COMMON NONCONFORMITIES DURING PROCEDURE FOR ACCREDITATION OF THE FOOD TESTING LABORATORIES IN THE R. MACEDONIA

During laboratory assessment in the frame of the accreditation procedure, they faced with number of nonconformities which are challenge for receiving the Certificate for accreditation and appropriate corrective measures shall be undertaken. Requirements that should be met by the food testing laboratories in the Republic of Macedonia, in order to gain accreditation certificate, contained in the standard МКС ENISO/IEC 17025:2006, ILAC (International Laboratory Accreditation Cooperation) document, ЕА (European Cooperation for Accreditation) document, Regulations and Procedures of the Institute for Accreditation of the Republic of Macedonia. In this paper the analysis is made and different proposals are given for the different ways of fulfilling of those requirements. The aim of this study is to emphasis the common nonconformities which are observed during realization of the Procedure of Accreditation of food testing laboratories and corrective measures undertaken. This investigation is of huge meaning for food testing laboratories which are already accredited and those which are planning to be accredited in the Republic of Macedonia. Furthermore, it is a very important for the Institute for accreditation of the Republic of Macedonia to come to conclusions for the weakest sides of the food testing laboratories and the assessment thereof. Such conclusions should initiate undertaking appropriate measures for improvement the Institute’s lead and technical assessors work towards nonconformities interpretation, identification and acceptance of the most suitable corrective measures

An approach to assess flooding and erosion risk for open beaches in a changing climate

This paper examines the vulnerability to flooding and erosion of four open beach study sites in Europe. A framework for the quantitative estimation of present and future coastal flood and erosion risks is established using methods, data and tools from across a range of disciplines, including topographic and bathymetric data, climate data from observation, hindcast and model projections, statistical modelling of current and future climates and integrated risk analysis tools. Uncertainties in the estimation of future coastal system dynamics are considered, as are the consequences for the inland systems. Different implementations of the framework are applied to the study sites which have different wave, tidal and surge climate conditions. These sites are: Santander, Spain—the Atlantic Ocean; Bellocchio, Italy—the Adriatic Sea; Varna, Bulgaria—the Black Sea; and the Teign Estuary, UK—the northern Atlantic Ocean. The complexity of each system is first simplified by sub-division into coastal "impact units" defined by homogeneity in the local key forcing parameters: wave, wind, tide, river discharge, run-off, etc. This reduces the simulation to that of a number of simpler linear problems which are treated by applying the first two components of the Source–Pathway–Receptor–Consequence (S–P–R–C) approach. The case studies reveal the flexibility of this approach, which is found useful for the rapid assessment of the risks of flooding and erosion for a range of scenarios and the likely effectiveness of flood defences

Integrated report on design of innovative coastal structures and best practices for coastal defence. Results from numerical, experimental and prototype testing.

General aim of WP2 was the development of innovative "climate proof\u201d defence methods for mitigation of coastal flooding and erosion hazards in the context of increasing storminess and sea level rise (scenarios defined by WP 1). More specific objectives were: - to estimate wave reduction at the shoreline induced by barriers for wave energy conversion, - to quantify wave dissipation and related morphological effects induced by multi\u2010purpose low impact structures such as artificial reefs and bottom vegetation, - to analyse performance of different cover layers for overtopping resistant dikes, - to improve management of sediment stocks, knowledge of the impact of sandy borrow areas, technologies for nourishment and dredging, in the perspective of optimised beach maintenance plans. This report presents a synthesis of the prototype observations, physical and numerical modelling performed within WP 2 by all the partners

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use

Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study

Item does not contain fulltextOBJECTIVES: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. DESIGN: A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. SETTING: EPIC II included 1265 intensive care units in 76 countries. PATIENTS: Patients in participating intensive care units on study day. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. CONCLUSION: Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use