<p>Cilj doktorske disertacije je pobolj&scaron;anje hidrodinamičkih i<br />masenoprenosnih karakteristika airlift reaktora sa<br />spolja&scaron;njom recirkulacijom umetanjem samo-rotirajućih<br />impelera u uzlaznu cev. Uticaj ugradnje samo-rotirajućih<br />impelera na osnovne hidrodinamičke i masenoprenosne<br />osobine ispitivan je pri radu sa različitim tečnostima i<br />distributorima gasa. Rezultati su tumačeni poređenjem<br />vrednosti za sadržaj gasa u uzlaznoj cevi, za brzinu<br />tečnosti u silaznoj cevi, i za zapreminski koeficijent<br />prenosa mase, dobijenih za dve konfiguracije reaktora (sa<br />i bez impelera).<br />Rezultati disertacije ukazuju da ugradnja samo-rotirajućih<br />impelera dovodi do znatnog razbijanja mehurova i<br />smanjenja srednjeg prečnika mehurova gasa, naročito u<br />viskoznim rastvorima karboksimetilceluloze. Prividna<br />brzina gasa, vrsta tečne faze i tip distributora gasa u<br />velikoj meri utiču na efikasnost samo-rotirajućih impelera.<br />Dobijene vrednosti sadržaja gasa u uzlaznoj cevi su do<br />47% veće u konfiguraciji sa impelerima u odnosu na<br />konfiguraciju bez impelera. Iako samo-rotirajući impeleri<br />predstavljaju dodatni otpor proticanju tečnosti, njihovom<br />ugradnjom je u svim ispitivanim sistemima postignuto<br />relativno malo smanjenje brzine tečnosti (oko 10%).<br />Zahvaljujući impelerima, zapreminski koeficijent prenosa<br />mase uvećan je do 82% pri manjim protocima gasa. Pri<br />većim protocima, koji odgovaraju uslovima rada koji se<br />sreću u većini fermentacionih procesa, postignute su oko<br />20-30% veće vrednosti zapreminskog koeficijenta prenosa<br />mase.<br />Pored empirijskih modela, u ovom radu uspe&scaron;no su<br />razvijeni i modeli ve&scaron;tačkih neuronskih mreža kojim se<br />predviđaju sadržaj gasa u uzlaznoj cevi, brzina tečnosti i<br />zapreminski koeficijent prenosa mase za obe konfiguracije<br />airlift reaktora sa spolja&scaron;njom recirkulacijom.</p> / <p>The aim of this study was intensification of<br />hydrodynamic and mass transfer properties of<br />external-loop airlift reactor by means of self-agitated<br />impellers mounted in the riser section. The influence<br />of impellers&rsquo; insertion on the main hydrodynamic<br />and mass transfer characteristics was investigated for<br />various liquid phases and sparger types. The values<br />of riser gas holdup, downcomer liquid velocity and<br />volumetric mass transfer coefficient obtained in<br />configurations with and without impellers were<br />compared.<br />Results showed that the installment of self-agitated<br />impellers led to a significant bubble breakage and<br />decrease of bubble size, especially in viscous<br />carboxymethylcellulose solutions. The efficiency of<br />self-agitated impellers was immensely influenced by<br />superficial gas velocity, liquid phase, and distributor<br />type. Obtained riser gas holdup values were up to<br />47% higher in the configuration with impellers, in<br />comparison to the configuration wthout impellers.<br />Despite the fact that self-agitated impellers<br />represented an obstacle to liquid flow, relatively low<br />reduction of downcomer liquid velocity was attained<br />(about 10%). Furthermore, the insertion of impellers<br />induced up to 82% higher values of volumetric mass<br />transfer coefficient at lower superficial gas velocities.<br />At higher superficial gas velocities, i.e. conditions<br />mainly operated in various fermentation processes,<br />about 20-30% higher values of volumetric mass<br />transfer coefficient were achieved with impellers.<br />In addition to empirical correlations, artificial neural<br />network models were sucessfully developed to<br />predict riser gas holdup, downcomer liquid velocity<br />and volumetric mass transfer coefficient in both<br />external-loop airlift configurations.</p>

