Integrated primary care-behavioral health program development and implementation in a rural context

Objective:Despite the known benefits of integrated primary care and behavioral health services,integrated behavioral health services have not been readily used in medical clinics in interior Alaska.With minimal resources,we recently developed an integrated primary care-behavioral health program in a medical clinic in interior Alaska to meet clinic and community needs.The objective of this study was to explore initial program outcomes and determine the feasibility of program development and implementation.Methods:We initially conducted a needs assessment for integrating behavioral health services into primary care.Program development was informed by specific clinic needs.Following program implementation,initial program outcomes were tracked with use of data from the electronic health record and patient and provider use and satisfaction surveys.The level of integration of primary care and behavioral health services was evaluated with the Practice Integration Profile.Results:A total of 188 patients were seen by behavioral health consultants during the initial pilot phase,including 44.0%referred for mental health symptoms,33.1%referred for physical health issues,and 22.3%referred for both mental and physical health issues.The initial program outcomes indicate modest clinical improvement(measured by the nine-item Patient Health Questionnaire)as well as patient and provider satisfaction with the model,and a moderate level of practice integration.Conclusion:On the basis of the initial findings,it appears that our integrated primary care-behavioral health program has the potential to serve an important role in addressing the behavioral health needs of the local population.Our implementation procedure and initial program outcomes suggest that such models are feasible in rural and small-scale settings with minimal overhead costs.

A Type-Theoretic Approach to Program Development

A paradigm of program development using type theories is given after analyzing some typical exam- ples.In order to carry this approach forward,a language ALT is designed.It is a linguistic description of a generalized higher order typed lambda calculus with Π,∑ types and Π,∑ kinds (supertypes). Four examples are given to show how ALT can be used to implement many concepts of software engi- neering and artificial intelligence.They are intuitionistic logic,Peano arithmetic,approximate reasoning and program transformations.ALT is described formally,using a structural operational approach.

Mechanisms of developmental programming of the metabolic syndrome and related disorders

There is consistent epidemiological evidence linking low birth weight, preterm birth and adverse fetal growth to an elevated risk of the metabolic syndrome (obesity, raised blood pressure, raised serum triglycerides, lowered serum high-density lipoprotein cholesterol and impaired glucose tolerance or insulin resistance) and related disorders. This "fetal or developmental origins/programming of disease" concept is now well accepted but the "programming" mechanisms remain poorly understood. We reviewed the major evidence, implications and limitations of current hypotheses in interpreting developmental programming and discuss future research directions. Major current hypotheses to interpret developmental programming include: (1)thrifty phenotype; (2) postnatal accelerated or catchup growth; (3) glucocorticoid effects; (4) epigenetic changes; (5) oxidative stress; (6) prenatal hypoxia; (7) placental dysfunction; and (8) reduced stem cell number. Some hypothetical mechanisms (2, 4 and 8) could be driven by other upstream "driver" mechanisms. There is a lack of animal studies addressing multiple mechanisms simultaneously and a lack of strong evidence linking clinical outcomes to biomarkers of the proposed programming mechanisms in humans. There are needs for (1) experimental studies addressing multiple hypothetical mechanisms simultaneously; and (2) prospective pregnancy cohort studies linking biomarkers of the proposed mechanisms to clinical outcomes or surrogate biomarker endpoints. A better understanding of the programming mechanisms is a prerequisite for developing early life interventions to arrest the increasing epidemic of the metabolic syndrome, type 2 diabetes and other related disorders.

Developmental programming of the metabolic syndrome critical windows for intervention

Metabolic disease results from a complex interaction of many factors,including genetic,physiological,behavioral and environmental influences.The recent rate at which these diseases have increased suggests that environmental and behavioral influences,rather than genetic causes,are fuelling the present epidemic.In this context,the developmental origins of health and disease hypothesis has highlighted the link between the periconceptual,fetal and early infant phases of life and the subsequent development of adult obesity and the metabolic syndrome.Although the mechanisms are yet to be fully elucidated,this programming was generally considered an irreversible change in developmental trajectory.Recent work in animal models suggests that developmental programming of metabolic disorders is potentially reversible by nutritional or targeted therapeutic interventions during the period of developmental plasticity.This review will discuss critical windows of developmental plasticity and possible avenues to ameliorate the development of postnatal metabolic disorders following an adverse early life environment.

