THE STRUCTURE OF THE MECHANISM FOR STRENGTHENING THE TRUST OF THE AUTHORITIES: THEORETICAL AND METHODOLOGICAL ANALYSIS

В статье представлена структура механизма укрепления доверия власти. Исследование механизма укрепления доверия власти актуально, так как в условиях распространения коронавирусной инфекции COVD-19 наблюдается снижение доверия населения к основным социальным институтам, в том числе политическим. Актуальность рассматриваемого вопроса связана с важностью выявления информационных, организационных, правовых и управленческих технологий формирования доверия, которые могут быть реализованы региональными органами власти. При этом доверие как социальный феномен интерпретируется с позиций трех базовых оснований: «позитивных ожиданий», «позитивного настроя» и «доверительных отношений». Посредством обобщения исследовательского опыта представителей структурно-функционального подхода в статье определены основные элементы механизма укрепления власти: субъект, объект, базовые нормы взаимодействия, средовые условия, взаимодействие, планируемый и реальный результат. На основе проведенного теоретического исследования делается вывод о том, что укрепление доверия власти предполагает взаимодействие между субъектами социально-политических процессов, представленными управленческими группами, средствами массовой информации, общественными объединениями и группами, гражданами, результатом которого становится гармонизация отношений общественных структур и органов власти. The paper presents the structure of the mechanism for strengthening the trust of the authorities. The study of the mechanism of strengthening the trust of the authorities is relevant, since in the conditions of the spread of coronavirus infection, there is a decrease in public confidence in the main social institutions, including political ones. The relevance of the issue under consideration is related to the importance of identifying information, organizational, legal and managerial technologies for building trust that can be implemented by regional authorities. The work defines the main elements of the mechanism: subject, object, basic norms of interaction, environmental conditions, interaction, planned and real result. Basing on a theoretical study, we conclude that strengthening the trust of the authorities involves interaction between the subjects of socio-political processes, represented by management groups, the media, public associations and groups, citizens, which results in the harmonization of relations between social structures and authorities.

Observed risk of recurrent bleeding and thromboembolic disease in COVID-19 patients with gastrointestinal bleeding

Background and study aim COVID-19 patients are at increased risk for venous thromboembolism (VTE) requiring the use of anticoagulation. Gastrointestinal bleeding (GIB) is increasingly being reported, complicating the decision to initiate or resume anticoagulation as providers balance the risk of thrombotic disease with the risk of bleeding. Our study aimed to assess rebleeding rates in COVID-19 patients with GIB and determine whether endoscopy reduces these rebleeding events. We also report 30-day VTE and mortality rates. Methods This was a retrospective study evaluating 56 COVID-19 patients with GIB for the following outcomes: 30-day rebleeding rate, 30-day VTE rate, effects of endoscopic intervention on the rate of rebleeding, and 30-day mortality. Results The overall rates of VTE and rebleeding events were 27 % and 41 %, respectively. Rebleeding rates in patients managed conservatively was 42 % compared with 40 % in the endoscopy group. Overall, 87 % of those who underwent invasive intervention resumed anticoagulation vs. 55 % of those managed medically (P = 0.02). The all-cause 30-day mortality and GIB-related deaths were 32 % and 9 %, respectively. Mortality rates between the endoscopic and conservative management groups were not statistically different (25 % vs. 39 %; P = 0.30). Conclusions Although rebleeding rates were similar between the endoscopic and conservative management groups, patients who underwent intervention were more likely to restart anticoagulation. While endoscopy appeared to limit the duration that anticoagulation was withheld, larger studies are needed to further characterize its direct effect on mortality outcomes in these complex patients.

Factors that Hinder Effective Conflict Management in Ghana: Evidence from Asante Akyem North District

The purpose of the study was to examine the factors that hinder effective conflict management in Asante Akyem North District in the Ashanti Region of Ghana. The Population of the study included leaders of the various conflict management groups/individuals who have been involved in forestalling peace in Agogo in Asante Akyem North District in the Ashanti Region of Ghana. The case study design was adopted for the study. A purposive sampling technique was used to select all the twelve (12) participants for this study. The main instrument used for data collection for the study was an interview guide. The study revealed that the conflict between the farmers and the nomads in the Agogo could only be dealt with if there is no political power backing Fulani herdsmen in the enclave of Agogo. The study also concluded that the Fulanis have been able to defy the orders of the court by not withdrawing from the Agogo area. It is also recommended that the Government of Ghana and traditional authorities in Agogo State should be firm and fair in the management and implementation of court decisions with regard to the farmer-nomad conflict of Agogo. The politicisation of farmer and nomad conflicts, in particular, is thwarting efforts at forging cooperation and resolution of the conflict.

