APPROACHES TO THE METHOD OF BUILDING A HYGIENE, SANITARY AND OCCUPATIONAL HEALTH MANAGEMENT SYSTEM

In transport, ensuring safe conditions and labor protection are of particular importance, as the lives ofpassengers and the safety of rail transport depend on the health of workers in this industry. The incidence of temporarydisability, occupational and chronic morbidity of employees of a number of transport professions have been studied.This assessment of diseases depending on age and length of service according to medical examination from thestandpoint of evidence-based medicine, which revealed the cause of increased morbidity associated with adverseworking conditions and assess the degree of its professional conditionality. It is established that the leading harmfulinfluences in the organization of work of railway transport workers are noise, vibration, nervous and emotional stressand a nuфmber of other factors. Studies have shown that prolonged and repeated exposure to factors of the productionenvironment leads to a violation of adaptive mechanisms, and their failure, contributes to pathological processes in thebody. On the basis of the conducted research the concept of interaction of object with hygiene and sanitation at theenterprise and model of integrated management of object as ecological and economic system is formulated. In theprocess of research the model of the organization of management of health of workers which organically fits into modelof conceptual balanced interaction of the enterprise with environment is developed. This model provides for the primaryprevention of diseases, both occupational and occupational, and is a tool that allows you to maintain and strengthen thehealth of workers through activities such as prevention of the causes of risk factors.

NEW APPROACHES TO THE DEFINITION AND CLASSIFICATION OF BRONCHOPULMONARY DYSPLASIA IN PRETERM INFANTS

Bronchopulmonary dysplasia (BPD) remains a pressing problem of modern neonatology and pediatrics. Since this disease is chronic and often results in negative long-term consequences, the search for the optimal definition of BPD that would be accuratein predicting long- term respiratory and neurological outcomes is ongoing. It has been 20 years since the definition and classification of BPDs that are currently used had been approved. Over time, the patient population prone to BPD development has changed and new factors have emerged that make it difficult to apply this classification in contemporary clinical practice. In particular, it concerns greater survival of extremely premature infants, which form the majority of patients with BPD. Oxygen dependence during the first month in such infants may be determined by the immaturity of the respiratory system and may not be associated with the development of BPD. Also, new methods of respiratory support have been introduced into practice of intensive care units, which is not accounted for by the current classification. The population of infants with severe BPD, according to classical definition, is heterogeneous with different indicators of long-term chronic morbidity and development. All this justifies the need for new methodological approaches and criteria for the definition and classification of BPD in the modern population of premature infants.This review presents new data, proposals and clarifications for the definition and classification of BPD, which take into account modern features of clinical practice.

Morbidity of Children's Population of Lermontov City, Located in the Uranium Legacy Area

Purpose: To carry out assessment the health status of the child population of the Lermontov city. This child population living in the area, of uranium legacy, and they are critical group of the population in terms of sensitivity to adverse environmental factors. Materials and methods: The object of the study was the morbidity of children 0–14 years old (primary, chronic, oncological). The research material was the data of reporting forms of medical statistics, presented in the following forms: 7 – information on malignant neoplasms and 12 - information on the number of diseases in children. The development included data from Clinical hospital # 101 of the FMBA of Russia for 2014–2018. Statistical data processing was carried out using standard methods used for the analysis of biomedical data. Results: The morbidity of children 0–14 years old in Lermontov in 2014–2018 averaged 2310.9 ± 115.7 per 1000. In the structure of morbidity, the leading places were occupied by diseases of the respiratory system – 59.2 %, the digestive system – 8.8 %, skin and subcutaneous tissue 5.5 %, trauma and poisoning – 4, 8 % and infectious and parasitic diseases. The frequency of chronic morbidity does not exceed the population estimates – 73.0 ± 4.1 per 1000. The peculiarity of chronic morbidity is the relatively high incidence of skin diseases – 25.3 % and the musculoskeletal system – 20.4 %. The morbidity of children in the first year of life is 2348.0 ± 135.1 per 1000. A feature of the morbidity structure is the high incidence of respiratory diseases, which makes up 66.3 % of the total morbidity, with population estimates – 20–30 %. Conclusion: The increased radiation background can be considered as one of the possible negative environmental factors affecting the health of the population.

Managing an acute asthma exacerbation in children

Children and youth with acute asthma exacerbations frequently present to an emergency department with signs of respiratory distress. The most severe episodes are potentially life-threatening. Effective treatment depends on the accurate and rapid assessment of disease severity at presentation. This statement addresses the assessment, management, and disposition of paediatric patients with a known diagnosis of asthma who present with an acute asthma exacerbation. Guidance includes the assessment of asthma severity, treatment considerations, proper discharge planning, follow-up, and prescription for inhaled corticosteroids to prevent exacerbation and decrease chronic morbidity.

