Official Instructions Research Articles

Pharmacotherapy with alpha-1 adrenergic blockers and lipid spectrum correction in patients with urinary disorders

The study was based on treatment outcomes in a group of 130 patients aged 18–81 years. Subgroups were formed according to gender and age criteria, which included 56 men and 74 women, and were also divided into subgroups under 65 years of age and after 65. Treatment lasting continuously from 11 to 18 months was carried out in the form of combination therapy with the prescription of α1‑blockers (terazosin, doxazosin) in combination with vitamin-like drugs (levocarnitine, alpha-lipoic acid) in dosages according to the official instructions for the drug. The work involved systems for tabular assessment of the clinical symptoms of urinary disorders, as well as instrumental, laboratory, and statistical methods (Mann — Whitney test, Spearman's rank correlation coefficient).Results. Against the background of the prescribed treatment, HDL levels significantly changed from 1.3 to 1.38 mmol/L, as well as VLDL from 0.88 to 0.72 mmol/L in the general observation group. In some indicators, particularly total cholesterol, low-density lipoprotein, and triglycerides, no dynamics were noted. In the men subgroup, the indicators of both HDL and VLDL changed significantly and reliably from 1.2 to 1.29 mmol/L and, accordingly, from 0.79 to 0.65 mmol/L. In the 65-yearold subgroup, VLDL levels significantly decreased from 0.88 to 0.76 mmol/L and triglyceride levels from 1.9 to 1.65 mmol/L, respectively. In the subgroup of patients aged >65 years, there was a significant increase in HDL from 1.29 to 1.46 mmol/L.Conclusion. Long-term combination therapy over 11 months, including alpha1 inhibitors in combination with vitamin-like drugs, significantly changed the lipid spectrum. The best outcomes of pharmacotherapy were observed in the male subgroup and in patients aged >65 years.

The use of low doses of gabapentin in patients with neuropathic pain and with thrombocytopenia

Introduction. Approximately 21–27% of patients with blood system diseases receive opioid analgesics, with neuropathic pain being one of the most common reasons for prescription. Gabapentin is used as a first-line drug for neuropathic pain (NP), but has been poorly studied in patients with blood system diseases.The objective was to study the effectiveness and safety of gabapentin in patients with blood system diseases with chronic pain.Materials and methods. A single-center, prospective observational study included 24 patients with thrombocytopenia and pain between October 2017 and October 2022. The patients’ age ranged from 18 to 71 years (median 40 years). All patients with blood system diseases: non-tumor blood system diseases (aplastic anemia) in 8% (n = 2), myeloid tumor blood system diseases (acute myeloid leukemia) in 34% (n = 8), lymphoid tumor blood system diseases (acute lymphoblastic leukemia, follicular lymphoma, diffuse B – large cell lymphoma, T-cell lymphomas, multiple myeloma) in 58% (n = 14). All patients had thrombocytopenia less than 150∙109/l, 66% (n = 16) had less than 90∙109/l. All patients were diagnosed with neuropathic pain (NP), localized according to the neuroanatomical distribution and accompanied by sensory disturbances typical of NP. The localization of pain was different, pain predominated in the lower extremities (63% (n = 15), 95% CI: 43 – 79%), caused by peripheral polyneuropathy of predominantly toxic origin (vincristine, bortezomib), and pain was also caused by the course of the underlying disease: cephalalgia and neck pain, this pain was caused by compression of the nerve structures by the lymph nodes, postherpetic neuralgia, trigeminal neuralgia caused by tumor growth. All patients had intractable, high-intensity pain requiring trimeperidine at a dose of 20–40 mg/day. All patients were prescribed gabapentin therapy at a dose of 900–1200 mg/day.Results. When taking gabapentin in the study group of patients (n = 24), already on the 3rd day, there was a clinically and statistically significant decrease in pain intensity: 1) by median: from the initial 6 to 4 points, p = 0.01 (and up to 3 points by 7th day of therapy) and 2) on average: from initial 6.5 to 3.9 points, p = 0.01 (and up to 3.2 points by the 7th day). Stratification of the dynamics of pain intensity reduction by type of blood system disease (BSD) shows that the decrease by day 3 (sustained and further by day 7) was clinically and statistically significant (p = 0.01) for groups of patients with lymphoid and myeloid BSD, and clinically and approximately statistically significant in patients (n = 2) with non-tumor BSD. Analgesic therapy using small doses of gabapentin gave a pronounced, stable positive effect (pain intensity statistically significantly decreased by an average of 50%). After 7 days of gabapentin therapy, a decrease in the opioid dose was noted in 52% of patients. Side effects were dominated by drowsiness 67% (n = 16), dizziness 32% (n = 8).Conclusion. The results of this study indicate that gabapentin is effective in the treatment of chronic neuropathic pain in patients with BSD and is safe when used in minimal/average therapeutic doses within the daily dosing ranges established by the official instructions for use.

