ÜBER DEN PROZESS DER DE- / RE- PROFESSIONALISIERUNG DER APOTHEKER: eine kritische Analyse der Grundformen des Fungierens von Apothekern in der zeitgenössischen Gesellschaft

Pristupnu točku i načelne odredbe u ovom radu predstavljaju ideal-tipske, jedinstvene i jednako važne značajke profesije: znanje, autoritet, autonomija, pružanje usluga, monopol i altruistička orijentacija. Pitanja o zbiljskom fungiranju ljekarničke profesije predznačeno je Bourdieuovih pojmovima socijalnog polja i simboličkog kapitala. Ekstrapolacijom navedenih pojmovnih konstrukata zaključuje se sljedeće: profesionalni status neprestano se mijenja pod uplivom cijelog niza objektivnih, povijesno konstruiranih veza između položaja osiguranih određenim oblicima moći / kapitala. Nova usloženost birokratsko-administrativne, poslovno-menadžerske, industrijske, komercijalne i konzumerove logike u polju liječenja ima za posljedicu ništenje profesionalne logike ljekarnika. U krajnje komercijaliziranom društvu, profesije, naime, nisu više u mogućnosti promicati profesionalnu logiku (podređenu općem interesu), već logiku ekonomskog i financijskog kapitala (podređenu pravim donosiocima odluka u društveno-političkom životu). U radu se potanko propituje forma i opseg procesa deprofesionalizacije ljekarnika kao i njegove negativne posljedice: svođenje ljekarnika na pukog trgovca sve manje važnog za naše zdravlje. Na pozadini takvih analiza postavlja se ključno pitanje: Kako je moguće da sama „kičma“ ljekarničke profesije - specijalizirano, sofisticirano znanje i, što je najvažnije, stvarna socijalna potreba za takvim znanjem - ostanu netaknute, a sve druge značajke ljekarničke profesije „odumiru“? Na kraju se razlaže strategija reprofesionalizacije ljekarničke profesije. Ljekarnikovo sve veće nezadovoljstvo vlastitim statusom, zbog sve napetijeg odnosa spram drugih agensa u polju liječenja, te zbiljska socijalna potreba za učinkovitom farmakoterapijom, urodila je konceptom ljekarničke skrbi.This paper begins with the discussion about specific, important, as well as ideal characteristics of the pharmaceutical profession, such as: knowledge, authority, autonomy, services, monopole and altruism. The examination of the role of pharmacists is based on Bourdieu’s concepts of social field and symbolic capital. In particular, we infer the following: the professional status of pharmacists is continually changing under the influence of a whole range of objective, historically constructed relations with capital and power. The increasing complexity of bureaucracy and administration, as well as the introduction of managerial, industrial, commercial and consumer logic in the field of health care and pharmacy, resulted in the decrease in the professional work of pharmacists. In a completely commercialized society, professions can no longer promote their professional logic (to provide service in the public interest) but must promote the logic of economic and financial capital (to provide service in the interest of decision makers in the socio-political system). The paper examines in detail the process of deprofessionalization of pharmacy, as well as its negative consequences: the reduction of pharmacists to mere salespersons, without any bigger role in the health care system. Based on our analysis, we ask a crucial question: How is it possible that we are witnessing a decline in the importance of pharmaceutical profession while, at the same time, it’s key characteristics - specialized, sophisticated knowledge that it provides, as well as, most importantly, the very need for such knowledge – remain relevant? In conclusion, we discuss the strategy of re-professionalization of pharmacy. A new concept of pharmaceutical care arose as pharmacists became increasingly dissatisfied with their professional status, which created tensions between them and other health care professionals, but also because of a genuine need for a more efficient pharmacotherapy.Den Zugangspunkt und die prinzipiellen Bestimmungen stellen in dieser Arbeit idealtypische, einheitliche und gleich wichtige Eigenschaften des Berufes dar: Wissen, Autorität, Autonomie, Dienstleistung, Monopol und altruistische Orientierung. Die Fragen zum realen Fungieren des Apothekerberufs ist durch Bourdieus Begriffe des sozialen Feldes und symbolischen Kapitals vorgezeichnet. Durch die Extrapolation der genannten begrifflichen Konstrukte kann man schließen: der professionele Status ändert sich ständig unter dem Einfluß einer Reihe objektiver, geschichtlich konstruierter Verbindungen innerhalb der durch bestimmte Formen der Macht/des Kapitals gesicherten Lagen. Die neue Komplexität der bürokratisch-administrativen, geschäftlich-managerialen, industriellen, kommerziellen und konsumorientierten Logik im Bereich des Heilens hat die Abschaffung der profesionellen Logik der Apotheker zur Folge. In einer äußerst kommerzialisierten Gesellschaft sind die Professionen nämlich nicht mehr im Stande, die professionelle (dem allgemeinen Interesse dienende) Logik zu fördern, sondern die Logik des ökonomischen und finanziellen Kapitals (die den echten Entscheidungsträgern im gesellschaftspolitischen Leben unterworfen ist). In der Arbeit wird detailliert die Form und der Umfang des Deprofessionalisierungsprozesses der Apotheker geprüft, sowie seine negativen Folgen: Apotheker werden zu gewöhnlichen Verkäufern, die immer weniger wichtig für unsere Gesundheit werden. Im Hintergrund solcher Analysen stellt sich die Schlüsselfrage: Wie ist es möglich, dass „der Rückgrat“ des Apothekerberufs selbst - spezialisiertes, sofistiziertes Wissen und, was am wichtigsten ist, der wirkliche soziale Bedarf nach solchem Wissen – unberührt bleiben und dass alle anderen Eigenschaften des Apothekerberufes „absterben“? Am Ende wird die Strategie der Reprofessionalisierung des Apothekerberufes erörtert. Die, wegen eines immer gespanteren Verhältnisses zu den anderen Agenzien auf dem Feld des Heilens, immer größer werdende Unzufriedenheit des Apothekers mit dem eigenen Status, sowie der wirkliche soziale Bedarf nach einer effizzienten Pharmakotherapie, haben mit dem Konzept der Betreuung durch Apotheker resultiert

