Статті в журналах з теми "Drugs sports policy"

AbstractThis article concerns the legal issues that surround the prohibition of doping in sport. The current policy on the use of performance enhancing drugs (PEDs) in sport is underpinned by both a paternalistic desire to protect athletes' health and the long-term integrity or ‘spirit’ of sport. The policy is put into administrative effect globally by the World Anti-Doping Agency (WADA), which provides the regulatory and legal framework through which the vast majority of international sports federations harmonise their anti-doping programmes. On outlining briefly both the broad administrative structures of international sport's various anti-doping mechanisms, and specific legal issues that arise in disciplinary hearings involving athletes accused of doping, this article questions the sustainability of the current ‘zero tolerance’ approach, arguing, by way of analogy to the wider societal debate on the criminalisation of drugs, and as informed by Sunstein and Thaler's theory of libertarian paternalism, that current policy on anti-doping has failed. Moreover, rather than the extant moral and punitive panic regarding doping in sport, this article, drawing respectively on Seddon's and Simon's work on the history of drugs and crime control mentality, contends that, as an alternative, harm reductionist measures should be promoted, including consideration of the medically supervised use of certain PEDs.

Recently, the controversy surrounding the use of steroids and performance-enhancing drugs by Olympic and professional athletes has captured the media spotlight, in part as a response to the very public and pervasive steroids scandal plaguing Major League Baseball (MLB). This article examines trends in Americans’ attitudes toward the use of steroids and performance-enhancing drugs in Olympic and professional sport as a way to better understand the messaging challenges that policy makers, players, managers, coaches, and publicists face when trying to influence the media agenda. As the poll data presented suggest, Americans feel that the incidence of performanceenhancing- drug use in professional sport is significant, especially in MLB. Furthermore, Americans suggest that the leadership of various professional sports is not doing enough to combat the use of steroids and performance-enhancing drugs by top competitors.

ObjectivePharmacy services at large multisport events support safe and effective medication use. Our aim is to describe the contribution of pharmacists and to share the pharmacy experiences at the 2018 PyeongChang Olympic and Paralympic Games.MethodsThe data collected included the accreditation details of patients and prescribers indicating: sport, country, athlete or non-athlete status, and prescription details including: medication, strength, frequency, length of treatment, for the period of the Olympic Games (1–26 February 2018) and the Paralympic Games (5–20 March 2018). The numbers of prescriptions dispensed were analysed by medication category, sports and country of the patient.ResultsA total of 5313 medication items were dispensed over the course of the Olympic and Paralympic Games (athletes: 670; non-athletes: 4615; unknown: 28), for a total of 2360 patients. 72 of 82 countries (87.8%) had fewer than 20 patient visits. The first high peak (Olympic: 5.0%; Paralympic: 7.3%) of daily volume of prescriptions were dispensed in the 2 days prior to the Olympic and the 1 day prior to Paralympic opening ceremonies. Therapeutic Use Exemption (TUE) and International Olympic Committee NeedlePolicy were well managed and compliant with the regulations.ConclusionPharmacy services at major multisport games include dispensing over 5000 prescriptions, supporting the TUE and IOC Needle Policy processes and providing clinical information to athletes and prescribers on drugs in sports and the World Anti-Doping Agency regulations of drugs prohibited in sport. During the PyeongChang 2018 Olympic and Paralympic Winter Games, pharmacists played a crucial role in delivering safe and effective pharmacy service based on their expert knowledge in antidoping and the clinical use of drugs in sport.

The nature of sports is characterized by a strong competitive component that generates inequalities among athletes at different levels, specifically in relation to gender, technology, and doping. These inequalities can be represented according to the Red Queen effect perspective, which has been previously hypothesized in other competitive environments (evolutionary biology and economics, for instance). The Red Queen effect considers each competitive environment to require a constant effort to maintain a position of competitive advantage in order reach the best result possible. Therefore, the aim of the current paper is to provide an innovative perspective for the understanding of competition in sports, identifying factors (i.e., physical appearance for gender equality, socioeconomic status of a sport team for technology, and antidoping rules for doping) influencing athletes’ possibilities to win a competition. Concerning gender differences, the disparity between genders reflects a lower coverage in sports news, and media are more likely to focus on female athletes’ physical appearance than their performance in sports. Therefore, women struggle more with increasing their visibility and in affirming their status as an athlete. On the other hand, the introduction of science and technological innovations in sports has generated economic interests in sport competitions, which reached superior performance levels compared to the past. Teams that cannot afford financial burdens of technological innovation risk being left out from sport competitions. Finally, doping creates a Red Queen environment since antidoping rules catch a small portion of athletes using performance enhancement drugs.

Introduction and purpose of the study. In article to perform that doping is one of the serious of problem of modern sport. Defines important questions regarding antidoping rules and anti-doping control in sport. Given the promising solutions to the problems of doping in Ukraine. It is an extremely complex because it involves the interrelated medical, legal, political, moral, organizational, social and pedagogical aspects. To use the doping is the same to spread and the most to chase’s infringement of the law in branch of sport which to lie in the area of several fields by law. Just for this offence to foresee the several kinds of responsibility at the same time-administrative, civic. discipline’s and is particular event the criminal. The hypothesis of the study lies in the fact that in modern Olympics sport to observe the tendency of introduction in quality of doping by new improved substances and methods, gene and cellular doping and other achievement by medicine and biology. And according constantly to widen a list of drugs and methods WADA-AMA which inclusive three measures of inhibition: complete forbidden, forbidden only on the match and the drugs what limited at kinds of sport. Experts of Olympics sport by Ukraine would be constancy monitoring that tendencies and to improve of legislative and normative-legal base and infrastructure of the anti-doping policy which should be brought in line with modern international standards. The aim of the research is to determine the parents’ attitude to systematize the modern knowledge about the ways of effective counteraction to infringe by anti-doping legislation. Methods. Analysis, synthesis and systematization of scientific literature data and materials from the Internet. Results. The analysis of literary sources has found the next. To suppose that the partial modification’ athletes on the gene and cellular level will be appearance earlier than will be official to approve of cellular technologies treatment by ills. The world anti-doping code to action joint with International standards as documents what to concern by of all constituent part doping checkup that nostrified in Ukraine. By effort of WADA-AMA to exploit a new analytic methods to research of human growth hormone and biomarkers of gene doping and steroid profile of athletes. A list complete forbidden by WADA-AMA of drugs and methods include: anabolic mediators, hormones and modulators of metabolism, diuretics and camouflage agents, beta-2 agonists, peptide hormones and factors of growth, to manipulate with blood and urine, genetics doping (sexual modifications). The drugs that forbidden only on the match: stimulates, narcotics, cannabinoids, steroid hormones glucocorticoids. The drugs what limited at kinds of sport: beta-blocks. Method of doping checkup as analysis by proofs of biological passport athlete what to put together with steroid, hematological and endocrinology modules, don’t substitution traditional doping checkup by method search of forbidden substances in specimens but to add its. The underline what adversary of doping to insist on therefore that ergolitic substances and methods to kill the just idea of “fair play” - the moral code of world sport. According to code on the start all athletes must to have equal chances on the victory. Conclusions. Defines such class from forbidden WADA-AMA from a list of drugs and methods what is: complete forbidden; forbidden only on the match; limited the kinds of sport and frequency offence there for internal use. Defines that analysis by proofs of biological passport athlete to add the traditional doping checkup. To accentuate on the fact that doping pursuit to threaten for social functions of sport. Key words: doping, athlete, sport, anti-doping measures

Relevance of the Research Topic. The forthcoming Olympic Games in July 2021 in Tokyo – the capital of the rising Sun country – in the view of most heads of international sports federations, which absolutely support the aspects of the current Olympic concept, and the athletes preparing to demonstrate the best sides of modern Olympic sports during the Tokyo Olympic Games, can become most scandalous in the context of determining the winners of the Games, the fairness of Olympic records, especially in women’s competitions and Athletes-Transgenders’ participation in the Games. In the history of the modern Olympic movement, these will be the first Olympics Games in which, alongside biological women, will compete representatives of the male half of humanity, who have artificially changed gender. The last four years, following the Games in Rio de Janeiro, have been marked by a total struggle against doping in sports. The purpose of the research is to study the issues of transgender ontology in modern Olympic sport and solutions to this problem. Being used research methods are analysis, comparison and generalization of historical information and its systematization according to the dialectic of the problem’s development. Results of the study. The International Olympic Committee has decided to purge modern Olympic sports from this shameful phenomenon, because peaceful Olympic rivalry is a demonstration of the individual qualities of the athlete, not a rivalry of the modern achievements in medicine and pharmacology. This struggle demonstrated the fundamental position of the IOC towards athletes, teams and national teams, who, for the sake of high sport achievements, used prohibited pharmacological drugs, manipulated of doping tests, etc. in the preparation for official competitions. The result of this struggle is the removal of specified subjects from participation in 2021 Games. Conclusions. The authors of the article tried to explore the dialectic of the transgender phenomenon in modern Olympic sports and to identify aspects of the IOC policy regarding the admission of transgender athletes to the 2021 Summer Olympics.

