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This study explores the synergy among factors influencing Ghanaian pre-service science teachers’ perceptions of inclusive education. The factors considered were desirable outcomes (DO) of inclusive education, implementation of inclusivity (IM), and willingness to adopt inclusivity (W). The study employed the explanatory sequential variant of the mixed-methods research design, using 503 pre-service science teachers from the Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development. The instruments used were a five-point Likert scale questionnaire and a semi-structured interview guide. Quantitative data were analysed using path analysis through structural equation modelling (SEM) employing Analysis of Moment Structures (AMOS) version 23. Qualitative data from the interviews were, however, analysed using thematic analysis. Quantitative findings revealed that the implementation of inclusive education significantly predicted Ghanaian pre-service science teachers’ perceptions of inclusive education. However, willingness to adopt inclusivity and desirable outcomes of inclusive education were not significant contributors. Qualitative findings, however, revealed that practical application and hands-on experience, availability of resources and support, self-efficacy, classroom diversity and time constraints, and the need for further training might have explained the non-significant influence of desirable outcomes of inclusive education and willingness to adopt inclusivity on the perceptions of Ghanaian pre-service science teachers regarding inclusive education. It was therefore recommended, among other things, that teacher training institutions in Ghana should prioritise experiential learning opportunities, such as intensive inclusive teaching practicums, classroom simulations, and mentorship programmes, which can bridge the gap between theoretical instruction and practical application.

Abstract This study explored the potential of three local microalgal isolates as feed for oyster larvae in laboratory‐rearing experiments, towards the optimisation of seed production of Crassostrea tulipa to support its large‐scale farming along the West African coast. Three species of local microalgae—Rhodomonas sp., Nannochloropsis sp. and Pseudanabaena sp.—were isolated from waters off the coast of Ghana, West Africa, following a serial dilution technique. The growth performance of the isolates was assessed in the laboratory through daily estimation of cell density until the stationary phase was observed. Characterisation of the microalgal isolates was carried out by estimation of their biovolume, carbon content and energy content. Biovolumes of the microalgae were calculated from the estimated equivalent spherical diameters using proposed geometric shapes and formulae. Carbon weight and carbon energy content were subsequently calculated using derived conversions. The three microalgal isolates showed potential for large‐scale cultivation in the laboratory with marked differences in daily increases in cell densities. Nannochloropsis sp. and Rhodomonas sp. recorded the highest and the lowest peak densities of 2.4 × 105 and 1.5 × 105 cell mL−1, respectively, from an initial inoculating cell density of 1.05 × 105 cell mL−1. The estimated mean biovolumes of Rhodomonas sp., Nannochloropsis sp. and Pseudanabaena sp. were 238.9, 8.182 and 42.42 µm3, respectively, and the corresponding derived carbon energy contents were 1.7 × 10−6, 7.13 × 10−8 and 1.05 × 10−7 J, respectively. Results from a laboratory rearing experiment indicated that the individual microalgal isolates supported the growth and survival of oyster larvae at different scales, but a mixed diet of the three promoted superior growth and survival of C. tulipa larvae. The three local microalgal isolates‐ Rhodomonas sp., Nannochloropsis sp., and Pseudanabaena sp.‐ were well adapted to laboratory culture conditions, and the observed differences in growth and survival of the oyster larvae fed on these algal diets could be due to the differences in diet properties and biochemical compositions of the different species. A combination of the three algal diets, however, provided complementaery nutrients for the optimal growth and survival of C. tulipa larvae. The outcome of this study shows that local microalgal isolates have the potential to support hatchery rearing of C. tulipa, which is essential for the development of commercial mangrove oyster aquaculture in West Africa.

