The Impact of Health Resort Treatment on the Nonenzymatic Endogenous Antioxidant System.

Introduction. Oxygen, reacting with organic compounds in living organisms, oxidizes them without being completely reduced due to numerous exogenous as well as endogenous factors. As a consequence, free radicals or reactive oxygen species are formed. Health resort-based balneophysiotherapy is a comprehensive therapeutic intervention that triggers positive therapeutic effects within the entire system. Material and Methods. The objective of the study was to assess the impact of health resort-based balneophysiotherapy on the levels of nonenzymatic endogenous antioxidants in patients with degenerative motor organ diseases, as well as to determine potential correlation of these changes with free radical-mediated processes. Observation was carried out in patients undergoing health resort therapy as part of 21-day stay periods. The study population consisted of n = 110 patients with articular and spinal pains due to degenerative diseases or discopathies. RESULTS: Reduced bilirubin and albumin levels as well as increased uric acid levels were observed in the study group following the health resort treatment. CONCLUSIONS: Bilirubin and albumin levels were reduced while uric acid levels were increased as the result of health resort therapy in patients with degenerative motor organ diseases. The observed changes in the levels of nonenzymatic endogenous antioxidants depend on free radical-mediated systemic transformations. The trial is registered with NCT03405350.

Natural medicinal resources and their therapeutic applications

Natural medicinal resources are a country's natural wealth. Natural medicinal waters, medicinal gases, and peloids have many properties that enable their use in the treatment of gastrointestinal, circulatory, respiratory, bone and joint, and skin and soft tissue disorders. Balneotherapy can be also applicable in prevention of many diseases and rehabilitation. At present, because there are several chemicals of synthetic origin, there is a need to search for nonpharmacological approaches and explore natural healing sources, which better fit the human body. Compared to synthetic drugs, these resources rarely show side effects, which increases the comfort of therapy. The use of natural medicinal resources in the form of treatments in health resort medicine centers under the supervision of balneologists, combined with the healing properties of the climate, contributes not only to the reduction of treatment time for many diseases but also to improvement of therapy's results. The article discusses natural medicinal resources and some of their therapeutic applications.

Killing the goose with the golden eggs: Litter effects on scenic quality of the Caribbean coast of Colombia.

137 coastal sites located along the Caribbean coast of Colombia were surveyed to determine scenic quality, litter content, and typology. Scenic evaluation categorized sites into five classes. 26 appeared in Class I; 18 in Class II; 19 in Class III; 30 in class IV; and 44 in Class V. Beach type was categorized into urban (31), resort (18), rural (46), village (32) and remote (10). Litter gave 17 sites an "A" grade (excellent); 34 sites a "B" grade; 53 sites a "C" grade and 33 locations a "D" grade (poor). Almost all sites surveyed have a low scenic quality and also significant litter content. Currently, litter directly produces aesthetic problems along the study area, and improvements are necessary to favor coastal scenic quality. Stakeholders should make a significant effort to improve the scenic human parameters along the study area, litter removal and prevention being the most important.

[Guidelines for dental care in departmental sanatoriums for workers with hazardous working conditions]. / Obosnovanie reglamenta okazaniia v vedomstvennykh sanatoriiakh stomatologicheskoi pomoshchi rabotnikam proizvodstv s opasnymi usloviiami truda.

The aim of the study were protocols of dental care in departmental sanatoriums for workers with hazardous working conditions (HWC). Provided dental care and staff features were analyzed in 10 sanatoriums basing on their annual 2016 reports. In Central Clinical Sanatorium 'Malakhovka' dental care need was assessed in 402 males (mean age 39.2±1.2 years) with HWC. The study results were used for guidelines of departmental 'Dental care in resort rehabilitation of workers with hazardous working conditions'.

