Модернізація промисловості як передумова перспективного розвитку внутрішнього ринку України

Исследованы проблемы государственной промышленной политики по внедрению модернизационных процессов в развитии внутреннего рынка Украины. Представлены инструменты влияния на процесс модернизации промышленного комплекса. Предложено решение проблемных задач модернизации промышленного комплекса, направленного на обоснование развития внутреннего рынка Украины. Ключевые слова: внутренний рынок, инвестиции, инновации, кластеры, модернизация, промышленный комплекс, промышленная политика.Досліджено проблеми державної промислової політики щодо впровадження модернізаційних процесів у розвитку внутрішнього ринку України. Подано інструменти впливу на процес модернізації промислового комплексу. Запропоновано вирішення проблемних завдань модернізації промислового комплексу, спрямованого на обґрунтування розвитку внутрішнього ринку України. Ключові слова: внутрішній ринок, інвестиції, інновації, кластери, модернізація, промисловий комплекс, промислова політика.The establishment of the market economy and modern transformational processes give rise to new requirements to the development of the national economy. Modernization of changes in the social and economic development of the state have already matured. However, the crisis political processes and deep social stratification hindered the development of Ukraine and threw the country to the edge of the world progress. The future of Ukraine depends much on extensive development of the national economy and especially of its center – the internal market that is the most important factor of further economic growth of the state. The aim of the paper is to combine the achievements of the modern economic science with solution of problems of the industrial sector modernization aimed at substantiating the development of Ukraine’s internal market. The processes of the Ukrainian industrial complex modernization were studied. It is stressed that the lack of balanced industrial policy is the key restrictive factor for modernization of the national economy and its development according to the objectives set in Ukrainian society. The problems of the state industrial policy connected with modernization of the Ukrainian internal market development are analyzed. Factors of the industrial modernization influence on the development of the Ukrainian internal market are identified. The instruments influencing the process of the industrial complex modernization are shown. The idea of introducing clusters into the industrial sector in order to improve the organizational processes aimed at modernization of the industrial complex is promoted. The attention is paid to the importance of the investment activity and innovative technologies introduction into production of the industrial enterprises. The paper offers solutions of the problem concerning modernization of the industrial complex directed to substantiation of the Ukrainian internal market development. Keywords: internal market, investments, innovation, clusters, modernization, industrial complex, industrial policy

Teens @ Culture: The Online Communications of Dutch High School Teenagers on Popular and Highbrow Culture

Teenagers’ interest in highbrow culture like classical music, museums and plays is somewhat low, but this group’s extensive Internet use may heighten this interest and increase their cultural participation online. In contrast to previous research, we examined teenagers’ online involvement in both popular and highbrow culture. An investigation among 892 high school teenagers indicated that explanations from the fields of cultural participation and media use account for differences in online cultural involvement. Teenagers with parents who are more highly educated and culturally active, and those with culturally interested friend are in turn more interested in culture, and communicate online more about both highbrow and popular culture. In addition to interest and socialization, there appears to be a minor mobilization effect of Internet use, as those with better digital skills and spending more time online engage more in online cultural communications

Prospective Evaluation of Ischemia in Brachial–Basilic and Forearm Prosthetic Arteriovenous Fistulas for Hemodialysis

Ischemia is a devastating complication after arteriovenous fistula (AVF) creation. When not timely corrected, it may lead to amputation. Symptomatic ischemia occurs in 3.7–5% of the hemodialysis population. Upper arm AVFs have a higher incidence of ischemia compared to forearm AVFs. As more patients may need upper arm AVFs in the growing and older hemodialysis population, occurrence of symptomatic ischemia may increase. The purpose of this study is to identify predictors for occurrence of ischemia.MethodsA prospective evaluation of ischemia was performed in patients randomised for either a brachial–basilic (BB-) AVF or a prosthetic forearm loop AVF. Clinical parameters, preoperative vessel diameters, access flows, digital blood pressures, digit-to-brachial indices (DBI) and interventions for ischemia were recorded.ResultsSixty-one patients (BB-AVF 28) were studied. Seventeen patients (BB-AVF 8) developed ischemic symptoms. Six patients (BB-AVF 3) needed interventions for severe symptoms. Age, history of peripheral arterial reconstruction and radial artery volume flow were significant predictors for the occurrence of ischemia.ConclusionSymptomatic ischemia occurred in 28% of patients with brachial–basilic and prosthetic forearm AVFs. Age, history of peripheral arterial reconstruction and radial artery volume flow might be important for prediction of ischemia

Hoe cultureel is de digitale generatie?

