Artykuły w czasopismach na temat „Equality – Health aspects – Great Britain”

In recent years, the range of publications concerning the high likelihood of teachers developing syndromes of professional burnout and professional destruction has been increasingly expanding. This trend is almost equally characteristic of most countries over the world: from Great Britain, Germany, and Scandinavia in Europe to China, Japan in Asia and Nigeria in Africa, and, over the last decade, in Russia. In other words, the problem under consideration is global in nature and depends little on the level of economic development of the country and its ethno-geographical characteristics. Purpose of work. Study foreign and domestic scientific literature directly related to the problems of creating working conditions and their impact on the health in education workers. The presented review is based on the publications of a number of domestic and foreign studies. The literature search was carried out using the databases Pubmed, Scopus, Web of Science, MedLine, RSCI. A total of forty two publications were analyzed for the period from 2001 to 2022. A systematic analysis of the world scientific literature was conducted on the management of events aimed at assessing the working conditions and health in teachers. The study examined various aspects related to the provision of medical care to education workers. After evaluating the results of the study, it became clear that there is some discrepancy between reports in the field of psychology and hygiene. In the first group of works devoted to the psychological aspect, insufficient attention is paid to the study of working conditions and their impact on the health of teachers, despite the widespread prevalence of professional burnout syndrome among the teaching community. At the same time, in the second group of studies devoted to hygienic aspects, the role of psychosocial factors influencing the health of teachers is not sufficiently addressed. Conclusion. In general, the analysis of the characteristics of working conditions and health of pedagogical workers allows concluding this topic to be relevant and in demand in the scientific world. It also highlights the need for further research and development in this area to improve diagnosis, treatment, and prevention of related diseases.

ABSTRAK Dalam Undang-Undang Cipta Kerja, Perizinan Lingkungan telah diubah menjadi Persetujuan Lingkungan yang berarti berbentuk persetujuan atau rekomendasi dari Pemerintah. Perubahan tersebut berdampak pada regulasi sektor lingkungan, ditambah lagi terdapat perubahan konsep bahwa perizinan lingkungan menggunakan pendekatan berbasis risiko. Di sisi lain, perubahan tersebut merupakan suatu inovasi yang dilakukan oleh Pemerintah untuk menyederhanakan regulasi untuk meningkatkan perekonomian nasional. Konsep Pendekatan Berbasis Risiko merupakan hal baru di Indonesia. Pendekatan tersebut sebelumnya telah diterapkan di berbagai negara seperti Inggris dan Kanada. Pendekatan Berbasis risiko dalam melakukan kegiatan usaha memperhitungkan berbagai aspek seperti, kesehatan, lingkungan, potensi, serta ancaman yang akan dihadapi. Konsep Pendekatan Berbasis Risiko tidak menggantikan amdal melainkan sebagai pelengkap dalam melakukan setiap perhitungan dalam kegiatan usaha. Implementasi pendekatan berbasis risiko dalam persetujuan lingkungan harus diperhatikan baik dari tahap perencanaan, pelaksanaan hingga pengawasan, sehingga kegiatan usaha yang memiliki risiko dapat dicegah dan dikendalikan. Pendekatan Berbasis Risiko dalam Undang-Undang Cipta Kerja diharapkan dapat memberikan keseimbangan antara pembangunan ekonomi dan kesehatan lingkungan. Kata kunci: Cipta Kerja; Perizinan; Risiko; Lingkungan ABSTRACT On the Job Creation Law, Environmental Permit changed bcome an Environmental Agreement. Environmental Agreement agreed or recommended by the centra government or regional government. The alteration has impact on the regulatons, especially in environmental sector, furthermore environmental agreement use a new approach as known as Risk Based Approach. On the otherside, the new approach become an inovation by the Government to simplified many regulaton that exist to increase economic growth. Risk Based Approach is a new concept in Indonesia. The approach is also used by Great Britain and Canada. Risk Based Approach is a tool for identifying a risk based on many aspects such as, environmental aspect, health aspect (public health care, human health, environmental health etc), strength and threat from the business activity. Risk based on environmental study called ‘Environmental Risk Assessment'. The environmental risk assessment didn't remove the environmental impact assessment but as complementary. The Implication on Risk Based Approach on the Environmental Agreement must be considered from the planning phase, implementation and monitoring, so any business activity that have a risk are under control. Risk Based Approach on the Job Creation Law are expected to bring the equality between economic growth and environmental health. Keywords: Environment; Job Creation; Permit; Risk

Abstract: Zeal for curing the public ill of discrimination can lead to approaches that ignore the more private concerns of individual victims of discrimination. This article explains that the forward-looking project of changing society to eliminate inequality is quite a different project from that of providing accessible and effective individual remedies for discrimination victims. To that end, the nature and divergence of these two projects is described in abstract terms, and then concretely illustrated by reference to US employment discrimination law, where a clear conflict has evolved between the two. The article then traces the development of anti-discrimination law in Great Britain, and the subtly emerging tension between the two projects here. Finally, the article assesses the contemporary discourse on reform of equality law in Britain, and suggests how a new single equality act might drive for social change without eroding the benefits of the existing system for individual dispute resolution.

The subject field of this article, devoted to the manifestation of the Islamic factor in the socio- political life of the Great Britain, is localized within the borders of Scotland. The authors emphasize the special (different from other regions of the UK) nature of the interaction of the Muslim ethno- confessional minority with the indigenous population of Scotland. Most attention is paid to the identity of Scottish Muslims. The article highlights that Scotland demonstrates its winning position for Muslims through the development of an inclusive identity. The authors make a prognostic conclusion that Scotland will maintain a policy of affirming common civic values that ensure the pluralism of various socio- cultural communities. According to the authors, the future of Scotland is a post-ethnic, transcultural socio- political state- organized space in which British-wide tensions between Muslims and non- Muslims will gradually decrease, and the Scottish tradition of equality and social justice will be strengthened.

Purpose Organisational culture (OC) shapes individuals’ perceptions and experiences of work. However, no instrument capable of measuring specific aspects of OC in community pharmacy exists. The purpose of this paper is to report the development and validation of an instrument to measure OC in community pharmacy in Great Britain (GB), and conduct a preliminary analysis of data collected using it. Design/methodology/approach Instrument development comprised three stages: Stage I: 12 qualitative interviews and relevant literature informed instrument design; Stage II: 30 cognitive interviews assessed content validity; and Stage III: a cross-sectional survey mailed to 1,000 community pharmacists in GB, with factor analysis for instrument validation. Statistical analysis investigated how community pharmacists perceived OC in their place of work. Findings Factor analysis produced an instrument containing 60 items across five OC dimensions – business and work configuration, social relationships, personal and professional development, skills utilisation, and environment and structures. Internal reliability for the dimensions was high (0.84 to 0.95); item-total correlations were adequate (r=0.46 to r=0.76). Based on 209 responses, analysis suggests different OCs in community pharmacy, with some community pharmacists viewing the environment in which they worked as having a higher frequency of aspects related to patient contact and safety than others. Since these aspects are important for providing high healthcare standards, it is likely that differences in OC may be linked to different healthcare outcomes. Originality/value This newly developed and validated instrument to measure OC in community pharmacy can be used to benchmark existing OC across different pharmacies and design interventions for triggering change to improve outcomes for community pharmacists and patients.

The present world is characterized by the growth of conflicts. Dividing lines and fractures are increasingly appearing in societies. Migration reinforces such phenomena. The West is no longer an area of stability and prosperity. Moreover, in the last two decades, the problem of integrating the descendants of migrants into society has become clear. In this regard, the scientific discussions of cultural identity acquire a high practical significance. The paper presents an analysis of the scientific discourse on the Muslim issue in the UK. The choice of the case is due to the fact that the UK is a typical Western state, where there is a steady trend to strengthen the cleavage of society. At the same time, it is noted that migration has become one of the key processes in the history of the United Kingdom. The authors apply the concepts of a divided society and responsible development. It is noted that in practice multiculturalism is changing to interculturalism as a more adequate concept of solving existing problems. According to the authors, the ethno-religious discourse on the issue of the Muslim diaspora in the UK consists of four areas: migration, school and higher education, gender, and radicalization of young people. Discourses on the problems of migration policy and functioning of diasporas, Muslim education, gender equality, and radicalization of Islamic youth can be considered derived from a higher discourse – the discourse of identity, which is based on value-worldview aspects. In conclusion, it is noted that negative processes are taking place in British society, which are of strategic importance for responsible development. According to the authors, success in overcoming divisions in British society will depend on coordinated planned actions at all levels (international, national, regional, local). “Indigenous” residents and the Muslim diaspora need to build a model of partnership, which implies mutual responsibility. The analysis of scientific discourses presented in the article inspires moderate optimism, as it offers well-founded and concrete solutions to the existing problems of British society. Although British society is divided, British scientific discourse has a common platform where researchers of different backgrounds and faiths successfully engage in dialogue.

The article examines the experience of the health care system, in particular medical rehabilitation: Germany, the Netherlands, Great Britain, which work with the application of the international Classification of Functioning. The measures and principles of the organization of the rehabilitation process as medical care are presented, which indicates the need to use new forms and approaches in the professional education of relevant specialists.

The article provides a comprehensive analysis of counteracting human rights violations due to age discrimination in the social and communicative sphere to identify problematic aspects of this discrimination; to study current changes in connection with the pandemic threat and generalize a set of legal guarantees to prevent and counteract inappropriate legal policy in this area. The research is based on a humanistic approach, which determines the individual value criterion of the research methodology and is manifested through the ideology of anthropocentrism; a complementary approach to scientific research and a balanced combination of national and international state-building and law-making principles. A comparative legal method was used, which made it possible to summarize the legal requirements of various states, including the United Arab Emirates, Great Britain, Serbia, Bosnia and Herzegovina, and Colombia, on measures to counteract the spread of the COVID-19 pandemic. Statistical and information reports of the European Union countries, monitoring of the Equality Representatives of individual countries (Serbia, Lithuania), analytical data, government decisions and practical cases were used.

