Покращення основних показників трансформаторів з витими нероз’ємними магнітопроводами шляхом зміни формування кругових витків обмотки

Introduction. With the adoption of standards to reduce losses in transformers it is necessary to change the design of transformers that remain unchanged. Further energy saving is possible with the use of non-traditional technical solutions for the improvement of transformers. Problem. In order to reduce idle losses, the curved magnetic circuits of power transformers are carried out in the form of low-volume circuits. Windings are injected into assembled magnetic conductors by shuttle machines. The shuttle of windings provides technological gaps in winding windows, which results in an increase in size, metal capacity and losses. Goal. Rationale for transformer performance improvement by excluding process gaps in winding windows. Methodology. The definition of the change in transformer indicators is performed using optimization functions of the dimensionless indicators of the technological level. The adequacy of the functions is confirmed by the calculation of the mass of the electromagnetic system and the losses of the transformer. The figures of the compact analogue are calculated from the named serial analogue. Results. The result is a reduction in mass and a loss in the compactness of the transformer. Originality. The improvement of the indicators and the simplification of the winding technology are provided by a change in the design of insulating frames of winding coils. Winding on the rods is ensured by rotating the outer part of the composite insulating frame. Practical significance. Replacement the design of the windings of transformer with power of 40 kVA of 1000 V voltage class with a spatially twisted, small-dimensional magnetic conductor on a compact analogue leads to a reduction in mass and overall dimensions by 15 % and (17-18) %. Efficiency increases by 0.3 %.Виконано аналіз конструктивно-технологічних особливостей електромагнітних систем трансформаторів з витими нероз’ємними магнітопроводами і круговими утворюючими контурами стрижнів та обмоткових витків. Запропоновано конструкцію обмоткової котушки з зовнішньою рухомою та внутрішньою нерухомою частинами опорно-ізоляційного каркасу та заміну вмотки витків на технологію намотки. Показано, що використання замість човникової вмотаної конструкції виконання обмотки з зовнішньою частиною ізоляційного каркаса, що обертається, призводить до поліпшення масогабаритних і енергетичного показників трансформатора

О СОСТОЯНИИ ЗДРАВООХРАНЕНИЯ В РЕГИОНАХ СИБИРИ И ВЫПОЛНЕНИИ ПОСЛАНИЯ ПРЕЗИДЕНТА РОССИЙСКОЙ ФЕДЕРАЦИИ ФЕДЕРАЛЬНОМУ СОБРАНИЮ РОССИЙСКОЙ ФЕДЕРАЦИИ ОТ 12 ДЕКАБРЯ 2013 ГОДА

The aim of the study was to identify the key problems of regional health services in the Siberian Federal district and justification of the priority directions of their decision. For the first time using the method of expert estimations conducted a study of health problems in the Federal district, identified key issues, as well as justifies the priority directions of their decisions. The study was conducted on the basis of statistical materials of the health authorities of the regions of Siberian Federal district, as well as expert assessments. Identified key health issues and priorities of their decision. Based on the systematic work of the expert community and across government levels defined key for the regions of Siberia health problems and justify the priority directions of their solutions tailored to focus efforts in the social sphere, which will allow to coordinate policies in the health sector on the territory of the Siberian Federal district, which in turn, will increase its effectiveness.Целью исследования было определение ключевых проблем регионального здравоохранения в Сибирском федеральном округе (СФО) и обоснование приоритетных направлений их решения. Впервые с использованием метода экспертных оценок проведено изучение проблем здравоохранения в федеральном округе, выявлены ключевые проблемы, а также обоснованы приоритетные направления их решения. Исследование проведено на основе статистических материалов органов управления здравоохранением регионов СФО, а также экспертных оценок. Определены ключевые проблемы здравоохранения и приоритетные направления их решения. На основе системной работы экспертного сообщества и органов государственного управления разных уровней определены ключевые для регионов Сибири проблемы здравоохранения и обоснованы приоритетные направления их решения с учетом фокусных усилий в социальной сфере, что позволит скоординировать политику в сфере здравоохранения на территории СФО, что, в свою очередь, позволит повысить ее эффективность

Удовлетворенность качеством медицинской помощи: «всем не угодишь» или «пациент всегда прав»?

Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation В рамках реализации концепции пациент-ориентированного здравоохранения все большее значение приобретает оценка качества услуг медицинских организации с позиции пациента. С этой целью используется комплексный показатель удовлетворенности пациентов качеством медицинской помощи, который отражает степень соответствия реальных условий оказания медицинской помощи ожиданиям пациента, сформированным под влиянием социокультурных, экономических факторов, а также личного опыта каждого потребителя медицинских услуг. Показатель удовлетворенности является субъективным, при этом степень удовлетворенности не связана непосредственно с качеством медицинской помощи. Кроме того, необходимо всегда учитывать особенности пациента, его социально-культурный и экономический статус, которые могут оказывать влияние на отношение потребителя к полученным услугам.В данной статье был проведен обзор публикаций, посвященных вопросу факторов, оказывающих влияние на уровень удовлетворенности населения медицинской помощью. В ходе работы были проанализированы данные научных коллективов разных стран с участием различных групп населения.На основании обзора был сделан ряд выводов о том, что факторы, определяющие удовлетворенность пациентов, могут быть разделены на две группы. В первую группу входят факторы, являющиеся характеристиками непосредственно пациентов, такие как пол, возраст, этнические и культурные особенности. При этом исследователи в разных странах выявляют различную значимость факторов данной группы для конкретных групп населения и медицинских организаций. Вторую группу составляют факторы, относящиеся к процессу оказания медицинской помощи, ее организации и образуют группу модифицируемых факторов. Кроме того, отмечено, что изменение удовлетворенности пациентов носит волнообразный характер с подъемами и спадами, по этой причине целесообразно проводить политику поддержания определенного уровня удовлетворенности наравне с его увеличением. С этой целью необходимо осуществлять мониторинг уровня удовлетворенности пациентов, для чего требуется разработка нового или адаптация существующего опросника по оценке удовлетворенности, который был бы унифицированным для всех медицинских организаций Российской Федерации.

