Ministry Of Labour Research Articles

რეცეპტის ინსტიტუტის დანერგვის გამოწვევები საქართველოს ჯანდაცვის ინსტიტუციურ განვითარებაში

Ministry of Labour, Health and Social Affairs realized reform from 1th february till 1th september in 2014 for prescription system implementation. According to these changes pharmaceutical products of second group becamethe prescription medicines. In Georgia, access to and supply Rx medicines is governed by a regulatory framework. Second group drugs are only available to the public when prescribed by doctors on new prescription form N 3. The aim of research is to reveal and evaluate positive and negative sides of new prescription system; to study it, sinfluence on achievement process to drugs. As part of the quantitative research, doctors and pharmacists of the medical institution were interviewed. As part of the qualitative research, in-depth interviews with healthcare experts were conducted. The special questionnaire was designed for each aimed group. The questionnaires consist of open and closed questions. The results of the study revealed the positive aspects of the Prescription Institute: with this reform, the system returned to the logic of normal clinical medicine; The role of the doctor in relation to the patient's pharmacotherapy has been strengthened; The competence of the pharmacist was included in the appropriate framework and the specific skills of selling medicinal products by prescription were developed; The culture of purchasing medicines with prescriptions has been established among the population; At the same time, the results of the research revealed such actual problems that are an obstacle to the introduction of the prescription institute: prescription drugs are sold without a prescription; In the doctor's offices opened next to the pharmacies, the doctor is limited to prescribing only prescriptions; In case of chronic or long-term diseases, patients' access to prescription drugs is complicated; Doctors do not have complete information about the dispensing mode of this or that pharmaceutical product from the pharmacy. Pharmacists talk about the lack of specific skills in prescribing prescriptions: in the case of more than one medicine prescribed on one prescription form, the prescription is cancelled; Prescriptions not certified with a seal are invalid; Incorrectly indicated generic name, inconsistency between generic and trade names, prescription of a combined pharmaceutical product with a generic name prolongs the service of the user; Incorrectly indicated course of treatment, drug release forms, medicinal dose are the cause of misunderstanding; e.g. A pharmacist is prohibited from selling a 10 mg tablet of the same name medicine instead of a specified 5 mg tablet. One of the goals of the reform planned by the Ministry of Health is the correct treatment, the reduction of the share of expenses on medicine and the harm caused by self-medication. It is too early to talk about these achievements within the framework of the conducted research, however, one of the details was revealed that will contribute to the reduction of expenses on medicines, namely: it is necessary to indicate the diagnosis in the prescription according to ACD-10; The doctor's prescription should always be consistent with the diagnosis; The institute of prescriptions should reveal the rationality of the prescription issued by the doctor, compliance with the guidelines, which will partially reduce the costs of medicines. The reform implemented in connection with the restoration and establishment of the Institute of Recipes in Georgia is a step forward. The medical community unequivocally welcomes this change. The competence and authority of the doctor increased; the specific rules for prescribing by a doctor and issuing prescription medication by a pharmacist are gradually being established. Along with the highlighted positive aspects, significant systemic errors and technical flaws are visible. The sale of drugs of the second group without a prescription is an obstacle to the introduction of the Institute of Prescriptions. At this stage, fining the pharmacy cannot solve the problem. The Ministry of Health considers the establishment of an electronic prescription system to eliminate this problem. The current activity of the "pharmacy" doctor also hinders the reform. Access to medicines for patients with chronic diseases is complicated. The existing classification of medicines has flaws. Recommendations Based on the conducted research, the following recommendations were developed: • Improving the administration of the prescription institute implementation process; • Study of the activities of "pharmacy" doctors by the Agency for the Regulation of Medical Activities; • Refinement of regulatory normative base, administration tools; • Revision of the classification of pharmaceutical products and periodically making rational changes taking into account the data of AMEA, WHO, PSUR; • In order to use medicines rationally, it is advisable to introduce a system of electronic prescriptions.

