The article presents the foundational didactic principles that are the theoretical basis for the organization of distance teaching in the field of "Human Anatomy and Physiology" using network teaching aids. In particular, the scientific principle of the teaching material is described. The application of this principle guarantees a comprehensive knowledge of facts and concepts that are scientifically proven, have a worldview and practical significance. The principle of comprehensibility involves the layout and design (presentation of material), the interaction with the educational content, elements of the network educational-methodical complex, developed taking into account the mental and physical age of students. The principle of systematization ensures goal-oriented regulation of students' knowledge and skills. The principle of visualization of the educational material provides demonstration of the studied objects, processes and events. The principle of variability of educational material allows to individualize the process of distance teaching of the subject "Human Anatomy and Physiology" on the basis of a network of educational and methodical complexes.
This study was designed to examine administrative change and the enhancement of relevance in state higher education system in Cameroon. The study was guided by two objectives which examine how change in administrative policy and administrative skills will enhance the relevance in state higher education system in Cameroon. This is supported by the theory of Fullan who state that that educational change is a process and to begin the change process you must be able to fully involve all human participants (stakeholders) in the change process for a better sustainability. This is supported by the theory of Fullan who state that that educational change is a process and to begin the change process you must be able to fully involve all human participants (stakeholders) in the change process for a better sustainability. The concurrent mixed-methods research design specifically the concurrent triangulation design was adopted for the study. Questionnaire and an interview guide were the instruments used for the study. The questionnaire consisted of both close and open ended questions for lecturers and post graduate students and interview guide for university administrators (HODs). The sample population for the study was made up of 1,915 lecturers, and 40 administrators (HODs) from the universities of Buea, Yaounde II, Douala, Bamenda, Yaounde I, Dschang, Maroua and Ngaoundere. The purposive and stratified sampling techniques was adopted for the study. Data from close ended questions was analysed using SPSS 23.0, with the aid of descriptive and inferential statistical tools while open ended questions were analysed thematically. The Spearman’s rho was used to test the research hypotheses formulated in the study. Majority of the lecturers (86.4%) agreed that there is a need for change in administrative policy to enhance relevance of Higher Education and a majority of the lecturers (71.3%) equally agreed that there is a need for change in administrative skills to enhance relevance of Higher Education. Hypothetically, there is a significant, positive and moderate relationship between administrative change and the enhancement of relevance in state Universities (R- value 0.207**, p-value < 0.001 < 0.05). Therefore, it was generally recommended that, for the enhancement of relevance in state higher education system in Cameroon orientation services should be organized before admission to enable student understand and make correct chooses. Specifically, in line with change in administrative policy most administrative posts should be elective for a given term of office in order to enable efficiency. Elective positions for HOD, Deans, Directors, Registrar and Vice Chancellors and in line with change in administrative skills, there should be innovation at the level of the administration by bringing in competent personal who will bring about the desired change to better enhance the relevant of HE.
The article analyzes the role of the principle of the closest connection principle in the regulation of relations of international private law character, the nature of this principle as both a collision principle and a collision binding. The scope of application of the closest connection principle is highlighted as a collision binding and as a trend observed today. The value of this principle in improving international private law and its role in law-making is revealed
This article analyzed the mechanism of
implementing the principle of comprehensiveness in the complex autonomous codification of private international law by establishing a system of collision linkings based on the principle of closest connection.
This article discusses the basic principles of systematic analysis in pedagogy, which is a topical concept in the modern innovative educational environment.
In this article author had searched the ideas on the principle of the expediency in the criminal proceeding and given the opinions, positions of the scientists about this matter. Also in this article author had given his opinions about opinions and ideas on the principle of the expediency, regulated the criminal proceeding relations as well as given his suggestions and recommendations.
The study specifically is aimed at determining the relevance of promotion in marketing: an investigation on why companies promote their products.
The study involves the relevance of promotion in marketing and impact of all promotional tools to every marketing activity. Promotion as one of the marketing mix element is important in understanding today’s success to marketing through endeavors on how to carefully implement it.