AbstractThis section discusses the regulation of “lifestyle risks” a term that can apply to both substances and behaviours. Lifestyle risks take place along the line of “abstinence - consumption - abuse - addiction”. This can concern substances such as food, alcohol or drugs, as well as behaviours such as gambling or sports. The section also addresses the question of the appropriate point of equilibrium between free choice and state intervention (regulation), as well as the question of when risks can be considered to be acceptable or tolerable. In line with the interdisciplinary scope of the journal, the section aims at updating readers on both the regulatory and the scientific developments in the field. It analyses legislative initiatives and judicial decisions and at the same time it provides insight into recent empirical studies on lifestyle risks.

AimWe report on the results of the ‘IOC Needle Policy’ applied during the course of the Games of the XXXI Summer Olympiad in Rio de Janeiro, Brazil. The policy was intended to empower physicians to ensure appropriate clinical use of needles within team medical environments, enhance the safety of those responsible for housekeeping services and others in the Olympic environment, and permit documentation of such procedures as an adjunct to the doping control programme. Any needle use required the submission of an ‘Injection Declaration Form’ to IOC medical officials.MethodAll ‘Injection Declaration Forms’ were reviewed and archived. The declarations provided basic information regarding the nature of the needle use and the product(s) involved, the physician, athlete and respective National Olympic Committee (NOC). The details of the declarations were subsequently categorised.ResultsA total of 367 declarations were received from physicians representing 49 NOCs. Needle-use declarations were more common in athletics, gymnastics, football and aquatics. A single product was administered in 60% of the cases, and more than one product was administered in 40%. The majority of declarations indicated the use of local anaesthetics, glucocorticoids, non-steroidal anti-inflammatory drugs and analgesics.ConclusionThe introduction of a ‘Needle Policy’ in the Olympic Games setting was intended to minimise the use of needles by non-physicians, promote evidence-based practice and to deter needle-based doping practices. Declarations were received from 49 of 209 NOCs suggesting either that needle use is minimal among certain teams or opportunities remain to enhance compliance with such policies at future games.

Abstract The aim of this study was to evaluate the resilience of adolescents participants and non-participants of social projects for sports relating it to their sociodemographic profile. Cross-section Study, comparative and analytical, covered 134 adolescents, from ages 12 to 17, residing in a social zone of high vulnerability in a Northeastern Brazilian city. The data collected was obtained through structured interviews and a questionnaire/resilience scale, developed by Wagnild and Young (1993). The descriptive and inferential statistical analysis was used, especially the Student ‘T’ Test for the independent samples and the chi-square test. In both cases, the statistical significance level adopted was p < 0.05. The overall mean resilience was 110.6 (±15.9) and the participants in social projects demonstrated better resilience (p = 0.063), with a predominance of male gender, age group 15 to 17 years old, without health problems, parents (father/mother) self-employed, retired, pensioner or unemployed with income less than 1 minimum wage, without alcohol/cigarette and other drugs. The participants of the social projects presented a better level of resilience, even though there were several unfavorable situations and many risks presented as well.

Спорт высших достижений является отражением экономического и политического влияния на международном уровне. Россия со времен СССР, являясь одним из мировых лидеров, занимала ведущие позиции в мировом спорте. Вместе с тем последние события в сфере крупных международных соревнований, серьёзные допинг-скандалы, отстранение ведущих спортсменов от соревнований показывают, что успех в современном спорте высших достижений неизменно связан с правильной трактовкой и реализацией на национальном уровне международно-правовых норм, связанных с допингом. Особую роль занимает уголовно-правовая охрана «чистоты» спорта от преступных посягательств в сфере использования и оборота допинговых средств. Автором проанализированы основы законодательства Российской Федерации и Китайской Народной Республики в области противодействия применению запрещённых препаратов в спорте. Осуществлена оценка на-ционального законодательства двух стран в контексте их соответствия междуна-родно-правовым договорам и соглашениям. Проведён сравнительный анализ действующих административных и уголовно-правовых норм. Систематизированы ос-новные положения и подходы в правовом регулировании данной сферы в России и Китае. Отдельно рассмотрены нормы, регламентирующие уголовную ответствен-ность за преступные деяния, в которых допинг является предметом преступления. Также в работе уделяется внимание уголовной политике в сфере борьбы с использованием допинга национальными спортсменами. Автор приходит к выводу, что две страны – на правильном пути, модифицируя нормы, касающиеся допинга, в соответствии с текущими реалиями спорта высших достижений. Несмотря на необ-ходимость внесения некоторых изменений, в дальнейшем принятые меры в России и Китае должны дать положительный результат. Ключевые слова: спорт высших достижений, законодательство, существующее в России и в КНР, субъекты международной спортивной деятельности, правоотношения, ответственность, борьба с допингом, незаконное употребление, наказание. The sport of records reflects the economic and political influence at the international level. Since the times of the USSR, Russia has been one of the world leaders, hold-ing leading positions in world sports. At the same time, the latest events in the sphere of large international competitions, serious doping scandals, banishment of the leading athletes from the competitions demonstrate that a success in modern sports of the highest achievements is inevitably connected with the correct interpretation and implementation of international legal norms related to doping at the national level. A special role is played by criminal legal protection of sport "cleanliness" from criminal encroachments in the sphere of use and circulation of doping means. The author analyzed the basics of legislation of the Russian Federation and the People's Republic of China in the sphere of counteraction to the use of prohibited drugs in sport. National legislation of the two countries was assessed in the context of their compliance with international legal treaties and agreements. A comparative analysis of existing administrative and criminal legal norms was made. The main provisions and approaches to legal regulation in this area in Russia and China were systematized. The norms regulating criminal liability for criminal acts in which doping is a subject of crime are considered separately. Also, attention is paid to criminal policy in the sphere of struggle against doping by national sportsmen. The author comes to the conclusion that the two countries are on the right track by modifying the norms concerning doping according to the current realities of the high-performance sport. Despite the necessity to make some changes in the future, the measures taken in Russia and China should give positive results. Keywords: sport of records, legislation existing in Russia and the PRC, subjects of international sports activities, legal relations, liability, the fight against doping, illegal use, punishment.

Pharmaceutical companies routinely engage physicians, particularly those with prestigious academic credentials, to deliver educational talks to groups of physicians in the community to help market the company's brand-name drugs. These speakers receive substantial compensation to lecture at events sponsored by pharmaceutical companies, a practice that has garnered attention, controversy, and scrutiny in recent years from legislators, professional associations, researchers, and ethicists on the issue of whether it is appropriate for academic physicians to serve in a promotional role. These relationships have become so contentious that three years ago the pharmaceutical industry trade association, the Pharmaceutical Research and Manufacturers of America (PhRMA), adopted voluntary guidelines stating that drug companies should stop giving doctors free pens, calendars, sports bags, or tickets to entertainment events. Further, numerous medical associations, such as the Association of American Medical Colleges (AAMC), the American Board of Internal Medicine (ABIM) and the Institute on Medicine as a Profession (IMAP), and government bodies such as the Institute of Medicine (IOM) have recommended that medical schools and teaching hospitals prohibit or strongly discourage faculty from participating in so-called industry Speakers Bureaus — promotional events designed solely to market pharmaceutical products.

This paper examines a football doping incident that occurred at the University of Waterloo (UW) in Canada, and critically analyzes the doping policy recommendations for intercollegiate sport sparked by the scandal. In March 2010 a police raid led to the discovery of a large quantity of performance-enhancing drugs at a home linked to a former student-athlete, which resulted in an entire football team being subjected to mandatory drug testing. After the release of the test results, a task force was formed by the Canadian Centre for Ethics in Sport (CCES) to investigate doping in Canadian sport. Using a triangulation approach, which includes a case study of the UW doping scandal, semistructured interviews with student-athletes, and policy analysis of the reports that transpired, we critically examine the potential effects and scope of applicability of the new recommendations put forward by the task force. In critiquing the resulting recommendations, this paper cautions that replacing a culture of silence with a culture of surveillance can have detrimental effects in the fight against doping in sport.

AbstractPerformance enhancing drugs (PEDs) crises in sport provide stories for the mass media. From individuals such as Ben Johnson and Lance Armstrong, to countries and organisations such as Russian Athletics and Major League Baseball. More recently, research has emerged that suggests that those who take drugs, even the once, are permanently advantaged over those who never have (Egner et al., 2013; Eriksson, 2006). This has expanded existing arguments related to PEDs, even extending debate to one that argues that PED use should be monitored and legalised in order to create a level playing field – as opposed to ‘banning’ athletes. In contrast, there are varying reasons for the rationale of ‘clean’ sports. In the first kind of discussion related to this the central premise is often about health concerns and PED use. In the second discussion, we hear much about cheating, unfairness, and the perversion of sport (Schneider & Butcher, 2000). At the present time, the World Anti-Doping Agency (WADA) police PED use in sport and use Anti-Doping Rule Violations (ADRVs) that allow a sliding scale of transgressions with lifetime bans not given in the first instance of a failed test. Put simply then, these ADRVs do not facilitate a system for those not wishing to compete with others who, at any time, have used PEDs. However, in the 1980’s a number of people in Britain made the decision to distance themselves from what they saw as significant doping in British and international Weightlifting. They achieved this through creating competitive strength organisations dedicated to a drug free for life ethos. In this paper I draw on the experiences and reflections of some of these key people, and contend that it was the ideology of fairplay that influenced this movement, and that the rules on PED use should not be fully authoritative and determinate.

