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Background: Pharmaceutical compounding ensures access of individuals with specific requirements to individualized therapy. However, there is an inconsistency of compounded medication quality. Therefore, advancing the rational use of compounded medication is essential for patient safety and medication effectiveness.Objective: The presented study was aimed to investigate the healthcare practitioners' knowledge, perception, and practice of extemporaneous compounding and its contribution to the prevalence of antimicrobial resistance.Method: A descriptive cross-sectional survey using a structured questionnaire was conducted. The study participants were 300 healthcare practitioners working in Jimma University Medical Center, hospital pharmacies, and community pharmacies in Jimma and Mettu Town, Southwest Ethiopia.Results: Most respondents were pharmacists (62.7%) and first-degree holders (48.3%). The majority of them had experience in administering (57.7%), preparing (38%), prescribing (21%), and repackaging and labeling (14%) compounded medications. Commonly they request compounded medications when prepackaged products (77.7%) and needed dosage regimens (72.3%) were not available in the market. However, most of them believed that compounded medications might lack quality (49%) and had poor patient compliance (40.7%). Moreover, they fear that inappropriate preparation processes (75%) and under-dose administration (59%) of compounded medication might contribute to the development and prevalence of antimicrobial resistance.Conclusion: Most healthcare practitioners practice rational use of compounded medications and strongly agree that inappropriate compounding of antimicrobials contributes to antimicrobial resistance development. [ABSTRACT FROM AUTHOR]

The object of the study is river basins, in which many irrigation complexes have been allocated for the development of agricultural production. Each irrigation complex, in turn, serves a set of farms - the main links of agricultural production. Naturally, the task of irrigation development in the river basin is considered in a certain sequence (river basin - irrigation system - irrigated economy); which allows to link sectoral planning with territorial planning and to take into account the interests of the development of agricultural sectors, economic zones and districts. [ABSTRACT FROM AUTHOR]

Copyright of JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde is the property of JBES: Brazilian Journal of Health Economics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Scire Salutis is the property of CBPC - Companhia Brasileira de Producao Cientifica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hypertension is one of the most frequently occurring noncommunicable diseases, and it causes a variety of cardiovascular complications and mortality. Diagnosis and treatment in elderly patients are very difficult due to their changes in physiology and physiological responses to the therapy. Drug utilization studies are plausible instrument in the evaluation in health care practice. Objective: To assess drug utilization pattern and rational use of antihypertensive therapy in geriatric patients. Materials and methods: This is a prospective observational study that took place in 200 inpatients over the course of six months. The study includes subjects with age group of 65 years and above with all comorbidities. The collected data was statistically evaluated by appropriate descriptive statistical analysis. Here the prescription pattern and rationality were analysed. Results: In this study out of 200 patients, 53% of prescriptions contain combination therapy and remaining 47% contains mono therapy. Most commonly prescribed class as mono therapy was Calcium channel blockers 79. 00% (Amlodipine). Among two drug regimen Calcium channel blockers + Diuretics and the three-drug regimen Calcium channel blockers + Angiotensin Receptor Blocker + Diuretic combination are generally prescribed. Here the overall rate of adherence to JNC 8 is 95%. Conclusion: In this study by analysing prescription pattern, we concluded that most commonly prescribed drug class was Calcium channel blockers (Amlodipine). The present study results demonstrate that, most of the physicians are adherent to the JNC 8 recommendations. [ABSTRACT FROM AUTHOR]

Copyright of Justicia (0124-7441) is the property of Universidad Simon Bolivar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antimicrobial resistance (AMR) is an important public health concern globally. For India, undoubtedly, AMR has had profound impact on its health & socioeconomic parameters. Several hospital and community-based surveys have indicated alarming rise in incidence of multidrug resistant microbes, especially ‘superbugs’, having direct links with antibiotic use/misuse. Additionally, paucity in data with regards to quantification of AMR crisis & its determinants has been concerning. However, the national commitment to address AMR has steadily increased of late, with an oft-restated realization – it is time to act. Recent initiatives like National Policy for Containment of AMR (2011), Chennai Declaration (2012), Anti-microbial Resistance Surveillance and Research Network (2013), The Red Line Campaign (2016), National Action Plan (NAP) for AMR (2017), ICMR Treatment Guidelines for Antimicrobial Use in Common Syndromes (2019) are promising measures expected to have positive impact on both clinical and economic outcome in India. This paper provides a snapshot of major strategies proposed in recent years, including educational and awareness initiatives, infection control guidelines, audit and feedback, antimicrobial stewardship, surveillance projects etc. It also identifies technical challenges & opportunities for improved AMR mitigation in India.

The article proposes a new focus in the interpretation of the access to justice clause aimed not only to an improvement in the judicial service quality but also as a result of the constitutional principle of solidarity. In this way, no one can be given the right to waste time or resources of others unjustifiably through misuse (but tacitly and day-to-day admitted use) of the judiciary. Concepts and ideas are adopted in the European Union and Colombia that there is no violation of the universal access to justice clause when a prior attempt at conciliation or mediation is required. Far from hampering access to justice, it serves to characterize and demonstrate a real justification for suing from now on exposed by the impossibility of resolving the conflict between plaintiff and defendant. At least, a brief interpretation of the justification for suing based on the doctrine of mandatory conciliation and mediation for the rational use of the judiciary machine is given.

