Ethical committees and benefits of their functioning for healthcare professionals and patients

Налагащата се роля на морала в съвременното здравеопазване се свързва с заобикалящата ни среда - несигурността и риска. Етично отговорното поведение е предпоставка за предотвратяване и противодействие на множество морални рискове в обществото. Моралната отговорност означава да се носи отговорност за всеки конкретен избор в нашето ежедневие и да се зачитат етичните стандарти, налагани от обществото. По отношение на моралната отговорност етическите кодекси се явяват ефективен механизъм за въздействие. В лечебните заведения в Република България на основата на медицинската етика, морално отговорното поведение и съществуването на етични кодекси се създават етични комисии. Тяхната функция е да защитават интересите на здравните специалисти, пациентите и лечебните заведения, като ограничават здравните неравенства и осигуряват етично и отговорно поведение спрямо пациентите и медицинските специалисти. Резултатите от проведено анкетно проучване сред 149 медицински специалисти и 269 пациенти, работещи и лекувани в три различни лечебни заведения в страната, показва, че съществува ниско ниво на информираност относно етичните комисии, техните функции и роля. 83.2% от анкетираните медицински специалисти и 70.3% от анкетираните пациенти не са информирани, че етичните комисии в лечебните заведения имат консултативна функция. Непознаването на института етични комисии ограничава правата на медицинските специалисти и пациентите, като възпрепятства достъпа им до тях. Анализът на резултатите от анкетното проучване сред медицински специалисти и пациенти показва, че съществува ниско ниво на информираност относно етичните комисии, реализиращи дейност в лечебните заведения в страната и техните функции. Необходимо е да се създадат работни групи и обучителни модули, които да запознаят медицинските специалисти със съществуващите етични комисии в страната и с техните функции, като това би се отразило положително върху медицинската практика и самите пациенти.The important role of morality in modern healthcare is bound by our environment - insecurity and risk. Ethically responsible conduct is a prerequisite for preventing and counteracting multiple moral risks in society. Moral responsibility means responsibility for every specific choice in our everyday life and respecting ethical standards imposed by society. Regarding moral responsibility, ethical codes are an effective mechanism of action. In medical institutions in the Republic of Bulgaria ethical committees are established on the basis of medical ethics, morally responsible behavior and the existence of codes of ethics. Their function is to protect the interests of healthcare professionals, patients and healthcare institutions by reducing health inequalities and ensuring ethical and responsible behavior towards patients and healthcare professionals. The results of a survey conducted among 149 medical specialists and 269 patients working and being treated in three different healthcare establishments in the country show that there is a low level of awareness of ethical committees, their functions and role. A total of 83.2% of the surveyed medical specialists and 70.3% of the patients surveyed were not informed that the ethics committees in the healthcare establishments have consultative function. Not knowing the ethics committees of the institute limits the rights of medical professionals and patients by hindering their access to them. The analysis of the results of the survey among medical specialists and patients shows that there is a low level of awareness of the ethical committees operating in the healthcare institutions in the country and their functions. It is necessary to create working groups and training modules to familiarize the medical specialists with the existing ethical committees in the country and their functions, which would have a positive effect on the medical practice and the patients themselves

PROBLEMS AND PERSPECTIVES FOR THE LABOUR MARKET IN HEALTH CARE BULGARIA AS A PART OF THE EUROPEAN UNION AND THE COMMUNITY POLICIES

Specialists working in health care are the main ssets which each EU member state has. There are many tasks and challenges for the health systems in the Union. The demand for health services in the Community is increasing, and concurrently there are certain restrictions in the offering of such services. National policies and healthcare authorities in all EU member states need to consider current issues of the Community and adapt their healthcare systems according to the lack of a sufficient number of health specialists and the ageing population. On 1 March 2005, Bulgaria signed the EU accession treaty, and since 1 January 2007, the country is a member of the Community. As such, it must follow European sources of law and conduct a harmonized policy of governance along with the rest of the member states. In 2008 the EU accepted a Green Book on workers in health care in Europe [1]. The demand for health services in the Community is increasing, and concurrently there are certain restrictions in the offering of such services. In order to verify and analyse the attitude for training and career development of students in nursing care, a survey was conducted among first year students in nursing care from the Faculty of Public Health, Medical University - Sofia. The average age of the first year students is 30, and the results show a need for change and attracting younger people into medical majors. 66,04% of respondents believe that nursing care would be more attractive for future students if their competencies were expanded, while 54% of the respondents believe that medical majors could be more attractive for future students if mass media and Internet advertising are included to promote such majors. There are many challenges on a national and Community level. Health is a main value and healthcare is a part of the national security of any country. Ceaseless migration of health professions and the outflow of candidates for the medical specialities in Bulgaria present serious challenges to the country. It is necessary to take adequate measures to solve actual problems in health care and to ensure the labour market with health professionals

