System-didactic complex of training for teachers of natural and geographical disciplines

© Medwell Journals, 2016.Purpose of the study the development and using in the process of training teachers of natural geographical disciplines of system-didactic complex that includes diagnostics readiness of the teacher to the creative teaching activities, the implementation of inter-subject relationship, the competence approach. System-didactic complex built on metamethodic and holistic ideas. System-didactic complex allows: to claim the creativity of the teacher, the scientific potential of the fundamental disciplines of the creative potential of the teacher, going beyond disciplinary disunity, transfer logical form of scientific knowledge in activity-shape, forming a complete picture of the world, the relationship of various phenomena

Classroom-based and remote methods of creative potential development of a teacher in the process of advanced training

The goal of the article is the use and comparison of classroom-based and remote methods of creative potential development of a teacher in the process of advanced training. The use of classroom-based and remote methods, which promote the development of creative potential of a teacher, is considered on the example of complex integrated tasks

Education of ecological culture of school children on the basis of ethnopedagogy

© Medwell Journals, 2016.Of the pedagogical system based on knowledge of the Tatar people on the nature, implemented on the lessons of natural sciences and geography of Tatarstan is an interconnected set of means, methods and processes that contribute to the formation of ecological culture of the students. The funds of the national pedagogies, traditions, rites and customs of the people of their environmental content establish stable norms and rules of behavior of children in nature, contribute to the education of ecological culture

Changes in the urban population in the republic of the volga federal district of Russia

© Medwell Journals, 2016.The study considers the the dynamics of the urban population in the republics of the Volga Federal District (VFD) Russia: Bashkortostan, Mari El, Mordovia, Tatarstan, Udmurtia, Chuvashia from 1990-2013. The main factors affecting to the changing in the urban population in these republics: decline in industrial production; internal and external migration; deterioration of the socio-economic conditions of the population, especially in small cities and towns associated with unemployment; aggravation of environmental problems in large cities and others. Of the 6 republics of the VFD the positive dynamics of the urban population is observed only in the Republic of Tatarstan to 197 thous. people from 1990-2012. And in the other republics of VFD there are negative indicators of the dynamics of the urban population

The composition and thermal properties of waxes in oil asphaltenes

© 2015 Akadémiai Kiadó, Budapest, Hungary. Asphaltenes of four Russian and Kyrgyzstan crude oils were investigated with calorimetry, gas chromatography and X-ray diffraction analysis. It was established that asphaltenes contain waxes. Hydrocarbon composition and the thermal properties of waxes co-precipitated with asphaltenes and isolated by acetone from crudes oils according to the EN 12606-2 method were determined and compared. It was found that n-alkanes C40+ dominate in the waxes co-precipitated with asphaltenes. Waxes in asphaltenes are characterized by high temperature and enthalpy of melting/crystallization. Co-precipitation of high molecular weight waxes with asphaltenes is necessary to consider in order to determine the actual content and composition of asphaltenes and total content and composition of waxes in crude oil more accurately

Fullerene-mediated electrosynthesis of Ag–C<inf>60</inf>nanocomposite in a water-organic two-phase system

© 2017 By example of fullerene-mediated electrosynthesis of Ag–C 60 nanocomposite in water–o-dichlorobenzene, the possibility of using a liquid–liquid two-phase system for the electro- synthesis of metal nanoparticles has been demonstrated for the first time

Ревматоидный артрит в реальной клинической практике. Результаты проекта «Компьютерные терминалы самооценки для пациентов с ревматическими заболеваниями» («ТЕРМИНАЛ-I»)

