Saratov JOURNAL of Medical and Scientific Research

Original article

Anatomical variability of greater palatine canal and greater palatine foramen in men of the first period of adulthood

Year: 2020, volume 16 Issue: №4 Pages: 974-978
Heading: Human anatomy Article type: Original article
Authors: Kalmin O.V., Efremova A.V., Zyulkina L.A.
Organization: Penza State University
Summary:

The purpose of research is to reveal the anatomical variability of the shape and size of the greater palatine canal and the greater palatine foramen in men of the first period of adulthood. Material and Methods. The object of the study included 129 men of the first period of adulthood (from 20 to 35 years). The number of the greater palatine foramen, their shape, antero-posterior and medio-distal diameters, the length of the greater palatine canal, its shape, its medio-distal and antero-posterior diameters in the upper, middle and lower thirds of the canal were determined on cone-ray computed tomograms. Results. In men of the first period of adulthood, the medio-distal diameter of the greater palatine foramen on the right averaged 3.67±0.79 mm; on the left, 3.64±0.80 mm; the antero-posterior diameter of the greater palatine foramen on the right averaged 5.79 ±0.86 mm; on the left, 5.73±0.84 mm. 10 forms of the greater palatine foramen were identified: oval, elongated in the antero-posterior direction, helical, crescent-shaped, triangular, teardrop-shaped, round, bean-shaped, diamond-shaped, semicircular and ovoid. The length of the greater palatine canal on the right is 33.59±2.87 mm, on the left — 32.94±2.92 mm. 6 forms of the greater palatine canal were identified: wave-shaped, funnel-shaped with a bend in the lower third, hourglass shape, zigzag, crescent, straight shape. Conclusion. The greater palatine canal and the greater palatal foramen have a pronounced variability in size, shape and topography in men of the first period of adulthood. However, no significant bilateral differences in the medio-distal and anteropos-terior diameters of the greater palatine foramen and the length of the greater palatine canal were found.

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Professional characteristics of a pharmaceutical specialist in chemist's

Year: 2020, volume 16 Issue: №4 Pages: 968-973
Heading: Sociology of Medicine Article type: Original article
Authors: Smolina V.A., Novokreshchenova I.G., Novokreshchenov I.V.
Organization: Saratov State Medical University
Summary:

Purpose: to characterize pharmaceutical specialist in a pharmacy as a professional group based on the formation of a social portrait. Material and Methods. A survey was conducted in the form of a questionnaire of pharmaceutical specialists in a pharmacy (n=407). The author's questionnaire included 2 blocks of questions to identify the social and professional characteristics of the respondents. Results. The main characteristics of the social portrait of a pharmacy employee are: female (96.1±0.5%), average age 30.8±0.5 years, secondary pharmaceutical education (74.7±0.4%), work experience in the specialty 8.63±0.5 years. The specialist carries out professional activities in chain pharmacies (84.3±0.5%) and holds the position of "pharmacist" (77.9±0.4%). A pharmaceutical specialist rarely changes his job (80.6±0.4%), is satisfied with his job (77.1 ±0.4%), is confident in the right choice of profession (71.0±0.4%), and feels the social significance of the work performed (88.7±0.5%). Conclusion. The socio-professional group of pharmaceutical specialists in a pharmacy is homogeneous in its cha.acteristics; working in a pharmacy environment affects the formation and implementation of a pharmaceutical specialist as a professional.

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Analyzing strategies for overcoming personnel crisis in regional healthcare settings: the results of a focus group study

Year: 2020, volume 16 Issue: №4 Pages: 963-967
Heading: Sociology of Medicine Article type: Original article
Authors: Erugina M.V., Krom I.L., Eremina M.G., Kovalev E.P., Bochkaryova G.N., Dolgova E.M., Grigoryeva E.A.
Organization: Saratov State Medical University, Azerbaijan Medical University
Summary:

