John zizioulas’ concept of the person: A critical appraisal

Much of John Zizioulas’ treatment of the human being as a person revolves around four crucial concepts: being, otherness, ontology, and freedom. Our critical appraisal of Zizioulas’ concept of human personhood emphasizes the importance of creative tension between (ontological) freedom and contingency as understood within the frame of reference of the human being’s intrinsic contingency as a finite, created being. According to this concept, the other (another distinct embodied personhood) is neither an object nor competition but rather a gift for one’s self who reminds me of one’s limitedness, dependence, and deep relatedness. Thus, the other helps the human self realize his/her potential in a mutual sharing of love. We examine Zizioulas’ critical stance to the modern notion that ‘otherness is necessary for freedom to exist’ against the background of his treatment of ‘otherness’ and ‘nature,’ as well as ‘otherness’ and ‘new being,’ ‘Logos,’ and ‘new nature.’ Finally, we lay out Zizioulas’ mature ontology of human personhood as a profound albeit mystical account of what it means to be human in our fragmented age. © 2021, Slovenska Vzdelavacia Obstaravacia. All rights reserved

Analysis of Articles on Education and Instructional Technologies (Scopus)

© 2020. All Rights Reserved. It is an indisputable fact that technology is a part of our lives. It is known that research and education technologies are concentrated. By examining the articles and dissertations published in the field, the scope, strengths and weaknesses of the studies were determined. An important gap has been filled in to guide researches what kind of studies may be needed in the future. Many studies for this purpose were found in the literature. However, since similar studies dealing with educational technologies are outdated, this study is considered important in terms of gathering current research trends and results. The aim of this study is to analyse the articles published in the Scopus database on educational technologies and instructional technologies, thematically and methodologically. The study was designed by adopting a case study from qualitative research models. The sample has not been determined for postgraduate dissertations to be included in the study, and it was aimed to reach the whole universe. In this context, all articles have been accessed through the library system of the university in the Scopus database included. The keywords ‘educational technologies’ and ‘instructional technologies’ were used in the article search. The document types have been examined by year, by country, by authors, by field research and by place of publication

Analysis of Articles on Education and Instructional Technologies (Scopus)

It is an indisputable fact that technology is a part of our lives. It is known that research and education technologies are concentrated. By examining the articles and dissertations published in the field, the scope, strengths and weaknesses of the studies were determined. An important gap has been filled in to guide researches what kind of studies may be needed in the future. Many studies for this purpose were found in the literature. However, since similar studies dealing with educational technologies are outdated, this study is considered important in terms of gathering current research trends and results. The aim of this study is to analyse the articles published in the Scopus database on educational technologies and instructional technologies, thematically and methodologically. The study was designed by adopting a case study from qualitative research models. The sample has not been determined for postgraduate dissertations to be included in the study, and it was aimed to reach the whole universe. In this context, all articles have been accessed through the library system of the university in the Scopus database included. The keywords ‘educational technologies’ and ‘instructional technologies’ were used in the article search. The document types have been examined by year, by country, by authors, by field research and by place of publication. © 2020. All Rights Reserved

Medication adherence in patients with stable coronary artery disease in primary care

