Status Position Research Articles

Governmental implementation of information and communication technology at the local level: Digital co‐production during a crisis

AbstractThe rapid expansion of volunteerism, especially during COVID‐19, requires efficient organisation of citizen volunteers, thus leading professionals to utilise information and communication technology (ICT) as an enabling tool for interaction and coordination. This study focuses on professionals’ perspectives at the local level regarding governmental steps towards digitalisation and its application in volunteer co‐production. The policy implementation approach was used through in‐depth interviews with 19 local coordinators in Israel during the COVID‐19 crisis. This study found that, while central government invested efforts in training, guidance, and ICT support for professionals, the implementation of digital technologies was not successful at the local level. This highlights the need for digital platforms for volunteer coordination to be be tailored to specific cultural characteristics and local contexts. Neglected but important factors in ICT implementation were identified, including intra‐organisational dynamics, the local community, and authority. By addressing these contextual factors and adopting a more inclusive and context‐sensitive approach, digital platforms can better support local volunteer coordination efforts.Points for practitioners Adopt a holistic approach to digitalisation: Senior‐level administrators in central government should adopt a holistic approach to digitalisation, one that accounts for local contexts—cultural characteristics and collaborative governance structures. This approach should involve coordinators in the development process, together with other stakeholders involved in co‐production. Focus on user‐centric platform design and implementation: To ensure usability and acceptance among coordinators, practitioners should prioritise a user‐centric approach to platform design and implementation. This entails constructing intuitive, user‐friendly platforms, meeting the needs of the coordinators involved in the digitalisation process. Address organisational characteristics and overcome barriers: Practitioners should recognise municipal organisational characteristics, thus obviating potential barriers to digital technology implementation. This includes such factors as status and professional position within the municipality, securing bureaucratic commitment, and overcoming governmental bureaucracy or a lack of leadership.

Comparing the Health Status of Immigrant and New Zealand-Born Older Adults in Aotearoa New Zealand: The Role of Socioeconomic Position.

The study investigated the health status of older migrants relative to their New Zealand-born peers. We adopted a holistic view of health (physical, mental, and social) and a structural approach to health disparities based on migrant status and socioeconomic position. Using case-control matching based on age, gender, and education, the health status of 357 older migrants and 357 New Zealand-born older adults was compared. Older migrants reported significantly poorer social health. Health inequities were patterned by socioeconomic status. Working class older migrants had significantly poorer physical, mental, and social health than their New Zealand-born peers. Inequities in social wellbeing persisted even at the upper end of the social gradient. Migrant background is an important social determinant of health in older age. The reduced social wellbeing of economically advantaged migrants highlights vulnerabilities regardless of socioeconomic position and the need for targeted social policies.

Personal, Institutional, and Societal Barriers to Educators’ Engagement with Datafication on Campus

Datafied digital systems have permeated higher education over the past decade. Registration, grading, financial operations, alumni communications, and often teaching take place through digital platforms that extract and collate data, about students as well as faculty and staff. At the level of these data system processes, academics may not have the knowledge or practices to fully grasp the shift in their workplace that datafication represents. However, our research suggests that educators do understand the paradigm shift that datafication represents and have strong beliefs about how institutions should proceed to protect students and academia itself. Our team conducted an in-depth Comparative Case Study (CCS) investigation of how university educators make sense of the datafied infrastructures in and on which they work. This presentation overviews the knowledge, practices, experiences, and perspectives of educators in various institutional status positions from six different countries, in relation to datafied digital tools. We will focus particularly on the barriers that participants articulated to their own engagement with data, at personal, institutional, and societal levels. We will frame ways barriers are reinforced by institutional approaches to datafication, overview participants’ concerns, and explore how datafication has altered faculty’s power position as knowers within the academy.

Effects of Loading Forces, Loading Positions, and Splinting of Two, Three, or Four Ti-Zr (Roxolid®) Mini-Implants Supporting the Mandibular Overdentures on Peri-Implant and Posterior Edentulous Area Strains.

