High priority scores were assigned for progression during preoperative therapy. Low scores were assigned for re-excisions, atypical lesions and other benign indications. There was good agreement of the tool's ranking of sample patients with rankings by experienced clinicians. The tool generates risk-stratified patient lists by surgeon or institution to facilitate assignment of surgery dates.

This tool generates a clinically consistent, risk-stratified priority list of breast surgical procedures delayed by the COVID-19 pandemic. This systematic approach may facilitate surgical scheduling as conditions normalize.
This tool generates a clinically consistent, risk-stratified priority list of breast surgical procedures delayed by the COVID-19 pandemic. This systematic approach may facilitate surgical scheduling as conditions normalize.
The data about treatment results of Ewing sarcoma in adult patients are limited. The aim of our study was to analyze prognostic factors and outcomes of therapy in this group of patients.

Between 2000 and 2018, 180 patients at the age of > 18years old diagnosed with Ewing sarcoma were treated in referral center according to multimodal protocols. In 50 patients (28%) treatment was initiated outside our hospital, and 23 of them had started recommended therapy after 3months since the date of biopsy/unscheduled operation. We analyzed clinical prognostic factors and overall survival (OS).

The median age was 28years (18-67years), primary tumor was localized axially in 114 patients (63%), metastases at presentation were detected in 51 pts (28%). 5-year OS rate was 65% for patients with localized disease, in metastatic disease it was 15%; the presence and the number of metastases was a prognostic factor. 5-year PFS was significantly better in patients treated at referral center (or when the patients were admitted to referral center within 3months from the date of biopsy, which was performed outside referral center), comparing to patients treated initially outside referral center; 5-year PFS rates in total population were 28 and 13%, respectively. In terms of OS, unfavorable prognostic factor showing a statistical trend (p = 0.098) was lower dose density of neoadjuvant chemotherapy due to toxicity.

