A Pharmacist’s Role in the Prevention of Depression in Patients with Chronic Diseases

Depression is one of the leading disability factors worldwide, causing a loss of workability as well as economic and financial burdens. Depression walks hand-in-hand with different chronic illnesses like cardiovascular, endocrine, neurodegenerative, rheumatological, or oncological, due to which it can be overlooked and stay undiagnosed for a long time. The pharmacist’s role in finding and preventing depression in patients that are at risk, suffering from concomitant chronic diseases, has been researched. Patients were screened with the help of a specifically made questionnaire that gathers information on patients’ socio-demographic characteristics, as well as the PHQ-9, which focuses on finding how big the risk of depression is. The questionnaires were filled out in pharmacies in Sliven and Yambol from March to April 2022 and included 74 patients with chronic diseases. Results from the screening show that every chronically ill person who answered the questionnaire is at risk for depression, with 34% having moderately severe depression, 30% being severely depressed, 27% being moderately depressed, and only 9% showing slight signs of depression. This reinforces previous medical research indicating individuals suffering chronic diseases are more prone to developing depression, which might go unnoticed due to their primary illness. Implementing screening programs in pharmacies and making them available around the country can be an effective tool for the early identification of depressive symptoms in patients with chronic diseases.

Legal personality of artificial intelligence under international law

To be able to offer a deeper understanding of the topic this work will first examine the concept of legal personality, its meaning and application in the legal framework of international law over the years. Without claiming advanced technological knowledge in scientific areas like robotics and engineering the paper will then try to present some basic overview over the latest developments concerning Artificial Intelligence, such as quantum computing and emotional intelligence. Consequently some suggestions about possibilities of connecting these two topics will be made. The questions introduced will engage with the nature and different forms of legal personhood, its connection to intelligence, autonomy and/or consciousness. This paper aims to create a more practical and not a general, hypothetical idea of how an AI agent could be granted international legal personality and what could be the possible effects of that (for example rights and obligations). For this purpose it will focus on the recognised subjects of international law and examine on their example an AI agent as a possible future actor in international legal relationships. Subject of reference will be international law and recent developments in EU law, such as the European Parliament initiative to regulate Artificial Intelligence as well as some regulations and “visions” of national legislation, for example Estonia and China. Consequently the dangers of granting legal personhood to AI agents will be presented and discussed. The arguments against the creation of a “technical veil” will be examined closely. The work will then refer to possible advantages and positive aspects of an AI’s legal personhood under international law. In the final chapter a conclusion and some recommendation will be made

Awareness and Attitudes of Patients with Osteoporosis and Bone Density Disorders Regarding Treatment and Prevention of the Disease

Introduction Osteoporosis is a socially significant disease with a serious burden on society that, despite advances in medicine, remains late-diagnosed and difficult to treat. Its treatment is a long and challenging process and long-term commitment to therapy is hard to achieve.Aim: The purpose of this article is to study and analyse the awareness and attitudes of osteoporosis patients and those at risk about disease diagnosis, prevention and treatment.Methods and methodology: During the months of April and May 2022, an anonymous online survey was conducted among patients with osteoporosis and people with risk factors. The questionnaire for patients and persons at risk included questions about the patient’s demographic characteristics and the attitudes of the patient and a questionnaire for determining the level of adherence to therapy.Results: Patients are well aware of the risk factors for the disease and try to lead a healthy lifestyle. Adherence to therapy was found to be suboptimal in individuals diagnosed with osteoporosis and undertaking treatment. The following are the primary reasons: prominent ADRs; inconvenience when taking medication; forgetting a dose; discontinuing medications; fear of ADRs; lack of motivation. Financial problems are also highlighted, both throughout the treatment process and for prevention and diagnostics, mainly due to the lack of free tests.Conclusion: Supporting early disease detection, patient education, and compliance and adherence to therapy are critical to treatment effectiveness. It is necessary to build a system to improve the health culture of the population through the implementation of complex health prevention programs as well as screening for early diagnosis of patients with osteoporosis and people at risk

Financial income planning at the community pharmacy based on financial flows and morbidity data

Introduction: Financial planning is one of the main ways to manage a company. As a health facility, the pharmacy should combine planning with necessity of medicines nomenclature, and availability of medicines service and care.One of the most important parameters in the planning process id forecasting the financial income of the entity. Its aim is to ensure the proper tracking of future cash flow, based on only income parameters of the community pharmacy, without taking into account the specifics of the work environment.Materials and Methods: All the provided data has been collected from a pharmacy in the period 2016 to 2020. The financial income of the pharmacy has been comparted to acute infectious diseases morbidity for the same period.We used descriptive statistics for calculating the share distribution of indicators, graphic and tabular analysis. The charts are built in Excel.Results: In the months January – April, for the period 2016 – 2019, there are opportunities to apply the economic methods for financial planning of the incomes. The financial parameters for 2020 can’t be predicted by any of the financial methods, because of the frequency changes and the proceeds for short amount of time. There are ways to predict the financial income for all of the analyzed periods, except 2020, because of the situation with Covid.While tracking the number of sick patients and comparing those figures to the movement in the cash flow, an observation could be made that there is no apparent dependency between both of these parameter

Allergic rhinits and its impact on asthma - aria. Control and prevention of respiratory allergies in pharmacy practice

