Multidisciplinary Research Articles

Administrators’ Perceptions of Alternative Service Delivery Models and the School-Based Occupational Therapists’ Role

ABSTRACT School-based occupational therapists provide a range of services with collaborative consultation amongst interdisciplinary team members being one of their responsibilities. One perspective that has not been thoroughly examined within previous research is the administrators’ perceptions of the occupational therapists’ roles and responsibilities within the school setting, which may impact how therapists can implement alternative service delivery models for effective staffing. This study aimed to determine administrators’ perceptions of the workload model used for staffing for school-based occupational therapists, to explore their understanding of the school-based occupational therapists’ role and responsibilities, and to understand their perceptions regarding collaborative consultation. An anonymous electronic survey was distributed to public school administrators within Rhode Island. The survey was created using the Qualtrics platform and the data was analyzed using descriptive statistics. The results show that most administrators believe that school-based occupational therapists should be involved in all three tiers of the multi-tiered system of support (MTSS). Approximately 20% of administrators report that they are not at all familiar with the workload model. Many respondents feel that there are barriers to using alternative service delivery models, with staff being unclear as to how to transition to an alternative service delivery model being noted as the biggest barrier (63.2%). This study fills a void in the literature where administrators’ perspectives regarding alternative service delivery models and their views on collaborative consultation in relation to the school-based occupational therapists’ role were not explored. Understanding administrators’ perspectives can guide future research and help practitioners that are seeking to transition to a workload/staffing model.

A new holistic approach to preventing accounting fraud in the non-profit organisation (NPO) sector: some propositions and research agenda

PurposeThis paper systematically reviewed research on accounting fraud in the non-profit organisation (NPO) sector during 2004–2024 to identify gaps in theory and practice with the aim of producing a new parsimonious global fraud model.Design/methodology/approachThis paper utilised a structured literature review methodology.FindingsWe propose a new holistic approach for the NPO sector worldwide, with two foci of “what may contribute to fraud” and “what may prevent fraud”.Research limitations/implicationsThe future research agenda for the new holistic approach is provided.Practical implicationsThe approach helps donors promote accountability and transparency in the NPO sector worldwide, thereby sustaining the development of this sector.Originality/valueTo the best of the authors’ knowledge, this paper is the first comprehensive worldwide fraud research review, making distinct contributions. Globally, the approach is the first dedicated to the NPO sector, including different stages of fraud occurrence (undetected, suspected, actual/detected and future), and using a multi-disciplinary approach to prevent these stages. The approach is also the first to incorporate individual-level, organisational-level, industry-level and country-level factors into predicting future fraud.

Introduction: Crossroads of Psychedelic Studies

Since the 1960s, Harvard Divinity School has been an influential hub of research on psychedelics and religion. Yet, in many ways, the work of building a rich scholarly community around this area of study is just beginning. The Psychedelic Intersections: 2024 Conference Anthology is one step in that larger project. This volume is drawn from Harvard’s “Psychedelic Intersections: Cross-cultural Manifestations of the Sacred” conference, and the essays here feature original interdisciplinary research from scholars and practitioners working at the crossroads of psychedelics, religion, medicine, race, Indigeneity, law, and the underground, history, anthropology, and beyond. We see these intersections as sites for collaboration and innovation in two ways: psychedelics as intersections where unlikely peoples, entities, and institutions meet, and as intersectional forces where the study of psychedelics highlights, challenges, or qualifies pre-existing conceptions, be they imbalances of power, uses of law, or notions of religion and spirituality. In light of these intersections, the Anthology invites readers to imagine new futures for the field of psychedelic studies with a vision of scholarship that is multidisciplinary, collaborative, optimistic yet self-critical, involved both within and beyond the academy, attuned to complexity and diversity, and both sympathetic and intelligent.