The purpose of the study is to substantiate the directions of overcoming the personnel crisis, which is relevant to the professional group of doctors, in the regional health care system. Material and Methods. To form an objective understanding of the characteristics of the personnel crisis in the regional health care system and the directions for improving the medical personnel potential of the Saratov region, the authors conducted a sociological focus group study in which 8 experts-organizers of health care took part. In the conditions of the marginalization of professional groups in the regional health care system, a shortage and suboptimal structure of medical personnel, a systematic approach was used to solve the problem of developing the personnel potential of the region. Results. Based on the study, the main directions of development of the medical personnel potential of the regional health care system were formed: targeted training of specialists for regional health care; elimination of age and financial deprivations of a professional group of doctors; the formation an attractive professional environment for doctors; implementation of individual and organizational practices to minimize the risks of professional activity; organization of mentoring for young professionals; the formation of «social elevators» for doctors in primary care; overcoming the shortage and suboptimal structure of medical personnel in regional health care. The guide scenario for the focus group study included discussion by experts of the characteristics of the personnel crisis relevant to the professional group of doctors, and ways to overcome it. Conclusion. Verification of the main risk factors for a personnel crisis relevant to the professional group of doctors, eliminating personnel imbalances and solving the problem of developing the personnel potential of regional healthcare is a condition for increasing the availability and quality of medical care for the population.

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Analysis of medical and social characteristics of day inpatients with gynecological profile

Year: 2020, volume 16 Issue: №4 Pages: 959-962
Heading: public health Article type: Original article
Authors: Fomina A.V., Dzidzariya F.G.
Organization: Peoples' Friendship University of Russia
Summary:

Objective: analysis of the influence of medical and social characteristics of women on the organization of gynecological care in the one day hospital. Material and Methods. The study involved 263 women, undergoing treatment in a gynecological day hospital, organized on the basis of a large multidisciplinary hospital in Moscow. The following research methods were used: sociological (self-developed questionnaire), statistical (descriptive statistics, comparison of mean values, Chi-square). Results. The age and social characteristics of women, their referral fortreatment by primary care or hospital doctors, the possibility of choosing the type of hospitalization are medical and social factors that affect the organization of the activities of the day hospital of the gynecological profile. The largest group (33.1%) included women in the age of 31-40. Most of the patients were referred for one day hospital treatment by doctors of primary care medical organizations (87.5% of cases). The share of women who were treated in a day hospital for the first time was 80.3%. Half of the respondents (51.0%) noted the opportunity to undergo treatment without leaving their family and home. The distribution of the choice between treatment in a 24-hour hospital and in a day hospital is statistically significant for age groups (p <0.05): the choice was given to a greater extent to persons aged 61 and older. Conclusion. The analysis of the obtained medical and social characteristics of the patients of the day hospital of the gynecological profile showed that the organization of specialized medical care in the conditions of hospital-replacing technologies is justified. Factors such as the employment rate of women, their age and social characteristics, and factors related to referral to treatment are taken into account.

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Peculiarities of psychological tests for pregnant women prone to abandoning a newborn

Year: 2020, volume 16 Issue: №4 Pages: 956-959
Heading: public health Article type: Original article
Authors: Manerova О.А., Markina A.Yu.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, South Ural State Medical University
Summary:

The goal is to develop and use psychological tools (test) as an element of the system of primary prevention of early social orphanhood being created in a large industrial region. Material and Methods. The developed psychological test was empirically tested in 2018 on a group of pregnant women, consisting of 113 respondents aged 15-40 years, living in the Chelyabinsk region. The electronic version of the test (questionnaire) was introduced into the work of the regional obstetric and gynecological service in September 2019. Results. The questionnaire showed high sensitivity, identifying in 95% of abandoned mothers in 2019 an increased tendency to abandon a newborn. Most of the pregnant women inclined to abandon the child were identified in urban districts of the region (51 women), and the least — in rural areas (17 women). During the year, a positive effect in the prevention of abandonment was achieved in relation to 54.0% of women initially inclined to abandon a newborn. The best result was shown in the regional center — 60.0%. Conclusion. An effective diagnostic technique has been obtained, which makes it possible to purposefully carry out preventive work to prevent early social orphanhood. The developed test made it possible to exclude as much as possible the subjective moment in the statements of pregnant women about the fate of newborns, which led to a more expeditious start of preventive measures to counter refusals.