Annual trends of ophthalmic surgeries in Japan’s super-aged society, 2014–2020: a national claims database study

This study aimed to analyze the trends and factors influencing the number of ophthalmic surgeries in Japan using the open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan published by the Ministry of Health, Labour and Welfare. We calculated the number of cataract, glaucoma, and vitreoretinal surgeries, categorized by sex, age, and surgical type, for the fiscal years (FY) 2014 to 2020. The number of cataract surgeries remained stable at approximately 1.45 million cases from FY 2014 to 2018, increased to nearly 1.6 million cases in FY 2019, and decreased to 1.45 million cases in FY 2020. Among glaucoma surgeries, surgical treatments were increased 1.8 times over 7 years, from 33,000 to 60,000 cases. Laser treatment remained steady at around 55,000 cases from FY 2014 to 2017 and then increased to approximately 60,000 cases. The number of vitreoretinal surgeries was increased 1.2 times from FY 2014 to 2019, from 120,000 to 140,000, and decreased to 130,000 by FY 2020. Trends in ophthalmic surgeries over the past 7 years may be influenced by population aging, minimally invasive surgery, and the coronavirus disease pandemic. These findings have implications on surgical decision-making and resource allocation.

A Review of Registration and Approval Process of Medical Device in India and Japan

Today, millions of people rely on medical device-based treatment to manage and diagnose a variety of disorders. The regulatory requirements determine the device's quality and safety. Because of the enormous population and the potential severity of the consequences of introducing inferior and dangerous materials to the market, medical device production in India should be regarded seriously. As a result, a legislation including suitable guidelines for rules and regulations is required to monitor the introduction of such devices into public health use. Currently, the regulatory body CDSCO governs device regulation in India, and amendments to the law will give public health safety ensure over time. In Japan, pharmaceutical regulatory affairs are overseen by the Ministry of Health, Labor, and Welfare (MHLW or Koseirodosho in Japanese). Formal authorization and licenses obtained from the MHLW are required for drug marketing in Japan. The regulatory plans are one of the most difficult components of launching a medical device because every medical device is unique. Every significant market, such as India and Japan, has its own specific set of legal requirements. Understanding the critical need for national standardization in order to reduce regulatory burdens, ease commerce, and provide access to innovative technology requires more research.

Algorithm for expert rehabilitation assessment of autism syndrome in children

BACKGROUND: Despite the long-applied international classifications of diseases and disorders, in our country, no approved methodology has been approved for a comprehensive assessment of autism syndrome, considering categorical and dimensional approaches, age of the child, and polymorphism of symptomatology, which creates significant difficulties in diagnosis, determining the complex of rehabilitation measures, and assessing their effectiveness.
 AIMS: To develop an algorithm for the expert rehabilitation diagnosis of autism spectrum disorders (ASDs) in children with disabilities according to the domains of the International Classification of Functioning, Disability, and Health (ICF).
 MATERIALS AND METHODS: The study enrolled children recognized to have a disability for the first time due to autism in the St. Petersburg and Voronezh regions for 2016–2021. Data sources included state statistical reporting forms 7-D (sobes), acts and protocols of examinations, statistical maps, and data obtained from the Federal State Information System “Unified Automated Vertical Integrated Information and Analytical System”. The study is longitudinal and continuous. Analytical, documentary, data excavation, questionnaires, interviewing, statistical methods of research were employed. The methodology of the World Health Organization was used to study the functional profile according to the basic set for children with autism.
 RESULTS: Data on functioning and life activity limitations of children with autism-related disability were analyzed taking into account the clinical form of autism, age of the child (0–3, 4–7, 8–14, and 15–17 years), and presence of comorbid symptomatology according to the ICD-10 criteria (1992) and IFC domains (2001). The main predictors of the severity of autism manifestations were identified depending on the age of the child: 0–3 years, rates of psychomotor and speech development in epicrisis terms; 4–17 years, degree of deficit of social communication/social interaction; and assessment of limited stereotypical forms of behavior. In children aged 3 years, comorbid symptomatology was also assessed, taking into account the use of psychometric scales and research methods approved in the Russian Federation. Predictors of autism severity were translated into expertly significant domains of the basic set of the ICF for ASDs. Quantitative assessment was performed in a unified format using ICF qualifiers comparable to the system of quantitative assessment adopted in medical and social expertise.
 CONCLUSIONS: The results of the study allowed us to converge international and domestic standards of assessment of impaired functions and limitations of life activity in autism using the order of the Ministry of Labor of Russia № 585n as a ranking tool to translate the data on the functioning and life activity limitations of children with disability into the ICF determinants. The developed algorithm for expert rehabilitation diagnostics of autism syndrome is an important criterion for expert diagnostics, determining complex rehabilitation measures and evaluating the effectiveness of rehabilitation measures.

