Emakamüoomi embolisatsioon fertiilses eas naisel

Emaka müoomid (nimetatud veel leiomüoomideks ja ingliskeelses kirjanduses emaka fibroidideks) on sagedasemad healoomulised günekoloogilised kasvajad. Tihti on nad asümptomaatilised, kuid 30%-l juhtudest võivad põhjustada valu, menorraagiat, survetunnet väikevaagnas, harvem infertiilsust, rasedus- ja sünnituskomplikatsioone. Ravi on enamasti kirurgiline, millest hüsterektoomia ehk emaka eemaldamine on kõige radikaalsem. Lisaks on olemas emakat säästvad sekkumised, milleks on kirurgiline müomektoomia ja müoomi arterite embolisatsioon. Viimaseid eelistatakse nendel patsientidel, kes planeerivad rasestuda või soovivad säilitada emakat. Artiklis on käsitletud haigusjuhtu, kus fertiilses eas naisel avastati suur müoomisõlm. Naine planeeris lähiajal rasestuda. Raviprotseduurina tehti emaka müoomi varustavate arterite angiograafiline embolisatsioon. Patsient sai oma kaebustest vabaks, tal õnnestus loomulikul teel rasestuda ja kanda loodet edukalt kogu raseduse vältel ning sünnitada õigel ajal terve laps. Eesti Arst 2018; 97(6):327–330 &nbsp

Of the People, by the People, for the People: Critical Pedagogy and Government Information

This chapter focuses on pedagogical frames and techniques that encourage student engagement and problematize the process-and-product model of government information. These strategies reflect four interconnected ideas, namely • that government information is political, • that access to government information is political, • that government information has value both in scholarly contexts and in individuals’ daily lives, and • that we can intervene in the production and dissemination of government information

Emakamüoomi embolisatsioon fertiilses eas naisel

Emaka müoomid (nimetatud veel leiomüoomideks ja ingliskeelses kirjanduses emaka fibroidideks) on sagedasemad healoomulised günekoloogilised kasvajad. Tihti on nad asümptomaatilised, kuid 30%-l juhtudest võivad põhjustada valu, menorraagiat, survetunnet väikevaagnas, harvem infertiilsust, rasedus- ja sünnituskomplikatsioone. Ravi on enamasti kirurgiline, millest hüsterektoomia ehk emaka eemaldamine on kõige radikaalsem. Lisaks on olemas emakat säästvad sekkumised, milleks on kirurgiline müomektoomia ja müoomi arterite embolisatsioon. Viimaseid eelistatakse nendel patsientidel, kes planeerivad rasestuda või soovivad säilitada emakat. Artiklis on käsitletud haigusjuhtu, kus fertiilses eas naisel avastati suur müoomisõlm. Naine planeeris lähiajal rasestuda. Raviprotseduurina tehti emaka müoomi varustavate arterite angiograafiline embolisatsioon. Patsient sai oma kaebustest vabaks, tal õnnestus loomulikul teel rasestuda ja kanda loodet edukalt kogu raseduse vältel ning sünnitada õigel ajal terve laps. Eesti Arst 2018; 97(6):327–330 &nbsp

Challenges, responses and partnership for achieving sustainable tourism and heritage preservation

The process of globalization has created the situation where the expectations of tourists are the same both with respect to the quality of services in all destinations and with respect to the authencity based on local attractions and experiences, which should be unique and different for each destination. The key element in maintaining destination attractiveness is the protection and presentation of natural and cultural heritage and its sustainable utilization for tourism development. The sustainability concept is of equal importance for long-term tourism development, destination competitiveness and heritage protection. The paper deals with the main challenges to achieving sustainable tourism and points to some key responses to them. Participation, cooperation and partnership should be a vital prerequisite for the implementation and performance of sustainable tourism and heritage protection. This attitude has been tested on several examples of good practice in heritage protection and the sustainable development of tourism destinations in Serbia.

Methodological approach to the spatial plan of the river belt

Based on the main assumptions of the Spatial Plan of the Republic of Serbia in regard to the Danube-Sava river belt, this paper gives an overview of the methodology of this area's spatial plan elaboration. The importance of this belt for the integration and development of Serbia, the spatial scope and complexity of the task, imposed new approaches to defining methodology and the elaboration procedure of this spatial plan. During the preparation phase oft the Spatial Plan of the Danube-Sava River belt it was projected that it should be elaborated in two main phases. The first phase ought to define the overall development strategy, the space utilization, protection and arrangement of the river belt and its gravitating areas (outlined by districts' territories along the Danube and the Sava). The second phase of the Spatial Plan should be elaborated as a structural/physical plan divided into seven belt's segments (outlined by territories of local communities along two rivers)

Creation of an observation network for assessment of the impact of the pig complex on the groundwater aquifer

