Methodological Basis of KPI Motivation

A well-built system of motivation can become a source of long-term competitiveness of the enterprise development. The article presents an overview of the main stages of the KPI motivation development and its deployment process. The purpose of this research paper is to reveal the fundamental aspects of building a motivation system based on KPI. The general theoretical basis of this study is the concept of methodology "Management by Objectives", method of "Performance management". It is proposed to integrate the KPI's system into the enterprise management system. It has been proven that the KPI system is a tool for specifying and bringing business strategy to each department and employee through the mechanism of motivating each employee to achieve this goal. The article identifies the place of the KPI system in the structure of business processes. A typology of KPI system options is based on the resources required to develop and implement such system. It has been proven that the system of motivation based on the KPI is a tool for achieving long-term and short-term company goals and is not just a monetary and non-monetary incentive system

Methodological Basis of KPI Motivation

A well-built system of motivation can become a source of long-term competitiveness of the enterprise development. The article presents an overview of the main stages of the KPI motivation development and its deployment process. The purpose of this research paper is to reveal the fundamental aspects of building a motivation system based on KPI. The general theoretical basis of this study is the concept of methodology "Management by Objectives", method of "Performance management". It is proposed to integrate the KPI's system into the enterprise management system. It has been proven that the KPI system is a tool for specifying and bringing business strategy to each department and employee through the mechanism of motivating each employee to achieve this goal. The article identifies the place of the KPI system in the structure of business processes. A typology of KPI system options is based on the resources required to develop and implement such system. It has been proven that the system of motivation based on the KPI is a tool for achieving long-term and short-term company goals and is not just a monetary and non-monetary incentive system

Prognostic value of molecules of average mass in patients with chronic obstructive pulmonary disease

Background. Chronic obstructive pulmonary disease is a socially significant disease affecting patient’s quality of life. Assessment of endogenous intoxication in patients with chronic obstructive pulmonary disease will allow to understand pathogenetic features of different phenotypes of this disease, which can be taken into account when predicting its course.The aim of the study. To determine the prognostic value of levels of mediumand low-molecular-weight substances and oligopeptides in patients with chronic obstructive pulmonary disease.Materials and methods. One hundred and four patients with chronic obstructive pulmonary disease (COPD) and 110 somatically healthy individuals were examined. Molecular weight medium and low molecular weight substances (LMWSM) and oligopeptides (OP) were determined in blood plasma, erythrocytes and urine. Based on these indicators mathematically calculated indices of endogenous intoxication and coefficient of elimination were defined. Statistical processing of the data was performed using the SPSS 26.0 software package (IBM Corp., USA).Results. In all biological fluids, the levels of average molecules and calculated indices in the COPD patients’ group were statistically significantly different from those in the control group. The indices characterizing endotoxin accumulation were statistically significantly higher, while those characterizing toxin elimination were lower. The level of endotoxemia was correlated with the frequency of exacerbations, clinical manifestations severity, quality of life, COPD group and phenotype.Conclusions. Frequent exacerbations, groups C and D, bronchitic and mixed COPD phenotypes are characterized by more severe endotoxicosis manifested by high levels of LMWSM, OP and calculated indices

Dynamics of Stroke Incidence and Mortality Indicators over Eight-Year Period in the Territories Included into the Federal Program of Reorganization of Care for Patients with Stroke

Background. Stroke is a severe medical, social and economic burden for all countries of the world. The leading indicators characterizing the “epidemiological picture” of stroke are the incidence and mortality rates from stroke.Aims. Analyze the dynamics of stroke incidence and mortality rates in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke for the period from 2009 to 2016.Material and methods. The study was based on the data of the territorial-population register for seven study areas in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke (Republic of Bashkortostan, Sverdlovsk region, Republic of Tatarstan, Sakhalin region, Stavropol Territory, Ivanovo Region and Irkutsk Region). The age of the examined persons was 25 years and older.Results. In the period from 2009 to 2016, in the studied territories, there was a consistent stable decrease in the value of the stroke incidence rate. Stroke mortality rates fluctuated with a single increase in 2012. When comparing the average incidence of stroke and mortality from it between 2009 and 2016, we discovered a statistically significant decrease in the incidence of stroke – by 1.4 times and in the rate of mortality from stroke – by 2.3 times. According to the results of the cluster analysis, we revealed a significant conformity (similarity) of mortality rates between regions by 2016 and the absence of monotony (stability) of the rate of stroke incidence.Conclusion. In all the regions under study, an almost systematic annual decrease in the incidence and mortality rates from stroke among the adult population was revealed in seven studied territories. The results of cluster analysis of the “picture” of stroke incidence and mortality from it also demonstrate a positive trend by 2016 in all studied territories. Only one of the studied territories – the Republic of Tatarstan – despite the presence of a positive dynamics of stroke incidence over an eight-year period, in 2016 belonged to the rank with a high integral incidence rate

Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage

Purpose: To analyze neurovascular coupling in the retina of untreated primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. Patients and methods: Maximal vessel dilation in response to flicker light was analyzed with Retinal Vessel Analyzer (RVA) in temporal superior/inferior arterioles and veins in 51 POAG patients, 46 OHT and 59 control subjects. RVA parameters were compared between groups, between contralateral POAG eyes, and correlated to intraocular pressure, visual field mean defect and retinal nerve fiber layer thickness. Results: POAG eyes demonstrated generally smaller response of all vessels to flicker light than the other two groups (ANOVA p = 0.026; mean arterial flicker response in percent of baseline, averaged superior and inferior was 3.48 ± 2.22% for controls , 2.35 ± 2.06 % for POAG patients , and 2.97 ± 2.35 % for OHT patients; corresponding values for venules were 3.88 ± 1.98%, 2.89 ± 1.72%, 3.45 ± 2.77%). There was no difference in flicker response between the eye with more and less advanced damage in each patient of the POAG group (ANOVA p = 0.79). Correlation of flicker response to intraocular pressure (IOP) was borderline at best, correlations to the level of glaucomatous damage were not significant. Correlation of flicker response of superior and inferior vessels of the same eye was significant for the arteries (Pearson r = 0.23, p = 0.004), as well as venules (r = 0.52, p < 0.001). Conclusion: General vessel response to flicker light was decreased in POAG patients, compared to normal controls and OHT patients. In contrast to significant correlation between the two contralateral eyes of the flicker response itself, only its borderline correlation to IOP was seen. There was no correlation to the level of damage, altogether indicating a systemic dysregulation phenomenon. Grants: Swiss National Foundation Grant 3200B0-113685, Velux Stiftung Grant, Freie Akademische Gesellschaft (FAG) Grant, Pfizer Inc. Grant Clinical trial registration reference number: ClinicalTrials.gov NCT0043020

Dynamics of retinal vessel response to flicker light in glaucoma patients and ocular hypertensives

Purpose: To analyze dynamics of retinal vessel dilation response to flicker light in patients with glaucoma and ocular hypertension. Patients and methods: Response to flicker light was measured in retinal vessels by means of Retinal Vessel Analyzer. After the baseline 50seconds long diameter recording of inferior and superior temporal artery and vein, three flicker stimulations of 20seconds duration was applied, with a 80seconds break in between. Area under the curve of the vessel diameter (AUC) was compared during 3 flicker periods in the open angle glaucoma patients group (POAG, n = 47) and ocular hypertensives (OHT, n = 46) and age-matched healthy controls (n = 56) Results: POAG eyes demonstrated smaller response of all vessels to flicker light in general than the other two groups (p = 0.0008), but the response dynamics was significantly different between the groups (p = 0.038), showing in three flicker periods a delayed increasing response in the POAG and OHT groups, and remaining stable in healthy subjects. Conclusion: General vessel response to flicker light was decreased in POAG patients despite the slow improvement in repeated flicker stimulation, indicating an altered response patter

THE PROGNOSIS OF DEVELOPMENT OF THE PAROXYSM OF ATRIAL FIBRILLATION IN PATIENTS WITH POST-INFARCTION CARDIOSCLEROSIS

Aim. Create an algorithm predicting the risk of development of paroxysmal atrial fibrillation in patients with coronary heart disease on the background of post-infarction cardiosclerosis (PICS).Material and Methods. There was conducted the deep analysis of a number of laboratory and functional indicators (indicators of peroxidation of proteins, lipids, antioxidant protection and skin microcirculation) at 85 patients with atrial fibrillation (AF). All patients were divided into 4 groups: patients with paroxysmal and chronic AF without PICS (27 people), patients with paroxysmal and chronic AF with PICS (12), patients with permanent AF without PICS (26) and patients with permanent form of AF with PICS (20). Results. There was created the mathematical model to predict the development of atrial fibrillation in patients with PICS with calculation of the odds ratio of atrial fibrillation. Methods of correlation and factor analysis revealed the greatest value for the prognosis of paroxysmal atrial fibrillation in patients with PICS two factors: the total level of deep oxidation products of protein and an indicator of microcirculation by laser Doppler flowmetry. The diagnostic sensitivity of the developed prognostic model was 86%, specificity of the test – 94%, the diagnostic efficiency of the test – 90%.Conclusion. The study has been proven clinical diagnostic and prognostic value of a comprehensive study of indicators of oxidation-reduction reactions, and the microcirculation indices in combination with standard laboratory and instrumental investigations in patients with AF. The developed mathematical model allows to predict the development of atrial fibrillation in patients with PICS

Methods of Screening for Meibomian Gland Dysfunction

The relevance of the modern diagnosis of meibomian glands dysfunction (MGD) increases daily. Firstly, it is caused by changing of the perception about the prevalence of this disease, according to various data it is from 40 to 71% of the population in different age groups. Considering the increasing number of patients suffering from MGD, there is the need to develop screening methods for diagnosis of this disease. Screening methods should be available not only for specialists involved in the treatment of xerosis keratoconjunctival in specialized ophthalmology clinics, but also in out-patient sector. An important aspect in the diagnosis of the severity of the functionaldisorders of the meibomian glands is the assessment of morphological status that determines the further choice of therapy. To evaluate the morphological and functional state of the meibomian glands proposed to use biometrics of meibomian glands. A slit lamp is used for examination. Furthermore, objective data characterizing the morpho-functional state of the meibomian glands, can be obtained by carrying out meibography. Authors used not only white light but also infrared light for the visualization of meibomian glands during meibography. The multifunctional ophthalmic devices equipped with infrared lighting can be used for lighting. For example, specialized slit lamps, corneal topographs, Sheympflyug camera, the fundus camera and others. We applied nonmidriatic fundus camera TOPCON TRC-NW300, using for fotoregistration of the ocular fundus. A feature of the proposed method — meyboskopy — was simplicity and absence of necessity of the investigator skills by scanning with the fundus camera of the inner surface of the eyelid. Meiboskopy doesn’t require  additional equipment and software of the fundus camera and allows to receive objective quality video of meibomian glands, it opens new diagnostic possibilities. Extending of the range of diagnostic capabilities in detecting of MGD based on the screening methods will allow time to assess the severity of this disease and to appoint pathogenetically substantiated therapy