China's Biotechnology Development Program during the Tenth Five-Year Plan Period (2001-2005)

Bioengineering TechnoIogy(Ⅰ)1. Crop molecular marker-assisted selection and pyramiding breeding technology2. Super hybrid

The Program for the Development of Chinese New and Renewable Energy (1996-2010) Worked Out

The State Science and Technology Commission, State Economic and Trade Commission, and State Planning Commission of China have jointly worked out the Program for the Development of Chinese New and Renewable Energy recently.

A Glimpse at Program for Children's Development in China

Continuedonpage20Notes:1.Datain1990forinfant.andunderfivemortalityratesaredatain1991.2.Datumin1997forincidenceofunderweightofchildrenisthatin1995.3.Datain1997foruniversalizationofsafedrinkingwaterandsanitarytoiletsaredatain1998.4.Datain1997forHIVcarr...

Gender Equality:Now a Basic State Strategy——On the Salient Features of the National Program on the Development of Chinese Women(2011-2020)

The National Program on the Development of Chinese Women （2011-2020）, herein- after referred to as the ＂NewProgram,＂ was published in August 2011. This is an important document designed to ensure implementation of the basic state strategy of gender equal- ity and the all-round development of Chinese women. The New Program is a part of China＇s policy program for the protection of human rights. It sets 57 major targets to be attained over the decade. The targets cover seven fields, namely, health, education, economy,

China's Biotech Achievements——Development of China's 863 Program in the Ninth Five-Year Plan Period

Modern biotechnology booms in the molecular life science. It brings about a promising future for improving human health, foodstuff, environment and energy and is of significance to improve traditional agriculture, druamakins and other

Need for education of psychiatric evaluation of offenders with mental disorders:A questionnaire survey for Japanese designated psychiatrists

BACKGROUND The management of offenders with mental disorders has been a significant concern in forensic psychiatry.In Japan,the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue.However,numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization(AIH)scheme,which lacks clarity and updated standards.AIM To explore current as well as optimized learning strategies for risk assessment in AIH decision making.METHODS We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders.RESULTS The findings of this study’s survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training.CONCLUSION This underscores the pressing need for structured training protocols in AIH consultations.Moreover,feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

不同因素对西藏阿旺绵羊胚胎冷冻与移植效果的影响

为探究西藏阿旺绵羊推行胚胎移植及胚胎冷冻技术的可行性,以阿旺绵羊为供体,澳湖羊为受体,探讨发情期内不同月份对阿旺绵羊超排效果的影响、不同发育阶段鲜胚和移植数量对母羊受胎率及产羔率的影响,以及冷冻方法对胚胎移植的影响。结果显示:发情期7月超排组平均可用胚数(3.95±4.23)显著低于10月超排组(5.45±4.03);阿旺绵羊胚胎移植2枚桑椹胚的受体妊娠率最高,达到81.81%,产羔率达57.58%,具有显著性差异;阿旺绵羊胚胎程序化冷冻组受体妊娠率为35.48%,显著优于玻璃化冷冻组受体妊娠率13.63%。以上结果表明,西藏推行阿旺绵羊胚胎移植技术的可行性较高。

Application of Mindsets to Health Education and Behavior Change Programs

Successful health promotion programs are characterized in part, by the willingness of audiences to engage, participate, and adopt healthier behaviors. But presentation of messages that reach and resonate with the intended audience remains challenging. This is due in part to the variety of mindsets—viewpoints, attitudes, and beliefs—within a population. These mindsets play an essential role in understanding and predicting behaviors and lifestyle factors associated with health or chronic diseases. The purpose of this study is to demonstrate how a specific survey-based method of mindset segmentation can distinguish predominant mindsets and then be used to create, adapt, and/or market health programs to appeal to these mindsets. Steps in survey construction, distribution, and analysis are described. Interpretation of the results, yielding three primary mindsets, is the critical outcome of this segmentation method. The applications of this interpretation to community health education programs are suggested. This approach has potential to inform, enhance, or customize programs, tailoring activities, methods, and messages to the preferences of the community.