Background: Resistance to antibiotics, including aminoglycosides (AMG) is one of the problems associated with inappropriate administration of broad-spectrum antibiotics. Objectives: This study aimed to assess the clinical features of aminoglycosides consumption based on the Defined Daily Dose (DDD) index in open heart surgery. Methods: This study was done on 268 patients who underwent heart surgery during 2015 and 2016. Clinical and demographic characteristics, laboratory data, and aminoglycoside-related data such as dose and the total duration of administration were collected through a questionnaire designed by the authors. The patients’ DDD/100 bed-days were calculated, too. Results: Out of 268 patients, 170 patients (63.4%) were male. The Mean±SD age of the patients was 60.65±10.71 years and the Mean±SD duration of hospitalization was 12.19±7.02 days. Ischemic heart disease was the most prevalent cause of hospitalization. The Mean duration of receiving aminoglycosides was 3.61 days. In 134 patients (50%), creatinine clearance was less than 60 mL/min during aminoglycosides administration. In 25 patients (9.32%), a 50% increase in serum creatinine during receiving aminoglycosides was observed. Creatinine clearance had not been calculated for any patient. Conclusion: In this study, monitoring the side effects of aminoglycosides and the serum concentration was not routinely performed. Dose adjustment of aminoglycosides based on renal function test was not considered in a large number of patients and as a result, the dose was inappropriate in many patients. Therefore, it is recommended that the guidelines of drug usage were followed and the patients were monitored more closely for side effects.

Introduction. Deep-sea fauna of the North Atlantic has a great potential for the development of food industry. Rabbitfish (Chimaera monstrosa) is a hydrobionts that makes up a significant proportion of bycatch in the traditional trawl and longline fishery. The research objective was to determine the technochemical composition and biochemical properties of organs and tissues of rabbitfish. Study objects and methods. The size-mass and total chemical composition was performed by standard methods. The amino acid composition of proteins was determined by chromatographic separation of amino acid derivatives obtained by reaction with orthophthalic aldehyde and β-mercaptoethanol. The method of one-dimensional thin-layer chromatography made it possible to determine the fractional composition of lipids. The fatty acid composition was determined using an S-180 gas-liquid chromatograph (Yanaco, Japan). The fat-soluble vitamins were determined by the saponification of samples with alkali, extraction, and separation of the unsaponifiable part. The fractional composition of proteins became clear after a planar polyacrylamide gel electrophoresis on (MultiPhor II, Sweden). Results and discussion. The research featured the size-mass and chemical composition of body parts, the fractional and amino acid composition of proteins, as well as the fractional and fatty acid composition of lipids, vitamins, heavy metals, and organochlorine compounds in the tissues and organs of the rabbitfish. The sensory properties of the samples proved quite high. Hot smoked rabbitfish meat can be recommended for snack foods. Waste (heads, entrails, skin, cartilage, fins) makes up more than 50% of total body weight and can be used in feed production or as a protein-containing raw material for hydrolysates in microbiology, medicine, and food industry. Conclusion. The research involved a complex biochemical study of the rabbitfish organs and tissues. The performed technochemical studies made it possible to give preliminary recommendations on the directions of its most rational integrated use.

Abstract Background Good dispensing practice is vital for rational use of medicines. There are many paediatric specific challenges when maintaining good dispensing practices to children. Lack of age appropriate dosage forms, lack of medicines in strengths suitable for children, lack of palatable medicines, lack of expertise in paediatric pharmacy are few challenges faced when maintaining good dispensing practices to children. These challenges contribute to poor dispensing practices. Hence there is an urgent need to investigate whether oral dosage forms of medicines are dispensed rationally to children. The objective of this study was to describe the rational dispensing practice of oral dosage forms of medicines to children in a Teaching Hospital in Sri Lanka. Methods A descriptive cross sectional study was conducted to assess the dispensing practice of 1800 oral dosage forms of medicines dispensed to children under the age of 12 years in two outdoor pharmacies over a period of 1 year using validated indicators. Required data were extracted from the prescriptions and by observation using a structured pre-tested observation sheet. Descriptive statistics and wherever relevant, chi square test were used in analysing the data. Results Information on 1800 oral dosage forms was obtained from 1889 medicines dispensed to 727 children. Liquids were 52% [95% CI: 50–55%] of these oral dosage forms. Of the solid dosage forms, about one quarter required manipulation prior to administration such as splitting and dissolving or crushing the adult dosage form. None of the medicine packs or bottles had the patient name on the label. Conclusion Dispensing practice of oral dosage forms of medicines to children has room for improvement.

Background: Linezolid-induced anemia (LI-AN) is a severe adverse reaction, but risk factors of the LI-AN for elderly patients have not been established., Objectives: The objective of this study was to develop a nomogram capable of predicting LI-AN in elderly patients., Design: This is a retrospective study to develop and validate a nomogram for anemia prediction in elderly patients treated with linezolid., Methods: We retrospectively screened elderly patients treated with linezolid at Inner Mongolia People's Hospital from January 2020 to December 2023 and validated our findings using the MIMIC-IV 2.2 database. Anemia was defined as hemoglobin reduction to 75% of baseline value. Univariate and multivariable logistic regression models were used to identify predictors and construct the nomogram, which was evaluated using receiver operating characteristic (ROC) curve analysis, calibration plot, and decision curve analysis., Results: A total of 231 patients were enrolled in this study. The training set comprised 151 individuals, and anemia occurred in 28 cases (18.54%). In the external validation set of 80 individuals, 26 (32.5%) were diagnosed with anemia. The predictors included duration of linezolid therapy, patient estimated glomerular filtration rate value, and sequential organ failure assessment score ⩾2. The ROC curve for the training set was 0.830 (95% CI: 0.750-0.910), while a similar ROC curve of 0.743 (95% CI: 0.621-0.865) was obtained for the validation set. The calibration curve demonstrated good correlation between predicted and observed results, indicating that this study effectively predicts risk factors associated with LI-AN in elderly patients., Conclusion: The developed prediction model can provide valuable guidance for clinicians to prevent anemia and facilitate rational linezolid use in elderly patients., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

Rising antimicrobial resistance (AMR) is causing therapeutic failures with antibiotics. Inappropriate use is a contributing factor. One such antibiotic on the radar is faropenem, a broad spectrum antibiotic approved in 2005 in India. Recently, faropenem sodium suspension was approved for use in children. There is a potential danger of overuse due to the convenience of oral administration. Other carbapenems such as meropenem are used parenterally. Overuse of faropenem may promote cross-resistance with other carbapenems making them ineffective. [ABSTRACT FROM AUTHOR]