This paper emanates from a problem with general reference to basic conditions of family life and food practices. More specifically it concerns the striving of preventive health care in persuading contemporary Western Europeans to change their attitudes to food in a health oriented direction. The question is: Do gender roles at home influence people's attitudes towards food? A survey of current sociological and ethnological research in Great Britain and Sweden shows two partly different gender role patterns, one (the British) with obvious traits of role segregation and the other (the Swedish) comparatively more integrated. From these observations follows an analysis of how each pattern respectively affects food practices on a household level. One conclusion is that segregated roles seem to favour conservatism while equality oriented relations create prerequisites for changeability. The discussion comments on social and historical conditions generating differences in gender role patterns, with special emphasis on working class culture and peasant culture as important historical factors. The paper concludes by asserting that the conditions for political initiative aimed at increased equality at home are better today than ever before during the twentieth century. But to succeed these initiatives must primarily focus upon the male role and its relation to domestic work.

The article is devoted to the analysis of gender equality in family legal relations taking into account the European experience. The theoretical essence and place of gender issues in the family policy of Ukraine has been established. The gender legislation, which forms the basis of legal regulation of family relations in Ukraine, is analyzed: the main norms of the Constitution of Ukraine in the field of gender equality; norms of the Family Code of Ukraine and other national normative legal acts that ensure the equality of men and women in the institution of the family; international documents that were ratified by Ukraine in this area. The problem of discrimination against men according to social stereotypes and the problem of violence in the family are considered. It is noted that the war on the territory of Ukraine has an extremely negative effect on family legal relations, as it causes such negative consequences as the absence of a father or mother in the family, a broken psyche of children, an increase in cases of deviant behavior, changeable family relations, the spread of single-parent families, etc. European experience in solving the main problems of gender policy was studied and parallels with Ukrainian legislation were drawn. The directions of European family policy are considered, such as: children's well-being, gender equality, combination of family life and employment. The research conducted by MORI as part of the Here and Now task in Great Britain is analyzed; Sweden's experience in regulating the equal participation of men and women in household chores and parental responsibilities; The Gender Equality Index, which represents the current state of European gender roles and their formation, through indicators relating to the dimensions of Knowledge, Work, Money, Time, Power and Health. It is proposed to develop a national concept of family development and gender equality, based on the analysis of modern national processes and world experience.

The allocation of resources for health, as well as the distribution of other social goods, being a political problem, can also be observed as belonging to the universe of distributive justice, considering that all citizens must have the necessary means for an acceptable physical, psychological and social performance. Individual autonomy, paradigm of a full citizenship in a modern society, cannot otherwise be achieved. Human dignity seems to imply that no citizen can be excluded from the basic health system due to the lack of financial resources. Indeed, equal access of all citizens to basic social goods and therefore to key places in society – principle of fair equality of opportunities – is one of the core aspects of Rawls's difference principle. It is, in essence, about ensuring the exercise of the right to individual self-determination in the relationship between the individual and society, as well as the right to play a social role according to skills and merit. But, it is not only the theory of the social contract that provides for a fair equality of opportunities. Different perspectives of justice contemplate this ideal. As suggested by Tristram Engelhardt Jr individual autonomy must be interpreted as a value in itself and a determining factor for the exercise of a full citizenship. But, justice is an ideal that must be progressively built. Whether in a specific society or on a global scale. And, the great challenge of humanity is precisely to recognize the existing intercultural differences and propose sufficiently flexible ideological systems that can be applied in different countries with very different levels of social and economic development. Without detracting from the ethical principles that should underpin the construction of the 21st century global society.

Two contemporary strategies in cadaver organ transplantation, both with the potential to affect significantly expanding organ transplant waiting list sizes, have evolved: elective ventilation (EV) and use of nonheart-beating donors (NHBDs). Both are undergoing a period of critical review. It is not clear how widely EV is practiced around the world. In Great Britain, the Royal Devon and Exeter Hospital was the first hospital to develop an EV protocol (the Exeter Protocol), in 1988, after which other British hospitals followed suit. In the 1980s, new NHBD protocols of two distinct types were implemented worldwide, although both rely on death confirmed by traditional cardiopulmonary criteria. The first type involves the removal of organs immediately after death, the preeminent example being the University of Pittsburgh Medical Center Protocol (the Pittsburgh Protocol). The second involves the perfusion and cooling of kidneys immediately following death and subsequent organ removal. Protocols of this type have sprung up in Holland, Great Britain (for example, at Leicester General Hospital), Italy, France, Spain, Japan, and the United States (for example, the Regional Organ Bank of Illinois).

There is a stark difference between American and British policy on embryo science and research cloning. The following survey of the discourse offered both in support of and in opposition to research cloning and embryo science in the United States and Great Britain will show that the same arguments were made in both countries. The fact that similar ethical argumentation occurred in environments where different policy was set is an indicator that current frames for ethical discourse on embryonic stem cell research and human cloning do not effectively capture the debate in the form that politicians and possible consumers of services to be derived from embryo science face.The ethics surrounding embryo research and human cloning have been presented from virtually every possible viewpoint in all forms of medium. It is impossible to reprise every argument made on embryo science and research cloning; therefore, this survey will focus on some of the arguments made during the time leading up to the enactment of Great Britain's Human Fertilisation and Embryology Act of 1990 and the Human Fertilisation and Embryology regulations added to it in 2001.

Objectives: To inform professionals providing care to individuals with cleft lip and palate on the legal aspects and organizations available to protect individuals with this alteration, and to advocate that cleft lip and palate should be considered a handicap, even though it is provisional and may be rehabilitated, to assure afflicted individuals basic rights and complete personal, social, and economic welfare. Design: Literature review on the issue, including assessment of national and international laws, doctrines, and jurisprudences; conceptual analysis of the word “handicapped” in dictionaries. Analysis included the federal constitutions of Brazil, France, Argentina, Spain, Cuba, Italy, China, Portugal, Japan, Great Britain, and Colombia, regarding the protection of handicapped people. Results: Constitutional protection of handicapped people is a recent issue that has been addressed only in the last few decades in some countries such as Brazil, Italy, Spain, China, and Portugal. The Brazilian Federal Constitution of 1988 addresses the protection of handicapped people to assure them access to social and individual rights, freedom, security, welfare, development, equality, and justice as supreme values of a fraternal, pluralist, and prejudice-free society. Conclusions: Individuals with cleft lip and palate should be included in national policies for integration of handicapped people, in agreement with programs of human rights, establishing a collaborative action between state and society. This would assure their inclusion in the socioeconomic and cultural context and equal opportunities in society, without privileges or paternalism.

BackgroundAims of the Defeat Depression Campaign between 1991 and 1996 included the reduction of stigma associated with depression, education of the public about the disorder and its treatment and encouragement of earlier treatment-seeking. Newspaper and magazine articles, radio and television programmes and other media activities were employed.MethodSurveys of public attitudes were conducted by MORI in late 1991, early 1995 and mid-1997. Each covered approximately 2000 subjects, sampled to be representative of the population of Great Britain. Structured interviews covered views on depression, treatment and general practitioners (GPs).ResultsThere were significant positive changes regarding attitudes to depression, reported experience of it, attitudes to antidepressants, and less consistently, to treatment from GPs. Changes were of the order of 5–10%. Throughout, attitudes to depression and to treatment by counselling were very favourable, whereas antidepressants were regarded as addictive and less effective.ConclusionsPositive attitude change was achieved during the Campaign, although there is still room for improvement in some aspects.

A decade ago, Jonathan Mann made a powerful case that human rights could provide a vocabulary and mode of analysis for understanding and advancing health. He made the case well, and put the idea into inspired practice, but the idea was neither new nor his alone. The idea that social justice — and henceforth in this article we will use that term loosely (and with obvious imprecision) to embrace goods like human rights, social equality, and distributive justice — was intrinsically important to health resonated with the social epidemiology already gathering force (not to mention an enduring theme running through the history of public health work). That social structure and relations of power explain a great deal about the level and distribution of population health was implicit in the work of pioneers like Geoffrey Rose, evident in Marmot’s seminal Whitehall studies, explicit in the writings of Mervyn Susser, and the main thrust of scholars like Nancy Krieger and Meredeth Turshen. Although researchers tend to avoid using a term with such normative weight, it is safe to say that Mann — and Susser, and Marmot and Krieger among others — were right: social justice is central to the proper understanding of health.

Since August 10 th 2020 entered into force the first Romanian normative act expressly regulating the moral harassment, Law no. 167/August 7th 2020 amending Government Ordinance no. 137/2000 on the prevention and sanctioning of all forms of discriminations, and Law no. 202/2002 on equal opportunities and treatment for women and men. In July 2020, about one month before the coming into effect of the regulation on moral harassment, the Law 53/2003 -the Labour Code- was amended through Law no. 151/2020 which supplements the provisions safeguarding the principle of equality of treatment and the principle of human dignity. The paper is an analysis of the rights and obligations provided for by the recently adopted legal framework, of the legal measures having as purpose to improve the protection of these principles, identifying the legal aspects of an absolutely new character, highlighting the benefits of the new regulations for vulnerable holders of such rights, as well as some of Romanian legislator's reasons. Even if moral harassment is not a new phenomenon at all, the abuse behaviour and its numerous faces, its consequences on physical, mental and emotional health, the existence of equality and dignity rights and the possibility to defend them are less known in Romania, and therefore less respected. The new regulations above safeguarding against visible and invisible abuse, particularly the Law no. 167/August 7th 2020 modifying the Government Ordinance no. 137/2000, should be considered a great first step toward a new age of fundamental rights protection in the Romanian society. Keywords: moral harassment, principle of human dignity, principle of equality of treatment, physical, mental and emotional health, stress and physical exhaustion, high liability standards.

In this article, the author examines the principle of equality and emphasizes the importance of using various research methods to understand this principle. The author considers the system-structural method, the phenomenological method, the method of comparative analysis, the prognostic method and the historical-legal method as tools that help to get a more complete picture of the problem. The study of the principle of equality helps to understand how to ensure equality and justice in society, to identify inequalities and discrimination, as well as to improve legislation and create equal conditions for all citizens. The article is devoted to the study of the principle of equality and the use of various research methods for its better understanding. The author notes that the principle of equality is a fundamental concept in various fields of knowledge, and its understanding is key to creating a fair and equal society. The article discusses various research methods that can be used to study the principle of equality. For example, the system-structural method allows you to analyze the problem in the context of the system, identify relationships and the influence of various factors on equality. The phenomenological method focuses on researching the experiences of individuals who have experienced discrimination, which helps to gain a deeper understanding of the problem and its consequences. The method of comparative analysis of legal norms and legislation of different countries makes it possible to identify the best practices and experience of other countries, which can be used to improve legislation in a specific country. Forecasting and modeling allow us to predict future outcomes and evaluate the effectiveness of different measures to achieve equality. The historical-legal method of research allows analyzing the past and finding the causes and consequences of discrimination in the past, which can be useful for developing strategies to combat discrimination in modern society. The use of various research methods allows obtaining detailed information about the problem of discrimination and inequality. This allows to analyze the problem from different criteria, taking into account social, economic, cultural and other aspects. Studying the principle of equality is of great importance for society. It helps to reveal systemic inequalities and discrimination that may exist in various areas of life, including employment, education, health care and others. Equality research helps identify negative trends and develop strategies to counter discrimination and ensure equal opportunities for all. Overall, this article highlights the importance of using a variety of research methods to understand the principle of equality. This allows you to get a comprehensive picture of the problem of discrimination and inequality, to reveal their causes and consequences, as well as to develop effective strategies for improving society and creating more equal and fair conditions for all citizens. The use of various research methods allows collecting various data, analyzing them from different perspectives and obtaining a more objective understanding of the problem. Key words: women from vulnerable groups, methodological principles, vulnerable categories of persons, research on the principle of equality.

