Medical Volunteers Research Articles

RE-AIM evaluation of accreditation process in Turkey

BackgroundEffects of accreditation on various areas of medical education were studied in literature. However, data about comprehensive evaluation of accreditation activities is limited. This paper aims to present how an accreditation agency self-evaluates its own accreditation activities.MethodsAssociation for Evaluation and Accreditation of Medical Education Programs (TEPDAD) is an accreditation agency in Turkey. RE-AIM evaluation framework was used to evaluate TEPDAD’s activities. The accreditation processes were evaluated through indicators set for each of five RE-AIM evaluation framework dimensions (reach, effectiveness, adoption, implementation and maintenance). Data for evaluation for each dimension were gathered from the documents available in TEPDAD website and archives. Qualitative and quantitative analysis methods were used when necessary to investigate the degree of achievement for each indicator.ResultsSeventy-five (83%) of 90 medical schools meeting the application criteria are registered in the accreditation system. Effectiveness analyses revealed that medical education programs improved in eight areas (education program, student representation, documentation, assessment, infrastructure/facilities, faculty development, educational management). Accreditation processes were well adopted by medical schools and TEPDAD volunteers. The number of medical education programs registered in the accreditation system has gradually increased over years. For the accreditation implementation process, medical schools and TEPDAD evaluators provided positive feedback. Medical schools and TEPDAD invested efforts to maintain the accreditation process over time and changing conditions. All of the previously accredited schools have applied for reaccreditation for the second or third cycles to maintain their status. TEPDAD has maintained its recognition status by national and international authorities by several times. The accreditation standards have been continuously reviewed and renewed when necessary. The organizational structure of TEPDAD has been changed in time considering feedback and past experiences. TEPDAD also arranges meetings to promote and maintain its activities.ConclusionsTEPDAD has achieved significant success in terms of reaching majority of the Turkish medical schools, leading to prominent developments in medical education programs without any significant problems related to process, procedures and maintenance. There are still areas of improvement for TEPDAD such as reaching all targeted schools and guiding medical schools to improve quality in diverse elements of medical education programs.

The Motivation and Sense of Meaning of College Student Volunteers in Nanjing Medical College Research on the Relationship with the Persistence of Voluntary Behavior

College student volunteers are an important part of China's volunteers, and medical college student volunteers play an indispensable role in earthquake relief, health assistance and other volunteer activities due to their medical professional knowledge and background. As of 2021, the number of medical students volunteers in China has reached 37,000, and while the team is growing, the team construction of volunteers is also facing a series of problems, such as the lack of sustainability of volunteer behavior, which also restricts the sustainable development of volunteer service in China. The study came to the following conclusions: (1) There was a positive correlation between the motivation of medical college students and the sense of meaning of work. (2) There was a positive correlation be-tween the participation motivation of medical college students and the persistence of volunteer behavior. (3) There was a positive correlation between the sense of meaning of work and the persistence of volunteer behavior. (4) The sense of meaning of work of college student volunteers played a mediating role in the relationship between participation motivation and the persistence of volunteer behavior. Based on the research, this paper proposes strategies to boost medical students' service motivation and work meaning, fostering sustainable volunteer behavior and stabilizing the volunteer base.

The Use of Diabetes Educational Videos for Enhancing Medical Student Volunteers’ Patient Education Skills at a Student-Run Clinic

The Use of Diabetes Educational Videos for Enhancing Medical Student Volunteers’ Patient Education Skills at a Student-Run Clinic

Haplotype-based Analysis of 6q24-25 for Association with Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a multisystem inflammatory disorder. Family history of RA is an important risk factor as it is strongly linked with the inherited HLA-DR4 (most specifically DR0401 and 0404). The aim of this study is to conduct the haplotype-based analysis of 6q24-25 and evaluate its association with RA. Case-control study which included all patients attending outpatient department (OPD) at Sardar Patel Medical College, Bikaner, Rajasthan and volunteers (only for blood samples). Blood samples of patients were collected. As per inclusion and exclusion criteria, a total of 103 subjects lacking history of disease were included under control group, while 48 cases were recruited as study group. Any significant departure of genotype distribution is evaluated using Hardy-Weinberg equilibrium by Chi-squared test. Case-control association was done using data from 151 genomic deoxyribonucleic acid (DNA) samples, which were allele typed. RA is significantly associated with >305bp (the longer allele of D6S1053 corresponding to 11 tetramer (GATA) repeats. Differences in individual allele frequency within the control population and RA cases were observed which shows the bimodal distribution of the 10 alleles of D6S1053 short tandem repeat (STR) marker observed in the cohort tested by us. No significant association with the risk for RA is shown by the allele for D6S1053 and the mutant allele 118G. Similarly, OPRM1 gene's haplotype frequency for rs1799972 for D6S1053 allele has not shown any added risk with the wild allele 17C compared to controls. The polymorphism showed that 17T depicted a higher odds ratio of 1.3 with an associated risk of 1.15 in the presence of longer allele of DS61053. Significance observed between short allele and RA was lost when haplotype analysis for the two genes were taken together. There was no difference observed between the short or long allele and 17T/C while there was a significant difference observed when haplotype frequencies were compared with alleles of A118G and the long and short allele of DS61053. We concluded that the short allele of µ-opioid receptor (MOR) gene offered a clear protection from a risk of getting RA.