Humans used plants for thousand of years as food, drugs, or fuel to keep homes warm. People commonly used fruits and roots, and other parts of the plant were often wasted. This review aims to discuss the potential of rational stem-to-stern use of three highly versatile and valuable plants with hepatoprotective properties. Milk thistle (Silybum marianum L. Gaertn.), artichoke (Cynara cardunculus), and chicory (Cichorium intybus L.) have well-characterized hepatoprotective properties. These plants have been chosen since liver diseases are significant diseases of concern worldwide, and all parts of plants can be potentially utilized. Artichoke and chicory are commonly used as food or dietary supplements and less often as phytodrugs. Various dietary supplements and phytodrugs prepared from milk thistle (MT) fruits/seeds are well-known to consumers as remedies supporting liver functions. However, using these plants as functional food, farm animal feed, is not well-described in the literature. We also discuss bioactive constituents present in various parts of these plants, their pharmacological properties. Distinct parts of MT, artichoke, and chicory can be used to prepare remedies and food for humans and animals. Unused plant parts are potentially wasted. To achieve waste-free use of these and many other plants, the scientific community needs to analyze the complex use of plants and propose strategies for waste-free technologies. The government must stimulate companies to utilize by-products. Another problem associated with plant use as a food or source of phytodrug is the overharvesting of wild plants. Consequently, there is a need to use more active cultivation techniques for plants. [ABSTRACT FROM AUTHOR]

Humans used plants for thousand of years as food, drugs, or fuel to keep homes warm. People commonly used fruits and roots, and other parts of the plant were often wasted. This review aims to discuss the potential of rational stem-to-stern use of three highly versatile and valuable plants with hepatoprotective properties. Milk thistle (Silybum marianum L. Gaertn.), artichoke (Cynara cardunculus), and chicory (Cichorium intybus L.) have well-characterized hepatoprotective properties. These plants have been chosen since liver diseases are significant diseases of concern worldwide, and all parts of plants can be potentially utilized. Artichoke and chicory are commonly used as food or dietary supplements and less often as phytodrugs. Various dietary supplements and phytodrugs prepared from milk thistle (MT) fruits/seeds are well-known to consumers as remedies supporting liver functions. However, using these plants as functional food, farm animal feed, is not well-described in the literature. We also discuss bioactive constituents present in various parts of these plants, their pharmacological properties. Distinct parts of MT, artichoke, and chicory can be used to prepare remedies and food for humans and animals. Unused plant parts are potentially wasted. To achieve waste-free use of these and many other plants, the scientific community needs to analyze the complex use of plants and propose strategies for waste-free technologies. The government must stimulate companies to utilize by-products. Another problem associated with plant use as a food or source of phytodrug is the overharvesting of wild plants. Consequently, there is a need to use more active cultivation techniques for plants.

Having analyzed research results, it is ensured that sustainable land use of US agricultural lands for the support to farmers to improve the efficiency of their major activities and adherence to the principles of soil protection and rational land use in farms. An analysis of the American experience allows us to make conclusions that the success of the process of improving land relations depends on the level of their scientific validity, the degree of balance of government regulation and the degree of coordination of participants' interests in transformations and land market transactions. Land lease in the United States of America as one of the economic methods of land use regulation has been analyzed in the article. It has been established that long-term lease relations are beneficial for both parties concerning soil improvement and pollution control in case of clear legislation. Having analyzed foreign experience, the main measures of land use rationalization in the USA, which people can use in Ukraine, have been proposed. It is also possible to implement the US experience in actively controlling the ecological condition, intended use and other quality characteristics of agricultural land to improve regulation of land use in Ukraine. After analyzing the measures for land protection in the United States, taking into account the considered and researched American experience of agricultural land use, ways to improve the existing system of use and protection of agricultural land in Ukraine are proposed. [ABSTRACT FROM AUTHOR]

Boutique towns, of which there are many examples globally, are practical towns with more ergonomic features for the natural, historical, cultural, religious, social, economic and recreational activities of townspeople removed from the conditions in complicated towns. The towns appear different to most towns, with the whole town located within bicycling or walking distance and occasional narrow street textures. The word “boutique” with French origin was used in the sense of shop or store in Turkey in the past, before later gaining the expanded meaning of different, unique or careful design. From this aspect, the presence of pedestrian streets and avenues in Çanakkale town center can be mentioned due to different designs linked to use. These orientations and features of the town texture are undoubtedly the effect of structural planning of the town at the point of clearly being a boutique town, and also location, settlement plan and compact town texture, in addition to multiple actors comprising non-governmental organizations, public and local administrators. However, contrary to this dynamism, based on the current structure the presence of the pier found in a central location in the town distances Çanakkale from the practical town perception due to directing of vehicular traffic into the town all year round, with increases especially linked to the tourism season. In this study, supported by visual images of the current status and a literature review, the plan is to contribute greatly to the boutique town structure of Çanakkale with steps made to remove the negativities caused by the pier structure and linked vehicular traffic and decisions taken in line with rational and sustainable approaches at the point of landscape planning.

