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The experience of health-centric career counseling for schoolchildren in a pediatric clinic 以健康为中心的儿童职业生涯咨询在儿科诊所的经验
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.029
V. Ganuzin, G. Maskova
The article reviews the issues of career counseling for adolescents with health problems. Goal. Show the possibilities and share the experience of providing career advice with focus on health to adolescents with health problems in the settings of primary health care establishments. Patients and methods. Nine hundred forty schoolchildren were counseled in the career advice room. The participants were divided into 3 groups: group 1 — participants with disabilities since early childhood, group 2 — children with chronic diseases, group 3 — children at risk of developing chronic diseases. The inclusion criteria were: status of a schoolchild, signed and submitted informed consent form, lack of exposure to occupational hazards. The conducted study does not endanger the participants and complies with the biomedical ethics requirements. Statistica 10.0 software was used for statistical processing of the data collected. Based on the results of this work and review of the relevant publications, authors of the study suggest a structure of the health- centric career advice service. Conclusions Career advice that factors in health aspects is an important link in medical and psychological rehabilitation aimed at helping the teenager to adapt to current socio-e conomic conditions and realize his/her physical and intellectual capabilities.
本文综述了青少年健康问题的职业咨询问题。的目标。展示在初级保健机构向有健康问题的青少年提供以健康为重点的职业咨询的可能性并分享经验。患者和方法。940名学童在职业咨询室接受咨询。参与者被分为三组:第一组——从幼儿时期就有残疾的参与者,第二组——患有慢性病的儿童,第三组——有患慢性病风险的儿童。纳入标准为:在校儿童身份,签署并提交知情同意书,缺乏职业危害暴露。本研究不危及受试者,符合生物医学伦理要求。采用Statistica 10.0软件对收集的数据进行统计处理。基于本研究的结果和相关文献的回顾,作者提出了以健康为中心的职业咨询服务结构。结论职业咨询中健康方面的因素是医学和心理康复的重要环节,旨在帮助青少年适应当前的社会经济条件,实现自己的身心能力。
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引用次数: 0
Omparative analysis of physical development in children living in Samara and Nizhny Novgorod 萨马拉和下诺夫哥罗德儿童身体发育的比较分析
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.031
O. Sazonova, E. Bogomolova, EA Kalyuzhny, M. Gavryushin, S.R. Trubetskaya
Analysis of physical development in children and adolescents is an integral to the monitoring of child population. Health status of children and adolescents is an essential criterion of societal welfare. Numerous studies of physical development in children indicate the heterogenous nature of growth and develpmental processes in children living in various regions of Russia. The study was aimed to perform the comparative analysis of physical development between children aged 15–17 living in Samara (a total of 714 children were examined, among them 368 boys and 346 girls) and children of the same age group living in Nizhny Novgorod (a total of 689 children, among them 351 boys and 338 girls). In school students aged 16–17, significant differences in the mean height were revealed: adolescents living in Samara were taller than those living in Nizhny Novgorod (p = 0.001). The same trend was observed in girls of the same age group. Comparative analysis showed that girls aged 15–17 living in Samara were significantly taller (p < 0.001) than girls who lived in Nizhny Novgorod. Assessment of body weight showed that the weight of boys aged 15–16 who lived in Samara was significantly higher compared to boys living in Nizhny Novgorod (p = 0.009). No significant differences were revealed between the groups of 17‑year‑old boys and the groups of girls aged 15–17 (р = 0.7). The findings on the differences in the anthropometric indicators of children living in Samara and Nizhny Novgorod justify the need for periodic development and use in healthcare practice of the regional standards for assessment of physical development in children and adolescents.
