Prescription Form Research Articles

Gardening work in an urban environment and the notion of territory.

There are several characteristics of working in an urban environment that challenge the usual forms of work prescription. This is a case study on the work of gardeners in an urban setting in the north of Paris. This paper develops the notion of territory, which we define as a system that is locally rooted in an open environment through the situated actions of gardeners' work. As the employees do their work in an outside environment, interactions in real-life situations are beyond the control of work organization. City gardeners' work is carried out in a green, living and human environment. We conducted detailed open observations in a town's green zones. These were complemented by individual interviews in work situations and by collective interviews within the boundaries of the municipality. We use the notion of territory to highlight the particularity of work within organizations where the work environment cannot be limited to the space inside their walls. The gardeners' work makes it possible to link residents and passers-by (on foot or in vehicles) with the town's green spaces (micro-ecosystems). Their work consists in connecting the different expectations and needs of the various life forms: the human beings (with a variety of lifestyles), as well as the plants, insects and animals. The particularities of working in an open environment create complex forms of prescription. The notion of territory, rarely used in ergonomics, proves to be fruitful for considering work in these contexts.

Medicalização da subjetividade e fetichismo psicofármaco: uma análise dos fundamentos

Abstract This study deals with the foundations of the psychiatric drug epidemic, aiming to analyze the medicalization of subjectivity and the fetishism of psychotropic drugs in their fundamental bases. It is a theorical reflection in the light of discourse analysis inaugurated by Michel Pêcheux, from which it presents a gesture of interpretation, allowing the identification of the psychiatric drug epidemic as an expression of the medicalization of life. Based on the critique of the foundations of the capitalist form of consumption and prescription of psychotropic drugs, this analysis demonstrated how the social metabolism model of capital imposes a fetishized therapy on the subjects. We hope to contribute to the practices of those who fight for the legacy of the anti-asylum movement and thus add to the efforts of the subjects involved in the production of effectively humanized and critical practices.

An Assessment of Pharmaceutical Care Rendered by Community Pharmacists to Type 2 Diabetes Mellitus Patients in South-West Nigeria

Background: Diabetes mellitus is a chronic medical condition that requires a life-long management. Community pharmacists render pharmaceutical care services that help in the resolution of medication related problems associated with chronic diseases thereby improving the quality of life of patients. Objectives: This study focused on assessing pharmaceutical care services rendered to type 2 Diabetes Mellitus (T2DM) by community pharmacists in Osun State, Nigeria. Method: Thirty-five (35) community pharmacists in major towns in Osun State, South-west, Nigeria were sampled using convenient sampling technique. ‘Secondary’ mystery patient (undercover patient relative) consultation was made with the community pharmacists in their pharmacies. The consultation involved the use of prescription form that had intentional drug therapy problems and complaints of oedema. Some of the services assessed included availability of point of care tests, prescription screening and patient education and counselling. Field notes were taken after each consultation with the pharmacists. Results: A little above one-third (37.0%) of the community pharmacists check blood glucose for T2DM patients. Some (23) of the pharmacists highlighted the need for the patient to come in-person or report to a physician citing the complaint (oedema) as an indication of possible complication(s). Five pharmacists identified the overdose of metformin and Glibenclamide in the prescription. Six pharmacists flagged possible drug-drug interaction between metformin and cimetidine. Majority (34) of the pharmacists counsel patients and provide patient education on T2DM. Conclusion: Community pharmacists in Osun State counsel T2DM patients and provide patients education. Few of them screen prescriptions and provide point of care test.

CONCEPTUAL PREMISES FOR SKETCHING A RATIONALE FOR THE INSTITUTION OF PRESCRIPTION

The author observes that the concerns of substantiating the institution of prescription belong to the theory of civil law and that the presentations of the civil model are made separately for the two forms of prescription (extinctive and acquisitive). This, in a context where criminal jurisprudence faces one of the most intense debates on how to apply the criminal rules regarding the prescription of criminal liability, a debate which, however, omits the idea of substantiating the institution. The thesis is updated according to which time - movement in sequence of events, external and unavoidable natural element of subjective rights - is presented as a modality of obligations, a concept that can be used both in the scope of civil and criminal norms. Time with the stated legal meaning can be accepted as the basis of prescription. The model offers a consistent methodological potential for the hypotheses in which the legal norm - whatever its origin - finds its meaning with difficulty. Hence the consequence: the subjective rights - interests with high legal protection of the subjects in the relationship - placed in time, can be understood in a unitary way and applied to all branches of law.