Clinical indications for the Ti-Zr alloy (Roxolid®) mini-implants (MDIs) in subjects with narrow ridges are still under review. The aim was to analyze peri-implant and posterior edentulous area strains dependent on the MDI number, splinting status, loading force, and loading position. Six models were digitally designed and printed. Two, three, or four Ti-Zr MDIs, splinted with a bar or unsplinted (single units), supported mandibular overdentures (ODs), loaded with 50-300 N forces unilaterally, bilaterally, and anteriorly. The artificial mucosa thickness was 2 mm. Strain gauges were bonded on the vestibular and oral peri-implant sides of each MDI, and on the posterior edentulous area under the ODs. Loadings were performed through the metal plate placed on ODs' artificial teeth (15 times repeated). Arithmetic means with standard deviations and the significance of the differences (MANOVA, Sheffe post hoc) were calculated. Different MDI numbers, loading positions, forces, and splinting elicited different peri-implant microstrains. In the two-MDI models, 300 N force during unilateral loading elicited the highest microstrains (almost 3000 εμ on the loaded side), which can jeopardize bone reparation. On the opposite side, >2500 εμ was registered, which represents high strains. During bilateral loadings, microstrains hardly exceeded 2000 εμ, indicating that bilateral chewers or subjects having lower forces can benefit from the two Ti-Zr MDIs, irrespective of splinting. However, in subjects chewing unilaterally, and inducing higher forces (natural teeth antagonists), or bruxers, only two MDIs may not be sufficient to support the OD. By increasing implant numbers, peri-implant strains decrease in both splinted and single-unit MDI models, far beyond values that can interfere with bone reparation, indicating that splinting is not necessary. When the positions of the loading forces are closer to the implant, higher peri-implant strains are induced. Regarding the distal edentulous area, microstrains reached 2000 εμ only during unilateral loadings in the two-MDI models, and all other strains were lower, below 1500 εμ, confirming that implant-supported overdentures do not lead to edentulous ridge atrophy.

Trans-becoming: decoding interactionist trans identity in Nagarkirtan (2019) and Chitrangada: The Crowning Wish (2012)

The unique characteristics of Indian trans-identity are shaped by cultural intricacies, setting it apart from its Western counterparts. Despite facing marginalisation in mainstream Indian society, the intricacies of their constructed trans-culture further complicate their experiences. According to the interactionist perspective of gender identity within sociological theory, an individual’s interactions with peers, family, and society influence the development of their gender identity. Examining this concept within the diverse Indian context reveals the significant nuances of Indian trans-identity. Two Bengali-Indian films, Kaushik Ganguly’s Nagarkirtan (2019) and Rituparno Ghosh’s Chitrangada: The Crowning Wish (2012), depict the intense and challenging journeys of individuals embracing their trans identities. This research aims to analyse the films from an interactionist perspective, exploring how the Indian cultural discourses portrayed in the films influence the formation of trans identities. The findings suggest that the development of trans identity involves complex processes influenced by social interactions, where conflicts between one’s generalised self and instinctual self arise due to sexual digression. Additionally, this study indicates that the sexual scripting of trans individuals is influenced by various factors, including class, culture, financial status, and social position, making it challenging to conform to the binary gender script of a normalised society. This qualitative research utilises the Interactionist theory of gender identity to analyse the two Bengali-Indian films.

Non-invasive versus arterial pressure monitoring in the pre-hospital critical care environment: a paired comparison of concurrently recorded measurements

