The principles of oncological alertness at the outpatient therapeutic stage

Цель данной работы состоит в увеличении выявления ранних стадий онкологических заболеваний с помощью анкетирования на амбулаторном этапе. В исследование включены 25 467 пациентов, обратившихся к терапевту или врачу общей практики по любому поводу. Врачи первичного звена вне зависимости от цели посещения проводили структурированное анкетирование по вопросам рисков развития злокачественных новообразований. Частота выявления онкологических заболеваний возросла до 60,4% за первое полугодие 2018 г. против 56,3% за аналогичный период 2017 г. Выявляемость рака желудка выросла на 3%, ободочной кишки – на 2%, злокачественных новообразований трахеи, бронхов и легких – на 6%, опухолей молочной железы, шейки матки и предстательной железы на 1%, 8% и 2% соответственно. Формирование четкого стереотипа онкологической настороженности у врача первичного амбулаторного звена способствует раннему выявлению и снижению частоты продвинутых стадий опухолей и более раннему началу специализированного лечения. Выявление подозрительной на злокачественные новообразования симптоматики с использованием алгоритмизированного подхода с последующим направлением пациента в специализированное учреждение должно улучшить результаты лечения. Objective of the study is an increasing the detection rate of oncological diseases in the early stages using questionnaires. The study involved 25,467 patients who came to an appointment with a general practitioner/general practitioner for any request. During the study, primary care physicians, regardless of the purpose of the visit, purposefully asked questions regarding the risks of malignant neoplasms. The detection rate of oncological diseases was 60,4% in the first half of 2018 against 56,3% in the same period of 2017. In accordance with specific localizations, the following results were obtained: detection of stomach cancer increased by 3%, colon cancer by 2%, malignant neoplasms of the trachea, bronchi and lungs increased by 6%, and the mammary gland, cervix and prostate increased by 1%, 8%, and 2%, respectively. The presence of a clear stereotype of oncological alertness in the primary care physician may contribute to a decrease in the number of advanced stages of tumors due to the initiation of specialized treatment at earlier stages. In such a situation, the main task of the therapist and general practitioner is to identify suspicious symptoms of malignant neoplasms using an algorithmized approach and refer the patient to a specialized institution.

THE ESSENCE OF MODERN TERRORISM AND THE DEVELOPMENT OF COMPREHENSION OF THE NATURE OF TERRORISM

Terrorism as a phenomenon has a complex structure in which ideological, social, religious, ethnic, psychological and other elements are intertwined. Modern terrorism is a complex and dynamic phenomenon that successfully adapts to the political and economic situation. Effective counteraction is beyond the power of any independent specialized institution or individual country. Understanding of the concept of terrorism is linked to the analysis of the common features of modern terrorism. Based on the content of ideology and motivation, as well as the specifics of the methods of action, there are differences between terrorism based on left and right ideologies, on nationalism and separatism, and with different religious motivations.

Good practices, in educational inclusion experiences in a Higher Education Dependence

The Academic Body of Academic-Administrative Management of an Engineering Higher Education Unit studied school trajectories to contribute to school success in a group of students who a specialized institution warned that their prognosis of permanence in training as engineers was reserved. This study is oriented towards the inclusion of quality members of the Collegiate Corps who undertook the task of preventing their desertion, analyzing each case with the support of academic advice and tutorials. They were presented with various factors that influenced their career transition during this period, from school procedures, special programs, study habits, teaching methods, pandemics, etc. The satisfactory results are shown through a descriptive, historical-logical, documentary method, highlighting that 40% were favorable when they managed to conclude their higher education studies within their academic training.

Study of the prevalence and the structural features of pseudoexfoliative glaucoma

Purpose. To analyze the prevalence of pseudoexfoliative glaucoma (PEG) and to determine the structural markers of impaired intraocular fluid outflow (IOF) in the sclera. Materials and methods. There were analyzed the case histories of 7603 patients with primary open-angle glaucoma (POAG), including pseudoexfoliative glaucoma (PEG), aged 50 to 86 years, who applied to The Novosibirsk branch of S.N. Fedorov' NMRC «MNTK «Eye Microsurgery» of Minzdrav of Russia from 2011 to 2016. In 43 patients with PEG (43 eyes, average age 67±17 years), who were first treated with surgical treatment (non-penetrating deep sclerectomy and those who agreed to participate in the scientific study, a comprehensive histological analysis of the scleral flaps was performed. Results. PEG was diagnosed in 3981 cases (60.8%). The predominance of advanced stages – moderate and advanced-is due to the referral of patients for consultation and surgical treatment in a highly specialized institution. In the majority of patients, the histological examination of scleral flaps revealed markers of an increased risk of fibrosis of the artificial transcleral outflow pathways of the IOF: an increase in the number and biosynthetic activity of matrix-producing cells. Conclusions. PEG occupies a leading position in the structure of POAG among patients of The Novosibirsk branch of S.N. Fedorov' NMRC «MNTK «Eye Microsurgery». Histological examination of the scleral flaps of patients with PEG revealed markers of an increased risk of fibrosis of the artificial transcleral outflow pathways of the IOF. Key words: pseudoexfoliative glaucoma, fibrosis, NSE.

