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In both plastic surgery and burn treatment departments, the management of postoperative wounds is a crucial element of surgical care, profoundly influencing patient recovery and the broader spectrum of healthcare outcomes. The monitoring of wound flatness after surgery, although a pivotal component of this process, is frequently underemphasized. In most cases, this parameter can only be judged based on doctors' personal experience. Here, we propose a compact, fully integrated wireless sensing system encapsulated by soft biocompatible materials for quantitative assessment of wound flatness and long-term temperature. The absence of physical tethers and the ion-gel-based construction of the micro-structured sensor represent key defining features, resulting in high measurement resolution of 2 mm radius and 0.096 Ω / ° C and reliable capabilities. In addition, these sensors can be connected to the server network or mobile clients to evaluate the state of postoperative suture wounds and monitor the patient's recovery status. With our devices, detailed data on smoothness and temperature of sutured wounds can be collected, analyzed, and stored for medical assistance as well as being used to improve the quality of surgery. [ABSTRACT FROM AUTHOR]

To study the fertility outcomes of women who tried to conceive after breast cancer (BC) treatment and fertility preservation. Retrospective observational, bicentric cohort study. University hospital. Patients with BC. All patients who had undergone fertility preservation before BC treatment between January 2013 and July 2019 were included (n = 844). The endpoint date was March 1, 2022. Patients with missing data on pregnancy attempts after a cancer diagnosis (n = 195) were excluded from the pregnancy analysis. Cumulative incidences of pregnancy and live birth (LB) were calculated. For women who became pregnant, the time to conception was calculated between the first fertility preservation consultation and the estimated day of conception. For those who did not conceive, we considered the time between the first fertility preservation consultation and the endpoint date, or the date of patient death. A Cox regression model was used to study the predictive factors for pregnancy and LB. Among the 649 patients with available data on pregnancy attempts after BC diagnosis, 255 (39.3% [35.5–43.2]) tried to conceive (median follow-up of 6.5 years). Overall, 135 (52.9% [46.6–59.2]) of these patients achieved a pregnancy, mainly through unassisted conception (79.3% [72.8–84.8]), and 99 reported an LB (representing 38.8% of patients who attempted conception). In our cohort, 48 months after the first fertility preservation consultation, the cumulative incidence of pregnancy was 33.1% ([27.6–37.9]). After adjustment for age, parity, type of chemotherapy administration, and endocrine therapy, only multiparity at diagnosis and absence of chemotherapy were positive predictive factors of pregnancy after cancer. Of the 793 patients who had vitrified oocytes and embryos, 68 used them (27% [21.3–32.5] of the patients who tried to conceive), resulting in 8 LBs (11.8% [5.2–21.9]). Women who used their cryopreserved oocytes and embryos were older at the first consultation of fertility preservation (hazard ratio 1.71 [1.42–2.21]), and chose more often to vitrify embryos (hazard ratio 1.76 [1.28–2.23]). Although pregnancy rates after fertility preservation for patients with BC are low, most conceptions are achieved without medical assistance. Our findings provide useful information to advise women on the different techniques of fertility preservation, their efficacy, and safety, as well as the relatively high chances of unassisted conception. [ABSTRACT FROM AUTHOR]

Every health system should provide access to quality health and social services to elderly people with functional dependencies and to provide them with support and quality of life. Through telemedicine, it is possible to provide highly qualified medical assistance at any time and in any place through reliable audio and video connections. Health care consumers, medical professionals and assistants strongly stated in our survey that telemedicine methods will provide better access to care and a better quality of life for people with functional dependence due to chronic disease. By using digital assistants, healthcare will be more accessible – remote consultations, treatment recommendations, user education. Telemedicine will also be applicable in health promotion and disease prevention. Telemedicine is an information and medical service, but there is still no legal regulatory framework for its application. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Helicopter emergency services (HEMS) are widely used to bring medical assistance to individuals that cannot be reached by other means or individuals that have time‐critical medical conditions, such as chest pain, stroke or severe trauma. It is a very expensive resource whose use and importance depends on local conditions. The aim of this study was to describe flight and patient characteristics in all HEMS flights done in Iceland, a geographically isolated, mountainous and sparsely populated country, over a 5‐year course.This retrospective study included all individuals requiring HEMS transportation in Iceland during 2018–2022. The electronic database of the Icelandic Coast Guard was used to identify the individuals and register flight data. Electronic databases from Landspitali and Akureyri hospitals were used to collect clinical variables. Descriptive statistics was applied.The average number of HEMS transports was 3.5/10,000 inhabitants and the median [IQR] activation time and flight times were 30 min [20–42] and 40 min [26–62] respectively. The vast majority of patients were transported to Landspitali Hospital in Reykjavik. More than half of the transports were due to trauma, the most common medical transports were due to chest pain or cardiac arrests. Advanced medical therapy was provided for 66 (10%) of individuals during primary transports, 157 (24%) of individuals were admitted to intensive care, 188 (28%) needed surgery and 53 (7.9%) needed a coronary angiography.In Iceland, the number of transports is lower but activation and flight times for HEMS flights are considerably longer than in other Nordic countries, likely due to geographical features and the structure of the service including utilizing helicopters both for HEMS and search and rescue operations. The transport times for some time‐sensitive conditions are not within standards set by international studies and guidelines. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine the factors that influence deaths in road accidents in India. The study uses panel econometric methodologies such as the fixed effects model, random effects model, and Hausman–Taylor instrumental variable technique to achieve this goal. Unobserved heterogeneity between states/union territories (UTs) and time is accounted for by time-fixed and state-fixed effects. Based on the panel data set from Indian states/UTs for the period 2004–2018, the study confirms previous results that motorisation, population, urbanisation and income level are all potential contributors to road accidents and fatalities. It also shows that spending on health care and law enforcement appears to help the Indian states minimise mortality in road traffic accidents. On the one hand, spending on health care facilities can provide health-related assistance to persons who have been involved in traffic accidents; on the other hand, spending on police increases the enforcement of rules, resulting in a reduction in traffic accidents. Thus, to lessen the economic and financial cost of road accidents in the country, the government should focus on boosting both per capita health expenditure and per capita police expenditure. JEL Codes: C23, C26, H51, I18, L92, O18, R41, R42 [ABSTRACT FROM AUTHOR]

