Suchergebnisse

An overview of the tested in the Russian Federation in 2009–2018 is presented. Models of cooperation between organizations of science, education and industrial partners: Resolutions of the Government of the Russian Federation of April 9, 2010 No. 218, Federal law of August 2, 2009 No. 217-FZ, aimed at creating a ring of small innovative enterprises around universities, as well as the project of the Association of Entrepreneurial universities. It is proposed to be guided by the understanding of the criteria for technological development, which is proposed by the strategic planning documents, when determining the key functions of scientific and educational centers (SEC). The assumption is made that formalizing this concept would allow developing a more harmonious system of indicators of the technological development of the country as a whole and individual regions and more clearly formulating the goals and objectives of SEC as a model of technological development. It is noted that the SEC efficiency indicators proposed by the methodology of The Ministry of Science and Higher Education of the Russian Federation to a greater extent reflect the totality of the functions of the cooperation participants, but not the quality of initiatives aimed at accelerating the technological development of the region. The basic conditions for productive cooperation are proposed to include the critical mass of specialized companies, ensuring the dominance of private initiative, attracting and retaining highly qualified specialists from scientific and business circles, as well as venture investors. ; Представлен обзор апробированных в Российской Федерации в 2009–2018 гг. моделейкооперации организаций науки, образования и индустриальных партнеров: Постановления Правительства РФ от 9 апреля 2010 г. № 218, Федерального закона от 2 августа 2009 г. № 217-ФЗ, направленного на создание кольца малых инновационных предприятий вокруг вузов, а также проекта Ассоциации предпринимательских университетов. Предложено при определении ключевых функций научно-образовательных центров (НОЦ) руководствоваться пониманием критериев технологического развития, которое предлагают документы стратегического планирования. Делается предположение, что формализация этого понятия позволила бы разработать более стройную систему показателей технологического развития страны в целом и отдельных регионов, и более четко сформулировать цели и задачи НОЦ как модели технологического развития. Отмечено, что показатели эффективности НОЦ, предложенные методикой Минобрнауки России, в большей степени отражают совокупность функций участников кооперации, но не качество инициатив, направленных на ускорение технологического развития региона. К базовым условиям продуктивной кооперации предлагается отнести критическую массу профильных компаний, обеспечивающую доминирование частной инициативы, привлечение и удержание высококвалифицированных специалистов из научных и деловых кругов, а также венчурных инвесторов.

The article reviews the regulatory framework on the basis of which the creation and functioning of innovation clusters as an association of objects of innovative infrastructure of Ukraine.During the research, the author concludes that it is advisable to classify the regulatory regulation of the activity of innovation clusters in Ukraine into two categories: general and special. The general regulatory framework is aimed at creating elements of innovation clusters as legal entities; special aimed at regulating issues of innovation and intellectual property.At the same time, the basic principles of creation and functioning of the legal framework governing the issues of innovation clusters are highlighted: systematicity, accessibility and legality.In the article it is stated that legislative regulation, covering the issues of the functioning of the innovation clusters is incomplete and fragmented, which in turn impedes the full, strategic and cost-effective development of innovation clusters. Hence, the author advices to propose the legislator to regulate the investigated issue at the level of a separate legal act.Besides proper legislative framework, the author pays attention to the necessity of the attraction of budgetary and extra-budgetary funding, including facilitating the participation of clusters in competitions and events conducted by state and regional development institutes, state authorities and local self-government bodies. It is also obvious that there is a need of facilitating the promotion and sale of innovative products of cluster participants in the domestic and world markets; implementation of projects of cluster participants with involvement of state and regional development institutes.At the end of the research the author generates the basic directions of improvement of the policy of legal regulation of the cluster innovation system of Ukraine, proposes concrete measures in the direction of its improvement and modernization. ; В статье сделан обзор нормативно-правовой базы, на основе которой осуществляется создание и функционирование инновационных кластеров как объединения объектов инновационной инфраструктурыУкраины. По ходу изложения материала осуществляется обобщенный обзор законодательных актов, на основании которых осуществляется эффективное функционирование инновационных кластеров, а также формируются предложения о потенциальных путях совершенствования их положений. ; В статті здійснено огляд нормативно-правової бази, на основі якої здійснюється створення та функціонування інноваційних кластерів як об'єднання об'єктів інноваційної інфраструктури України. Під час викладу матеріалу здійснюється узагальнений огляд законодавчих актів, що уможливлюють ефективне функціонування інноваційних кластерів, здійснюється їх класифікація за цільовим призначенням у контексті нормативно-правового регулювання досліджуваного об'єкта. Висвітлюються недоліки нормативно-правової бази функціонування інноваційної інфраструктури. Формуються пропозиції щодо потенційних шляхів вдосконалення її положень.