Identify adolescents' help-seeking intention on suicide through self- and caregiver's assessments of psychobehavioral problems: deep clustering of the Tokyo TEEN Cohort study

Psychopathological and behavioral problems in adolescence are highly comorbid, making their developmental trajectories complex and unclear partly due to technical limitations. We aimed to classify these trajectories using deep learning and identify predictors of cluster membership. We conducted a population-based cohort study on 3171 adolescents from three Tokyo municipalities, with 2344 pairs of adolescents and caregivers participating at all four timepoints (ages 10, 12, 14, and 16) from 2012 to 2021. Adolescent psychopathological and behavioral problems were assessed by using self-report questionnaires. Both adolescents and caregivers assessed depression/anxiety and psychotic-like experiences. Caregivers assessed obsession/compulsion, dissociation, sociality problem, hyperactivity/inattention, conduct problem, somatic symptom, and withdrawal. Adolescents assessed desire for slimness, self-harm, and suicidal ideation. These trajectories were clustered with variational deep embedding with recurrence, and predictors were explored using multinomial logistic regression. Five clusters were identified: unaffected (60.5%), minimal problems; internalizing (16.2%), persistent or worsening internalizing problems; discrepant (9.9%), subjective problems overlooked by caregivers; externalizing (9.6%), persistent externalizing problems; and severe (3.9%), chronic severe problems across symptoms. Stronger autistic traits and experience of bullying victimization commonly predicted the four "affected" clusters. The discrepant cluster, showing the highest risks for self-harm and suicidal ideation, was predicted by avoiding help-seeking for depression. The severe cluster predictors included maternal smoking during pregnancy, not bullying others, caregiver's psychological distress, and adolescent's dissatisfaction with family. Approximately 40% of adolescents were classified as "affected" clusters. Proactive societal attention is warranted toward adolescents in the discrepant cluster whose suicidality is overlooked and who have difficulty seeking help. Japan Ministry of Health, Labor and Welfare, Japan Agency for Medical Research and Development, and Japan Science and Technology Agency.

Investigation on the accumulation of background and pregnancy outcome information on cases consulted by the Japan Drug Information Institute in Pregnancy.

Since pregnant women are excluded from clinical trials, it is essential to accumulate post-marketing information to evaluate the effects on the fetus of medication use during pregnancy. The Japan Drug Information Institute in Pregnancy (JDIIP) was established at the National Center for Child Health and Development as a Ministry of Health, Labour, and Welfare project to provide patients with information and conduct follow-up surveys. In this study, we investigated the status of the accumulation of JDIIP consultation cases to identify issues for enhancing clinical information appropriate for use during pregnancy and to examine how information should be collected and provided. In addition, the status of descriptions of Japanese package inserts, which are representative of those used by healthcare professionals as a source of information, was confirmed for medications used by JDIIP consultation cases. The characteristics of the JDIIP consultation cases information were that the contents that needed to be adjusted when evaluating the effects on the fetus of medication use during pregnancy were obtained. In addition, the follow-up rate was 83.1%. However, although the number of consultation facilities has increased, the number of consultations has not, indicating the need to further increase the number. It was found that there is limited information on epidemiological studies of clinical use in Japanese package inserts. To improve clinical information on the appropriate use of medications during pregnancy, it is necessary to accumulate more information in the future, and it is considered necessary to consider new approaches utilizing the JDIIP system.

