SMES DEVELOPMENT AND CORRUPTION: CASE OF KAZAKHSTAN

The article presents a study of the corruption perception and the involvement of SMEs in corruption practices. The main goal of the paper is to provide an analysis of corruption perception of the SMEs representatives, its parts and research methodology to provide an adequate picture and analysis of corruption of the Kazakhstan. For obtaining a comparative picture, we interviewed 500 representatives of SMEs and 500 civil servants. We used a mass survey (face-to-face) method. The results show that the presence of “gap” between perception of corruption and degree of the respondents’ involvement in corrupt practices. The respondents believe that corruption is widespread, but they themselves were rarely involved in corrupt practices. The key message is that the SMEs representatives consider this problem to be acute, but they are not ready to talk about their own experience in this regard

Лечение больных туберкулезом легких с устойчивостью к изониазиду с использованием адъювантой терапии

The purpose of the study was to assess the efficacy of glutamyl-cysteinyl-glycine disodium (Glu) as adjuvant therapy in patients with isoniazid resistant pulmonary tuberculosis. Methods. This was a randomized placebo-controlled blind study. The study involved 67 patients who was randomly assigned to the treatment with Glu and antituberculosis cchemotherapy (group 1; n = 23), or placebo (group 2; n = 10), or antituberculosis chemotherapy (group 3; n = 34). All patients were positive for M.tuberculosis (MBT). The treatment included a standard intensive chemotherapy in a hospital (DOTS strategy) during 5 months (2S 3–5HRZE/5RSE). Glu was administered intramuscularly in the dose of 60 mg once daily during 10 days followed by 60 mg once daily every other day during 20 days; the total course included 20 doses. Results. Single-drug resistant MBT was detected in 26.1%, 20.0%, and 8.8% of patients in groups 1, 2, and 3, respectively. Multiple drug resistance was detected in 73.9%, 77.8%, and 91.2%, respectively. Sputum conversion was achieved in 26.1%, 52.2%, and 21.7% of group 1 patients in one, two and three months of the treatment, respectively. Sputum conversion in group 2 was achieved over 3 months of the treatment only (n = 3 at 3 months, n = 4 at 4 months, and n = 2 at 5 months); two patients were still MBT-positive to the end of the treatment. In group 3, sputum conversion was achieved in 18 patients (53.0 %) at 3 months, in 6 patients (18%) at 4 months, and in 5 patients (14.7%) at 5 months; 5 patients remained MBT-positive to the end of the treatment. Median time to sputum conversion was 62, 114, and 100 days in groups 1, 2, and 3, respectively. Conclusion. The adjuvant treatment with Glu in patients with isoniazid-resistant pulmonary tuberculosis was associated with earlier sputum conversion. This strategy can shorten the duration of the intensive treatment.Целью исследования явилась оценка эффективности использования глутамил-цистеинил-глицин динатрия (ГЦГД) как адъюванта при комплексном лечении пациентов с устойчивостью к изониазиду. Материалы и методы. При проведении рандомизированного слепого плацебо-контролируемого исследования больные (n = 67) были распределены на 3 группы: 1-я (n = 23) – получавшие ГЦГД и химиотерапию (ХТ); 2-я (n = 10) – плацебо; 3-я (n = 34) – только противотуберкулезные препараты. Все пациенты являлись бактериовыделителями (БВ). Тактика лечения туберкулеза в стационаре состояла из интенсивной фазы стандартного режима ХТ по II категории Directly Observed Treatment Short (DOTS) – изониазид, рифампицин, пиразинамид и этамбутол в течение 5 мес. (2S 3–5HRZE / 5RSE). ГЦГД вводился внутримышечно по 60 мг 1 раз в сутки в первые 10 дней – ежедневно, в последующие 20 дней – через день по 60 мг (1 инъекция) в сутки, всего 20 инъекций. Результаты. Монорезистентные микобактерии туберкулеза (МБТ) у пациентов 1–3-й групп определялись в 26,1, 20,0 и 8,8 %, а полирезистентные – в 73,9, 77,8 и 91,2 % случаев соответственно. Прекращение БВ у пациентов 1-й группы наступило в первые 3 мес.: в конце 1-го месяца – у 26,1 %, в конце 2-го – у 52,2 % и 3-го – у 21,7 % больных. Во 2-й группе определение МБТ в мокроте прекратилось, начиная с 3-го месяца лечения (n = 3); на 4-м месяце – у 3, на 5-м – у 2 пациентов. К концу интенсивной фазы БВ сохранялось в 2 случаях. В 3-й группе к концу 3-го месяца выделение МБТ прекратилось у 18 (53,0 %), к концу 4-го месяца – у 6 (18 %), 5-го месяца – у 5 (14,7 %) пациентов; в 5 случаях БВ сохранялось. Медиана сроков негативации мокроты в 1–3-й группах составила 62, 114 и 100 дней соответственно. Заключение. Показано, что при включении ГЦГД в комплексное лечение пациентов с туберкулезом, резистентным к изониазиду, абацилирование происходит в первые 3 мес., что подтверждает адъювантные свойства препарата и позволяет сократить сроки интенсивной фазы.

