Application of the Energy Service Contract to Improve Energy Efficiency in Use of Resources in the Housing and Utility Complex

The need for development of new efficient technologies in the modern world arises from growth in resource consumption. One of the main consumers of fuel and energy resources in Russia is a housing and utility complex. More than half of the buildings in the country were built more than 40 years ago. Despite the fact that the buildings, for the most part, have not yet their service life expired, the systems that provide electricity, heat and water to housing and utility services are in an unsatisfactory condition, they are morally outdated and do not meet modern needs. In recent decades, many developments that bring significant savings in resources appeared, both by reducing losses during their transportation, and by introducing technologies that optimize using of the resources. Implementation of such projects, although it brings tangible savings in resources, requires significant financial investments. Households and large municipalities often do not have an opportunity to find such significant money at a time. A solution to this problem can be involvement of an energy service company, which at its own expense implements a project to improve the energy efficiency of using resources, and then, within several years, it will receive some income for cost of saved resources. The article examines one of such projects, presents possible ways of implementing energy service activities, and presents the results of financial and economic calculations of consequences of a potential investor’s participation in such a project. As a result of implementation of the energy service project, electricity consumption will decrease by 15 %, the saved funds will allow the investor to have the return on investment from participation in the project in the amount of more than 25 % per annum, and the customer will significantly improve reliability and quality of providing the population with electricity. Results of the research conducted by the author demonstrate a great potential of practice of implementing energy service contracts for solving priority tasks of increasing the energy efficiency of the housing and utility complex

Православные братства Русской православной церкви: религиозный и социальный проекты

Статья посвящена анализу такого яркого феномена религиозного пространства России, как современные неприходские православные братства. Автор полагает, что появление неприходских православных братств маркирует процесс реинституционализации русской православной церкви (РПЦ) в современных обществах. Изучен способ конструирования идентичности неприходских братств с использованием нарратива «церковности» или рефлексии о канонических, мистических и мистериальных границах РПЦ. В фокусе рассмотрения четыре этапа институционализации православных братств и конструирование их типологии. Анализируя этапы институционализации братств, автор показывает, что специфичная для них организационная форма является традиционной для РПЦ и в периоды общественно- политических кризисов, и в периоды подъема церковной жизни. В статье детально рассмотрены три выявленные типа братств: духовные союзы, социально ориентированные религиозные организации, политизированные фундаменталистские организации. И если первые две группы способны консолидировать свою деятельность и сохранить православие в его церковной форме, то фундаменталистские политизированные сообщества им противостоят, стремясь выдать только себя за представителей церкви

ОСОБЛИВОСТІ ПРОПОЗИЦІЇ ТУРИСТИЧНОГО ПРОДУКТУ В УМОВАХ КЛАСТЕРИЗАЦІЇ ЕКОНОМІКИ ТА ЕФЕКТИВНОГО ВИКОРИСТАННЯ СУЧАСНИХ ІНФОРМАЦІЙНИХ ТЕХНОЛОГІЙ

The proposals of the tourist complex were studied in this paper. An essence of the recreation load has been determined. A role of the information technologies in forming of the proposal of the tourist complex has been studied. The authors have analyzed the appreciable and imperceptible components of the tourist complex. Material and not a material manifestation of some tourist complex elements has been substantiated. The dependence of a proposal on an image, prestigiousness of the tourist complex, and sustainability of the business entity has been determined. The authors have proved dependence of a quality of the tourist complex on an implementation degree of the scientific and technical achievements. The high dependence of a proposal on quality, volume and advertising activity has been studied. The attention of the season character of a realization of the tourist complex and non-durability of the tourist service has been accented.В статье исследованы предложения туристического продукта. Определена сущность рекреационной нагрузки. Исследована роль информационных технологий в формировании предложения туристического продукта. Проанализированы ощутимые и неощутимые компоненты туристического продукта. Обоснованно материальное и не материальное проявление составляющих туристического продукта. Определена зависимость предложения от имиджа и престижности туристского продукта и устойчивости субъекта хозяйствования. Доказана зависимость качества туристического предложения от степени внедрения научно-технических достижений. Исследована высокая зависимость предложения от качества, объема и активности рекламы. Подчеркнуто сезонный характер реализации туристического продукта и недолговечность туристической услуги.В статті досліджено пропозиції туристичного продукту. Визначено сутність рекреаційного навантаження. Досліджено роль інформаційних технологій у формуванні пропозиції туристичного продукту. Проаналізовано відчутні та невідчутні компоненти туристичного продукту.  Обґрунтовано матеріальний і нематеріальний прояв складових туристичного продукту. Визначено залежність пропозиції від іміджу та престижності туристичного продукту та стійкості суб’єкта господарювання. Доведено залежність якості туристичної пропозиції від ступеня впровадження  науково-технічних досягнень. Досліджена висока залежність пропозиції від якості, об’єму та активності реклами. Підкреслено сезонний характер реалізації туристичного продукту та недовговічність туристичної послуги.

