September 25th Research Articles

Multi-scale analysis of the community structure of the Twitter discourse around the Italian general elections of September 2022

We perform a multi-scale analysis of the geometric structure of the network of X (Twitter at the time of data collection) interactions surrounding the Italian snap general elections of September 25th 2022. We identify within it the communities related to the major Italian political parties and after it we analyse both the large-scale structure of interactions between different parties, showing that it resembles the coalitions formed in the run-up to the elections and the internal structure of each community. We observe that some parties have a very centralised communication with the major leaders clearly occupying the central role, while others have a more horizontal communication strategy, with many accounts playing an important role. We observe that this can be characterized by checking whether the network in the community has a strongly connected giant component or not.

From legislation to reality: Understanding gender-based violence in Tunisia

IntroductionTunisia marked a significant milestone in the fight against gender-based violence with the adoption of Organic Law No. 2017-58. This pioneering law in the region enhanced the protection of women and girls’ rights and introduced harsher penalties for perpetrators of sexist violence. However, the journey toward eradicating violence against women is complex and multifaceted.ObjectivesOur aim is to explore how tunisian women perceive gender-based violence and their attitudes towards it.MethodsA cross sectional online survey designed using Google Forms and distributed on social media platforms (Facebook, Instagram) was conducted from August 30th to September 25th 2023. The questionnaire, presented in the tunisian dialect, included questions about personal experiences with violence, knowledge of gender-based violence laws as well as their perceptions and attitudes towards gender-based violence. The sample consisted of women from various regions of Tunisia.ResultsIn our study, we analyzed a sample comprising 110 tunisian women, with 46.4% falling within the 20 to 30 age bracket and 36.4% belonging to the 30 to 40 age range. Half of the survey participants were unmarried, and the majority of them (97.3%) had attained a university-level education.Our research revealed that 45.5% of the surveyed women reported instances of gender-based violence in Tunisia. However, only a minority of these individuals (22.2%) initiated legal proceedings, primarily citing a lack of confidence in the judicial system and fear of potential reprisals as their reasons.A majority of the participating women expressed deep concern regarding the issue of violence against women in Tunisia.When asked about their perceptions of the most prevalent types of violence in Tunisia, 76.36% believed that psychological violence was the most common, followed by sexual violence (21.3%). Economic and physical violence were perceived as less frequent (9.9%; 12.6%). These women attributed the primary factors contributing to violence against women in Tunisia to cultural norms and laws that they considered inadequately stringent. Indeed, 83.3% of them believed that the current legislation was not stringent enough to deter potential perpetrators, and 37.3% indicated that they were unaware of the existing legal framework.ConclusionsDespite legislative advancements, gender-based violence remains a pressing concern in Tunisia. These findings underscore the importance of increasing awareness about available resources for victims, educating individuals about women’s rights and mental health, and building trust in the judicial system.Disclosure of InterestNone Declared

Alcidodes karelinii (Coleoptera: Curculionoidea: Molytinae): New weevil species for the fauna of Serbia

This paper reports the first findings of the allochthonous weevil species Alcidodes karelinii (Boheman, 1844) in Serbia. It is distributed throughout the Eurasian steppe belt, and recently it has been spreading westwardly. The specimens from Serbia were found thanks to citizen science in two localities in Vojvodina Province (North Serbia): Ada Municipality, North Banat District, December 16th , 2022, and March 16th , 2024; and the Village of Bački Brestovac, Odžaci Municipality, West Bačka District, September 25th, 2023.

The national COVID-19 vaccination campaign targeting the extremely vulnerable: the Florence Medical Oncology Unit experience in patients with cancer