Les établissements de santé sont confrontés à de nouveaux défis tels que le vieillissement de la population, la hausse des coûts des soins et les progrès rapides des technologies médicales. Les nouvelles politiques de contrôle du budget des soins ont été introduites pour augmenter l'efficacité, réduire les déchets et remodeler le système de santé.Ces établissements cibles présentent des réseaux complexes incluant de ressources humaines,financières, structurelles et technologiques visant à garantir les meilleurs soins. Ces enjeux concernent d'autant plus les services d'urgence engorgés par l'afflux massif des passages, qui doivent fournir des décisions rapides et assurer le dimensionnement de ses ressources afin de réduire les délais d'attente des patients sans compromettre la qualité de soin.L'objectif de cette thèse est de proposer des solutions appropriées aux services d'urgences permettant d'améliorer la prise en charge des patients en termes de temps d'attente. Nous avons commencé par analyser les problématiques de la filière des urgences afin d'engager une démarche d'amélioration. Par la suite, nous avons modélisé le processus de prise en charge des patients au service d'accueil des urgences à l'aide d'un système multi-agent ouvert et dynamique. Le système proposé permet de fournir une aide à la décision sur la planification de l'activité médicale et l'affectation des ressources humaines dans une unité où on se trouve souvent face à une situation d'urgence nécessitant une prise en charge rapide et efficace. Dans ce contexte, nous abordons le problème réactif d'optimisation de l'ordonnancement des opérations de soin et le problème de coordination du personnel médical. Nous nous intéressons au dimensionnement des ressources humaines au SU en adoptant une approche de prise en compte des compétences maîtrisées dans le but de trouver une adéquation avec celles requises par l'activité médicale afin avant tout d'accroitre la qualité, réduire les délais d'attente et permettre de dégager des gains de gestion

Depuis la fin des années 1980, les structures électromagnétiques à bandes interdites (EBG) et les structures à plan de masse usinée (DGS) ont attiré l'intérêt de beaucoup de recherche dans l'électromagnétisme et tout particulièrement dans le domaine de la télécommunication. Leurs intégrations miniaturisées et leurs propriétés électromagnétiques particulières présentent de fort intérêt en termes de suppression d'ondes électromagnétiques de surface et de coupe-bandes pour des fréquences bien déterminées. Dans ce manuscrit, nous allons développer des filtres reconfigurables miniaturisés pour des systèmes de communication sans fil. Dans un premier temps, un état de l'art des structures électromagnétiques à bandes interdites sera exposé afin de distinguer les avantages et les inconvénients pour des applications souhaitées. La première étude se portera sur une structure périodique multicouche unidimensionnelle en utilisant la théorie de l'onde couplée et le formalisme de l'onde de Block. Comme les structures à base d'EBG sont difficiles à modéliser à cause de leurs nombreux paramètres de conception, les motifs à base de DGS attirent de plus en plus l'intérêt de plusieurs chercheurs. Effectivement, ceux-ci peuvent offrir les avantages des structures à base d'EBG tout en gardant une modélisation simplifiée. . Dans une deuxième partie, notre étude se portera sur les différentes techniques de modélisation électromagnétique sur des structures DGSs, en s'appuyant sur des modèles électriques équivalents LC, le RLC et circuit p - etc&. A partir de ces modèles développés, des filtres passe-bande d'ordre trois sont conçus et simulés sur des lignes de transmission de type micro-rubans et coplanaires (CPW). Dans une troisième partie, un résonateur reconfigurable à base de DGS pour filtre multi coupe-band est présentée sur une gamme de fréquence 0 - 11 GHz en technologie CPW. La structure est composée de trois commutateurs de type "MEMS'' qui permettent d'obtenir quatre configur ations différentes. Dans notre démarche de conception, les commutateurs sont d'abord considérés comme idéaux, c'est-à-dire que le commutateur est représenté par un état non actif (OFF) où par un état actif (ON). Dans chaque configuration, la structure a été modélisée en utilisant un circuit RLC en parallèle. Après fabrications, les mesures et les simulations présentent une excellente concordance. Ensuite, un résonateur a été réalisé à base de diodes PIN pour remplacer les commutateurs pour obtenir une agilité du système. Des mesures seront présentées dans cette partie. Une autre possibilité est d'utiliser un DGS pour la réalisation de filtres passe-bande. Dans cette partie, deux applications des DGSs sont présentées. La première est un filtre passe-bande