Enhancing perianal disease management with integrated physical and psychological approaches

This article provides a comprehensive analysis of the study by Hou et al , focusing on the complex interplay between psychological and physical factors in the post-operative recovery (POR) of patients with perianal diseases. The study sheds light on how illness perception, anxiety, and depression significantly influence recovery outcomes. Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery. The article explores the critical role of pre-operative psychological assessment, highlighting the need for mental health support and personalized recovery plans in enhancing POR quality. A multidisciplinary approach, integrating mental health professionals with surgeons, anesthesiologists, and other specialists, is emphasized to ensure comprehensive care for patients. The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.

In Silico Evaluation of Algorithm-Based Clinical Decision Support Systems: Protocol for a Scoping Review

Background Integrating algorithm-based clinical decision support (CDS) systems poses significant challenges in evaluating their actual clinical value. Such CDS systems are traditionally assessed via controlled but resource-intensive clinical trials. Objective This paper presents a review protocol for preimplementation in silico evaluation methods to enable broadened impact analysis under simulated environments before clinical trials. Methods We propose a scoping review protocol that follows an enhanced Arksey and O’Malley framework and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines to investigate the scope and research gaps in the in silico evaluation of algorithm-based CDS models—specifically CDS decision-making end points and objectives, evaluation metrics used, and simulation paradigms used to assess potential impacts. The databases searched are PubMed, Embase, CINAHL, PsycINFO, Cochrane, IEEEXplore, Web of Science, and arXiv. A 2-stage screening process identified pertinent articles. The information extracted from articles was iteratively refined. The review will use thematic, trend, and descriptive analyses to meet scoping aims. Results We conducted an automated search of the databases above in May 2023, with most title and abstract screenings completed by November 2023 and full-text screening extended from December 2023 to May 2024. Concurrent charting and full-text analysis were carried out, with the final analysis and manuscript preparation set for completion in July 2024. Publication of the review results is targeted from July 2024 to February 2025. As of April 2024, a total of 21 articles have been selected following a 2-stage screening process; these will proceed to data extraction and analysis. Conclusions We refined our data extraction strategy through a collaborative, multidisciplinary approach, planning to analyze results using thematic analyses to identify approaches to in silico evaluation. Anticipated findings aim to contribute to developing a unified in silico evaluation framework adaptable to various clinical workflows, detailing clinical decision-making characteristics, impact measures, and reusability of methods. The study’s findings will be published and presented in forums combining artificial intelligence and machine learning, clinical decision-making, and health technology impact analysis. Ultimately, we aim to bridge the development-deployment gap through in silico evaluation-based potential impact assessments. International Registered Report Identifier (IRRID) DERR1-10.2196/63875

A Comprehensive Review of Vision-Based Sensor Systems for Human Gait Analysis

Analysis of the human gait represents a fundamental area of investigation within the broader domains of biomechanics, clinical research, and numerous other interdisciplinary fields. The progression of visual sensor technology and machine learning algorithms has enabled substantial developments in the creation of human gait analysis systems. This paper presents a comprehensive review of the advancements and recent findings in the field of vision-based human gait analysis systems over the past five years, with a special emphasis on the role of vision sensors, machine learning algorithms, and technological innovations. The relevant papers were subjected to analysis using the PRISMA method, and 72 articles that met the criteria for this research project were identified. A detailing of the most commonly used visual sensor systems, machine learning algorithms, human gait analysis parameters, optimal camera placement, and gait parameter extraction methods is presented in the analysis. The findings of this research indicate that non-invasive depth cameras are gaining increasing popularity within this field. Furthermore, depth learning algorithms, such as convolutional neural networks (CNNs) and long short-term memory (LSTM) networks, are being employed with increasing frequency. This review seeks to establish the foundations for future innovations that will facilitate the development of more effective, versatile, and user-friendly gait analysis tools, with the potential to significantly enhance human mobility, health, and overall quality of life. This work was supported by [GOBIERNO DE ESPANA/PID2023-150967OB-I00].