BackgroundInternational and national oncology societies had released recommendations in favor of COVID-19 vaccination in cancer patients. In the context of the national vaccination campaign targeting the so called extremely vulnerable, we aimed to assess the safety and efficacy of the mRNA vaccines in a cohort of 623 patients. MethodsBetween March 26 and April 04, 2021, the Pfizer and BioNTech BNT162b2 mRNA and the Moderna mRNA-1273 vaccines were given as a two-dose prime-boost regimen. Starting on September 25th 2021 a third dose was offered to patients in whom a suboptimal immunogenicity with COVID-19 vaccination could be expected. Safety assessments were performed by phone call 7 days after each dose. Electronic health records were accessed to review demographic information, disease history, treatment detail, and outcome events of participants patients’. FindingsNo toxicities were reported in 63.7%, 54%, and in 48.7% patients with cancer after each dose. Mild-to-moderate pain at the injection site was the most commonly adverse event. After the second dose, 46% of the 610 patients reported toxicity, with more systemic side-effects observed. Fever was reported in 45% of patients, with a temperature ≥ 38 °C in 21.4% of them. Of the 335 patients receiving a third vaccine dose, 51% reported toxicity, with 13% of patients reporting more than one effect. Logistic regression analysis reported mixed results, with limited variables or categories reporting a significant odd ratio. The type of vaccine reported a significant value at first dose (OR = 0.12; CI 0.52, 0.26; p = 0.00). Thirty-four cases of COVID-19 infection were reported with only one patient requiring a short-term hospitalization for monitoring. InterpretationThe safety profile of the mRNA vaccines does not raise any specific concerns and support prioritization of vaccination for cancer patients.

Focal Mechanism Analysis of the September 25th, 2019 Mw 6.5 Ambon Earthquake and Its Implication for Seismotectonics

On September 25th, 2019, an Mw 6.5 earthquake occurred in Ambon, Maluku Province, Indonesia, and caused casualties and infrastructures damages. The epicenter located in a tectonically active region with the potential strike-slip and thrust faulting earthquake sources, yet the responsible fault is still not well understood. Based on focal mechanism solutions from available seismological agencies, i.e. USGS, GFZ, GCMT, and BMKG, the earthquake has a similar strike-slip focal mechanism, although there are discrepancies on detailed source parameters. To provide a better understanding of the earthquake mechanism and seismotectonic, we apply the Cut-and-Paste (CAP) focal mechanism inversion method to broadband seismic waveforms from regional and teleseismic distances. The CAP inversion results on the regional data grouped in different distance ranges show a robust strike-slip solution. We then refine the earthquake focal depth by performing the CAPtele inversion and resulted in a depth of 12 km with similar fault plane solution as the regionals. The ruptured fault plane is resolved by a directivity analysis using azimuthal pattern of the apparent source durations, which indicates an obvious unilateral rupture propagation toward SSE direction. Our result suggests the NNW-SSE orientated fault is the ruptured fault plane, which is also consistent with the near N-S distributed aftershocks. This fault is located in a narrow sea between Seram, Ambon and Haruku island and was not reported yet in previous studies. The Coulomb failure stress (CFS) changes analysis of the mainshock shows that the Ambon earthquake has promoted the off-fault aftershocks which occurred to the west of the ruptured fault.

Special Issue on PHM for Human Health and Performance II

This special issue was conceived during the 11th Annual Conference of Prognostic and Health Management Society’s Panel session on the September 25th at Scottsdale, AZ, USA. We would like to thank the panel members and their colleagues in their participation in this special issue focusing on engineered technologies for older adults. This work was partially funded by the NSF ERC seed grant from an interdisciplinary group of researchers from Iowa State University, Arizona State University, Georgia Tech, Florida State University, Chapman University and the University of California Irvine who are engaged in developing a large-scale grant proposal that will be focused on integrated technologies to promote resilient aging and reducing healthcare costs.The manuscripts exemplify our research focus and illustrates contributions in the fields of wearable smart sensors, sensor-data-fusion, machine learning and data mining, prediction and diagnosis, and electronic health records and databases - all in the context of prognostics and health management for human health and performance.We would like to thank the PHM Society for providing an opportunity to publish in their premier journal, and importantly, we are grateful for help of the Editor-in-Chief – Marcos Orchard, Ph.D. for his countless hours to edit and make it best possible of this special issue. Finally, we would like to express sincere appreciation to all the reviewers who have contributed their time and thoughtful feedback to making this special issue publication a success.

