Municipal Enterprises Research Articles

The challenges in diagnosing hypertrophic cardiomyopathy in the presence of arterial hypertension: a clinical case

Aim. To describe a clinical case and analyze the challenges in diagnosing hypertrophic cardiomyopathy (HCM) in a patient with concomitant arterial hypertension (AH). Materials and methods. The article presents the clinical case of HCM in the patient with concomitant AH that was observed in an ambulatory setting in the Municipal Enterprise “Dnipropetrovsk Regional Clinical Center for Diagnostics and Treatment” of Dnipropetrovsk Regional Council. Results. A 66-year-old woman N., diagnosed by her family physician with coronary artery disease (CAD): stable angina FC II, grade 2 AH, chronic heart failure FC II NYHA, was referred to a cardiologist because of experiencing exertional dyspnea, chest pain, and uncontrolled blood pressure despite treatment compliance. Echocardiography identified concentric left ventricular hypertrophy with the left ventricular outflow tract (LVOT) obstruction (a mean gradient of 35 mmHg as per catheterization). Cardiac MRI confirmed the diagnosis and coronary angiography ruled out CAD. Adjustments to the treatment regimen, taking into account HCM with LVOT obstruction, effectively alleviated the patient’s symptoms and stabilized her blood pressure. Conclusions. It is especially important to follow the guidelines of AH management and perform echocardiography in all patients with high blood pressure, so as not to miss the signs of concomitant HCM, particularly with LVOT obstruction. In addition, in the case of HCM, it is necessary to timely detect, provide prevention and manage patients at risk for sudden cardiac death. Since HCM encompasses various diagnoses with different pathogenesis and distinct management, cardiac MRI, enzymatic or genetic testing may be needed according to guidelines. As HCM is a relatively common inherited cardiac disease, general practitioners could often encounter such patients in everyday clinical practice. Hence, they should have a certain suspicion of this diagnosis in persons with AH whose left ventricular mass meets the criteria for HCM.

AUTHORITY OF LOCAL GOVERNMENT BODIES TO ENSURE THE ECONOMIC SECURITY OF THE COMMUNITY

The content of the scientific article corresponds to its title and consists in determining the powers of local self-government bodies to ensure the economic security of the community. It was emphasized that an important aspect of the effective provision of the economic security of Ukraine is an optimally constructed and functioning system of public administration bodies, whose activities, among other things, should ensure the economic security of the state, ensuring proper control of the implementation of the relevant policy. Subordination to political power, enforcement and application of laws are essential features of such a subject of public administration as local self-government bodies; activity in the public interest, the presence of the prerogative of public authority. The powers of local self-government bodies to ensure economic security include: obtaining from enterprises the necessary information about draft plans, mandatory coordination of enterprise plans; submitting proposals to projects on issues related to meeting the needs of the population; preparation of proposals for the privatization of municipal enterprises; receiving payment for land use; establishing cooperation with managers of enterprises of all forms of ownership in the direction of improving the state of development of the economic sphere of the region, analyzing and forecasting the development of the economic potential of the territory; development and implementation of models for the recovery of the local economy, entrepreneurship, diversification of production, etc. In order to improve the activities of military administrations in the field of ensuring economic security, along with the competences for ensuring national security, we suggest: streamlining the provisions of the legislation regarding their powers to make decisions on banning the trade in weapons, potent chemical and poisonous substances, alcoholic beverages and substances produced on an alcohol basis; to attribute to the competence of regional and district military administrations the authority to assist the activities of judicial and law enforcement bodies, bodies of the bar; carrying out joint analysis and holding meetings with the prosecutor’s office and other law enforcement agencies on security issues, in particular in the economic sphere in the relevant territory; participation in the preparation, approval and organization of the implementation of relevant regional and local programs. It is substantiated that the introduction of appropriate changes to the legislation will make it possible to standardize the principles and methods of activity of local self-government bodies and military administrations, to reflect the issues of responsibility and guarantees of legal status and, among other things, to formulate powers in the field of ensuring economic security.

PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH CONGENITAL HEART DISEASE: RATIONALE FOR MANAGEMENT ALGORITHM BASED ON A LITERATURE REVIEW

The substantial progress achieved in cardiology and paediatric cardiac surgery has led to a considerable increase of life expectancy of patients with congenital heart disease (CHD), and at the same time to growing number of adult patients developing pulmonary arterial hypertension (PAH) associated with congenital heart defects. Nowadays guidelines were developed and updated for PAH, but no expert recommendations exist for effective management of PAH associated with CHD. Thus, it is important to develop an algorithm for managing these patients, based on international standards and a comprehensive understanding of prognostic markers of worsening the course of pulmonary arterial hypertension (PAH), considering local cardiac tertiary hospitals' capabilities.
 The aim. To highlight the pathophysiology and clinical characteristics of PAH-CHD patients, identify prognostic markers for its onset and progression, and develop a management algorithm for patients.
 Results. The article presents the pathophysiology of PAH-CHD, the mechanisms of right ventricle adaptation to pressure overload, which determine the functional abilities of patients and prognosis, PAH formation, and progression after defects correction. The accurate identification of stages in PAH-CHD (volume overload, mixed, stage of pulmonary vascular disease) is essential for the timely determination of surgical intervention, selecting conservative treatment strategies, and predicting the outcomes of surgical defect correction. The type of defect, its size, and the volume of blood flow through the defect influence the onset and progression of PH-CHD. We review the pathophysiology and clinical features of PAH-CHD, as well as the reasons for the late diagnosis of heart failure at the stage of severe decompensation and irreversible remodelling of the lung vessels when diuretic therapy is not effective enough and inotropic support, circulatory mechanical support and heart / lung complex transplantation are required. The necessity of developing new scales for stratifying the risk of PAH-CHD is justified considering the particularities of the disease course and cardiac hemodynamic in different anatomical types of the defects. Based on this literature review, at the Municipal Enterprise «Dnipropetrovsk Regional Clinical Center for Diagnostics and Treatment» of the Dnipropetrovsk Regional Council» the algorithm for managing patients with PAH-CHD was devised and implemented into clinical practice.
 Conclusions. PAH is a common complication of CHD. The prevalence of PAH-CHD is substantial and it can manifest and progress even in patients with previously corrected heart defects. To effectively manage patients with PAH-CHD, an algorithm has been devised and implemented in clinical practice. It includes factors that have demonstrated associations with poor prognosis which are more than two hospitalizations for HF in the last year, pulmonary vascular resistance (PVR) (or index of PVR), mean pressure in the pulmonary artery, pulmonary capillary wedge pressure, left ventricular ejection fraction, heart failure with a reduced ejection fraction, right ventricle heart failure, NYHA FC, high risk of atrial fibrillation or flutter, 6-minute walking test distance, NTproBNP, highly sensitive C-reactive protein, B-lines on lung ultrasound, glomerular filtration rate, haemoglobin, platelet count, sodium, Model for End-Stage Liver Disease scale.

Research Directions of the Energy Transformation Impact on the Economy in the Aspect of Asset Analysis

The challenges of climate change encourage immediate solutions by creating the conditions for energy transformation. This process is significantly related to capital investments and the conversion of existing assets to clean energy sources. Due to the need to save resources, workplaces, and public favor, specific studies involving different data groups are necessary. This article presents key data sources for analyzing the impact of energy transformation on Lithuanian regions—governance, potential, and existing power indicators. The economic, social, and governance data combined in the article will allow us to determine the perspectives of sustainable energy transformation in the regions. The article showed that in certain regions there may be major, complex problems that hinder the breakthrough of the energy system. Cluster analysis and a generic system diagram were used for the research, which showed that municipalities have a wide potential for energy transformation. The research emphasizes the governance component as a key success factor. After reorganizing the management of municipal enterprises, further actions can be initiated, since emerging competences allow progress to be made efficiently and with less time spent. The asset analysis methodology presented in the article allows for the identification of the main groups of assets that can be converted in the short term for the purpose of energy transformation, according to sustainable development principles. These decisions provide an opportunity for decision-makers to consistently implement energy transformation decisions.

Analysis of the dynamics of the ecological state of watercourses in the sub-basin of the Syan River