对儿童和青少年身体发育的分析是监测儿童人口的一个组成部分。儿童和青少年的健康状况是社会福利的一项重要标准。许多关于儿童身体发育的研究表明,生活在俄罗斯不同地区的儿童的生长和发育过程具有异质性。该研究的目的是对生活在萨马拉的15-17岁儿童(共714名儿童接受了检查,其中包括368名男孩和346名女孩)和生活在下诺夫哥罗德的同年龄组儿童(共689名儿童,其中包括351名男孩和338名女孩)的身体发育进行比较分析。在16-17岁的学生中,平均身高有显著差异:萨马拉的青少年比下诺夫哥罗德的青少年高(p = 0.001)。在同一年龄组的女孩中也观察到同样的趋势。对比分析显示,萨马拉15-17岁的女孩明显高于下诺夫哥罗德的女孩(p < 0.001)。体重评估显示,萨马拉15-16岁男孩的体重明显高于下诺夫哥罗德男孩(p = 0.009)。17岁男孩组和15-17岁女孩组之间无显著差异(χ = 0.7)。关于萨马拉和下诺夫哥罗德儿童人体测量指标差异的调查结果证明,有必要定期制定和在保健实践中使用评估儿童和青少年身体发育的区域标准。
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引用次数: 1
Risk factors of atopic dermatitis in children and the means for individual prognosis 儿童特应性皮炎的危险因素及个体预后分析
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.026
O. Milushkina, EA Dubrvina, M. Timerzyanov, L. Khaertdinova
Despite considerable progress in prevention and treatment of atopic dermatitis made in recent years, the issue remains topical, since in recent decades a significant increase in the prevalence of atopic disorders is observed all over the world. The increased incidence of atopic dermatitis results from the human body exposure to the wide range of factors, as well as from the factors’ specificity and mutual activation. Atopic dermatitis is a multifactorial disorder associated with genetic predisposition to atopy, realized under the influence of environmental factors. The risk factors of pediatric atopic dermatitis are divided into endogenous and exogenous factors, which are also affected by genetic susceptibility. It is worth paying attention to the fact that the factors are enhanced by triggers, which both directly and indirectly influence the body in children and adolescents. A combination of multiple factors plays a key role in chronic pediatric atopic dermatitis. Also do not forget about the impact of sanitation, hygiene, environmental factors, urbanization of the area of residence, and the presence of industrial enterprises in the residential area on the health of children and adolescents. Atopic dermatitis has a negative impact on the quality of life of children and their families. There is a clear need for further research. Currently, monitoring the effects of atopic dermatitis becomes relevant, it is aimed at addressing the issues of prevention. For its part, timely identification of the risk factors and concomitant disorders are of inestimable value for the course of the disorder.
尽管近年来在预防和治疗特应性皮炎方面取得了相当大的进展,但这个问题仍然是热门话题,因为近几十年来,在世界各地都观察到特应性疾病的患病率显著增加。特应性皮炎发病率的增加是由于人体暴露于多种因素,以及这些因素的特异性和相互激活。特应性皮炎是一种与遗传易感性相关的多因素疾病,在环境因素的影响下实现。小儿特应性皮炎的危险因素分为内因和外因,也受遗传易感性的影响。值得注意的是,这些因素因触发因素而增强,直接或间接地影响儿童和青少年的身体。多种因素的结合在儿童慢性特应性皮炎中起关键作用。此外,不要忘记环境卫生、个人卫生、环境因素、居住地区的城市化以及居住地区存在工业企业对儿童和青少年健康的影响。特应性皮炎对儿童及其家庭的生活质量有负面影响。显然需要进一步的研究。目前,监测特应性皮炎的影响变得相关,它的目的是解决预防问题。就其本身而言,及时识别危险因素和伴随疾病对疾病的病程具有不可估量的价值。
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引用次数: 0
Nutritional status and life span of humans 人类的营养状况和寿命
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.027
AV Skrebneva, E. Melikhova, MV Vasilieva
Social factors such as bad living conditions, harmful labor conditions, low quality of medicine, loss of social contacts, etc., and lifestyle factors such as mal- and over-nutrition, hypodynamia, bad habits, etc. are the main issues of premature ageing. In this article, the alimentary factor such as the risk of premature ageing has been considered from the point of view of over- and malnutrition (protein-e nergy undernutrition) and its influence on the rate of ageing. The effect of overnutrition has been examined in the literature review of Russian and foreign investigators. Scientific publications show that one alimentary factor can be used to produce a significant influence on life span and frequency of some degenerative diseases. The relationship between malnutrition in the older population and biological age has been evaluated. 408 those surveyed from the city of Voronezh aged 55 to 70 were included into the study. The examination was nonrecurrent. The biological age of those surveyed was determined using the method by V. P. Voitenko. Malnutrition was assessed with the MNA (Mini Nutritional Assessment) tool. Malnutrition is observed among 2.2% of elderly patients, 58.8% of those surveyed are at risk for malnutrition, whereas 39% of them have a normal alimentary status. It is established that the biological age is correlated with the alimentary status. Statistically significant differences are found in the mean group values of the biological age in the subgroup of people with a normal alimentary status in relation to the subgroup of people with a risk for malnutrition (p<0.05): the values were 56±1.7 and 64±1.4, respectively. The publication shows a direct and indirect influence of the alimentary status (both overnutrition, and malnutrition) on the rate of senescence.
