integration

Integration
  • 文章类型: Journal Article
    病例概念化是治疗过程成功的核心。然而,整合案例概念化研究落后于整合治疗干预技术的研究。一个成功的案例概念化提供了(A)一个动态的,上下文敏感,然而,客户功能的简约模型;(b)相关治疗目标和相关评估程序;以及(c)包括干预阶段和潜在障碍的治疗计划。案例概念化的成功是临床心理学受训人员的核心临床能力目标,甚至是专业临床医生的职业学习目标。新兴的技术趋势和对抗性协作团队的形成可能有助于研究构建良好的案例概念化的效用。
    Case conceptualization is central to the success of the therapeutic process. However, integrative case conceptualization research has lagged behind research on integrating therapeutic intervention techniques. A successful case conceptualization provides (a) a dynamic, context-sensitive, yet parsimonious model of the client\'s functioning; (b) relevant treatment targets and associated assessment procedures; and (c) a treatment plan including intervention phases and potential obstacles. Success in case conceptualization is a core clinical competency goal for trainees in clinical psychology and a career-long learning goal even for expert clinicians. Emerging technological trends and the formation of adversarial collaborative teams may assist research on the utility of well-constructed case conceptualizations.
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  • 文章类型: Journal Article
    中枢神经系统(CNS)的布鲁氏菌病很少见,经常致命,经常被忽视或误诊。
    2023年4月,济南市疾病预防控制中心通过脑脊液(CSF)培养在一名54岁妇女中发现了一例CNS布鲁氏菌病。在确认布鲁氏菌病的诊断后,济南市疾控中心立即通知山东大学齐鲁医院,病人被转移到那里,她随后被追踪并成功治疗。
    成功的结果可以归因于系统的有效整合,该系统促进了公共卫生服务与临床机构之间的协调和协作行动。
    UNASSIGNED: Brucellosis of the central nervous system (CNS) is rare and frequently fatal, often being overlooked or misdiagnosed.
    UNASSIGNED: In April 2023, the Jinan CDC identified a case of CNS brucellosis in a 54-year-old woman through cerebrospinal fluid (CSF) culture. Upon confirming the diagnosis of brucellosis, the Jinan CDC immediately informed Qilu Hospital of Shandong University, to which the patient had been transferred, and she was subsequently tracked and successfully treated.
    UNASSIGNED: The successful outcome can be attributed to the effective integration of a system that facilitated coordinated and collaborative actions between public health services and clinical institutions.
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  • 文章类型: Journal Article
    高效的信息管理是空间规划项目有效执行的关键,然而,许多人遇到了信息系统和流程脱节带来的障碍。在这篇文章中,作者认为空间规划领域内的信息管理的复杂性,利用多方面的MAKING-CITY项目的见解来阐明共同的挑战并提出创新的解决方案。提出的集成信息管理系统的概念模型提供了一个整体方法,旨在通过将不同的信息组件无缝集成到一个统一的框架中来消除现有信息环境中固有的弱点。通过促进强大的沟通渠道并同步所有项目参与者和利益相关者的行动,这种模式增强了协作,简化工作流程,并促进知情决策。重要的是,开发模型的适应性和多功能性确保了其在各种空间规划计划中的适用性,提供可扩展的解决方案,以满足城市发展项目不断变化的需求。通过对现实世界的挑战和实际解决方案的细致考察,这篇文章有助于推进空间规划中的信息管理实践,为提高效率奠定基础,可持续,和包容性的城市发展过程中的今天的动态景观。
    Efficient information management is pivotal for the effective execution of spatial planning projects, yet many encounter hurdles stemming from disjointed information systems and processes. In this article, authors consider the intricacies of information management within the realm of spatial planning, leveraging insights from the multifaceted MAKING-CITY project to elucidate common challenges and propose innovative solutions. The proposed conceptual model for an integrated information management system offers a holistic approach, aiming to eliminate weaknesses inherent in existing information landscapes by seamlessly integrating diverse information components into a unified framework. By facilitating robust communication channels and synchronizing the actions of all project participants and stakeholders, this model enhances collaboration, streamlines workflows, and fosters informed decision-making. Importantly, the adaptability and versatility of developed model ensure its applicability across various spatial planning initiatives, offering a scalable solution to address the evolving demands of urban development projects. Through a meticulous examination of real-world challenges and practical solutions, this article contributes to the advancement of information management practices in spatial planning, laying the groundwork for more efficient, sustainable, and inclusive urban development processes in today\'s dynamic landscape.