Based on the generalization of the results of regime observations by environmental monitoring services, an analysis of the dynamics of the ecological state of watercourses in the sub-basin of the Syan River (at six observation points) has been carried out. The dynamics of water use in the Syan River sub-basin for 2021–2022 were analyzed, according to which the total discharge in the Syan sub-basin in 2022 decreased by a quarter. The discharge of polluted wastewater in 2022 was a third higher, accordingly, the discharged volume of treated sewage was also lower than in 2021. An analysis of potentially possible sources of pollution of water bodies in the Syan River sub-basin has been carried out. The most significant impact on the water quality change here is caused by the wastewater discharges of municipal enterprises: the municipal enterprises “Novoyavorivskvodokanal” and “Yavorivvodokanal”. A significant cause of surface water pollution is the discharge of wastewater by the private sector. The Yavoriv quarry “Sіrka” causes the ingress of sulfates into the Shklo River, a significant trend towards their reduction has been observed from 2020 to 2022 by 71.9 %. In Lviv region, agriculture accounts for about 11%, which also negatively affects the state of water bodies. According to the results of monitoring of surface waters within the Ukrainian part of the Vistula River basin, presented by the Basin Water Resources Management of the Western Bug and Syan Rivers for 2021–2022, a high total content of pesticides was observed in 2022, in particular, at the observation point of the Vishnya River in Mostyska – about 5.5 µg/dm3. Also, a high content of manganese, zinc and iron was recorded here. The analysis of monitoring observations of the state of water bodies in the Syan River sub-basin and the calculated water pollution coefficients based on them show that the cleanest water in this area is the water of the Vyar River (the highest Pollution Index in 2021 – 1.463) and the water of the Zavadivka River (the highest Pollution Index in 2021 – 1.218). The most polluted water was the water of the Vishnya River at the observation point in Mostyska, especially due to the high content of iron (7.6 MPC) and manganese (30 MPC), where the pollution coefficient in 2020 was 4.761, and in 2022, it decreased by half. Also, the water of the Shklo River in urban-type settlement Krakivets was quite polluted, where the pollution coefficient in 2022 was 2.057. The BOD5 value was highest in 2021 in the Shklo River – 3.5 MPC and in the Vishnya River in Chernove village – 2.9 MPC, however, in 2022, it decreased to 1.8 MPC across the study area. The COD value in 2021 in all investigated observation points was above the norm, the highest in the Vishnya River, in Chernove village – 2.3 MPC, in 2022, it significantly decreased across the study area, the highest was in the Shklo River in urban-type settlement Krakivets – 1.6 MPC. A high content of ammonium salts and nitrites was recorded in 2022, respectively: in the Shklo River – 3.8 MPC and 2.7 MPC; in the Vishnya River in Chernove village – 2.5 MPC and 3.2 MPC. The phosphate content was highest in 2022 in the Vishnya River in Chernove village (2.6 MPC), however, in 2021 and 2022, it was below the permissible level across the study water area. In all observation points of the Syan River sub-basin, a significant zinc content was observed in the water, the highest was in 2020 in the Vyаr River in Pidmostychi village (5.2 MPC) and in 2022 in the Shklo River in urban-type settlement Krakivets – 4.7 MPC. A high content of sulfates was observed in the Shklo river, especially in 2020 (4.4 MPC), which may be the cause of the influence of the Yavorivsky “Sirka” quarry. Regarding the assessment of water quality in the Syan River sub-basin by pollution levels, in all observation points during the analyzed period, the water is mainly characterized as “slightly polluted”, only at the observation point of the Vishnya River in Mostyska in 2020 and 2021 – “moderately polluted”, in the Zavadivka River, Grushiv village in 2020 the water was “slightly polluted; bordering on clean”.

О правовом статусе нанимателей жилых помещений в бывших ведомственных общежитиях

The article analyzes changes in housing legislation regarding the regulation of the legal status of tenants of residential premises in former departmental dormitories, in violation of the law transferred to private ownership of organizations. The position is expressed on the arbitrary differentiation of citizens living in such dormitories into two categories, depending on the legality of the actions of state and municipal enterprises and institutions. The necessity of recognizing the right of employers to apply to the court with a demand for recognition of ownership of occupied residential premises during the pre-trial period established for its implementation is substantiated.

Evaluation of Technological Solutions to Enhance the Operational Efficiency of the WWTP “Apa-Canal” Magdacesti Municipal Enterprise

Evaluation of Technological Solutions to Enhance the Operational Efficiency of the WWTP “Apa-Canal” Magdacesti Municipal Enterprise

ЗАБЕЗПЕЧЕННЯ СТАЛОГО РОЗВИТКУ НА БАЗІ АНАЛІЗУ ТА ОЦІНКИ ХАРАКТЕРИСТИК ШАХТНИХ ВОД ЯК ДЖЕРЕЛ ВОДОПОСТАЧАННЯ ТА ОТРИМАННЯ ЦІННИХ РЕЧОВИН З ВІДХОДІВ ОПРІСНЕННЯ

