Global Reality Research Articles

The relevant role of caregivers of patients using opioid analgesics

Aging is a global reality that is accompanied by an increase in polypharmacy. In this vital stage, caregivers emerge as relevant actors since their intervention impacts on the safety of the medication use process and on the quality of life of the patient they assist. As the knowledge about the treatments that caregivers supervise for the patient under their care conditions the health outcomes of the medications, the main objective of this study is to characterize the caregivers of patients who use opioid analgesics and to identify factors that increase the risk of the appearance of Medication Related Problems (DRP).The results reveal that the caregiver profile affects the health outcomes of this therapeutic group in both the prevalence and type of DRP. Of the 63 patients using opioid analgesics under pharmacotherapeutic follow-up during this study, 17 (27%) had caregivers. The caregiver in this study was predominantly female (61.1%).Considering DRP and kinship, a higher prevalence of DRP was observed when the caregivers were children or external personnel.Analyzing the pharmacotherapy of these caregivers, 4.8% have started antidepressant treatment, 3.2% hypnotic treatment after becoming caregivers of these patients. The Zarit Test reveals that 29.4% of the caregivers of these patients manifest overload.We conclude that Pharmaceutical Care should consider the opportunity and relevance of designing and implementing intervention and education protocols focused on caregivers.

International migration of human resources in the conditions of geo-economic transformations as the main influence on the components of sustainable development of Ukraine in the context of national security

The article makes an attempt to comprehend state of the art, perspectives and risks within the realm of human resources migration from Ukraine in the context of today geoeconomic and geopolitical processes and the need to ensure the proper level of national security, as well as maintaining the course towards achievement of sustainable development goals. In the process of study, based on method of synthesis and neorealism philosophical paradigm of research, cases were considered, in particular cases of EU and China, which allow systematizing the vision of countries’ performance in today complex global realities and latent backgrounds of migration processes.

The paradox of medical dramas: global aspirations versus realities

The paradox of medical dramas: global aspirations versus realities

Agroecology for the City—Spatialising ES-Based Design in Peri-Urban Contexts

The design of urban systems that allow growth while also maximising ecosystem services is identified as an important priority for creating a Good Anthropocene. An ecosystem service (ES)-based approach to landscape interventions maximises the provision of ESs, and in doing so, repairs and reinforces threatened ecological planetary boundaries. As an urbanising planet, cities are critical frontiers of human interaction with these planetary boundaries, and therefore a critical arena for ES-based intervention. Globally, the predominant pattern of urbanisation is dedensification, an outwardly expanding trend where cities are growing in physical extent at a higher rate than their population growth. We therefore require spatially explicit tools capable of reconciling dedensification and Good Anthropocene visions. We propose a methodology that integrates agroecology and urbanisation and is focussed specifically on the supply of targeted regulating ESs. This ‘Agroecology for the City’ differs from conventional urban agriculture discourse and its preoccupation with food security. Our research interest is agroecological farm systems’ (AFSs) capacity to provide critical life support services in a spatially effective manner to urban systems. Our recent research introduced a new GIS-based model (ESMAX) and a spatial agroecology approach that identified AFS configurations at a 1 ha scale which maximised the supply of three regulating ESs, as well as multifunctional performance across all three ESs combined. In the present research, we apply this process at a larger scale, with 1 ha and 4 ha AFS parcels being integrated with a real-world 200 ha peri-urban residential development. The AFS parcels and built-up areas are configured differently to maximise the supply of ESs identified as critical by the local community. We found that arrangements with AFS parcels interspersed evenly with built-up areas provided the best multifunctionality across the four ESs tested. This supports pathways for a Good Anthropocene that work with the global urbanising reality of dedensification and underpin the need for a hybrid science of rural/urban systems.

Linking functional and phylogenetic diversity to assess decay in ecosystem services induced by metacommunity‐level mammal extirpations