In recent years drug abuse by college athletes has received greater attention. Because of the recognition of the growing problem of drug use in athletics, the new NCAA drug testing policy, and recent deaths of elite athletes, the sport psychologist should be prepared to deal with this issue. In many college settings the sport psychologist may be expected to provide support with counseling or participate in the development of a drug abuse prevention program for student athletes. Therefore sport psychologists need to closely examine the factors that may predispose athletes toward using drugs, understand the role of prevention, and develop a thorough knowledge of positive, viable alternatives to drugs. This article addresses five important issues that relate to drug abuse in college athletics: (a) why athletes are at risk, (b) athletic leadership and its relationship to substance abuse, (c) the role of the sport psychologist, (d) issues related to the effectiveness of drug education for athletes, and (e) recommendations for athlete drug education programs.

IntroductionChina is one of the twenty-seven countries with a high burden of Multidrug-resistant tuberculosis (MDR-TB) in the world. Of the new TB patients in China in 2017, about 63,000 are MDR-TB patients, accounting for one-third of the number of new MDR-TB patients worldwide.In the latest “China's 13th Five-Year Plan” national TB prevention and control plan promulgated in 2017, it is clearly emphasized that all regions should gradually incorporate TB into the payment catalogue of special outpatient medical insurance, according to local conditions. However, for this special group of MDR-TB patients, there is no specialized prevention and control policy at the national level, and there are also blind spots in the medical security policy.Responding to the drug needs of MDR-TB patients, it is necessary to provide patients with stable and affordable second-line anti-TB drugs. It is also necessary to understand the overall drug demand for second-line drugs nationwide to guide further policy formulation and budget research.MethodsThrough semi-structured group interviews and key informant interviews, five provinces and cities were investigated. Qualitative analysis was conducted based on stakeholder theory selected doctors and staff from Centers for Disease Control.ResultsThrough investigations in this study, problems like low purchasing price, insufficient purchasing volume, low drug supply efficiency, and monopoly producers were found. Through the analysis of roles and relationships among the major stakeholders in the second-line drug supply system, together with the motivation and resistance factors, it was found that all stakeholders have the motivation to solve the problem and face their dilemmas and obstacles at the same time.ConclusionsPatients with MDR-TB still have difficulties in obtaining medicines. The interests of various stakeholders need to be balanced to improve drug accessibility and affordability. It is recommended to take advantage of the country's centralized procurement, encourage the development and listing of new anti-tuberculosis drugs and generic drugs, and improve the supervision system to ensure the supply of drugs to benefit more patients with tuberculosis.

Objective: The purpose of this study was to investigate the prevalence of antibiotic resistance among Helicobacter pylori isolates obtained from patients suffering from peptic ulcer disease in Rawalpindi and Islamabad, Pakistan, and to propose a novel anti-H. pylori therapy strategy for use in these locations. Methodology: A total of 132 H. pylori from the patients suffering with peptic ulcer disease were reported for clinical treatment in institutions in the twin Cities that provide tertiary care. Antibiotics such as ciprofloxacin, clarithromycin, amoxycillin, metronidazole, and tetracycline were tested on the isolates to determine their levels of susceptibility to these drugs. The Epsilometer test, often known as the E-test, is a quantitative disc diffusion method that is used to determine antibiotic sensitivity. This test was utilised for the purpose of verifying isolates. Results: The overall rate of resistance among H. pylori was found to be 27.9% for amoxycillin, 38.9% for clarithromycin, and 73.6% for metronidazole. 47 out of 132 isolates exhibited multiple drug resistance, with metronidazole, clarithromycin, and amoxycillin showing the highest frequency of two, three, and four drug resistance patterns. Ciprofloxacin had a low level of tetracycline resistance, ranging from 1.2 to 4%, whereas metronidazole resistance was substantial. In the population of Pakistan, the frequency of H. pylori resistance to metronidazole is quite high, whereas it is moderate in response to clarithromycin and amoxycillin, and low in response to ciprofloxacin and tetracycline. The rates of resistance to clarithromycin and amoxycilin were higher in Rawalpindi than they were in Islamabad. It is imperative, for the sake of the public's health, that Pakistan make an adjustment to its policy regarding antibiotics, one that will permit the use of antibiotic rotation in the treatment of H. pylori. Keywords: Peptic ulcer, Helicobacter pylori, antibiotic susceptibility.

Məqalə idman oyunları zamanı sağlamlığın təmini, mədəni, mənəvi və fiziki tərbiyənin təşkili kontekstində dopinqin qadağan olunması sahəsində beynəlxalq müqavilə və institusional mexanizmlərin fəaliyyəti, habelə bu əməkdaşlıq prosesində Azərbaycan Respublikasının iştirakına toxunmuşdur. Həmçinin, Beynəlxalq Cinayət Polisi Təşkilatı – İNTERPOL çərçivəsində aparılan əməliyyatlar və onların əhəmiyyəti, eləcə də BMT-nin BMT-nin Narkotik və Cinayətkarlığa Qarşı Mübarizə İdarəsinin müvafiq sahədə fəaliyyəti də nəzərdən keçirilmişdir. Açar sözlər: dopinq, idman, Azərbaycan Milli Antidopinq Agentliyi, Ümumdünya Antidopinq Agentliyi, Ümumdünya Antidopinq Məcəlləsi, YUNESKO, Avropa Şurası, İNTERPOL, Beynəlxalq Test Agentliyi Narmin Azar Abuzarli International mechanisms in the fields of fight against doping and the Azerbaijan Republic Abstract The article touched upon the activities of international treaties and institutional mechanisms in the field of doping control in the context of ensuring health, cultural, spiritual and physical education during sports games, as well as the participation of the Republic of Azerbaijan in this cooperation process. The operations carried out within the framework of the International Criminal Police Organization - INTERPOL and their importance, as well as the activities of the UN Office on Drugs and Crime in the relevant field were also considered. Key words: doping, sports games, Azerbaijan National Anti-Doping Agency, World Anti-Doping Agency, World Anti-Doping Code, UNESCO, Council of Europe, INTERPOL, International Testing Agency

Purpose Highly popular these days, eSport is inviting increasing scholarly attention and research. Scholarly work on eSport, however, remains focused on whether eSport is a “real” sport, that is, its sporting qualities and status, excluding ethical issues. This paper analyzes ethical issues about cognitive enhancement drugs often associated with eSport in order to suggest guidelines for resolving these issues. Methods First, environmental features of eSport are examined to find out types of cheating in eSport, as well as the ways eSport athletes are exposed to drugs. Next, ethical issues of cognitive enhancement drug use and why they are important are discussed, drawing upon multiple scholars. Last, this paper argues that the ban on drug use conventionally implemented in sport is not appropriate to eSport due to the characteristics of eSport. The paper concludes with possible future approaches to this issue. Results The ban lists administered by ESIC and WADA would not work for the need of eSport athletes and even run a risk of stunting the growth of eSport industries. It is thus important to think up an appropriate drug-related policy for eSport. Preemptive education for eSport athletes is also required to promote the ethical consciousness and judgment regarding drug use. Conclusions Insofar as eSport’s huge popularity leads to the increased status of eSport athletes, thereby exerting much influence on young people, ethical questions about eSport, drug use in particular, need to be urgently discussed for the sake of eSport’s wholesome development.

This article explores policing and urban ordering in the Philippine war on drugs. With an empirical point of departure in ethnographic fieldwork conducted in Bagong Silang, a poor urban area on the outskirts of Metro Manila, the article highlights the perspective of the state police in an area that has been heavily exposed to the drug war and can be considered as one of its hot spots. It is examined how inspirations from counter-insurgency strategies are implemented in policing the war on drugs and discussed how this form of policing is negotiated and what implications it produces on the ground. In doing so, the article asks, ‘how have counter-insurgency policing strategies transformed urban space and the possibility of life in the poorer sections of Manila’? Drawing on a conceptual framework on borders, policing and the production of fear, the article argues that there exists an intimate connection between the employed policing strategies and the transformation of urban space with the potential of fundamentally reconfiguring urban sociality in areas such as Bagong Silang.

