[Features of methodology for the formation of standard operational procedure in the practice of bureau of forensic medical expertise]. / Osobennosti metodologii formirovaniya standartnykh operatsionnykh protsedur v prakticheskoi deyatel'nosti byuro sudebno-meditsinskoi ekspertizy.

OBJECTIVE: To analyze and summarize data on formation and implementation in practice of standard operational procedures for developing algorithm to improve the quality management system of bureau of forensic medical expertise. MATERIAL AND METHODS: Normative legal documents regulating principles of standardization in healthcare were studied. Literature was analyzed in PubMed, Google Scholar, eLIBRARY search engines in English and Russian languages on the issues of development and implementation of standard operational procedures in practice. RESULTS: Data on using standard operational procedures as a standardization element in medical practice have been analyzed and generalized. Specific proposals for developing system of standard operational procedures, based on general principles for the creation of such documents, in forensic medical expert institutions have been proposed. CONCLUSION: Suggested recommendations can be used in practice to develop new common standard operational procedures.

[Evaluation of the effectiveness of children's health improvement in camps: actual problems and its solutions]. / Otsenka effektivnosti ozdorovleniya detei v lageryakh: sovremennye problemy i puti resheniya.

Currently, there is a decrease in the total number of organizations for summer recreation of children in the country while the share of organizations of group II of sanitary and epidemiological well-being among them remains at a consistently high level that determines the potential risk of harm to the health of the child population. At the same time, there is an increase in the number of children with a pronounced health-improving effect. So, it becomes necessary to analyze the information content of modern criteria for assessing the effectiveness of health improvement and to search for ways to resolve the noted contradictions. OBJECTIVE: Analysis and scientific and methodological substantiation of modern criteria for assessing the effectiveness of children's health improvement in recreation organizations (camps). MATERIAL AND METHODS: An analysis of the literature data, our own research results' systematization and effectiveness assessment of the health improvement of 195 children aged 10 to 15 years (112 girls and 83 boys) belonging to I and II health groups and vacationers in the inpatient organization of the Samara region in the 2019 summer campaign were carried out. Anthropometric, physio-metric, and bio-impedance metrics were studied in two stages (on the 1st or 2nd day of arrival and 1 day before the camp leaving). In a comparative analysis the differences were considered significant when p<0.05. RESULTS: Stationary rest and recreation organizations in the all-Russian structure of recreation organizations for children account for 5.8%. During staying in the camp, there was a significant decrease in the proportion of girls with underweight (p=0.039); among boys no significant changes were found. The general trend towards a change in the level of physical development is not statistically significant. Bio-impedance analysis revealed only 51.3% of children with changes in indicators characterizing the health-improving effect. The tendencies to change in the proportion of children with different levels of arm muscle strength and lung capacity during the staying in then camp are statistically significant. Correlations were established between muscle strength with basal metabolism (r=0.86) and muscle mass (r=0.86), as well as negative links between average strength and the percentage of adipose tissue (r= -0.52). During the staying in the camp, the 4 cases of acute respiratory infections were registered that did not affect the assessment of the recovery effectiveness. CONCLUSION: In order to assess the health-improving effect among children during one trial in the camp, the leading functional signs are muscle strength of the arms and vital capacity of the lungs. Additional criteria can be the morbidity during the staying in the camp, and in terms of the nutritional status analysis - the results of bio-impedance analysis. To assess the physical development at the beginning of the camp trial, the use of regional regression scales is informative that requires a corresponding explanation in the documents. In turn, the data from the baseline measurements should be used to build individual health measures during the staying in the camp.

[Chemical pollution of baby food products in the Russian Federation].

One of the main problems of nutrition of children and adolescents is to assess chemical contamination of baby food products and the establishment of the relation with the health of the child population. With the entering different chemical compounds in the body of the child there can be observed disorders of the nervous, urinary, cardiovascular system, gastrointestinal tract, as well as metabolic deteriorations, degenerative processes in parenchymal organs and bone destruction. The aim of the study was to analyze data on chemical contamination of baby food products in the Russian Federation for 2012-2014. The analysis was executed on the data of Federal Information Fund of social and hygienic monitoring of the Russian Federation. There were identified priority pollutants (toxic elements, nitrites, nitrates, nitrosamines, pesticides, hydroxymethylfurfural, mycotoxins) and risk areas (the Lipetsk region, the Krasnodar Territory, the Republic of Adygea, city of Moscow, Tatarstan, the Kabardino-Balkar Republic, the Ryazan region). There are detected contamination levels not exceeding MAC (in the dynamics of the three years offollow up, on average 22%), requiring their hygienic assessment. There were determined the baby food products containing most common occurred chemical contaminants: fruits and vegetables products, canned products, canned meat, cereals, dairy products, liquid and adapted and partially adapted milk formalas. Identified data indicate to a need for further studies of chemical substances in products for children's nutrition in order to establish the causal relationships with a various diseases and the substantiation of methodological approaches to the risk assessment of combined exposure to chemical contaminants in concentrations up to the MPC on health of children, including infants.