[Features of medical care provision in the profile «Maxillofacial surgery¼ in the Southern Federal District of the Russian Federation]. / Osobennosti okazaniya meditsinskoi pomoshchi po profilyu «chelyustno-litsevaya khirurgiya¼ v Yuzhnom federal'nom okruge Rossiiskoi Federatsii.

OBJECTIVE: To study the actual state of the organization of medical care for patients with the profile of «maxillofacial surgery¼ in the Southern Federal District of the Russian Federation in order to develop proposals for its optimization within the framework of a three-level system of medical care. MATERIAL AND METHODS: We analyzed accounting and reporting materials characterizing the organization of medical care in the field of «Oral and maxillofacial surgery¼ to the population in the Southern Federal District of the Russian Federation. RESULTS: The population of the Southern Federal District of the Russian Federation is currently provided with accessible round-the-clock medical care in the field of maxillofacial surgery. The forces and means at the disposal of the district government allow this to be implemented. However, the article describes a number of obstacles to the provision of high-quality medical care in the field of maxillofacial surgery and suggests ways to eliminate them. CONCLUSION: Preparation of an Order defining the functioning of a three-level system of medical care for adults and children with maxillofacial pathology in the Southern Federal District of the Russian Federation, as well as more effective use of telemedicine consultations will significantly improve the availability and quality of medical care.

Short-term acceptability of the Woman's Condom and influencing factors among internal migrants in China.

BACKGROUND: The Woman's Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman's Condom and influencing factors among internal migrants. METHODS: A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects. RESULTS: Three-level model analysis revealed statistically higher short-term acceptability of the Woman's Condom among subjects who lived in Shanghai (ß = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (ß = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (ß = - 1.69, t = - 7.55, p < 0.01) and lower educational attainment (ß = - 2.30, t = - 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (ß = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants' acceptability of the Woman's Condom would significantly increase over time (ß = 1.09, t = 5.54, p < 0.01). CONCLUSIONS: The findings indicate that the Woman's Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women's Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.

Cognitive expertise in esport experts: a three-level model meta-analysis.

Objectives: The cognitive expertise of experts has been an intriguing theme; there has been rapid growth in cognitive research related to esports. Given the close association between esports activities and cognition, esports holds promise in offering new perspectives for understanding cognitive expertise. This meta-analysis aims at quantitatively delineating the cognitive disparities between esports experts and amateurs. Methods: The expert group comprised professional video game players and high-ranking players (top 1%), while amateurs were assigned to the control group. Research studies published between January 2000 and December 2023 were systematically searched in databases. A three-level model with cluster-robust variance estimation was used to calculate the overall effect size. The moderating variables included professional level, cognitive abilities, dependent variable type, game genre, gender and age. Results: A total of 15 studies containing 142 effect sizes and 1085 participants were included in this meta-analysis. The results indicated that, compared to amateurs, video game experts demonstrated superior cognitive abilities with a small effect size (Hedges' g = 0.373, 95% CI [0.055-0.691], p = .012). The differences between experts and amateur players mainly manifest in spatial cognition and attention. Sensitivity analysis, risk of bias, and publication bias results indicated the reliability of these findings. Conclusions: This meta-analysis confirms that esports experts possess superior cognitive abilities compared to amateurs, particularly in aspects of spatial cognition and attention. These can provide an effective reference for future selection and training in esports.

Clinical Evidence, Triangulation of Perspectives and Contextualization. Part 1: The Beginning of Carla's Treatment.

We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM). We analyze the case of a patient treated with transference-focused psychotherapy (TFP), making explicit the theoretical-clinical agreements and disagreements of the authors. We discuss the strengths and limitations of triangulation and contextualization, concluding that they make clinical work and psychoanalytic writing more reliable, transparent, auditable, and replicable.

Debates in psychoanalysis: A Latin American perspective.

While pluralism allows for the recognition of different psychoanalytic models, it still remains a challenge to build processes and arguments strong enough to resolve basic disagreements. The Three-Level Model constitutes a valuable tool to an open critical discussion among analysts of different theoretical orientations regarding a clinical material, by providing sources of evidence about patient transformations in an analytic process.

Agreements and differences between psychoanalysts with regard to changes observed during a treatment. A quantitative exploration using the Three-Level Model (3-LM).