The Feshbach Resonances Applied to the Calculation of Stark Broadening of Ionized Spectral Lines: An Example of Interdisciplinary Research

In the present paper, we revisit the determination of Feshbach resonances in the elastic and fine-structure cross-sections of the spectral lines of ionized atoms colliding with electrons. The Gailitis approximation will be recalled and used to calculate the Feshbach resonances. A historical point of view will be used, emphasizing the interest of interdisciplinary research, with a back and forth between physics and astrophysics. First, the theory of Feshbach (arising at end of the 1950s and beginning of the 1960s) resonances will be briefly recalled and applied to the calculation of the cross-sections. In the beginning of the 1970s, the insertion of Feshbach resonances in spectroscopic diagnostics calculations permitted researchers to interpret the intensities of solar coronal lines. Then, in the middle of the 1970s, this gave rise to the idea of including the Feshbach resonances in the calculation of electron impact broadening (the so-called “Stark” broadening) of isolated spectral lines of ionized atoms. Finally, in the recent example of the Stark broadening of the Mo VI 5d D5/22−5p P°3/22 line, the S-matrices will be calculated using the semi-classical perturbation formalism and will be compared to those of the more recent quantum distorted wave formalism.

Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios

Mid-trimester preterm premature rupture of membranes is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. In addition, there is an increased risk of miscarriage, preterm birth, and chorioamnionitis, contributing to septic morbidity in the mother–baby dyad. This case report describes the management and outcomes of an infant born at 32 weeks following the rupture of membranes at 16 weeks of gestation, resulting in severe oligohydramnios. Soon after birth, the infant had respiratory compromise, requiring high-frequency oscillatory ventilation and nitric oxide. Despite the initial poor prognosis, the infant remained stable with various ventilation modalities managed by a multidisciplinary team. He was discharged home after 108 days in the hospital and remained on non-invasive ventilatory support until 8 months of age while the home care and hospital specialty teams monitored him. The favorable respiratory outcome of this case is a rarity for cases with similar clinical circumstances, in which the managing team counsels parents about poor fetal outcomes and many proceed to terminate the pregnancies. In this reported case, we highlight the importance of multidisciplinary and interprofessional team management from antepartum monitoring and planning delivery time to subsequent short- and long-term postnatal care involving maternal-fetal medicine specialists, neonatologists, pediatric cardiology and respiratory specialists, and home care teams.

Multidisciplinary Approach in the Treatment of Gastric and Duodenal ulcer Complicated by Bleeding

A multidisciplinary team is a team of specialists from different fields of medicine, united by the solution of one problem on previously agreed principles. A possible example of this approach in the treatment of gastric ulcer and duodenal ulcer complicated by bleeding is the joint interaction of doctors - general surgeons, endoscopists, gastroenterologists, general practitioners, therapists, nutritionists, psychologists. Since these specialists often encounter these dangerous diseases, a joint approach to their treatment is fully justified. When considering many medical problems, cooperation and joint work of several at once is necessary, both narrow specialists and general practitioners who work in the same team and try to achieve a common goal. In modern world medical practice, this approach is used more and more, because it allows you to combine the knowledge of different doctors, for the benefit of the patient and make the treatment closer to this patient. Today, a multidisciplinary approach of a team of doctors of different specialties is increasingly engaged in the treatment of patients in the world's leading clinics. It is believed that this approach has a future, because it allows to easily and quickly determine the sequence and priority of treatment methods. Also, recommendations to the patient are given in agreement and situations where one contradicts the other are excluded. Collegiality is observed.