The study constructed Valency Arm and Y-shaped Model Kits using local materials from the school community, serving as interventions for Sekyere Central District junior high students in Ghana. Effectiveness was tested using a quasi-experimental pre-test post-test control group design in teaching binary compounds writing and naming. We randomly selected four intact classes, two as the experimental group (n = 69) and the other two as the control group (n = 67). After constructing and using the model kits in the teaching and learning process of writing and naming binary compounds, it was found that the experimental group, who received instruction with the model kits, had better retention of the concepts and principles than the control group. These improved learning gains were evident in the three successive tests (Pillai's Trace = 0.440, F (2, 133) = 52.319, p = 0.000, partial eta squared = 0.440). Additionally, a semi-structured interview was conducted with 11 randomly selected respondents from the experimental group. This interview identified four critical features that the junior high school students perceived as benefits of using the model kits in teaching writing and naming binary compounds. These benefits were a better understanding of the principles, improved attitude towards writing and naming binary compounds, better retention of concepts, and active participation and interest in class lessons. The results imply that junior high school science teachers who want to promote effective teaching and learning of writing and naming binary compounds should consider using these model kits if the original models are unavailable.

The study entails an investigation into the impact of blended model on students’ learning outcomes. The study was carried out at the Master of Philosophy (MPhil) Educational Innovations and Leadership Science (MELS) at the Institute of Distance Learning, Kwame Nkrumah University of Science and Technology. The study looked at areas such as identification of the components of the model that makes it helpful in distance learning, assessing the advantages and challenges of the model, and impact of the model on learning outcomes. The theoretical frameworks of the study are the Complex Adaptive Blended Learning System and the Community of Inquiry. The research utilised a mixed method approach, and information was gathered through semi-structured surveys, interviews, and observations. The study involved twenty-five participants consisting of twenty distance learning students and five instructors. The results indicated that the most impactful aspect of the blended approach lies in the integration of both online systems and conventional in-person instruction. It as well has some advantages which include flexibility, recorded videos being available after lectures, with internet connectivity being the main challenge. The impact of the model can be assessed in terms of its ability to help students understand a particular topic, and by comparing it to the conventional in-person instruction. The study will help the institution figure out the actual impact of the model on students’ learning outcomes, and the research should be replicated on other levels of learning institutions like undergraduate studies. Résumé : L'étude porte sur une recherche sur l'impact du modèle mixte sur les résultats d'apprentissage des étudiants. Elle a été réalisée dans le cadre du Master of Philosophy (MPhil) Educational Innovations and Leadership Science (MELS) à Institute of Distance Learning, Kwame Nkrumah Université of Science and Technology. L'étude examine des domaines tels que l'identification des composants du modèle qui le rendent utile dans l'enseignement à distance, l'évaluation des avantages et des défis du modèle, et l'impact du modèle sur les résultats d'apprentissage. Les cadres théoriques de l'étude sont le Système d'Apprentissage hybride Adaptatif Complexe et la Communauté de l'Enquête. La recherche a utilisé une approche mixte, et les informations ont été recueillies à travers des études semi-structurées, des entretiens et des observations. L'étude a impliqué vingt-cinq participants, dont vingt étudiants en apprentissage à distance et cinq instructeurs. Les résultats ont indiqué que l'aspect le plus impactant de l'approche hybride réside dans l'intégration des systèmes en ligne et de l'instruction conventionnelle en présentielle. Elle présente également des avantages tels que la flexibilité, la disponibilité des vidéos enregistrées après les cours, avec la connectivité Internet constituant le principal défi. L'impact du modèle peut être évalué en termes de sa capacité à aider les étudiants à comprendre un sujet particulier, en le comparant à l'instruction conventionnelle en personne. L'étude aidera l'institution à déterminer l'impact réel du modèle sur les résultats d'apprentissage des étudiants, et la recherche devrait être reproduite dans d'autres niveaux d'institutions d'apprentissage, comme les études de premier cycle. Mots-clés : Modèle d'apprentissage hybride, Résultats d'apprentissage, Étudiants, Impact