Approximately two-third of adult patients with localized Ewing sarcoma survive 5years. In order to improve survival of this patients the multidisciplinary treatment in referral center is mandatory.
Approximately two-third of adult patients with localized Ewing sarcoma survive 5 years. In order to improve survival of this patients the multidisciplinary treatment in referral center is mandatory.Diabetes mellitus is a prevalent metabolic disorder associated with multiple complications including neuropathy, memory loss and cognitive decline. Despite a long history of studies on diabetic complications, there are no effective therapeutic strategies for neuroprotection in diabetes. Hyperglycemia-induced imbalance in programmed cell death could initiate a decline in neural tissue cells viability. Various nanomaterials can induce either cell death or cell survival dependent on the type and surface features. Pristine C60 fullerene is a nontoxic nanomaterial, which exhibits antioxidant and cytoprotective properties. However, the precise molecular mechanism with which the C60 nanoparticle exerts cytoprotective effect in diabetic subjects has not yet been fully addressed. Thus, this study aimed to determine whether C60 fullerene prevents oxidative stress impairment and to explore the effects of C60 fullerene on apoptosis and autophagy in diabetes mellitus to clarify its potential mechanisms. These effects have, C60 fullerene regulates a balance of autophagy via BCL-2/Beclin-1 reciprocal expression that could prevent functional disturbances in hippocampus.Alzheimer's disease (AD) is the most common cause of dementia among older people in worldwide. miR-29c-3p was reported to play a role in AD development. However, the detail function of miR-29c-3p in AD remains unclear. The aim of this research is to analyze the functional mechanism of miR-29c-3p in AD. https://www.selleckchem.com/products/mpp-dihydrochloride.html The RNA levels of miR-29c-3p and Tumor necrosis factor-α-inducible protein-1 (TNFAIP1) were detected by Quantitative real time polymerase chain (qRT-PCR) reaction. Western blot assay was carried out to examine the protein levels of TNFAIP1, Bax, B-cell lymphoma-2 (Bcl-2), Cleaved caspase 3, and Nuclear factor-k-gene binding (NF-κB). The interaction between miR-29c-3p and TNFAIP1 was predicted by online tool TargrtScan and verified using the dual luciferase reporter assay and RNA immunoprecipitation RIP (RIP) assay. Besides, cell proliferation and apoptosis rate were determined by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) assay and flow cytometry analysis, respectively. Aβ treatment decreased miR-29c-3p expression and increased TNFAIP1 expression. Overexpression of miR-29c-3p mitigated the effects of Aβ on proliferation and apoptosis. Similarly, knockdown of TNFAIP1 also reversed the effects of Aβ on cell progression. Interestingly, miR-29c-3p suppressed the expression of TNFAIP1 via binding to 3'UTR of TNFAIP1 mRNA. As expected, overexpression of TNFAIP1 reversed the effects of miR-29c-3p on Aβ-mediated cell progression. Besides, we also confirmed that miR-29c-3p affected Aβ-mediated cell progression by regulating TNFAIP1/NF-κB signaling pathway. In conclusion, our findings confirmed that miR-29c-3p attenuated Aβ-induced neurotoxicity through regulation of NF-κB signaling pathway by directly targeting TNFAIP1, providing the potential value for the treatment of AD patients.Wild roses store and emit a large array of fragrant monoterpenes from their petals. Maximisation of fragrance coincides with floral maturation in many angiosperms, which enhances pollination efficiency, reduces floral predation, and improves plant fitness. We hypothesized that petal monoterpenes serve additional lifelong functions such as limiting metabolic damage from reactive oxygen species (ROS), and altering isoprenoid hormonal abundance to increase floral lifespan. Petal monoterpenes were quantified at three floral life-stages (unopened bud, open mature, and senescent) in 57 rose species and 16 subspecies originating from Asia, America, and Europe, and relationships among monoterpene richness, petal colour, ROS, hormones, and floral lifespan were analysed within a phylogenetic context. Three distinct types of petal monoterpene profiles, revealing significant developmental and functional differences, were identified Type A, species where monoterpene abundance peaked in open mature flowers depleting thereafter; Type B, where monoterpenes peaked in senescing flowers increasing from bud stage, and a rare Type C (8 species) where monoterpenes depleted from bud stage to senescence.