compact à couplage inductif implémenté à base d'une cellule DGS à 5GHz. Ensuite, pour valider notre théorie, un filtre d'ordre deux est implémenté à la même fréquence suivi d'un filtre passe-bande reconfigurable en utilisant cette structure DGS. En utilisant un commutateur MEMS, la structure se transformerait d'une structure à une seule résonance à 5GHz à une structure à résonances multiples à 2.8GHz et 8GHz. La deuxième application concerne l'amélioration du filtre de résonateur en anneau. Ce type de filtres, pourtant qu'il possède des caractéristiques attrayantes, souffre de deux inconvénients majeurs qui limitent son utilisation dans des applications réelles. Le premier inconvénient réside dans sa grande taille due aux stubs d'accordement, alors que le deuxième concerne l'existence des modes d'ordres supérieurs, ce qui limite la réjection hors bande. Le but de ce manuscrit est de proposer quelques solutions pour réduire la taille et d'augmenter la bande de réjection du filtre, tout en gardant ses performances globales (largeur de bande passante, la bonne réjection et de faible pertes d'insertion. Afin de faire ainsi, deux approches sont considérées. La première approche est au niveau du design du filtre, pa r une conception économisant l'espace occupé par les stubs d'accordement, alors que la deuxième est au niveau de la propagation des ondes, par l'exploitation des propriétés des DGS. Pour les futurs travaux, nous proposons la réalisation de nos structures sur des substrats de silicium en utilisant des commutateurs MEMS afin d'améliorer les performances du filtre ainsi que leurs réalisations sur des matériaux ferroélectriques en vue d'une accordabilité.

<p>U okviru doktorske disertacije izvedena su eksperimentalna istraživanja osnovnih hidrodinamičkih i maseno-prenosnih karakteristika airlift reaktora sa spoljnom recirkulacijom sa ugrađenom vi&scaron;ekanalnom cevnom membranom u silaznu cev (ALSRM). ALSRM je radio na dva načina rada: bez mehurova u silaznoj cevi (način rada A) i sa mehurovima u silaznoj cevi (način rada B) u zavisnosti od nivoa tečnosti u gasnom separatoru. Ispitivani su uticaji prividne brzine gasa, povr&scaron;inskih osobina tečne faze, tipa distributora gasa i prisustva mehurova gasa u silaznoj cevi na sadržaj gasa, brzinu tečnosti u silaznoj cevi i zapreminski koeficijent prenosa mase u tečnoj fazi u ALSRM. Rezultati su poređeni sa vrednostima dobijenim u istom reaktoru ali bez membrane (ALSR). Sadržaj gasa u uzlaznoj i silaznoj cevi određivan je pomoću piezometarskih cevi merenjem hidrostatičkog pritiska na dnu i vrhu uzlazne i silazne cevi. Brzina tečnosti merena je pomoću konduktometrijskih elektroda dok je zapreminski koeficijent prenosa mase dobijen primenom dinamičke metode merenjem promene koncentracije kiseonika u vremenu optičkom elektrodom. Eksperimentalni rezultati pokazuju da sadržaj gasa, brzina tečnosti i zapreminski koeficijent prenosa mase zavise od prividne brzine gasa, vrste alkohola i tipa distributora gasa kod oba reaktora. Vi&scaron;ekanalna cevna membrana u silaznoj cevi uzrokovala je povećanje ukupnog koeficijenta trenja za 90% i time dovela do smanjenja brzine tečnosti u silaznoj cevi do 50%. Smanjena brzina tečnosti u silaznoj cevi povećala je sadržaj gasa do 16%. Predložene neuronske mreže i empirijske korelacije odlično predviđaju vrednosti za sadržaj gasa, brzinu tečnosti i zapreminski koeficijent prenosa mase.</p> / <p>An objective of this study was to investigate the hydrodynamics and the gas-liquid mass transfer coefficient of an external-loop airlift membrane reactor (ELAMR). The ELAMR was operated in two modes: without (mode A), and with bubbles in the downcomer (mode B), depending on the liquid level in the gas separator. The influence of superficial gas velocity, gas distributor&rsquo;s geometry and various diluted alcohol solutions on hydrodynamics and gas-liquid mass transfer coefficient of the ELAMR was studied. Results are commented with respect to the external loop airlift reactor of the same geometry but without membrane in the downcomer (ELAR). The gas holdup values in the riser and the downcomer were obtained by measuring the pressures at the bottom and the top of the riser and downcomer using piezometric tubes. The liquid velocity in the downcomer was determined by the tracer response method by two