Analysis of pharmaceutical interventions at the discharge from University Rehabilitation Institute, Republic of Slovenia – Soča

Brezšivna skrb ob odpustu je pomemben del bolnišnične obravnave bolnika, kjer klinični farmacevt s svojim strokovnim znanjem prispeva k varnejšemu in učinkovitejšemu zdravljenju z zdravili. Brezšivna skrb ob odpustu se na URI Soča izvaja od leta 2013 in se je v preteklih 6 letih dobro uveljavila. Usmerja se v usklajevanje zdravljenja z zdravili ob odpustu, pripravo zdravil ter opolnomočenje in izobraževanje bolnika za zdravljenje z zdravili po odpustu. Namen magistrske naloge je bil pridobiti podatke o farmacevtskih intervencijah ob odpustu, jih klasificirati po izbrani klasifikaciji in analizirati. Poleg tega smo želeli s pomočjo kazalnikov kakovosti ovrednotiti farmacevtske storitve v okviru brezšivne skrbi ob odpustu ter predlagati ukrepe za izboljšanje procesa. Vir podatkov je bila sistematično vodena dokumentacija, ki jo izpolnjuje farmacevt skozi celotno oskrbo bolnika. V obdobju med 1. 9. 2018 in 30. 11. 2018 je bilo iz dveh oddelkov URI Soča odpuščenih 98 bolnikov. V nadaljevanju smo obravnavali 80/96 (83,3 %) bolnikov z zdravili, pri katerih je bil farmacevt pravočasno obveščen o odpustu za izvedbo potrebnih aktivnosti. 78/80 (97,5 %) bolnikov je imelo opravljeno usklajevanje zdravljenja ob odpustu in pri 79/80 (98,8 %) je bila narejena osebna kartica zdravil. Opolnomočenje in izobraževanje glede zdravil sta bila izvedena pri 75/79 (94,9 %) bolnikov z zdravili na recept in pri 45/47 (95,7 %) bolnikih z zdravili brez recepta, prehranskimi dopolnili ali medicinskimi pripomočki. V okviru preskrbe bolnika z zdravili ob odpustu je bilo predpisanih 309 receptov, od tega je bilo izdanih 277 (89,6 %) receptov. Farmacevtske intervencije so bile izvedene pri 48/80 (60 %) odpuščenih bolnikov z zdravili. Celokupno je bilo zabeleženih 126 intervencij, povprečje intervencij na bolnika je bilo 2,6. Najpogosteje so se te pojavile v skupini N po klasifikaciji ATC (40/12631,7 %), sledi skupina A (36/12628,6 %). Po klasifikaciji PharmDISC je bila večina intervencij (67/12653,2 %) izvedena zaradi tehničnih/formalnih problemov in le pri 23/126 (18,3 %) intervencijah je bil problem z varnostjo ali učinkovitostjo terapije. Najpogostejši vzrok za izvedbo intervencij je bil logistične narave (47/12637,3 %), najpogostejše intervencije pa razjasnjevanja in dodatne informacije bolniku (43/12634,1 %) ter zamenjava zdravila (29/12623 %). Poleg farmacevta je bil pri intervencijah najpogosteje vključen bolnik (102/12681 %). Na podlagi posameznih ukrepov farmacevta je bilo sprejetih in izvedenih 86/126 (68,3 %) intervencij. Ugotovili smo tudi, da klasifikacija po Lekarniški zbornici Slovenije ni ustrezna za namen naše raziskave, saj smo uspeli razvrstiti le 32 (25,4 %) intervencij. Učinkovitost izvajanja brezšivne skrbi ob odpustu na izbranih oddelkih URI Soča potrjujejo tudi kazalniki kakovosti farmacevtskih storitev, ki smo jih spremljali v raziskavi. Delež bolnikov, ki je prejelo svetovanje in izobraževanje glede zdravljenja z zdravili ob odpustu je 76/96 (79,2 %). Dokumentacijo o preteklih, trenutnih zdravilih in spremembah pri zdravljenju z zdravili je prejelo 74/96 (77,1 %) bolnikov. 