Aim: Self-medication is developed to encourage responsible self-care but is often carried out without sound rationality. This study assesses the reasons, knowledge, attitude, and practices toward self-medication in rural areas of south-western Saudi Arabia. Materials and Methods: A cross-sectional, descriptive, and questionnaire-based study was carried out on respondents visiting the primary healthcare center. Data were collected, analyzed using SPSS software version 23 and presented as frequencies and percentage. Association between variables was established using the Chi-square test, and logistic regression. Results: Among the 500 responses obtained, 58% were female, and 42% were male. Self-medication was practiced for pain (38.3%), influenza (26.3%), cough (24%), and allergy (11.4%). Over 70% failed to consult a physician, lacked awareness of medicine information inserts (71.06%), and failed to check the expiration date (85.2%). Recurrence of symptoms and accessibility of medicines in pharmacies or online stores were a widely accepted reason for self-medication. The respondents were 2.5 times likely to use medications based on others recommendations (odds ratio [OR]: 2.56; 95% of confidence interval [CI]: 1.59–4.13); however, this was lower in females (OR: 0.55; 95% CI: 0.38–0.79; P = 0.002). A significant association was observed between the reasons for self-medication and practices undertaken if symptoms persist with demographic characteristics. Conclusion: Recurrence of symptoms, adopting others advice, the absence of information about medication inserts, and expiration date were issues that can impede responsible self-medication in rural areas. Appropriate patient counseling and conscious dispensing of medications are needed to minimize risks associated with self-medication.

Background: Monitoring and measuring of the medicine utilisation enables to assess the quality of use of medicines, providing the evidence-based data for the improvement of the prescribing practice and a more rational use of medicines. The aim of this study was to analyse utilisation patterns of medicines and to compare the results with other countries. Methods: A retrospective, observational study to analyse outpatient medicines utilisation in the Republic of Srpska between 2009 and 2017. Data of medicines utilisation were retrieved from the national database in the Public Health Institute of the Republic of Srpska and calculated and analysed by using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. The results were expressed as Defined Daily Doses (DDDs) per 1,000 inhabitants per day. Results: Total medicines utilisation increased, from 448 DDDs in 2009 to 1,036 DDDs in 2017. Cardiovascular medicines (group C) were the most used medicines, and their share in the total utilisation increased from 36.6% in 2009 to 44.4% in 2017. Among them, the most frequently used were angiotensin-converting enzyme inhibitors, plain and in combinations with diuretics, namely enalapril. The share of medicines used in diabetes in the total utilisation increased from 3.9% in 2009 to 5.1% in 2017. Metformin and glimepiride accounted for about 83% of the blood glucose lowering medicines group (A10B). Among the antithrombotic medicines, the most frequently used were platelet aggregation inhibitors (B01AC), mainly acetylsalicylic acid whose use tripled since 2009. Diclofenac was the most frequently used non-steroidal anti-inflammatory and antirheumatic drug (M01). Conclusion: The trend of increased medicines utilisation was observed in this study. This finding is comparable with other countries. Variations between countries in the preferred medicines within a class as well as the extent of medicines use were observed. These differences were probably consistent, but not solely attributable, to differences in local guidelines and reimbursement policies.

Background: The emerging threat of antibiotic resistance is growing exponentially and antibiotic stewardship programs are cornerstone to fight against this global threat. The study aimed to explore the knowledge, perspectives and practices of physicians regarding various aspects of antibiotic stewardship program including antibiotic stewardship activities, rational use of antibiotics, antibiotic resistance, prescribing practices and factors associated with these practices.Methods: In this qualitative study, a total of 17 semi-structured, in-depth interviews with doctors of three tertiary care public sector hospitals in Bahawalpur and Rahim Yar Khan were conducted. The convenient sampling method was adopted to collect the data and the saturation point criterion was applied to determine the sample size. Thematic analysis approach was used to draw conclusions from the data.Results: The analysis of data yielded five themes, 12 subthemes and 26 categories. The themes included, (i) perception about antibiotic use and antibiotic stewardship, (ii) antibiotic prescription practices, (iii) antibiotic resistance, (iv) limited strategies adopted by hospital administration to ensure quality and safe distribution of antibiotics, (v) implementation of antibiotic stewardship program: barriers, suggestion and future benefits. Doctors had misconceptions about the rational use of antibiotics. The perception regarding antibiotic stewardship programs was poor. Moreover, very few activities related to ASP existed. The participants gave many suggestions for successful implementation of ASP in order to reduce the burden of antibiotic resistance, including development of guidelines for the use of antibiotics, strict legislation regarding use of antibiotics, active participation of healthcare professionals and awareness program among general public about the use of antibiotics.Conclusion: This study concluded that poor knowledge of doctors regarding ASP, non-existence of antibiogram of hospital and lack of rules for the safe use of antibiotics were the main driving factors associated with irrational antibiotic prescription practices and development of AR. [ABSTRACT FROM AUTHOR]

Background: Access to essential medicines is an integral part of effective health systems. Analysis of medicine procurement may assist with ensuring sustainable access. Aim: To describe the profile and cost of medicines procured for managing mental, neurological and substance use (MNS) disorders during the 2017–2018 financial year. Setting: The study was conducted in the public health sector in the Gauteng province, South Africa. Method: A secondary analysis of the Gauteng Medical Stores Administration System database was performed. Medicine procurement for managing MNS disorders was analysed descriptively by using the World Health Organization’s Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Procurement of each medicine was evaluated in local currency (Rands) and in DDD/1000 population served. The District Health Information System was used to estimate population served. Results: Of the total provincial medicines expenditure in 2017–2018, 3.73% was for MNS disorders, which is similar to the spending on cardiovascular (4%) and respiratory (3%) disorders. Antivirals for systemic use comprised 44% of the total expenditure, followed by vaccines at 13%. Of the medicines for MNS disorders, 32.5% of DDDs procured were for anti-epileptics (ATC N03A) at 47.5% of expenditure; 26.2% of DDDs were for antipsychotics (ATC N05A) at 30.9% of expenditure; and antidepressants accounted for 30.8% of DDDs at 6% of expenditure. Conclusion: Less than 4% of provincial medicines expenditure was on medicines for MNS disorders, of which almost 78.4% of expenditure was on anti-epileptics and antipsychotics. With limited financial resources, evaluation of procurement patterns raises awareness of relative costs.