conductivity probes in the downcomer. The volumetric mass transfer coefficient was obtained by using the dynamic oxygenation method by dissolved oxygen probe. According to experimental results gas holdup, liquid velocity and gas-liquid mass transfer coefficient depend on superficial gas velocity, type of alcohol solution and gas distributor for both reactors. Due to the presence of the multichannel membrane in the downcomer, the overall hydrodynamic resistance increased up to 90%, the liquid velocity in the downcomer decreased up to 50%, while the gas holdup in the riser of the ELAMR increased maximally by 16%. The values of the gas holdup, the liquid velocity and the gas-liquid mass transfer coefficient predicted by the application of empirical power law correlations and feed forward back propagation neural network (ANN) are in very good agreement with experimental values.</p>

Cette étude porte sur l’analyse du mécanisme de transfert du carvacrol (molécule antimicrobienne volatile) au travers de films à base de chitosan. La composition, la structure, les paramètres de procédés et de séchage de la couche de chitosan ont été corrélés aux propriétés physico-chimiques et fonctionnelles des films. La compréhension de ces facteurs et de leurs influences est cruciale à l’optimisation de la production de films actifs à base de polyéthylène enduits de chitosan. En effet, composition, microstructure et condition environnementale (température, humidité) conditionnent la rétention puis la libération contrôlée du carvacrol. La présence d’humidité induit absorption, gonflement, et plastification du chitosan, et par conséquent influe sur la structure, ses propriétés thermiques et de surface. L’absorption d’humidité, due au changement de structure, entraîne une forte augmentation de la perméabilité aux gaz et à la vapeur d’eau, et favorise ainsi la libération du carvacrol, nécessaire à une efficacité antimicrobienne rapide. Cette dernière, ainsi que l’impact sensoriel sur l’aliment emballé, sont directement corrélés aux aspects cinétiques et de partage des vapeurs de carvacrol. Ces travaux ont ainsi mis en évidence l’importance le compréhension de mécanismes de transfert dans les emballages à base de bio-polymères sur leur production et application industrielles / The aim of this study is the analysis of structure and transfer mechanisms through chitosan based food packaging materials with incorporated carvacrol as a model of antimicrobial active substance. Integration of composition parameters, structure, processing and drying of chitosan systems is correlated to its physico chemical and functional properties. Understanding and detailed analyses of processing parameters is crucial in production of active chitosan coatings applied on conventional materials such as polyethylene. So, the knowledge of composition and microstructure in association to environmental conditions, control the retention and the release kinetics of carvacrol from chitosan film. Water vapour was crucial parameter that strongly influenced adsorption, swelling and plasticization of chitosan based films, as well as thermal, surface and mechanical properties. By changing the matrix structure, penetrating water molecules decreased gas barrier efficiency and increased release of carvacrol. Furthermore, release of carvacrol in the headspace was correlated to the antimicrobial efficiency and to the organoleptic impact on packed food products. Such investigation highlights the transfer mechanism within bio-based materials, prior to efficiency prediction for their industrial development.In dry conditions, all chitosan films were fairly good gas barriers (about 10 17 g/m∙s∙Pa). Chitosan coated polyethylene films were up to 10000 times less permeable than uncoated PE. Increase in the environmental humidity above 60% and up to 96% (that represents the conditions of a real fresh food packaging system), significantly increased gas permeability of all chitosan films. Mechanical tests confirmed that when relative humidity increased, structural changes were induced. Therefore, extensive water plasticization of chitosan matrix was observed.Diffusion coefficients of carvacrol from chitosan film increased up to 1000 times when humidity increased from 0% to 100%. Water vapour triggers the release of carvacrol in the vapour phase. This