Accessibility Criteria Research Articles

Pediatric Cardiac Xenotransplantation and Expanded Access: Ethical Considerations.

Due to the current organ shortage waitlist, alternatives to allotransplantation are necessary. Xenotransplantation is currently being pursued as one such alternative in adults in need of kidney or heart transplantation. Cardiac xenotransplantation of genetically modified pig hearts has been conducted twice in adults under the United States Food and Drug Administration (FDA) expanded access criteria. Because of the shortage of transplantable hearts for children as well as the lack of mechanical circulatory support in this population, pediatric researchers are exploring FDA expanded access in high-risk neonates and infants who lack alternative options for survival. The adult cardiac xenotransplantation experience with expanded access can provide lessons and highlight nuances for researchers preparing pediatric application. This includes aspects of informed consent, biosurveillance, and protection of bystanders from potential xenozoonoses.

PROBLEMS OF FREIGHT CAR FLOWS DISTRIBUTION ON RAILWAY NETWORKS

Purpose. The purpose of the article is a critical analysis of the existing methods of freight car flows distribution on the railway network and the determination of the directions of these methods adaptation to the operating conditions of the Ukrainian railway transport. Methodology. The research was carried out on the basis of the processing of literary sources in the scientometric databases Scopus and Google Scholar. Results. The distribution of car flows on the railway network is one of the stages of developing a plan for the trains formation. The methods of solving this problem, which are currently used in the practical work of railway transport, were developed during the time of the planned state economy. They are based on the solution of a single-criterion optimization problem aimed at finding such a distribution of car flows on the network that minimizes the cost of transportation for the railway. Reforming the railway transport market with the aim of introducing competition requires the complication of methods of solving the problem of distribution of car flows to take into account the conflicting goals of independent participants in the transport process. The conducted studies showed that the main method of modeling the structure of the railway transport network and the volumes of car flows in it is the theory of graphs; determination of the carrying capacity of elements of the railway network is carried out by the methods of the theory of railway operation, simulation modeling and correlation analysis; determination of the optimal distribution of bandwidth is carried out by comparing competing options, as well as by linear and non-linear programming methods, adaptive control methods using neural networks; the behavior of participants in the transportation process during the allocation of bandwidth is investigated by game theory methods. It has been established that in modern conditions, the task of determining the criterion of equal access to congested sections on the branched railway network and the task of distributing car flows on the network in conditions of fluctuating car flows during transportation by regular trains and trains to order require additional research. Originality. The scientific novelty of the work consists in the critical analysis and generalization of modern methods used to solve the problem of distribution freight car flows distribution on railway networks. Practical value. The practical significance of the results lies in determining the inconsistency of the methods that are practically used on the railways of Ukraine for the distribution of car flows, with the modern conditions of operation of railway transport. Scientific methods have been established that allow to improve approaches to solving the problem of rational distribution of car flows, taking into account the interests of various participants in the transportation process.

Optimizing sustainable multiple biomass-to-biofuel conversion network with integrated water resource management utilizing data-driven robust planning

Until now, the biofuel supply chain has lacked an integrated approach to address its fundamental challenges in real-world implementation. The first challenge is maintaining a continuous supply flow in the biofuel network, which can significantly impact economic outcomes and performance measures. The second challenge involves managing water resources for biofuel production to preserve freshwater reserves. The third challenge is managing operational risks, such as uncertainty in biofuel demand, which leads to conservative planning and underscores the need for realistic uncertain programming approaches. To address these challenges, the proposed study designs a biofuel conversion network that utilizes third-generation feedstocks and non-edible seed sources, sourcing necessary water from wastewater resources. This practical solution addresses water-energy relationship concerns, reducing dependency on limited freshwater supplies. To achieve a continuous and cost-effective feed supply, this study incorporates a pre-processing phase using a hybrid Multi-Criteria Decision-Making model. This approach ensures the feed supply remains consistent, economical, and sustainable. To manage the uncertainty in biofuel demand, we developed a robust optimization model with an intersected uncertainty set using a data-driven approach. This approach aims to reduce conservatism in the obtained solutions, making the model more practical for real-world implementation. The numerical results reveal some practical implementation for policymakers. The proposed robust optimization using the configured uncertainty set offers a tool to manage the conservatism of renewable energy demand uncertainty and operational risks more effectively than traditional approaches (0.914%). This formulation can help policymakers to maintain greater robustness against fluctuations in confidence levels. Additionally, the simultaneous use of third-generation and non-edible feedstocks creates a multi-biomass-to-biofuel conversion network, offering practitioners a practical solution that significantly reduces reliance on freshwater resources. Furthermore, policymakers can leverage the proposed pre-processing phase to promote economic and continuous supply feed based on geographical, resource accessibility, and infrastructure criteria.