[Optimization of the algorithm for the detection and the differential non-pharmacological correction of the risk factors and the preclinical stages of atherosclerosis at the level of the health resort-based primary care]. / Optimizatsiia algoritma vyiavleniia i differentsirovannoi nemedikamentoznoi korrektsii faktorov riska i doklinicheskikh stadii ateroskleroza v pervichnom zvene zdravookhraneniia na kurorte.

This article presents the results of a comparative prospective study of 276 subjects at the age between 40 and 65 years presenting with risk factors (RF) of atherosclerosis and its preclinical stages (APC). All of them were reckoned to be at a moderate risk of developing APC based on the results of evaluation with the use of the SCORE scale which implied the necessity of their differential non-pharmacological treatment during a two-year period with the application of a variety of preventive therapeutic strategies. The patients were allocated to three different (initially comparable) groups. The main group (group 1) was comprised of 98 subjects who received the optimized combined treatment including climatotherapy, dietary therapy, psychotherapy, hydrotherapy, physiotherapy, and hypoxytherapy; in addition, they were involved in the program of therapeutic physical exercises and in the educational program. The group of comparison (group 2) consisted of 88 subjects who were advised to withstand pernicious habits, to keep to the prescribed diet, and intensify the physical activity. The subjects included in the control group 3 were given no preventive treatment whatsoever. The optimized system for the early diagnostics and identification of the risk factors and/or ACD was employed for examining the members of group 1. By the end of the study, risk factors of atherosclerosis and APC were documented in 86.2% and 76.6% of the patients of group 1, respectively. The number of disability days averaged 7.2 per person versus 16.3 and 22.6 in comparison and control groups, respectively. There were no newly diagnosed cases of cardiovascular diseases (CVD) over the study period among the patients of group 1, in contrast to 11.4% and 25.6% such cases in groups 2 and 3, respectively. The results of this study give evidence that the optimized strategy of non-pharmacological correction of the risk factors and the preclinical stages of atherosclerosis at the level of the health resort-based primary care has advantages over the standard therapy because it makes it possible to reduce the frequency of development of new cases of cardiovascular diseases and to decrease the disability rate. It is concluded that the proposed approach enhances the effectiveness of primary prophylaxis of cardiovascular diseases associated with atherosclerosis and relieves the burden of this pathology. It can therefore be recommended for the more extensive application at the level of the health resort-based primary care settings.

[The fundamental principles behind the evaluation of the bioclimatic potential of the Alma-Ata health resort (Kazakhstan) for the medical purposes]. / Osnovnye printsipy otsenki bioklimaticheskogo potentsiala kurorta Alma-Ata (Kazakhstan) dlya meditsinskikh tselei.

This article reports the results of the analysis of long-term observations carried out at the Almaty health resort (Kazakhstan) with the purpose of evaluating of balneotherapeutic potential of this facility with special reference to the elucidation of its seasonal dynamics and characteristic of the comfort conditions for the inclusion into the program of spa and health resort-based treatment and climatic therapy programs.

[The prospects for the further development of the Belokurikha spa and health resort territory in the Altai Krai (region)].

We undertook a balneological survey of the Belokurikha spa and health resort territory with the purpose of distinguishing and identifying the potential health-improvement areas most promising for the extension and optimization of the therapeutic, tourist and recreational activities. The assessment was focused on the characteristic of the landscape and climatic conditions of the territory, the possibilities for the development of the existing resources of mineral waters and therapeutic muds as well as for the discovery of the potential new ones. The recommendations are proposed to promote the development of different forms of tourism with special reference to its medical and health-improvement aspects. It is suggested that the territory of the «Belokurikha¼ resort¼, «Belokurikha-2¼ and «Belokurikha-3¼ health-improvement areas should be integrated into a single spa-and-health resort district of federal importance.

[The topical problems of pediatric balneotherapy and the spa and health resort-based treatment of the children].

