zuzana , Nagyova Iveta 
Published: January 2023

IntroductionDementia is currently one of the major causes of disability and dependency among older adults worldwide. Cognitive dysfunction, neuropsychiatric symptoms, somatic complaints, and functional impairment fundamentally affect not only a person living with dementia (PLwD), but also his/her informal caregiver(s), often resulting in a high caregiver burden. A number of variables, including the caregiver's sociodemographic characteristics, the clinical characteristics of PLwD, social support, and the caregiver's personal resources determine the caregiver's burden.ObjectivesThe aim of this study was to investigate the associations of caregiver burden in informal caregivers of PLwD with perceived social support, positive caregiving experience, and applying therapeutic communication methods.MethodsThe data were collected from September 2021 to February 2022 among 115 “PLwD—informal caregiver” dyads in the community settings in Slovakia. Measures included the Zarit Burden Interview (ZBI-12), the Oslo Social Support Scale (OSSS-3), the Positive Aspects of Caregiving Scale (PACS), and two questions on applying therapeutic communication methods—reminiscence and validation according to Naomi Feil. The Short IQCODE was used for assessing cognitive decline in PLwD. Pearson's and Spearman's correlations, t-tests, Chi-square, ANOVA, and linear multiple regression analyses were used to analyze the data (IBM SPSS 27).ResultsThe mean age of informal caregivers was 54 ± 12.4 years (81.7% of women) and the mean caregiving duration was 4.8 ± 4.8 years. The mean age of PLwD was 80.5 ± 8.3 years (73.0% of women) and their Short IQCODE mean score was 4.1 ± 1.0. Lower caregiving burden was significantly associated with higher perceived social support (β = 0.33, p &lt; 0.01), with higher positive caregiving experience (β = 0.33, p &lt; 0.01), and higher caregiving intensity (β = 0.24, p &lt; 0.05) among informal caregivers of PLwD. The associations between caregiver burden and applying two therapeutic communication methods were not significant.ConclusionsImplementing psycho-social and educational public health interventions focused on strengthening social support and maintaining positive perceptions of caregiving can help reduce the increased risk of caregiver burden in informal caregivers of older adults with dementia.
Subtle impairments of perceptual-motor function and well-being are detectable among military cadets and college athletes with self-reported history of concussion
Authors: Wilkerson Gary B. , Colston Marisa A. , Acocello Shellie N. , Hogg Jennifer A. , Carlson Lynette M. 
Published: January 2023

IntroductionA lack of obvious long-term effects of concussion on standard clinical measures of behavioral performance capabilities does not preclude the existence of subtle neural processing impairments that appear to be linked to elevated risk for subsequent concussion occurrence, and which may be associated with greater susceptibility to progressive neurodegenerative processes. The purpose of this observational cohort study was to assess virtual reality motor response variability and survey responses as possible indicators of suboptimal brain function among military cadets and college athletes with self-reported history of concussion (HxC).MethodsThe cohort comprised 75 college students (20.7 ± 2.1 years): 39 Reserve Officer Training Corp (ROTC) military cadets (10 female), 16 football players, and 20 wrestlers; HxC self-reported by 20 (29.2 ± 27.1 months prior, range: 3–96). A virtual reality (VR) test involving 40 lunging/reaching responses to horizontally moving dots (filled/congruent: same direction; open/incongruent: opposite direction) was administered, along with the Sport Fitness and Wellness Index (SFWI) survey. VR Dispersion (standard deviation of 12 T-scores for neck, upper extremity, and lower extremity responses to congruent vs. incongruent stimuli originating from central vs. peripheral locations) and SFWI response patterns were the primary outcomes of interest.ResultsLogistic regression modeling of VR Dispersion (range: 1.5–21.8), SFWI (range: 44–100), and an interaction between them provided 81% HxC classification accuracy (Model χ2[2] = 26.03, p &lt; .001; Hosmer &amp; Lemeshow χ2[8] = 1.86, p = .967; Nagelkerke R2 = .427; Area Under Curve = .841, 95% CI: .734, .948). Binary modeling that included VR Dispersion ≥3.2 and SFWI ≤86 demonstrated 75% sensitivity and 86% specificity with both factors positive (Odds Ratio = 17.6, 95% CI: 5.0, 62.1).Discussion/ConclusionDetection of subtle indicators of altered brain processes that might otherwise remain unrecognized is clearly important for both short-term and long-term clinical management of concussion. Inconsistency among neck, upper extremity, and lower extremity responses to different types of moving visual stimuli, along with survey responses suggesting suboptimal well-being, merit further investigation as possible clinical indicators of persisting effects of concussion that might prove to be modifiable.
The Influence of Symbiosis on the Proteome of the Exaiptasia Endosymbiont Breviolum minutum
Authors: Mashini Amirhossein Gheitanchi , Oakley Clinton A. , Beepat Sandeep S. , Peng Lifeng , Grossman Arthur R. , Weis Virginia M. , Davy Simon K. 
Published: January 2023

