72 research outputs found
Эскалация этнополитических конфликтов: рациональный расчет элит и эмоциональная реакция масс
The authors of the article have tasked themselves with demonstrating that ethnopolitical conflicts always have a significant emotional component, which lies in cultural stereotypes, unmet (imaginary and real) expectations, historical grievances, parties’ mythologized ideas about each other, etc. In turn, the rejection of any dissent by the conflict parties determines a dualistic view of the world, which demonstrates the division into absolute good and absolute evil, and leads to a tough confrontation between the carriers of the “highest truth” with those who prevent its implementation. The authors emphasize that it is due to this excessive emotional component actualized by the demands of ethnic identity that ethnopolitical conflicts are characterized by a high degree of irrationality, expressed in a huge potential for aggressiveness and hostility, far beyond the rational awareness of the interests of the conflict parties, and the choice of a strategy for interaction and search for a compromise. A particularly rapid escalation of conflict occurs when an ethnic group tends to perceive itself as a “victim” of value claims on the part of “alien” groups. However, the authors believe that it is impossible to reduce the ethnopolitical conflict solely to the affective behavior of its participants. Longterm use of violence is a social process; therefore, it cannot be based only on strong emotions, but, on the contrary, has to presuppose the development of certain norms, sanctions, roles, etc. That is, violence must be rationalized, explained and channeled. Therefore, the authors emphasize the crucial role of “ethnic entrepreneurs” in the escalation of ethnopolitical conflicts. Their activity can be viewed as a “production of ideological conflicts”, i.e., as a deliberate indoctrination of ordinary conflict participants in order to strengthen ethnic solidarity and/or armed struggle as a means of “national liberation” and achievement of other goals that are significant to ethnic entrepreneurs. Consequently, since emotions cannot be completely separated from rational thinking, the nature of most ethnopolitical conflicts depends both on subjective factors and on objective structural elements. Thus, all of them, combining rational and emotional activities, in one proportion or another, produce three types of conflicts: the struggle for resources, the clash of interests, the emotional upholding of ethnocultural identity
Biochemical monitoring in sports: focal points for improvement
Literature data analysis along with decades of experience in sports medicine (biochemistry of sports included) enabled us to classify and explain key points that would be appropriate to consider when conducting biochemical research in sports, but in doing so we believe that the relevant research studies make just a part of a comprehensive medical and pedagogical monitoring
Overcoming stability problems in microwave-assisted heterogeneous catalytic processes affected by catalyst coking
Microwave-assisted heterogeneous catalysis (MHC) is gaining attention due to its exciting prospects related to selective catalyst heating, enhanced energy-efficiency, and partial inhibition of detrimental side gas-phase reactions. The induced temperature difference between the catalyst and the comparatively colder surrounding reactive atmosphere is pointed as the main factor of the process selectivity enhancement towards the products of interest in a number of hydrocarbon conversion processes. However, MHC is traditionally restricted to catalytic reactions in the absence of catalyst coking. As excellent MW-susceptors, carbon deposits represent an enormous drawback of the MHC technology, being main responsible of long-term process malfunctions. This work addresses the potentials and limitations of MHC for such processes affected by coking (MHCC). It also intends to evaluate the use of different catalyst and reactor configurations to overcome heating stability problems derived from the undesired coke deposits. The concept of long-term MHCC operation has been experimentally tested/applied to for the methane non-oxidative coupling reaction at 700¿C on Mo/ZSM-5@SiC structured catalysts. Preliminary process scalability tests suggest that a 6-fold power input increases the processing of methane flow by 150 times under the same controlled temperature and spatial velocity conditions. This finding paves the way for the implementation of high-capacity MHCC processes at up-scaled facilities
Antibiotic-associated diarrhea: state-of-the-art