The Impact of EG and DEG Cases on Sales of Over-The-Counter Syrup

The Indonesian Food and Drug Authority (BPOM) investigated and listed safe and unsafe syrup products in response to the contamination of Ethylene Glycol (EG) and Diethylene Glycol (DEG), causing Acute Kidney Injury in pediatric patients. Unsafe products were recalled and removed from distribution, leading to uncertainty and panic among the public and significantly impacting over-the-counter syrup sales in several pharmacies. This retrospective observational study assessed the impact of EG and DEG contamination on the sales of over-the-counter syrup in Pharmacy X in South Denpasar. Data from three months before (August to October 18th, 2022) and three months following the official instruction was published (October 19th, 2022 to December 2022) were analyzed using Wilcoxon test. The findings reveal a staggering decline in the sales of over-the-counter syrup by 35,03% (p-value of 0.03). Moreover, there was a notable increase of prescriptions in powder forms. The contamination cases caused panic, resulting in changes in behavior and consumption patterns. Despite the availability of safety information on an official website, public hesitance toward syrup products persists, indicating the need to implement a more effective strategy to address misinformation and restore public trust. Each individual must be responsible for educating the public during crises to prevent the spread of misinformation, ultimately restoring trust and normal consumer behavior. Furthermore, efficient stock management should be implemented to anticipate potential health crises in the future proactively.

Reducing Error Rate in Property Tax Declaration Forms through Simplification and Highlighting Instructions

Abstract The paper is mixed-method research on reducing administrative burden and, more specifically, the learning costs of filling out a property tax declaration form. It presents the development process of a guidebook, which simplified the instructions and experimentally tested the effectiveness of the guidebook in lowering the error rate. Young Slovak adults (N=43) were divided into two groups; the treatment group worked with the guidebook, and the control group used the official instructions the Ministry of Finance provided. The guidebook aimed to decrease learning costs using behavioural support (simplification, highlighting, examples, and the like). The results suggest that the guidebook helps significantly decrease the number of errors compared to the complex instructions the Ministry of Finance provided. However, while the guidebook is very effective in reducing errors in simple tasks, it may not be sufficient help for more complex tasks such as mathematical calculations. Therefore, simplified instructions must go hand-in-hand with interventions such as pre-populating of forms.

Engendered Perceptions

Abstract This article considers how Chinese Communist Party (CCP) officials understood, perceived, and experienced enemy female tewu (special agent) activities and “honey traps” during the early People’s Republic of China. Drawing upon internally circulated party reports and newsletters, speeches of officials, newspapers, films, literature, and dramas, it finds that officials saw enemy female tewu as real threats that had tangible impact on both civilians and men affiliated with the party through honey traps and gendered manipulations. It further argues that narratives of female tewu in official instructions, newspaper reports, and popular cultural works played a larger role in the CCP’s broader efforts to combat and resist enemy espionage than previously understood. This article contextualises existing arguments about CCP counterespionage propaganda. It counterbalances perspectives that suggest the utilisation of these narratives was largely based on irrational wartime sentiments, with the primary aim of increasing the party’s societal control.

