The effect of co-trimoxazole on serum potassium concentration: safety evaluation of a randomized controlled trial

AIMS: Co-trimoxazole maintains a well-established role in the treatment of Pneumocystis jirovecii and Toxoplasma gondii, as well as urinary tract infections. Observational studies report hyperkalemia associated with co-trimoxazole which may stem from an amiloride-like potassium sparing effect. Our study reports on changes in serum potassium on patients without acute infections, and the influence of concomitant anti-kaliuretic drugs on this effect.  METHODS: Post-hoc analysis of a randomised controlled trial in patients with interstitial lung disease who were assigned to placebo or 960 mg twice daily co-trimoxazole. Serum potassium and creatinine were measured at baseline, six weeks, 6, 9 and 12 months. Primary outcome was difference in mean serum potassium concentrations between co-trimoxazole and placebo at six weeks.  RESULTS: Mean serum potassiums were similar at baseline, 4.24 (±0.44) mmol/L in the 87 co-trimoxazole group participants and 4.25 (±0.39) mmol/L in the 83 control participants. Co-trimoxazole significantly increased mean serum potassium at 6 weeks, difference between means compared to placebo of 0.21 mmol/L (95% Confidence Intervals [CI] 0.09-0.34; p = 0.001). This significant increase in serum potassium was detectable even after exclusion of patients on anti-kaliuretic drugs, difference between means for co-trimoxazole compared to placebo 0.23 mmol/L (95% CI 0.09-0.38, p = 0.002). There were 5/87 (5.7%) patients on co-trimoxazole whose serum potassium reached concentrations ≥5.5 mmol/L during the study period.  CONCLUSIONS: Co-trimoxazole significantly increases serum potassium concentration, even in participants not using anti-kaliuretic drugs. Whilst the magnitude of increase is often minor, a small proportion in our outpatient cohort developed hyperkalaemia of clinical importance

FACTORS INFLUENCING THE OCCURRENCE OF ANXIETY LEVELS IN CHILDHOOD AND COPING STRATEGIES

Anxiety disorders in childhood constitute a serious phenomenon nowadays, as they impede academic and social functioning, such as school performance, social-emotional development and interaction with the family environment. In order to minimize or overcome abnormal stress, children may develop several coping strategies. The current study examined the occurrence of anxiety disorders in childhood, as well as the use of coping strategies in relation to various demographic data. 461 students of 5th and 6th Primary School Grade participated in the study which was conducted in urban and suburban areas of Greece. Two scales were used: a) The Spence’s Anxiety Scale (SCAS), which examines anxiety disorders in childhood and b) Brodzinsky’s Coping Scale for Children and Youth, which detects stress coping strategies. The results showed that gender and the educational level of the mother were significantly related to both of these concepts, whilst age was related to anxiety disorders.   Article visualizations

THUCYDIDES AND BREXIT: PARALLELS AND FUNCTIONAL PRINCIPLES

When the majority of UK citizens voted to exit the EU almost nobody could tell the main impact of the most important event in global politics in the beginning of the 21st century. Two years after the referendum none is sure what exactly Brexit means, especially on the relationship the UK will have with EU in the future. The UK invoked the Article 50 of the Lisbon Treaty and until 1 January 2021 there will be a transition period which is necessary for both parts to prepare and strike their own new trade deals. What lessons can a modern political thought learn from antiquity? According to Thucydides, the inventor of political science, and theorist of political and financial autonomy, there might be a new set of ways of thinking and values, for both UK’s major political parties. Through his political view of the cultural and institutional explanation of the democratic Athenian paradigm we could find some of the fundamentals of the first known democracy in the world and transfer them to our times. How could an observer conceive the risks and the opportunities of the future UK role after Brexit putting Thucydides’ theory into praxis? What is the relationship between modern UK politics decisions with the strategies of Pericles, Cleon, and Alcibiades, during the Peloponnesian War? Article visualizations

REVISITING THE ROLE OF VISUAL PERCEPTION ON THE READING SKILLS OF STUDENTS WITH LEARNING DISABILITIES: SOME EDUCATIONAL PLANNING CHALLENGES

Students with learning disabilities often struggle with reading skill acquisition, due to the nature and complexity of the reading process (Brown, 2009). In addition, it has been documented that students experiencing reading disabilities, have problems with the basic cognitive skills of visual perception (Stokes, Matthen & Biggs, 2015). The purpose of the present study was to investigate the role of the cognitive parameters of visual perception, assessed by the Developmental Test of Visual Perception-2nd Edition (DTVP-2, Hammill, Pearson & Voress, 1993) on the reading ability of students with learning disabilities, assessed by Test A (Panteliadou & Antoniou, 2007, Standardized test for reading disabilities in Greek). The sample consisted of 73 children (N=73) attending the 4th and 5th grade of Primary school, diagnosed with learning disability in reading. The results indicated that visual perception was a predictive factor for reading performance. Implications of these findings are discussed in terms of developing early detection programmes as well as effective educational interventions for pre-school and primary school students.  Article visualizations

