International experience in providing emergency psychological assistance to minors

Relevance. The development of a system for providing emergency psychological assistance to minors in our country involves taking into account the leading international experience, both in terms of the practice of providing emergency psychological assistance and at the level of its methodological support.Intention. To review the key aspects of international experience in providing emergency psychological assistance to minors.Methodology. The object of the work was scientific articles indexed in the abstract-bibliographic database of the Russian Science Citation Index, and articles included in international databases.Results and Discussion. There were analyzed the main meta-analytical reviews, as well as data on the implementation of the emergency psychological assistance system in different countries. The article considers such characteristics of emergency psychological assistance as types, terms, place and agents of rendering, as well as the main modalities of psychological practice in which psychological support and assistance to minors is provided. The degree of methodological development of the problem of providing emergency psychological assistance to minors in the international community is revealed through the analysis of two main guidelines with recommendations in relation to working with stress reactions in emergency situations for children and adolescents.Conclusion. The variability of embedding the system for providing emergency psychological assistance both in the structure of the educational sphere and in various departments in different countries makes it possible to reasonably choose the optimal model, taking into account the realities of our country in general and regional characteristics in particular.

The state of the resident intestinal microbial association and its relationship with concentrations of dioxins in blood lipids of firefighters

Relevance. Career firefighters are involved in extreme activities, and their functional reserves are probabilistically disturbed. Toxic products of combustion can significantly affect their health state.Intention – To analyze and evaluate effects of blood lipid dioxins on the microbiome of the parietal intestinal flora in firefighters of the Federal Fire Service of the Emercom of Russia.Methodology. Relationships between the microbiota composition and concentrations of blood lipid dioxins were analyzed in firefighters vs Emercom employees not involved in firefighting (control group).Results and Discussion. Microbiota concentrations in firefighters were associated with levels of blood lipid dioxins. In firefighters with dioxins > 350 pg/g lipids in the blood, normal microflora concentrations significantly decreased and conditionally pathogenic microflora concentrations significantly increased compared to firefighters with lower concentrations of dioxins and the control group.Conclusion. Disturbances in the microbiome of the parietal intestinal flora in the examined firefighters are related to exposure to toxic products of combustion, including dioxins, during firefighting. The microbiome disorders detected in firefighters can predict development of the digestive tract pathology, thus necessitating control and targeted correction of the somatic state and microecological status of this contingent.

Assessment of the working conditions of medical personnel in military medical organizations during the pandemic of new coronavirus infection

Relevance. During the pandemic of new coronavirus infection, healthcare professionals have increased occupational risks of exposure to the pathogen SARS-CoV-2, as well as physical and psychological stress, especially when treating Covid patients in “red zones”. Such a change in working conditions wasn’t reflected in the results of a special assessment, which requires the development of an individual scientifically based approach to its organization in conditions equated to emergency situations. Intention. Evaluate the results of a special assessment of working conditions and their compliance with actual working conditions, taking into account the health risks for healthcare professionals taking care of Covid patients.Methodology. We retrospectively conducted a comparative analysis of 295 cards for a special assessment of the working conditions of medical personnel of military medical organizations of therapeutic and infectious profile over 2015–2019, and 266 cards from the same organizations for 2020.Results and Discussion. Study of cards for special assessment of working conditions of medical personnel of military medical organizations for 2015–2020 showed the leading role of biological factors for all categories of medical personnel. Working in the “Red zone” should be assessed as 3.3 (Degree III harmful) based on biological hazard or 4 (dangerous) due to risks of acute occupational diseases and death. This should be reflected in the results of special assessment of working conditions and compensated via reduction of working hours. However, in the context of the pandemic, actual working hours of healthcare professionals exceeded the established 39 hours per week (Article 350 of the Labor Code of the Russian Federation), and the medical personnel were allowed to work with the pathogen of Group II pathogenicity without preliminary medical examinations.Conclusion. Analysis of the results of special assessment of the working conditions of medical personnel showed that they do not reflect the actual harmful (dangerous) working conditions of employees involved in providing care to patients with new coronavirus infection in these medical and preventive institutions.

