Reikalavimų automatizuotų ogranizacinių procesų valdymui analizė

The selection and implementation of an automated system into business processes for SME leads to the problem of decision, evaluation and reliability of the system. In order to solve such problems adequate applied research is required, along with software analysis. Reliable, integrated, flexible and open management system for different organizational processes is an indispensable condition for the growth for the enterprise’s competitiveness. The article presents the principles and aspects of requirements analysis, coming from organizational processes and leading to potencial decisions. Apart from dealing with the factors expressing the reliability of chosen decisions, it also estimates IT enterprises efforts of such system integration. It considers the information technology system requirements for four possible decision options considered: a) a universal system developed from scratch, b) an existing system which is improved by adding some minor add-ons, c) a system best suitable only for a specific company, d) a platform suitable for development and integration of flexible and adjustable components, covering all aspects of SME activities. The analysis of the organizational management systems‘ functionality of components requirements strongly favours to the decision of design of a platform suitable for the development and integration of flexible and adjustable components. This work is supported by the project “Integrated, flexible and open automated organizational processes management system for small and medium enterprises: applied research and development of software demo version” (project identification number BPD04-ERPF-3.1.7-03-05/0019), in realization of Lithuanian 2004-2006 single programming document 3 priority “Development of productive sector” 1 measure “Direct support for business” action group “Research and development activities (applied research and development of technologies)” for industry and business.Kiekvienai įmonei, atsižvelgiant į jos veiklą, svarbu valdyti procesus: pardavimo, pirkimo, projektų, paslaugų, personalo, kanceliarijos, sutarčių ir kt. Jie turi būti valdomi greitai, patogiai, logiškai, kad būtų patenkinti įmonės darbuotojai ir klientai, užtikrintas produktyvumas, pelno augimas ir darbuotojų tobulėjimas. Straipsnyje analizuojami automatizuotų organizacinių procesų valdymo sistemų reikalavimai vidutinėms ir mažoms verslo įmonėms. Analizė paremta informacinių technologijų sektoriaus plėtros tendencijomis Lietuvoje ir kitose šalyse, autorių patirtimi informacinių technologijų srityje bei atliktais rinkos tyrimais. Tyrimų metodai – klasifikacinė ir kategorinė analizė, apklausos metodai, o jų tikslas – pateikti konkrečias reikalavimų tenkinimo rekomendacijas. Gautus rezultatus tikslinga naudoti atliekant tolesnius taikomuosius mokslinius tyrimus ir kuriant programinės įrangos produktus – organizacines procesų valdymo sistemas. Šis straipsnis parengtas vykdant projektą „Integruota, lanksti bei atvira automatizuotų organizacinių procesų valdymo sistema mažoms ir vidutinėms įmonėms: moksliniai taikomieji tyrimai ir bandomojo programinės įrangos produkto kūrimas“ (identifikacijos projekto Nr. BPD04-ERPF-3.1.7-03-05/0019), įgyvendinant Lietuvos 2004–2006 m. bendrojo programavimo dokumento 3 prioriteto „Gamybos sektoriaus plėtra“ 1 priemonės „Tiesioginė parama verslui“ veiklų grupę „Mokslinių tyrimų ir plėtros veikla (taikomieji tyrimai ir technologinė plėtra)“, skirtą pramonei ir verslui

Padidėjusi laktatų koncentracija plazmoje kaip prognostinis didesnio mirštamumo ir komplikacijų po miokardo revaskuliarizavimo operacijų rodiklis

