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Abstract: Introduction/Context: The term core value (CV) can be defined as fundamental beliefs or principles, guiding one's behavior in a social context. Though core competencies of family medicine (FM) have been clearly defined by WONCA, there has been an ongoing debate on what the CVs are for family doctors (FDs). Ukraine is a developing country in the middle of Europe with a population of 43 million inhabitants, gained independence from the Soviet Union in 1991. Ukraine is a low-income country, developing a modern European healthcare system, especially regarding FM. To implement WONCA standards, it is mandatory to assess the ongoing understanding of CVs in clinical daily practice among active FDs, working in different countries of Europe including Ukraine. Research questions: How do Ukrainian FDs (Delphi group experts) define the CVs of FM in Ukraine and how important are these CVs to a wider population of Ukrainian FDs in their everyday practice? Methods: A mixed method study was conducted in two steps during August and September 2020 in Ukraine. The first part was a qualitative Delphi round (three rounds) design among 20 Ukrainian FDs who were familiar with teaching and terms like CV. A consensus list of six CVs has emerged from the Delphi round study. The second part was a quantitative survey among Ukrainian FDs, who were not specially used to discussing CVs. The consensus list of those six CVs was then submitted to 2000 FDs (randomly selected) who were not involved in the Delphi team, to rank those values from one to nine, according to the importance from their personal point of view. Demographic characteristics have been assessed for all the participants of the Delphi round and quantitative survey. Results: Twenty FDs were involved as experts in the first Delphi round, whereas only five experts continued their participation in the second and the third rounds of the survey. The following six CVs emerged from the Delphi round: comprehensive approach, care coordination, first recourse, continuity of care, integrated approach, and patient and family centered care. The final sample consisted of 375 FDs (19% response rate). There were 323 (88.7%) female and 34 (9.3%) male FDs in the sample. The mean age of the participants was 44.6+-13.5 years. Discussion/Conclusion: Defining CVs for FM by Ukrainian FDs in a given socio-economical and historical-cultural setting is crucial to optimize primary medical care and to guarantee an appropriate and successful implementation of WONCA standards as well as CVs in different countries including those where reformation of the health system is ongoing.
Keywords: family medicine, Ukraine, core values, delphi, mixed methods, Ukraine
Published in DKUM: 27.08.2024; Views: 88; Downloads: 13
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Abstract: Background: Cold urticaria (ColdU), i.e. the occurrence of wheals or angioedema in response to cold exposure, is classified into typical and atypical forms. The diagnosis of typical ColdU relies on whealing in response to local cold stimulation testing (CST). It can also manifest with cold-induced anaphylaxis (ColdA). We aimed to determine risk factors for ColdA in typical ColdU. Methods: An international, cross-sectional study COLD-CE was carried out at 32 urticaria centers of reference and excellence (UCAREs). Detailed history was taken and CST with an ice cube and/or TempTest® performed. ColdA was defined as an acute cold-induced involvement of the skin and/or visible mucosal tissue and at least one of: cardiovascular manifestations, difficulty breathing, or gastrointestinal symptoms. Results: Of 551 ColdU patients, 75% (n=412) had a positive CST and ColdA occurred in 37% (n=151) of the latter. Cold-induced generalized wheals, angioedema, acral swelling, oropharyngeal/laryngeal symptoms, and itch of earlobes were identified as signs/symptoms of severe disease. ColdA was most commonly provoked by complete cold water immersion and ColdA caused by cold air was more common in countries with a warmer climate. Ten percent (n=40) of typical ColdU patients had a concomitant chronic spontaneous urticaria (CSU). They had a lower frequency of ColdA than those without CSU (4% vs 39%, p=0.003). We identified the following risk factors for cardiovascular manifestations: previous systemic reaction to a Hymenoptera sting, angioedema, oropharyngeal/laryngeal symptoms, and itchy earlobes. Conclusion: ColdA is common in typical ColdU. High-risk patients require education about their condition and how to use an adrenaline autoinjector.
Keywords: adrenaline autoinjector, cold urticaria, COLD-CE, risk factors, systemic reactions, epinephrine, therapeutic use, self administration, injections, intramuscular, methods
Published in DKUM: 06.08.2024; Views: 139; Downloads: 8
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Abstract: In dispersed multiphase flow processes we encounter coupled heat, mass and momentum transfer between the disoersed and the continuous phase. In the context of the subdomain Boundary Domain Integral Method (BDIM) solution of the Navier-Stokes equations a two-way coupling model is presented based on the use of the elliptic fundamental solution and the Dirac delta function properties which leads to accurate evaluation of the heat and mass point particle source impacts on the continuous (air) phase. In addition, the two-phase flow case under consideration is extended to the case of porous spherical particle drying with internal moving drying front, which is solved by the Boundary Element Method (BEM).
Keywords: heat transfer, mass transfer, Boundary Element Methods
Published in DKUM: 01.07.2024; Views: 113; Downloads: 13
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Abstract: The health education in schools became the focus of public attention during the global pandemic of COVID-19. Teaching practice changed to meet the increased demand for pupils’health, triggering a reevaluation of higher education curricula for pedagogical students. Therefore, this mixed methods study aimed to investigate the lifestyle of university students of pedagogy in Slovenia during the COVID-19 pandemic.One hundred and four students (87.4% females and 12.6% males) met the criteria and participated in an online survey in which they self-assessed their physical activity, eating habits, mental well-being, and sleep quality. The convergent parallel mixed methods design was used to obtain qualitative descriptions of student experiences withlifestyle domains and quantitative data on their attitudes towards the impact of lifestyle on physical and mental well-being during the pandemic. The results suggestthat the pandemic did significantly impact student lifestyles, especially their mental well-being. Although most students maintained a healthy lifestyle during the pandemic, they also reported a deterioration in other measured domains of health-related behaviour. Particular attention should, therefore, be paid to the curriculum of pedagogical students to develop their competences in health education and readiness toassume an active role as educators for their future pupils’ health.
Keywords: health education, university students, curriculum development, education professions, pedagogy, university students, mixed methods research
Published in DKUM: 13.05.2024; Views: 238; Downloads: 11
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Abstract: It is necessary to adapt constantly to the business environment with its changing demands. Understanding the objectives, scope, and limitations of actual process changes is crucial, and can be achieved with numerous measures, methods, and techniques. This research demonstrates an innovative approach to organizational changes to enable sustainable processes. In the first part of this research, relevant measures, methods, and techniques are selected through an in-depth literature review. Then, an international online questionnaire is executed among 213 enterprises from four countries. In the last part of this research, the developed approach is tested for the example of waste minimization in the process of developing coatings. Based on the analysis of the survey questionnaire, the usability and benefits of various measures are demonstrated, namely from the point of view of their positive impact on structural and operational efficiency indicators. At the end of the article, a case study presents the success of the innovative approach in terms of 88% waste minimization and up to 48% time and cost reductions in the process of developing coatings. The proposed approach enables better choices to be made and the more efficient use of various measures, which can lead to more sustainable processes and improve the efficiency of enterprises.
Keywords: organizational changes, key performance indicators, measures, methods and techniques, sustainable processes, waste minimization
Published in DKUM: 02.04.2024; Views: 286; Downloads: 15
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