Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome:Mixed Methods Study With Patients and Health Care Professionals

Background: Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way.Objective: We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them.Methods: We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify “antecedents” (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention.Results: Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place).Conclusions: We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention’s acceptability, scalability, and cost-effectiveness

‘It’s like equality now; it’s not as if it’s the old days’: an investigation into gender identity development and football participation of adolescent girls

This article explores the influence participating in football has on the development of adolescent girls’ gender identity, an area which currently lacks academic attention. Data were taken from an ethnographic study with a group of adolescent girls and boys and compared to Jeanes’ research. A social constructionist framework was deployed with links to both critical theory and feminist literature. Qualitative and participatory methods were used to fully engage with the complex issue of gender identity. The girls within this study were aware of the normative gender expectations linked to ‘being a female’ but did not find this restrictive. The girls moved between many changing identities and organised their ‘web of selves’ accordingly. The apparent need to measure success by the parameters of male standards created a barrier to girls’ identity development

Severidad de dehiscencias y fenestraciones en pacientes orto quirúrgicos con maloclusión Clase III evaluados con tomografía computarizada cone beam

Objective. Determine the frequency and severity of vestibular dehiscences and fenestrations of anterior teeth in orthodontic–surgical patients with skeletal malocclusion, Angle’s Class III; evaluated with presurgical cone-beam computed tomography Methods. Thirty cone-beam computed tomographies of skeletal malocclusion Class III patients with presurgical orthodontic treatment; were evaluated. The sample consisted of on – probabilistic and consecutive cases seen at the Universidad Nacional Mayor de San Marcos Dental School and at the Guillermo Almenara Irigoyen National Hospital’s Dental Service in Lima, Perú in 2018. The dehiscence was considered as the apical migration of the alveolar margin bone starting at 2 mm from the cementoenamel junction, and the fenestration was considered as the exposure of the root portion, excluding the alveolar margin bone; starting at 0.5 mm. Results. Out of all tomographies, 43.3% were from women and 56.7% were from men. Dehiscences were observed in all tomographies, most frequently in the mandible (91.6%) and inferior canines (100%). Fenestrations were observed in 66.7%, most frequently in the maxilla (28.3%) and maxillary canines (31.7%). The severe level was more frequently in dehiscences (65.8%) and fenestrations (13.9%), affecting the inferior canines (100%) and maxillary canines (26.7%), respectively in each defect. Conclusions. Dehiscences were observed in all tomographies, affecting most frequently mandible canines in severe level and fenestrations were observed in most tomographies, affecting most frequently maxillary canines in severe level.Objetivo. Determinar la frecuencia y severidad de las dehiscencias y fenestraciones vestibulares en las piezas anteriores de pacientes orto quirúrgicos con maloclusión de Angle Clase III evaluados con tomografía computarizada de haz cónico pre quirúrgica o tomografía computarizada cone beam. Métodos. Se evaluaron 30 tomografías de pacientes con maloclusión Clase III esquelética con tratamiento de ortodoncia pre quirúrgica. La muestra fue no probabilística, de casos consecutivos, atendidos en la Facultad de Odontología de la Universidad Nacional Mayor de San Marcos y en el Servicio de Odontología del Hospital Nacional Guillermo Almenara Irigoyen durante el año 2018. Se consideró dehiscencia a la migración apical de la cresta alveolar a partir de 2 mm desde la unión cemento–esmalte y fenestración, a la porción radicular expuesta sin afectar el margen óseo a partir de 0,5 mm. Resultados. Del total de tomografías, 43,3% fueron de mujeres y 56,7% fueron de varones. Se observaron dehiscencias en todas las tomografías, con mayor frecuencia en la mandíbula (91,7%) y caninos inferiores (100%). Las fenestraciones se observaron en el 66,7%, con mayor frecuencia en el maxilar (28,3%) y caninos superiores (31,7%). El grado severo fue más frecuente en dehiscencias (65,8%) y fenestraciones (13,9%), afectando los caninos inferiores (100%) y superiores (26,7%), respectivamente en cada defecto. Conclusiones. Las dehiscencias estuvieron presentes en todas las tomografías, afectando a los caninos inferiores en el grado severo y las fenestraciones estuvieron presentes en la mayoría de las tomografías, afectando con mayor frecuencia a los caninos superiores en el grado severo

Plan de negocios para determinar la viabilidad econ?mica de una plataforma acad?mica digital que permita medir y reforzar el progreso escolar individual