Abstract Background The Coronavirus Infectious Disease 2019 (COVID-19) pandemic has continuously affected human life with several devastating effects. Currently, there are effective vaccines to protect people from COVID‐19 and the World Health Organization (WHO) has highlighted strategies to influence COVID-19 vaccine uptake in hard-to-reach communities in Ghana. However, prior studies on COVID-19 vaccine acceptability in Ghana are online surveys targeting the literates and those in urban areas, leaving residents in far-flung communities. We assessed knowledge, attitude and acceptability of COVID-19 vaccine among residents in rural communities in Ghana. Methods This study was a community-based cross-sectional study and was conducted at three selected regions in Ghana (Northern, Ashanti and Western North) from May to November, 2021. This study included residents 15–81 years, living in the selected rural communities for more than 1 year. Study participants were recruited and questionnaires administered to collect data on knowledge, attitude and acceptance of the COVID-19 vaccine. Statistical analyses were performed using Statistical Package for Social Science (SPSS) version 26.0 and GraphPad Prism Version 8.0 software. Results Of the 764 participants included in this study, more than half had inadequate knowledge (55.0%), poor attitudes (59.4%) and bad perception about COVID-19 vaccine (55.4%). The acceptability of COVID-19 vaccine in this study was 41.9%. The acceptability of COVID-19 vaccine in Ashanti, Northern and Western North regions were 32.5%, 26.2% and 29.6% respectively. In a multivariate logistic regression analysis, receiving recent or previous vaccine such as HBV vaccine [aOR = 1.57, 95% CI (1.23–3.29), p = 0.002], having good attitude towards COVID-19 vaccine [aOR = 61.47, 95% CI (29.55–127.86), p

With the proliferation of privacy issues surrounding the Internet of Medical (IoMT) recommender system data, this study presents a Secure Recommendation and Training Technique (SERTT) which is contingent on a combination of both federated learning and blockchain approaches. Firstly, the study presents a new framework for recording, sorting, and transmission of IoMT data while incorporating blockchain to ensure that the IoMT data transmitted to cloud servers is not made vulnerable by the sharing of the original data. Secondly, by utilizing medical data, the study designs a Recommender Data Management Neural Architecture (REDMANA) which is based on federated learning and model searching training framework. The proposed technique guarantees that the model gradients which are trained by each node are not disclosed all through the universal training and modeling procedure. This makes the raw data inaccessible to either the IoMT data provider or the user. Considering that the model ensures that users can only obtain their necessary inquiries, neither medical data suppliers nor users can obtain access to raw data. Thus, it reduces the issues of safeguarding medical data sets to the issues of securing data processing. Using numerical analysis and experiments the proposed technique is compared with other existing techniques, the result shows that the proposed SERTT system is efficient and secures recommender data management training and modeling technique and that it performs previously designed techniques as compared.

The matrix completion technique based on matrix factorization for recovering missing items is widely used in collaborative filtering, image restoration, and other applications. We proposed a new matrix completion model called hierarchical deep matrix completion (HDMC), where we assume that the variables lie in hierarchically organized groups. HDMC explicitly expresses either shallow or high-level hierarchical structures, such as taxonomy trees, by embedding a series of so-called structured sparsity penalties in a framework to encourage hierarchical relations between compact representations and reconstructed data. Moreover, HDMC considers the group-level sparsity of neurons in a neural network to obtain a pruning effect and compact architecture by enhancing the relevance of within-group neurons while neglecting the between-group neurons. Since the optimization of HDMC is a nonconvex problem, to avoid converting the framework of the HDMC models into separate optimized formulations, we unify a generic optimization by applying a smoothing proximal gradient strategy in dual space. HDMC is compared with state-of-the-art matrix completion methods on applications with simulated data, MRI image datasets, and gene expression datasets. The experimental results verify that HDMC achieves higher matrix completion accuracy.