The cellular mechanisms responsible for the regulation of nutrient exchange, immune response, and symbiont population growth in the cnidarian–dinoflagellate symbiosis are poorly resolved. Here, we employed liquid chromatography–mass spectrometry to elucidate proteomic changes associated with symbiosis in Breviolum minutum, a native symbiont of the sea anemone Exaiptasia diaphana (‘Aiptasia’). We manipulated nutrients available to the algae in culture and to the holobiont in hospite (i.e., in symbiosis) and then monitored the impacts of our treatments on host–endosymbiont interactions. Both the symbiotic and nutritional states had significant impacts on the B. minutum proteome. B. minutum in hospite showed an increased abundance of proteins involved in phosphoinositol metabolism (e.g., glycerophosphoinositol permease 1 and phosphatidylinositol phosphatase) relative to the free-living alga, potentially reflecting inter-partner signalling that promotes the stability of the symbiosis. Proteins potentially involved in concentrating and fixing inorganic carbon (e.g., carbonic anhydrase, V-type ATPase) and in the assimilation of nitrogen (e.g., glutamine synthase) were more abundant in free-living B. minutum than in hospite, possibly due to host-facilitated access to inorganic carbon and nitrogen limitation by the host when in hospite. Photosystem proteins increased in abundance at high nutrient levels irrespective of the symbiotic state, as did proteins involved in antioxidant defences (e.g., superoxide dismutase, glutathione s-transferase). Proteins involved in iron metabolism were also affected by the nutritional state, with an increased iron demand and uptake under low nutrient treatments. These results detail the changes in symbiont physiology in response to the host microenvironment and nutrient availability and indicate potential symbiont-driven mechanisms that regulate the cnidarian–dinoflagellate symbiosis.
Union responses to workforce. Feminization in the United States
Authors: Milkman Ruth 
Published: January 2023

La question de la mixité dans les organisations syndicales américaines.
La féminisation rapide de la force ouvrière aux Etats-Unis dans les dernières décennies a aussi provoqué une féminisation des syndicats : 40% des membres des syndicats américains sont maintenant des femmes, la plupart se trouve dans le secteur public. Ce phénomène est sans précédent dans toute l'histoire américaine. Toutefois, le pourcentage global de la force ouvrière qui est syndiqué est maintenant beaucoup plus faible qu'avant -en 1956, 36% des ouvriers américains (des deux sexes) étaient syndiqués ; en 1991, ce pourcentage était seulement de 16%.
Ici je veux explorer les implications politiques de la féminisation des syndicats et présenter une analyse empirique que j'ai faite des élections syndicales aux Etats-Unis, de la relation entre la composition sexuée de la force de travail et le succès électoral des syndicats. Les résultats de cette analyse indiquent que c'est dans les situations où la force ouvrière est homogène, c'est-à-dire constituée essentiellement de femmes ou essentiellement d’hommes, que les syndicats obtiennent plus fréquemment un succès électoral. Bien sûr, ceci pose des questions.
Par ailleurs, il y a maintenant dans les syndicats une politique nouvelle concernant le genre, sans précédent aux Etats-Unis, et qui prend en compte l'ancienne opposition féministe entre différence et égalité. Les femmes syndicalistes maintenant essaient de négocier cette contradiction quand elles font des revendications spécifiques pour les ouvrières, comme par exemple l'égalité des salaires pour des métiers comparables (pay equity ) le congé maternité, des exigences basées sur le rôle traditionnel féminin mais orientées en même temps vers l'obtention de l'égalité de genre. Ceci semble aussi être un effet de la féminisation des syndicats.
Working class women : psychological and social aspects of survival
Authors: Walkerdine Valerie 
Published: January 2023