Analysis of Phonological Errors Made by Grade 4 Learners with Communication Difficulties in Kieni East Sub-County

Inclusive education in Kenyan primary schools brings together learners with special needs and their peers without special needs in the mainstream classroom. Some learners in inclusive classrooms have challenges that hinder the acquisition of literacy skills. Official instruction in ESL in primary schools begins in Grade 4. Learners who fail to acquire basic language skills in Grade 4 will struggle to master ESL in the upper classes. Against this backdrop, this study set out to analyze the phonological errors made by Grade 4 learners of ESL in Kieni East Sub-County. The study adopted a descriptive research design. Seven primary schools in Kieni-East were randomly sampled, and 11 students with communication difficulties purposively sampled for data collection. The 11 learners were observed during an ESL listening and speaking lesson. The researcher turned Sony ICD-UX570 Digital Voice Recorder on and left it on the learner’s desk for a 35-minute lesson. The study identified twenty-seven (27) words with phonological errors. The phonological errors were categorized into five classes such as cluster reduction (22%) followed by reduplication (19%), distortion (15%), deletion (15%), stopping (11%), backing (11%) and gliding (7%), respectively. The audio-recorded data was transcribed, and the correct forms provided in a table. Data was analyzed qualitatively using Error Analysis and Natural Phonology Theory to describe the phonological errors. The study found that Grade 4 learners with communication difficulties make phonological errors due to word complexities, biological disorders, and poor cognitive development. Further, the study established that inclusive schools do not have adequate assistive resources to instruct learners with communication difficulties. This study recommends that teachers should partner with speech therapists and language researchers to assist learners with communication needs. Further, EARC should equip all inclusive classrooms with assistive resources to address the needs of learners with communication needs.

Tanzimat Dönemi’nde Malatya’da Yapılan İdarî Düzenlemeler (1845-1883)

In this research, administrative reforms implemented after the Tanzimat across the Ottoman Empire is studied by taking as a sample the reform practices made through the city of Malatya. With the declaration of the Tanzimat Edict on November 3, 1839, the Ottoman Empire made some reforms in many state institutions and organizations in accordance with the exigencies of the modern era. The starting of implementing the articles in the Tanzimat Edict throughout the country was accepted as the initial basis for modernization in state administration. However; by taking into account the conditions of the Empire, the financial, administrative, and military reforms envisaged by the Tanzimat were not implemented all at once. These reforms were first initiated in nearby states in which the government has absolute control and on where in case of any problem, can be intervened in a short time. After the success in those states, reforms are started to implement in other states. This study is important in terms of analyzing the administrative reforms of the provincial organizations adopted by the Ottoman Empire after the Tanzimat Edict. In the period between the years 1845-1883, when the reform program was carried out, official instructions were published as a requirement of the new regulations, and new governors were appointed to the cities. In the states where the aimed success was not achieved, other new regulations have been adopted. It has been determined that Malatya was subject to various administrative applications from when it was included in the Tanzimat implementation program until 1883, when the work was terminated. It is known that the Tanzimat was not applied all at once throughout the country and was applied in a certain order in the states. By establishing the Sancak Meclisi, Malatya, one of the Sancaks of the Diyarbakır State, was also included in the Tanzimat on April 15, 1845. In the following process, as a result of the continuation of the innovations brought by the Tanzimat, Harput was included in the Tanzimat and Malatya, due to its border between Diyarbakır and Harput, was connected in 1846 to the Harput State as a “county”. After the Provincial Regulations put into effect in 1867, new administrative arrangements made throughout the country, and Malatya was once again elevated to the status of “sancak” in 1869, being connected to the Diyarbakır Province. This new organizational structure continued until 1883. In this article, the reforms that were aimed to be achieved in the administrative field with the Tanzimat were implemented in Malatya, and acquired results will be observed for the period of study and will be evaluated if the Ottoman Empire achieved the success it aimed in the reform practices in the administrative field after the Tanzimat. Our research was carried out on the methods followed by Ottoman historians. Archival documents related to the subject were examined, and the information in the “Salnames” of the period was analyzed. In the light of new information belonging to this period, the administrative structure of Malatya was tried to be illuminated. In this study, it has been seen that the Ottoman Empire managed to reach the people, and the people participated in the government with the newly adopted administrative structure after the Tanzimat Edict. The fact that different new regulations had to be put into action one after another showed that the desired success in reform efforts could not be achieved. In addition, new boundaries were drawn as a requirement of reform practices during the period, and the list of managers working in Malatya were determined. * This paper is derived from Inonu University, Institute of Social Sciences, Department of History, a Ph.D. dissertation entitled "Malatya in the Second Half of the 19th Century (1839-1900)", prepared under the supervision of Prof. Dr. Mehmet Karagöz.