The aim of review. To analyse modern concepts on antibiotic-associated diarrhea, to determine its place in the pattern of total morbidity.Key points. Wide antibiotic application in all sections of medicine along with beneficial action has series of essential side effects, including antibiotic-associated diarrhea. Its extreme and most severe manifestation is pseudomembranous colitis, caused by toxin-producing Clostridium difficile strains. This etiological agent in modern world has got significant association with hospitals and assisted-care facilities, therefore it can spread in out-patient conditions as well at the present time. Mutations resulting in antibiotic resistance, increasing toxin production or promoting sporulation, considerably increase virulence and prevalence of these opportunistic microorganisms.Conclusion. The further studies on development of effective prophylactic and treatment methods of antibiotic-associated diarrhea are required, especially for most severe complication — pseudomembranous colitis. It is necessary to limit application of antibiotics, develop strict indications to their application
Methods of physical rehabilitation of elderly people for the prevention and treatment of sarcopenia
The aim of the review is to analyze the prevalence of sarcopenia in the elderly age group, the causes of its occurrence, and to present modern methods of prevention and physical rehabilitation. The study focuses on the relationship between exercise, training effects and physiological mechanisms, as well as the safety of various types of strength, anaerobic and multimodal training, which have a positive impact during the prevention and rehabilitation treatment of sarcopenia. Literature reviews, meta-analyses, and original studies are included that focus on older people in all settings, using validated assessment tools and methods. A literature search was conducted in four electronic databases – PubMed, Cochrane Library, Scopus, Springer, for the period from 2012 to June 30, 2022. There were no restrictions on the language bias of the publication. Search strategy. The keywords used to define the terms of participation in the review are “older/advanced age”, “sarcopenia” and “sarcopenic obesity”. Articles were included if they met the following criteria – cohorts with mean or median age ≥ 60 years and any of the following definitions of sarcopenia: European Working Group on Sarcopenia in the Elderly (EWGSOP), Asian Working Group on Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS). To ensure comparability of interventions, the review included studies that were conducted for at least 8 weeks, and the distribution of patients by study design was randomized. Also, articles involving hospitalized patients are excluded
Results of formation of primary and secondary smallintestinal reservoirs at ulcerative colitis
Aim of investigation. Improvement of results of surgical treatment and quality of life of patients with severe forms of ulcerative colitis.Material and methods. Investigation is based on analysis of results of surgery of 123 ulcerative colitis patients operated in coloproctology center of Ministry of Health of Russia in 2007 to 2013, that was completed by reconstructive — plastic stage. Formation of smallintestinal reservoir in one stage with total resection of large intestine was carried out in 46 (37,4%) patients (the first group) and secondary, remote — in 77 (62,6%, the second group).Results. At analysis of complication types it was revealed, that complications related to stapling device prevailed in groups. At the present moment of 123 patients who have underwent surgical treatment with formation of smallintestinal reservoir, in 101 (82,1%) ileostoma was liquidated. Of them in the first group it has been closed in 31 (67,4%) patient, in the second — in 70 (90,1%). Thus only in 2 (4,3%) patients of the first and in 1 (1,2%) patient of the second group with developed postoperative complications closure of imposed ileostoma was not performed.Conclusions. Today formation of smallintestinal reservoirs is unique way of rehabilitation of patients with ulcerative colitis after total colectomy. Comparable results of treatment in analyzed groups have been received due to refusal of primary reservoir formation in patients with more severe course of disease and more intensive and long-term steroid therapy
Enchanced preoperative rehabilitation as part of the complex perioperative rehabilitation of patients with super-obesity and obstructive sleep apnea syndrome (clinical outlook)
Obesity is a global social and economic problem. The bariatric surgery is a most effective treatment for obesity. The presented clinical case demonstrates the usage of principles of enchanced perioperative rehabilitation for the preoperative preparation of a patient with super obesity and with severe obstructive sleep apnea and alveolar hypoventilation syndrome.A 54-year-old patient was hospitalized with complaints of obesity, impossibility of persistent weight loss conservatively, severe daytime sleepiness, frequent nocturnal awakenings (up to 8 times per night). The patient’s weight was 230 kg with a height of 157 cm (BMI 93.5 kg / m2). The examination revealed a syndrome of sleep apnea of mixed genesis of extremely severe degree, chronic night hypoxemia of an extremely severe degree. Preoperative preparation was performed in accordance with the program of enchanced