70/96 (72,9 %) dokumentacij vsebuje zabeležene spremembe glede zdravljenja z zdravili in pojasnili zanje.Seamless care at hospital discharge is an important part of patient care, where a clinical pharmacist with his expertise contributes to safer and more effective drug treatment. Seamless care at discharge has been practiced at URI Soča since 2013 and has become well established over the past 6 years. It focuses on medication reconciliation at discharge, the preparation of medicines, and empowering and educating the patient for treatment with medicines after discharge. The purpose of the master\u27s thesis was to obtain data on pharmaceutical interventions at discharge, to classify it according to the chosen classification and to analyse it. In addition, the goal was to evaluate (through quality indicators) pharmaceutical services in the context of seamless care at discharge and to propose measures to improve the process. The data source was systematically managed documentation, which is filled out by the pharmacist during the entire patient care. Between September 1st, 2018 and November 30th, 2018, 98 patients were discharged from two departments of the URI Soča. In further analysis we included 80/96 (83.3%) patients who were treated with medicines and where the pharmacist has been informed of discharge in due time to perform the necessary activities. 78/80 (97.5%) patients underwent medication reconciliation at discharge and 79/80 (98.8%) received a personal medication card. Empowerment and education about medicines were conducted in 75/79 (94.9%) patients with prescription medicines and in 45/47 (95.7%) patients with over-the-counter medicines, nutritional supplements or medical devices. As part of the patient\u27s supply of medicines at discharge, 309 prescriptions were prescribed, of which 277 (89.6%) were dispensed. Pharmaceutical interventions were present in 48/80 (60%) discharged patients with medicines. A total of 126 interventions were recorded and the average of interventions per patient was 2,6. Most commonly these occurred in group N according to ATC classification (40/12631.7%), followed by group A (36/12628.6%). According to the PharmDISC classification, most interventions (67/12653.2%) were performed due to technical/formal intervention problems and in only 23/126 (18.3%) interventions there was a problem with the safety and efficacy of therapy. The main reason for implementing the interventions was logistics (47/12637.3%) and the most common interventions were clarifications and addition of information to the patient (43/12634.1%) and drug replacement (29/12623%). In addition to the pharmacist, the patient was most frequently involved in interventions (102/12681%). Based on the actions of the individual pharmacist, 86/126 (68.3%) interventions were accepted and implemented. It was also found out that the classification by the Slovene Chamber of Pharmacies was not appropriate for the purpose of our study, as it was possible to classify only 32 (25.4%) interventions. The effectiveness of performing seamless care at discharge in selected departments of URI Soča is also confirmed by the quality indicators of the pharmaceutical services that were monitored in the study. The proportion of patients who received counselling and education about medicines at discharge was 76/96 (79.2%). Documentation on past, current medicines and changes in medication treatment was received by 74/96 (77.1%) patients. 70/96 (72.9%) documentation contained changes in medication treatment and explanations for them

