Objective – Outbreaks of sepsis caused by multidrug-resistant Acinetobacter baumannii in neonatal intensive care units have been reported, but rarely from our country. We describe such an outbreak in the Department of Paediatrics of the University Clinical Centre Tuzla in 2012 to investigate risk factors, the mode of transmission and to assess control measures. Setting – An 18 bed, level 3 neonatal intensive care unit in a university affiliated teaching hospital. Patients and methods – Seventeen neonates who developed multidrug-resistant Acinetobacter baumannii nosocomial infection were matched to 17 neonates who were admitted to the same unit without infections, during the outbreak period. Cases and controls were compared for possible risk factors (birth weight, gender, intubation, antibiotic use, etc.). Surveillance cultures were collected from health care personnel and the environment. Results – Six out of the 17 neonates (35.3%) died. Surveillance cultures were negative. Seventeen isolates from newborns had the same patterns of resistance. Multidrug-resistant Acinetobacter baumannii was brought into the unit by an infected infant who was transferred from the neurosurgery hospital. Risk factors significantly associated with the infection were: incubator care (OR 6.66; p =0.034), exposure to a central venous catheter (OR 13.75; p=0.004), mechanical ventilation (OR 5.25;p =0.031) and exposure to a patient with Acinetobacter baumannii infection (OR 38.40; p =0.02). Conclusion – Surveillance cultures for all newborns transferred from other hospitals and isolation measures are important to prevent nosocomial infections and outbreak. Negative environmental and health care worker cultures have to be meticulously analyzed. Cohorting of affected newborns and nursing staff, contact isolation, and environmental cleaning are crucial to control the outbreak.
Objective – Teratomas with sacrococcygeal, mediastinal and gonadal locations are the most frequently occurring pediatric germ cell tumors. Cervicofacial and intracranial locations are rare. Approximately 20% of giant cervical teratoma causes airway compression. We report a congenital cervical teratoma with partial airway compression diagnosed post-natally in a preterm infant. Case report – A 27 year old mother delivered a male infant at 35 weeks gestation after her first uneventful pregnancy. The newborn had a notable anterior neck mass measuring 4x5 cm. The alpha fetoprotein level was elevated at 317.5 ng/ml and I²-HCG was less than 1.2 mI U/ml. An MRI scan showed a 24x53x27 mm prelaryngeal and paratracheal solid-cystic mass compressing and shifting the larynx and trachea to the right. The tumor was approached via a wide collar incision. It did not communicate with the oesophagus, trachea or thyroid gland and did not infiltrate the surrounding tissues. It was completely excised. Pathological examination revealed an immature teratoma. The recovery was uneventful. Conclusion – Teratoma in infancy may present in an unusual cervical location. Not only giant tumors may compress the airway.
Background and Purpose: The forest related conflicts has not been often a research topic in SEE. The first regional survey was conducted in five countries: Albania, Bosnia and Herzegovina, Croatia, Macedonia and Serbia, under the scope of the FOPER project. The aim of the study was to identify the most frequent forest related conflicts in terms of types, conflicts attributes, actors, their attitudes and power relations, as well as to investigate more in-depth nature of conflicts and the way how they’ve been managed and how it influenced forest policy development. Materials and Methods: Analytical framework consisted of progressive triangle with three conflict attributes-substance (S), relation (R) and procedure (P) [13] embedded in four conceptsculture (CU), conflicts (CO), conflict management (CM) and policy development (PD) [12]. In total 840 semi-structured interviews were sent to decision makers resulted in response rate of 60%. Results were statistically analyzed by using methods of descriptive and inferential statistics, such as correlation analysis, logistic regression and decision path models. Results and Conclusions: Analytical framework proved appropriate for studying forest related conflicts in SEE. The most frequent conflicts were between forestry and (1) Nature protection, (2) Wood processing industry, (3) Grazing and overgrazing, (4) Building and construction, and (5) Water management, with significant differences among countries involved. Conflict management depended on the culture, as an aggregate variable comprising education, professional competences, communication skills and previous experience. DIJANA VULETI] MERSUDIN AVDIBEGOVI] MAKEDONKA STOJANOVSKA RADOVAN NEVENI] HAJRI HASKA STJEPAN POSAVEC SILVIJA KRAJTER LEONIDA PERI BRUNO MARI] Croatian Forest Research Institute, Cvjetno naselje 41 10450 Jastrebarsko, Croatia Faculty of Forestry, University of Sarajevo, Zagreba~ka 20 71000 Sarajevo, Bosnia and Herzegovina University »St. Kiril and Method«, Faculty of Forestry Blv. Aleksandar Makedonski 66, 1000 Skopje, FYR Macedonia Institute of Forestry, Kneza Vi{eslava 3, 11030 Belgrade, Serbia Agricultural University of Tirana, Faculty of Forest Sciences 1029 Kamez Koder, Tirana, Albania Faculty of Forestry, University of Zagreb, Sveto{imunska 25, 10002 Zagreb, Croatia
Intrapreneurship holders are entrepreneurial employ ees who develop entrepreneurial activities within the existing enterprises, which i n turn produces improved business performances. However, in order for entrepreneuria l employees to act and release their creative energy, it is necessary to provide the spe cific organizational requirements. Specifically, the rigid traditional o rganizational structures and bureaucratic approach to job design, which is often inherent in large enterprises, are not suitable infrastructures for developing entrepreneu rial climate in the organization. Consequently, the identification and analysis of the dominant type of organizational structure as well as the degree of c entralization and formalization and the degree of specialization and application of teamwor k in Bosnian companies, in light of ensuring organizational assumptions for the develop ment of intrapreneurship in these companies, are only some of the goals of this paper . This analysis will be based on the results of the empirical research conducted back in 2011, which covered a hundred of Bosnian companies, and also on the results of the G EM research back in 2011. This paper will include both the presentation and debate on the basic obstacles to the development of stronger Bosnian intrapreneurship in companies, but also recommendations regarding the content of the organi zational changes that should be undertaken for this purpose.
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