It is very important to note that promotion is in existence for a very long period of time thoughout the world. The work carryout on relevance of promotion in marketing
Relevance of the problem.Despite the great successes of angiosurgery, the problem of surgical treatment of abdominal aortic aneurysms does not lose its relevance. World health statistics records a steady increase in the incidence of abdominal aortic aneurysm (ABA). According to L.J. Melton et al. (1984) and L.K. Bickerstaff et al. (1984) in the USA the number of patients with abdominal aortic aneurysm has increased 7 times in 30 years since 1951. In England and Wales, according to F.G. Fowkers et al. (1989) for the same period revealed a 20-fold increase in abdominal aortic aneurysms in men and 11-fold in women. According to the results of multicentre screening studies ABA was detected in 8% of the examined (E.S. Vourvouri, 2001), and in the age group of 64-69 years ABA was detected in 5.7% of the examined, and in the age group of 75-81 years - in 8.9% (R.A.P. Skott et al., 2001). A similar trend is observed in other countries. Accordingly, mortality from ABA is also increasing - aneurysm rupture in a number of countries is one of the ten most frequent causes of death among elderly and senile people (F.A. Lederle et al., 1990)
Currently, planned aneurysm resection has become a recognised standard of radical treatment of ABA patients and the number of these operations is steadily increasing. For example, about 40,000 ABA resections are performed annually in the USA (J.J. Grange et al., 1997). In Sweden during the period from 1987-89 to 1993-95 the number of ABA operations increased 5 times and currently 10 operations per 100,000 population are performed (A.Hallin et al., 2001), although this is 1.5 - 2 times less than the required number. However, postoperative lethality is still quite high and makes 5-7% (A.V.Pokrovskiy et al., 1992; Y.V.Belov et al., 1992; V.V.Vakhidov et al., 1992; A.W. Bradbury et al. Bradbury et al., 1997; A.Hallin et al., 2001).
E.W. Steyeberg et al. (1995) summarised the data of literature on 17238 ABA resection operations and gave an average mortality of 6.8%.
Multicentre studies in five major hospitals in the Netherlands found that only 74% of patients underwent ABA resection without complications; 26% had some complications, 9% of which were severe and 4.1% of which were fatal (G.J. Akkersdijk et al., 1998). Similar results were obtained in the Canadian Cooperative Study (K.W. Johnston et al., 1990). It was established that the peculiarity of complications in the majority of patients was their systemic character (L.L. Lau et al, 2001) The course of the postoperative period is most often complicated by cardiac, respiratory, renal, cerebrovascular, as well as complications associated with thrombosis and bleeding (W.E. Lloyd et al., 1996; R.D. Sayers et al., 1997; J.D. Blankenstein et al., 1998; R. Ayari et al., 1998). Ayari et al., 2001)
The undisputed leadership, without doubt, belongs to cardiac complications, the incidence of which varies from 10% to 20%. Moreover, cardiac complications account for 50-70% of total mortality. Cerebrovascular complications, although not uncommon, account for no more than 1-1.5%, but their mortality reaches 40%. Complications associated with thromboses and haemorrhages in the perioperative period reach 2-5% (M.M.Reigel et al., 1987; K.W.Johnson et al., 1990; N.Franklin et al., 1993; A.A.Milne et al., 1994).
Certainly, a large number of complications after resection of abdominal aortic aneurysms is caused by the initial severity of patients' condition, however, many unresolved tactical and technical issues of patients' preparation for the operation, stage of performance in case of combined lesions of several vascular basins play a practically significant role. Adequate management of the operation itself and the immediate postoperative period is no less important, taking into account the possibility of such dreadful complications as thrombosis and embolism, cerebral and cardiac death. Until now there is no unified complex analysis of the results of treatment of uncomplicated abdominal aortic aneurysms and, accordingly, recommendations for the prevention of possible complications.
All this determined our aim and objectives of the study.
The aim of the study is to improve the results of surgical treatment of ABA by developing an effective system for determining the main risk factors of surgical treatment and optimal surgical tactics to prevent possible complications.
Scientific novelty.For the first time a complex analysis of indications and contraindications to surgical treatment of abdominal aortic aneurysms was carried out
The most significant concomitant pathology capable to lead to formidable complications and lethality during the intervention and in the nearest postoperative period was revealed. Adequate measures of their prevention and treatment were proposed.
The algorithm of surgical treatment tactics for patients with combined pathology of coronary arteries and aortic arch branch lesions was developed
The state of haemostasis system at all stages of reconstructive surgery on abdominal aorta, starting from skin incision to wound closure, was studied for the first time.
Conclusions:
1. The proposed original classification of ABA, based on mutual dependence on the etiology of the disease, localisation, concomitant diseases, clinic and its course, allows to determine the strategy of early diagnosis, to estimate the most significant risk factors, the stage of intervention in combined lesions of adjacent and distant vascular basins and, ultimately, to determine the ways to reduce complications and mortality in patients with ABA.