This article presents the current issues in the law of international organizations and contemporary international law in general. It is pointed out that the division of international law into branches and institutions, in order to ensure the effective legal regulation of new spheres of relations, led to the emergence of autonomous legal regimes, even within one region, namely on the European continent. To date, these include European Union law and Council of Europe law. It is emphasized the features of the established legal relations between the Council of Europe and the European Union at the present stage. It is determined that, along with close cooperation between regional organizations, there is a phenomenon of fragmentation, which is accompanied by the creation of two legal regimes within the same regional subsystem, proliferation of the international legal norms, institutions, spheres and conflicts of jurisdiction between the European Court of Human Rights and the Court of Justice of the European Union. It is revealed that some aspects of fragmentation can be observed from the moment of establishing relations between the Council of Europe and the European Union, up to the modern dynamics of the functioning of the system of law of international organizations, the law of international treaties, law of human rights. Areas and types of fragmentation in relations between international intergovernmental organizations of the European continent are distinguished. One way to overcome the consequences of fragmentation in the field of human rights is highlighted, namely through the accession of the European Union to the Convention on Human Rights and Fundamental Freedoms 1950. Considerable attention has also been paid to defragmentation, which is partly reflected in the participation of the European Union in the Council of Europe's conventions by the applying «disconnection clause». It is determined that the legal relations established between an international intergovernmental organization of the traditional type and the integration association sui generis, the CoE and the EU, but with the presence of phenomenon of fragmentation in a close strategic partnership, do not diminish their joint contribution into the development of the law of international organizations and contemporary international law in general. Key words: defragmentation; European Union; European Court of Human Rights; Convention on Human Rights and Fundamental Freedoms 1950; conflict of jurisdictions; «disconnection clause»; Council of Europe; Court of Justice of the European Union; fragmentation; sui generis.

Driving is increasing across the world and road traffic accidents are a major cause of serious injuries and fatalities. The link between alcohol consumption and impaired driving has long been established and has led to legislation in many countries, with enforcement of legal limits based on blood alcohol concentration levels. Alcohol hangover research is an emerging field with a range of laboratory and naturalistic studies now clearly demonstrating the significant impairments that can result from hangover, even when alcohol levels are measured at or close to zero the day following a social drinking occasion. Driving is a commonplace activity but requires competency with a range of complex and potentially demanding tasks. Driving impaired can have serious consequences, including death and serious injury. There have been only limited alcohol hangover driving studies. The studies presented examined the consequences of alcohol hangover with a driving simulator contrasting a group with zero residual alcohol (N = 26) next day and another with residual alcohol (N = 26) assessed with breathalyzer in the morning before undertaking a 20 min commute to work. All participants completed a morning drive after a night without alcohol consumption and another after a night of social drinking. The driving scenarios were relatively demanding including traffic and pedestrians, traffic lights and other potential hazards in a mixed rural and urban journey. Subjective hangover and workload were assessed in addition to a range of driving performance variables, including divided attention, steering control and driving violations. Analyses contrasted driving in the no alcohol condition with the residual alcohol condition. The combined groups data (N = 52) was contrasted with the zero and residual alcohol groups. Significant contrasts were found for a range of driving measures, including divided attention, vehicle control, and driving violations as well as perceived workload. The pattern of impairment was broadly similar across both groups, indicating that whether or not residual alcohol was present, consistent driving impairment was seen. The relatively high number of significant variables may reflect the increased cognitive demand of the 20 min commute drive including busy and complex urban environments. This was also reflected in the significant increase in perceived workload recorded across the 6 dimensions of the National Aeronautics and Space Administration Task Load Index (NASA-TLX). Associations between subjective measures and driving performance with hangover suggested a potential lack of awareness of impairment, though were limited in number. The overall findings indicate that the levels of impairment seen reflect those seen with alcohol impaired driving, even when breath alcohol is zero.