Blockchain is a recent revolutionary technology primarily associated with cryptocurrencies. It has many unique features including its acting as a decentralized, immutable, shared, and distributed ledger. Blockchain can store all types of data with better security. It avoids third-party intervention to ensure better security of the data. Deep learning is another booming field that is mostly used in computer applications. This work proposes an integrated environment of a blockchain-deep learning environment for analyzing the Electronic Health Records (EHR). The EHR is the medical documentation of a patient which can be shared among hospitals and other public health organizations. The proposed work enables a deep learning algorithm act as an agent to analyze the EHR data which is stored in the blockchain. This proposed integrated environment can alert the patients by means of a reminder for consultation, diet chart, etc. This work utilizes the deep learning approach to analyze the EHR, after which an alert will be sent to the patient's registered mobile number.

Recommender systems offer several advantages to hospital data management units and patients with special needs. These systems are more dependent on the extreme subtle hospital-patient data. Thus, disregarding the confidentiality of patients with special needs is not an option. In recent times, several proposed techniques failed to cryptographically guarantee the data privacy of the patients with special needs in the diet recommender systems (RSs) deployment. In order to tackle this pitfall, this paper incorporates a blockchain privacy system (BPS) into deep learning for a diet recommendation system for patients with special needs. Our proposed technique allows patients to get notifications about recommended treatments and medications based on their personalized data without revealing their confidential information. Additionally, the paper implemented machine and deep learning algorithms such as RNN, Logistic Regression, MLP, etc., on an Internet of Medical Things (IoMT) dataset acquired via the internet and hospitals that comprises the data of 50 patients with 13 features of various diseases and 1,000 products. The product section has a set of eight features. The IoMT data features were analyzed with BPS and further encoded prior to the application of deep and machine learning-based frameworks. The performance of the different machine and deep learning methods were carried out and the results verify that the long short-term memory (LSTM) technique is more effective than other schemes regarding prediction accuracy, precision, F1-measures, and recall in a secured blockchain privacy system. Results showed that 97.74% accuracy utilizing the LSTM deep learning model was attained. The precision of 98%, recall, and F1-measure of 99% each for the allowed class was also attained. For the disallowed class, the scores were 89, 73, and 80% for precision, recall, and F1-measure, respectively. The performance of our proposed BPS is subdivided into two categories: the secured communication channel of the recommendation system and an enhanced deep learning approach using health base medical dataset that spontaneously identifies what food a patient with special needs should have based on their disease and certain features including gender, weight, age, etc. The proposed system is outstanding as none of the earlier revised works of literature described a recommender system of this kind.

Context: The processes of acquiring education in jewellery in Ghana has been dominated by the informal apprenticeship system and it forms the backbone of the workforce of the jewellery industry in Ghana. However, the patronage of informal jewellery apprenticeship in Ghana in recent times has been on decline even though it has the potential of training human resources to transform Ghana’s precious mineral resources sector.This is based on the belief that jewellery trade and its training are shrouded in secrecy, in other words, the jewellery trade is considered to be a sacred profession where information on its operating systems are not allowed to be shared easily. It is believed to be associated with cult and magic, hence the reluctant to admit people who are from outside the family of particular jewellery enterprise. This study is sought to bring to fore the understanding nature, processes and challenges of the informal jewellery apprenticeship in Ghana. Approach: The study adopted the descriptive and phenomenology research designs (qualitative research methods). Jewellers who own a jewellery business and who are training other people through apprenticeships as well as people who are trained are observed and interviewed. A sample size was selected through purposive and convenience sampling techniques from four jewellery enterprises in Accra, Ghana. A thematic analysis plan was adopted to generate fndings of the study. Findings: The results show that for a person to train as a jeweller, s/he has to enrol by going through induction, futhremore fees (money and perishable items) are to be paid. The training content is driven by orders received by the master jeweller, thereby making it unstructured and lacking criteria for assessing the performance and progress of apprentice jewellers. Teaching and learning methods are usually on-the-job training that rely on demonstrations and observation. Conclusion: Informal jewellery apprenticeship in Ghana uses a fexible, cost-efective approach for transferring jewellery making skills from masters to apprentice jewellers, and it has substantial potential for improving skills training in the country. Sometimes the reluctant of some jeweller to train others is to keep the trade to family members only.

