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Item Epilepsy care delivery during COVID-19 in resource limited countries: A survey in collaboration with International Epilepsy Equity Group(Elsevier, 2023-01) von Gaudecker, Jane; Clarke, Dave; Perkins, Susan; Ali, Amza; Sanjuan, Daniel; Vidaurre, JorgeBackground: The impact of the pandemic has had worse effects in countries with already stretched healthcare resources. The study aim was to explore changes in epilepsy care delivery in resource-limited countries during and since the acute phase of the COVID-19 pandemic. Method: A cross-sectional survey was conducted in 22 countries among health care providers (HCPs) caring for persons with epilepsy (PWE), in collaboration with newly formed global collaborators, the International Epilepsy Equity Group. Findings were compared based on World Bank Ranking (WBR) and HCPs’ practice type. Data were analyzed using Chi-square tests (α= 0.05) and pairwise multiple comparisons with α= 0.017 (Bonferroni adjustment). Open-ended responses were analyzed using thematic analysis. Findings: A total of 241 HCPs participated in the study. Of these, 8.30%, 65.98%, and 21.99% were from high-income (HIC), upper-middle-income (UMIC), and lower-middle-income countries (LMICs), respectively. Among HCPs, 31.12% were adult specialists, and 43.98% were pediatric specialists. During the acute phase of the pandemic, HCPs reported that the major barrier for PWE was difficulty reaching physicians/healthcare providers. Except for difficulty reaching physicians/healthcare providers (WBR P=0.01 HICItem Selecting a change and evaluating its impact on the performance of a complex adaptive health care delivery system(Dove Medical Press, 2010-05-05) Boustani, Malaz A.; Munger, Stephanie; Gulati, Rajesh; Vogel, Mickey; Beck, Robin A.; Callahan, Christopher M.; Medicine, School of MedicineComplexity science suggests that our current health care delivery system acts as a complex adaptive system (CAS). Such systems represent a dynamic and flexible network of individuals who can coevolve with their ever changing environment. The CAS performance fluctuates and its members’ interactions continuously change over time in response to the stress generated by its surrounding environment. This paper will review the challenges of intervening and introducing a planned change into a complex adaptive health care delivery system. We explore the role of the “reflective adaptive process” in developing delivery interventions and suggest different evaluation methodologies to study the impact of such interventions on the performance of the entire system. We finally describe the implementation of a new program, the Aging Brain Care Medical Home as a case study of our proposed evaluation process.