UIDB/04647/2020 UIDP/04647/2020 ; Las ciudades, o los complejos espacios urbanos en que se están transformando, son vitales en la sociedad del futuro, particularmente en un contexto de globalización en que la fragmentación del poder y la transición de la gobernación tradicional a la gobernanza acompañan movimientos urbanos que aumentan su relevancia, ya sea a través de acción directa o por el incremento de la responsabilidad democrática. En Portugal, sin embargo, los movimientos urbanos y las asociaciones cívicas en general son discretos en sus actividades, dimensión y relevancia. De hecho, no hay indicios de que la crisis de 2008–2014 haya provocado un cambio muy significativo. En este artículo intentamos arrojar alguna luz sobre las causas de esta aparente inercia. Creemos que aun que haya algunos signos de cambio, en un contexto de transición a la gobernanza y de nuevas dinámicas urbanas, todo queda muy distante de lo que se está produciendo en otros países europeos. En un contexto de cambio para un abordaje multiescalar de la política, de las políticas públicas, de la planificación y de la acción, después de siglos de enfoque jerárquico y sectorial (aún) dominante, nuestro examen centra-se no contexto do poder de las ciudades y en las ciudades. Cities -or the urban complex spaces that they are becoming- are vital in society's future, particularly in a general context of globalization. In this setting, power fragmentation and government to governance transitions, which are indisputable and significant phenomena, go hand in hand with urban movements that are becoming increasingly relevant, both through their direct action, and as a consequence of democratic responsibility. In Portugal, however, urban movements and civic associations in general seem rather discreet in their activities, dimension and role. In fact, there is no strong evidence that the 2008-2014 crisis has brought any dramatic change in these aspects. In this article we aim to shed some light on plausible explanations for this apparent inertia. Signs of change, in a context of increased governance and new urban dynamics do exist but do not seem to follow the trend that is thriving in several cities on other European countries. In face of new opportunities for a multiscalar approach to politics, planning and action, after centuries of a (still) dominant hierarchical and sectorial approach, we examine the context of the power of the cities and in the cities in Portugal. ; publishersversion ; published

Industry 4.0 encompasses adopting opportunities from end-to-end digitalisation with connected computers and increasingly autonomous automation systems equipped with intelligent machine learning algorithms that control the robotics without much input from humans. Smart manufacturing technologies (a part of the smart industry, an extension of Industry 4.0 initiatives and implementation) involve automating various processes. It aims to connect various units in real-time while enhancing profitability by reducing costs, increasing labour productivity, and improving overall efficiency. The impetus for our paper is the assumption that the adoption of smart manufacturing technologies such as advanced robotics, cyber-physical systems, or the Internet of Things (IoT) continues to be a challenge for Small and Medium Enterprise (SME) manufacturing firms in Singapore. Industry 4.0 adoption issues include significant capital investment, developing technical skills, recruiting new talent, re-skilling of the workforce, training needs, top management support, etc. But the traditional manufacturing model is fast evolving. Ultimately, adopting the right enabling technologies in a phased manner with proper planning remains a critical factor for the success of Industry 4.0 initiatives. This paper contributes to the minimal Asian management literature about Industry 4.0 matters in SMEs by interviewing eight key experts who are very knowledgeable about the subject matter. The qualitative study sheds light on the drivers and barriers to better understand current business dynamics, potential issues, focus areas, and initiatives to smoothen this implementation, to help catapult local manufacturers to the next level. A structured questionnaire was designed based on the current body of knowledge to conduct qualitative semi-structured interviews with key specialists and decision-makers across Government agencies, Institutes of Higher Learnings (IHL's), suppliers/providers of Industry 4.0 technology, business associations, and the SME sector. The analysis of the interviews suggests that factors or drivers such as technology push by the Government with robust funding and training support, skilled labour shortages including imported labour dependence, productivity and efficiency issues, the pressure to innovate business models due to increased competition, and the impact of Covid-19 are propelling SMEs to adopt Industry 4.0. Some of the barriers include high investment costs and return on investment concerns, capability concerns, mindset issues, and lack of ecosystem concerns. The extent to which local SMEs are ready for Industry 4.0 will be further examined during the 2nd phase of the research project.

