The acute odontogenic infection in maritime medicine: clinical and radiological parallels

Relevance. The main thing in the prevention of acute odontogenic infection in sailors during long voyages is the full implementation of the pre-voyage sanitation of the oral cavity, which provides for the elimination of chronic foci of odontogenic infection.The aimof the study was to identify chronic foci of odontogenic infection in sailors after the completion of their prevoyage sanitation of the oral cavity and before going sailing.Material and methods. Dental and X-ray (orthopantomography) examination of 169 men aged 22 to 52 years after completion of dental treatment (oral cavity sanitation) before a long sea voyage was carried out, followed by analysis of clinical and radiological parallels to identify chronic odontogenic foci of infection, which can be a potential source of microorganisms for the development of acute odontogenic infection during swimming.Results and discussion.It was found that, despite the ongoing treatment and prophylactic work on the rehabilitation of the oral cavity with the sailors in the pre-voyage period, in 30.4-77.2% of cases they retain chronic foci of odontogenic infection during a long sea voyage, which can become the cause of the development of acute odontogenic infection. For the qualitative detection of chronic odontogenic foci of infection, it is necessary to supplement the dental examination of sailors in the pre-voyage period with an X-ray examination, which will allow timely identification and elimination of chronic odontogenic inflammation of the maxillary sinuses, as well as chronic periapical and periodontal foci of odontogenic infection.

Determinants of the Implementation of Telemedicine in the German Navy—A Mixed Methods Study

ABSTRACT Introduction The history of the use of telemedicine in maritime medicine dates back to the 1930s. In the early 2000s, the German Navy built up a telemedicine network which today is installed in all ships and provides a connection to the medical infrastructure ashore. The objective of this study was to optimize the implementation of telemedicine based on the experience gained in the German Navy. For this purpose, qualitative and quantitative methods were used to identify determinants which affect the use of telemedicine in order to determine whether there is any need for optimization. Methods The study was conducted using a mixed methods design. First, guideline-based interviews were conducted with Navy medical officers who had been recruited via various email distribution lists. The interviews were then transcribed and coded. In an analysis, deductive and inductive categories were derived from the codes. Hypotheses were deduced from the interviews, too, and used to develop a questionnaire. Besides the medical officers, other Navy medical personnel with experience in the field of telemedicine took part in the survey. The study was concluded by a descriptive analysis of the quantitative data. Results The analysis of the interviews revealed that a regular use of telemedicine workstations increased the users’ confidence and, in their opinion, improved medical treatment. Technical and organizational problems posed obstacles, which increased the use of partly insecure alternatives. A proper technical support was regarded as a precondition for effectively using telemedicine. The results of the quantitative analysis showed that consultation was mainly sought for dermatological (46%), surgical (24%), and internal (22%) conditions. Conclusion The study revealed determinants for the use of telemedicine in the German Navy. Factors improving the motivation of the users should be strengthened in order to optimize the use of telemedicine. Furthermore, it can be assumed that a successful implementation will be supported by reducing or eliminating obstacles. The findings on the main reasons for seeking medical advice could be taken into account in the further planning of specific training.

FSUE SRI IMM: Evolution of Devices for Radon Control and its DPR

Preparation and implementation of measures to reduce radiation doses to personnel of enterprises engaged in the extraction and processing of uranium-containing ores, and the population of the territories adjacent to uranium deposits, require an increase in the accuracy of estimates of absorbed and effective doses to the personnel of enterprises and the population with the inhalation of radon and its progeny. This can only be done by taking into account the contribution of the aerosol-unattached fraction of the radon decay progeny to the effective and absorbed radiation doses, which are evaluated on the basis of direct measurements. Alpha spectrometer SAT-03 – a means of measurement of the third generation, has been developed in the Research Institute of Industry and Maritime Medicine for these purposes. Widespread domestic radiometers of the previous generation (RAA-10, RRA-01M) do not have the technical capabilities to perform such studies.

Maritime doctors’ skills and competencies: a review for policy analysis

Background: Maritime medicine deals with the health of seafarers, fishermen and off shore employees and more specifically with their employment, working, living conditions, health and safety at sea. Maritime doctors should have the appropriate training and competencies to provide equivalent service as in land. This review discusses the required skills and competencies of maritime doctors and explores the associated ongoing discussions for the establishment of a global accredited training programme in maritime health. Methods: Literature review was done in two databases PubMed and Google scholar. Search terms included: maritime doctors, maritime medicine, occupational health, skills and competencies. Literature published between 1990 and 2018 was prioritised. Thirty-five articles that discussed the skills, competencies and education of maritime doctors and health professional were retrieved, reviewed and discussed plus 8 reports and documents from relevant International Organisations webpages. Results and discussion: The doctors who serve in the sector, should have extensive knowledge about medical practice but also about the environment of seafaring. The complexity of their roles coupled with the provision of high quality of services in global shipping call for high quality accredited training and harmonisation of maritime health practices. The analysis for policy using two policy models i) the health triangle and ii) the Kingdon model showed that a window of opportunity appears to be in favour of such a policy regarding the recognition of the maritime medicine as a medical specialisation. The international stakeholders together with the International Maritime Health Association should actively advocate such a perspective which will be in favour of the seafarers who will enjoy better health and wellbeing with higher income avoiding ill-health as well as the shipping industry which will employ satisfied and loyal employees and enjoy higher reputation.