Epidemiological studies on respiratory allergies have shown that allergic rhinitis (AR) and bronchial asthma (BA) often coexist in the same patient. The premise `one respiratory system, one disease` marks a change in diagnostic and therapeutic treatment of respiratory allergies. Allergic Rhinits and Its Impact on Asthma-ARIA Initiative at WHO aims to spread, educate and implement evidence-based management of allergic rhinitis as a risk factor for development of asthma worldwide. This study reviews current concepts and trends in the management of respiratory allergies in compliance with the recommendations of ARIA

Pharmaceutical care for patients with postoperative history

Surgical wounds are the most commonly treated wounds in today's global medical practice. Often, patients are not aware of exactly how they should treat their post-surgical wounds at home. A model for pharmaceutical care of patients with postoperative wounds was developed on the basis of literary sources and guidelines. The Life Value (LV) of the patients was evaluated using the generic SF12 v2 instrument.  SF12 v2 was administered to consulted patients and  not consulted patients in a control group. The results showed an improvement in all measured LV scores within the group of the consulted patients. Pharmacists are the most accessible healthcare professionals and with their knowledge and competencies, they can contribute to the process

Function and morphology in macular retinoschisis associated with optic disc pit in a child before and after its spontaneous resolution

Optic disc pit (ODP) is a rare congenital defect within the optic nerve head. Macula elevation associated with ODP develops in 75-93% of the adult patients. Macular involvement in children with optic disc pit is rare, and only a few cases have been published to date. In the present case, we have observed morphology and function of the central retina in a child with ODP-associated macular detachment and following its spontaneous resolution. An 8-year-old white boy diagnosed with a macular detachment in an eye with an ODP. Optical coherent tomography (OCT) and multifocal electroretinography (mfERG), as well as visual acuity and visual field, were performed in the follow-up of the unilateral schisis—like retinal detachment. A large retinoschisis associated with ODP in a child showed a tendency to spontaneously resolve at 3months, which was confirmed on OCT. At this time, an mfERG revealed markedly reduced responses. Despite morphologic reattachment at follow-up and improvement in visual acuity, increased mfERG responses were still not the same as in the fellow healthy eye. In contrast to the OCT which is very helpful to assess the extent of the neurosensory detachment, the mfERG offers an additional tool for follow-up of retinal function in this disorder. The good visual outcome in our patient shows that in the presence of residual retinal function on mfERG and in the absence of further lesions on OCT, follow-up is a valid option in children with an ODP-associated macular detachmen

Specialized Electronic Tracking and Analysis System for the medicinal products (SETASMP) - challenges and attitudes for community pharmacists

The specialized electronic system for tracking and analyzing medicines / SETASMP/, included in The Positive Drug List / PDL/, is used to collect information for delivered/ sold medicines in the country. The main purpose is to provide people’s access to medicines and to prevent their shortage and lack.Aim: To track the awareness, attitudes, and the need of additional training to work with SETASMP among pharmacists in community pharmacy, in the process of introduction to practice.Materials and methods: An anonymous survey was conducted on the territory of Varna, among pharmacists in community pharmacy. Descriptive statistics, graphical analysis of results and non-parametric methods for hypothesis check are applied.Results: There is uncertainty between the respondents, connected with the technical performance in the daily work with the system. At the time of the survey, there is a lack of positive attitude of the pharmacists towards the benefit of SETASMP and the set goals. There is a desire for additional courses or training for pharmacists, related to practical application. No statistical significance was found between the experience of the pharmacist and the need for clarification and training for working with SETASMP

Pharmacists’ attitudes and preparedness prior to introducing the system of electronic prescriptions in Bulgaria

INTRODUCTION: By introducing electronic prescribing in December 2020, Bulgaria took a major step towards the digitalization of healthcare in the country. The regulatory framework was swiftly changed which resulted in little time for testing and implementing the e-prescription system.AIM: This study aims to explore the awareness, preparedness and attitudes of pharmacists towards the innovation prior to its mandatory launch.МATERIALS AND METHODS: A sociological method was used: a face-to-face anonymous survey among pharmacists in the region of Varna, utilizing paper questionnaires.RESULTS: The results showed the respondents’ positive attitudes and well equipped pharmacies. However, a number of challenges were also identified, such as insufficient information and trainings, a short trial period leading to concerns and lack of confidence in community pharmacists.CONCLUSION: The functioning e-healthcare system is a priority goal of healthcare development in Bulgaria. The introduction of the electronic prescription is an important step for the future digital transition in our country. Despite pharmacists’ positive attitudes towards the innovations and the expectations that it would enhance medical care, we should note that at the start of the project the focus was more on technological performance and not on staff training.  Trainings, time and experience are needed to build an effective functioning system in support of professionals and society

Assessment of health related quality of life in paediatric patients with asthma - methods and disease determinants

The purpose of this article is to provide an overview of the methods for assessing Health Related Quality of Life (HRQOL) in children with a focus on both the instruments available for measuring HRQOL in pediatric patients with asthma and the disease determinants. Adolescents with bronchial asthma often have substantially lower HRQOL. Frequent exacerbations impair children`s normal daily routines such as school activities, play and sleep. The factors affecting children`s HRQOL largely vary from those affecting the HRQOL in adults. Chronic diseases in childhood are a risk factor associated with serious psychosocial consequences - low self-esteem, behavioral problems, and difficulties in learning. Assessment of HRQOL can be successfully integrated in achieving the primary aim of the disease management - to maintain health as a state of complete physical, mental and social well-being