Alastus eesti nüüdisteatris

Bakalaureusetöö eesmärk on uurida, kuidas on kasutatud alastust eesti nüüdisteatris ning kuidas see vaatajatele mõjub. Analüüsitakse viimase paari aasta jooksul esietendunud lavastusi, mis on sisaldanud alastistseene, hõlmates vaid olulisemaid ja eripalgelisemaid alastuse kasutamisi, mis loovad ülevaate lavalise alastuse trendidest eesti teatris. Bakalaureusetöö jaguneb kolmeks osaks, millest esimene teeb sissejuhatuse alastuse ajalukku – räägitakse nii maailma kui eesti teatrist ning alastikultuurist üldiselt. Töö teine peatükk räägib teoreetilistest lähenemismeetoditest – kehalisusest, performatiivsuse esteetikast, fenomenoloogilisest analüüsist ning peatükis on toodud ülevaade ka ühe tuntuma alastuse käsitleja, ameeriklase Karl Toepferi loodud alastuse kategooriatest. Töö kolmandas osas analüüsitakse eesti teatri lavalise alastuse näitei

Multiresistentse tuberkuloosi ravi kulutulusus ja ravitulemused erinevate ravistrateegiate rakendamisel

Järjest laialdasemalt rakendatakse multiresistentse tuberkuloosi haigete raviks DOTS-Plus strateegiat, kasutades teise rea ravimeid, kuid teadmised nende efektiivsuse ja kulutulususe kohta on vähesed. Uuringus hinnati alates 2001. a augustist Eestis rakendatud DOTS-Plus strateegia tõhusust, maksumust ja kulutulusust võrreldes 3 alternatiivset ravi strateegiat: DOTS-Plus strateegia, pre-DOTS-plus strateegia ja DOTS-strateegia. Kulud arvutati 2002. a kehtinud hindades, tõhususe näitajateks olid tuberkuloosist põhjustatud surmade arv, kaotatud haiguskoormus ja kulutulususe näitajaks säästetud haiguskoormuse maksumus. Saadud andmete alusel võib väita, et kasutades DOTS-Plus strateegiat, on võimalik oluliselt paran dada multiresistentse tuberkuloosi haigete ravitulemusi ning võrreldes teiste võimalustega on see kulutulusaim. Eesti Arst 2006; 85 (3): 148–15

Pärilik hemorraagiline teleangiektaasia: pulmonaalsed manifestatsioonid

Pärilik hemorraagiline teleangiektaasia (HHT) ehk Rendu-Osleri-Weberi tõbi on harva esinev ning aladiagnoositud pärilik haigus, millele on iseloomulikud veresoonte malformatsioonid ninas, suulimaskestas, ajus, maksas, gastrointestinaaltraktis, nahas ja kopsudes. Pulmonaalsete arteriovenoossete malformatsioonide (PAVM) kaudu liigub veri kopsuringest kapillaare läbimata süsteemsesse vereringesse, millest on omakorda tingitud hüpokseemia ja embooliad süsteemses vereringes. Viimased võivad olla isheemia ja abstsesside põhjuseks, eeskätt peaajus. Artiklis on toodud ülevaade HHT etioloogiast, patogeneesist, diagnostikast (k.a sõeluuringute näidustused) ja ravi põhimõtetest, keskendudes PAVMile. Peamiselt juurdetoova arteriaalse soone sulgemisel põhineva PAVMi ravi põhieesmärgid on komplikatsioonide ennetamine ja hüpokseemia korrigeerimine. Patsientide ravijärgseks jälgimiseks on olemas ajakohastatud käsitlusjuhendid. Lisaks on artiklis esitatud 2 haigusjuhtu, kus PAVM oli diagnoositud alles tüsistuste tekke tõttu. Eesti Arst 2011; 90(6):280–28

The State of Competitive Intelligence within New Zealand Private and Public Sector Organisations: a Comparison Study of Competitive Intelligence within New Zealand in 2009