Development of Regional Innovative Clusters and Supply Chain Strategy in Terms of Lean Production Principles

The article considers the genesis, content and relevance of the cluster approach in socio-economic regional development. Certain aspects of the innovativeness of this approach have been discussed in a number of national strategic documents since 2008. In our opinion, their further development and updating is relevant for the upcoming international forum, “Partnership for Cluster development: Creating the future,†which will be held in the Republic of Tatarstan in 2020. The key goal as part of the development of regional innovative clusters is the development of effective intra-cluster interaction to increase labor productivity. The authors introduce the hypothesis regarding the increase of production systems' efficiency. The necessity of implementing the lean production concept according to the certain cluster model is identified and justified. In relation to this, the conditions and possibilities of having a synergies-tic effect on the joint, interconnected and mutually reinforcing use of lean principles are analyzed. In addition, the model that is implemented by all the participants in the innovative cluster in the product value chain is developed. The authors refer to provisions in international and domestic documents on the sphere of cluster development, recommendations from the national standard GOST R 57524-2017 “Lean production. Value Stream,†methods for calculating process performance indicators, product stocks in buffers, and cycle time of the reverse processes. According to the results of the study, it was concluded that the implementation of lean production principles for the development of innovative regional clusters is universal and effective. Moreover, it has a high degree of feasibility for any organizational model of a cluster. There is scientific and practical interest in the implementation of the entire complex of lean principles to provide for the quality of products and processes, as well as their continuous improvement

Належна фармацевтична практика: імплементація протоколів провізора / фармацевта у післядипломну освіту спеціалістів фармації

The article deals with the current state of implementation of the protocols of provisor/pharmacists in practical activities of of pharmacy specialists as an important component of good pharmacy practice in Ukraine. The authors summarize the experience of short cycles of thematic improvement in the form of workshops and seminars as a promising form of continuing professional education, most adapted to modern conditions of existence of the pharmaceutical sector, the health care industry. The successful combination of initiatives of governmental regulatory bodies, in particular the Ministry of Health, with the latest educational technologies, leading specialists practitioners, teachers can become real method to improving the quality of pharmaceutical care.Статья освещает современное состояние внедрения протоколов провизора/фармацевта в практическую деятельность аптечных учреждений как важной составляющей надлежащей фармацевтической практики в Украине. Авторами обобщен опыт проведения краткосрочных циклов тематического усовершенствования в форме научно-практических семинаров как перспективной формы непрерывного профессионального образования, наиболее адаптированной для современных условий существования фармацевтического сектора отрасли здравоохранения. Удачное сочетание инициативы государственных регуляторных органов, в частности Министерства здравоохранения Украины, с новейшими образовательными технологиями, привлечением ведущих специалистов-практиков, педагогов может стать реальным путем повышения качества фармацевтической помощи населению.Стаття висвітлює сучасний стан впровадження протоколів провізора/фармацевта у практичну діяльність аптечних закладів як важливої складової належної фармацевтичної практики в Україні. Авторами узагальнено досвід проведення короткотривалих циклів тематичного удосконалення у формі науково-практичних семінарів як перспективної форми безперервної професійної освіти, найбільш адаптованої для сучасних умов існування фармацевтичного сектору галузі охорони здоров’я. Вдале поєднання ініціативи державних регуляторних органів, зокрема міністерства охорони здоров’я України з новітніми освітніми технологіями, залученням провідних фахівців-практиків, освітян може стати  реальним шляхом підвищення якості фармацевтичної допомоги населенню

Individual neuropsychological characteristics in patients with juvenile myoclonic epilepsy

Background. An association between juvenile myoclonic epilepsy (JME) and nonpsychotic psychiatric and cognitive disorders has been described in recent years. Scientists are trying to link JME with certain personality traits marked by emotional instability. Objective. The goal of our research was to assess the state of cognitive functions in young adult patients with JME–excluding the adverse side effects (ASEs) of antiepileptic drugs (AEDs)–and analyze the level of personality and situational anxiety, neuroticism, and depression in young adult patients with JME. Design. We tested 26 patients with JME and 26 healthy adults with the computer program NS-PsychoTest (Neurosoft Company, RF), a program which is aimed at studying and evaluating neuropsychological characteristics. Results. Our study showed that the frequency of depressive symptoms, according to the cognitive-affective subscale (Beck’s Depression Inventory), in patients with JME was statistically significantly higher than among people without epilepsy. Comorbid personality and nonpsychotic psychiatric disorders are common interdisciplinary problems in JME management. Most practitioners pay attention only to the treatment of seizures caused by JME, and their patients, accordingly, do not receive adequate psychotherapeutic help. Conclusion. Cognitive disorders are often associated with epilepsy, and are a result of a combination of factors. According to our study, in the presence of statistically significant differences in short-term memory and mental performance in patients with JME, compared to healthy young adults, the main indicators of cognitive function in patients with JME generally correspond to the norm. Our findings highlight the etiological heterogeneity of cognitive disorders in JME and the importance of early screening for them

Rigid indicators of knee meniscus strength on data of shear-wave elasticity imaging depending on the stage of prim ary osteoarthritis