Pilot of a multicomponent program for people with dementia and their care partners: Health services staff expectations, experiences and observations

There is increased recognition of the need to improve post-diagnostic pathways for people with dementia and their care partners living in the community to access rehabilitation services to support independence and wellbeing. However, there is minimal evidence on implementing rehabilitation services for this population. The study aimed to present the expectations and experiences of allied health staff involved in piloting the Sustainable Personalised Interventions for Cognition, Care and Engagement (SPICE) program based at an outpatient clinic of a public rehabilitation hospital. Over twelve weeks, the program combines small group and dyadic evidence-based interventions including cognitive stimulation therapy, occupational therapy, physical activity, care partner education, and dietetics. A qualitative exploratory methodology was used with pre- and post-program interviews conducted with ten allied health staff. Questions were designed to elicit the expected and actual benefits and challenges of the initial implementation of the multicomponent program. The multidisciplinary team were motivated by the potential for the SPICE program to meet an important service gap, and confident people with dementia and their care partners would benefit. Staff reported enjoyment, satisfaction, and confidence in delivering the program, and believed the multiple components had synergistic effects on participants, particularly regarding social connection and functional engagement. While staff had pre-program concerns regarding retention, participant fatigue, and managing challenging situations, these were not realised. At times, staff observed program intensity to cause unintended stress for some care partners. Resourcing and strategies to ensure sustainability were identified as important by staff, as well as the need for ongoing support to participants post-program. Overall, the SPICE program exceeded expectations and was rewarding for staff. Further work to refine and evaluate the program is necessary to support its potential to continue providing dementia rehabilitation to promote the independence and wellbeing of people with dementia and care partners living in the community.

An Aortic Root Abscess Mimic Identified by Multi-disciplinary Imaging Review: a Case Report

Abstract Background While echocardiography and cardiac Positron Emission Tomography (PET) can aid in the diagnosis of prosthetic valve endocarditis (PVE), post-operative changes can lead to false-positive imaging findings. We report a case of a patient with an aortic valve prosthesis with remnant BioGlue deposits mimicking a paravalvular abscess on imaging in the setting of suspected PVE. Case Summary A 67-year-old man presented with two days of fever, chills, and altered mentation. He had a history of two prior aortic root replacements—nineteen and four years prior to his presentation. He had blood cultures that were persistently positive for Pseudomonas aeruginosa. Initial transesophageal echocardiogram (TEE) was notable for a thickening of the posterior aortic root thought to be consistent with post-surgical changes. Cardiac PET showed significant uptake around the prosthetic aortic valve, concerning for a paravalvular abscess. However, given the patient’s high risk for re-do surgery, clearance of blood cultures and preserved valve function, our multidisciplinary endocarditis team (MET) recommended non-surgical management, and close follow-up. After six weeks of appropriate antibiotics, a TEE demonstrated concern for an evolving paravalvular abscess. The MET performed extensive review of his prior surgical interventions and cardiac imaging, revealing the previous use of surgical BioGlue and stability in the aortic root on imaging, consistent with non-infectious post-surgical changes and conservative management was recommended. Discussion Thorough review of prior interventions and serial imaging in patients with suspected PVE through a multidisciplinary team approach is essential in elucidating the complete, often complex, clinical picture and recommending the most appropriate management.

The impact of cross disciplinary communication methods on the support needs, quality of life, and emotions of patients with advanced lung cancer

Background: The condition of advanced lung cancer patients is already quite severe. At this stage, the tumor has basically spread to other areas or caused multiple recurrent lesions, which not only increases the difficulty of treatment but also leads to a significant decrease in disease control rate. Aim: To analyze the impact of cross disciplinary communication methods on patients with advanced lung cancer. Methods: A comparative study involving 152 advanced lung cancer patients from January 2022 to January 2024 was conducted. Patients were randomly divided into an observation group (73 cases, using interdisciplinary communication) and a control group (79 cases, using routine nursing). An interdisciplinary team, including nurses, physicians, head nurses, and psychology experts, developed communication plans. The study compared emotional states (DASS-21), supportive care needs (SCNS-SF34), disease uncertainty (MUIS), quality of life (FACT-L), and compliance between the two groups. The study's limitation is the relatively single sample selection, potentially affecting result generalizability. Result: After intervention, the DASS-21 score, SCNS-SF34 score, and MUIS score in the observation group were lower than those in the control group, while the FACT-L score was higher than that in the control group (P < 0.05); the good compliance rate of the observation group was 97.26% (71/73), which was higher than that of the control group (86.08% (68/79) (P < 0.05). Conclusion: For patients with advanced lung cancer, adopting cross disciplinary communication for intervention can not only effectively alleviate their negative emotions and reduce their sense of disease uncertainty, but also maximize the satisfaction of their supportive care needs, ensure their quality of life, and to some extent, obtain good cooperation from patients.