indicates the importance of controlling the environmental conditions in the packaging at the time of the application but also during the active film storage.Films with carvacrol concentrations in the vapour phase above 2x10-7 g/mLair were efficient against large spectrum of bacteria, including some Gram-positive bacteria, Gram-negative bacteria and fungi. In some instances the concentration that was required for carvacrol antimicrobial efficiency was not organoleptically acceptable to consumers. / Cilj ovog rada je analiza strukture i mehanizama prijenosa tvari kroz ambalažne materijale za pakiranje hrane na bazi kitozana s inkorporiranim karvakrolom kao modelnom aktivnom antimikrobnom tvari. Integrirani sastavni parametri, struktura, proizvodnja i sušenje kitozanskog sustava korelirani su sa njegovim fizikalno-kemijskim i funkcionalnim svojstvima. Razumijevanje i detaljna analiza procesnih parametara predstavlja ključan korak u proizvodnji aktivnih kitozanskih prevlaka na konvencionalnim materijaima kao što je polietilen. Dakle, poznavanje sastava i mikrostrukture u ovisnosti o okolnim uvjetima, osnovni je preduvjet za kontrolirano zadržavanje i otpuštanje karvakrola iz filmova na bazi kitozana. Vodena para predstavlja ključni parametar koji značajno utječe na adsorpciju, bubrenje i plastifikaciju kitozanskih filmova, kao i na njegova toplinska, površinska, i mehanička svojstva. Penetracijom (prodiranjem) molekula vode dolazi do promjene strukture matriksa, smanjuje se učinkovitost barijernih svojstava prema plinovima i povećava otpuštanje karvakrola. Otpuštanje karvakrola u zračnom prostoru u korelaciji je sa antimikrobnom učinkovitosti i organoleptičkim svojstvima upakiranih prehrambenih proizvoda. Ovo istraživanje prije svega naglašava značaj poznavanja mehanizma prijenosa tvari unutar biomaterijala koji je neophodan za predviđanje učinkovite primjene na industrijskoj razini

<p>Dijabetes melitus je metaboliĉki poremećaj koji karakteri&scaron;e hroniĉna hiperglikemija i predstavlja veoma ozbiljan javno-zdravstveni problem u celom svetu. Najveći potencijal za pobolj&scaron;anje zdravlja obolelih leţi u postizanju i odrţavanju optimalne glikoregulacije. Podaci iz literature pokazuju da se sprovođenjem strukturiranih edukativnih programa o tipu 2 dijabetesa postiţu pozitivni efekti na zdravstveno pona&scaron;anje i glikoregulaciju kod obolelih koji su pohađali edukaciju. Cilj ovog istraţivanja bio je da se proceni efekat strukturirane edukacije o tipu 2 dijabetesa u primarnoj zdravstvenoj za&scaron;titi na promenu nivoa znanja, zdravstveno pona&scaron;anje, antropometrijske i biohemijske parametre glikoregulacije pacijenata. Istraživanje je sprovedeno u vidu prospektivne studije od februara do avgusta 2018. godine u Savetovali&scaron;tu za dijabetes Doma zdravlja Subotica. Ispitivanje je obuhvatilo 91 pacijenta sa dijagnostikovanim tipom 2 dijabetesa. Ispitanici su pohađali strukturirani &scaron;estonedeljni grupni edukativni program, kreiran za potrebe ovog istraţivanja. U cilju procene efekata edukativnog programa, na poĉetku i ĉetiri meseca nakon edukacije, prikupljeni su podaci o: zdravstvenom pona&scaron;anju, nivou znanja o dijabetesu (Diabetes Knowledge Test), o aktivnostima samonege u prethodnih sedam dana (The Summary of Diabetes Self-Care Activities) i o aktivnostima samonege prethodnih osam nedelja (The Diabetes Self-Management Questionnaire), određeni su antropometrijski (telesna teţina, indeks telesne mase, obim struka i nivo arterijskog krvnog pritiska) i biohemijski parametri glikoregulacije (nivo &scaron;ećera u krvi na&scaron;te, dva sata nakon jela, nivo HbA1c) i lipidni status pacijenata. Na početku strukturirane edukacije 79% pacijenata imalo je nizak nivo znanja o dijabetesu, prosečna vrednost na DKT bila je 46,4%. Nivo samonege pacijenatna bio je nizak i prethodnih 7 dana (SDSCA 45,8%) i prethodnih 8 nedelja (DSMQ 6,75). Trećina (35%) pacijenata imala je prekomernu telesnu masu, a njih 45% bilo je gojazno (BMI 29,85&plusmn;5,47). Povi&scaron;ene vrednosti sistolnog krvnog pritiska imalo je 43%, a dijastolnog 54% pacijenata. Polovina (54,9%) pacijenata imala je idealnu glikoregulaciju (HbA1c 6,56&plusmn;0,96%). Trećina (35%) pacijenata imala je visokorizičan nivo holesterola, a 26% visokoriziĉan nivo triglicerida u krvi. Ispitivanja sprovedena ĉetiri