Purpose. Rationale for the integrated use of the resource potential of coal-mining enterprises, which is aimed at obtaining technical and drinking water for their own production needs, local population and obtaining valuable substances from desalination waste. Methodology. Analysis of world experience, information about aquifer complexes in the Western Donbas mines, conducting chemical analyses of mine waters and salt mixtures obtained after using reverse osmosis products. Results. Based on the accumulated world experience in desalination of highly mineralized waters, it can be concluded that it is possible to effectively implement this experience at mining enterprises. Description of aquifer complexes has been given in detail using the example of the Zakhidno-Donbaska Mine of PJSC “DTEK Pavlohradvuhillia”, chemical analyses of water before and after discharge into settling ponds. A rational technological scheme for desalination, volumes of purified water obtained for drinking and technical water supply, as well as the quantitative and qualitative composition of the dry residue components of mine water desalination waste, and recommendations on possible use of products on the market have been determined. Scientific novelty. Analytical and laboratory studies have been conducted to determine the component composition of mine water desalination waste from Western Donbas coal-mining enterprises. It has been determined that the resulting salt product is a mixture of pure salts and valuable microcomponents, and the resulting distillate is fuel for the operation of hydrogen electrolyzers, which creates prerequisites for modern “green” hydrogen energy infrastructure. Practical significance. The qualitative and quantitative mine water parameters on complex use as an alternative source of water supply and obtaining related reverse osmosis products have been analyzed. The road services propose the consumption of the resulting salt products by municipal enterprises, and the dry distillation residue – to prevent dust. This approach allows solving not only the problem of desalination waste utilization, but also applying the separated valuable substances in the industrial market of food, medical, cosmetic, paint and varnish, chemical, as well as building materials, plastics and polymers production industries. Keywords: mine water, waste recycling, mineral resource, coal-mining enterprises.

Application of the ALM model in the analysis of changes in the work content of organizational positions in a municipal enterprise

Application of the ALM model in the analysis of changes in the work content of organizational positions in a municipal enterprise

I INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE “DOCTORS AND NURSING – MEDICAL FRONT IN UKRAINE AND THE WORLD”

On May 11–12, 2023, the I International Scientific Practical Conference “Doctors and Nursing – Medical Front in Ukraine and the World” took place in Lutsk, Ukraine. The conference was dedicated to the 150th anniversary of the Shevchenko Scientific Society (SSS).
 The conference was organized by the Municipal Institution of Higher Education Volyn Medical Institute of Volyn Region Council, in collaboration with Danylo Halytsky Lviv National Medical University, I.Y. Horbachevsky Ternopil National Medical University, Vilnius University (Lithuania), Higher Private Educational Institution Lviv Medical University, the Shevchenko Scientific Society, and Health Tech Without Borders (Switzerland, USA). The conference was held with the support of the State Institution “Center for Nursing Development of the Ministry of Health of Ukraine”. Partners in conference organization also included Volyn Orthodox Theological Academy, Maastricht University (the Netherlands), Volyn Region Emergency Medical Center and Disaster Medicine Municipal Enterprise, German-Ukrainian Association of Nurses, NeanderklinikHarzwald (Germany), “Myloserdia” Association of Volyn Nurses PO and Lviv Association of Allergists, Immunologists, and Rehabilitologists Charitable Organization.
 During the course of the event, a total of over 100 speeches were delivered by medical scientists and practicing physicians, as well as researchers in diverse disciplines from Ukraine, the United States, Great Britain, Poland, Lithuania, Germany, the Netherlands, and Switzerland. Workshops were conducted on relevant issues in medical practice in times of war.
 A total of approximately 1100 individuals participated in the conference, comprising physicians from diverse disciplines and nurses, emergency medical professionals and disaster medicine specialists, scientific and pedagogical personnel, employees of the State Emergency Service, physical rehabilitation specialists, psychologists, representatives of the clergy and public organizations, and young scientists.
 A new interdisciplinary format of scientific dialogue has been started between representatives of medical and nursing specialities, the education sector, psychologists, and clergy. It helps find ways to address relevant issues in the medical sector in complex conditions of the present day.