Recommender systems (RS) have been widely deployed in many real-world applications, but usually suffer from the long-standing user/item cold-start problem. As a promising approach, cross-domain recommendation (CDR), which has attracted a surge of interest, aims to transfer the user preferences observed in the source domain to make recommendations in the target domain. Traditional machine learning and deep learning methods are not designed to learn from complex data representations such as graphs, manifolds and 3D objects. However, current trends in data generation include these complex data representations. In addition, existing research works do not consider the complex dimensions and the locality structure of items, which however, contain more discriminative information essential for improving the performance accuracy of the recommender system. Furthermore, similar outcomes between test samples and their neighboring training data restrained in the kernel space are not fully realized from the recommended objects belonging to the same object category to capture the embedded discriminative information effectively. These challenges leave the problem of sparsity and the cold-start of items/users unsolved and hence impede the performance of the cross-domain recommender system, causing it to suggest less relevant and undistinguished items to the user. To handle these challenges, we propose a novel deep learning (DL) method, Discriminative Geometric Deep Learning (D-GDL) for cross-domain recommender systems. In the proposed D-GDL, a discriminative function based on sparse local sensitivity is introduced into the structure of the DL network. In the D-GDL, a local representation learning (i.e., a local sensitivity-based deep convolutional belief network) is introduced into the structure of the DL network to effectively capture the local geometric and visual information from the structure of the recommended 3D objects. A kernel-based method (i.e., a local sensitivity deep belief network) is also incorporated into the structure of the DL framework to map the complex structure of recommended objects into high dimensional feature space and achieve an effective recognition result. An improved kernel density estimator is created to serve as a weighing function in building a high dimensional feature space, which makes it more resistant to geometric noise and computation performance. The experiment results show that the proposed D-GDL significantly outperforms the state-of-the-art methods in both sparse and dense settings for cross-domain recommendation tasks.

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

Co-composting organic solid waste with dewatered sewage sludge was carried out to determine its suitability for managing waste on a University campus. Windrow composting method was employed in which dewatered sewage sludge and organic solid waste were mixed at volume ratios: 1:1, 1:2, 1:3, 0:1 and 1:0 sludge/organic solid waste. Parameters such as pH, percentage N, C, P, K, Ca, Mg, organic matter, ash content and C/N ratio were determined weekly. Total and faecal coliform population were measured biweekly with Pb and Cd levels determined at the beginning and end of the composting. With the exception of ratio 1:0 sludge/organic solid waste, all other ratios attained a favourable Carbon to Nitrogen (C/N) ratio both at the start and end of the composting process. Levels of major nutrients measured were found to be favourable for use as organic fertilizer. There was a general decline in carbon and organic matter in all the compost piles except the sewage sludge pile (1:0). Apart from the compost ratio 1:0 sludge/organic solid waste, all other ratios attained a temperature of 55°C within 8 days of composting. Generally the compost ratios 1:2, 1:3 and 0:1 (sludge/organic solid waste) were found to be the most suitable for use as organic fertilizer. International Journal of Environment Vol. 5 (1) 2016, pp: 14-31

Asante temples are small edifices built over 100 or 200 years ago to house the shrines of some of the deities of the Asante. They are adorned with beautiful motifs which are a body of knowledge about the culture of the Asante, yet not much scholarly work has been done on these motifs on the temples. As a result, a lot of Ghanaians do not know much about the motifs on the traditional temples. This research therefore presents a brief history of selected Asante temples and the symbolic significance of their motifs. The research revealed that the motifs are a storehouse of information regarding the religious beliefs and social norms of the Asante. They enlighten us about symbolism in Asante art and serve as decorations on the temples. The symbols represent concepts and beliefs personified in human and animal forms and geometric shapes. They as well echo some philosophies and wise sayings of the Asante.