社会因素如恶劣的生活条件、有害的劳动条件、低质量的药品、失去社会联系等,生活方式因素如营养不良和营养过剩、动力不足、不良习惯等是早衰的主要问题。本文从营养过度和营养不良(蛋白质-能量营养不足)及其对衰老速度的影响的角度考虑了早衰风险等消化因素。营养过剩的影响在俄罗斯和国外研究者的文献综述中得到了检验。科学出版物表明,一种饮食因素可以对某些退行性疾病的寿命和频率产生重大影响。老年人营养不良与生理年龄之间的关系已经得到了评估。来自沃罗涅日市的408名年龄在55岁至70岁之间的受访者参与了这项研究。检查没有复发。被调查者的生理年龄是用v.p. Voitenko的方法确定的。营养不良评估采用MNA(迷你营养评估)工具。2.2%的老年患者存在营养不良,58.8%的调查对象存在营养不良风险,而39%的调查对象的消化状况正常。研究表明,生物年龄与动物的营养状况有关。营养状况正常亚组与营养不良危险亚组生物年龄的平均组值差异有统计学意义(p<0.05),分别为56±1.7和64±1.4。该出版物显示了营养状况(营养过剩和营养不良)对衰老速度的直接和间接影响。
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引用次数: 0
Food patterns and chemical contamination of baby food 食物模式和婴儿食品的化学污染
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.032
Y. Tikhonova
Для анализа качества питания населения, в том числе детского, остается актуальным изучение структуры питания детей. Питание детей — это фактор окружающей среды, который в дальнейшем определяет состояние здоровья и продолжительность жизни детей. Появление на рынке большого количества адаптированных и частично адаптированных молочных смесей для искусственного вскармливания способствует тому, что часто матери отказываются от грудного вскармливания и переходят на искусственное вскармливание, что может быть небезразлично для детского организма. Продукты докорма и прикорма могут содержать различные чужеродные вещества, что будет увеличивать химическую нагрузку на растущий детский организм через продукты питания. Целью исследования явилось: изучение структуры питания детей первого года жизни по данным анкетирования 600 матерей в различных ЛПУ; оценка химической контаминации продуктов для искусственного вскармливания/докармливания и прикорма на первом году жизни по данным федерального информационного фонда социально- гигиенического мониторинга Российской Федерации (ФИФ СГМ РФ) по 65 субъектам за 2012–2017 гг. Полученные данные обрабатывались с использованием компьютерных программ «Microsoft Word 2010» и «Microsoft Excel 2010». Установлено, что 37,3% детей первого года жизни находятся на грудном вскармливании, 62,7% детей получают искусственное вскармливание/ докармливание. Возраст введения прикорма в 74,7% случаев — это 4–6-й месяц первого года жизни. В качестве первого прикорма чаще используются фруктовые и овощные продукты, далее вводят злаковые продукты (каши) и мясные консервы. Эти же виды продуктов имеют самые высокие показатели по содержанию тяжелых металлов (свинец, кадмий, мышьяк, ртуть).