Over the past decade, young people in the Netherlands have developed into fervent Internet users. At the same time, cultural institutions have digitised a great deal of their content and made it accessible online. This was seen as a challenging combination, or a new opportunity to reach this target audience, since most young people are online. It is however unclear how much use the digital generation actually makes of the online opportunities for cultural purposes. This report describes how culturally active teenagers are on the Internet and to what extent their cultural activities are related to the extent of their Internet use, their digital skills, the cultural activities of their family and friends, and the (cultural and digital) activities at their school. For this study, 1592 Dutch secondary school students were interviewed in 2008, with questionnaires being completed by students in 167 classes at 32 schools distributed across five large cities, 11 medium-sized cities and three small municipalities. The students varied in age from 12 to 18 years and were attending courses at pre-vocational secondary, senior general secondary or pre-university level (students in final examination classes were not interviewed). In order to investigate the digital cultural participation of 12-18 year-olds, a distinction was made between three types of Internet use. These can be summarised using three ‘C’s: − content (using the Internet to search for various kinds of information, such as text, images and sound); − contact (personal communication or interaction in peer-to-peer networks); − creation (production of text, images or sound and uploading these to the Internet, as well as responding online to contributions from others and posting tags).In het afgelopen decennium hebben jongeren zich geprofileerd als fervente internetgebruikers. Tegelijkertijd hebben culturele instellingen veel aanbod gedigitaliseerd en online toegankelijk gemaakt. Dit werd als een uitdagende combinatie of een nieuwe kans gezien, aangezien de meeste jongeren online zijn. Het is echter de vraag in hoeverre de digitale generatie de online mogelijkheden inderdaad benut voor culturele doeleinden. In dit rapport is beschreven hoe cultureel actief tieners op internet zijn en in hoeverre die activiteiten samenhangen met de omvang van hun internetgebruik, hun digitale vaardigheden, de culturele activiteiten in hun gezin en van hun vrienden, en de (culturele en digitale) activiteiten op hun school. Voor het onderzoek zijn leerlingen in het voortgezet onderwijs geïnterviewd. In 2008 vulden 1592 leerlingen uit 167 klassen van 32 scholen in de klas een vragenlijst in. De scholen zijn verdeeld over vijf grote steden, elf middelgrote steden en drie kleine gemeenten. De leerlingen varieerden in leeftijd tussen de 12 en 18 jaar en zaten op een vmbo-, havo- of vwo-opleiding (leerlingen in eindexamenklassen zijn niet ondervraagd). Om de digitale cultuurparticipatie van 12-18-jarige scholieren te onderzoeken is een onderscheid gemaakt in drie rollen bij het internetgebruik. Deze drie rollen kunnen samengevat worden met drie C’s: − content (gebruik internet voor verschillende soorten informatie zoals tekst, beeld als geluid); − contact (persoonlijke communicatie of interactie in peer-to-peer-netwerken); − creatie (het zelf produceren van tekst, beeld of geluid en deze uploaden op internetalsmede het online reageren op bijdragen van anderen en het plaatsen van tags)

Rosenthal's potential and a discrete version of the Debreu--Gorman Theorem

The acyclicity of individual improvements in a generalized congestion game (where the sums of local utilities are replaced with arbitrary aggregation rules) can be established with a Rosenthal-style construction if aggregation rules of all players are "quasi-separable." Every universal separable ordering on a finite set can be represented as a combination of addition and lexicography

Effectiveness of an attachment-based intervention for the assessment of parenting capacities in maltreating families: a randomized controlled trial

