Social impacts of mining: Changes within the local social landscape

Understanding the social impacts at a community level triggered by mining operations is a challenging exercise. This paper reflects on a community’s perceptions and interpretation of these impacts as well as on the qualitative changes in the local social landscape and their implications for a sustainable future. The findings are based on an exploratory research carried out in a small established settlement in Western Australia. Considered as an agricultural community for decades, Boddington currently hosts two mining operations. Even though mining has been carried out there for decades, the recent opening of a large-scale mining operation is triggering significant demographic changes which result in a structural and functional transformation of the local social environment. Two new phenomena, namely transiency and a dependency culture are identified. Maintaining existing levels of social and economic capital as well as mobilising the community’s resources to capitalise on the opportunities associated with mining, are identified as key challenges for the settlement’s sustainability

The Nurse and prophylactic care for children in their early age

Introduction: The prophylactic care for children in their early age, traditionally provided by Children consultations, today is delivered by the General practitioners and the role of the nurse was minimized if not missing.Aim: To analyze the relevant legislation concerning health and preventive care for children and the role of nurse and to point out the problems to be solved in order to improve quality of service.Methods: Document analysis, Inquiries of nurses (188) working at children healthcare facilities.Results: Document analysis show that there is no regulation that mandates nurse’s participation in the team that provides basic health care service including prophylactic care for children. There is no good definition or distinction for the functions of GPs and nurses in the terms of prophylactic care for children. There is contradiction in the established professional competencies for a nurse and the restrictions in the existing legislation towards healthcare for children.Inquired nurses find their role in improving the quality of the health care service in children consultations by helping doctors in the routine activities like immunizations and anthropometry and also in educating parents in terms of health culture and prevention. Home visits or patronage is suggested as appropriate action in this regard.Conclusion: Changes in the legislation and reorganization focused on the recipients may lead to better inclusion of the nurse with an increased capacity for improving the prophylactic care for children in their early age

Parthicopolis’in mozaik döşemelerinin tesserae kökeni üzerine (4.- 6. yüzyıl). yerel ocaklar, yataklar ve ithalat (2 numaralı bazilika’dan bazı mozaik tesseralar için ön rapor)

This article examines several mosaic tesserae from the mosaic panel of the exonarthex of the early Christian basilica No 2 in Parthicopolis (today’s town of Sandanski). The studied mosaic tesserae are made of glass, brick and stone - marble and sandstone. After the analysis: micro- and macroscopic, method applied: EDS; XRD analysis of the mineral phases and others. The composition and possible production of glass for the smalta tesserae has been established, the composition of the brick tesserae; of two types of white marble tesserae, of sandstone tesserae has been determined. In antiquity, and especially in the early Byzantine period, several marble quarries of very good quality were exploited in the Middle Strymon area. It has been established that the stone tesserae were mined from deposits around the ancient and early Byzantine city, quarries Ilindentsi (‘The marble quarries of Trajan’), and the glass is imported. An assumption has been made about the possible production on site in the city of a type of glass tesserae - with a degree of crystallization. The chemical and structural analysis of the tesserae reveals the origin of the material, stone and glass, the latter in the form of a finished product distributed as an import by Thessaloniki merchants and undergoing only the final stage of heating, cutting and polishing in local workshops. Although research on the origin of tesserae from mosaic panels from the early Christian basilica complexes in Parthicopolis is only in the beginning, research proves the origin of tesserae materials, the supply of mosaic workshops mainly with local stone material, and trade in imported glass for enamel mosaic and its final stage of in situ preparation in Particopolis.Bu makalede, Parthicopolis’teki (bugünkü Sandanski Kasabası) 2 numaralı erken Hristiyan bazilikasının eksonarteksinin mozaik panelindeki birkaç mozaik tessera incelenmektedir. İncelenen mozaik tesseralar cam, tuğla ve taş - mermer ve kumtaşından yapılmıştır. Analizden sonra, ki bu analizde mikro ve makroskopik yöntemler uygulanmıştır: EDS; Mineral fazların XRD analizi ve diğerleri yapılmıştır. Smalta tessera için camın bileşimi ve olası üretimi belirlenmiştir, ve tuğla tessera’nın bileşiminin, beyaz mermer tessera, kumtaşı tessera olmak üzere iki tipte olduğu tespit edilmiştir. Antik çağda ve özellikle erken Bizans döneminde, Orta Strymon bölgesinde çok kaliteli birkaç mermer ocağı işletilmiştir. Taş tesseraların antik ve erken Bizans kenti, Ilindentsi taş ocakları (‘Trajan’ın mermer ocakları’) çevresindeki yataklardan çıkarıldığı ve camın ithal edildiği tespit edilmiştir. Şehirde bir tür cam tesseranın bir dereceye kadar kristalleşme ile üretildiği olasılığı üzerine bir varsayım yapılmıştır. Tesseraların kimyasal ve yapısal analizi, malzemenin, taş ve camın kökenini ortaya koymaktadır; ikincisi, Selanik tüccarları tarafından ithal olarak dağıtılan ve yerel atölyelerde yalnızca son ısıtma, kesme ve cilalama aşamalarından geçen bitmiş bir ürün biçimindedir. Parthicopolis’teki erken Hristiyan bazilika komplekslerindeki mozaik panellerdeki tesseraların kökenine ilişkin araştırmalar henüz başlangıç aşamasında olmasına rağmen, araştırmalar tessera malzemelerinin kökenini kanıtlamaktadır. Ağırlıklı olarak yerel taş malzeme ile mozaik atölyelerinin temini ve mine mozaik için ithal cam ticareti ve Particopolis’te yerinde hazırlığının son aşamasıdır