Vpliv učiteljeve zaznave ravnateljevih vedenj, ki opolnomočijo na dimenzije psihološkega opolnomočenja

Background and Purpose: School leader has an effect on teachers in divergent ways. If school leader wants their teachers to be successful and satisfied, he or she must have the potential to prompt work conditions that build up teachers’ psychological empowerment. Main aim of our research was to empirically test the relations between teachers’ perceptions of school leaders’ empowering behaviours and all dimensions of psychological empowerment (meaning, competence, self-determination and impact). Design/Methodology/Approach: We tested four hypotheses in one structural model by using structural equation modelling (SEM). The quantitative data was collected through an online survey on a sample of 525 primary school teachers in Slovenia by using two already validated questionnaires, The School Leader Empowering Behaviours (SLEB) and Psychological Empowerment Questionnaire (PEQ). Results: Findings show that teachers’ perceptions of school leaders’ empowering behaviours are positively and statistically significantly related to all dimensions of psychological empowerment (meaning, competence, self-determination and impact). Conclusion: Knowledge of psychological empowerment can be beneficial for school leaders, because with this comprehension they can strengthen apprehension and potential in exercising empowering behaviours towards their teachers to maximize their psychological empowerment.Ozadje in namen: Ravnatelj na različne načine vpliva na učitelje. Ravnatelj, ki si želi uspešnih in zadovoljnih učitel­jev, je sposoben ustvariti delovne pogoje, ki vplivajo na povečanje psihološkega opolnomočenja učiteljev. Glavni cilj naše raziskave je bil empirično preveriti razmerje med učiteljevimi zaznavami ravnateljevih vedenj, ki opolnomočijo in dimenzijami psihološkega opolnomočenja učiteljev (pomen, kompetentnost, samodoločenost in vpliv). Oblikovanje/Metodologija/Pristop: S pomočjo strukturnega modeliranja (SEM) smo testirali štiri hipoteze v enem strukturnem modelu. Podatke za raziskavo smo zbrali s pomočjo spletne ankete, ki je bila izvedena med 525 slov­enskimi učitelji, zaposlenimi v osnovnih šolah. Za merjenje učiteljevih zaznav ravnateljevih vedenj, ki opolnomočijo smo uporabili vprašalnik SLEB avtorjev Lee in Nie, za merjenje dimenzij psihološkega opolnomočenja pa Spreitzerin PEQ. Rezultati: Rezultati raziskave kažejo, da učiteljeva zaznava ravnateljevih vedenj, ki opolnomočijo, pozitivno in statistično značilno vpliva na vse dimenzije psihološkega opolnomočenja učiteljev (pomen, kompetentnost, samod­oločenost in vpliv). Sklep: Poznavanje psihološkega opolnomočenja je za ravnatelje izjemnega pomena, predvsem pa je ključno, da ravnatelji ozavestijo svoje veščine vodenje in s povečanjem vedenj, ki opolnomočijo učitelje, ustvarijo delovno okolje, ki bo učitelje še bolj opolnomočilo. Raziskave na področju ravnateljevega vodenja so dokaj nove, zato je opravljena raziskava prispevala nova spoznanja na področju vodenja v vzgoji in izobraževanju ter področju psihologije dela

Pandemic babies? Fertility in the aftermath of the first COVID-19 wave across European regions

Early evidence demonstrates that the fertility response to the COVID-19 pandemic has varied across European countries. Yet, prior research indicates that fertility responses to disasters are often localized sub-nationally. Moreover, SARS-CoV-2 incidence, economic pandemic impacts, and the affectedness by virus containment measures varied subnationally across Europe during the first year of the COVID-19 pandemic. Sub-national variation in the fertility response seems therefore possible. We conducted a rigorous data collection effort in 28 European countries (equaling 241 European sub-national regions) and used cutting-edge forecasting methods to assess sub-national variation in the fertility response to the first six months of the COVID-19 pandemic. While we find sub-national variation, our results reveal that the fertility response to the pandemic was dominated by the country level, with Southern European countries witnessing more negative fertility response to the early pandemic than Northern Europe. Variance decomposition even indicates a ‘nationalization’ of birth rates during the winter months of 2020, as the withincountry variance in fertility declined and between-country variance increased. Nonetheless, highly urbanized areas in Europe experienced significantly steeper fertility declines as a response to the beginning of the pandemic, which is partly explained by their higher SARSCoV-2 incidence rates. SARS-CoV-2 incidence rates emerged as another important predictor of the fertility response more broadly. Higher incidences were associated with steeper fertility declines across the regions. Overall, country-level estimates represent fertility responses to the COVID-19 pandemic generally well, but the regional dimension provides additional important insight into how the COVID-19 pandemic has impacted fertility.publishedVersio

Pandemic babies? Fertility in the aftermath of the first COVID-19 wave across European regions

</p

Phisical mechanical properties of woven fabrics with CO/PTO core yarns in weft direction