BackgroundBlood pressure monitoring is important in the pre-hospital management of critically ill patients. Non-invasive blood pressure (NIBP) measurements are commonly used but the accuracy of standard oscillometric cuff devices may be affected by extremes of physiology and adverse conditions (e.g. vibration) during transport. This study aimed to quantify the accuracy of NIBP measurements amongst patients requiring pre-hospital critical care.MethodsA retrospective cohort study was undertaken using data from patients treated by a pre-hospital critical team between 1st May 2020 and 30th April 2023 that had NIBP measured concurrently with invasive blood pressure (IBP) arterial manometry. An acceptable difference was determined a priori to be < 20mmHg for systolic blood pressure (SBP) and diastolic blood pressure (DBP), and < 10mmHg for mean arterial pressure (MAP). The primary outcome was “pairwise agreement”, i.e. the proportion of paired observations that fell within this range of acceptability. Bland-Altman plots were constructed together with 95% limits of agreement to visualise differences between pairs of data. Associations with patient age, reason for critical care, transport status, haemodynamic shock, severe hypertension, and arterial catheter position were explored in univariate analyses and by fitting multivariable logistic regression models.ResultsThere were 2,359 paired measurements from 221 individual patients with a median age of 57. The most frequent reason for transport was cardiac arrest (79, 35.7%). Bland-Altman analyses suggested unacceptably wide limits of agreement with NIBP overestimating both SBP and MAP during hypotension and underestimating these values during hypertension. Haemodynamic shock (SBP < 90mmHg) was independently associated with reduced pairwise agreement for SBP (adjusted odds ratio [aOR] 0.52, 95% CI 0.35 to 0.77), DBP (aOR 0.65, 95% CI 0.42 to 0.99) and MAP (aOR 0.53, 95% CI 0.36 to 0.78) and severe hypertension (SBP > 160mmHg) with reduced pairwise agreement for SBP (aOR 0.17, 95% CI 0.11 to 0.27). There was no association between patient transport and agreement between the methods for SBP, DBP, or MAP.ConclusionsNon-invasive blood pressure measurements are often inaccurate in the pre-hospital critical care setting, particularly in patients with haemodynamic instability. Clinicians should be cautious when interpreting NIBP measurements and consider direct arterial pressure monitoring when circumstances allow.

Status anak diluar nikah komparasi hukum islam dan hukum positif

One of the legal consequences of the status of a child out of wedlock is the status (position) of the child out of wedlock. In Indonesian legislation, there are several laws that explain the status of children out of wedlock, although there are differences in the law and status of these children between these laws. In Islamic law, children out of wedlock have a different position from legitimate children, biological children, adopted children, and children resulting from adultery. The existence of this position affects in determining guardianship, nasab, inheritance and hadhanah. This research uses a normative study approach, namely comparing the status of adopted children according to Islamic law and positive law. This research is a type of Library Research (literature), the author will present library data in the form of books, journals, research reports, papers and other library materials that are accurate to the object of the subject matter. Based on the results of the research conducted, it can be concluded that, the status of children outside of marriage based on Islamic law is not the same as biological children, and legal children in Islamic law the status of children outside of marriage in terms of nasab, remains with the mother and her mother's family. According to positive law, Constitutional Court Decision Number 46/PUU-VIII/2010 stipulates that the status of children out of wedlock can only be related to the mother and her family, unless there is recognition from a biological father who can be proven scientifically and technologically. This is different from Constitutional Court Decision Number 43/PUU-VIII/2010 which regulates other aspects of children's rights. This is because the status of extramarital children is only dinasabkan to the mother and the mother's family, so directly from the Constitutional Court's decision stipulates that the position or nasab of extramarital children (either due to adultery or nikah sirri) is to their biological father who can be proven by science and technology.

Subgroups of relational job characteristics and their differences in turnover intention and subjective well-being among nurses: a latent profile analysis

ObjectiveRelational job characteristics include perceived social worth and perceived social influence. Good relational job characteristics mean that nurses have high prosocial behavior. The purpose of this study was to explore the potential profile of nurses’ relational job characteristics, influencing factors and their differences in turnover intention and subjective well-being, thus finding the most suitable clinical relationship job characteristics.MethodsA cross-sectional survey was conducted among 1013 clinical nurses using the general demographic data questionnaire, Relational Job Characteristics scale, Turnover Intention Questionnaire and Campbell index of well-being. A latent profile analysis was performed to explore relational job characteristics latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the turnover intention and subjective well-being in each latent profile.ResultsFive latent profiles were identified and labeled ‘High prosocial job characteristics’ profile (20.7%), ‘Moderate prosocial job characteristics’ profile (41.7%), ‘High social worth-low social impact perceived’ profile (6.3%), ‘Low social worth‐high social impact perceived’ profile (18.8%) and ‘Low prosocial job characteristics’ profile (12.5%). Factors affecting the different types of nurse relationship job characteristics include age, marital status, hospital department, nursing years, professional title and hospital position. Among them, chief nurse, nurses with more than 20 years of nursing experience and obstetrics and gynecology nurses were more likely to be ‘high prosocial job characteristics’ profile. The turnover intention of nurses in ‘high prosocial job characteristics’ profile was significantly lower than that of other profiles, and their subjective well-being was significantly higher than that of other profiles.ConclusionImproving nurses’ perception of social worth and social impact on clinical work can improve nurses’ prosocial behavior and subjective well-being, and reduce their turnover intention. Nursing managers or policy makers can formulate targeted intervention measures according to the influencing factors of potential profiles.