THE IMPACT OF ANXIETY AND DEPRESSION ON THE MENTAL WELL-BEING OF PATIENTS WITH HYPERTENSIVE DISEASE

Introduction: at present, hypertension is the most common non-infectious disease worldwide, with a progressively growing number of patients each year. This escalating prevalence results in increased disability and early mortality in both rural and urban populations. Currently, it is believed that psychosomatic disorders contribute to the progression of hypertension. Consequently, a comprehensive examination of this relationship is highly relevant.
 The aim of the research is to analyze the presence of anxiety and depression in patients with isolated and comorbid hypertensive disease and to determine their influence on mental well-being, depending on the territorial affiliation of the patients.
 Materials and methods: we analyzed the results of treatment of 152 patients with isolated and comorbid (ischemic heart disease, type 2 diabetes) course of hypertensive disease. These patients received medical care at the Municipal Enterprise “Poltava Regional Clinical Medical Cardiovascular Center of the Poltava Regional Council” between 2018 and 2022. We categorized these patients into three groups based on the course of hypertension. Group 1 consisted of 45 patients with an isolated presentation (26 (57.8%) residing in urban areas and 19 (42.2%) in rural settings). Group 2 comprised 68 patients with a combined presentation of hypertension and coronary heart disease, with an even distribution between urban (34 (50.0%)) and rural (34 (50.0%)) backgrounds. Group 3 encompassed 39 patients with a combined presentation of hypertension, coronary heart disease, and type 2 diabetes, with 24 patients (61.5%) from urban areas and 15 (48.5%) from rural areas. Patients in all groups were comparable in terms of age (ranging from 22 to 85 years), gender, and disease duration. Anxiety and depression levels were assessed using the HADS scale, and quality of life was evaluated using the SF-36 scale through self-questionnaires.
 Results: the study revealed a notable decline in the mental component of quality of life as comorbidity increased, affecting both rural and urban residents. At the same time, a corresponding increase in the levels of anxiety and depression was observed with escalating comorbidity. A strong inverse correlation was established between the levels of anxiety and depression and all indicators of the mental component of quality of life (r from -0.94 to -0.91). Furthermore, the research highlighted that in patients with an isolated presentation of hypertension, psychosomatic factors exerted the most substantial influence on the mental health index (MH). In contrast, for patients with comorbid conditions, the presence of psychosomatic factors more frequently impacted the levels of social functioning (SF) and vitality (VT).
 Conclusions: Patients residing in rural areas who have comorbid conditions such as hypertensive disease, coronary heart disease, and type 2 diabetes are particularly susceptible to experiencing anxiety and depression.

Assessment of Denitrification and Nitrification Processes during Landfill Leachate Treatment

Landfill leachate is generated from waste degradation in landfill sites, and its treatment includes biological or combined treatment with physico-chemical methods. A frequently applied technology in the biological stage of landfill leachate treatment plants is based on denitrification and nitrification. Nevertheless, with the availability of a huge number of scientific reports, the management of denitrification and nitrification (D/N) processes in the frame of real wastewater treatment plants (WWTPs) is rather difficult and always remains a critical technological problem. This study aims to perform a comparative assessment between denitrification and nitrification processes during landfill leachate treatment in three different situations in the WWTP of the Municipal Enterprise for Waste Treatment in Sofia City, Bulgaria. The comparative assessment is based on the biotransformation effectiveness of ammonium ions in the course of nitrification and of nitrates in the course of denitrification. Mixed samples (wastewater and activated sludge) were taken from the sequencing batch reactors operating in the mode of denitrification and nitrification. All physico-chemical (pH, dissolved oxygen, organics concentration, BOD5:COD, nitrogen and phosphorous) and biological (sludge volume index, sludge biotic index, quantity of aerobic heterotrophs, denitrifiers and nitrifiers, total dehydrogenase activity) indicators were investigated in the samples from the biobasins in the mode of denitrification and nitrification. The conditions for the implementation of the two processes were compared, along with the state of the activated sludge in the different reactors. The obtained results showed that denitrification was the critical process in the technology on the base of D/N. A major factor that managed the denitrification was the lower concentration of biodegradable organic matter which led to a deformation of the activated sludge structure, a decrease in the count of heterotrophic microorganisms, a decrease in the total activity of the activated sludge and an inhibition of the nitrate reductase activity. The nitrification processes were accomplished with high intensity. The results confirmed that D/N could be optimized and controlled using specific wastewater treatment technology parameters and purposely applied indicators.

