جستجوی مقالات مرتبط با کلیدواژه "competition" در نشریات گروه "پزشکی"

Wackers and colleagues’ scoping review provides an informative and well-structured overview of hospital-based case studies focusing on integrated hospital strategies that seek to improve quality, while reducing or containing costs. Wackers et al take a hospital level perspective and evaluate facilitators and barriers to the successful implementation of those hospital strategies. I complement the hospital level perspective of Wackers et al with an analysis from a health system perspective. Regulations at the superordinate system level might influence decisions at the hospital level that are relevant for costs and quality of care. In this commentary, I discuss how interventions at the system level might affect hospital quality. The results suggest that especially competition between hospitals, pay for performance (PfP) initiatives in combination with publication of quality information, but also greater experience of hospital staff (as proxied by the volume outcome relationship) may provide impulses for improving quality of care.

Various kinds of stressors and psychological problems have been reported in the adolescent student population. This study assessed and compared depression, anxiety, and various coping styles among high school students attending coaching classes for medical entrance examination (MEE) and those not.

Systemic random sampling technique was used to recruit 400 high school students with equal number of those attending (Group 1) and those not attending any coaching class for MEE (Group 2). They underwent screening for depression and anxiety through Patient Health Questionnaire‑9 and Generalized Anxiety Disorder 7‑item. Coping styles were assessed through brief COPE inventory. Screening positive subjects were assessed in detail by a psychiatrist using ICD‑10 (International Classification of Diseases 10th Revision), Diagnostic Criteria for Research (DCR). The severity of depression and anxiety was measured through HAM‑D and HAM‑A, respectively.

Depression and anxiety were reported by higher proportion of Group 1 (36%) than Group 2 (22%), χ2 (1) = 9.52; P = 0.002. In both the groups, depressive disorder was the most common, followed by generalised anxiety–disorder and mixed anxiety–depression. The severity of depression (HAM‑D score) and anxiety (HAM‑A Score) was significantly more Group 1. “Active coping” (χ2 = 4.79 P = 0.02) and “Humor” (χ2 = 30.90, P ≤ 0.01) were more commonly used by healthy students, while “Religious coping” (χ2 = 37.92 P ≤ 0.01) were the most common among those diagnosed with depression/anxiety disorder.

Higher prevalence of the psychological problems in adolescent school students preparing for MEE highlights the importance of aptitude assessment, career counseling, and school mental health program before their exposure to the competitive academic atmosphere.

Studies in this domain help focus on the techniques with high application to improve the point attainment, without providing points for the other opponents.

The purpose of this study was to analyze and investigate the most common scoring techniques used and the highest intensity competition times that have been fulfilled by the champions of the World Karate Leagues 2019 and the World Championship 2018.

One hundred and eighteen karate competitions in 5 weight groups (-60, -67, -75, -84, and +84) and from each weight rank, including 5 top-level athletes of the World Karate Federation ranking, were analyzed and studied. This study data were collated using Video Analyzer, Microsoft Excel, and SPSS, and the data were assessed using the Chi-square statistical tests (χ2).

This study indicated that only 31.9% of total attacks fulfilled by the world champions were successful in gaining points, the last minute of competition was the highest intensity time in a three-minute competition (with 46.70% of attacks happening then), and the techniques of Ashi Barai and Gia Kuzuki were the most commonly used techniques among the techniques for scoring used by world champions.

The coaches must develop new strategies during the training sessions and compare their athletes’ techniques with those of the world elites to gain uniform endeavors and improve their athletes’ performance to reach the level of world champions.

Stress is inevitable in competitive sports. Table tennis in the world known as a fastest ball game that requires attention and control stress. The main purpose of this study was investigation of physiological stress responses in elite table tennis players during competition. 16 female table tennis players (age average of 18.7 ± 3.8, height average of 161.6 ± 3.4 cm and weight average of 50.1 ± 4.2 kg) that participating in elective national team selected. During 8 competitive racing, salivary levels of Cortisol (C), testosterone (T) and Immunoglobulin A (sIgA) at rest, 60 and 30 minutes before and 60 and 30 minutes after racing were measured through saliva by enzymatic methods (ELISA). Data were analyzed using two-way repeated-measures analysis of variance. The findings presented that Cortisol level in loser player was significantly increased than winner player (p<0.05); while there was no significant difference in testosterone and sIgA levels (p>0.05). Also significant difference in salivary testosterone, Cortisol and sIgA periods of 60 and 30 minutes before and after competition observed in the group of winners and losers than rest(p<0.05). Table tennis competition puts high stress on young players, that probably these indicators affect the performance table tennis players. Cortisol as an indicator of stress has an important effect on losers than winners.

Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests.
This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier’s Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semistructured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women’s and Children’s Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions.
The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival.
As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actorcoalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process.

An important determinant of health system performance is contracting. Providers often respond to financial incentives, despite the ethical underpinnings of medicine, and payers can craft contracts to influence performance. Yet contracting is highly imperfect in both single-payer and multi-payer health systems. Arguably, in a competitive, multi-payer environment, contractual innovation may occur more rapidly than in a single-payer system. This innovation in contract design could enhance performance. However, contractual innovation often fails to improve performance as payer incentives are misaligned with public policy objectives. Numerous countries seek to improve healthcare contracts, but thus far no health system has demonstrably crafted the necessary blend of incentives to stimulate optimal contracting.

The role of competition in healthcare is much debated. Despite a wealth of international experience in relation to competition, evidence is mixed and contested and the debate about the potential role for competition is often polarised. This paper considers briefly some of the reasons for this, focusing on what is meant by “competition in healthcare” and why it is more valuable to think about the circumstances in which competition is more and less likely to be a good tool to achieve benefits, rather than whether or not it is “good” or “bad,” per se.