The case of coronary artery disease in a patient with isolated dextrocardia

The article presents a clinical case of coronary artery disease in patient with dextrocardia. The article describes the clinical features and diagnosis of coronary heart disease associated with dextrocardia.В статье приводится клинический случай ИБС у пациента с декстрокардией. Описываются особенности клинического течения и диагностики ИБС, связанные с декстракардией

Integration of aqueous (micellar) two-phase systems on the proteins separation

A two-step approach combining an aqueous two-phase system (ATPS) and an aqueous micellar two-phase system (AMTPS), both based on the thermo-responsive copolymer Pluronic L-35, is here proposed for the purification of proteins and tested on the sequential separation of three model proteins, cytochrome c, ovalbumin and azocasein. Phase diagrams were established for the ATPS, as well as co-existence curves for the AMTPS. Then, by scanning and choosing the most promising systems, the separation of the three model proteins was performed. The aqueous systems based on Pluronic L-35 and potassium phosphate buffer (pH = 6.6) proved to be the most selective platform to separate the proteins (SAzo/Cyt = 1667; SOva/Cyt = 5.33 e SAzo/Ova = 1676). The consecutive fractionation of these proteins as well as their isolation from the aqueous phases was proposed, envisaging the industrial application of this downstream strategy. The environmental impact of this downstream process was studied, considering the carbon footprint as the final output. The main contribution to the total carbon footprint comes from the ultrafiltration (~ 49%) and the acid precipitation (~ 33%) due to the energy consumption in the centrifugation. The ATPS step contributes to ~ 17% while the AMTPS only accounts for 0.30% of the total carbon footprint.publishe

From Barbie to the oligarchs wife: Reading fantasy femininity and globalisation in post-Soviet Russian womens magazines

This article shows how an analysis of fantasy femininity sheds light on how norms of gender, class and national identity reflect global and local cross-cultural currents in post-Soviet Russia. Drawing on a discourse analysis of women’s magazines and in-depth interviews with readers, it shows how, in the globalized post-Soviet cultural landscape, fantasy femininity represents both change and continuity. Feminine archetypes in women’s magazines, from fairytale princesses to Barbie dolls, reflect a wider post-Soviet cultural hybridisation, and show how Western women’s magazines have adapted to the Russian context. Furthermore, the article highlights readers’ ambiguous attitudes towards post-Soviet cultural trends linked to perceived Westernisation or globalisation, such as individualism, conspicuous consumption, and glamour

Termination of the leprosy isolation policy in the US and Japan : Science, policy changes, and the garbage can model

BACKGROUND: In both the US and Japan, the patient isolation policy for leprosy /Hansen's disease (HD) was preserved along with the isolation facilities, long after it had been proven to be scientifically unnecessary. This delayed policy termination caused a deprivation of civil liberties of the involuntarily confined patients, the fostering of social stigmas attached to the disease, and an inefficient use of health resources. This article seeks to elucidate the political process which hindered timely policy changes congruent with scientific advances. METHODS: Examination of historical materials, supplemented by personal interviews. The role that science played in the process of policy making was scrutinized with particular reference to the Garbage Can model. RESULTS: From the vantage of history, science remained instrumental in all period in the sense that it was not the primary objective for which policy change was discussed or intended, nor was it the principal driving force for policy change. When the argument arose, scientific arguments were employed to justify the patient isolation policy. However, in the early post-WWII period, issues were foregrounded and agendas were set as the inadvertent result of administrative reforms. Subsequently, scientific developments were more or less ignored due to concern about adverse policy outcomes. Finally, in the 1980s and 1990s, scientific arguments were used instrumentally to argue against isolation and for the termination of residential care. CONCLUSION: Contrary to public expectations, health policy is not always rational and scientifically justified. In the process of policy making, the role of science can be limited and instrumental. Policy change may require the opening of policy windows, as a result of convergence of the problem, policy, and political streams, by effective exercise of leadership. Scientists and policymakers should be attentive enough to the political context of policies

Circumventing 'free care' and 'shouting louder':Using a health systems approach to study eye health system sustainability in government & mission facilities of north-west Tanzania.