LEGO and the Infrastructural Limits of Open Play

LEGO and the Infrastructural Limits of Open Play

Polecenie w administracji publicznej. Wybrane problemy

The article presents selected problems concerning instructions in public administration. First, attention is paid to the official instruction. It is issued in service relationships, which differ from employment relationships. By issuing an official direction, the service superior obliges a subordinate employee to perform a specific official activity, including to submit a declaration of knowledge on public issues. An official direction is an individual administrative act.These official instructions are issued when it is necessary to correct the performance of public tasks by a subordinate employee. The obligation to comply with an official instruction is not absolute. The addressee of the instruction may raise objections and even refuse to execute an unlawful official instruction.Instructions issued by a superior authority to a subordinate authority constitute a separate group. Such an instruction is an internal act. It may concern the method of performing tasks or taking specific actions within the scope of operation of a subordinate authority. Instructions issued between public administration authorities are aimed at adapting activities to the directions of public policy and correcting the manner of performing public tasks. There is no appeal against an instruction issued by a superior authority. These are binding.The last category concerns intervention orders. The intervention order does not result from organizational superiority or official subordination. This is a request addressed to the public administration authority to take action to abolish the danger in emergency situations. Intervention orders are issued in particular in matters of protection of life, public health, property, protection of civil rights, maintenance of public policy.

Application of the cost-effectiveness method in improving the pharmacotherapy of multiple myeloma

Multiple myeloma (MM) accounts for 1 % of all cancers and about 10 % of all hemoblastoses. The use of innovative technologies with the inclusion of targeted drugs leads to a significant improvement in the quality of pharmacotherapy and the achievement of overall survival (OS).The aim of the work is to conduct a pharmacoeconomic analysis of the most used MM therapy regimens with the use of targeted drugs and to determine the dominant treatment regimens using a costeffectiveness analysis.Materials and methods. To determine the cost of a course of treatment, we summed up the costs of drugs included in the pharmacotherapy regimen, taking into account taxes, marginal trade markup and duration of the course. Dosing of the targeted drug included in the regimen was determined according to the official instructions for the drug. Progression-free survival (PFS) was adopted as the main criterion for the effectiveness of treatment. Information on PFS of targeted drugs was obtained from data from international phase III RCTs — ASPIRE, TOURMALINEMM1, POLLUX and ELOQUENT2.Results. Based on the results of the pharmacoeconomic analysis, the dominant treatment regimen for MM was determined — daratumumab / lenalidomide / dexamethasone, which has the best cost-effectiveness ratio. The combination of elotuzumab / lenalidomide / dexamethasone was recognized as the least effective technology.

What was Killing Babies in Trondheim? An Investigation of Infant Mortality Using Individual Level Causes of Death, 1830–1907

This paper examines infant mortality amongst newborns in Trondheim city, 1830–1907, working specifically with individual level cause of death data. Findings show that infant mortality in the city started to drop from 1895, primarily as a result of a decline in post-neonatal mortality. At the start of the decline air-borne diseases accounted for nearly half of the deaths, and water-food borne for around one third. The drop was predominantly driven by a decline in these two causal groups, and seasonal fluctuations became less pronounced. Because of the fall in post-neonatal mortality, the relative risk of dying amongst neonates rose towards the end of the period. Although 'convulsions' accounted for 50–70% of all infant deaths between 1830 and 1860, this cause had faded away to near insignificance by the beginning of the 1900s. Here we aim to assess the extent to which this particular aspect of decline can be explained by alterations to official instructions regarding registration and in registration practice itself. This article proposes that the decline in deaths from 'convulsions' can be explained by a relabelling of such deaths into 'congenital and birth disorders' amongst neonates, and a mix of 'water-food borne' and 'air-borne diseases' amongst post-neonates. This argument is supported by the fact that the timing of the decline corresponds with the introduction of cause of death certificates issued by medical practitioners, and which most likely resulted in fewer causes of death being reported by lay informants who could only offer vague symptoms rather than informed diagnoses.