Interesados en cambiar la realidad de la Educaci?n B?sica Regular del Per?, debido a que nuestro pa?s ocupa uno de los ultimos lugares en resultados de evaluaciones internacionales. Las instituciones Educativas se han visto en la necesidad de implementar o contratar servicios que le permitan contar con indicadores eficientes de progreso acad?mico, le permitan mejorar el aprendizaje estudiantil y por ende la calidad educativa. En ese sentido el presente trabajo tiene por objetivo evaluar la viabilidad econ?mica de una plataforma acad?mica digital que permita medir y reforzar el progreso escolar con indicadores basados en inteligencia artificial. La propuesta tiene como mercado objetivo los colegios particulares con pensiones superiores a los 300 soles mensuales y pertenecientes a los Niveles Socioecon?micos A y B de Lima provincia y el Nivel Socioecon?mico C de Lima moderna. Se estima que el proyecto requerir? una inversi?n inicial de 134,028 soles para el cual se ha considerado un financiado equivalente al 50% obteniendo como resultado dentro del an?lisis econ?mico un VAN de S/ 367,663 y una TIR de 39% para un horizonte de 5 a?os con lo que concluimos la viabilidad de nuestra propuesta de negocio. As? mismo considerando la incertidumbre generada por la pandemia se ha realizado an?lisis de escenarios adicionales los cuales validaron y robustecieron nuestra propuesta

Manejo de residuos sólidos en el barrio Sinaí y propuesta de educación ambiental, distrito Elías Soplín Vargas-Rioja-San Martín-2015

Once the research on solid waste management in the Sinai neighborhood has been developed, a proposal is made to improve final disposal. Collection, storage and transport are presented as a dimension, as is the proposal for environmental education; through a collection system that works in a timely manner. In this way, benefits are obtained from the separation and commercialization of solid waste that is still usable, creating a circle that cares for resources, health, the environment, and the well-being of the entire population. The design of the research methodology had a qualitative approach, of a descriptive-purpose type, with a qualitative approach and a non-experimental design in its natural context; with a theoretical proposal for its execution. For data collection, the interview technique and the questionnaire instrument were used for 1,300 residents with a sample of 100 members. It is concluded that the management is inadequate due to a deficiency of environmental awareness; causing pollution, diseases, poverty and others. Therefore, it is recommended in the theoretical proposal to the authorities and to each resident of the Sinai neighborhood to create various participatory strategies with projects of prevention and control of the adequate and safe final disposal with a culture of recycling.Desarrollado la investigación sobre el manejo de residuos sólidos en el Barrio Sinaí, plantea una propuesta para mejorar la disposición final. Se presenta como dimensión la recolección, almacenamiento y transporte, como la propuesta de educación ambiental; a través de un sistema de recolección que funcione en tiempo y forma. De esta manera se obtenga beneficios por la separación y comercialización de los residuos sólidos aun aprovechables, creando un circulo que cuide los recursos, la salud, el ambiente y el bienestar de toda la población. El diseño de la metodología de la investigación tuvo un enfoque cualitativo, de tipo descriptivo-propósito, con enfoque cualitativo y de diseño no experimental en su contexto natural; con una propuesta teórica para su ejecución. Para la recolección de datos, se empleó la técnica de la entrevista y el instrumento el cuestionario a los 1300 pobladores con una muestra de 100 miembros. Se concluye que el manejo es de manera inadecuada por deficiencia de conciencia ambiental; causando la contaminación, enfermedades, pobreza y otros. Por lo tanto, se recomienda en la propuesta teórica a las autoridades y a cada poblador del Barrio de Sinaí crear diversas estrategias participativas con proyectos de prevención y control de la disposición final adecuada y segura con cultura de reciclaje

Blueprint for Creating a Community of Care and Support for People with Serious Illness

There is growing awareness nationwide about the importance of care during serious illness and at endof-life.2 The Institute of Medicine (IOM) Report, Dying in America, released in 2014, recommends a person-centered, family-oriented approach that honors individual preferences and promotes quality of life. The IOM Report emphasizes that implementing this vision is a matter of national priority and urgency. In Whatcom County, there is a rising tide of initiatives, interest, and excitement about the idea of creating a community of excellence for people with serious illness. Whatcom County has supported a successful Hospice and inpatient palliative care service for a number of years, and we enjoy a community-wide culture of collaboration that has spawned a university-based institute for palliative care. The NWLP Coalition Task Force was established in 2014 and developed a blueprint that articulates a coherent vision and a plan for collaborative community action toward achieving community excellence for end-of-life care. The original Task Force produced five White Papers that helped inform the original Blueprint. Posted on the WAHA website, the papers cover the following topics: Advance Care Planning; Palliative Care; Community Culture; Provider Training; and Financing the Future. The 2014 Blueprint provided brief background statements for each of these topics, along with keys to excellence, community assets, and recommended steps toward realizing the Blueprint vision. Two years into implementation, the NWLP Coalition is issuing this revised blueprint. Under an expanded title that invites community excellence in “serious illness care” as well as end-of-life care, the Coalition is re-affirming the original vision, and revising the Blueprint with new recommendations that reflect projects completed and lessons learned as well as a set of aspirational community measures