Management of cardiac emergencies in women: a clinical consensus statement of the Association for Acute CardioVascular Care (ACVC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the Heart Failure Association (HFA), and the European Heart Rhythm Association (EHRA) of the ESC, and the ESC Working Group on Cardiovascular Pharmacotherapy.

Cardiac emergencies in women, such as acute coronary syndromes, acute heart failure, and cardiac arrest, are associated with a high risk of adverse outcomes and mortality. Although women historically have been significantly underrepresented in clinical studies of these diseases, the guideline-recommended treatment for these emergencies is generally the same for both sexes. Still, women are less likely to receive evidence-based treatment compared to men. Furthermore, specific diseases affecting predominantly or exclusively women, such as spontaneous coronary dissection, myocardial infarction with non-obstructive coronary arteries, takotsubo cardiomyopathy, and peripartum cardiomyopathy, require specialized attention in terms of both diagnosis and management. In this clinical consensus statement, we summarize current knowledge on therapeutic management of these emergencies in women. Key statements and specific quality indicators are suggested to achieve equal and specific care for both sexes. Finally, we discuss several gaps in evidence and encourage further studies designed and powered with adequate attention for sex-specific analysis

Безопасность новых режимов профилактического лечения туберкулеза и приверженность к их соблюдению по данным Республики Казахстан

The objective: to assess the safety and compliance with new regimens for preventive treatment of drug susceptible and drug resistant tuberculosis.Subjects and Methods. The study was carried out in Almaty, the Republic of Kazakhstan; 182 patients from the groups facing the high risk of developing active tuberculosis received preventive tuberculosis treatment with new regimens: 71 patients were treated with isoniazid and rifampicin for 3 months (3 HR), 55 - with isoniazid and rifapentine for 1 month (1 HR), 56 - with levofloxacin for 6 months (6 Lfx).Results. During treatment with regimens 3 HR, 1 HP, 6 Lfx, no adverse events of severity degree 3-4 developed , while adverse events of severity degree 1-2 were rare and relieved. The patient-oriented approach to the organization of preventive chemotherapy made it possible to achieve high treatment completion rates: in the group receiving 3 HR, it was 97.2% of cases, in the group receiving 1 HP - 96.4%, and in the group receiving 6 Lfx - 82.2%.Цель исследования: оценка безопасности и приверженности к соблюдению новых режимов профилактического лечения лекарственно чувствительного и лекарственно устойчивого туберкулеза.Материалы и методы. Исследование выполнено в г. Алматы Республики Казахстан; новые режимы профилактического лечения туберкулеза получили 182 пациента из групп высокого риска развития активного туберкулеза: 71 – изониазид и рифампицин в течение 3 месяцев (3 HR), 55 – изониазид и рифапентин 1 месяц (1 НР), 56 – левофлоксацин 6 месяцев (6 Lfx).Результаты. При приеме режимов 3 HR, 1 HP, 6 Lfx нежелательных явлений 3-4 степени тяжести не наблюдалось, нежелательные явления 1-2 степени токсичности встречались редко и были купированы. Пациентоориентированный подход организации превентивной химиотерапии позволил достигнуть высоких показателей завершения лечения: в группе, получавшей 3 HR, в 97,2% случаев, 1 HP – в 96,4% и 6 Lfx – в 82,2%

Education and certification on heart failure of the Heart Failure Association of the European Society of Cardiology

In order to ensure that the next generation of heart failure specialists will receive high-quality training, this document outlines the new European training and certification requirements for physicians with an interest in heart failure and for those working in certified heart failure centres, required by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

