Enhancement of the health care system in Russia continues to be one of key directions of National development. In conditions of deficiency of personnel, systemic changes are needed to transit to qualitatively new level. The application of digital platforms permits to resolve a number of issues related to accessibility and quality of medical services. The paper characterizes current state of health care digitization and level of competitiveness of medical institutions. On the basis of analysis of corporate culture of medical institutions, conclusions are made that it contributes to successful implementation of unified medical information system and development of best corporate standards and traditions.

Checking each item placed in a separate collection bin of recyclables to examine contamination is often difficult for a researcher relying on such data. This is because of the time and inconvenience involved to manually identify items. We test a proof-of-concept experiment on the ability of trail cameras to identify items placed within separate collection bins. After a pre-test of seven camera models, we selected one with the best image quality. We use this camera for lab and field trials to count the number of identifiable items based on photos compared to manual hand-counts of the items. Three lab trials of this camera resulted in an average of 82% accuracy in item identification. We then conducted a field experiment, testing photo quality to identify items in six separate collection bins across a university campus over a one-month period with a total of over 9,700 photos. Of the 1343 items placed in the separate collection bins, the trail cameras provided photographs of high enough quality such that successful identification occurred for 68.5% of the items, with poor identification for paper items and small items. We conclude that trail cameras can be useful for data collection in separate collection behavior, especially for items with the largest surface size greater than a credit card.

Intercollegiate Horse Show Association (IHSA) competitions evaluate riders on equitation and skills when riding randomly drawn horses. This study considered demographic and competition-related variables of horses involved in IHSA competitions, and their correlation to performance through points accumulated. Demographics were recorded for fifty-nine horses in two-day Hunter Seat and Western IHSA shows along with use of artificial riding aids, day of competition, number of rides, and points, to evaluate performance. Data were analyzed using a mixed effect model and correlation coefficients with significance set at P < 0.05 (SAS 9.4). Hunter Seat horses averaged more rides per day than Western (P < 0.0001), but points per ride were not different between disciplines (P = 0.57) or days of shows (P = 0.47). Use of artificial aids did not impact points per ride a horse accumulated (P = 0.63 Hunter Seat, P = 0.41 Western). Age, (r = -0.10, P = 0.60; r = 0.02, P = 0.90), BCS (r = 0.15, P = 0.42; r = 0.17, P = 0.34), height (r = 0.20, P = 0.28; r = 0.15, P = 0.39), and weight (r = 0.23, P = 0.23; r = 0.20, P = 0.25) were weakly correlated with points earned for Hunter Seat and Western horses, respectively. Random draw in IHSA is suggested to be effective for equitation competitions, allowing a fair opportunity for riders, regardless of the horse-related factors evaluated in this study.

BACKGROUND: Self-guided web-based interventions have the potential of addressing help-seeking barriers and symptoms common among university students, such as depression and anxiety. Unfortunately, self-guided interventions are also associated with less adherence, implicating motivation as a potential moderator for adherence and improvement for such interventions. Previous studies examining motivation as a moderator or predictor of improvement on web-based interventions have defined and measured motivation variably, producing conflicting results.
OBJECTIVE: This secondary analysis of data from a randomized controlled trial aimed to examine constructs of motivation as moderators of improvement for a self-guided 8-week web-based intervention in university students (N=1607).
METHODS: Tested moderators included internal motivation, external motivation, and confidence in treatment derived from the Treatment Motivation Questionnaire. The primary outcome was an improvement in depression and anxiety measured by the Depression Anxiety Stress Scale-21.
RESULTS: Piecewise linear mixed effects models showed that internal motivation significantly moderated symptom change for the intervention group (t1504=-2.94; P=.003) at average and high (+1 SD) motivation levels (t1507=-2.28; P=.02 and t1507=-4.05; P<.001, respectively). Significant results remained even after controlling for baseline severity. The results showed that confidence in treatment did not significantly moderate symptom change for the intervention group (t1504=1.44; P=.15). In this sample, only internal motivation was positively correlated with service initiation, intervention adherence, and intervention satisfaction.
CONCLUSIONS: The combination of a web-based intervention and high or moderate internal motivation resulted in greater improvement in the total Depression Anxiety Stress Scale-21 score. These findings highlight the importance of conceptually differentiating motivation-related constructs when examining moderators of improvement. The results suggest that the combination of a web-based intervention and high or moderate internal motivation results in greater improvement. These findings highlight the importance of conceptually differentiating motivation-related constructs when examining moderators of improvement. To better understand the moderating role of internal motivation, future research is encouraged to replicate these findings in diverse samples as well as to examine related constructs such as baseline severity and adherence. Understanding these characteristics informs treatment strategies to maximize adherence and improvement when developing web-based interventions as well as allows services to be targeted to individuals likely to benefit from such interventions.
BACKGROUND: ClinicalTrials.gov NCT04361045; https://clinicaltrials.gov/study/NCT04361045.