Conceptual basis of international jurisdiction

Constant changes in international relations and global challenges in the geopolitical arena disrupt the effectiveness and relevance of existing approaches to international justice. In this context, there is a need to analyze the conceptual foundations of this field in order to adapt to modern realities. The main goal of this study is to analyze the conceptual foundations of international justice, taking into account the latest scientific achievements and global perspectives. The focus of the research is the formation of new theoretical approaches and conceptual frameworks for the analysis and understanding of international criminal law. The methodological basis of the study is based on the analysis of scientific works in the field of international criminal law, as well as the use of modern scientific approaches to information processing. The article reveals new aspects and perspectives of the study of the conceptual foundations of international justice, which can contribute to the further development of the theory and practice of disclosure and investigation of serious violations of international law. The author highlights four conceptual ideas that underlie International Criminal Justice. The first concept concerns the principle of legality, which takes into account not only legal norms, but also social and legal transformations. The second idea considers the principle of international crime, which covers serious violations of international law. The third concept concerns individual responsibility for international crimes, regardless of the social status and official position of the subject of the offense. The fourth idea is the principle of universal jurisdiction, which provides a legal response to serious violations of international law, regardless of the circumstances and the subject of their commission. These concepts reflect the goal of international criminal justice, which is the inevitability of punishment for serious violations of international law, since their commission threatens the security of all humanity.

LEGAL STATUS AND LEGAL POSITION OF PRIVATE MILITARY COMPANIES (ON THE EXAMPLE OF THE WAGNER PMC)

The article provides an analytical assessment of the legal regulation of the activities of a private military company on the example of PMC “Wagner”. The purpose of the article is to study the process of legalization of a private military company in Russia and to consider it as an element of the country’s defense capability system. Achievement of the intended goal was carried out by studying normative legal acts of both the Russian Federation and international ones. The result of the study is the consideration of legal legalization of PMCs, in compliance with international standards, in particular, the Geneva Conventions of August 12, 1949. The authors also proposed legal recommendations on legal regulation of the legal status and legal position of PMC “Wagner”.

ABOUT THE ESSENCE OF LEGAL CATEGORIES "LEGAL STATUS" AND "LEGAL POSITION"

The article examines the essence of the legal categories "legal status" and "legal position", the meaning of which has not yet received precise regulatory regulation, and therefore disagreements arise between scientists about the application of such concepts in scientific circulation. To determine the meaning and correlation of these categories, it is proposed to resort to the philosophy of law and, in particular, to the comprehensive theory of law, which allows, on the basis of a universal method, to obtain objective and complete knowledge, without idealizing legal phenomena and without allowing the superiority of any legal theory. In its context, the essence of the legal status and legal position is revealed, according to which the legal position reflects the set of real rights, duties and responsibilities of the subject established by the rules of law, associated with specific legal facts that arise in the process of legal relations in everyday life, while the legal status is stable, legally enshrined character, representing a stable, static legal state and at the same time being the initial level of development of the legal position. In conclusion, the author comes to the conclusion that knowledge of the essence of a number of legal phenomena goes beyond the narrow legal understanding of it, therefore, to obtain complete and objective knowledge it is necessary to use a philosophical and legal approach.

Social Characteristics and Adherence to Adjuvant Endocrine Therapy in Premenopausal Women With Breast Cancer.

