Search

Εισαγωγή: Τα αυτοάνοσα νοσήματα επηρεάζουν τις γυναίκες αναπαραγωγικής ηλικίας και αυτό μπορεί να αποτελεί πρόβλημα στον οικογενειακό προγραμματισμό τους. Η εγκυμοσύνη σε αυτές τις ασθενείς διαφέρει σε σχέση με τις γυναίκες του γενικού πληθυσμού, καθώς μπορεί να υπάρξουν αρκετές επιπλοκές τόσο στις ίδιες όσο και στο έμβρυο. Σήμερα η συνεχιζόμενη βελτίωση τόσο στη θεραπεία, όσο και στη διαχείριση έχει βελτιώσει σημαντικά την έκβαση της εγκυμοσύνης στις ασθενείς με αυτοάνοσα νοσήματα. Παρά την πρόοδο που σημειώνεται σε αυτόν τον τομέα, υπάρχει ετερογένεια στη διαχείριση αυτών των περιστατικών που αποτυπώνεται και στις συστάσεις που έχουν δημοσιευτεί κατά́ καιρούς από τις διεθνείς ρευματολογικές εταιρείες. Σκοπός: Σκοπός της παρούσας μελέτης είναι η σύγκριση των κατευθυντήριων οδηγιών- της EULAR (European league against rheumatism), του ACR (American College of Rheumatology) και του BSR (British Society of Rheumatologists) που αφορούν στη χρήση των ρευματολογικών φαρμάκων - κλασσικών και βιολογικών - στη διάρκεια της κύησης, όπως και στην προγεννητική συμβουλευτική, καθώς και η ανάδειξη των μεταξύ τους διαφορών. Υλικά και μέθοδος: Πρόκειται για μια συγκριτική και περιγραφική ανασκόπηση των πιο πρόσφατα δημοσιευμένων διεθνών κατευθυντήριων οδηγιών για τη διαχείριση των ρευματικών νοσημάτων και τη χρήση των φαρμάκων στη διάρκεια της κύησης. Πιο ειδικά αναγνωρίστηκαν πέντε διεθνείς οδηγίες: 1. Της EULAR (European league against rheumatism) Συστάσεις για τη χρήση των αντιρευματικών φαρμάκων πριν από, κατά τη διάρκεια της κύησης και τον θηλασμό (Skorpen, 2016), 2. Συστάσεις για την αντισύλληψη, τον οικογενειακό προγραμματισμό, την υποβοηθούμενη αναπαραγωγή, την κύηση και την εμμηνόπαυση στις γυναίκες με ΣΕΛ και/ή αντιφωσφολιπιδικό σύνδρομο (Andreoli, 2017), 3. Συστάσεις της EULAR για την αντιμετώπιση του αντιφωσφολιπιδικού συνδρόμου μαιευτικού και μη (Tektonidou, 2019), 4. Του ACR (American College of Rheumatology) Οδηγίες για τη διαχείριση της αναπαραγωγικής υγείας στα ρευματικά νοσήματα (Sammaritano, 2020), 5. Του BSR (British Society Of Rheumatology) Συνταγογράφηση φαρμάκων στην κύηση και τον θηλασμό: βιολογικοί παράγοντες, κλασικά ανοσοτροποποιητικά φάρμακα και κορτικοειδή (Russell, 2022). Αποτελέσματα: Σε όλες τις συστάσεις είναι κοινός τόπος η συζήτηση με τον ασθενή για τον οικογενειακό προγραμματισμό του, η σύλληψη σε περίοδο όπου η νόσος είναι ανενεργή και παραμένει έτσι για τουλάχιστον τους τελευταίους έξι μήνες. Η θεραπεία της νόσου με Αζαθειοπρίνη, Υδροξυχλωροκίνη, Σουλφασαλαζίνη, Κυκλοσπορίνη, Τακρολιμους, κορτιζόνη, Introduction: Autoimmune diseases may affect women of reproductive age and this could be an obstacle in their family planning. Pregnancy in these patients differs from that in women in the general. Today, continued improvement in both treatment and management has significantly improved pregnancy outcomes in patients with autoimmune diseases. Despite progress in this area, there is heterogeneity in the management of these cases, which is reflected in the recommendations that have been published from time to time by international rheumatology societies. Aim: The purpose of this study is to compare the international guidelines - EULAR (European league against rheumatism), ACR (American College of Rheumatology) and BSR (British Society of Rheumatologists) regarding the use of rheumatological drugs - classical and biological - in duration of pregnancy, as in prenatal counseling as well as to highlight the differences among them. Materials and methods: This is a comparative and descriptive review of the most recently published international guidelines for the management of rheumatic diseases and the use of drugs during pregnancy. More specifically, five international guidelines were recognized: 1. By EULAR (European league against rheumatism) - Recommendations for the use of antirheumatic drugs before, during pregnancy and breastfeeding (Skorpen, 2016), 2. Recommendations for contraception, family planning, assisted reproduction, pregnancy and menopause in women with SLE and/or antiphospholipid syndrome (Andreoli, 2017), 3. EULAR recommendations for the treatment of obstetric and non-obstetric antiphospholipid syndrome (Tektonidou, 2019), 4. By ACR (American College of Rheumatology) - Guidelines for managing reproductive health in rheumatic diseases (Sammaritano, 2020), 5. By BSR (British Society Of Rheumatology) - Prescribing drugs in pregnancy and breastfeeding: biological agents, classical immunomodulatory drugs and corticoids (Russell, 2022). Results: All recommendations suggest that the discussion with the patient about family planning, the conception during a period where the disease is inactive and remains like that for at least six months is of high importance. They all agree that the treatment of the disease with Azathioprine, Hydroxychloroquine, Sulfasalazine, Cyclosporine, Tacrolimus, cortisone