UNASSIGNED: Investigate the association between perceived social support and depressive symptoms at different stages of academic progress.
UNASSIGNED: Undergraduate students (n = 505) enrolled at a large southeastern university.
UNASSIGNED: Students completed a cross-sectional survey about their self-reported physical and mental health. Logistic regression was used to assess the relationship between depressive symptoms, perceived social support, and academic class standing.
UNASSIGNED: Academic class standing and perceived social support were both significantly associated with depressive symptoms. Compared to freshman, odds of having depressive symptoms were 2.15 times higher for sophomores and 3.94 times higher for seniors. For every one unit increase in perceived social support, the odds of depressive symptoms decreased by 51%.
UNASSIGNED: A significant association between depressive symptoms and social support was identified for all undergraduates in this sample. The differences identified between social support and depressive symptoms reveal the need to tailor support provided at different academic stages.

OBJECTIVE: Acute appendicitis is a wide spectrum disease, from simple inflammation to evident intestinal perforation. The correct interpretation of the degree of inflammation is crucial to guarantee appropriate treatment and adherence to protocols and guidelines. In order to investigate this concordance, the authors compared the definition of appendicitis and the predicted treatment among all surgeons affiliated to a single Pediatric Surgery School (consisting of 8 different centers).
METHODS: Twenty-two short recordings of intra-operative manipulation of appendices were shown to 56 surgeons, blindly to clinical information. Four items were collected and analyzed: classification of appendicitis, type and length of predicted antibiotic therapy, day of re-alimentation. Data were analyzed to identify the concordance kappa coefficient, stratified according to expertise of the responding surgeon.
RESULTS: The 1232 evaluations obtained in all valued items low overall concordance. Subgroup analysis identified a good agreement between younger surgeons only in the choice of antibiotic (k 0.47). However, if the centers were divided between University and non-University Hospitals, a strong agreement was found in the former both for classification (k 0.45 vs 0.32) and type of antibiotic (k 0.42 vs 0.24).
CONCLUSIONS: The overall concordance between surgeons in different centers in the diagnostic classification and predicted treatment of appendicitis is quite low. University Hospital have a highest concordance in both items at all levels of expertise; it might be postulated that teaching to younger surgeon increase the comparison between experts and finally the concordance and adherence to protocols within the center.

The aim of this research is to analyze the impact of mental health on the academic performance of junior and senior students studying in a university setting during the 2022-2023 academic year, in the post-COVID period. The study was conducted in Beijing, China, with the participation of 600 students, including 300 first-year students and 300 fifth-year students. DASS (Depression, Anxiety, and Stress Scale) and PHQ-9 (Patient Health Questionnaire-9) questionnaires were employed to measure mental health. The DASS assesses symptoms of depression, anxiety, and stress, while the PHQ-9 specifically evaluates depression severity. Academic performance was evaluated using a 12-point scale, which incorporated various criteria such as exam scores, coursework performance, and participation in extracurricular activities. The research was conducted across five faculties of the university from 2022 to 2023. In the study, fifth-year students demonstrated a higher level of mental health compared to first-year students, with an average DASS score of 27.1 and 24.2, respectively. Interestingly, despite this, first-year students achieved higher academic performance indicators, with an average score of 8.2 compared to 9.8 in fifth-year students. Correlation analysis revealed significant associations between stress, depression, and anxiety levels with academic performance (stress: r = -0.25, p < 0.001; depression: r = -0.20, p = 0.003; anxiety: r = -0.18, p = 0.008). These findings highlight the critical importance of addressing students\' mental well-being, particularly in later academic years. Recommendations include implementing support programs and developing online resources for students.