Hiding in Plain Sight: Modern Thiamine Deficiency

Thiamine or vitamin B1 is an essential, water-soluble vitamin required for mitochondrial energetics—the production of adenosine triphosphate (ATP). It is a critical and rate-limiting cofactor to multiple enzymes involved in this process, including those at the entry points and at critical junctures for the glucose, fatty acid, and amino acid pathways. It has a very short half-life, limited storage capacity, and is susceptible to degradation and depletion by a number of products that epitomize modern life, including environmental and pharmaceutical chemicals. The RDA for thiamine is 1.1–1.2 mg for adult females and males, respectively. With an average diet, even a poor one, it is not difficult to meet that daily requirement, and yet, measurable thiamine deficiency has been observed across multiple patient populations with incidence rates ranging from 20% to over 90% depending upon the study. This suggests that the RDA requirement may be insufficient to meet the demands of modern living. Inasmuch as thiamine deficiency syndromes pose great risk of chronic morbidity, and if left untreated, mortality, a more comprehensive understanding thiamine chemistry, relative to energy production, modern living, and disease, may prove useful.

The association among health behaviors, shift work and chronic morbidity: A cross-sectional study on nurses working in full-time positions

Background: Nurses are known to work in conditions of stress and physical overload. Health behaviors are modifiable factors that may reduce the adverse effects of work on general health. The present study examined health-related behaviors and their association with current night shift work and chronic morbidity among female nurses.Design and Method: Four hundred seventy-two female nurses (M ± SD = 44.28±7.14 years) self-reported their health habits, physical activity, body mass index (BMI), and chronic disorders that required current treatment. Instruments used in the study consisted of an author-developed questionnaire and the Health Behavior Inventory (HBI). Reported diagnoses were classified as cardio-vascular, gastro-intestinal, malignant neoplastic, endocrine, or other.Results: The most common reported disorders were cardiovascular disorders (5.7% of nurses) followed by other (7.6%), endocrine (7.4%), gastro-intestinal (6.4%), and malignancy (0.2%). On average, health-related behaviors on the HBI were average (83.49 ± 14.33). Overweight and/or obesity (i.e., BMI ≥ 25 kg/m2) were reported by 41.5% of nurses, 24.2% were current smokers, and 36% reported no recreational physical activity. The remaining 64% of nurses who performed physical activity did not report activity levels that met World Health Organization recommendations. Physical activity and HBI scores (total and subscales; i.e., positive attitude, preventive behaviors, proper dietary habits, health-related practices) were not associated with current night shift work or morbidity.Conclusion: Health-promoting programs are needed to support weight control and promote health-related behaviors among nurses. Future research should identify potential barriers to healthy lifestyle recommendations in the workplace.

Right destroyed lung due to tuberculosis in a Nigerian child: Case report and review of the literature

Destroyed Lung Syndrome (DLS) is total lung destruction from recurrent and chronic infections especially Tuberculosis (TB). It is rare in children and associated with chronic morbidity. It presents with chronic cough, progressive difficulty in breathing, hemoptysis and progressive respiratory failure. The pathology of DLS includes lung fibrosis, collapse, tracheal and mediastinal shift. We report the case of a 9 years old girl referred after three courses of anti-TB treatment for suspected TB reinfection with worsening clinical and radiologic features. Investigations revealed a destroyed right lung. Genexpert was initially positive and subsequently along with TB culture was negative. She improved on antibiotics and chest physiotherapy. Destroyed lung though rare in children should be considered in those who despite TB treatment present with worsening clinical and radiologic features. Early diagnosis and multi- disciplinary approach will prevent irreversible lung damage.

Feeding, cachexia, and malnutrition in children’s palliative care

Feeding a child is considered basic care. As such, when a medical condition impacts a child’s desire or ability to feed and grow, the concerns and negative feelings experienced by the family can be profound. This chapter reviews strategies to promote safe feeding in children, especially those with underlying neurological impairment, in an effort to optimize growth and overall quality of life. The indications and challenges with enterostomy tubes and total parental nutrition (TPN) are also discussed. The concept of ‘feeding for comfort’ at the end of life in children who no longer desire to feed or when feeding causes suffering are explored, as well as the medical and psychosocial interventions to address anorexia and cachexia. Lastly, while the authors wholeheartedly support steps to rectify global malnutrition, a palliative care approach is provided to this problem which continues to result in chronic morbidity and mortality in millions of children annually.