COVID-19 Impact on Heart Organ Transplantation - New Insights from a Single-Center Experience

PurposeDuring the COVID 19- pandemic, there is no consensus on management strategies for treating infected heart transplant patients. The outcomes of these patients vary by institution. We report our center experience and management strategies to date.MethodsAll patients who received heart transplantation, from January 4th 2018 to September 25th 2020 and were diagnosed with SARS-CoV-2 were included and full chart review was performed.ResultsThere were 113 heart transplants at our institution by September 2020. A total of 13 (12%) patients were infected with SARS-CoV-2: 9 (69%) isolated heart, 3 heart -kidney (23%) and 1 heat- lung (8%). The median (IQR) time from transplant to diagnosis was 10 (5-16) months. The mean age was 57 years and 50% were male; 50% were of Hispanic ethnicity. The main presenting symptoms were fever (43%), cough (86%) and SOB (43%). Chest x-ray was abnormal in all patients. We evaluated all patients and 79% were hospitalized and 21% were closely monitored as outpatients. None of our patients were hospitalized at outside institutions. Two (14%) required intubation and none required V-V ECMO support. The immunotherapy was modified in all patients: MMF and prednisone were discontinued, tacrolimus dose was reduced. COVID19 treatment was: 71% received hydroxychloroquine, 50% azithromycin, 15% remdesevir, 7% convalescent plasma. All hospitalized patients received anticoagulation. One patient had 2R/3A rejection within 30 days prior to diagnosis. Graft function was maintained in all patients with median LVEF% 65 (59-65%) except one patient who had received thymoglobulin 2 weeks prior to COVID 19 infection (LVEF 30%). The patient had a prolonged intubation but ultimately recovered and was discharged from the hospital. The one death (7.1%) was a heart - kidney recipient who concomitantly presented with pseudomonas sepsis and severe neutropenia. The remaining patients have all been discharged home.ConclusionWe present our single center experience in managing COVID 19 infected heart transplant patients. We implemented uniform management strategies by incorporating aggressive reduction of immunosuppression, frequent scheduled contacts with infected outpatients and making sure all infected patients requiring hospitalization were treated at a transplant center.

Latin American forum on immunization services during the COVID-19 pandemic

ABSTRACT Introduction: The Latin American Society of Pediatric Infectology (SLIPE for its acronym in Spanish) is working hard to contribute with strategic actions to prevent the recurrence of Vaccine-Preventable Diseases and to prevent the reduction of vaccine coverage in the region of the Americas. Areas covered: On Friday, September 25th, a Latin American forum of experts on immunization services during the COVID-19 pandemic was held through Webex platform. Issues such as: the imminent risk of occurrence and outbreaks of vaccine-preventable diseases, the importance of epidemiological surveillance and the vaccination campaign challenges, in the context of a pandemic were discussed. Expert opinion: Vaccination campaigns should no longer be postponed or delayed; instead, they must be reactivated; governments, scientific societies, and physicians must promote vaccination programs to avoid outbreaks of vaccine-preventable diseases. On the eve of a SARS-CoV-2 vaccine, it is necessary to insist on the availability of sufficient doses to avoid dose shortages in disadvantaged areas of the region.

Abstract GS1-02: Phase III study of palbociclib combined with endocrine therapy (ET) in patients with hormone-receptor-positive (HR+), HER2-negative primary breast cancerand with high relapse risk after neoadjuvant chemotherapy (NACT): First results from PENELOPE-B