Low Rates of Radiographic Knee Osteoarthritis 5 Years After ACL Reconstruction or Rehabilitation Alone: The Delaware-Oslo ACL Cohort Study

Background: Patients and clinicians often struggle to choose the optimal management strategy for posttraumatic knee osteoarthritis (OA) after an anterior cruciate ligament (ACL) injury. An evaluation of radiographic outcomes after a decision-making and treatment algorithm applicable in clinical practice can help to inform future recommendations and treatment choices. Purpose: To describe and compare 5-year radiographic outcomes and knee pain in individuals who had gone through our decision-making and treatment algorithm and chosen (1) early (<6 months) ACL reconstruction (ACLR) with pre- and postoperative rehabilitation, (2) delayed (>6 months) ACLR with pre- and postoperative rehabilitation, or (3) progressive rehabilitation alone. Study Design: Cohort study; Level of evidence, 2. Methods: We included 276 patients with unilateral ACL injury from a prospective cohort study. Patients chose management using a shared decision-making process and treatment algorithm, and 5-year postoperative radiographs of the index and contralateral knees were assessed using the Kellgren and Lawrence (K&L) classification and minimum joint space width measurements. We defined radiographic tibiofemoral OA as K&L grade ≥2 and knee pain as a Knee injury and Osteoarthritis Outcome Score for Pain ≤72. To further explore early radiographic changes, we included alternative cutoffs for radiographic knee OA using K&L grade ≥2/osteophyte (definite osteophyte without joint space narrowing) and K&L grade ≥1. Results: At 5 years, 64% had undergone early ACLR; 11%, delayed ACLR; and 25%, progressive rehabilitation alone. Radiographic examination was attended by 187 patients (68%). Six percent of the cohort had radiographic tibiofemoral OA (K&L grade ≥2) in the index knee; 4%, in the contralateral knee. Using the alternative cutoffs at K&L grade ≥2/osteophyte and K&L grade ≥1, the corresponding numbers were 20% and 33% in the index knee and 18% and 29% in the contralateral knee. Six percent had a painful index knee. There were no statistically significant differences in any radiographic outcomes or knee pain among the 3 management groups. Conclusion: There were no statistically significant differences in any 5-year radiographic outcomes or knee pain among the 3 management groups. Very few of the patients who participated in our decision-making and treatment algorithm had knee OA or knee pain at 5 years.

Strategi Pengembangan Potensi Kuliner Lokal Dalam Menunjang Desa Wisata Ekologis (DWE) Di Desa Nyambu Kediri, Tabanan

The culinary potential of Nyambu Village cannot be seen if tourists visit and travel alone in Nyambu Village to enjoy local food. After tourists take the DWE tour package in Nyambu Village, local food is served by the Ecological Tourism Village (DWE) in Nyambu Village for guests visiting DWE in Nyambu village. The purpose of this study is to determine the development strategy and implications of developing local culinary potential in supporting the Ecological Tourism Village (DWE) in Nyambu Kediri Village, Tabanan. This study used descriptive qualitative method. The data was collected by means of observation techniques, in-depth interview techniques, and document study. The collected data were analyzed using SWOT analysis techniques, verified (data display), and concluded in narration, tables, photos, and charts. The theory used is Community Based Tourism (CBT) and the Theory of Tourist Attraction. The strategy for developing local culinary potential in supporting DWE in Nyambu Kediri Village, Tabanan is determined through a SWOT analysis and a SWOT analysis matrix, as follows: SO (StrengthOpportunity) strategy, namely a strategy to develop local culinary potential and a tourism village development strategy; WO (WeaknessesOpportunity) strategy, namely the strategy for the formation of local culinary management groups / organizations and CBT development strategies; ST (Strength-Threats) Strategy, namely a strategy to increase cooperation in the culinary field and a strategy to increase promotion; WT (Weaknesses-Threats) strategy, which is a strategy to increase stakeholder support for the formation of local culinary groups. The implications of developing culinary potential for local culinary processors, DWE and the people of Nyambu Village are enormous. The greater the support from the stakeholders, the greater the local culinary potential in Nyambu Village, and vice versa. Keywords: Development Strategy, Local Culinary Potential, Ecological Tourism Village