Introduction: Lack of research targeting non-adherence to cardiovascular medications in Russia prevents from developing effective interventions to improve adherence. The aim was to study medication adherence in patients with stable coronary artery disease in primary care. Material and methods: The study was conducted in a primary care setting of Moscow. Demography, medical history, pharmacotherapy data were obtained retrospectively from 386 coronary patients’ medical records. Medication adherence was measured by 8-item Morisky Medication Adherence Scale (MMAS-8). A statistical analysis was performed using SPSS Statistics V16.0. Results and discussion: According to the results from MMAS-8, 188 (48.7%) coronary patients had high medication adherence, 135 (35.0%) – moderate, and 63 (16.3%) – low. By the dichotomous interpretation: 48.7% (n = 188) – were adherent, 51.3% (n = 198) – were non-adherent. These groups were similar in gender distribution, age, and medical history profile (p > 0.1 for all variables). Smokers prevailed in the non-adherent group (13.6 vs. 5.3%; p = 0.009). Both groups were equally prescribed beta-blockers, antiplatelets, and statins (p > 0.1 for all). Use of fixed dose combinations (11.7 vs. 5.6%; p = 0.048) and the number of pills taken (mean 5.64 ± 1.52 vs. 5.99 ± 1.62; p = 0.029) were associated with better adherence. Higher values of total cholesterol (mean 5.2 ± 1.4 vs. 4.7 ± 1.2 mmol/L; p < 0.001) and low-density lipoprotein cholesterol (mean 2.9 ± 1.2 vs. 2.4 ± 0.9 mmol/L; p < 0.001) were revealed in non-adherents. Subjects with suboptimal adherence visited general practitioners more frequently (median 5 vs. 3 visits; p = 0,003). Conclusion: Medication non-adherence in coronary outpatients exceeded 50%. High adherence was associated with more frequent use of fixed dose combinations and fewer pills taken by patient. Smoking and poorer control of blood lipids prevailed in non-adherents, who also caused higher load on general practitioners. Copyright Zyryanov SK et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Effects of Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease: a randomized controlled study [Рандомизированное контролируемое исследование влияния программы “Фармацевтическая опека” на приверженность фармакотерапии амбулаторных больных стабильной ишемической болезнью сердца]

Aim. To assess the effects of the Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease (SCAD). Material and methods. An open randomized controlled study was conducted in primary care clinic over the period of 20192020. All subjects (n=126) were randomized at visit 1 into the multifaceted intervention group (n=63) or control group (n=63) and invited 12 months after to visit 2. Patients of intervention group were included into the Pharmacy Care Program, which consisted of the following components: pharmacistled counseling, provision of education materials and 7day pillbox, weekly SMSreminders. Medication adherence was measured initially and at the end of the study period by means of eightitem Morisky Medication Adherence Scale (MMAS8) and SelfEfficacy for Appropriate Medication Use Scale (SEAMS). Results. The implementation of the Pharmacy Care Program improved medication adherence in SCAD outpatients with MMAS8 median score of 7,08,0 (p<0,001) and SEAMS median score of 35,036,0 (p=0,017). In the control group, no changes (p=0,123) in MMAS8 score were revealed, while SEAMS score decreased from 35,0 down to 34,5 (p=0,003). The reduction in systolic blood pressure (p=0,049) and risk of urgent hospital admission (OR=0,28; 95% CI, 0,080,99; p=0,041) was registered in the intervention group in contrast to the control group over the 12month period. Conclusion. The multicomponent intervention within the Pharmacy Care Program contributed to an increase in the adherence to pharmacotherapy of outpatients with stable CAD. © 2022 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved

ПРИВЕРЖЕННОСТЬ К ФАРМАКОТЕРАПИИ У ПОЖИЛЫХ ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА В УСЛОВИЯХ ПЕРВИЧНОГО АМБУЛАТОРНОГО ЗВЕНА