Abstract Background: About one third of patients with hormone-receptor-positive (HR+), HER2- primary breast cancer with residual invasive disease after neoadjuvant chemotherapy will relapse despite adjuvant endocrine therapy. The risk of relapse can be assessed more accurately using the CPS-EG scoring system (Mittendorf et al. JCO 2011). Therapeutic inhibition of cyclin-dependent kinase 4 and 6 (CDK 4/6) by palbociclib combined with endocrine therapy demonstrated highly relevant efficacy in metastatic breast cancer. Thus, we hypothesize that palbociclib may also be active in these high-risk patients with primary breast cancer. Methods: PENELOPE-B (NCT01864746) is a double-blind, placebo-controlled, phase III study in women with centrally confirmed HR+, HER2- primary breast cancer without a pathological complete response after taxane-containing neoadjuvant chemotherapy and at high-risk of relapse (CPS-EG score ≥3 or 2 and ypN+). After completion of neoadjuvant chemotherapy and locoregional therapy, patients were randomized (1:1) to receive 13 cycles of palbociclib 125mg daily or placebo on days 1-21 in a 28d cycle in addition to standard endocrine therapy. Randomization was stratified by lymph node status (at surgery), age, Ki-67, global region, and CPS-EG score. Primary endpoint is invasive disease-free survival (iDFS). Final analysis was planned after 290 iDFS events with efficacy boundary p<0.0463 due to 2 interim analyses. Main secondary endpoints include iDFS excluding second primary invasive non-breast cancers, overall survival, and safety. Results: A total of 1250 patients were randomized between 2/2014 and 12/2017. Median age was 49.7 years [range 19-79]; 96.8% had residual disease in the breast, 94.6% were ypN+; G3 was reported in 47.4%, Ki-67 >15% in 27.7 %; 54.7% of patients had risk status CPS-EG score ≥3. 1118 patients (89%) completed at least 7 cycles of therapy. 50.1% of patients received aromatase inhibitor (AI), 49.8% tamoxifen, 6.6% AI + gonadotropin-releasing hormone (GnRH) and 9.7% tamoxifen + GnRH. Most common related serious adverse events (SAEs) were infections and vascular disorders. 8 fatal SAEs were reported. Conclusions: PENELOPE-B evaluates the effect of palbociclib for 1 year compared to placebo in addition to endocrine therapy in high-risk primary breast cancer patients. The database was locked with 308 events on September 25th 2020. After breaking the blind for analysis, top line results will be available as of mid October 2020. Results of the final iDFS analysis will be presented at the meeting. Citation Format: Sibylle Loibl, Frederik Marmé, Miguel Martin, Michael Untch, Hervé Bonnefoi, Sung-Bae Kim, Harry Bear, Nicole Mc Carthy, Mireia Melé Olivé, Karen Gelmon, José García Sáenz, Catherine M Kelly, Toralf Reimer, Masakazu Toi, Hope S Rugo, Sabine Seiler, Valentina Nekljudova, Carsten Denkert, Michael Gnant, Andreas Makris, Nicole Burchardi, Gunter von Minckwitz. Phase III study of palbociclib combined with endocrine therapy (ET) in patients with hormone-receptor-positive (HR+), HER2-negative primary breast cancerand with high relapse risk after neoadjuvant chemotherapy (NACT): First results from PENELOPE-B [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS1-02.

Las Las transfiguraciones del arte en la agenda de los objetivos de desarrollo sostenible 2030

El 25 de septiembre de 2015, los países miembros de las Naciones Unidas aprobaron por unanimidad la Agenda 2030 sobre el Desarrollo Sostenible del mundo, que se pretende como una oportunidad para que las sociedades comprendan un nuevo camino con el que mejorar la vida de la comunidad, con el lema: sin dejar a nadie atrás. Este trabajo muestra los aportes que las Humanidades y las Artes realizan a la agenda desde la praxis que cada disciplina compone en materia de desarrollo sostenible y procurando la salud de las democracias en América Latina. Nuestro recorrido dialoga con las propuestas teoríco-críticas de Graciela Speranza y Martha Nussbaum e intentará mostrar algunas marcas de dichos aportes en acciones que, en materia de ODS 2030, están realizando algunas Universidades del mundo. Asimismo, desde las cinco herramientas propuestas por Naciones Unidas, articularemos la resiliencia con la crítica literaria (Roland Barthes), con Land art (Bernabé) y con la literatura (Horacio Quiroga) para bocetar un diagnóstico crítico y un análisis de las acciones de las Humanidades y las Artes en el desarrollo sostenible del planeta.

Stretching and relaxing the plantar fascia may change plantar fascia thickness but not pressure pain thresholds: a cross-sectional study of patients with plantar fasciopathy