რეცეპტის ინსტიტუტის დანერგვის გამოწვევები საქართველოს ჯანდაცვის ინსტიტუციურ განვითარებაში

Ministry of Labour, Health and Social Affairs realized reform from 1th february till 1th september in 2014 for prescription system implementation. According to these changes pharmaceutical products of second group becamethe prescription medicines. In Georgia, access to and supply Rx medicines is governed by a regulatory framework. Second group drugs are only available to the public when prescribed by doctors on new prescription form N 3. The aim of research is to reveal and evaluate positive and negative sides of new prescription system; to study it, sinfluence on achievement process to drugs. As part of the quantitative research, doctors and pharmacists of the medical institution were interviewed. As part of the qualitative research, in-depth interviews with healthcare experts were conducted. The special questionnaire was designed for each aimed group. The questionnaires consist of open and closed questions. The results of the study revealed the positive aspects of the Prescription Institute: with this reform, the system returned to the logic of normal clinical medicine; The role of the doctor in relation to the patient's pharmacotherapy has been strengthened; The competence of the pharmacist was included in the appropriate framework and the specific skills of selling medicinal products by prescription were developed; The culture of purchasing medicines with prescriptions has been established among the population; At the same time, the results of the research revealed such actual problems that are an obstacle to the introduction of the prescription institute: prescription drugs are sold without a prescription; In the doctor's offices opened next to the pharmacies, the doctor is limited to prescribing only prescriptions; In case of chronic or long-term diseases, patients' access to prescription drugs is complicated; Doctors do not have complete information about the dispensing mode of this or that pharmaceutical product from the pharmacy. Pharmacists talk about the lack of specific skills in prescribing prescriptions: in the case of more than one medicine prescribed on one prescription form, the prescription is cancelled; Prescriptions not certified with a seal are invalid; Incorrectly indicated generic name, inconsistency between generic and trade names, prescription of a combined pharmaceutical product with a generic name prolongs the service of the user; Incorrectly indicated course of treatment, drug release forms, medicinal dose are the cause of misunderstanding; e.g. A pharmacist is prohibited from selling a 10 mg tablet of the same name medicine instead of a specified 5 mg tablet. One of the goals of the reform planned by the Ministry of Health is the correct treatment, the reduction of the share of expenses on medicine and the harm caused by self-medication. It is too early to talk about these achievements within the framework of the conducted research, however, one of the details was revealed that will contribute to the reduction of expenses on medicines, namely: it is necessary to indicate the diagnosis in the prescription according to ACD-10; The doctor's prescription should always be consistent with the diagnosis; The institute of prescriptions should reveal the rationality of the prescription issued by the doctor, compliance with the guidelines, which will partially reduce the costs of medicines. The reform implemented in connection with the restoration and establishment of the Institute of Recipes in Georgia is a step forward. The medical community unequivocally welcomes this change. The competence and authority of the doctor increased; the specific rules for prescribing by a doctor and issuing prescription medication by a pharmacist are gradually being established. Along with the highlighted positive aspects, significant systemic errors and technical flaws are visible. The sale of drugs of the second group without a prescription is an obstacle to the introduction of the Institute of Prescriptions. At this stage, fining the pharmacy cannot solve the problem. The Ministry of Health considers the establishment of an electronic prescription system to eliminate this problem. The current activity of the "pharmacy" doctor also hinders the reform. Access to medicines for patients with chronic diseases is complicated. The existing classification of medicines has flaws. Recommendations Based on the conducted research, the following recommendations were developed: • Improving the administration of the prescription institute implementation process; • Study of the activities of "pharmacy" doctors by the Agency for the Regulation of Medical Activities; • Refinement of regulatory normative base, administration tools; • Revision of the classification of pharmaceutical products and periodically making rational changes taking into account the data of AMEA, WHO, PSUR; • In order to use medicines rationally, it is advisable to introduce a system of electronic prescriptions.

Janus kinase inhibitors: between prescription authorization and reimbursability.

Following the restrictions on the reimbursability of Janus kinase inhibitors introduced by the Italian Medicines Agency, the Italian Society of Rheumatology has drafted this document to shed light on the clinical conditions and reimbursability criteria set out in the prescription forms.