The Effect of Job Burnout on Generating Organizational Silence - an Analytical Study in the Ministry of Labor and Social Affairs

Diagnosing the nature of the correct relationship between the variables studied (functional burnout, organizational silence) for their expected relationships after testing them empirically at the level of the sample studied within the research community. The research was conducted in the Iraqi Ministry of Labor and Social Affairs, and (100) questionnaires were distributed to employees working in the ministry. At the middle and lower organizational levels, the questionnaires were collected and analyzed statistically by adopting the ready-made data package (SPSS V26), using several statistical tools, including the arithmetic mean, median, standard deviation, and confirmatory factor analysis. And social affairs, they feel satisfied with their job, self-confidence, high morale, and willingness to work with vigor and activity. Accordingly, the researcher recommends the ministry continue on the same path of interest in providing a work environment based on cooperation and good communication between it and the workers.

Designing in students’ training in the field of law

According to the Ministry of Labor and Social Protection of the Russian Federation, there is an opinion among leading employers that only 8 % of professional educational organizations graduates are fully prepared to perform their job duties. Modern economy, especially in the stage of import substitution and sanctions, requires a strong and highly qualified competitive employee. Modern vocational education has special requirements, it needs transformation. Professional competencies of modern graduates continue to be the center of attention. Continuous development of techniques and technologies requires mobility, flexibility, and timely actualization from professional education. The study analyzes experience of Law project training of students as a way to increase the demand for law graduates in labor market. The analysis has been conducted on legal specialists training.

Association Between Changes in Alcohol Consumption Before and After the Great East Japan Earthquake and Risk of Hypertension: A Study Using the Ministry of Health, Labour and Welfare National Database.

The 2011 Great East Japan Earthquake has resulted in a nuclear accident, forcing residents of the surrounding areas to evacuate. To determine any association between excessive drinking and hypertension in the setting of disaster, we assessed whether the proportion of excessive drinkers increased and if post-disaster excessive drinking was a risk factor for hypertension. This retrospective study assessed data from the Japanese National Database. Cumulative population data for Fukushima Prefecture (3,497,576 people) were analyzed by categorizing residents into four areas-evacuation, coastal, central, and mountainous-to calculate the proportion of excessive, heavy (equivalent to binge drinking), and at-risk drinkers for 2008-2017. The hazard ratios (HRs) for the incidence of hypertension for 2012-2017 were examined in association with changes in drinking status pre- and post-disaster, which included 136,404 people who received specific health checkups pre-disaster (2008-2010) and post-disaster (2011-2012). The proportion of excessive drinkers among women increased after the disaster in all areas examined. The association between excessive drinking and the incidence of hypertension was determined among men and women in all areas; it was stronger among women in the evacuation areas, with the sex- and age-adjusted HRs for the incidence of hypertension of 1.41 for pre-disaster excessive drinking, 2.34 for post-disaster excessive drinking, and 3.98 for pre- and post-disaster excessive drinking, compared with not excessive drinking pre- and post-disaster. Excessive drinking post-disaster may be associated with an increased risk of hypertension among men and women, especially among women in the evacuation areas.

Pathophysiology of Childhood-Onset Myasthenia: Abnormalities of Neuromuscular Junction and Autoimmunity and Its Background.

The pathophysiology of myasthenia gravis (MG) has been largely elucidated over the past half century, and treatment methods have advanced. However, the number of cases of childhood-onset MG is smaller than that of adult MG, and the treatment of childhood-onset MG has continued to be based on research in the adult field. Research on pathophysiology and treatment methods that account for the unique growth and development of children is now desired. According to an epidemiological survey conducted by the Ministry of Health, Labour and Welfare of Japan, the number of patients with MG by age of onset in Japan is high in early childhood. In recent years, MG has been reported from many countries around the world, but the pattern of the number of patients by age of onset differs between East Asia and Western Europe, confirming that the Japanese pattern is common in East Asia. Furthermore, there are racial differences in autoimmune MG and congenital myasthenic syndromes according to immunogenetic background, and their pathophysiology and relationships are gradually becoming clear. In addition, treatment options are also recognized in different regions of the world. In this review article, I will present recent findings focusing on the differences in pathophysiology.

