Vol 4, No 4 (2018)

The article discusses the problematic issues of medical support of naval aviation: in the organizational and staff structure of the medical service, in the field of material support of the medical service units, medical and psychological rehabilitation of the flight personnel, in the field of social protection of aviation medicine specialists of the Navy. The authors suggested ways to solve these problems. Necessity of centralization and effective quantitative and qualitative optimization of the medical personnel who provide medical support for naval aviation is noted. Attention is paid to the developing of a system for training medical personnel providing flights, as well as the creation of conditions that guarantee high-quality medical and psychological rehabilitation of flight personnel. Introduction of modern technologies and equipment into practice of aviation medicine of the Navy, construction and implementation of total renovation and external repairs of buildings of medical units is considered to be an important independent direction in the development of the medical support system for naval aviation. The authors emphasize the expediency of the improving the regulatory framework aimed at ensuring the social protection of aviation medical personnel of the Navy. Development of the medical support system for naval aviation for the period up to 2025 is proposed to be implemented by the stages: the first stage (2018-2020), the second stage (2019-2025). General and particular indicators of effectiveness of package of measures aimed to improve the system of medical support of naval aviation are formulated.

The paper presents the experience of rehabilitation treatment for servicemen who had suffered from acute nonrheumatic myocarditis. The treatment was conducted in the 1469 Naval Clinical Hospital of the Northern Fleet with using an 8-modular system of medical rehabilitation activities: a laboratory-diagnostic cluster with a patient’s rehabilitation and expert evaluation and a rehabilitation prognosis; drug therapy, diet therapy, psychosomatic diagnosis and correction of the emotional state; therapeutic exercise with restoration of physical performance and adaptive health parameters; information cluster — providing the patient with a complete and accessible understanding of information about a healthy lifestyle; physiotherapeutic non-pharmacological correction of physiological disorders, activation of endogenous protective systems of the body; functional diagnostics complex: a study of restoration of functioning parameters for cardiovascular and respiratory systems, the development of the body’s adaptation to physical exertion. As a result of using the modular system, a decrease in the average bed-day during the rehabilitation phase for patient after mild acute myocarditis was 16,6% (from 17,5±1,3 to 14,6±2,7 days); after moderate myocarditis — 8.1% (from 22,3±2 to 20.5±1,8 days); and after severe — 5,9% (from 27,2±3,5 to 25,6±1,2 days). The rehabilitation program, which has been developed basing on principles of the theory of modules, is a dynamic, easily simulated system with a combination of variable and permanent elements, that allows to reduce the cost of treatment and rehabilitation in mild myocarditis by 10,6±0,9%, in moderate myocarditis — by 7,2±0,8%, and in severe myocarditis — by 3,7±0,4%.

The purpose of the study was to assess the physical activity of naval specialists in the conditions of the march, for which they evaluated their physical performance and revealed its dependence on the regularity of the exercise program. In total, 80 crew members of the ship aged 20 to 40 years old were surveyed during a two-month hike with a different physical training regime — not engaged, engaged in physical training under the guidance of a ship-driver according to a specially developed program, and doing it independently. As a result of the study, it was revealed that naval specialists who were not engaged in physical training during a hike, have multidirectional dynamics of their physical performance, improving in the middle of the hike, and returning to the initial state by the end of the hike. Naval specialists, who regularly exercised independently, have a positive dynamics of their physical performance, which significantly increases both in the middle and at the end of the cruise. A tendency towards a deterioration in the level of physical performance is observed among persons engaged in independent and irregular ways at the end of a hike. As a result of the research, it has been established that the use of a specially developed training program for physical activity allows us not only to preserve, but also improve the physical performance of naval specialists in the conditions of a hike.

The article is devoted to the analysis of medico-social factors that determine the outlook Image of the system of medical care for victims in emergency situations in the Arctic Zone of the Russian Federation. The social and economic development of the Russian Arctic zone is a strategic priority of the Russian Federation’s state policy in the Arctic. The goals of Russia’s state policy in the Arctic are to expand the resource base of the Arctic zone, to support the necessary combat potential of groups of troops of the Armed forces of the Russian Federation in the region, to preserve the natural environment, to ensure an adequate level of fundamental and applied scientific research, etc. Strategic priorities of the state policy of the Russian Federation in the Arctic are determined to increase the efforts of the Arctic States in creating a unified regional system of search and rescue, as well as prevention of man-made disasters and elimination of their consequences, including coordination of rescue forces; improving the quality of life of indigenous people and social conditions of economic activity in the Arctic. The main areas of development of the Russian Arctic include hydrocarbon production, fisheries, improvement of transport infrastructure and tourism. Three directions of socio-economic transformation of the Arctic zone of Russia, in the near future, can affect the formation of the appearance of the system of medical care for victims of emergencies: spatial expansion and increase of the economic potential of the Arctic zone of Russia; orientation to the concept of Trinity « innovative economy of energy efficiency sustainable development»; implementation of the concept of the formation in the Arctic eight reference zones of socio-economic development, of which the Kola, Nenets and Yamalo-Nenets reference zones are defined as pilot.

Review of basic approaches of therapeutic physical training in military personnel being under follow-up monitoring due to medical reasons in connection with main body systems diseasesis represented in this article. The survey examined questions of standard medical examination for military as evidence-based system of preventive and curative interventions directed at conservation and promotion of health in military staff. Surveyed are divided into groups depending on the age and health status. Different options of physical activities in full according to the age group are suggested: competitions and various health check arrangements; restrictions of physical activities through gradual mastering movement skills on initial stage of training, physical exercises in physical therapy group under the guidance of chief medical officer of unit due to specifically developed training programs for each military man. Fundamentals of therapeutic physical training are considered as a complex of measures applied in sick or weakened person in hospital environment as well as after hospital maintenance. Following measures are taken as the basis of therapeutic physical training: physical exercises, physical activities and sanitarian regimen, nature factors, labour therapy, massage, physiotherapy, musicotherapy, phytotherapy, aerotherapy, hands-on therapy. Physical exercises take the lead among physical rehabilitation measures as physical activities are the essential condition of formation of healthy lifestyle and the basis of proper medical rehabilitation. Correct choice of rehabilitation program, physical exercises complex, intensity of therapy measures determines the favorable treatment outcome,medical rehabilitation and preparedness, restoration to service in short time.

The paper observes works by Vasily Ivanovich Shestov who described the experience of fleet health maintenance organization in rough conditions in the Arctic Region. Also practical recommendations on improving health services were given in works. Issues of health service organization during navigation the Northern Sea Route were considered in depth. Bibliographic list of papers that observe issues of delivery of health-care services on ships during navigation in the Arctic Region. Analysis of structure and the contents of the manuscript ready for publication of works by VI.Shestov « Organization of health service on ships during navigation in the Arctic». Data and practical proposals set out by VI.Shestov in works of consideration are especially relevant at the present time when the rate of navigation the Northern Sea Route increases and issues of delivery of health-care service for seacraft’s crew and crew complement of navy vessels remain undetermined.

The Great Patriotic War of 19411945 was an unprecedented ordeal for the team of the Kronstadt Naval Hospital. One of the first difficult tests for the team was the raid of the fascist aviation on September 21, 1941. The Society of Marine Doctors of Kronstadt devoted its regular meeting to this tragic date.