Abstract C138: The benefit of Ma recipe, A combination of Chinese herbal medicines for patients with advanced esophageal cancer: A retrospective case report series

Abstract Background- Ma recipe is an ancient Chinese medicine recipe used for venomous snake bites. Four Chinese herbal medicines, prunella, vitex seed, red grass and eucalyptus leaves, were deemed essential ingredients in the Ma recipe prescription. Since Ma recipe has a powerful analgesic effect, it has been used to treat serious cancer pain in our clinic for over decade. It has observed that patients with advanced lung cancer、advanced liver cancer and some of other solid tumor also survive significantly longer after the elimination of cancer pain. In this small number of retrospective case series, we report the efficacy of Ma recipe therapeutics and pathological changes of tumor lesion before and after treatment in patients with advanced esophageal cancer. Methods-Treatment was in the form of prescriptions written by traditional Chinese doctors. This behavior is consistent with the norms of traditional Chinese medicine, and does not deviate from the conventional clinical practice. Ma recipe should be taken orally every day at 10 grams. Benefits from Ma recipe therapeutics was assessed by comparing symptom improvement and pathological changes before and after treatment, as well as by survival analysis. Results- A total of 12 patients with advanced esophageal cancer were treated by Ma recipe therapeutics. Seven of 12 had severe obstructive symptoms of eating difficulty and weakness that it must be treated symptomatically. These symptoms were reduced or disappeared within 7 to 30 days of Ma recipe treatment and were sustained clinical recovery maintained thereafter. There were no events of death and disease progression occur in all the patients with Ma recipe intervention at the data cutoff point of the median duration of exposure to Ma recipe therapeutics was 48 months (range, 12-85 months). All the treated patients returned to normal life. Of the 12 cases, 9 had pathological examinations before and after administration of Ma recipe. Results all 9 patients were diagnosed esophageal cancer in the pathological biopsy tissue specimens obtained prior to administration of Ma recipe, but no cancer cells were found in all Pathological biopsy tissue specimens were obtained after Ma recipe treatment. Of the 9 cases undergoing pathological examination, 6 received radiotherapy after administration of Ma recipe. Ma recipetherapeutics has not been found to have serious side effects in years of clinical practice. Conclusions- The survival benefit of Ma recipe therapeutics for patients with advanced esophageal cancer is enormous. The ability of Ma recipe treatment to rapidly improve obstructive symptoms in advanced esophageal cancer is a highlight. The pathological changes before and after treatment support that Ma recipe therapeutics has a definite curative effect on esophageal cancer. However, this study is a post hoc secondary analysis and the limitation of the insufficient number must be treated with caution. This study can only give an indication that Ma recipe therapeutics has the potential to become an approach for patients with advanced esophageal cancer. Citation Format: Jiangnan Feng, Zhenghua Ma, Hua Wu, Meiying Gao, Chengsheng Yi, Xia LIU, Jiangnan Feng. The benefit of Ma recipe, A combination of Chinese herbal medicines for patients with advanced esophageal cancer: A retrospective case report series [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr C138.

National health insurance scheme improves access and optimization of antimicrobial use in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

Nigeria instituted the National Health Insurance Scheme (NHIS) for universal health coverage. This study compared the NHIS and out-of-pocket (OOP) antibiotic prescribing with the World Health Organization (WHO) optimal values. A total of 2190 prescription forms from the NHIS and OOP were included in this study conducted at Obafemi Awolowo University Teaching Hospitals Complex, Nigeria from January 2021 to December 2022 and analysed using WHO drug prescribing guidelines. The average number of drugs per encounter was higher in the NHIS prescribing (χ2=58.956, p=0.00) than in OOP prescribing. The percentage of encounters with an antibiotic prescribed is higher in NHIS prescribing (χ2=46.034, p=0.000) than in OOP prescribing. The percentage of parenteral antibiotic prescribing is higher in OOP prescribing (χ2=25.413, p=0.000) than in NHIS prescribing. The percentage of antibiotic prescribed from the National Essential Medicine List is higher in NHIS prescribing (χ2=8.227, p=0.000) as well as the antibiotics prescribed from the Access category of the WHO Access, Watch and Reserve (AWaRe) Classification of antibiotics (χ2=23.946, p=0.000) when compared with OOP prescribing. Prescribing indicators show better performances with NHIS antibiotic prescribing and are closer to the WHO-recommended optimal values than in OPP prescribing. Hence NHIS prescribing can be an easy target for hospital antibiotic stewardship intervention for optimal antibiotic prescribing.