The adapted tracking algorithm includes a movement estimation in the cost function to re-link tracks with missing segmentation masks over a short sequence of frames. Our combined tracking by detection method has proven its potential in the IEEE ISBI 2020 Cell Tracking Challenge (http//celltrackingchallenge.net/) where we achieved as team KIT-Sch-GE multiple top three rankings including two top performances using a single segmentation model for the diverse data sets.Career aspirations are considered to be one of the most important motivation variables in the study of psychology and career development, as well as being connected to an individual's career-related goals, intentions or options. The aims of this study were (a) to develop and validate a model for predicting career aspirations, and (b) to investigate direct and indirect links between paternal education, self-esteem, resilience, future orientation, and career aspirations of university students. The participants were 445 students from two universities in Thailand. Confirmatory factor analysis confirmed that the factor structure of four measurement models presented in the study was suitable and compatible. To achieve the intended research objectives, the empirical data were analyzed using structural equation modeling with decomposition analysis of total effects in direct and indirect effects. Results showed that paternal education, resilience, and future orientation have significant direct effects on students' career aspirations, while self-esteem has an indirect effect. This suggests that self-esteem can help students develop their resilience, as well as promoting their development of a positive future orientation, which also helps foster a higher level of career aspiration. These results can be fundamental to supporting the continued use of the structural equation model in future research on career development.In the absence of curative therapies, treatment of metastatic castrate-resistant prostate cancer (mCRPC) using currently available drugs can be improved by integrating evolutionary principles that govern proliferation of resistant subpopulations into current treatment protocols. Here we develop what is coined as an 'evolutionary stable therapy', within the context of the mathematical model that has been used to inform the first adaptive therapy clinical trial of mCRPC. The objective of this therapy is to maintain a stable polymorphic tumor heterogeneity of sensitive and resistant cells to therapy in order to prolong treatment efficacy and progression free survival. Optimal control analysis shows that an increasing dose titration protocol, a very common clinical dosing process, can achieve tumor stabilization for a wide range of potential initial tumor compositions and volumes. Furthermore, larger tumor volumes may counter intuitively be more likely to be stabilized if sensitive cells dominate the tumor composition at time of initial treatment, suggesting a delay of initial treatment could prove beneficial. While it remains uncertain if metastatic disease in humans has the properties that allow it to be truly stabilized, the benefits of a dose titration protocol warrant additional pre-clinical and clinical investigations.
It is unclear how dual-task gait influences the lower limb range of motion (RoM) in people with Parkinson's disease (PD) and freezing of gait (FOG). The lower limb kinematics during dual-task gait might differ from regular gait, but during what events in the gait cycle?