PURPOSESocial characteristics, including cohabitation/marital status and socioeconomic position (SEP)-education level, employment status, and income-influence breast cancer prognosis. We investigated the impact of these social characteristics on adherence to adjuvant endocrine therapy (AET) from treatment initiation to 5 years after diagnosis.METHODSWe assembled a nationwide, population-based cohort of premenopausal women diagnosed in Denmark with stage I-III, estrogen receptor-positive breast cancer during 2002-2011. We ascertained prediagnostic social characteristics from national registries. AET adherence was based on information from the Danish Breast Cancer Group and operationalized as (1) adherence trajectories (from group-based trajectory modeling) and (2) early discontinuation. We computed odds ratios (ORs) and associated 95% CI to estimate the association of cohabitation and SEP with AET adherence using multinomial and logistic regression models adjusted according to directed acyclic graphs.RESULTSAmong 4,353 patients, we identified three adherence trajectories-high adherence (57%), slow decline (36%), and rapid decline (6.9%). Compared with cohabiting women, those living alone had higher ORs of slow (1.26 [95% CI, 1.08 to 1.46]) or rapid decline (1.66 [95% CI, 1.27 to 2.18]) versus high adherence. The corresponding ORs for women not working versus employed women were 1.22 (95% CI, 1.02 to 1.45) and 1.76 (95% CI, 1.30 to 2.38). For early discontinuation (17%), the ORs were 1.48 (95% CI, 1.23 to 1.78) for living alone and 1.44 (95% CI, 1.17 to 1.78) for women not working.CONCLUSIONAdherence to AET was lower among women living alone or unemployed than cohabiting or employed women, respectively. These women may benefit from support programs to enhance AET adherence.

«Право на город»: Кронштадт глазами горожан

The article examines the social space of modern Kronstadt, a small historical town within the boundaries of St. Petersburg, whose residents still claim to preserve a special collective identity. The work is based on materials collected during interviews with locals in the spring of 2021. Kronstadt’s social space is characterized and described as an assemblage in which heterogeneous forces interact, thereby determining the prospects for the town’s development — both in terms of urban economy and the perception of the townspeople. There are four main elements of the current urban identity— or four components of the “Kronstadt palimpsest”: first, the townspeople’s perception of the town’s status and resource position within the hierarchy of St. Petersburg’s urban environment. Second, the determination of the administrative and “natural” boundaries of the town on the territory of Kotlin Island. Third, the ranking of neighborhoods based on the degree of prestige, along with the folklorization of “disadvantaged” zones. And fourth, the attitude toward the influx of tourists and the perception of “strangers” by local residents, as well as the division of city attractions into “ceremonial” and “personal” ones. It is concluded that the townspeople’s ongoing pursuit of the “right to the city”, based on the history, geographical location of the settlement, and their own ideas about the preferred urban way of life, largely determines the uniqueness of the Kronstadt assemblage. This sets this small town apart from the array of satellite towns around Russian megacities.

IMPACT ASSESSMENT ON THE EXTENSION AND COMMUNITY SERVICES OF THE COLLEGE OF INDUSTRIAL TECHNOLOGY (2019-2021)

Extension and community service of the college provides an in-depth evaluation of many aspects of community extension activities and their impact on beneficiaries. The demographic profile of beneficiaries, which includes age, gender, educational attainment, work status, income levels, and occupational positions, provides valuable insights into the characteristics of program participants. In particular, there is a gender discrepancy among recipients, with men outnumbering women, indicating potential biases or barriers to equal participation. The data also shows a high degree of participation and agreement among extension project beneficiaries and implementers, underscoring the importance of community involvement and collaboration in achieving good results. Data provides insight into the frequency and percentage of participants in various training and seminar programs, demonstrating the variable levels of involvement across efforts. Respondent ratings for acquired knowledge, skills, values, attitudes, economic impact, social impact, environmental impact, planning, implementation, monitoring, and overall satisfaction with extension services show a strong alignment on the programs positive effects and benefits. The high ratings across a variety of factors indicate a high degree of satisfaction and agreement with the trainings effectiveness in developing skills, knowledge, attitudes, economic outcomes, social impact, and environmental sustainability. Findings highlight the necessity of individualized extension programs that satisfy participants different needs and preferences, encourage community engagement, and empower individuals to improve their knowledge, skills, and overall well-being. The extension services have a good impact on the community, underlining the importance of continuing to provide innovative and timely training to improve self-capabilities and contribute to beneficiaries overall growth and empowerment. KEYWORD: demographic profile, acquired knowledge, skills, values, attitudes, economic impact, social impact, environmental impact, planning, implementation, monitoring

