Socio-economic Indicators Influence in Terms of Natural Gas Supply Policy and Decision Making - Macedonian Case

Sustainable energy planning is very important in creating energy policies that underpin reliable energy systems. Macedonia has mainly coal based energy production, implying significant air pollution. Thus, natural gas is pointed out as a solid substitute. In order to analyze the combined implications of economic and social aspects when assessing six natural gas supply options vs. a set of selected relevant indicators, the Multi Criteria Decision Making (MCDM) and Analytic Hierarchy Process (AHP) technique were applied. The purpose of this paper is to address the combined effects of economic and social indicators affecting natural gas supply policy and decision making

Ustrezna merila za prehod s konvencionalnega na trajnostno skladiščenje

This research paper conducts the process of selecting the criteria that are the most appropriate for a transition from conventional to sustainable warehousing. SWOT analysis is used to emphasise the weaknesses of conventional and the strengths of sustainable warehousing to select the most appropriate for the herein presented study. The results have been verified via a questionnaire filled out by professionals in economics, logistics and warehousing, and mechanical engineering. be added under the methodology section. The results gave the five most important criteria by transforming the conventional into sustainable warehousing. Finally, the paper concluded that renewable energy sources are the most important criteria for transforming by conventional to sustainable warehousing by environmental aspects, as well as the smart technology is above all other criteria by economic aspect. Moreover, providing personal protection equipment and servicing machinery and vehicle on regular basis are the two mainly criteria by social (safety) aspect.Ta članek obravnava postopek izbire meril, ki so najprimernejša za prehod s konvencionalnega na trajnostno skladiščenje. Analiza SWOT je uporabljena za poudarjanje slabosti konvencionalnega in prednosti trajnostnega skladiščenja, da bi izbrali najprimernejše, za tukaj predstavljeno študijo. Rezultate smo preverili z vprašalnikom, ki so ga izpolnili strokovnjaki iz področja ekonomije, logistike, skladiščenja in strojništva. Rezultati so podali pet najpomembnejših meril za preoblikovanje konvencionalnega v trajnostno skladiščenje. Ugotovili smo, da so obnovljivi viri energije najpomembnejše merilo za preoblikovanje konvencionalnega skladiščenja v trajnostno po okoljskih vidikih, pametna tehnologija pa je nad vsemi drugimi merili po ekonomskih vidikih. Poleg tega sta zagotavljanje osebne zaščitne opreme ter redno servisiranje strojev in vozil dve glavni merili z družbenega (varnostnega) vidika

Evaluation of Measles Outbreak During 2010/2011 in Skopje, Macedonia

Background Due to low rates of vaccination coverage, in mostly rural in Skopje and as a result of military conflict in 2001, lead to spillover of the measles from neighboring countries, where outbreak of measles was already declared. Methods and materials: Measles reporting is mandatory in Macedonia. Cases analyzed had to meet the national case definition. Case-series investigation were conducted, surveys of rates of vaccination coverage. Results From 07.09.2010 to 22.07.2011, we have registered 596 cases of measles. Of these 596, twenty five case after getting a negative result from laboratory testing were discarded, so the number of cases of measles in the area of Skopje was 572 (Mb = 97.0/100.000). The first case was during a 13 months of age unvaccinated child. Out of 572 cases of measles 235 (41.0%) were hospitalized, mostly with severe clinical symptoms. According to the patients vaccination status the conclusion was that: 517 (90.4%) persons were vaccinated, of which 59 not subject to the vaccination, 19 (3.3%) persons no data, 36 (6.3%) persons were vaccinated, of which a portion of MMR are 30 and 6 with two doses. During the outbreak, laboratory confirmed 84 cases out of 103 taken materials, were positive. Conclusions The high rate of vaccine coverage in most municipalities in Skopje, unvaccinated children with a first dose and absence of the second dose in the first grade in elementary school, mostly in rural areas affected by the military conflict in 2001, were the cause of measles in epidemic form

The Role and Interdependence of Economic Indicators in Optimal Natural Gas Supply in Macedonia as a transitional Economy

This paper elaborates the importance of the economic set of indicators relevant for assessing natural gas supply options, as a part of the multi criteria decision making (MCDM) method. Such an approach is a useful tool for decision makers. Thus, the paper is not only dealing with economic indicators arising from investment and other types of costs, but it mostly focuses on macroeconomic environment and macroeconomic preconditions strongly related to energy infrastructure. MCDM is firstly utilized to calculate the indicator’s weighting factors, and further, regression analyses are performed in terms of identifying interdependencies among the indicators

Clinical and radiological evaluation of CNS changes in tuberculosis sclerosis: Case report

Tuberous sclerosis (TS) is an autosomal dominant disorder with variable expressivity and high potential for hamartromatous growths in multiple organs. The incidence is approximately 1:10 000 to 50 000, although a forme furste of the disease is probably much more common

Importance of HR computed tomography in the differential diagnosis of pneumothorax and emphysematous bullas

Pneumothorax is a condition caused by air in the pleural space and may result from a defect in the visceral pleura that allows communication between the pleural space and bronchoalveolar air. It may be traumatic, iatrogenic or spontaneous