Validation of Administrative Data and Timing of Point Prevalence Surveys for Antibiotic Monitoring

Point prevalence surveys (PPSs) are used globally to collect data on antibiotic prescriptions. However, the optimal frequency for data collection to ensure comprehensive understanding of antibiotic use and to target and monitor stewardship interventions remains unknown. To identify the optimal frequency for collecting data on antibiotic use among the pediatric population through PPSs leveraging administrative data. This prognostic study used a cross-sectional validation approach and was conducted in pediatric outpatient and inpatient settings in the Veneto region of Italy. Antibiotics were classified according to the World Health Organization Access, Watch and Reserve criteria. Prescribing rates of access antibiotics were analyzed for pediatric inpatients with records dated between October 1, 2014, and December 31, 2022, and outpatients with records dated between January 1, 2010, and December 31, 2022. The study included children younger than 15 years with an antibiotic prescription who were admitted to the pediatric acute care unit or evaluated by a primary care pediatrician. Data analysis was performed from October 2023 to January 2024. An algorithm was developed to identify optimal time frames for conducting PPSs. This approach sought to minimize the discrepancy between quarterly and yearly PPS results, aiming to accurately estimate annual antibiotic prescribing rates in both inpatient and outpatient settings (primary outcome). External validity of the optimal PPS time frames derived from outpatient data when applied to the inpatient setting was also investigated. Validation involved assessing the effectiveness of administrative data in identifying strategic PPS periods for capturing inpatient antibiotic use patterns (secondary outcome). This analysis included 106 309 children: 3124 were inpatients (1773 males [56.8%]) and 103 185 were outpatients (53 651 males [52.0%]). A total of 5099 and 474 867 antibiotic prescriptions from inpatients and outpatients were analyzed, respectively. Outpatients tended to be older than inpatients, with a median age of 3.2 (IQR, 1.3-6.3) years vs 2.6 (IQR, 0.6-6.6) years, respectively, and with a lower burden of clinical comorbidities (≥1 comorbidity: 6618 [6.4%] vs 1141 [36.5%], respectively). The algorithm successfully identified distinct time frames within the calendar year from inpatient and outpatient records optimized for PPS data collection. Rates obtained from the quarterly PPS during these identified periods exhibited greater agreement with annual antibiotic prescribing rates (inpatient: r = 0.17, P < .001; and outpatient: r = 0.42, P < .001) than those derived from the yearly PPS (inpatient: r = 0.04, P = .58; and outpatient: r = 0.05, P = .34), with a Δ reduction of up to 89.8% (where Δ represents the percentage point change in antibiotic prescribing rates). Furthermore, the optimal PPS time frames gleaned from the outpatient data demonstrated robust applicability to the inpatient setting, yielding comparable results in both scenarios. This study evaluated the potential of administrative data in determining the optimal timing of PPS implementation. The quarterly PPS balanced precision and sustainability, especially when implemented during strategically selected periods across different seasons. Further studies are needed to validate the algorithm used in this study, especially in post-COVID-19 pandemic years and different settings.