Robertas Samalavičius1, Irina Misiūrienė1, Karolis Urbonas1, Ieva Norkienė1, Gintaras Kalinauskas2, Gediminas Norkūnas2, Arūnas Valaika2, Alis Baublys1 1 Vilniaus universiteto ligoninės Santariškių klinikų Anesteziologijos, intensyvios terapijos ir skausmo gydymo centras, Santariškių g. 2, LT-08661 Vilnius 2 Vilniaus universiteto Širdies chirurgijos centras, Santariškių g. 2, LT-08661 Vilnius El paštas: [email protected] Įvadas / tikslas Šio darbo tikslas buvo nustatyti padidėjusios laktatų koncentracijos miokardo revaskuliarizavimo operacijų metu dažnį ir įvertinti šio rodiklio galimybes prognozuojant pooperacinį mirštamumą ir pooperacinių komplikacijų kilimą. Ligoniai ir metodai Nuo 2003 m. sausio 5 d. iki 2003 m. gruodžio 31 d. mūsų klinikose atlikta 600 vainikinių arterijų apeinamųjų jungčių suformavimo operacijų dirbtinės kraujo apytakos sąlygomis. Šie ligoniai ir sudarė tiriamąją grupę. Laktatų koncentracija plazmoje buvo nustatoma prieš prijungiant dirbtinę kraujo apytaką, prieš atleidžiant aortą, neutralizavus hepariną protaminsulfatu ir ligonio atkėlimo po operacijos į Intensyvios terapijos skyrių metu. Rezultatai Didesnė nei 5 mmol/l laktatų koncentracija plazmoje buvo nustatyta 2,5% ligonių dirbtinės kraujotakos metu, 6,7% – protamino neutralizavimo metu ir 10,8% – atvykimo į Intensyviosios terapijos skyrių metu. Ligonių, kurių laktatų koncentracija kraujyje buvo didesnė nei 5 mmol/l, mirštamumas siekė 19,3% ir 59,6%, taip pat jiems pooperaciniu laikotarpiu pasitaikė komplikacijų, o ligonių, kurių laktatų koncentracija mažesnė, mirštamumas buvo 3,2%, ir tik 10,3% jų pooperaciniu laikotarpiu pasitaikė komplikacijų. Išvados Laktatų koncentracija plazmoje po kardiochirurginių operacijų gana dažnai padidėja. Didesnė nei 5 mmol/l laktatų koncentracija kraujyje buvo daugiau nei 10% pacientų atvykimo į Intensyviosios terapijos skyrių po miokardo revaskuliarizavimo operacijų metu. Padidėjusi laktatų koncentracija poperfuziniu laikotarpiu leidžia nustatyti, kurių ligonių operacinio mirštamumo ir komplikacijų susidarymo rizika gerokai didesnė. Pagrindiniai žodžiai: laktatai, rizikos veiksniai, mirštamumas, pooperacinės komplikacijos Serum lactate level as predictor of mortality and morbidity following coronary artery bypass grafting Robertas Samalavičius1, Irina Misiūrienė1, Karolis Urbonas1, Ieva Norkienė1, Gintaras Kalinauskas2, Gediminas Norkūnas2, Arūnas Valaika2, Alis Baublys1 1 Vilnius University Hospital „Santariškių klinikos“, Center of Anesthesia, Intensive Care and Pain Management, Santariškių str. 2, LT-08661 Vilnius, Lithuania 2 Vilnius University , Heart Surgery Center, Santariškių str. 2, LT-08661 Vilnius, Lithuania E-mail: [email protected] Background / objective Risk stratification for predicting mortality and morbidity is widely used in cardiac surgery. However, prediction of individual outcome shortly after cardiac surgery is difficult. Postoperative hyperlactemia has been related to an increased rate of postoperative complications and increased mortality following cardiac surgery. The aim of this study was to evaluate the frequency of intraoperative and postoperative hyperlactemia and to assess the value of serum lactate level in predicting mortality and morbidity following surgery. Patients and methods 600 consecutive CABG from January 5, 2003 to December 30, 2003 at the Vilnius University Hospital Santariskiu Clinics were investigated. Serume lactate levels were measured before cardiopulmonary bypass, before declamping of the aorta, after heparin neutralization and at ICU admission. Morbidity was defined as the presence of one or more of the following categories of complications: cardiac, pulmonary, neurological and renal. Results Lactate level greater than 5 mmol/l was found in 2.5% of patients during cardiopulmonary bypass, in 6.7% of patients shortly after weaning from CPB, and in 10.8% of patients on ICU admission. The mortality rate of patients with hyperlactemia at ICU admission was 19.3% and morbidity 59.6%. The mortality rate of patients without hyperlactemia was 3.2% and morbidity 10.3%. Conclusions Hyperlactemia was quite frequent following cardiac surgery. Increased lactate levels (> 5 mmol/l) were found in more than 10% of patients following CABG surgery on ICU admission. Increased serum lactate levels following coronary artery bypass grafting identifies a group of patients with an increased risk of postoperative mortality and morbidity. Key words: hyperlactemia, outcomes, morbidity, mortalit

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Analysis of requirements to automatized management of organizational proceses

The selection and implementation of an automated system into business processes for SME leads to the problem of decision, evaluation and reliability of the system. In order to solve such problems adequate applied research is required, along with software analysis. Reliable, integrated, flexible and open management system for different organizational processes is an indispensable condition for the growth for the enterprise's competitiveness. The article presents the principles and aspects of requirements analysis, coming from organizational processes and leading to potential decisions. Apart from dealing with the factors expressing the reliability of chosen decisions, it also estimates IT enterprises efforts of such system integration. It considers the information technology system requirements for four possible decision options considered: a) a universal system developed from scratch, b) an existing system which is improved by adding some minor add-ons, c) a system best suitable only for a specific company, d) a platform suitable for development and integration of flexible and adjustable components, covering all aspects of SME activities. The analysis of the organizational management systems' functionality of components requirements strongly favours to the decision of design of a platform suitable for the development and integration of flexible and adjustable components.This work is supported by the project "Integrated, flexible and open automated organizational processes management system for small and medium enterprises: applied research and development of software demo version" (project identification number BPD04-ERPF-3.1.7-03-05/0019), in realization of Lithuanian 2004-2006 single programming document 3 priority "Development of productive sector" 1 measure "Direct support for business" action group "Research and development activities (applied research and development of technologies)" for industry and business