Evaluating duloxetine for pruritus and psychiatric comorbidities in lichen simplex chronicus.

The use of antidepressant medications in the treatment of lichen simplex chronicus (LSC) also known as neurodermatitis, is not well-documented in the literature. The primary aim of our study is to evaluate the impact of duloxetine 30mg on the quality of life in patients with LSC, focusing on both pruritus and psychopathological aspects. The secondary aim is to investigate the relationship between LSC and anxiety and depression. The observational prospective clinical study, conducted from November 2023 to November 2024, included male and female patients aged 18 and older diagnosed with neurodermatitis (lichen simplex chronicus). Inclusion criteria required a confirmed diagnosis by a dermatologist. Exclusion criteria included other skin conditions, polyneuropathies (e.g., diabetic, chemotherapy-induced), malignancy, current use of antidepressants or neuropathic pain medications, and medications known to cause itching (e.g., β-blockers, ACE inhibitors, antacids). Patients with LSC at the dermatology clinic were assessed by a dermatologist using the DLQI and a neurologist using the Beck Depression and Anxiety Inventory before and after three months of treatment. The study included 219 patients with a mean age of 39.6 (12.2) years, 69.5% female and 30.5% male. Post-treatment, the Duloxetine 30mg + 0.05% alpha clobetasol propionate group showed the most significant improvement in DLQI scores (p < 0.05). This group also had a notable reduction in itchiness scores by the third month, with more change over time. The greatest reduction in scores on the Beck Depression Inventory-II and Beck Anxiety Inventory was observed in the Duloxetine 30mg + 0.05% alpha-clobetasol propionate group, with this reduction continuing in a decreasing pattern in the Duloxetine 30mg and 0.05% alpha-clobetasol propionate groups, respectively. Significant changes in the time-group interaction were observed only in the Duloxetine 30mg + 0.05% alpha-clobetasol propionate and Duloxetine 30mg groups (p < 0.05). No significant time effect was seen in the 0.05% alpha clobetasol propionate group. In the regression analysis, both BAI and BDI-II showed significant and strong effects on DLQI (p < 0.05). Our study suggests that duloxetine 30mg may be effective in treating LSC by reducing pruritus and addressing comorbid psychiatric conditions like anxiety and depression. The multidisciplinary approach, involving both dermatological and neuropsychiatric evaluations, is essential for treatment. Long-term, multicenter studies are needed to confirm these findings.

Melanoma in pregnancy: multidisciplinary treatment management and outcome

Pregnancy-associated melanoma affects both maternal and fetal health. This study aims to demonstrate how a specialized center and a multidisciplinary approach can provide the best outcomes. From January 2006 to September 2023, a bicentric observational study was conducted at the Plastic Surgery Department of Policlinico Umberto I, Sapienza University of Rome, and at the Plastic and Regenerative Surgery Department of the San Gallicano Dermatological Institute IRCCS, Rome, Italy. Out of 6800 melanoma cases, twenty pregnant women were selected: thirteen underwent only wide local excision (WLE), while seven also had sentinel node biopsy (SLNB). All preoperative, operative, and postoperative steps were performed to ensure the safety of mothers and fetuses. Two patients developed metastases, with one fatality from hepatic metastases. The overall survival rate at 5-year follow-up was 86%, and 72% for advanced stages and disease-free patients. No maternal or fetal complications related to surgery were reported. Additionally, early deliveries at 7 and 8 months did not result in neonatal complications. Surgical treatment should be conducted in centers with both surgeons and gynecologists, and special care is necessary for procedures on pregnant women. Based on our experience, pregnancy does not seem to be a negative prognostic factor for melanoma.