It is noted that in the conditions of rapid development of society, scientific and technical progress and the emergence of new diseases, the issue of the realization of the right to health care acquires special significance. The growth of the planet's population, increasing man-made load on the environment, deterioration of the ecological situation and armed conflicts significantly affect the exercise of this right. The lack of a minimum level of health makes it impossible for a person to fully participate in state and social life, limits the realization of his rights, which, in turn, threatens economic development, stability and security of society. This scientific article defines the content and types of guarantees for the realization of the right of individuals to health care and medical assistance. The subject of the application of guarantees is the state in the person of authorized competent bodies that act to promote the realization of the specified right and its protection. Various approaches of scientists to the definition of the concept of «guarantee» and their classification have been analyzed. The main role in the system of guarantees for the realization of the human right to health care and medical care belongs to legal guarantees, which are enshrined in law and ensure the implementation of its norms. Legal guarantees include all legal means by which human and citizen rights and freedoms are implemented and protected, as they provide legal responsibility for authorized subjects for failure to fulfill or violate the rights and legitimate interests of citizens, as well as contribute to increasing the guarantees of the realization of rights. It is proposed to consider the guarantees of the right to health care and medical care as a system consisting of two groups - general and legal (special) guarantees, which in turn contain a certain set of elements. The group of general guarantees includes political, economic, social, cultural and informational guarantees; legal (special) guarantees include regulatory, institutional (organizational) and international legal guarantees. The author proposed an author's definition of the concept and content of the relevant components of both general guarantees and legal (special) guarantees. The author actualizes the issue of wider use of stimulating constitutional guarantees of the human right to health care and medical care. [ABSTRACT FROM AUTHOR]

The article examines the mechanisms of ensuring the rights and freedoms of internally displaced persons (IDPs) by local self-government bodies in Ukraine. As a result of the armed conflict in the east of the country and the annexation of Crimea, the number of IDPs has increased significantly, which creates serious challenges for the state and society. The author analyzes the legal framework that regulates the rights of IDPs, including the Constitution of Ukraine, the Laws "On Ensuring the Rights and Freedoms of Internally Displaced Persons" and "On Local Self-Government in Ukraine", as well as international regulations. Practical mechanisms for ensuring the rights of IDPs are considered, including the provision of housing, medical care, access to education and employment. Various forms of temporary and permanent housing provided to IDPs are described, including rental of state and municipal housing, construction of housing complexes for displaced persons, and subsidized mortgage lending programs. Ways to provide IDPs with access to medical services, including primary medical care, specialized medical services and psychosocial support, are analyzed. Programs for the integration of IDP children into local schools and kindergartens, as well as support for immigrant students in higher education institutions, are being considered. Measures to promote the employment of IDPs, including programs for retraining, vocational training and support for small businesses, are being studied. Particular attention is paid to the problems and obstacles faced by IDPs and local self-government bodies. The main challenges were identified, including: the lack of necessary funds at the local level for the implementation of IDP support programs, complex assistance procedures that complicate IDPs' access to necessary resources, and problems of IDPs' integration into local communities, including social tension and discrimination. The author offers recommendations for overcoming these problems, emphasizing the need for active cooperation between state bodies, public organizations and international partners. The importance of developing comprehensive support programs, including financial assistance, simplification of administrative procedures, as well as measures to promote the social integration of IDPs into local communities, is emphasized. Attention is focused on the need to strengthen the legal protection of IDPs and develop long-term strategies to ensure their rights and freedoms. Thus, a comprehensive analysis and practical recommendations are offered aimed at improving the mechanisms for protecting the rights and freedoms of internally displaced persons in Ukraine, which is extremely relevant in modern conditions. [ABSTRACT FROM AUTHOR]

The article states that the right to health care and medical care is a guarantee of the right to life. To the state in accordance with Part 2 of Art. 3 of the Constitution of Ukraine is entrusted with the duty to affirm and ensure human rights and freedoms, including the right of everyone to health care and medical assistance. Such a duty of the state is defined as the main one among its other duties. For its implementation, Ukraine must create an effective mechanism for ensuring the above-mentioned right. The Covid-19 pandemic, Russia’s aggression against Ukraine and, as a result, Russia’s temporary occupation of part of the territory of Ukraine, the commission of crimes in such territories that fall under the jurisdiction of the International Criminal Court and testify to violations of human rights in the field of health care, have actualized the issue of the specifics of international cooperation of states in the field of health care under conditions of military occupation, pandemics, etc. and its role in ensuring the above-mentioned right of every person. The doctrinal approaches to defining the concepts of «cooperation», «international cooperation», and international treaties on human rights are analyzed. It has been established that diametrically opposite points of view are expressed in the scientific literature: from the declaration of cooperation as a duty of states to the complete denial of the legal force of this principle. The author’s definition of the concept of international cooperation in the field of health care is formulated - it is a complex of legal means, methods and institutions that are the result of joint multilateral or bilateral activities of states and which they use to achieve common goals of sustainable development in the field of health care in accordance with generally recognized principles and norms of international law. Attention is focused on the fact that the result of international cooperation are international standards of human rights in the field of health care, which are adopted by international organizations of a universal and regional nature, and which are implemented in national legislation, but such standards are the result of the cooperation of states, albeit within the framework international intergovernmental organizations, since these organizations are not endowed with special competence by nature, but are endowed by states by defining it in the charter of such organizations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research was to examine the influence of entrepreneurial orientation on social performance and the influence of social performance on financial performance of microfinance institutions (MFIs) in Indonesia. These tests use environmental dynamism as antecedents. Design/methodology/approach: The research was conducted on a sample of 235 CEOs/top leaders of MFIs spread across all provinces in Indonesia. Data collection used survey questionnaires. Data testing used SPSS version 25, and structural modeling used Amos version 25. Findings: The findings show that entrepreneurial orientation significantly influences the social performance of MFIs in Indonesia. Entrepreneurial orientation does not influence financial performance but must go through social performance mediation. Social performance has a significant effect on financial performance. The importance of MFIs improves social performance (depth and breadth of reach) to improve financial performance. Practical implications: MFIs need to increase social contribution and responsibility to improve social performance which will impact financial performance. Originality/value: Entrepreneurial orientation influence on financial performance goes through social performance. Social performance includes the depth of the reach to contribute to improving the quality of life of people experiencing poverty around the MFI's operations and the social responsibility of MFIs to the community through scholarships, free medical assistance, basic food assistance and building/renovating houses of worship and others. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-06-2023-0478 [ABSTRACT FROM AUTHOR]