Indigenous cultural practices play a significant role in the conservation of forests. Most of the forests within traditional communities in the Ashanti region of Ghana were preserved centuries ago through traditional beliefs and practices. Yet, less attention has been given to them in modern forest management. In most communities, these traditional practices are gradually “dying out.” This work identified cultural practices that have been used to successfully conserve forests by four communities purposively selected from the Ashanti region of Ghana (i.e., Semanhyiakrom, Akegyesu, Kubease, and Jachie), their benefits, and the perceived reasons for their neglect in the management of public forests. Qualitative data were collected through semistructured interviews using stratified random sampling technique to select respondents. The study found that beliefs, taboos, myths, proverbs, and songs were vital traditional systems used by the Ashantis to effectively conserve their forests. The Ashantis believe that the neglect of cultural practices in the management of public forests has resulted in increasing rate of deforestation, destruction of water bodies, and disasters inflicted by the gods such as prolonged drought and loss of soil fertility. To avoid forest degradation, it is important for forest managers, decision makers, and governments to recognize various cultural practices and traditional beliefs as very useful tools and integrate them into current national and international forestry plans and programs.

Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

Background: Suicide and mood disorders (especially major depressive disorder (MDD) and bipolar affective disorder (BD)) represent a significant global health burden. Major depressive disorder and bipolar affective disorder have been associated with increased risk for suicide. Some specific suicide risk factors might be found in underlying individual personality traits. Specific personality features may predispose an individual to mood disorders (MDD or BD) hence increased suicide risk. The specificity of this research is in the assessment of personality features during the acute phase of illness immediately after suicide attempt which resulted in psychiatric inpatient treatment., Subjects and Methods: The study included 119 unrelated Caucasian participants with MDD-severe depressive episode without psychotic symptoms (MDD) and BD-severe depressive episode without psychotic symptoms (BD-sDE). Both groups of patients with MDD and BD-sDE were divided into the suicide attempters and non-suicidal group. The diagnoses of the severe depressive episode without psychotic symptoms in major depressive disorder (MDD; F32.2) and bipolar disorder (BD-sDE; F31.4) were made according to ICD-10 (WHO 1992) diagnostic criteria. Methods of suicide attempts were also assessed according to ICD-10 and a self-report questionnaire, the Temperament and Character Inventory (TCI) was applied., Results: The participants who exhibited suicide attempt had significantly higher scores on harm-avoidance (HA) (p<0.001), significantly lower score on persistence (PS) (p=0.037) and lower score, however not statistically significant, on novelty-seeking (NS) (p=0.319) regarding temperament dimensions. In character dimensions, the patients with suicidal attempt had significantly lower scores on self-directedness (SD) (p<0.001) and significantly lower scores on cooperativeness (CO) (p=0.001)., Conclusion: Patients who had suicide attempt may have some significantly different personality traits than non-suicidal patients with mood disorders. The combination of high harm-avoidance (HA) and low self-directedness (SD) may be specific for depressive episode while the combination of high HA, novelty-seeking (NS), and self-transcendence (ST) with low SD may be related to suicide attempts during the depressive episode in bipolar disorder. The novelty-seeking (NS), self-transcendence (ST) and self-directedness (SD) may be specific for suicidal group of bipolar patients.