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.

Abstract. The main goal of any country's health care system is to improve the health of the population and life expectancy. Studying the experience of developed countries allows to make reasonable proposals for improving the existing model of healthcare in Ukraine.Research into the practical aspects of the functioning of health care, its financing and development is a priority.The issues of adapting the experience of developed countries to the model of financing health care in Ukraine, taking into account the socio-economic state of its development, remain unsolved in full.The purpose of the article is to analyze the existing global models of health care financing and leading countries, as well as to identify areas for adapting foreign experience to the Ukrainian model of health care financing.There were analyzed the three major models of health care in the world. The advantages and disadvantages of each of them are identified, as well as the areas of implementation suitable for Ukraine. The experience of the leading countries in eachof the studied models -Great Britain, Germany, USA is considered.The study allowed to obtain systematic information on global models of health care and identify areas for improvement for Ukraine (development of state insurance programs, introduction of compulsory health insurance, increasing the level of innovation).

When her baby was born last June, Rossana Dalla Corte, age sixty-two, was thought to be the oldest woman ever to have given birth. Her pregnancy was achieved at a private fertility clinic in Italy, the same clinic that treated “Jennifer F.,” a London woman who, on Christmas day, 1993, at the age of fifty-nine, gave birth to twins. The reproductive procedure, likely to become more common during the next few years, has received intense scrutiny from health officials in Great Britain, France, and Italy. Moral questions concerning that procedure already have been taken up by the popular press in the United States. Such questions can be expected to take on a new urgency as the United States considers reshaping its health care system and, specifically, the circumstances under which coverage for infertility treatment will be provided.

AbstractThe paper focuses on temporal aspects of informal caring for older people. Limitations of large-scale surveys in capturing such data are noted and time-use methodology, despite its own limitations, is proposed as a promising alternative. Adopting a critical perspective on time that includes carers’ own conceptualisations, we report the findings of a qualitative study of carers’ time use. Sixty-two interviews with carers, male/female, co-resident/not co-resident, employed/not employed, and located across Great Britain were conducted. Analysis considered people's own diverse and ambiguous views of their care activities. Carers’ accounts of their time revealed non-linear experiences and a sense of being permanently on call. Interviewees often travelled distances to engage in support activities with or for older people. Changes over time were pervasive, increasing or reducing care requirements. Unanticipated events could precipitate radical changes in time use. Managing time, exercising temporal agency, was particularly apparent in accounts of care, employment, other family responsibilities and choices about friendship. Measurement of carers’ time use which draws on the conceptual foundation of carers’ own perspectives on time may provide more effective quantitative understanding of the temporal aspects of caring. It should not pre-define time, must grasp a variety of tasks, take account of intermittent activity, incorporate the 24–7 experience of many carers and demonstrate how caring time interacts with other time.

The question of why women, in consultation with their physicians, should choose hormone therapy (HT) in response to menopause represents a renewed controversy at the beginning of the new century. Conflicting messages regarding the health risks and benefits of HT have been conveyed in the mainstream media, especially information in the media regarding the results of large-scale studies of the health impact of hormone therapy. Women who have been on one or another of the hormone replacement regimes have been forced to reconsider continuing on HT. Doctors who suggest these hormones to their patients are somewhat confused, as are perimenopausal women who are considering HT. Pharmaceutical companies that produce these compounds are worried, and public health officials are on the defensive.Media coverage of HT research has been extensive. In particular, two large-scale studies, one here in the U.S. (the Women's Health Initiative, or WHI) and the other in Great Britain, have recently cast a negative light on the use of hormone therapy, after years of routine prescription of HT for menopausal women.

Abstract Distance caregiving has increasingly attracted the attention of the gerontological research community. This indicates the importance of this caregiving arrangement in the face of progressive demographic change including fewer and fewer individuals providing local care. There have been attempts to define distance caregiving for more than two decades. The literature focuses predominantly on North America and Great Britain (e.g. Cagle & Munn, 2012; Franke et al., 2019). Although Cagle and Munn defined distance caregiving broadly, recent literature continues to focus on individual aspects, such as distance or time. Thus, future research on distance caregiving may benefit from using a uniform definition to compare findings across studies. Accordingly, we reviewed the literature of the last five years by means of a scoping review in 13 English and German databases. Following the systematic review on distance caregiving by Franke et al., we used May 2019 as the starting point of our search. Two independent raters classified the articles using prespecified inclusion and exclusion criteria. We identified a total of N=14,546 articles. After removal of duplicates, and title and abstract screening, we identified a total of n=59 articles for full text screening. We found the broad definition of distance caregiving by Cagle and Munn in 26 articles. The remaining articles referred to aspects like distance in miles or kilometers, time required, or other circumstances. In sum, our findings indicate that gerontological research on distance caregiving does not always build on existing knowledge.

Among the writers of his generation, Alecsandri is the most comprehensive one, expressing not only the patriotic aspirations and desires, but also the discoveries from the universe of the private life and trying to make himself noticed in almost all the main literary genres and species. By different circumstances, Alecsandri gets to travel through Moldavia, Wallachia, Bucovina and Transylvania, to the European part of Turkey, to Italy, Austria, Germany, France, Spain, Great Britain, North of Africa, either for personal pleasure, to accompany Elena Negri, who was trying to find a more favourable climate for her fragile health, or for official business. All these travels and each of them separately are part of the development of his creation, leaving marks in his fiction and poetry and “it is printed on the screen of the human experience which defines his public and private personality”. In one of these travels, Alecsandri will discover the folk poetry, discovery which will profoundly mark his destiny as a writer and it will also have immeasurable consequences on the entire development of the Romanian literature from the last century, but also from the years to follow. As a result of the translations into French, German and English of the folk poems or of some of his original poems, Alecsandri becomes one of our first modern writers who became famous also abroad, being accessible to the foreign world.

Introduction. Higher medical education is one of the most sought-after and elite degrees worldwide. Systems of higher medical education differ from country to country, although they have certain features in common. Core differences are as follows: Training duration at various stages, contents of educational programs, learning technologies, etc. Much attention is paid to physicians training, which is determined by the high social significance of medical education. Aim: To provide an overview of the contemporary global trends in the development of higher medical education in the USA, Great Britain, France, and China. Materials and Methods. World literature was analyzed on trends in the development of higher medical education. Results and Discussion. Development of the healthcare system in the UK requires an integrated approach that considers various aspects in higher medical education, personnel policy, and workplace management. French healthcare system is experiencing various problems, such as the affordability of medical services and staffing shortages in remote regions. The Government of France shall continue to invest in healthcare and address the challenges to ensure universal access to quality medical services, including through its higher education system. US medical education keeps pace with the challenges healthcare systems are facing in the 21st century. To address today’s challenges, US medical education is taking a more interdisciplinary and inclusive approach, focusing on public health, interdisciplinary teamwork, and community-based training. Chinese medical universities pay more attention to practical skills and to integrating various disciplines in training, which allows graduates to be the best medical experts able to solve complex practical problems. Conclusions. Global trends identified herein in the development of higher medical education in the USA, Great Britain, France, and China require reflection, while the best practices should be introduced into the Russian system of higher education. However, approaches to be implemented should be first adapted to the historical, cultural, social, geographical, political, and other realities of Russia.

The aim of the article is to study the problems of territory branding in the scientific works of domestic and foreign scholars. The research methodology is based on bibliometric analysis, which allows accumulating an array of publications on a particular topic and processing it. For data collection, the Web of Science scientometric database was chosen. After applying a number of criteria – the choice of subject area, type of publications, language and year of publication – 948 papers between 2000 and 2023 were selected for final review. Valuable results obtained on the basis of the study include the following. Firstly, the authors’ publication activity stabilized and began to grow gradually in 2000, during the 1990s only 12 works were published. In 2021, the authors published the most – 113 works, and the highest level of citations was reached in 2023. Thus, the article by C. Fornell of 1981 was mentioned 72 times, the article by K. L. Keller of 1993 – 64 times, the publication by J. F. Hair of 1998 – 60 times. The composed chronology of citations in the analyzed scientific publications made it possible to trace the order of joint citation of literary sources. Thirdly, scholars from China, the United States and Great Britain show the greatest interest in the topic under study. Their joint scientific achievement makes 35% of the total number of analyzed publications. Fourthly, the words «branding» and «brand», «marketing», «destination» and «place» are often used both in keywords and in the titles of articles. Fifth, half of the analyzed articles meet at least one Sustainable Development Goal. The eleventh (Sustainable Cities and Communities), ninth (Innovation and Infrastructure) and third (Good Health) goals are most often reflected. Sixthly, Ukrainian scholars have published 13 articles on the topic of territory branding, which indicates interest in this topic and the presence of development potential. Further research will be aimed at deepening the typology of approaches to determining territory branding strategies.