This article is devoted to the topical problems of pediatric balneotherapy with special reference to the organization of the spa and health resort-based treatment of the children in the Russian Federation. The main issues discussed by the authors include the current state of health resort care for the children, the problem of statutory regulation of the activities of the children's spa and health resort facilities, the approaches to increasing the availability of the spa and health resort-based treatment for the children at the enhanced risk of the development of chronic diseases, disabilities, and tuberculosis. Also considered are the problems of the development of the regulatory framework for the medical rehabilitation of the children based at the spa and health resort facilities. The principal goals to be sought in climatotherapy, physiotherapy, balneotherapy, and pelotherapy in the pediatric context are outlined along with the further prospects for the development of the main areas of pediatric balneology.

[Medical support of the Armed Forces of the Russian Federation: results of activity and tasks for 2016].

The author gives an analysis of activity of the medical service of the Armed Forces in 2015 concerning development of normative legal basis for the military health care, improvement of the level of operational and mobilization readiness of subunits of army group, and military-medical institutions, improvement of effectiveness of treatment and evacuation measures, health resort treatment, medical stuff training optimization, sanitary-and-epidemiologic support, material and technical support improvement, adoption of advanced scientific achievements focusing on medical care delivery to army group, active development and increase in medical information systems, telehealth. system. The author gives data characterizing state and level of development of medical service of the Armed Forces and its dynamics. Main tasks and parameters of development of the service in 2016 and up to 2020 are formulated.

[Analysis of Efficiency of the Standard of Sanatorium Care of Patients With Arterial Hypertension].

Analysis of efficiency of the standard of sanatorium care of patients with arterial hypertension is presented. Rates of arbitrary use of methods of care and their use in accordance with requirements of the standard were compared in patients with diferent results of treatment. It was found that existing standard was insufficiently adequate for application in the work of attending physician. Observance of requirements of the standard was associated with 93 ± 0.8% achievement of positive results. Rates of use of methods of care in groups of patients with positive and negative result of sanatorium stay were significantly different.

Heavy metal levels in dune sands from Matanzas urban resorts and Varadero beach (Cuba): Assessment of contamination and ecological risks.

Concentrations of chromium (Cr), nickel (Ni), copper (Cu), zinc (Zn) and lead (Pb) in dune sands from six urban and suburban Matanzas (Cuba) resorts and Varadero beach were estimated by X-ray fluorescence analysis. Ranges of metal contents in dune sands show a strong variation across the studied locations (in mg/kg(-1)): 20-2964 for Cr, 17-183 for Ni, 17-51 for Cu, 18-88 for Zn and 5-29 for Pb. The values of contamination factors and contamination degrees how that two of the studied Matanzas's resorts (Judio and Chirry) are strongly polluted. The comparison with Sediment Quality Guidelines shows that dune sands from Judio resort represent a serious risk for humans, due to polluted Cr and Ni levels, while sands from the rest of the studied resorts, including Varadero beach, do not represent any risk for public use.

[The use of a "buffet" style meals in the system of health-resort treatment].

The authors summarized literature sources, concerning modern ideas about the role of nutritional therapy in the system of health-resort treatment. The authors also made a research on the basis of literature, concerning health-resort nutrition divided into two systems-- buffet system and special-order system. On the basis of sanatorium establishments of the Ministry of Defense authors summarized an experience of clinical nutrition in different age groups and categories of patients. On the basis of current regulatory acts were defined forms and methods of meal catering in the Russian Federation. The results of the study are a scientific supposition for substantiation of management decision-making process, which allows to increase an efficiency of health-resort treatment via nutrition therapy.

[Normative legal aspects of health-resort treatment organization for military servicemen of the Armed Forces].

Normative legal aspects of health- resort treatment organisation for military servicemen oft he Armed Forces. The authors of the article gave an analysis of the main normative documents, regulating organization of health-resort treatment in the Russian Federation and the Armed Forces, and determining selection procedure, referral to health-resort institutions, indications and contraindications to health-resort treatment. The authors defined probable ways of improvement of normative legal regulation of health-resort treatment for military servicemen.