Management of change and its reflection in the job performance of employees - research in the Ministry of Labor and Social Affairs

Management of change and its reflection in the job performance of employees - research in the Ministry of Labor and Social Affairs

A Trial of Practical Training on Online Medication Instructions in Clinical Preparatory Education: Development of Human Resources to Provide New Forms of Medical Care after the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic has considerably affected several social services. The Ministry of Health, Labour, and Welfare has partially revised the Pharmaceuticals and Medical Devices Law and established legislations on permanent online medication instructions. Based on these social needs, the development of human resources to provide online medication instructions is vital. Therefore, we developed a training program for providing online medication instructions in preparatory clinical education. Pharmacy students who had conducted medical interviews with standardized patients participated in the training. Educational outcomes were evaluated using an objective multiple-choice test and free description before and after practical training. The median number of correct answers on objective tests on the legislation on online medication instructions increased significantly. Based on the free description analysis, students were able to comprehend the influence of communication environment on the quality of medication instructions. Based on the results of the direct evaluation using objective testing and indirect evaluation by analyzing the free descriptions, they also acquired the skills necessary for providing online medication instructions. Therefore, this training program can contribute to mastering the provision of online medication instructions.

Review of a Series of Surveys on Adverse Reactions to the COVID-19 mRNA-1273 Vaccine at Okayama University.

This paper presents the results of a series of surveys conducted from July 2021 to March 2023 to investigate the post-vaccination adverse reactions to the mRNA-1273 (Moderna) vaccine among faculty, staff, and students at Okayama University. These studies complement the official surveys conducted by the Ministry of Health, Labour and Welfare (MHLW) and provide a more representative picture of adverse reactions in the general population including large numbers of healthy young people. Pain, swelling, redness at the injection site, fever, headache, and malaise were the main adverse reactions reported. The proportion of adverse reactions was generally higher after the second vaccination and decreased with each additional vaccination. No statistically significant differences in the adverse reactions were found for males and females and those with/without a history of allergy, but a lower proportion of fever was observed in older participants and those with underlying medical conditions. We also evaluated the association between adverse reactions and antibody titers after the third vaccination and found no significant differences in antibody levels one month after vaccination. This series of studies highlights the importance of conducting surveys in diverse populations to provide a more representative picture of post-vaccination adverse reactions during a pandemic.

Causes of Countermeasures Against Serious Accidents Caused by Health Hazards of Chemical Substances, Based on Cases of Occupational Accidents in Japan

The purpose of this study was to summarize the typical and specific causes and risk reduction measures of serious accidents in Japan caused by chemical substances in terms of the 10 types of human health hazards in the UN GHS (Globally Harmonized System of Classification and Labelling of Chemicals) classification. The list of "Cases of Major Accidents Caused by Chemical Substances" published on the "Safety in the Workplace Website" of the Ministry of Health, Labor and Welfare (MHLW) was linked to the "Results of GHS Classification by the Government" of the National Institute of Technology and Evaluation (NITE). Analysis was conducted by health hazards in order to obtain reference examples of measures taken against health hazards in response to the revision of the law on autonomous chemical substance management in 2022. Using the text mining tool KH Coder ver. Three using cluster analysis, we grouped causes and measures among serious disasters by health hazard, illustrated co-occurrence networks, and extracted typical examples of each in a co-occurrence network. Representative causes of and measures against occupational accidents caused by health hazardous properties were summarized from the extracted typical cases. Although few occupational accidents were caused by the health hazards of chemicals, when all health hazards were classified into acute toxicity, acute health hazard, and chronic health hazard, contact was a clear cause for many of the acute toxicity and acute health hazards, such as corrosiveness and sensitization. However, many occupational accidents were caused by the physical hazardous aspects of the chemical substances or by the safety aspects of the workplace. Causes of occupational accidents due to health hazards included unsafe behavior and unsafe conditions, or lack of understanding of the physicochemical properties of a substance and specific reactions such as mixing or hydrolysis of the substance. Typical risk reduction measures for health hazards included equipment to prevent human contact with health hazardous substances, systems to control unsafe behavior, promoting understanding of chemical reactions, and providing information about chemicals to all persons involved in testing, research, and subcontract work. The data of occupational accident cases of "death or more than 4 days lost from work" were used. Most of the cases were related to acute health hazards, but relatively few to chronic health hazards, and few occupational accidents were caused by health hazards. Most of the occupational accidents were caused by health hazards due to the physical hazards of chemical substances and inadequate workplace safety. In light of the above, it is necessary in autonomous chemical substance management to first take risk reduction measures for workplace safety and chemical physical hazards, then to prevent contact with acute toxicity and acute health hazards such as corrosiveness and sensitization, and, lastly, to take risk reduction measures for chronic health hazards, using allowable concentrations and controlled concentrations as indices.