Legal Support for the Development and Use of Municipal Information Systems

The paper deals with the current issues of development and use of municipal information systems, and proposes their legal solutions. In particular, it is noted that federal legislation lacks a precise definition of a municipal information system. The analysis of regional and municipal lawmaking allows us to identify several attributes of municipal information systems: development or acquisition of the system by a decision of a local governing body; the powers of local governing bodies to implement the systems; full or partial financing from the local budget. In this regard, the Federal Law “On Information, Information Technologies and Information Protection” proposes to define a municipal information system as an information system created or acquired through a decision of a local governing body at the expense of the local budget and designed to solve the issues that are in jurisdiction of municipalities. The current municipal information systems can be divided into two groups: specialized information system complying with federal laws and general information systems designed to support the functioning of local governing bodies or municipal enterprises and institutions. At the same time, general municipal information systems of different municipal entities are rarely integrated. Therefore, when it is necessary, it becomes impossible or very difficult. This problem is mainly of organizational and technical nature. However, it is also a result of collisions and gaps in the regulatory framework of municipal information systems. To solve them, it seems necessary, firstly, to state in article 13 of the Federal Law “On Information, Information Technologies and Information Protection” the possibility to define the specifics of legal regulation of municipal information systems not only by legislative, but also bylaws on local selfgoverning; secondly, to indicate in the Federal Law “On General Organizational Principles of Local Self- Governing in the Russian Federation” the possibility of the subjects of the Russian Federation to be involved in lawmaking in municipal information systems.

ASSESSMENT OF HAND FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS AS A RESULT OF PHYSICAL THERAPY

Assessment of hand function is the great importance in physical therapy for patients with rheumatoid arthritis, as the choice of rehabilitation measures and evaluation of their results depends on the functional capacity of the hand.
 The purpose is to evaluate hand function in patients with rheumatoid arthritis as a result of physical therapy using the Sollerman test.
 Materials and methods. The research was conducted on the basis of the rheumatology department and the department of rehabilitation treatment using traditional and alternative methods of the Municipal Enterprise “Rivne Regional Clinical Hospital named after Yuriy Semeniuk” in Rivne. The results of the research were accumulated as patients were admitted for inpatient treatment. A total of 188 patients with rheumatoid arthritis were examined, with an average age of 44.9±7.6 years. All patients were randomly assigned to the control (n=92) and main (n=96) groups. Patients of the control group underwent rehabilitation in accordance with the recommendations of the regulatory document of the Ministry of Health of Ukraine. Patients in the main group were treated according to the proposed physical therapy technology, which included the following elements: therapeutic exercises, therapeutic massage, physiotherapy, hydrotherapy, orthotics, kinesiotaping of the upper extremities, mechanotherapy and psychological support. A physical therapy programme was developed for each patient for a long-term period of 6 months. To determine the function of the arm, the Sollerman test was used. The obtained digital material was processed statistically using the Statistica 10 statistical analysis package (Serial Number: STA999K347150-W).
 Results. The initial examination revealed the presence of disorders of the basic functions of the hand and deviations from the norm, as well as impaired fine motor skills and various types of hand grip according to the Solleraman test. We analysed the quality of different types of grasping in patients with rheumatoid arthritis, in particular, the greatest difficulties were in performing spherical and cylindrical grasping – in 82.9% of patients and 89.3% of cases, respectively. Forceps grasping was also difficult in 76.5% of patients. During the repeated examination after 3 and 6 months, patients in both groups showed positive dynamics in the performance of individual test tasks. Thus, in patients of the main group, after 3 months, the average Sollerman test scores increased to 65.1±5.3 points, in the control group this figure was significantly lower than 61.8±3.6 points (x ±S) (p<0.05). In 6 months after hospitalisation, the mean values of the Sollerman test in the main group of patients with rheumatoid arthritis increased significantly and were close to normal values. In patients of the control group, the average values of this test also increased, but they were significantly lower than those of the main group. Accordingly, the mean Sollerman test score in patients of the main group increased from 65.1±5.3 points to 70.2±6.3 points, which is significantly higher than in patients of the control group – from 61.8±3.6 points to 65.1±3.8 points (x±S) (p<0.05). The results of the Sollerman test in the main group are significantly higher than those of the control group, which indicates the effectiveness of the developed rehabilitation technology for patients in the main group.
 Conclusions. The increase in the functional capacity of the upper extremities of patients in the main group with rheumatoid arthritis confirms the effectiveness of the implemented physical therapy technology.

