Advances in the treatment of prolactinomas

Prolactinomas account for approximately 40% of all pituitary adenomas and are an important cause of hypogonadism and infertility. The ultimate goal of therapy for prolactinomas is restoration or achievement of eugonadism through the normalization of hyperprolactinemia and control of tumor mass. Medical therapy with dopamine agonists is highly effective in the majority of cases and represents the mainstay of therapy. Recent data indicating successful withdrawal of these agents in a subset of patients challenge the previously held concept that medical therapy is a lifelong requirement. Complicated situations, such as those encountered in resistance to dopamine agonists, pregnancy, and giant or malignant prolactinomas, may require multimodal therapy involving surgery, radiotherapy, or both. Progress in elucidating the mechanisms underlying the pathogenesis of prolactinomas may enable future development of novel molecular therapies for treatment-resistant cases. This review provides a critical analysis of the efficacy and safety of the various modes of therapy available for the treatment of patients with prolactinomas with an emphasis on challenging situations, a discussion of the data regarding withdrawal of medical therapy, and a foreshadowing of novel approaches to therapy that may become available in the future

Assessment of the practices and experiences on mentorship and mentoring of nurse educators in the school of nursing, University of Namibia

Thesis submitted in fulfilment of the requirements for the degree of master in nursing scienceMentoring in nursing academia is receiving more attention as many senior academics are retiring and new nurse educators are joining nursing education. Mentoring is an important tool for clinical practice, nursing education, administration, and research that contributes to the competencies of many new nurse educators, who are recruited with a clinical background and little or no experience in an academic environment. It is expected for an expert nurse to become a novice in a new environment or role and needs mentoring to become an expert nurse educator. Despite the emphasis on the mentoring relationship among nursing academics, there is no established standard practice and nurse educators experience difficulty in their new role in the absence of mentoring. This study aimed to assess and describe the practices and experiences of nurse educators in the School of Nursing1 at the University of Namibia on mentorship and mentoring. The study adopted a comparative descriptive convergent parallel mixed method where quantitative and qualitative data were collected at the same time, analyzed separately, and merging occurred by comparing the two data sets and representing the merging results in a narrative discussion. The target population was nurse educators who were registered nurses by profession, teaching at the four campuses of the University of Namibia where the School of Nursing was established among the 12 campuses. The researcher opted for the same individuals in both quantitative and qualitative objectives that help to minimize threats during data collection and allowed the results to be compared. Likewise, both strands focused on the same study concepts of mentorship and mentoring to allow interpretation and comparison. For objective one, which was quantitative and focused on the practices, due to small population of nurse educators employed in the School of Nursing the total target population of 74 was included in the study as it was small and feasible for the researcher to contact everyone using a self-administered questionnaire. The target population was stratified as per campus and various teaching ranks. The mentees were nurse educators who were registered nurses by profession who had worked for less than five years at the School of Nursing while mentors should have worked for five years or more at the same school. The response rate for the quantitative strand was 82% (n= 40 questionnaires received out of 49 for the mentees and 96 % for the mentors (n=24 questionnaires received out of 25). Purposive sampling was done for objective two, which was qualitative to select the participants who participated in the semi-structured interviews at each campus as per respective study groups. For the qualitative strand, data saturation was determined per campus due to the different settings and heterogenous teaching ranks that had different experiences. A total of 36 mentees and 16 mentors participated across the different campuses. The interpretation of data sets shows convergent and discordant results in the quantitative data between the mentees and mentors in mentorship and mentoring practices. Likewise, similar four main themes emerged from both groups, with some variants of unique sub-themes across the groups. The quantitative results show that mentees and mentors agreed on mentorship practices but had discordant results on mentoring aspects as mentees disagreed with mentors’ positive ratings. Variables with significant p-values were identified and compared first within each group of mentees and mentors first and then finally with the finding from the qualitative data set. Equally, the qualitative results also had convergent and discordant results between mentees and mentors as well within each group supported by various sub-themes. The common approach of primary data analysis integration procedure was used. The representation of merging integration results was done by a side-by-side comparison of significant p- values of quantitative and main themes and sub-themes of the qualitative results through a narrative discussion. The discussion narrated how qualitative themes and sub-themes either confirm, disconfirm, or complemented the quantitative results or vice versa. This study concluded that mentoring and mentorship practices were described differently by mentors and mentees as well that positive and negative experiences emerged in both groups. Recommendations included the facilitation of good relationships as well as establishing trust, respect, and healthy communication between mentors and mentees. It was also recommended for the School of Nursing to have a school-specific orientation for nurse educators and develop a formal mentoring programme. Finally, there was a need to revisit the workload of nurse educators and develop a guideline for virtual mentoring of mentee