일본에서 사회보장의 아동복지에 관한 연구

The Child Welfare Act aims to ensure the welfare of children so that they can be born healthy and grow up happily and safely. Japan's right to social security has been developed through the reorganization of various social security law-related systems, and the Child Welfare Act has also been institutionalized through various efforts to actively respond to society's demand for child welfare. Therefore, in this study, we would like to examine the Child Welfare Act among Japan's social security rights and find its implications for Korea.
 In accordance with the Child Welfare Act, Japan operates premature birth facilities, nursing care children's facilities, disabled child detention facilities, and maternal and child support facilities for pregnant women, and also introduces a foster parent system. Public involvement in the operation of facilities is high, and the role and responsibility of the state, metropolitan local governments, and basic local governments are clarified for the installation or operation of facilities and the implementation of child protection policies. In addition, in order to efficiently and integrally promote child welfare-related policies, the Ministry of Health, Labor and Welfare established the Child and Family Office in April 2023 for child abuse and transferred it to the direct agency of the Prime Minister.
 Child welfare in Korea is similar to Japan, but there is no dedicated department that acts as a control tower to oversee child welfare because ministries are separated from child welfare targets such as the Ministry of Health and Welfare, the Ministry of Gender Equality and Family, and the Ministry of Education. Children's guardians should raise children healthy and safe at home according to the developmental stage, and the state and local governments should take necessary measures to prevent children from being discriminated against, such as religion, property, or disability of their parents. In order to realize such child welfare, it is urgent to establish an integrated dedicated department, expand child protection facilities, and overhaul a careful and balanced system to implement effective policies suitable for changes in social structure. In this respect, the establishment of the Child and Family Agency in Japan has great implications for Korea.

건설업 안전관리자 인식도 조사를 통한 스마트안전기술 활성화 방안

To prevent accidents in the construction industry, the government is using smart safety technologies such as ICT and IoT to increase efficiency by digitization and automating existing safety management methods. However, at the present time, where quantitative effectiveness has not been shown, such as overlapping policies divided between the Ministry of Land, Infrastructure and Transport and the Ministry of Employment and Labor, and the reduction of accident rates due to the introduction of smart safety technology, a revitalization plan is needed through a survey of awareness of smart safety technology. In order to derive measures to revitalize smart safety technology in the construction industry from the government, developer, and construction company perspectives, survey items were determined through visits and brief interview targeting smart safety experts, construction company headquarters, and field workers. The general survey items and smart safety technology introduction and application groups were classified into groups, and a population was selected targeting safety managers at construction sites across the country, and a survey was conducted using a self-administered survey method. Research results: First, as a result of the survey on awareness, introduction status, and effectiveness of smart safety technology, the effectiveness of smart safety technology introduction and application was found to be high. Second, “Construction machinery and equipment access warning system” was the highest among the smart safety technologies currently operating and scheduled to be introduced in the future by groups that are currently introducing and operating smart safety technologies. Third, in terms of excellence in smart safety technology, “Easy to monitor work situation” was the highest, and excellent results were also found in groups that have not currently introduced smart safety technology at construction sites but are planning to introduce it in the future. Fourth, in terms of lack of effectiveness and ways to improve the effectiveness of smart safety technology, “introduction of technology that does not suit the construction site situation” was analyzed the most highly, and the same result was analyzed for groups that are currently not introducing smart safety technology to construction sites but are planning to introduce it in the future. It has been done. As a way to address the problems of introducing and applying smart safety technology and to prevent disasters, the government provides active education and promotion, produces and distributes smart safety technology guidelines that can be applied to each construction type, and provides clear guidelines so that owners and constructors can clearly understand them.
 Specific settlement method for the use of smart safety technology, development of customized smart safety technology for practical introduction by type of work, preemptive and quick solution of after-sales service problems for developers, management of smart safety technology at the construction company headquarters level and clarification of work scope for each person in charge and labor cost support, continuous It was concluded that measures such as improving managers' awareness through education are necessary.