[Organization of health resort for the Armed Forces of the Russian Federation during peacetime].

Organization of health resort support for the Armed Forces of the Russian Federation during peacetime. The authors analysed legal documents and presented data on modern organization of health resort support in the Russian armed forces during peacetime, procedure of referral of military personnel and members of their families and other categories of citizens to health resort treatment and organized recreation. The authors showed the advantages of health resort treatment as a primary stage psychological rehabilitation of servicemen, including "preventive" rehabilitation, as evidenced by positive dynamics of indicators of health, and significant economic effect. Besides the authors determined prospective ways of improving health resort support in the Armed Forces.

Regulación de la expresión sexual de los mayores ingresados en residencias: la visión de los profesionales / Regulation of sexual expression in residential aged care facilities: a professional point of view

Introducción. El objetivo de este estudio es explorar la opinión que tienen los profesionales que trabajan en residencias sobre la regulación de la sexualidad en dichas instituciones. Material y métodos. Un total de 53 profesionales de 5 residencias del área metropolitana de Barcelona respondieron sobre si convenía regular la sexualidad en las residencias, los agentes que deberían contribuir a tal efecto y los aspectos que dicha regulación debería contemplar. Resultados. Alrededor del 50% de los participantes reconocieron la conveniencia de disponer de algún mecanismo para regular la sexualidad en las residencias que, de acuerdo con sus respuestas, debería ser elaborado teniendo en cuenta la opinión de los profesionales, pero también la de los residentes y la de sus familiares. Las normas aconsejables más mencionadas fueron garantizar que cualquier situación de tipo sexual ocurriera en un entorno privado y el desarrollo de estrategias para diferenciar a aquellas personas con demencia que pueden dar su consentimiento sexual de las que no. Conclusiones. La opinión de los profesionales que trabajan en residencias sobre la conveniencia de establecer mecanismos de regulación de la sexualidad parece estar bastante dividida. Así, mientras aproximadamente la mitad de ellos reconoce la potencial utilidad de tales mecanismos, la otra mitad los considera innecesarios o incluso perjudiciales para la libertad sexual de los residentes. La asociación de regulación a prohibición, y de sexualidad a práctica sexual fue común entre las respuestas de los participantes (AU)

Introduction. The purpose of this study is to determine the opinion of professionals working in residential aged care facilities on the regulation of sexuality in these settings. Materials and methods. Fifty-three professionals from five residential aged care facilities located in the metropolitan area of Barcelona answered several questions regarding the advisability of establishing measures for the regulation of sexuality in RACFs, the elements that could contribute to this, and the aspects that such regulations should consider. Results. Around 50% of the participants recognized the advisability of having some type of measures for sexuality regulation in residential aged care facilities. According to their responses this should be developed taking into account professional opinions, but also the points of view of the residents and their relatives. The most frequently mentioned regulations were those that ensured that any kind of sexually charged situation occurred in a private environment. The development of strategies are suggested to distinguish those people with dementia that are competent to consent to sexual acts from those who are not. Conclusions. The opinion of professionals working in RACFs regarding the advisability of establishing measures for sexuality regulation seems to be considerably divided. Thus, whilst around 50% of them recognize their potential usefulness, the other half consider them unnecessary or even counterproductive for the sexual freedom of residents. Associating regulation with prohibition and sexuality with sexual activity was not uncommon among the responses of the participants (AU)

Las residencias para personas con Trastorno Mental Grave como un recurso Terapéutico-Rehabilitador / The residences for persons with Several Mental Disorder as a Therapeutic-Rehabilitation resource