Influence of personal and social characteristics on the formation of mental trauma in police officers in the context of the COVID-19 pandemic

Relevance. Due to the peculiarities of professional activity, the COVID-19 pandemic for police officers was associated not only with a high risk of infection, but also pronounced mental stress and emotional destabilization, with higher risk of developing severe psychological consequences. In police officers, incidence of a new coronavirus infection, according to departmental statistics, was 6.6 times higher than in general population and close to that of healthcare workers of the Ministry of Health of Russia. High risk of COVID-19 infection in police officers during performance of their duties contributes to the symptoms of psychoemotional maladjustment and a constant state of chronic tension and emotional stress. Identification of the causes of professional maladjustment is important for justification of preventive measures and search for markers of professional success in employees of internal affairs bodies.Intention. To identify the influence of personal and social characteristics on the formation of mental trauma in police officers in the context of the COVID-19 pandemic.Methodology. A complete empirical study of 371 male employees of the divisions of the Main Directorate of the Ministry of Internal Affairs of Russia in Moscow was conducted. Three groups were identified: 1st – 127 police officers with positive test results and clinical manifestations of COVID-19; 2nd – 118 persons released from duty and quarantined due to their contacts with COVID-19 patients; 3rd – 126 police officers who were on duty to protect public order in crowded places during the COVID-19 pandemic. An experimental psychological survey of the police officers was conducted using electronic digital resources to comply with anti-epidemic measures.Results and Discussion. Symptoms of emotional burnout against the background of stressful service were shown to contribute to the formation of mental trauma during the COVID-19 pandemic in all surveyed police officers. Specifically, Group 1 typically demonstrates anxiety-phobic reactions; Group 2 – dysthymic-pessimistic outlook; and Group 3 – decreased neuropsychiatric stability, pronounced exhaustion and fatigue associated with official duties.Conclusion. The obtained data should be taken into account when conducting psychocorrection and medical and psychological rehabilitation of police officers in emergency situations associated with the long-term psychosocial and occupational stress.

Airmobile hospital of EMERCOM of Russia: tasks, main units, equipment, deployment options for eliminating consequences of emergencies

Relevance. The Airmobile Hospital (AMH) of the EMERCOM of Russia is part of the State Central Airmobile Rescue Team of the EMERCOM of Russia (the “Tsentrospas” squad) and is always ready to eliminate medical and sanitary consequences of various emergencies in Russia and other countries. However, there are very few publications on its tasks, structure, main divisions, equipment, deployment options and features of work when mitigating health consequences of emergencies. In this regard, a number of publications are planned to consistently reflect the tasks and main tactical and technical characteristics (report 1), experience of the EMERCOM of Russia AMH in Russia (report 2), in foreign countries (report 3), as well as when mitigating consequences of some most significant emergencies (report 4).Intention: To summarize and analyze the tasks, types of medical care, staff structure, equipment, features of the deployment and functioning of the EMERCOM of Russia AMH when mitigating medical and sanitary consequences of emergencies.Methodology. There were analyzed regulatory documents, staff, reports on the work of the EMERCOM of Russia AMH for the period from 17.04.1996 to 01.01.2021.Results and Discussion. The tasks, structure, main types of medical care and options for deploying an airmobile hospital of the Russian EMERCOM, as well as information on its equipment are given. It is shown that the AMH operation in the field can be organized via two main deployment options for 50 and 100 beds. Information is provided on the licensed activities of the airmobile hospital and the features of its functioning as well as engineering and technical support.Conclusion. These data are an important basis for improving the activities of field mobile medical units of the Ministry of Health of Russia, the EMERCOM of Russia, the Armed Forces of Russia intended for mitigating medical and sanitary consequences of emergencies.

