Benefits and limitations of implementing Chronic Care Model (CCM) in primary care programs: a systematic review

Background: Chronic Care Model (CCM) has been developed to improve patients' health care by restructuring health systems in a multidimensional manner. This systematic review aims to summarize and analyse programs specifically designed and conducted for the fulfilment of multiple CCM components. We have focused on programs targeting diabetes mellitus, hypertension and cardiovascular disease. Method and results: This review was based on a comprehensive literature search of articles in the PubMed database that reported clinical outcomes. We included a total of 25 eligible articles. Evidence of improvement in medical outcomes and the compliance of patients with medical treatment were reported in 18 and 14 studies, respectively. Two studies demonstrated a reduction of the medical burden in terms of health service utilization, and another two studies reported the effectiveness of the programs in reducing the risk of heart failure and other cardiovascular diseases. However, CCMs were still restricted by limited academic robustness and social constraints when they were implemented in primary care. Higher professional recognition, tighter system collaborations and increased financial support may be necessary to overcome the limitations of, and barriers to CCM implementation. Conclusion: This review has identified the benefits of implementing CCM, and recommended suggestions for the future development of CCM

Transport in rough self-affine fractures

Transport properties of three-dimensional self-affine rough fractures are studied by means of an effective-medium analysis and numerical simulations using the Lattice-Boltzmann method. The numerical results show that the effective-medium approximation predicts the right scaling behavior of the permeability and of the velocity fluctuations, in terms of the aperture of the fracture, the roughness exponent and the characteristic length of the fracture surfaces, in the limit of small separation between surfaces. The permeability of the fractures is also investigated as a function of the normal and lateral relative displacements between surfaces, and is shown that it can be bounded by the permeability of two-dimensional fractures. The development of channel-like structures in the velocity field is also numerically investigated for different relative displacements between surfaces. Finally, the dispersion of tracer particles in the velocity field of the fractures is investigated by analytic and numerical methods. The asymptotic dominant role of the geometric dispersion, due to velocity fluctuations and their spatial correlations, is shown in the limit of very small separation between fracture surfaces.Comment: submitted to PR

ELECTRONIC AND TRANSPORT PROPERTIES OF LIQUID QUENCHED AMORPHOUS (Mo1-xxRux) 80P20 SUPERCONDUCTORS

Les résultats sur les propriétés supraconductrices et les susceptibilités magnétiques d'alliages amorphes à base de molybdène obtenus par trempe du liquide sont présentés et discutés. Les températures de transition supraconductrice de ces alliages varient de 3 K à 9 K. La corrélation entre Tc et la susceptibilité magnétique est observée. Néanmoins, la variation prévue de la densité d'états au niveau de Fermi avec la valence ne permet pas dans le cadre des théories de "l'alliage sale", d'expliquer la variation du champ critique supérieur.Results of superconductive properties and magnetic susceptibilities of amorphous molybdenum based alloys obtained by liquid quenching are presented and discussed. These alloys have superconducting transition temperatures ranging from 3 K to 9 K. Correlation between Tc and magnetic susceptibility is observed. However, the predicted variation of density of states at the Fermi level with electron valence fails to explain the observed variation in the upper critical field within the framework of "dirty alloy" theories

Self-regulated learning strategies & academic achievement in online higher education learning environments: a systematic review

© 2015 Elsevier Inc. All rights reserved. As enrolments in online courses continue to increase, there is a need to understand how students can best apply self-regulated learning strategies to achieve academic success within the online environment. A search of relevant databases was conducted in December 2014 for studies published from 2004 to Dec 2014 examining SRL strategies as correlates of academic achievement in online higher education settings. From 12 studies, the strategies of time management, metacognition, effort regulation, and critical thinking were positively correlated with academic outcomes, whereas rehearsal, elaboration, and organisation had the least empirical support. Peer learning had a moderate positive effect, however its confidence intervals crossed zero. Although the contributors to achievement in traditional face-to-face settings appear to generalise to on-line context, these effects appear weaker and suggest that (1) they may be less effective, and (2) that other, currently unexplored factors may be more important in on-line contexts

APOE ϵ4, rated life experiences, and affect among centenarians

Additional authors include M. Gearing, W. R. Markesbery, J. S. Tenover, W. L. Rodgers, D. B. Hausman, & C. Rott who are involved with the Georgia Centenarian Study.Objectives: The purpose of this study was to assess the relationship between apolipoprotein E (APOE), life events and engagement, and subjective well-being (as measured by positive and negative affect) among centenarians. Based on the life stress paradigm, we predicted that higher levels of stress would allow APOE to influence positive and negative affect. Method: 196 centenarians and near-centenarians (98 years and older) of the Georgia Centenarian Study participated in this research. The APOE, positive and negative affect, the number of recent (last 2 years) and lifelong (more than 20 years prior to testing) events, as well as a number of life engagement tasks were assessed. Results: Results suggested that centenarians carrying the APOE ϵ4 allele rated lower in positive affect, the number of lifelong events, and in engaged lifestyle, when compared to centenarians without the APOE ϵ4 allele (t = 3.43, p < .01; t = 3.19, p < .01; and t = 2.33, p < .05, respectively). Blockwise multiple regressions indicated that the APOE ϵ4 predicted positive but not negative affect after controlling for demographics. Gene–environment interactions were obtained for the APOE ϵ4 and lifelong events, suggesting that carriers of the APOE ϵ4 allele had higher scores of negative affect after having experienced more events, whereas noncarriers had reduced negative affect levels after having experienced more events. Conclusion: APOE ϵ4 is directly related to positive affect and is related to negative affect in interaction with life events

Clinical features and survival outcomes of ocular melanoma in a multi-ethnic Asian cohort

10.1038/s41598-020-73534-xScientific Reports1011636