Steven Pinker presents four ideals of Enlightenment in his popular book Enlightenment Now: The Case for Reason, Science, Humanism, and Progress. He argues his case brilliantly and convincingly through cogent arguments in a language comprehensible to the reader of the present century. Moreover, whether it is reason or science or humanism or progress, he defends his position powerfully. He justifies his views by citing 75 graphs on the upswing improvement made by humanity in terms of prosperity, longevity, education, equality of men and women, health, political freedom and medical breakthroughs. Though Pinker makes an excellent case for the positive contributions of Enlightenment; however he ignores the negative aspects that are responsible for causing a great schism between the white race and others who are black and brown. The paper highlights some of these negative comments made by such Enlightenment thinkers as Montesquieu, Voltaire, Chambers, Down and Down and others. Through their literary and scientific writings, these scholars and researchers downgraded the black and brown races, thus causing a rift that led to slavery, colonialism and apartheid. The paper reveals these negative aspects ignored by Pinker in his otherwise well-researched book on Enlightenment. Since Pinker presents a one-sided case by including only the positive contributions of Enlightenment, I recommend that he should write a sequel to his present work outlining the negative aspects responsible for numerous political, social and environmental problems facing humanity today. By using dialectical logic in place of logic of contraries, he might be able to synthesize both the positive and negative aspects of Enlightenment. He can then argue that humanity might be propelled to make progress more efficiently at a faster pace toward humanism and world peace.

In the absence of agreed institutional arrangements for the post-Brexit EU-UK relationship the present contribution explores whether guidance can be found for the institutional dimension of their future relationship in a number of other documents and principles. We will, first of all, examine the institutional framework laid down in the ‘Agreement on the withdrawal of the United Kingdom of Great Britain and Northern Ireland from the European Union and the European Atomic Energy Community, done at Brussels and London on 24 January 2020’, and its implementation. Second, we will uncover some aspects of the future institutional relationship based on the ‘Political Declaration setting out the framework for the future relationship between the European Union and the United Kingdom’ of 17 October 2019, which was adopted by the EU and the UK in parallel with the Withdrawal Agreement. Third, we will explore how the Commission sees that relationship based on its March 2020 draft text. Fourth, we will discuss at a meta level the principles which will in any event govern the institutional side of the future relationship, in particular the principle of good faith. Some brief concluding remarks round up. Brexit, Institutional Framework, European Union, United Kingdom, Withdrawal Agreement, Political Declaration

In a previous study (Gomm et al., 1991) people with a variety of respiratory diseases were tested and criteria defined for assessing their ability to provide samples for Breath Alcohol Testing Instruments. This study investigated the possible problems which may be encountered by healthy people of small stature — 5ft 5in (166cm) or less — who do not suffer from a respiratory disease. This study followed the same pattern as the earlier work in that lung function (Forced Expiration Volume in One Second (FEV1) and Forced Vital Capacity (FVC)) was measured by spirometry, and Peak Expiration Flow Rate (PEFR) was measured using a Wright peak flow meter. Following the lung function measurements the subjects were requested to provide samples for Breath Alcohol Testing Instruments used by the Police in Great Britain. As with the previously reported work (Gomm et al., 1991), this study found that the FEV1 and FVC gave the most reliable indication of a person's capability of satisfying the sampling requirements of Breath Alcohol Testing Instruments, but on this occasion the PEFR also provided a good confirmatory indication. Because there were no subjects with interstitial lung diseases the values determined by this study on 48 healthy adults indicate that a healthy person of small stature should be capable of supplying a suitable breath sample if their FEV1, FVC and PEFR are greater than 2.31, 2.61 and 330 1/min respectively.

The given research paper studies the regulatory normative acts of the Russian Federation and foreign states related to the legal meaning of the bill of lading applying the following scientific methods: dialectical method, the comparative legal and historical ones, systematic, formal legal method and special legal interpretation approach. Particular attention is paid to the legal documents of the United States of America and Great Britain as the legal acts of these countries have had the greatest impact on all foreign legislation related to the carriage of goods by sea in general, and the bill of lading, in particular. The authors highlight the points that require a more detailed study as well as other general and different features of the bill of lading in the Russian Federation and in other foreign states legislation. The problematic aspects of the bill of lading caused by the peculiarities of the Russian Federation historical development are also determined in the article. The studied material allows the authors to propose certain amendments to the current legislation of the Russian Federation: to include the legal regulations of the bill of lading into the legislative codified act – the Code of Merchant Shipping of the Russian Federation while at present they are mainly located in by-laws.

Communication is a major aspect of medical practice in such areas as the consultation, counselling, team work, management duties, health education and teaching. Many communication skills essential to the clinical consultation are different from those used in everyday life. They require an understanding of the doctor/patient relationship and of the self as well as of others. They also require a subserving repertoire of specific behavioural skills. The present paper sets out to emphasize this pervasive importance of communication skills in medical practice and to suggest some educational goals and objectives for those skills of particular relevance to the consultation. It describes one attempt to pursue these within the author's own school despite the piecemeal nature of such teaching. In Britain great emphasis is placed on the importance of clinical skills and this is reflected in the priority given to them in the final professional examination, and yet their communication aspects are rarely well defined within the curriculum or directly assessed. The author advocates the teaching and assessment of communication skills as a continuous process throughout undergraduate and postgraduate medical education for clinical practice.

Sudden infant death syndrome (SIDS) remains a pressing issue worldwide, with a significant number of cases occurring within the first six months of life. Many of these tragedies can be prevented by adhering to safe sleep guidelines. The effectiveness of large-scale educational programs focusing on these guidelines has been well-documented in developed countries, resulting in the saving of thousands of children's lives.In Ukraine, there are currently no national guidelines for the prevention of SIDS. To address this gap, we have compiled modern guidelines from other countries such as the USA, Great Britain, and Germany, along with the latest research data, to develop recommendations for safe sleep practices for children under one year of age. These recommendations cover various aspects, including the recommended sleep position (on the back), requirements for the sleeping surface and crib, suggestions for safe co-sleeping, and guidelines for maintaining an appropriate temperature. We also provide information on the beneficial effects of breastfeeding and vaccination in preventing SIDS, as well as the increased risks associated with overheating, the presence of soft objects near a sleeping child, and parental smoking and alcohol consumption.These recommendations should be disseminated to both parents and healthcare professionals involved in infant care.

Abstract Introduction Women constitute a significant portion of the global workforce and remain underrepresented in occupational health research and frameworks for occupational health and safety management. Methods This study describes women’s work-related ill-health (WRIH) reported to the Occupational Physicians Reporting Activity (OPRA) scheme between 2003 and 2022. OPRA is a national reporting scheme run from the University of Manchester as part of The Health and Occupation Research (THOR) network, covering Great Britain and Northern Ireland. Estimated cases were weighted and adjusted for temporal changes in reporter numbers. Results 51,464 estimated cases were reported to OPRA with the largest proportion being mental ill-health (64%) followed by musculoskeletal conditions (27%). 57% of musculoskeletal and 54% of mental ill-health cases were women employed in Human Health and Social Work activities, with the most common job roles being nurses and nursing auxiliaries and assistants. The most reported tasks for musculoskeletal WRIH were accidents, including assaults (22%), and heavy lifting (20%). The most reported events for mental ill-health were factors intrinsic to the role (48%) and interpersonal difficulties (34%). Discussion Work-related musculoskeletal conditions have historically been a concern with cases gradually decreasing over the years. However post-COVID-19 figures have started to rise, particularly with consideration to the sudden shift in remote working. Psychological conditions continue to dominate women’s WRIH, particularly attributed to workload and interpersonal difficulties. Conclusion Occupational diseases in women present a complex and underexplored domain. Recognising and addressing the gender-specific aspects of WRIH is crucial for creating safer and more equitable work environments.

Routinely-collected statistics show considerable variation between local authorities in Great Britain, in the proportions of supported residents placed in nursing and residential care. This raises the question of whether this is due to variations in demand (the type of resident approaching authorities), supply (the level and type of provision available for local authorities to purchase), or policy (in terms of eligibility criteria or interpretations of need at field level). Data were used from a national longitudinal survey of individuals admitted to publicly-funded residential and nursing home care. Information was collected from 18 local authorities on a cohort of 2,544 local authority supported residents who had been admitted to residential and nursing home care. The paper examines the pattern of admissions, the characteristics of people admitted and the relationship between these characteristics and admissions to residential or nursing home care. Characteristics of the individual explained the placement of over 80 per cent of admissions. Supply factors were statistically significant but did not improve the explanatory power of the model. Survival among those admitted to a type of care that was not predicted by the model, suggested that some unmeasured aspects of prognosis may account for some of the residual variation in placements. Overall, the results indicate a reasonably high level of consistency between authorities in nursing home placement decisions. This suggests that either there is considerable variation in the types of individual approaching local authorities or, more likely, that some authorities are more successful in maintaining people for longer at home than others. In addition to maintaining people at home to a higher level of dependency, prevention of admission to residential care is likely to be associated with: interventions that address carer support, safety issues among people who are deaf, and motivation.

The aim of the research: to conduct an analysis and generalization of scientific publications on the engaging patients to shared decision-making and partner participation in the treatment process. Materials and methods. The analysis and generalization of scientific publications on the implementation of shared decision-making strategy and the engaging of patients to self-management and participation in the treatment process were carried out. Methods were used: systematic approach, bibliosemantic, analytical. Results. In modern conditions, partner participation of patients in the treatment process has become a mandatory component of the development of a patient- centered model of medical care and is recommended by the WHO. A necessary component of this process is the implementation of shared decision-making strategy by the doctor and the patient. Organizational approaches to the implementation of the shared decision-making strategy in clinical practice are being improved and generalized, in particular, in 2021 NICE (Great Britain) experts published guideline NG197 «Shared decision-making». One of the most important factors of the shared decision-making strategy implementation in clinical practice is the training of medical staff on improving communication skills and empathy, engaging the patient to independent control of the disease, etc. WHO pays considerable attention to the engaging of patients self-management of health status and treatment results, as a component of patient partnership in the organization of medical care. It has been proven that self-management programs reduce the number of unplanned hospitalizations of patients with chronic obstructive pulmonary disease and bronchial asthma, heart failure, etc. A wide range of approaches have been proposed to support patient engagement in self-management and partnership in treatment, including information leaflets, online peer support, individual counselling, group educational sessions, telephone coaching, symptom monitoring technologies and change interventions psychological behavior. Conclusions: The implementation of a patient-centered model of medical care requires engaging patients in the treatment process as partners, which involves joint decision-making by the doctor and patient and self-management. It is essential to improve the communication skills of physicians and educate patients about participating in shared decision-making and self-management.

