Комплексна оцінка рівня фінансової стійкості підприємства сфери послуг

Цель данной статьи заключается в обобщении теоретических основ и обоснование целесообразности применения комплексной оценки финансового состояния предприятия сферы услуг.Мета даної статті полягає в узагальненні теоретичних основ і обґрунтування доцільності застосування комплексної оцінки фінансового стану підприємства сфери послуг

Формирование подхода и методики, влияющих на процесс генерации стратегии предприятия

Цель исследования состоит в формировании нового подхода и методики, влияющих на процесс генерации стратегии предприятия

Challenges and satisfaction in Cardiothoracic Surgery Residency Programmes: insights from a Europe-wide survey.

OBJECTIVES: The increasing complexity of surgical patients and working time constraints represent challenges for training. In this study, the European Association for Cardio-Thoracic Surgery Residents' Committee aimed to evaluate satisfaction with current training programmes across Europe. METHODS: We conducted an online survey between October 2018 and April 2019, completed by a total of 219 participants from 24 countries. RESULTS: The average respondent was in the fourth or fifth year of training, mostly on a cardiac surgery pathway. Most trainees follow a 5-6-year programme, with a compulsory final certification exam, but no regular skills evaluation. Only a minority are expected to take the examination by the European Board of Cardiothoracic Surgery. Participants work on average 61.0 ± 13.1 h per week, including 27.1 ± 20.2 on-call. In total, only 19.7% confirmed the implementation of the European Working Time Directive, with 42.0% being unaware that European regulations existed. Having designated time for research was reported by 13.0%, despite 47.0% having a postgraduate degree. On average, respondents rated their satisfaction 7.9 out of 10, although 56.2% of participants were not satisfied with their training opportunities. We found an association between trainee satisfaction and regular skills evaluation, first operator experience and protected research time. CONCLUSIONS: On average, residents are satisfied with their training, despite significant disparities in the quality and structure of cardiothoracic surgery training across Europe. Areas for potential improvement include increasing structured feedback, research time integration and better working hours compliance. The development of European guidelines on training standards may support this

Prevention of Cardiac Surgery-Associated Acute Kidney Injury : A Review of Current Strategies

Acute kidney injury is a common and often severe postoperative complication after cardiac surgery, and is associated with poor short-term and long-term outcomes. Numerous randomized controlled trials have been conducted to investigate various strategies for prevention of cardiac surgery-associated acute kidney injury. Unfortunately, most trials that have been conducted to date have been negative. However, encouraging results have been demonstrated with preoperative administration of corticosteroids, leukocyte filtration, and administration of inhaled nitric oxide intraoperatively, and implementation of a Kidney Disease: Improving Global Outcomes bundle of care approach postoperatively. These findings require validation in large, multicenter trials

Aortic homograft replacement in a patient with a porcelain aorta : A case report

Patients with a severely calcified (porcelain) aorta are often unsuitable candidates for cardiac surgery because of the high risk of neuroembolic complications from loose calcified particles.We describe a surgical technique in a patient with a porcelain aorta undergoing an aortic homograft replacement for infective endocarditis that used an oscillating saw and a surgical hand drill for suturing the calcified plates