Ukraine, as a party to the Association Agreement, in accordance with Directive 2000/60/EC of the European Parliament and of the Council, recognizes water as the most expensive resource on our planet, which must be protected and saved. Every country and every inhabitant of the planet must do everything possible to reduce the thoughtless use of water and stop water pollution. The priority is the identification of water users and "polluters", as well as the detection and prevention of pollution of water resources, which includes the identification of water sampling points around potential sources of pollution. The aim of the research is to determine the impact of pig farms on the qualitative and quantitative characteristics of groundwater using existing water intakes to preserve natural water resources from pollution and depletion. An important point for monitoring in this situation is the use of existing water intakes (bores and wells) without additional construction of observation bores and interference in the environment. To complete the study, it is necessary to create an observation (monitoring) network of selected points and establish the frequency of their study. The observation network should determine the level (static and dynamic) as well as the quality of groundwater, which reflects background concentrations (natural or "conditionally natural"). "Conditionally natural" concentrations may indicate an excess of pollutants, associated with anthropogenic impacts that occurred prior to the activities of a particular entity, in respect of which the study is conducted. Given the changes in the quality characteristics of water, caused by external factors, "conditionally natural" concentrations can be taken as background. The obtained information will allow, depending on the quality and quantity of groundwater (their level) to make management decisions on the management of groundwater resources. Groundwater in rural settlements near enterprises is in most cases the only source of water supply. The laboratory analysis of water samples from selected points in 2020 showed an excess of color, odor at 60 °C, turbidity, total iron in bores and wells. The detected elevations are due to the peculiarity of the geological structure (aquifer of Eocene sediments). The excess in the hydrogen index is almost 10 times from the surface water body, which can be taken as "conditionally natural" (background) with further study of the specific impact of the complex on the environment. The main indicators that may indicate direct contamination of the pig complex, such as nitrates, nitrites, ammonium nitrogen and microbiological studies, do not exceed the normalized values, set for drinking water. In this case, the specific indicators are within normal limits. Petroleum products were not detected in the studied sample

Sustainable spatial development of tourism destinations in time of crisis in Serbia

The purpose of this paper is to analyze and discuss the challenges and possibilities for sustainable spatial development of tourism destinations at the time of economic crisis in Serbia. At a time of crisis, the sustainability of more developed tourism destinations is challenged, as the pressure from the tourism industry for intensive construction of tourism facilities and their spatial concentration prevails. The proposed development is then more likely to cause negative impacts on environment, as well as on social and economic development of local communities. Primary tourism destinations in the initial stage of development do not experience the pressure of tourism industry for intensive development, thus enabling the public sector to prepare for and support their sustainable spatial development. On the other hand, in times of crisis the public sector will have difficulties to provide for necessary investments of the private sector in tourism facilities and supply. In the paper primary tourism destinations - mountain tourism destinations, Danube and Lower Danube, have been analyzed and compared in terms of sustainability and spatial development changes. Based on results of the analyzed cases, the challenges and possibilities for sustainable spatial development of tourist destinations have been evaluated and discussed. The research has multiple implications. It suggests necessary adaptations in the spatial and tourism sector planning and management of tourism destination at different stages of development. It also calls for stakeholder participation, public-private arrangements, and local community involvement in the sustainable spatial development of tourism destinations in Serbia

Implementasi Pelaksanaan Progam PPPK Menurut UU No 5 Tahun 2014

Abstrack: In today's era, employee welfare is very important. Because with the welfare of employees, it can improve the quality and quality of the employees themselves in an agency or company. Often we still find problems in the field regarding the welfare of employees, such as temporary employees. There are still many honorary employees who do not feel or enjoy the welfare of their hard work. Especially in areas and in remote areas. Therefore, the central government in order to accommodate the aspirations of honorary employees and civil society, the government created a program for non-PNS ASN (State Civil Apparatus) employees, namely the PPPK Program. It is hoped that this program will be able to improve the welfare of the community and provide a sense of calm in the community for their lives. The Probolinggo City Government is one of the cities in Indonesia that has begun to select and implement the PPPK program in the scope of its personnel. This is reflected, in 2019, the Probolinggo City Government recruited PPPK. The PPPK program is an implementation of the regulation of Law No. 5 of 2014. The PPPK program or also called Government Employees with Work Agreements, every ASN with PPPK status gets the same rights and facilities as civil servants. PPPK has the same obligations and rights as civil servants with civil servant status. It is hoped that this journal will be able to provide broad and specific knowledge of the PPPK program, especially within the Probolinggo City Government. Keywords: PPPK, Welfare, Employees, Regulations. &nbsp

Spatial Planning Of Peripheral Rural Regions In Serbia

After the establishment of the new legislative framework on planning and construction, territorial organization of the Republic of Serbia and regional development, as well as adoption of the Spatial Plan of the Republic of Serbia 2010-2020 (SPRS), the strategic spatial plans at regional level have been elaborated. Over the last few years, the total of 10 regional spatial plans (RSP) have been either adopted or in final stage of elaboration, five of them for peripheral rural regions of Serbia. The paper analyzes concepts and models used in planning the sustainable territorial development of peripheral, rural and mountain regions in Serbia. It refers to several key questions of sustainable territorial development of peripheral regions: accessibility, urban-rural development, rural settlement network and depopulation of peripheral mountain areas, tourism development, sustainable natural resources utilization and potentials for trans-border cooperation. One of the models discussed is for rural settlement network. Aging of rural population and depopulation of peripheral mountain regions hinders the preservation of micro rural centers, in particular the provision of public and commercial services. Emerging model is of mobile services, now developed dominantly for social and medical services, which can be expanded to almost all services, or combined with the revitalization of micro rural centers, namely those within urban centers' gravity zone, main transport corridors or tourism destinations. Potentially most attractive tourism assets are located at peripheral regions of Serbia. Spatial pattern of assets allows for dispersed development of tourist nodes, gateways and paths. The question is how much of dispersion or concentration in the spatial pattern of tourism infrastructure and supply is acceptable and sustainable. The benefits and constraints for implementing some of proposed models are discussed. Short critical overview on constrains of regional development and implementation of regional spatial plans related to undeveloped regional level of governance, as well as to weak vertical and horizontal coordination of other levels of governance has been indicated. The purpose of this paper is to discuss the challenges and possibilities of regional spatial planning to contribute sustainable regional territorial development of peripheral and rural regions