Elite student-athletes (SAs) in higher education (HE) have distinct mental health (MH) risks. The COVID-19 pandemic put pressure on systems and increased elite SA vulnerability to adverse MH outcomes. The aim of this study was to explore the provision and management of MH in elite HE sports settings during the time of COVID-19 pandemic stress. The secondary aim was to identify lessons and opportunities to enhance future mental healthcare systems and services for elite SAs. A qualitative study design was used to investigate the views of three groups (athletic directors, coaches and sport healthcare providers). Ten key leaders were purposively recruited from HE institutions in Canada, the USA and the United Kingdom. They represented various universities from the National College Athletic Association, U SPORTS Canada and British Universities and Colleges Sport. Semistructured interviews were conducted, recorded, transcribed and thematically analysed. Five key themes were identified: (1) The pandemic disruption had salient impacts on motivation and how elite SAs engaged with sport (2) when student sport systems are under pressure, support staff perceive a change in duties and experience their own MH challenges, (3) the pandemic increased awareness about MH care provision and exposed systemic challenges, (4) digital transformation in MH is complex and has additional challenges for SAs and (5) there were some positive outcomes of the pandemic, lessons learnt and a resulting motivation for systems change. Participants highlighted future opportunities for MH provision in elite university sport settings. Four recommendations were generated from the results.

Commercial environments and food acquisition methods significantly shape dietary practices and impact health. This study assesses dietary choices among Portuguese university students regarding vending machines, canteens, and lunches from home. It also evaluates their use of the university canteen and their tendency to bring lunch from home. This pilot cross-sectional study used a self-administered electronic questionnaire, made available in early 2023. Participants were recruited through snowball sampling. The study included 137 students from Portuguese higher education institutions, mainly women (74.5%), pursuing degrees or integrated Master\'s degrees (83.2%), primarily in health-related fields (55.5%). The median age was 21 years (20 to 23.5 years). About 70.0% regularly consumed food from vending machines, while approximately 60.0% brought lunch from home, avoiding the canteen. Factors such as convenience (48.5%), price (47.5%), product availability (40.6%), and taste (39.6%) mainly influenced vending machine choices. Monthly, chocolates, water, coffee, cookies, treats, and soft drinks were the most commonly acquired items, with coffee being the most frequent daily purchase. These findings provide insights for creating policies and initiatives to promote healthier and more accessible food options for students and strategies to encourage positive eating behaviors.

BACKGROUND: The start of the COVID-19 pandemic resulted in the implementation of nonpharmaceutical interventions by US institutions of higher education at an unprecedented level. During the backdrop of an emerging pandemic, younger adults (eg, college students) had an overall lower risk for severe outcomes for SARS-CoV-2, making this population a potential source of transmission for age groups with high susceptibility and negative health outcomes. We examine how college students\' level of concern for COVID-19 was influenced by different sources of information, their living status, income level, and other demographic identifiers and its association with prevention behavior change.
OBJECTIVE: We sought to examine the level of concern, defined as the extent to which the participant would take corrective action to mitigate contracting or spreading the virus (to family or friends) by using personal protective equipment such as a face mask, practicing social distancing, and following other public health recommendations, among college students during the COVID-19 pandemic.
METHODS: A cross-sectional, web-based survey was conducted in 2021 among 185 college students aged 18-41 years, with most living in New York City and the United States (n=134, 72.4%). Out of 185 college students, 94 provided their zip codes, with 51 of those college students indicating they lived in New York City areas. The participants completed the survey via a QR code. Study participants who did not complete the full survey or were not college students in any US college or university were excluded. Analyses were conducted using R (version 4.2.2; R Foundation for Statistical Computing).
RESULTS: Of 185 respondents participated in the study, 25 (13.5.%) used emails from their schools, 51 (27.6%) used mainstream media, and 109 (58.9%) used social media and other sources to obtain information about COVID-19. Of the 109 participants who learned about the pandemic from social media, 91 (83.5%) were concerned; however, only 63% (32/51) and 60% (15/25) of the participants who sourced information from mainstream media and their schools\' email, respectively, were concerned. Further, the participants who received information from social media and other sources were about 3 times more likely to be concerned about COVID-19 than participants who received information from the university via email (P=.036; OR=3.07, 95% CI: 1.06-8.83)..
CONCLUSIONS: College students who received information from social media and other sources were more likely to be concerned about COVID-19 than students who received information from their school via emails.