Objective: to describe the portrait of a patient with rheumatoid arthritis (RA) in real clinical practice, to assess disease activity from the point of view of a physician and a patient, functional status, quality of life (QOL), and the efficiency of the therapy performed.Patients and methods. The investigation enrolled 976 RA patients from a cohort of patients in the TERMINAL-I multicenter study, who, when visiting a rheumatologist, independently assessed the disease activity and QOL using a computer system (the «Computer Terminals of SelfAssessment for Patients with Rheumatic Diseases» project). The mean age of the patients was 52.30±13.3 years; women accounted for 85%; the median disease duration 8.0 [4.0; 14.0] years. Baseline clinical parameters and pharmacotherapy were evaluated for 6 months. The disease activity was determined by the DAS28 and RAPID-3 indices; functional status and quality of life were evaluated by the HAQ and the EQ-5D, respectively.Results. 83% of the RA patients were positive for rheumatoid factor and 60% were for anti-cyclic citrullinated peptide antibodies. There was a preponderance of patients with high (40.5%) and moderate (46.8%) RA activity; 6.9% were observed to have a low activity; 5.8% had clinical remission. The mean values of DAS28 and RAPID-3 were 4.7±1.3 and 13.7±3.6, respectively. Only 14.3% of patients had a good functional status that was comparable with the population-based control (HAQ≤0.5). The remaining patients were found to have a substantial decrease in joint functional parameters (median HAQ 1.88 [1.0; 2.5]) and EQ-5D QOL (0.60 [0.60; 0.74). Prosthetic joints were present in 7.4% of patients. At visit 1 to a rheumatologist, the therapy was changed in 15% of patients. During 6-month follow-up, conventional disease-modifying anti-rheumatic drugs were taken by almost all (91.2%) patients. Of them, 70.9% of the patients were treated with methotrexate (MTX): 77.0% received the latter at a dose of 15 mg/week and 23.0% had it at a dose of &gt;15 mg (17.5 to 40 mg/week). Glucocorticoids could be stopped in 20.5% of the patients within six months. Tumor necrosis factor-α inhibitors and anti-B-cell therapy were used in 6.6 and 16.2% of patients, respectively. At 6-month follow-up (Visit 2), 54% of patients achieved a 20% clinical improvement in the ACR criteria. At the same time, the DAS28 scores decreased substantially from 4.5±1.2 to 3.8±1.1 (p = 0.0001). There was a minimal functional improvement in the HAQ index in 64% of patients and a better EQ-D QOL scores in 16%.Conclusion. The majority of RA patients who came to the rheumatologists showed high to moderate disease activity. This was due to long disease duration, inadequate MTX dose, and insufficient patient monitoring in real clinical practice. Introduction of a computer system for selfassessment of their health status by RA patients in an outpatient setting could improve the interaction of physicians, nurses, and patients, better monitor disease activity, and enhance therapeutic efficiency. Цель исследования – описание «портрета» пациента с ревматоидным артритом (РА) в реальной клинической практике, оценка активности заболевания с точки зрения врача и пациента, функционального состояния, качества жизни (КЖ) и эффективности проводимой терапии.Пациенты и методы. В исследование включено 976 пациентов с РА из когорты больных, входящих в многоцентровое исследование «ТЕРМИНАЛ-I», которые при обращении к ревматологу самостоятельно оценивали активность заболевания и КЖ с помощью компьютерной системы (проект «Компьютерные терминалы самооценки для пациентов с ревматическими заболеваниями»). Средний возраст пациентов составил 52,30±13,3 года, 85% – женщины, медиана длительности заболевания – 8,0 [4,0; 14,0] лет. Проводилась оценка базовых клинических параметров и фармакотерапии в течение 6 мес. Активность заболевания определялась по индексам DAS28 и RAPID-3, функциональный статус – по индексу HAQ, качество жизни – по EQ-5D.Результаты. 83% больных РА были позитивными по ревматоидному фактору и 60% – по антителам к циклическому цитруллинированному пептиду. Преобладали пациенты с высокой (40,5%) и умеренной (46,8%) активностью РА, у 6,9% отмечалась низкая активность, у 5,8% –клиническая ремиссия. Среднее значение индекса DAS28 составило 4,7±1,3, RAPID-3 – 13,7±3,6. Только 14,3% пациентов имели хорошее функциональное состояние, сравнимое с популяционным контролем (HAQ ≤0,5). У остальных больных отмечалось значительное снижение показателей функции суставов (медиана HAQ 1,88 [1,0; 2,5]) и КЖ по индексу EQ-5D (0,60 [0,60; 0,74]). Протезированные суставы имели 7,4% больных. При 1-м визите к ревматологу терапия была изменена у 15% пациентов. В течение 6 мес наблюдения практически все пациенты (91,2%) получали стандартные базисные противовоспалительные препараты. Из них 70,9% пациентов находились на терапии метотрексатом (МТ): 77,0% получали его в дозе 15 мг/нед и 23,0% – &gt;15 мг (от 17,5 до 40 мг/нед). 20,5% пациентам в течение полугода удалось отменить глюкокортикоиды. Ингибиторы фактора некроза опухоли α использовали 6,6% больных, анти-В-клеточную терапию – 16,2%. После 6 мес наблюдения (2-й визит к врачу) 20% клиническое улучшение по критериям ACR достигнуто у 54% больных. При этом отмечалось значительное снижение индекса DAS28 (с 4,5±1,2 до 3,8±1,1 балла; p=0,0001). Минимальное функциональное улучшение по индексу HAQ зафиксировано у 64% пациентов, улучшение КЖ по EQ-5D – у 16%.Выводы. Высокая и умеренная активность заболевания, снижение показателей КЖ были характерны для большинства пациентов с РА, обратившихся к ревматологу. Это было связано с большой длительностью заболевания, неадекватной дозой МТ и недостаточным мониторингом пациентов в реальной клинической практике. Введение компьютерной системы самооценки состояния здоровья пациентов с РА на поликлиническом уровне позволило улучшить взаимодействие врачей, медицинских сестер и пациентов, более качественно контролировать активность заболевания и повысить эффективность терапии.