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Information from the top: A monthly study on stress and also social support during a army deployment to a combat zone.
Medication alone is not sufficient to treat insomnia. In addition, the side effects of sleep medications themselves cannot be ignored during treatment. Insomnia begins with poor sleep quality and discomfort, but as it continues, patients fall into a vicious circle of insomnia with negative thoughts and dysfunctional and distorted perceptions related to sleep. Mindfulness-based intervention for insomnia corrects these sequential cognitive and behavioral processes. The mindfulness technique basically recognizes all the thoughts, feelings, and experiences that occur to us as they are, nonjudgmentally, and then trains them to return to the senses of our body. In this way, while noticing all the processes of the sequential vicious cycle and training them to return to our bodies (e.g., breathing), mindfulness determines whether we are really sleepy or just fatigued. This mindfulness-based intervention can be a useful nonpharmaceutical intervention for insomnia, and its stability and efficacy has been proven by many studies.Background International development partners and research councils are increasingly funding research management and support (RMS) capacity strengthening initiatives in sub-Saharan Africa (SSA) as part of a broader investment in strengthening national and regional research systems. However, the evidence-base to inform RMS capacity strengthening initiatives is limited at present. This research note presents a synthesis of 28 RMS capacity assessments completed in 25 universities/research institutions from across 15 SSA countries between 2014 and 2018. Methods All 28 capacity assessments were completed following a standardised methodology consisting of semi-structured interviews conducted with research and research support staff at the respective institution as well as document reviews and observation of onsite facilities. Data were extracted from the 28 reports detailing the findings of each assessment according to a framework synthesis approach. Results In total, 13 distinct capacity gap categories emerged from across the 28 RMS capacity assessment reports. Almost all the institutions assessed faced multiple gaps in RMS capacity within and across each of these 13 categories. The 13 categories were not independent of each other and were often closely inter-connected. Commonalities were also evident across multiple categories, the two most obvious of which were severe fiscal constraints and the often-complex bureaucracy of the institutional operating environment. Conclusions The synthesis findings reveal multiple, commonly shared RMS capacity gaps in universities and research institutions across SSA. No single intervention type, or focus, would be sufficient to strengthen capacity across all 13 areas; rather, what is needed to facilitate a significant shift in RMS capacity within such SSA universities and research institutions is a combination of interventions, consisting of differing levels of cost and complexity, variously led (or supported) by both internal and external actors.Background In 2014 the Lebanese Ministry of Public Health integrated pay-for-performance into setting hospital reimbursement tiers, to provide hospitalization service coverage for the majority of the Lebanese population. This policy was intended to improve effectiveness by decreasing unnecessary hospitalizations, and improve fairness by including risk-adjustment in setting hospital performance scores. Methods We applied a systematic approach to assess the impact of the new policy on hospital performance. Triptolide molecular weight The main impact measure was a national casemix index, calculated across 2011-2016 using medical discharge and surgical procedure codes. A single-group interrupted time series analysis model with Newey ordinary least squares regression was estimated, including adjustment for seasonality, and stratified by case type. Code-level analysis was used to attribute and explain changes in casemix index due to specific diagnoses and procedures. Results Our final model included 1,353,025 cases across 146 hospitals with althcare system may contribute to improving effectiveness. Effective hospital regulation can be achieved through systematic collection and analysis of routine data.T-cell cancer therapy is a clinical field flush with opportunity. It is part of the revolution in immuno-oncology, most apparent in the dramatic clinical success of PD-1/CTLA-4 antibodies and chimeric antigen receptor T-cells (CAR-Ts) to cure certain melanomas and lymphomas, respectively. Therapeutics based on T cells ultimately hold more promise because of their capacity to carry out complex behaviors and their ease of modification via genetic engineering. But to overcome the substantial obstacles of effective solid-tumor treatment, T-cell therapy must access novel molecular targets or exploit existing ones in new ways. As always, tumor selectivity is the key. T-cell therapy has the potential to address target opportunities afforded by its own unique capacity for signal integration and high sensitivity. With a history of breathtaking innovation, the scientific foundation for the cellular modality has often been bypassed in favor of rapid advance in the clinic. This situation is changing, as the mechanistic basis for activity of CAR-Ts and TCR-Ts is backfilled by painstaking, systematic experiments-harking back to last century's evolution and maturation of the small-molecule drug discovery field. We believe this trend must continue for T-cell therapy to reach its enormous potential. We support an approach that integrates sound reductionist scientific principles with well-informed, thorough preclinical and translational clinical experiments.Background Cystic fibrosis (CF) is a multiorgan disease affecting the lungs pancreas and gastrointestinal tract. Pulmonary complications are the most common manifestation of the disease. Recent advances in the treatment of pulmonary complications have resulted in substantial improvement in life expectancy. Less than 10% of persons with CF (PWCF) develop liver disease (CFLD). There is conflicting evidence about impact of liver disease on mortality in CF, with evidence suggesting that CFLD contributes to increased mortality in CF, while other studies suggest that the impact on mortality is limited. Understanding the contribution of liver disease to mortality in CF is essential if further improvements in life expectancy are to be achieved. Objective To document the impact of liver disease on life expectancy for PWCF. Methods This systematic review will be conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P 2015). PubMed, Medline and Embase will be searched for English language publications (1949-2020).
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