meseca nakon strukturirane edukacije pokazuju značajno povi&scaron;en nivo znanja pacijenata o dijabetesu, tj. visok nivo sa prosečnom vredno&scaron;ću DKT 81,5%. Nivo aktivnosti samonege prethodnih 7 dana i prethodnih 8 nedelja dostigao je umeren nivo (SDSCA 57,7%; DSMQ 7,9). Utvrđeno je značajno smanjenje telesne mase pacijenata za 1,5 kg i indeksa telesne mase, BMI, za 0,58 kg/m2. Procenat gojaznih pacijenata smanjen je na 40%. Povi&scaron;ene vrednosti sistolnog krvnog pritiska imalo je 26,4% (uz proseĉno smanjenje od 4 mmHg), a dijastolnog krvnog pritiska kod 44% pacijenata (uz prosečno smanjenje od 3 mmHg). Utvrđeno je znaĉajno smanjenje nivoa HbA1c za 0,36%, idealnu glikoregulaciju postiglo je 68% pacijenata. Zabeleţeno je smanjenje nivoa ukupnog holesterola za 0,3 mmol/L i nivoa triglicerida u krvi pacijenata za 0,23 mmol/L. Broj pacijenata sa visokorizičnim nivoom holesterola smanjen je za 19,6%, a u visokoriziĉnoj kategoriji triglicerida za 12%. Rezultati studije ukazuju da su efekti strukturiranog edukativnog programa o tipu 2 dijabetesa u primarnoj zdravstvenoj za&scaron;titi značajni, povećani su nivoi znanja i aktivnosti samonege, znaĉajno je smanjena telesna masa, vrednosti arterijskog krvnog pritiska su smanjene a pobolj&scaron;ane su vrednosti pokazatelja glikoregulacije i lipidnog statusa pacijenata.</p> / <p>Diabetes Mellitus is a metabolic disorder characterised by chronic hyperglycaemia and is a very serious public health issue worldwide. Achieving and maintaining optimal glucoregulation represents major potential for the improvement of affected persons&rsquo; health. According to information available in relative literature, the implementation of restructured Type 2 diabetes education programmes, positive results on health behaviour and glucoregulation in persons who took part in the education. The objective of the research was to assess the effect of structured education on Type 2 diabetes in primary health care, on changes in the level of knowledge, health behaviour and the anthropometric and biochemical parameters of patients&rsquo; glucoregulation. The research was conducted in the form of a prospective study between February and August 2018 in the Diabetes Support Group of the Subotica Health Centre. The research included 91 patients who were diagnosed with Type 2 diabetes. Research subjects attended a structured six-week group educational programme, which was specifically developed for the purpose of this research. In order to assess the effects of this educational programme from its outset and four months following the education, data concerning the following were gathered: health behaviour, level of knowledge on diabetes (Diabetes Knowledge Test - DKT), self care activities in the past seven days (The Summary of Diabetes Self-Care Activities - SDSCA) and self care activities in the past eight weeks (The Diabetes Self-Management Questionnaire - DSMQ). These data were anthropomorphic measurements (weight, height, waist circumference and the level of arterial blood pressure) and biochemical glucoregulation parameters (blood sugar levels on an empty stomach, two hours after a meal, HbA1c levels) and patient lipid status. When the structured education first started, 79% patients had a low level of knowledge on diabetes, and the average score at the DKT was 46.4%. The level of patient self care was also low in the past seven days (SDSCA 45.8%) and past eight weeks (DSMQ 6.75%). One third (35%) of patients had excess body mass, of whom 45% were obese (Body Mass Index &ndash; BMI 29.85&plusmn;5.47). 43% of patients had higher systolic blood pressure values while 54% had higher diastolic blood pressure values. In one half of patients (54.9%), glucoregulation was ideal (HbA1c 6.56&plusmn;0.96%). One third of patients (35%) had highly elevated cholesterol levels, with 26% who had highly elevated triglyceride blood levels. Research conducted during the four-month structured education show a significantly higher level of patient knowledge of diabetes, i.e. high level with the average DKT score of 81.5%. The level of self care activities in the past seven days and eight weeks reached a moderate level (SDCA 57.7%; DSMQ 7.9). A significant reduction in body mass by 1.5 kg as well as Body Mass Index, BMI by 0.58 kg/m2 was determined. The percentage of obese patients was reduced to 40%. 