Planning and development of an antimicrobial stewardship program in penitentiary facilities: strategies to optimize therapeutic prescribing and reduce the incidence of antibiotic resistance.

In correctional facilities, due to the high incidence of bacterial infections, antibiotics are widely prescribed. As a result, it may occur a massive and improper use of antibiotics, which promotes the development of antibiotic-resistant bacteria. However, in literature, specific experiences, interventions or guidelines aimed to optimize their prescription within prisons are sporadic. In an Italian hospital where belong patients from four penitentiary institutions, a multidisciplinary team has implemented an antimicrobial stewardship project. The aim of the project was to reduce the incidence of antibiotic resistance in penitentiary institutions by optimizing and rationalizing antibiotic prescribing. Following the analysis of microbiological prevalence and antibiotic consumption data within correctional facilities, the Antimicrobial Stewardship Team developed operational tools to support prison healthcare staff to manage properly antibiotic therapies. The analysis showed a gradual increase in antibiotic resistance: in 2021 the prevalence of resistant microorganisms was 1.75%, four times higher than in 2019. In contrast, between 2019 and 2021, antibiotic consumption decreased by 24%. Based on consumption data, pharmacy has drafted an antibiotic formulary for correctional facilities, supplemented with guidelines and data sheets, and also developed a prescription form for critical antibiotics. Results showed an increasing incidence of antibiotic resistance within prisons, highlighting the need to establish a dedicated antimicrobial stewardship program. This project may impact positively not only on prisoners, but also for the entire community, as prisons can be considered as places of health education and promotion.

The anti-liver fibrosis effect of Tibetan medicine (Qiwei Tiexie capsule) is related to the inhibition of NLRP3 inflammasome activation in vivo and in vitro

Ethnopharmacological relevanceQiwei Tiexie capsule (QWTX) is an improved form of a classical prescription of Tibetan medicine—Qiwei Tiexie pill. It has been employed in the treatment of a variety of chronic liver disorders, including liver fibrosis. Uncertainty still exists regarding the mechanism of QWTX action in liver fibrosis. Aim of the studyConfirm the anti-liver fibrosis effect of QWTX and reveal its mechanism from the perspective of NOD-like receptor protein 3 (NLRP3) inflammasome activation. Materials and methodsIn vivo experiment: A rat model of carbon tetrachloride -induced liver fibrosis was constructed. All rats were randomly divided into six groups: a control group, a model group, a group receiving the positive drug (Biejia Ruangan tablet), and three groups receiving QWTX at high, medium, and low doses. The contents of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBil) were detected in serum. Hematoxylin and eosin staining and Masson's staining were used to assess the histomorphological alteration of the liver. The levels of glutathione peroxidase, hydroxyproline, tumor necrosis factor alpha (TNF-α), and interleukin 1 beta (IL-1β) in the liver were determined using the corresponding detection kits. Real-time polymerase chain reaction, immunofluorescence, and western blotting were used to determine the expression levels of NLRP3, adaptor protein (ASC), caspase-1, and alpha-smooth muscle actin (α-SMA). In vitro experiment: Four groups of rat hepatic stellate cell line (HSC-T6) cells were created: the control group, the low-dose QWTX group (0.05 mg/mL), the medium-dose QWTX group (0.1 mg/mL), and the high-dose QWTX group (0.2 mg/mL). Cell viability was assessed using a cell counting kit, and the amounts of collagen type I (Col I) and IL-1β in the cell lysate were measured using an enzyme-linked immunosorbent assay kit. The mRNA and protein expression of NLRP3, ASC, caspase-1, and α-SMA were also estimated. ResultsQWTX had an inhibitory effect on liver fibrosis and a negative effect on HSC activation, while it improved liver histopathological injury and abnormal liver function and increased hydroxyproline content and glutathione peroxidase activity in vivo. QWTX decreased the expression of α-SMA, NLRP3, caspase-1, ASC, and IL-1β both in vitro and in vivo. ConclusionsTibetan medicine QWTX had a significant anti-liver fibrosis effect that was related to the inhibition of NLRP3 inflammasome activation in vivo and in vitro.