BackgroundDespite the established relevance of ultrasonography and assessment of pressure pain thresholds in patients with plantar fasciopathy, patient and probe positioning has been mostly ignored and are not necessarily reported in research. The primary aim of this study was to compare plantar fascia thickness in stretched and relaxed positions in patients with plantar fasciopathy. The secondary aim was to compare plantar heel pressure pain thresholds in these positions.MethodsIn this cross-sectional study, we measured the plantar fascia thickness with ultrasonography, and localised pressure pain thresholds using pressure algometry of 20 patients with plantar fasciopathy. These were assessed bilaterally, with the plantar fascia in both a stretched and relaxed position. In the stretched position, toes were maximally dorsiflexed, while in the relaxed position participants’ feet were hanging freely over the end of the table.ResultsThe plantar fascia of the most symptomatic foot was significantly thicker when stretched compared with the relaxed position (sagittal: mean difference 0.2 mm, 95%CI: 0.1–0.4, P = 0.013; frontal: mean difference − 0.27, 95%CI: − 0.49 to − 0.06, P = 0.014). The plantar fascia was significantly thinner in the frontal plane compared with the sagittal plane in both positions (stretched: mean difference − 0.2 mm, 95%CI: − 0.42 to − 0.03, P = 0.025; relaxed: mean difference − 0.3 mm, 95%CI:-0.49 to − 0.08, P = 0.008). There was no difference between pressure pain thresholds in stretched or relaxed positions in either foot (P > 0.4).ConclusionsThe plantar fascia was significantly thicker in a stretched compared with a relaxed position and in the sagittal compared with the frontal plane, but differences were smaller than the standard deviation. Pressure pain thresholds were not different between the positions. These results highlight the importance of how ultrasonography is performed and reported in research to allow for replication.Trial registrationThe study was pre-registered September 25th, 2017 on ClinicalTrials.gov (NCT03291665).

Testosterone treatment is associated with reduced adipose tissue dysfunction and nonalcoholic fatty liver disease in obese hypogonadal men

PurposeIn both preclinical and clinical settings, testosterone treatment (TTh) of hypogonadism has shown beneficial effects on insulin sensitivity and visceral and liver fat accumulation. This prospective, observational study was aimed at assessing the change in markers of fat and liver functioning in obese men scheduled for bariatric surgery.MethodsHypogonadal patients with consistent symptoms (n = 15) undergoing 27.63 ± 3.64 weeks of TTh were compared to untreated eugonadal (n = 17) or asymptomatic hypogonadal (n = 46) men. A cross-sectional analysis among the different groups was also performed, especially for data derived from liver and fat biopsies. Preadipocytes isolated from adipose tissue biopsies were used to evaluate insulin sensitivity, adipogenic potential and mitochondrial function. NAFLD was evaluated by triglyceride assay and by calculating NAFLD activity score in liver biopsies.ResultsIn TTh-hypogonadal men, histopathological NAFLD activity and steatosis scores, as well as liver triglyceride content were lower than in untreated-hypogonadal men and comparable to eugonadal ones. TTh was also associated with a favorable hepatic expression of lipid handling-related genes. In visceral adipose tissue and preadipocytes, TTh was associated with an increased expression of lipid catabolism and mitochondrial bio-functionality markers. Preadipocytes from TTh men also exhibited a healthier morpho-functional phenotype of mitochondria and higher insulin-sensitivity compared to untreated-hypogonadal ones.ConclusionsThe present data suggest that TTh in severely obese, hypogonadal individuals induces metabolically healthier preadipocytes, improving insulin sensitivity, mitochondrial functioning and lipid handling. A potentially protective role for testosterone on the progression of NAFLD, improving hepatic steatosis and reducing intrahepatic triglyceride content, was also envisaged.Clinical Trial RegistrationClinicalTrials.gov Identifier: NCT02248467, September 25th 2014

Effect of Pioneer Aeromedical Evacuation Program on Flight Medics’ Practices toward Emergency Casualties at Army Aviation Bases in Iraq

Objective(s): The study aims to determination the effect of aeromedical evacuation program on flight medics’ practices. Method: A pre-experimental design is carried in army aviation bases in Iraq, for the period of February 1st 2019 to September 25th 2019. Non-probability “purposive” sample of (30) flight medics are selected from army aviation bases. Non-probability “purposive” sample of (30) flight medics are selected from army aviation bases. The questionnaire is composed of two main parts (demographic characteristics of the flight medics, and the second part involves five domains which as (67) items concerning flight medics’ practices regarding first aid of emergency casualties format, the researcher used SPSS version 20 to analyze the data. The reliability of the participant responses was estimated by alpha correlation (r) practice test was (r= 0.94), and content validity of the instrument was determined through a panel of (twenty-five) experts. Data was analyzed through the use of descriptive and inferential statistical analysis. Results: The results of the pretest for flight medics revealed that flight medics’ practices about five domains of aeromedical evacuation program toward emergency casualties was moderate, while the posttest I and II results shows that flight medics’ practices was improved to high level because of the positive impact of the instruction program, and there were significant association between the effectiveness of present program on flight medics’ practices and there level of education at P?0.05. Conclusion: The study concluded that the present program was effective on flight medics’ practices. Recommendation: The study recommended to increase the training courses for flight medics inside and outside Iraq, and included the present program on their plan of training.