Analysis of requirements to automatized management of organizational proceses

The selection and implementation of an automated system into business processes for SME leads to the problem of decision, evaluation and reliability of the system. In order to solve such problems adequate applied research is required, along with software analysis. Reliable, integrated, flexible and open management system for different organizational processes is an indispensable condition for the growth for the enterprise's competitiveness. The article presents the principles and aspects of requirements analysis, coming from organizational processes and leading to potential decisions. Apart from dealing with the factors expressing the reliability of chosen decisions, it also estimates IT enterprises efforts of such system integration. It considers the information technology system requirements for four possible decision options considered: a) a universal system developed from scratch, b) an existing system which is improved by adding some minor add-ons, c) a system best suitable only for a specific company, d) a platform suitable for development and integration of flexible and adjustable components, covering all aspects of SME activities. The analysis of the organizational management systems' functionality of components requirements strongly favours to the decision of design of a platform suitable for the development and integration of flexible and adjustable components.This work is supported by the project "Integrated, flexible and open automated organizational processes management system for small and medium enterprises: applied research and development of software demo version" (project identification number BPD04-ERPF-3.1.7-03-05/0019), in realization of Lithuanian 2004-2006 single programming document 3 priority "Development of productive sector" 1 measure "Direct support for business" action group "Research and development activities (applied research and development of technologies)" for industry and business

Informacinių technologijų rinkos analizė automatizuotų organizacinių procesų valdymo požiūriu

Mažoms ir vidutinio dydžio įmonėms aktuali problema yra pasirinkti ir įdiegti integruotą, lanksčią&nbsp;ir atvirą automatizuotų organizacinių procesų valdymo sistemą. Siekiant tai padaryti efektyviai,&nbsp;reikalingi adekvatūs moksliniai taikomieji tyrimai ir programinės įrangos produkto parinkimo&nbsp;etapai. Bendras skirtingų organizacinių procesų valdymas yra būtina prielaida šių įmonių konkurencingumui didėti. Straipsnyje pateikiama informacinių technologijų rinkos analizė ne&nbsp;tik atskleidžia veiksnius, nusakančius poreikį įmonėms įdiegti veiklos procesus automatizuojančias&nbsp;sistemas, bet ir vertina informacinių technologijų įmonių bandymus integruoti šias sistemas.&nbsp;Kadangi analizė remiasi atlikto projekto darbais, ji pateikia sistemų lanksčios integracijos&nbsp;ir plėtros sprendimų rekomendacijas. Šis darbas parengtas pagal projektą „Integruota, lanksti&nbsp;bei atvira automatizuotų organizacinių procesų valdymo sistema mažoms ir vidutinėms įmonėms:&nbsp;moksliniai taikomieji tyrimai ir bandomojo programinės įrangos produkto kūrimas“ (identifikacijos&nbsp;projekto Nr. BPD04-ERPF-3.1.7-03-05/0019), įgyvendinant Lietuvos 2004–2006 m. bendrojo&nbsp;programavimo dokumento 3 prioriteto „Gamybos sektoriaus plėtra“ 1 priemonės „Tiesioginė&nbsp;parama verslui“ veiklų grupę „Mokslinių tyrimų ir plėtros veikla (taikomieji tyrimai ir&nbsp;technologinė plėtra)“, skirtą pramonei ir verslui.&nbsp;Reikšminiai žodžiai: informacinės sistemos, organizacinių procesų valdymas, informacinių technologijų&nbsp;rinka, integruoti sprendimai Information technologies market analysis&nbsp;in the aspect of automated management of organizational processesAlgimantas Juozapavičius, Kazimieras Mickus, Gediminas Mikaliūnas,&nbsp;Mindaugas Pelanis, Evaldas Urbonas SummayAn urgent issue of small and medium enterprises&nbsp;is to select and implement an integrate, flexible&nbsp;and open management system for automated organizational&nbsp;processes. To do this effectively, adequate&nbsp;applied research is required along with software&nbsp;selection stages. United management of different&nbsp;organizational processes is an indispensable&nbsp;condition for increasing the competitiveness of&nbsp;enterprises.&nbsp;The information technologies market analysis&nbsp;presented in the article not only deals with the&nbsp;factors expressing the necessity for enterprises to&nbsp;implement automated systems of business processes,&nbsp;but also estimates efforts of IT eterprises&nbsp;in such systems’ integration. Since this analysis&nbsp;is based on the performed project work, it&nbsp;presents recommendations for the integration and&nbsp;development of a flexible system.&nbsp;This work is supported by the project “Integrated,&nbsp;flexible and open system of automated organizational&nbsp;process management for small and medium&nbsp;enterprises: applied research and the development&nbsp;of software demo version” (project identification&nbsp;number BPD04-ERPF-3.1.7-03-05/0019), in the&nbsp;realization of the Lithuanian 2004–2006 single programming&nbsp;document 3 priority “Development of productive&nbsp;sector” meassure 1 “Direct support of business”&nbsp;action group “Research and development activities&nbsp;(applied research and development of technologies)”&nbsp;for industry and business.&nbsp;Key words: information systems, organizational&nbsp;process management, IT market, integrated&nbsp;solutions

