P.091 Consensus Guidelines for Utilization and Monitoring of Intravenous Immunoglobulin for Central Nervous System Disorders in British Columbia

Background: Intravenous immunoglobulin (IVIG) may benefit many inflammatory central nervous system (CNS) disorders based on multiple immunomodulatory effects. IVIG is being used in inflammatory CNS conditions however robust evidence and guidelines are lacking in many disorders. Over the last 5 years, the percentage of IVIG used for CNS indications within neurology almost doubled in British Columbia (BC), Canada. Clear local guidelines may guide rational use. Methods: Consensus guidelines for IVIG use for CNS indications were developed by a panel of subspecialty neurologists and the Provincial Blood Coordinating Office, informed by focused literature review. Guidelines were structured similarly to existing BC peripheral nervous system guidelines and Australian Consensus Guidelines. Utilization and efficacy will be monitored provincewide on an ongoing basis. Results: Categories of conditions for Possible Indication (N=11) and Exceptional Circumstance Use (N=4) were created based on level of evidence for efficacy. Dosing and monitoring recommendations were made and outcomes measures defined. Rationale for Not Indicated conditions (N=3) was included. Guidelines will be distributed to BC neurologists for feedback and re-evaluated after 1 year. Conclusions: IVIG use in CNS inflammatory conditions has an emerging role. Guidelines for use and monitoring of outcomes will help improve resource utilization and provide further evidence regarding effectiveness.

Electronic management under the Corona pandemic

This study deals with the topic of electronic management in light of the Corona pandemic, the most important obstacles and solutions highlighted by the current crisis, and how countries, including Iraq, deal with these exceptional circumstances by relying on modern technology methods in managing and organizing public facilities in various health, educational and professional sectors, highlighting the most important advantages and disadvantages of this system and areas Applying it with highlighting the importance of oversight, whether legislative or judicial, or that which the administration exercises automatically or on the basis of individuals ’grievance, with an emphasis on the need to separate between decisions issued by the administration as a judicial control authority and those issued by the administration in an organizational or individual manner related to the rights and privileges of individuals or that Which organize and deliver public facilities And the provision of services therein, the study also deals with the substantive aspects of the Corona pandemic and its legal adaptation as an exceptional circumstance that requires the legislator to intervene in the issuance of legislation related to proof and research the reasons and suitability of electronic administrative decisions. And its widespread adoption, especially in light of the Corona pandemic, which led to important changes to political objectives and the need to adapt them to economic requirements.

The Impact of Corona Pandemic on Legal Protection of Jordanian Employee's Right to Salary and Its Extensions

The topic of the study is of special importance, as it relates to the source of public employee income and contemplates unusual events imposed by the Corona pandemic; Led to multiple preventive measures being taken to counter them; including the validity of the emergency defense law, which has multiple effects at all levels. To address negative economic conditions, administrative decisions were issued by the Cabinet against employees, which led to a reduction in their salaries and benefits. Hence, the study problem arose. Because it was not issued by the authority specified by the Defense Law which gives this authority to the Prime Minster, and accordingly many decisions exceeded its established legal rules and specific constitutional texts. The study aims to shit light on many aspects pertaining to the legal protection of Jordanian employee's right to salary and the basis on which the administration can modify it? We reached a set of results, most notably: The validity of the Defense Law specifically gives the Prime Minister, and not the Cabinet, the power to take exceptional measures to face the exceptional circumstance, by invoking exceptional legal rules stipulated by this law and not on the ground of the Civil Service Regulation. The most important recommendation was to cancel the new amendment of Article (193) of the Civil Service Regulation in line with the rule of legislative progression, as it contradicts the defense law and constitutes a violation of the constitutional provisions.

DOKTRIN PIERCING THE CORPORATE VEIL: KETENTUAN DAN PENERAPANNYA DI INGGRIS, AUSTRALIA DAN INDONESIA

This article discusses about provisions and application of the Piercing The Corporate Veil (PVC) doctrine in the United Kingdom, Australia and Indonesia. The main issue is when and how the courts apply the PVC doctrine, also whether the doctrine can be applied outside the courts or not. In some states such as the United Kingdom and Australia which exercise common law tradition, the courts may apply the PVC doctrine on share holders and directors when there is an exceptional circumstance which requires to apply the doctrine. Similar to both states, Indonesia, through the Indonesian Supreme Court, has already applied the doctrine long before the law on Limited Liability Company was enacted. In 1998, a unique legal case about the Liquidity Aid of Bank Indonesia shows a phenomenon that was beyond the normal understanding of the Law. In that time, the Indonesian Bank Restructuring Agency applied an out-of-court settlement model to hold shareholders' liability. Finally, this article recommends that a legal and economic study should be considered to examine the effectiveness of this approach.