The number of deaths by suicide after the Great East Japan Earthquake based on demographic statistics in the coastal and non-coastal areas of Iwate, Miyagi, and Fukushima prefectures

Objective The number of deaths by suicide after the Great East Japan Earthquake was surveyed based on demographic statistics. In particular, this study examined whether or not there were excessive deaths due to suicide (excluding people who were injured in the earthquake) after the Great East Japan Earthquake disaster. This examination surveyed municipalities in coastal and non-coastal areas of Iwate, Miyagi, and Fukushima prefectures (referred to below as the "three prefectures").Methods The demographic statistics questionnaire survey information supplied by Article 33 of the Statistics Act (Ministry of Health, Labour and Welfare's published statistics Vol. 0925 No.4, September 25th, 2014) were used as the basic data with particular reference to the information on the deaths from January 1st, 2010 to March 31st, 2013. The information obtained included the date of death, the municipality where the address of the deceased was registered, the gender of the deceased, age at the time of death, and cause of death codes (International Classification of Disease Codes 10th revision: ICD-10). Additionally, information was gathered about the population based on the resident register from 2009 to 2013 and the 2010 National Census; the number of deaths by suicide was then totalled by period and area. The areas were classified as municipalities within three prefectures and those located elsewhere using the municipality where the address of the deceased was registered.Results The SMR for suicides did not show a tendency to increase for coastal or non-coastal areas throughout the two-year period after the earthquake disaster (from March 2011 to February 2013). The SMR for the three prefectures 0-1 years after the disaster compared with the year before the disaster was 0.92 and for 1-2 years after the disaster was 0.93. Both these values were significantly low. Looking at both the non-coastal and coastal areas from each of the three prefectures, the SMR for suicides for 0-1 and 1-2 years after the disaster compared with the year before the disaster ranged from 0.73 to 1.07. None were significantly high.Conclusion The above results indicate that there was no increase in deaths by suicide in these three prefectures in the two years following the earthquake disaster.

Assessment of the Effect of Pregnancy Age (40 Years and Older) on The Outcomes of Pregnancy among Women Who Were Attending The Obstetric Teaching Hospital in Sulaimani

Background: The age of advanced mothers is still associated with a range of adverse pregnancy outcomes Objective: To assess pregnancy outcome at 40 years and older among women attending to obstetric teaching hospital of Suleiman Methodology: A descriptive study was applied on mothers in sulaimani governorate from September 25th 2014 to May 11th, 2015. Non-probability sampling of (200) pregnant women 40 years and older who were attended to obstetric teaching hospital of sulaimani for following up their health. A questionnaire was developed for the purpose of the study. It was comprised of two parts; the first part includes the demographic characteristics of women and the second part consists of questions related to maternal health and fetus. A pilot study was carried out for the period from September 11th to 25th, 2014 to determine the questionnaire reliability through the use of (Test- Retest). A panel of (8) experts was involved in the determination of the questionnaire content validity. Data were analyzed through the application of descriptive statistical data analysis approach (frequency and percentage), and inferential data analysis approach (chi-square).Results: The results of the study revealed that pregnant women more seasoned than 40 years had more chronic diseases, for example, such as hypertension, diabetes mellitus, so they require visit medical and dietetically treatment, likewise mal presentation, fetal demise happened more in women %40 years old, contrasted with women more youthful than 35 years, cesarean section in women %40 years had a more than two times, they required longer remaining in hospital. While placenta abroptia were about four times more in younger mothers compared to old age. Also abortion in younger women occurred more and needed more medical treatment continues check-ups.Conclusion: The study conclude that high incidence of complications such as hypertension, diabetes mellitus ,malpresentation, placenta praevia, cesarean section, low birth weight, preterm delivery and fetal death deliverywere seen in pregnant women age 40 years & older.Recommendations: The risks of pregnancy may be further lowered by promotion excessive health education regarding a healthy lifestyle during pregnancy and interventions with excellent well trained health care giver are important.

Evaluation and assessment of prescribing patterns in elderly patients using two explicit criteria based screening tools: (The PRISCUS list and STOPP/START criteria).