THE IMPACT OF BUDGET FINANCING ON THE MUNICIPAL-OWNED ENTERPRISES PERFORMANCE: CASE OF KYIV CITY

In recent years, many European studies have focused on municipal companies’ problems, particularly their efficiency in terms of public importance and quality of services provided and return on capital. These issues are directly related to the current series of topical issues of the expediency of public property and issues of reasonable choice between public property and privatization. In our opinion, one of the criteria for the expediency of a business entity being in public ownership is the efficiency of its activities, in particular financial efficiency. This paper aims to clarify the local authority approach to determining the efficiency of municipal-owned enterprises in the capital of Ukraine.In the research, the dynamic and distribution of budget funds between the municipal-owned enterprises of Kyiv were studied, and the dynamics of their return on assets were analyzed. In the course of the research financial statements data of the 128 municipal enterprises were collected and analyzed. It is established that the largest recipients of budget funds are municipal construction companies, while municipal public transport companies receive insufficient funding to cover their needs. The four-year distribution of return on assets was also studied, and its miserable level was stated. With the hypothesis testing regarding the impact of budget financing on the municipal-owned enterprises' efficiency, it is established that the availability and level of budget financing of investments and the presence of budget funds in the revenues of municipal-owned enterprises do not have a significant impact on their profitability.

ДИСЦИПЛІНИ БУХГАЛТЕРСЬКОЇ СФЕРИ У НАВЧАЛЬНИХ ПРОГРАМАХ ЛЬВІВСЬКИХ АКАДЕМІЧНИХ ЗАКЛАДІВ УНІВЕРСИТЕТСЬКОГО ТИПУ В ХІХ – ПЕРШІЙ ПОЛОВИНІ ХХ СТ.: ІСТОРИЧНИЙ ЕКСКУРС

The expediency is substantiated, and the results of the study on the history of accounting knowledge provision for non-core specialization specialists in Lviv academic institutions of the university type from the 19th to the first half of the 20th centuries are presented. The study reveals the content and position of accounting disciplines in the educational programs of the examined institutions. By analyzing the content of accounting subjects and their placement in educational programs for the training of managerial specialists in various profiles (management and technical specialties), it was established that the main motive behind the educational process was to acquire skills in the professional use of accounting data in management. The necessity of such knowledge was also determined by the managerial responsibility of organizing accounting and presenting accounting statements. It was found that the establishment of the regional accounting system (“provincial accounting”) and the consolidation of its teaching tradition in educational institutions had a significant influence on university professors, who were also official representatives of the Galician provincial accounting department and members of the state examination commission on state accounting. An analytical review of educational and practical manuals and textbooks developed by the professors of the examined educational institutions for acquiring practical accounting skills and constructing different types of accounting for organizing state, national, municipal enterprises, and private farms was conducted. The article argues that the ideas established in the past regarding the acquisition of accounting knowledge by specialists in various fields as future managers can be utilized in the development of modern university educational and professional programs. Based on the study’s findings on the methodological connection between theoretical accounting disciplines and practical subjects (courses), it is concluded that their integration can be beneficial in creating a comprehensive system of scientific and methodological support for the modern educational process in managerial, financial, and economic specialties. An alternative approach could involve incorporating historical practices of organizing economic studies for a theoretical review of the accounting and reporting subject area into the current training processes for non-accounting specialized professionals.

Privatisation of State and Municipal Enterprises: Legal Regulation

"The relevance of the subject under study is exceedingly high since this process is one of the main vectors of system-changing transformations in Ukrainian society. Thus, this vector includes the reform of property relations, which occurs through the privatisation of property of state and municipal enterprises. It is privatisation that should contribute to increasing the efficiency of property management, the emergence of a clear motivation for work, accelerating structural adjustment, and development of the country’s economy, improving the investment climate in the state, as well as improving the state property management system. The purpose of this study is to investigate the basic principles of privatisation of state and municipal enterprises, to identify the advantages and disadvantages in the legal regulation of this phenomenon. That is why several scientific and methodological means were used in this study, specifically the systematic and functional approaches, including such general logical methods as analysis and synthesis, the comparative method, deduction, the formal legal method, and the method of scientific literature analysis. The main results obtained in this paper constitute the theoretical and practical foundations of the issue under study. The article covered the general principles and features of state and municipal enterprises and analysed the efficiency of the legal regulation"

