Russian nationally-biased units in the sphere of transportation in German travel notes of the XIX century

The article considers words reflecting nationally-biased units in the sphere of transportation (in Russia in XIX c.) basing on German travel notes: means of transportation, people connected with the organization of cabbing, travel documents, etc. Methods to introduce these Russian words into German texts and their functions are investigated

Modern approaches to digital product development in the conditions of market variability

Currently, the interest in design thinking in the world has made it possible to add many techniques and visual schemes that can solve various kinds of problems, including for building a strategy to achieve the company’s goals, its corporate spirit and the development of creative skills of its employees. Already today, it is possible to call the merit of design thinking the shift of emphasis in corporate goals to customer orientation, to the mobilization of collective intelligence to solve problems, to understanding the importance of empathy, creativity and entrepreneurship. A comparative analysis of existing design thinking frameworks is given, including from researchers of companies and design centers such as Hasso Plattner Institute of Design at Stanford University (d.school), The HPI-Stanford Design Thinking Research Program, Stanford d.school’s Design Thinking framework (IDEO), Google, Intel. Frameworks structure the process of design thinking in 5-6 phases: from empathy, when the needs and requests of consumers are studied, to testing an innovative product or service being created. The place of “design thinking” approach in the general concept of human-centered design is shown. The task of design thinking, the development of innovative products or services focused on human needs, is to provide a solution to a specific problem of a certain target audience. The paper outlines the principles of designing a digital innovative product. The five steps of designing a new product are described and the features of using various visualization techniques are given. The study uses such tools as the “Persona” model, Job Stories and User Stories frameworks. The creating process features of an innovative product based on the integration of design thinking, Lean Startup methodology and the theory of Jobs to Be Done are described. The life cycle of the innovation development “Creation – Evaluation – Training” is presented which is based on the process of validated learning. Changes in the outline of the business model in the lean startup methodology are presented. New segments have been added to the Lean Canvas business model – “Key Partners”, “Key Activities”, “Key Resources”, “Consumer Relations”

Рефрактерная одышка у пациента в терминальной стадии идиопатического легочного фиброза (клиническое наблюдение в отделении паллиативной помощи)

Treating dyspnea in patients with idiopathic pulmonary fibrosis is a challenge. The foreign experience of using low doses of opioids to relieve dyspnea in patients with progressing diseases is controversial among Russian specialists. The presented clinical case is an 83-year-old patient with idiopathic pulmonary fibrosis in the terminal stage and refractory dyspnea, progressive respiratory failure of II - III degrees, and concomitant exertional angina II FC and organic anxiety disorder. The patient was offered low-dose morphine injections (2 mg 5 times a day subcutaneously) to relieve the shortness of breath. The patient, who had not previously received opioids, and his relatives gave prior consent to the use of morphine. Within a week from the moment of hospitalization, the general and psycho-emotional state of the patient improved, dyspnea decreased, and night sleep was partially normalized. However, а week later, being in a severe but relatively stable condition, the patient died from a massive nosebleed. Shown, that the traditional approach to reducing dyspnea and the associated agitation in patients with interstitial lung disease is the use of corticosteroids and psychotropic therapeutics in increasing doses. The use of low doses of opioids to relieve dyspnea in patients with non-cancer disease meets many organizational, medical, and psychological barriers. At the same time, this therapy is recognized as successful and safe in the foreign palliative practice. Overcoming the existing barriers based on the evidence from clinical trials, as well as the domestic and foreign clinical practice of the safe use of low doses of opioids would expand the arsenal of effective treatments for refractory dyspnea.Одышка у пациентов с идиопатическим легочным фиброзом (ИЛФ) представляет сложную терапевтическую задачу. Зарубежный опыт использования малых доз опиоидов для облегчения одышки у пациентов с прогрессирующими заболеваниями неоднозначно оценивается российскими специалистами. Представлено клиническое наблюдение пациента 83 лет с ИЛФ в терминальной стадии и рефрактерной одышкой, прогрессирующей дыхательной недостаточностью II—III степени, сочетанной патологией в форме стенокардии напряжения II функционального класса и сопутствующим органическим тревожным расстройством. Для купирования одышки пациенту предложены инъекции морфина в малой дозе (по 2 мг 5 раз в сутки подкожно). От пациента, который ранее не получал опиоиды, и его родственников получено предварительное согласие на использование морфина. В течение 1 нед. с момента госпитализации общее и психоэмоциональное состояние больного несколько улучшились, одышка уменьшилась, усиливаясь любой физической активности, ночной сон частично нормализовался, однако через 1 нед., находясь в тяжелом, но относительно стабильном состоянии, больной скончался от массивного носового кровотечения. Показано, что традиционным подходом для уменьшения одышки и связанной с ней ажитацией у пациентов с интерстициальными заболеваниями легких является применение глюкокортикостероидов и психотропной терапии в увеличивающихся дозах, в то время как в зарубежной паллиативной практике с целью купирования одышки у лиц с неонкологическим заболеванием используется терапия малыми дозами опиоидов, признанная успешной и безопасной. В отечественной практике при этом встречаются многочисленные организационные, медицинские и психологические барьеры. Таким образом, на основании доказательной базы клинических исследований и опыта отечественной и зарубежной клинической практики безопасного применения малых доз опиоидов показано, что в случае преодоления имеющихся барьеров следовало бы ожидать расширения арсенала средств эффективной терапии рефрактерной одышки

The System Approach to Construction of the Complex Automated System of Safety of the City

Residing at a modern megacity conceals in itself a set of the latent and obvious dangers which are increased in proportion to globalization of criminal structures and in process of occurrence of new terrorist and technogenic threats. Accordingly, if the city infrastructure is more difficult and non-uniform, the requirement to safety of its citizens should be more serious. In the given work the structure of system of monitoring and safety engineering the city constructions, developed with use of methodology of the system approach, is offered