This final report of the Lancet Commission into liver disease in the UK stresses the continuing increase in burden of liver disease from excess alcohol consumption and obesity, with high levels of hospital admissions which are worsening in deprived areas. Only with comprehensive food and alcohol strategies based on fiscal and regulatory measures (including a minimum unit price for alcohol, the alcohol duty escalator, and an extension of the sugar levy on food content) can the disease burden be curtailed. Following introduction of minimum unit pricing in Scotland, alcohol sales fell by 3%, with the greatest effect on heavy drinkers of low-cost alcohol products. We also discuss the major contribution of obesity and alcohol to the ten most common cancers as well as measures outlined by the departing Chief Medical Officer to combat rising levels of obesity—the highest of any country in the west. Mortality of severely ill patients with liver disease in district general hospitals is unacceptably high, indicating the need to develop a masterplan for improving hospital care. We propose a plan based around specialist hospital centres that are linked to district general hospitals by operational delivery networks. This plan has received strong backing from the British Association for Study of the Liver and British Society of Gastroenterology, but is held up at NHS England. The value of so-called day-case care bundles to reduce high hospital readmission rates with greater care in the community is described, along with examples of locally derived schemes for the early detection of disease and, in particular, schemes to allow general practitioners to refer patients directly for elastography assessment. New funding arrangements for general practitioners will be required if these proposals are to be taken up more widely around the country. Understanding of the harm to health from lifestyle causes among the general population is low, with a poor knowledge of alcohol consumption and dietary guidelines. The Lancet Commission has serious doubts about whether the initiatives described in the Prevention Green Paper, with the onus placed on the individual based on the use of information technology and the latest in behavioural science, will be effective. We call for greater coordination between official and non-official bodies that have highlighted the unacceptable disease burden from liver disease in England in order to present a single, strong voice to the higher echelons of government.