Peningkatan keterampilan public speaking melalui metode Monroe’s Motivated Sequence kelas XI OTKP SMKN 1 Surakarta

<p><em>The purpose of this study was to find out: 1) how the teaching pattern of office administration teachers on PKWU subjects has changed in the new normal era, starting from the preparation to the evaluation process at SMKN 1 Banyudono; and 2) the obstacles found in learning at SMKN 1 Banyudono. The PKWU learning process in the new normal period was applied face-to-face, limited to face-to-face at SMKN 1 Banyudono; and 3) the efforts made to overcome the obstacles in the application of face-to-face were limited to PKWU subjects at SMKN 1 Banyudono. This type of research is descriptive-qualitative with a case study approach. The research was conducted at SMKN 1 Banyudono. Research data was obtained from informants, events, and documents with purposive and snowball sampling. Data collection techniques include observation, interviews, and documents. The validity of the data was obtained in four ways: credibility, transferability, dependability, and confirmability. The data analysis technique used interactive model data analysis with the following stages: 1) data collection, 2) data concession, 3) data presentation, and 4) drawing conclusions. The results showed that the teacher had carried out PKWU learning quite well in accordance with the official instructions.</em></p>

Official instructions for the primary school class that can be achieved through chess in Poland and France

Chess teaching is being introduced in primary schools in the European Union following a 2012 European Parliament recommendation. The author had the experience of introducing chess to pupils in the first class of primary school. She set up an innovative scheme that introduces learners to chess while taking into account the disciplines provided for in the official instructions for this educational stage.In the first part of this article, the “General Curriculum Framework for the Primary School” is related to chess teaching. The author proves that much of the curriculum can be achieved through chess in a lively and diversified way. This approach makes it possible to introduce the general public to chess and, at the same time, to prepare interested and/or gifted individuals for further training. The first class of the primary school is a space of holistic development of the child and cross-curricular teaching can use chess as a canvas.The second part of the article presents the above thesis in light of French legislation. The comparison of the organisation of the teaching provided in the Polish and French school systems allows for determining the hourly volume of a chess project if it were to be conducted in both countries simultaneously. Moreover, the analysis of the French “Programmes d’enseignement” shows many similarities with the Polish guidelines. The specificities of the basic learning cycle are scrutinised and, for the second time, it is shown that chess contributes to the development of most of the competencies specified by the legislator. The author illustrates how to adapt chess lessons to achieve objectives in mathematics, languages, physical and artistic education as well as in the social and technical fields.The article is addressed to all those for whom the harmonious education of 7-year-olds is as dear as the appropriate teaching of chess. It is an invitation to consider chess as a unifying element, opening to the Other.

Psychopharmacotherapy of mental disorders in hematological patients: security concerns

Evaluation of the safety of psychopharmacotherapy (PFT) of mental disorders in modern protocols for the treatment of patients with blood disorders. The data of medical records of 552 patients with blood disorders who received PFT during treatment at the clinic of the National Medical Research Center for Hematology were analyzed. Any adverse events recorded while taking PFT were taken into account. Statistical analysis included descriptive statistics, frequency analysis, and assessment (Student's t-test) of changes in blood parameters (before and after taking psychotropic drugs). Signs of hematotoxicity were found only in 7.1% (n=37) patients, in all cases while taking benzodiazepines (n=12) in combination with hematotoxic drugs for the treatment of blood disorders. Other significant adverse events (which caused premature discontinuation or dose reduction) were detected in 4.8% (n=25) cases, of which 9 were associated with the appointment of anxiolytics (hydroxyzine, zopiclone), 11 with antidepressants (clomipramine, amitriptyline, duloxetine, trazodone, ademethionine) and 5 with antipsychotics (risperidone, alimemazine, haloperidol). Most psychotropic drugs are effective in relation to psychopathological disorders that develop in hematological patients and are safe when used at minimum/average therapeutic doses within the daily dosage ranges established by the official instructions for use.