REGULATIONS IN THE MARITIME MEDICINE USING EXAMPLES OF 19 COUNTRIES

In 2013, The IMO and ILO published the Guidelines on the medical examinations of seafarers. The ILO was responsible for the Maritime Labour Convention (MLC) and IMO for the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers (STCW). The purpose of the Guidelines was to develop a document reflecting the contents of both Conventions and which will be helpful for the flag State on their implementation. Prior to the beginning work on a ship, the seafarers must hold a valid medical certificate stated that they are medically fit to perform their duties at sea. However, what kind of medical specialist should conduct such examinations and issue medical certificates? Where to find such a specialists? Only some countries offer Marine Medicine as an independent discipline on medicine faculties or as a postgraduate course on three-five days’ courses preceded by Self training preparations by materials sent to a course participant by education institution. However special training is not required. Some marine administrations require special accreditations to enable regular pre-sea examinations of sailors in preference to general practitioners, specialists in occupational disease and, in some cases, to surgeons and anesthesiologists. In some countries, it is sufcient to receive accreditation from the embassy.

ROLE AND PLACE OF MARITIME MEDICINE IN RUSSIAN HEALTHCARESERVICE

Problematic issues of the organization of maritime medicine in Russia werecovered in the article. It was noted that today there is no specialty «maritime medicine» in the Order of the Ministry of Health of the Russian Federation of October 7, 2015 No. 700n «About the nomenclature of professions of the specialists having higher medical and pharmaceutical education». Authors gave definition of maritime medicine as field of the medicine intended for preservation and health promotionof subjects of maritime activities. It was pointed that the most important sphere of responsibility of maritime medicine is scientific justification and challenges implementation of life prolongation, health promotion and maintenance of the population of seaside territorial subjects of the Russian Federation. It was noted that the state system of seamenhealth protection in Russiawas consistently dismantled from 90th years of the 20th century. The arisen vacuum in questions of statutory regulation of maritime medicine can lead to losses of quality of professional selection of seamen, deterioration of fleet personnelhealth and safety concern of navigation. In article it was paid special attention to harmonization of fundamental principlesof health service support system of seamen with requirements of the International Labor Organization Convention of 2006 No. 186 «About work in maritime industry», ratified by Russian Federation in 2012. In Russia there are no mechanisms (licensing or accreditations) regulating activity of medical commissions of fleet personnel. Authors pay attention to outstanding issues in the field of medical training of fleetpersonnel for healthcare delivery on the ships, which do not have the physician onboard. Authors stressed the need of creation of maritime medical centers based on the medical centers (clinics) of Federal Medical Biological Agency of the Russian Federation located in the large ports (Vladivostok, St. Petersburg, Novorossiysk, Arkhangelsk, Astrakhan) which met both international and national safety requirements of navigation. Authors considered that the solution of the problematical questionin the sphere of maritime medicine considered in article will allow to create the new effective state system of health service support of subject of maritime activities.

CONCEPTUAL APPROACHES TO DEVELOPMENT OF MARINE MEDICINE IN ATLANTIC REGIONAL DIRECTION OF NATIONAL NAVAL POLICY OF THE RUSSIAN FEDERATION

The paper represents fundamental principles of concept of development of naval medicine in one of six main regional directions of national naval policy of the Russian Federation — Atlantic regional direction that includes the Atlantic Ocean, rims of the Black Sea, Azov Sea, Baltic Sea and Mediterranean Sea. Attention is drawn to the notion of «Marine medicine», its role and place in national health care is argued. The necessity of practical implementation of the Convention of the International Labor Organization, ratified by the Russian Federation in 2012, No. 186 «On labor in maritime navigation», is primarily emphasized, first of all, the creation of national and regional centers of maritime medicine, bringing various issues of medical provision of subjects of marine activity in line with international standards. The author notes that the problem of adaptation the national medical education to the international system of education in the field of maritime health care in the coming years will require the introduction of additions to the list of medical specialties and qualification requirements in the part related to marine medicine. It is on the basis of the national and regional centers of maritime medicine in the Russian Federation that it is proposed to organize training (postgraduate training, retraining) of the medical staff. It is noted that the Russian Federation, based on wide and positive experience of medical provision of seafarers in the Soviet Union, taking into account the organizational, scientific, methodological and practical features of the activities of the international centers of maritime medicine, will consistently and steadily develop the medical supply system of the state’s maritime power.