AbstractDefaunation is an increasingly pervasive process, reaching ever larger spatial scales worldwide. We integrated data on thousands of putative local mammal assemblages across the Neotropics into 518 metacommunities to predict the phylogenetic trait‐based effects of regional defaunation—here defined as meta‐extirpation (i.e. extinction at the metacommunity level)—on dozens of putative ecosystem services (ESs). Further, based on 1029 real‐world mammal assemblages coalesced into 236 metacommunities, we assessed the spatial extent of meta‐extirpations across the Neotropics, while empirically quantifying losses in ESs in comparison with putative scenarios. Using observed data, we also sought to understand changes in the mean body size of metacommunities for different dietary guilds. We examined patterns of mammal diversity, evaluated the erosion of ESs based on ecological networks and measured the relationships between diversity metrics and ESs via dissimilarity arrangements and generalized linear models. Meta‐extirpation regimes lead to a mean loss of 49.6% of the ESs provided by Neotropical mammals within metacommunities, whereas real‐world meta‐extirpations derived 47.2% of ES loss. We show that simulated meta‐extirpations penalizing large‐bodied species, induced the most severe losses in ESs. Regional‐scale meta‐extirpations lead to changes in the metabolic allometry and trophic structure of consumers, inducing significant metacommunity downsizing. We conclude that once‐thriving mammal‐mediated roles in natural ecosystems are fading, with significant consequences for human livelihoods. Many mammal populations have succumbed in several Neotropical ecoregions; so it is critical to protect representative fractions of Neotropical landscapes and regional species pools. Finally, we reinforce the appeal for effective conservation action, given that meta‐extirpations are already a global reality.

FEATURES OF THE USE OF THE TERMS “OVERSEAS STUDENT”, “FOREIGN STUDENT” AND “INTERNATIONAL STUDENT” IN DIFFERENT EDUCATIONAL AND CULTURAL CONTEXTS

The article analyzes the peculiarities of using the terms “overseas student”, “foreign student” and “international student” in various educational and cultural contexts. It was found that British scientists prefer to use the term “international student”, because it better reflects the realities of globalization, internationalization and student mobility, which meets the modern needs of educational institutions and the international community. It is emphasized that the term “foreign student” remains the dominant term in Ukrainian education due to its legal certainty and established practice, however “international student” is also gradually coming into use, especially in the context of European integration and educational exchanges. Analysis of the use of the terms “foreign” and “international” student on the example of the British Council and HESA shows how important is the correct definition of students in international education statistics. A change in the HESA counting methodology in 2009, when students were classified by nationality rather than place of residence, revealed a significant difference in the number of international students in the UK (a difference of 32%), highlighting the extent to which counting methodology can influence research outcomes and state policy.

Exploring the harmony between contemporary values and Islamic identity through the lens of the Gülen movement's teachings

There is a growing need for new Muslim identities that reflect global realities. Fethullah Gülen, a notable Turkish-Muslim cleric, is influential and persuasive. Gülen emphasizes spirituality, religious pluralism, discussion, and education to promote peaceful coexistence and integrate faith and reason in Western democracies. This study examines how Gülen's ideas and the global volunteer organization he created promote Muslim-non-Muslim harmony. We use text linguistics' seven principles—cohesion, coherence, intentionality, acceptability, informativity, situation, and intertextuality—to assess Gülen's teachings and movement. In the social sciences, we also use textual language norms as a fresh theoretical and methodological approach to studying social movements and events. This study's focus on movement-text relationships and cognitive processes in information creation, reproduction, and dissemination makes it distinctive. This study investigates these issues in Muslim countries, multicultural cultures, and liberal democracies. This research is useful because it explains the Gülen movement's domestic and worldwide advancements. This article figuratively depicts Fethullah Gülen as the author, his movement as the text, and humanity as the readers.

Ferulic Acid-Loaded Nanostructure Maintains Brain Levels of ACh, Glutamate, and GABA and Ameliorates Anxiety and Memory Impairments Induced by the D-Galactose Aging Process in Rats.

Population aging is a global reality driven by increased life expectancy. This demographic phenomenon is intrinsically linked to the epidemic of cognitive disorders such as dementia and Alzheimer's disease, posing challenges for elderly and their families. In this context, the search for new therapeutic strategies to prevent or minimize cognitive impairments becomes urgent, as these deficits are primarily associated with oxidative damage and increased neuroinflammation. Ferulic acid (FA), a natural and potent antioxidant compound, is proposed to be nanoencapsulated to target the central nervous system effectively with lower doses and an extended duration of action. Here, we evaluated the effects of the nanoencapsulated FA on d-galactose (d-Gal)- induced memory impairments. Male Wistar adult rats were treated with ferulic acid-loaded nanocapsules (FA-Nc) or non-encapsulated ferulic acid (D-FA) for 8weeks concurrently with d-Gal (150mg/kg s.c.) injection. As expected, our findings showed that d-Gal injection impaired memory processes and increased anxiety behavior, whereas FA-Nc treatment ameliorated these behavioral impairments associated with the aging process induced by d-Gal. At the molecular level, nanoencapsulated ferulic acid (FA-Nc) ameliorated the decrease in ACh and glutamate induced by d-galactose (d-Gal), and also increased GABA levels in the dorsal hippocampus, indicating its therapeutic superiority. Additional studies are needed to elucidate the mechanisms underlying our current promising outcomes. Nanoscience applied to pharmacology can reduce drug dosage, thereby minimizing adverse effects while enhancing therapeutic response, particularly in neurodegenerative diseases associated with aging. Therefore, the strategy of brain-targeted drug delivery through nanoencapsulation can be effective in mitigating aging-related factors that may lead to cognitive deficits.