To the history of formation of medical volunteering in Russia: from ancient Russia to modern Russia

To the history of formation of medical volunteering in Russia: from ancient Russia to modern Russia

의료봉사프로그램이 간호대학생의 간호전문직관, 자기효능감, 셀프리더십, 전공만족도 및 봉사활동만족도에 미치는 효과

Purpose: This study attempted to determine the effects of a healthcare volunteer program on nursing students’ professionalism, self-leadership, self-efficacy, major satisfaction, and volunteer activity satisfaction. Method: This study collected data before and after the implementation of a healthcare volunteer program consisting of 4 hours of education including 3-hour lecture and 1-hour practice, and 70 hours of medical volunteer activities over a period of 2 months from January to February 2024. The subjects who participated in this study were 55 freshmen and sophomore in nursing students. The effectiveness of the program was analyzed using the IBM SPSS WIN program, and the effects of nursing professional intuition, self-leadership, self-efficacy, and major satisfaction were analyzed using paired t-tests, and volunteer activity satisfaction was analyzed using mean and standard deviation. Results: In this study, the experimental group's nursing professionalism increased from 115.35±11.85 points to 122.91±12.46 points (t=3.26, p=.002), and self-leadership increased from 64.27±7.16 points to 66.98±7.41 points (t=2.10, p=.041), self-efficacy increased statistically significantly from 65.69±8.70 points to 69.45±10.45 points (t=2.31, p=.025). However, major satisfaction increased from 24.24±3.75 points to 24.78±4.06 points, but there was no statistically significant difference (t=0.72, p=.472). In this study, volunteer activity satisfaction was 96.90±13.67 points, which when converted to a perfect score of 100, was 86.52 points. Conclusion: The results shows volunteer activities at medical institutions can increase nursing students' professionalism, self-leadership, and self-efficacy before clinical practice. Therefore, we suggest volunteer work at medical institutions to increase nursing students' professional intuition, self-leadership, and self-efficacy.

Welcoming new neighbors: Minnesota's rapid response model to address the urgent health needs of Afghan newcomers, 2021-2022.

As a result of the United States withdrawal from Afghanistan in fall 2021, 1,260 Afghan evacuees arrived in Minnesota between October 2021 and February 2022. Several contextual factors including an overtaxed health system under duress from COVID-19 and uncertain benefit eligibility prompted a coordinated public health response to appropriately address the acute and pressing medical concerns of our new neighbors. This community case study describes the State of Minnesota's cross-sectoral response that created a welcoming environment, identified public health concerns, and addressed acute medical needs. Medical volunteers provided an initial health and safety check for Afghan families upon arrival. Volunteers also offered onsite culturally and linguistically appropriate mental health assessments, group therapy, women's clinics, vaccine clinics, medication refills, and ongoing walk-in primary care. Care coordinators facilitated primary care and specialty care referrals. The majority (96%) of eligible arrivals were screened as part of this response and the median time between arrival to Minnesota and initial health screening was 2 days. Half of all arrivals screened reported at least one health concern and 56% were referred to a specialty for further evaluation. Almost one in four adults (24%) reported mental health concerns. Existing partnerships across local sectors can be leveraged to provide comprehensive physical and mental health services to newcomers in an emergency response.

A Call for Protection of Medical Workers and Volunteers

A Call for Protection of Medical Workers and Volunteers

Exploring Divergent Views: A Comparative Study of Uterus Transplantation Perceptions among Transplant and Obstetrics/Gynecology Providers.

