Vol 8, No 3 (2022)

INTRODUCTION: Disadaptation to the conditions of military service is manifested in young recruits in the first 1– 2 months of service, in graduates of training military units — within 2–4 weeks after arrival, and in contract military personnel — during the first three months of service. The effectiveness of the prevention of these risks primarily depends on the quality of the study of military personnel, the adoption of the necessary measures for the early identification of persons with unstable mentality, deviations in physical development and mental health.

OBJECTIVE: to develop a mathematical model for predicting the maladjustment of the military personnel of the navy.

MATERIALS AND METHODS: 307 men, conscripts aged 18–23 years old in the joint training center of the Navy were examined. 14 of them with objective signs of maladjustment. The following methods were used: a questionnaire of volitional self-control, a technique for diagnosing a dominant mental state, a test «Communicative and organizational inclinations», a brief orientation test, a multifactorial personality questionnaire «Adaptiveness», a questionnaire for character traits of an adult, a test for determining a tendency to deviant behavior, a test «Forecast-2».

RESULTS: When performing discriminant analysis using the «forward step by step» method, a highly informative model was obtained: Lambda Wilks: 0.82590 approx. F(7.299)=9.0041 p<0.0001. Linear classification function «Norm»=–47.1631+2.6336׫Personal adaptive potential»+1.1769׫Self-control»+2.3582׫Tendency to overcome norms and rules»+0.1035׫Behavioral regulation»+0.6821׫Social desirability»–0.1497׫Emotional stability»+7.8663׫Number of solved intelligence tasks». Linear classification function «Disadaptation»=–44.6142+1.6254׫Personal adaptive potential»+0.5151׫Self-control»+1.9143׫Tendency to overcome norms and rules»+0.5895׫Behavioral regulation+0.1439׫Social Desirability»+0.1439׫Emotional Stability»+8.5341׫Number of Solved Intelligence Tasks». DISCUSSION: Predictors of maladjustment in the navy is a combination of indicators: personal adaptive potential and behavioral regulation of the Adaptability method, the self-control subscale of the volitional self-control questionnaire, the indicator of the propensity to overcome the norms and rules of the test for determining the propensity for deviant behavior, the scale of emotional stability and the scale of orientation toward social the desirability of a methodology for diagnosing a dominant mental state, the number of completed tasks of a short orientation test. >< 0.0001. Linear classification function «Norm»=–47.1631+2.6336׫Personal adaptive potential»+1.1769׫Self-control»+2.3582׫Tendency to overcome norms and rules»+0.1035׫Behavioral regulation»+0.6821׫Social desirability»–0.1497׫Emotional stability»+7.8663׫Number of solved intelligence tasks». Linear classification function «Disadaptation»=–44.6142+1.6254׫Personal adaptive potential»+0.5151׫Self-control»+1.9143׫Tendency to overcome norms and rules»+0.5895׫Behavioral regulation+0.1439׫Social Desirability»+0.1439׫Emotional Stability»+8.5341׫Number of Solved Intelligence Tasks».

DISCUSSION: Predictors of maladjustment in the navy is a combination of indicators: personal adaptive potential and behavioral regulation of the Adaptability method, the self-control subscale of the volitional self-control questionnaire, the indicator of the propensity to overcome the norms and rules of the test for determining the propensity for deviant behavior, the scale of emotional stability and the scale of orientation toward social the desirability of a methodology for diagnosing a dominant mental state, the number of completed tasks of a short orientation test.

CONCLUSION: The developed mathematical model for predicting maladjustment of military personnel of the navy is expedient to use when conducting medical and psychological support for conscripts.

INTRODUCTION: The relevance of this issue is due to the fact that nowadays there is no common understanding of the influence degree of high partial oxygen pressures on a body functions’ state, depending on individual resistance.

OBJECTIVE: Research the state of the functions of the central nervous, cardiovascular and respiratory systems among people with different resistance to the toxic oxygen effect in the descending and the nearest post-descending period.

MATERIALS AND METHODS: There was an examination of 11 divers aged 23 to 43 (the average age is 35.5±6.5 years) in conditions of a simulated descent in a pressure chamber to the depth of 15 m (0.25 MPa) while breathing oxygen, and also during 3 days after its termination. Statistic: Software SPSS, v. 20.0 (IBM) was applied for statistical processing of the results.