Analysis of the need for rehabilitation measures for children with disabled living in boarding schools in Moscow

BACKGROUND: The low efficiency in restoring impaired functions and overcoming of limitations in daily activity in children with disabilities living in children’s psychoneurological boarding houses in Moscow determined the relevance of the study.
 OBJECTIVE: The study aimed to examine the contents of individual rehabilitation or habilitation programs developed in the Federal State Institution “Main Bureau of Medical and Social Expertise in the Moscow Region” of the Ministry of Labor of Russia for 2019–2021 for disabled children living in children’s psychoneurological boarding houses and determine the need for rehabilitation services to make changes and additions.
 MATERIALS AND METHODS: The study included a population of disabled children in the Moscow’s children’s homes (n=843) (sources: certificates of examination, individual rehabilitation or habilitation programs for 2019–2021, and statistical reporting forms № 7-D [Sobes]). An analysis of the contents of individual rehabilitation or habilitation programs and the need for rehabilitation measures was conducted.
 RESULTS: The contingent of children with disabilities living in children’s psychoneurological boarding houses included children with varying degrees of disability, resulting from persistent disorders impairing body function. The dynamics of 2019–2021 revealed need for complex rehabilitation, including medical, sociopsychological, and sociocultural rehabilitation measures.
 CONCLUSION: The obtained data indicate the need to study ways to improve the effectiveness of rehabilitation measures to assess implementation results at each stage and their timely actualization.

Ophthalmopatology as a cause of primary disability in the adults of Krasnoyarsk region: A 15-year (2007–2021) overview

BACKGROUND: Understanding the dynamics and regional features of primary disability formation is crucial for developing organizational and managerial measures to improve the provision of medical care and the system of rehabilitation measures to reduce the level of disability in the population.
 OBJECTIVE: The study aimed to assess the state and dynamics of primary disability due to ophthalmopathology in the adult population of the Krasnoyarsk Region from 2007 to 2021.
 MATERIALS AND METHODS: Data sources include forms № 7-SOBES (Information on the medical and social examination of persons aged 18 years and older), statistical collections of the Federal State Budgetary Institution Medical and Social Expertise of the Ministry of Labor of Russia, and reporting documents of the Main Bureau of Medical and Social Expertise in Krasnoyarsk territory from 2007 to 2021. The comparative characteristics of the analyzed data were carried out for three periods: 2007–2011, 2012–2016, and 2017–2021.
 RESULTS: For 2007–2021, 5,708 people were recognized as disabled for the first time due to the pathology of the eye. The dynamics of primary disability was characterized by unevenness. The values of the intensive indicator of primary disability ranged from 1.7 to 2.6 (mean 1.9) per 10,000 population aged 18 and above. Among those initially recognized as disabled, individuals at retirement age prevailed with an increased instance of 8.5% every subsequent five years. People with disabilities were mainly residents of the cities in the region. Compared with 2007–2011 and 2012–2016 in the last 5 years, the share of IDPs in groups I and II increased (27.1% [524/1,930] and 43.4% [837/1930]), while the proportion people with disabilities of group III decreased (29.5% [569/1930]). The leading cause of disability was glaucoma (32.0% [606/1,891], 30.1% [569/1,887], and 31.1% [599/1,930] in groups I, II, and III, respectively). Second place in the list is occupied by age-related macular degeneration (15.7% [298/1,891], 20.3% [383/1,887], and 27% [522/1,930] in groups I, II, and III, respectively), and the third is myopia (14.1% [268/1,891], 11.2% [211/1,887], and 11.9% [231/1,930] in groups I, II, and III, respectively).
 CONCLUSION: The dynamics of primary disability due to eye pathology in the adult population of the Krasnoyarsk Territory in 2007–2021 are variable, partly associated with an increase in the number of people with disabilities of retirement age. There was an increase in disability groups during 2017–2021. Therefore, improving the efficiency of preventive medicine and providing the region with medical personnel can help reduce the level of primary disability in the region.