Minoritized mother politicians in Ireland: Subjectivities and subjectivation in the political workplace

AbstractMinoritized mother politicians that include ethnic racialized minority Traveller (an Irish indigenous community), racialized ethnic minority women, and migrant women face considerable disadvantages as workers arising from the intersection of their maternal status, gender, racialized or migrant and class position. The experiences of minoritized mother candidates and politicians in Ireland are viewed through the lens of subjectivities providing insight into how these mother‐workers mediate identities and status positions that place them outside of, or in tension with, a predominantly white masculinist workplace. Empirical data analysis reveals how minoritized mother candidates and politicians respond in strategic ways to forces of subjectivation that may risk affirming idealized motherhood, while obscuring gendered and racialized inequalities in the political workplace. Paradoxically, motherhood seeds political ambition while acting as a material, temporal, and affective constraint, a source of invisible labor and violence in gendered and racialized ways. However, minoritized mothers' presence and representations also offer an important challenge to this white masculinist workplace.

Retrospective analysis of the effects of impacted third molar on hematologic patients undergoing hematopoietic stem cell transplantation

ObjectiveThis study aimed to investigate the incidence, treatment status, and impact position of impacted third molars (ITM) and their effects on patients undergoing hematopoietic stem cell transplantation (HSCT). MethodsA retrospective analysis was conducted on the medical records of 454 patients who underwent HSCT, out of which 188 patients had ITM. The presence of ITM and its association with transplant-related infections and complications were recorded and analyzed. ResultsPatients with ITM were significantly younger. The number of mandibular ITM was notably higher than maxillary ones, and the risk of pericoronitis in mandibular ITM was significantly higher than in maxillary ones. Out of 311 ITM in 188 patients, 25 were extracted before transplantation. The proportion of extraction and treatment for ITM with pericoronitis or caries was significantly higher than that for ITM without such problems. Moreover, patients with a history of pre-transplant pericoronitis had a significantly higher probability of developing tooth-related complications during transplantation, caused by pericoronitis in ITM compared to patients without a history of pericoronitis. ConclusionPre-transplant examination and treatment of ITM are essential, especially in cases with a history of pericoronitis. Oral intervention can significantly reduce the occurrence of tooth-related complications related to ITM during transplantation.

Deterrence icons as status symbols: American forces in NATO’s eastern flank

How can a signal of extended deterrence, such as prepositioning of foreign military forces, signify status for the beneficiaries of the allied deterrence/reassurance chain? This article explores how the manifestation and communication of allied deterrence can concurrently constitute an affectively charged status symbol for the protégé states of this international security practice. It does so on the example of the Baltic states and Poland, probing the presence and functionality of the American forces as a status marker in North Atlantic Treaty Organization (NATO)’s eastern flank states after 2014. Engaging discourse analysis and expert interviews, the article shows (1) how the intersubjectively determined success of deterrence is dependent on historically potent symbols which have become emblematic of extended deterrence and (2) how deterrence icons can simultaneously serve as multifarious status symbols in intra-alliance politics. The self-identification of protégé states as worthy stakes to deter over emerges as an ambivalent status position defined by the shortage of attributes, rather than a function of their tally. The article contributes to the understanding of the symbolic form of (allied) deterrence and the multivocal status value ascribed to the American ‘boots on the ground’.

