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Вестник Ка^НМУ №2-2019
BflEEHETTEP TI3IMI
1 Anogianakis G, Ilonidis G, Milliaras S, Anogeianaki A, Vlachakis-Milliaras E. Developing prison telemedicine systems: the Greek experience // Journal of Telemedicine and Telecare. - 2003. - №9, Suppl 2. - P. 4-7.
2 Bellali T, Kalafati M. Greek psychiatric care reform: new perspectives and challenges for community mental health nursing // Journal of Psychiatric and Mental Health Nursing. - 2006. - №13(1). - P. 33-39.
3 Belos G, Lionis C, Fioretos M, Vlachonicolis J, Philalithis A. Clinical undergraduate training and assessment in primary health care: experiences gained from Crete, Greece // BMC Medical Education. - 2005. - №5(1). - P. 13-18.
4 INTEGRATED HEALTH SERVICES- WHAT AND WHY // Technical Brief No.1, May 2008 URL: https://www.who.int/healthsystems/technical_brief_final.pdf
5 Jamison D et al. Priorities in health. - Washington DC: World Bank, 2006. - 359 p.
Л.К. Кошербаева12, Л.Б. Сейдуанова1, А.К. Жуманова1, К.А. Толганбаева1, К. Косаева1
1 Казахский Национальный медицинский университет имени С.Д. Асфендиярова 2Казахский Национальный университет имени аль-Фараби
ИНТЕГРИРОВАННАЯ ПОМОЩЬ НА УРОВНЕ ПЕРВИЧНОГО ЗВЕНА
Резюме. Новые демографические изменения, проблемы психического здоровья, влияющие на благосостояние отдельных лиц и сообществ, а также глобальное давление со стороны спроса и предложения, создают международные проблемы требующие трансформации системы здравоохранения, особенно в странах с ограниченными финансовыми и людскими ресурсами. Международный опыт подчеркивает необходимость создания эффективных направлений и служб с участием медицинских сестер, социальных работников, психологов и других медицинских работников. В рамках нашего исследования был изучен вопрос знания медицинских сотрудников политики в области оказания интегрированной помощи на уровне первичного звена. Ключевые слова: здоровья, медико-санитарная помощ, медицинские работники
L.K. Kosherbaeva12, L.B. Seiduanova1, A.K. Jumanova1, K.A. Tolganbaeva1, K. Kosaeva1
1Asfendiyarov Kazakh National medical university 2Al-Farabi Kazakh National University
INTEGRATION PUMP HEART SURFACE POWDER
Resume: New demographic changes, problematic psychological health, good health and welfare, as well as global response to the challenges and tendencies, the international challenges of transformation of the system of health protection, especially in the financial and human resources with restricted access. The international optimism effectively raises the effectiveness of effective and direct linkages with medical problems, social workers, psychologists and other health care providers. In the frames of our research, we have examined the question of the medical workers in the field of integration into the integral part of the primary health care workers. Keywords: Health, Health Care, Medical Workers
UDC 611.08:612.833.81-092.19:614.876
M.Zh. Sengaliy
NPJSC "Astana Medical University"
COMBINED EFFECT OF HIGH DOSES OF IRRADIATION AND EMOTIONAL STRESS ON REFLEX ACTIVITY OF RATS
The article presents a comparative analysis of the isolated radiation exposure at a dose of 6.0 Gray (Gy) and stress factors, as well as the effects of their combined influence to the conditioned reflex activity of rats. The positive dynamics of the conditioned passive avoidance reflex (CPAR) was found in animals with combined exposure of radiation and stress, where there was a slower, in comparison with experimental rats, time spent in the safe compartment of the installation.
Keywords: conditioned passive avoidance reflex, combined effect, ionizing irradiation, immobilization stress
Relevance. The problem of studying the effects of combined exposure of ionizing radiation and emotional stress on the functional activity of the brain continues to be relevant, as among the various segments of the population of radioactively contaminated areas are found such negative neuropsychiatric disorders as increased anxiety, conflict, alienation, depression, memory loss, impaired concentration [1,2]. Together, such effects can have significant consequences and acquire social significance, affecting to the performance of the adult population of radioactively contaminated territorias [3]. In connection with the above-mentioned, the purpose of our research was to study the the conditioned-reflex activity parameters of rats in case of combined effect of high doses of gamma radiation and the stress factor in the experiment.