Background Nonspecific low back pain (NSLBP) carries significant socioeconomic relevance and leads to substantial difficulties for those who are affected by it. The effectiveness of app-based treatments has been confirmed, and clinicians are recommended to use such interventions. As 88.8% of the German population uses smartphones, apps could support therapy. The available apps in mobile app stores are poorly regulated, and their quality can vary. Overviews of the availability and quality of mobile apps for Australia, Great Britain, and Spain have been compiled, but this has not yet been done for Germany. Objective We aimed to provide an overview of the availability and content-related quality of apps for the treatment of NSLBP in the German language. Methods A systematic search for apps on iOS and Android was conducted on July 6, 2022, in the Apple App Store and Google Play Store. The inclusion and exclusion criteria were defined before the search. Apps in the German language that were available in both stores were eligible. To check for evidence, the apps found were assessed using checklists based on the German national guideline for NSLBP and the British equivalent of the National Institute for Health and Care Excellence. The quality of the apps was measured using the Mobile Application Rating Scale. To control potential inaccuracies, a second reviewer resurveyed the outcomes for 30% (3/8) of the apps and checked the inclusion and exclusion criteria for these apps. The outcomes, measured using the assessment tools, are presented in tables with descriptive statistics. Furthermore, the characteristics of the included apps were summarized. Results In total, 8 apps were included for assessment. Features provided with different frequencies were exercise tracking of prefabricated or adaptable workout programs, educational aspects, artificial intelligence–based therapy or workout programs, and motion detection. All apps met some recommendations by the German national guideline and used forms of exercises as recommended by the National Institute for Health and Care Excellence guideline. The mean value of items rated as “Yes” was 5.75 (SD 2.71) out of 16. The best-rated app received an answer of “Yes” for 11 items. The mean Mobile Application Rating Scale quality score was 3.61 (SD 0.55). The highest mean score was obtained in “Section B–Functionality” (mean 3.81, SD 0.54). Conclusions Available apps in the German language meet guideline recommendations and are mostly of acceptable or good quality. Their use as a therapy supplement could help promote the implementation of home-based exercise protocols. A new assessment tool to obtain ratings on apps for the treatment of NSLBP, combining aspects of quality and evidence-based best practices, could be useful. Trial Registration Open Science Framework Registries sq435; https://osf.io/sq435

The cybersecurity of medical devices is paramount in a world where everything is increasingly digitised. Attention to how this important defence against malicious actors is regulated must, therefore, also increase. This paper uncovers how the cybersecurity of medical devices is currently regulated and how it can be improved going forward. First, the paper compares the regulation of medical device cybersecurity in the European Union, the United States and the United Kingdom (UK)—differentiating between Great Britain and Northern Ireland as per the current state of the law in the UK. Second, the paper develops a model of how cybersecurity shapes three key areas in the ecosystem of medical devices. These areas are the medical device itself; the structure between the surrounding institutional systems (such as manufacturers and healthcare providers); and the security of the data, the surrounding institutional system and the medical device. Third, based on a comparative analysis and a view of the system from above, the paper puts forward four recommendations on what future regulation should contain to properly regulate the cybersecurity of medical devices: technology specificity, circumvention protection, genuine privacy and security by design. The paper recommends that these four principles be followed. Technology specificity because it guarantees legislation that understands the necessary technical aspects to promote security and safety. Circumvention protection because preventing manufacturers and others from circumventing these requirements decreases risks to the health and wellbeing of patients. Finally, genuine privacy and security by design should be followed to align cybersecurity and privacy with current and future technical capacities.

Pharmacists have traditionally supported the prescribing process, arguably in reactive or corrective roles. The advent of pharmacist prescribing in 2004 represented a major shift in practice, leading to greater responsibility for making clinical decisions with and for patients. Prescribing rights require pharmacists to take a more prescriptive role that will allow them to contribute to long-standing prescribing challenges such as poor medication adherence, overprescribing, and the need for shared decision-making and person-centered care. Central to these endeavors are the development and possession of effective consultation skills. University schools of pharmacists in the UK now routinely include consultation skills training, which is also provided by national education bodies. These challenges remain difficult to overcome, even though it is understood, for example, that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments. More recently, a concerted effort has been made to tackle overprescribing and the harm that may occur through the inappropriate use of medication. In routine pharmacy work, these priorities may linger at the bottom of the list due to the busy and complex nature of the work. Solutions to these problems of adherence, optimizing benefits of medication, and overprescribing have typically been pragmatic and structured. However, an arguably reductionist approach to implementation fails to address the complex patient interactions around prescribing and taking medication, and the heterogeneity of the patient’s experience, leaving the answers elusive. We suggest that it is essential to explore how person-centered care is perceived and to emphasize the relational aspects of clinical consultations. The development of routine pharmacist prescribing demands building on the core values of person-centered care and shared decision making by introducing the concepts of “relational prescribing” and “open dialogue” to cultivate an essential pharmacotherapeutic alliance to deliver concrete positive patient outcomes. We provide a vignette of how a clinical case can be approached using principles of relational prescribing and open dialogue. We believe these are solutions that are not additional tasks but must be embedded into pharmacy practice. This will improve professional satisfaction and resilience, and encourage curiosity and creativity, particularly with the advent of all pharmacists in Great Britain becoming prescribers at graduation from 2026.

The relationship between vitamin D deficiency and the metabolic syndrome has recently been revealed. Vitamin D deficiency was hypothesized to cause increased insulin resistance and decreased insulin secretion, which can result in the development of diabetes mellitus and obesity. Cardiovascular diseases are also closely related to the metabolic syndrome. Vitamin D has been shown to have complex multistep metabolism and act as a hormone at many extraskeletal targets. In this literature review, a comprehensive analysis of publications from Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health databases, as well as scientific libraries of Ukraine, European Union, Great Britain, USA and other countries was performed. Our goal is to identify and analyze scientific publications discussing various biological effects of vitamin D and its use in the comprehensive treatment of various diseases. In addition to the previously known role of vitamin D in calcium metabolism and the musculoskeletal system functionality, a wide range of its pleiotropic effects has been discovered recently. Modern studies have shown a relationship between low levels of vitamin D and development of neurocognitive dysfunction, mental and neurological disorders, infertility, immune reactivity and autoimmune disorders, various types of cancer, and cardiovascular pathologies. More recent data also revealed a relationship of vitamin D deficiency with practically all aspects of metabolic syndrome, namely diabetes mellitus type 2 and type 1, hyperglycemia, dyslipidemia, obesity, hypertension, and insulin resistance. It was concluded that the data of the modern literature regarding the effectiveness of vitamin D in the treatment and prevention of metabolic disorders and structural and functional changes of the liver in diabetes and non-alcoholic fatty liver disease are quite contradictory: at the same level as the numerous publications on the effective use of vitamin D, there are studies with unconfirmed effectiveness of therapy and even its toxicity for the indicated pathologies.

Scientific research consists of substantiation and development of conceptual foundations and recommendations for the development of a financial mechanism for providing state guarantees of medical care to the population based on foreign practice. The paper substantiates the relevance of building an effective financial mechanism for ensuring state guarantees of medical care for the population for the Ukrainian medical sphere is: the need to reform the healthcare system in Ukraine; changing the paradigm of financing the medical industry; financing of the medical industry is experiencing critical problems; catastrophic situation in ensuring the provision of specialized and highly specialized inpatient care; imperfection of mechanisms for ensuring financing of the health care system of Ukraine. In this work, the author examines in detail the features of the three main models of healthcare at the global level, classifies the healthcare systems of leading countries according to three main models, systematizes in tabular form the practice of six countries – Israel, Sweden, France, the USA, Great Britain Germany, in which these models received the most bright embodiment. The aim of the work consist of studding the general principles of financing models and organization of the health care system in the coordinates of globalization changes and European integration; analysis and characterization of the financial mechanism that provides state guarantees in the field of medical care Applied aspects are based on the systematization of the instrumental base for modelling the financial mechanism for providing state guarantees of medical care to the population, taking into account foreign experience. In the work, the author analyzed the calculations of the ratio of costs and indicators of the effectiveness of the health care system in 2020, the analytical dependence of average life expectancy on per capita expenditures in the health sector, % of GDP. The analysis carried out on the selected research issues provides a conceptual basis for the formation of an effective financial mechanism for budget policy in Ukraine to ensure state guarantees of medical care for the population; forms a platform for the development of macroeconomic stabilization policy. The prospects for further research are the improvement of the issues of the mechanism for the effective functioning of the public sector and the implementation of integrated management analysis.

IntroductionDementia has a significant psychological and emotional impact on families, especially for caregivers of people living with dementia. In this perspective, the World Health Organization has developed iSupport for Dementia, an online training and skills program to prevent and/or reduce mental health problems associated with the provision of care and improve the quality of life of caregivers. It is being translated and adapted in different countries and as of August 2022, 31 adaptations using 27 different languages were in progress. However, the availability of the program should only be carried out after evaluating its effects on caregivers’ mental health outcomes (such as burden, depressive and anxious symptoms, quality of life, among others).ObjectivesTo analyze randomized clinical trial protocols to assess the effects of the iSupport program in different countries.MethodsThis is a data survey carried out in October 2022 on clinical trial registry platforms Clinical Trials, The Brazilian Registry of Clinical Trials, Cochrane Central Register of Controlled Trials, Netherlands Trial Register and Australian New Zealand Clinical Trials Registry by two independent researchers. Descriptive analyzis were performed for sample size, primary outcomes, secondary outcomes and intervention design.ResultsSeven clinical trial registries were identified, conducted in Australia/China, Brazil, Great Britain, the Netherlands, India, Japan and Portugal, published in English, from 2018 to 2022. The sample size ranged from 184 to 390 participants. Regarding the primary outcomes linked to the effect of using iSupport, five countries will analyze burden, anxiety and depression. Only in Australia/China and the Netherlands, the primary outcome will be quality of life and stress, respectively. Secondary outcomes vary between studies, with measures of quality of life (n=6), self-efficacy (n=4), program usability (n=4), cognition and problematic behaviors (n=3), attitudes (n=3), quality of support (n=3), positive aspects of care (n=2), knowledge, competence, resilience and informal costs of care (n=1). Most studies will carry out assessments at baseline, 3 and 6 months after the intervention, with the exception of Japan that will perform at baseline and at 1 and 3 months after the intervention and 6 months.ConclusionsAnalysis of the effectiveness of iSupport is one of the World Health Organization guidelines for countries that are culturally adapting this program. Brazil is the only country in Latin America with a clinical trial registration so far. Burden, anxiety and depression are outcomes considered by most countries. The results could provide evidence to strengthen and expand the possibilities for collaboration between researchers, as internet-based interventions have shown promising results on the mental health and well-being.Disclosure of InterestNone Declared

