Об одном подходе к построению математической модели сложной системы по ее формальному описанию

В данной работе представлена методика и технология объектно-ориентированного моделирования сложных систем. Разработана технология построения математической модели системы по ее формальному описанию.The methods and the technique of object-oriented complex system modeling is presented in the paper. The technique of building the mathematical model of the system according to its formal description has been developed

Alcohol-Dependent Inpatients in Northern Vietnam : A Follow-Up Study on Relapse and Co-Occurring Psychiatric Disorders

Background: The prevalence of alcohol dependence has been increasing in several countries in the world as well as in Vietnam. This study aims to describe relapse among alcohol-dependent inpatients in Northern Vietnam and some co-occurring psychiatric disorders in these patients. Methods: This study followed 53 alcohol-dependent patients who were treated for six months at the Vietnam National Institute of Mental Health. At the point of one month, three months, and six months after being discharged from the hospital, the patients were monitored for their alcohol consumption, relapse into alcohol dependence, and co-occurring psychiatric disorders by clinical psychiatrists, using the International Classification of Diseases, the 10th edition, Hamilton depression rating scale, Hamilton anxiety rating scale, Pittsburgh Sleep Quality Index, and the EQ-5D-5L Life Quality Assessment. Results: The prevalence of relapse into alcohol dependence was 81.1%. The highest relapse rate was found in the first month after alcohol withdrawal (46.5%), then it decreased gradually. 53.9% of the relapsed patients had at least four alcohol withdrawals; they mainly used home-brewed alcohol. The average daily alcohol intake was fairly high: 14.4 ± 8.5 standard drinks. Mental disorders such as depression, anxiety, and sleep disorder were very prevalent among patients with relapsed alcohol dependence. Conclusions: The rate of relapsed alcohol dependence in Northern Vietnam was very high. It is important to detect and treat psychiatric disorders simultaneously with alcohol dependence to achieve better treatment effectiveness and reduce relapse rates

Нейрогуморальная регуляция и качество жизни при диспепсии билиарного типа, после курса гипобароадаптации

ДИСПЕПСИЯ /ТЕРРЕЦЕПТОРЫ НЕЙРОТРАНСМИТТЕРОВКАЧЕСТВО ЖИЗНИБАРОКАМЕРАПРИЗНАКИ И СИМПТОМЫ ПИЩЕВАРИТЕЛЬНЫЕПИЩЕВАРИТЕЛЬНОЙ СИСТЕМЫ БОЛЕЗНИАДАПТАЦИЯ ФИЗИОЛОГИЧЕСКАЯГИПОБАРИЧЕСКАЯ ГИПОКСИЯБИЛИАРНОЙ СИСТЕМЫ БОЛЕЗН

Why do graduates choose to work in a less attractive specialty? A cross-sectional study on the role of personal values and expectations

Background: Primary health care (PHC), of which preventive medicine (PM) is a subspecialty, will have to cope with a deficiency of staff in the future, which makes the retention of graduates urgent. This study was conducted in Vietnam, where PM is an undergraduate degree in parallel to medical training. It aims to identify facilitating and hindering factors that impact recruitment and retention of PM graduates in the specialty. Methods: A cross-sectional study enrolled 167 graduates who qualified as PM doctors from a Vietnamese medical school, between 2012 and 2018. Data were collected via an online questionnaire that asked participants about their motivation and continuation in PM, the major life roles that they were playing, and their satisfaction with their job. Multiple regression analyses were used to identify which life roles and motivational factors were related to the decision to take a PM position and to stay in the specialty, as well as how these factors held for subgroups of graduates (men, women, graduates who studied PM as their first or second study choice). Results: Half of the PM graduates actually worked in PM, and only one fourth of them expressed the intention to stay in the field. Three years after qualification, many graduates had not yet decided whether to pursue a career in PM. Satisfaction with opportunities for continuous education was rated as highly motivating for graduates to choose and to stay in PM. Responsibility for taking care of parents motivated male graduates to choose PM, while good citizenship and serving the community was associated with the retention of graduates for whom PM was their first choice. Conclusions: The findings demonstrate the importance of social context and personal factors in developing primary care workforce policy. Providing opportunities for continued education and enhancing the attractiveness of PM as an appropriate specialty to doctors who are more attached to family and the community could be solutions to maintaining the workforce in PM. The implications could be useful for other less popular specialties that also struggle with recruiting and retaining staff

An Automated Mobile Game-based Screening Tool for Patients with Alcohol Dependence