RESULTS: Baseline heart rate (HR) in the low toxic oxygen resistant group (group I) is 10% (р<0.05) higher than the subjects, recognized as resistant (group II). To 60 minutes oxygen breathing (pO2=0.25 MPa) there is a decrease in heart rate (HR) by 12.5% in group I and 11% in group II, comparing the baseline (р><0.05). An increase of diastolic pressure level in group II is 10.5% to 15 min descent and 18% to 45 min, comparing the baseline (р><0.05). In group I the pulse pressure level reduced by 18%, comparing the baseline (р><0.05). Gencha test results after descent rose by 55% in group I and by 62.5% in group II, comparing the baseline (р�0.05), and indicators higher than initial remained for 3 days more. In group I there was reduction of information processing speed by a visual analyzer of 16% (from 0.788 to 0.661 b/sec) and increase in escape latency of a simple visual-motor reaction by 11.7%, comparing the baseline (р><0.05). DISCUSSION: Divers with different resistance to the toxic oxygen effect experience multidirectional reaction of the central nervous, cardiovascular and respiratory systems. Individuals, resistant to the toxic oxygen effect, are characterized by more active inclusion of counteraction mechanisms to hyperoxia and significant reduction in the level of adaptation reserves and the efficiency of the cardiovascular system. People with low resistance experience a decrease in the functionality level of the central nervous system. CONCLUSION: The results obtained have a basis for admitting the application of the method of determining individual body resistance to the toxic oxygen effect and tests with increasing dosed physical activity in order to estimate adaptation reserves and efficiency. >< 0.05) higher than the subjects, recognized as resistant (group II). To 60 minutes oxygen breathing (pO2=0.25 MPa) there is a decrease in heart rate (HR) by 12.5% in group I and 11% in group II, comparing the baseline (р< 0.05). An increase of diastolic pressure level in group II is 10.5% to 15 min descent and 18% to 45 min, comparing the baseline (р< 0.05). In group I the pulse pressure level reduced by 18%, comparing the baseline (р< 0.05). Gencha test results after descent rose by 55% in group I and by 62.5% in group II, comparing the baseline (р 0.05), and indicators higher than initial remained for 3 days more. In group I there was reduction of information processing speed by a visual analyzer of 16% (from 0.788 to 0.661 b/sec) and increase in escape latency of a simple visual-motor reaction by 11.7%, comparing the baseline (р< 0.05).

DISCUSSION: Divers with different resistance to the toxic oxygen effect experience multidirectional reaction of the central nervous, cardiovascular and respiratory systems. Individuals, resistant to the toxic oxygen effect, are characterized by more active inclusion of counteraction mechanisms to hyperoxia and significant reduction in the level of adaptation reserves and the efficiency of the cardiovascular system. People with low resistance experience a decrease in the functionality level of the central nervous system.

CONCLUSION: The results obtained have a basis for admitting the application of the method of determining individual body resistance to the toxic oxygen effect and tests with increasing dosed physical activity in order to estimate adaptation reserves and efficiency.

INTRODUCTION: The pandemic of novel coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus has forced physicians to reconsider traditional approaches to the treatment of patients with viral pneumonia and acute respiratory distress syndrome, when normobaric oxygenation methods were ineffective. The way out of this situation was the inclusion of hyperbaric oxygenation in the complex therapy of patients with COVID-19, as a recognized means of eliminating any form of oxygen debt due to more efficient delivery of oxygen to organs and tissues. OBJECTIVE: To evaluate the effectiveness of hyperbaric oxygenation in the complex therapy of patients with a novel coronavirus infection with severe lung damage (more than 50%). MATERIALS AND METHODS: We examined 75 patients with the diagnosis «Coronavirus infection caused by the virus SARS-CoV-2» (64 patients with CT-3, 11 patients with CT-4), 50 of whom were prescribed a course of hyperbaric oxygen therapy (HBOT). The procedures were carried out in a Sechrist 2800 resuscitation pressure chamber (USA) at 1.4–1.6 ATA for no more than 60 minutes. Before and after each HBOT session, subjective indicators of the patients’ condition were assessed and blood oxygen saturation was measured. In addition, the dynamics of the level of leukocytes, platelets, ALT, AST and C-reactive protein were evaluated. In order to analyze oxygen support, the type (low-flow oxygen therapy, high-flow oxygen therapy) and daily oxygen consumption were recorded.