Background: Prevalence of prescribing psychotropic medications, particularly inappropriate prescription, is widespread in older adults, both in nursing home residents as well as community-dwelling older adults. This review describes prevalence and prevention of inappropriate prescribing and risk factors associated with psychotropic medications., Methods: MEDLINE and GOOGLE SCHOLAR data base were searched for the key words "older adults", "psychotropic drugs", "inappropriate prescribing", "nursing home residents", "community-dwelling older adults". The study was limited to the articles published in English in the period from 2007 to 2014. The list of references includes additional articles that were searched manually., Results: The utilization of different psychotropic medications is prevalent among older adults worldwide, regardless of whether they live in nursing homes or in the community. Among older adults, nursing home residents are the most vulnerable individuals for potentially inappropriate drug prescription. The most common potentially inappropriate prescribed medications in the elderly are benzodiazepines, particularly long-acting, antipsychotics and antidepressants, particularly SSRIs. All classes of listed medications have been associated with different adverse events, particularly falls and falls-related fractures and increased risk for mortality. Many different pharmacological and non-pharmacological interventions, such as monitoring polypharmacy, reviewing medications, spending more time in the institution by a physician, reducing the number of prescribers in the institution as well as greater involvement of geriatricians, general practitioners and pharmacists should be implemented to reduce this health issue., Conclusion: The prevalence of prescribing psychotropic medications to older adults is high. Inappropriate prescribing of psychotropic drugs and polypharmacy are present in institutionalized and non-institutionalized older adults and can cause adverse health events, and can significantly reduce the quality of life of these vulnerable groups. Multidisciplinary approach is needed in addressing widespread problem of prevalence of psychotropic medications in older adults.

The psychopathological dynamics in suicidality overcomes actual diagnostic distribution therefore pharmacotherapy has restricted role in overall prevention of suicidal behaviour among mentally ill and is demanding for clinician. This role is achieved through reduction and alleviation of suicidal risk with rational and individual pharmacotherapeutic approach emphasising effective, safe and tolerable treatment. The genetic and epigenetic factors, dysfunction of neurotransmitter, neuroendocrine system and stress response system has been determining for neurobiology of suicidality. Therefore, pharmacotherapeutic approach should be focused, not only on prevention and reduction of suicidality, but adjusted for general and diagnosis-specific risk factors. Suicidality represents trans-diagnostic issue, however making the correct diagnosis is of great importance. Identical group of psychiatric medications or even the same drug, could be palliating for suicidal behaviour in one diagnostic category and in other aggravating concerning suicidal ideations. Clinician should be reserved towards epidemiological studies about reducing suicidal rate due to increased consumption of antidepressants. Detailed data analysis showed there is no relevancy which antidepressants were given to specific patient, in what age and phase of illness. The FDA has issued warnings about possible increased risk of suicidal behaviour in children and adolescents when given antidepressant therapy. In general, serotoninergic drugs have neutral or mildly protective effect on potential suicidal behaviour while noradrenergic drugs may have activating effect or could even worsen suicidal ideation in certain phase of the illness. When given in appropriate dose and the right time, dual or noradrenergic antidepressants, could also have good protective impact on specific patient. In patients with bipolar disorder, antidepressive drug could be trigger for suicidal behaviour. Greater susceptibility when diagnosing bipolar disorder and broader usage of mood stablizing medications, alone or combined with other psychopharmacotherapy, has the significant role in suppression and elimination of suicidal behaviour. The lithium and sodium valproate are found to be particularly suitable for prevention and elimination of suicidal behaviour along with some other mood stabilizers. Pharmacotherapy of suicidality in patients with schizophrenia represents specific problem. Confirmed drug with anti-suicidal effect, clozapine, is not first choice medication and does not represent general solution for suicidality in schizophrenia. For clinician, the pharmacotherapy of suicidal behaviour consists of skilled individual and rational drug administration accompanied with appropriate psychotherapeutic support.

The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task execution, language difficulties, loosing perception of time and space, changes in mood and behaviour, personality alterations, loss of interests and initiative). Towards more accurate determination of legal competency the psychometric tests are being used. The appliance of these tests must be guided with basic question during evaluation: "For what is or is not he/she capable?" In prediction of possible dementia development, the modern diagnostic procedures are used as help for potentially demented individuals in order to plan own affairs and by oneself determine future guardian. This ensures the maximal respect and protection of rights among persons with dementia in order to independently manage life one step ahead of progressive illness. Finally, it is to be distinguished medical concept of legal capacity which is universal and judicial concept which is restricted by rules of national legal system differing from country to country.