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  • 文章类型: Journal Article
    目的:评估在基于社区的主动病例发现(ACF)期间使用分子和放射筛查工具对TB和COVID-19进行整合检测的诊断产量和可行性。
    方法:使用移动诊所招募了以社区为基础的假定结核病和/或COVID-19患者。参与者同时接受了结核病(痰;Xpert-Ultra)和COVID-19(鼻咽拭子;Xpert-SARS-CoV-2)的现场护理(POC)检测。痰培养和SARS-CoV-2RT-PCR作为参考标准。参与者接受了具有计算机辅助检测(CAD)的超便携式POC胸片摄影。使用涂片显微镜评估TB传染性,咳嗽气溶胶采样研究(CASS),和胸部X光腔检测。通过用户评估评估POC测试的可行性。
    结果:纳入了601名参与者,144/601(24.0%)报告症状提示TB和/或COVID-19。16/144(11.1%)参与者的结核病检测呈阳性,而10/144(6.9%)的COVID-19检测呈阳性(2/144[1.4%]的结核病/COVID-19并发)。7/16(43.8%)的结核病患者可能具有传染性。测试特异性敏感性和特异性(95%CI)为:Xpert-Ultra75.0%(42.8-94.5)和96.9%(92.4-99.2);Xpert-SARS-CoV-266.7%(22.3-95.7)和97.1%(92.7-99.2)。CAD4TB的曲线下面积(AUC)为0.90(0.82-0.97)。用户评估表明POCXpert具有“良好”的用户友好性。
    结论:在基于社区的ACF中使用POC分子和放射学工具整合TB/COVID-19筛查是可行的,有很高的诊断率,并且可以识别可能有传染性的人。
    OBJECTIVE: To evaluate diagnostic yield and feasibility of integrating testing for TB and COVID-19 using molecular and radiological screening tools during community-based active case-finding (ACF).
    METHODS: Community-based participants with presumed TB and/or COVID-19 were recruited using a mobile clinic. Participants underwent simultaneous point-of-care (POC) testing for TB (sputum; Xpert Ultra) and COVID-19 (nasopharyngeal swabs; Xpert SARS-CoV-2). Sputum culture and SARS-CoV-2 RT-PCR served as reference standards. Participants underwent ultra-portable POC chest radiography with computer-aided detection (CAD). TB infectiousness was evaluated using smear microscopy, cough aerosol sampling studies (CASS), and chest radiographic cavity detection. Feasibility of POC testing was evaluated via user-appraisals.
    RESULTS: Six hundred and one participants were enrolled, with 144/601 (24.0%) reporting symptoms suggestive of TB and/or COVID-19. 16/144 (11.1%) participants tested positive for TB, while 10/144 (6.9%) tested positive for COVID-19 (2/144 [1.4%] had concurrent TB/COVID-19). Seven (7/16 [43.8%]) individuals with TB were probably infectious. Test-specific sensitivity and specificity (95% CI) were: Xpert Ultra 75.0% (42.8-94.5) and 96.9% (92.4-99.2); Xpert SARS-CoV-2 66.7% (22.3-95.7) and 97.1% (92.7-99.2). Area under the curve (AUC) for CAD4TB was 0.90 (0.82-0.97). User appraisals indicated POC Xpert to have \'good\' user-friendliness.