Background: The healthcare system in India is facing multitude of challenges owing to the changing epidemiology of health as well as diseases. Despite having the distinction of being one of the largest public healthcare delivery systems in the world, our health indicators reflect a grim picture in comparison to global targets. India has large number of national healthcare programs and sub-programs, policies, and legislations. Though they are meant to be inclusive and comprehensive the results are far from the desired vision.Methods: Using a logically constructed ontology based on the common body of knowledge as a lens, we map all the programs and policies to reveal the ‘bright’, ‘light’, and ‘blind/blank’ spots in them. The ontological maps are constructed at different levels of granularity–monads and dyads. They provide a synoptic, systematic, and systemic assessment of the policies while highlighting their emphases and biases.Results: In terms of the Focus, the dominant focus of the programs and policies is on information (30) and education (39), drugs (26), administration (31), finance (24), and treatment (28). These are the ‘bright’ spots. Their secondary focus is on technology (18), personnel-staff (12), personnel-physician-specialist (7), and personnel-nurses (8). These are the ‘light’ spots. The tertiary focus is on insurance (4). These are the ‘blind/blank’ spots.Conclusions: The coverage of the National Programs/Policies on healthcare, viewed through the lens of the ontology is patchy. Yet, overall, almost all elements in the ontology find expression in at least one program/policy – an indicator of their extensive coverage. There is absence of frequent co-occurrence of the outcomes, except quality and accessibility. This paper presents the first step in a program of research which can be used to analyse and direct healthcare policy globally, nationally, and locally.

Abstract Sleep quality and duration as well as activity-rest-cycles at individual level are crucial for maintaining physical and mental health. Although several methods do exist to monitor these parameters, optimal approaches are still under consideration and technological development. Wrist actigraphy is a non-invasive electro-physical method validated in the field of chronobiology to record movements and to allow for monitoring human activity-rest-cycles. Based on the continuous recording of motor activity and light exposure, actigraphy provides valuable information about the quality and quantity of the sleep–wake rhythm and about the amount of motor activity at day and night that is highly relevant for predicting a potential disease and its targeted prevention as well as personalisation of medical services provided to individuals in suboptimal health conditions and patients. Being generally used in the field of sleep medicine, actigraphy demonstrates a great potential to be successfully implemented in primary, secondary and tertiary care, psychiatry, oncology, and intensive care, military and sports medicines as well as epidemiological monitoring of behavioural habits as well as well-being medical support, amongst others. Prediction of disease development and individual outcomes Activity-rest-cycles have been demonstrated to be an important predictor for many diseases including but not restricted to the development of metabolic, psychiatric and malignant pathologies. Moreover, activity-rest-cycles directly impact individual outcomes in corresponding patient cohorts. Targeted prevention Data acquired by actigraphy are instrumental for the evidence-based targeted prevention by analysing individualised patient profiles including light exposure, sleep duration and quality, activity-rest-cycles, intensity and structure of motion pattern. Personalised therapy Wrist actigraphic approach is increasingly used in clinical care. Personalised measurements of sedation/agitation rhythms are useful for ICU patients, for evaluation of motor fatigue in oncologic patients, for an individual enhancement of performance in military and sport medicine. In the framework of personalised therapy intervention, patients can be encouraged to optimise their behavioural habits improving recovery and activity patterns. This opens excellent perspectives for the sleep-inducing medication and stimulants replacement as well as for increasing the role of participatory medicine by visualising and encouraging optimal behavioural patterns of the individual.

Sport jako forma zorganizowanej rywalizacji od wieków jest nieodłączną częścią kultury w różnych cywilizacjach. Tak było również w Polsce od XIX wieku, kiedy pod zaborami zaczęły pojawiać się pierwsze stowarzyszenia i kluby sportowe. Sportowcy nie tylko promowali rozwój fizyczny i ducha rywalizacji wśród młodych ludzi, ale także kształtowali postawy patriotyczne. W Polsce, która odzyskała niepodległość po pierwszej wojnie światowej, sport stał się jedną z najpopularniejszych niekomercyjnych dziedzin życia, jednocząc różne środowiska, dostarczając emocji i przynosząc wiele sukcesów. Kulminacją kariery wielu sportowców był udział w igrzyskach olimpijskich, uważanych za największe święto sportów wyczynowych na świecie. Polscy przedstawiciele (ogółem 288) brali udział w ośmiu igrzyskach w okresie międzywojennym. Druga wojna światowa stała się czasem wielkiego patriotyzmu polskich sportowców olimpijskich. Zdecydowana większość z nich wykazała się godnością i odwagą, nierzadko poświęcając własne życie: w bitwach na różnych frontach, w ruchu oporu, w podziemiu, w obozach zagłady i egzekucji. Niektórzy z nich przenieśli się z dala od okupowanej Polski z powodu wojny, inni pozostali na wygnaniu do końca życia. Niektórzy polscy sportowcy olimpijscy współpracowali z okupantami niemieckimi i sowieckimi (zwykle pod przymusem). Sportowcy często też służyli ojczyźnie po wojnie ze względu na swoje doświadczenia wojenne.

Background:Middle age and older (mean = 58.7 y), racial/ethnic minority women report low levels of physical activity. Recommendations to change the social and built environments to promote physical activity in this group are underdeveloped. Two research questions guided this study: What environmental changes are recommended by racial/ethnic minority women? What policies are related to the environmental changes?Methods:The findings from nine Nominal Group Technique sessions with 45 subjects were analyzed.Results:More police protection, cleaner streets, removal of drugs from streets, more street lights, walking groups, and free gyms were prioritized by subjects as the most important recommendations. The relevant policies included municipal, police department, sanitation department, public works, and transportation department.Conclusions:Racial/ethnic minority women living in low income, urban areas recommend improvements that affect overall quality of life. Meeting basic needs may be a prerequisite for use of physical activity resources.

In this essay, the author proposes that, in order to understand how the issue of performance-enhancing-drug use in professional baseball has been defined for mass audiences, scholars need to consider the political and economic interests of both baseball and the media companies that have covered the issue. Where performance-enhancing drugs are concerned, media characterizations have had a significant impact on the formation of public and organizational policy, and the author seeks to demonstrate that portrayals and perceptions of drug use in baseball can be understood through the media product that results from an intersection of normative standards with powerful influences on those standards. Calling out the heavy hitters in a culture of pervasive drug use is unfair to elite performers in that media reports sometimes give the impression that athletes have reached superstar status because they were willing to do what others were not; this is a basic falsehood.

There is consistent and strong scientific evidenceabout the numerous health benefits related to thephysical activity (PA). Regular PA can improve physicalfitness and health and assist in the prevention of variousdiseases. In general, physically active adults are healthierand present higher physical performance in comparisonwith inactive adults worldwide. Among some desirablebehaviors, PA can be considered as part of a healthy lifestyleand can be categorized into occupational, sports,conditioning, household, or other activities involvingmovement of the body generated by skeletal muscleswith energy expenditure. Aligned with that, it is undeniablethe relevance of the physical inactivity as a riskfactor for premature mortality and for cardiovasculardisease and a variety of other chronic diseases, includingdiabetes mellitus, cancer (colon and breast), obesity,hypertension, bone and joint diseases (osteoporosis andosteoarthritis), and depression. Moreover, exercise inpatients with hematologic cancer, like leukemia, couldimprove immune function.Due to the relevance of the PA, it is important to stimulatebehaviors involving the physical practice. There areseveral factors that can influence these behaviors, suchas: personal (biological, health and psychological attributes),social (family, affiliation group, and work factors),and environmental (contexts for different forms of PAand policy factors that could determine availability ofrelevant settings and opportunities).The outbreak of the coronavirus disease 19 (COVID--19) has interfered in different factors of the PA behaviors.Depending of the severity of the COVID-19 inan individual, there are limitations to performed PA.Furthermore, aiming to contain the COVID-19 infectionsand to reduce interaction between infected andnon-infected individuals, strategies and restrictivepolicies have been suggested, such as quarantine, localconfinement, lockdown and isolation. It is clear that,while the individuals are confined at home the levelof PA, in general, decreases, due to the reduction of (i)daily activities outside, (ii) the participation in socialevents and, (iii) sometimes, of laboral activities. Thismay have a negative impact in general heath becauseit can contribute to sedentary behaviors. Besides theconfinement, it is important to consider other actionsto protect against the COVID-19 infection that is theuniversal use of masks.In addition to those facts, as an environmental factor,in confinement, the sunlight exposure is reduced.The relevance of the ultraviolet B radiation present insunlight to the active production of vitamin D in theorganisms is well known. This vitamin has a relevantrole to metabolic responses and protection againstdiseases, including cancer. Vitamin D deficiency hasbeen recognized as an undesirable global public healthproblem and it plays a wide role in health and in theprevention of several diseases, including the COVID-19.As the reduction of the muscle strength is observedin the individuals that had COVID-19, PA or exercisescould be important for their rehabilitation. There aredifferent modalities of exercises that could be also usedfor them, including the whole-body vibration exercisesto improve the muscular performance.Putting together, people in the world is living, or istrying to live, in conditions to maintain a minimal, butconvenient level of PA to have health to contercousethe bad situation of the COVID-19 up to a definitiveand confident vaccin be available to the human beings.The researchers are working hard to aid the worldpopulation to win this fight against the COVID-19 andthe sedentary behaviors.Naturally, COVID-19 and the sedentarism are problemsfor the world, but the continuous education aboutthe importance of PA, the studies about the effects ofmedications that can be used in the treatments of diseases,the control of use of drugs, as the pesticides, andthe discussion about the biological and legal aspects ofreprocessing of medical-hospital material are welcometo contribute to improve the health.