IX International Scientific Conference dedicated to the memory of academicians V.P. Alexeev and T.I.Alexeeva, was held in Moscow from October 17th to October 20th, 2022. This time, the leading organizer of the event was the Institute of Ethnology and Anthropology N.N. Miklukho-Maclay of the Russian Academy of Sciences, although as in the previous Alexeevsky readings, the Scientific Research Institute and the Museum of Anthropology named after D.N. Anuchin Moscow State University and the Institute of Archaeology of the Russian Academy of Sciences were actively involved in it’s organization. Despite the fact that this time all presentations were held online, it should be noted that the quality of papers, as well as the activity of the participants of the event, turned out to be at the highest level. 90 papers were presented by 120 authors from Russia, Armenia, Belarus, India, Poland, Mongolia and Great Britain. Russian speakers represented scientific institutions from Moscow, Krasnodar region, Nizhny Novgorod, Kemerovo, Tyumen and Rostov regions, Volgograd, Ufa, Magadan, Pskov and St.Petersburg. At the opening of the conference, the names of the winners of the V.P Alexeev and T.I.Alexeeva Award in the field of interdisciplinary research in archaeology and anthropology in 2022 were announced. They were DSci Balabanova Aria Afanasievna and PhD Pererva Evgeny Vladimirovich. We sincerely congratulate our Volgograd colleagues and wish them new discoveries and scientific achievements. The topics of the meeting reflected the main modern trends in biological anthropology and related disciplines and included the Russian-Indian roundtable “Children’s Growth and Health”, conducted in English, as well as the sections “Human Evolution and Behavior: Modern Approaches and Perspectives”, “Modern Problems in Applied Anthropology”, “Adaptation Processes in the Indigenous People from the Modern Human Populations”, “Sports Anthropology”, “Modern Issues of the Ethnogenesis of Ancient Populations”, “Factors of the Population Variability – New Approaches and Perspectives of Research”, “Bioarchaeological Reconstruction – Perspectives and Limits of the Method”, “Paleoecological Aspects of Human Studies in the Context of Modern Biogeochemical Research”, “Demography as a tool for analyzing the stress resistance of a population in the past and present”.

Physicians in the United States have been affected by significant changes in the pattern(s) of medical practice evolving over the last several decades. These changes include new measures to 1) curb increasing costs, 2) increase access to patient care, 3) improve quality of healthcare, and 4) pay for prescription drugs. Escalating healthcare costs have focused concerns about the financial solvency of Medicare and this in turn has fostered a renewed interest in the economic basis of interventional pain management practices. The provision and systemization of healthcare in North America and several European countries are difficult enterprises to manage irrespective of whether these provisions and systems are privatized (as in the United States) or nationalized or semi-nationalized (as in Great Britain, Canada, Australia and France). Consequently, while many management options have been put forth, none seem to be optimally geared toward affording healthcare as a maximized individual and social good, and none have been completely enacted. The current physician fee schedule (released on July 12, 2007) includes a 9.9% cut in payment rate. Since the Medicare program was created in 1965, several methods have been used to determine physicians’ rate(s) for each covered service. The sustained growth rate (SGR) system, established in 1998, has evoked negative consequences on physician payment(s). Based on the current Medicare expenditure index, practice expenses are projected to increase by 34.5% from 2002 to 2016, whereas, if actual practice inflation is considered, this increase will be 90%. This is in contrast to projected physician payment cuts that are depicted to be 51%. No doubt, this scenario will be devastating to many practices and the US medical community at large. Resolutions to this problem have been offered by MedPAC, the Government Accountability Office, physician organizations, economists, and various other interested groups. In the past, temporary measures have been proposed (and sometimes implemented) to eliminate physician payment cuts. At present, the US Senate and House of Representatives are separately working on 2 different mechanisms to address and rectify these cost-payment discrepancies. The effects of both the problem and the potential solutions on interventional pain management may be somewhat greater than those on other specialties. Physician payments in interventional pain management may evidence cuts of 10% to 15%, whereas if procedures are performed in an office setting, such cuts may range from 29% to 39% over the period of the next 3 years if the proposed 9.9% cut is not reversed. Medicare cuts also impact other insurance payments, incurring a “ripple effect” such that many insurers will seek to pay at or around the Medicare rate. In this manuscript, we discuss universal healthcare systems, the CMS proposed ruling and its attendant ripple effect(s), historical aspects of the Medicare payment system, the Sustained Growth Rate system, and the potential consequences incurred by both proposed cuts and potential solutions to the discrepant cost-payment issue(s). As well, ethical issues of policy development upon the infrastructure and practice of interventional pain management are addressed. Key words: Health policy, physician payment policy, physician fee schedule, Medicare, sustained growth rate formula, interventional pain management, regulatory reform, ethics

Deferred taxes are an important object of accounting observation, which has a significant impact on management decision-making by users. At the current stage of development of accounting and tax accounting theory and practice, many aspects of tax effect recognition in the financial information system still remain debatable. This provides possibilities, including for accounting fraud, associated with veiling profit indicators and items in the enterprises’ financial statements. This causes the relevance of studying the essential features of deferred taxes, as well as the analysis of global experience in the assessment of arising “differences”, their classification, and accounting methods. The scientific novelty of the study lies in the development and substantiation of classification features of deferred taxes, including their systematization by methods of accounting, assessment and varieties. The paper characterizes the reason for accounting and taxation deviations, the evolution of the key deferred taxes types is described, the criteria for their registration in finance accounting are considered as the legislation in the USA, Great Britain, and other countries is improved. The paper defines the key challenges of accounting and estimation of deferred taxes, including the questions on theoretical inconsistency of deferred taxes with the concepts of assets and liabilities. The unresolved problems include the deferred tax depreciation procedure which is not regulated by the Russian accounting standards. In its turn, IFRS ascribes this procedure to the competence of the specialists who actively apply the method of creation (restoration) of valuation allowance for opportunistic purposes, which increases the importance of research in this area. The results of this work are useful for a wide range of experts specializing in the theory and practice of financial analysis, accounting and tax accounting and auditing and can serve as a basis for overcoming contradictions in the practice of deferred tax accounting. The prospects of the research lie in the empirical tests confirming the informational significance of deferred taxes in the financial statements of the Russian companies. What is more, the possible areas of scientific interest are the development of the accounting methods for deferred taxes depreciation and the connection of deferred taxes with bankruptcy and the company’s financial stability indicators. The growing attention of the academic community to deferred taxes could lead to the inclusion of a deferred taxes category in a comprehensive financial analysis of business activities.

Aim: The aim of this publication is to present the most important aspects concerning the conditions for evacuation of people with various types of disabilities – from mobility problems, to reduced perception in the event of a threat, and to indicate the most important challenges both in terms of legal regulations, as well as organizational and technological conditions for ensuring effective evacuation of disabled people. Introduction: People with disabilities are a group that requires special consideration when planning evacuation from public utility facilities, because many of these people – depending on the type and degree of their dysfunction – will not be able to evacuate from the danger zone on their own. The inspection carried out in 2019 by the Delegation of the Supreme Audit Office in Poznań confirmed the need to adapt the applicable legal regulations in this regard (in practice, fire safety instructions, evacuation plans, staff training and equipping facilities with adequate equipment supporting the evacuation of people with disabilities) [1]. In addition to legal and technological aspects, a very important factor in the effective evacuation of disabled people are organizational solutions adopted in a given facility, which should take into account the individual specificity (cubature) and functions of a given facility. Methodology: As part of the research process, theoretical research was used, such as: analysis of literature and legal documents, synthesis, general- ization, inference, comparison and analogy. During the research, national and foreign sources (from the United States and Great Britain) were analyzed. The selection of individual countries was guided by the level of development of the solutions adopted in these countries dedicated to supporting the evacuation of disabled people in a situation of threat to their life or health, as well as the availability of data sources. Conclusions: The presented analysis of the conditions for the evacuation of people with disabilities from public utility buildings shows the challenges that both the legislator and managers of facilities in the country face in this area, as well as the emergency services. The latter – similarly to people with disabilities – are the systemic beneficiaries of the desired changes in the area of law and tactics of rescue operations, from the moment of alerting about an event in the facility where there are people who are unable to evacuate themselves. Introducing good practices, verified in other countries, into common application, should significantly improve rescue operations. The expected effect will be to shorten the time of providing help to all people unable to evacuate themselves in an emergency – regardless of their number, as well as the type and specificity of the public facility in which the life or health threatening situation occurred. Keywords: evacuation of disabled people, public utility buildings, intelligent construction, modelling and computer simulations, individual evacuation plan Type of article: review article

Background Care home staff have a critical bearing on quality. The staff employed, the training they receive and how well they identify and manage residents’ needs are likely to influence outcomes. The Care Act 2014 (Great Britain. The Care Act 2014. London: The Stationery Office; 2014) requires services to improve ‘well-being’, but many residents cannot self-report and are at risk of exclusion from giving their views. The Adult Social Care Outcomes Toolkit enables social care-related quality of life to be measured using a mixed-methods approach. There is currently no equivalent way of measuring aspects of residents’ health-related quality of life. We developed new tools for measuring pain, anxiety and depression using a mixed-methods approach. We also explored the relationship between care home quality, residents’ outcomes, and the skill mix and employment conditions of the workforce who support them. Objectives The objectives were to develop and test measures of pain, anxiety and depression for residents unable to self-report; to assess the extent to which regulator quality ratings reflect residents’ care-related quality of life; and to assess the relationship between aspects of the staffing of care homes and the quality of care homes. Design This was a mixed-methods study. Setting The setting was care homes for older adults in England. Participants Care home residents participated. Results Three measures of pain, anxiety and low mood were developed and tested, using a mixed-methods approach, with 182 care home residents in 20 care homes (nursing and residential). Psychometric testing found that the measures had good construct validity. The mixed-methods approach was both feasible and necessary with this population, as the majority of residents could not self-report. Using a combined data set (n = 475 residents in 54 homes) from this study and the Measuring Outcomes in Care Homes study (Towers AM, Palmer S, Smith N, Collins G, Allan S. A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England. Health Qual Life Outcomes 2019;17:22) we found a significant positive association between residents’ social care-related quality of life and regulator (i.e. Care Quality Commission) quality ratings. Multivariate regression revealed that homes rated ‘good/outstanding’ are associated with a 12% improvement in mean current social care-related quality of life among residents who have higher levels of dependency. Secondary data analysis of a large, national sample of care homes over time assessed the impact of staffing and employment conditions on Care Quality Commission quality ratings. Higher wages and a higher prevalence of training in both dementia and dignity-/person-centred care were positively associated with care quality, whereas high staff turnover and job vacancy rates had a significant negative association. A 10% increase in the average care worker wage increased the likelihood of a ‘good/outstanding’ rating by 7%. Limitations No care homes rated as inadequate were recruited to the study. Conclusions The most dependent residents gain the most from homes rated ‘good/outstanding’. However, measuring the needs and outcomes of these residents is challenging, as many cannot self-report. A mixed-methods approach can reduce methodological exclusion and an over-reliance on proxies. Improving working conditions and reducing staff turnover may be associated with better outcomes for residents. Future work Further work is required to explore the relationship between pain, anxiety and low mood and other indicators of care homes quality and to examine the relationship between wages, training and social care outcomes. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 19. See the NIHR Journals Library website for further project information.