26.4% of patients had increased values of systolic blood pressure (with an average reduction of 4 mmHg), diastolic blood pressure 44% of patients (with an average reduction of 3 mmHg). A significant reduction in HbA1c level by 36% was determined, while 68% of patients achieved ideal glucoregulation. The reduction of total cholesterol level by 0.3% mmol/L as well as triglycerides level by 0.23% mmol/L was recorded. The number of patients with a high-risk cholesterol level was reduced by 19.6%, and the number of patients in high-risk category of triglycerides by 12%. The results of the study indicate that the effects of a structured educational programme on Type 2 diabetes in primary health care are significant. Knowledge levels were increased along with self care activities, body mass was significantly reduced, arterial blood pressure values were reduced and glucoregulation and lipid status values improved.</p>

<p>Ispitivanu grupu činilo je 1247 ispitanika sa povredama prednje ukr&scaron;tene veze kolena koji su operativno lečeni u periodu 2012.-2017. godina na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Ciljevi istraživanja bili su utvrđivanje uticaja nivoa sportske aktivnosti i mehanizama povređivanja na nastanak povreda prednje ukr&scaron;tene veze kolena, zatim uticaj spolja&scaron;njih faktora rizika (vrsta sporta, rang takmičenja, vrsta podloge, trening ili utakmica, period treninga) na nastanak povreda prednje ukr&scaron;tene veze kolena, odnosno uticaj unutra&scaron;njih faktora rizika (pol, starost, BMI) na nastanak povreda ove strukture kolena. Od ukupnog broja ispitanika njih 517 (41,5%) su činili aktivni sportisti, a 730 (58,5%) rekreativci. Značajnu većinu u posmatranom uzorku su činili mu&scaron;karci (82,6%), osobe starosti od 16 do 25 godina (62,6%) i normalno uhranjenje osobe (62%). Do povrede prednje ukr&scaron;tene veze do&scaron;lo je kod njih 504 (40,5%) prilikom aktivnog bavljenja sportom, dok su se povrede prilikom rekreativnog bavljenja sportom dogodile kod 741 ispitanika (59,5%). Među aktivnim sportistima, vi&scaron;e od dve trećine se takmičilo na internacionalnom ili republičkom nivou, odnosno u najvi&scaron;im rangovima takmičenja. Kontaktnim kolektivnim sportovima (fudbal, ko&scaron;arka i rukomet) bavilo se 77,9% ispitanika. Nekontaktnim sportovima kao &scaron;to su odbojka, borilački sportovi i skijanje bavilo se 22,1% ispitanika, pri čemu je najveći broj povreda nastao prilikom igranja fudbala (51,3%). Statistički značajno vi&scaron;e povreda (i prilikom aktivnog i prilikom rekreativnog bavljenja sportom) je nastalo bez direktnog kontakta (nekontaktne povrede koje su činile 78,7% povreda), pri čemu je najveći broj povreda nastao usled promene pravca i ritma kretanja. Kod aktivnih sportista najvi&scaron;e povreda dogodilo se na utakmicama (73,8%), slede povrede na treningu (24,1%), dok se na rekreaciji povredilo svega 2,1% ispitanika. Značajno vi&scaron;e povreda dogodilo se na sredini bavljenja sportskom aktivno&scaron;ću (47,4%) u odnosu na povrede na zagrevanju, početku, odnosno kraju sportske aktivnosti. Povrede su značajno če&scaron;će nastajale na travi (42%) i parketu (28%), nego na drugim vrstama podloge. Najveći broj ispitanika povredio se noseći patike prilikom bavljenja sportskom aktivno&scaron;ću. Postoje značajne razlike u kontekstu povređivanja u zavisnosti od pola ispitanika. Žene su u značajno većem procentu povređivane prikom aktivnog bavljenja sportom, dok su se mu&scaron;karci če&scaron;će povređivali na rekreaciji. Žene su se najče&scaron;će povređivale na rukometu, mu&scaron;karci na fudbalu. U odnosu na mu&scaron;karce, kod žena su povrede znatno ređe nastajale prilikom direktnog kontakta, a kad je u pitanju mesto povređivanja, žene su se če&scaron;će nego mu&scaron;karci povređivale na treningu. Preko 50% žena je povređeno na parketu, dok se najveći broj mu&scaron;karaca povredio na travi. Ispitanici sa prekomernom telesnom masom značajno če&scaron;će su se povređivali prilikom rekreacije, dok su se normalno uhranjeni če&scaron;će povređivali prilikom aktivnog bavljenja sportom. Faktori rizika za nastanak povreda prednje ukr&scaron;tene veze su brojni i specifični, odnosno da za svaku populacionu kategoriju postoje rizici, ali se uočava da su u svim sportovima, na svim podlogama i kod svih ispitanika povrede najče&scaron;će nastajale nekontaknim mehanizmom povređivanja. Formiranjem registra povređenih omogućilo bi se bolje razumevanje faktora rizika i njihovog međusobnog uticaja, kao i definisanje profila osoba pod najvećim rizikom za nastanak povrede prednje ukr&scaron;ene veze kolena. Na taj način obezbedile bi se potrebne informacije za planiranje preventivnih programa usmerenih na smanjenje rizika od povređivanja i omogućilo bi se sprovođenje odgovarajućih mera selektivne prevencije.