A Qualitative Study Investigating Gender Differences in Primary Work Stressors and Levels of Job Satisfaction in Greek Junior Hospital Doctors

Primary work stressors and job satisfaction/dissatisfaction in Greek Junior Hospital Doctors (JHDs) are investigated to identify similarities and differences in the reports obtained from male and female hospital doctors. Participants in the study included 32 male and 28 female Greek hospital doctors who provided information through semi-structured, in-depth interviews. The findings revealed that a majority of Greek JHDs considered their profession very stressful, and that various differences were identified between male and female JHDs, with regard to perceived stress and satisfaction. The study has implications for the possible introduction of in-house stress management training programmes, both at a generic, and gender specific level. Future research aimed at increasing the individuals’ coping mechanism s, and identifying environmental sources of stress are recommended

Discussing Museum Learning Opportunities For Children With Disabilities

The chapter is part of a book uniting various fields in a multidisciplinary venture drawing on academics and clinicians from medicine, psychology and educational sciences. The interdisciplinary approach has assembled medical, educational and health specialists with scholarly contributions from many different countries and institutes. A plethora of scientific studies have shown that in order for children to maintain good health, both physically and psychologically, families, teachers, physicians and psychologists have to work closely together. Few scientific books address the wide spectrum of challenges required to resolve such developmental issues: for example, when families migrate to unfamiliar countries, the influence of grandparents in childrearing practises, impact of having a disabled children on family structures and social interactions, socioeconomic factors which impose limits on healthy growth, and families which have to cope with debilitating emotional crises whether originating from the parents or their offspring. This collection of essays is an attempt to bridge theoretical and research concepts and findings with clinical practise, adopting an interdisciplinary and cross-cultural perspective. It reveals determinants and other factors which are implicated in the effectiveness of health promotion and therapeutic interventions, as well as identifying reliable diagnostic and health programs and / or enhance learning and teaching programmes

Royal Holloway, University of London and the Afghanistan and Central Asian Association : new partnerships and challenges during Covid-19 in the clinical legal world

In January 2020, Royal Holloway, University of London set up a new Legal Advice Centre offering free legal advice to the local community, including building upon key partnerships to address unmet legal needs. This practice-paper discusses Royal Holloway’s Legal Advice Centre (LAC) and the Afghanistan and Central Asian Association’s (ACCA) collaborative approach and response to the global pandemic since March 2020. It will highlight the unprecedented challenges that they have faced, and their efforts to overcome them. In addition, the paper will discuss their research project, which provides Royal Holloway’s student volunteers with the opportunity to gain unique multidisciplinary understandings of the effect of the pandemic in Afghanistan, and a chance to put their legal skills into practice by producing legal information to support local users of both Royal Holloway’s LAC and the Law Clinic at the ACAA. This practice-paper includes a road map to Royal Holloway’s long-term goal, namely, to work with ACAA to research the legal vulnerabilities of women in Afghanistan, with the aid of a research grant supporting international collaboration. Recent reports highlight that lockdown and quarantine measures will have a long-term impact on the basic rights and freedoms of Afghan women, who already face hardship

THUCYDIDES AND BREXIT: PARALLELS AND FUNCTIONAL PRINCIPLES

When the majority of UK citizens voted to exit the EU almost nobody could tell the main impact of the most important event in global politics in the beginning of the 21stcentury. Two years after the referendum none is sure what exactly Brexit means, especially on the relationship the UK will have with EU in the future. The UK invoked the Article 50 of the Lisbon Treaty and until 1 January 2021 there will be a transition period which is necessary for both parts to prepare and strike their own new trade deals. What lessons can a modern political thought learn from antiquity? According to Thucydides, the inventor of political science, and theorist of political and financial autonomy, there might be a new set of ways of thinking and values, for both UK’s major political parties. Through his political view of the cultural and institutional explanation of the democratic Athenian paradigm we could find some of the fundamentals of the first known democracy in the world and transfer them to our times. How could an observer conceive the risks and the opportunities of the future UK role after Brexit putting Thucydides’ theory into praxis? What is the relationship between modern UK politics decisions with the strategies of Pericles, Cleon, and Alcibiades, during the Peloponnesian War

Letting Nietzsche inside schools? Educational potential and an acknowledgement of the optimism of his philosophy

The aim of this article is to identify the educational interest of Nietzsche’s funda-mental philosophical principles. To this end, Nietzsche’s work “The Gay Science”and corresponding references from other fragments of his corpus have been aggre-gated for the needs of this goal. An analysis of the book’s major propositions indi-cates an epistemological approach to educational matters, based on knowledge’s ref-utability and its validation through experimentation. Other parts of this work, stressout the incompatibility of Nietzsche’s philosophy with a democratic education. Hisphilosophical concepts of social order and destiny’s accomplishment are presentedin favour of this claim. Finally, the most unique propositions in The Gay Science areunveiled and their potential incorporation into the educational process is proposed.In particular, the values of appearance and fallacy emerge, illuminating the optimis-tic side of his philosophy. From an educational perspective, these values recommendlimiting excess rationalism in classrooms and maintaining students’ learning interestby focusing on their emotional need