RESULTS: The inclusion of hyperbaric oxygenation in the complex therapy of patients with a novel coronavirus infection led to a significant increase in the level of SpO2 by the 7th day in the study group to 92% (89; 94) vs. 88% (87; 92) in the control group (p=0.011), and by 14th day to 96% (95; 97) vs. 95% (90; 96) (p<0.001). This circumstance led to a significant decrease in the number of patients requiring additional oxygen support, which was 94% in the study group and 100% in the control group by the 7th day, and 16% in the study group and 44% in the control group by the 14th day. In particular, the number of patients requiring high-flow oxygen therapy in the study group decreased from 34% on the 5th day to 2% on the 14th day, while in the control group over the same period there was a decrease from 60% to 32%. When analyzing the volumetric oxygen consumption in the study group, even taking into account the oxygen consumption for hyperbaric oxygenation, a decrease in the average daily oxygen consumption was recorded from 13.9 L/min on the 5th day to 9.3 L/min on the 14th day, while in the control group for the same period from 17.2 L/min to 14.5 L/min. The length of stay of patients in the intensive care unit in the study group was 10 (8; 12) vs. 13 (11; 23) bed-days (p=0.002) in the control group, and the total length of hospitalization was 16 (13.3; 20) vs. 21 (19; 29) bed-days (p><0.001) in the study and control groups, respectively. DISCUSSION: The early inclusion of hyperbaric oxygen therapy in the complex therapy of patients with a new coronavirus infection led to a significant increase in the level of SpO2 starting from the 7th day. This circumstance led to a significant decrease in number of patients requiring additional oxygen support in the study group compared to the control. This, in turn, affected the reduction in volumetric oxygen consumption in the study group, even taking into account the oxygen consumption on hyperbaric oxygenation. In addition, in the study group, positive dynamics according to CT data, a more rapid decrease in the level of C-reactive protein, were more often recorded. All these observations indicate a more rapid normalization of the state of the body due to the elimination of hypoxia, a decrease in the inflammatory response and restoration of lung function in patients who underwent hyperbaric oxygen therapy. CONCLUSION: The inclusion of HBO in the complex therapy of patients with a new coronavirus infection with severe lung damage (more than 50%) allows to stabilize the condition in a short time due to a more intensive decrease in the degree of lung damage according to CT data, early refusal of additional oxygen support, improvement of the psycho-emotional state, which in generally leads to a reduction in the length of stay of patients both in the ICU and in the hospital department.>< 0.001). This circumstance led to a significant decrease in the number of patients requiring additional oxygen support, which was 94% in the study group and 100% in the control group by the 7th day, and 16% in the study group and 44% in the control group by the 14th day. In particular, the number of patients requiring high-flow oxygen therapy in the study group decreased from 34% on the 5th day to 2% on the 14th day, while in the control group over the same period there was a decrease from 60% to 32%. When analyzing the volumetric oxygen consumption in the study group, even taking into account the oxygen consumption for hyperbaric oxygenation, a decrease in the average daily oxygen consumption was recorded from 13.9 L/min on the 5th day to 9.3 L/min on the 14th day, while in the control group for the same period from 17.2 L/min to 14.5 L/min. The length of stay of patients in the intensive care unit in the study group was 10 (8; 12) vs. 13 (11; 23) bed-days (p=0.002) in the control group, and the total length of hospitalization was 16 (13.3; 20) vs. 21 (19; 29) bed-days (p< 0.001) in the study and control groups, respectively.

DISCUSSION: The early inclusion of hyperbaric oxygen therapy in the complex therapy of patients with a new coronavirus infection led to a significant increase in the level of SpO2 starting from the 7th day. This circumstance led to a significant decrease in number of patients requiring additional oxygen support in the study group compared to the control. This, in turn, affected the reduction in volumetric oxygen consumption in the study group, even taking into account the oxygen consumption on hyperbaric oxygenation. In addition, in the study group, positive dynamics according to CT data, a more rapid decrease in the level of C-reactive protein, were more often recorded. All these observations indicate a more rapid normalization of the state of the body due to the elimination of hypoxia, a decrease in the inflammatory response and restoration of lung function in patients who underwent hyperbaric oxygen therapy.

CONCLUSION: The inclusion of HBO in the complex therapy of patients with a new coronavirus infection with severe lung damage (more than 50%) allows to stabilize the condition in a short time due to a more intensive decrease in the degree of lung damage according to CT data, early refusal of additional oxygen support, improvement of the psycho-emotional state, which in generally leads to a reduction in the length of stay of patients both in the ICU and in the hospital department.