Aim. To study medication adherence in elderly patients with coronary artery disease (CAD) in primary care practice. Material and methods. The study conducted in out-patient clinic of Moscow city. 293 elderly (>= 65 years) patients with established CAD included. The following patient data obtained via electronic medical record system: demography, medical history, modifiable risk factors and prescribed pharmacotherapy. Level of medication adherence measured by Morisky scale (MMAS-8) via telephone survey. Results. According to Morisky scale high adherence was identified in 146 (49.8%) elderly patients, moderate adherence - in 99 (33.8%) patients, low adherence - in 48 (16.4%) patients. Analysis of specific questions of the scale done in non-adherent patients revealed signs of unintentional non-adherence due to forgetfulness (45.9%) and signs of intentional non-adherence due to patients feeling worse (35.8%) or better (28.4%). By means of dichotomic interpretation of Morisky scale results the population under research was divided into two groups: 147 (50.2%) non-adherent patients and 146 (49.8%) - totally adherent patients. These groups were comparable in terms of sex (female 71.2 vs 68.0%; p>0.05) and age (median 73.5 vs 73.0 years; p>0.05) distribution, and medical history: myocardial infarction (39.0% vs 38.8%), atrial fibrillation (37.0 and 41.5%), chronic heart failure (90.4% vs 91.2%), diabetes (26.7% vs 24.5%). There were fewer smokers in adherent group (0.7% vs 6.5%; p0.05). Drugs that improve prognosis were also prescribed comparably: antiplatelets (66.4% vs 61.9%; p>0.05), anticoagulants (36.3% vs 44.9%; p>0.05), statins (82.2% vs 79.6%; p>0.05), renin-angiotensin system inhibitors (89.0 and 87.8%; p>0.05). Adherent patients had lower mean values of lipids: total cholesterol (4.7 +/- 1.2 vs 5.2 +/- 1.4 mmol/l; p0.05). Conclusion. Half of elderly patients with CAD are non-adherent to treatment in primary care setting. Medical history and structure of pharmacotherapy do not influence level of adherence in this population. Among adherent patients fewer individuals smoke and mean values of lipids are lower. Non-adherent elderly patients cause higher load on general practitioner, supplementary pharmaceutical provision program provided no better adherence in the population under research.Цель. Изучить приверженность к фармакотерапии у пожилых пациентов с ишемической болезнью сердца (ИБС) в условиях амбулаторнополиклинической практики.Материал и методы. Исследование проводилось в амбулаторном лечебно-профилактическом учреждении г. Москвы. Включено 293 пожилых (≥65 лет) пациента с установленным диагнозом ИБС. С помощью Единой медицинской информационно-аналитической системы (ЕМИАС) регистрировали демографические и анамнестические характеристики пациентов, информацию о модифицируемых факторах риска и рекомендованную фармакотерапию. Уровень приверженности оценен с помощью шкалы Мориски (8-вопросная версия) посредством телефонного опроса.Результаты. По результатам шкалы Мориски высокий уровень приверженности установлен у 146 (49,8%) пожилых пациентов, средний - у 99 (33,8%), низкий - у 48 (16,4%). При анализе ответов неприверженных больных на отдельные вопросы шкалы выявлены как признаки непреднамеренной неприверженности по причине забывчивости (45,9%), так и признаки намеренной неприверженности по причине ухудшения (35,8%) или улучшения самочувствия (28,4%). Посредством дихотомической интерпретации результатов шкалы Мориски изучаемая популяция была разделена на две группы: 147 (50,2%) пациентов не привержены фармакотерапии, 146 (49,8%) - абсолютно привержены. Данные группы оказались сопоставимы по полу (женщин 71,2% и 68,0%; p>0,05) и возрасту (медиана 73,5 и 73,0 лет; p>0,05), а также по наличию сопутствующих заболеваний: инфаркт миокарда в анамнезе (39,0% и 38,8%), фибрилляция предсердий (37,0% и 41,5%), хроническая сердечная недостаточность (90,4% и 91,2%), сахарный диабет (26,7% и 24,5%). Среди приверженных больных было меньше курящих (0,7% против 6,5%; p0,05). Препараты, снижающие риск сердечно-сосудистых осложнений, также были рекомендованы с сопоставимой частотой: антиагреганты (66,4% и 61,9%; p>0,05), антикоагулянты (36,3% и 44,9%; p>0,05), статины (82,2% и 79,6%; p>0,05), блокаторы ренин-ангиотензиновой системы (89,0% и 87,8%; p>0,05). В группе приверженных больных выявлены более низкие средние значения основных параметров липидного спектра: общий холестерин (ОХС 4,7±1,2 против 5,2±1,4 ммоль/л; p0,05).Заключение. В условиях первичного амбулаторного звена половина пожилых пациентов с ИБС не привержена фармакотерапии. Основные сопутствующие заболевания и структура лекарственных назначений в рамках фармакотерапии ИБС не оказывают значимого влияния на приверженность в изучаемой популяции. Среди приверженных лечению меньше курящих и ниже средние значения ОХС и ХС ЛПНП. Неприверженность пожилых пациентов оказывала большую нагрузку на врача общей практики, а дополнительное лекарственное обеспечение не способствовало более высокой приверженности таких больных