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Rethinking how to deal with demand and supply in CAP : a European training perspective
No full textMental health care is suffering from a substantial gap between current service provision capacity and demand. For the generation of young doctors in psychiatry training programs today, this means they face substantial and potentially overwhelming challenges in their clinical practice. This situation calls for creative solutions in psychiatry training to prepare them best for these challenges. Perspectives of European trainers in child and adolescent psychiatry (CAP) were collected and analysed following an iterative procedure in three rounds using thematic analysis of focus groups. The three iterative rounds resulted in five proposed strategies for meeting the challenges of current and future demand in CAP specifically addressing implications for CAP training. Examples were provided illustrating how these strategies could be put into daily training practices. Four strategies aimed mainly at increasing capacity: efficiency (making best use of the existing CAP workforce); consultation (task-sharing); innovation (practicing differently); and wellbeing of the CAP workforce. An additional strategy focusing on prevention and early intervention was identified to decrease demand upstream. Rethinking CAP training practices through a European perspective on the balance between capacity and demand yielded strategies for aspects of training that are not yet universally applied. Implementation is partly dependent on the larger service provision system of care while training has leverage for future capacity and quality of care
Investigating the relationship between self-regulated learning and language proficiency among EFL students in Vietnam
Get PDFSelf-regulated learning (SRL) strategies have received significant attention among researchers and become the topic of many empirical studies, since they are believed to significantly influence achievement levels in acquiring a foreign language. The current research investigated the SRL strategies most commonly employed by Vietnamese English as a foreign language (EFL) students, as well as any potential correlation between these strategies and language proficiency levels. The study randomly selected 140 undergraduate students. The participants had different levels of English proficiency and learning backgrounds. They completed an SRL questionnaire consisting of 50 items, which is comprised of two parts. Quantitative methods were used to collect data, and descriptive statistics and correlation analysis were employed to determine the correlation between learners’ SRL and language proficiency. Results indicated that the participants often employed a range of self-regulation strategies for language learning. The three strategies that were most frequently used were elaboration, help-seeking, and time and study environment management, while critical thinking and effort regulation were the least common. Furthermore, a notable positive relation was observed between students’ SRL strategies and language proficiency. It was clear that language proficiency and elaboration correlated most significantly, while the lowest correlation was found between language proficiency and effort regulation. Therefore, key adjustments should be made to curricula by educators and institutions to strengthen students’ SRL skills. Educators should also receive specialized training in incorporating SRL strategies into language instruction to support learners’ SRL skills development
A Review of the Chebyshev Inequality Pertaining to Fractional Integrals
Get PDFIn this article, we give a brief review of a well-known integral inequality that gives information about the integral of the product of two functions using synchronous functions, the Chebyshev inequality. We have compiled the most relevant information about fractional and generalized integrals, which are one of the most dynamic topics in today's mathematical sciences. After presenting the classical formulation of the inequality using Lebesgue integrable functions, the most general results known from the literature are collected in an attempt to present the reader with a current overview of this research topic
English summary: Javaheri, Mohammad; Shen, Harry: On a cyclic inequality related to Chebyshev polynomials. Involve 17 (2024), no. 3, 519--530.