对于包括儿童在内的人口的营养质量分析,仍有必要研究儿童的营养结构。儿童营养是环境因素,这将进一步决定儿童的健康状况和寿命。市场上大量适应性和部分适应性奶粉的出现,导致母亲经常拒绝母乳喂养,转而人工喂养,这可能对婴儿的身体很重要。食材和食材可能含有不同的外来物质,这将增加通过食物对正在生长的婴儿体内的化学压力。研究的目标是:根据600名不同lpa母亲的调查,研究第一年儿童的营养结构;根据俄罗斯联邦社会卫生监测信息基金会(fcc) 2012年至2017年,根据俄罗斯联邦社会卫生监测信息基金会(fcc)对65名受试者的化学补充性评估,这些数据是通过“微软Word 2010”和“微软Excel 2010”计算机程序处理的。据估计,第一年37.3%的儿童靠母乳喂养,62.7%的儿童接受人工喂养/喂养。在74.7%的情况下,喂食年龄是生命第一年的第4 - 6个月。第一种食物通常是水果和蔬菜,其次是谷物(粥)和肉罐头。这些产品的重金属含量最高(铅、镉、砷、汞)。
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引用次数: 0
Hygienic assessment of the academic load in modern students 现代学生学业负担卫生评价
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.025
E. Bulycheva
In modern school education, a system, developing high academic loads among schoolchildren, is being formed. The loads pose a serious problem, creating inevitable medical consequences, and producing a negative effect on the morbidity and structure of the pathology for this group of children and adolescents. Given the situation, control over the academic load, its rational distribution and initiating supervision over the academic process intensity are relevant. Basic negative factors of academic process organization were found in the course of academic schedule analysis in 1.728 classes and estimating the academic process intensity during 3.500 lessons. The maximum non-conformities to hygienic standards were found in high school students from cities. It was established that a weekly academic load was exceeded after school owing to extended learning activities, and irrational distribution of a weekly academic load because of difficult subjects. Intellectual, sensory and emotional loads were the leading criteria of an intense academic process. Highly intense academic load was noted for such school subjects as Russian, Algebra, Foreign language, Chemistry and Geometry. The same subjects are taught in different major classes with a various degree of intensity. This required scored correction of how difficult the subjects are in senior major classes.
在现代学校教育中,正在形成一种使学生学业负担加重的制度。这些负担构成了一个严重的问题,造成了不可避免的医疗后果,并对这一儿童和青少年群体的发病率和病理结构产生了负面影响。在这种情况下,对学业负荷的控制、学业负荷的合理分配以及对学业过程强度的初始监督都是相关的。通过对1728个班级的学习进度分析和3500个班级的学习过程强度估算,发现学业过程组织的基本负性因素。最不符合卫生标准的是来自城市的高中生。研究发现,由于学习活动的延长,以及由于学科难度大,每周的学习负荷分配不合理,导致课后超过了每周的学习负荷。智力、感官和情感负荷是高强度学术过程的主要标准。俄罗斯、代数、外语、化学和几何等科目的课业负担非常沉重。同样的科目在不同的主要班级以不同的强度教授。这需要对高年级专业课程的难度进行分数修正。
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引用次数: 3
Key hearing loss risk factors for children, adolescents and youth associated with use of mobile electronic devices with headphones 儿童、青少年和青年听力损失的主要风险因素与使用带耳机的移动电子设备有关
Pub Date : 2022-04-01 DOI: 10.24075/rbh.2021.028
GV Pavlova, S. Markelova, V. Martiusheva
The number of research papers about the impact electronic devices produce on the younger generation that uses them is constantly growing. This study aimed to identify the leading hearing loss risk factors for children, adolescents and youth associated with use of mobile electronic devices with headphones In the 2017–2021 academic years, we surveyed 518 students in Moscow and 1000 schoolchildren and students in the towns of Izhevsk and Tchaikovsky. The survey was designed to collect data on the conditions in which the respondents use mobile electronic devices with headphones, design features of the headphones used and their hearing health status. The inclusion criteria were: status of a schoolchild, student, signed and submitted informed consent form, questionnaire correctly completed by the respondent or his/her legal representative, one or more years of using mobile electronic devices. The conducted study does not endanger the participants and complies with the biomedical ethics requirements. Statistica 13 PL software was used for statistical processing of the data collected. Fourteen percent of the respondents reported hearing deterioration in the course of the last year. Prolonged use of mobile electronic devices with headphones increases the risk of hearing loss by 10.4 times, listening to audio files at maximum volume — by 3.2 times, listening to audio files while in a moving vehicle — by 7.1 times. Most schoolchildren and students with hearing impairments have been using headphones for at least a year, preferred in-ear headphones with silicone tips, used them at maximum volume daily, for more than two hours a day, including while in a moving vehicle. The recommendations for students and schoolchildren is to limit the time of use of their electronic devices with headphones and use them at a lower volume; complying with the recommendations can improve the functional state of their health. It is also recommended not to use headphones while in a moving vehicle. If hearing begins deteriorating, it is necessary to cease using mobile electronic devices with headphones. Today, schoolchildren and students are exposed to the hearing impairment risks associated with use of mobile electronic devices with headphones, which makes the search for the most efficient ways of forming healthy lifestyle habits among them even more urgent.
