Noise as a Criterion for Designating Sanitary Protection Zones of Traffic Arteries

The article is devoted to the study of a possibility of designating the boundaries of sanitary zones (distancing) for traffic arteries outside settlements within the right-of-way.The study was conducted regarding the current Russian laws, projects of possible changes in legislation and draft amendments. It offers definitions of the right-of-way and of sanitary zone and highlights topics that have not yet been regulated.At the same time, the research methods are of universal character and after introducing other regulatory parameters may be applied for similar research in other countries as well.Calculations and field studies allowed to find that within the railway right-of-way and with the existing train traffic intensity, equivalent continuous sound pressure level in aggregate does not exceed the established maximum permissible level of 80dBA for personnel performing their labour functions within the railway rightof-way.A growth in the Leq/LAeq on the right-of-way from 80,0 to 95,0 dBA may lead to an increase in the hazard class (subclass).An analysis of the actual results of a special assessment of working conditions at JSC Russian Railways showed in the vast majority of cases the acceptability of working conditions evaluated according to noise factor measured at the workplaces of employees working during full or part-time shift on the right-of-way. Hazardous working conditions at the level of some subclasses for certain professions (operator of track measurement, railway track worker) arise rather due to indicators of severity of the labour process.

Robust, Primitive, and Unsupervised Quality Estimation for Segmentation Ensembles

A multitude of image-based machine learning segmentation and classification algorithms has recently been proposed, offering diagnostic decision support for the identification and characterization of glioma, Covid-19 and many other diseases. Even though these algorithms often outperform human experts in segmentation tasks, their limited reliability, and in particular the inability to detect failure cases, has hindered translation into clinical practice. To address this major shortcoming, we propose an unsupervised quality estimation method for segmentation ensembles. Our primitive solution examines discord in binary segmentation maps to automatically flag segmentation results that are particularly error-prone and therefore require special assessment by human readers. We validate our method both on segmentation of brain glioma in multi-modal magnetic resonance - and of lung lesions in computer tomography images. Additionally, our method provides an adaptive prioritization mechanism to maximize efficacy in use of human expert time by enabling radiologists to focus on the most difficult, yet important cases while maintaining full diagnostic autonomy. Our method offers an intuitive and reliable uncertainty estimation from segmentation ensembles and thereby closes an important gap toward successful translation of automatic segmentation into clinical routine.

RISK FACTORS IN THE PROCESS OF EMPLOYMENT OF MEDICAL WORKERS OF THE DENTAL PROFILE

One of the most socially important types of work is the work of medical workers. Due to the presence of a significant number of harmful and dangerous factors, the medical profession is divided into a separate group, which in turn is characterized by unique aspects of work. The work of doctors and nurses of different specialties of the dental profile differs significantly in the density of the working day, the volume and nature of professional activities; responsibility for the life of the patient, which affects many physiological processes. The purpose. Assessment and comparative characterization of the presence of occupational risks in the dental field, which are daily exposed to factors of aggressive and dangerous nature, as well as the development of a set of preventive measures aimed at reducing occupational morbidity. Materials and methods. Hygienic research of working conditions of medical staff of the University Dental Clinic in the form of a questionnaire. Statistical analysis of data of special assessment of working conditions; sanitary and hygienic characteristics, acts, maps of cases of nosocomial diseases; laboratory and instrumental research conducted as part of production control; dosimetric control, air sampling with subsequent sowing on the nutrient medium of IPA. Results. It was found that in the studied premises, the total microbial count varied from 756 ± 0.8 CFU / 1m3 to 6497 ± 3.4 CFU / 1m3. In most medical institutions, the level of artificial lighting in the workplaces of medical workers was insufficient. The largest negative contribution was provided by such production factors as: labor intensity and intensity - 26.41%; physical: noise, vibration, non-ionizing and ionizing radiation - 25.32%; chemical - 12.77%. The total contribution of the main factors was 91.78%. Assessment of working conditions is based on hygienic criteria to assess the degree of deviations of the parameters of the production environment and labor process from the current hygienic standards, as well as after analysis and processing of data submitted by employees in the format of their questionnaires. In this regard, the distribution of harmful production factors and their degree of impact on the health of medical personnel was established with the help of multifactor analysis. Conclusions. Thus, the research interprets the results, which clearly in the format of a specific percentage, identify those factors that have a strong driving impact on the health of dental professionals. The most substantiated are such production factors as: chemical (exposure to drugs and chemicals), physical (noise and vibration, non-ionizing and ionizing radiation), the severity and intensity of the labor process, lighting (non-compliance with regulations for artificial lighting in the workplace) and microclimate and biological (work with biological, potentially contaminated material, samples, patients), non-ionizing and ionizing radiation, labor intensity (tension of the visual organs).

