State intervention, local indebtedness, investment overheating and their systemic background during global crisis in China

This paper focuses on the immediate economic and systemic reasons of steadily increasing local government indebtedness and investment overheating in China. These two phenomena emerged between 2008 and 2011 as a direct consequence of an external shock caused by the global crisis and the subsequent internal reaction in the form of intensified stimulating state intervention. New chances for resource distribution and investments through state intervention mobilized distribution priorities and politically rational economic behavior of actors, characteristic to party-state systems. Locations of mobilization were defined by the decentralized Chinese system specifics along the intertwined institutional party-state structure. Systemic characteristics and its Chinese specifics together resulted in investment overheating, and steadily growing local indebtedness through large and state-owned enterprises and local governments. This process was further amplified by the characteristics of transforming economy in China as actors in the private sphere were mobilized by the increased input demand of those privileged by the systemic priorities of state intervention

How and why systemic inflammation worsens quality of life in patients with advanced cancer

Introduction: The presence of an innate host systemic inflammatory response has been reported to be a negative prognostic factor in a wide group of solid tumour types in both the operable and advanced setting, both local and distant. In addition, this host systemic inflammatory response is associated with both clinician reported patient performance status and self-reported measures of quality of life in patients with cancer. Areas covered: A variety of mechanisms are thought to underlie this, including the influence of the host immune response on physical symptoms such as pain and fatigue, its effect on organ systems associated with physical ability and well being such as skeletal muscle, and bone marrow. Furthermore, this innate inflammatory response is thought to have a direct negative impact on mood through its action on the central nervous system. Expert commentary: It is clear that the host systemic inflammatory response represents a target for intervention in terms of both improving quality of life and prognosis in patients with advanced cancer. Based on this paradigm, future research should focus both on pathways which might be targeted by novel agents, but also on whether existing anti-inflammatory drugs might be of benefit

Study of local manifestations of snake bite and its surgical implications, at a rural hospital in India

Background: Manifestations of snakebite have local and systemic implications. While systemic manifestations can be life-threatening, local complications like cellulitis, necrosis, and compartment syndrome secondary to snakebite can threaten limb survival. This study undertakes the recognition of local complications and its outcome.Methods: A retrospective observational study was conducted at our tertiary center in India. 219 snake bitten patients presenting in between January 2013 to December 2020, were studied. Surgical interventions whenever required for managing local surgical complications were recorded and analyzed.Results: Of the 219 patients, 118 (53.88%) of the patients were bitten by venomous snakes requiring systemic therapy and 101 (46.12%) were non-venomous. Of the 118 patients with venomous snakebite, 78 (35.62%) had signs and symptoms. 83.11% reported to the hospital within 6 hours of the bite, while 45.66% within 2 hours. There were 169 (77.17%) patients who had local signs of inflammation, ischemic changes in 28 (12.79%), compartment syndrome in 15 (6.88%). 167 (76.26%) patients were treated conservatively while 52 (23.74%) had to undergo surgical interventions. Those undergoing surgical interventions had longer hospital stays (mean=8.09615) as compared to those treated conservatively (mean=4.82635) (p value=< 0.001). In patients with no local inflammation, only 1 (0.46%) required surgical intervention as compared to 51 (23.29%) (p value=< 0.001) patients with local inflammation requiring surgical intervention.Conclusions: Along with systemic medical treatment, local manifestations of most snakebites can be well managed with suitable surgical intervention. Surgical complications of snakebite are not infrequent leading to interventions. Such patients usually have a longer hospital stay

Gendered systemic analysis : systems thinking and gender equality in international development

Systemic intervention (Midgley, 2000) and Feminist Systems Thinking (Stephens, 2013a), both branches of Critical Systems Thinking, have been used widely to improve social and organisational systems. According to Midgley (2000), a systemic intervention can be defined as a “…purposeful action by an agent to create change” (113, emphasis original). Building on Midgley’s work, Stephens (2013a) created a non-hierarchical “… framework for feminist systems thinking, as a set of five principles that provide common sense guidelines for applied research and social action…” (8, emaphsis added). Presently, the small amount of gendered systemic research is troubling in a world where no country has achieved gender equality. The purpose of this research is to conduct a participatory systemic intervention working in partnership with a U.S. non-governmental agency in Washington D.C. in the United States, and Nicaragua in Central America, I conducted a feminist systemic intervention in an international development organisation. This study found that a more structured systemic intervention method, currently named Gendered Systemic Analysis, was needed to support stakeholders in identifying potential improvements in their businesses: previous work on Feminist Systems Thinking left too much of a gap between theory and practice. In this research, I follow Midgley’s (2011:11-12) use of ‘method’ as: “as a set of techniques operated in a sequence (or sometimes iteratively) to achieve a given purpose. GSA uses a boundary critique process, which concentrates attention on gender, nature and voices from the margin as a means to create social change. The contribution of this research deepened the understanding of how to empower individuals and groups to engage with systemic thinking and contextualise its theoretical and methodological underpinnings into a local knowledge generating systems leading to more sustainable change