3D MODEL OF THE MECHANICAL PART OF A WEED RECOGNITION SYSTEM IN AN AGRICULTURAL ROBOT IN 3D EXPERIENCE ENVIRONMENT

The damage from weeds in the cultivation of agricultural crops is ubiquitous and they adversely affect the yields of agricultural production. The soil conditions of the places where the crops are grown deteriorate. Contribute to the development of diseases and the enemies on them. Apart from this, it is difficult to carry out mechanized processing and harvesting activities. Weeds also worsen the very quality of the harvested produce. That is why the availability of a recognition system to the agricultural robot is essential to reduce the adverse influence. It is part of a system of control and destruction. In this weed recognition system, an essential element is a robotic arm to enable a camera to perform video surveillance.The aim of this paper is to modelling only the mechanical anchorage system for weed recognition elements that it does not interfere with the other elements with which it interacts. To be as effective as possible, this system must be as close as possible to the plants and at the same time close to the weed eradication system in agricultural robot.A three-dimensional model of the weed recognition mechanical parts from system is discussed in the paper. It is designed in a 3D Experience environment, taking into account the parameters necessary for the movement of the system. Strength sizing of the structure and working simulations of the model were made.

Negative Kaons in Dense Baryonic Matter

Kaon polarization operator in dense baryonic matter of arbitrary isotopic composition is calculated including s- and p-wave kaon-baryon interactions. The regular part of the polarization operator is extracted from the realistic kaon-nucleon interaction based on the chiral and 1/N_c expansion. Contributions of the Lambda(1116), Sigma(1195), Sigma*(1385) resonances are taken explicitly into account in the pole and regular terms with inclusion of mean-field potentials. The baryon-baryon correlations are incorporated and fluctuation contributions are estimated. Results are applied for K- in neutron star matter. Within our model a second-order phase transition to the s-wave K- condensate state occurs at rho_c \gsim 4 \rho_0 once the baryon-baryon correlations are included. We show that the second-order phase transition to the p-wave $K^-$ condensate state may occur at densities $\rho_c \sim 3\div 5 \rho_0$ in dependence on the parameter choice. We demonstrate that a first-order phase transition to a proton-enriched (approximately isospin-symmetric) nucleon matter with a p-wave K- condensate can occur at smaller densities, \rho\lsim 2 \rho_0. The transition is accompanied by the suppression of hyperon concentrations.Comment: 41 pages, 24 figures, revtex4 styl

It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.Peer reviewe

It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened

Release of Graphene and Carbon Nanotubes from Biodegradable Poly(Lactic Acid) Films during Degradation and Combustion: Risk Associated with the End-of-Life of Nanocomposite Food Packaging Materials

Nanoparticles of graphene and carbon nanotubes are attractive materials for the improvement of mechanical and barrier properties and for the functionality of biodegradable polymers for packaging applications. However, the increase of the manufacture and consumption increases the probability of exposure of humans and the environment to such nanomaterials; this brings up questions about the risks of nanomaterials, since they can be toxic. For a risk assessment, it is crucial to know whether airborne nanoparticles of graphene and carbon nanotubes can be released from nanocomposites into the environment at their end-life, or whether they remain embedded in the matrix. In this work, the release of graphene and carbon nanotubes from the poly(lactic) acid nanocomposite films were studied for the scenarios of: (i) biodegradation of the matrix polymer at the disposal of wastes; and (ii) combustion and fire of nanocomposite wastes. Thermogravimetric analysis in air atmosphere, transmission electron microscopy (TEM), atomic force microscopy (AFM) and scanning electron microscope (SEM) were used to verify the release of nanoparticles from nanocomposite films. The three factors model was applied for the quantitative and qualitative risk assessment of the release of graphene and carbon nanotubes from nanocomposite wastes for these scenarios. Safety concern is discussed in respect to the existing regulations for nanowaste stream

A case of tumor megaendoprosthesis for sarcoma of the proximal part of tibia

Our aim was to present a rare case of tumor megaendoprosthetic replacement with restitution of the extensor mechanism of the knee via reattachment of the patellar tendon to the prosthesis and myoplasty with the medial head of gastrocnemius muscle