2. The most informative methods of ABA diagnostics are duplex scanning and computed tomography. Non-invasive diagnostics capabilities are enough to determine the aneurysm size, its relation to the renal arteries, as well as to find out the state of visceral branches and aortic bifurcation. Abdominal aortography is indicated in patients with concomitant arterial hypertension to identify the state of the renal arteries.
3. Significant risk factors in these patients are ischaemic heart disease (44.1%), arterial hypertension (49%), haemostasis disorders (almost 100%).
4. The leading concomitant disease in the development of postoperative complications is ischaemic heart disease. Its share in abdominal aortic aneurysms is 40%. Postoperative cardiac complications reach 14.9%. Diagnostics of ischaemic heart disease should be based on the stage-by-stage detection of coronary lesions and its functional-compensatory abilities.
5. The main complications of the postoperative period after ABA resections are acute heart failure (14,9%), cerebral circulatory disorders (1,5%), acute renal failure (3,33%).
6. When significant coronary vascular channel lesions are detected in patients with ABA, it is fundamental to solve the issue of intervention staging. At 3-4 functional classes of circulatory insufficiency, appearance of new zones of hypo- or akinesia, decrease of ejection fraction below 40%, the first stage should be myocardial revascularisation surgery
7. In patients with combined lesions of brachiocephalic vessels in patients with ABA it is reasonable to assess the cerebral blood flow. In the presence of 70% or more stenosis of VCA, presence of embologenic plaque, bilateral haemodynamically significant stenosis it is necessary to perform carotid artery intervention as the first stage.
8. One of the most difficult problems of reconstructive operations in ABA is the contiguous lesion of renal and visceral branches of the abdominal aorta. The principle is their one-stage reconstruction. The types of reconstruction of these branches should be variable depending on the volume and extent of the pathological process.
9. Patients with aneurysmal lesion of abdominal aorta initially always have significant disorders of haemostasis system. In 30% of patients with occlusive diseases of aorta and its branches in the preoperative period the activity of thrombocytic-vascular link of hemostasis is increased, antithrombotic ability of vascular wall endothelium is decreased and blood rheological properties are disturbed. Activation of fibrinolysis was noted in patients with aneurysmal lesion of abdominal aorta.
10. During the operation for abdominal aortic aneurysmal lesion, after starting the blood flow the level of plasminogen increases additionally by 30%, which is a risk factor for haemorrhagic complications in the perioperative period. On the 1-3 day after the operation there is a significant decrease of blood anticoagulant potential - antithrombin-Sh by 25-27%, protein C by 23-25%. This period is the most dangerous in terms of thrombohemorrhagic complications development.
11. When using standard heparin during the operation there is a consumption of antithrombin-Sh by 30-45% and increase of platelet aggregation by 10%, which is a threatening condition for the occurrence of thrombosis of deep veins of the lower extremities with subsequent TELA. When using fraxiparin during reconstructive vascular surgeries the consumption of antithrombin-Sh and increase in platelet aggregation do not occur, prothrombin time, activated partial thromboplastin time, thrombin time are lengthened insignificantly that testifies to expediency of its use for prevention of thrombohemorrhagic complications.
12. Application of the diagnostic methods proposed by us to detect the main risk factors during the operation and in the nearest postoperative period, use of the algorithm of stage and volume of intervention allowed to reduce significantly the number of threatening complications, thus the lethality decreased 4 times, and the number of non-fatal complications - 4 times non-fatal complications - 1.5 times.
In the introductory part of the article the author characterizes competitiveness as independent criminallyremedial principle. In the basic part of the article the urgency and the importance of the given problem are considered. In the conclusion the author comes to opinion, that for achievement of original competitiveness in criminal legal
proceedings it is necessary to fix a principle of competitiveness in the Constitution of Republic Uzbekistan and to raise a role of legal profession by expansion of its rights in collecting proofs.
The article contains an analysis of the theoretical and practical features of the principle of autonomy of arbitration agreement in foreign economic transactions. The article highlights the importance of the existence of an arbitration clause in foreign economic agreements, the nature of the arbitration clause in foreign economic transactions in international and national law, and the current problem of the independence of the arbitration clause from the contract.
Article analyses matters of consideration of the principle of reciprocity and international politeness as the bases for recognition and execution of decisions of the courts of the foreign states proceeding from the theory of the international private law, develops the relevant recommendations