INTRODUCTION: Ensuring Russia’s presence in all regions of the oceans requires trained personnel on board to provide medical care in everyday conditions as well as in case of emergency situations.

OBJECTIVE: To study the features of crew members’ training in providing medical care, to identify the main problems in this sphere and to develop solutions.

MATERIALS AND METHODS: The analysis of regulatory legal framework of international and governmental levels was performed. Educational and methodological materials of training and medical assistance on board ship from 2012 to 2022 were studied.

RESULTS: The analysis of the requirements of the legislative acts found inconsistencies in the international and state legislation on the crew members’ training of medical care on board ships.

DISCUSSION: Currently providing first medical aid service by responsible persons on board ship to the crew members, regulated by «the Maritime Labour Convention», contradicts the national legislation in the healthcare sector. The status of a person, responsible for the first aid and care for the sick and injured on board ship, their admittance to medicines, including narcotic and psychotropic as a part of first aid kit in the territory of Russia is not stated.

CONCLUSION: During the study some solutions of the existing inconsistencies in the legislative acts of the Russian Federation and international conventions were offered.

INTRODUCTION: Athlete’s training activity in conditions of the European North involves severe physical exertion in extreme climatic conditions. In this case emerging physiological and meteopathic reactions might have a negative impact on the functional state of persons of military age.

OBJECTIVE: Identify the characteristics of seasonal changes in the state of nervous system among skiers of the military age.

MATERIALS AND METHODS: 20 skiers of the military age took part in the study. It was carries out over a year and included 4 stages, complying with the stages of athletes’ preparation. During the work by means of the device «Psychophysiologist» there was recording indicators of mean, minimum and mean-square deviation of time of simple and complex visual-motor reaction and also the duration of cardiointervals. Statistics: Statistical software package SPSS 20.0 was used for analyzing the results.

RESULTS: As a result of the study, it was found that the skiers experience deterioration of visual-motor reaction with the increasing impact of training activities and negative factors of the north.

CONCLUSION: Functioning of the athlete’s body in conditions of the European North leads to deterioration of indicators of nervous system activation level and capacity in the winter training period.

OBJECTIVE: To assess the impact of applying active thermal protection by diving specialists based on electric heating to ensure thermal comfort as a part of a series of measures to prevent occupational diseases while performing underwater works under low ambient temperature.

MATERIALS AND METHODS: The test evaluated the time spent by divers in the water maintaining thermal comfort without active heating and using the system of electric heating. The diver’s thermal comfort was estimated according to subjective sensations. The test was held using the diving equipment SLVI-71, SSP-М, SN-21, GVS ХС1200, SVG-200, SVC «Amphora», SVU-5/1, SVU-3 with АВМ-12к, at depth from 2 m to120 m, at a water temperature from +1° С to +16° С.

RESULTS: The test determined the compatibility of the electric heating developed system for divers with components of special diving equipment of the above types; showed the necessity of applying the elements of hands and feet’s warming as a part of the heating system; proved the positive impact of the heating system on divers in the period of maintaining thermal comfort while performing diving works, including different levels of heating power.

DISCUSSION: Diver’s hypothermia predisposes to oxygen starvation, contributes to the emergence of decompression sickness, oxygen and carbon dioxide poisoning. The average time of providing divers thermal comfort by using FEC at a water temperature from +1° С to +4° С exceeds 3,5–4,6 times the period of the diver’s staying in the water without using active heating. Using elements of hands and feet’s warming in the electric heating suit provides decrease in appearance of primary hypothermia signs of the extremities, contributing to the maintenance of the diver’s optimum heat sensation for a long time. Applying electric heating system significantly reduces the risk of hypothermia while performing diving works under low ambient temperatures and helps to prevent occupational diseases, directly or indirectly related to the impact of low ambient temperatures on the body.

CONCLUSION: The application of electric heating system for divers significantly reduces the risk of hypothermia while performing diving works under low ambient temperatures, enables to increase allowable time in water in the diving suit 3,5–4,6 times and helps to prevent occupational diseases, directly or indirectly related to the impact of low ambient temperatures on the body.

OBJECTIVE: the assessment of potential benefits of implementing hardware technologies, available for supply in the Russian Armed Forces to hold mass rapid screening test of servicemen for RNA virus SARS-CoV-2 by PCR on «endpoint» in field conditions.