Regulatory conflict and a latent public safety risk? The case of gas infrastructure

AbstractWhile the literature on regulatory compliance is extensive, little scholarly attention has focused on how companies respond to conflicting regulatory requirements. As a case in point, gas pipelines and networks—deemed monopolies—are subject to economic regulation to emulate the price pressures of competition and encourage “efficient” expenditure. Technical (safety) regulation of the same infrastructure also addresses an expenditure trade‐off with safety, potentially drawing different conclusions as to the most appropriate balance. This article reports on a study—drawing on 49 interviews, document review and case studies—analyzing if these two regulatory regimes, as enacted in Australia, are in conflict. We find a significant tension between the two regimes, exhibited through the impact that economic regulation has on a company's planned safety‐related expenditure and thus, long‐term public safety outcomes may be at risk. Australian safety regulation is performance‐based, requiring “reasonably practicable” measures are in place to minimize risk to the public. The San Bruno California disaster, in which eight people died as a result of failed gas infrastructure in the US, shows that such regulatory conflicts also exist in jurisdictions that have adopted prescriptive forms of safety regulation.

Прескриптивный и дескриптивный перевод идиоматических выражений с русского языка на английский

The aim of the paper is to study the patterns and distinctive features of prescriptive and descriptive translation forms of idiomatic transfer from Russian into English. The scientific novelty lies in the identification of fundamental differences regarding the prescriptive and descriptive approaches to the translation of idiomatic expressions from Russian into English. This makes it possible to present translation as a constant process of renewal, affecting the gap between said compared languages and cultures. As a result, some issues in the understanding of the theory of natural and artificial (arbitrary, directed) equivalence are identified. Thus, equivalence in prescriptive translation studies is considered as natural, while in descriptive – as directed/oriented. At the same time, in descriptive translation studies, the theory of equivalence is controversial in many aspects, since the norms of adaptive translation in the linguistic and cultural space of intercultural communication are not fully defined. If two components are the most important for prescriptive translation: similarity and difference, then in descriptive translation, a key role is assigned to mediation in intercultural interaction.

HPLC combined with chemometrics for quality control of Huamoyan Granules or Capsules

ObjectiveHuamaoyan Granules (HMYG) and Huamaoyan Capsules (HMYC) are Chinese patent medicines with different dosage forms of the same prescription. Due to the different preparation process, the chemical composition of these Chinese patent medicines varies greatly among different forms, but there were few studies on the difference comparison and quality control of them. In order to improve the effectiveness and safety in its clinical application, an idea combining high performance liquid chromatography (HPLC) and chemometrics was put forward to study the quality control of Chinese patent medicines in different dosage forms of the same prescription. MethodsThe differential markers of HMYG and HMYC were explored based on HPLC fingerprint and chemometrics including orthogonal projections to latent structures-discriminant analysis (OPLS-DA), principal component analysis (PCA), and hierarchical cluster analysis (HCA). Finally, the quantitative analysis method of related components was established by HPLC. ResultsA quality control method for HMYG and HMYC was established. Firstly, the chemical components of HMYG and HMYC were systematically analyzed by HPLC fingerprinting. Further exploration showed that there were 20 characteristic peaks and 57 common peaks. Then, the potential differential markers between HMYG and HMYC were explored by chemometrics, and the differential markers were screened after intersection with the 20 characteristic peaks. Finally, HPLC quantitative analysis methods for nine components were established, including seven differential markers (neochlorogenic acid, protocatechualdehyde, chlorogenic acid, cryptochlorogenic acid, caffeic acid, rosmarinic acid and salvianolic acid A). The results of HPLC quantitative analysis showed that the contents of eight components in HMYG and HMYC samples were significantly different. According to the above results, the differential markers between HMYG and HMYC screened based on HPLC fingerprint and chemometrics can effectively characterize the differences between the two dosage forms. ConclusionThe present work provides a rapid and effective method for routine quality evaluation and control of HMYG and HMYC. This work also provides feasible methods for the quality evaluation and control of Chinese patent medicines with different dosage forms of the same prescription.