Adapting the Form of the sanitary and hygienic characteristics of working conditions to the new Sanitary Law

Introduction. The current Form No. 362-1/y-2001 "The sanitary and hygienic characteristics for the working conditions of an employee having suspicion of an occupational disease (poisoning)" does not meet the requirements of Sanitary Law developed within the framework of the "regulatory guillotine". It complicates the investigation of occupational diseases and carrying out an objective examination of the connection between the disease and the profession. The study aims to analyze the Form for the sanitary and hygienic characteristics (SHC) of working conditions and substantiate proposals for its adaptation to the current regulatory legal acts to objectify the investigation of occupational diseases cases and the examination of the connection between the disease and the profession. Materials and methods. We carried out the expert-analytical study. We analyzed and compared data from Rospotrebnadzor (2001-2020) on occupational morbidity and Rosstat (2014-2020) on employment in harmful and (or) hazardous working conditions. We also studied the SHC (503) submitted for examination of the connection between disease and profession (including forensic medical examination). The structure of the Form for the completeness of the presentation of issues on various aspects of working conditions, the quality of the compilation and content of the SHS was determined in accordance with the current Sanitary Law. The authors evaluated the structure of the Form for the presentation of questions on various aspects of working conditions, determined the quality of the compilation and content of the SHC in accordance with the current Sanitary Law. Results. With a decrease in the number of newly registered cases of occupational diseases over 20 years by more than 3.7 times, the share of workers in harmful and(or) hazardous working conditions in the main types of economic activity decreased in 2020 relative to 2014 in 1,1 time (37.3%). A comparative assessment of the standardized indicators of harmful production factors specified in the SHC and the ones approved in SanPiN 1.2.3685-21 revealed their complete inconsistency. The results of in-depth analysis of 503 SGH allowed us to determine the most typical errors in assessing production factors at workplaces: incorrect assessment of standardized single-digit noise indicators (equivalent sound level A for an 8-hour working day), vibration (equivalent level corrected along the Z-, Y-, X-axes ); lack of data on dust load and the average value of air temperature - THC-index; assessment of the labour severity without considering the technological operations performed, etc. We noted the predominant assessment of working conditions by the main factor developing an occupational disease, without considering the accompanying risk factors that aggravate its effect. We also noted a significant underestimation of the levels when assessing the general transport, technological and technological vibration due to the differences between hygienic standards and the norms adopted in the Methodology for conducting a special assessment of working conditions. SCH contains no information on lighting, biological factor, labour intensity in 67.0-75.0% of cases. Conclusion. We substantiated proposals for improving Form No. 362-1/y-2001 of the SHC of working conditions, considering an electronic form of the document, revising the instructions for filling out the SHC.

The Practice of Indigenous Education for Students with Disabilities in the Selected Church Schools of South Gondar Administrative Towns-Ethiopia

The main objective of this study is to assess the practice of indigenous education for students with disabilities in Ethiopian indigenous schools. Therefore, 20 Orthodox Church schools were purposefully selected in order to make them representatives of South Gondar Administrative towns. The result of the study showed that there was no ability difference between students with disabilities and students without disabilities in the different levels of the church schools(X 2 =0.62 and its Chi-square per item is 1.509, .521, .036, 1.393, .158, .015, .793, .100, and 1.050 at df =1, p =.220, .471, .850, .238, .691, .902, .373, .751 and .305 >0.05 from items 1-9 respectively). In addition, church scholars could not use special assessment techniques for students with disabilities in the different church schools. Inaccessible environment is the major challenge that impede the educational performance of students with disabilities. Therefore, students with disabilities need different support services from stakeholders.