ГОСУДАРЕВА СЛУЖБА ПЕТРОВСКОГО ЛЕЙБ-МЕДИКА Г. ПОЛИКАЛЫ В РОССИИ И ОСМАНСКОЙ ИМПЕРИИ

The article explores the activities of the Russian agent in Istanbul, doctor Georgy Polikalа. It analyzes the medic’s contacts with the Russian diplomatic representative P. A. Tolstoy, who gave secret instructions to Policala. Since 1711, he has been officially registered for service in Russia as a life physician of Tsarina Ekaterina Alekseevna. The doctor enjoyed special favor of both Peter I and his second wife. The facts of the participation of Polycalа in the treatment of other members of the royal family, such as Princess Charlotte Christina Sofia, the wife of Tsarevich Alexei Petrovich, are also noted. The surviving sources make it possible to partly reconstruct Polycalа’s mission in Istanbul in 1721, when, in addition to the official instructions of Peter I, related to the presentation of the tsar’s letter to the sultan, he was also engaged in preparing the escape of A. Cantemir, who was in Turkish captivity. The authors also consider Polikala’s connections with the family of the Moldavian ruler, in particular, examining a plot common in historiography about the participation of the medic in the termination of Maria Cantemir’s pregnancy by order of Ekaterina Alekseevna. The documents available to historians do not allow confirming this fact. There was also an attempt to engage Polycalа in January 1725 to the treatment of Peter I. The last fact of the physician’s biography confirmed by archival sources is filing a request for resignation in May of the same year.

La traduction des documents authentiques dans les manuels scolaires Tunisiens entre pertinence et transgression linguistico-culturelle

The Translation of Authentic Documents in Tunisian School Textbooks between Relevance and Linguistic-Cultural Transgression
 The didactics of foreign languages is a discipline that covers all teaching/learning operations and more particularly didactic transposition. This operational approach requires the presence of several actors: a learner who receives the knowledge and a teacher who plays a pedagogical role of mediator between the knowledge and the learner, using tools, and approaches adapted to the level of the learners. To succeed in this task, the teacher must select and prepare relevant authentic documents. In addition, he will try to plan the lessons and themes to be treated and select the accompanying resources in better working conditions (time/space).
 The authentic document is a practical and tangible document that was not designed for pedagogical purposes but for communicative purposes. It is initially intended for native speakers; the teacher exploits it to enhance it in activities that he will propose in class. The authentic document can take various forms: written, oral, or audiovisual. But if it turns out that any change concerning the form and content has been made to the document such as the deletion or addition of one or more paragraphs, or their rhetorical flesh-out; or the addition of articulators between the proposals to facilitate for example the deduction, in this case we will rather speak of a manufactured didactic document.
 Pedagogical resources play an important role in the teaching-learning process, since their content should improve learners' skill levels. In the context of the use of textbooks very strongly recommended by official instructions. The translation of authentic documents into mother tongues is undeniable, their relevance depends on the needs of the learners and therefore on the learning processes. On the other hand, the translation of these documents requires prior language skills and cultural knowledge on the part of translators-pedagogues but also learners, at the risk of being inappropriate or even counterproductive.
 In fact, talking about relevance refers us to detecting the acts of receipt and authenticity of a document. In class and in a well-defined production context, the authentic document is subject to different acceptance conditions. It is therefore necessary to prepare learners in advance to receive the translation of this document, so that they can grasp certain linguistic and contextual connivances.
 However, the translation of authentic documents presents a large number of constraints that restrict the possibility of their use in the teaching-learning process. Moreover, it is not always easy to find relevant translations whose content is adapted to the level of learners cognitively and culturally, their relative ambiguities can be prohibitive at the beginner and intermediate levels. On the other hand, translations with simple proposals, stated at a concise and slow pace with a clear articulation will be perfectly preferred. It is also necessary that the translated content corresponds to the pedagogical challenges of the teacher and the needs of the learners.
 This research deals with the translation of authentic documents into textbooks in Tunisia. It is an exploratory research with a comprehensive and analytical aim that relies on the quality of the texts produced in Arabic resulting from the translation of the source texts. It is objective to analyze the gap between the original texts in terms of authentic documents and their translation proposed in printed manuals. In particular, emphasis is placed on the linguistic-cultural relevance of translated texts and its relationship to the history of source texts. To achieve this objective, we opted for a tripartite analysis: The first part is a grammatical-comparative analysis of textual supports, the second part is a discursive and structural analysis of translated texts, while the last part, it focuses on the establishment and mobilization of cognitive and cultural baggage.