The Quality of anticoagulation therapy among warfarin-treated patients with atrial fibrillation in a primary health care setting

Background and objectives: Long-term therapy with oral anticoagulants is recommended for stroke prevention in patients with atrial fibrillation (AF). This study evaluated the quality of anticoagulation therapy among warfarin-treated AF patients in selected primary health care centres in Lithuania. Materials and Methods: This was a retrospective study conducted in nine primary health care centres in Lithuania. Existing medical records of randomly selected adult patients with AF who were treated with warfarin for at least 12 months were reviewed and analysed. Physicians’ decisions to adjust warfarin dose were considered as consistent with the approved warfarin posology if warfarin dose was increased in case of international normalized ratio (INR) 3.0 or unchanged in case of INR within 2.0 to 3.0. Results: The study population included 406 patients. The mean duration of treatment with warfarin was 5.4 years. The median number of INR measurements per patient per year was 8.0. More than half (57.3%) of available INR values were outside the target range, with 13.6% INR values being above 3.0 and 43.7% INR values—below 2.0. The median time in therapeutic range (TTR) was 40.0%; only 20% of patients had TTR of 65%. In about 40% of the cases with INR values outside the target range, no dose corrections were implemented. About 27% of decisions on warfarin dose adjustment were not consistent with the recommended warfarin posology. The median number of INR measurements was lower among patients living in urban areas, while the median TTR was significantly higher in urban patients than in rural patients. In the multivariate regression model, gender, HAS-BLED score and warfarin treatment duration were associated with a TTR of 65%. Conclusions: Anticoagulation control is suboptimal in routine clinical practice with a median TTR of 40%. [...]

Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study

Background and Objectives: Although multimorbidity poses many challenges for both individuals and healthcare systems, information on how these patients assess the quality of their healthcare is lacking. This study assessed the multimorbid patients’ satisfaction with their healthcare. Materials and Methods: This cross-sectional study was a part of a project Joint Action—Chronic Diseases and Promoting Healthy Ageing across the Life Cycle and its implementation. The study included 400 patients with arterial hypertension and at least one concomitant chronic disease. Patients completed The Patient Assessment of Care for Chronic Conditions Plus (PACIC+) questionnaire, EuroQol Five-Dimensions—Three-Level Quality of Life questionnaire, and Hospital Anxiety and Depression scale. Results: The mean age of the participants was 65.38 years; there were 52.5% women. The mean PACIC+ 5As summary score was 3.60. With increasing age, participants rated worse on most PACIC+ subscales. Participants who assessed their quality of life as worse were also less satisfied with their healthcare. The presence of three or more concomitant diseases negatively affected PACIC+ scores. Patients with ischemic heart disease and heart failure had lower PACIC+ scores on most subscales, whereas patients with atrial fibrillation had lower scores only on the Agree subscale. The presence of diabetes was not associated with worse PACIC+ scores; moreover, the scores in Assist and Arrange subscales were even better in diabetic patients (3.36 vs. 2.80, p = 0.000 and 3.69 vs. 3.13, p = 0.008, respectively). Patients with chronic obstructive pulmonary disease, asthma, and musculoskeletal disorders showed lower PACIC+ scores. Conclusions: Older age, worse self-assessed health state, presence of three or more diseases, and certain chronic diseases were associated with lower patients’ satisfaction with their healthcare. Personalized healthcare, increasing competencies of primary healthcare teams, healthcare services accessibility, and financial motivation of healthcare providers may increase multimorbid patients’ satisfaction with their healthcare