MATERIALS AND METHODS: PCR on «endpoint» was applied according to the protocol of RNA virus detection by the set of test system PCR-RV «PolivirSARS-CoV-2» with extraction reagent «RNA-express», joint production of LLC NPF «Litech» and the Federal Research and Clinical Centre of Physical-Chemical Medicine FMBA. The biomaterial for the research was 157 samples of nasal-pharyngeal smears, taken from patients with clinical symptoms of respiratory disease who had contacts with COVID-19. Statistics. The data received from pilot studies had standard statistical processing in the program «Statistica 6,0». Non-parametric Pearson’s chi-square (c2) criteria was used to assess the significance of different observation frequencies of the studied feature in independent groups. Probability p≤0,05 and higher was considered sufficient to conclude statistical importance of the differences received.

RESULTS: It is stated that out of 157 biomaterial samples, assessed for the content of SARS-CoV-2 virus’s genetic markers by PCR on «endpoint» and PCR «Realtime», 141 and 146 samples, respectively, turned out to be positive. In addition, there were no statistically important differences between the received data in these methods (c2=1,013, р=0,31).

DISCUSSION: It is shown that comparative characteristics of the studied methods in laboratory SARS-Соv-2 virus diagnostics suggested the possibility of detecting specific segment of the virus genome by PCR «endpoint» technology, using expendable reagents, made for PCR «Realtime».

In this paper we present an overview of the two main types of hybrid (combined) studies — nested case-control studies and case-cohort studies. Main research questions that can be addressed using these study designs are presented. The methodological features of nested case-control and case-cohort studies as well as their strengths and limitations are described in detail. Moreover, we present how to interpret the results of these studies and give examples from the international peer-reviewed literature.

The results of medical care with employees of remote offshore and industrial facilities in oil and gas production in the Russian North are presented over the past two decades. Best practices, providing maximum efficiency, including risk assessment and management, emergency planning, telemedicine, staff training in basic medical concepts and first aid, formation and maintenance of staff health registers. Each of the areas significantly improved medical statistics.

Simulation training plays an important role in the preparation of future naval surgeons. In this regard, nowadays in the department of naval surgery there is a training simulator, modernized on the model of the most modern diesel submarine. In contrast to the previous simulator it contains necessary devices for solving situational tasks with the use of telemedicine technologies. The simulator is equipped with sanitary stretchers and a tripod with medical melts. It allows to organize a military medical game with the introductory on transporting conditionally sick and injured both inside and outside the ship that improves the quality of preparing future naval surgeons.

INTRODUCTION: Global challenges facing humanity make us take a fresh look at the problem of human health, first of all, in the context of forming a stable plan to maintain and increase health reserves. Such a plan does not appear by itself, it requires some person’s efforts to self-educate and to acquire special knowledge.

OBJECTIVE: Substantiate the principles and mechanisms of individual health based on the analysis of literature sources and results of own research.

MATERIALS AND METHODS: There was analysis of articles, placed in the databases and information systems: scientific electronic library Elibrary.ru, RISC, CyberLeninka, Scopus, WoS with the study about the basic components of individual health for the last 20 years. Keywords were used, such as health, homeostasis, adaptation, principles of individual health, valeology. The results of the authors’ own long-term studies have been also used in developing principles of health, relating to the issues of ensuring health of power structure specialists.

RESULTS: High aerobic capacity does not only prevent the development of chronic somatic diseases, but also helps to resist different adverse environmental factors. In other words, high aerobic capacity can ensure overcoming extreme situations without activating anaerobic mechanism of energy supply. It is especially important as a part of valeological approach because, as a rule, in extreme conditions there is drastic reduction in adaptation reserves that leads to a risk of a disease.

DISCUSSION: Priority principle of health is the principle of shaping health. Its essence is systematic teaching to manage your own health based upon a number of factors: gender, age, the level of physical and intellectual activity, the presence of predisposition to certain diseases, professional employment, etc. Its following ensures a person implementation of other principles — preservation and strengthening of health on somatic, mental and social levels. Knowledge about individual health mechanisms may become the theoretical basis for practical activities of medical, educational and social services in improving quality and life expectancy in Russia.

CONCLUSION: In the structure of individual health pedagogical component is considered to be system-forming, the essence of which is to contribute to the formation of morality (positive personality traits and willingness to care for one’s own well-being and that of others) via continuing valeological education. Through morality an individual gets involved in activities of forming somatic, mental and social components of health, building and integration of which tend to happen over the whole period of their growth and development.