卷 19, 编号 1 (2015)

The use of outdated medical information and lack of awareness of family physicians and neurologists on the results of modern scientific and clinical research has led to a rise in the cost of unjustified inspections and wrong therapeutic tactics. The absence of new and regularly updated national clinical guidelines and standards for the diagnosis and treatment of neurological diseases and syndromes, leads to a wide variability of the actions of the physician in outpatient practice. In circumstances where there is no clear and unified standardization in the management of neurological patients, and the application of the principles of evidence-based medicine is not the rule, in the environment of outpatient physicians practice formed the basis for delusions and the gap between domestic and international clinical approaches.

There is an analysis of the prevalence of passive smoking, occupational hazards, exposure to biomass smoke in the home as a risk factors for chronic obstructive pulmonary disease (COPD) among the population aged 35-70 years of St. Petersburg on the basis of the results of the first phase of an epidemiological study RESPECT (RESearch on the PrEvalence and the diagnosis of COPD and its Tobacco-related aetiology). High prevalence of passive smoking was found among persons those aged older than 35 years, who are exposed to over 10 years in childhood and adolescence. They were accounted 43,5% (95% CI 41,4-45,7%). Overall, the prevalence of second-hand smoke among people older than 18 years more than 10 years was found 32,8% (95% CI 30,8­34,9%). Among them, women were significantly more exposed to the secondary effects of tobacco in the home than men (36,9 and 23,9%, respectively, p < 0,001). In opposite, men significantly more often than women exposed to environmental tobacco smoke at work (25,0 and 11,6%, respectively, p < 0,001). The proportion of participants who had never smoked, exposed to passive smoking more than 1 hour per week during the last week before the survey, was 22,4%. Never smoked persons with higher education less exposed anywhere (home or work) second-hand smoke (OR = 0,59, 95% CI 0,44-0,80). Over a quarter of the participants were exposed to of professional risk factors more than one year: 27,5% of dust at work (95% CI 25,5-29,6%); 23,7% gaz or chemical vapors/fumes (95% CI 21,8-25,7%).

For choosing of prevention and correction methods of disorders at professional burnout of medical workers due their high workload, preference should be given to activities that can be carried out independently and do not require time-consuming. Under these conditions using of non-specific methods psycho-training helping to the positive thinking formation is effectively. The effectiveness of the combined using of light and sound stimulation that create a positive psycho-emotional state and verbal background information for development of positive thinking has been proven. This technique can reduce the level of burnout of specialists on a scales of «emotional exhaustion», «depersonalization» and «reduction of personal achievements».

In the article the authors examined the insurance compensation injury suffered in the workplace as a result of occupational accidents and diseases, as well as the place and role of medical organizations in matters of medical and social assistance to victims in the workplace.