Materials and methods. The series of carried out researches was made on 88 white outbred rats, weighing 200-220 grams, which were subsequently divided into 4 groups: I group - intact animals (n=22); II group - rats, which were once irradiated on the day of the research on the medical linear electron accelerator Clinac 600 C at a dose of 6.0 Gray (n=22); III group - animals undergoing chronic immobilization stress (CIS), during 5 days for 4 hours (n = 22); IV group - rats, which were irradiated by external acute ionization at a dose of 6.0 Gy. in combination with the subsequent chronic immobilization stress (CIS) during 5 days for 6 hours (n=22). The animals of I group were compared group for II group of rats. Accordingly, irradiated animals (II group) served as a control for III group of rats.
The conditioned passive avoidance reflex (CPAR), which based on emotional negative reinforcement [4], was carrying out on the
Vestnik KazNMU №2-2019
basis of a single electrical stimulation according to a modified method of J. Bures and O.Buresova (1963 y.). The strength of the performance skill was tested 24 hours after training [5]. The criterion for the performance of the passive avoidance reflex after application of the pain electrical-skin stimulation was the stay of animals in the light compartment of the camera 80% (144 s) or more of the total observation time (180 s) [6]. In all examinated groups, the keeping of the memory engram was studied during 14 days of the research.
The research results were processed statistically using the parametric Student's t-test using a set of standard Microsoft Excel programs [7].
Results and discussion. The results of studies are shown on Diagram 1, where it can be seen that on the first day of observation (24 hours after training) the duration of placing in
the illuminated compartment of the camera in the intact group was 177.45±1.53 seconds. The studied parameter turned out to be more than the 144-second criterion for the performance of a reflex [6]. The obtained data testified about successful performance of the conditioned passive avoidance reflex by the control animals. Further observations made possible to establish that the trained rats demonstrated indicators which exceeding the criterion of the performance of reflex on the 2nd (173.54±2.17 s), 7th (174.09±2.05 s) and 14th (176,35±1.35 s) day of the experiment. In this group, were registered the largest number of rats with a maximum residence time (180 s) in the light compartment of the camera. So, starting from the 1st day and until the end of the observation, the number of rats that fully reproduced CPAR, reached a maximum - 100% (Table 1).
Table 1 - The number of rats that completely reproduced the reflex passive avoidance throughout the experiment
Study groups, n-number of rats The number of rats that completely reproduced the passive avoidance reflex (%)/observation period
1 cyT. 2 cyT. 7 cyT. 14 cyT.
I group - intact animals (n=22); 100% 100% 100% 100%
II group - rats, which were once irradiated on the day of the research on the medical linear electron accelerator Clinac 600 C at a dose of 6.0 Gray (n=22); 41% PK0,001 41% P1<0,001 4,5% P1<0,001 11,8% P1<0,001
III group - animals undergoing chronic immobilization stress (CIS), during 5 days for 4 hours (n = 22); 54,5% pK0,001 31,8% p1<0,001 27% p1<0,001 0% p1<0,001
IV group - rats, which were irradiated at a dose of 6.0 Gy. in combination with the subsequent CIS 50% p2<0,001 P3<0,001 18,2% p2<0,001 P3<0,001 31,2% p2<0,001 P3<0,001 23,5% p2<0,001 P3<0,001
Notes: p1 - the significance of differences compared with group I; p2- the significance of differences compared with group II; p3 - the significance of differences compared with group III.