The aim of this paper is to report the partial results of an exploratory investigation into how twelve psychoanalysts of different theoretical-clinical orientations perceive and use hypotheses about the phenomena of change in connection with selected material from a psychoanalytic treatment. The Three-Level Model (3-LM) was used for the observation of patient transformations and for the collection of data. This was followed by the statistical analysis of the behaviour and relationship of a set of variables relating to the type and degree of change perceived in the patient's mental functioning during the course of her treatment. The results reported here show that there was significant agreement among the participants, irrespective of their theoretical-clinical orientation, as regards the following: 1) the positive impact of the application of psychoanalytic treatment in diverse areas of the patient's mental functioning; 2) the explanatory hypotheses of the changes observed in the patient under consideration; 3) the usefulness of the experience of group exchange using the 3-LM in observing and understanding the changes in the patient.

Giant NLO response and deep ultraviolet transparency of dual (alkali/alkaline earth) metals doped C6O6Li6 electrides.

The designing of new materials having outstanding nonlinear optical (NLO) response is much needed for use in latest optics. Herein, the geometric, electronic and NLO properties of alkali and alkaline earth metals doped C6O6Li6 (alk-C6O6Li6-alkearth, alkearth = Ca, Mg, Be and alk = K, Na, Li) electrides is studied via quantum chemical approach. The interaction energies (Eint) are examined to illustrate their thermodynamic stability. The strong interaction energy of -39.99 kcal mol-1 is observed for Ca-C6O6Li6-Li electride in comparison to others. Frontier molecular orbitals (FMOs) energy gap of considered complexes is changed due to the electronic density shifting between metals and C6O6Li6 surface, which notifies the semi conducting properties of these electrides. The FMOs isodensities and natural bond orbital (NBO) charge analysis are performed to justify charge transfer between dopants and complexant. UV-Visible study also confirmed the application of these electrides as deep ultra-violet laser devices. NLO response is studied through calculation of first hyperpolarizability (ßo). The highest ßo value of 1.68 × 105 au is calculated for Mg-C6O6Li6-K electride. NLO response is further rationalized by three- and two-level models approach.

Psychoanalytic identity in vivo: Permanence and change.

Psychoanalytic identity "in vivo" means psychoanalysis as an authentic, lived experience, socially and historically situated. What we have inherited from the psychoanalytic tradition now needs to be collectively and individually updated and shaped as therapy, as research and as theory. The focus of this paper is on developing a more critical and realistic sense of psychoanalytic identity, grounded in our clinical experience. We need to recognise our identity in what we actually do and achieve with our patients in our daily practice and avoid idealisations or devaluations arising from theoretical speculation. The important role of the Three Level Model (3-LM) and similar working parties is discussed. Psychoanalysts need a pluralistic professional identity, which implies triangulating our clinical perspectives with those of other colleagues, as happens in 3-LM clinical discussion groups, and contextualizing our knowledge from a broad perspective, including extra-clinical research and interdisciplinary dialogue with both health sciences and hermeneutic disciplines. A psychoanalytic identity that is open to the future requires an acknowledgement of the different positions that exist within our discipline and neighbouring fields, and a willingness to critically examine and discuss these differences.

Transformation and Interpretation: The Case of Adam, A Clinical Narrative and Discussion.

This paper demonstrates how the Three-Level Model for Observing Transformations in Psychoanalysis permits a lively discussion among analysts on change and absence of change in the patient. The authors debate the nature and degree of the difficulties and explore conceptual questions and theoretical ideas to shed further light on change and mechanisms of change in the case of Adam.

The Influence of Sample Size on Parameter Estimates in Three-Level Random-Effects Models.

In educational psychology, observational units are oftentimes nested within superordinate groups. Researchers need to account for hierarchy in the data by means of multilevel modeling, but especially in three-level longitudinal models, it is often unclear which sample size is necessary for reliable parameter estimation. To address this question, we generated a population dataset based on a study in the field of educational psychology, consisting of 3000 classrooms (level-3) with 55000 students (level-2) measured at 5 occasions (level-1), including predictors on each level and interaction effects. Drawing from this data, we realized 1000 random samples each for various sample and missing value conditions and compared analysis results with the true population parameters. We found that sampling at least 15 level-2 units each in 35 level-3 units results in unbiased fixed effects estimates, whereas higher-level random effects variance estimates require larger samples. Overall, increasing the level-2 sample size most strongly improves estimation soundness. We further discuss how data characteristics influence parameter estimation and provide specific sample size recommendations.