Evaluation of the Potential for Medication Error in Outpatient Elderly Patients at Siti Fatimah Az-Zahra Regional Hospital

Medication error is an event or situation that can be prevented and avoided, but if drugs cannot be controlled it can lead to inappropriate or harmful use of drugs. Medication error is an error made unintentionally in prescribing (Prescribing), reading prescriptions (transcribing), preparing prescriptions (dispensing) and administration. The purpose of this study was to determine the incidence of medication errors in the prescribing and transcribing phase in elderly patients. This study included descriptive observational research in a retrospective manner with purposive sampling method in the form of prescriptions of elderly patients at Siti Fatimah Az-Zahra Hospital Palembang. The results obtained in this study indicate that the occurrence of medication errors at the Prescribing stage, namely no prescription date 12%, no doctor's SIP 15%, no doctor's signature 10%, no dosage unit 35%, no amount of drug administration 3% and at the Transcribing stage, namely unclear / complete drug names 34%, unclear / complete drug doses 34% and unclear / complete drug amounts 3%.
 Keywords: medication error, prescribing, transcribing

Clinical audit on in-patient diabetes care in a university medical unit

Introduction: Auditing is integral to recognising deficits in care and providing sustainable improvements. Auditing of in-patient diabetes care has not been practised in Sri Lanka despite its impact on patient outcomes. The objectives were to assess the quality of in-patient diabetes care at a University Medical Unit measured against the standards in 'National diabetes in-patient audit, UK' and American Diabetes Association. This was followed by implementing changes and re-auditing, completing the clinical audit cycle. Methods: Data were retrieved retrospectively from medical records of in-patients with diabetes at the medical ward, University Hospital - KDU. Documentation of outpatient medications, appropriateness of blood glucose monitoring, achieved glycaemic control and medication management errors were assessed. The first cycle was conducted in August 2021, followed by remedial measures, including educating medical and nursing staff and introducing hypoglycaemia and blood glucose monitoring algorithms and a structured insulin prescription form. The second cycle was conducted in July 2022. Results: Data were collected from 76 and 73 patient records in the first and second cycles, respectively. Outpatient medication regime was documented in 22 (28.9%) in the first cycle and 61 (83.6%) in the second cycle (p<0.001). Blood glucose monitoring was inadequate in 34.2% and 57.5% in the first and second cycles, respectively. Persistent hyperglycaemia was observed in 52.6% in the first cycle and 55.7% in the second. Ten patients had hypoglycaemia during the first cycle, while four incidences occurred during the second cycle. Medication adjustment for persistent hyperglycaemia was not performed in 50% and 43.6% of patients in the first and second cycles. Conclusions: Unprecedented scarcity of resources during the second cycle posed limitations in glycaemic monitoring. Observed deficiencies in in-patient diabetes care that remained resistant to the remedial measures necessitate strong consideration of more proactive care improvement initiative

From rules to examples: Machine learning's type of authority

This paper analyzes the effects of a perceived transition from a rule-based computer programming paradigm to an example-based paradigm associated with machine learning. While both paradigms coexist in practice, we critically discuss the distinctive epistemological and ethical implications of machine learning's “exemplary” type of authority. To capture its logic, we compare it to computer programming rules that date to the middle of the 20th century, showing how rules and examples have regulated human conduct in significantly different ways. In contrast to the highly constructed, explicit, and prescriptive form of authority imposed by programming rules, machine learning models are trained using data that has been made into examples. These examples elicit norms in an implicit, emergent manner to make prediction and classification possible. We analyze three ways that examples are produced in machine learning: labeling, feature engineering, and scaling. We use the phrase “artificial naturalism” to characterize the tensions of this type of authority, in which examples sit ambiguously between data and norm.

Effects of N-acetylcysteine on oxidative stress biomarkers, depression, and anxiety symptoms in patients with multiple sclerosis.

