Non-steroidal anti-inflammatory drugs (NSAIDs) are most popular medications for the treatment of pain in common musculoskeletal diseases such as osteoarthritis (OA) and non-specific low back pain (LBP). However, the factors affecting the effectiveness of these drugs have not been determined fully. Aim: to identify factors affecting the effectiveness of NSAIDs in patients with OA and LBP. Materials and methods. An observational study was conducted to evaluate the effectiveness of a 2-week course of NSAIDs in OA and LBP in real clinical practice. The study group consisted of 3604 patients with OA and LBP (60.6% women and 39.4% men, mean age 55.0±13.4 years). According to the study design, aceclofenac (Airtal) and other NSAIDs used in the ratio 1:1. The main criterion of effectiveness was the frequency of complete pain relief after 2 weeks of therapy. In addition, the decrease of pain and general health were determined on a 10-point numerical rating scale (NRS). We compared the frequency of complete pain relief in patients who had and did not have the studied factors. The value of the studied factors was determined using OR (95% CI). Results and discussion. Most patients received aceclofenac (54.9%), as well as diclofenac (2.0%), ketoprofen (1.9%), lornoxicam (2.2%), meloxicam (13.7%), naproxen (2.1%), nimesulide (5.8%), celecoxib (5.9%), ethicoxib (7.1%) and other NSAIDs (4.4%); 56.2% of patients received muscle relaxants, mainly tolperisone (74.7%), vitamin B (10.4%), and proton pump inhibitors (42.8%). Complete pain relief was achieved in 54.8% of patients. The pain decrease and general health improvement were (for NRS) 63.9±13.4% and 61.7±14.8%, respectively. The efficacy of aceclofenac was slightly higher than in the whole group: complete pain relief was in 59.9% of patients. Adverse events in aceclofenac use were observed in 2.3% of patients, other NSAIDs-from 2.4 to 14.1%. The frequency of complete pain relief was higher in men: OR 1,239 (95% CI 1.08-1.418; p=0.002), who had the first episode of pain - OR 3.341 (95% CI 2.873-3.875; p=0.000), a good" response " to NSAIDs in history - OR 1.656 (95% CI 1.385-1.980; p=0.000) and received NSAIDs in combination with muscle relaxants - OR 1.218 (95% CI 1.067-1.390; p=0.004). The effect of therapy is lower in patients 65 years and older-OR 0,378 (95% CI 0.324-0.442; p=0,000), with body mass index >30 kg/m² - OR 0.619 (95% CI 0.529-0.723; p=0.000), with severe pain (≥7 points NRS) - OR 0.662 (95% CI 0.580-0.756; p=0.002), with pain at rest, - OR 0.515 (95% CI 0.450-0,589; p=0.000), pain at night - OR 0.581 (95% CI 0.501-0.672; p=0.000) and the presence of stiffness - OR 0.501 (95% CI 0.438-0,573; p=0.000). Treatment results are significantly worse in the cases of combination of LBP and joint pain, as well as pain in the trochanter major and pes anserinus area (p

The article is devoted to the actual problem of development in the professional tourist education. The tourist education in contemporary Russia is reflecting the process of formation the tourism as a new cultural phenomenon and business industry. The Russian contemporary tourism service market demands the new approach for the tourist education, in which process of the specialist learning in tourism must comply with the requirements of service technology about tourists and excursionists. Now the tourist education of guides is newly subject to matter in the education science.Our article is focused on the issue of learning in disciplines about the culture of the region in the process of professional training in the sphere of tourism. We discussed the educational effectiveness of problemoriented and project-based learning methods and the method of the project in the learning about the Culture of region tourist's disciplines. The essence of this method consists in the creation of the excursion project about several objects of interests in the cultural region. The plan of the project includes the stage of lections about objects of interesting with visits to the sights of the region: historical, ethnic and art museums, art galleries, religious centres and Christian Orthodox monasteries, libraries, zoos, natural parks, and reserves. Lectors from the university and members of those institutions work together and have a function of teaching and tutoring. After then there are some workshops on the objects of interesting, where students have researched a lot of interesting buildings, pictures, monuments, artefacts, shows, animals, trees and flowers, and the tourist reality is created from them. The last stage of the project contains the elaborating of new excursion: the writing the text of guidebook and the exhibition of photographs for the guidebook, and the recording the text of the audio guide.In the summary, we concluded that the problem-oriented and project-based learning methods and the method of the project are the most effective one for the learning of new generations of guides for the tourist industry.