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Availability of the specialized oncological health care at federal research centre

Year: 2020, volume 16 Issue: №4 Pages: 950-955
Heading: public health Article type: Original article
Authors: Lomakov S.Y., Chernobrovkina А.Е., Vishnyakov N.I., Kochorova L.V., Smirnova N.Yu.
Organization: Pavlov First Saint Petersburg State Medical University
Summary:

Objective: to assess the availability of specialized medical care for malignant neoplasms of the female genital organs in the Federal research center for residents of various regions of Russia. Material and Methods. A special questionnaire was used to conduct a survey of patients (n=164) at the Federal cancer center on the availability of oncological and gynecological care. The data had a normal distribution, statistically processed with calculation intensive, extensive and mean values (M±m) with the risk of error of 0.05, correlations of Pierson, significance of difference by student f-criterion, scoring (five-point system, where 5 is maximum points). Results. Unsatisfactory availability of oncological and gynecological care for regional patients in the Federal clinic was revealed: 56.3% of patients were not offered to choose a hospital, 41.0% waited 14-30 days for hospitalization, 60.3% were forced to pay for radiation tests before hospitalization due to their low availability at the place of residence. This is reflected in the patients' satisfaction with medical care and its timeliness: when conducting radiation tests before hospitalization, the average waiting time is 15.5±2.7 days, in the absence of it— 18.1±4.2 (f =3.5, p<0.05). Conclusion. Restrictions on the availability of medical care in the Federal clinic for residents of Russian regions are due to the lack of coordination of inter-regional cooperation in the organization of examinations, including radiation, which requires the development of measures to improve it.

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Technology for optimizing medical decision-making

Year: 2020, volume 16 Issue: №4 Pages: 944-949
Heading: public health Article type: Original article
Authors: Korshever N.G., Pomoshnikov S.N.
Organization: Saratov State Medical University
Summary:

The objective of the study is the development of optimization techniques for making management decisions in healthcare institutions. Material and Methods. We combined the research findings obtained earlier and interviewed two groups of healthcare managers (49 set the optimization principles for making management decisions, 79 tested the technology we designed). Methods of analytical, logical, sociological, content-analysis of official and medical documentation, flow charts, organizational experiment, statistical were used. Results. We established the optimization principles for making management decisions in healthcare institutions: goal orientation, system approach (isomorphism and multiparameter interaction), prospectivity, use of adequate criterial and diagnostic apparatus, flexibility, differentiation, competence, democratization. These enabled designing and testing of the optimization technology guided by the authors' automated multicriterial assessment of successfulness for the studied approach; it provided making and implementing the management decisions that were the most appropriate for achieving results of the medical institution (number of institutions) performance. Conclusion. The technology considered in the study enables setting the trend and implementing goal-oriented measures for optimization of the management decisions in healthcare institutions.

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Prevalence of risk factors of chronic non-communicable diseases among medical students with different levels of physical activity

Year: 2020, volume 16 Issue: №4 Pages: 940-943
Heading: public health Article type: Original article
Authors: Apoyan S.A., Guryanov M.S., Pozdeeva A.N.
Organization: "Nizhny Novgorod Regional Center for the Prevention and Control of AIDS and Infectious Diseases", Privolzhskiy Research Medical University
Summary:

The purpose is to identify the prevalence of the leading risk factors for the occurrence of chronic non-infectious diseases among medical students, depending on their physical activity. Material and Methods. Screening-diagnostics of the main risk factors were carried out, taking into account the commitment of students to sports: students (326 people) who do sports regularly, and students (1014 people) who do not have physical activity, except for physical education at a university. Results. Students who are not committed to sports are characterized by a low level of physical activity (76.6%), a high frequency of stress — 34.7% compared to student who do sports regularly 16.2%, (p<0.01) and smoking (15.9 and 5.6%, respectively, p<0.05). Violations of the eating regime and an unbalanced died were recorded in both study groups (with a frequency of 39.2 and 55.5 per 100 respondents, p<0.05), however, low physical activity contributes to the appearance of deviations in body weight in 24.6% of students not committed to sports. The ranking of the most frequently encountered risk factors showed that the leading places among the non-athlete students belong to low physical activity, inadequate diet, low sleep duration and high stress levels. Conclusion. Authors emphasize that a higher prevalence of risk factors for the development of chronic non-communicable diseases was found among medical students who do not have physical activity on the regular basis, which may indicate a possible positive effect of sports on reducing the frequency of discovering risk factors for chronic non-communicable diseases among the soon-to-be doctors.