N-acetylcysteine (NAC), a thiol-containing antioxidant and glutathione (GSH) precursor, attenuates oxidative stress, and possibly improves psychiatric disorders. This study aimed to evaluate the effects of oral NAC on oxidative stress, depression, and anxiety symptoms in patients with multiple sclerosis (MS). This clinical trial was conducted on 42 MS patients randomly assigned to intervention (n = 21) and control (n = 21) groups. The intervention group received 600 mg of NAC twice daily for 8 weeks, and the control group received a placebo with the same prescription form. An analysis of serum malondialdehyde (MDA), serum nitric oxide (NO), and erythrocyte GSH was carried out on both groups, along with a complete blood count. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of depression (HADS-D) and anxiety (HADS-A). Compared to the control group, NAC consumption significantly decreased serum MDA concentrations (-0.33 [-5.85-2.50] vs. 2.75 [-0.25-5.22] μmol/L; p = 0.03) and HADS-A scores (-1.6 ± 2.67 vs. 0.33 ± 2.83; p = 0.02). No significant changes were observed in serum NO concentrations, erythrocyte GSH levels, and HADS-D scores (p > 0.05). Based on the findings of the present study, NAC supplementation for 8 weeks decreased lipid peroxidation and improved anxiety symptoms in MS patients. The aforementioned results suggest that adjunctive therapy with NAC can be considered an effective strategy for MS management. Further randomized controlled studies are warranted.

The Pattern of NSAIDs Drugs Use by Libyans Patients for Acute Tissue Injury

Introduction: NSAIDs are a family of drugs that have achieved widespread use in sports medicine in both prescription and over-the counter (OTC) forms. NSAIDs are often administered after acute soft tissue injury in an effort to reduce pain and inflammation and thus speed an injured athlete's return to competition. However, recent evidence suggests that the short term benefits of NSAID therapy may adversely affect the long-term healing of injured soft tissues. Method: The study was performed to test pattern of NSAIDs use by Libyan patients. Patients were asked to complete a self-report questionnaires while attending orthopedic clinic at Al-Haraysh hospital at Darna City (Libya) during the period from March to May 2022. Result: Panadol (acetaminophen) consumption was reported by 6 (40%). Equivalent data for ketoprofen (Fastum gel) were 6 (40%) for topical preparation. Tewinty percent (3) of the participants consumed Muscadol (Paracetamol 450mg + Orphenadrine citrate 35mg)-based drugs. These were ibuprofen (ketoprofen)-based drugs used by 3 (20%) of respondent . The 2 (13%) consumed Naproxen (Nopain) and only the 1 (6.6%) used Aspirin for their injuries. Conclusion: NSAIDs are commonly used in the treatment of acute soft tissue injuries in athletes. Because of the diverse of adverse effects associated with NSAIDs, athletic trainers must be aware of the potential benefits and liabilities of NSAIDs use by injured.

Evaluating the feasibility and outcomes of a resident-led school-based pediatric clinic.

A resident-led school-based clinic to serve low-income populations was established in 2019 and served as a continuity clinic for pediatric residents at a single university. Our aim was to assess the feasibility, clinic outcomes, and resident experience of a resident-led school-based clinic (RLSBC), established in an elementary school that serves an underserved population. A retrospective chart review for the first 6 months (October 2019 to March 2020) of clinic operations was conducted. Feasibility metrics included the number of patients, visits and planned follow-ups; clinic outcomes included the number and type of presenting complaint, new diagnoses and interventions. Residents were also surveyed to assess their satisfaction and perceived learning in training at the school-based clinic. Over the first 19 clinic days, 48 children were seen at the school-based clinic. Of the clinic users, 60% did not have a primary care physician, 46% received a new diagnosis, 46% received an intervention in the form of medication prescription, laboratory/imaging requisitions or referrals, and 96% received a treatment plan. Residents positively rated the experience of staffing the school-based clinic in all aspects, including learning environment, clinic and team environment, teaching obtained, practice management, and overall experience. A RLSBC is feasible and our outcomes suggest that such clinics may address health care needs of low-income families and children, while being a positively rated educational experience for pediatric residents.

Between theory and practice: the influence of documentation on the preservation of installation art—a case study of Hiding/Unhiding by Ana Vieira (1940–2016)

In the artist’s absence, the conservation of installation art has come to rely on instructions or other forms of documentation which all play a fundamental role in the processes of acquisition and activation. Drawing on the relationship between theoretical documentation models and collecting institution practice, this article focusses on the process of ‘doing artworks’ and examines the posthumous acquisition and activation of the installation Hiding/Unhiding (1978) by Ana Vieira (1940–2016) in a museum context. By highlighting these processes, the article aims to articulate how open-ended documentation methodologies diverge from museum practices that otherwise tend to stabilise complex artworks by using more prescriptive forms of documentation. In comparing these practices, we question the impact of documentation on the future preservation and trajectory of these ‘unruly objects’, particularly in the artist’s absence.