The report documents consolidated results on open science of an expert meeting in June 2022 in the succeeding order: open science focal points in June 2022, important policy initiatives in June 2022, and conclusions for the year 2022. On 16 June 2022, Path2Integrity organised a conference at the Steigenberger Hotel in Kiel involving six informed stakeholders to discuss priorities for promoting open science in Europe. The stakeholders represented research-funding and research-producing organisations with different fields of interest, specifically open science infrastructure, educational and legal best practices, national and international science agents, research ethics, and the issue of reproducibility. This gender-balanced group discussed how far Europe had come in the open science movement and how research quality, efficiency and creativity and society's trust in science could be improved. They focused on tackling the reproducibility crisis, responding to societal challenges, accessing and sharing results, and combating the knowledge gap concerning the FAIR principles. This report concisely identifies and examines the issues that have been discussed in the small circle meetup on open science., Written on behalf of the six experts attending the small circle meetup.

This article is based on the results of an empirical research conducted about scales and others decision aid tools in France. Created by practitioners, these tools facilitate the work of judges. They also reflect a renewed conception of this work, less individualistic, between the magistrates, as well as with other authorities. This text proposes a definition of the wide variety of tools: they all hold a form of interpretation of the rules in force. It also shows the difficulties linked to the absence of a cross-cutting policy capable to promote their construction and dissemination., Este artículo se basa en los resulta¬dos de una investigación empírica acerca de « escalas y otras herramientas técnicas de ayuda en la toma de decisiones » en el funcionamiento de la justicia en Francia. Estas herramientas, sacadas de la prác¬tica, facilitan el trabajo de los jueces. Ellas reflejan igualmente una concepción ren¬ovada de este trabajo, menos individu¬alista, ya sea dentro de las jurisdicciones o en las cooperaciones que favorecen con otras instancias decisorias. Partiendo de la definición de una amplia diversidad de estos objetos, pero todos portadores de una forma de interpretación de las nor¬mas legales vigentes, la investigación muestra la ausencia de una política transversal susceptible de promover la construcción y la difusión de estas herramientas., Cet article se fonde sur les résultats d’une recherche empirique consacrée aux « barèmes et autres outils techniques d’aide à la décision » dans le fonctionnement de la justice en France. Ces outils, issus de la pratique, facilitent le travail des juges. Ils traduisent aussi une conception renouve¬lée de ce travail, moins individualiste, que ce soit au sein des juridictions ou dans les coopérations qu’ils favorisent avec d’autres autorités décisionnelles. À partir d’une définition de ces objets, de factures très diverses mais tous porteurs d’une forme d’interprétation des règles de droit en vigueur, la recherche montre l’absence de politique transversale susceptible de pilo¬ter la construction et la diffusion de ces outils.

2018 6th International Conference on Environment Pollution and Prevention (ICEPP 2018) : Brisbane, Australia, December 6-8, 2018 / Herausgeber: Iticescu, Catalina; Guo, Zhihua 6th International Conference on Environment Pollution and Prevention, ICEPP 2018, Brisbane, Australia, 6 Dec 2018 - 8 Dec 2018; Les Ulis : EDP Sciences, E3S web of conferences 96, [1]-7 (2019). doi:10.1051/e3sconf/20199603004, Published by EDP Sciences, Les Ulis

В данной работе был настроен и отлажен учебный стенд, базирующийся на контроллере семейства Twido компании Schneider Electric – TWDLCAE 40DRF. Составлены принципиальные электрические схемы подключения вводов и выводов контроллера. Реализован проект для управления приводом по протоколу CANOpen. Составлены лабораторные работы для изучения возможностей учебного стенда и возможностей контроллеров, объединенных в сеть., In the given work a training stand, based on the Schneider Electric Twido controller – TWDLCAE 40DRF, was configured and debugged. The basic electrical diagrams of the connection of the controller’s inputs and outputs have been compiled. Project for controlling the drive unit using the CANOpen protocol was created. Also, laboratory works for studying the capabilities of the training stand and the capabilities of the network of controllers were compiled.

