Healthcare system efficiency evaluation: foreign experience

Актуальность представленного исследования определяется возрастающим в последние десятилетия значением качества жизни населения при реализации текущей государственной политики и планирования стратегического развития страны. Как в развитых, так и в развивающихся странах острой остается проблема повышения эффективности государственного управления в сфере здравоохранения. В настоящее время не существует единой, наиболее эффективной модели системы здравоохранения, что приводит к необходимости проведения реформ даже в странах с высокими показателями здоровья населения и уровня жизни. Цель работы: проанализировать специфические особенности формирования и функционирования моделей здравоохранения, обобщить опыт применения различных методов управления системой здравоохранения в развитых и развивающихся странах. Методы исследования. Для исследования проблемы в качестве инструментально- методического аппарата используются дескриптивные методы исследования, метод аналогии, группировок, научно-фактологический, системный, сравнительный и ретроспективный анализ с применением общенаучных методов исследования - индукции, дедукции, сбора и обработки статистической информации, являющейся основой для сравнений развития инструментов управления здоровьем населения, применяемых в зарубежных странах. Результаты. Анализ направлений раз- вития систем здравоохранения развитых и развивающихся стран позволяет сделать вывод о том, что цели, задачи и механизмы развития могут быть как схожи, так и существенно отличаться, в зависимости от существующей системы оказания медицинской помощи.The relevance of the research is determined by the increasing value of population life quality due to current national policy and state strategic management. In both developed and developing countries the problem of increasing the efficiency of public administration in the health sector remains relevant. Currently there is no single one most effective healthcare system model which leads to the necessity of reforming healthcare systems, even in countries with high levels of public health and quality of life. The main aim of the study is to analyze specific features of healthcare systems, summarize the experience of health system management in developed and developing countries. Methods. As instrumental and methodological apparatus to investigate the problem, we used descriptive research methods, analogy method, groups method, scientific, factual, systematic, comparative and retrospective analysis with scientific methods of research - induction, deduction, methods of collection and processing of statistical information, which is the basis for the comparison of health population management tools used in foreign countries. Results. An analysis of development trends in developed and developing countries' healthcare systems leads to the conclusion that the goals, objectives and mechanisms of development can be both similar and differ significantly, depending on the existing healthcare system. The search of optimal model in both developed and developing countries is associated with the lack of possibility to create a unified approach to healthcare system development, which could ensure the creation of the most effective model. The effectiveness of the healthcare system, progress in achieving its goal (to improve population health) depends on the implementation of specific control methods as well as on social and economic conditions of their implementation. This is confirmed by similar growth rate of life expectancy at birth in developed countries, despite the significant difference in the management tools

The importance of scientific competencies in German medical curricula - the student perspective

Background: Scientific competencies are of great importance for physicians; not only for conducting reliable research, but also for patient care. However, there is growing concern that a lack of scientific competencies among physicians may lead to a deterioration in the quality on biomedical research. This study aims at assessing medical students’ perspectives on the implementation of scientific competency training in German medical curricula. Methods: An online survey was conducted in order to collect German medical students’ opinions on the importance of acquiring scientific competencies during their medical studies and to provide us with an assessment of their current levels of basic scientific competencies by having them conduct a self-evaluation. Moreover, we wanted to understand their perceptions of current curricular content and to receive suggestions for improving scientific competency training. Participants were reached via the mailing lists of the German Medical Students’ Association, as well as of local medical student committees, and the German Medical Students’ Associations social media channel on Facebook. Results: In total, 2380 medical students from across all 37 German medical faculties participated in the survey. The majority of students agreed that the ability to critically evaluate the relevant literature is an important competency for physicians, and that every student should conduct a research project during their medical studies. However, the students evaluated their scientific competencies as unsatisfactory, especially with regard to statistics and scientific writing. They were strongly in favor of receiving extended research training. Conclusion: Our study provides insight into German medical students’ self-perception in relation to both patient care and biomedical research, and makes recommendations for potential improvements in scientific training. The study demonstrates that scientific competencies are of great importance to medical students in Germany. Students are not lacking motivation for scientific practice and have numerous ideas for enhancing scientific teaching opportunities. Scientific training should follow a holistic approach based on three pillars: (i) a scientific core curriculum, (ii) intracurricular research projects, and (iii) special research programs for students strongly interested in medical research