Zero-dose children in Latin America: analysis of the problem and possible solutions

Introduction Zero-dose children (ZDC) are defined as those that have never been reached by routine immunization services. In Latin America, almost 2.7 million infants younger than 1 year of age, have incomplete vaccination schedules, and vaccine preventable diseases such as measles or polio have increase worldwide. ZDC are reported to reside in high risk and fragile settings, including remote-rural areas, urban slums, and conflict-affected areas. Identifying the problem and settings in each country is mandatory to propose possible solutions to the immunization coverage situation. Areas covered In November 2023, a group of experts of the Latin America Society of Pediatric Infectious Diseases (SLIPE) analyzed the global and regional reality of ZDC, and present in this document an updated reality of the Latin American region and the weight of the possible interventions to overcome this problem. Expert commentary Communication is a key element to improve vaccination coverage, as it is quality and use of vaccination data. Campaigns that deliver targeted and effective messages to communities and families, provide education about vaccination, avoid missed vaccination opportunities, and coordinate efforts across different sectors and communities, among other strategies, could improve the current immunization situation.

In the Zone: On Quinn Slobodian’s Crack-Up Capitalism and the Spaces of Political Economy

Quinn Slobodian has established himself as a leading historian of neoliberalism. Crack-Up Capitalism continues where his Globalists left off, but shifts focus from visions of global ordering to the fragmentation of the world into special economic zones (SEZs). In Slobodian’s provocative analysis, SEZs become a late neoliberal solution to the entrenched problem of democracy at the nation-state level. We follow Slobodian into the zone, thinking with him about the spatial dimensions of contemporary political economy. Although we problematize the disjuncture between Crack-Up Capitalism’s group biography of market radicals and its analysis of zones as a global economic reality, our intent is not to critique Slobodian, but to use his new book as a jumping off point to foreground other possible frames for understanding the zone: a longue durée historical outlook that can help de-exceptionalize the zone as a phenomenon of late neoliberalism, a focus on the internal diversity and political possibility of the zone form, and an emphasis on the causal link between the recent proliferation of zones and the ascendance of export-oriented industrialization as a global development paradigm.

Navigating Global Realities: An In-Depth Analysis of The Legal and Institutional Framework of Nigerian Foreign Policy

Navigating Global Realities: An In-Depth Analysis of The Legal and Institutional Framework of Nigerian Foreign Policy

Rethinking the exercise of sovereignty in the Anthropocene: From extraction to environmental protection in Arctic Svalbard

This paper explores the implications of the Anthropocene and its associated planetary awareness on the concept and exercise of sovereignty, particularly through the lens of the Svalbard Treaty. The Arctic archipelago of Svalbard is not only a space undergoing rapid environmental change today, but its treaty-based governance arrangements are based on an early-twentieth century spatial imaginary of fishery, coal, and resource extraction. By examining Norway's governance shift from resource extraction to environmental stewardship on Svalbard, this paper reflects on transformations of the practice of sovereignty in response to global environmental challenges. Through interviews with local stakeholders, the research highlights the contentious nature of these shifts, revealing how increased environmental regulations, while necessary, may paradoxically entrench existing power structures and complicate the presence of non-Norwegian entities. This case study of the Svalbard Treaty serves as a normative microcosm for broader issues of sovereignty, treaty obligations, and international governance as they may evolve due to planetary change, pointing to the urgent need to rethink these evolving dynamics. The paper underscores the pressing and complex challenges facing the international system in the Anthropocene, suggesting that while Svalbard's geopolitical stability may be maintained and Norwegian sovereignty remains uncontested, the instability of global environmental realities is already leading to changes to the ways in which sovereignty is exercised in the present.

'Successfully' Aging 'Alone'?: Unequal Global Opportunities and Rising Risks in Family-Based Models of Care Cross-Nationally.