Background & Objectives:Rational prescribing can prevent medication errors and the associated harm, especially in old age patients, as they are being frequently prescribed with drugs for various ailments. Moreover, polypharmacy is a common practice in them. Therefore, a significant threat of potential drug interactions and adverse effects exist. Current study focuses on assessment of Potentially Inappropriate Medication (PIM) in medication prescribed to old age patients.Methods:It was a forty days, descriptive and observational study conducted from August 15th 2017 to September 25th 2017 in which prescriptions given to elderly patients were reimbursed for collecting various sets of information. In order to assess PIMs (in Pakistani Set-up), STOPP/START addition 2008 (including examples of misprescribing, overprescribing and under prescribing) and the PRISCUS list (misprescribing and overprescribing) was used. Statistical analysis of results was performed using SPSS version 20.Results:One hundred forty six cases of PIMs (including incorrect prescribing, overprescribing and under prescribing) were detected. It included incorrect prescriptions 104, under prescription 28 and over prescriptions 14. NSAIDS accounted for most incorrect prescriptions followed by benzodiazepines. Mostly NSAIDS were used for myalgia, backache and rheumatoid disorders.Conclusion:Current findings highlighted Potentially Inappropriate Prescribing (PIP), particularly of NSAIDs and under prescribing of statins in cardiovascular diseases. Study findings suggest introducing pertinent interventions at the stages involved in prescribing, prescription review and its follow up to reduce the PIP and PIMs.

Financial Risk Management and Sustainability The Sufficiency Economy Philosophy Nexus

With the September 25th 2015 United Nations Resolution 70/1 “Transforming our world: the 2030 Agenda for Sustainable Development”, the case for integrating SUSTAINABILITY criteria at the heart of economic development programmes in particular, as well as the prerogative to pursue Sustainable Development Goals as the global response to humanity’s very existential threat in general, are no longer a matter of academic debate. Likewise, the wisdom of embedding sustainability ethos within the core strategy of business and social enterprises alike is gaining universal traction. However, exactly how and why sustainability principles intersect with mainstream Financial Risk Management models and methodologies, especially for corporate entities and financial institutions, is not so obvious. This, despite the fact that sustainable development proponents and risk management professionals are kind of kindred spirits: both dedicated to ensuring that there is a kind of longevity to something we desire and pursue as an active enterprise (be it economic development or financial profitability). By necessity, this piece is never going to be about showcasing actualised practices. Rather it is about making the case for what is possible, indeed necessary, but admittedly quite illusive in practice. The nexus between sustainability mandate and risk management discipline will be examined through the lens of Sufficiency Economy Philosophy Inspired and promulgated by H.M. King Bhumibol Adulyadej of Thailand, it is generally considered first and foremost a compelling paradigm governing humanity’s pursuit of sustainable development, applicable to every sphere of our social/cultural, economic/political, and ecological/environmental existence as humankind.

Working as a physiotherapist before and after the signing of the Physiotherapists Act of September 25th 2015 into law: selected aspects

Article 68 of the Constitution establishes a universal right to health care. However, when considering the legal regulation of the profession of a physiotherapist, the security provided by the constitution is not guaranteed. There is no single, strict act, which would regulate the rights and obligations of patients and physiotherapists. What constituted working as a professional physiotherapist raised many doubts. The Physiotherapists Act of September 25th 2015 has long been awaited by physiotherapists. Its entry into force has a lot of positive aspects. Adopted with the consensus of the professional environment, it provides an opportunity to guarantee the patients’ safety better than ever, and also to develop treatment and cooperation with the countries of Western Europe. The previous lack of legal regulations for the profession of a physiotherapist still carries negative consequences for both the patients and physiotherapists, as it creates a gap that can be exploited by non-physiotherapists who offer their services. The aim of the study was to present the current legal status of the physiotherapist’s profession and to compare it after the Physiotherapists Act entered into force.

Critical thinking to realize sustainability in tourism systems: reflecting on the 2030 sustainable development goals

On September 25th 2015, countries adopted a set of goals to end poverty, protect the planet, and ensure prosperity for all as part of a new sustainable development agenda. Each goal has specific ta...

OVERUSE PROBLEMS IN ICELANDIC MALE HANDBALL

BackgroundThe majority of studies in handball register only time loss injuries. From previous studies and our experience working with handball players we know that playing with overuse problems are common...