Objectives: The study aims to know about drug utilization pattern among paediatric patients admitted in a government headquarters hospital. It also analyses the prescriptions of those patients using WHO's core prescribing indicators. Methods: This is a prospective observational study involving 159 paediatric patients. It was a six month study conducted between September 2019 and March 2020. Relevant information for analysis were obtained through accessing case sheets of patients. Results: Majority of paediatric patients were chidren (54.72%). There was a male preponderance (58%) Most patients were admitted for the treatment of infectious diseases (72.96%). Total number of drugs prescribed was 844. Out of them 791 drugs were prescribed in generic name (93.72%). The average number of drugs per prescription was found to be five. Majority of prescriptions contain one antibiotic (47.80%). Polypharmacy issue was detected in 111 prescriptions out of 159 prescriptions (69.81%). Conclusion: This study will promote rational use of drugs among patients and health care professionals and thus pave a way to minimize medication errors. [ABSTRACT FROM AUTHOR]

Background: Access to essential medicines is an integral part of effective health systems. Analysis of medicine procurement may assist with ensuring sustainable access. Aim: To describe the profile and cost of medicines procured for managing mental, neurological and substance use (MNS) disorders during the 2017-2018 financial year. Setting: The study was conducted in the public health sector in the Gauteng province, South Africa. Method: A secondary analysis of the Gauteng Medical Stores Administration System database was performed. Medicine procurement for managing MNS disorders was analysed descriptively by using the World Health Organization's Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. Procurement of each medicine was evaluated in local currency (Rands) and in DDD/1000 population served. The District Health Information System was used to estimate population served. Results: Of the total provincial medicines expenditure in 2017-2018, 3.73% was for MNS disorders, which is similar to the spending on cardiovascular (4%) and respiratory (3%) disorders. Antivirals for systemic use comprised 44% of the total expenditure, followed by vaccines at 13%. Of the medicines for MNS disorders, 32.5% of DDDs procured were for anti-epileptics (ATC N03A) at 47.5% of expenditure; 26.2% of DDDs were for antipsychotics (ATC N05A) at 30.9% of expenditure; and antidepressants accounted for 30.8% of DDDs at 6% of expenditure. Conclusion: Less than 4% of provincial medicines expenditure was on medicines for MNS disorders, of which almost 78.4% of expenditure was on anti-epileptics and antipsychotics. With limited financial resources, evaluation of procurement patterns raises awareness of relative costs. [ABSTRACT FROM AUTHOR]

Background & objectives Medication-related harm is known to be the cause for about 1/10th of hospitalizations. Some estimates from India show that about 90 per cent of medicines consumed are inessential or irrational and contribute towards high out-of-pocket expenditure on health. In this context, the Indian Council of Medical Research in 2022 constituted a National Task Force (NTF) to explore possible solutions that could improve safe and rational use of medicines (SRUMs). The objective of this study was to identify research ideas in the field of SRUM through a survey of relevant stakeholders, and further to prioritize the research ideas using a pre-identified set of criteria. Methods The responses from the identified stakeholders were assessed using the Child Health and Nutrition Research Initiative method, which is an established research priority-setting methodology. First, the NTF asked for two to six research ideas from relevant Indian and global stakeholders on solutions to improve SRUM. The ideas were checked for duplicates, re-phrased where necessary and classified into various sub-themes. Subsequently, the research ideas were scored by Indian experts with relevant technical expertise using a pre-defined set of five criteria: innovativeness, effectiveness, translational value, answerability and applicability. Each research idea received from a stakeholder was assigned a score under each of the five criteria. The overall research priority score was calculated as a mean of all five criteria-specific scores and converted into a percentage. Results The final output of the prioritization process was a list of research ideas or questions, ranked by their scores. Total 209 unique ideas were received from 190 respondents, which were scored by 27 experts. The top three research topics on medication safety focused on cost-effective strategies for improving antimicrobial stewardship, safe use of poly-pharmacy in geriatric patients and drug take-back policy interventions. Regarding the rational use of medicine, the top three topics included testing mobile application-based antimicrobial stewardship interventions, development of diagnostics for antimicrobial resistance, and behavioural interventions. Interpretation & conclusions Several priority ideas found in this study also align with those of global priority, e.g., safe disposal practices and enhanced pharmacovigilance, rational use of medicines. Patient engagement, which underlines many of the top scoring ideas found in this study, is also inclined with the top research priorities reported by the WHO priority exercise on research into the safe use of medicines. However, to the best of our knowledge, this is the first such work from a low- and middle- income country on medication safety and rational use of medicines. The findings of this research priority-setting exercise can help to guide research for the development of policy-relevant and novel interventions to improve SRUM in India.

According to the World Health Organization (WHO), antibacterial resistance is a serious problem worldwide. In Spain, knowledge about the use of antibiotics is scarce, being the third country with the highest consumption of antibiotics in the world and the first in Europe. This problem is due, partly, to the abusive use of these drugs in human medicine, livestock, and agriculture. The objective of this study was to evaluate the impact that the Tiny Earth project has had on the antibiotic knowledge in pre-university students. To do this, a survey was conducted before and after the Tiny Earth project in three different school years (2017–2020) to 322 pre-university students belonging to seven schools in the province of Valencia. The survey consisted of 12 multiple-choice questions with a single valid answer. We observed 67.6% success at the beginning and 81.2% at the end. These data indicate that they correctly answered an average of 1.64 more questions after completing the project. In view of the results, we can affirm that the Tiny Earth project has contributed to an improvement in scientific knowledge and awareness of the correct use of antibiotics and the emergence of resistances by pre-university students, which could also be transmitted to their social environment, thus improving awareness global on these issues.