Assessment of the Clinical Progression of Diabetic Kidney Disease

Diabetic microangiopathy is a specific, generalized damage of microcirculation (arterioles, capillaries and venules). Diabetic nephropathy is a chronic microvascular complication of diabetes mellitus, characterized by progressive proteinuria and deterioration of renal function, expressed in a decrease in glomerular filtration rate. In recent years, diabetic kidney disease has taken first place among the causes of end-stage renal disease. The term diabetic kidney disease (DKD) is generally used to cover the spectrum of people with diabetes who have either albuminuria or reduced glomerular filtration rate. The risk of developing diabetic nephropathy (DN) varies between individuals and depends not only on the duration of diabetes mellitus, but is also influenced by other factors, such as glycemic control, blood pressure, and genetic predisposition. While most DN cases arise in type 2 diabetes, which accounts for 90% of global diabetes cases, it is often linked to arterial hypertension and heightened cardiovascular morbidity and mortality. The main objective in managing diabetic nephropathy involves preventing the progression of microalbuminuria to macroalbuminuria, delaying the decline in glomerular filtration rate, and preventing associated cardiovascular complications

Social impacts of mining : a Western Australian community case study

Social impacts of mining is not a new area of study. The intensive resource extraction over the last ten years, together with the societal challenges occurring at a global scale, and the progress of the sustainability agenda, are changing the way mining impacts on local communities. Understanding the social implications of mining operations at the local community level appears to be a challenging research exercise that resembles a complex puzzle.The study presented in this thesis seeks to explore the complexities and drivers generating social impacts of mining at a local community level and how this relates to community’s long-term development. The concept of social sustainability is the primarily focus used to examine and interpret the consequences from contemporary mining operations. Studying the rural community of Boddington in south-west Australia, the research links the concepts of social impacts and social sustainability. It reflects on the qualitative changes occurring in the social landscape and analyses the role of mining for long-term community development by examining its contribution against the social implications it evokes.The findings of this inquiry demonstrate the complex nature of the social impacts caused by mining operations. It identifies three new phenomena impacting the social sustainability prospects of the community, namely the appropriation of human resources, transiency and dependency culture. The case study unveils the inextricable links between the drivers that generate impacts and brings forward the importance of analysing and exploring the dynamic interactions between the various social indicators in order to understand how mining affects local communities

The nutcracker syndrome – case report

The Nutcracker syndrome represents a congenital vascular defect in which the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery. The most common symptom of the disease is hematuria, with or without left flank pain. The condition is often underdiagnosed due to the absence of specific symptoms. We present a clinical case of a 56-year-old woman with complaints of general fatigue, intermittent flank pain, and microscopic hematuria. A contrast-enhanced CT scan of the abdomen and pelvis revealed compression of the left renal vein between the superior mesenteric artery and the aorta, along with a bulging left ovarian vein, confirming the diagnosis of Nutcracker syndrome. In this specific case, observation is recommended, but in the event of more pronounced clinical symptoms, such as unbearable pain, severe hematuria, renal failure, or lack of response to conservative treatment, various endovascular interventions may be performed

Quality management in hospitals: analysis of the prescribing practice of cardiovascular medicines

The goal of this study is to analyse the prescribing practice and risk of drug related errors in a Cardiology clinic of University Hospital. Semistructured open-ended interview aiming to reveal the risk of potential errors was performed with physicians, nurses, pharmacists, and hospital managers. Observational analysis of 915 prescriptions, prescribed by the physicians in two cardiology departments was conducted. Prescribing practice was evaluated by the means of its complexity, frequency of prescribing of particular pharmacology groups, and the related costs. Most often gaps detected in prescribing and dispensing of medicinal products were associated with missing or incorrect dosages, and unspecified quantity. Our analysis showed preference to combination therapies. Monotherapy was given only in 24.82% of the acute cases treated and in 24% of the cases treated in the internal ward. Two medicinal products were identified in 24.48% of the prescriptions (intensive care unit) and in 19.24% of the prescriptions from the internal ward. The most prescribed medicinal products were bisoprolol and glyceryl trinitrate in a combination. Approximately 45% of the patients were prescribed up to 3 medicinal products.The increase of therapy complexity leads to increase of probability for drug-drug interactions and nearly 30% of prescriptions were evaluated as potentially risky for interactions. The relative shares of potentially risky combinations vary from 4% to 32% out of all prescriptions reviewed. The likelihood of drug-related problems in the observed Cardiology clinic was determined as high but no practice for recording of ADRs was found in place