    CONCLUSIONS: Integrating TB/COVID-19 screening during community-based ACF using POC molecular and radiological tools is feasible, has a high diagnostic yield, and can identity probably infectious persons.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    背景:使各个部门的交付和融资系统保持一致,以创建更广泛的护理系统,可以改善经历逆境的家庭的健康和福祉。我们旨在确定最佳实践的结构和关系因素,以实现美国家访计划之间的成功跨部门合作。
    方法:我们使用了多案例研究方法来确定最佳实践,以便在家庭访客和其他社区服务提供商之间进行成功的跨部门合作。我们选择了五个不同的示例案例,这些案例具有跨部门合作,执行机构类型和地理位置各不相同。基于与先前调查数据中确定的不同社区服务提供商类型的强大协调和整合,使用积极偏差方法选择了案例。我们对家访人员进行了深入的定性访谈,社区提供者,和客户,从2021年到2022年共进行了76次采访。我们写了备忘录,通过使用访谈数据的数据三角测量来综合每个案例中的主题,文件,和现场访问观察。我们比较了五个案例的主题,以创建成功的跨部门合作的最佳实践的跨案例综合。
    结果:在五个案例中,关系因素,包括各级领导,各行各业的冠军,社区提供者之间的共同目标是成功合作的关键因素。人际关系,再加上参与的愿望和能力,促进有效协调,以满足家庭需求。在结构层面,共享数据系统,书面协议,并在同一地点进行了护理协调活动。社区顾问委员会为发展伙伴关系提供了场所,关系建设,资源共享,和提高家访意识。
    结论:我们在五个案例研究中确定了成功的跨部门合作的关键要素,其中家庭访客经常协调护理和/或与一系列提供商在结构上整合。这些学习将为未来的干预措施提供信息,以改善与其他社区提供者的家访合作,以创建一个护理系统,以增强家庭幸福。
    BACKGROUND: Aligning delivery and financing systems across sectors to create broader systems of care can improve the health and well-being of families experiencing adversities. We aimed to identify structural and relational factors for best practices to achieve successful cross-sector collaboration among home visiting programs in the United States.
    METHODS: We used a multiple case study approach to identify best practices for successful cross-sector collaboration between home visitors and other community service providers. We selected five diverse exemplary cases with cross-sector collaboration with variation in implementing agency type and geographic location. Cases were selected using a positive deviance approach based on strong coordination and integration with different community service provider types identified from previous survey data. We conducted in-depth qualitative interviews with home visiting staff, community providers, and clients with a total of 76 interviews conducted from 2021 to 2022. We wrote memos to synthesize themes within each case through data triangulation using interview data, documents, and site visit observations. We compared themes across the five cases to create a cross-case synthesis of best practices for successful cross-sector collaboration.
    RESULTS: Across the five cases, relational factors including leadership from all levels, champions across sectors, and shared goals between community providers were key factors for successful collaboration. Interpersonal relationships, coupled with the desire and capacity to engage, facilitated effective coordination to address families\' needs. At the structural level, shared data systems, written agreements, and co-location enabled care coordination activities. Community Advisory Boards provided a venue for developing partnerships, relationship-building, resource-sharing, and increasing awareness of home visiting.
    CONCLUSIONS: We identified key elements of successful cross-sector collaboration across five case studies where home visitors coordinate care frequently and/or are structurally integrated with a range of providers. These learnings will inform future interventions to improve home visiting collaboration with other community providers to create a system of care to enhance family well-being.
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  • 文章类型: Journal Article
    背景:下一代测序(NGS)技术的不断发展导致了大规模基因组数据的产生。虽然基因组数据整合和分析的工具变得越来越可用,在许多生物学背景下,概念和分析的复杂性仍然是一个巨大的挑战。
    结果:要解决此问题,我们描述了基因组数据集成最佳实践的六步教程,包括(1)设计数据矩阵;(2)针对数据描述制定特定的生物学问题,选择和预测;(3)选择适合目标问题的工具;(4)对数据进行预处理;(5)进行初步分析,最后(6)执行基因组数据集成。
    结论:本教程已在杨树(PopulusL.)产生的公开基因组数据上进行了测试和演示,木本植物模型.我们还为无监督多块分析开发了一种新的图形输出,cimDiablo_v2,可在https://forgemia获得。inra.fr/umr-gdec/omics-整合在杨树上,并允许在基因组数据变异和相互作用中选择主驱动因素。
    BACKGROUND: The ongoing evolution of the Next Generation Sequencing (NGS) technologies has led to the production of genomic data on a massive scale. While tools for genomic data integration and analysis are becoming increasingly available, the conceptual and analytical complexities still represent a great challenge in many biological contexts.