Individer med intellektuell funktionsnedsättning blir idag äldre än tidigare. Detta leder till att de utvecklar ett kombinerat omsorgsbehov utifrån intellektuell funktionsnedsättning och åldersproblematik. Syftet med studien var att undersöka hur yrkesverksamma inom LSS-verksamhet förhåller sig till målgruppen och vilka möjligheter som finns att få sitt behov till­godosett utifrån både funktionsnedsättning och åldrande. Frågeställningarna berör vilka insatser som finns för att möta målgruppens behov av stöd och omsorg samt hur samverkan ser ut utifrån lagstiftning och organisation. Studien har genomförts med en kvalitativ metod där det empiriska materialet har insamlats genom intervjuer med utgångspunkt i en halvstruk­turerad intervjuguide. Resultatet har analyserat utifrån intersektionellt perspektiv. Resultatet visade att det finns en gemensam syn på målgruppen och dess omsorgsbehov men att det saknas riktlinjer och kunskap om vilka alternativ som står till förfogande. Vidare framkom att det finns individer som kan vara aktuella för insatser genom både LSS och äldreomsorgen men att lagstiftningens uppdelning kan utgöra hinder för att utveckla insatsmodeller som till­godoser individernas kombinerade omsorgsbehov. Detta leder till slutsatsen att det inom lag­stiftningarna LSS och SoL finns möjlighet att skapa lösningar för målgruppen genom individuella behovsprövningar samtidigt som målgruppens tillhörighet till LSS kan begränsa möjlighet till insatser via annan lagstiftning. Utmaningen ligger i att skapa samverkan och samsyn mellan LSS och äldreomsorgen och utveckla insatser som tillgodoser målgruppens kombinerade behov.

In the Lutheran Church of Sweden, Guidelines for the Confirmation Work serves as a framework for the confirmation process and presents the conditions within which Swedish church congregations can conduct high-quality confirmation work. The latest version of the document was presented in 2008; the previous version was released in 2000 and the version before that was published in the late 1990s. The present article aims to contribute to a perspective on the 2008 edition by exploring the discourses that are reflected in the document. The analysis reveals three dominant Orders of discourse: the target group, the context, and the content. The results raise the question of how guidelines can be expected to balance the expectations and visions from the national church, the dioceses, and the congregations.Nøkkelord: kirkelig konfirmasjon, retningslinjer, diskursanalyse, svensk kirke

Background: Stratified Medicine (SM) is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. Methodological standards and guidelines exist for economic evaluations in clinical pharmacology and are an important component for health technology assessments (HTAs) in many countries. However, these guidelines have initially been developed for traditional pharmaceuticals and not for complex interventions with multiple components. This raises the issue as to whether these guidelines are adequate to SM interventions or whether new specific guidance and methodology is needed to avoid inconsistencies and contradictory findings when assessing economic value in SM.Objective: This article describes specific methodological challenges when conducting health economic (HE) evaluations for SM interventions and outlines potential modifications necessary to existing evaluation guidelines/principles that would promote consistent economic evaluations for SM.Results/Conclusions: Specific methodological aspects for SM comprise considerations on the choice of comparator, measuring effectiveness and outcomes, appropriate modeling structure and the scope of sensitivity analyses. Although current HE methodology can be applied for SM, greater complexity requires further methodology development and modifications in the guidelines.

In early 2008, the UN Department of Peacekeeping Operations (DPKO) released a hundred page document entitled: “United Nations Peacekeeping Operations: Principles and Guidelines”. The Peacekeeping Best Practices Section of the UN DPKO and the Training for Peace Programme at NUPI, with support from the Royal Norwegian Ministry of Foreign Affairs, organized a seminar in Oslo, on 14-15 May 2008, with the aim of providing a small but globally representative group of researchers the opportunity to discuss the new doctrine with the drafters. The aim of the seminar was to create an opportunity for the research community to engage the authors of the doctrine, to facilitate a dialogue on the key issues contained in the doctrine, and to stimulate further knowledge development about the future of UN peacekeeping operations. Utenriksdepartementet

This article represents the update of « Recommendations for stroke management» , first published in this Journal in 2001. The recommendations are stiching to the Recomendations of three European societies which are represented in the European Stroke Initiative: the European Stroke Council, the European Neurological Society and the European Federation of Neurological Societies, and are in concordance with the Guidelines of American Heart Association/American Stroke Association Council on Stroke affirmed by American Academy of Neurology. The recommendations are endorsed by Croatian Society for Neurovascular Disorders of Croatian Medical Association, Croatian Stroke Society, University Department of Neurology, University Hospital “ Sestre milosrdnice” , which is The Reference Center for Neurovascular Disorders of Croatian Ministry of Health.