Changing business models is a topical issue in a pandemic. Recent research has shown that the search for environmentally friendly and sustainable solutions in various sectors has become relevant. The article aims to promote cooperation and adaptation of good practices between countries. Comparing the country’s history and economic situation and economic development and traditions can be seen as a precondition for success. The article examines the introduction of sharing economy and the creation of environment-friendly trends establishing a circular economy by minimizing the population’s expenses, online business growth, and accessibility of Internet technologies. The article explores the difference between the linear economic model and the circular model by adopting sharing and the efficient joint use of materials to enhance and assess sustainable development. Based on a combination of theoretical and practical research, the article explores the dynamic system and development model of sharing a circular economy. The new concept of circular economy does not promote the overproduction of new goods but the rational use of already produced ones, which significantly reduces the amount of waste generated at all stages of the product life cycle. Population groups by different income groups for sharing services are analysed. An analysis of the price characteristics of popular sharing products was used from data from Internet portals. One concludes that due to the increase in Internet users, especially mobile apps, and social networks, C2C sharing has become quite popular over the past years. Other areas also show positive development indicators but have less demand, affecting supply. Based on an in-depth study of the economic situation in Ukraine, the authors have critically chosen an industry to set as an example with the actual business situation. Therefore, three packages were created: pessimistic, standard and optimistic ones with different characteristics of implementing circular economic projects. The chosen method allows rational management decisions for attracting financing and sustainable solutions. The company’s business scenarios analysed in the article will allow to choose a system based on circular economy principles successfully.

Статтю присвячено дослідженню актуальних питань щодо особливостей охорони земель та інших природних ресурсів у процесі землевикористання. Проаналізовано наукові погляди щодо поняття «охорона земель», «використання земель». Підкреслено, що розглядати комплексне використання земель без їх охорони та охорони інших природних ресурсів, які взаємопов’язані з нею, не є правильним. При комплексному використанні земель охорона повинна носити також комплексний характер. У процесі використання земельної ділянки бережному ставленню та охороні повинні підлягати й природні ресурси, які пов'язані з цією ділянкою.

Productivity and qualitative state of the lands of forestry depend on efficient and rational use by land users of these lands. The greatest negative impact on soils is detected in the process of their use. Inappropriate use of forest lands leads to a decrease in their productivity, which directly affects the soil fertility and ultimately leads to land degradation. The choice of the topic of the article is determined by the relevance of the problems raised in it concerning the rational use of land, their degradation. A progressive course of land degradation, including forestry, leads in the first place to the loss of their productivity. Unfortunately, nowadays the use of land and other natural resources does not meet the requirements of rational nature management. Land resources of Ukraine are characterized by an extremely high level of development, there is also insufficient economic and ecological substantiation of the distribution of land by purpose, lack of attention to land protection problems has led to a decrease in the area of productive lands, all this leads to land depletion, soil fertility decline, degradation, etc. Failure by land users to meet the requirements for rational and efficient use of land leads to a decrease in the area of productive lands of forest management, and to deterioration of the quality state of these lands, as well as forest resources. Thus, the organization of rational use of forest lands is a priority task in preserving and improving the productivity of these lands.

Detonite M is the most powerful of nitro- ether- containing industrial explosives used to destroy rather hard rocks in the mining industry. STS JSC «FNPTs» «Altai» as the only producer of nitro- ether- containing explosives in Russia in 2003 started to produce detonite M in 32 mm diameter cartridges. The recipe was modernized improving its technological production parameters and the increasing power and detonation characteristics. However, at present, the selling prices for detonite M are significantly higher than those for ammonite 6ZGV, and despite its high efficiency and energy characteristics, sales are limited. The paper presents some studies results on the rational use of detonite M while heading the openings in the Kaz branch mines of AO “Evrazruda”. The use of detonite at the faces along with ammonite 6ZGV significantly increases the blastholes utilization rate and production volume with improved crushing quality.

According to the World Health Organization (WHO), antibacterial resistance is a serious problem worldwide. In Spain, knowledge about the use of antibiotics is scarce, being the third country with the highest consumption of antibiotics in the world and the first in Europe. This problem is due, partly, to the abusive use of these drugs in human medicine, livestock, and agriculture. The objective of this study was to evaluate the impact that the Tiny Earth project has had on the antibiotic knowledge in pre-university students. To do this, a survey was conducted before and after the Tiny Earth project in three different school years (2017–2020) to 322 pre-university students belonging to seven schools in the province of Valencia. The survey consisted of 12 multiple-choice questions with a single valid answer. We observed 67.6% success at the beginning and 81.2% at the end. These data indicate that they correctly answered an average of 1.64 more questions after completing the project. In view of the results, we can affirm that the Tiny Earth project has contributed to an improvement in scientific knowledge and awareness of the correct use of antibiotics and the emergence of resistances by pre-university students, which could also be transmitted to their social environment, thus improving awareness global on these issues. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is an important public health concern globally. For India, undoubtedly, AMR has had profound impact on its health & socioeconomic parameters. Several hospital and community-based surveys have indicated alarming rise in incidence of multidrug resistant microbes, especially 'superbugs', having direct links with antibiotic use/misuse. Additionally, paucity in data with regards to quantification of AMR crisis & its determinants has been concerning. However, the national commitment to address AMR has steadily increased of late, with an oft-restated realization -- it is time to act. Recent initiatives like National Policy for Containment of AMR (2011), Chennai Declaration (2012), Anti-microbial Resistance Surveillance and Research Network (2013), The Red Line Campaign (2016), National Action Plan (NAP) for AMR (2017), ICMR Treatment Guidelines for Antimicrobial Use in Common Syndromes (2019) are promising measures expected to have positive impact on both clinical and economic outcome in India. This paper provides a snapshot of major strategies proposed in recent years, including educational and awareness initiatives, infection control guidelines, audit and feedback, antimicrobial stewardship, surveillance projects etc. It also identifies technical challenges & opportunities for improved AMR mitigation in India. [ABSTRACT FROM AUTHOR]