    RESULTS: To address this issue, we describe a six-steps tutorial for the best practices in genomic data integration, consisting of (1) designing a data matrix; (2) formulating a specific biological question toward data description, selection and prediction; (3) selecting a tool adapted to the targeted questions; (4) preprocessing of the data; (5) conducting preliminary analysis, and finally (6) executing genomic data integration.
    CONCLUSIONS: The tutorial has been tested and demonstrated on publicly available genomic data generated from poplar (Populus L.), a woody plant model. We also developed a new graphical output for the unsupervised multi-block analysis, cimDiablo_v2, available at https://forgemia.inra.fr/umr-gdec/omics-integration-on-poplar , and allowing the selection of master drivers in genomic data variation and interplay.
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  • 文章类型: Journal Article
    解剖学教学中的课程面临着越来越大的压力,要从传统向跨学科融合转变,从基于尸体到基于系统的多模式指令。教育技术正变得至关重要,并敦促将其纳入医学教学中。在健康科学学院,VinUniversity,本科医学培训计划中的人体结构和功能(HBSF)模块旨在根据基于系统的集成结构的原理,通过相关基础医学科学教授解剖学。为了支持学生实现预期的学习成果,采用适应-标准化-集成-合规(ASIC)框架,在四个关键术语中引入了多种创新技术平台:适应,标准化,一体化,和合规。在本文中,课程开发过程中介绍了选定的技术平台以及使用ASIC模型吸取的教训。
    The curriculum in teaching anatomy is under increasing pressure to transform from traditional to interdisciplinary integration, from cadaver-based to multimodal instruction with a system-based approach. Educational technologies are becoming critical and urged to be integrated into teaching medicine. At the College of Health Sciences, VinUniversity, the block of Human Body Structure and Function (HBSF) within the undergraduate medical training program was designed to teach anatomy with relevant basic medical sciences based on the principles of the system-based integrated structure. To support students in achieving the intended learning outcomes, multiple innovative technological platforms have been introduced into the curriculum using the moderation of the Adaptation - Standardization - Integration - Compliance (ASIC) framework over four key terms: adaptation, standardization, integration, and compliance. In this paper, the process for curriculum development is presented with an illustration of the selected technological platforms and the lessons learned using the ASIC model.
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  • 文章类型: Journal Article
    本文是研究主题“COVID-19和旷日持久的冲突背景下的卫生系统恢复”的一部分,利比里亚是2014-2016年西非埃博拉病毒病(EVD)爆发最严重的三个国家之一,在此期间,它记录了超过10,000个案例,包括卫生工作者。估计表明,卫生系统崩溃导致的非EVD发病率和死亡率超过了EVD的直接影响。疫情的教训是明确的,不仅对利比里亚,而且对区域和全球社区:通过综合方法建立卫生系统的复原力是对人口健康和福祉的投资,以及经济安全和国家发展。因此,从2015年疫情减弱之时起,利比里亚将恢复和复原力作为国家优先事项也就不足为奇了。恢复议程为利益攸关方提供了平台,以努力恢复爆发前卫生系统功能的基线,同时旨在建立更高水平的复原力。借鉴了埃博拉危机的教训。根据共同作者的实地国家支持工作经验,这项研究旨在提供由KOICA资助的利比里亚卫生服务弹性项目(2018-2023年)的概述,并为国家当局和捐助者提出一系列建议,源自作者对最佳实践和与项目相关的关键挑战的看法。我们使用了定量和定性的方法,通过审查已发表和未发表的技术和操作文件来生成本研究中代表的数据,和通过情况和需求评估以及常规监测和评估活动得出的数据集。该项目为实施利比里亚建设弹性卫生系统投资计划和成功应对利比里亚COVID-19疫情做出了贡献。虽然范围有限,卫生服务复原力项目表明,卫生系统复原力可以通过采用集水和综合方法并鼓励多部门合作来运作,伙伴关系,地方所有权,并推广初级卫生保健方法。该试点中采用的原则可以指导在类似利比里亚及其他地区的其他资源有限的环境中开展卫生系统复原力工作。
    This article is part of the Research Topic \'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict\' Liberia is one of the three countries worst hit by the 2014-2016 West Africa Ebola Virus disease (EVD) outbreak, during which it recorded over 10,000 cases, including health workers. Estimates suggest that the non-EVD morbidity and mortality resulting from the collapse of the health system exceeded the direct impact of EVD. Lessons from the outbreak were clear, not only for Liberia but also for the regional and global communities: that building health system resilience through an integrated approach is an investment in population health and wellbeing, as well as economic security and national development. It is therefore no surprise