RESEARCHING AND PLANNING THE RURAL SPACE: THE WORK OF BRANISLAV KOJIĆ

An architect and ruralist, professor and academician, Branislav Kojić made a remarkable contribution to the study of village architecture and villages, their design and planning. His approach was thorough, systematic, comprehensive and interdisciplinary, and resulted in the establishment of a special trend in the study of the village in these regions — “ruralism”. His research had interregional aspect, encompassing space of all the six former republics of the Socialist Republic of Yugoslavia, and with consideration of local and regional specificities. Creativity of Branislav Kojić united the elements of architecture, urbanism, ethnology, human geography, and allowed the filling of gaps in the former knowledge and approaches to rural issues. In order to present Branislav Kojić’s scientific opus and contribution, the paper presents the basic lines of his work, thinking and development of ideas, following the hierarchy of spatial units - from a rural house, a courtyard, through a village atar, a rural settlement, a system of settlements and a rural region, and finally to the villages in the regional spatial frames

USE OF BOTULINUM TOXIN TYPE A IN THE TREATMENT OF SPASTICITY IN CHILDREN WITH CEREBRAL PALSY

Cerebral palsy has an incidence of about 1-2 per 1000 live births, and in spite of the progress of neonatal medicine, it seems that the incidence will not subside in the near future. The most important characteristic of cerebral palsy is movement abnormality: spasticity, chorea, athetosis, ataxia, dystonia, as well as their different combinations. About 70% of children who suffer from cerebral palsy also suffer from some form of spasticity. Spasticity is a type of muscle hypertonicity characterized by rapid increase in resistance to passive stretching of muscles. The interest for botulinum toxin application in the treatment of spasticity has dramatically increased in the last 10 years. Botulinum toxin is the most powerful neurotoxin that is found in nature. It is produced by anaerobic bacteria – clostridium botulinum. It is produced in eight serotypes of which type A is the most commonly used. Botulinum toxin blocks neuromuscular transmission and causes irreversible weakness of the treated muscle. It has been used since 1993 in the treatment of cerebral palsy in children. The toxin effect is permanent and it results in irreversible denervation. Functional recovery is possible after 2-4 months, due to sprouting of nerve endings and the formation of new synaptic contacts. Treatment with botulinum toxin is safe. Adverse effects are rare, temporary and completely reversible. Application of botulinum toxin prevents or reduces contractures and deformities, and thus delays or avoids surgical treatment. Yet, physical therapy, which prolongs and improves the effects of botulinum toxin, remains an essential and most important form of therapy in the treatment of children with cerebral palsy

EVIDENCE-BASED STROKE REHABILITATION

Stroke can have different clinical characteristics and consequences, with unequal disability and outcome, thus demanding individual approach, specific skills and general knowledge. Treatment of stroke has significantly improved during the last twenty years, mainly because of clinical and experimental studies, adequate medicamentous therapy, and the use of new technologies as well. Use-dependent rehabilitation strategy includes repetitive training with proper adjustment of the program. Other rehabilitation practices should also be incorporated, such as self-care, recreation, and home-based activities. Motivation of the patients, improving quality of life, functional independence, activities of daily life are crucial. Holistic approach means that the patient as a whole should be considered and treated. Scientific evidence is sufficient to confirm the necessity of physical rehabilitation of patients after stroke in order to achieve the optimal results. Current evidence on the effect of physical therapy in stroke rehabilitation is presented

Pulsed electromagnetic field during cast immobilization in postmenopausal women with Colles’ fracture

Introduction. Although Colles’ fracture i.e. a dorsally displaced distal radius fracture (DRF) is one of the most common fractures, there is no enough evidence to determine the best form of rehabilitation. Objective. To assess whether the use of pulsed electromagnetic field (PEMF) therapy during cast immobilization of DRF provides beneficial effects on pain, edema, wrist range of motion and function, as well as on the frequency of complications immediately after cast removal. Methods. The prospective randomized controlled study included 60 women over the age of 55 years with extra-articular displaced DRF treated with reduction and cast immobilization. The patients were alternately allocated to either a PEMF group (n=30, received 10 days of PEMF therapy during immobilization), or a control group (n=30, without PEMF therapy). Pain, function, hand circumference, wrist and forearm range of motion and frequency of complications for each patient was evaluated within two to three days of cast removal. Results. Better mean values for the majority of examined parameters were recorded in the PEMF group than in the control group, but the difference was statistically significant just for edema (p<0.001), flexion, extension and supination range (p<0.01). Conclusion. During immobilization PEMF therapy in DRF patients gave better results immediately after cast removal in terms of edema and wrist range of motion (ROM)

ВОДНИТЕ РЕСУРСИ И ПОВЕЌЕНАМЕНСКОТО ИНВЕСТИРАЊЕ ВО ФУНКЦИЈА НА ОДРЖЛИВИОТ РАЗВОЈ НА СЛИВОВИТЕ

Construction of the of water management facilities i.e. infrastructure for the use of water resources usually requires significant financial funds. This implies that there is a need for examination of different solutions in order to select the most economical way of building. One of the possibilities is the multipurpose investment. This paper analyses the possibilities for multipurpose investment in constructing water management infrastructure while respecting principles of sustainable development. It proposes a modality for finding the optimal mode of multipurpose investment for construction of facilities in water management. The variant which complies with the most of requirements is the one that should be selected for the implementation. The general conclusion is that R Macedonia should pay more attention to multipurpose investment in the use of water resources