Remote in vivo stress assessment of aquatic animals with microencapsulated biomarkers for environmental monitoring

Remote in vivo scanning of physiological parameters is a major trend in the development of new tools for the fields of medicine and animal physiology. For this purpose, a variety of implantable optical micro- and nanosensors have been designed for potential medical applications. At the same time, the important area of environmental sciences has been neglected in the development of techniques for remote physiological measurements. In the field of environmental monitoring and related research, there is a constant demand for new effective and quick techniques for the stress assessment of aquatic animals, and the development of proper methods for remote physiological measurements in vivo may significantly increase the precision and throughput of analyses in this field. In the present study, we apply pH-sensitive microencapsulated biomarkers to remotely monitor the pH of haemolymph in vivo in endemic amphipods from Lake Baikal, and we compare the suitability of this technique for stress assessment with that of common biochemical methods. For the first time, we demonstrate the possibility of remotely detecting a change in a physiological parameter in an aquatic organism under ecologically relevant stressful conditions and show the applicability of techniques using microencapsulated biomarkers for remote physiological measurements in environmental monitoring

Patient satisfaction with medical care

Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federatio

DIAGNOSTICS AND SURGICAL TREATMENT OF DEEP VENOUS THROMBOSIS LOWER LIMBS AND PELVIS

OBJECTIVE. Based on our own experience and analysis of the literature, we want to demonstrate the features of diagnosis and treatment of ascending deep phlebothrombosis of the lower limbs and pelvis.MATERIAL AND METHODS. During the period from October 2008 to September 2016, in the First Clinic of Surgery (postgraduate medical education) of ”Military Medical Academy named after S. M. Kirov” we analyzed the results of treatment of 44 patients with this pathology. Selective surgical tactics was based on the evaluating of general status, activity of the patient, the presence of concomitant pathology, complications of the disease. Implantation of the cava-filter was performed in 23 patients. In active patients, without significant concomitant pathology, open thrombectomy operations were performed from the deep veins of the lower limbs or from the inferior vena cava and iliac veins (21 patients). In some of these patients, a removable cava-filter was implanted before thrombectomy (8 patients). Thrombectomy from the deep veins of the lower limbs was supplemented in 12 patients by the plication of the main vein.RESULTS. This tactic made it possible to achieve favorable results in the majority of patients (27 patients, 87 %) – there were no signs of recurrence of venous thromboembolic complications, there was complete or almost complete (more than 90 %) recanalization of thrombosed veins, venous insufficiency was limited by the presence of transient edema. Small hemorrhagic complications were noted in 2 patients. Relapses of venous thromboembolic complications occurred in a distant period in 3 patients. In order to prevent fatal pulmonary embolism, patients with ascending deep phlebothrombosis need surgical treatment.CONCLUSION. The choice of surgical treatment (cava filter implantation, deep vein thrombectomy) should be determined depending on the general status, patient activity, the presence of concomitant pathology, complications of the disease, and also individually in each specific clinical situation

Functional bread enreached with regional bioactive food additives

The scientific work presents materials of theoretical and experimental substantiation of the use of regional bioactive food additives, namely wild plants of the legume family (Fabaceae), permitted for use in the food industry: sweet clover (Melilotus officinalis), red meadow clover (Trifolium pratense), white acacia (Robinia pseudoacacia) in the production of functional foods [1]. Experimental studies of the safety indicators of food wild-growing plants (FWP) have been carried out. It was found that the studied FWP growing in ecologically clean areas of the North Ossetia-Alania are distinguished by a low mass fraction of toxic substances. Two fractions of cellulose were investigated: 1 - water-soluble (pectic acid, pectin, methylcellulose); 2 - water-insoluble (protopectin, cellulose, hemicellulose). The increased content of dietary fiber in WGP powders has been established, corresponding to the physiological norms of satisfying the daily requirement for FWP and, in this regard, indicating the expediency of using functional food in formulations for the prevention and treatment of diabetes mellitus, obesity, and atherosclerosis. The sorption capacity of WGP powders with respect to lead has been investigated. All studied powders of WGP modification products are characterized by high sorption capacity. The technologies of flour products with the addition of FWP powders have been developed. The results of clinical and preclinical studies of the developed functional bread show a corrective effect of glycemic blood parameters, as well as a decrease in the lead content in the blood of fed laboratory rat pups by almost two times, compared with the control