As the ongoing COVID-19 pandemic poses a global threat, it is of utmost importance that governments should find effective means of combating vaccine hesitancy and encouraging their citizens to vaccinate. In our article, we compare the vaccination outcomes in the past months in two neighbouring post-communist EU states, Lithuania and Poland. Both introduced COVID-19 certificates, but only the former followed with gradual limitations for those who failed to get vaccinated, beginning with restricted access to restaurants, sports facilities and indoor events, and finally banning residents without a certificate from entering supermarkets or larger shops and using most services. By contrast, in Poland, the certificate remained a tool for international travel only. We show using statistical data that Lithuania’s strict policy, regardless of its social implications, led to markedly higher vaccination outcomes in all age groups than those in Poland at the time.

Agility have been defined by the capacity to retain or determine the location of body by shifting its direction rapidly in a sequence of movements. Agility, speed and explosive power are qualifying components of physical fitness and desirable athletic performance, and play a key role in most sports. Agility can enhance the coordination and regulation of locations of the body throughout movement. Objective: To study the efficacy of the 6-weeks and 12-weeks Plyometric training on the agility in police cadets. Method: 40 Cadets aged above 18 years were grouped into two. A group continued their regular activities while rest underwent 2 sessions of plyometric training every week for 6 weeks, along with their daily activities. Analysis was then carried out with assessment of T-test Agility test, Illinois Agility Test, Edgren Side Step Test. Study duration is 6 months and intervention duration is 12-weeks, hence participants will be enrolled during first 3-months of study so 12 week intervention has been completed successfully. Assessment will be done on 1st day of visit then at the end of 6th week and again at the end of 12th week. Participants would have to perform 2 session of Plyometric Training per week in other group. Result: The results show that there is improvement the agility of the police cadets through the outcomes measures taken as a instrument to measure the difference in 1st day, 6th week and 12th week. There is decrease in time period of Agility T-test from 14.04±1.64 to 10.96±1.39 in group A and from 14.16±1.43 to 13.53±1.52 in group B. There is increase in steps of Edgren Side Step test from 34.95±4.84 to 40.93±4.17 in group A and from 34.97±4.17 to 36.31±4.34 in group B. There is decrease in time period of Illinois Agility test from 20.61±4.36 to 18.33±4.14 in group A and from 20.73±4.45 to 20.47±4.42 in group B. Conclusion: This study concludes that plyometric training intervention have improved the agility among the police cadets and it can be implemented among personnel’s from law enforcement agencies.

Performance and Image Enhancing Drugs (PIEDs) are a cause of concern for those seeking to reduce health harms and associated transgressive behaviour. This form of behaviour is associated with moral disengagement and is collectively used to refer to acts that can have negative interpersonal consequences (Kavussanu, 2019). Moral disengagement (Bandura 1991) refers to cognitive mechanisms that separate our moral values from our actions, resulting in behaviour that conflicts with our moral values. This model has been used to theorise the use of PIEDs for occupational performance gains - for instance, in the police or in private security- with the development of the psychometric Moral Disengagement for Occupational Gains Scale. In this investigation, 84 participants (34 PIED and 50 Non-PIED users) from 10 occupations completed an online questionnaire, shared via social media. The questionnaire was based on an 8-factor model proposed by Bandura et al. (1996), with items adapted from validated scales investigating doping in sport. Twenty items measured the following factors: Moral Justification, Euphemistic Labelling, Advantageous Comparison, Diffusion of Responsibility, Distortion of Consequences and Displacement of Responsibility. Participants completed the questionnaire using a 7-point scale (1 = strongly disagree to 7 = strongly agree). The Moral Disengagement for Occupational Gains Scale (MDOGS) has demonstrated initial psychometric properties that support the use as a valid and reliable measure of moral disengagement for research into the use of PIEDs in an occupational context.

Abstract An increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised “normal” body weight and individually optimal weight. To this end, the basic principle of personalised medicine “one size does not fit all” has to be applied. Contextually, “normal” but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyle parameters—all included into comprehensive individual patient profile. Even if only slightly deviant, both overweight and underweight are acknowledged risk factors for a shifted metabolism which, if being not optimised, may strongly contribute to the development and progression of severe pathologies. Development of innovative screening programmes is essential to promote population health by application of health risks assessment, individualised patient profiling and multi-parametric analysis, further used for cost-effective targeted prevention and treatments tailored to the person. The following healthcare areas are considered to be potentially strongly benefiting from the above proposed measures: suboptimal health conditions, sports medicine, stress overload and associated complications, planned pregnancies, periodontal health and dentistry, sleep medicine, eye health and disorders, inflammatory disorders, healing and pain management, metabolic disorders, cardiovascular disease, cancers, psychiatric and neurologic disorders, stroke of known and unknown aetiology, improved individual and population outcomes under pandemic conditions such as COVID-19. In a long-term way, a significantly improved healthcare economy is one of benefits of the proposed paradigm shift from reactive to Predictive, Preventive and Personalised Medicine (PPPM/3PM). A tight collaboration between all stakeholders including scientific community, healthcare givers, patient organisations, policy-makers and educators is essential for the smooth implementation of 3PM concepts in daily practice.

Background: The World Health Organization has recommended that individual governments identify vaccine hesitancy areas. It is proposed that the governments, with the aid of local organizations, educate and implement social insights on the vaccination so that high population levels are covered with this safe immune program. Methods: A longitudinal online survey covered 3000 adults from India. We examined the demography, behavioral (socio-economic) attitude, vaccine hesitancy, vaccine resistance for the COVID-19 vaccine. The specific reasons for the COVID-19 vaccine decline were also evaluated. Results: Our survey revealed 59% definite response, 29% low-level response, and 7% high-level response for vaccine hesitancy, while 6% had resistant views on the COVID-19 vaccine. Individuals who had higher income levels, lived in a society, maintained social distancing, had downloaded the COVID-19 update app, showed a positive attitude towards their government, and more confidence in their healthcare system were more inclined towards the vaccination. On the contrary, individuals who had overstated the risks of COVID-19 and had a religious and populistic attitude towards vaccination were more hesitant/resistant to vaccination. The respondents who declined vaccine administration were further evaluated for their specific reason for their response. The most common reasons for declining the COVID-19 vaccine were post-vaccine scare of adverse health effects and accepting the information spread by social media. Conclusions: The results in our study show that by identifying population “hot spots” that have negative or unclear information on the COVID-19 vaccination, these “hot spots” can be addressed by involving friendly organizations that can clear their strong disbeliefs and increase the percentage of vaccine-definite people within the population. The role of government-induced COVID-19 vaccine policy measures can always be beneficial to cause this shift from disbelief to confidence within the population.

The Movement Control Order (MCO) has been enforced on 18th March 2020 following the COVID-19 pandemic in Malaysia. This MCO is hoped that it is able to lower the number of infection cases in Malaysia. However, some groups of societal members were found as non-compliant with the MCO as reported by the online news. The objective of this research was to identify the display category on the news of non-compliant citizens in MCO period. Data analysis had been performed on online news starting from 18th March 2020 until 28th April 2020 which is based on MCO Phase 1 up to Phase 3. More than 100 online news headlines about MCO violation had been analysed using content analysis method based on Social Interaction Theory. The research outcome has found that social interaction plays a vital role in non-compliance issue within the enforcement period of MCO as reported by online news. The categories for non-compliance of MCO are as follows i) Movement without a valid reason, ii) Sports and recreational activities, iii) Religious activities, iv) Visiting and having feast, v) Chatting at restricted area, vi) Drugs-related violation, vii) Crime involvement and police record, viii) Gambling and Entertainment, ix) Intake of drinks leading to intoxication and imagination and x) Violation by foreigners. The use of social interaction theory in this research has clearly illustrated that non-compliance of MCO shows self-control of the perpetrator as a result of social control is very weak. Generally, the violation of MCO has a relationship with the environment of social interaction. Social interaction has a conflict that leads to deviant act which causes the breach of rules and norms.

