Functional Reliability of the Employee in Operation Safety Management System Facilities for the Use of Nuclear Energy

Ensuring the safety of operation of particularly radiation-hazardous and nuclear-hazardous industries and facilities in the field of nuclear power is carried out using various methods, one of which is medical professional selection, selection and admission of personnel to perform official duties. The implementation of medical selection measures in the course of medical examinations using lists of medical contraindications is focused on the possibility of issuing permits to perform certain types of activities at the oiae to persons who do not have appropriate diagnoses. The presence of a disease included in the list of medical contraindications, detected during preliminary and periodic medical examinations and psychophysiological examinations, is evidence of late diagnosis and lack of data on pre-nosological disorders that are important for the selection and implementation of preventive rehabilitation and health measures. There was a need to introduce the concept of functional reliability (FR) and methods of its assessment into the practice of medical and psychophysiological support. FR is considered as a property of the functional systems of the employee's body to ensure the performance of prescribed job duties for a certain time and with a given quality, without reducing the psychophysiological adaptation (a person's systemic response to external and internal stimuli and factors aimed at achieving a useful adaptive result to an unacceptable level). The obtained data allowed us to draw a conclusion about the need to take into account the medical component of professional reliability – FR, along with assessments of the motives for choosing a profession and moral qualities, professional competence, compliance of psychological qualities and physical endurance with the requirements of the profession.

Professional psychological selection of military personnel: structure and main characteristics

The article examines the essential characteristics of professional psychological selection of military personnel through the analysis of professional selection and its structure. The problem of effective implementation of professional psychological selection is considered by the authors as a problem of mutual correspondence of the individual and the profession. It is noted that it is solvable only if a certain set of requirements is met: both the individual's requests for a certain type of professional activity, and the requirements of the activity itself for the subjective characteristics of the «person of labor». Professional selection of military personnel structurally includes: social selection; medical selection; professional psychological selection; educational and qualification selection; assessment of the level of functional development and general physical fitness. The scientific results of the study include the fact that the general characteristics of the candidate and the military specialist performing professional psychological selection, the conditions and means of its implementation are disclosed.

Ethical Advice for an Intensive Care Triage Protocol in the COVID-19 Pandemic: Lessons Learned from The Netherlands

At the height of the COVID-19 crisis in the Netherlands a shortness of intensive care beds was looming. Dutch professional medical organizations asked a group of ethicists for assistance in drafting guidelines and criteria for selection of patients for intensive care (IC) treatment in case of absolute scarcity, when medical selection criteria would no longer suffice. This article describes the Dutch context, the process of drafting the advice and reflects on the role of ethicists and lessons learned. We argue that timely interaction between clinical and ethical expertise is necessary since the distinction between medical and non-medical considerations is not as clearcut as sometimes assumed. Furthermore, pragmatic considerations related to the specifics of an epidemic are of importance, for example, in relation to prioritizing health care workers. As a consequence, any protocol already present before the pandemic would need alterations to fit the current situation. The ‘fair innings’ criterion we proposed, rephrased as an argument of intergenerational solidarity, was considered reasonable by professionals as well as patient organizations. While it is desirable to draft ethical guidelines in ‘peacetime’ as a matter of pandemic preparedness, the pressure of an actual crisis facilitates decision-making, although it will also complicate a more democratic approach.

The importance of occupational medicine in traffic accidents prevention

The aim of this study is the analysis of medical selection of drivers and candidates for car drivers sent to preliminary, periodic or special medical examination in the last ten years period. At the preliminary medical examination 2,3% of candidates were declared to be incapable, 8,2% of candidates had a limited driving ability. At the periodic medical examination 12,2% of drivers were declared to be incapable to driving and 28,7% of drivers had a limited driving ability. At the special medical examination 37,3% of drivers were declared to be incapable for driving and 53,9% of drivers had a limited driving ability. In our opinion, medical selection of drivers and candidates for car drivers is a significant preventive measure of traffic trauma.

Does ‘online confidence’ predict application success and later academic performance in medical school? A UK-based national cohort study

ObjectivesThe UK Clinical Aptitude Test (UKCAT) previously piloted an assessment of ‘online confidence’, where candidates were asked to indicate how confident they were with their answers. This study examines the relationship between these ratings, the odds of receiving an offer to study medicine and subsequent undergraduate academic performance.DesignNational cohort study.SettingUK undergraduate medical selection.Participants56 785 UKCAT candidates who sat the test between 2013 and 2016 and provided valid responses to the online confidence pilot study.Primary outcome measuresTwo measures of ‘online confidence’ were derived: the well-established ‘confidence bias’, and; a novel ‘confidence judgement’ measure, developed using Item Response Theory in order to derive a more sophisticated metric of the ability to evaluate one’s own performance on a task. Regression models investigated the relationships between these confidence measures, application success and academic performance.ResultsOnline confidence was inversely related to cognitive performance. Relative underconfidence was associated with increased odds of receiving an offer to study medicine. For ‘confidence bias’ this effect was independent of potential confounders (OR 1.48, 1.15 to 1.91, p=0.002). While ‘confidence judgement’ was also a univariable predictor of application success (OR 1.22, 1.01 to 1.47, p=0.04), it was not an independent predictor. ‘Confidence bias’, but not ‘confidence judgement’, predicted the odds of passing the first year of university at the first attempt, independently of cognitive performance, with relative underconfidence positively related to academic success (OR 3.24, 1.08 to 9.72, p=0.04). No non-linear effects were observed, suggesting no ‘sweet spot’ exists in relation to online confidence and the outcomes studied.ConclusionsApplicants who either appear underconfident, or are better at judging their own performance on a task, are more likely to receive an offer to study medicine. However, online confidence estimates had limited ability to predict subsequent academic achievement. Moreover, there are practical challenges to evaluating online confidence in high-stakes selection.