Frequency of chronic kidney disease among the population of Dalgopol municipality, Varna district – results from screening – campaing of the Clinic of Nephrology

Chronic kidney disease (CKD) is part of the modern pandemic of chronic, non-communicable diseases, which is one of the leading causes and causes of death among the world's population. CKD affects nearly 850 million people worldwide and is the 6th leading cause of death. In Bulgaria, the incidence is 12.8%, and 90% of the patients have advanced kidney disease. According to the summarized data of the National Statistical Institute (NSI) and the National Center for Public Health and Analysis at the Ministry of Health for 2018, urogenital diseases accounted for 1.4% of mortality in the country, and this percentage increased in 2019 by 1.7%. The reasons for this probably lie in the increasing frequency of risk factors among the population. In order to early detect the risk factors for CKD and the timely diagnosis of patients with hidden kidney disease and their further follow-up, in July 2020, the Clinic of Nephrology at the St. Marina University Hospital in Varna, supported by a project of the Medical University of Varna, conducted a free screening campaign for 147 people among the population of Dalgopol municipality. In addition, the campaign aimed to raise public awareness of CKD and renal replacement therapy methods (hemodialysis, peritoneal dialysis, and kidney transplantation). During the campaign, 58 participants (39%) were newly diagnosed with kidney disease. This indicates the lack of routine physical, imaging and laboratory tests and failure to diagnose kidney disease in its early stages. The financial burden that undiagnosed kidney problems, and subsequently end-stage renal disease, entail, puts even highly developed economies to a severe test. Screening and prevention can prevent chronic kidney disease, and where management strategies are in place, the incidence of end-stage renal disease is reduced

The health related quality of life for kidney transplant patients in Bulgaria - A pilot study

The aim of the present study was to analyze the pharmacotherapy cost and quality of life of patents after kidney transplantation compared to those with chronic kidney disease in Bulgaria. This retrospective pharmacotherapy cost study and prospective health related quality of life (QoL) study was performed during 2010 - 2011 at the biggest Sofia hospital serving all transplant patients. The cost of pharmacotherapy was analyzed after reviewing patients' records. The health related quality of life was evaluated with the multi-attributable questionnaire SF-36, which measures 9 health domains. Forty-two percent of the patients with chronic kidney disease, and 26% of those with kidney transplant were female. The average age of the transplanted patients was 39.7 for male patients and 42.2 for female ones, while in the group suffering from chronic kidney disease the average male age was 48.3 and that of female patients, 51.2. No statistically significant difference was observed among the mean monthly cost of therapy per patient during the two-year period. The QoL was with lower values in the role limitations domain for patients with chronic kidney diseases and this difference was statistically significant. We found a correlation among the mean cost of pharmacotherapy and mean QoL in both groups of patients. In the group of patients with kidney transplantation the place of living and general health state were positively correlated. The cost of pharmacotherapy and the health state in comparison with the previous year were also positively correlated. This is the first Bulgarian study of the quality of life of kidney transplant patients. It shows that the SF-36 could be successfully used in this group of patients as well as for comparison with the QoL of patients with chronic kidney disease

A health-related quality of life and pharmacotherapy costs study for patients with cystic fybrosis, gaucher disease and chronic myeloid leukemia in Bulgaria

The aim of the present study was to analyze the cost of pharmacotherapy and quality of life of patients with cystic fibrosis (CF), Gaucher disease (GD) and chronic myeloid leukemia (CML) in Bulgaria. Data for the pharmacotherapy cost were compiled retrospectively. The second part of the study included a prospective quality-of-life survey (conducted at the Medical University Hospital "Alexandrovska" in 2010 and 2011). We estimated the average monthly pharmacotherapy costs according to data from the hospital registries. The quality-of-life survey was done through interviews based on the short form of SF-36, which measures 9 health domains. The total number of patients was 18, of which 10 were with CML, 5 with cystic fibrosis and 3 with Gaucher disease. The average age of the male and female patients with CML was 49.1 years and 48.3 years, respectively; 25 and 24 years in the group with GD, respectively; and 29.5 and 35.3 years in CF group, respectively. No statistical difference between the average monthly pharmacotherapy costs for the observed period was revealed In all patients the quality of life was below the maximum possible value, which is equal to 100 points. The lowest values for the different indicators of quality of life were observed in the CF patients, most likely due to the chronic progression of this particular rare disease. The average range of quality of life for this group was 53.75. We found a statistical correlation between the pharmacotherapy costs and the quality of life. The Spearman correlation analysis revealed a correlation between the drug therapy costs and some quality-of-life indicators only in the patients with CIVIL. The correlation between the pharmacotherapy costs and physiological functions in patients with CIVIL was positive, i.e. higher costs improved this indicator The pharmacotherapy costs were high, the average values for the three groups of patients being: BGN 9221.61 for 2010 and BGN 8254.64 for January March 2011 for patients with CF, BGN 32954.08 for those with GD, and BGN 6389.38 for 2010 and BGN 6591.19 for the second period for the CML patients. The quality of life was significantly reduced for the observed patients: the average value for quality of life were 53.75, 65.03 and 67, respectively, from a maximum of 100