Årsliste 2002 Konsentrasjon av kvikksølv i stor gjedde og stor abbor fra innsjøer i sydlige deler av Hedmark var høy (opp mot 4 mg Hg/kg). Dette er blant de høyeste verdier som er funnet i fisk fra norske innsjøer som kun mottar kvikksølvforurensninger fra atmosfæren. Det var særlig rovfisk som gjedde, lake, stor abbor og stor ørret som hadde konsentrasjoner over de grenser som EU, inkl. EØS-land, har satt for omsetning av fisk til konsum (0,5 mg/kg). Ørret, abbor, røye og sik som lever av bunndyr eller dyreplankton hadde lave verdier. Når fisk i en bestand går et trinn opp i næringskjeden (f.eks. fra bunndyrspiser til fiskespiser) øker konsentrasjonen av kvikksølv 3,5 ganger. En tilsvarende økning, uten vesentlig endring i dietten, oppnås først etter 10 års alder. Derfor har gammel rovfisk de høyeste konsentrasjonene av kvikksølv. Ei "standard gjedde" (5 år, ca. 1 kg), som ikke endret trofisk posisjon med alderen, hadde 4 ganger høyere konsentrasjoner i sydlige deler av fylket enn de nordlige. Det samme mønsteret hadde 5-årig, 150 g abbor. Dette skyldes antagelig høyere konsentrasjoner av metylkvikksølv i innsjøene i sydlige deler. Fiskespisende storørret oversteg grensa for omsetning i nordlige deler, mens nivået i småvokste bestander av bunndyr-spisende ørret i sydlige deler var lavere. For storørreten var effekten av høyere posisjon i næringskjeden og noe høyere alder, større enn den gunstige effekten av lavere metylkvikksølv konsentrasjoner i vannet. Omsetningsgrensa ble passert i gjedde ved ca. 4 kg i nord og ca. 1 kg i syd. Store individer av gjedde, abbor og lake er ikke egnet som mat i sydlige deler av Hedmark. For de som spiser mye fisk anbefaler vi å følge kostholdsrådene gitt av Statens Næringsmiddeltilsyn. Særlig gjelder dette for gjedde, abbor og lake fra innsjøer i sydlige deler der omsetningsgrensa kan overskrides allerede i ung fisk. INTERREG-prosjektet "Fisketurisme i grenseland" gjennom Hedmark Reiseliv BA, og kommunene Engerdal, Trysil, Eidskog og Nord Odal

Årsliste 2002 Vi har undersøkt kvikksølv i fisk fra Fundin, Elgsjøen, Gjersjøen, Fjellsjøen og Forelsjøen. Konsentrasjonene av kvikksølv i ørret fra alle innsjøene var lave (< 0,12 mg/kg v.v). De var klart lavere enn den grensen som EU og Statens Næringsmiddeltilsyn har satt for fisk som skal omsettes (0,5 mg/kg v.v), og de er så lave at det heller ikke er nødvendig med kostholdsråd for de som spiser mye fisk. Hovedårsaken til de lave kvikksølvnivåene i fisk er at netto-produksjonen av metylkvikksølv er lav i de klare og kalde fjellsjøene i Nord-Østerdalen. Variasjonen i konsentrasjonene i bestandene var i all hovedsak bestemt av fiskens alder i Fundin, Fjellsjøen og Elgsjøen, mens trofisk posisjon var viktigst i Gjersjøen og Forelsjøen. Dette viser at ørret i Gjersjøen og Forelsjøen er delvis fiskespisere. Konsentrasjonene av kvikksølv i ørekyt økte med størrelsen (lengden), og de største individene hadde verdier på nivå med de eldste ørretene. Klimaendringene har ikke endret produksjonsesongens lengde i innsjøene de siste 30 årene og de har derfor sannsynligvis heller ikke bidratt til endrede vekstvilkår for næringsdyr og fisk i denne perioden. Analysene av stabile isotoper indikerte at i den betydelig regulerte Fundin var næringskjedens karbonkilder i hovedsak planktonalger og detritus tilført fra nedbørfeltet, mens i den mindre regulerte Elgsjøen hadde også strandnære primærprodusenter en betydning. I de andre innsjøene var karbonkildene dominert av fastsittende alger fra grunne deler av sjøene. Marflo var et viktig næringsdyr for produksjon av fiskekjøtt. Hedmark fylkeskommune Glommen og Laagens Brukseierforening Os kommune Tolga kommune Folldal kommune