Unemployment insurance for platform workers: Challenges and approaches from a comparative perspective

This contribution presents an overview of the challenges involved in ensuring that persons performing platform work (as either employees, self-employed, or in a third category) are able to effectively access unemployment insurance protection. It also addresses the specific approaches taken by European countries to tackle these challenges, relying especially on the contributions to this special issue on unemployment protection for the self-employed and platform workers. After presenting a brief definition of platform work, the contribution provides an overview of the main challenges linked to unemployment protection insurance posed by the features of platform work; we use primarily the Council Recommendation on access to social protection for workers and the self-employed as an evaluative framework. These challenges relate to both formal exclusion (due to classification as self-employed or marginal work) and effective exclusion (due to difficulties meeting minimum work requirements and lack of transparency on algorithmic management and platform work). The contribution then analyses some of the main approaches taken by European countries to address such challenges. Actions targeting platform work comprise (a) employment status reclassification; (b) establishment of a presumption of an employment relationship; (c) the setting of requirements to inform on the use of algorithmic management; (d) facilitation of transparency on platform work information; and (e) exemption from formal social security coverage of some forms of (marginal) platform work. General approaches with consequences for the unemployment insurance protection of platform workers include the application of the same criteria for access to unemployment benefits across employment statuses, as well as greater leniency on these criteria for certain forms of non-standard work. The contribution ends with a conclusion, which highlights the main gaps in unemployment insurance protection for platform work, and discusses avenues for action regarding platform work.

Knowledge, Attitudes, and Challenges: Irish General practitioners’ preparedness for publicly funded Assisted reproductive technologies

ObjectivesGlobal access to assisted reproductive technologies (ART) remains highly inequitable. Until recently, access to ART in Ireland was solely available through private fertility clinics. Publicly funded ART was introduced in September 2023 but eligibility requires patients to meet strict access criteria that include referral by their primary care general practitioner (GP) to the local fertility service. Previous studies report that fertility training amongst doctors, including GPs, is variable and an obstetrics and gynaecology (O&G) rotation is not mandatory for GP trainees in Ireland. This study aimed to investigate GPs’ knowledge of fertility investigations and management, as well as attitudes towards publicly funded ART access criteria. Study DesignA cross-sectional online survey was distributed to GPs working in Ireland between September 2023 and January 2024. The survey questionnaire explored attitudes to, and knowledge of, ART including the publicly funded access criteria. Responses to free-text questions were qualitatively analysed using content analysis. ResultsThe study had 154 respondents, representing approximately 4 % of GPs in Ireland. Three quarters (n = 120, 78 %) of respondents were female, 68 % (n = 105) had completed an O&G training rotation and 72 % (n = 111) had further O&G qualifications. However, 69 % (n = 107) reported that they had no training in subfertility investigation and management, and 34 % (n = 53) were not aware of the access criteria for publicly funded ART prior to completing the survey. Almost all GPs (97 %, n = 149) felt that they would benefit from more education on fertility. Qualitative content analysis generated two themes regarding publicly funded ART: (i) the access criteria are too restrictive and (ii) the workload for GPs will increase. ConclusionsGPs in Ireland are now being tasked with managing infertility and fertility treatment referrals, but most have not been provided with sufficient training. Our study shows that GPs in Ireland desire broader access criteria for publicly funded ART and better fertility training and education for their own clinical practice.

A spatial ranking of optimal sites for solar-driven green hydrogen production using GIS and multi-criteria decision-making approach: A case of Tunisia

The unpredictable nature of renewable energy sources, such as solar and wind, raises concerns about consistent power supply based on a single type. Green hydrogen presents a promising solution to mitigate the environmental effects of fossil fuels and control the unpredictability of renewable energy sources. Yet, developing green hydrogen systems mandates immense financial commitments, vitally stressing the importance of determining the most appropriate locations before constructing them. As such, the primary purpose of this paper was to propose an initial spatial analysis and prioritize the most suitable locations for installing solar-based green hydrogen systems in Tunisia. For this reason, an exhaustive literature survey was conducted to develop a GIS-based MCDM approach, taking into account technical, topography, environmental, and accessibility criteria. Then, EDAS, ARAS, MOORA, and COPRAS techniques were used to rank the most promising sites resulting from the previous stage. The study revealed that sites of high suitability, primarily in the southeastern and southwestern parts of Tunisia, spanned a total area of 1591 km2 (0.78%). Among such regions, Sfax, Monastir, and Sousse appeared to hold the top ranking as the most suitable locations for solar-based hydrogen. The “most suitable” sites had a hydrogen potential capacity of 9910 Mt per year, with Sfax, Monastir, and Sousse accounting for 14.5% of that capacity. By tapping into this immense potential and embracing the green hydrogen industry, Tunisia has the opportunity to lead in renewable energy adoption. This move could help ensure energy security, reduce dependence on imports, stimulate economic growth, and steer the nation toward a more sustainable and prosperous future.