No full textDefining early vascular aging in youth: an expert consensus document from the youth vascular consortium
No full textThe concept of early vascular aging (EVA) was introduced to identify adults at risk of developing premature cardiovascular disease. EVA, or the dissociation between chronologic and biologic age of large arteries, is an evolving concept. In this review, we propose that EVA in youth characterizes the early life biological and environmental risk factors that precede overt EVA. During early infancy, childhood and/or adolescence, structural and/ or functional characteristics of the macrovascular and/or microvascular system may deviate from that expected for the chronological age of the individual. Assessing vascular aging from a young age may help detect and prevent the early onset of cardiovascular disease. This consensus document from the Youth Vascular Consortium outlines the principles of EVA in youth (birth to 24years), examines factors influencing vascular growth, and identifies current knowledge gaps. It also provides an expert consensus on defining EVA in youth. Supplementary Tables 1–3, http://links.lww.com/HJH/C733, http://links.lww.com/HJH/C734,http://links.lww.com/HJH/C735 supply key references for risk factors associated with EVA at different points in development; 1. Neonates to childhood; 2. Adolescence; 3. Young adults. Supplementary Table 4, http://links.lww.com/HJH/C736 displays reference ranges of EVA in adults. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved
Structural elucidation of four fungal hydrophobins belonging to classes I and II: Results from Alphafold and accelerated molecular dynamics simulations
Get PDFA matematikai szöveges feladatok és a szövegértés összefüggése, illetve azok alkalmazása óvodáskorban
Get PDFEKG-eltérések gyakorisága hypertrophiás cardiomyopathiában: aki keres, az talál [Prevalence of ECG abnormalities in hypertrophic cardiomyopathy: who seeks will find]
Get PDFBevezetés: Az Európai Kardiológus Társaság 2023-ban publikált, Cardiomyopathia Irányelve a cardiomyopathiák diagnosztikájában a multiparametrikus megközelítés fontosságát hangsúlyozza. A hypertrophiás cardiomyopathia kivizsgálásában az echokardiográfia, a szív mágnesesrezonancia-vizsgálata mellett az EKG is fontos szerepet játszik. Szakirodalmi adatok alapján a hypertrophiás cardiomyopathiában szenvedő betegek mindössze 4–18%-a rendelkezik eltérés nélküli EKG-val, ám a megfigyelt EKG-eltérések gyakorta aspecifikusak. Célkitűzés: Tercier kardiológiai centrumunk, a Gottsegen György Országos Kardiovaszkuláris Intézet Szívelégtelenség Ambulanciáján gondozott, hypertrophiás cardiomyopathiában szenvedő betegpopuláció EKG-jellemzőinek értékelése. Módszer: Intézetünk Szívelégtelenség Ambulanciáján 2023. 11. 01. és 2024. 09. 30. között gondozásba vett, a szív mágnesesrezonancia-vizsgálatával és/vagy genetikai vizsgálattal igazolt hypertrophiás cardiomyopathiában szenvedő betegek adatait, első ambuláns EKG-paramétereit elemeztük retrospektív módon. Eredmények: A vizsgált betegek (n = 72 fő) 58%-a volt férfi, mediánéletkoruk 49 (34–62) év, bal kamrai ejekciós frakciójuk 63 (47–72)%, NYHA funkcionális osztályuk 2 (1–2) volt, ICD-t/CRT-D-t 47%-uk viselt. A balkamrakiáramlási-pályaobstrukciójának ≥30 Hgmm értéke alapján a betegek 31%-a tartozott a hypertrophiás obstruktív cardiomyopathia csoportba. Az elemzett EKG-kon a betegek 6%-a pitvarfibrillált, az interatrialis vezetési zavarok a 29%-ukat érintették. Atrioventricularis és intraventricularis vezetési zavarok a betegek 50%-ában jelentkeztek (AV blokk: 20% [PQ-szakasz-megnyúlás: 18%, II. fokú AV blokk: 2%, III. fokú AV blokk: 0%], jobb-Tawara-szárblokk: 14%, bal-Tawara-szár-blokk: 16%, bal anterior hemiblokk: 13%, bal posterior hemiblokk: 3%, aspecifikus intraventricularis vezetési zavar: 8%). A Cornell, a Sokolow–Lyon-, illetve a Peguero–Lo Presti „high voltage” kritériumok szenzitivitása alacsonynak