Oncological alertness in patients at outpatient therapeutic stage

Objective. Increasing the detection rate of oncological diseases in the early stages using questionnaires.Materials and methods. The study involved 25,467 patients who came to an appointment with a general practitioner / general practitioner for any request. During the study, primary care physicians, regardless of the purpose of the visit, purposefully asked questions regarding the risks of malignant neoplasms.Results. The detection rate of oncological diseases was 60.4% in the first half of 2018 against 56.3% in the same period of 2017. In accordance with specific localizations, the following results were obtained: detection of stomach cancer increased by 3%, colon cancer by 2%, malignant neoplasms of the trachea, bronchi and lungs increased by 6%, and the mammary gland, cervix and prostate increased by 1%, 8%, and 2%, respectively.Conclusions. The presence of a clear stereotype of oncological alertness in the primary care physician may contribute to a decrease in the number of advanced stages of tumors due to the initiation of specialized treatment at earlier stages. In such a situation, the main task of the therapist and general practitioner is to identify suspicious symptoms of malignant neoplasms using an algorithmized approach and refer the patient to a specialized institution.

The Arts@ Program: The Creation and Impact of an Arts Community at a Specialized Institution

This paper will examine the Arts@ Program, an arts and leadership program run by a director at a specialized institution of higher education in the northeastern United States. This paper offers the opportunity for readers to: 1.) Analyze a community arts program from a leadership perspective; 2.) Examine ways in which leadership, decision-making, and related factors can impact a community arts program; and 3.) Apply concepts of the Arts@ Program toward future virtual programmatic efforts. Key learnings from this paper include the following: 1.) Arts communities provide opportunities for all community members to engage in, build lasting memories from, and benefit from arts-related programmatic efforts, including arts instructors; 2.) Community arts programs have the potential to encourage aspects of self-leadership while also allowing participants to develop a deep, cogent appreciation for the arts; and 3.) Many of the design and delivery aspects of arts programs such as those discussed about the Arts@ Program can be applied toward future programmatic efforts, particularly in virtual formats. Reflections and recommendations for future research are presented.

PREGNANCY AND ANORECTAL MALFORMATIONS

A wide range of pathology from ectopia of the anal opening to combined anomalies of the rectum and genitourinary tract refers to malformations of the anorectal region. Since the results of their treatment, both long-term and short-term, are not always satisfactory, the course of pregnancy can worsen the condition of the pregnant woman and affect the intrauterine fetus. This circumstance provides for the management of childbirth in a specialized institution.

International Environmental Law-Making Process

The chapter seeks to make a modest effort in making sense of the international environmental law-making process. It comprises the subtle normative process currently at work, including ‘global conferencing’ technique resorted to by the UN General Assembly how it draws upon the basic legal underpinnings of international law, the unique treaty-making enterprise at work, and what this enormous legal churning process portends for the protection of the global environment at this critical time of perplexity in the Anthropocene epoch. It calls for taking serious cognizance of mass destruction of plant and animal species, heavy pollution of fresh water resources, choking of the oceans with plastic and other litter, and alteration of the atmosphere, among other lasting impacts that imperil our only abode Earth. International environmental law-making process is ad hoc and piecemeal and is generally understood to be the product of a lack of a single, central specialized institution having expertise on the subject, scientific uncertainty on many environmental issues, and the hard-headed economic interests of sovereign states. Still, the international environmental law-making process with its inherent resilience could possibly be able to adapt to the vagaries of scientific assessments and the political realities of in the future.