Municipal housing queues as a generator of housing inequalities between natives and immigrants in Sweden

The ongoing debate on Swedish municipal housing’s universalist characteristics has focused on declining supply, stricter access criteria, and changing tenant demographics. This study addresses a research gap by examining how Swedish municipal housing queues, prioritizing apartment allocation by registration duration, influence tenant selection. Using a unique dataset from Bostaden, Umeå’s municipal housing company, linked to register data, the study investigates factors influencing housing queue accumulation and usage, with a focus on immigrant background. It further analyses how immigrant background affects the timing of exiting the housing queue to secure apartments. Furthermore, the study explores how the immigrant background of individuals obtaining queue-assigned apartments influences neighbourhood demographics. The findings highlight the substantial challenges faced by immigrants, particularly those from the Global South, in terms of housing queue accumulation, utilization, and neighbourhood attainment. These insights reveal how housing queues, as seniority-based rationing mechanisms, contribute to the perpetuation of housing and socio-spatial inequalities in Swedish cities.

Topological network and fuzzy AHP modeling framework for the suitability analysis of evacuation shelters: A case study in Japan

Evacuation shelters play a critical role in disasters, providing a safe environment for evacuees to remain safe from threats or disasters. In this study, we analyze the suitability of evacuation shelters using a topological network and fuzzy analytic hierarchy process (AHP) modeling framework with GIS applications, in which potential shelters are assessed according to their accessibility, reachability, and critical criteria within an evacuation network. The accessibility and reachability of evacuation shelters are identified using network analysis, whereas the critical criteria for evacuation shelters are deduced from the referenced requirements. The accessibility, reachability, and criteria of shelters are then weighted with fuzzy AHP analysis, and the suitability of potential shelters for use as evacuation shelters are then analyzed. An illustrative case study was conducted to illustrate the modeling framework; an evacuation network with 2797 nodes was constructed in the study area. Of the 2797 nodes, nine were identified as suitable for use as evacuation shelters. These nine included four accredited designated evacuation shelters and another five potential shelters as alternative shelters. The modeling framework in this study provides a systematic approach to identifying the characteristics of potential shelters, which is expected to be useful in decision making for evacuation planning, disaster preparedness and response, and postdisaster activities in recovery and restoration.

The Importance of Narrative Texts in Teaching and Learning Activities in Primary School

Narrative texts play a very important role in the instructional activities of primary school classrooms as they significantly contribute to the development of communication skills, thinking, and creativity of young students. These texts must be carefully selected, taking into account both aesthetic and ethical elements, as well as those related to stimulating and developing students' language and communication abilities. The criterion of accessibility must be fulfilled by choosing appropriate works based on the students' age categories. In the first and second grades, epic works should not be too lengthy, with a cohesive plot, and often featuring fictional characters to engage children. By the third and fourth grades, works become longer, with more characters and more developed plots, and students begin to study dense, concentrated epic creations such as novellas and novels. Thus, through the use of epic texts, students learn to analyze deeply what they read, identify subtle details from the content, form various opinions about events, and express their opinions about characters in a correct and coherent manner.

Dual-Level Location Suitability Index for Optimum Site Selection

COVID-19 pandemic has spread rapidly affecting the entire world. During the fight against the pandemic, hospitals are insufficient to meet the needs. This study aims to set the basis for optimal site selection of quarantine hospitals. Further, to determine the critical factors influencing this selection. The Dual Level Location Suitability Index (DLLSI) proposed methodology provides decision maker with the optimal city and the optimal sites in the selected city for hospital construction. Analytical Hierarchy Process approach is implemented as a part of this study with 14 criteria used to evaluate the alternatives. Safety, accessibility, and availability criteria are also influencing the site selection. The results of DLLSI proposed methodology implementation show the optimal city and the optimal potential sites. It is observed that potential optimal sites located in optimal city. This is considered as self-evaluation, one of the contributions for the proposed methodology. Furthermore, the results of the proposed model are robust, realistic, and supportive for decision makers.

