261 research outputs found

    ROLE OF TEST ABRASION IN THE DIAGNOSTICS AND TREATMENT OF FEMALE INFERTILITY

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    SURGICAL TREATMENT OF SUPPURATIVE INFLAMMATION OF OVARIES

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    Dynamics of basic planning indicators of the surgical wards at fifth multiprofile hospital for active treatment-Sofia ad

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    The hospital is the most complex institutions in modern healthcare system. (1) It is a service facility with properties that provide its specific complexity. As such institution, the hospital has a set of resources that are used in various out- put processes. The efficiency degree is a ratio between the activity results resources expenses. Achieving the optimum level of efficiency, means reaching a certain level of activ- ity with an optimum level of resources (5). Continuously rising health care funds put to health officials the issue of cost-effective allocation and spending of health resources. Management of diagnostic and treatment process in the hospital has to ensure efficient use of personnel labour and the medical equipment, available diagnostic and therapeu- tic methods, and tools of different nature (including future development in this respect), so as to achieve the most fa- vourable outcome of disease in the most rational use of hospital resources (3). Hospital bed is the main material resources of the hospital. It is necessary a link to established between the actual use of beds and their theoretical maximum use (5). Whether the beds are more or less used, in terms of effec- tiveness, the stay can be adequate or not. The stay is a clas- sic intermediate product and as such is used for diagnosis and / or treatment of patients (6). Bed/day ratio for each patient is determined by the disease and in a direct relation of clinical discretion of the physi- cian. It also depends on external factors, from the foreign medical decision and outcome processes in other units. The most important indicators for the organization of hospital services are: (St. Gladilov) (2). Utilization of beds (in days) - shows on average how many days within a year one bed was occupied by patients. Bed/day number for the period is divided by the average number of beds;The hospital is the most complex institutions in modern healthcare system. (1) It is a service facility with properties that provide its specific complexity. As such institution, the hospital has a set of resources that are used in various out- put processes. The efficiency degree is a ratio between the activity results resources expenses. Achieving the optimum level of efficiency, means reaching a certain level of activ- ity with an optimum level of resources (5). Continuously rising health care funds put to health officials the issue of cost-effective allocation and spending of health resources. Management of diagnostic and treatment process in the hospital has to ensure efficient use of personnel labour and the medical equipment, available diagnostic and therapeu- tic methods, and tools of different nature (including future development in this respect), so as to achieve the most fa- vourable outcome of disease in the most rational use of hospital resources (3). Hospital bed is the main material resources of the hospital. It is necessary a link to established between the actual use of beds and their theoretical maximum use (5). Whether the beds are more or less used, in terms of effec- tiveness, the stay can be adequate or not. The stay is a clas- sic intermediate product and as such is used for diagnosis and / or treatment of patients (6). Bed/day ratio for each patient is determined by the disease and in a direct relation of clinical discretion of the physi- cian. It also depends on external factors, from the foreign medical decision and outcome processes in other units. The most important indicators for the organization of hospital services are: (St. Gladilov) (2). Utilization of beds (in days) - shows on average how many days within a year one bed was occupied by patients. Bed/day number for the period is divided by the average number of beds

    A non‐proteolytic release mechanism for HMCES‐DNA‐protein crosslinks

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    The conserved protein HMCES crosslinks to abasic (AP) sites in ssDNA to prevent strand scission and the formation of toxic dsDNA breaks during replication. Here, we report a non‐proteolytic release mechanism for HMCES‐DNA‐protein crosslinks (DPCs), which is regulated by DNA context. In ssDNA and at ssDNA‐dsDNA junctions, HMCES‐DPCs are stable, which efficiently protects AP sites against spontaneous incisions or cleavage by APE1 endonuclease. In contrast, HMCES‐DPCs are released in dsDNA, allowing APE1 to initiate downstream repair. Mechanistically, we show that release is governed by two components. First, a conserved glutamate residue, within HMCES' active site, catalyses reversal of the crosslink. Second, affinity to the underlying DNA structure determines whether HMCES re‐crosslinks or dissociates. Our study reveals that the protective role of HMCES‐DPCs involves their controlled release upon bypass by replication forks, which restricts DPC formation to a necessary minimum