Even though Parenting Capacity Assessments (PCAs) are essential for child protection services to support placement decisions for maltreating families, presently no evidence-based PCA protocols are available. In this randomized controlled trial, we tested the quality of an attachment-based PCA protocol based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). We recruited 56 parent-child dyads (M(age)children = 3.48 years) in Dutch family residential clinics that conduct PCAs to support placement decisions. After pretest, families were randomized to receive the Regular Assessment Procedure (RAP) (n= 28), or an additional assessment based on VIPP-SD (n= 28). An immediate post-test and a 10-month follow-up were conducted. Multilevel models showed that therapists felt equally confident about their recommendations regarding child placement for both groups and that they equally often modified their initial placement recommendations. Moreover, children in the VIPP-SD group did not show fewer behavior problems and did not experience recurring child maltreatment less often than children in the RAP group. Thus, we found no evidence that PCAs incorporating the VIPP-SD protocol outperformed PCAs as usual. We discuss possible explanations why in the current study VIPP-SD did not seem to add to the quality of the RAP.Education and Child Studie

Optimising Access Surgery in Senior Haemodialysis Patients (OASIS): study protocol for a multicentre randomised controlled trial

Introduction Current evidence on vascular access strategies for haemodialysis patients is based on observational studies that are at high risk of selection bias. For elderly patients, autologous arteriovenous fistulas that are typically created in usual care may not be the best option because a significant proportion of fistulas either fail to mature or remain unused. In addition, long-term complications associated with arteriovenous grafts and central venous catheters may be less relevant when considering the limited life expectancy of these patients. Therefore, we designed the Optimising Access Surgery in Senior Haemodialysis Patients (OASIS) trial to determine the best strategy for vascular access creation in elderly haemodialysis patients. Methods and analysis OASIS is a multicentre randomised controlled trial with an equal participant allocation in three treatment arms. Patients aged 70 years or older who are expected to initiate haemodialysis treatment in the next 6 months or who have started haemodialysis urgently with a catheter will be enrolled. To detect and exclude patients with an unusually long life expectancy, we will use a previously published mortality prediction model after external validation. Participants allocated to the usual care arm will be treated according to current guidelines on vascular access creation and will undergo fistula creation. Participants allocated to one of the two intervention arms will undergo graft placement or catheter insertion. The primary outcome is the number of access-related interventions required for each patient-year of haemodialysis treatment. We will enrol 195 patients to have sufficient statistical power to detect an absolute decrease of 0.80 interventions per year. Ethics and dissemination Because of clinical equipoise, we believe it is justified to randomly allocate elderly patients to the different vascular access strategies. The study was approved by an accredited medical ethics review committee. The results will be disseminated through peer-reviewed publications and will be implemented in clinical practice guidelines. Protocol version and date V.5, 25 February 2021.Clinical epidemiolog

Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older:a randomised controlled trial

Background: Inguinal hernia belongs to the most common surgical pathology worldwide. Approximately, one third is asymptomatic. The value of watchful waiting (WW) in patients with asymptomatic or mildly symptomatic inguinal hernia has been established in a few randomised controlled trials (RCTs). The aim of this study was to assess long-term outcomes of a RCT comparing WW and elective surgery.Methods: In the original study, men aged ≥50 years with an asymptomatic or mildly symptomatic inguinal hernia were randomly assigned to WW or elective repair. In the present study, the primary outcome was the 12-year crossover rate to surgery, secondary outcomes were time-to-crossover, patient regret, pain, quality of life and incarceration. Dutch Trial Registry: NTR629. Findings: Out of 496 originally analysed patients, 488 (98.4%) were evaluable for chart review (WW: n = 258, surgery: n = 230), and 200 (41.0%) for telephone contact (WW: n = 106, surgery: n = 94) between November 2021 and March 2022 with a median 12 years follow-up (IQR 9–14). After 12 years, the estimated cumulative crossover rate to surgery was 64.2%, which was higher in mildly symptomatic than in asymptomatic patients (71.7% versus 60.4%, HR 1.451, 95% CI: 1.064–1.979). Time-to-crossover was longer in asymptomatic patients (50% after 6.0 years versus 2.0 years, p = 0.019). Patient regret was higher in the WW group (37.7 versus 18.0%, p = 0.002), as well as pain/discomfort (p = 0.031). Quality of life did not differ (p = 0.737). In the WW group, incarceration occurred in 10/255 patients (3.9%). Interpretation: During 12-year follow-up, most WW patients crossed over to surgery, significantly earlier with mildly symptomatic hernia. Considering the relatively low incarceration rate, WW might still be an option in asymptomatic patients with a clear preference and being well-informed about pros and cons.</p

Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older:a randomised controlled trial

Background: Inguinal hernia belongs to the most common surgical pathology worldwide. Approximately, one third is asymptomatic. The value of watchful waiting (WW) in patients with asymptomatic or mildly symptomatic inguinal hernia has been established in a few randomised controlled trials (RCTs). The aim of this study was to assess long-term outcomes of a RCT comparing WW and elective surgery. Methods: In the original study, men aged ≥50 years with an asymptomatic or mildly symptomatic inguinal hernia were randomly assigned to WW or elective repair. In the present study, the primary outcome was the 12-year crossover rate to surgery, secondary outcomes were time-to-crossover, patient regret, pain, quality of life and incarceration. Dutch Trial Registry: NTR629. Findings: Out of 496 originally analysed patients, 488 (98.4%) were evaluable for chart review (WW: n = 258, surgery: n = 230), and 200 (41.0%) for telephone contact (WW: n = 106, surgery: n = 94) between November 2021 and March 2022 with a median 12 years follow-up (IQR 9–14). After 12 years, the estimated cumulative crossover rate to surgery was 64.2%, which was higher in mildly symptomatic than in asymptomatic patients (71.7% versus 60.4%, HR 1.451, 95% CI: 1.064–1.979). Time-to-crossover was longer in asymptomatic patients (50% after 6.0 years versus 2.0 years, p = 0.019). Patient regret was higher in the WW group (37.7 versus 18.0%, p = 0.002), as well as pain/discomfort (p = 0.031). Quality of life did not differ (p = 0.737). In the WW group, incarceration occurred in 10/255 patients (3.9%). Interpretation: During 12-year follow-up, most WW patients crossed over to surgery, significantly earlier with mildly symptomatic hernia. Considering the relatively low incarceration rate, WW might still be an option in asymptomatic patients with a clear preference and being well-informed about pros and cons. Funding: The initial trial was funded by the Netherlands Organisation for Health Research and Development (ZonMW). This long-term study did not receive funding.</p

Molecular characteristics of carbapenemase-producing Enterobacterales in the Netherlands; results of the 2014–2018 national laboratory surveillance

Objectives: Carbapenem resistance mediated by mobile genetic elements has emerged worldwide and has become a major public health threat. To gain insight into the molecular epidemiology of carbapenem resistance in The Netherlands, Dutch medical microbiology laboratories are requested to submit suspected carbapenemase-producing Enterobacterales (CPE) to the National Institute for Public Health and the Environment as part of a national surveillance system. Methods: Meropenem MICs and species identification were confirmed by E-test and MALDI-TOF and carbapenemase production was assessed by the Carbapenem Inactivation Method. Of all submitted CPE, one species/carbapenemase gene combination per person per year was subjected to next-generation sequencing (NGS). Results: In total, 1838 unique isolates were received between 2014 and 2018, of which 892 were unique CPE isolates with NGS data available. The predominant CPE species were Klebsiella pneumoniae (n = 388, 43%), Escherichia coli (n = 264, 30%) and Enterobacter cloacae complex (n = 116, 13%). Various carbapenemase alleles of the same carbapenemase gene resulted in different susceptibilities to meropenem and this effect varied between species. Analyses of NGS data showed variation of prevalence of carbapenemase alleles over time with blaOXA-48 being predominant (38%, 336/892), followed by blaNDM-1 (16%, 145/892). For the first time in the Netherlands, blaOXA-181, blaOXA-232 and blaVIM-4 were detected. The genetic background of K. pneumoniae and E. coli isolates was highly diverse. Conclusions: The CPE population in the Netherlands is diverse, suggesting multiple introductions. The predominant carbapenemase alleles are blaOXA-48 and blaNDM-1. There was a clear association between species, carbapenemase allele and susceptibility to meropenem