关于电子设备对使用它们的年轻一代产生影响的研究论文数量在不断增长。本研究旨在确定与使用带耳机的移动电子设备相关的儿童、青少年和青年的主要听力损失风险因素。在2017-2021学年,我们调查了莫斯科的518名学生和伊热夫斯克和柴可夫斯基城镇的1000名学童和学生。该调查旨在收集受访者使用带耳机的移动电子设备的情况、所使用耳机的设计特点以及他们的听力健康状况等数据。纳入标准为:在校儿童身份、学生身份、已签署并提交的知情同意书、被调查者或其法定代理人正确填写的问卷、使用移动电子设备一年或一年以上。本研究不危及受试者,符合生物医学伦理要求。采用Statistica 13pl软件对采集的数据进行统计处理。14%的受访者表示,在过去的一年里,他们的听力出现了下降。长时间使用带耳机的移动电子设备会使听力损失的风险增加10.4倍,以最大音量收听音频文件的风险增加3.2倍,在行驶的车辆中收听音频文件的风险增加7.1倍。大多数有听力障碍的小学生和学生使用耳机至少有一年的时间,他们更喜欢带硅胶头的入耳式耳机,每天使用耳机的音量达到最大,每天使用两个小时以上,包括在行驶中的车辆上。对学生和学童的建议是,限制使用带耳机的电子设备的时间,并降低音量;遵守这些建议可以改善他们的健康功能状态。在行驶的车辆中也建议不要使用耳机。如果听力开始恶化,有必要停止使用带耳机的移动电子设备。今天,学童和学生面临着与使用带耳机的移动电子设备相关的听力损伤风险,这使得寻找在他们中间形成健康生活习惯的最有效方法变得更加紧迫。
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引用次数: 0
Comparative analysis of chemical contamination of baby foods and primary pediatric morbidity 婴儿食品化学污染与儿童原发性发病的比较分析
Pub Date : 2021-12-01 DOI: 10.24075/rbh.2021.021
Yu. N. Tikhonova
The safety of baby foods is key to a child’s health, which, in turn, is one of the prioritized national goals. As they grow, children get exposed to numerous negative environmental impacts. Chemical contamination of baby foods can increase pediatric morbidity. The aim of this study was to investigate possible correlations between baby food contamination and primary pediatric morbidity using data on 65 Russian regions collected in 2012–2017 by the Russian Federal Information Public Health Surveillance Foundation. The data were processed in Microsoft Word 2010 and Microsoft Excel 2010. Of 67,940 samples of baby foods analyzed for chemical contamination, priority pollutants (toxic element) were detected in 14.1%. The most contaminated were fruit and vegetable purees (47.1%), followed by milk formulas and cultured dairy products (19.9%). We also analyzed 32,914 indicators of pediatric morbidity. The Pearson correlation analysis detected reliable correlations between baby food contamination and the primary incidence of endocrine disorders in infants, as well as the primary incidence of obesity, diabetes mellitus and cancer in children aged 0 to 14 years.