In our previous article, a so-called "mortality pattern" was considered: the graphic ratio of the theoretical and real rate of decrease in the number of birds in the cohort considered by years. In this report, a numerical index of the population demographic status is derived based on the mortality pattern obtained from bird ringing data. This index is the mean deviation of the real mortality from the theoretical one calculated with a number of conditional restrictions and using additional coefficients. The degree of waterfowl population demographic status (the population size is stable, decreasing or growing) was estimated in two ways: using the numerical index derived and based on large-scale accounting and observations in nature. A good coincidence of both estimations was demonstrated for almost all waterfowl species. The numerical index of the population demographic status is proposed as one of the criteria for estimating the rational use of hunting species. This index allows us to make a conclusion about the possibility of hunting of various species of waterfowl birds or about the need for their protection (together with an indication of the required security measures). Based on calculations from bird ringing data, the harvest rate for those hunting species, the demographic status of which allows it, is substantiated. The harvest rate of waterfowl hunting species should not exceed one-third of the annual mortality rate for adult mature birds, no more than 67% for first year ducks, and no more than 45% for first year geese. Based on the method applied, it was possible to calculate the harvest rate for each hunting species of waterfowl, depending on the portion of yearlings in the population at the time of autumn surveys. [ABSTRACT FROM AUTHOR]

Background: Antibiotics are among the most frequently used drugs worldwide. An average 35% of the total health budget is spent on antibiotics. Overuse and/or misuse of antibiotics has significant consequences, such as increased cost, bacterial resistance, therapeutic failure, drug toxicity and drug interactions. The objective of this study was to evaluate the prescribing pattern of antibiotics in Medicine ward of a tertiary care hospital in Bangalore. Methods: Hospital based retrospective study carried out in medicine ward of a tertiary care hospital in Bangalore. A retrospective study was carried out by collecting the data of the medication orders given for a period of 12 months. A total of 741 medication order was studied of which 470 were for males and 271 for females, between the age group of 15-92 years. Results: The results showed that the most commonly prescribed class of antibiotics were: Cephalosporins 571 (47.22%), Quinolone 237 (19.6%), Cephalosporins + Penicillinase inhibitors 159 (13.15%), Penicillin + Penicillinase inhibitor 73 (6.03), Aminoglycoside 27 (2.23%), Macrolides 13 (1.07%), Sulphonamides 1 (0.08%), Tetracyclines 2 (0.16%) and others 126 (10.4%). Conclusion: The most commonly prescribed class of antibiotics was Cephalosporins. Detailed knowledge of antibiotic prescription pattern is important to monitor the rational use of antibiotics and is important before the therapeutic policies and measures can be implemented. It's recommended to involve an active clinical pharmacist in the hospital to study the drug use pattern and intervention as and when necessary. [ABSTRACT FROM AUTHOR]

Without cadastral information, it is difficult to make any decisions about land. But in order for the system of state land cadastre to work effectively, it is necessary that the information in it is up-to-date, complete and reliable. The article analyzes in detail the existing legislative and regulatory acts and draws conclusions from the methodological principles of keeping the state land cadastre in the part concerning the consideration of factors of influence on the quality of land accounting. The status of agricultural land use was monitored and land conservation measures recommended. The authors have analyzed in detail the public information on the soil cover of Ukraine, which is displayed on the Public Cadastral Map of Ukraine. The necessity of enrichment of the cadastre with new information and indicators is investigated, which allows to solve a wider range of problems regarding the use of land as a spatial basis and the purpose of development of the multifunctional cadastre. [ABSTRACT FROM AUTHOR]

Antibiotics emerged through the observation of Alexander Flemming, when his culture plates were contaminated by the Penincillium fungus. It was notable that this fungus was capable of producing a substance which inhibited bacterial growth. In 1940, the scale production of penicillin began, marking the beginning of the "Age of Antibiotics". With this important landmark, humans can treat infectious diseases with less toxicity and greater effectiveness, resulting in a decrease in mortality and an increase in life expectancy. Over the years, antibiotics have been used in an indiscriminate and banal manner and, as a result, bacteria have been able to evolve mechanisms of resistance against antibiotics, reversing the breakthroughs discovered in the 1940s. Currently, the greatest challenge for prescribing professionals is finding a drug that is effective, low toxicity and does not induce resistance against its patient. Rational drug use seeks therapies that are economical, effective, and safe, in addition to combating the indiscriminate use of these drugs, for example, selfmedication and use to induce boar and bird growth. The research also seeks to develop new drugs capable of dribbling resistance mechanisms without compromising the safety of the patient user. A promising alternative is the use of essential oils, compounds derived from plants composed mainly of terpenes, capable of eliminating various microorganisms, mainly bacteria and fungi. Its profile is of high tolerability and efficacy, with low induction of resistance. Thus, the present work aims to review in a narrative and objective manner the mechanisms of action of drugs and bacterial resistance, as well as to update future perspectives in the area of antimicrobials. [ABSTRACT FROM AUTHOR]

Background: Good dispensing practice is vital for rational use of medicines. There are many paediatric specific challenges when maintaining good dispensing practices to children. Lack of age appropriate dosage forms, lack of medicines in strengths suitable for children, lack of palatable medicines, lack of expertise in paediatric pharmacy are few challenges faced when maintaining good dispensing practices to children. These challenges contribute to poor dispensing practices. Hence there is an urgent need to investigate whether oral dosage forms of medicines are dispensed rationally to children. The objective of this study was to describe the rational dispensing practice of oral dosage forms of medicines to children in a Teaching Hospital in Sri Lanka.Methods: A descriptive cross sectional study was conducted to assess the dispensing practice of 1800 oral dosage forms of medicines dispensed to children under the age of 12 years in two outdoor pharmacies over a period of 1 year using validated indicators. Required data were extracted from the prescriptions and by observation using a structured pre-tested observation sheet. Descriptive statistics and wherever relevant, chi square test were used in analysing the data.Results: Information on 1800 oral dosage forms was obtained from 1889 medicines dispensed to 727 children. Liquids were 52% [95% CI: 50-55%] of these oral dosage forms. Of the solid dosage forms, about one quarter required manipulation prior to administration such as splitting and dissolving or crushing the adult dosage form. None of the medicine packs or bottles had the patient name on the label.Conclusion: Dispensing practice of oral dosage forms of medicines to children has room for improvement. [ABSTRACT FROM AUTHOR]