Analysis of traumatism in officers of the Armed Forces of the Russian Federation and the Republic of Belarus (2003–2020)

Relevance. Traumatism in military personnel is defined as injuries and their consequences occurring over a specified period of time, usually over a year. Trauma rates in the Armed Forces (AF) are important for occupational safety.Intention: To compare trauma rates in officers of the AF of Russia and Belarus over 18 years (2003–2020).Methodology. Medical reports on the state of health of personnel and activities of the medical service were selectively analysed according to Form 3 / MED from those military units where no less than 80% of the total number of officers of the AF of Russia and Belarus served. Blocks of injuries are consistent with Chapter XIX «Injuries, poisoning and certain other consequences of external causes» of the International Statistical Classification of Diseases and Problems Related to Health, 10th revision (ICD-10). Injuries were calculated per 1000 officers (‰), mortality - per 100 thousand officers.Results and Discussion. Among officers of the Russian AF and Belarusian AF in 2003–2020, there were observed average annual rates of injuries (17.25 ± 1.33) and (13.37 ± 1.43) ‰, respectively; hospitalizations with injuries (10.68 ± 0.64) and (7.13 ± 0.81) ‰ (p < 0.01); work days lost (344.4 ± 26.4) and (299.9 ± 25.6) ‰; dismissal rates (0.356 ± 0.068) and (0.118 ± 0.022) ‰; and injury-related mortality (47.24 ± 3.71) and (33.37 ± 5.40) (p < 0.05) per 100 thousand officers of the Russian AF and Belarusian AF, respectively. The congruence (consistency) of trends for injuries, hospitalizations and work days lost among officers of the AF of Russia and Belarus was considered positive and strong, while mortality trends were positively and moderately consistent, thus indicating effects of similar (unidirectional) military occupational factors. Polynomial trends in the dynamics of injuries, hospitalizations, work days lost and mortality among officers of the AF of Russia and Belarus with high determination coefficients showed a decrease. Injuries to the head (Block 1 according to ICD-10), injuries to the hip and lower limbs (Blocks 8-10), injuries involving multiple body regions (Block 11), and injuries to the shoulder girdle and upper limbs (Blocks 5-7) were of high military epidemiological significance for officers of the AF of Russia and Belarus. In addition, sequelae of injuries, of poisoning and of other consequences of external causes (Block 22) turned out to be significant for the Russian AF officers, and injuries to the thorax (Block 3) were significant for the Belarusian AF officers. The above blocks accounted for 88.6 and 85.5% of assessed military epidemiological significance among Russian and Belarusian AF officers, respectively.Conclusion. Traumatism can be managed and is not limited to medical issues. Various military professionals should be actively involved in the analysis of the causal relationships of injuries and their prevention. For example, among officers of the AF of Russia and Belarus injuries often occur during physical training and sports (9.8 and 6.1%, respectively) and during off-duty time (40.4 and 61.2%, respectively).

Genetic predictors of destructive and constructive types of digital behavior among young people

Relevance. In the context of globalization, manifestations of extremism, negativism, aggression, asocial and dissocial behavior on the Internet tend to increase. However, biological determinants of destructive and constructive forms and transformations of users’ behavior are under debate.Intention – To study genetic predictors of digital behavior among young adults.Methodology. The study involved 115 people (51 males, 64 females) aged 18 to 22 years. In order to study the digital behavior, we used the author’s questionnaire “Strategies of digital behavior”. Molecular genetic analysis was performed through the DNA isolation from buccal epithelial cells. Statistical methods included comparative analysis, very simple structure method (VSS), principal component analysis, and ANOVA.Results and Discussion. It is shown that in most respondents active conditionally “constructive” digital behaviors prevail (45 %), active “destructive” and passive conditionally “constructive” digital behaviors are expressed almost equally (27 and 28 %, respectively). The active-destructive digital behavior is significantly more often observed in carriers of the combination of BDNF G/G, COMT G/A, and DRD2 T/T polymorphisms. For the constructive digital behaviors, neither biological determinants nor associations with the studied genes were observed.Conclusion. The above associations of COMT, BDNF, and DRD2 genes with the behavioral strategies of Internet users expand the existing knowledge about biological determinants of digital behavior.