Predicting Behavioral Intentions Related to Cervical Cancer Screening Using a Three-Level Model for the TPB and SCT in Nanjing, China.

: Objective: Exploring how the theory of planned behavior (TPB), social capital theory (SCT), cervical cancer knowledge (CCK), and demographic variables predict behavioral intentions (BI) related to cervical cancer screening among Chinese women. METHODS: Self-administered questionnaires were distributed to 496 women, followed by a path analysis. RESULTS: The three-level model was acceptable, χ2(26, 470) = 26.93, p > 0.05. Subjectively overcoming difficulties, support from significant others, screening necessity, and the objective promotion factor promoted BI, with effect sizes of 0.424, 0.354, 0.199, and 0.124. SCT and CCK promoted BI through TPB, with effect sizes of 0.262 and 0.208. Monthly income, education, age, and childbearing condition affected BI through TPB, SCT, and CCK, with effect sizes of 0.269, 0.105, 0.065, and -0.029. CONCLUSION: The three-level model systematically predicted behavioral intentions relating to cervical cancer screening.

The interplay of contextual layers: A multilevel analysis of income distribution, neighborhood infrastructure, socioeconomic position and self-rated health in Brazil.

Our hypothesis is that neighborhood infrastructure modifies the association between state-level income distribution and self-rated health. In our findings neighborhood infrastructure amplifies the association between income equality and self-rated health, yet with a differential impact on health according to sex, race and education level favoring individuals at higher socioeconomic positions. Most of the individual health variation attributed to context happens at neighborhood level, based on random effects analyses. Our findings contribute to a further understanding of health inequalities in Brazil. The demonstrated synergism between state, neighborhood and individual level determinants of health supports inter-sectoral policies and interventions in a clearly multileveled way.

A common ground in clinical discussion groups: Intersubjective resonance and implicit operational theories.

Clinical discussion groups based on the Three-Level Model for Observing Patient Transformations (3-LM) enable us to reflect on the clinical common ground shared by psychoanalysts who have different theoretical frameworks. The very existence of this common ground is controversial. While analysts such as Wallerstein support it, others, like Green, think it is just a myth. In their 2005 controversy Wallerstein and Green proposed an observation procedure that might clarify this matter. This procedure bears great similarity to the one used by clinical discussion groups that apply the 3-LM. The study of numerous theoretically heterogeneous groups that use this model shows that communication is possible in crucial areas. We may thus conclude that a partial and dynamic common ground exists. At a phenomenological level, certain fragments of material produce a shared resonance that enriches clinical understanding for the whole group. Communication is also possible with regard to the conceptualization of patient changes, although some controversial issues persist at this level. Finally, at the level of theoretical explanations, divergences concerning abstract theories do not prevent a fertile interaction among 'in vivo' personal implicit theories. The latter give rise to the actual operational frameworks underlying participants' approach to clinical problems.

Assessing meta-regression methods for examining moderator relationships with dependent effect sizes: A Monte Carlo simulation.

Dependent effect sizes are ubiquitous in meta-analysis. Using Monte Carlo simulation, we compared the performance of 2 methods for meta-regression with dependent effect sizes-robust variance estimation (RVE) and 3-level modeling-with the standard meta-analytic method for independent effect sizes. We further compared bias-reduced linearization and jackknife estimators as small-sample adjustments for RVE and Wald-type and likelihood ratio tests for 3-level models. The bias in the slope estimates, width of the confidence intervals around those estimates, and empirical type I error and statistical power rates of the hypothesis tests from these different methods were compared for mixed-effects meta-regression analysis with one moderator either at the study or at the effect size level. All methods yielded nearly unbiased slope estimates under most scenarios, but as expected, the standard method ignoring dependency provided inflated type I error rates when testing the significance of the moderators. Robust variance estimation methods yielded not only the best results in terms of type I error rate but also the widest confidence intervals and the lowest power rates, especially when using the jackknife adjustments. Three-level models showed a promising performance with a moderate to large number of studies, especially with the likelihood ratio test, and yielded narrower confidence intervals around the slope and higher power rates than those obtained with the RVE approach. All methods performed better when the moderator was at the effect size level, the number of studies was moderate to large, and the between-studies variance was small. Our results can help meta-analysts deal with dependency in their data.