Background and Objectives: Miscarriage is a complication that is influenced by many risk factors that have been reported in different studies and that vary among countries. Despite the influence of various known risk factors for miscarriage, 30% to 50% of miscarriages are from unidentified causes. The aim of this study is to determine the prevalence of miscarriages in Jordan and the associated risk factors. Materials and Methods: A cross-sectional online survey was conducted in Jordan among married women to investigate the prevalence of miscarriages and identify potential risk factors. Results: Women (n = 704) were surveyed, and 17.9% reported a history of miscarriage. The identified risk factors were being an active smoker during pregnancy, having more than four children, having a family history of miscarriage, having fertility problems, receiving medical assistance for conception, and traveling by air during pregnancy. Conclusions: The results suggest that there are both modifiable and non-modifiable risk factors for miscarriages in Jordan and that a proportion of these may be preventable. The findings can be used to enhance patient awareness and inform policy development to decrease the incidence of miscarriage in the country. [ABSTRACT FROM AUTHOR]

The need to study patient satisfaction with specialized outpatient medical care is related to the need to improve the quality and efficiency of this medical care. The purpose of this article is to present and analyze the opinion of patients about their satisfaction with the specialists in outpatient care /ophthalmologists/. A survey was conducted among 516 patients who visited a specialist ophthalmologist in the specialized outpatient medical center in the city of Sofia in the period 02/01/2021. - 31.01.2022. The opinion of the respondents was studied regarding their satisfaction with the work /examination and prescribed treatment/ of the doctor they visited, the waiting time in front of the examination office, the assessment of the medical assistance provided by the doctor. The results show that 53.6% of the respondents who visited a specialist ophthalmologist are completely satisfied with his work, although they waste a lot of time waiting in front of the office for an examination. 71.3% of those examined by an ophthalmologist gave an excellent and very good assessment of the medical care provided by the doctor they visited.. [ABSTRACT FROM AUTHOR]

With the rapid development of computer vision and other technologies, the rapid rise of human-computer interaction, medical assistance, security monitoring and other fields, facial landmark detection as one of the important tasks of concern, it can locate and detect facial landmark in images or videos, with high practical value. By combing and analyzing the current research status of face key point detection methods, this paper divides them into traditional facial landmark detection methods and deep learning-based facial landmark detection methods.It compares and analyzes the principles, advantages and disadvantages of various methods, introduces common data sets and evaluation indicators, and comprehensively evaluates the performance of key methods on different data sets. The application field of facial landmark detection is summarized, and its future development direction is forecasted. [ABSTRACT FROM AUTHOR]

The miR-21 emerges as a pivotal biomarker for lung cancer diagnosis, However, the effective detection of miR-21 poses a significant challenge due to its low abundance and the complexity of clinical samples. A highly sensitive MXene-based field effect transistor (FET) sensor is proposed to detect miR-21, which is designed to diagnose lung cancer. The unique morphology of the nano-flower-shaped MXene (NSMX) has been characterized and the elements have been confirmed. The transconductance of MSMX increased 70.4% from 0.61 mS to 1.04 mS through secondary etching with hydrogen peroxide and sodium hydroxide. The NSMXFETs sensors achieved detection limits of 0.87 fM and a range of detection ranging from 1 fM to 100 nM. The NSMXFETs were systematically optimized in terms of aptamer sensitivity, incubation temperature and time, showing favourable specificity, reproducibility (RSD = 1.71%) and stability (decreased only by 0.59% in 1 month). In clinics, NSMXFETs were effective in differentiating lung cancer samples from healthy controls (p = 0.035 o 0.05) and showed a high correlation with target values (R² = 0.9753). The uniqueness of nano-flower-shaped MXene in clinical decision-making lies in their ability to assist biosensors in achieving highly sensitive detection of low-abundance biomarkers in clinical biosamples. We envision promising MXene-based FET sensors with nano-flower morphology to enhance sensitivity in detecting other biomarkers, providing efficient medical assistance for clinical diagnosis. [ABSTRACT FROM AUTHOR]

The article presents a case study of the work of Doctors with Africa (CUAMM) in Africa. CUAMM was founded in Italy in 1950 and focuses on providing medical assistance and well-being to communities in Africa. Over the years, CUAMM's work has evolved to support local healthcare personnel and improve healthcare facilities in seven African countries. Currently, CUAMM is present in 8 sub-Saharan African countries, providing maternal and child health, nutrition, and infectious and chronic disease services. The organization works to reduce social inequality and improve access to healthcare in the region. [Extracted from the article]

The Emergency Department (ED) is a facility meant to treat patients in need of medical assistance. The choice of triage system hugely impactsed the organization of any given ED and it is important to analyze them for their effectiveness. The goal of this review is to briefly describe selected triage systems in an attempt to find the perfect one. Papers published in PubMed from 1990 to 2022 were reviewed. The following terms were used for comparison: "ED" and "triage system". The papers contained data on the design and function of the triage system, its validation, and its performance. After studies comparing the distinct means of patient selection were reviewed, they were meant to be classified as either flawed or non-ideal. The validity of all the comparable segregation systems was similar. A possible solution would be to search for a new, measurable parameter for a more accurate risk estimation, which could be a game changer in terms of triage assessment. The dynamic development of artificial intelligence (AI) technologies has recently been observed. The authors of this study believe that the future segregation system should be a combination of the experience and intuition of trained healthcare professionals and modern technology (artificial intelligence). [ABSTRACT FROM AUTHOR]

Objective To investigate the current status and influencing factors of the utilization of medical assistance policy resources by difficult groups with chronic diseases and economic difficulties in urban villages, analyze the existing problems, and propose corresponding strategies to promote precision management of diseases for vulnerable groups and facilitate health poverty alleviation in the new era. Methods Firstly, using a questionnaire survey, two out of four urban village streets in a certain district of Chengdu were randomly selected to investigate the existing problems in the utilization of medical assistance by difficult groups. Secondly, telephone interviews were conducted to analyze the reasons for not utilizing medical assistance even though meeting the conditions, and countermeasures were proposed. Results Difficult groups utilized the policy of subsidizing and participating in insurance the best, while the utilization of outpatient, inpatient, and supplementary medical assistance policies was the worst. The results of multivariate Logistic regression analysis showed tliat having more than three comorbidities (O7=0.134) was a risk factor for assistance utilization. Having disabilities (OR=2.625), higher educational level (OR =3.500), and higher average monthly medical expenses (OR =4.148) were protective factors for utilization of assistance. The follow-up results indicated that factors such as patientsJ lack of policy awareness, misunderstandings about policies, not seeking treatment at designated hospitals, some Chinese medicine not being reimbursed, and complex application procedures were the main causes leading to their non-utilization of policies. Conclusion Difficult groups with diseases utilize well the government assistance policies obtained through direct help, but the utilization of policies requiring proactive application is poor. The characteristics of patientsJ own diseases, inadequate explanation of policies, high reimbursement thresholds, and limited reimbursement scope are the main reasons for difficult groups not applying for medical assistance. [ABSTRACT FROM AUTHOR]