This is an observational within-subjects study. Thirty-two individuals with PD and FOG underwent a gait analysis. Single and dual-task gait was assessed by a 3D motion analysis system and the RoM data of the lower limb were extracted from hips, knees and ankles in the sagittal plane. Dual-task assignment was performed using word-color interference test. https://www.selleckchem.com/products/apo866-fk866.html To compare both gait conditions, we used two different analyses (1) common discrete analysis to provide lower limb RoM and (2) Statistical Parametric Mapping analysis (SPM) to provide lower limb joint kinematics. A correlation between lower limb RoM and spatiotemporal gait parameters was also performed for each gait condition.

Common discrete analysis evidenced reductions in RoM of hips, knees and ankles during the dual task gait when compared to single gait. SPM analysis showed reductions in flexion-extension of hip, knees and ankles joints when dual task was compared to single task gait. These reductions were observed in specific gait events as toe off (for knees and ankles) and heel strike (for all joints). The reduction in lower limb RoM was positively correlated with the reduction in step length and gait speed.

Lower limb joints kinematics were reduced during toe off and heel strike in dual task gait when compared to single gait. These findings might help physiotherapists to understand the influence of dual and single walking in lower limb RoM throughout the gait cycle in people with PD and FOG.
Lower limb joints kinematics were reduced during toe off and heel strike in dual task gait when compared to single gait. These findings might help physiotherapists to understand the influence of dual and single walking in lower limb RoM throughout the gait cycle in people with PD and FOG.
This study aimed to identify differences in physical performance across various socioeconomic groups within an older population and to convert those differences into a common metric to facilitate comparisons of aging speed across socioeconomic subgroups.

We employed data from the 2009 National Health Examination Survey of Thailand. Physical performance was assessed using three health characteristics grip strength, as a measure of upper body strength; walking speed, as a measure of lower body strength; and a combined measure of grip strength and walking speed, to capture the strength of the whole body. Education level and income were used to distinguish socioeconomic subpopulations. We followed a characteristic-based age approach to transform these population characteristics, which were measured in different units, into a common and comparable aging metric, referred to as α - age.

Physical aging trajectories varied by sex and socioeconomic status. Some education, particularly secondary or higher education levels, was significantly associated with greater physical strength in older age for both men and women, whereas higher income was significantly associated with physical strength only for men.