The article deals with the problems of designing and updating study programmes during the integration process of the Lithuanian education system into the European education space. After the substantial change of general programmes of Basic education(2008) and Secondary education (2011) and seeking to fully involve self-development of general cultural, subject specific, generic and specific competencies which are necessary for teachers, it is important to update the study programmes.The problem of the research: what content of technology teacher training programme should be from the innovations point of view in order to meet the expectations of the changing society.The object of the research: the innovative content of the technology teacher training programme.The aim of the research: to highlight the innovative aspects of the content of technology teacher training programmes, having performed content analysis of technology teacher training programmes of the universities of Lithuania and some European countries.Research methods:analysis of scientific literature, analysis of the programmes of universities of some European countries which provide training for technology teachers as well as the analysis of the legal acts and strategic education policy documents of the European Union and the Republic of Lithuania.Updating of the study programme of technological education is a permanent process, which is conditioned by the following factors: market economy and the needs of information society, the fact that higher education is becoming mass, penetration of humanistic ideas into the content of education as well as the valid unified study quality assessment policy in the European Union.Taking into account the recommendations of the international experts’ group and considering international changes of analogous study programmes, the Committee of Technology Pedagogics Study Programmes of Lithuanian University of Educational Sciences in cooperation with the social partners carried out a research of opinions of students, graduates, university lecturers and employers on the study quality.They also performed a comprehensive analysis of the Bachelor’s degree study programmes of some Western European universities. The analysis revealed that theoretical models of study programmes design of different European universities have similarities and differences, which are determined by the philosophical aspect, humanistic ideas and the context of the national education policy. In the research the experience of five universities from the innovations point of view was used: the University of Helsinki (Finland), Queen Margaret University, Edinburgh (Great Britain), the Polytechnic Institute of Tomar (Portugal), and the University of Iceland.The following elective subjects have been included in the study programme of technology pedagogics: pedagogical ethics, sustainable development and social welfare, educational creative projects, family health education, health promoting nutrition education, visualization of technology education, eco creations, national and global food culture, interior design, technology education for special needs students, art therapy, development of leadership competencies, formation of study archives. The hidden curriculum of the study programme of technology pedagogics is ethnic culture, ecology, project activities.

In my postgraduate formation during the last years of the 80’s, we had close to thirty hospital beds in a pavilion called “sépticas” (1). In Colombia, where abortion was completely penalized, the pavilion was mostly filled with women with insecure, complicated abortions. The focus we received was technical: management of intensive care; performance of hysterectomies, colostomies, bowel resection, etc. In those times, some nurses were nuns and limited themselves to interrogating the patients to get them to “confess” what they had done to themselves in order to abort. It always disturbed me that the women who left alive, left without any advice or contraceptive method. Having asked a professor of mine, he responded with disdain: “This is a third level hospital, those things are done by nurses of the first level”. Seeing so much pain and death, I decided to talk to patients, and I began to understand their decision. I still remember so many deaths with sadness, but one case in particular pains me: it was a woman close to being fifty who arrived with a uterine perforation in a state of advanced sepsis. Despite the surgery and the intensive care, she passed away. I had talked to her, and she told me she was a widow, had two adult kids and had aborted because of “embarrassment towards them” because they were going to find out that she had an active sexual life. A few days after her passing, the pathology professor called me, surprised, to tell me that the uterus we had sent for pathological examination showed no pregnancy. She was a woman in a perimenopausal state with a pregnancy exam that gave a false positive due to the high levels of FSH/LH typical of her age. SHE WAS NOT PREGNANT!!! She didn’t have menstruation because she was premenopausal and a false positive led her to an unsafe abortion. Of course, the injuries caused in the attempted abortion caused the fatal conclusion, but the real underlying cause was the social taboo in respect to sexuality. I had to watch many adolescents and young women leave the hospital alive, but without a uterus, sometime without ovaries and with colostomies, to be looked down on by a society that blamed them for deciding to not be mothers. I had to see situation of women that arrived with their intestines protruding from their vaginas because of unsafe abortions. I saw women, who in their despair, self-inflicted injuries attempting to abort with elements such as stick, branches, onion wedges, alum bars and clothing hooks among others. Among so many deaths, it was hard not having at least one woman per day in the morgue due to an unsafe abortion. During those time, healthcare was not handled from the biopsychosocial, but only from the technical (2); nonetheless, in the academic evaluations that were performed, when asked about the definition of health, we had to recite the text from the International Organization of Health that included these three aspects. How contradictory! To give response to the health need of women and guarantee their right when I was already a professor, I began an obstetric contraceptive service in that third level hospital. There was resistance from the directors, but fortunately I was able to acquire international donations for the institution, which facilitated its acceptance. I decided to undertake a teaching career with the hope of being able to sensitize health professionals towards an integral focus of health and illness. When the International Conference of Population and Development (ICPD) was held in Cairo in 1994, I had already spent various years in teaching, and when I read their Action Program, I found a name for what I was working on: Sexual and Reproductive Rights. I began to incorporate the tools given by this document into my professional and teaching life. I was able to sensitize people at my countries Health Ministry, and we worked together moving it to an approach of human rights in areas of sexual and reproductive health (SRH). This new viewpoint, in addition to being integral, sought to give answers to old problems like maternal mortality, adolescent pregnancy, low contraceptive prevalence, unplanned or unwanted pregnancy or violence against women. With other sensitized people, we began with these SRH issues to permeate the Colombian Society of Obstetrics and Gynecology, some universities, and university hospitals. We are still fighting in a country that despite many difficulties has improved its indicators of SRH. With the experience of having labored in all sphere of these topics, we manage to create, with a handful of colleagues and friend at the Universidad El Bosque, a Master’s Program in Sexual and Reproductive Health, open to all professions, in which we broke several paradigms. A program was initiated in which the qualitative and quantitative investigation had the same weight, and some alumni of the program are now in positions of leadership in governmental and international institutions, replicating integral models. In the Latin American Federation of Obstetrics and Gynecology (FLASOG, English acronym) and in the International Federation of Obstetrics and Gynecology (FIGO), I was able to apply my experience for many years in the SRH committees of these association to benefit women and girls in the regional and global environments. When I think of who has inspired me in these fights, I should highlight the great feminist who have taught me and been with me in so many fights. I cannot mention them all, but I have admired the story of the life of Margaret Sanger with her persistence and visionary outlook. She fought throughout her whole life to help the women of the 20th century to be able to obtain the right to decide when and whether or not they wanted to have children (3). Of current feminist, I have had the privilege of sharing experiences with Carmen Barroso, Giselle Carino, Debora Diniz and Alejandra Meglioli, leaders of the International Planned Parenthood Federation – Western Hemisphere Region (IPPF-RHO). From my country, I want to mention my countrywoman Florence Thomas, psychologist, columnist, writer and Colombo-French feminist. She is one of the most influential and important voices in the movement for women rights in Colombia and the region. She arrived from France in the 1960’s, in the years of counterculture, the Beatles, hippies, Simone de Beauvoir, and Jean-Paul Sartre, a time in which capitalism and consumer culture began to be criticized (4). It was then when they began to talk about the female body, female sexuality and when the contraceptive pill arrived like a total revolution for women. Upon its arrival in 1967, she experimented a shock because she had just assisted in a revolution and only found a country of mothers, not women (5). That was the only destiny for a woman, to be quiet and submissive. Then she realized that this could not continue, speaking of “revolutionary vanguards” in such a patriarchal environment. In 1986 with the North American and European feminism waves and with her academic team, they created the group “Mujer y Sociedad de la Universidad Nacional de Colombia”, incubator of great initiatives and achievements for the country (6). She has led great changes with her courage, the strength of her arguments, and a simultaneously passionate and agreeable discourse. Among her multiple books, I highlight “Conversaciones con Violeta” (7), motivated by the disdain towards feminism of some young women. She writes it as a dialogue with an imaginary daughter in which, in an intimate manner, she reconstructs the history of women throughout the centuries and gives new light of the fundamental role of feminism in the life of modern women. Another book that shows her bravery is “Había que decirlo” (8), in which she narrates the experience of her own abortion at age twenty-two in sixty’s France. My work experience in the IPPF-RHO has allowed me to meet leaders of all ages in diverse countries of the region, who with great mysticism and dedication, voluntarily, work to achieve a more equal and just society. I have been particularly impressed by the appropriation of the concept of sexual and reproductive rights by young people, and this has given me great hope for the future of the planet. We continue to have an incomplete agenda of the action plan of the ICPD of Cairo but seeing how the youth bravely confront the challenges motivates me to continue ahead and give my years of experience in an intergenerational work. In their policies and programs, the IPPF-RHO evidences great commitment for the rights and the SRH of adolescent, that are consistent with what the organization promotes, for example, 20% of the places for decision making are in hands of the young. Member organizations, that base their labor on volunteers, are true incubators of youth that will make that unassailable and necessary change of generations. In contrast to what many of us experienced, working in this complicated agenda of sexual and reproductive health without theoretical bases, today we see committed people with a solid formation to replace us. In the college of medicine at the Universidad Nacional de Colombia and the College of Nursing at the Universidad El Bosque, the new generations are more motivated and empowered, with great desire to change the strict underlying structures. Our great worry is the onslaught of the ultra-right, a lot of times better organized than us who do support rights, that supports anti-rights group and are truly pro-life (9). Faced with this scenario, we should organize ourselves better, giving battle to guarantee the rights of women in the local, regional, and global level, aggregating the efforts of all pro-right organizations. We are now committed to the Objectives of Sustainable Development (10), understood as those that satisfy the necessities of the current generation without jeopardizing the capacity of future generations to satisfy their own necessities. This new agenda is based on: - The unfinished work of the Millennium Development Goals - Pending commitments (international environmental conventions) - The emergent topics of the three dimensions of sustainable development: social, economic, and environmental. We now have 17 objectives of sustainable development and 169 goals (11). These goals mention “universal access to reproductive health” many times. In objective 3 of this list is included guaranteeing, before the year 2030, “universal access to sexual and reproductive health services, including those of family planning, information, and education.” Likewise, objective 5, “obtain gender equality and empower all women and girls”, establishes the goal of “assuring the universal access to sexual and reproductive health and reproductive rights in conformity with the action program of the International Conference on Population and Development, the Action Platform of Beijing”. It cannot be forgotten that the term universal access to sexual and reproductive health includes universal access to abortion and contraception. Currently, 830 women die every day through preventable maternal causes; of these deaths, 99% occur in developing countries, more than half in fragile environments and in humanitarian contexts (12). 216 million women cannot access modern contraception methods and the majority live in the nine poorest countries in the world and in a cultural environment proper to the decades of the seventies (13). This number only includes women from 15 to 49 years in any marital state, that is to say, the number that takes all women into account is much greater. Achieving the proposed objectives would entail preventing 67 million unwanted pregnancies and reducing maternal deaths by two thirds. We currently have a high, unsatisfied demand for modern contraceptives, with extremely low use of reversible, long term methods (intrauterine devices and subdermal implants) which are the most effect ones with best adherence (14). There is not a single objective among the 17 Objectives of Sustainable Development where contraception does not have a prominent role: from the first one that refers to ending poverty, going through the fifth one about gender equality, the tenth of inequality reduction among countries and within the same country, until the sixteenth related with peace and justice. If we want to change the world, we should procure universal access to contraception without myths or barriers. We have the moral obligation of achieving the irradiation of extreme poverty and advancing the construction of more equal, just, and happy societies. In emergency contraception (EC), we are very far from reaching expectations. If in reversible, long-term methods we have low prevalence, in EC the situation gets worse. Not all faculties in the region look at this topic, and where it is looked at, there is no homogeneity in content, not even within the same country. There are still myths about their real action mechanisms. There are countries, like Honduras, where it is prohibited and there is no specific medicine, the same case as in Haiti. Where it is available, access is dismal, particularly among girls, adolescents, youth, migrants, afro-descendent, and indigenous. The multiple barriers for the effective use of emergency contraceptives must be knocked down, and to work toward that we have to destroy myths and erroneous perceptions, taboos and cultural norms; achieve changes in laws and restrictive rules within countries, achieve access without barriers to the EC; work in union with other sectors; train health personnel and the community. It is necessary to transform the attitude of health personal to a service above personal opinion. Reflecting on what has occurred after the ICPD in Cairo, their Action Program changed how we look at the dynamics of population from an emphasis on demographics to a focus on the people and human rights. The governments agreed that, in this new focus, success was the empowerment of women and the possibility of choice through expanded access to education, health, services, and employment among others. Nonetheless, there have been unequal advances and inequality persists in our region, all the goals were not met, the sexual and reproductive goals continue beyond the reach of many women (15). There is a long road ahead until women and girls of the world can claim their rights and liberty of deciding. Globally, maternal deaths have been reduced, there is more qualified assistance of births, more contraception prevalence, integral sexuality education, and access to SRH services for adolescents are now recognized rights with great advances, and additionally there have been concrete gains in terms of more favorable legal frameworks, particularly in our region; nonetheless, although it’s true that the access condition have improved, the restrictive laws of the region expose the most vulnerable women to insecure abortions. There are great challenges for governments to recognize SRH and the DSR as integral parts of health systems, there is an ample agenda against women. In that sense, access to SRH is threatened and oppressed, it requires multi-sector mobilization and litigation strategies, investigation and support for the support of women’s rights as a multi-sector agenda. Looking forward, we must make an effort to work more with youth to advance not only the Action Program of the ICPD, but also all social movements. They are one of the most vulnerable groups, and the biggest catalyzers for change. The young population still faces many challenges, especially women and girls; young girls are in particularly high risk due to lack of friendly and confidential services related with sexual and reproductive health, gender violence, and lack of access to services. In addition, access to abortion must be improved; it is the responsibility of states to guarantee the quality and security of this access. In our region there still exist countries with completely restrictive frameworks. New technologies facilitate self-care (16), which will allow expansion of universal access, but governments cannot detach themselves from their responsibility. Self-care is expanding in the world and can be strategic for reaching the most vulnerable populations. There are new challenges for the same problems, that require a re-interpretation of the measures necessary to guaranty the DSR of all people, in particular women, girls, and in general, marginalized and vulnerable populations. It is necessary to take into account migrations, climate change, the impact of digital media, the resurgence of hate discourse, oppression, violence, xenophobia, homo/transphobia, and other emergent problems, as SRH should be seen within a framework of justice, not isolated. We should demand accountability of the 179 governments that participate in the ICPD 25 years ago and the 193 countries that signed the Sustainable Development Objectives. They should reaffirm their commitments and expand their agenda to topics not considered at that time. Our region has given the world an example with the Agreement of Montevideo, that becomes a blueprint for achieving the action plan of the CIPD and we should not allow retreat. This agreement puts people at the center, especially women, and includes the topic of abortion, inviting the state to consider the possibility of legalizing it, which opens the doors for all governments of the world to recognize that women have the right to choose on maternity. This agreement is much more inclusive: Considering that the gaps in health continue to abound in the region and the average statistics hide the high levels of maternal mortality, of sexually transmitted diseases, of infection by HIV/AIDS, and the unsatisfied demand for contraception in the population that lives in poverty and rural areas, among indigenous communities, and afro-descendants and groups in conditions of vulnerability like women, adolescents and incapacitated people, it is agreed: 33- To promote, protect, and guarantee the health and the sexual and reproductive rights that contribute to the complete fulfillment of people and social justice in a society free of any form of discrimination and violence. 37- Guarantee universal access to quality sexual and reproductive health services, taking into consideration the specific needs of men and women, adolescents and young, LGBT people, older people and people with incapacity, paying particular attention to people in a condition of vulnerability and people who live in rural and remote zone, promoting citizen participation in the completing of these commitments. 42- To guarantee, in cases in which abortion is legal or decriminalized in the national legislation, the existence of safe and quality abortion for non-desired or non-accepted pregnancies and instigate the other States to consider the possibility of modifying public laws, norms, strategies, and public policy on the voluntary interruption of pregnancy to save the life and health of pregnant adolescent women, improving their quality of life and decreasing the number of abortions (17).