In recent times, the prevalence of chatbot technology has notably increased, particularly in the realm of medical assistants. However, there is a noticeable absence of medical chatbots that cater to the Hungarian language. Consequently, Hungarian-speaking people currently lack access to an automated system capable of providing assistance with their health-related inquiries or issues. Our research aims to establish a competent medical chatbot assistant that is accessible through both a website and a mobile app. It is crucial to highlight that the project's objective extends beyond mere linguistic localization; our goal is to develop an official and effectively functioning Hungarian chatbot. The assistant's task is to answer medical questions, provide health advice, and inform users about health problems and treatments. The chatbot should be able to recognize and interpret user-provided text input and offer accurate and relevant responses using specific algorithms. In our work, we put a lot of emphasis on having steady input so that it can detect all the diseases that the patient is dealing with. Our database consisted of sentences and phrases that a user would type into a chatbot. We assigned health problems to these and then assigned the categories to the corresponding cure. Within the research, we developed a website and mobile app, so that users can easily use the assistant. The app plays a particularly important role for users because it allows them to use the assistant anytime and anywhere, taking advantage of the portability of mobile devices. At the current stage of our research, the precision and validation accuracy of the system is greater than 90%, according to the selected test methods. [ABSTRACT FROM AUTHOR]

Background & Aims: Helicobacter pylori (H. pylori) infection has an unknown prevalence in certain Romanian regions. We aimed to estimate it in communities from Southern regions of Romania with limited access to health services. Methods: We designed a cross-sectional study to include adult voluntary participants in the “Health in the neighborhood” medical assistance program. This was offered in villages with deprived healthcare availability from Southern regions of Romania. An immunochromatographic assay for the qualitative detection of H. pylori stool antigen was used for testing. Results: We included 708 adult voluntary participants in 10 villages, 6 from Muntenia and Oltenia Regions (Southern Romania), 2 from Dobrogea and 2 from Moldova (2.4% of all village inhabitants). H. pylori prevalence in Romanian Southern regions was 28.2%, (95%CI: 24-32.6%), and overall was 27.1%, (95%CI: 23.9-30.6%). There were no significant differences of H. pylori infection pertaining to regions distribution (p=0.711), gender ratio (p=0.779), age distribution (p=0.471) and hemoglobin value (p=0.503). Conclusions: H. pylori prevalence in communities from Southern regions of Romania with limited access to health services was 28.2%, 95%CI: 24-32.6%. [ABSTRACT FROM AUTHOR]

In recent years, the Republic of Moldova has been subject to a series of socio-economic and political challenges. Among the most notable are the Covid-19 pandemic (CoronaVirus 2019), the energy crisis and the political crisis (war in Ukraine). The impact of these crises have radically changed the way of life of the population and influenced the economy, bringing both negative and positive changes. Data were collected from external sources, using qualitative and quantitative method, as well as method of analysis and synthesis, induction, deduction and statistical inference. Comparative analysis was used as a research method in conducting the empirical study. In this article we aim to analyze the positive impact of the Covid-19 pandemic period on the healthcare system, namely: strengthening the public health system through digitalization in the Republic of Moldova and the Transnistrian Moldovan Republic. In order to make a comprehensive analysis of this phenomenon, the indicators that determine the level of development of public health were analysed, namely: the evolution of health expenditure and its share in GDP; life expectancy; medical staff in medical institutions; the degree of sickness and the level of requests for emergency medical assistance. The article presents the digital innovations implemented. Budget execution as an influencing factor was established by analysing the financing of the Semashko and Bismark health systems to expose the degree of flexibility of health service provision in the Republic of Moldova and the Transnistrian region. Thus, following the research, the authors concluded that the consolidation of the public health system through digitization in the Transnistrian region is at an early stage compared to the Republic of Moldova, which is in a stable development. This discrepancy is due to the fact that the Transnistrian region is developing the public health system according to its own scenario and without the involvement of external funding sources. Despite this, digital innovations are developing and are expected to be implemented in the future. Thus, we can observe a much slower development of the implementation of digital innovations to strengthen the health system. [ABSTRACT FROM AUTHOR]

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Examining reported costs for Children with Medical Complexity (CMCs) is essential because costing and resource utilization studies influence policy and operational decisions. Our objectives were to (1) examine how authors identified CMCs in administrative databases, (2) compare reported costs for the CMC population in different study settings, and (3) analyze author recommendations related to reported costs. We undertook a systematic search of the following databases: Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library with a focus on CMCs as a heterogeneous group. The most common method used n = 11 (41%) to identify the CMC population in administrative data was the Complex Chronic Conditions methodology. The majority of included studies reported on health care service costs n = 24 (89%). Only n = 3 (11%) of the studies included costs from the family perspective. Author recommendations included standardizing how costs are reported and including the family perspective when making care delivery or policy decisions. Health system administrators and policymakers must consider the limitations of reported costs when assessing local costing studies or comparing costs across jurisdictions. [ABSTRACT FROM AUTHOR]

The purpose of this article is to analyze the legislation of Ukraine on the protection of gambling players from the formation of gambling addiction, to identify ways and means of protection, to evaluate their effectiveness and to formulate proposals for improving (strengthening) the protection of the rights of gambling players. The research used general scientific and special scientific methods of scientific knowledge. In particular, the dialectical method of learning the phenomena of the surrounding reality, comparative-legal, systemic-structural, methods of logic (analysis, synthesis, induction, deduction, analogy). Many prevention measures have already been implemented in Ukraine. In addition, the player is protected by the right to receive free psychosocial assistance in the event of problems with gambling and free medical assistance in the event of a diagnosis of gambling addiction. The state also provides free socio-psychological rehabilitation of players during and after treatment for gaming addiction. The disadvantage is the bringing of the player to administrative responsibility for participating in illegal gambling and the impossibility of recognizing him as a victim in criminal proceedings to compensate for the damage caused by the crime (engagement in the gambling business). [ABSTRACT FROM AUTHOR]

