Mental Health and Access to Medical Care in Patients with Chronic Cardiovascular Conditions: An Analysis of the Behavior Risk Factor Surveillance System

Introduction. Poor mental health is associated with worse outcomes for chronic diseases. It is unclear whether mental illness predisposes to difficulties with healthcare access. Methods. Using a combined dataset of the 2016-2019 behavioral risk factor surveillance system, we included individuals who reported a chronic cardiovascular condition. Weighted multivariable logistic regression analyses were used to explore the association between domains of mental health and measures of healthcare access including delaying medical care, > 1 year since last routine checkup, lack of a primary care physician (PCP), and cost-related medication nonadherence (CRMNA). Results. Among 1,747, 397 participants, 27% had a chronic cardiovascular condition, 12% had clinical depression, and 12% had poor mental health. Those with poor mental health (OR 3.20 [3.08 – 3.33]) and clinical depression (OR 2.43 [2.35 – 2.52]) were more likely to report delays in medical care. Those with greater stress frequency (OR 8.47 [6.84 -10.49] stressed all of the time), lower levels of emotional support received (OR 3.07 [2.21 – 4.26] rarely get needed emotional support), and greater life dissatisfaction (6.66 [4.14 – 10.70] very dissatisfied) reported greater delays in medical care. Conclusions. Individuals with poor mental health have greater difficulty accessing medical care independent of socioeconomic variables.

Users Awareness and Usage of Open Educational Resources in Central Universities of North India

Technological advancements and open educational resources (OER) together have opened up wider opportunities to access globally created educational resources by anyone across the globe. A paradigm shift has been witnessed in the format of learning resources, their access methods, and the medium of delivery of the knowledge content. The findings of this research reveal that the academic community of central universities (CU) of North India is well aware of open educational resources. E PG Path Shala is the most popular and most widely used, followed by NPTEL and YouTube. The majority of users use OERs as and when they require them. The purpose of using OERs for the majority of respondents is to prepare class notes. Most of the faculty and research scholars use OERs to improve their professional competency. The majority of respondents desired that the institutions should provide free internet/Wi-Fi on campus and should also provide regular updates about OERs.

Construction of University Online Examination System Based on Cloud Computing Technology

With cloud computing's powerful computing power, many end users can create a variety of effective network applications using the cloud's services without having to worry about computing technology or access methods. Based on CC technology's on-demand service characteristics and unlimited dynamic expansion capability, this article designs and implements a shared network examination system. In the Web mode, the functions of receiving and distributing examination data, identity verification, online examination, and examination result collection can be realized using the SaaS deployment structure, MVC three-tier architecture, Java modeling language, XFIE, JSON, web service, DES, and other technologies combined with MySQL database. At the same time, the improved parallel genetic annealing algorithm (IPGAA) is proposed as a CC resource scheduling strategy. The IPGAA has better adaptability in the CC system with various cloud resources because it combines the fast global search ability of the genetic algorithm (GA) with the local search ability of the simulated annealing algorithm. Simulation tests show that the IPGAA is effective.

A Hierarchical Spatial Network Index for Arbitrarily Distributed Spatial Objects

The range query is one of the most important query types in spatial data processing. Geographic information systems use it to find spatial objects within a user-specified range, and it supports data mining tasks, such as density-based clustering. In many applications, ranges are not computed in unrestricted Euclidean space, but on a network. While the majority of access methods cannot trivially be extended to network space, existing network index structures partition the network space without considering the data distribution. This potentially results in inefficiency due to a very skewed node distribution. To improve range query processing on networks, this paper proposes a balanced Hierarchical Network index (HN-tree) to query spatial objects on networks. The main idea is to recursively partition the data on the network such that each partition has a similar number of spatial objects. Leveraging the HN-tree, we present an efficient range query algorithm, which is empirically evaluated using three different road networks and several baselines and state-of-the-art network indices. The experimental evaluation shows that the HN-tree substantially outperforms existing methods.

Comparative evaluation of surgical methods for low invasive surgical treatment of diseases of the kidneys and urinary tract

Background. The rapid development of laparoscopic surgery can significantly reduce trauma during operations in the retroperitoneal space. These goals are also achieved by retroperitoneoscopy (RPS), which has become widespread in the last twenty years. The main difficulties for surgeons were associated with a small workspace and a lack of clear anatomical landmarks. Different access methods have different features, advantages and disadvantages, the analysis of which helps to optimize surgical treatment and accelerate patient rehabilitation.Aim: to study the advantages and disadvantages of retroperitoneoscopic and transperitoneal laparoscopic surgical methods of treatment.Materials and methods: We analyzed 305 case histories of patients operated on for various kidney diseases. The patients were divided into 2 groups: Group 1 – patients who underwent surgery using an extraperitoneal retroperitoneoscopic approach, Group 2 – patients who used the transperitoneal laparoscopic approach. A comparison of two methods of surgical treatment of kidney diseases, retroperitoneoscopic and laparoscopic access, was carried out. The following indicators were compared: duration of surgery, length of hospital stay, need for analgesics, frequency of postoperative complications.Results. The duration of the operation with retroperitoneoscopic surgery was reduced by more than 15 % compared with the laparoscopic approach. Shorter periods of pain relief were required, and the number of complications also decreased. The duration of inpatient treatment did not differ significantly.Conclusion. Retroperitoneoscopic approach can be used as the method of choice for operations on the retroperitoneal space.

Community Perspectives on Addressing and Responding To HIV-Testing, Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) Among African, Caribbean and Black (ACB) People in Ontario, Canada

Background The African, Caribbean, and Black (ACB) population of Ontario, Canada is comprised of individuals with diverse ethnic, cultural and linguistic backgrounds and experiences; some of whom have resided in Canada for many generations, and others who have migrated in recent decades. Even though the ACB population represents less than 3.5% of the Canadian population, this group accounts for 21.7% of all new HIV infections. It is well-documented that ACB populations, compared to the general population, experience multi-level barriers to accessing appropriate and responsive HIV services. In this paper, we present qualitative findings on the ACB population’s experiences with HIV-testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and obtain their perspectives on how to improve access. Methods We conducted twelve Focus Group Discussions (FGDs), within a two-day World Café event and used socio-ecological framework and community-based participatory research (CBPR) approaches to guide this work. We meaningfully engaged ACB community members in discussions to identify barriers and facilitators to HIV testing, PEP and PrEP and how these may be addressed. The FGDs were transcribed verbatim and thematic analysis guided data interpretation. Credibility of data was established through data validation strategies such as external audit and peer-debriefing. Results Our analyses revealed multi-level barriers that explain why ACB community members do not access HIV testing, PEP and PrEP. Fear, health beliefs, stigma and lack of information, were among the most frequently cited individual- and community-level barriers to care. Health system barriers included lack of provider awareness, issues related to cultural sensitivity and confidentiality, cost, and racism in the health care system. Participants identified multi-level strategies to address the HIV needs including community-based educational, health system and innovative inter-sectoral strategies. Conclusion CBPR, co-led by community members, is an important strategy for identifying the multi-level individual, interpersonal, community, institutional and structural factors that increase HIV vulnerability in ACB communities, notably anti-Black systemic racism. Study findings suggest the need for targeted community-based strategies and strategies aimed at reducing health system barriers to testing and care.