Office wall color influence on subjective response in patients with chronic heart failure

Heart failure is defined as a clinical state, which occurs as a result of structural or functional damage of ventricle with consequential blood hypo perfusion of organs (reduced stroke volume of heart muscle and/or increased intracardial pressure in rest or during work activity). Therapeutical monitoring of patient is imperative, and it includes assessment of objective and subjective state of patient, which is often guide for optimizing of pharmacological treatment. The aim of paper is assessment of the room wall color influence as one of the factor for optimizing the therapeutic modality of patients with diagnosis of heart failure. Findings suggest that the influence of color in environment can be neutral, enabling or disabling, and this is the aspect of treatment that needs to be investigated further in future.&nbsp

Proces rafinisanja biomase sa superkritičnom vodom

Biobased industries, based on renewable sources and energy are still in development to supporting a decentralized production that can be alternative to the well – supported centralized petrochemical production plants. In recent time conversion of different organic supstances, including wastes, sludge, biomass to biofuels and biobased chemicals has attracted a lot of researcher attention. Supercritical water is emerging as a solvent and reaction medium capable of providing selective processes while significantly reducing the reaction time, leading to the possibility of developing compactequipment for the use in biomass decentralized production plants. Hydrothermal processes that use sub or supercritical water as processing media are consider as promising technologies for the conversion of organic substances into biofuls and biobased chemicals. In this paper a short review of the hydrothermal processes and potentials of their use for the conversion of organic wastes and biomass into fuels and chemicals is given.Bioindustrija zasnovana na obnovljivim sirovinama i energiji je u stalnom razvoju i doprinosi decentralizaciji proizvodnje. Ona predstavlja alternativu dosadašnjim centralizovanim petrohemijskim postrojenjima. U novije vreme konverzija različitih organskih supstanci uključujući otpad, mulj i biomasu u biogoriva i biohemikalije privlači sve veću pažnju istraživača. Superkritična voda se sve više u procesima koristi kao rastvarač i reakcioni medijum čime se omogućava selektivnost procesa i značajno skraćuje vremena trajanja reakcije. Skraćenjem vremena reakcije omogućava se lakši izbor procesne opreme u decentralizovanim postojenjima za preradu biomase. Hidrotermalni procesi koji koriste subkritičnu i superkritičnu vodu kao procesni medijum se sve više posmatraju kao obećavajuća tehnologija za konverziju organskih supstanci u biogoriva i biohemikalije. U ovom radu daje se kratak pregled hidrotermalnih procesa i mogućnosti njihovog korišćenja za konverziju organskog otpada i biomase u gorivo i hemikalije

Bioetanol kao alternativno gorivo

Great demographic expansion of the population as well as steady increase in industrial production led to a substantial decline in natural resources, of energy, and thus contributed to the dramatic environmental pollution. Benzin obtained from crude oil by burning gives hazardous products such as carbon monoxide, sulfur dioxide, oxides of nitrogen and lead compounds. Addition of ethanol to gasoline reduces the pollution of the atmosphere and increases the octane number of gasoline. The greatest significance of the application of ethanol in terms of reducing atmospheric pollution is the reduction in emissions of carbon monoxide, which belongs to gases that significantly contribute to the greenhouse effect.Velika demografska ekspanzija stanovništva kao i stalni porast industrijske proizvodnje doveli su do osetnog smanjenja prirodnih resursa energije, a time doprineli i dramatičnom zagađenju životne okoline. Benzin dobijen iz nafte, sagorevanjem daje štetne produkte kao što su ugljenmonoksid, sumpordioksid, oksidi azota i olovna jedinjenja. Dodatkom etanola benzinu smanjuje se zagađenje atmosfere i povećava se oktanski broj benzina. Najveći značaj primene etanola sa aspekta smanjenja zagađenja atmosfere je smanjenje emisije ugljenmonoksida koji pripada gasovima koji značajno doprinose efektu staklene bašte

Smanjenje potrošnje energije korišćenjem metode visokog pritiska

Using high pressure as a processing tool surpasses legal limitations for solvent residues and restrictions on use of conventional solvents in chemical processes. Additionally, new, high valuable products with special properties can be produced. The presentation will give a limited overview of applications of sub-and supercritical fluids and will present energy savings compared to conventional production methods. The main advantages of these tools are low environmental impact, low energy consumption and sustainability. For these processes recent advances and trends of developments will be presented.Korišćenjem visokog pritiska prilikom izvođenja nekog procesa prevazilaze se zakonske barijere u pogledu količine zaostalih organskih rastvarača i određena ograničenja u vezi njihove primene. Ovom metodom mogu se dobiti novi visokovredni proizvodi sa posebnim karakteristikama. Dat je pregled subkritičnih i superkritičnih fluida i prikazana je ušteda energije u poređenju sa primenom konvencionalnih metoda. Glavne prednosti ovog postupka su mali uticaj na okruženje, niska potrošnja energije i ekonomska održivost. Prikazi postignutih poboljšanja kao i pravci daljeg razvoja ove metode, takođe su dati u radu

