1. Synthesis of Heat-Integrated Water Networks Using a Modified Heat Exchanger Network SuperstructureNidret Ibrić, Elvis Ahmetović, Andreja Nemet, Zdravko Kravanja, Ignacio E. Grossmann, 2022, original scientific article Keywords: water network, water integration, heat exchanger network, heat-integrated water network, superstructure optimisation
Published in DKUM: 14.02.2025; Views: 0; Downloads: 0
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2. A multi-level approach to circular economy progress : linking national targets with corporate implementationJan Drofenik, Tine Seljak, Zorka Novak-Pintarič, 2025, original scientific article Abstract: An integrated top-down methodology for assessing and promoting progress towards a circular economy at macro (national) and micro (company) levels is presented. It is based on the MICRON (MIcroCirculaR ecOnomy iNdex) framework developed by Baratsas et al. (2022) for companies. In this paper, it has been extended to enable a consistent assessment for companies and countries. The methodology facilitates the analysis of key categories: energy, emissions, water, materials, and waste. A quantitative analysis of circularity, including a sensitivity analysis, is conducted at the macro level, identifying critical areas and the most influential factors for the circular economy. Based on this analysis, existing national strategies are evaluated, and implementation plans with specific measures are developed. This is followed by micro-level implementation, which involves techno-economic assessment of circular projects. Using this methodology, coordinated improvements in circularity are achieved at all levels. The methodology was tested in Slovenia, where the national circularity index revealed stable performance over five years, averaging slightly above 50 points out of 100. Analysis identified significant improvement potential in areas such as energy and emissions, aligning with the country's focus on decarbonization and energy efficiency in its climate strategies. At the company level, circularity assessments highlighted critical challenges in renewable energy use and overall energy efficiency. The proposed measures showed potential for significantly improving circularity and reducing emissions, while the results provided valuable insights into the economic feasibility of these transitions.
Keywords: circular economy, integrated assessment framework, micro level, energy transition, renewable energy
Published in DKUM: 10.02.2025; Views: 0; Downloads: 1
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3. Scaling-up an integrated care for patients with non-communicable diseases : an analysis of healthcare barriers and facilitators in Slovenia and BelgiumČrt Zavrnik, Katrien Danhieux, Miriam Hurtado Monarres, Nataša Stojnić, Majda Mori-Lukančič, Monika Martens, Zalika Klemenc-Ketiš, Edwin Wouters, Josefien Van Olmen, Tonka Poplas-Susič, 2021, original scientific article Abstract: Introduction: Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.
Methods: This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries.
Results: Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals.
Conclusions: This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
Keywords: scale-up, noncommunicable diseases, patientcentered care, primary healthcare, integrated healthcare
Published in DKUM: 22.10.2024; Views: 0; Downloads: 7
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4. Successful implementation of integrated care in Slovenian primary careTonka Poplas-Susič, Zalika Klemenc-Ketiš, 2021, preface, editorial, afterword Abstract: For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.
Keywords: primary care, integrated care, person-centred care, family medicine, Slovenia
Published in DKUM: 11.10.2024; Views: 0; Downloads: 2
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5. Attitudes of teachers towards the inclusion of children with special needs in primary and secondary schoolsMajda Schmidt, Ksenja Vrhovnik, 2015, original scientific article Abstract: Many researchers emphasize teachers' attitudes as a decisive component in ensuring successful inclusion of students with special needs (SN students). The empirical research that is presented in the main part of this article analyzes the attitudes of primary and secondary teachers towards the inclusion of SN students with respect to the type of school, the teachers' age, the number of SN students in the class, and the teachers') acquired skills. A questionnaire was devised for the study, based on two previous questionnaires: the Questionnaire on Attitudes towards Integration and the Teacher Stress and Coping Questionnaire. The secondary teachers showed more positive attitudes towards SN students than did their primary colleagues, as well as towards teaching and adaptation with respect to the students' SN and towards the psychophysical strain related to such work. The youngest group of teachers, those aged from 20 to 30, shows a higher level of agreement related to the provision of adequate support. Teachers with fewer SN students in class (up to two students) show a higher degree of support for inclusion of SN students than do other groups of teachers. Teachers without training for work with SN students in comparison with their colleagues who had it show a lower level of agreement with respect to support and assistance at educational work with SN students.