525. Comparison of the acceptability and safety of molnupiravir in COVID-19 patients aged over and under 80 years

Abstract Background Molnupiravir is being widely used as a treatment for coronavirus disease 2019 (COVID-19); however, its acceptability and safety in older patients aged ≥ 80 years in real-world clinical practice is not well understood. Methods We conducted a single-centre retrospective study and assessed the outcome of patients with COVID-19 treated with molnupiravir according to the following criteria: (A) discontinuation rate of molnupiravir; (B) type, frequency, and severity of adverse events; (C) all-cause mortality within 30 days of the diagnosis of COVID-19. Results Forty-seven patients (46.1%) were aged ≥ 80 years (older patients) and 55 (53.9%) were aged < 80 years (younger patients). There were no significant differences in coexisting diseases and history of vaccination for COVID-19 between older and younger patients. Older patients were significantly more likely to have moderate disease (moderate 1 and 2) according to the Japanese Ministry of Health, Labour and Welfare classification than younger patients. During treatment, 8.5% of older patients and 1.8% of younger patients stopped taking molnupiravir, but the difference was not significant. Adverse events were observed in 39/102 (38.2%) patients. The most common adverse events were diarrhoea (9.8%), exacerbation of coexisting diseases (6.9%), bone marrow suppression (6.9%), liver dysfunction (5.9%), and loss of appetite (4.9%). Most adverse events were minor, ranging from grades 1 to 3. The all-cause mortality rate was 10.8%, and no molnupiravir-related deaths were observed. Conclusion Molnupiravir treatment is acceptable and safe in older patients with COVID-19 aged ≥ 80 years. Disclosures All Authors: No reported disclosures

Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital

BackgroundThe World Health Organization (WHO) defines Preterm Birth (PTB) as “a live birth taking place before the expected 37 weeks of gestation”. Annually, approximately 15 million infants are born prematurely, constituting significantly to infant mortality during the initial four weeks of life, responsible for 40% of deaths among children under the age of five. Evidently, preterm deliveries have contributed to 46% of admissions to the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH) over the past three years. Paradoxically, while the prevalence of preterm births remains high, there is a lack of documented information regarding the underlying risk factors. Consequently, the primary objective of this study was to assess the potential risk factors associated with preterm birth at LRRH.MethodsAn analytical cross-sectional research was undertaken at LRRH, employing a quantitative methodology. The study utilized secondary data obtained from a total of 590 comprehensive maternal medical records, of deliveries that occurred at the facility between April 2020 and July 2021. The collected data underwent analysis using STATA version 17 software. To identify predictors of preterm birth, a Logistic regression model was applied, yielding adjusted odds ratios (AOR) alongside 95% confidence intervals (CI). The significance level was set at p < 0.05 to establish statistical significance. Furthermore, assessments for multicollinearity and model fitness were conducted using the Variance Inflation Factor (VIF) and linktest, respectively.ResultsThe prevalence of preterm delivery among mothers who gave birth at LRRH stood at 35.8%. The outcomes of logistic regression analysis revealed that maternal employment status had a statistically significant association with preterm birth (AOR = 0.657, p = 0.037, 95%CI: 0.443–0.975); having a baby with low birth weight (AOR = 0.228, p < 0.001, 95% CI: 0.099–0.527) and experiencing preeclampsia (AOR = 0.142, p < 0.001, 95% CI: 0.088–0.229) were also identified as significant predictors of preterm birth in the study.Conclusions and recommendationsThe occurrence of preterm delivery is significantly higher (35.8%) among mothers who gave birth at LRRH when compared to the national average (13.6%). The prevalence of preterm birth among mothers was linked to factors such as employment status, delivery of low birth weight infants, and the presence of preeclampsia. Consequently, the research proposes a set of recommendations. Firstly, the Ministry of Health (MoH) should evaluate the present state of readiness within the healthcare system to effectively handle cases of preterm birth both within medical facilities and the community. Secondly, the Ministry of Gender, Labour, and Social Development should leverage Labor Officers to implement and uphold the regulations stipulated in the Employment Act and Labor Laws.