Analysis of improving business processes by implementing the lean concept at the level of tertiary healthcare

Introduction. The success of healthcare organizations depends on the quality and speed of providing services to patients. Synonym for the term success of health care organization is the implementation of modern concepts Synonymous with the success of healthcare organizations is the implementation of modern concepts. In this paper, the emphasis is on the lean concept, affects the quality and speed of providing health services. Subject of research. The subject being researched in this paper is a lean concept which essence is determined by the implementation of methods that affect the speed and quality of providing health services. The aim of the work is to point out the actuality of the lean concept and its application at the tertiary level of health care. Examine the opinion of healthcare workers about the effects that would be achieved by applying the new management system (lean concept). Aim of this paper is to indicate the actuality of the lean concept and its application at the tertiary level of health care system. Examine the opinion of healthcare workers about the effects that would be achieved by applying the new management system (lean concept). More precise possibilities of imple- menting the lean methodology, which can be used to improve clinical processes. Materials and methods. The research was conducted by designing and using research questionnaires. Questionnaire structured by the author for the purposes of research in this paper. The questionnaire was sent to 472 employees’ mail addresses and was filled out by 91 employees. One of the reasons for the lower questionnaire return rate is the lack of familiarity of employees with the lean concept and its effects on the provision of health services. The return rate of referrals indicates the need for prior presentation and familiarization with the concept itself and its impact on business processes. A Likert scale was used to assess the opinions of healthcare services workers about the effects that would be achieved by applying the lean concept at the tertiary level. Medical wastes are shown in the oncology department (case analysis). We statistically processed the data obtained from the questionnaire using the SPSS 20.0 software package. The results are presented tabularly and graphically. The following methods are used in the paper: analysis method, inductive - deductive method, synthesis method, description method and proof method. Results. The results of the research showed that (analysis of health organizations that apply the lean concept) and the opinion of health workers about the possibility of applying the lean concept at the tertiary level of health care has a positive impact on improving the efficiency of the provision of health services. The interpretation of the correlation coefficient from the previous table indicates the exist- ence of a positive relationship between the effectiveness and efficiency of business processes (r=0.846; p<0,05). Based on the literature review and the obtained results, it was determined that there is no formalized concept with instructions on the implementation of clinical process improvement methods. There was a positive impact on improving the efficiency of the provision of health services, through the imple- mentation of modern methods. The review of the literature and the obtained results revealed that there is no formalized concept with instructions on the implementation of clinical process improvement methods. Conclusion The expected positive effects of the implementation of the lean concept at the tertiary lev- el of the health care of are manifested through: faster service delivery to patients, reduction of service waiting time and general improvement of business processes. The implementation of the lean concept would reduce medical waste, which would positively affect the quality of health care services

Analysis of improving business processes by implementing the lean concept at the level of tertiary healthcare

Introduction. The success of healthcare organizations depends on the quality and speed of providing services to patients. Synonym for the term success of health care organization is the implementation of modern concepts Synonymous with the success of healthcare organizations is the implementation of modern concepts. In this paper, the emphasis is on the lean concept, affects the quality and speed of providing health services. Subject of research. The subject being researched in this paper is a lean concept which essence is determined by the implementation of methods that affect the speed and quality of providing health services. The aim of the work is to point out the actuality of the lean concept and its application at the tertiary level of health care. Examine the opinion of healthcare workers about the effects that would be achieved by applying the new management system (lean concept). Aim of this paper is to indicate the actuality of the lean concept and its application at the tertiary level of health care system. Examine the opinion of healthcare workers about the effects that would be achieved by applying the new management system (lean concept). More precise possibilities of imple- menting the lean methodology, which can be used to improve clinical processes. Materials and methods. The research was conducted by designing and using research questionnaires. Questionnaire structured by the author for the purposes of research in this paper. The questionnaire was sent to 472 employees’ mail addresses and was filled out by 91 employees. One of the reasons for the lower questionnaire return rate is the lack of familiarity of employees with the lean concept and its effects on the provision of health services. The return rate of referrals indicates the need for prior presentation and familiarization with the concept itself and its impact on business processes. A Likert scale was used to assess the opinions of healthcare services workers about the effects that would be achieved by applying the lean concept at the tertiary level. Medical wastes are shown in the oncology department (case analysis). We statistically processed the data obtained from the questionnaire using the SPSS 20.0 software package. The results are presented tabularly and graphically. The following methods are used in the paper: analysis method, inductive - deductive method, synthesis method, description method and proof method. Results. The results of the research showed that (analysis of health organizations that apply the lean concept) and the opinion of health workers about the possibility of applying the lean concept at the tertiary level of health care has a positive impact on improving the efficiency of the provision of health services. The interpretation of the correlation coefficient from the previous table indicates the exist- ence of a positive relationship between the effectiveness and efficiency of business processes (r=0.846; p<0,05). Based on the literature review and the obtained results, it was determined that there is no formalized concept with instructions on the implementation of clinical process improvement methods. There was a positive impact on improving the efficiency of the provision of health services, through the imple- mentation of modern methods. The review of the literature and the obtained results revealed that there is no formalized concept with instructions on the implementation of clinical process improvement methods. Conclusion The expected positive effects of the implementation of the lean concept at the tertiary lev- el of the health care of are manifested through: faster service delivery to patients, reduction of service waiting time and general improvement of business processes. The implementation of the lean concept would reduce medical waste, which would positively affect the quality of health care services