For the first time in human history, older adults will outnumber children and a substantial and growing proportion will live alone and lack one or more nuclear family tie. Such unprecedented shifts require a reevaluation of existing models of "successful aging", particularly in terms of long-term care policies. This paper draws on country-level data from multiple publicly available sources (e.g., World Bank, Organization for Economic Cooperation and Development, Our World in Data, and the World Values Survey) to examine cross-national patterns of development, health, demography, resources and policies, and cultural values in low-, middle-, and high-income countries. Although there exists substantial heterogeneity across countries, country-level patterns illustrate the economic privilege of living alone and the dominance of "successful aging" opportunities in high income countries. Cultural values about family reflect standard patterns of economic development, yet friendship emerges as a particularly consistent global value. At the country-level, living alone and health are associated in higher income countries with lower within-country inequality. Aging "alone" is a risk factor in some contexts, yet a marker of privilege in others. Models of "successful aging" are largely unobtainable in lower income countries or high inequality countries, and therefore require a thorough incorporation of global realities, or final abandonment in favor of more nuanced structural perspectives. Long-term care policies that assume the presence of family will yield increasing risk over time across all global contexts and represent a key vulnerability in the future of healthy aging policy.

Chronic Kidney Disease, Mortality in the Elderly in Cuba

Introduction: Population aging is a global reality. Age is the most important prognostic factor for kidney disease. Objective: To characterize the mortality of the elderly with chronic kidney disease (CKD) in Cuba, in the period 2011-2019. Methods: Cross-sectional descriptive research. The universe corresponded to the 24 181 deceased over 60 years with CKD in Cuba in the period. The information was taken from the mortality database of the Ministry of Public Health. Absolute and relative frequencies, crude rates of mortality, specific and years of life potentially lost were calculated. Mortality was stratified by province of residence. Results: Among the deceased older than 60, males (52,%) and white-skinned subjects (64,%) predominated. The average mortality rate during the period was 12,5 per 10,000 inhabitants (h). The risk of death was higher in those older than 85 years (34,5 x 10,000 h). The highest rates corresponded to the provinces: Artemisa (18,2), Cienfuegos (15.7), Matanzas (14,5) and Havana (14,5). The main cause of death in the subjects studied was hypertensive kidney disease (42,3 per 100,000 h). Conclusions: There is a slight tendency to increase mortality in the group studied in the country. The risk of death from CKD at the provincial level presents differences; it is higher in the provinces of Artemisa, Cienfuegos, Matanzas and Havana. The main causes of death in individuals with the characteristics studied are hypertensive kidney disease and diabetes mellitus.

CONCEPTUALIZING THE SUBJECTIVITY OF GLOBAL LEADERSHIP IN CONTEMPORARY INTERNATIONAL RELATIONS THEORY

This article, based on an interdisciplinary approach and structural-functional analysis tools, examines the transformation of classical forms of conceptualizing the subjectivity of global leadership in contemporary international relations theory under the influence of new global political realities. It emphasizes that the initial classical positioning of international leadership as the primacy or hegemony of a single state on the international stage is yielding to other political practices that have not yet gained normative consolidation and theoretical conceptualization. It has been identified that modern international processes demonstrate a trend towards the institutionalization of international leadership in the form of a collective subject of international relations, endowed with exceptional powers and special status. New theoretical approaches increasingly note a shift in focus from classical factors ensuring leadership in international relations by enhancing the status and leadership potential of individual actors to the formation of collegial global leadership, including the concept of global governance, which is increasingly seen as the most probable and conventionally interpreted prognostic model for the transformation of the modern world order. Contemporary international relations theory identifies several subjects of international relations, with the nation-state traditionally occupying a leading position. In recent decades, other actors have been added to the list, including international governmental and non-governmental organizations, transnational corporations, civil associations, and private individuals. The emergence of new types of international relations subjects on the international stage, combined with the increasing importance of integration associations and the growing technological potential of digital networks, alongside the practical impossibility of establishing control over them, and the transfer of certain sovereign powers from national states to international institutions, indicates that traditional methods of governance and regulation in world politics are becoming outdated, losing their relevance and effectiveness in contemporary conditions. This necessitates the formation of an institutional foundation appropriate to the modern international system. Increasingly, this foundation of world order is associated with the phenomenon of global leadership. However, attempts to conceptualize it based on classical subjects of international relations are demonstrating increasing methodological inefficiency, leading to the search for new forms of the subjectivity of global leadership on the international stage.

Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system.

Data from the World Health Organization's International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022. Liver and pancreatic cancers accounted for the highest number of new cases. Real-world data (RWD) is now widely preferred to traditional clinical trials in various fields of medicine and healthcare, as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated. Additionally, research results from the RWD match global reality better than those from traditional clinical trials. To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors. This study analyzed RWD 1137 cases within the HB1 group (patients who underwent pancreatectomy, hepatectomy, and/or shunt surgery) in 2023. It distinguished different expenditure categories, including medical, nursing, technical, management, drug, and consumable costs. Additionally, it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal-Wallis test. This study used the Steel-Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables. The study found that in HB11 and HB13, the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy. Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy, both were significantly longer than those who underwent liver resection. In HB15, no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy; however, both were significantly higher than those in hepatectomy. Additionally, the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection. China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs. Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

Role of registry offices regarding the expiration of precautionary measures according to Law 1579 of 2012

In the context of Colombian legislation, the registry offices of public instruments play a role of significant relevance. These offices operate as intermediaries for the materialization of the transfer of real estate, pursuant to Article 756 of the Civil Code. In this analysis, we address the crucial role of the registry offices of public instruments in relation to the expiration of precautionary measures, framed in Article 64 of Law 1579 of 2012. Since more than ten years have passed since the implementation of this provision, the processes involving the renewal of precautionary measures have been addressed in correspondence with the interested parties and their legal representatives. In order to understand this approach, a methodology based on documentary review has been adopted, analyzing relevant research on the subject. Through this analysis, it has been possible to corroborate the usefulness and relevance of forfeiture as it has been conceived in the legislation. It is evident that precautionary measures were designed with the purpose of ensuring compliance with judicial rulings, in response to a global reality in the field of the administration of justice: the time required to initiate, develop and conclude a legal process. In the Colombian context, this duration is excessive. However, these measures are essential to safeguard the results of judicial decisions and have been conceived as a response to the prolonged time involved in carrying out a legal process in various justice systems (Case T-356/18, Constitutional Court, 2018)

„Die schlimmste Seuche unserer Tage ist die Angst.“ – Krankheit und Pandemie in Thea Dorns Trost. Briefe an Max

In the course of the pandemic since 2020 we have experienced different ways of life in public and private spaces, healthcare as well as work. Doris Bachmann-Medick talks about a ‘pandemic turn’ and claims, that the coronavirus pandemic implies a kind of crisis situation for human existence in our global reality. Everything has changed with the pandemic. Especially the biopolitical measures as well as health policy have entailed significant changes in social and individual living conditions. Literary discourses as a particular part of culture have the significant potential to reflect and criticize certain aspects of society and culture. Thea Dorn’s Corona novel Trost. Briefe an Max can obviously be described as a reaction to and literary reception of the Corona-era since 2020. The first-person narrator Johanna works as a culture journalist. She recently lost her mother, who travelled to Italy despite the pandemic. In her letters to her philosophy teacher, she expresses her immeasurable sadness and anger due to the new way of living because of the pandemic. The critical attitude of the novel is remarkable in terms of absolutization since helping becomes a part of biopolitics in times of the pandemic that leads to a tragic situation for the subject. In this article, I will analyze Thea Dorn’s Trost. Briefe an Max with reference to the approaches of Giorgio Agamben in Homo Sacer concerning biopolitics. In this context, especially the critical potential and attitude of this novel get important.

What will it take to make precision health a global reality.

What will it take to make precision health a global reality.

The effect of communication methods and image culture on audience type

The aim of the current study is to identify the diversity of style in the works of the artist Naziha Salim. The importance of it lies in The impact of the means of communication and the culture of the image on the public is very large, especially in recent years, because of its effective impact on the family and society in general, and especially on social identity, and struck many social and religious values. The effect of the image is very great on children, especially what appears in their behavior when imitating what is seen in the means of communication, this was a large part of the responsibility of the family in socialization, as well as the school in consolidating the social culture among the members of society, one of the negative effects of the image culture has become a reality imposed on everyone because of its overtones that are linked to the local culture and affect the mentality of the emerging individual. The culture of the image hit all the social and religious values that were well-established in society, upbringing is no longer confined to the family and school. The image and means of communication are a large part of the process of socialization, as the image has a place in the global social reality, especially in the collective behavior of individuals in imitating many behaviors that do not correspond to the customs, traditions or religion of society