The review presents the pathogenetic, diagnostic, therapeutic and rehabilitation aspects of computerized visual syndrome (CVS). The importance of an integrated approach to the implementation of treatment and rehabilitation measures is emphasized. The promising directions of scientific and practical activity on the problem of treating patients with GLC symptoms from the standpoint of modern requirements for medical rehabilitation have been determined.
Background. Osteopathic methods are used in practical medicine, but there is little scientific research in this area, especially in the treatment of somatic diseases. The purpose of the research is to evaluate the effectiveness of osteopathy in the complex therapy of patients with chronic stone-free cholecystitis from the point of view of evidence-based medicine. Methods. The study involved 114 patients who were divided into two groups, the control group and the main group, in which osteopathic procedures were applied. The functions of the gallbladder, bile and blood biochemistry, and cholecystokinin secretion were analyzed. Results. It was found that osteopathic methods significantly increased the effectiveness of standard therapy both in terms of regression of clinical symptoms of the disease and in the functioning of the gallbladder. It is proved that the main group of patients significantly increases the secretion of cholecystokinin, which correlates with an improvement in the biochemistry of bile and its allocation. It was found that the effectiveness of osteopathic treatment methods does not depend on the gender of patients. Conclusion. The results of the study indicate a fairly pronounced therapeutic effect of osteopathic procedures in the complex therapy of patients with chronic stone-free cholecystitis. The increase in the secretion of cholecystokinin is difficult to explain from the point of view of correction of functional blocks, and this problem remains the subject of further research.
Purpose: scientific substantiation and development of methodological principles of the “quality of life” (QOL) assessment questionnaire in patients with symptoms of computer visual syndrome (CVS).Material and мethods. As part of the first stage of the study, an individual interview was carried out (according to the standard developed methodology) with 100 patients with visually strenuous labor, according to the results of which the entire spectrum of complaints arising during prolonged work with a computer was determined (44 complaints in total). As part of the second stage, a special questionnaire was developed, in which the identified complaints were transformed into questions. The study involved 96 ophthalmologists aged 32 to 62 years with an average of 17.3 ± 1.4 years. The task of an expert ophthalmologist was to assess the relevance each of the questions in terms of the influence degree on the patient’s QOL, as well as the “severity” of the complaint in terms the of occurrence frequency.Results. The development of the questionnaire was based on the sequential implementation of five stages (development of a conceptual framework; development of a preliminary version and confirmation of validity content; additional modification; scaling procedure development; psychometric properties determination). The results obtained made it possible to form the questionnaire (22 questions) the final version, which (according to the analysis) meets the requirements of meaningful and constructive validity (specificity, reflection of questions and scales of significance for the patient, the results of an expert assessment by ophthalmologists of the psychometric response scale) with the weight coefficients development, the required values correlation coefficients (according to Pearson) between the relevance assessment of the question from the points according to the symptom severity, as well as the high level of consistency according to the “Cronbach-α” indicator.Conclusion. The main direction of the assessment QOL improving of a patient with GLC is active participation in the ophthalmologist’s questionnaire development. Our results determine that the expert assessment provides a mathematically confirmed choice of the most significant (in terms on QoL impact) subjective manifestations, which (in conjunction with the development of each patient’s possible responses expert assessments, in points) provides the required level of the questionnaire meaningful and constructive validity. The developed questionnaire can be recommended for further clinical testing.
Goal of research - the study aims to compare and evaluate of the functional state of the bodies of young children who were born with the help of medical labor induction and surgical delivery.Materials and methods. The authors conducted a complex clinical and instrumental examination of 150 young children of different sex, born via medical labor induction and surgical delivery. Modern clinical and physiological and experimental methods were used in the study. Results. The study revealed adverse functional changes in children′s health due to the characteristics of delivery. Children born via medical labor induction showed more pronounced changes in the functional state of the body compared with the children born via surgical delivery.Conclusion. The results of the correlation analysis showed that in comparison with the operative delivery, medical labor induction leads to stronger and more numerous interrelations between the factors of the functional state of children′s bodies, which is an unfavorable sign.
Introduction. Motivational factors are determinants of well-being and quality of life in professional activity. Motivation of medical workers is mainly determined by such factors as the possibility of self-realization, achievement of respect and interest in the content of work.The aim to assess the motives of professional activity of future osteopathic physicians.Materials and methods. A questionnaire was administered to 62 physicians of various specialties during their first year of study according to the Educational Program for Additional Professional Education of Professional Retraining for 3 504 hours in the specialty «Osteopathy» at the Institute of Osteopathy (Moscow). The average age of those surveyed was about 37,8±7,4 years, of whom 27 individuals were male and 35 — female. And they were split into two age groups: 38 people under 40 years old and 24 people over 40 years old. All surveyed people were also divided into two groups according to their medical specialty: therapists (42 people) and surgeons (20 people). We also formed two groups based on the place of residence: those from Moscow and St. Petersburg (33 people) and those arriving from other regions (29 people). Motivational interviewing was performed using a software psychodiagnostic complex APC Multipsychometer. The «Motivational Profile» psychological questionnaire was used to assess professionally significant motives of professional activity. The assessed indicators were: money, career, relationships with management, relationships with colleagues, intrinsic (inner) motivation, recognition, success, responsibility and interesting work. Mathematical processing of the obtained research materials was carried out on a PC using Statistica 6.0 application software packages. In psychophysiology, it is generally accepted to translate «raw» grades (scores) into standard «sten» (sn) grades using tables. Linear conversion of «raw» scores into standardized scales (stens) was carried out using Statistica 6.0 and Excel.Results. The highest values of the indicators were noted on the scales of interesting work and intrinsic motivation (over 7 sn). Success and responsibility scales also showed high values (6,3–6,8 sn). The career and relations with management values (4,3 sn) were below the average alongside with the relations with colleagues scales (3,6 sn). The results of factor analysis showed that in 68,4 % cases the linear combination of initial attributes of surveyed doctors was determined by 3 main factors: responsibility (35,2 %), attitude to recognition and career (17 %) and the level of relationships with colleagues (16,2 %). Responsibility for professional performance was more pronounced for men (19,3 %; p<0,03) than for women. For women, however, the motif of relations with colleagues had greater value by 28,1 % (p<0,03). In the age group up to 40 years old, the values of the career indicator were greater by 33,3 % (p<0,05), compared to those aged 41 and over, where the expression of the management relation motif was 25,6 % greater (p<0,05). The correlation of expression of professional motives with the region of doctors′ residence has been revealed. The money motive was 20,4 % higher for those living in peripheral regions of Russia (Altai, Siberia, Ural, South of Russia) in comparison with those living in Moscow and St. Petersburg. It was also found that doctors with up to 20 years of medical experience had a greater importance of motives regarding career and responsibility (43,3 %; p<0,05) than those with more than 20 years of experience (36,2 %; p<0,05). The importance of money as a motive was 24 % greater (p<0,05) if the duration of work experience was 20 years or more. The comparative characteristic of the indicators of motives in connection with the medical specialty (therapeutic, surgical) before admission to study did not reveal any significant differences.Conclusion. There has been established leading role of internal motivation and high responsibility factors, not related to monetary reward. The indicators varied depending on the gender, length of service and the region of residence of the doctors.
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