perioperative rehabilitation. The duration of preoperative preparation was 19 days; weight loss — 40 kg (%WL -17,4), compensation of comorbidities was achieved as well. After that the patient underwent a laparoscopic sleeve gastrectomy. There were no complications in the postoperative period. Length of postoperative hospital stay was 6 days. At follow-up examination one year after surgery, body weight dropped from 230 to 153 kg (% WL-33.5), a significant improvement of the quality of life was achieved.The enchanced perioperative rehabilitation program can be successfully used as an effective method for preoperartive preparation of the patients with morbid obesity in combination with severe obstructive sleep apnea syndrome.and obesity hypoventilation. It can be a reasonable alternative to the standard program with preoperative intragastric balloon treatment. The use of this technique allows to increase the effectiveness of treatment of these high-risk patients, as well as to reduce the risk of perioperative complications
Влияние полноты реализации программы ускоренного выздоровления пациентов, перенесших резекцию ободочной кишки по поводу рака, на эффективность лечения
Objective: to assess ERP implementation results in patients with colon cancer and to reveal correlation between compliance of ERP protocol and efficacy of perioperative care.Materials and methods. 124 patients were included in the study. Main group consisted of 62 patients with ERP, others were controls. ERP compliance was assessed using original formula which considers number of accomplished elements of the Protocol and quality of performance of each element.Results. No significant difference between the groups in morbidity was obtained (1.6 % in main group vs 9.8 % controls; р = 0.06). Minor dependence in self-care was obtained in 90.5 % at third post-op day in main group vs 58.0 % in controls (p < 0.0001). Postoperative hospital stay was lower in main group (4.7 ± 0.1 vs 9.0 ± 0.6 days; p < 0.0001). Total hospital stay was lower in main group as well (7.2 ± 0.1 vs 14.1 ± 0.7 days; р < 0.0001). No mortality and readmissions occurred. ERP compliance rate was 80.0 % (56.9–93.3 %). Рostoperative hospital stay in patients with high protocol compliance (≥ 80 %) was significantly shorter then in patients with low protocol compliance (< 80 %): 4.3 ± 0.2 vs 5.1 ± 0.2; р = 0,005).Conclusion. ERP is effective and safe method of postoperative care in patients after colon resection and the effectiveness of the treatment correlates with protocol compliance rate resulted in shorter hospital stay.Целью работы стала оценка непосредственных результатов применения программы ускоренного выздоровления (ПУВ) пациентов, подвергшихся операциям на ободочной кишке, и изучение влияния полноты ее реализации на эффективность лечения.Материалы и методы. В исследование включены 124 пациента. Первую (основную) группу составили 63 больных, в отношении которых которых была применена ПУВ. Пациенты 2-й (контрольной) группы (n = 61) получали стандартное лечение. Для подсчета процента реализации ПУВ нами разработана формула, учитывающая не только количественную реализацию элементов программы, но и качество выполнения каждого из заявленных элементов.Результаты. Частота послеоперационных осложнений в группах и подгруппах достоверно не отличалась (1,6 % (n = 1) – в основной и 9,8 % (n = 6) – в контрольной; р = 0,056). Количество послеоперационных койко-дней ниже в основной группе и составила 4,7 ± 0,1 по сравнению с 9,0 ± 0,6 в контрольной (р < 0,0001). Достоверно ниже было и число общих койко-дней в основной группе (7,2 ± 0,1 против 14,1 ± 0,7 в контрольной (р < 0,0001)). Случаев повторной госпитализации и летальности не отмечено. Доля реализации ПУВ в нашей клинике составила от 56,9 до 93,3 %, медиана – 80 %. Число послеоперационных дней у пациентов с реализацией программы на 80 % и более был достоверно ниже, чем у пациентов с реализацией ПУВ < 80 %: 4,3 ± 0,2 против 5,1 ± 0,2, (р < 0,0001).Заключение. Предложенная ПУВ является эффективным и безопасным методом ведения пациентов, подлежащих хирургическому лечению по поводу рака ободочной кишки. Эффективность лечения, ассоциированная с укорочением сроков пребывания в стационаре, коррелирует с процентом реализации ПУВ
Improvement of anal sphincter function before preventive stoma closure: modern options
Aim of investigation. To investigate options of improvement of anal sphincter function of defunctioning loop by BFT and tibial nerve stimulation.Material and methods. Overall 23 patients with preventive stoma were included in original investigation. Diagnostic profilometry and sphincterometry were carried out. Treatment included BFT and tibial nerve stimulation for 10 days. Results. After treatment profilometry revealed statistically significant increase of mean resting pressure, while sphincterometry — at conation as well.Conclusions. Muscular structures of the defunctioning anal sphincter respond to BFT and tibial nerve stimulation, increasing both tension and force of voluntary contractions
- …