Tako smo naslovili tretjo številko v štiriindvajsetem letu izhajanja Sodobnih vojaških izzivov. Izhajali smo iz sprememb, ki so se dogajale v zadnjih nekaj letih. V mislih smo imeli povečane migracijske tokove v smeri Evropske unije, izkušnje iz obdobja epidemije covida-19, podnebne spremembe, ki nas presenečajo vsakič znova, čeprav se jih zavedamo in se jim poskušamo prilagoditi ter ustrezno odzivati nanje. Marca letos je nastal »Strateški kompas za varnost in obrambo – za Evropsko unijo, ki varuje svoje državljane in državljanke, vrednote in interese ter prispeva k mednarodnemu miru in varnosti«, konec junija pa novi Natov strateški koncept. Namen obeh je bil prevetriti, uskladiti in poenotiti pogled na trenutne varnostne izzive ter oblikovati nove varnostne perspektive. V začetku leta nas je presenetil oborožen napad Ruske federacije na Ukrajino. Nekateri so ga napovedovali, drugi samo predvidevali. Številni so bili prepričani, da tak pojav v sodobni demokratični družbi sploh ni mogoč. Huntingtonova teorija o spopadu civilizacij, ki se je zdela v sodobni evropski družbi preživeta in že presežena, je znova postala aktualna. Realističen pogled na sodobne varnostne, družbene in politične razmere v svetu, predvsem pa kriza vrednot in posledično potreba po poenotenju sta spodbudila Evropsko unijo k ambiciji postati globalni varnostni akter v mednarodnem okolju. Vojna v Ukrajini sili Evropsko unijo k ukrepanju. Ta je pripravila sveženj ekonomskih ukrepov oziroma sankcij, s katerimi želi vplivati na Rusko federacijo v smislu izražanja svojega nestrinjanja glede njenih enostranskih potez. Kljub temu si države članice niso povsem enotne glede stališča, kako se spoprijeti s stanjem in se mu upreti. Brez enotnosti ter enotnih političnih stališč in ukrepov Evropska unija ne more postati globalni varnostni akter, kot si je to zastavila v strateškem kompasu. Pri tem je treba omeniti tudi njeno skupno varnostno in obrambno politiko, ki je predvsem politika, in dejstvo, da Evropska unija nima svojih vojaških zmogljivosti, ki bi jih upravljala. Vojaške zmogljivosti imajo države članice, ki za svojo obrambo namenjajo različne zneske. V zadnji dekadi je večina držav članic svoje obrambne izdatke zniževala, čeprav je bilo na Natovem vrhu v Walesu leta 2012 dogovorjeno, da bodo ti znašali dva odstotka BDP. Vse države članice Evropske unije niso tudi članice zavezništva, vendar pa je med njimi enaindvajset takih, ki so članice obeh. Douglas Barrie je skupaj s sodelavci leta 2020 pripravil posebno poročilo na temo European defence policy in an era of renewed great-power competition, v katerem so ugotovili, da bi Evropska unija s svojimi državami članicami ob predpostavki, da bi res vse namenjale dva odstotka BDP za obrambo, potrebovala od deset do petnajst let, da bi lahko bila v varnostnem smislu s svojimi zmogljivostmi ustrezno pripravljena na morebitno agresijo države z vojaškimi zmogljivostmi, kot jih ima Ruska federacija danes. Ob vlaganjih na tem področju, kot so leta 2022, pa bi za to potrebovala dvajset let. Navedeno vodi v logičen sklep. Rusko federacijo je mogoče ustaviti pri njenih ozemeljskih in političnih ambicijah le na dva načina. Prvi in najustreznejši je političen, drugi vojaški. Ker Evropska unija v obrambnem in vojaškem smislu ne pomeni resnega nasprotnika tej veliki in vojaško močni državi, je edini način, da doseže svoj status globalnega varnostnega akterja, političen. Vojaški spopad v Ukrajini je velika preizkušnja tako za Unijo kot za zavezništvo. Evropska unija ima zdaj priložnost, da preveri, kako močni in verodostojni so njeni ideali, vrednote in prepričanja. So njeni visoki predstavniki dovolj modri in inovativni, da poleg ekonomskih sankcij poiščejo še druge diplomatske poti, po katerih lahko dosežejo, kar so zapisali v strateškem kompasu, in sicer biti globalni akter? Odgovor na to vprašanje bo prinesel čas. Do takrat bodo znanstveniki in drugi strokovnjaki proučevali različne vplive in pojave na področju varnosti. Nekateri med njimi jih bodo delili tudi z bralci Sodobnih vojaških izzivov. V času ekonomskih sankcij, ki ji sprejema Evropska unija, se Tamas Somogyi in Rudolf Nagy osredotočata na zaščito kritične infrastrukture, katere pomembni del je tudi finančno področje. V prispevku Kibernetske grožnje in varnostni izzivi na področju financ na Madžarskem raziskujeta varnostna tveganja, s katerimi se spoprijema bančni sistem v njuni državi. Prispevek Geostrateške perspektive Slovenije v spreminjajočem se svetu izhaja iz dveh geopolitičnih teorij avtorjev Mackinderja in Spykmana, ki sta v njih razvila svoje poglede na evropski prostor. Uroš Tovornik je raziskoval geostrateško lego Slovenije na temelju njunih teorij s poudarkom na njenih geopolitičnih značilnostih. Svoje ugotovitve je strnil v štiri mogoče scenarije, ki jih te determinirajo, iz njih pa tudi izhajajo mogoče geopolitične usmeritve v prihodnosti. Kakšen je vpliv svetovnih velesil in kako se kaže na primeru posamezne države, je raziskoval Olusola Kolawole Oluwagbire. Afrika kot zelo velika celina je sestavljena iz številnih in raznolikih držav. Vpliv velesil je bil vedno zelo močan in sestavni del afriškega življenja ter varnosti njenih prebivalcev. Kakšen je ta v zadnjih letih in kako vpliva na varnost posamezne države, avtor predstavlja v prispevku Ocena vpliva odnosov z velesilami na nacionalno varnost: primer Nigerije. Mariann Minkó-Miskovics in Csaba Szabó ugotavljata, da je na področju predpisovanja izdelkov za dvojno rabo, torej za civilne in obrambne namene, med evropsko in madžarsko zakonodajo nedoslednost. Še več. Prepričana sta, da neusklajenost lahko pomeni varnostno tveganje. Kaj to pomeni v praksi, predstavljata v prispevku Primerjava razlag civilne in vojaške opreme v evropski in madžarski sodni praksi O pomenu pravilega razumevanja jezika med različnimi deležniki v mednarodnem vojaškem okolju piše Jarosław Włodarczyk. Njegova študija je osredotočena na poučevanje angleškega jezika med vojaškimi osebami na Poljskem in na tiste vrste besed, ki nimajo neposrednega prevoda v angleški jezik ali obratno v poljski jezik. Poseben izziv pri tem je, kako ustrezno razložiti in poučiti o tem vojaške osebe v izobraževalnem procesu. Svoje ugotovitve je strnil v prispevku Problem leksikalnih vrzeli pri pouku vojaške angleščine.

Mucormycosis is a rare opportunistic fungal infection in human caused by fungi belonging to the fungal order Mucorales and the family Mucoraceae which are now classified in the (new) phylum Glomeromycota (earlier Zygomycota), class Glomeromycetes (earlier Zygomycetes), subphylum Mucoromycotina, order Mucorales. The Mucorales comprise 55 genera with 261 species. Out of these, 39 species belonging to 12 genera viz. Actinomucor, Apophysomyces, Cokeromyces, Cunninghamella, Lichtheimia, Mycotypha, Mucor, Rhizomucor, Rhizopus, Saksenaea, Syncephalastrum, and Thamnostylum have been reported to be involved in human infections of mucormycosis. However, their prevalence niches in the states or countries is not yet well studied and documented. Clinical presentations of mucormycosis primarly include rhinocerebral, pulmonary, and cutaneous (superficial) and less frequently, gastrointestinal, disseminated, and miscellaneous forms. Pathophysiology involves inhalation of spores through the nose or mouth or even through a skin laceration. The fungus may then spread to the paranasal sinuses and consequently to the orbit, meninges, and brain by direct extension. The unchecked infection results in surgical debridement and even can be fatal. Individuals with compromised cellular and humoral defense mechanisms, diabetic patients, patients on steroid medication, and persons who had major surgeries are prone to mucormycosis infection. A surge in the cases of mucormycosis in post covid patients in the second wave of covid infection were observed in India where the mucormycosis cases increased upto 150 % in 3 weeks (May 25th to June 20th 2021) with 6.7 % of deaths.The number of cases with mortality % varied in different states of the country. The percentage of surgical debridement of eye due to mucormucosis in Nagpur district of Maharashtra state is reported for 78% patients. Even a six month old child’s death is reported due to mucormycosis in Ahmadnagar district of the state indicating the gravity of the disease. However, these mucormycosis infection is generalized as infection due to black fungus, white fungus, yellow fungus, or green fungus without naming the etiological species responsible in different parts of the country. To control this mucormycosis infection, the antifungal drug Amphotericin B is used. However, the development of resistance to this drug is already reported in some of the species causing mucormycosis. Furthermore, different species of mucormycosis fungus is reported to vary in their sensitivity to this drug. Moreover, the Amphotericin B deoxycholate is also reported to cause nephrotoxicity in some of the patients. The mucorales species are characterized by high level resistance to some of the currently available antifungal drugs. Antifungal specificity within the group may be species specific, therefore knowledge of species prevailed in the particularly area of the country is atmost important in the management strategies of the mucormycosis. Amphotericin B, Posaconazole and Isavuconazole are currently the most active drug against mucorales, however, their activity remains sub-optimal and new therapeutic strategies are needed Various known and unknown factors supportive for mucormycosis are summerised in this paper with an emphasis to have a better understanding on these for the prevention of the infections. Handling of issues like monitoring of air quality data for mucorales in metro cities and in hospitals and their displays at fortnight intervals will be worth to forecast the mucormycosis infections and management of etiological agent. Such forecast will prove a milestone for immunocompromised patients to avoid such places and thereby mucormycosis infection. The governments should make a policy for municipal corporations and hospitals to monitor and display the air quality data for mucormycosis fungi. WHO also should look and consider such important policy issues of monitoring air quality data for mucorales to deal with the emerging trends of Mucormycosis.