Background:The safety of direct-to-consumer telemedicine (TM) is closely related to red flag detection and correct referrals. The adherence to referral criteria from current guidelines is not well quantified. Objective:To analyze the emergency department (ED) referral rate and adherence to referral guidelines in TM encounters of acutely ill patients calling a center that adopts stewardship protocols. Methods: This is a retrospective observational unicentric study, between March 2020 and March 2022, with patients who spontaneously sought direct-to-consumer urgent virtual medical assistance. A video-based teleconsultation was provided immediately after connection. Physicians managed situations according to their clinical judgment. Current guidelines, containing specific guidance for referral if red flags were identified, were available for consultation. Physicians' semiannual performance feedback was carried out. We analyzed the patterns for referral to immediate face-to-face medical evaluation and the agreement degree with the institutional guidelines. Results:A total of 232,197 patients were available, and 14,051 (6.05%) patients were referred to ED. A total of 8,829 (68.4%) referrals were based in specific guidelines according to the International Classification of Diseases hypothesis, and 8,708 (98.6%) were justified according to guidelines. Diarrhea had the highest guidelines' adherence to referral (97.6%), followed by COVID-19 (90%), headache (84.2%), and conjunctivitis (78.8%). Policies did not support 5,222 (31.6%) referrals, though 5,100 (97.6%) of these were justified according to the doctor's clinical judgment. Conclusion:TM doctors' assessment of acutely ill patients has high rates of adherence to guidelines regarding referral. Stewardship protocol adoption provides high rates of red flag description, even in the referral of nonpolicy diseases. [ABSTRACT FROM AUTHOR]

Background: Methotrexate is a widely used immunosuppressant with good efficacy and cost‑effectiveness. However, one of the drawbacks of methotrexate has been toxicity due to accidental overdose. During the COVID pandemic, there was an alarming increase in the number of patients with methotrexate toxicity which prompted us to do this study. Objective: To evaluate the clinical features and contributing factors in patients presenting with methotrexate toxicity. Materials and Methods: A detailed evaluation of the clinical features, laboratory indices, contributing factors, and outcomes of the patients presenting with methotrexate toxicity was analyzed. Results: A total of 19 cases were seen during the study period. All of the patients had oral mucositis and several developed cutaneous ulcerations. Laboratory abnormalities included cytopenia, transaminitis, and renal impairment. While sixteen patients recovered successfully, three people died as a result of delays in medical assistance. In addition to comorbidities, pandemic‑induced restrictions played a major role in patients accidentally overdosing with methotrexate. Conclusion: This study highlights the fact that even low‑dose methotrexate taken incorrectly can result in a lethal outcome, which is preventable [ABSTRACT FROM AUTHOR]

BACKGROUND ART differs in effectiveness, side-effects, administration, and costs. To improve the decision-making process, we need to understand what factors patients consider to be most important. OBJECTIVE AND RATIONALE We conducted this systematic review to assess which aspects of ART treatment (effectiveness, safety, burden, costs, patient-centeredness, and genetic parenthood) are most important in the decision-making of patients with an unfulfilled wish to have a child. SEARCH METHODS We searched studies indexed in Embase, PubMed, PsycINFO, and CINAHL prior to November 2023. Discrete choice experiments (DCEs), surveys, interviews, and conjoint analyses (CAs) about ART were included. Studies were included if they described two or more of the following attributes: effectiveness, safety, burden, costs, patient-centeredness, and genetic parenthood. Participants were men and women with an unfulfilled wish to have a child. From each DCE/CA study, we extracted the beta-coefficients and calculated the relative importance of treatment attributes or, in case of survey studies, extracted results. We assessed the risk of bias using the rating developed by the Grading of Recommendations Assessment, Development and Evaluation working group. Attributes were classified into effectiveness, safety, burden, costs, patient-centeredness, genetic parenthood, and others. OUTCOMES The search identified 938 studies of which 20 were included: 13 DCEs, three survey studies, three interview studies, and one conjoint analysis, with a total of 12 452 patients. Per study, 47–100% of the participants were women. Studies were assessed as having moderate to high risk of bias (critical: six studies, serious: four studies, moderate: nine studies, low: one study). The main limitation was the heterogeneity in the questionnaires and methodology utilized. Studies varied in the number and types of assessed attributes. Patients' treatment decision-making was mostly driven by effectiveness, followed by safety, burden, costs, and patient-centeredness. Effectiveness was rated as the first or second most important factor in 10 of the 12 DCE studies (83%) and the relative importance of effectiveness varied between 17% and 63%, with a median of 34% (moderate certainty of evidence). Of eight studies evaluating safety, five studies valued safety as the first or second most important factor (63%), and the relative importance ranged from 8% to 35% (median 23%) (moderate certainty of evidence). Cost was rated as first or second most important in five of 10 studies, and the importance relative to the other attributes varied between 5% and 47% (median 23%) (moderate certainty of evidence). Burden was rated as first or second by three of 10 studies (30%) and the relative importance varied between 1% and 43% (median 13%) (low certainty of evidence). Patient-centeredness was second most important in one of five studies (20%) and had a relative importance between 7% and 24% (median 14%) (low certainty of evidence). Results suggest that patients are prepared to trade-off some effectiveness for more safety, or less burden and patient-centeredness. When safety was evaluated, the safety of the child was considered more important than the mother's safety. Greater burden (cycle cancellations, number of injections, number of hospital visits, time) was more likely to be accepted by patients if they gained effectiveness, safety, or lower costs. Concerning patient-centeredness, information provision and physician attitude were considered most important, followed by involvement in decision-making, and treatment continuity by the same medical professional. Non-genetic parenthood did not have a clear impact on decision-making. WIDER IMPLICATIONS The findings of this review can be used in future preference studies and can help healthcare professionals in guiding patients' decision-making and enable a more patient-centered approach. [ABSTRACT FROM AUTHOR]

Photoacoustic imaging (PAI) is a noninvasive emerging imaging method based on the photoacoustic effect, which provides necessary assistance for medical diagnosis. It has the characteristics of large imaging depth and high contrast. However, limited by the equipment cost and reconstruction time requirements, the existing PAI systems distributed with annular array transducers are difficult to take into account both the image quality and the imaging speed. In this paper, a triple-path feature transform network (TFT-Net) for ring-array photoacoustic tomography is proposed to enhance the imaging quality from limited-view and sparse measurement data. Specifically, the network combines the raw photoacoustic pressure signals and conventional linear reconstruction images as input data, and takes the photoacoustic physical model as a prior information to guide the reconstruction process. In addition, to enhance the ability of extracting signal features, the residual block and squeeze and excitation block are introduced into the TFT-Net. For further efficient reconstruction, the final output of photoacoustic signals uses 'filter-then-upsample' operation with a pixel-shuffle multiplexer and a max out module. Experiment results on simulated and in-vivo data demonstrate that the constructed TFT-Net can restore the target boundary clearly, reduce background noise, and realize fast and high-quality photoacoustic image reconstruction of limited view with sparse sampling. [ABSTRACT FROM AUTHOR]