Les femmes de la classe ouvrière : survie psychologique et sociale.
Dans ce texte, l’auteur se propose d’étudier certains aspects du discours produit autour des femmes de la classe ouvrière, dans un contexte, la période d’après-guerre, où la notion de classe ouvrière, à la fois surestimée, dénigrée et crainte, pose problème. Dans ces discours et ces pratiques, les femmes ont une place centrale en tant que mères ayant à leur charge la production de citoyens dans un ordre démocratique bourgeois en extension. En effet, le discours de la mobilité sociale, de l’égalité des chances transforme en pathologie tout échec d’entrer dans la classe moyenne définie comme normale. Il s’agit donc de “normaliser” les groupes potentiellement pathologiques et entre autres les mères de la classe ouvrière dont la capacité à exercer la maternité doit être mise sous surveillance. Inadéquates, ne sont-elles pas responsables d’un large éventail de maux sociaux (criminalité, délinquance...) ?
Ce modèle normatif et normalisant, ce nouveau mode de régulation sociale fait l’impasse sur les conséquences de l’oppression, et sur les réalités psychologiques qui découlent de la souffrance vécue, d’une subjectivité construite à travers des “vérités” projetées sur 1’ ’’autre”.
L’auteur a mené une recherche auprès de femmes d’origine ouvrière ayant eu accès à l’Université pour comprendre la spécificité de ce groupe et les mécanismes de défense mis en place pour vivre et survivre l’oppression.
PROBLEMS AND PROSPECTS FOR THE DIGITAL SECTOR OF THE REGIONAL ECONOMY DEVELOPMENT
Authors: Тасуева Т. С. 
Published: January 2023

В научной статье рассмотрены основные тенденции развития цифровой среды региона. Обосновано принципиальное значение цифровизации как фактора конкурентоспособности современной экономики. Особое внимание в работе уделено анализу институциональных и инфраструктурных условий для развития цифрового сектора в экономике региона. По результатам SWOT-анализа выявлены сильные и слабые стороны, возможности и угрозы развития экономики Чеченской Республики. В ходе проведенного исследования определены перспективы развития цифрового сектора экономики региона.
The scientific article considers the main trends in the development of the digital environment of the region. The fundamental importance of digitalization as a factor in the competitiveness of the modern economy is substantiated. Particular attention is paid to the analysis of institutional and infrastructural conditions for the development of the digital sector in the region’s economy. Based on the results of the SWOT analysis, strengths and weaknesses, opportunities and threats to the development of the economy of the Chechen Republic were identified. In the course of the study, the prospects for the development of the digital industry in the region were determined.
ON THE IMPLEMENTATION OF THE STATE PERSONNEL POLICY IN THE HEALTH CARE SYSTEM: DOMESTIC AND FOREIGN EXPERIENCE
Authors: Магомадова Т.Л. 
Published: January 2023

Система современного государственного управления строится на основах оказания услуг населению, в которой отрасль здравоохранения занимает одну из главных позиций в концепции кадрового обеспечения данной сферы. В статье рассматриваются проблемы развития российской системы здравоохранения, также затрагивается ее региональный аспект. Проведена сравнительная характеристика российской системы здравоохранения с системами здравоохранения развитых стран. Проанализировано участие органов государственной власти в обеспечении кадрами лечебно-профилактических учреждений. На основе проведенного анализа выявлены проблемы обеспеченности населения Чеченской Республики врачами и средним медицинским персоналом, оказывающими медицинские услуги, а также обоснована необходимость усиления регулирующей роли государства над качеством оказываемых услуг посредством формирования эффективной государственной кадровой политики.
The system of modern public administration is based on the basics of providing services to the population, in which the healthcare industry occupies one of the main positions in the concept of staffing in this area. The article discusses the problems of the development of the Russian healthcare system, also touches on its regional aspect. A comparative characteristic of the Russian healthcare system with the healthcare systems of developed countries is carried out. The participation of state authorities in providing medical and preventive institutions with personnel is analyzed. Based on the analysis, the problems of providing the population of the Chechen Republic with doctors and secondary medical personnel providing medical services are identified, and the need to strengthen the regulatory role of the state over the quality of services provided through the formation of an effective state personnel policy is substantiated.