that Liberia made recovery and resilience a national priority from the time the outbreak waned in 2015. The recovery agenda provided the platform for stakeholders to work toward the restoration of the pre-outbreak baseline of health system functions while aiming to build a higher level of resilience, informed by lessons from the Ebola crises. Based on the co-authors\' experiences of on-the-ground country-support work, this study sought to provide an overview of the Liberia Health Service Resilience project (2018-2023) funded by KOICA, and propose a set of recommendations for national authorities and donors, derived from the authors\' perceptions of best practices and key challenges associated with the project. We used both quantitative and qualitative approaches to generate the data represented in this study by reviewing published and unpublished technical and operational documents, and datasets derived through situational and needs assessments and routine monitoring and evaluation activities. This project has contributed to the implementation of the Liberia Investment Plan for Building a Resilient Health System and the successful response to the COVID-19 outbreak in Liberia. Although limited in scope, the Health Service Resilience project has demonstrated that health system resilience could be operationalized by applying a catchment and integrated approach and encouraging multi-sectoral collaboration, partnership, local ownership, and promoting the Primary Health Care approach. Principles applied in this pilot could guide the operationalization of health system resilience efforts in other resource-limited settings similar to Liberia and beyond.
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  • 文章类型: Journal Article
    学习东道国社会的语言和找到工作是难民融入社会的重要步骤。特别是语言能力是整合低文化程度的关键障碍。通常,在集成过程中,语言培训和获得工作技能是分开的。我们调查了荷兰一个为期1年的低识字率难民试点计划,结合了语言培训(日常课程,与工作相关的语言)具有庇护就业(二手店)的工作经验,以促进语言学习,并为该群体更好地为劳动力市场做好准备。以阿格和斯特朗的概念整合框架(2008年)为基础,我们期望这一合并计划应该改善代理(沟通策略,为劳动力市场做好准备)通过工作中的群体间联系。我们使用混合方法方法纵向跟踪参与者(N=10)的发展(基线,6个月后,11个月后)。我们收集了问卷数据,采访了老师和学生,并观察课堂和工作中的互动。总的来说,沟通策略的使用增加。分析个别案例(配置文件)提供了细致入微的见解,以了解谁以及为什么该计划似乎具有不同的影响,特别是在劳动力市场准备方面。我们讨论了结果以及建立群体间联系以促进新社会融合的重要性。
    在线版本包含补充材料,可在10.1007/s12134-023-01028-6获得。
    Learning the host society\'s language and finding a job are important steps for the societal integration of refugees. Especially language proficiency is a key barrier for the integration of low literates. Often language training and gaining work skills are separated during the integration procedure. We investigated a 1-year pilot program for refugees with low-literacy levels in the Netherlands, which combined language training (daily classes, work-related language) with work experience in sheltered employment (second-hand shop) to facilitate language learning and prepare this group better for the labour market. Building on Ager and Strang\'s conceptual integration framework (2008), we expected that this combined program should improve agency (communication strategies, preparedness for the labour market) via intergroup contact at work. We used a mixed-method approach to follow the development of participants (N=10) longitudinally (baseline, after 6 months, after 11 months). We gathered questionnaire data, interviewed teachers and students, and observed interactions in classes and at work. Overall, use of communication strategies increased. Analyzing individual cases (profiles) offered nuanced insights into for whom and why the program seems to have differential impact, especially in terms of labour market preparation. We discuss results and the importance of creating intergroup contact to facilitate integration in a new society.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s12134-023-01028-6.
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