Best practices for engaging healthcare providers who smoke: lessons learned from the adapted Certified Tobacco Treatment Specialist (aCTTS) training initiative in the Republic of Macedonia

Introduction The CTTS program has been shown to decrease smoking among lay populations but has not been applied to healthcare providers (HCP) who smoke. The program was adapted into a 1 ½ day training for Macedonian physicians, 1/3 of whom are active smokers. An important objective was to understand how aCTTS impacts the smoking behavior and counseling activities of healthcare providers. Methods A mixed-methods design was used. A longitudinal survey was conducted at baseline and 6- and 12-months post-intervention. Bivariate and multivariate analyses were used to determine significant changes across time and refine associations between HCP demographic characteristics, smoking history, and changes in knowledge and self-efficacy for counseling. Qualitative interviews were conducted with key informants at baseline and with HCP who use tobacco at 6 months post-intervention. Interviews were transcribed, coded, and analyzed thematically to surface key findings from interview transcripts, which were then compared with salient quantitative findings. Results While 1/3 of HCPs currently smoke, almost half indicated they had smoked at least 100 cigarettes in their lifetime. While half of current HCP who smoke indicated, at baseline, an interest in quitting within the next 6 months, that number did not decrease significantly. Interviews with HCP who smoke revealed a lack of specialized training, lack of medications and resources, and feelings of stigma and hypocrisy drove behavior. Despite this, HCP who smoke counseled patients at the same average rate as their nonsmoking peers. HCP who smoke framed patient counseling as a matter of managing exacerbation instead of preventing disease. Conclusions Overcoming fatalism among HCP who smoke is a vital first step to achieving universal cessation among the healthcare establishment. Further research is needed to reverse attitudes that prioritize secondary over primary prevention, in addition to providing skills to manage stigma and training and resources to support quitting. Funding Authors gratefully acknowledge funding through Pfizer Grants for Learning and Change (European Division) and the Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic

A longitudinal outcomes evaluation of an adapted Certified Tobacco Treatment Specialist (aCTTS) for physicians in the Former Yugoslavian Republic of Macedonia (FYROM)

Introduction The CTTS program has been shown to decrease smoking in populations within the United States. The program was adapted into a 1 ½ day training for Macedonian physicians. The overall program aim was to train 100 medical providers in the aCTTS curriculum. The objectives were to: 1) increase provider knowledge and self-efficacy for patient counseling; and, 2) counsel at least 500 patients to quit tobacco use over a one-year period. Methods A longitudinal survey was conducted at baseline, immediate post-intervention (knowledge only), and 6- and 12-months post-intervention. Data were analyzed in SPSS (version 25). Data are analyzed through 6-months post-intervention. Analysis included descriptive data, bivariate analysis to determine significant changes across time, and multivariate analysis to further refine associations between physician demographic characteristics, physician personal smoking history, and changes in knowledge and self-efficacy for counseling between baseline and 6-months post-intervention. In addition, weekly data has been collected from physicians regarding their engagement in tobacco counseling with patients. Results On a 30-item knowledge scale, scores increased between baseline and immediate post-intervention from 10.9 to 17.4 (t=-10.04, p<0.001). Post-intervention, physicians report counseling over 70% of patients who use tobacco. Additional data presented will include impact of the training on physicians’ knowledge about tobacco use, addiction, and health risks, physician-patient communication, physician perceptions and attitudes regarding tobacco use, perceived peer and systemic support for tobacco counseling, and perceived self-efficacy for patient counseling. Conclusions The adapted CTTS program has been well-received by physicians in Macedonia and is contributing to increased counseling for patients of trained providers. Future efforts include expanding the training across Macedonia with potential for use in the broader region. Funding Authors gratefully acknowledge funding through Pfizer Grants for Learning and Change (European Division) and the Global Bridges Healthcare Alliance for Tobacco Dependence Treatment, Mayo Clinic

Predicting the quantifiable impacts of ISO 50001 on climate change mitigation

Energy consumption in the industrial and commercial (service) sectors accounts for nearly 40% of global greenhouse gas emissions. Reducing this energy consumption will be critical for countries to achieve their national greenhouse gas reduction commitments. The ISO 50001-Energy management standard provides a continual improvement framework for organizations to reduce their consumption. Several national policies already support ISO 50001; however, there is no transparent, consistent process to estimate the potential impacts of its implementation. This paper presents the ISO 50001 Impacts Methodology, an internationally-developed methodology to calculate these impacts at a national, regional, or global scale suitable for use by policymakers. The recently-formed ISO 50001 Global Impacts Research Network provides a forum for policymakers to refine and encourage use of the methodology. Using this methodology, a scenario with 50% of projected global industrial and service sector energy consumption under ISO 50001 management by 2030 would generate cumulative primary energy savings of approximately 105 EJ, cost savings of nearly US $700 billion (discounted to 2016 net present value), and 6500 million metric tons (Mt) of avoided CO2 emissions. The avoided annual CO2 emissions in 2030 alone are equivalent to removing 210 million passenger vehicles from the road