Analysis of Citizen Participation in Urban Planning of Comala,Colima,Mexico-A Secondary Publication

The objective of this study was to determine the degree of citizen participation in urban planning processes in the municipality of Comala,Colima,Mexico to have a broader vision of the citizens and the environment in which they live.An instrument was designed specifically to perform this study and the instrument was validated by calculating Cronbach’s Alpha.The results showed that citizens were highly involved in issues concerning their urban environment,and the main problems of the public spaces were also identified.

健康和疾病的发育起源理论研究进展

基于生活环境、健康和疾病在分子水平上密切相关的核心理念,健康和疾病的发育起源(developmental origins of health and disease,DOHaD)理论为健康与疾病间的关联研究提供了全新视角。该理论通过多学科、多领域的知识互通,追溯不同的生活经历如何影响生命全过程中的健康和疾病风险。成人期疾病的敏感窗口期不再局限于妊娠前和妊娠期,分娩期至成年早期也成为暴露因素发挥作用的重要时段。母源性/父源性因素、环境因素、新生儿出生状况、儿童期代谢情况等能够通过影响表观遗传、代谢和免疫调控、氧化应激等,改变发育程序并对子代远期健康产生正向或负向影响。因此,为实现健康促进,需要同步推进早期生命阶段预防、后期随访及健康干预的关口前移,以期有效降低成年期疾病风险,提升生命全周期健康水平。综述DOHaD领域最新研究进展对阐明人类发展早期阶段发生的不良事件影响健康和疾病模式及发现有效干预措施具有积极意义。

Fetal programming of obesity and type 2 diabetes

The prevalence of obesity and type 2 diabetes mellitus has increased rapidly over the past few decades,and prevention efforts have not been successful.Fetal programming involves the earliest stage of obesity development,and provides a novel concept to complement other strategies for lifelong prevention of obesity and type 2 diabetes mellitus.The World Health Organization now advocates a life-course approach to prevent/control obesity,starting with pre-conceptional and antenatal maternal health.Maternal overnutrition,gestational diabetes mellitus and excessive gestational weight gain lead to fetal overgrowth,and“programs”the offspring with an increased risk of obesity and type 2 diabetes mellitus in childhood and adulthood.This review summarizes current data on fetal programming of obesity and type 2 diabetes mellitus including potential causative factors,mechanisms and interventions to reduce its impact.

An Early Warning Model of Telecommunication Network Fraud Based on User Portrait

With the frequent occurrence of telecommunications and networkfraud crimes in recent years, new frauds have emerged one after another whichhas caused huge losses to the people. However, due to the lack of an effectivepreventive mechanism, the police are often in a passive position. Usingtechnologies such as web crawlers, feature engineering, deep learning, andartificial intelligence, this paper proposes a user portrait fraudwarning schemebased on Weibo public data. First, we perform preliminary screening andcleaning based on the keyword “defrauded” to obtain valid fraudulent userIdentity Documents (IDs). The basic information and account information ofthese users is user-labeled to achieve the purpose of distinguishing the typesof fraud. Secondly, through feature engineering technologies such as avatarrecognition, Artificial Intelligence (AI) sentiment analysis, data screening,and follower blogger type analysis, these pictures and texts will be abstractedinto user preferences and personality characteristics which integrate multidimensionalinformation to build user portraits. Third, deep neural networktraining is performed on the cube. 80% percent of the data is predicted basedon the N-way K-shot problem and used to train the model, and the remaining20% is used for model accuracy evaluation. Experiments have shown thatFew-short learning has higher accuracy compared with Long Short TermMemory (LSTM), Recurrent Neural Networks (RNN) and ConvolutionalNeural Network (CNN). On this basis, this paper develops a WeChat smallprogram for early warning of telecommunications network fraud based onuser portraits. When the user enters some personal information on the frontend, the back-end database can perform correlation analysis by itself, so as tomatch the most likely fraud types and give relevant early warning information.The fraud warning model is highly scaleable. The data of other Applications(APPs) can be extended to further improve the efficiency of anti-fraud whichhas extremely high public welfare value.