Keywords: defektologija, pristopi učiteljev, starost učiteljev, otroci s posebnimi potrebami, otroci z motnjami, integrirani otroci, socialna integracija, emocionalna integracija, motivacijska integracija, osnovne šole, srednje šole, defectology, teachers' attitudes, teachers' age, impaired children, integrated children, integration, social integration, emotional integration, motivational integration, primary schools, secondary schools
Published in DKUM: 17.09.2024; Views: 0; Downloads: 2
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6. Implementation of integrated primary care for patients with diabetes and hypertension : a case from SloveniaZalika Klemenc-Ketiš, Nataša Stojnić, Črt Zavrnik, Nina Ružić Gorenjec, Katrien Danhieux, Majda Mori-Lukančič, Tonka Poplas-Susič, 2021, original scientific article Abstract: Introduction: Research on models of integrated health care for hypertension and diabetes is one of the priority issues in the world. There is a lack of knowledge about how integrated care is implemented in practice. Our study assessed its implementation in six areas: identification of patients, treatment, health education, self-management support, structured collaboration and organisation of care. Methods: This was a mixed methods study based on a triangulation method using quantitative and qualitative data. It took place in different types of primary health care organisations, in one urban and two rural regions of Slovenia. The main instrument for data collection was the Integrated Care Package (ICP) Grid, assessed through four methods: 1) a document analysis (of a current health policy and available protocols; 2) observation of the infrastructure of health centres, organisation of work, patient flow, interaction of patients with health professionals; 3) interview with key informants and 4) review of medical documentation of selected patients. Results: The implementation of the integrated care in Slovenia was assessed with the overall ICP score of 3.7 points (out of 5 possible points). The element Identification was almost fully implemented, while the element Self-management support was weakly implemented. Discussion: The implementation of the integrated care of patients with diabetes and/ or hypertension in Slovenian primary health care organisations achieved high levels of implementation. However, some week points were identified. Conclusion: Integrated care of the chronic patients in Slovenia is already provided at high levels, but the area of self-management support could be improved.
Keywords: delivery of health care, integrated, primary care, self-care
Published in DKUM: 27.08.2024; Views: 105; Downloads: 5
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7. Peer support as part of scaling-up integrated care in patients with type 2 diabetes and arterial hypertension at the primary healthcare level : a study protocolTina Virtič, Matic Mihevc, Črt Zavrnik, Majda Mori-Lukančič, Tonka Poplas-Susič, Zalika Klemenc-Ketiš, 2023, original scientific article Abstract: Introduction: Type 2 diabetes (T2D) and arterial hypertension (AH) are among the greatest challenges facing health systems worldwide and require comprehensive patient-centred care. The key to successful management in chronic patients is self-management support, which was found to be only weakly implemented in Slovenia. The aim of the study is to develop an evidence-based model of peer support for people with T2D and AH at the primary healthcare level in Slovenia, which could represent a potential solution for upgrading integrated care for these patients.
Methods: A prospective interventional, mixed-methods pilot study will begin by recruiting approximately 40 eligible people with T2D and AH through purposive sampling. The participants will receive structured training, led by a specialist nurse, to become trained peer supporters. Each will voluntarily share their knowledge and experience at monthly group meetings with up to 10 people with T2D and AH over a three-month period in the local community. Data will be collected through interviews and focus groups and questionnaires about socio-demographic and clinical data, knowledge about T2D and AH, participants’ quality of life, level of empowerment and acceptability of the intervention.
Expected results: The study will provide an evidence-based model for integrating peer support into the local community. It is expected that the intervention will prove feasible and acceptable with educational, psychosocial and behavioural benefits.
Conclusion: Peer support through empowerment of people with T2D and AH, family members and other informal caregivers in the local community could scale-up the integrated care continuum and contribute to sustainability of the healthcare system.