Остеоартрит залишається одним із найбільш розповсюджених та інвалідізуючих захворювань сьогодення. Відомо, що колінні суглоби відносяться до місць із найбільшим ризиком розвитку остеоартриту серед інших суглобів організму людини. У той же час, відомо, що у розвитку та прогресуванню остеоартриту приймають участь як внутрішньосуглобові, так і позасуглобові структури, серед яких найбільшу увагу заслуговують меніски. Серед різноманітних методів дослідження на сьогодні тільки еластометрія дозволяє визначити стан менісків без зовнішніх ознак їх ураження. Метою нашого дослідження було визначення відмінностей показників пружності менісків у пацієнтів в залежності від стадії остеоартриту. Було виявлено, що у пацієнтів із ОА навіть І ст. присутня суттєва різниця по пружності менісків із пацієнтами контрольної групи, при чому відмічається статистично достовірна відмінність перш за все по пружності медіальних менісків. Показник щільності менісків збільшується із підвищенням ступеню артрозних змін та пов'язаний із ступенем дегенеративних змін менісків у суглобі. Еластометрія є високочутливим методом діагностики дегенеративних змін менісків колінних суглобів і може бути використаною для виявлення ранніх, доклінічних стадій патологічних змін менісків; Osteoarthritis is one of the most common and debilitating diseases of our time. Osteoarthritis of the knee is a complex peripheral joint disorder with multiple risk factors. The molecular basis of osteoarthritis has been generally accepted; however, the exact pathogenesis is still not known. Management of patients with osteoarthritis involves a comprehensive history, thorough physical examination and appropriate radiological investigation. Knee joints are known to be at the highest risk for developing osteoarthritis among other joints in the human body. At the same time, it is known that in the development and progression of osteoarthritis participate both intra-articular and extra-articular structures, among which meniscuses deserve the most attention. Among the various methods of investigation today, only elastometry can determine the status of meniscuses, provided there are no external signs of their lesion. The purpose of our study was to determine the differences in meniscus elasticity in patients depending on the stage of osteoarthritis by shear-wave elasticity imaging. It was found that in patients with minimal changes in the joints there is a significant difference in the shear-wave elasticity imaging of the meniscus with the patients of the control group, with a statistically significant difference noted primarily in the elasticity of the medial meniscus. The index of meniscus density increases with the degree of arthrosis changes in the joint and is associated with the degree of degenerative changes of the meniscus in the joint. Ultrasound elastometry has been used as a method of evaluating the stiffness of soft tissues, particularly abdominal tissues in which neoplastic or global organ diseases alter composition and increased stiffness. Elastometry may be an ideal tool to assess loss of stiffness in tissues such as diseased or damaged cartilage and damaged knee meniscus. The shear-wave elasticity imaging is a highly sensitive method of diagnosing degenerative changes in the meniscus of the knee joints and can be used to detect early, preclinical stages of pathological changes in the menisci

Determine the effectiveness of lipid-lowering therapy in patients with chronic obstructive pulmonary disease combined with coronary heart disease

Introduction: In complex treatment of chronic obstructive pulmonary disease (COPD) combined with ischemic heart disease (IHD) more and more attention is drawn to pleiotropic effect of statins. The aim of our researches became determining the effectivity of utilization of rosuvastatin (Crestor®, IPR Pharmaceuticals, Inc.) in complex treatment of COPD combined with IHD. Materials and methods: Basing on pulmonology department of Poltava regional clinical hospital, 30 patients with COPD combined with IHD have been examined (stable effort angina FC II) aged from 51 to 67 y.o. (average age was 57,03±3,51). The patients were divided into two age compatible groups. Patients of the main group (n=15) underwent regular COPD and IHD treatment, addind 20 mg of rosuvastatin per night. The observed group (n=15) didn't receive rosuvastatin. The examination of patients was held before and half year of treatment, included the estimation of respiratory symptoms of the disease, the degree of intensity of dyspnea (Medical Research Council Dyspnea Scale). The tolerance to physical exercise was studied with 6 minute walking test. The cholesterine level, HDL, LDL, function of ventilation have been tested as well. The average frequency of aggravations during the year was estimated through retrospective examination of anamnesis. Results: After the treatment the improvement of clinical state has been noticed at both groups due to decrease of intensity of respiratory symptoms of the disease, such as cough, amount of expectoration, dyspnea and also increase of tolerance to physical exercise and improvement of laboratory-instrumental indexes. Though the patients of the main group were noticed to have significantly less amount of expectoration and cough. The distance covered in 6 minutes was positively longer (р<0,05). It has to be noted that the patients of the main group had positive decrease of wheezing after treatment, due to increase of FEV1, GI (р<0,01). The retrospective studying of the anamnesis revealed that the frequency of arrogations during the year was 1-2 times a year (1,6±0,48). Conclusions: Including rosuvastatin into the treatment scheme allows to decrease and stabilize the main clinical symptoms of this constellation of diseases, improving the quality of life, reduce the frequency of exacerbations