Special and inclusive education in Israel

The present paper aims to describe the Israeli special education system historically and currently, as related in particular to the 1988 National Special Education Law, and to appraise future systemic trends. Discussion focuses on three major aspects: (a) changes in specia! education concepts and ideological perceptions, (b) systemic structural changes locally and nationally; and (c) curricular and intervention perspectives. The conceptual/ideological review includes changes in theoretical approaches to definitions and classifications, which influenced implementation issues such as diagnostic and intervention planning. The discussion of systemic structural changes focuses on the expanding process of inclusion for children with special needs into the regular education system and on the growing process of decentralisation in resource distribution toward local and regional support centres. Diverse solutions are examined to resolve the enduring major conflict between the need to provide the optimal help and support to meet the special needs of each individual child and at the same time to strive for the highest level of inclusion. Developments in curricula and intervention are described, consisting of revised goals. modified definitions, and new approaches to remedial education and intervention. including the integration of new technologies. In appraising future trends, the importance is highlighted of appropriate modifications in teacher training. student skill development. and setting design, as well as the evaluating and supervising resource distribution and treatment efficacy.peer-reviewe

Apicotomy: a root apical fracture for surgical treatment of impacted upper canines

Impacted canines, due to systemic or local factors, represent a frequent problem in most populations. Surgical intervention usually involves exposure for spontaneous eruption, exposure for orthodontic traction or extraction. The author presents the apicotomy technique, which has been successfully used during the past twenty years for conservative intervention in cases of impacted upper canines with dilaceration or apical root-ankylosis. This original method involves surgical fracture of the root apex, followed by orthodontic traction of the corono-radicular region

COMPARISON OF SYSTEMIC AND LOCAL APPLICATION OF TRANEXAMIC ACID ON BLEEDING AND BLOOD TRANSFUSION NEED IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS

Abstract: Comparison of the effect of systemic administration and transamine position on bleeding and the need for blood transfusion in patients undergoing coronary artery bypass surgery, goals, comparing the amount of bleeding and blood transfusion in 48 hours after surgery, design by random sampling by blocking, 180 patients will enter this study, How to do after seeking consent, 60 patients will be assigned to the systemic intervention group and 60 patients will be assigned to the intervention group and 60 patients will be in the control group. Entry requirements: All patients undergoing coronary artery bypass graft surgery for the first time. Exclusion criteria in patients with renal failure, anemic patients, patients with low cardiac output, patients with coagulation disorder, and intervention; patients undergoing anesthesia induction of 10 mg / kg of body weight within the regimen Receive a dose of 1 mg of the drug per kg body weight per surgical hour until the end of surgery, after the surgery. In the local group, 1 g of the transamine solution was dissolved in 100 ml of chloride. 0.9% at the end of the surgery in the pericardial cavity of the heart. 60 patients will not receive the drug control group, all of the surgery will be performed by two surgeons under the same anesthetic and bypass procedure, the main outcome of the cerebral hemorrhage 6, 12, 24, 48 hours after surgery, and the rate of blood transfusion in 48 hours. From surgery.Key word: Local Tranexamic acid, systemic tranexamic acid, coronary artery bypass surgery, bleeding, blood transfusio

Towards Systemic Evaluation

Problems of conventional evaluation models can be understood as an impoverished ‘conversation’ between realities (of non-linearity, indeterminate attributes, and ever-changing context), and models of evaluating such realities. Meanwhile, ideas of systems thinking and complexity science—grouped here under the acronym STCS—struggle to gain currency in the big ‘E’ world of institutionalized evaluation. Four evaluation practitioners familiar with evaluation tools associated with STCS offer perspectives on issues regarding mainstream uptake of STCS in the big ‘E’ world. The perspectives collectively suggest three features of practicing systemic evaluation: (i) developing value in conversing between bounded values (evaluations) and unbounded reality (evaluand), with humility; (ii) developing response-ability with evaluand stakeholders based on reflexivity, with empathy; and (iii) developing adaptive rather than mere contingent use(fulness) of STCS ‘tools’ as part of evaluation praxis, with inevitable fallibility and an orientation towards bricolage (adaptive use). The features hint towards systemic evaluation as core to a reconfigured notion of developmental evaluation