To compare the success rates of medical management using a combined mifepristone and misoprostol protocol in cases of early pregnancy loss (EPL) between women who conceived without medical assistance and those who conceived through in vitro fertilization (IVF), after fresh or frozen embryo transfer, and evaluate for the predictive factors of success, time to first passage of tissue, and time to complete resolution of pregnancy. Retrospective cohort study. University hospital. Women who presented with EPL below 13 weeks of gestation between June 2013 and July 2021 who were managed medically with mifepristone 200 mg orally and misoprostol 800 mcg vaginally were included in the study. Medical management with mifepristone and misoprostol; conception without medical assistance vs. post-IVF, after fresh or frozen embryo transfer. We evaluated overall success and performed subgroup analysis according to the mode of conception and compared fresh vs. frozen-thawed embryo transfers for IVF pregnancies. In all groups, we also calculated success according to gestational age and compared the time to first passage of tissue. The potential predictive factors of treatment success were analyzed. The side effects and complications of treatment were recorded. A total of 930 women were included in the study, 99 (11%) of whom achieved pregnancy after IVF. The overall success of medical treatment was 89% with no statistically significant difference according to the mode of conception (89% vs. 89%) or type of transfer (fresh 89% vs. frozen 89%). Only lower gestational age by sonography was independently predictive of treatment success, showing a negative regression coefficient of β = −0.333 and an odds ratio of 0.717. The mean time to first passage of tissue was 5.0 ± 2.1 hours. Altogether, 666 women (72%) showed pregnancy resolution on the day of medication administration, an additional 110 women at 1-week follow-up, and a further 74 women after ≥4 weeks on ultrasound. Medical management of EPL with mifepristone and misoprostol is a highly successful treatment option that results in completed abortion in a timely fashion in both pregnancies conceived without medical assistance and those conceived after IVF. [ABSTRACT FROM AUTHOR]

Their health industry is facing challenges due to a rise in mortality rates brought on by various multi‐drug‐resistant bacterial strains. As a result, new and improvedantibacterial drugs are urgently needed. Similarly, when some unwanted foreign pathogensenter the cellular premises to disturb its homeostasis, inflammation develops as an immune reaction. However, these immune responses also become a double‐edged sword when the inflammatory reaction lasts for a long time, and pain is also linked to inflammatory responses. Inflammation and pain are both signs of tissue injury. Pain is,by definition, an unpleasant experience that ultimately interferes with their normalwell‐being. Hence, bacterial infection, inflammation, and pain need medical assistance to maintain homeostasis. Conventional medicines possess so many repercussive effects, which then demand a replacement with a less toxic and more efficient modern drug. In their review article, for the first time, they present recent advancements in biomedical applications such as the antimicrobial, anti‐inflammatory, and analgesic properties of noble metal nanoparticles. Noble metals have limited availability in the earth's crust. Hence, their physicochemical characterizations and applications are greatly limited. Still, there are some interesting research findings that offer a significant ray of hope for the health sector all over the world. [ABSTRACT FROM AUTHOR]

Unsafe abortion refers to induced abortions performed without trained medical assistance. While previous studies have investigated predictors of unsafe abortion in India, none have addressed these factors with accounting sample selection bias. This study aims to evaluate the contributors to unsafe abortion in India by using the latest National Family Health Survey data conducted during 2019–2021, incorporating the adjustment of sample selection bias. The study included women aged 15 to 49 who had terminated their most recent pregnancy within five years prior to the survey (total weighted sample (N) = 4,810). Descriptive and bivariate statistics and the Heckman Probit model were employed. The prevalence of unsafe abortion in India was 31%. Key predictors of unsafe abortion included women's age, the gender composition of their living children, gestation stage, family planning status, and geographical region. Unsafe abortions were typically performed in the early stages of gestation, often involving self-administered medication. The primary reasons cited were unintended pregnancies and health complications. This study underscores the urgent need for targeted interventions that take into account regional, demographic, and social dynamics influencing abortion practices in India. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Medical Ethics-Law & History / Türkiye klinikleri tıp Etiği, Hukuku ve Tarihi Dergisi is the property of Turkiye Klinikleri 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/Aim. Resuscitation and surgical medical aid are the most important medical procedures in disaster relief operations. The limited time frame available for lifesaving activities in such circumstances demands that resuscitation and surgical medical teams be established and trained for timely reaction and disaster medical support prior to disaster occurrence. The aim of the study was to analyze the awareness among the hospital medical staff in the Plovdiv Region of the hospital response plan in case of disaster, which concerns surgical and resuscitation team composition and tasks for disaster medical support. Methods. An anonymous survey, consisting of 55 questions about hospital staff awareness of the medical activities described in the hospital disaster medical support plan, was conducted between July and September 2019 among 295 hospital medical professionals in the Plovdiv Region, Bulgaria. Descriptive statistics and Pearson's χ2 test were used in the statistical analysis of results. Results. The survey showed that the majority of medical staff demonstrated complete ignorance regarding the presence, number, and tasks of the specialized medical teams planned for hospital disaster response. Employees of multidisciplinary hospitals for active treatment were more familiar with the aforementioned plans than their colleagues from the university multidisciplinary hospitals. Conclusion. Insufficient awareness about human resources foreseen for disaster medical support negatively impacts the hospital surge capacity, leading to inadequate medical assistance in such cases. Hospital tactical disaster preparedness must be ameliorated by conducting a more rigorous training program among medical staff related to the planned hospital activities in case of disastrous events, especially for those working in emergency departments, intensive care units, and surgical departments. [ABSTRACT FROM AUTHOR]

Copyright of Revista Crítica de Relaciones de Trabajo, Laborum is the property of Ediciones Laborum S.L. 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 study is based on administrative data received from General Directorates of Social Work and Child Protection (DGASPCs) and Directorates of Social Work/The Departments of Social and Medical Assistance and Public Social Work Services (DASs/ DASMs/SPASs) in Romania in 2022. In none of the DGASPCs in the country does the number of male managers exceed the number of female managers. Half of the DGASPCs in the country have women in positions with management attributions. The average number of women in management positions in all 48 DGASPCs in the country is 37, the most are in a DGASPC in Bucharest, the fewest in DGASPC Bistriţa-Năsăud. More than half of the DGASPCs in the country, 26 DGASPCs, have a female director general at the head of the institution, compared to only 15 DGASPCs headed by men. In the DASs of the county town halls, the majority of the managers are also female. Of the total number of DASs in county capitals across the country, 78.23% have women in management positions in their own apparatus or in subordinate units and structures. So, whether we are talking about county or local social welfare institutions, the majority are headed by women. In order to interpret these data, in further studies it is worth conducting interviews to see why women assume leadership positions to a greater extent than men in the social work field, or is the trend due to the higher number of female persons working in the field compared to male persons. [ABSTRACT FROM AUTHOR]

