The comparison of use of antibiotics due to acute respiratory infections in the rural population of primary care in 2010 and 2017

Respiratory tract infections are the most common reason because of which patients report to a family doctor. The role of the family doctor is to assess both the symptoms suggesting the aetiology of infection, as well as performing additional tests, in order to make a definitive diagnosis. An increasing clinical problem is antibiotic resistance. Therefore, the objectives of this study were to assess and compare antibiotic use due to acute respiratory infections in the rural primary care population for over a 7-year period. A retrospective examination of electronic medical records covered 4355 declared patients in 2010 and 3959 patients declared in 2017. The analysis included advice - medical consultations due to acute respiratory infections, related or not related to the antibiotic prescription. In 2010, 2531 such consultations were given, and in 2017 - 1687. The results of our analysis indicate that in the surveyed rural population there was a decrease in both the frequency of consultations for respiratory infections (58.12% vs 42.61%) and the frequency of prescribing antibiotics / chemotherapeutics for this reason (50.8% vs 34, 6%). The type of antibiotic, which was most often used in the diagnosis of J06 (dominating both in 2010 and in 2017), has changed as well - from azithromycin to amoxicillin. The structure of diagnoses of respiratory tract infections systemized by ICD-10 has also been slightly changed. The reducing frequency of prescribing antibiotics as well as the change of the "first choice" antibiotic in the treatment of acute respiratory infections is a favorable trend and may result from the doctors' greater awareness of antibiotic resistance. Likewise, the change in the structure of diagnoses made by doctors from unspecified to specific ones may indicate greater awareness, resulting in treating specific diseases with targeted antibiotics. Further studies are needed to assess the choice of antibiotic therapy by the general practitioner

The concept of sovereignty in transatlantic relations : new realities versus old debate

Artykuł dotyczy zagadnienia suwerenności w kontekście rozwoju stosunków transatlantyckich. Analizie poddano zastosowanie tego, kluczowego dla studiów międzynarodowych pojęcia we współczesnej rzeczywistości budowania wspólnoty i negocjowania różnic pomiędzy Ameryką i Europą.Few subjects in the theory and practice of international relations are as sensitive and widely discussed as the meaning of sovereignty. Concentrating on transatlantic perspecive, this article adds new evidence to the fundamental debate on the nature of sovereign authority in the international system. Many transnational economic and technological forces encourage the state to retreat from its traditional role. On the other hand, economic integration, monetary unification and the development of modern economies and cutting -edge technologies - the assets of partners of the Transatlantic Alliance - are possible only in stable political systems. So, are we witnessing the end of sovereignty or just a phase in history in which relations of power between political authorities, nations, groups of interests and individuals must be negotiated in order to create a new model of governa nce in a complex world

Acupuncture Treatment in the Reduction of Knee Pain Due to Osteoarthritis

Objective: As knee osteoarthritis (KOA) is a very common, progressive, irreversible, and painful disease that affects many as they age, treatment modalities to alleviate symptoms are important to explore. This work aims to gather evidence as to the efficacy of a minimum of 4 weeks of acupuncture for the treatment of patients with knee pain secondary to osteoarthritis. Methods: Google Scholar and Valpo Library Databases were perused with a variety of search phrases to yield potential sources. The date of publication was set to be within the last 5 years. Studies needed to include trials of traditional/ conventional acupuncture. Treatment outcome measures varied between studies but most relied on pain scores and joint functioning protocols. No age, gender or racial exclusions were made. Results: Most studies indicate consensus that acupuncture therapy is beneficial for KOA when done for periods of longer than 4 weeks, however many are concerned with limitations in existing studies regarding variability between execution of trials and quality of reporting. Conclusion: Further research is needed to confirm acupuncture benefits and to determine the optimal frequency, duration, and mode of acupuncture treatment for KOA so that providers can recommend it as a truly effective treatment option for patients. Keywords: knee osteoarthritis, joint, traditional Chinese medicine, acupuncture, pain, needl

A market analysis for high efficiency multi-junction solar cells grown on SiGe

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Materials Science and Engineering, 2007.Includes bibliographical references (leaves 50-53).Applications, markets and a cost model are presented for III-V multi-junction solar cells built on compositionally graded SiGe buffer layers currently being developed by professors Steven Ringell of Ohio State University and Eugene Fitzgerald of MIT. Potential markets are similar to those currently occupied by high efficiency multi-junction space solar cells grown on a Germanium substrate. Initial cost analysis shows that at production volumes similar to those of the state of the art, cost could be reduced by a factor of' four. Significant market share may be gained in both the space and terrestrial PV markets due to improved performance associated with superior materials properties advantages as well as production cost reductions.by Zachary Steele Judkins.M.Eng