LEAN concept – possibilities of implementation and improvement of business processes in public healthcare organizations

Uvod: Osnovni je postulat lean koncepta da se veća efikasnost procesa rada može postići kroz proces kontinuiranog poboljšanja. To znači eliminiranje otpada i maksimiziranje aktivnosti koje dodaju vrijednost. Zdravstveni sustavi u Nizozemskoj, Velikoj Britaniji, Italiji i Sjedinjenim Američkim Državama implementirali su lean koncept. Cilj rada: Ispitati mišljenje zdravstvenih radnika javne bolnice na području Sarajeva o mogućnostima unaprjeđenja poslovnih procesa implementacijom lean koncepta. Metoda: Istraživanje je provedeno kao presječna studija u javnoj bolnici na području Sarajeva. Upitnik je poslane-poštom zdravstvenim radnicima. Obuhvaćen je 91 ispitanik oba spola (doktori medicine, specijalizanti, diplomirane medicinske sestre, medicinske sestre i administrativno osoblje). Rezultati: Utvrđena je pozitivna korelacija stavova o efektivnosti i efikasnosti poslovnih procesa. Prema mišljenju ispitanika, veća efektivnost poslovnih procesa pridonosi većoj efikasnosti (r = 0,846; p < 0,05). Spearmanov koeficijent rs = 0,81 pokazuje jaku povezanost efektivnosti i efikasnosti poslovnih procesa. Zaključak: Istraživanje je pokazalo da postoji pozitivan stav o utjecaju lean koncepta na poboljšanje učinkovitosti poslovnih procesa. Očekivani pozitivni učinciimplementacije lean koncepta manifestiraju se kroz: brže pružanje usluge pacijentima, smanjivanje vremena čekanja usluge i generalno poboljšanje poslovnih procesa.Introduction: The basic postulate of the lean concept is that greater efficiency of the work process can be achieved through a process of continuous improvement, which aims to eliminate waste and maximize activities that add value.The Netherlands, Great Britain, Italy and the United States were examples of healthcare systems that implemented the lean concept. Aim: To examine the opinion of health workers of a public hospitals in the Sarajevo area about the possibilities of improving business processes by implementing the lean concept. Method: The cross-sectional study was conducted using a questionnaire. The questionnaire was sent to the e-mail addresses of health workers of public health organizations. 91 respondents of both sexes (doctors of medicine, residents, registered nurses, nurses and administrative staff) were included. Results: A positive correlation was establishedin the attitude toward the effectiveness and efficiency of business processes. According to the participant’s opinion, the greater effectiveness of business processes contributes to greater efficiency (r=0.846; p<0,05). Spearman’s coefficient rs=0.81 shows a strong connection between the effectiveness and efficiency of business processes. Conclusion: The study showed that there is a positive attitude towards the impact of the lean concept on improving the efficiency of business processes. The reducexpected positive effects of the implementation of the lean concept are manifested through faster provision of services to patients, reduction of service waiting times and general improvement of business processes

Palivizumab prophylaxis of RSV infections in Bosnia and Herzegovina

Background: Palivizumab is indicated for respiratory syncytial virus (RSV) prophylaxis in high-risk children. Methods: Observational study, based on 4 sites in Bosnia and Herzegovina (B&H), with institutional reports of infants at high risk for RSV who received at least 1 dose of palivizumab during the 2008-2013 RSV seasons. Results: Across 6 RSV seasons, from 2008/9 to 2013/14, 589 infants were enrolled (0.29% of livebirths population). Of all infants, 290 (49.2%) were enrolled for prematurity only, 82 (13.9%) for bronchopulmonary dysplasia/chronic lung disease (BPD/CLD), 201 (34.1%) for congenital heart disease (CHD), and 13 (2.2%) for other reasons; 365 (61.9%) infants in total were born before 33 weeks. Average gestational age of preterm infants enrolled for prematurity only was 30.2 ± 3.2 weeks; for preterm infants with BPD/CLD it was 28.3 ± 3.7 weeks. Overall average of palivizumab injections was 4.1 ± 1.0. Hospitalization rate related to severe lower respiratory infections (LRI) during the period of protection by palivizumab was 1.2%. Respiratory infections which deserved medical attention were observed in 3.7% infants included in palivizumab prophylaxis. Conclusion: RSV prophylaxis in B&H is provided systematically and successfully, following the national guidance established in 2009, with the aim of achieving a good cost-benefit ratio, with very low hospitalization rate for severe LRI in prophylaxed infants. New randomized controlled trials (RCTs) and American Academy of Pediatrics (AAP) guidance revised in 2014 will be taken into account in establishing a new national recommendation