The main disadvantages of the sanitary and hygienic characteristics of working conditions which complicate the expertise of the relation between the disease and occupation

Introduction. Examining the disease’s connection with the occupation being the cornerstones in occupational health cannot be based on template solutions. When considering the aetiology of the disease, the entire document was the sanitary and hygienic characteristics of working conditions, the quality of which often determines the patient’s fate. Materials and methods. A retrospective analysis of the sanitary and hygienic characteristics of 647 inpatient medical records from 2013 to 2020, aimed at examining the relationship of the disease with the occupation: 562 cards with an established diagnosis, 85 - with an unspecified final diagnosis of an occupational disease. The contingent of the surveyed: 98.0% - employees of various industries and enterprises of the Republic of Bashkortostan, 2.0% - residents of other regions of the country, as well as the republic working in the Far North on a shift basis. Results. When preparing the characteristics in 73.0% of cases, the employees of Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing were based only on the data of a special assessment of working conditions, in which there was no complete information about the working conditions of the employee, which often leads to the inability to establish an occupational disease to the patient. In 7.0% of cases, the values of harmful industrial factors in the presented characteristics were on the border with the hygienic standard, which, with significant work experience and the presence of clear signs of occupational disease in the patient, also puts expert doctors in a difficult position. The situation mentioned above may be the cause of a legal dispute on the part of the employee if he refuses to establish an occupational illness and the employer if the issue is resolved positively for the employee. The reasons for delaying the terms of the examination were the need to request additional documents in connection with the data provided in the characteristics on the nature of the influencing harmful factors, based only on literary sources. Non-compliance with the deadlines for submitting the attributes to the Center of Occupational Pathology was observed in almost 100.0 % of cases. In 75.0% of cases, employees signed it without receiving explanations of quantitative and qualitative indicators. Conclusion. There is an urgent need to review the methodological approaches to compiling sanitary and hygienic characteristics of working conditions, develop an algorithm for its preparation, and the level of responsibility of all stakeholders for the quality of the document.

Special assessment of working conditions and assessment of occupational risks

A special assessment of working conditions (SAUT) is a unified set of measures to identify harmful and (or) hazardous factors that should be carried out in production in the course of labor activity. An overview of judicial practice in terms of SAUT and professional risk assessment is presented by Konstantin Panin, head of the SRG-ECO labor conditions assessment department, developer of methodological programs, lecturer at the RANEPA under the President of the Russian Federation.

VARIASI MODEL SUPERVISI PEMBELAJARAN (STUDI KASUS : SD MADINA ISLAMIC SCHOOL, TEBET, JAKARTA SELATAN)

(English) Variations of learning supervision models can improve the quality of education. This research aims to describe the supervision models developed in SD Madina Islamic School. The research used qualitative descriptive-naturalistic approach. Through triangulation of data collection and processing techniques, the findings of research that SD Madina Islamic School combined models of supervision of learning, secretive and spontaneous principles, and has the benefit for habits teachers in learning. Through the mix of curriculum namely DIKNAS, Al-Azhar Cairo, and Cambridge, variations of learning supervision are applied using special assessment criteria, to produce an optimal, directed, and authentic assessment and guidance. Abstrak (Bahasa Indonesia) Supervisi pembelajaran yang variatif dapat meningkatkan kualitas pendidikan. Penelitian ini bertujuan untuk mendeskripsikan model supervisi yang dikembangkan oleh SD Madina Islamic School. Penelitian menggunakan pendekatan kualitatif deskriptif-naturalistik. Melalui triangulasi teknik pengumpulan dan pengolahan data, didapatkan temuan penelitian bahwa SD Madina Islamic School memadukan model supervisi pembelajaran secara variatif, berprinsip rahasia dan spontanitas, serta bermanfaat habitualiasasi guru dalam pembelajaran. Melalui perpaduan kurikulumnya yakni DIKNAS, Al-Azhar Cairo, dan Cambridge, maka variasi supervisi pembelajaran diterapkan dengan berbagai kriteria penilaian khusus, guna menghasilkan penilaian dan bimbingan yang optimal, terarah, dan otentik.