How can soil data and information become actionable knowledge to advance sustainable land management?

AbstractPromoting sustainable land management is key to addressing land degradation but its progress is impeded by the availability and accessibility of the ‘right’ soil data and information. We focus on government‐funded data collection or publicly collected soil data as it is central to effective soil governance. Taking a governance perspective, we discuss what soil information is created and used for, who are the actors involved and how soil information is contributing (or not) to the creation of actionable knowledge. We investigated two countries in depth through a desk‐based review and consultation with 40 key informants, collating which soil data and information is collected, analysed, stored, retrieved and used in the UK and Australia. We present a comprehensive overview of public soil databases, including location, year established, stated purpose, current governing institution, accessibility, digital product/s available, cycle of assessment, scale of sampling, soil data presented and depth of soil assessment. The analysis highlights that current shortcomings in soil governance are a result of not adequately valuing legacy soil data and information, and with the loss of human capital, diminished accessibility to soil information leads to disrupted information flows. A critical assessment suggests that available soil information plays a limited role in knowing the soil types of a locality, the condition of soil under various land uses and associated management, which limits its potential for informing sustainable land management. In both countries, there is a mismatch in scale and intention of use for the soil information between the provider and the user: information is currently held at the scale for regional‐ or nation‐level reporting on targets to meet national and international obligations rather than improving soil health or SLM at the farm scale. In addition, available soil data repositories only partially meet accessibility criteria (discoverability, language applicable to audience, open source and interpretative layer for land management implications). We outline steps to improve soil information and knowledge exchange embedded in effective governance arrangements to ensure that soil data and information can become actionable knowledge for SLM. Applying principles and strategies for facilitating knowledge exchange is of particular relevance to this process.

Expert consensus on the diagnosis and management of pollen-food allergy syndrome

Pollen-food allergy syndrome (PFAS) is a unique type of food allergy that specifically affects individuals with pollen allergy. In recent years, pollen allergy is increasingly and shows younger tendency. PFAS has also become a topic of interest in China. The characteristics of PFAS vary across regions and show obviously heterogeneity due to different pollen sensitization profile. Currently, diagnostic methods for PFAS in China are limited, which may lead to underdiagnosed and underrecognized of this syndrome, there are currently no accessible diagnostic criteria and procedures for clinical use. Unlike primary food allergy, the management of PFAS need a combined strategy which involves managing both pollen allergy and food allergy. Therefore, its management is particularly complex and varies among doctors in clinical practice. This consensus has developed a diagnosis and management flow chart based on current domestic and foreign guidelines, as well as relevant research evidence in China. The aim is to improve the standard diagnosis and treatment of PFAS and provide guidance to allergists, healthcare professionals, and general practitioners for accurate understanding, diagnosis, and standardized management of PFAS.

Investigating the Influence of Simulation-Based Instruction on Advancing Nursing Proficiency: A Rapid Review.

Nursing practice is continuously evolving, requiring nurses to update their knowledge and skills. A common approach in nursing education is simulation-based training. Although its effectiveness was studied in a sample of undergraduate students, evidence of its effectiveness in nursing continuing education is lacking. This review examined the effectiveness of simulation-based instruction in advancing nursing proficiency in lifelong or continuing learning. Searches of EMBASE, MEDLINE via PubMed, Web of Science, and Google Scholar were performed. Studies conducted between 2000 and 2023, focusing on postregistration or postlicensure nurses undergoing simulation-based training to improve their nursing proficiency, were considered for review. The quality of the studies was assessed using the transparency, accuracy, purpose, utility, propriety, accessibility, and specificity (TAPUPAS) criteria. Data were synthesized with narrative summaries. A total of 14 studies with a total sample size of 1,204 nurses met the eligibility criteria. Studies showed that simulation-based instruction in nursing continuing education improves knowledge and skills. Some studies showed disagreements on the effectiveness of simulation-based training on other factors. Embracing high-fidelity simulation in continuing education is crucial for advancing proficiency. Tailoring simulation scenarios to specific competency domains is recommended to address variations in outcomes. Policymakers are encouraged to integrate simulation into education policies and support ongoing research to refine best practices and align policies with evolving nursing needs. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