Moreover, the total private and the total public health expenditures seem to have a bidirectional long-run relationship and significant cointegration. The same was observed regarding the public expenditure and household medical services expenditure, as well as pharmaceuticals. Furthermore, the results indicate that over the years of recession, the monthly HHE decreases, due to the confiscation of middle-class income, which led to consumerism restrictions. However, as households are now spending a bigger portion of their shrunken income for health (as health is an inelastic commodity), HHE, as a proportion of total private expenditure, has eventually risen.Introduction The knowledge of the pattern and the features of pediatric endocrinology referrals is crucial to optimize resources and guide public health interventions. We explored the numbers and the reasons for referral to a pediatric endocrinology outpatient clinic and investigated their features in terms of assignment of priority ranks, sex, age differences, the prevalence of pathological findings among referred cases, and the agreement among referrals, final diagnosis, treatment, and follow-up. Methods Retrospective study with data collection for pediatric endocrinology first visits between November 2012 and February 2019 in a tertiary center. Results A total of 1930 first visits were performed with an overall number of referrals of 2,165, and an increasing trend over the years. The most frequent referral reasons were slow growth, precocious puberty, and obesity; 14% of visits were classified as "urgent" ( less then 7 days), 35% as "deferrable" ( less then 30 days), and 51% as "planned" ( less then 180 days). Sex and age differences among referrals were detected, with criticality in the appropriate timing for referral. Thirty-eight percent of patients had pathological findings. In 4% of the cases the final diagnosis was not concordant with the reason for referral. Treatment was prescribed in 35% of cases, and 67% returned at least for one follow-up visit. Conclusion The study highlighted the need to target medical education of primary care on the definition of priority ranks, the need for more extended observation periods for subclinical or para-physiological conditions, the appropriate timing for referral, based on the definition of conditions or the best window of intervention.Hematopoietic cell transplants using stem cells from umbilical cord blood are used worldwide for the treatment of malignant and non-malignant disorders. Transplant procedures from this stem cell source have shown promising outcomes in successfully treating various hematologic, immunologic, malignant, and inherited metabolic disorders. Rapid availability of these stem cells is an important advantage over other unrelated donor transplants, especially in situations where waiting can adversely affect the prognosis. The umbilical cord blood is rich in CD34+ stem cells, though with a limited cell dose and usually takes longer to engraft. Limitations around this have been addressed by in vivo and ex vivo expansion techniques as well as enhanced engraftment kinetics. Development of adoptive immunotherapy using other components of umbilical cord blood such as regulatory T cells, virus-specific T cells, and natural killer cells has further transformed the field and enhanced the utility of umbilical cord blood unit.Background Neonatal intensive care unit (NICU) patient satisfaction is measured as parent satisfaction. Parents are critical to the family-centered care model and can evaluate care. Several EMpowerment of PArents in THe Intensive Care (EMPATHIC) instruments were developed in the Netherlands to measure parent satisfaction with neonatal and pediatric intensive care. EMPATHIC instruments comprise five domains and a total score information, care and treatment, organization, parental participation, and professional attitude. https://www.selleckchem.com/products/Oridonin(Isodonol).html To our knowledge, the EMPATHIC has not been adapted for USA use. Objectives (1) To select a relevant EMPATHIC instrument for our study. (2) To expand the content reflecting the role of nurses and the cultural heterogeneity of USA NICU infants. (3) To adapt the selected EMPATHIC instrument to USA English. (4) To establish psychometric properties of the linguistically adapted instrument. (5) To evaluate instrument performance with additional items. Methods The EMPATHIC-30 was selected based on seliability. Correlations between the domain, total scores, and validity indicators ranged from 0.30 to 0.57, indicating positive, moderate associations. Results were replicated in demographic subgroups. Reliability and validity of the three domains with additional items were better than or equivalent to values for the original. Conclusion The linguistically adapted EMPATHIC-30-NICU-USA and the expanded EMPATHIC-38-NICU-USA exhibit satisfactory psychometric properties and are suitable for use in USA NICUs.Objectives This study investigates the impact of an early systematic interdisciplinary developmental follow-up and individualized intervention program on the neurodevelopment of children with complex congenital heart disease (CHD) who required cardiac surgery. Study Design We prospectively enrolled 80 children with CHD 41 were already followed at our neurocardiac developmental follow-up clinic from the age of 4 months, while 39 were born before the establishment of the program and therefore received standard health care. We conducted cognitive, motor, and behavioral assessments at 3 years of age. We used one-way multivariate analyses of variance to compare the neurodevelopmental outcome of both groups. Results Between-group analyses revealed a distinct neurodevelopmental profile with clinically significant effect size (P less then 0.001, partial η2 = 0.366). Children followed at our clinic demonstrated better receptive language performances (P = 0.048) and tended to show higher scores on visuo-constructive tasks (P = 0.080). Children who received standard health care exhibited greater performances in working memory tasks (P = 0.032). We found no group differences on global intellectual functioning, gross and fine motor skills, and behaviors. Referral rates for specific remedial services were higher in patients followed at our neurocardiac clinic compared to the historical cohort (P less then 0.005). Conclusions Overall, the impact of the developmental follow-up and individualized intervention program on neurodevelopmental outcomes remains subtle. Nevertheless, results, although limited by several factors, point toward an advantage for the children who took part in the program regarding receptive language skills over children who received standard health care. We hypothesize that group differences may be greater with growing age. Further research involving larger cohorts is needed to clearly assess the effectiveness of neurocardiac developmental follow-up programs at school age.