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Потенциальный риск для здоровья сельского населения, связанный с потреблением местных продуктов питания, содержащих остаточные количества тяжелых металлов

Year: 2020, volume 16 Issue: №4 Pages: 934-939
Heading: Hygiene Article type: Original article
Authors: Chekhomov S.Yu., Eliseeva Yu.V., Pichugina A.A., Eliseev Yu.Yu.
Organization: Saratov State Medical University
Summary:

Purpose: hygienic assessment of the potential health risks of consuming local food products produced in ecologically poor areas and containing residual amounts of heavy metals. Material and Methods. Based on the established concentrations of heavy metals (HM): lead (Pb), cadmium (Cd), mercury (Hg) and arsenic (As) in local food products of the Saratov region, the potential risk to the health of the rural population associated with their consumption was assessed. The median and 90th percentile of HM content in local foods were used to calculate exposure, hazard coefficient (HQ), total hazard indices (HI), individual carcinogenic risk (CR), and population carcinogenic risk (PCR). Results. Indicators of the HQ values calculated at the level of the median HM content in food products of the regional districts indicated the acceptable level of their impact. In some areas of the region at the concentration of HM at 90 percentile calculated HQ and total HI of contamination of the HM exceeded the value of 1.0, which required in-depth evaluation of the exposure. Bread and dairy products made the greatest contribution to the level of HM contamination in the majority of the studied areas. Conclusion. High level of CR forthe health of the population of some districts of the Saratov region was associated with contamination of food products As calculated at the 90th percentile. The high PCR forthe population of the same regions of the region, associated with contamination of local food products As, was due to a specific level of the carcinogenic potential factor (SFo=1.5), which sharply increased the likelihood of cancer development with oral exposure to this carcinogen.

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Complex hygienic assessment of labor conditions in the modern production of dairy products

Year: 2020, volume 16 Issue: №4 Pages: 927-934
Heading: Hygiene Article type: Original article
Authors: Novikova Т.А., Lutsevich I.N., Baregamyan L.A., Aleshina Yu.A.
Organization: Saratov Hygiene Medical Research Center of Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Saratov State Medical University
Summary:

Aim: to conduct a comprehensive hygienic assessment of working conditions of the main professional groups of workers in the modern production of dairy products. Material and Methods. The object of the research icluded labor conditions of the workers of the dairy plant typical for modern milk processing enterprises. The factors of the working environment (microclimate, illumination, noise, vibration) and the labor process were studied using standard methods, equipment and measuring instruments. A total of 3740 studies of working environment factors, 39 professional studies were carried out. Results. Working conditions in the production of dairy products are harmful with varying degrees of deviation from the current hygiene standards. Take place increased (27.5-28.8°C in the cold and 29.5-29.8°C in the warm seasons) and low (4.5-18.35°C) air temperatures, exceeding the maximum permissible level (MPL) noise (by 1.6-9 dBA), insufficient artificial and natural lighting, physical overloads due to excessive dynamic and static physical load, lifting and moving loads manually (one-time 20 kg), maintaining uncomfortable and forced working positions (up to 50% and up to 25% shift time, respectively), body inclinations (440±28 times per shift). The overall assessment of working conditions corresponded to classes 3.1-3.3. Conclusion. Harmful working conditions pose a low to high health risk to workers. Priority measures have been identified to improve working conditions and prevent health disorders of workers: normalization of the microclimate and light environment, noise reduction, and a decrease in labor severity.

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