Authors’ Responsibilities and Ethical Publishing

The International Cardiovascular Forum Journal requires authors to abide by the following guidelines:Manuscript: The corresponding author declares that the manuscript has not been published and is not under consideration elsewhere.Authorship: The corresponding author takes full responsibility for the list of authors. Any modification to the author list including order and composition can only be approved by the Editor-in-Chief following signed agreement from all the authors listed on the original submission.Ethics: The corresponding author states that the material presented has been obtained with the approval of all appropriate animal and/or human ethics committee(s).Permissions: The corresponding author on behalf of all authors confirms whether explicit written consent to publish has been received from any people described, pictured, or recorded and that formal copyright clearance is obtained to publish any video or audio recordings.Registration of Clinical Trials: Prospective registration of any clinical trial in a publically accessible database is a requirement for later publication of such trials in ICFJ. In exceptional circumstance if the trial is not registered, or is registered retrospectively, the reasons for this must be given.Competing Interests: All authors must declare all relevant competing interests (financial, or non-financial, professional, or personal) and state all funding sources.Attribution: The corresponding author accepts full responsibility for the accurate citation and acknowledgement of any material reproduced from other publications including the author’s own prior work.It is incumbent upon the corresponding author to consult the Editor-in-Chief should there be any variance of the above. The Editor-in-Chief retains the right to retract any submission found to be in breach of the above guidelines.

Historical Case of Cervical Penetrating Wound: From First Aid to Surgical Intervention

Objective. We report a case of cervical penetrating wound by posing the problem of its support and by analyzing the chain of survival of a patient to human sacrifice. Case Report. It was an 11-year-old boy admitted to the hosting service of cervical penetrating wound emergency occurring in a context of human sacrifice by weapon (knife). On admission, the conscious patient had a left cervical hematoma at the level of the cervical zone II and severe signs of acute anemia. The exploratory cervicotomy, carried out 12 hours after the trauma under transfusion, allowed us to highlight a section of the front edge of the sternocleidomastoid and previous jugular muscles under hyoid. We noted the presence of a linear wound of 1 cm at the level of the left internal jugular vein. The wound of the internal jugular vein has been repaired with the Prolene 4.O. The outcome was good, allowing the exit 10 days after cervicotomy. Conclusion. The causal circumstances of cervical penetrating wounds are diverse. Their importance or their severity depends on the causative circumstances dominated by aggression and attempts to autolysis. Human sacrifice, with use of the weapon, is an exceptional circumstance.

Analysis Air Cooling Mechanism for Photovoltaic Panel by Solar Simulator

Measurement the outdoor efficiency of photovoltaic (PV) panels is essential, but it is not likely an exceptional circumstance at any given moment is always repeating itself. A solar simulator was designed and fabricated for the purpose of analyzing the performance of PV panel with and without an air cooling mechanism in indoor test. Twenty units of 500 W halogen lamps with build-in reflector support by the steel structure holder act as a natural sunlight. The uniformity of the solar radiation was measured in the test area. Two units of PV panel with same characteristics were experimental in three sets of uniformity of solar radiation, which are 620, 821 and 1016 W/m². The operating temperature of PV panel with an air cooling mechanism can be decreased 2-3 ˚C compared to PV panel reference. The PV panel with an air cooling mechanism can be increased in 3-7 % of maximum power output based on solar radiation. An overall method and procedure of the measurement by the solar simulator are discussed and proposed.

Medicare and chronic disease management: integrated care as an exceptional circumstance?

Chronic disease represents a significant challenge to the design and reform of the Australian healthcare system. The Medicare Benefits Schedule (MBS) provides a framework of numerous chronic disease management programs; however, their use at the patient level is complex. This analysis of the MBS chronic disease framework uses a hypothetical case study of a diabetic patient (with disease-related complications and a complex psychosocial background) to illustrate the difficulties in delivering appropriate multidisciplinary chronic disease care under the MBS. The complexities at each step – from care planning, service provision, and monitoring and review – are described, as are the intricacies involved in providing patient care under different MBS programs as well as those in the broader health and community care system. As demonstrated by this case study, under certain circumstances the provision of truly integrated care to this hypothetical patient would constitute an ‘exceptional circumstance’ under the MBS. Although quality improvement efforts can improve functioning within the limitations of the current system, system-wide reforms are necessary to overcome complexity and fragmentation. What is known about the topic?Chronic disease management requires optimal health system design to provide appropriate patient care. In Australia, the Medicare Benefits Schedule (MBS) provides chronic disease-focussed programs, but the multitude of available programs and items are administratively complex, overlapping and subject to claiming incompatibilities. What does this paper add? This paper illustrates the complexity of the various MBS programs for chronic disease management using a case study of the potential service response to a single diabetic patient with disease-related complications and a complex psychosocial background. This analysis illustrates the manifold problematic interactions and incompatibilities that may arise in relation to this hypothetical patient. What are the implications for practitioners?Under the current MBS framework, providing patients with optimum chronic disease management requires both clinical and administrative skill on the part of GPs. Time spent on administrative requirements is time away from clinical care. Although quality improvement efforts may improve functioning within the existing system to a certain extent, broader system reforms are necessary to support optimal chronic disease management in Australia.

SPORTS PENALTIES: AN ALTERNATIVE MEANS OF MEASURING AGGRESSION

The official records of all games played in the Western Hockey League (N = 432) during a season provided the data for a Principal Components analysis of 19 aggressive penalties. The solution suggested that inter-personal aggression in the sport is multiply determined and can arise from eight different sets of conditions or antecedents. The advantages to research designs of using penalty indices as measures of aggression were discussed within the exceptional circumstance of a subculture which is supportive of aggressive behaviors.