Forensіc psychіatrіc evaluatіon of persons who have sexual offenses

Purpose: this research is devoted to solving scientific and practical problems, which is to develop forensic-psychiatric expert evaluation of persons who have committed sexual offenses. The author analyzed 287 sub-experts who committed sexual offenses and were on forensic psychiatric examination (FPE) at the Kyiv City FPE Center, during the period 2000— 2015 (16 years). Research methods used in the work: information-analytical, socio-demographic, clinical-psychopathological, experimental-psychological, expert, situational analysis, statistical. In the group of “limitedly sane” compared to “sane”, sub-experts significantly prevailed, in whom aggressive- violent psychopathological motivation was combined with the satisfaction of a perverted sexual desire. In the group of “sane” compared to “limitedly sane” the sub-experts with selfish, aggressive, selfish-violent motivations significantly prevailed. The majority of subjects found a compulsive sexual perversions (91.8 %): 65.8 % of subjects suffered from pedophilia, exhibitionism — 13.7 %, gerontophilia — 4.1 %, necrophilia — 1.4 %, sadism — 5.5 %. The majority of subjects were mentally healthy (71.2 %). In 13.7 % of cases, organic brain damage of residual genesis, personality disorder was observed in 5.5 % of cases, mild mental retardation — 5.5 %, dependence syndrome due to alcohol consumption — 4.1 %, simple schizophrenia, incomplete remission — 1.4 %.Most subjects did not have comorbid pathology (58; 79.5 %). The criterion for the use of coercive medical measures in the form of referral to a specialized institution for mental health care is the recognition of a person as “insane”, the provision of compulsory outpatient care — “limitedly sane" and suffering from a sexual desire disorder. The conducted research and the received results allow to improve forensic psychiatric expert research, cause increase of its quality and provability of expert conclusions, which is an additional guarantee of human rights protection, prevents unjustified appointment of re-examination, shortens the time of expert research.

Associação de Pais e Amigos dos Excepcionais (APAE): delineamento de uma gênese histórica

O artigo aborda como a então designada problemática do excepcional, confi gurada no começo do século XX, possibilitou, no Brasil, a emergência da primeira Associação de Pais e Amigos dos Excepcionais (Apae), na década de 1950, estendendo as análises apresentadas até o começo da década de 1960, quando surgiu a Federação Nacional das Apaes. Apesar de sua longevidade e capilaridade no país, pouco se tem abordado sobre a gênese da instituição Apae, o que tem impedido de se problematizar o contexto sócio-histórico, político e cultural em que esta emergiu. Para tanto, recorreu-se às contribuições de pesquisas histórica e bibliográfica. Com os dados encontrados, pôde-se constatar que a Apae surgiu impulsionada pelos princípios do pragmatismo e do modelo liberal de cidadania estadunidenses, pautada na fi lantropia e na ótica da higidez social, bem como recebeu infl uência do trabalho de Helena Antipoff . Entre as décadas de 1950 e 1960, a instituição se ramifi cou pelo país, levando à necessidade de se criar, já em 1962, uma Federação Nacional para congregar as associações e formular diretrizes de ação, o que ampliou seu espectro de atuação e sua difusão institucional.Palavras-chave: Educação de excepcionais. História da Educação Especial. Instituição especializada. Movimento apaeano.Associação de Pais e Amigos dos Excepcionais (APAE):development of a historical genesisAbstractThe article discusses how the so-called problem of the exceptional, confi gured at the beginning of the 20th century, made possible, in Brazil, the emergence of the fi rst Associação de Pais e Amigos dos Excepcionais (Apae), in the 1950s, extending the analyzes presented until the beginning the 1960s, when the Federação Nacional das Apaes emerged. Despite its longevity and capillarity in the country, little has been discussed about the genesis of the Apae institution, which has prevented the problematic of the socio-historical, political and cultural context in which it emerged. To this end, we used contributions from historical and bibliographical research. With the data found, it could be seen that Apae emerged driven by the principles of pragmatism and the liberal model of American citizenship, guided by philanthropy and the perspective of social health, as well as infl uenced by the work of Helena Antipoff . Between the 1950s and 1960s, the institution branched across the country, leading to the need to create, already in 1962, a National Federation to congregate associations and formulate guidelines for action, which expanded its range of action and its institutional diffusion .Keywords: Education of exceptional. History of Special Education. Specialized institution. Apaeano movement.Associação de Pais e Amigos dos Excepcionais (APAE): delineamiento de una génesis históricaResumenEl artículo analiza cómo el llamado problema de lo excepcional, configurado a principios del siglo XX, hizo posible, en Brasil, la aparición de la primera Associação de Pais e Amigos dos Excepcionais (Apae), en la década de 1950, ampliando los análisis presentados hasta el comienzo. la década de 1960, cuando surgió la Federação Nacional das Apaes. A pesar de su longevidad y capilaridad en el país, poco se ha discutido sobre la génesis de la institución Apae, que ha evitado la problemática del contexto sociohistórico, político y cultural en el que surgió. Para este fin, utilizamos contribuciones de investigaciones históricas y bibliográficas. Con los datos encontrados, se pudo ver que Apae surgió impulsado por los principios del pragmatismo y el modelo liberal de ciudadanía estadounidense, guiados por la filantropía y la perspectiva de la salud social, así como influenciados por el trabajo de Helena Antipoff. Entre las décadas de 1950 y 1960, la institución se expandió por todo el país, lo que llevó a la necesidad de crear, ya en 1962, una Federación Nacional para congregar asociaciones y formular directrices para la acción, lo que amplió su rango de acción y su difusión institucional.Palabras clave: Educación de excepcionales. Historia de la Educación Especial. Institución especializada. Movimiento apaeano.