    Strategic investment in tuberculosis control in the Republic of Bulgaria

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    As Bulgaria transitions away from Global Fund grant, robust estimates of the comparative impact of the various response strategies under consideration are needed to ensure sustained effectiveness of the tuberculosis (TB) programme. We tailored an established mathematical model for TB control to the epidemic in Bulgaria to project the likely outcomes of seven intervention scenarios. Under existing programmatic conditions projected forward, the country's targets for achieving TB elimination in the coming decades will not be achieved. No interventions under consideration were predicted to accelerate the baseline projected reduction in epidemiological indicators significantly. Discontinuation of the 'Open Doors' program and activities of non-governmental organisations would result in a marked exacerbation of the epidemic (increasing incidence in 2035 by 6-8% relative to baseline conditions projected forward). Changing to a short course regimen for multidrug-resistant TB (MDR-TB) would substantially decrease MDR-TB mortality (by 21.6% in 2035 relative to baseline conditions projected forward). Changing to ambulatory care for eligible patients would not affect TB burden but would be markedly cost-saving. In conclusion, Bulgaria faces important challenges in transitioning to a primarily domestically-financed TB programme. The country should consider maintaining currently effective programs and shifting towards ambulatory care to ensure program sustainability

    Materialising architecture for social care: brick walls and compromises in design for later life.

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    This article reports on an ethnography of architectural projects for later life social care in the UK. Informed by recent debates in material studies and ‘materialities of care’ we offer an analysis of a care home project that is sensitive to architectural materials that are not normally associated with care and wellbeing. Although the care home design project we focus on in this article was never built, we found that design discussions relating to both a curved brick wall and bricks more generally were significant to its architectural ‘making’. The curved wall and the bricks were used by the architects to encode quality and values of care into their design. This was explicit in the design narrative that was core to a successful tender submitted by a consortium comprising architects, developers, contractors, and a care provider to a local authority who commissioned the care home. However, as the project developed, initial consensus for the design features fractured. Using a materialised analysis, we document the tussles generated by the curved wall and the bricks and argue that mundane building materials can be important to, and yet marginalised within, the relations inherent within an ‘architectural care assemblage.’ During the design process we saw how decisions about materials are contentious and they act as a catalyst of negotiations that compromise ‘materialities of care.

    Star Architecture as Socio-Material Assemblage

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    Taking inspiration from new materialism and assemblage, the chapter deals with star architects and iconic buildings as socio-material network effects that do not pre-exist action, but are enacted in practice, in the materiality of design crafting and city building. Star architects are here conceptualized as part of broader assemblages of actors and practices ‘making star architecture’ a reality, and the buildings they design are considered not just as unique and iconic objects, but dis-articulated as complex crafts mobilizing skills, technologies, materials, and forms of knowledge not necessarily ascribable to architecture. Overcoming narrow criticism focusing on the symbolic order of icons as unique creations and alienated repetitions of capitalist development, the chapter’s main aim is to widen the scope of critique by bridging culture and economy, symbolism and practicality, making star architecture available to a broad, fragmented arena of (potential) critics, unevenly equipped with critical tools and differentiated experiences

    POSIWID and determinism in design for behaviour change

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    Copyright @ 2012 Social Services Research GroupWhen designing to influence behaviour for social or environmental benefit, does designers' intent matter? Or are the effects on behaviour more important, regardless of the intent involved? This brief paper explores -- in the context of design for behaviour change -- some treatments of design, intentionality, purpose and responsibility from a variety of fields, including Stafford Beer's "The purpose of a system is what it does" and Maurice Broady's perspective on determinism. The paper attempts to extract useful implications for designers working on behaviour-related problems, in terms of analytical or reflective questions to ask during the design process

    AN ANALYSIS OF STUDENT SATISFACTION WITH THE ORGANIZATION OF HYBRID TEACHING IN THE DEPARTMENT OF HEALTH ECONOMICS

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    The PURPOSE of this research is for a survey to be conducted among the students of the Faculty of Public Health “Prof. Tzekomir Vodenicharov, МD, DSc” at Medical University – Sofia to study whether they are satisfied with how hybrid teaching has been organized in the Department of Health Economics. MATERIALS AND METHODS: An anonymous questionnaire survey was conducted. Out of all students who were invited to participate, 309 joined. The questionnaire was distributed through the Google Forms platform from June to October 2022. Chi-Quadrant analysis was used in order to find relationships between categorical variables. RESULTS: the result shows a statistically significant connection between the students who are studying different specialties in the FPH and their satisfaction with the organization of the hybrid classes carried out by the Department (p <0.001). From the participants’ responses, it is clear that the implementation of hybrid form of teaching (in-person classes for practical training and online classes for theoretical study) carried out through open educational resources and implementing innovative teaching methodology is preferred by the students. CONCLUSION: The scientific evidence arising from our empirical research can aid in the development of guidelines for practical improvement of the hybrid teaching organization in disciplines taught in the Department. The conclusions drawn presuppose continuous research with proper methodologies applied
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