Дотик до вічності. Про розроблення нового історико/архітектурного плану м. Керчі

У 2009 р. автору статті було доручено очолити історико-містобудівні дослідження одного з найцікавіших стародавніх міст нашої країни Керчі. Метою досліджень було складання нового історико/архітектурного опорного плану з визначенням історичного ареалу і зони охорони найбільш цінних територій в межах сучасного міста

Overcoming communication barriers in a multicultural radiography setting

Background: Effective communication between the patients and radiographers can be a daunting task in a multicultural, multilingual environment. With 11 official languages, South Africans experience language barriers amongst themselves, which pose unique communication challenges on a daily basis. It is thus important to explore how radiographers overcome such challenges to provide an effective service to their patients. Aim: The aim of this study was to explore and describe the experiences of radiographers in Gauteng province in communicating with patients in a multilingual, multicultural healthcare setting and make recommendations towards overcoming such barriers. Setting: The focus group discussions were conducted in English and at a private location that was convenient for the participants in Gauteng. Method: The study employed a qualitative phenomenological approach using focus group interviews (FGIs) to solicit the experiences of participants and gain an in-depth understanding of the phenomenon. Results: The findings showed that patient–radiographer cross-cultural communication is ineffective whilst language barriers are encountered daily. Participants subsequently offered a number of recommendations to enhance communication with patients from different cultural and linguistic backgrounds. These included workshops or short courses to improve language skills, posters to allow for non-verbal communication, the use of professional interpreters or mobile translation technology, employment of a diverse workforce and a focus on cultural sensitivity and learning an additional language at tertiary level. Conclusion: Although a variety of communication strategies are available, the most appropriate combination should be explored for individual radiology practices in order to serve their respective diverse patient base. Recommendations that emanated from this study can, therefore, be used as a guide to radiology practices to facilitate effective patient–radiographer communication

Characterisation of penA and tetM resistance genes of Neisseria gonorrhoeae isolated in southern Africa - epidemiological monitoring and resistance development

Objective. To investigate penA and tetM resistance gene variation of Neisseria gonorrhoeae in order to define gene types for epidemiological monitoring and resistance development. Design. Isolates of N. gonorrhoeae which were susceptible and resistant to penicillin and/or tetracycline were selected. Strains comprised South African isolates (22 from Bloemfontein, 13 from Transvaal, 20 from the Cape) and 15 Botswana and 4 Namibia isolates. The penA genes (2 kb) of all strains and tetM genes (765 bp) of 11 high-level tetracycline-resistant strains were amplified and restricted with Hpall. Results and conclusions. Twelve different Hpall fingerprint patterns were obtained from the 74 isolates analysed for penicillin-binding protein (PBP) 2 gene (penA) alterations. Focusing on the transpeptidase domain, 25 isolates (3 whole gene patterns, minimal inhibitory concentrations (MICs) ~ 0,03 - 0,125 ug/ml) had restriction sites equivalent to those previously described for a susceptible strain. Of the remaining 9 PBP 2 'gene groups, 25 strains fell into a designated group E. Penicillin/ penicillin + clavulanic acid MICs determined on these group E isolates gave a range of 0,125 - 2,0 ug/ml, although MICs against 4 strains were ~ 0,03 ug/ml. MICs of penicillin/penicillin + c1avulanic acid for the 24 isolates that contained altered PBP 2 transpeptidase gene regions not designated group E were only ~ 0,03 - 0,125 ug/ml. The lack of a Hpall restriction site at nucleotide 1934 in the PBP 2 gene of group E strains was indicative of a small terminal region of N. cinerea DNA. This gene block, which was found in all the southern African areas studied, appears to predispose isolates to increased penicillin resistance. The 25,2 MDa conjugative plasmid carrying the tetM resistance determinant was readily demonstrated in 11 Botswana Namibia isolates exhibiting high-level resistance to tetracycline (MICs > 16 ug/ml). The tetM gene was shown to be of the American type

Chromium Speciation Analysis by Ion Chromatography Coupled with Inductively Coupled Plasma - Optical Emission Spectroscopy

Two methods coupling ion chromatography with inductively coupled plasma - optical emission spectroscopy (ICP-OES) were developed for the simultaneous separation and determination of Cr(III) and Cr(VI) species. In the first method, anion chromatography with sodium bicarbonate/carbonate solution as the eluent was utilized. Cr(III) species were protected from precipitation by complexation with ethylenediaminetetra-acetic acid (EDTA) prior to analysis. The detection limits were determined experimentally as 0.05 mg L-1 for both species. Most of the common cations were found to interfere with the accurate determination of Cr(III) when present in excess of 50 mg L-1. In the second method using cation chromatography, a guard column was employed in conjunction with a stepwise elution programme to elute the chromium species. The detection limits were experimentally determined as 0.1 mg L-1 for both species. South African Journal of Chemistry Vol.57 2004: 8-1