The purpose of the article is to study the priority areas of reconfiguration of business models of industrial enterprises to solve the problem of increasing their stability in an unstable economic situation. The paper reveals the essence and structural components of business models. It is proved based on the analysis of literary sources that the business model with the help of narratives, figures, and graphic models describes how the organization creates, delivers, and captures value in the existing context. With this in mind, the key vectors of business model innovation of industrial companies using the potential of Industry 4.0 technologies are identified. First, the possibilities of transforming business models based on the introduction of digital technologies as drivers of transformation (blockchain, Internet of Things, Artificial intelligence, etc.) are justified, and the feasibility of complex application of digital technologies for business model innovation is established. Secondly, the content of the reconfiguration of business models in line with the ecosystem approach and the creation of open digital ecosystems of economic entities in the industrial sphere is revealed. Third, the importance of creating circular business models of industrial companies that reflect the transition from the classical linear model of production to the closed-cycle model is justified. It is determined that together these vectors of reconfiguration of business models of industrial enterprises will ensure the growth of the sustainability of manufacturing companies as a result of the growth of the connectivity of the environment, resource efficiency, and data-driven “smart” management.

Цель исследования – изучить показатели концентраций серосодержащих аминокислот и их метаболитов в сыворотке крови у женщин с хирургической и естественной менопаузой и установить корреляционные взаимосвязи со степенью тяжести климактерического синдрома, уровнем гонадотропных и половых стероидных гормонов. Материал и методы. Нами обследованы 192 женщины, из них 93 с хирургической менопаузой (I группа), 68 с естественной менопаузой (II группа), 31 в позднем репродуктивном и пременопаузальном возрастах (контрольная группа). Пациенткам проводилось исследование содержания гомоцистеина (Hcy), цистеина (Cys), глутатиона (GSH) и цистеинилглицина (CysGly) в сыворотке крови методом высокоэффективной жидкостной хроматогафии (ВЭЖХ). Результаты. Установлено, что у женщин с хирургической менопаузой медианное значение показателей гомоцистеина, цистеина, цистеинилглицина в 1,5 раза, на 17,0% и 23,2% соответственно выше, чем у женщин с естественной менопаузой, и в 2,2, 2,0 и 1,8 раза соответственно выше, чем у пациенток контрольной группы (p<0,05). Медиана концентрации глутатиона в крови у пациенток с хирургической менопаузой была снижена (на 26,7% (p<0,01), у пациенток с естественной менопаузой – на 16,2% ниже (p<0,05), чем у контрольной группы. Нарастание степени тяжести климактерического синдрома (КС) по шкале Куппермана-Уваровой соответствовало увеличению Hcy, Cys, CysGly и уменьшению GSH в сыворотке крови обследованных женщин (p<0,01). Заключение. Установленные прямые и обратные статистически значимые корреляционные связи между показателями концентрации серосодержащих аминокислот (их производных) и гонадотропными, стероидными половыми гормонами и клиническими проявлениями климактерического синдрома свидетельствует об участии изученных показателей в развитии патологии менопаузального периода.

This article discusses the issues of training of future speech therapists for work in inclusive educational environment. One of the prioritized tasks of modern education is training of personnel for working with students with specific learning difficulties. In recent years due to modernization of the Russian education system the training of experts for work in inclusive educational environment becomes more and more important. However, the issue of analysis of professional competences of future speech therapists is insufficiently studied. This article is aimed at analysis of educational programs of training students in Moscow universities for work with children with specific learning difficulties on the basis of their knowledge and attitude to inclusive education. Aiming at analysis of competences of future speech therapists, the students were surveyed by various blocks: from knowledge of regulatory documents to personal attitude of students to foundations of inclusive education. The obtained results have confirmed the assumption that in general the students have positive attitude to inclusive education, the disputable issue concerns readiness of society for conditions of inclusive education and understanding of special demands of children with limited health capacities by teachers of educational entities. This article defines various approaches and trends of formation of tolerant attitude to students with specific learning difficulties, as well as the required professional competences corresponding to the requirements of Federal State Education Standard of higher education. Due to increased number of children with severe speech pathologies and expanded competences of speech therapists of educational entities, it would be reasonable to increase the number of disciplines expanding skills and habits of future speech therapists under conditions of inclusive education.