Posodobljeni strateški politični in usmerjevalno-planski dokumenti Republike Slovenije (RS so sorazmerno dobra podlaga za nadaljnji razvoj obrambnega sistema in transformacijo Slovenske vojske (SV. V dvajsetih letih je bilo narejenega veliko, predvsem SV je glede na čas doživela najbolj dramatične spremembe. Uresničevanje novih strategij je treba nadaljevati in preseči trenutno ambivalentnost. Zastavljene cilje je mogoče doseči s krepitvijo konsistentne obrambne politike in načrtovanja, podprtih z ustreznimi viri. Obrambni sistem in SV bosta morala biti vedno bolj pri- lagodljiva za različne naloge in potrebe, zato utegne modularni pristop organizira- nja prispevati k njuni učinkovitosti. Pri definiranju organizacije SV je treba osvojiti celovit pristop. SV bo še naprej organizirana kot enovita vojska, brez delitve na zvrsti. Glede na prostor in potrebe usklajenega načrtovanja sil in delovanja v Natu pa bo upoštevala delitev sil znotraj zavezništva za opravljanje nalog na kopnem, v zračnem prostoru in na morju. Njena organizacija bo temeljila na delitvi na bojne enote, enote bojne podpore, enote za zagotovitev bojnega delovanja in enote za podporo pove- ljevanju. Organizacijska struktura SV bo leta 2025 zagotavljala možnost modular- nega sestavljanja sil za izvajanje nalog ob največji mogoči racionalizaciji povelj- niške strukture. Pri organiziranju sil bodo upoštevana predvsem vojaškostrokovna načela in načela učinkovitosti ob upoštevanju načel gospodarnosti. Obseg Slovenske vojske, pa tudi njeno konfiguracijo in značaj, bodo določali različni, med seboj pre- pleteni dejavniki, kot so demografski, ekonomski, politični in drugi. Celovit pristop pri dodeljevanju nalog znotraj države in celostna uporaba virov pri upravljanju in reševanju varnostnih izzivov pa sta ključnega pomena. Slovenija bo v prihodnosti samozavestnejša v premisleku o svoji organiziranosti, delovanju, dojemanju prilo- žnosti in uresničitvi svojih ambicij. The updated strategic policy as well as steering and planning documents of the Republic of Slovenia represent a relatively good platform for further development of the defence system and the transformation of the Slovenian Armed Forces (SAF). A lot has been achieved in the past twenty years. The Slovenian Armed Forces in parti - cular have faced dramatic changes considering the period in which they were imple- mented. Slovenia should continue to implement new strategies and try to overcome the temporary ambivalence. The planned goals can be achieved by reinforcing consi- stent defence policy and planning, supported by appropriate resources. The Defence System and the SAF in particular will have to be increasingly flexible when it comes to different assignments and needs, and perhaps the modular approach to its orga- nization will contribute to its efficiency. A comprehensive approach will have to be taken when defining SAF structure. The SAF will continue to be organized as a unified force, without branches. However, because of coordinated force planning and work within NATO, it will respect the division of forces for the performance of tasks on land, in the air and at sea. The organization of the SAF will be based on Combat, Combat Support, Combat Service Support and Command and Control Support units. The 2025 SAF structure will allow for modular force generation for the performance of tasks, taking into account the highest possible rationalization of the command structure. The organisation of forces will mainly follow the principles of the military profession, efficiency and economy of effort. The size of the SAF as well as its configuration and character will be determined by several interrelated factors, such as demographic, political, economic factors, etc. Nevertheless, a com- prehensive approach and comprehensive use of resources in managing and dealing with the security risks will be crucial. In the future, Slovenia will demonstrate more self-confidence when it comes to considering the organization of its defence, perfor- mance, understanding of opportunities and realisation of the existing and growing ambitions.

In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a ‘20 metre Shuttle run’ and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10–15 years), not sleeping under a bednet, low socioeconomic status, parents’ or guardians’ with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7–0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0–0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72–76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents’ or guardians’ illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control.

In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular.

In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular. Outbreaks, defined as excess cases of a particular disease or illness which outweighs the response capabilities, have the capacity to overwhelm health care facilities and need timely response and attention to details in order to avoid potentially disastrous sequelae . In this day and age when improvement in public health practices have significantly curtailed outbreak of various diseases, certain viral illnesses continue to make headlines. One of the notable vector borne infectious disease affecting significant portions of south east Asia in the early part of twenty first century is 'Dengue fever'. Dreaded as it is by those suffering from the illness, a lot of the hysteria created is secondary to a lack of education and understanding of the nature of the disease and at times a result of disinformation campaign for vested interests by certain political and media sections.'Dengue' in fact is a Spanish word, assumed to have originated from the Swahili phrase -ka dinga peppo -which describes the disease as being caused by evil spirit. 1 Over the course of time it has been called 'breakbone fever', 'bilious vomiting fever', 'break heart fever', 'dandy fever', 'la dengue' and 'Phillipine, Thai and Singapore hemorrhagic fever' Whilst the first reported case referring to dengue fever as a water poison spread by flying insects, exists in the Chinese medical encyclopedia from Jin Dynasty (265-420 AD), the disease is believed to have disseminated from Africa with the spread of the primary vector, aedes egypti, in the 15th to 19th century as a result of globalisation of slave trade 45In 80% of the patients affected by this condition the presentation is rather insidious and at best characterized by mild fever. The classical 'Dengue fever' present in about 5% of the cases is characterized by high temperature, body aches, vomiting and at times a skin rash. The disease may regresses in two to seven days. However inrare instances (<5%) it may develop into more serious conditions such as Dengue hemorrhagic fever whereby the platelet count is significantly reduced leading to bleeding tendencies and may even culminate in a more life threatening presentation i.e Dengue shock syndrome.6To understand the actual dynamics of Dengue epidemic it is important to understand the mode of its spread in affected areas. Aedes mosquito (significantly Aedes Egypti) acts a vector for this disease. Early morning and evening times7 are favoured by these mosquitos to feed on their prey. There is some evidence that the disease may be transmitted via blood products and organ donation. 8 Moreover vertical transmission (mother to child) has also been reported 9Diagnostic investigations include blood antigen detection through NS-I or nucleic acid detection via PCR. IO Cell cultures and specific serology may also be used for confirming the underlying disease. Whilst sporadic and endemic cases are part of routine medical practice and may not raise any alarm bells, outbreaks certainly need mobilization of appropriate resources for effective control. Needless to say 'prevention is better than cure' and should be the primary target of the health authorities in devising strategies for disease control.The WHO recommended 'Integrated Vector control programme', lays stress on social mobilisation and strengthening of public health bodies, coherent response of health and related departments and effective capacity building of relevant personnel and organisations as well as the community at risk. For Aedes Egypti the primary control revolves around eliminating its habitats such as open sources of water. In a local perspective in our city Peshawar, venue of the recent dengue epidemic, it may be seen in the form of incidental reservoirs such as receptacles and tyres dumped in open areas such as roof tops with rain water accumulating in them and provtdjng excellent breeding habitats, Larvicidal and insecticides may be added to more permanent sources such as watertanks and farm lands. There is not much of a role for spraying with organophosphorous agents which is at times resorted to for public consumption. Public education is the key to any effective strategy which must highlight the need for wearing clothing that fully covers the skin, avoiding unnecessary early morning and evening exposure to vector agents, application of insect repellents and use of mosquito nets. It is also important not to panic if affliction with the disease is suspected as in a vast majority of instances it is a self limiting illness without any long term harmful effects and needs simple conservative management like antipyretics and analgesics.An important consideration for responsible authorities in a dengue epidemic is to ensure that maximum management facilities for simple cases are provided at the community level through primary and secondary health care facilities and that the tertiary care hospitals are not inundated with all sort of patients demanding consultation. These later facilities should be reserved for those patients who end up with any complications or more severe manifestation of the disease.Research is underway to develop an ideal vaccine for Dengue fever. In 2016, a vaccine by the name 'Dengvaxia' was marketed in Phillipines and Indonesia. However with development of new serotypes of the virus, its efficacy has been somewhat compromised.As for treatment , there are no specific antiviral drugs. Management is symptomatic revolving mainly around oral and intravenous hydration. Paracetamol (Acetaminophen) is used for fever as compared to NSAIDS such as Ibuprophen infusion as well as blood and platelet transfusion.Data to date shows that slightly more than twenty three thousand people have been diagnosed with dengue over the past three months ie August to October there is a lower risk of bleeding with the former. Those with more severe form of the disease may need Dextran 2017, in Peshawar, Pakistan with around fourteen thousand needing admission and about sixty nine recorded deaths. The mortality is well within the acceptable international standards of less than 1% for the disease. In the backdrop of all the debate surrounding the current epidemic, one can infer that such outbreaks are best addressed with effective planningwell ahead of the time before the disease threatens to spiral out of control. Simple measures such as covering water storage facilities, using larvicidals where practical, use of insect repellents, mosquito nets and avoiding unnecessary exposure can offerthe best protection. Public health messages via print and electronic media can help educate people in affected areas and allay any anxiety building up from a fear of developing life threatening complications. Health department must mobilise all its resources to ensure local management of diagnosed patients with simple dengue fever and facilitate hospital admission only for those suffering from more severe form of the disease. Moreover the media hype into such situations needs to be addressed through constant updates and discouraging any negative politicking on the issue. To sum up Dengue fever is not really an affliction to be dreaded provided it is viewed and managed in the right perspective.