Trophic interactions of the freshwater jellyfish Craspedacusta sowerbii

The predatory impact and the trophic role of the freshwater jellyfish, Craspedacusta sowerbii, was studied using microcosm and enclosure experiments as well as a 3-year pond survey. The results showed a significant decrease of small herbivorous crustaceans, i.e. Bosmina longirostris and juvenile cyclopoid copepods, in the medusa treatments of the microcosms and the enclosure experiments. Chlorophyll concentrations in the enclosure experiment were significantly increased in the medusa treatment, suggesting that C. sowerbii may cause cascading effects in the food chain. A comparison of daily zooplankton losses during the pond survey caused by medusae and fish (roach, Rutilus rutilus), and their food selectivities suggest food separation of these two predators and reveal a strong negative impact of medusae on the copepod pond community. In the case of a jellyfish bloom, our results show that both food chains can co-occur in lakes because of a weak interaction between these top predators, fish and jellyfish, with simultaneous impacts on the zooplankton structur

РОЛЬ ПСИХОЛОГИЧЕСКИХ АСПЕКТОВ ПЕДАГОГИЧЕСКОГО ПРОЦЕССА В ФОРМИРОВАНИИ БУДУЩЕГО СПЕЦИАЛИСТА

В условиях формирования в Украине рыночной экономики увеличивается роль системы высшего образования как фактора социально -экономического роста через обеспечение рынка труда молодыми квалифицированными специалистами , произво дительный труд которых влияет на темпы выхода из глубокого кризиса . При вступлении молодежи на рынок труда сложились особенно жесткие условия в связи с ее низкой конкурентоспособностью . Это обусловлено действием следующих факторов : недостатком профессиональных знаний , умений и навыков ; необходимостью предоставления молодым людям дополнительных льгот ; трудо вой нестабильностью молодежи , связанной с увольнениями в связи с призывом в вооруженные силы , уходом на учебу , длительными отпусками в связи с рождением и воспитанием детей ; инфантильностью части молодежи , привыкшей основные жиз ненные блага получать бесплатно от родителей и государства ; несоответствием психологических , мыслительных , поведенческих качеств студентов требованиям , предъявляемым к молодым специалистам

Синтез подсистемы управления скоростью движения конвейера

We consider the problem of engine speed control conveyor. The problem is solved in the class of linear optimal regulators. As a criterion of optimality adopted quadratic functional integral characterizes the quality of the transient process and the amount of the cost of energy for movement. On the basis of the conducted research the author suggests a transitional with optimal configuration of the controller

Micrometer-sized Water Ice Particles for Planetary Science Experiments: Influence of Surface Structure on Collisional Properties

Models and observations suggest that ice-particle aggregation at and beyond the snowline dominates the earliest stages of planet formation, which therefore is subject to many laboratory studies. However, the pressure–temperature gradients in protoplanetary disks mean that the ices are constantly processed, undergoing phase changes between different solid phases and the gas phase. Open questions remain as to whether the properties of the icy particles themselves dictate collision outcomes and therefore how effectively collision experiments reproduce conditions in protoplanetary environments. Previous experiments often yielded apparently contradictory results on collision outcomes, only agreeing in a temperature dependence setting in above ≈210 K. By exploiting the unique capabilities of the NIMROD neutron scattering instrument, we characterized the bulk and surface structure of icy particles used in collision experiments, and studied how these structures alter as a function of temperature at a constant pressure of around 30 mbar. Our icy grains, formed under liquid nitrogen, undergo changes in the crystalline ice-phase, sublimation, sintering and surface pre-melting as they are heated from 103 to 247 K. An increase in the thickness of the diffuse surface layer from ≈10 to ≈30 Å (≈2.5 to 12 bilayers) proves increased molecular mobility at temperatures above ≈210 K. Because none of the other changes tie-in with the temperature trends in collisional outcomes, we conclude that the surface pre-melting phenomenon plays a key role in collision experiments at these temperatures. Consequently, the pressure–temperature environment, may have a larger influence on collision outcomes than previously thought

Quantifying global marine isoprene fluxes using MODIS chlorophyll observations

We report global distributions of marine isoprene flux, whose source is estimated by combining an empirical relationship for isoprene production rate with MODIS satellite chlorophyll observations from 2001. We use a steady-state water column model including losses to chemistry, bacteria, and air-sea exchange. Physical mixing is a negligible sink. Flux estimates range from 107–109 molecules cm−2s−1, with considerable spatial and temporal variability, resulting in a global annual total of 0.1 Tg C/yr. Air-sea exchange is the dominant isoprene sink in the surface oceans, with bacteria the second largest, but much less important, sink. The reported fluxes represent a small loss of OH in the remote marine boundary layer (MBL) compared to other oxidants. Application of our approach to other reactive compounds may improve a priori flux estimates for coupled atmosphere-ocean biogeochemistry inverse model studies