The Conceptual Change through Hybrid Evaluation among High School Students in Life and Earth Sciences

According to the literature, conceptual change is a primary challenge in science education. Several studies have indicated that learners use their intuitive conceptions even after science instruction. Therefore, our study aimed to create working conditions that would support learners' achievement of conceptual change. We hypothesized that integrating learners into the teaching-learning process in a collaborative setting will positively impact their performance to reflect the degree to which they achieve conceptual change. After the realization of a course respecting the official instructions and the curriculum of life and earth sciences, we proposed to the students of a public high school to pass a hybrid evaluation of this subject where we asked them to realize collaboratively in small groups, presentations of the synthesis of the course that they had received, in the form of a video capsule. This method has already been approached in other research works. The difference in this work is that the student's presentation was asynchronous, leaving the student the right to make mistakes and self-correction. A written evaluation in class completed this work to verify the achievement of the conceptual change in them. The analysis of the student's results in the hybrid evaluation and their comparison with the results they obtained in the first semester showed a considerable improvement in the level of the students, especially for those who had an average or even weak mastery according to the marks obtained in Life and Earth Sciences during the first semester. The collaborative work in small groups was an opportunity for exchange, sharing, and mutual help among the students, who were more motivated and showed great interest in this method.

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Venous thromboembolic complications (VTEO) after modern minimally invasive superficial vein interventions are an infrequent but very dramatic event. This article presents a review of the literature, covering the issues of prevalence, prognosis and pharmacological prevention of VTEO. The performed studies demonstrate that the incidence of symptomatic thrombotic complications after endovenous thermal obliteration does not exceed 0,5%, but taking into account asymptomatic thermally induced thromboses and subclinical occlusions of the muscular veins of the lower leg, this figure can exceed 10%. There is a high heterogeneity of the data, possibly due to differences in the individual risk of VTEO. The most validated tool for assessing the latter is the Caprini Scale, which has not been sufficiently studied in the surgical treatment of varicose veins. The administration of prophylactic doses of anticoagulants after thermal obliteration of saphenous veins is widely used in routine clinical practice, despite the lack of convincing evidence for the appropriateness of this approach. In recent years, the use of direct oral anticoagulants against the official instruction (off-label) has gained great popularity as an alternative to heparin. The largest evidence base has accumulated for the use of rivaroxaban 10 mg, which is associated with high efficacy and safety. Based on completed clinical trials, it is not possible to formulate unequivocal recommendations for prophylactic anticoagulant doses after thermal obliteration of superficial veins at this time. Additional studies are required to identify patients with an individually increased risk of thrombosis in whom prophylactic doses of anticoagulants may be of maximum benefit.

History Teaching, Sensitive Issues and Identity Building in France

The teaching of history is connected to sensitive issues, which provoke social divisions and debates and which do not have scientific consensus. Sensitivity is explained by the social missions of history teaching: to catalyse the construction of identity, to build a border between “us” and “the other - the stranger”. The questions addressed during history classes are “time bombs”. Teaching history implies the transposition of social debate into the classroom and drawing attention to the political dimension of the subject. The article is focused on sensitive issues in history teaching in France. In 2019, we conducted a study to assess which issues were experienced by teachers as sensitive in class, what are the reasons for the sensitivity, and what personal and institutional conditions might help teachers in overcoming such situations. The article analyses the practices of the main actors of education - teachers confronted with official instructions, with the pressure of curricula, and with the reaction of pupils and their parents in France. The questionnaire collected 188 responses of French history secondary school teachers from all regions, from different social contexts, teaching pupils of different ages (from 11 to 18 years old). The aim of the article is not to conduct a banal review of the superabundant literature on the issue, but to bring a fresh and value-added look at empirical results in a specific context.

Statistical Guideline #7 Adjust Type 1 Error in Multiple Testing.

This is one in a series of statistical guidelines designed to highlight common statistical considerations in behavioral medicine research. The goal is to briefly discuss appropriate ways to analyze and present data in the International Journal of Behavioral Medicine (IJBM). Collectively, the series will culminate in a set of basic statistical guidelines to be adopted by IJBM and integrated into the journal's official instructions for authors, and to serve as an independent resource. If you have ideas for a future topic, please email the Statistical Editor, Ren Liu atrliu45@ucmerced.edu.