ВЫЯВЛЕНИЕ ПОТЕНЦИАЛЬНЫХ ГОРОДСКИХ ЦЕНТРОВ НА ОСНОВЕ МОДЕЛИРОВАНИЯ ПАССАЖИРОПОТОКОВ (НА ПРИМЕРЕ САНКТ-ПЕТЕРБУРГА)

The article considers the development of methodological foundations and suggests methodological approaches to identify urban areas with signs of subcenters in the implementation of a polycentric model of urban development. It is demonstrated that the application of mathematical modeling of passenger flows contributes to solving the problem of urban areas differentiation according to criteria of transport accessibility, time costs and travel speeds. As part of the study, calculations of passenger flows and passenger turnover were performed on the example of the St. Petersburg agglomeration – using network and pre-network models. Comparing the values of transport demand and transport supply in the nodes of the network made it possible to identify the location of potential urban centers.

Assessment of wave energy location, technology, and converter toward sustainability using integrated spherical fuzzy MCDM approach

Due to climate change, fossil fuel reduction, growing energy usage, and ecological impacts, the need for renewable energy sources is rising quickly. A large amount of energy comes from the ocean through the tide; renewable energy must be exploited. One important energy source is wave energy converters (WECs), which enhance efficiency and grow energy. This study presented a case study from three layers of the Red Sea in Egypt for selecting optimal wave energy location (WEL), wave energy technology (WET), and WEC. The spherical fuzzy set (SFS) framework deals with uncertainty and vague information in this selection process. The SFS is integrated with multi-criteria decision-making (MCDM) to deal with various criteria in each layer. This study uses two MCDM methods under the SFS environment: The Stepwise Weighted Assessment Ratio Analysis (SWARA) method and the Weighted Euclidean Distance Based Approach (WEDBA) method. The SF-SWARA method is used to compute the criteria weights in each layer. Then, the SF-WEDBA method ranks the alternatives in each layer. The main results in each layer show that the accessibility criterion, Economic factors, and energy production criterion have the highest weight in the three layers. Sensitivity analysis and comparative analysis are conducted in each layer.

Controversies in minimally invasive surgery for invasive cervical cancer

Background. Determination of the feasibility of performing minimally invasive surgery for invasive cervical cancer and identification of criteria for optimal surgical access that ensures safety, effectiveness, and satisfactory immediate and long-term results remain challenging in gynecological oncology. The aim of the study was to evaluate the immediate and long-term treatment outcomes in patients with invasive cervical cancer who underwent radical hysterectomy via laparotomy compared to those who underwent minimally invasive surgery. Material and methods. Treatment outcomes of 91 patients with invasive carvical cancer were analyzed. The assessment of the objective tumor response to neoadjuvant chemotherapy using the RECIST scale (Response Evaluation Criteria in Solid Tumors) was confirmed by clinical, ultrasound and CT/ MRI findings. The Kaplan-Maier curves and the log-rank criterion were used to compare the time of relapse-free and overall survivals. Statistical analysis and visualization of the analysis results were performed using prism 9.5.1 (GraphPad, USA). Results. The presence of parametrial lymphovascular space invasion and the frequency of lymphadenopathy were comparable for both groups of patients. there were no statistically significant differences in the number of the resected lymph nodes, but there was a statistically significant difference in volume of blood loss and the duration of surgery between the groups (p=0.0001). Every third patient was diagnosed with stage IIIC after surgery (pelvic lymph node lesion). Intraoperative complications were significantly lower in the laparoscopy group than in the laparotomy group (6.7 % vs 13 %). No significant differences in the proportion of relapses of the disease between the groups were found (9.6 % in the laparotomy group vs 11.7 % in the laparoscopy group). There were no significant differences in overall and relapse-free survival between the groups. Conclusion. Minimally invasive surgery is a promising and adequate surgical technique for the treatment of cervical cancer. However, additional studies are needed to determine the indications for these surgeries.