VARIASI MODEL SUPERVISI PEMBELAJARAN (STUDI KASUS : SD MADINA ISLAMIC SCHOOL, TEBET, JAKARTA SELATAN)

(English) Variations of learning supervision models can improve the quality of education. This research aims to describe the supervision models developed in SD Madina Islamic School. The research used qualitative descriptive-naturalistic approach. Through triangulation of data collection and processing techniques, the findings of research that SD Madina Islamic School combined models of supervision of learning, secretive and spontaneous principles, and has the benefit for habits teachers in learning. Through the mix of curriculum namely DIKNAS, Al-Azhar Cairo, and Cambridge, variations of learning supervision are applied using special assessment criteria, to produce an optimal, directed, and authentic assessment and guidance. Abstrak (Bahasa Indonesia) Supervisi pembelajaran yang variatif dapat meningkatkan kualitas pendidikan. Penelitian ini bertujuan untuk mendeskripsikan model supervisi yang dikembangkan oleh SD Madina Islamic School. Penelitian menggunakan pendekatan kualitatif deskriptif-naturalistik. Melalui triangulasi teknik pengumpulan dan pengolahan data, didapatkan temuan penelitian bahwa SD Madina Islamic School memadukan model supervisi pembelajaran secara variatif, berprinsip rahasia dan spontanitas, serta bermanfaat habitualiasasi guru dalam pembelajaran. Melalui perpaduan kurikulumnya yakni DIKNAS, Al-Azhar Cairo, dan Cambridge, maka variasi supervisi pembelajaran diterapkan dengan berbagai kriteria penilaian khusus, guna menghasilkan penilaian dan bimbingan yang optimal, terarah, dan otentik.

Neutrophils to Lymphocytes Ratio (NLR) Variation in Relationship with Childhood Maltreatment in Patients with Anorexia Nervosa: A Retrospective Cohort Study

Purpose: Anorexia nervosa (AN) is a serious mental illness that is frequently accompanied with a history of childhood maltreatment (CM) which may constitute a specific ecophenotype of the eating disorder necessitating special assessment and management. Chronic stress inflicted by CM in patients with AN may manifest through increased low grade inflammation reflected by an increase in ratios from white blood cells count such as neutrophils to lymphocytes ratio (NLR) platelets to lymphocytes ratio (PLR) and monocytes to lymphocytes ratio (MLR). Methods: N=206 participants were evaluated in an eating disorders daycare unit in Montpellier, France between March 2013 and January 2020. CM was assessed using childhood trauma questionnaire (CTQ). AN clinical severity was assessed using eating disorder examination (EDE-Q). The MINI was used to assess other clinical characteristics. Results: NLR has been found to be higher in patients with AN and a history of CM (p=0.029) as well as in patients with AN and a history of emotional abuse (p=0.021) when compared to patients with AN and without a history of CM. In the multivariate analysis, emotional abuse (β=0.17; p=0.027) contributed significantly to NLR’s variability. Conclusion: NLR is a low grade inflammation marker that is influenced by multiple sociodemographic, clinical and biological factors in patients with AN. It is more directly affected by certain subtypes of CM, especially emotional abuse than by the presence or absence of a history of CM. Future studies may focus on mediators between CM and increased inflammation such as interoceptive awareness, emotional dysregulation, food addiction and stress-sensitization.Level of evidence: Level III: Evidence obtained from well-designed cohort or case-control analytic studies