BACKGROUND: Little is known about the contributions of faith-based organisations (FBOs) to health systems in Africa. In the specialist area of eye health, international and domestic Christian FBOs have been important contributors as service providers and donors, but they are also commonly critiqued as having developed eye health systems parallel to government structures which are unsustainable. METHODS: In this study, we use a health systems approach (quarterly interviews, a participatory sustainability analysis exercise and a social network analysis) to describe the strategies used by eye care practitioners in four hospitals of north-west Tanzania to navigate the government, church mission and donor rules that govern eye services delivery there. RESULTS: Practitioners in this region felt eye care was systemically neglected by government and therefore was 'all under the NGOs', but support from international donors was also precarious. Practitioners therefore adopted four main strategies to improve the sustainability of their services: (1) maintain 'sustainability funds' to retain financial autonomy over income; (2) avoid granting government user fee exemptions to elderly patients who are the majority of service users; (3) expand or contract outreach services as financial circumstances change; and (4) access peer support for problem-solving and advocacy. Mission-based eye teams had greater freedom to increase their income from user fees by not implementing government policies for 'free care'. Teams in all hospitals, however, found similar strategies to manage their programmes even when their management structures were unique, suggesting the importance of informal rules shared through a peer network in governing eye care in this pluralistic health system. CONCLUSIONS: Health systems research can generate new evidence on the social dynamics that cross public and private sectors within a local health system. In this area of Tanzania, Christian FBOs' investments are important, not only in terms of the population health outcomes achieved by teams they support, but also in the diversity of organisational models they contribute to in the wider eye health system, which facilitates innovation

The Cambridge companion to twentieth-century Russian literature

In Russian history, the twentieth century was an era of unprecedented, radical transformations – changes in social systems, political regimes, and economic structures. A number of distinctive literary schools emerged, each with their own voice, specific artistic character, and ideological background. As a single-volume compendium, the Companion provides a new perspective on Russian literary and cultural development, as it unifies both émigré literature and literature written in Russia. This volume concentrates on broad, complex, and diverse sources – from symbolism and revolutionary avant-garde writings to Stalinist, post-Stalinist, and post-Soviet prose, poetry, drama, and émigré literature, with forays into film, theatre, and literary policies, institutions and theories. The contributors present recent scholarship on historical and cultural contexts of twentieth-century literary development, and situate the most influential individual authors within these contexts, including Boris Pasternak, Alexander Solzhenitsyn, Joseph Brodsky, Osip Mandelstam, Mikhail Bulgakov and Anna Akhmatova

Petrified Utopia: Happiness soviet style

Petrified Utopia redresses the lack of scholarship on the issue of the pursuit of collective happiness in Soviet culture, and presents a collection of essays that discuss different manifestations of happiness in literature and visual culture

Efektywność finansowa banków spółdzielczych w Polsce kierowanych przez kobiety

The main objective of the study was to determine whether the fact that the chairpersons of the boards of cooperative banks in Poland are women, it affects the financial performance of these banks. The study used data for the years 2010-2014 from 40 cooperative banks in Poland. In the course of the study, it was found that the banks managed by women are significantly smaller than men’s managed banks, and hence the financial result is generally lower. However, the financial performance ratios in these banks were generally higher. Smaller banks are generally in rural areas, and banks with a larger total balance sheet are usually located in urban areas.Celem głównym badań było ustalenie, czy fakt, że prezesami zarządów banków spółdzielczych w Polsce są kobiety, wpływa na efektywność finansową tych banków. W badaniu wykorzystano dane za lata 2010-2014 z 40 banków spółdzielczych w Polsce. W toku badań ustalono, że banki zarządzane przez kobiety są zdecydowanie mniejsze niż banki zarządzane przez mężczyzn, stąd i wynik finansowy jest na ogół mniejszy. Jednak wskaźniki efektywności finansowej w tych bankach były na ogół wyższe. Mniejsze banki znajdują się zazwyczaj na terenach typowo wiejskich, a banki o większej sumie bilansowej mają siedzibę na terenach miejskich

Using microcomputers to monitor remote projects

In the past decade or so, development aid has tended to shift from the big capital projects to small projects at times initiated by the local communities. This is especially true in the fields of water supply and sanitation, squatter up-grading, irrigation and housing infrastructure. In spite of the advantages this shift has brought about, however, it has tended to highlight the difficulty in effective monitoring of any mini-projects spread over wide areas. In many circumstances, these projects have to be coordinated from a central point either at the agency's headquarters or at regional offices. The problem is how to access, update and analyse information about the performance of these projects both individually and collectively with a degree of reliability and speed for planning purposes. This paper looks at how the micro-computer can help in this task thereby enhancing the possibility of completing the projects on time, within budget and hopefully to the desired specifications