Figure 3 shows our conceptual framework that combines the primary care and integrated care literature into a holistic picture. The core value of primary care is the integration of the biomedical, psychological and social dimensions of health and well-being, expressed in our conceptual framework as person-focused and population-based care. The person-focused and population-based care perspectives provide a foundation upon which the entire conceptual framework rests.
The algebraic properties of functional integrals are used to develop series used to calculate properties in quantum electrodynamics and the standard model of particle physics. To inform about the uses and advantages of a product can be through social media. This is because the information disseminated through social media will be easily known by many people. Information spread through social media will make it easier for a product company to communicate with consumers.
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We formulate the functional integration for Hamiltonian evolution first in quantum mechanics which can be considered as quantum field theory in one space-time dimension. Feynman formulated his path integral integral on the physical basis of an interference of short time amplitudes. The composition of short time amplitudes has a mathematical version of the Trotter product formula. If the potentials and wave functions have an analytic continuation in the complex plane then the Feynman integral can be expressed by a well-defined Wiener measure. We show that if the perturbation series in the potential is convergent then the sum of the series is equal to the Feynman integral.
Though functional integration frequently relies on anatomic knowledge of the connections between brain areas, the emphasis is on how large clusters of neurons – numbering in the thousands or millions – fire together under various stimuli. These datasets are typically gathered in human subjects by non-invasive methods such as EEG/MEG, fMRI, or PET. The results can be of clinical value by helping to identify the regions responsible for psychiatric disorders, as well as to assess how different activities or lifestyles affect the functional integration definition functioning of the brain. To better understand cognitive consequence of functional integration between the two brain hemispheres, more studies are encouraged to explore the functional meaning of HoFC in human brain. As reviewed above, HoFC has been found to be related with particular cognitions, behaviors and specific symptom in both healthy and diseases. In healthy people, studies revealed only a few cognitions related with regional HoFC under resting state, such as executive function, visuospatial attention, language, etc.
Variational Perturbation Theory for Path Integrals
They serve as guiding principles for achieving better coordination of services across the entire care continuum. The integrative functions of primary care (first contact, continuous, comprehensive, and coordinated care) are incorporated implicit in the dimensions of integrated care. At the macro level system integration puts the individual needs at the heart of the system in order to meet the needs of the population. That is because system integration incorporates the notion that what is best for individuals within a population is best for the population. This holistic view requires simultaneous horizontal and vertical integration to improve the overall health and well-being of individuals and the population. Our framework is therefore visualised as a concentric circle, with the person-focused perspective at the centre.
Moreover, person-focused care is based on personal preferences, needs, and values (i.e., understanding the personal meaning of an illness). In contrast, a disease-focused view reflects a clinical professionals perspective, translating the needs of a person into distinct biological entities that exist alone and apart form a person [24–26]. The second feature, population-based care, attempts to address all health-related needs in a defined population. In this view services should be based on the needs and health characteristics of a population (including political, economic, social, and environmental characteristics) to improve an equitable distribution of health (and well-being) in a population [10].
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These partnerships can be characterised as forms of vertical and/or horizontal integration. Professionals have a collective responsibility to provide a continuous, comprehensive, and coordinated continuum of care to a population [6, 21, 32, 46, 47]. Especially in populations with a growing burden of disease, professionals from a range of disciplines and sectors have to take shared responsibility for the integration of services to assure good health and well-being. Integration led by professionals creates combined responsibilities for commissioning services and promotes shared accountability, problem solving and decision-making to achieve optimal health and well-being in a defined population [35].
However, in many high income countries integration of services is hampered by the fragmented supply of health and social services as a result of specialisation, differentiation, segmentation and decentralisation [5, 8, 11]. Fragmentation results in suboptimal care, higher cost due to duplication and poor quality of care [5]. In the Netherlands the Primary focus program aims to stimulate integration (both within primary care and between primary care and other health and social service sectors) by funding 70 collaboration initiatives [12]. To discover the critical factors that hamper or facilitate integration starting from a primary care perspective, the development process of these collaboration initiatives is monitored. A conceptual framework is needed to make systematic and comparable descriptions of these initiatives. However, the concept of integrated care is ambiguous, since it is often used as an umbrella term that differs in underlying scope and value [4, 5, 13–15].
Next, we connected the ambiguous concepts of integrated care with the key features of primary care into a first draft of the framework. To improve the content validity of the framework we discussed it with seven researchers in the field of integrated care and primary care. During six meetings of approximately one hour a discussion was held on the synthesis of the essential elements of primary care and integrated care. The presented conceptual framework is a first step to achieve a better understanding of the inter-relationships among the dimensions of integrated care from a primary care perspective.
- We used 12 articles to identify the key elements of primary care and 34 articles to describe the key elements of integrated care.
- This is especially important in the context of integrated care as the person-focused and population-based perspective can link the health and social systems.
- On the other hand, full integration contains hierarchical mechanisms of governance such as mergers and acquisitions.
- Feynman formulated his path integral integral on the physical basis of an interference of short time amplitudes.
Incorporating vertical and horizontal integration can improve the provision of continuous, comprehensive, and coordinated services across the entire care continuum. In other words, partnerships across traditional organisational and professional boundaries are needed in order to improve the efficiency and quality of a system [32, 33]. In an integrated system these partnerships can pass through the boundaries of the ‘cure’ and ‘care’ sector to provide a real continuum of care to people and populations. Figure 1 shows an integrated health system with the person-focused care and population-based care perspective as the foundation for system integration. They serve as guiding principles within a system, which requires simultaneously horizontal (x-axis) and vertical integration (y-axis). The aging population and the growing prevalence of chronic conditions increases the healthcare costs and utilization of many high income countries [1, 2].