Assignment of punishment for the totality of crimes in Ukrainian criminal law

Попій, А. С. Призначення покарання за сукупністю злочинів в кримінальному праві України : автореф. дис. ... канд. юрид. наук (д-ра філософіі) : 12.00.08 / Артем Сергійович Попій; МВС України, Харк. нац. ун-т внутр. справ. - Харків, 2020. - 16 с.Дисертацію присвячено кримінально-правовому аналізу порядку призначення покарання за сукупності злочинів. Встановлюється належність існуючих приписів щодо цієї проблематики до спеціальних засад призначення покарання. Аналізується практика призначення покарання за сукупністю злочинів як підґрунтя до науково-теоретичних висновків. Досліджено ґенезу законодавства про кримінальну відповідальність щодо призначення покарання за сукупністю злочинів, особливості регулювання такої діяльності у законодавстві зарубіжних країн. Здійснено аналіз субінституту спеціальних засад призначення покарання. Виділено основні наукові підходи до наукового опису цього субінституту. Окреслено типовий портрет особи, засудженої за вчинення сукупності злочинів. Проведено наукову розвідку застосування особливих правил призначення покарання за сукупністю злочинів: шляхом поглинення більш суворим покаранням менш суворого та шляхом повного або часткового складання покарань.The dissertation is devoted to the criminal law analysis of the procedure for imposing penalties for a set of crimes. It is proved that in the modern criminal law at the monographic level, the problem of sentencing on the basis of a set of crimes has remained practically without worthy study and reflection. By means of application of historical and legal method of scientific search the history of formation and further development of the subinstituent of assignment of punishment on the totality of crimes is analyzed. A study of the laws on criminal liability of foreign countries has shown that in the most countries of the world there is a procedure for the legal regulation of the mandatory increasing in the measure of punishment for the perpetrator of the acts constituting a set of crimes, which corresponds to the procedure established in the current Ukrainian Criminal Code. The main scientific and theoretical approach to the definition of «totality of offences» like the substantive legal basis for the imposition of punishment, if any, is being studied. During the course of analysing the subject matter of the study, it was established that the existence of a set of offences is a necessary and sufficient basis for establishing special rules for the imposition of punishment. The procedure of application of general rules of punishment in the case of a set of crimes is analyzed. The author’s point of view to the general commencement of punishment is given in the context of acceptance of the position about necessity of allocation of special commencement of punishment. The attention is focused on the lack of uniform understanding of both the general beginnings of punishment and their quantity and features. An analysis of special punishment as a sub-institutional of criminal law has been carried out. It has been noted that the procedure for the imposition of punishment for a set of crimes refers to the special commencement of punishment. The provisions of article 70 of the Criminal Code, which regulates the special procedure for the punishment determining for a set of crimes, have been studied. The dissertation study identified the main problematic aspects of the imposition of punishment for a set of crimes. The theoretical conclusions are supported by the study of the practice of punishment and appropriate proposals are made to improve existing legislation on criminal liability.Диссертация посвящена уголовно-правовому анализу порядка назначения наказания при совокупности преступлений. Устанавливается принадлежность существующих предписаний по этой проблематике к специальным началам назначения наказания. Анализируется практика назначения наказания по совокупности преступлений как основа для дальнейших научно-теоретических выводов. Исследовано развитие законодательства об уголовной ответственности при назначении наказания по совокупности преступлений, особенности регулирования такой деятельности в законодательстве зарубежных стран. Осуществлен анализ субинститута специальных начал назначения наказания. Выделены основные научные подходы к описанию этого субинститута. Определен типичный портрет лица, осужденного за совершение совокупности преступлений. Проведено научное исследование применения особых правил назначения наказания по совокупности преступлений: путем поглощения более строгим наказанием менее строгого и путем полного или частичного сложения наказаний