Non-compliance with treatment by epileptic patients at George Provincial Hospital

Non-compliance with anti-epileptic drug treatment in the George area, resulting in recurrent seizures and visits to the emergency department of the George Provincial Hospital, has been identified as a social and economic problem. The aim of this study was to determine the socio-economic and medical factors, the information given to patients by healthcare workers, and the understanding of patients living with epilepsy who presented to the emergency department with seizures. Methods A descriptive study design was employed and the data-collection tools were a questionnaire and structured interview. Results The median age of the study population was 32 years. The patients had suffered from epilepsy for a median of two years and visited a clinic for a median of seven times a year. The median education level was primary school and three quarters had no employment or government grant. The majority did not understand the disease, the side effects of the medication and why they should be on medication. In addition, it became apparent from patient reports that healthcare workers showed a lack of counselling skills, time and appropriate knowledge. Conclusions There is a general lack of understanding of epilepsy by the patient. Not only were the patients uninformed, but they also showed apathy towards the management of their condition.South African Family Practice Vol. 49 (9) 2007: pp. 1

The appropriateness of patients' visits to an emergency department.

Aim: The appropriateness of patient visits to an emergency unit was investigated in this study. Method: This descriptive study included 2968 patient cards from the National District Hospital, Bloemfontein emergency unit during 2003. Patient information was evaluated according to predetermined criteria to determine whether a visit was appropriate or not. Results: The patient's ages varied between 0 to 97 years (median 29 year) and 50.8% was female. Informal residencies presented 26.4% of patient's neighbourhoods. The most common chronic condition was hypertension (7.9%). Only 8.4% of patients already used medication for their presenting condition. Most (72.4%) patients presented after hours and 36.6% presented during weekends. The total number of injuries was 22.9% and 75.6% were examined for medical or surgical problems. The criterion with the most visits was the trauma category (21.8%). The criterion with the least patients (0.3%) was the criterion for significant bleeding. According to the results more than a third (35.4% ; 95% CI 33.7% ; 37.2%) of the patient visits can be seen as inappropriate. Conclusion: The emergency unit is used inappropriately South African Family Practice Vol. 49 (4) 2007: pp. 1

Особенности разработки термостабилизированных германиевых фотодиодов

Рассмотрены подходы к конструированию лавинных и нелавинных германиевых фотодиодов с применением эпитаксиальных структур и термоэлектрического охлаждения

Guideline versus non-guideline based management of rectal cancer in octogenarians

The number of octogenarians with rectal adenocarcinoma is growing. Current guidelines seem difficult to apply on octogenarians which may result in non-adherence. The aim of this retrospective cohort study is to give insight in occurrence of treatment-related complications, hospitalisations and survival among octogenarians treated according to guidelines versus octogenarians treated otherwise. 108 octogenarians with rectal adenocarcinoma were identified by screening of medical records. 22 patients were excluded for treatment process analysis because of stage IV disease or unknown stage. Baseline characteristics, diagnostic process, received treatment, motivation for deviation from guidelines, complications, hospitalisations and date of death were documented. Patients were divided in two groups depending on adherence to treatment guidelines. Differences in baseline characteristics, treatment-related complications and survival between both groups were evaluated. Diagnosis and treatment according to guidelines occurred in 95 and 54% of the patients, respectively. When documented, patient's preference and comorbidities were major reasons to deviate from guidelines. 66% of patients who were treated according to guidelines experienced complications versus 34% of those treated otherwise (p = 0.02). After adjustment for differences in age and polypharmacy, this association was not significant. Patients treated according to the guideline had better survival 18 months after diagnosis (80 versus 56%, p = 0.02). Treating octogenarians with rectal cancer according to guidelines seem to lead to better overall survival, but may lead to a high risk of complications. This may jeopardise quality of life. More and prospective studies in octogenarians with rectal cancer are needed to customize guidelines for these patients

Загальні засади формування та діяльності колегії Ніжинської районної державної адміністрації в 90-рр. ХХ ст.

The nature and scale of changes described in Part 1 indicate that, without additional policies, the global environment will degrade further – from a situation that already raises considerable concern. A crucial question, therefore, is how to halt and reverse such trends. While previous Global Environment Outlook (GEO) reports have explored several scenarios looking at very different futures (UNEP 2002, 2007), the emphasis of GEO-5 is on the choices and strategies that could, from 2012, lead to a sustainable future. This is advanced by looking at two very different storylines based on a review of existing scenario studies: • a view of the world in 2050 assuming business-as-usual paths and behaviours – “conventional world” scenarios; and • an alternative that leads to results consistent with our current understanding of sustainability and agreed-upon goals and targets on the road to 2050 – “sustainable world” scenarios