Utjecaj onečišćenosti zraka na pH-vrijednosti kore drveća na području Zagreba i Siska

The bark pH-values of deciduous trees were measured on the localities with different degrees of air pollution, i.e. S02 immission, in the regions of Zagreb and Sisak. In both cities Quercus robur and Tilia cordata were investigated, while Acer platanoides and A. pseudoplatanus were examined in Zagreb and Tilia tomentosa, Betula pendula and Populus italica only in Sisak. Lower bark pH-values were measured on the localities with greater air pollution, i.e. SO2 immission, and higher values were shown by specimens of the same species growing on comparatively less polluted localities. These data are in accordance with those obtained in some other areas of Europe (Sweden, Poland, FR Germany), confirming that bark pH-values could be used as indicators of SO2 immission.Istraživane su pH-vrijednosti kore drveća na području Zagreba i Siska na nekoliko lokaliteta koji se razlikuju s obzirom na onečišćenost zraka odnosno imisiju S02. U pokus je uzeto 7 vrsta drveća od kojih su Quercus robur i Tilia cordata istraživane u Zagrebu i Sisku, Acer platanoides i A. pseudoplatanus samo na području Zagreba, a Tilia tomentosa, Betula pendula i Populus italica samo na području Siska. Skupljanje i pripremanje uzoraka kore te određivanje pH-vrijednosti vršeno je po metodi kako su je opisali Lotschert i Kbhm (1973) s manjim modifikacijama (v. engleski tekst). Doneseni su i raspoloživi podaci o imisiji S02 na dva lokaliteta u Sisku (tab. 1) i na tri lokaliteta u Zagrebu (tab. 2, si. 1). U svih istraživanih vrsta kora je pokazivala kiselu reakciju, a prosječne vrijednosti izmjerene su u rasponu između pH 3,37, koliko je najniže pokazivala kora hrasta lužnjaka (Quercus robur) u središtu Zagreba i pH 6,17 u jablana (Populus italica) u okolici Siska u Starom Brodu (tab. 3 i 4, si. 2). I u Zagrebu i u Sisku u svake istraživane vrste najniže pH-vrijednosti (tj. najkiselija reakcija) izmjerene su na lokalitetima s većom imi- sijom S02, dok su najviše vrijednosti bile izmjerene na komparativnim (»čistim«) područjima izvan grada. U tom su smislu naši rezultati analogni onima iz nekih drugih područja Evrope (Švedska, Poljska, SR Njemačka) gdje je utvrđena ista pravilnost (tab. 5 i 6), pa se može zaključiti da pH-vrijednosti kore drveća mogu poslužiti kao indikator imisije SOs. Usporedba rezultata dobivenih na području Zagreba i Siska s onima iz Stockholma, Frankfurta i Krakowa, s obzirom na pH-vrijednosti kore istovrsnog drveća, pokazuje da je imisija S02 (u razdoblju na koje se odnose rezultati istraživanja u svakom od navedenih gradova) bila veća u Stockholmu i Frankfurtu nego u Zagrebu i (osobito) u Sisku i okolici. Rezultati za središte Zagreba i Krakowa pokazuju veliku podudarnost

Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study

Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs

Epidemiology, Practice of Ventilation and Outcome for Patients at Increased risk of Postoperative Pulmonary Complications: Las Vegas - an Observational Study in 29 Countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

7th International ConferenceThe Future of Information Sciences INFuture2019: Knowledge in the Digital Age

This is the seventh publication in the series of biennial international conferences, The Future of Information Sciences (INFuture) organised by the Department of Information and Communication Sciences, Faculty of Humanities and Social Sciences, University of Zagreb. Since its beginnings twelve years ago, the INFuture conference has been providing a platform for discussing both theoretical and practical issues in information organization and information integration through the explorations of how developments in information and communication technology influence the future of the field of information sciences. Education and research in information sciences and its interdisciplinary scope and application is of particular interest to this conference which is aimed at researchers and professionals from the broad field of information and communication sciences and related professions. The title of this year's conference is INFuture2019: Knowledge in the Digital Age. The conference explores the influence the information and communication sciences have on the society as a whole.The INFuture2019 conference consists of 26 papers from 58 authors from nine countries -Austria, Croatia, Germany, Netherlands, Norway, Slovenia, South Korea, Sweden and United States