The Key Elements About How to Improve English Language Educators’ Teaching Competence through Continuous Professional Development (CPD)

This study aims to assess the impact of Continuing Professional Development (CPD) training on the teaching competence of English language educators at application-oriented universities in Henan, China. By employing a systematic literature review and bibliometric analysis, the study gathers and evaluates relevant data to understand the current state of CPD in English language instruction within this specific geographical and educational context. The research analyzes previous trends and their effects, identifying key areas for future refinement and targeted development. The study provides significant insights and practical implications for enhancing English language teaching competence through CPD in Henan and within the broader educational landscape of China. The findings indicate that recent publications from 2022 to 2024 have a limited citation impact, suggesting a lack of studies specifically addressing CPD’s role in English language training. Addressing this gap will help in the development of customized CPD programs for application-oriented universities, aligning with China’s strategic goals to improve English proficiency and promote international business and technological capabilities. The study also highlights that CPD research often draws insights from psychology and medical training, implying that a multidisciplinary approach can enhance the effectiveness of CPD for English language instruction. The relatively declining citation impact of Chinese educational research compared to European studies underscores the need for Chinese institutions to strengthen global collaborations and publish important findings in accessible journals to increase the global visibility and influence of their CPD advancements.

Anesthetic Management of Renal Tumor with Level 3 Inferior Vena Cava Extension at a University Hospital in Vietnam: A Case Report

Background: Renal tumors with inferior vena cava (IVC) invasion pose significant challenges for surgical and anesthetic management. This report presents the anesthetic management of a patient with a level 3 IVC-invading renal tumor, emphasizing the complexity and multidisciplinary approach required. Case Presentation: A 55-year-old woman with a large left renal tumor causing complete obstruction of the left renal vein and near-total obstruction of the IVC was admitted for surgery. Multidisciplinary planning included a nephrectomy with removal of tumor from the IVC. The patient underwent general anesthesia with extensive hemodynamic monitoring and fluid management to mitigate potential blood loss and cardiovascular instability. The surgery, lasting 5 h, involved successful radical nephrectomy, tumor removal from the IVC, and resection of liver metastases. Postoperative recovery was without complications, and the patient was discharged 7 days. Conclusion: Managing anesthesia for renal tumors with IVC invasion requires careful preoperative planning, invasive monitoring, and multidisciplinary approach.

Cardiovascular diseases, prevention and management of complications in older adults and frail patients treated for elective or post-traumatic hip orthopaedic interventions.

Due to the aging population, focusing on healthy aging has become a global priority. Cardiovascular diseases (CVDs) and frailty, characterized by increased vulnerability to adverse stress and health events, interact synergistically in advanced age. In older adults, hip fractures are a frequent dramatic "life-transition" event. Conditions such as arrhythmias, orthostatic hypotension, heart failure, peripheral artery disease and adverse drug reactions may facilitate falls and thus bone fractures in older adults. Cardiovascular complications or the worsening of previous CVDs may increase the degree of frailty and disability following this surgery. The close relationship between older age, CVDs, frailty and orthopaedic surgery leads to the need to focus on the various phases of interventions in a multidisciplinary approach. This document aims to provide practical support to prevent cardiovascular complications in older and frail patients undergoing hip procedures by suggesting specific assessments and interventions. In particular, in pre-operative care the focus should be on the assessment and management of concomitant CVD and frailty, while immediate peri- and post-operative care should highlight specific concerns for anesthesia, prevention and management of thrombotic complications, specific nursing needs, including the prevention of infections and delirium, and the establishment of an integrated rehabilitation program focusing on CVDs and the risk of new falls, with a positive role for care-givers. Furthermore, by optimizing the "hip surgery pathway" the objective is to help avoid the deterioration of health and loss of independence that often result from this surgery through the correct management of cardiovascular patients in this peculiar context.