Population geography is a subdiscipline of Human geography and studies the distribution, concentration and density of population over the terestrial surface, as well as differences in population size, changes and characteristics, like structures, migrations, activity etc, among some places present compared to others. Population geography has had a perscientific stage as long as human history. First modern scientific treatis of population in geography was the F. Ratzels book Antropogeography in 1882. During the first half of the XX century, French geographer Vidal de la Blanche gave a capital importance of population studies in his work Principes de Geographie Humaine. In interwar years, various aspects of population were studied. After The Second World War started the renovating movement of geography and new tendencies appear in human geography and, consequently in population geography. Attempts were made to define population geography as a separate sub-discipline. The world wide trend of treating population geography as separate discipline was expressed by publishing monographs, bibliographies and textbooks. The most significant authors who worked on defining population geography were French geographers P. George (1951, 1959), Beaujen-Garnier (1965, 1966); North-american geographers: G. Trewarta (1953, 1969), W. Bunge (1962), J. Clance (1965, 1971), W. Zelinski (1966); in Great Britain: J.I. Clarke (1965); in USSR: Ju.G. Sauskin i D.N. Anucin (1950), V.V. Poksisevskij (1966), D.I. Valentej (1973); in Poland V. Ormotski (1931), L. Kosinski (1967) A. Jagelski (1980). Those authors and their works had the significant influence on the development of population science in the world and also in Serbia. Although the development of population geography was different in different countries and scientific research centers, we can clearly defined four stages. First stage lasted untill 1960s and was characterised by works of G.Trewarta, H. Doerres Ju.G. Sauskin, D.N. Anucin, J. Beaujeu-Gariner. G. Trewarta argued that the population is the point of reference from which all other elements are observed and from which all derive significance and meaning. This view was adopted and shared by authors dealing with population items, explicitly or implicitly. Second stage lasted from 1960s till 1970s and the most significant authors dealing with population problems were W. Zelinsky, W. Bunge; H.Bobek, W. Hartke, K.Ruppert, F.Schaffer; D.I. Valentej, K.Korcak. This phase was characterized by the application of quantitative methods and efforts for understanding the spatial structure of the population. Many scientists see this development phase as a particularly prosperous period, because it carried more intensive relations of geography and demography through the introduction of statistical, mathematical and demographic methods and techniques in studies of population geography. Third phase lasted from 1970s to 1980s, and was characterized by close relations between population geography and formal demography. Development and application of GIS and computer data, have made population studies more complex and applicable in practice, through population policy and population projections. The most significant authors in this period were L. Kosinski, A. Jagelski, H?gerstrand. And at last, fourth stage started in 1980s and in many countries lastes untill present days. In population geography appeared new tendencies associated with the critique of positivism, the establishment of humanistic approaches and modifications of general geographic concepts. In this period, spatial analysis and quantitative scientific methods were reaffirmed, and because of that some population studies were redefined in spatial demography, a time dimension advocated in historical demography. In this context, we emphasize the work of D. Plane and P. Rogerson. Population geography is viewed differently from one country to another. Its definition differs from too narrow to overly broad. But two research areas were of particular interest to geographers - population distribution and migration. Both items acquired an international dimension. Recently, eminent population geographers exchanged various view points in an attempt to provoke new thinking on subject and define the answers of new fields research in population geography. Population geography in the XXI Century is no longer a field comprised of spatial applications of fertility, mortality and migration only. Contemporary population geography is theoretically sophisticated, integrating spatial analysis, GIS and geo-referenced data. Future progress in the field of population geography will derive from more research at the intersections of population processes and societal issues and concerns. Major themes of future empirical researches in population geography should be: global population growth, studies of migration, transnationalism, human security issues, population-health-environment nexus, human-environment sustainability, economic development and poverty issues.