Introducción: El desarrollo de lugares de vida para personas con TMG está significando un factor importante en la consolidación de la atención comunitaria en Salud Mental. Las residencias deben considerarse como un lugar de rehabilitación psicosocial, al modificar una situación psicosocial disfuncional que influye negativamente en la calidad de vida y en la integración social del paciente. En esta línea se plantea el presente estudio con El objetivo: de evaluar la evolución de los residentes ingresados en las residencias Roger de Llúria, Tres Pins y Begur, (gestionadas por la Fundación de Salud Mental CPB), en sus dos primeros años de ingreso y poder definir los aspectos de mejoría en los usuarios. Material y Método: La muestra inicial es de 88 personas (usuarios ingresados durante los años. (2009- 2011). Se comparan las variaciones en el tiempo de ingreso psiquiátrico, la utilización de recursos de rehabilitación comunitaria, la estabilidad clínica, la realización de Actividades de la Vida Diaria (AVD) y la calidad de vida (desarrollo personal y social); tomando como valorares la información recogida durante el año anterior a su incorporación a la residencia y a los dos años de vinculación. Resultados y Conclusiones: Se puede afirmar que la estancia en las residencies favorece la estabilidad clínica del usuario, reduciendo el número de ingresos y su tiempo de estancia. El residente mejora en el funcionamiento general en las AVD, hábitos de salud y relaciones personales, recuperando su estatus de ciudadano, más activo y autónomo. La mejora en el ajuste social y ocupacional se refleja en el aumento de recursos de rehabilitación utilizados y la mayor participación en la vida comunitaria (tanto dentro como fuera de la residencia) (AU)

Introduction: The development of housing places for people with SMD is becoming an important factor in the consolidation of community care in mental health. Residences should be considered as a psychosocial rehabilitation place, modifying a dysfunctional psychosocial situation that negatively affects quality of life and social integration of the patient. In this line arises the present study in order to assess the evolution of the residents admitted to Roger de Llúria, Begur and Tres Pins residences (managed by the Mental Health Foundation CPB) in its first two years of admission to the mental health centre and being able to define improvement aspects on users. Material and Method: From an initial sample of 88 residents (admitted during the years 2009-2011). Comparing the variations during the required time of psychiatric admission, use of community rehabilitation resources, clinical stability, performing ADLs and quality of life (social and personal), taking as values the collected information during the year preceding their incorporation into the residence and the two years of relationship. Results: We could affirm that staying at residences favours users’ clinical stability, reducing the number of admissions and their length of stay. The resident improves in ADLs functioning, health habits and personal relationships, regaining his citizen ship status, more active and self-sufficient. The improvement in social and occupational residents adjustment is reflected in the increasing of rehabilitation resources used and a greater participation in community life (both inside and outside the residence) (AU)

[The role of standardization of the spa and resort-based treatment of the patients based at a neurological health resort].

The present paper was designed to summarize the experience with the standard use of the spa and resort-based treatment of the patients with the lesions in separate nerves, nerve roots and plexuses as well as polyneuropathies. It was shown that the existing standard helps to resolve certain marketing problems but is not sufficiently adequate for the choice of the set of therapeutic modalities on an individual basis. The importance of the correct choice of the combination of the methods for the treatment of neurological disorders and the achievement of the desired outcome of the disease is emphasized. The prognostically significant predictors of the effectiveness of the spa and resort-based treatment have been identified.

[The prospects for the development of therapeutic and health-promoting tourism in Gorny Altai].

The present balneological survey made it possible to identify the promising areas with a high potential for the health resort, recreational and touristic activities including the foothill, low-mountain, mid-mountain valleys and hollows of Northern, Northwestern, Central and Eastern bioclimatic provinces of Mountainous Altai. Recommendations have been proposed for the development of therapeutic and health-improving tourism in the Shebalinsk, Ust'-Kansk and Ulagansk districts of the Altai Republic.

[The basic system for the management of a spa and resort facility].

The authors propose the basic system for the management of a spa and resort facility that ensures functioning of all its divisions as an integrated process. It is maintained that organization of a spa and resort facility must include measures aimed at improving its working structure, material and technical resources, marketing plans, financial management, medical services, informational support, and personnel administration.