Orthopaedic Surgery in the Jehovah’s Witness Patient

➢ Jehovah’s Witnesses refuse allogeneic blood products based on religious beliefs that create clinical, ethical, and legal challenges in orthopaedic surgery, requiring detailed perioperative planning and specific graft selection.➢ Detailed perioperative planning is particularly important for procedures with high intraoperative blood loss.➢ Graft selection must align with Jehovah’s Witnesses patients’ religious beliefs, with options including autografts, allografts, and synthetic materials; this requires shared decision-making between the patient and surgeon.➢ A multidisciplinary approach, integrating medical, ethical, and religious considerations, ensures optimal care, with innovative techniques and open dialogue being key to successful outcomes.

The Relationship Between Fibromyalgianess and Clinical Features, Disease Activity in Patients With Systemic Lupus Erythematosus.

Fibromyalgia (FM) is a chronic syndrome characterised by widespread pain, fatigue, and symptoms such as sleep disturbances, cognitive impairment, and mood disorders. FM prevalence is notably higher among systemic lupus erythematosus (SLE) patients compared with the general population, often leading to diagnostic challenges. Misinterpreting FM as SLE activity can result in overtreatment. This study aimed to evaluate fibromyalgianess and its relationship with the clinical and immunological characteristics of SLE patients using comprehensive scoring methods for better diagnostic accuracy. This cross-sectional study included 50 SLE patients meeting the 2019 EULAR/ACR classification criteria. Patients with coexisting autoimmune diseases or severe systemic conditions were excluded. Clinical data, SLEDAI scores, and fibromyalgianess severity were assessed using the Polysymptomatic Distress Scale (PSDS). Patients were categorised into groups based on fibromyalgia diagnostic criteria: widespread pain and SLE-FM. Statistical analysis was performed using SPSS, with p<0.05 considered significant. Among 50 patients (45 female, 5 male; mean age 42.04±12.5), 24% had fibromyalgianess, and 18% experienced widespread pain. Female patients exhibited significantly higher PSDS scores (p<0.05). While NSAID use was associated with increased PSDS scores (p<0.001), no significant relationship was found between fibromyalgianess and SLEDAI scores or organ involvement. Fibromyalgianess in SLE patients primarily reflects heightened pain sensitivity and symptom severity rather than disease activity. Incorporating fibromyalgianess assessment into routine SLE management may prevent diagnostic and therapeutic pitfalls and improve treatment outcomes. Multidisciplinary approaches, including pharmacological and non-pharmacological strategies, are essential for effective care.

The earliest development of the Vilnius Franciscan Church and monastery area

When the German Town (a settlement of Catholic merchants and craftsmen) began to emerge in the western part of the present Old Town of Vilnius in the last decades of the 14th century, the Catholic community relocated to this area. St Nicholas Church was built here before 1387 and it was the first Catholic church in the Old Town, around which the German City was established. However, in addition to this house of worship, there was another in the Catholic part of the city – the Franciscan Church of the Assumption of the Blessed Virgin Maria and a monastery.This monastery is considered to be the oldest one in Vilnius, however, the exact time of its construction, as well as that of the church, has not been determined. Due to the lack of historical sources and precise dates, the construction has been dated by different researchers from the first half of the 14th century to the beginning of the 15th century, i.e., with an error of 100 years. Archaeological investigations in the vicinity of the church and the monastery, which have been carried out since 1993, have provided some new hypotheses concerning the chronology and the earliest nature of human activity in this territory. The most recent excavations took place here in 2023, providing new insights into the development of the area through the discovery of objects and interdisciplinary research (radiocarbon dating, analysis of archaeobotanical remains, architectural research). This paper discusses the chronology and nature of the earliest development of the Franciscan church and monastery area, based on the available historical sources, archaeological and architectural research, including the results of most recent investigations.