The global economy has been adversely affected by the COVID‐19 pandemic, leading to setbacks in development progress. Against this backdrop, donor countries have increased their expenditure on medical aid as part of their foreign assistance. As an emerging donor from the developing world, China has also been actively involved in providing medical assistance to other countries since 2020. This paper intends to investigate and elucidate China's motivation to offer medical aid to other countries amid the COVID‐19 pandemic. To this end, it utilizes a combination of quantitative and qualitative research methods. Specifically, the Tobit model is employed to conduct regression analyses on China's medical assistance during the pandemic. Additionally, two case studies, namely Chinese aid to Pakistan and the Democratic Republic of Congo, are examined to gain insights into the specific motivations driving China's medical aid. The results of this paper indicate that China's motivation for providing medical assistance during COVID‐19 is multifaceted, including self‐interested economic and political‐diplomatic factors rather than purely altruistic motives. Furthermore, the allocation of China's medical aid is significantly influenced by whether the recipient country is involved in the Belt and Road Initiative. [ABSTRACT FROM AUTHOR]

This Article investigates the character, nature, and application of Crisis Standards of Care ("CSC") in national emergency preparedness plans. Ideally, these standards allow a government to codify frameworks or models for allocating scarce medical resources. The principal mechanism used by healthcare decision-makers to evaluate individuals seeking medical assistance is through triage--a diagnostic process utilizing algorithms to sort, grade, or select those who "qualify" for medical treatment. This Article studies the principles and values incorporated into these medical algorithms and concludes that more federal government leadership is required to convince the states that CSC are an integral part of emergency preparedness; and, secondly, that diagnostic algorithms must be used in an equitable manner that does not discriminate among the medically injured, the aged, or those with comorbidities. [ABSTRACT FROM AUTHOR]

Background: Allergic Diseases (AD) are the most common chronic diseases in Europe. AD diagnosis poses a significant challenge due to the variety of definitions, diversity of symptoms, and the heterogeneous involvement of organs as well as the lack of diagnostic methods in our country. These problems in diagnosis, specifically in the Emergency Department (ED), occur even when differentiation is made of anaphylaxis with Anaphylactic Reactions (AR). Do you mean adverse reactions instead of anaphylactic reaction? Purpose of the study: Prevalence of allergic diseases and anaphylaxis in ED in University Clinical Center of Kosovo (UCCK), determination of the main causes that induce these reactions, the relation of the allergy trigger, and the time of symptoms' manifestation, observation of the correct approach and appropriate treatment of these cases. Materials and methods: The research is a cross-sectional study of patients over the age of 15 who presented in our center between January 1st 2020 and April 30th 2020. In the cases obtained from the recorded data, patients with a diagnosis of "Reactio allergica" (urticaria, angioedema, erythema, etc.) were selected. The data were obtained based on the anamnesis and present clinical status of the patient, where a questionnaire with 8 questions based on the questionnaire of "Agana Heights Elementary School, General Allergy and Anaphylaxis Questionnaire, Jan 2013" was used. Statistical analysis was done with SPSS program, data were not normally distributed therefore nonparametric tests were used with a confidence interval of 95% and 99%. Results: Out of 15,131 persons presented at the ED in Prishtina in UCCK for various emergency health problems, 74 allergic reactions were registered that required emergency medical assistance; gender ratio f/m=53/21 (p<0.001) with a predominance of 15 years-30 years of age (39 of them). Dominant symptoms in our patients were skin changes in the form of urticarial changes (36 of them), erythematous changes (51 of them), and angioedema manifested in 27 patients. Fortunately, during the research period 41 (55.4%) cases had mild forms of generalized reaction, 23 (31.0%) moderate and only 10 (13.6%) cases had severe form, according to Brown's classification. Of these, 18 (24.3%) cases were in anaphylaxis according to the criteria of the "Second symposium on the definition and management of anaphylaxis"; this incidence would be 0.1% of all visits in the ED, even though no patient was diagnosed with anaphylaxis by emergency doctors. The most commonly known causes were medications (44.6%). The most common causative drugs were the NSAIDs group (48.3%), ketoprofen lysine (brand name, OKI) leading the way with 25.8% of all cases of allergic reactions to the drugs. The second group of drugs was ß-lactam antibiotics with 7 (22.6%) cases, led by cephalosporins and followed by penicillin. The second most common cause was food in 12.1% of cases. Conclusion: Due to the lack of a unique protocol for anaphylaxis and AR, in our study we managed to identify 18 cases of anaphylaxis, which were not recorded with this diagnosis in the patient's medical history. Therefore, we consider that health care professionals would benefit from better education on setting criteria to distinguish an allergic reaction from an anaphylactic reaction or anaphylaxis and vice versa. [ABSTRACT FROM AUTHOR]

Purpose: In modern societies, motorcycle accidents have become a great problem for health systems worldwide. In Spain, the size and the power of the engine of 2-wheel vehicles determine the type of driving license and the age at which these vehicles can be used (mopeds and motorcycles, which at the same time can have a small or large engine capacity). The objective of the present study was to analyze and characterize low- and high-power motorcycle accidents in Spain, between 2014 and 2020, both included and compared these categories with each other. Methods: Retrospective, descriptive, and observational study of motorcycle and moped accidents in Spain between 2014 and 2020, both included. Results: The mortality of motorcycle accident riders in Spain is associated with males aged between 30 and 40 years old, with a high-power motorcycle, and an A or A1 driver's license, who is 6.7 times more likely to die in crossings and highways than a moped, while wearing a helmet, and if not, this increases to 4.89 times. During the COVID-19 pandemic, an increase in death at 24 h after a high-power motorcycle accident was observed, as compared with a large reduction in the total medical assistance provided in 2019–2020. Conclusions: High-power motorcycles had higher scores in mortality and morbity rates than low-power ones, with a significant increase in mortality during the pandemic, even though number of accidents and medical assistance provided were drastically reduced. [ABSTRACT FROM AUTHOR]

Deaf people are those who understand and interact with the world through visual language. Due to the linguistic and cultural differences that characterize the deaf population, this group still faces difficulties in accessing health services. For this reason, it was proposed to investigate communication difficulties in providing care to deaf patients. This is a qualitative study which was carried out at the Association of the Deaf of Maranhão (ASMA), in São Luís. The sample consisted of 10 women and 10 men, all over the age of 18. The information was collected through semi-structured interviews, with the help of Brazilian Sign Language (LIBRAS) interpreters. Data interpretation were performed based on thematic content analysis. Two thematic categories were identified: “communication” and “autonomy”. In the first, the interviewees pointed out the lack of knowledge of the doctors about the needs of the deaf community or about their language, LIBRAS. In an attempt to establish a dialogue, the patients reported the use of writing, gestures and orofacial reading during the consultations. These strategies, however, are insufficient, since the information cannot be well understood. The second evidenced the need for the presence of companions to mediate the dialogue, as the participants stated that they did not find LIBRAS interpreters in the health units, resulting in loss of autonomy and confidentiality of information. It is concluded that this scenario of adversity implies important consequences for the health of this population, as well as lower adherence to treatments and a decrease in the search for medical care.