Cross-sectional study of psychiatric disorders in patients with chronic musculoskeletal pain and individuals without pain

BackgroundMusculoskeletal chronic pain is a leading cause of global disability and laboral incapacity. However, there is a lack of population-based studies that investigate the relationship between chronic pain and mental disorders with a control group, particularly among low- and middle-income countries. Chronic pain is a serious public health problem in terms of human suffering, and in terms of socioeconomic implications. Frequent association with different mental disorders increases disability, decreases quality of life, and makes diagnosis and treatment challenging. The present study aimed to evaluate the presence of mental disorders in patients with chronic musculoskeletal pain and compare with a control group without pain.MethodsWe selected 100 patients in a regular follow-up at the Musculoskeletal Pain Outpatient Clinic of the University Hospital and compared them with 100 painless individuals from the control group from June 2016 to June 2018. The instruments used were the Mini International Neuropsychiatric Interview (MINI-PLUS) and a structured questionnaire to collect sociodemographic data. Statistical analysis used t-test, chi-square, Fisher’s exact test, Mann-Whitney, Kolmogorov-Smirnov tests, and multiple logistic regression.ResultsIn the sample evaluated, the majority of patients were women (83%), of brown color (54%), with lower-level education (51%), lower salary range (73%) and high absenteeism rate at work (60,7%). Patients with chronic pain had more psychiatric disorders (88% vs. 48% in the control group; p < 0.001). The most frequent diagnoses were anxiety disorders with panic attacks (44%), generalized anxiety (36%), mixed anxiety and depression disorder (33%), social phobia (30%), agoraphobia (29%), suicide risk (28%), and major depression (27%).ConclusionPositive correlations of mental disorders and chronic musculoskeletal pain have been documented. This suggests that psychiatric components must be taken into account in the management of chronic pain syndromes. The use of Mini Plus as a diagnostic tool for psychiatric disorders can contribute to optimizing the diagnosis and treatment of patients with chronic pain and encourage the creation of policies with strategies and criteria for quick access to Multi-professional Services.

The Impact of the European Union on the Endorsement of the Justice Reform in Albania

European integration has been the primary goal of Albanian foreign policy since the collapse of the communist regime, regardless of the ruling political party. The political elite and the Albanian people embrace and support the integration process. Also, the European Union has grown as a transformative power in Albania, fostering democracy, influencing structural reforms, and impacting the rule of law through the promise of future accession. However, the enlargement process has been slow due to internal and external factors. The article analyzes the EU as a transformative power and the use of Conditionality in Albania as an essential diffusion channel of the EU's values and norms, using the adoption of justice reform as a key study. The article's objective is to examine how the EU perspective membership has influenced the endorsement of justice reform in Albania. The paper argues that the EU approach has succeeded in fostering compliance with formal accession criteria but has yet to implement the justice reform due to internal factors and a not linear enlargement perspective. Progress Reports, literature, surveys, and media articles will be analyzed to fulfill the paper's objective. Received: 10 February 2024 / Accepted: 20 April 2024 / Published: 5 May 2024

EU Accession Criteria and Procedures: Up for the Challenge?

The article comprehensively analyses the evolution and challenges surrounding the criteria and procedures for accession to the European Union (EU). It traces the historical trajectory of EU accession criteria and procedures from pre- to post-Copenhagen phase. The article scrutinizes the emergence and formalization of democratic principles in EU accession and the various ongoing adjustments made to adapt to the changing circumstances, highlighting the multistep accession procedures and the introduction of flexibility, reversibility, and uncertainty into the process. While navigating the complexities of the evolving accession criteria and procedures, we address the many criticisms and plausible future developments. The article underscores the need for a return to the core normative accession criteria on democracy and the rule of law principles as a way to restore credibility and consistency in the EU accession process.