In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular. Outbreaks, defined as excess cases of a particular disease or illness which outweighs the response capabilities, have the capacity to overwhelm health care facilities and need timely response and attention to details in order to avoid potentially disastrous sequelae . In this day and age when improvement in public health practices have significantly curtailed outbreak of various diseases, certain viral illnesses continue to make headlines. One of the notable vector borne infectious disease affecting significant portions of south east Asia in the early part of twenty first century is 'Dengue fever'. Dreaded as it is by those suffering from the illness, a lot of the hysteria created is secondary to a lack of education and understanding of the nature of the disease and at times a result of disinformation campaign for vested interests by certain political and media sections.'Dengue' in fact is a Spanish word, assumed to have originated from the Swahili phrase -ka dinga peppo -which describes the disease as being caused by evil spirit. 1 Over the course of time it has been called 'breakbone fever', 'bilious vomiting fever', 'break heart fever', 'dandy fever', 'la dengue' and 'Phillipine, Thai and Singapore hemorrhagic fever' Whilst the first reported case referring to dengue fever as a water poison spread by flying insects, exists in the Chinese medical encyclopedia from Jin Dynasty (265-420 AD), the disease is believed to have disseminated from Africa with the spread of the primary vector, aedes egypti, in the 15th to 19th century as a result of globalisation of slave trade 45In 80% of the patients affected by this condition the presentation is rather insidious and at best characterized by mild fever. The classical 'Dengue fever' present in about 5% of the cases is characterized by high temperature, body aches, vomiting and at times a skin rash. The disease may regresses in two to seven days. However inrare instances (<5%) it may develop into more serious conditions such as Dengue hemorrhagic fever whereby the platelet count is significantly reduced leading to bleeding tendencies and may even culminate in a more life threatening presentation i.e Dengue shock syndrome.6To understand the actual dynamics of Dengue epidemic it is important to understand the mode of its spread in affected areas. Aedes mosquito (significantly Aedes Egypti) acts a vector for this disease. Early morning and evening times7 are favoured by these mosquitos to feed on their prey. There is some evidence that the disease may be transmitted via blood products and organ donation. 8 Moreover vertical transmission (mother to child) has also been reported 9Diagnostic investigations include blood antigen detection through NS-I or nucleic acid detection via PCR. IO Cell cultures and specific serology may also be used for confirming the underlying disease. Whilst sporadic and endemic cases are part of routine medical practice and may not raise any alarm bells, outbreaks certainly need mobilization of appropriate resources for effective control. Needless to say 'prevention is better than cure' and should be the primary target of the health authorities in devising strategies for disease control.The WHO recommended 'Integrated Vector control programme', lays stress on social mobilisation and strengthening of public health bodies, coherent response of health and related departments and effective capacity building of relevant personnel and organisations as well as the community at risk. For Aedes Egypti the primary control revolves around eliminating its habitats such as open sources of water. In a local perspective in our city Peshawar, venue of the recent dengue epidemic, it may be seen in the form of incidental reservoirs such as receptacles and tyres dumped in open areas such as roof tops with rain water accumulating in them and provtdjng excellent breeding habitats, Larvicidal and insecticides may be added to more permanent sources such as watertanks and farm lands. There is not much of a role for spraying with organophosphorous agents which is at times resorted to for public consumption. Public education is the key to any effective strategy which must highlight the need for wearing clothing that fully covers the skin, avoiding unnecessary early morning and evening exposure to vector agents, application of insect repellents and use of mosquito nets. It is also important not to panic if affliction with the disease is suspected as in a vast majority of instances it is a self limiting illness without any long term harmful effects and needs simple conservative management like antipyretics and analgesics.An important consideration for responsible authorities in a dengue epidemic is to ensure that maximum management facilities for simple cases are provided at the community level through primary and secondary health care facilities and that the tertiary care hospitals are not inundated with all sort of patients demanding consultation. These later facilities should be reserved for those patients who end up with any complications or more severe manifestation of the disease.Research is underway to develop an ideal vaccine for Dengue fever. In 2016, a vaccine by the name 'Dengvaxia' was marketed in Phillipines and Indonesia. However with development of new serotypes of the virus, its efficacy has been somewhat compromised.As for treatment , there are no specific antiviral drugs. Management is symptomatic revolving mainly around oral and intravenous hydration. Paracetamol (Acetaminophen) is used for fever as compared to NSAIDS such as Ibuprophen infusion as well as blood and platelet transfusion.Data to date shows that slightly more than twenty three thousand people have been diagnosed with dengue over the past three months ie August to October there is a lower risk of bleeding with the former. Those with more severe form of the disease may need Dextran 2017, in Peshawar, Pakistan with around fourteen thousand needing admission and about sixty nine recorded deaths. The mortality is well within the acceptable international standards of less than 1% for the disease. In the backdrop of all the debate surrounding the current epidemic, one can infer that such outbreaks are best addressed with effective planningwell ahead of the time before the disease threatens to spiral out of control. Simple measures such as covering water storage facilities, using larvicidals where practical, use of insect repellents, mosquito nets and avoiding unnecessary exposure can offerthe best protection. Public health messages via print and electronic media can help educate people in affected areas and allay any anxiety building up from a fear of developing life threatening complications. Health department must mobilise all its resources to ensure local management of diagnosed patients with simple dengue fever and facilitate hospital admission only for those suffering from more severe form of the disease. Moreover the media hype into such situations needs to be addressed through constant updates and discouraging any negative politicking on the issue. To sum up Dengue fever is not really an affliction to be dreaded provided it is viewed and managed in the right perspective.

The purpose of this critical commentary is to highlight the inconsistencies evident within the discourse of Performance Enhancing Drug (PED) use and Anti-Doping violations. Of most note, the issue related to proper rehabilitation and subsequent reintegration of athletes who have failed drugs tests is reliant on a notion that when athletes return to competition, fairness will prevail. We know that PEDS, in particular steroids and exogenous hormone treatment, confer an advantage even without concurrent training (see Bhasin et.al. 1996). That their effectiveness is not in doubt is consistent with current policy. However, the question of just how advantageous it is for athletes to use them, even just the once, and whether there are any permanent advantages to doing so, is not particularly evident in contemporary discourse. This paper takes the position, using emerging scientific evidence as well as the recollections of UK strength sports administrators, that any consideration of ‘clean’ sport needs to resolve policy with the evidence that permanent advantages accrued from PED use can only be combatted by promoting a ‘natural for life’ standard.

AbstractFirst evidence shows that some parents engage in the health-endangering practice of (mis-)using prescription drugs to boost their children’s school performance. But little is known about parental perspectives on this phenomenon. This study aims to better understand parents’ perspectives on the non-medical use of prescription drugs to improve healthy children’s cognitive functioning. We conducted twelve semi-structured face-to-face interviews with a diverse sample of parents in Germany, and applied qualitative content analysis to explore their perspectives on instrumentalizing prescription drugs for improving the performance of healthy children, including their underlying knowledge (gaps), moral evaluations, evaluations of accompanied risks and benefits, opinions on potential motivators, and wishes regarding policy-making. The results show that parents typically believed themselves knowledgeable about such prescription drug (mis-)use, although they were not aware of anyone in their social environment taking them for enhancement. Parents generally considered such behavior to be morally reprehensible, cheating, and similar to doping in sports, and they typically claimed that no situation or occasion could motivate them to administer prescription drugs to their healthy children. Health risks (including side effects or addiction) were a typical expectation of drug use. That doctors should give such drugs to healthy young people was seen as unjustifiable. The results suggest that morality and risk–benefit evaluations of parents play a major role in their decision-making concerning this potentially risky instrumentalization of non-medical drugs. These insights are of distinct importance, especially for future research and further discussions on this topic, such as an evidence-based public dialog and ethics debates.