Traditional methods for screening and diagnosis of alcohol dependence are typically administered by trained clinicians in medical settings and often rely on interview responses. These self-reports can be unintentionally or deliberately false, and misleading answers can, in turn, lead to inaccurate assessment and diagnosis. In this study, we examine the use of user-game interaction patterns on mobile games to develop an automated diagnostic and screening tool for alcohol-dependent patients. Our approach relies on the capture of interaction patterns during gameplay, while potential patients engage with popular mobile games on smartphones. The captured signals include gameplay performance, touch gestures, and device motion, with the intention of identifying patients with alcohol dependence. We evaluate the classification performance of various supervised learning algorithms on data collected from 40 patients and 40 age-matched healthy adults. The results show that patients with alcohol dependence can be automatically identified accurately using the ensemble of touch, device motion, and gameplay performance features on 3-minute samples (accuracy=0.95, sensitivity=0.95, and specificity=0.95). The present findings provide strong evidence suggesting the potential use of user-game interaction metrics on existing mobile games as discriminant features for developing an implicit measure to identify alcohol dependence conditions. In addition to supporting healthcare professionals in clinical decision-making, the game-based self-screening method could be used as a novel strategy to promote alcohol dependence screening, especially outside of clinical settings

Research to support and inform the development, implementation and/or evaluation of tobacco control policies in relation to the framework convention on tobacco control in low and middle-income countries

In order to enforce policies on tobacco control in Vietnam, reliable information on health and socio-economic hazards associated with tobacco farming is needed. The study investigates the harmful impact of tobacco cultivation and processing on health of tobacco farmers in a rural community in northern Vietnam. Objectives included estimation of health care costs as well as health beliefs related to tobacco cultivation and processing. The health of those who cultivate the crop is constantly put in peril. The study confirms that tobacco farming does not bring prosperity to the farmers while causing them a lot of health problems, especially among women

Health financing policies during the COVID-19 pandemic and implications for universal health care: a case study of 15 countries

Background The COVID-19 pandemic was a health emergency requiring rapid scal resource mobilisation to support national responses. The use of e ective health nancing mechanisms and policies, or lack thereof, a ected the impact of the pandemic on the population, particularly vulnerable groups and individuals. We provide an overview and illustrative examples of health nancing policies adopted in 15 countries during the pandemic, develop a framework for resilient health nancing, and use this pandemic to argue a case to move towards universal health coverage (UHC). Methods In this case study, we examined the national health nancing policy responses of 15 countries, which were purposefully selected countries to represent all WHO regions and have a range of income levels, UHC index scores, and health system typologies. We did a systematic literature review of peer-reviewed articles, policy documents, technical reports, and publicly available data on policy measures undertaken in response to the pandemic and complemented the data obtained with 61 in-depth interviews with health systems and health nancing experts. We did a thematic analysis of our data and organised key themes into a conceptual framework for resilient health nancing. Findings Resilient health nancing for health emergencies is characterised by two main phases: (1) absorb and recover, where health systems are required to absorb the initial and subsequent shocks brought about by the pandemic and restabilise from them; and (2) sustain, where health systems need to expand and maintain scal space for health to move towards UHC while building on resilient health nancing structures that can better prepare health systems for future health emergencies. We observed that ve key nancing policies were implemented across the countries— namely, use of extra-budgetary funds for a swift initial response, repurposing of existing funds, e cient fund disbursement mechanisms to ensure rapid channelisation to the intended personnel and general population, mobilisation of the private sector to mitigate the gaps in public settings, and expansion of service coverage to enhance the protection of vulnerable groups. Accountability and monitoring are needed at every stage to ensure e cient and accountable movement and use of funds, which can be achieved through strong governance and coordination, information technology, and community engagement. Interpretation Our ndings suggest that health systems need to leverage the COVID-19 pandemic as a window of opportunity to make health nancing policies robust and need to politically commit to public nancing mechanisms that work to prepare for future emergencies and as a lever for UHC.We thank the management team of the Bill & Melinda Gates Foundation and the Saw Swee Hock School of Public Health (National University of Singapore, Singapore) for all the administrative support given. This research was funded by the Bill & Melinda Gates Foundation (Investment ID INV-005598)

Smoke-free environment policy in Vietnam: What did people see and how did they react when they visited various public places?

Introduction: Since Vietnam has signed WHO framework on tobacco control (FCTC) in 2003 and has issued tobacco control law in 2013, there has been little research concerning about what impacts smoke-free regulations have had on public compliance. The objective of this study was to assess public exposure to secondhand smoke and reaction toward smoke-free policy regulations in Vietnam and the associated factor. Methods: Using the design of GATS (Global Adult Tobacco Survey), a nationally representative sample of 8,996 adults were approached for data collection. Logistic regression was used to examine the associated factor.Results: The study revealed that the prevalence of respondents exposed to secondhand smoke was much higher in bars/café/tea shops (90.07%) and restaurants (81.81%) than in any other public places, universities (36.70%), government buildings (31.12%), public transport (20.04%), healthcare facilities (17.85%) and schools (15.84%). 13.23% of respondents saw smokers violate smoke-free regulations. Among those who saw them violate smoke-free regulations, just one-third cautioned them to stop smoking. Strikingly, a higher rate of cautioning smokers to stop smoking was observed among the older, married, and better educated respondents. Respondents who were married, better educated and in lower economic status were more likely to remind smokers to stop smoking.Conclusions: The study has called for strengthening two of the six MPOWER (Monitor, Protect, Offer, Warn, Enforce and Raise) components of the tobacco free initiative introduced by WHO, Monitoring tobacco use and prevention policies and Protecting people from tobacco smoke