Decompressive laparotomy with temporary abdominal closure versus percutaneous puncture with placement of abdominal catheter in patients with abdominal compartment syndrome during acute pancreatitis: background and design of multicenter, randomised, controlled study

<p>Abstract</p> <p>Background</p> <p>Development of abdominal compartment syndrome (ACS) in patients with severe acute pancreatitis (SAP) has a strong impact on the course of disease. Number of patients with this complication increases during the years due more aggressive fluid resuscitation, much bigger proportion of patients who is treated conservatively or by minimal invasive approach, and efforts to delay open surgery. There have not been standard recommendations for a surgical or some other interventional treatment of patients who develop ACS during the SAP. The aim of DECOMPRESS study was to compare decompresive laparotomy with temporary abdominal closure and percutaneus puncture with placement of abdominal catheter in these patients.</p> <p>Methods</p> <p>One hundred patients with ACS will be randomly allocated to two groups: I) decompresive laparotomy with temporary abdominal closure or II) percutaneus puncture with placement of abdominal catheter. Patients will be recruited from five hospitals in Belgrade during two years period. The primary endpoint is the mortality rate within hospitalization. Secondary endpoints are time interval between intervention and resolving of organ failure and multi organ dysfunction syndrome, incidence of infectious complications and duration of hospital and ICU stay. A total sample size of 100 patients was calculated to demonstrate that decompresive laparotomy with temporary abdominal closure can reduce mortality rate from 60% to 40% with 80% power at 5% alfa.</p> <p>Conclusion</p> <p>DECOMPRESS study is designed to reveal a reduction in mortality and major morbidity by using decompresive laparotomy with temporary abdominal closure in comparison with percutaneus puncture with placement of abdominal catheter in patients with ACS during SAP.</p> <p>Trial registration</p> <p>ClinicalTrials.gov Identifier: NTC00793715</p

Inflation forecasting in the Western Balkans and EU: A comparison of Holt-Winters, ARIMA and NNAR models

The purpose of this paper is to compare the accuracy of the three types of models: Autoregressive Integrated Moving Average (ARIMA) models, Holt-Winters models and Neural Network Auto-Regressive (NNAR) models in forcasting the Harmonized Index of Consumer Prices (HICP) for the countries of European Union and the Western Balkans (Montenegro, Serbia and Northern Macedonia). The models are compared based on the values of ME, RMSE, MAE, MPE, MAPE, MASE and Theil's U for the out-of-sample forecast. The key finding of this paper is that NNAR models give the most accurate forecast for the Western Balkans countries while ARIMA model gives the most accurate forecast of twelve-month inflation in EU countries. The Holt-Winters (additive and multiplicative) method proved to be the second best method in case of both group of countries. The obtained results correspond to the fact that the European Union has been implementing a policy of strict inflation targeting for a long time, so the ARIMA models give the most accurate forecast of inflation future values. In the countries of the Western Balkans the targeting policy is not implemented in the same way and the NNAR models are better for inflation forecasting

Opportunities and challenges in promoting youth entrepreneurship in Montenegro

Purpose – The purpose of this paper is to examine the opportunities and challenges that youth entrepreneurs are facing in Montenegro, considering all aspects of youth participation in the development of the country. A quality research of several successful young entrepreneurs is presented. Design/methodology/approach – Several successful young entrepreneurs were interviewed. The principles of case study design and method were followed. Data collection involved both macro and micro level analysis of interviews and direct observation. Findings – The analysis shows that although in the areas of youth participation, significant progress has been made in the last several years, youth entrepreneurship programme in Montenegro is still in its early stages of development and needs strong sustainable commitment, assuring the development and efficient functioning of various youth participation mechanisms at the local, regional and national level. It is also essential to continue to standardize and support youth work, youth information and non-formal business education of young people. Surveys show that young people in Montenegro believe they have much to offer and can significantly contribute to all areas of the society’s development. However, their potential remains greatly untapped due to certain obstacles that they face. There are needs for encouraging programs to inform youth about the value of their participation in all aspects of society. Research limitations/implications – The main limitations were access to a greater number of successful young entrepreneurs making the analysis more descriptive and conclusive. Originality/value – The paper supports understanding of the complex employment challenges and opportunities facing youth and stimulates discussion on how to address this key development issue

Experiences from integrating water and sanitation safety planning in small systems in rural Serbia

The WHO recommends a risk management approach to ensure safe drinking-water and sanitation, so-called Water Safety Planning and Sanitation Safety Planning. However, applying these risk management approaches separately in small-scale drinking-water supply and sanitation systems might be challenging for rural communities with limited human, financial, and administrative resources. An integrated approach seems a better option. In this study, an integrated water and sanitation safety planning (iWSSP) approach was developed together with guidance and training material for the practical application of this novel approach. The integrated approach was piloted in three small systems in rural Serbia to identify benefits and suggestions for improvement which can be used for potential future scaling-up. Implementing iWSSP at the pilot sites contributed to a better understanding of both drinking-water supply and sanitation systems. It also resulted in increased awareness, knowledge, and understanding among staff of drinking-water supply and sanitation services. Key experts, including external facilitators, played a crucial role in the implementation of iWSSP. Future scaling-up of the integrated approach could be enabled if more guidance, easy-to-use training materials and templates become available which can be adapted and updated as needed. HIGHLIGHTS We developed and tested integrated drinking-water safety planning and sanitation safety planning (iWSSP).; iWSSP helps small rural systems to better understand how both systems influence each other which supports identifying hazardous events.