The return of the hero-leader? : Volodymyr Zelensky's international image and the global response to Russia's invasion of Ukraine

Artykuł omawia styl i rezultaty przywództwa prezydenta Ukrainy Wołodymyra Zełenskiego od momentu inwazji Rosji na Ukrainę, w kontekście koncepcji soft-power.This article focuses on the notion of heroic leadership as it has been applied as an analytical framework to Volodymyr Zelensky’s leadership during the Russian invasion of Ukraine in 2022. It presents an overview of Zelensky’s leadership strategies and their domestic and international reception and puts them in the wider context of the ways in which power is exercised in the global arena. It is argued that the authority and influence of Zelensky - the hero-leader - is the result of a reciprocal relationship between leader and followers, constructed out of the fear and desperation of warfare. One of the fundamental analytical tools in International Relations studies - the notion of soft and hard power - has been applied to Zelensky’s way of affecting the behaviors of others in order to shape their preferences and obtain his desired options. The perception of him as heroic has become the main instrument of the country’s power of attraction, which in turn enabled the president to expand his leadership. In this context the article reveals the mechanisms employed to build international recognition for Ukraine and build support for its resistance to the Russian invasion

Global Political Leadership

Global Political Leadership explores contemporary shifts in leadership, and the related leadership crisis, in the global world. Globalization is now perceived as a threatening and hostile force, with many of its advocates and political supporters turning away from it, but its processes cannot be reversed. New powers emerge, old ones re-emerge, and uncertainty about the future global order is increasing. This book tells the inside stories of global power games and asks important questions about the leadership crisis in the western world. The author provides an interpretative framework for contemporary shifts within the western political sphere based on the concept of global leadership. This framework presents the nature of the transformation caused by global processes, as part of which force and coercion have ceased to be the main modus operandi of the international realm. The issue of global political leadership has often been neglected in international relations literature, while being widely exploited by managerial and organizational studies. However, all social organizations have ‘gone global’ within the last several decades; they are more interconnected and more dependent on global processes, so the question of effective leadership strategies matching these new realities is highly necessary, even – or especially – at a time when globalization is no longer seen as a leading political programme. This book will be of great interest to students and scholars of global affairs, politics and international relations, leadership and development, and diplomatic studies

Effect of Media and Estrogen on Morphological Change in Candida albicans

Introduction: Candida albicans (C. albicans), an opportunistic pathogen, lives symbiotically within the intestine of its human host. Temperature and chemical factors have been shown to induce a morphological change in C. albicans from yeast to filamentous form turning C. albicans pathogenic. In this study, we investigated the intestinal cues that might be responsible for the change. We found that different solid media impact the morphological phenotype so we focused on characterizing these before further testing. We tested Estradiol (E2) because of its known linkage to sepsis and higher levels during infections. Experiments were conducted to compare solid agar plates of YEPD, Minimal Media (MM), and Spider Media (SP) for C. albicans growth to choose the best one for further testing with E2 and other factors that could be prone to causing morphological changes. Methods: C. albicans was inoculated through streak method on different solid media (YEPD, MM, SP) and incubated at 30℃. The effect of 0.1nM E2 on C. albicans morphology was also tested. Morphological changes were assayed through bright-field microscopy. Results: Using the three different medias, we found three distinctive phenotypes: A, B, and C. Out of 6 experiments of 14 MM plates, the expressed phenotype was 86% A and 14% inconclusive of the time. 8 experiments of 17 SP plates showed 100% of phenotype B. 6 experiments of 14 YEPD plates presented phenotype C 92% of the time and 8% inconclusive. For E2 trials, 2 experiments, 6 MM plates showed 50% phenotype A and 50% inconclusive. 4 experiments, 10 SP plates had phenotype B 100%. YEPD 2 experiments, 2 plates had phenotype C at 100%. Conclusion: We have established experimental conditions of media controls for further testing whether E2 and other cues, such as inflammatory cytokines, have inhibitory or positive effects on the growth of C. albicans