European Society of Cardiology: Cardiovascular Disease Statistics 2017

Background: The European Society of Cardiology (ESC) Atlas has been compiled by the European Heart Agency to document cardiovascular disease (CVD) statistics of the 56 ESC member countries. A major aim of this 2017 data presentation has been to compare high income and middle income ESC member countries, in order to identify inequalities in disease burden, outcomes and service provision. Methods: The Atlas utilizes a variety of data sources, including the World Health Organization, the Institute for Health Metrics and Evaluation, and the World Bank to document risk factors, prevalence and mortality of cardiovascular disease and national economic indicators. It also includes novel ESC sponsored survey data of health infrastructure and cardiovascular service provision provided by the national societies of the ESC member countries. Data presentation is descriptive with no attempt to attach statistical significance to differences observed in stratified analyses. Results: Important differences were identified between the high income and middle income member countries of the ESC with regard to CVD risk factors, disease incidence and mortality. For both women and men, the age-standardised prevalence of hypertension was lower in high income countries (18.3% and 27.3%) compared with middle income countries (23.5% and 30.3%). Smoking prevalence in men (not women) was also lower (26% vs 41.3%), and together these inequalities are likely to have contributed to the higher CVD mortality in middle income countries. Declines in CVD mortality have seen cancer becoming a more common cause of death in a number of high income member countries, but in middle income countries declines in CVD mortality have been less consistent where CVD remains the leading cause of death. Inequalities in CVD mortality are emphasised by the smaller contribution they make to potential years of life lost in high income compared with middle income countries both for women (13% vs. 23%) and men (20% vs. 27%). The downward mortality trends for CVD may, however, be threatened by the emerging obesity epidemic that is seeing rates of diabetes increasing across all ESC member countries. Survey data from the National Cardiac Societies (n=41) showed that rates of cardiac catheterization and coronary artery bypass surgery, as well as the number of specialist centres required to deliver them, were greatest in the high income member countries of the ESC. The Atlas confirmed that these ESC member countries, where the facilities for the contemporary treatment of coronary disease were best developed, were often those in which declines in coronary mortality have been most pronounced. Economic resources were not the only driver for delivery of equitable cardiovascular healthcare, as some middle income ESC member countries reported rates for interventional procedures and device implantations that matched or exceeded the rates in wealthier member countries. Conclusion: In documenting national CVD statistics, the Atlas provides valuable insights into the inequalities in risk factors, healthcare delivery and outcomes of CVD across ESC member countries. The availability of these data will underpin the ESC’s ambitious mission “to reduce the burden of cardiovascular disease” not only in its member countries, but also in nation states around the world

Ethno-Sociocultural deviationsin the educational environment of the modern Eurasian higher education institution asa reflection of transcultural globalization factors

In the XXI century socio-political communications as well as the functions of leader have underwent profound changes. In the middle of the second decade of the XXI century a communication system in educational and social policies has changed from a slow one-sided process having quite information character for the most part to a poly-variative communication that has caused some social deviations and conflicts in the conditions of multipolarity of an education sector and personal development. Ongoing changes in the sphere of higher education in the context of globalization to a greater or lesser extent have affected educational institutions of all Eurasian countries. These changes in their turn are the grounds for the educational market creation in planetary terms. Along with its traditional functions education today is the market also. And such is the market structure of communications that in the conditions of increasing competition between higher education institutions in search of students the educational market players must overcome language, mental, national, cultural, historical and pedagogical divides. While mass media has being developed the citizens have got much more opportunities to keep tabs on politicians' actions so long as mass media have been included in competition for event interpretations. In some states the fight began in the middle of the XX century, others have yet to experience. During the information era each deal of politicians potentially becomes an object to be discussed many segments of population. And the Internet sphere already discusses assignment of the new Minister of Education and Science of the Russian Federation in a variety of aspects. The construction of professional identity in the conditions of globalization is characterized, on the one hand, by isolation, distancing from other national and ethnic, social groups, searches for collective national Self, on the other hand, by inclusion of a resource of identity as a prize in competition for positions in the globalizing world (Council of Federations ..., 2016). In the conditions of social and economic update of Russia there is the significant increase of intensity and proneness to conflict in all spheres of social activity, including in the education system. The conflict is caused by economic, political, ideological, cultural and other factors of public life. Identity in the context of globalization is a process of differentiation, fragmentarization, complementarity of systemic and subjective factors. The complexity of the identification process of identity of a teacher consists in the multidimensionality of identity criteria, actualization of political, social, cultural and symbolical capitals. Cross-cultural conflicts, being a natural show of the urgent contradictions in education, have an essential impact on activity of educational systems, the quality of their operation and development in time. There is here a bruising matter in the form of a conflict of interests of higher education national systems (first of all, their cultural aspect) and interests of transnational educational corporations (an economic aspect). The goal of this research is to prove the need for the personality to be developed in the context of globalization and to offer certain practical ways of its construction in the conditions of university education. Transcultural competence of the personality as a peculiar navigation system allows the individual, being in the supercultural space, to overcome the subjectivity of estimate of friend and foe with their distinctions, to hold each of them and to take up an individual position in a dialogue of cultures. The paper has presented the results of the approbation of teaching methods directed on the construction of transcultural competence of the personality