Globalisation and rapid technology advancements are having a profound change on the competitiveness of local and global markets, and shaping the New Zealand marketplace. New Zealand companies are not just competing against other New Zealand companies, but are also competing against global companies. Competitive intelligence is critical for informing vital business decisions and potentially for the viability of a company. The purpose of this study was to research the state of competitive intelligence within the New Zealand private and public sectors and benchmark them against a similar study by Trengrove and Vryenhoek (1997). This research report further explores the relationship between knowledge management and competitive intelligence by examining the culture of competitive intelligence in an information (knowledge) economy through the analysis of competitive intelligence attitudes (Rouach and Santi 2001), 'Strategic Protection Factors' (Rothberg and Erickson, 2005), value and mindset of managing knowledge, and competitive intelligence within New Zealand companies

Enhanced tuberculosis case detection among substitution treatment patients: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Historically, HIV, TB (tuberculosis) and illegal drug treatment services in Estonia have been developed as vertical structures. Related health care services are often provided by different health care institutions and in different locations. This may present obstacles for vulnerable groups, such as injecting drug users (IDU), to access the needed services. We conducted a small scale randomized controlled trial to evaluate a case management intervention aimed at increasing TB screening and treatment entry among IDUs referred from a methadone drug treatment program in Jõhvi, North-Eastern Estonia.</p> <p>Findings</p> <p>Of the 189 potential subjects, 112 (59%) participated. HIV prevalence was 86% (n = 96) and 7.4% (n = 8) of participants were interferon gamma release assay (IGRA) positive (6.5% were both HIV and IGRA-positive, n = 7). Overall, 44% of participants (n = 49) attended TB clinic, 17 (30%) from control group and 32 (57%) from case management group (p = 0.004). None of the participants were diagnosed with TB. In a multivariate model, those randomized to case management group were more likely to access TB screening services.</p> <p>Conclusions</p> <p>These findings demonstrate the urgent need for scaling up TB screening among IDUs and the value of more active approach in referring substitution treatment patients to TB services.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01290081">NCT01290081</a></p

Clinical and operational value of the extensively drug-resistant tuberculosis definition.

Currently, no information is available on the effect of resistance/susceptibility to first-line drugs different from isoniazid and rifampicin in determining the outcome of extensively drug-resistant tuberculosis (XDR-TB) patients, and whether being XDR-TB is a more accurate indicator of poor clinical outcome than being resistant to all first-line anti-tuberculosis (TB) drugs. To investigate this issue, a large series of multidrug-resistant TB (MDR-TB) and XDR-TB cases diagnosed in Estonia, Germany, Italy and the Russian Federation during the period 1999-2006 were analysed. Drug-susceptibility testing for first- and second-line anti-TB drugs, quality assurance and treatment delivery was performed according to World Health Organization recommendations in all study sites. Out of 4,583 culture-positive TB cases analysed, 361 (7.9%) were MDR and 64 (1.4%) were XDR. XDR-TB cases had a relative risk (RR) of 1.58 to have an unfavourable outcome compared with MDR-TB cases resistant to all first-line drugs (isoniazid, rifampicin ethambutol, streptomycin and, when tested, pyrazinamide), and an RR of 2.61 compared with "other" MDR-TB cases (those susceptible to at least one first-line anti-TB drug among ethambutol, pyrazinamide and streptomycin, regardless of resistance to the second-line drugs not defining XDR-TB). The emergence of extensively drug-resistant tuberculosis confirms that problems in tuberculosis management are still present in Europe. While waiting for new tools which will facilitate management of extensively drug-resistant tuberculosis, accessibility to quality diagnostic and treatment services should be urgently ensured and adequate public health policies should be rapidly implemented to prevent further development of drug resistance

Rationing tests for drug-resistant tuberculosis - who are we prepared to miss?