In addition, we show how to decompose the total number of Life Years Lost into specific causes of death through a competing risks model, and how to calculate confidence intervals for the estimates using non-parametric bootstrap. We provide a description on how to use the method when the researcher has access to individual-level data (e.g. electronic healthcare and mortality records) and when only aggregated-level data are available.INTRODUCTION Chronic kidney disease of unknown origin (CKDu) is an epidemic concentrated in agricultural communities in Central and South America, including young, male sugarcane harvesters. The purpose of this analysis is to understand early changes in kidney function among a cohort of first-time sugarcane harvesters and to determine risk factors for kidney function decline. METHODS Joint latent class mixed models were used to model sub-population kidney function trajectory over the course of 4 years (2012-2016). Probability weighted logistic regression was used to determine personal health, community, and individual behavior risk factors associated with sub-population assignment. Data analysis occurred in 2019. RESULTS Of 181 new workers median age 19 years old (IQR 4), 39 (22%) were identified as having non-stable kidney function with an annual age-adjusted decline of estimated glomerular filtration rate (eGFR) of -1.0 ml/min per 1.73 m2 (95% CI -3.4, 1.3). Kidney function (OR 0.96; 95% CI 0.93, 0.98), mild hypertension (OR 5.21; 95% CI 2.14, 13.94), and having a local home of residence (OR 7.12; 95% CI 2.41, 26.02) prior to employment in sugarcane were associated with non-stable eGFR sub-population assignment. CONCLUSIONS Mild hypertension may be an early indicator of the development of CKDu. A better understanding of preexisting risk factors is needed to determine why individuals are entering the workforce with reduced kidney function and elevated blood pressure and increased risk of renal function decline.Rabies is a lethal zoonotic encephalomyelitis that causes an estimated 59,000 human deaths yearly worldwide. Although developing countries of Asia and Africa bear the heaviest burden, surveillance and disease detection in these countries is often hampered by the absence of local laboratories able to diagnose rabies and/or the difficulties of sample shipment from low-access areas to national reference laboratories. Filter papers offer a convenient cost-effective alternative for the sampling, shipment, and storage of biological materials for the diagnosis of many pathogens including rabies virus, yet the properties of diagnostic tests using this support have not been evaluated thoroughly. Sensitivity and specificity of molecular diagnosis of rabies infection using a reverse transcription followed by a hemi-nested polymerase chain reaction (RT-hn-PCR) either directly on brain tissue or using brain tissue dried on filter paper were assessed on 113 suspected field animal samples in comparison to the direct fluorescent antibody test (FAT) recommended by the World Health Organization as one of the reference tests for rabies diagnosis. Impact of the duration of the storage was also evaluated. The sensitivity and the specificity of RT-hn-PCR i) on brain tissue were 96.6% (95% CI [88.1-99.6]) and 92.7% (95% CI [82.4-98.0]) respectively and ii) on brain tissue dried on filter paper 100% (95% CI [93.8-100.0]) and 90.9% (95% CI [80.0-97.0]) respectively. No loss of sensitivity of RT-hn-PCR on samples of brain tissue dried on filter paper left 7 days at ambient temperature was detected indicating that this method would enable analyzing impregnated filter papers sent to the national reference laboratory at ambient temperature within a 1-week shipment time. It could therefore be an effective alternative to facilitate storage and shipment of samples from low-access areas to enhance and expand rabies surveillance.A potentially effective way to influence people's fire prevention behavior is letting them experience a fire in an immersive virtual environment (IVE). We analyze the effects of experiencing a fire in an IVE (versus an information sheet) on psychological determinants of behavior-knowledge, vulnerability, severity, self-efficacy, and locus of control-based mainly on arguments from Protection Motivation Theory and the Health Belief Model. Crucial in our setup is that we also relate these determinants to actual prevention behavior. Results show that IVE has the hypothesized effects on vulnerability, severity, and self-efficacy, and an unexpected negative effect on knowledge. Only knowledge and vulnerability showed subsequent indirect effects on actual prevention behavior. There remains a direct positive effect of IVE on prevention behavior that cannot be explained by any of the determinants. Our results contradict the implicit assumption that an induced change in these psychological determinants by IVE, necessarily implies a change in behavior. A recommendation for research on the effects of IVE's is, whenever possible, to study the actual target behavior as well.INTRODUCTION All individuals and couples have a basic human right to decide freely and responsibly the number, spacing, and timing of their child. However, In Ethiopia, the prevalence of contraceptive utilization remains low and it varies in different regions. https://www.selleckchem.com/products/super-tdu.html Therefore, this study was aimed to determine prevalence and determinant factors affecting the utilization of modern contraception in the reproductive age group (15-49 years) in Edaga-Hamus Town. METHODOLOGY A community based Cross-Sectional study was carried out on April 23 to May 10, 2017. A systemic random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. The data were entered into EPI-info version 7.1 and imported to SPSS version 20. Summary statistics and logistic regression analysis were performed using SPSS version 20. Those variables having a P-value of less than 0.2 in the bivariable analysis were fitted in multivariable analysis. AOR with 95% CI and P-value less then 0.05 were used during multivariable analysis to identify the factors associated with the utilization of modern in reproductive. RESULT In this study the overall prevalence of modern contraceptive utilization was 58.5%. Age (AOR = 0.406,95%,Cl (0.000,0.398)), Educational status (AOR = 0.901,95% Cl (0.340,4.107)), Feeling of husband towards Modern contraceptive (AOR = 0.186, 95% CI (0.056,0.617) had protective effect of utilization of modern contraceptive. But Number of children 1-3 and 4-5 wanted(AOR = 10.802,95%(4.027,28.975)), AOR = 2.624,95% CI (1.437,4.791), was a risk for utilization of modern contraceptive. CONCLUSION AND RECOMMENDATION The prevalence of Modern contraceptive utilization was still to be low (far below the national target). Therefore, providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization.