ABSTRACTIrrigation institutions in Indonesia generally have two forms, first there are institutions built by the government,secondly institutions built by communities that are managed communally. This research aims to analyze theprocess of the formation of communal irrigation institutions, the structure and functions of irrigation institutionsand analyze irrigation institutional rules communal, then compare it with other irrigation institutions. This researchis a qualitative study with a case unit in Tonasa Village. Primary data obtained through interviews and secondarydata obtained through data available from the relevant agencies. Data analysis was carried out by organizing databy sorting them into groups, involving the history of irrigation formation, institutional formation of the WaterUser Farmers Association (P3A), regulation of irrigation water use, irrigation maintenance, application ofsanctions to communal members who violated existing rules agreed on a communal-based irrigation in Tonasavillage, Buttonopao, Gowa district. The next step is the data will be synthesized to, search and find answers fromthe research questions and then publish it. The results showed that the irrigation institution of Tonasa Village wasbuilt from the bottom and already had a simple organizational structure and had regulations that were born fromthe community themselves, obeyed and enforced, for those who violated the sanctions imposed.Keywords: Institutional, Irrigation, Communal, PlateauABSTRAKKelembagaan irigasi di Indonesia secara umum ada dua bentuk, pertama ada kelembagaan yang dibangun olehpemerintah, kedua kelembagaan yang dibangun oleh masyarakat yang dikelola secara komunal.Penelitian inibertujuan untuk menganalisis proses terbentuknya kelembagaan irigasi komunal, struktur dan fungsi kelembagaanirigasi serta menganalisis aturan kelembagaan irigasi komunal, kemudian membandingkannya dengankelembagaan irigasi yang lain. Penelitian ini merupakan penelitian kualitatif dengan unit kasus Desa Tonasa.Data primer diperoleh melalui wawancara dan data sekunder diperoleh melalui data-data yang tersedia dariinstansi yang terkait. Analisis data dilakukan dengan mengorganisasikan data dengan memilah-milahnya dalambeberapa kelompok, menyangkut tentang sejarah terbentuknya irigasi, pembentukan kelembagaan PerhimpunanPetani Pengguna Air (P3A), pengaturan penggunaan air irigasi, pemeliharaan Irigasi, penerapan sanksi padaanggota komunal yang melakukan pelanggaran terhadap aturan yang sudah disepakati pada irigasi yang dikelolaberbasis komunal di desa Tonasa kecamatan Tombolopao kabupaten Gowa. Langkah selanjutnya data akandisintesis untuk, mencari dan menemukan jawaban dari pertayaan penelitian kemudian mempublikasikannya.Hasil penelitian menunjukkan bahwa kelembagaan irigasi Desa Tonasa terbangun dari bawah dan sudah memilikistruktur organisasi yang sederhana serta sudah memiliki peraturan yang lahir dari masyarakat sendiri, dipatuhidan ditegakkan, bagi yang melanggar ada sanksi yang diberlakukan.Kata Kunci : Kelembagaan, Irigasi, Komunal, Dataran tinggi

Information Technologies (IT) provides optimization, service improvement and a higher level of competitiveness, adding value to the strategic results of organizations. However, to maximize these potential IT contributions, organizations must achieve a high level of alignment between business strategies and IT strategies. Several authors have proposed different alignment strategies and have created measurement instruments to estimate the maturity degree of the alignment in each organization. One of the most recognized is the Luftman SAM (Strategic Alignment Maturity) model, which has a scale of 5 alignment levels and evaluates 6 dimensions (Communication, Value, IT Government, Association, Reach, IT Skills). In the Colombian Health System, each entity generally has different systems to cover business processes, generating duplication of information, low data quality, low coverage, delays in patient care and difficulties in reporting information to surveillance and control entities. In this project, the Luftman instrument is applied to a healthcare entity in Villavicencio (Colombia), to generate a diagnosis on the degree of alignment maturity in the institution. The results indicate that the organization has a level 2 of maturity. ; Las Tecnologías de la Información (TI) aportan optimización, mejora de servicios y mayor nivel de competitividad, agregando valor a los resultados estratégicos de las organizaciones. Sin embargo, para maximizar estas potenciales contribuciones de TI, las organizaciones deben llegar a un alto nivel de alineación entre las estrategias de negocio y las estrategias de TI. Varios autores han planteado diferentes estrategias de alineación y han creado instrumentos de medición para estimar su grado de madurez en una organización dada. Uno de los más reconocidos es el modelo SAM (Strategic Alignment Maturity) de Luftman, el cual especifica una escala de 5 niveles de alineación y evalúa 6 dimensiones (Comunicación, Valor, Gobierno TI, Asociación, Alcance, Habilidades TI). En el sector Salud en Colombia generalmente cada entidad cuenta con diferentes sistemas para el cubrimiento de los procesos de negocio creando duplicidad de información, baja calidad de los datos, baja cobertura, demoras en la atención a los pacientes y dificultades para reportar información a los entes de vigilancia y control. En este proyecto se aplicó el instrumento de Luftman a una Entidad de Salud de Villavicencio (Colombia), con el propósito de generar un diagnóstico sobre el grado de madurez de alineación en la institución. Los resultados indican que la organización tiene un nivel 2 de madurez. ; Línea de Investigación: Sistemas y Organizaciones ; Maestría

BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference. SETTING: Online Delphi survey and consensus conference. PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), and 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time when further evidence is available to guide our approach. PATIENT SUMMARY: This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available.