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low- and middle-income countries (LMICs). Oxytocin and misoprostol are used for the prevention and treatment of PPH. However, both medicines are chemically unstable and sensitive to environmental conditions. Previous studies reported a high prevalence of substandard oxytocin and misoprostol preparations in LMICs.Methods: In randomly selected health facilities of four districts of Malawi, the availability of oxytocin and misoprostol was determined, and the knowledge of health workers on storage requirements and use of oxytocics was assessed. Temperature loggers were used to record the storage temperature of oxytocics. Samples of oxytocin injections and misoprostol tablets were collected from the health facilities and from wholesalers. Oxytocin samples were analysed for identity, assay (= quantity of oxytocin) and for pH value according to United States Pharmacopeia 40. Misoprostol samples were analysed for identity, assay, dissolution and related substances according to the International Pharmacopeia 2017.Results: All visited hospitals and health centers had oxytocin available. At non-refrigerated storage sites, the recorded mean kinetic temperature exceeded the oxytocic's storage temperature stated on the labels in 42% of the sites. At refrigerated storage sites, the required temperature of 2-8 °C was exceeded in 33% of the sites. Out of 65 oxytocin samples, 7 (11%) showed moderate deviations from specification, containing 82.2-86.8% of the declared amount of oxytocin. Out of 30 misoprostol samples, 5 (17%) showed extreme deviations, containing only 12.7-30.2% of the declared amount. The extremely substandard misoprostol was reported to the national authorities and to WHO, leading to an immediate recall of the respective brand in Malawi. The UK-based distributor of this brand closed its business shortly thereafter.Conclusion: Availability of oxytocin was excellent in Malawi, and its quality was better than reported in previous studies in other LMICs. However, storage conditions at the health facilities often did not meet the requirements. Extremely substandard misoprostol tablets were found, representing a serious risk to maternal health. This shows the need for continued efforts for quality assurance in medicine procurement and registration, as well as for post-marketing surveillance. [ABSTRACT FROM AUTHOR]

Plateau environment will affect the metabolism of drugs in the body, which will cause changes in pharmacokinetic parameters, expression and function of drug metabolizing enzymes and transporters. With the rapid development of the pharmaceutical industry, therapeutic drug monitoring (TDM) has been widely paid attention to as a basis for personalized drugs. What impact does the plateau environment on monitoring drugs? In this literature review, we will summarize the types of commonly used therapeutic monitoring drugs, therapeutic windows, and blood samples, analyze the effects of plateau hypoxic environment on the metabolism of commonly used monitoring drugs, provide a reference for the clinical treatment and monitoring drugs of plateau, better ensure the rational use of drugs in the plateau population, and also provide a reference for the later research group to conduct the monitoring of plateau therapeutic drugs and the selection of research drugs. [ABSTRACT FROM AUTHOR]

Copyright of Scientific Bulletin of National Mining University is the property of National Mining University, State Higher Educational Institution and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Proton pump inhibitors (PPIs) are the class of drugs that is used indiscriminately, despite the increased reports of adverse events. Aim: The study is showed to assess the drug utilization form of PPIs in the in-patient department and to assess the rational prescription thereby improving the prescriber awareness and patient care. Methods: Prospective observational study on the drug utilization pattern of PPIs are showed for 3 months in the in-patients of general medicine and surgery departments. We collected 40 cases with PPI prescriptions and evaluated the rationality in the use of PPIs considering the frequency and route of administration, drug interactions, and concurrent medications prescribed. Results: In the study, out of 40 patients on PPI, 60% were females and the rest were males. Greatest of the patients belonged to the age assembly of 51 - 60 years (12). PPIs were most commonly prescribed for patients with a diagnosis of Respiratory tract infections (42.5%), followed by infectious diseases and gastrointestinal diseases. Pantoprazole was the most commonly prescribed PPI. They were commonly prescribed in the oral route (70%) and on a once-daily basis (62.5%). Antibiotics (50%) and NSAIDs (7.5%) were the most common drugs used along with PPIs. Conclusion: PPIs must be utilized additional sensibly and consciousness must be twisted between clinicians in the hospital so that suitable use of prescriptions with PPIs should recover patient care. [ABSTRACT FROM AUTHOR]

Copyright of Ajman Journal of Studies & Research is the property of Association of Arab Universities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The state of fisheries has been researched based on a systematic approach and comprehensive analysis of statistical data, the following issues have been characterized: the catch of aquatic biological resources (ABR), consumption of fish products, problems in the development of the fishing industry (fleet aging, lack of innovative technologies, the proliferation of IUU fishing4 , the high level of retail prices for fish, low degree of processing export products, overshoot "improper objects" of fishing, the gap in aquaculture development, low economic efficiency). To improve the quality of fishery management it has been proposed to form the organizational and economic mechanism of ABR rational use, which should include effective tools for the implementation of management decisions. Instead of the so-called "historical" principle it has been suggested to use the investment principle of quota allocation and rental payments. The basis for management of fishing industry should be scientifically based on the bioeconomic concept of ABR rational use, the essence of which is to preserve the ABR and at the same time to obtain the maximum output of finished products with high added value. To form the organizational and economic mechanism it is necessary to develop a programme of innovative development of the fisheries sector, a calendar programme of upgrading of fishing fleet, wellreasoned differential rates of rent payments for the ABR use, scenarios and graphic organization of work of fishing vessels in specific fishing areas, to form regional financial and industrial clusters, to expand the authority of the Fisheries Agency, to improve corporate social responsibility of the fishing business communities. Modernization of management system for ABR rational use can significantly reduce environmental pollution, ensure the effective delivery of catch to shore, their high-quality processing and the needs of the population in fish products.