PREGNANCY IN THE ERA OF COVID-19. A MULTIPLE BIO-PSYCHOLOGICAL CHALLENGE

Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks, like current COVID-19 Pandemic, given the fact that consequences of a period of intense stress and anxiety during pregnancy, as spontaneous preterm labor and psychiatric postpartum disorders, are already known. As fetal brain faces neurodevelopmental challenges in a cytotoxic environment of possible inflammation and increased catecholamine levels, mother also has to cope with a hostile environment of uncertainty, rich in bio-social threats that can be devastating for both maternal and fetal health, as well as for Public Health

PREGNANCY IN THE ERA OF COVID-19. A MULTIPLE BIO-PSYCHOLOGICAL CHALLENGE

Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks, like current COVID-19 Pandemic, given the fact that consequences of a period of intense stress and anxiety during pregnancy, as spontaneous preterm labor and psychiatric postpartum disorders, are already known. As fetal brain faces neurodevelopmental challenges in a cytotoxic environment of possible inflammation and increased catecholamine levels, mother also has to cope with a hostile environment of uncertainty, rich in bio-social threats that can be devastating for both maternal and fetal health, as well as for Public Health

FROM ANCIENT HATEI TO HUBRIS SYNDROME IN SARS-COV-2 HEALTH CRISIS MANAGEMENT

COVID-19 pandemic has highlighted, in a very inflictive way, the need for less hubristic political leadership, revealing the menaces of arrogant decision making of those in power. Hubris Syndrome is associated with power and it is more likely to manifest itself the longer the person exercises power and the greater the power he exercises, while our modern times ‘Hatei’ (the goddess that blinded ancient leaders committing hubris) may be called positive illusion enhancement due to prolonged exposure to power. Hatei might also blurs the decision makers’ vision through a hormonal pathway, since hormones seem to affect risk taking, as well as through serotonin, which is also involved in the regulation of decision making and processing punishment-related information, deficiencies of which could be relevant to Hubris Syndrome. Other findings may provide information regarding the neuro-anatomical ‘location’ of Hatei, since fronto-striatal and limbic-striatal dopaminergic pathways have been identified as important regulators of impulsive behaviors. Therefore we might consider choosing political leaders and state officials whose less illusionary character is more likely to become non-flammable against the fire of hubris, in periods of crisis like the current COVID-19 Pandemic. Especially in SARS-CoV-2 era we should bring whatever scientific data there may be to tackle the intoxicating effects of power, keeping also in mind that there are no anti-hubris medication and that it is unlikely to have this social construct improved via pharmacology. Before establishing constitutional procedures for the early diagnosis of hubris as well as for the subsequent constrain of our leaders’ power, we should focus on the criteria by which we elect them and maybe include the pre-existence of depressive diathesis among those criteria, especially if we consider that those leaders might have to handle tough situations like the COVID-19 pandemic outbreak, that require increased empathy in decision making

A Consistent Implementation of IFRS 13 and IAS 36 for Non-current Assets

There is much debate for both the academic community and accounting professionals with respect to the use of fair value and cost accounting, as well as the application of impairment to current and non-current assets. Fair value and impairment are two related concepts, the reason being that in order to proceed with the latter, the current market price of an asset should first be measured. IAS 36 came into force to stipulate that no asset should be valued above its current actual value. Assets’ revaluation affects not only the companies’ outcome but also the applied depreciation method, which must be adjusted accordingly to the new data. Assets that cannot be measured to their fair value, in accordance with the IAS instructions, are grouped to form identifiable units within the company that was able to generate cash inflows and be tested for impairment as a whole. In this article, we focused on presenting a methodology from a technical approach on these issues, whilst at the same time remaining compatible with the principles of both accounting and finance. Real-life data from existing companies have been used not only for the valuation of the same following their transformation into cash-generated units, but also for non-current assets by controlling both the impairment and the depreciation process. We use cash flow generation models through the business plan process and apply certainty and uncertainty techniques such as sensitivity analysis and Monte Carlo simulation. After having reviewed the estimations and bearing in mind the structure of the model, we have concluded that specific parameters are affecting the fair value measurement on non-current assets. The value of this article is to develop a methodology that can be easily applied to different companies and is compatible with the spirit and provisions of both the international accounting standards as well as those of financial accounting. Keywords: FVA, cost accounting, finance, impairment, O

GALA:an international multicentre randomised trial comparing general anaesthesia versus local anaesthesia for carotid surgery

BACKGROUND: Patients who have severe narrowing at or near the origin of the internal carotid artery as a result of atherosclerosis have a high risk of ischaemic stroke ipsilateral to the arterial lesion. Previous trials have shown that carotid endarterectomy improves long-term outcomes, particularly when performed soon after a prior transient ischaemic attack or mild ischaemic stroke. However, complications may occur during or soon after surgery, the most serious of which is stroke, which can be fatal. It has been suggested that performing the operation under local anaesthesia, rather than general anaesthesia, may be safer. Therefore, a prospective, randomised trial of local versus general anaesthesia for carotid endarterectomy was proposed to determine whether type of anaesthesia influences peri-operative morbidity and mortality, quality of life and longer term outcome in terms of stroke-free survival. METHODS/DESIGN: A two-arm, parallel group, multicentre randomised controlled trial with a recruitment target of 5000 patients. For entry into the study, in the opinion of the responsible clinician, the patient requiring an endarterectomy must be suitable for either local or general anaesthesia, and have no clear indication for either type. All patients with symptomatic or asymptomatic internal carotid stenosis for whom open surgery is advised are eligible. There is no upper age limit. Exclusion criteria are: no informed consent; definite preference for local or general anaesthetic by the clinician or patient; patient unlikely to be able to co-operate with awake testing during local anaesthesia; patient requiring simultaneous bilateral carotid endarterectomy; carotid endarterectomy combined with another operation such as coronary bypass surgery; and, the patient has been randomised into the trial previously. Patients are randomised to local or general anaesthesia by the central trial office. The primary outcome is the proportion of patients alive, stroke free (including retinal infarction) and without myocardial infarction 30 days post-surgery. Secondary outcomes include the proportion of patients alive and stroke free at one year; health related quality of life at 30 days; surgical adverse events, re-operation and re-admission rates; the relative cost of the two methods of anaesthesia; length of stay and intensive and high dependency bed occupancy. TRIAL REGISTRATION: Current Controlled Trials ISRCTN00525237