Savunma harcamaları ile ilgili bugüne kadar birçok çalışma yapılmıştır. Bu çalışmanın temel amacı özgürlüklerin ve kurumsal faktörlerin savunma harcamaları üzerindeki etkisini incelemektir. Özgürlük göstergeleri; güçlendirme hakları endeksi, toplanma ve örgütlenme özgürlüğü, konuşma özgürlüğü, seçimde öz tayin, din özgürlüğü, işçi hakları, kadının ekonomik hakları, kadının siyasi hakları, kadının sosyal hakları, yargının bağımsızlığı on farklı değişken çalışmaya dahil edilmiştir. Kurumsal faktör göstergesi olarak dokuz farklı değişken kullanılmıştır. Bu değişkenler; ifade özgürlüğü ve hesap verebilirlik, siyasi istikrar ve şiddetin yokluğu, devlet etkinliği, idari kalite, hukukun üstünlüğü, yolsuzluğun kontrolü, hukuk ve politikaya askeri müdahale, toplumsal cinsiyet eşitsizliği, hukuk sistemi ve mülkiyet hakları şeklinde çalışmaya dahil edilmiştir. Bu çalışmada özgürlüklerin ve kurumsal faktörlerin savunma harcamaları üzerindeki etkisi 1990-2017 yılları arasında 151 ülke için çalışma yapılmış olup ampirik olarak dengesiz panel veri setinden yararlanılmıştır.Kurumsal faktörler ile savunma harcamaları arasında negatif ve istatistiksel olarak anlamlı bir ilişki olduğu sonucuna varılmıştır.Ancak kurumsal faktör değişkeni olan yolsuzluğun kontrolü ve savunma harcamaları arasında pozitif ve istatistiksel olarak anlamlı bir ilişki olduğu sonucu tespit edilmiştir.Özgürlükler ile savunma harcamaları arasındaki ilişki tüm değişkenler için negatif ve istatistiksel olarak anlamlı bir ilişki olduğu ve tüm sonuçların beklenti ile paralel olduğu sonucuna ulaşılmıştır. ; There have been many studies on defense expenditures until today. The fundamental objective of this study is to analyze the impact of freedom and institutional factorson defense expenditures. Freedom indicators; the empowerment rights index, freedom of assembly and association, freedom of speech, self-determination in elections, freedom of religion, workers' rights, women's economic rights, women's political rights, women's social rights and independence of the judiciary have been included in the study. Nine different variables have been used as indicator of institutional factor. These variables which are voice and accountability, political stability and absence of violence/terrorism, government effectiveness, regulatory quality, rule of law, control of corruption, military intervention in law and politics, gender ınequality, legal system and property rights. In this study, the effects of freedoms and institutional factors on defense expenditures were studied for 151 countries between 1990 and 2017, and empirically unbalanced panel data set has been used. It was concluded that there is a negative and statistically significant relationshipbetween institutional factors and defense expenditures. Nevertheless, it was determined that there is a positive and statistically significant relationshipbetween the control of corruption and defense expenditures, which is a variable of institutional factor. It has been attained that there is a negative and statistically significant relationship for all variables and that all results are in line with expectations.