This article discusses the use of line-field confocal optical coherence tomography (LC-OCT) as a non-invasive imaging technique for the diagnosis and grading of allergic contact dermatitis. The study involved patch testing on the upper back of 20 patients with positive patch-test reactions, and the affected skin lesions were imaged using the LC-OCT device. The LC-OCT images successfully captured microanatomical features of allergic reactions, such as spongiosis, inflammatory cells, and vesicles. The severity of dermatitis correlated with the presence of certain morphological features observed in the LC-OCT images. The authors suggest that LC-OCT can enhance diagnostic accuracy and serve as an objective measurement tool for patch-test grading in allergic contact dermatitis. However, they also acknowledge the need for further research and validation of their findings. [Extracted from the article]

This study provides the underlying data on the inclusion of medical technologists in the category of medical personnel. Medical personnel are defined in the Medical Service Act as physicians, dentists, oriental medicine doctors, midwives, and nurses. In the act, medical technologists shall be classified into clinical laboratory technologists (clinical pathology technologists in the Korean language), radiological technologists, physical therapists, occupational therapists, dental technologists, and dental hygienists. Although South Korea’s medical personnel do not include medical technologists, Japan and Taiwan define them as medical personnel. Various standard occupational classification such as International Standard Classification of Occupations 2008, Korean Standard Classification of Occupations 2017, Japan Standard Occupational Classification 2009, Taiwan Standard Occupational Classification 2010, and USA Standard Occupational Classification 2018 were compared. The education system for medical health technologists was explained to include 4-year university and 3-year junior college programs. The roles of medical technologists in medical practice, therapy, and medical assistance were outlined. These basic materials incorporate the need for discussions about the meaning of including medical technologists in the type of medical personnel. These discussions will contribute to the legalization of medical technologists’ professionality with regard to their inclusion in the type of medical personnel.

Infertility is a common problem, affecting approximately one in six adults worldwide. Some studies have shown that male factors contribute to infertility in up to 50% of couples. Intracytoplasmic sperm injection (ICSI) is a common treatment for male infertility. This procedure requires a quick and accurate determination of whether sperm are suitable for ICSI. However, this assessment requires expertise and is time-consuming. Several computer-based systems for sperm analysis have been proposed to mitigate the burden on experts. However, there are no systems that can consider both sperm motility and morphology, or that can directly assess sperm suitability for ICSI. To address this problem, we constructed the multi-expert rated sperm video dataset for analysis, that includes motion information and developed an end-to-end sperm grade distribution estimation model using this dataset. Our model predicts a distribution that reflects multiple expert assessments, and thus helps to easily determine the suitability of a given sperm for ICSI. To develop this model, we conducted an exhaustive evaluation of various feature extractors and loss functions. Through this analysis, TimeSformer was identified as the optimal feature extractor from sperm videos, improving on average by $0.1\times 10^{-2}$ in MSE, 1.17% in grade distribution accuracy, and 3.41% in grade mode accuracy compared to ResNet, an image recognition model. Moreover, we identified earth mover’s distance loss as the most suitable loss function, particularly in segments with lower scores.

(1) Background: Unclear sonographic findings without adequate specialist expertise in abdominal ultrasound (AU) may harm patients in rural areas, due to overlooked diagnoses, unnecessary additional imaging (e.g., CT scan), and/or patient transport to referral expert centers. Appropriate telemedical sonography assistance could lead to corresponding savings. (2) Methods: The study was designed as a randomized trial. Selected study centers performed AU with the best local expertise. Patients were selected and monitored according to the indication that they required AU. The study depicted three basic scenarios. Group 1 corresponds to the telemedically assisted cohort, group 2 corresponds to the non-telemedically assisted cohort, and group 3 corresponds to a telemedically supported cohort for teaching purposes. The target case number of all three groups was 400 patients (20 calculated dropouts included). (3) Discussion: This study might help to clarify whether telemedicine-assisted ultrasound by a qualified expert is non-inferior to presence sonography concerning technical success and whether one of the interventions is superior in terms of efficacy and safety in one or more secondary endpoints. Randomization was provided, as every patient who needed an AU was included and then randomized to one of the groups. The third group consisted of a lower number of patients who were selected from group 1 or 2 for teaching purposes in case of rare diseases or findings. (4) Conclusions: The study investigates whether there are benefits of telemedical ultrasound for patients, medical staff, and the health care system. [ABSTRACT FROM AUTHOR]

Definition: The reality of the occurrence of burnout in human resources has been increasingly recognised as a result of today's transforming and competitive society, which exerts a very high level of stress and anxiety on workers, generating a notorious problem in the field of human resource management. Problems related to symptoms of exhaustion, mental weakness, personal devaluation, inability to solve professional problems, restlessness, and eating disorders. These problems manifest themselves in terms of personality, triggering feelings of threat, panic, nervousness, or suicide. Such disorders pose a threat not only to the person but also to the quality of their professional activities. In this way, burnout syndrome can cause a mental and physical breakdown requiring complex medical assistance. In view of the above, it is imperative that organisations take preventative and corrective measures to tackle this phenomenon. This entry covers topics such as the history of the concept of burnout, the concept, its causes and consequences, and predictive methods. By approaching the aforementioned topics using the existing literature on burnout syndrome, this entry aims to demystify the subject of burnout in human resources. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on the first evaluation of infertility counselling in Germany. Methods: Sixty-nine infertility counsellors provided feedback via 524 survey sheets and 182 questionnaires were filled in by clients. Results: The results show a high level of satisfaction on behalf of the clients. They valued the emotional support, information, and exploration of family-building options with and without medical assistance and the counsellors' expertise. During counselling, coping with the emotional burden of infertility was an important issue, but in more than half of all counselling sessions, future parental issues were addressed. The group of clients seeking support can be described to be very heterogeneous, and counselling issues comprise a wide range of aspects. Conclusions: This piece of research suggests that the following issues need to be considered to improve infertility counselling. Better integration of counselling in infertility clinics, more awareness for infertility counselling for other medical and non-medical professions Better funding for counselling so that its uptake is not dependent upon the financial resources of clients Awareness for new groups of clients and counselling issues such as single and transgender individuals, co-parenting families There is a need for more research and the development of counselling concepts. [ABSTRACT FROM AUTHOR]