bizonyult (23–14–25%). Patológiás Q-hullám 42%-ban, QRS-fragmentáció 43%-ban, korrigált QT-idő-megnyúlás 44%-ban fordult elő. Repolarizációs eltérések, mint a T-hullám-inverzió, a csoport 94%-ában, szignifikáns ST-eleváció a 21%-ában és ST-depresszió a 48%-ában volt megfigyelhető, mindössze a páciensek 3%-a rendelkezett negatív EKG-val. A hypertrophiás obstruktív cardiomyopathia és a nonobstruktív hypertrophiás cardiomyopathia alcsoportok között egyedül a Cornell-kritérium gyakoriságában adódott különbség (45% vs. 15%, p = 0,044). Következtetés: A hypertrophiás cardiomyopathia diagnosztikájában elengedhetetlen a multimodális szemlélet. Eredményeink alapján hypertrophiás cardiomyopathiában gyakorta azonosíthatók heterogén EKG-eltérések, ám a gyanújelek időbeli felismerése a további diagnosztikus lépéseket segítheti, hozzájárulva a célzott kezelés megkezdéséhez, a prognózis javításához. | ntroduction: The 2023 European Society of Cardiology Cardiomyopathy Guidelines emphasize the crucial role of a
multiparametric approach in diagnosing. During the diagnostic workup of hypertrophic cardiomyopathy, besides
echocardiography and cardiac magnetic resonance, ECG plays an important role. Based on literature data, only
4–18% of patients with hypertrophic cardiomyopathy have normal ECG, however, ECG deviations are often non-
specific.
Objective: To evaluate the ECG characteristics in a hypertrophic cardiomyopathy patient cohort followed-up at the
Heart Failure Outpatient Clinic of Gottsegen National Cardiovascular Center.
Method: We retrospectively analyzed the data and the first ECGs registered of patients with hypertrophic cardiomyo-
pathy, diagnosed by cardiac magnetic resonance and/or genetic testing, followed-up between 01. 11. 2023 and 30.
09. 2024 at our Heart Failure Outpatient Clinic.
Results: Data from 72 patients were evaluated, male: 58%, age: 49 (34–62) years, left ventricular ejection fraction: 63
(47–72)%, NYHA functional class: 2 (1–2), ICD/CRT-D: 47%. Based on the left ventricular outflow tract obstruc-
tion of ≥30 mmHg, 31% of the patients belonged to hypertrophic obstructive cardiomyopathy subgroup. Based on
the ECGs analyzed, atrial fibrillation occurred in 6%. Interatrial conduction disturbances affected 29% of the patients.
Atrioventricular and intraventricular conduction disturbances occurred in 50% (AV block: 20% [grade I: 18%, grade
II: 2%, grade III: 0%], right bundle branch block: 14%, left bundle branch block: 16%, left anterior hemiblock: 13%,
left posterior hemiblock: 3%, non-specific intraventricular conduction disturbance: 8%). The sensitivity of the Cor-
nell, Sokolow–Lyon, and Peguero–Lo Presti “high voltage” criteria were low (23–14–25%). Pathological Q wave
occurred in 42% of the patients, QRS fragmentation in 43% and corrected QT interval prolongation in 44%. T wave
inversion was present in 94%, significant ST elevation in 21%, ST depression in 48%, while only 3% of patients had
negative ECG. The only difference between hypertrophic obstructive cardiomyopathy and non-obstructive hyper-
trophic cardiomyopathy patients was the fulfillment of the Cornell criterion (45% vs. 15%, p = 0.044).
Conclusions: A multimodal approach is essential in the diagnosis of hypertrophic cardiomyopathy. Based on our re-
sults, hypertrophic cardiomyopathy is often associated with heterogeneous ECG abnormalities. However, the early
recognition of the ECG variations may help in the further diagnostic steps, contributing to the initiation of disease-
modifying treatment
A bírói illetmény mint a függetlenség garanciája
No full textOne of the guarantees of judicial independence is the adequate remuneration of judges, which is worthy of their profession. Several European and international documents have formulated different basic requirements in this regard. The study will present whether the current situation of Hungarian judges’ remuneration meets these requirements