Tkanje bombažnih tkanin s potencialno elastičnostjo, pridobljeno z vnosom bombažne preje z dodatkom PBT (polibutilen teraftalatne) filamenta, se razlikujejo od bombažnih tkanin z dodatkom elastana, npr. lycre, tako v proizvodnem postopku kot tudi uporabnih lastnostih. Izjemna elastičnost PBT-ja je dosežena s krčenjem pri obdelavi v vroči vodi, kar lahko izvedemo po tkanju. Stopnja elastičnosti tkanine je odvisna od deleža PBT-ja v konstrukciji tkanine in konstrukcijskih lastnostih tkanine. V diplomskem delu so bile raziskane fizikalno mehanske lastnosti šestih vzorcev bombažnih tkanin, ki so vsebovale v votku oplaščeno bombažno prejo s PBT filamentom v jedru. Za primerjavo vpliva PBT komponente so bile raziskane tudi konstrukcijsko enake tkanine brez PBT komponente. Polovica dolžine vzorcev je bila pred izvajanjem meritev obdelana v vreli destilirani vodi 30 minut in nato 24 ur sušena v nevpetem stanjupri tem postopku PBT razvije svoje elastične lastnosti. Vsem vzorcem tkanin, obdelanim in neobdelanim, so bile izmerjene naslednje fizikalno mehanske lastnosti: skrčenje preje in tkanine po obdelavi v vreli vodi, pretržna sila in raztezek prej in tkanin, debelina tkanin, gostota niti, ploščinska masa tkanin, zračna prepustnost ter obstojnost proti pilingu. Analiza rezultatov je pokazala, da so se vsi vzorci s PBT prejo v votku pri obdelavi precej skrčili. Največjo stopnjo krčenja je imel vzorec v vezavi šestvezni votkovni keper, kar je posledica manjšega števila prevezovalnih točk in velikega flotiranja niti. Pogostost prevezovanja niti določa vpetost niti v tkanino in s tem vpliv tornih površin med nitmi na stopnjo krčenja.The weaving of cotton fabrics with potential elasticity, obtained by introducing cotton yarn with the addition of PBT (polybutylene terephthalate) filament, differ from cotton fabrics including elastane, e.g. Lycra, both in the production process as well as in its useful properties. The excellent elasticity of PBT filaments is achieved by shrinkage in a hot water treatment, which can be carried out after weaving. The degree of elasticity of the threated fabric depends on the PBT share in its construction, as well as the structural properties of the fabric. The objective of this diploma was to observe the physical mechanical properties of six samples of cotton fabrics, with core spun cotton yarn with PBT filament as core in the weft direction. In order to compare the effect of the PBT component, we simultaneously studied fabrics with identical structure and without a PBT component. Half of the length of the samples was threated in boiling distilled water for 30 minutes before being dried for 24 hours in a relaxed state, in which the PBT develops its elastic properties. The following physical and mechanical properties were measured on all fabric samples, either treated or untreated: shrinkage of yarn and fabric after treatment, breaking strength and elongation of the yarn and fabrics, fabric thickness, yarn density, mass per surface area, air permeability and abrasion resistance. The obtained results showed that all samples containing PBT filaments in the weft had significantly shrunk during treatment. The largest degree of shrinkage was observed in the six-end weft faced twill in accordance with a smaller number of interlaceing points and floating threads. The frequency of interlacement determines the integration of the yarn into the weave thus influencing the friction surfaces between yarns which dictates the degree of shrinkage

Uporaba AFM-spektroskopije sil za spremljanje odziva polimernih molekul na v rani podobna okolja med celjenjem

Force spectroscopy is a very promising technique for the evaluation of interactions within different environments. Knowledge about them is especially important during the design and preparation of those modern wound dressings in contact with a changing wound-environment over a prolonged time. Such exposure can cause a drastic decrease in the materialćs mechanical performance, and can lead to degradation, thus lowering the success of any healing process. Our study tries to establish a model system, which would enable us to assess the applicability of the mentioned technique for the evaluation of any interaction changes between polymer molecules and a chosen surface, after exposure to different environments. Our proposed experimental setup consists of two representative polymers, a model silicon surface, and two solutions of various pHs and ionic strengths, respectively. Within the chosen range of parameters, we are confident that we can prove the usefulness of force spectroscopy for further research into polymer suitability, for the development of novel wound dressings.Spektroskopija sil je zelo obetavna tehnika za uporabo pri določanju interakcij v številnih različnih okoljih. Poznanje le-teh je še posebej pomembno pri načrtovanju in pripravi novodobnih obližev, ki morajo biti v stiku z rano dalj časa in so tako izpostavljeni spreminjajočemu se okolju. To lahko na samem materialu povzroči drastične spremembe in vodi v otežen potek celjenja. V tem delu smo želeli pripraviti modelni sistem, s katerim bi preverjali možnost uporabe omenjene tehnike za ugotavljanje sprememb interakcij med polimernimi molekulami ter izbrano površino po izpostavitvi različnim okoljem. Eksperimentalni sistem je vseboval dva vzorčna polimera, modelno silicijevo površino ter po dve raztopini z različnimi pH in ionskimi močmi. S takim naborom parametrov smo zajeli dovolj možnosti za ugotovitev uporabnosti tehnike za nadaljnje raziskave primernosti polimernih materialov za nove obliže