Background: Due to its ethical approach and its protection of patients and their interests, quaternary prevention can increase the quality-of-service provision and decrease costs and the wastage of resources. The present study used interpretive structural modeling (ISM) to classify the effective factors and determine a quaternary prevention model for Iran's Rural Family Physician Program.
Methods: This study was a qualitative study with an ISM approach. Twenty-five health system experts and faculty members participated in the study. The interrelationships between the factors were determined using ISM, and after classification, the driving and dependence power of the factors were specified using MICMAC analysis.
Results: The 20 factors were classified into five levels. The results indicated that patient interest and vulnerable groups had the highest effectiveness, and officials' and policymakers' commitment to providing serious support for family physicians had the highest affectability. The factors were placed into the two groups of linkage and dependence based on the MICMAC analysis.
Conclusions: The new technologies are costly and sometimes only suitable for a specific group of patients. Costs and the issues of induced demand and defensive medicine necessitate a different view of health service distribution. The preventive and strategic view and the comprehensiveness of family physician services make quaternary prevention possible by providing high-risk and vulnerable groups with essential services based on patient needs and conditions with more benefit than harm.
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http://dx.doi.org/10.4103/ijpvm.ijpvm_116_22 | DOI Listing |
Pediatr Crit Care Med
December 2024
Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO.
Objectives: To describe frequency of, and risk factors, for change in caregiver employment among critically ill children with acute respiratory failure.
Design: Preplanned secondary analysis of prospective cohort dataset, 2018-2021.
Setting: Quaternary Children's Hospital PICU.
Environ Sci Technol
December 2024
State Environmental Protection Key Laboratory of Formation and Prevention of Urban Air Pollution Complex, Shanghai Academy of Environmental Sciences, Shanghai 200233, China.
Reactive nitrogen (Nr) emissions significantly affect air quality and the nitrogen cycle in ecosystems. Heavy-duty diesel vehicles (HDDVs), as major sources of these emissions, exhibit complex emission characteristics because of the combined effects of different driving conditions and aftertreatment technologies. This study first investigated the emission factors (EFs) of Nr species, including NO, NO, HONO, NO, and NH, from HDDVs under different emission standards (China IV/V/VI) and cheating strategies, with a particular focus on the impact of selective catalytic reduction (SCR) systems.
View Article and Find Full Text PDFMolecules
November 2024
N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, 119991 Moscow, Russia.
While the pandemic is behind us, the world community faces a global threat of bacterial resistance outbreak. One of the key ways to combat the spread of multi-resistant bacteria is infection prevention and control tactics using modern antiseptic and disinfectant compositions. Herein, we continue the path to unravel the structure-activity relationship (SAR) of potent pyridine-derived biocide class bis-quaternary ammonium compounds (QACs).
View Article and Find Full Text PDFInnovation (Camb)
May 2024
Chengdu University of Information Technology, Chengdu 610225, China.
Streamflow and flood forecasting remains one of the long-standing challenges in hydrology. Traditional physically based models are hampered by sparse parameters and complex calibration procedures particularly in ungauged catchments. We propose a novel hybrid deep learning model termed encoder-decoder double-layer long short-term memory (ED-DLSTM) to address streamflow forecasting at global scale for all (gauged and ungauged) catchments.
View Article and Find Full Text PDFBioconjug Chem
December 2024
Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China.
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