Keywords: diabetes type 2, arterial hypertension, peer support, self-management, integrated primary, healthcare
Published in DKUM: 17.07.2024; Views: 103; Downloads: 4
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8. Advanced technologies in logistics engineering : automated storage systems with shuttles integrated with hoisted carriageTone Lerher, Primož Bencak, 2022, original scientific article Abstract: This paper presents automated storage systems with shuttles integrated with hoisted carriage for successful application in intralogistics. The first part of the paper presents classic and advanced AVS/RS along with specific intralogistics automation systems known as AutoStore from Swisslog and Skypod from Exotec. The second part of the paper focuses on an advanced system with shuttle vehicles capable of serving multiple tiers of the storage rack. An analytical model for the shuttle vehicles capable of serving multiple tiers of the storage rack is presented, which is based on (i) the sequences of acceleration, constant velocity and deceleration, and (ii) randomised assignment policy. Based on the presented model, the expected Single Command (SC) and Dual Command (DC) travel (cycle) time as well as the throughput performance of the shuttle vehicles capable of serving several tiers of warehouse, could be calculated. A programme code in MATLAB has been presented for the computation of throughput performances of automated storage systems with shuttles integrated with hoisted carriage capable of serving several tiers of the storage rack.
Keywords: analytical and numerical model, automated vehicle-storage and retrieval systems AVS/RS, automated warehouses, cycle time and throughput performance, shuttles integrated with hoisted carriage
Published in DKUM: 26.06.2024; Views: 162; Downloads: 16
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9. The reusage of water and steam utilities by using the integrated fork technique and the complete circular economyAnita Kovač Kralj, 2023, original scientific article Abstract: The reusage of water and steam utilities plays a key role in the mitigation of decarbonising and climate change, including reduced fossil-fuel energy consumption and reducing the dependence on natural gas. The water condensates can be used for utility and heat-recovery systems by an integrated fork technique, achieving economic benefits and a complete circular economy, presented in two steps. The main novelty of this fork technique includes the determination of a regulated heat flow rate for the integration between the dryer and evaporator, which enables an evaporation of the same water mass flow as by the existing evaporating system, which is performed in the first step. The main significance of this technique presents the manner of a fork system as a superstructure for waste condensates’ collection separately and combinedly, and sustainable reusage's alternatives of the condensates, such as steam or electricity cogeneration, presented in the second step. This technique is carried out in two steps, including real-simulated results using an Aspen Plus® simulator. This approach is illustrated using an existing sugar production, which is selected as the waste mass and energy reusage from the evaporator and dryer for low-pressure steam production, generating a possible increase profit of 1.9 MEUR/a. The saving of the heat flow rate after the integrated dryer with evaporator should be 15,816 kW, or 73 %, presenting as a percentage.
Keywords: steam utility, water condensate, fork technique, circular economy, integrated units, food industry
Published in DKUM: 10.05.2024; Views: 229; Downloads: 11
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10. Perceptions of the primary health care team about the implementation of integrated care of patients with type 2 diabetes and hypertension in Slovenia : qualitative studyNataša Stojnić, Zalika Klemenc-Ketiš, Majda Mori-Lukančič, Črt Zavrnik, Tonka Poplas-Susič, 2023, original scientific article Abstract: Background
Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation.
Methods
Eight focus groups were conducted with health care teams, involving a total of 48 health care professionals, including family physicians, registered nurses, practice nurses, community nurses, and registered nurses working in a health education center. Prior to conducting the focus groups, a thematic guide was developed based on the literature and contextual knowledge with the main themes of the integrated care package. The analysis was conducted using the NVivo program.
Results
We identified 12 main themes with 49 subthemes. Health care professionals highlighted good accessibility and the method of diagnostic screening integrated with preventive examinations as positive aspects of the current system of integrated care in Slovenia. They mentioned the good cooperation within the team, with the involvement of registered nurses and community nurses being a particular advantage. Complaints were made about the high workload and the lack of workforce. They feel that patients do not take the disease seriously enough and that patients as teachers could be useful.
Conclusion
Primary care teams described the importance of implementing integrated care for diabetes and hypertension patients at four levels: Patient, community, care providers, and state. Primary care teams also recognized the importance of including more professionals from different health care settings on their team.
Keywords: integrated health care system, type-2-diabetes, Hypertension, Health care team, interdisciplinary primary care, qualitative research
Published in DKUM: 19.04.2024; Views: 250; Downloads: 11
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