Salah H Elsafi Clinical Laboratory Science Department, Prince Sultan Military College of Health Science, Dammam 31448, Kingdom of Saudi ArabiaCorrespondence: Salah H ElsafiClinical Laboratory Science Department, Prince Sultan Military College of Health Science, P.O. Box 33048, Dammam 31448, Kingdom of Saudi ArabiaTel +966 13 8405448Fax + 966 13 8405577Email salahelsafi@hotmail.comBackground: Understanding the demographic features of blood donors is important for identifying the donor structure and guiding the recruitment and retention strategies of donors. This study was aimed to determine the demographic characteristics of blood donors, the types of donation drives, and the frequency and reasons for pre-donation deferral in our population.Methods: This cross-sectional study included data analysis of all prospective blood donors presenting themselves for donation at the Blood Bank of the King Fahad Military Medical Complex, Dhahran, Saudi Arabia between January 2010 and December 2018. Eligibility of blood donation was assessed using a standardized history questionnaire, physical examination, hemoglobin estimation, pulse rate, blood pressure, and temperature. The questionnaire included the demographic features of the donor such as age, gender, and the reason for donation and other specific risk factors that potentially affect the safety of the donor or the recipient. Data analyzed using the analysis of SPSS version 20 (SPSS Inc., Chicago, IL, USA) were used to calculate the unadjusted odds ratios (OR) and the respective 95% confidence interval for the association between the various demographic parameters.Results: A total of 28,189 potential donations were recorded during the study period; of these, 77.4% were family replacements with females accounting for only 1.8% of all donations. Most of the donors were Saudi nationals (92.1%) of whom donors between 18 and 34 years old constituted 87.9%, while those over 40 years old represented only 7.9% of the donations. Pre-donation temporary deferral occurred in 3300 (11.7%) of all potential donation attempts. The most common causes being the recent intake of medication (24.4%) followed by low hemoglobin (14.8%), low or high blood pressure (14.6%), low or high pulse rate (13.6%), and low weight (11.6%).Conclusion: A profile of blood donors consisting mainly of young male citizens who mostly donated for family replacement was detected. Deferral rate was found to be average when compared to other countries; the causes being similar to those detected in other developed countries. Simple descriptive statistics has shown no marked difference was noted over the 9 years of the study in neither the profile of blood donors nor the cause for temporary deferral of prospective blood donors.Keywords: blood donation, donor's demography, donor deferral

Mihajlo Jakovljevic,1– 3 Takuma Sugahara,2 Yuriy Timofeyev,4 Nemanja Rancic5,6 1Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; 2Institute of Comparative Economics, Hosei University, Tokyo, Japan; 3N.A.Semashko Department of Public Health and Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 4National Research University Higher School of Economics, Moscow, Russia; 5Centre for Clinical Pharmacology, Military Medical Academy, Belgrade, Serbia; 6Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, SerbiaCorrespondence: Mihajlo JakovljevicDepartment of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, SerbiaTel +381 34306 800Email sidartagothama@gmail.comPurpose: The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies.Methods: We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996– 2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used.Results: Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydrates is significantly linked with healthy life expectancy. In these non-OECD Asian countries, unsafe water drinking and per capita carbon dioxide emissions increase infant mortality. There is a strong negative association between GDP per capita and infant mortality in both sub-samples, although its impact is far larger in the OECD group. In Japan and South Korea, unemployment is negatively associated with infant mortality.Conclusion: Japan outperforms other countries from the sample in major healthcare performance indicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations' outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.Keywords: Asia, health expenditure, healthy life expectancy, infant mortality, nutrition, population health outcomes