accuracy of differences between I and II groups; - SSSSlSSy. °f differences between I and III groups;
Diagram 1 - The dynamics of the time spent in the light compartment of the camera in the study of the performance of passive avoidance reflex
in intact animals (group I) and experimental group rats
Analysis of the results which obtained in the II group, which undergo to a single external acute exposure at a dose of 6.0 Gy, showed that on the 1st day, as well as on the 2nd day of the study, the residence time in the light compartment of the camera decreased on average by 2 times compared with the intact group and amounted to 84.66±77.73 s (p1<0.001) and 82.85±79.92 s (p1<0.001), accordingly. In both groups, there were a low percentage of animals that fully reproduced the acquired skill (on average 41%). In the following days of the experiment was revealed a further progressive decrease in the degree of keeping of the acquired conditioned connection. So, on the 7th day of observation, the time spent in the safe compartment decreased to almost 90% in comparison with the I group of animals. Only 4.5% of the rats were able to stay in the light compartment of the experimental setup for 180 seconds. However, on the 14th day of
observation, the percentage of animals that fully reproduced the reflex of passive avoidance increased 2 times (40.06±58.34; p1<0.001) compared with the previous indicator. In animals of the third group which undergo to chronic immobilization, it was revealed that 1 week after the training procedure, the time in the light compartment of the camera was significantly less than in intact rats. In the study period, the duration of being in the illuminated part of the camera began to be 57.50±76.73 s (p2<0.001), which was on average 2.5 times less than the general criterion for the performance of reflex. No such animals were detected at all on the 14th day of observation. In IV group rats, which exposed by the combined effects of radiation and chronic immobilization stress, signs of decrement CPAR were observed on the 2nd day of the study, when the time spent in the light part of the camera was more than 2 times
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shorter and was 48.65±68.04 s At the same time, the number of different from that in the II and III groups of experimental
animals that fully reproduced the acquired skill was the smallest animals (diagram 2, 3): both the number of rats that completely
(18.2%). Despite this, in the following days of observation, the reproduced passive avoidance reaction and time spent in the
dynamics of passive avoidance reaction was significantly light compartment of the camera are increased.
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Diagram 2 - The dynamics of the time spent in the light compartment of the camera in the study of the performance of the passive avoidance
reflex in animals of the II and IV groups
+ - accuracy of differences between III andIVgroups
Diagram 3 - The dynamics of the time spent in the light compartment of the camera in the case of studying the performance of the passive avoidance reflex in animals of the III and IV groups
Conclusion. Thus, the results of the experiments showed that only in the group of animals which exposed to radiation is observed a steady decline in the residence time in the light compartment of the camera. The 14th day of the study is characterized by the shortest duration of stay of rats in a safe camera and the absence of animals that completely reproduced the acquired skill. In the II and IV groups, the dynamics of passive avoidance reaction was different: in both groups there was a
sharp reduction in the time spent in the light part of the camera (in the II group on the 7th day, in the IV group on the 2nd day of observation) with following time elongation of stay in the lighted compartment of setup. Positive dynamics of passive avoidance reaction reflex was detected in animals of the fourth group, when the combined effects of radiation and stress led to a slower reduction of the time spent in a safe chamber, in comparison with the II and III groups.
Vestnik KazNMU №2-2019
REFERENCES
1 Чуян Е. Н. Влияние электромагнитного излучения крайне высокой частоты на стрессорный ульцерогенез // Психофiзiологiчнi та в^церальш функци в нормi та патологи : матерiали VI Мiжнародно,í науково! конференций (Ки!в, 2012 г.). - Ки!в: 2012. - С. 226-232.
2 Румянцева Г. М., Левина Т. М., Чинкина О. В., Степанов А. Л., Соколова Т. Н. Особенности психолого-психиатрических последствий радиационных аварий // Экология человека. - 2007. - №9. - С. 42-47.
3 Bing Wang, TakanoriKatsube, Nasrin Begum and Mitsuru Nenoi. Revisiting the health effects of psychological stress—its influence on susceptibility to ionizing radiation: a mini-review // Journal of Radiation Research. - 2016. - Vol. 57. - №4.- Р. 325.-335.
4 Буреш Я., Бурешова О., Хьюстон Дж. П. Методики и основные эксперименты по изучению мозга и поведения. - М.: Высшая школа, 1991. - 267 с.
5 Kokhan V.S., Afanasyeva M.A., Van'kin G.I. // Behav. Brain Res. - 2012. - V. 231, №1. - P. 226-230.
6 Иноземцев А.Н., Бельник А.П., Островская Р.У. Изучение условного рефлекса пассивного избегания в модифицированной трехкамерной установке // Эксп. клин. фармакол. - 2007. - №2. - С. 67-69.
7 Ойвин И.А. - Статистическая обработка результатов экспериментальных исследований // Патологическая физиология и экспериментальная терапия. - 1960. - №4. - С. 76-85.