An Oral Combination of Turmeric-Pomegranate (With Ginger) Prevents Viral (Cold/ Flu) Episodes in Immunocompromised Patients

The aim of this pharma standard (“PS”) supplement, registry was the evaluation – in a period of 3 months – of the effects of the use of a standardized combination (oral supplement including turmeric, pomegranate and ginger) in preventing common, winter, viral events (cold and flu episodes). Results: No safety or tolerability problem was observed with the supplement. The two resulting registry management groups – standard management (SM) and SM+the supplement combination – were comparable. The number of viral (cold/flu) episodes (lasting more than 3 days), and the total number of subjects with any episode was in favor of the group managed with the preventive supplement combination (p<0.05). The average number of days of disease and the lost working days were lower with the combination (Phyto Relief). The use of other OTC products and the number of complications were significantly lower (<0.05) with the supplement combination. The number of subjects with a clinical extension of the disease to more than 7 days with bronchial or tracheal complications was also lower (p<0.05) with the supplements in comparison with the SM group. Salivation was improved more in the supplemented group (p<0.05). The results of this concept, preliminary study in mildly immuno-compromised subjects shows that Phyto Relief may help prevent some episodes of cold/flu and help (by shortening the length of the episodes) the evolution of viral episodes when used early, when the initial symptoms can be identified. More specific evaluations and larger prevention studies are needed, in a more heterogenous population. The extension of this supplementary prevention to more subjects and for longer periods may indicate a more permanent effect of this supplement combination on improving local, mucosal immunity and resistance to viral spread. Conclusions: The evaluation of immunocompromised subjects is significant in clinical conditions prevention (winter viral episodes) with this natural combination which may also avoid prolonged respiratory complications.

Comparison of the health-related quality of life of end stage kidney disease patients on hemodialysis and non-hemodialysis management in Uganda

Background Health-related quality of life is recognized as a key outcome in chronic disease management, including kidney disease. With no national healthcare coverage for hemodialysis, Ugandan patients struggle to pay for their care, driving families and communities into poverty. Studies in developed countries show that patients on hemodialysis may prioritize quality of life over survival time, but there is a dearth of information on this in developing countries. We therefore measured the quality of life (QOL) and associated factors in end stage renal disease (ESRD) patients in a major tertiary care hospital in Uganda. Methods Baseline QOL measurement in a longitudinal cohort study was undertaken using the Kidney Disease Quality of Life Short Form Ver 1.3. Patients were recruited from the adult nephrology unit if aged > 18 years with an estimated glomerular filtration rate ≤ 15mls/min/1,73m2. Clinical, demographic and micro-financial information was collected to determine factors associated with QOL scores. Results Three hundred sixty-four patients (364) were recruited, of whom 124 were on hemodialysis (HD) and 240 on non-hemodialysis (non-HD) management. Overall, 94.3% of participants scored less than 50 (maximum 100). Mean QOL scores were low across all three principal domains: physical health (HD: 33.14, non-HD: 34.23), mental health (HD: 38.01, non-HD: 38.02), and kidney disease (HD: 35.16, non-HD: 34.00). No statistically significant difference was found between the overall quality of life scores of the two management groups. Breadwinner status (p < 0.001), source of income (p0.026) and hemodialysis management type (p0.032) were the only factors significantly associated with QOL scores, and this was observed in the physical health and kidney disease principal domains only. No factors were significantly associated with scores for the mental health principal domain and/or overall QOL score. Conclusion The quality of life of Ugandan patients with ESRD has been found to be lower across all three domains of the Kidney Disease Quality of Life Short Form than reported anywhere in the world, with no difference observed between the non-HD and HD management groups. Interventions targeting all domains of QOL are needed among patients with ESRD in Uganda and, potentially, in other resource limited settings.