Iltaf Hussain,1 Muhammad Fawad Rasool,1 Imran Imran,2 Hamid Saeed,3 Furqan Hashmi,3 Muqarrab Akbar,4 Muhammad Asad Abrar,1 Basit Ramzan,5 Muhammad Omer Chaudhry,6 Muhammad Islam,3 Areeba Usman,7 Naveed Nisar,8 Abdul Majeed1 1Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; 2Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; 3University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore 54000, Pakistan; 4Department of Political Science, Bahauddin Zakariya University, Multan 60800, Pakistan; 5Al Shifa Pharmacy, Multan, Pakistan; 6School of Economics, Bahauddin Zakariya University, Multan 60800, Pakistan; 7Nishter Medical Hospital, Multan, Pakistan; 8Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, PakistanCorrespondence: Abdul MajeedDepartment of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, PakistanTel +92 3336139819Email abdulmajeed@bzu.edu.pkBackground and Purpose: Over the past few decades, the focus of pharmacy practice has been shifted from the classical role of drug dispenser to pharmacotherapy expert. Pharmacists now are more often involved in the patient care process by addressing the drug-related needs of the patients and this patient-centered approach is known as pharmaceutical care (PC). The present study was conducted to assess the attitude of pharmacy undergraduate students toward PC and various contributing factors that influence their preference towards it.Method and Instrument: A descriptive cross-sectional study was conducted in 422 undergraduate pharmacy students by using a simple random sampling method. A pre-validated and self-reported Pharmaceutical Care Attitude Scale (PCAS) was used for assessing a student's attitude towards PC.Results: Amongst the 422 undergraduate students, the majority were males (68.2%) and 70.4% were between the age group of 20 and 25 years. The students studying in third, fourth, and fifth year (final year) were 140 (33.2%), 142 (33.6%), and 140 (33.2%), respectively. Overall participant showed a positive attitude toward the PC. Professional year showed significant influence on professional duties (PD) (p< 0.001) and age was significantly associated with return on efforts (ROE) (p< 0.001) and professional benefits (PB) (p< 0.001).Conclusion: Most of the participants showed a positive attitude toward PC and showed motivation to practice it. To promote PC practice in Pakistan, the government along with other professional bodies like Pakistan Pharmacists Association (PPA) should work together in collaboration with global health agencies to develop a well-structured advanced healthcare system in which there is a defined role of PC practice.Keywords: attitude, clinical pharmacy, pharmaceutical care, pharmacy practice

Yuanqiang Zhu,1,* Fang Ren,1,* Yuanju Zhu,2,* Xiao Zhang,1 Wenming Liu,3 Xing Tang,1 Yuting Qiao,3 Yanhui Cai,3 Mingwen Zheng1 1Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China; 2Institute of Medicinal Chemistry, School of Pharmacy, Shandong University, Jinan, Shandong, People's Republic of China; 3Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China*These authors contributed equally to this workCorrespondence: Yuanqiang Zhu; Mingwen ZhengDepartment of Radiology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an 710032, People's Republic of ChinaTel/Fax +86-29-8477-5415Email Zhu_YQ_fmmu@163.com; zhengmw2007@163.comBackground: It is well known that circadian rhythms and sleep homeostasis contribute to a pronounced trough in sleepiness and behavioral performance at night. However, the underlying neuroimaging mechanisms remain unclear. How brain-function connectivity is modulated during sleep deprivation (SD) has been rarely examined.Methods: By increasing the number of scanning sessions during SD, the current study used voxel-mirrored homotopic connectivity (VMHC) to investigate dynamic changes in interhemispheric communication during one night of SD. Every 2 hours from 10 pm to 06 am (session 1, 10 pm; session 2, 12 am; session 3, 2 am; session 4, 4 am; session 5, 6 am), functional magnetic resonance–imaging data and Stanford Sleepiness Scale (SSS) scores were collected from 36 healthy participants with intermediate chronotype. Dynamic changes in SSS scores and VMHC were determined using one-way repeated-measure ANOVA with the false discovery–rate method to correct for multiple comparisons.Results: Significant time effects for VMHC were found mainly in the bilateral thalamus, bilateral superior temporal gyrus, and bilateral precentral gyrus. SSS scores and VMHC in these areas were both found to be monotonously increased during SD. Furthermore, significant positive associations were found between SSS valu and VMHC values in the left superior temporal and right superior gyri.Conclusion: These findings might represent the dynamic modulation of circadian rhythm merely or the interaction effects of both circadian rhythm and sleep homeostasis on interhemispheric connectivity within the thalamus, default-mode network, and sensorimotor network. Our study provides more comprehensive information on how SD regulates brain connectivity between hemispheres and adds new evidence of neuroimaging correlates of increased sleepiness after SD.Keywords: sleep deprivation, resting-state functional MRI, voxel-mirrored homotopic connectivity, Stanford Sleepiness Scale, dynamic changes