М.Ж. Сенгалий
КЕФ%«Астана медицина университетi»
ЕГЕУЦ¥ЙРЬЩТАРДЬЩ ШАРТТЫ-РЕФЛЕКСТ1К БЕЛСЕНД1Л1Г1 К6РСЕТК1ШТЕР1НЕ у-СЭУЛЕЛЕНУ МЕН ЭМОЦИОНАЛДЬЩ СТРЕССТЩ Б1РЛЕСКЕН ЭРЕКЕТ1
ТYЙiн: Осы ма;алада 6,0 Грей дозасында сэулелену мен стресстж фактордыц о;шауланган эсерi гана емес, олардыц ;осарлас;ан эрекетшщ егеу;уйрык;тардыц шартты рефлекстж белсендiлiгiне эсерi туралы салыстырмалы талдау жасалды. Шартты енжар ;ашу рефлексшш (ШЕЦР) оц динамикасы тэжiрибе тобыныц жануарларымен салыстырганда, ;аушаз камерада орналасу уа;ытыныц баяулауымен сипатталатын, радиация мен стресстщ ;осарлас;ан эсерi бар егеу;уйрык;тарда бай;алды. ТYЙiндi сездер: шартты енжар ;ашу рефлексi, бiрлескен эсер, иондаушы радиация, иммобилизациялы; стресс.
М.Ж. Сенгалий
НКАО «Медицинский Университет Астана»
СОЧЕТАННОЕ ВОЗДЕЙСТВИЕ у-ОБЛУЧЕНИЯ И ЭМОЦИОНАЛЬНОГО СТРЕССА НА УСЛОВНЫЙ РЕФЛЕКС ПАССИВНОГО ИЗБЕГАНИЯ КРЫС
Резюме: В данной статье представлен сравнительный анализ изолированного влияния облучения в дозе 6,0 Грэй (Гр) и стрессовых факторов, а также эффекты их сочетанного воздействия на условно-рефлекторную деятельность крыс. Положительная динамика условного рефлекса пассивного избегания (УРПИ) была обнаружена у животных с сочетанным воздействием радиации и стресса, где наблюдалось более замедленное, по сравнению с подопытными крысами других групп, сокращение времени нахождения в безопасном отсеке установки.
Ключевые слова: условный рефлекс пассивного избегания, сочетанное влияние, ионизирующая радиация, иммобилизационный стресс
УДК 616.12-005.4-084(574.51)
Д.А. Сон1, М.К. Кошимбеков1, М.А. Канушина2, Б.С. Турдалиева3, Г.Е. Аимбетова1
Казахский Национальный медицинский университет имени С.Д. Асфендиярова1 AC Institute of international education2 АО «Казахский медицинский университет непрерывного образования3
ПОДХОДЫ К ПРИМЕНЕНИЮ СОВРЕМЕННЫХ ИНФОРМАЦИОННЫХ ТЕХНОЛОГИЙ В ПРОФИЛАКТИКЕ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ
Мобильное приложение для профилактики сердечно-сосудистых заболеваний(ССЗ) является одним из современных решений. В статье описаны основные методы профилактики ССЗ: артериальной гипертензии и хронической сердечной недостаточности в мире и Республике Казахстан, описано значение использования мобильного приложения в снижении поведенческих факторов риска на основе рассчитанного сердечно-сосудистого риска и самоменджмента пациента.
Ключевые слова: Профилактика сердечно-сосудистых заболеваний, поведенческие факторы риска, информационные технологии в здравоохранении, мобильное приложение
Введение. Как показывает практика, мировая политика здравоохранения направлена в первую очередь на профилактику хронических неинфекционных заболеваний, первенство среди которых занимает группа сердечнососудистых заболеваний (ССЗ).По данным ВОЗ, ССЗ являются причиной половины зарегистрированных случаев смерти и инвалидизации во всем мире[1]. К ССЗ
принадлежат: ишемическая болезнь сердца (инфаркты), цереброваскулярная болезнь (инсульт), повышенное кровяное давление (гипертония), болезнь периферических артерий, ревматический порок сердца, врожденный порок сердца и сердечная недостаточность. Основными причинами развития сердечно-сосудистых заболеваний являются употребление табака, отсутствие физической