</p> / <p>The study group consisted of 1247 respondents with anterior cruciate ligament injuries who were surgically treated in the period 2012-2017. at the Clinic for Orthopedic Surgery and Traumatology of the Clinical Center of Vojvodina. The objectives of the study were to determine the impact of sports activity levels and injury mechanisms on the occurrence of anterior cruciate ligament injuries, then the impact of external risk factors (type of sport, competition rank, type of surface, training or match, training period) on the occurrence of anterior cruciate ligament injuries and the influence of internal risk factors (gender, age, BMI) on the occurrence of injuries of this knee structure. Out of the total number of respondents 517 (41.5%) were active athletes, and 730 (58.5%) were recreational athletes. A significant majority in the observed group were men (82.6%), persons aged 16 to 25 years (62.6%) and normal BMI respondents (62%). Anterior cruciate ligament injury occurred in 504 of them (40.5%) during active sports, while injuries during recreational sports occurred in 741 respondents (59.5%). Among active athletes, more than two thirds competed at the international or national level- in the highest ranks of the competition. Contact collective sports (football, basketball and handball) were practiced by 77.9% of respondents. 22.1% of respondents practiced non-contact sports such as volleyball, martial arts sports and skiing. The largest number of injuries occurring while playing football (51.3%). Statistically significantly more injuries (both during active and recreational sports) occurred without direct contact (noncontact injuries-78,7% of total injuries number), with the largest number of injuries caused by changes in the direction and rhythm of movement. Among active athletes, most injuries occurred in matches (73.8%), followed by injuries in training (24.1%), while only 2.1% of respondents were injured in recreation. Significantly more injuries occurred in the middle of engaging in sports activity (47.4%) compared to injuries during the warm-up, beginning and end of sports activity. Injuries occurred significantly more often on grass (42%) and floor (28%) than on other types of surfaces. Most of the respondents were injured wearing sneakers while doing sports. There are significant differences in the context of injury depending on the gender of the respondents. A significantly higher percentage of women were injured during active sports, while men were more often injured during recreational sport activities. Women were most often injured in handball, men in football. Compared to men, injuries were much less common in women during direct contact, and when it comes to the place of injury, women were injured more often than men during training acitivities. Over 50% of women were injured on the floor, while the largest number of men were injured on the grass. Subjects with overweight were significantly more likely to be injured during recreational sport acitivites, while those with normal BMI were more likely to be injured during active sports. Risk factors for anterior cruciate ligament injuries are numerous and specific and there are risks for each population category, but it is noticed that in all sports, on all surfaces and in all subjects, injuries were most often caused by a noncontact injury mechanism. The formation of a Register of injuries would enable a better understanding of risk factors and their mutual influence, as well as the definition of the profile of persons at greatest risk for the occurrence of an anterior cruciate ligament injury. This would provide the necessary information for planning prevention programs aimed at reducing the risk of injury and would enable the implementation of appropriate selective prevention measures.</p>