Engendering migrant counterpublics: fun, care, solidarity, and resistance among Ethiopian domestic workers in Lebanon

ABSTRACT Research documenting the re-configurations of ‘public–private’ boundaries encountered by migrant domestic workers has observed how they often create a sense of ‘home’ in public spaces in destination countries. Migrant workers’ occupation of, and interactions in, public spaces such as parks, malls, restaurants, and churches in effect create ‘private spheres’ where they can relax and be themselves with friends and sometimes partners. Yet migrant women also often face a double exclusion from the public sphere as political subjects, first as women and second as migrants. Their physical presence in the public sphere may be highly regulated by gender norms, and their participation in the public sphere is limited due to their exclusion from citizenship or even labour entitlements. Drawing on Nancy Fraser’s concept of subaltern counterpublics, this paper argues that migrant domestic workers’ experiences of re-configuring public and private spaces within Lebanon contribute to the creation of ‘migrant counterpublics’ that challenges the methodological-nationalist limitations of conceptualisations of citizenship and participation in the public sphere. I make these reflections through an auto-ethnographic account of my experiences while researching the working lives and conditions of Ethiopian migrant domestic workers in Lebanon. Central to these reflections on our navigation of public spaces is the consideration of our embodied experiences as racialised women, which intersected with our differential class, sexuality, and migrant status positioning.

The Existence of Mercenaries in Terms of Their Implications for The Fragility of International Peace-Building

This study aims to determine the development / history of the use of mercenaries from time to time, to explain the existence of mercenaries in relation to Private Military Companies (PMC), to determine the implications of the existence of mercenaries on the fragility of international peace-building. As for the results of this study 1). that the mercenary has existed for a long time, in the early Roman empire known the terms Balearic Slingers and Agean Bowmen. In medieval Germany there were known as Landsknechts. In America at the time of the revolution it was called Hessian and in Italy it was called Condottieri. The presence of mercenaries in the past generally originated from the desire of Kings in western countries to form a formidable and large army. However, this requires a large cost. Hence the Kings of Europe at that time, around the 15th-16th centuries, such as the Kings of France, Italy, England, the Netherlands and Switzerland, 2). that mercenaries are not identified with Private Military Company. PMCs do not meet the mercenaries criteria as provided for in Article 47 of the 1977 Protocol. The PMC is as civilian, the PMC is not assigned to fight in armed conflict, is not integrated in the armed forces of the state and does not hold a continuous combat function and thus is not eligible to participate directly in hostilities on behalf of the parties to the conflict, as required to categorize a person as a combatant, 3). That the distribution of mercenaries in various armed conflicts can imply that the existence of mercenaries can threaten world peace --- the fragility of peace-building. Regardless of the debate over legal status, entitled/not entitled, active or passive position in the field and so on

Health-related Quality of Life in Patients With Liver Cirrhosis: A Randomized Study

BackgroundHealth-related quality of life (HRQoL) relates to how people perceive illness and treatment affects their physical health, emotional health, functional status, and social position. Along with clinical goals, HRQoL is significant. Therefore, the present study evaluates the effect of patient counseling and education on HRQoL of cirrhotic patients. MethodologyThis prospective study was conducted in a tertiary care center of coastal Karnataka, Kasturba Medical College, Manipal, Karnataka from October 2022 with a three-month follow-up. Patients with a confirmed diagnosis of liver cirrhosis visiting the outpatient department of age ≥18 were enrolled in the study and divided on the basis of compensated and decompensated cirrhosis. Patients were randomized into two groups i.e., case and control in compensated and decompensated group through the envelop method of randomization. The case group received patient education and counseling along with standard medical therapy. CLDQ was used to evaluate HRQoL scores on baseline and after the third month. ResultsA total of 104 patients were enrolled with a mean age of 53.49±11.25, with most being male (80.7%). Out of 104, 60 and 44 had compensated and decompensated cirrhosis. Case and control groups did not differ significantly on baseline. However, on follow-up, the compensated group showed significant improvement in abdominal symptoms, fatigue, and emotional functions. Meanwhile, the decompensated group showed significant improvement in activity, emotional function, and worry domain of CLDQ. Higher MELD scores were the significant factor associated with lower HRQoL scores. ConclusionPatient education and counseling positively impacted the fatigue, emotional, and worry domain of the CLDQ. Hence, the present study recommends making an effort to promote patient counseling and education via leaflets or videos.