ENVIRONMENTAL POLLUTANTS OF THE RAINWATER DRAINAGE SYSTEM OF MYKOLAIV

The article is devoted to the study of the chemical composition and quantitative volume of pollutants entering the Bug Estuary with the rainwater sewage of Mykolaiv. It is known that sewage from industrial and municipal enterprises poses a threat of a significant additional burden on limited regional water resources. First and foremost, uncontrolled stormwater runoff is a major concern. In Mykolaiv, there are 49 registered stormwater drains, of which 19 are directly discharged into open water bodies. The purpose of the study was to investigate the chemical composition and volume of urban stormwater runoff into the Bug Estuary. The study was based on the results of chemical analyses of water samples from four storm sewers in Mykolaiv, performed in 2022. The materials of chemical analyses of water samples from five storm sewers of Mykolaiv in 1997 were also included. It was proved that phosphates, oil products, and nitrite nitrogen are present in the stormwater runoff from Mykolaiv to the Bug Estuary. The multiplicity of exceedances of the maximum permissible concentrations is: for biological oxygen consumption - 14-37 times; nitrite - 10-39 times; chemical oxygen consumption - 7-18 times. It has been shown that lead, nickel, iron, copper, chromium, and zinc are released into the Bug estuary with rainwater runoff. Excessive pollution of rainwater with suspended solids is associated with contamination of territories with dust, soil, clay, etc. Excessive pollution with oil products and heavy metals is associated with the operation of motor vehicles and industrial enterprises. It has been shown that unauthorized connections of domestic and industrial sewage systems are mostly responsible for some of the substances that pollute stormwater (phosphates, nitrates). Prospects for further research are the study of the sorption capacity of bottom sediments for the retention of pollutants and the assessment of the ecological capacity of the bottom sediments of the Bug estuary..

Circular Economy in Wastewater Treatment Plant—Water, Energy and Raw Materials Recovery

Nowadays, the main challenge for industrial and municipal enterprises is related to the tightening regulations and recommendations regarding environmental protection, which have been included in the circular economy (CE) package. Enterprises from all sectors, including water and sewage management, are obliged to actively participate in the CE transition. Modern wastewater treatment plants (WWTPs) should include actions aimed at a more sustainable use of available resources (water, energy, raw materials) to contribute to the protection of natural resources. In this way, they can be treated as resource facilities. This paper proposes a conceptual framework for a ‘Wastewater Treatment Plant of the Future’ that includes several technological solutions that take into account circular management of waste streams generated in WWTPs, such as wastewater (WW), sewage sludge (SS) and sewage sludge ash (SSA). Many actions have been already taken to modernize and build WWTPs that can respond to current and future challenges related to environmental protection. In the case of a CE ‘Wastewater Treatment Plant of the Future’, the recovery of water, energy and raw materials from available waste streams is strongly recommended. The implementation of CE solutions in analyzed facilities is incorporated into many strategies and policy frameworks, such as national and international (including European) documents. The proposed CE solutions could indirectly contribute to satisfying significant technological, social and environmental needs of the current and future generations, which is in line with sustainability principles.

КЛАСТЕРНЫЙ ПОДХОД В РАЗВИТИИ СУБЪЕКТОВ МАЛОГО АГРОБИЗНЕСА

The number of small agricultural business entities includes agricultural enterprises of various organizational and legal forms (with the exception of state and municipal enterprises, dependent and subsidiaries and partnerships), as well as agricultural consumer cooperatives, peasant (farmer) households, and household households. At present, the small agricultural business of the Republic of Tatarstan is represented by over 470 thousand personal, about 3 thousand farms and more than 300 agricultural consumer cooperatives. Personal subsidiary farms use 
 1 499.3 thousand hectares of agricultural land, and private farms own more than 312 thousand hectares of arable land, or 9% of the area of the entire arable land of the republic. If we consider the share of small agribusiness entities in the structure of the region's economy, then almost half of the gross agricultural output falls on them. To improve the efficiency of small agribusiness, the further development of small enterprises is associated with their clustering. This article examines the advantages of the cluster approach in the activities of small agricultural businesses. The clustering of small agribusiness entities opens up more opportunities for expanded production. Small enterprises that are members of the agro-industrial cluster increase their competitiveness and position in the commodity market. Functioning within clusters can contribute to the production of goods, endowing them with other properties and, accordingly, conquering new market niches. The stable development of regions, economic growth in production in many areas of the agro-industrial complex in recent years create real prerequisites for the creation of local clusters. Compared to Russia, in developed countries, clusters have been created for decades and, importantly, they show real profitability, as well as the inclusion of organizations in such clusters contribute to the exchange of experience in doing business. For the further development of small businesses, it is necessary to use a cluster approach, the advantages of which are the expansion of sales markets for products, the full cycle of production of finished products, savings with large volumes of purchases.