In programs with higher proportions of marks allocated to ongoing assessment, the students have higher overall marks than those with a lower proportion allocated to assessment. Little or no attention has been made to how the allocation affects the academic success of students in individual courses. The purpose of this study was to determine how the allocation of marks to examinations, tutorials and an assignment affects the performance of nursing students in a pharmacology course.

For students who passed a pharmacology course (i) the marks for examinations and ongoing assessment (tutorials and/or an assignment) were compared, and (ii) regression line and correlation analysis was undertaken to determine any association between these marks. In addition, for completing students, modelling was undertaken to determine the effects of changing the allocation of marks on passing and failing rates.

Nursing students who passed a pharmacology course obtained significantly lower marks in examinations than ongoing a(e.g. USA) are required to pass examinations prior to registration, whereas in others (e.g. Australia) they are not. Consideration needs to be given as to whether it is appropriate for nursing students who fail examinations to pass courses/programs.
The allocation of marks can have a major effect on student performance. As ongoing assessment is only a weak or moderate indicator of performance in examination this has implications for students who rely on passing examinations for their advancement. For instance, nursing students in some countries (e.g. USA) are required to pass examinations prior to registration, whereas in others (e.g. Australia) they are not. Consideration needs to be given as to whether it is appropriate for nursing students who fail examinations to pass courses/programs.
Macau and the Mainland China have different political and socio-economic policies but are both influenced by Chinese culture. https://www.selleckchem.com/products/mitosox-red.html By comparing the professional development experiences of male nurses from Macau and the Mainland, this study aims to explore factors influencing the recruitment and retention of male nurses.

A collaborative, qualitative approach was adopted in which researchers from Macau and the Mainland were jointly involved in carrying out interviews and analyzing data. A total of 24 clinical male nurses were invited, with 12 each from Macau the Mainland. Recruitment was based on purposive sampling from various health institutions in the two regions. Semi-structured interviews were conducted in 2017-2018 with similar interview guidelines for both Macau and the Mainland sites. Thematic analysis was used for data analysis, and Nvivo11 Plus software was used to facilitate the analysis.

Key facilitators/barriers to recruitment and retention of male nurses were clustered under the two research ques in professional development but have different views and values regarding nursing.
Medicines are one of the most common healthcare interventions, yet evidence shows patients often do not receive the information they want about their medicines. This affects their adherence and healthcare engagement. There is limited research exploring what information patients want about their medicines, from whom and in what format. The aim of this study was to determine the medicines information needs of patients admitted to the general medical service of a large New Zealand (NZ) hospital, and identify the barriers and enablers to meeting these needs.

A descriptive exploratory approach using semi-structured interviews was used to understand the needs and preferences of patients for information about their regular medicines and the barriers and facilitators to obtaining this information. Patients admitted to a general medical ward at a large NZ hospital, aged 18 years and over, prescribed one or more regular medicines, and self-managing their own medicines prior to hospitalisation were included. Semi-stth providers, were common to most. Considering these needs is important to optimise information delivery in general medical patients.
Although patients' medicines information needs varied between individuals, the importance of receiving information in an accessible, timely manner, and having good relationships with health providers, were common to most. Considering these needs is important to optimise information delivery in general medical patients.
Ethical medical practice requires managing health services to promote professionalism and secure accessibility to care. Commercially financed and industrially managed services strain the physicians' clinical autonomy and ethics because the industry's profitability depends on commercial, clinical standardisation. Private insurance companies also reduce access to care whilst fragmenting and segmenting health systems. Against this background, given the powerful, symbolic significance of their common voice, physicians' and patients' organisations could effectively leverage together political parties and employers' organisations to promote policies favouring access to professional care.

To provide a foundation for negotiations between physicians' and patients' organisations, we propose policy principles derived from an analysis of rights-holders and duty-bearers' stakes, i.e., patients, physicians and health professionals, and taxpayers. Their concerns are scrutinised from the standpoints of public health and lliance, physicians' associations should promote a public health culture amongst their members and a team culture in healthcare services. To promote a universal health system, patients' organisations should strive to represent universal health interests rather than those of patients with specific diseases, ethnic groups, or social classes.
Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study assessed knowledge and attitudes regarding falls, and fall-prevention activities of nurses working in small- and medium-sized hospitals.

Nurses (N = 162) from seven small- and medium-sized hospitals participated in the study. Data on participants' characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016.

Nurses' knowledge of patient falls was positively correlated with their experience with inpatient falls. Furthermore, nurses' attitudes regarding falls were influenced by their nursing experience and fall prevention education.