Organization of the provision of specialized medical care to injured in road accidents on the federal highway M-8 «Kholmogory» in the Arkhangelsk region during the hospital period

Relevance. Road traffic injuries are a global pandemic and one of the leading causes of death in the population. Federal highway M-8 “Kholmogory” is the leading transport artery of the European North of the country; has pronounced features inherent in all northern roads: significant distances between settlements and difficult road conditions, which together increase the risk of road traffic accidents (RTA) with medical consequences, and also seriously complicate the process of providing medical care to injured.Intention. To analize provision of specialized medical care to injured in RTA on the federal highway M-8 “Kholmogory” in the Arkhangelsk region during the hospital period and propose improvements.Methodology. Domestic and foreign publications on the organizational approaches to the provision of specialized medical care to injured in road traffic accidents during the hospital period were analyzed based on specialized scientific search engines (eLibrary, PubMed, Scopus).Results and Discussion. Problems in the organization of medical care to injured in RTA on the federal highway M-8 “Kholmogory” in the Arkhangelsk region during the hospital period were identified and systematized. The ways of its improvement are outlined.Conclusion. Implementation of the measures proposed will reduce medical and sanitary consequences, concomitant road traffic injuries on the federal highway, including disability and mortality in the medium and long term.

Management of intertrochanteric femoral fractures at Level 1 trauma center in Leningrad Region

Relevance. An in-house Protocol for proximal femoral fracture management was developed at Vsevolozhsk Clinical Interdistrict Hospital of Leningrad Region.Intention To demonstrate possible practical application of preliminary federal clinical guidelines at Level 1 trauma center in Leningrad Region including comparative analysis of its efficacy when treating intertrochanteric femoral fractures.Methodology. Post-surgery outcomes were retrospectively assessed in 86 patients of Vsevolozhsk Clinical Interdistrict Hospital (Group 1, per Protocol) and 28 patients of Tosno Clinical Interdistrict Hospital (Group 2, w/o Protocol) with intertrochanteric femoral fractures (31A by Arbeitsgemeinschaft für Osteosynthesefragen classification and S72.1 by ICD-10).Results and Discussion. There were no significant differences in patients’ age, methods of anesthesia and osteosynthesis between the groups. Group 1 demonstrated statistically significant decrease in preoperative bed-days, time to sitting up in bed after surgery, ambulation with walkers and duration of hospitalization. Group 1 patients needed less assistance from other health-care professionals, less intensive therapy and blood transfusions.Conclusion. Adoption of in-house protocols, optimization of supply and staffing as well as involvement of multidisciplinary teams will improve management of proximal femoral fractures.

Experience of using vacuum therapy in the burn department

Relevance. Indications, application techniques and contraindications for the use of vacuum therapy in surgery and orthopedics are formulated in clinical guidelines and are generally available. Indications for the use of a vacuum in patients with severe burns are scattered and depend on personal experience and preferences of the medical staff, and not on objective reasons.Intention. To analyze the results of using Negative Pressure Wound Therapy (NPWT) in patients of burn departments.Methodology. The study included 56 patients treated with local negative pressure in the Department of thermal injuries of the Saint-Petersburg institute of emergency care named after I.I. Dzhanelidze in 2017–2020. Statistical data processing was performed using Microsoft Office Excel 2007 and IBM SPSS 20.0 using descriptive and non-parametric statistics.Results and their Discussion. The frequency of using VAC-therapy in patients with burn injuries was 0.8 % (56 of 6764). The most common reasons for hospitalization of patients were contact injuries – 20 (36 %) and flame burns – 18 (32 %). The main indications for NPWT were stimulation of granulation formation – 21 (38 %), control of wound infection – 20 (36 %), and temporary wound closure after early excisions or atypical amputations – 11 (20 %). The main contraindications to the use of the method were cognitive disorders or impaired consciousness. The primary complication was the depressurization of the dressings, which we encountered in 9 cases (16 %). The expected results of vacuum therapy were achieved in 49 patients (88 %).Conclusion. Local negative pressure is relatively rarely used in burn treatment. A positive effect from the use of NPWT can be expected in the control of wound infections and in the preparation of wounds for skin grafting. The prospects for the introduction of the method can be considered its application in the treatment of partial-thickness burns and additional fixation of skin grafts. To objectify the choice of modes and duration of vacuum therapy in burned patients, it is necessary to conduct further multicenter studies with the preparation of clinical guidelines.