婴儿食品的安全是儿童健康的关键,这反过来又是国家优先目标之一。随着孩子们的成长,他们会接触到许多负面的环境影响。婴儿食品的化学污染会增加儿童的发病率。本研究的目的是利用俄罗斯联邦信息公共卫生监测基金会在2012-2017年收集的65个俄罗斯地区的数据,调查婴儿食品污染与原发性儿科发病率之间可能的相关性。数据在Microsoft Word 2010和Microsoft Excel 2010中处理。在67,940份婴儿食品化学污染分析样本中,检出优先污染物(有毒元素)的占14.1%。污染最严重的是果蔬泥(47.1%),其次是配方奶和培养乳制品(19.9%)。我们还分析了32,914项儿科发病率指标。Pearson相关分析发现,婴儿食品污染与婴儿内分泌失调的主要发病率,以及0 - 14岁儿童肥胖、糖尿病和癌症的主要发病率之间存在可靠的相关性。
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引用次数: 0
Analysis of health dynamics in children and adolescents based on the results of regular medical check-ups 基于定期体检结果的儿童和青少年健康动态分析
Pub Date : 2021-12-01 DOI: 10.24075/rbh.2021.019
V. Ganuzin, G. Maskova, IV Storozheva, NS Sukhova
The article deals with the issues of health in children and adolescents aged 7–17 years. The objective of this study is to analyze health experience in school-age children and adolescents based on regular medical check-up results. According to regular medical check-up results, 15,192 schoolchildren were examined in 2015, including 12,649 children aged 7–14 years and 2,543 children aged 15–17 years. In 2020, health of 18,708 schoolchildren was assessed, including 14,861 children aged 7 to14 years and 3,847 children aged 15 to 17 years. The authors analyze dynamics of distribution of children into health groups, and age-related incidence of school- related diseases. In children and adolescents of different age, eye disorders occupy first place in the rank of prevalent school- related diseases; the events are followed by musculoskeletal diseases, nervous and GIT diseases, progressing with age, including scoliosis. Percentage of healthy children without the signs of a school- related abnormality at school is reducing. In the majority of cases, pathological abnormalities are found in 15–17-year-old adolescents.
该条涉及7-17岁儿童和青少年的健康问题。本研究的目的是分析学龄儿童和青少年的健康经验,基于定期体检结果。根据定期体检结果,2015年对15 192名学童进行了体检,其中包括12 649名7-14岁儿童和2 543名15-17岁儿童。2020年,对18 708名学童的健康进行了评估,其中包括14 861名7至14岁儿童和3 847名15至17岁儿童。作者分析了儿童在健康组中的分布动态,以及与年龄相关的学校相关疾病发病率。在不同年龄的儿童和青少年中,眼病在流行的学校相关疾病中占据首位;随后是肌肉骨骼疾病、神经和胃肠道疾病,随着年龄的增长而发展,包括脊柱侧凸。在学校里没有学校相关异常迹象的健康儿童的百分比正在减少。在大多数情况下,病理异常见于15 - 17岁的青少年。
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引用次数: 5
Hygienic assessment of risk factors and health of forensic scientists 法医危险因素与健康的卫生评价
Pub Date : 2021-12-01 DOI: 10.24075/rbh.2021.020
M. Timerzyanov, OA Ilina, EA Dubrvina, O. Milushkina, DE Vasilev
The objective of the study was to develop and implement the system of hygienic measures eliminating (mitigating) the impact of risk factors in the work of forensic scientists and to estimate effectiveness of these measures and the program aimed at improvement of employment terms for forensic scientists [1, 2]. Forensic scientists were compared to a control group of other doctors. The following researches were carried out: survey of 303 forensic scientists, analysis of their employment terms based on employment terms special evaluation (2,736 materials of employment terms special evaluation), examination of forensic scientists’ health compared to other doctors by analyzing medical examination results (309 health records). Protection and promotion of working population’s health is the state priority. Its purpose is to preserve labor potential and create conditions for economic development of the country. Medical workers are exposed to a combined, complex, and associated effect of working environment conditions and parameters [3, 4]. Industrial and social factors can result in a rising incidence, reduction in life expectancy, ill health and medical staff performance increment, and require preventive measures. Those working for forensic expert organizations constitute a special population due to a large number of professional, medical and organizational, and social risk factors [5].
该研究的目的是制定和实施卫生措施系统,消除(减轻)法医科学家工作中风险因素的影响,并评估这些措施的有效性,以及旨在改善法医科学家就业条件的计划[1,2]。法医科学家与其他医生组成的对照组进行了比较。对303名法医学工作者进行了问卷调查,根据聘用条件特别评价对法医学工作者的聘用条件进行了分析(聘用条件特别评价资料2736份),通过分析体检结果对法医学工作者与其他医生的健康状况进行了对比(309份健康记录)。保护和促进劳动人口的健康是国家的优先事项。其目的是保持劳动力潜力,为国家的经济发展创造条件。医务工作者面临着工作环境条件和参数的综合、复杂和相关影响[3,4]。工业和社会因素可导致发病率上升、预期寿命缩短、健康状况不佳和医务人员绩效提高,因此需要采取预防措施。由于存在大量的专业、医疗、组织和社会风险因素,法医鉴定机构工作人员构成了一个特殊的人群[5]。
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引用次数: 0
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Российский вестник гигиены
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