ESTABLISHING A MODEL TO EVALUATE PUBLIC ADMINISTRATION PROJECTS

Public investment projects are projects in which the public interest is paramount. The public administration generates public projects, which can be grouped into portfolios. We often witness poor, disordered public investment and project selection. One reason is the lack of adequate, consistent methodology for evaluating and selecting projects. It can be difficult to choose from comparable projects within the portfolio, and the attitudes of the stakeholders can hinder decision-making, highlighting the need for multi-criteria analysis. To select the best project, we designed a model to evaluate and rank public administration projects. We presented a hierarchical structure of objectives and criteria for comparing projects. To select and compare projects according to these defined criteria and assigned weights, we used PROMETHEE II. We simulated and validated this model using the portfolio of the city of Kastav. This model contributes to higher quality and more consistent decision-making in selecting the best investment project from a public administration portfolio

Mjerenje i modeliranje radiološkog utjecaja odlagališta fosfogipsa na okoliš

Phosphogypsum (PG) is a waste product (residue) from the production of phosphoric acid characterized by technologically enhanced natural radioactivity. Croatia’s largest PG deposition site is situated at the edge of Lonjsko Polje Nature Park, a sensitive ecosystem possibly endangered by PG particles. This field study investigates two aspects relevant for the general radiological impact of PG: risk assessment for the environment and risk assessment for occupationally exposed workers and local inhabitants. Activity concentrations of natural radionuclides (238U, 235U, 232Th, 226Ra, 210Pb, and 40K) were measured in the PG (at the deposition site), soil, and grass samples (in the vicinity of the site). The ERICA Assessment Tool was used to estimate the radiological impact of PG particles on non-human biota of the Lonjsko Polje Nature Park. The average annual effective dose for occupationally exposed workers was 0.4 mSv which was within the worldwide range.Fosfogips je nusproizvod koji nastaje tijekom proizvodnje fosforne kiseline, a karakteriziran je tehnološki povišenom prirodnom radioaktivnošću. Odlagalište fosfogipsa u Hrvatskoj nalazi se na rubu Parka prirode Lonjsko polje, osjetljivom ekosustavu potencijalno ugroženom od čestica fosfogipsa. Istraživanje opisano u ovom radu sagledava dva aspekta značajna za radiološki utjecaj fosfogipsa: procjenu rizika za okoliš te procjenu rizika za profesionalno izložene radnike i lokalno stanovništvo. Koncentracije aktivnosti prirodnih radionuklida (238U, 235U, 232Th, 226Ra, 210Pb i 40K) izmjerene su u uzorcima fosfogipsa uzetima s odlagališta te u uzorcima tla i trave uzetima u blizini odlagališta. Za modeliranje utjecaja fosfogipsa na okoliš (biotu) korišten je program ERICA Assessment Tool. Prosječna godišnja efektivna doza za profesionalno izložene radnike iznosila je 0,4 mSv, što je na razini svjetskog prosjeka

Combined Usage of Inhaled and Intravenous Milrinone in Pulmonary Hypertension after Heart Valve Surgery

Secondary pulmonary hypertension is a frequent condition after heart valve surgery. It may significantly complicate the perioperative management and increase patients’ morbidity and mortality. The treatment has not been yet completely defined principally because of lack of the selectivity of drugs for the pulmonary vasculature. The usage of inhaled milrinone could be the possible therapeutic option. Inodilator milrinone is commonly used intravenously for patients with pulmonary hypertension and ventricular dysfunction in cardiac surgery. The decrease in systemic vascular resistance frequently necessitates concomitant use of norepinephrine. Pulmonary vasodilators might be more effective and also devoid of potentially dangerous systemic side effects if applied by inhalation, thus acting predominantly on pulmonary circulation. There are only few reports of inhaled milrinone usage in adult post cardiac surgical patients. We reported 2 patients with severe pulmonary hypertension after valve surgery. Because of desperate clinical situation, we decided to use the combination of inhaled and intravenous milrinone. Inhaled milrinone was delivered by means of pneumatic medication nebulizer dissolved with saline in final concentration of 0.5 mg/ml. The nebulizer was attached to the inspiratory limb of the ventilator circuit, just before the Y-piece. We obtained satisfactory reduction in mean pulmonary artery pressure in both patients, and they were successfully extubated and discharged. Although it is a very small sample of patients, we conclude that the combination of inhaled and intravenous milrinone could be an effective treatment of secondary pulmonary hypertension in high-risk cardiac valve surgery patient. The exact indications for inhaled milrinone usage, optimal concentrations for this route, and the beginning and duration of treatment are yet to be determined

Nonelective surgery at night and in-hospital mortality - Prospective observational data from the European Surgical Outcomes Study

BACKGROUND Evidence suggests that sleep deprivation associated with night-time working may adversely affect performance resulting in a reduction in the safety of surgery and anaesthesia. OBJECTIVE Our primary objective was to evaluate an association between nonelective night-time surgery and in-hospital mortality. We hypothesised that urgent surgery performed during the night was associated with higher in-hospital mortality and also an increase in the duration of hospital stay and the number of admissions to critical care. DESIGN A prospective cohort study. This is a secondary analysis of a large database related to perioperative care and outcome (European Surgical Outcome Study). SETTING Four hundred and ninety-eight hospitals in 28 European countries. PATIENTS Men and women older than 16 years who underwent nonelective, noncardiac surgery were included according to time of the procedure. INTERVENTION None. MAIN OUTCOME MEASURES Primary outcome was in-hospital mortality; the secondary outcome was the duration of hospital stay and critical care admission. RESULTS Eleven thousand two hundred and ninety patients undergoing urgent surgery were included in the analysis with 636 in-hospital deaths (5.6%). Crude mortality odds ratios (ORs) increased sequentially from daytime [426 deaths (5.3%)] to evening [150 deaths (6.0%), OR 1.14; 95% confidence interval 0.94 to 1.38] to night-time [60 deaths (8.3%), OR 1.62; 95% confidence interval 1.22 to 2.14]. Following adjustment for confounding factors, surgery during the evening (OR 1.09; 95% confidence interval 0.91 to 1.31) and night (OR 1.20; 95% confidence interval 0.9 to 1.6) was not associated with an increased risk of postoperative death. Admittance rate to an ICU increased sequentially from daytime [891 (11.1%)], to evening [347 (13.8%)] to night time [149 (20.6%)]. CONCLUSION In patients undergoing nonelective urgent noncardiac surgery, in-hospital mortality was associated with well known risk factors related to patients and surgery, but we did not identify any relationship with the time of day at which the procedure was performed

Food industry by-products : knjiga sažetaka : 3. međunarodni znanstveno-stručni skup FOOD INDUSTRY BY-PRODUCTS

Book of Abstracts includes abstratcs of plenary, invited lectures and poster presentations held at the 4th International Scientific and Professional Conference FOOD INDUSTRY BY-PRODUCTS, related to the issue of disposal and potential use of various by-products of the food industry. The holding of the Conference and the publication of the Book of Abstracts were co-financed by the Croatian Science Foundation with the project "The possibility of exploiting traditional apple cultivars for the production of apples and apple juice with the reduced patulin content"