BACKGROUND: Early identification of patients with drug-resistant tuberculosis (DR-TB) increases the likelihood of treatment success and interrupts transmission. Resource-constrained settings use risk profiling to ration the use of drug susceptibility testing (DST). Nevertheless, no studies have yet quantified how many patients with DR-TB this strategy will miss. METHODS: A total of 1,545 subjects, who presented to Lima health centres with possible TB symptoms, completed a clinic-epidemiological questionnaire and provided sputum samples for TB culture and DST. The proportion of drug resistance in this population was calculated and the data was analysed to demonstrate the effect of rationing tests to patients with multidrug-resistant TB (MDR-TB) risk factors on the number of tests needed and corresponding proportion of missed patients with DR-TB. RESULTS: Overall, 147/1,545 (9.5%) subjects had culture-positive TB, of which 32 (21.8%) had DR-TB (MDR, 13.6%; isoniazid mono-resistant, 7.5%; rifampicin mono-resistant, 0.7%). A total of 553 subjects (35.8%) reported one or more MDR-TB risk factors; of these, 506 (91.5%; 95% CI, 88.9-93.7%) did not have TB, 32/553 (5.8%; 95% CI, 3.4-8.1%) had drug-susceptible TB, and only 15/553 (2.7%; 95% CI, 1.5-4.4%) had DR-TB. Rationing DST to those with an MDR-TB risk factor would have missed more than half of the DR-TB population (17/32, 53.2%; 95% CI, 34.7-70.9). CONCLUSIONS: Rationing DST based on known MDR-TB risk factors misses an unacceptable proportion of patients with drug-resistance in settings with ongoing DR-TB transmission. Investment in diagnostic services to allow universal DST for people with presumptive TB should be a high priority

Determinants of Multidrug-Resistant Tuberculosis Clusters, California, USA, 2004–2007

TOC summary: Type of isoniazid resistance–conferring mutation may be a determinant of genotypic clustering

Characteristics and Treatment Outcomes of Patients with MDR and XDR Tuberculosis in a TB Referral Hospital in Beijing: A 13-Year Experience

Background: Information on treatment outcomes among hospitalized patients with multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are scarce in China. Methodology/Principal Findings: We conducted this retrospective study to analyze the characteristics and treatment outcomes in MDR- and XDR-TB patients in the 309 Hospital in Beijing, China during 1996-2009. Socio-demographic and clinical data were retrieved from medical records and analyzed. Logistic regression analysis was performed to identify risk factors associated with poor treatment outcomes and Cox proportional hazards regression model was further used to determine risk factors associated with death in TB patients. Among the 3,551 non-repetitive hospitalized TB patients who had drug susceptibility testing (DST) results, 716 (20.2%) had MDR-TB and 51 (1.4%) had XDR-TB. A total of 3,270 patients who had medical records available were used for further analyses. Treatment success rates (cured and treatment completed) were 90.9%, 53.4% and 29.2% for patients with non-MDR-TB, patients with MDR-TB excluding XDR-TB and patients with XDR-TB, respectively. Independent risk factors associated with poor treatment outcomes in MDR-TB patients included being a migrant (adjusted OR = 1.77), smear-positivity at treatment onset (adjusted OR = 1.94) and not receiving 3 or more potentially effective drugs (adjusted OR = 3.87). Independent risk factors associated with poor treatment outcomes in XDR-TB patients were smear-positivity at treatment onset (adjusted OR = 10.42) and not receiving 3 or more potentially effective drugs (adjusted OR = 14.90). The independent risk factors associated with death in TB patients were having chronic obstructive pulmonary disease (adjusted HR = 5.25) and having hypertension (adjusted HR = 4.31). Conclusions/Significance: While overall satisfactory treatment success for non-MDR-TB patients was achieved, more intensive efforts should be made to better manage MDR- and XDR-TB cases in order to improve their treatment outcomes and to minimize further emergence of so-called totally drug-resistant TB cases. © 2011 Liu et al.published_or_final_versio