Background: Uterus transplantation (UTx) provides women with absolute uterine-factor infertility (AUFI) the opportunity to carry their own pregnancy and deliver a child. There are multiple ethical and medical concerns associated with UTx. Since the last survey of US provider perceptions of UTx in 2018, there have been additional reports of successful transplantations and pregnancies. This study aimed to identify the perception of UTx among providers involved in the diagnosis of AUFI and on the transplant team to help us understand knowledge gaps and determine what barriers must be overcome for UTx to be used in general clinical practice. Methods: We administered REDCap surveys to conference attendees at the 2023 American College of Obstetricians and Gynecologists (ACOG) conference and 2023 American Transplant Congress (ATC). Participants were recruited by medical student volunteers. Results: Two hundred ACOG and ATC attendees completed the survey. Medical concerns related to UTx were reported by 42% of providers from ACOG compared to 22% of providers from ATC. Overall, 76% of participants agreed that UTx should be an option for patients with congenital AUFI. Lastly, 68% of participants agreed that the procedure should be presented as an option for transgender women. Conclusions: This study further elucidates the perception of UTx among obstetricians/gynecologists and transplant physicians. We found greater support for the procedure than in previous studies. This study also demonstrates provider support for presenting this procedure as an option for transgender women.

Prevalence and Assessment of Factors Associated With Malnutrition in Children Residing in Slums of Mumbai: A Cross-Sectional Study.

Background Malnutrition in children continues to be a serious public health problem in India. Therefore, this study aims to evaluate the prevalence of malnutrition and assess factors contributing to it in children of the marginalized slum population of India, masked in the metropolitan cities. Methods A retrospective data analysis with a cross-sectional model was conducted by medical volunteers affiliated with the Rotaract Club of Medicrew who had organized a free pediatric health check-up camp in the Dharavi village of Mumbai, India for children under five. Children under five years of age group of either sex residing in the slums of Dharavi and whose parents consented are included in the study. Neonates, children older than five years of age, and children whose parents did not consent for them to be included in the study were excluded. A pretested, pre-validated questionnaire was administered, and statistical analysis was done with p-values <0.05 considered to be statistically significant. Results A total of 126 children were included. Out of these children, 109 of them (86.50%) had a mid-arm circumference of more than 12.5 cm (normal), 11 (8.73%) were between 11.5 cm and 12.5 cm (moderate acute malnutrition), and five (4.77%) were less than 11.5 cm (severe acute malnutrition). Among the 126 kids, 86 kids were above the age of two and their BMI was assessed, 36 (44.19%) were found to be underweight (<5th percentile) while 14 (16.3%) were obese (>95th percentile), and four (4.65%) were overweight (85th-95th percentile). For 106 (84.13%) of these children, the caregivers were mothers while others were fathers (n=4; 3.18%), grandmothers (n=5; 3.97%), sisters (n=5; 3.97%), and aunts (n=6; 4.76%). Out of those who had commenced receiving formal education, only 39 (55.71%) were in an appropriate grade for their age. The mean expenditure on food as a proportion of the total household income was 36.40% (standard deviation (SD) 15.0%). On the single-item sleep quality scale, the sleep of only 36 kids (28.58%) was reported by their caregivers as excellent. A high proportion of other medical problems were reported in the children. Conclusion Our study reports a substantial burden of malnutrition among children residing in the slums of Dharavi. Rigorous strengthening and conceptualization of on-ground nutritional programs targeted towardslum children should be done by Indian healthcare policymakers.

The Systematic Construction of Emergency Medical Security System in Long-Distance Walking Movement on Urban Paved Roads

Objective To explore the scope of building emergency medical security mechanism in urban paved road environment, and to provide reference, sample data and improvement suggestions for building emergency medical security mechanism in such specific environment. Methods The data of rescue personnel deployment, rescue materials allocation, rescue force monitoring, actual rescue situation, emergency plan and relevant regulations setting, training and other aspects of the emergency medical security mechanism in March and April 2023 were collected, and the data were analyzed. Results (1) The hiking distance was 40km and the road conditions were urban paved roads. There were 1150 official trekkers and 65 people were treated medically. (2) The most common symptoms of outdoor hiking included skeletal muscle injury (19.48%), foot skin and soft tissue injury (18.17%), fever (2.61%) and diarrhea (0.61%). (3) In March, 18.36% of the core medical team members and 20.41% of the first aid volunteers who underwent systematic training took up the task of supporting hiking activities. In April, the core medical team personnel who undertook the task of supporting hiking activities accounted for 1.23% of the total number of the security team, and the first aid volunteers who underwent systematic training accounted for 37.04%. (4) According to local conditions, the multi-vehicle rescue and transport mode was adopted, which was combined with the modified commercial rescue vehicle (42.86%) with the on-board emergency medical unit (EMU) and the ordinary ambulance (28.57%). (5) More than 700 pieces of 34 kinds of medical materials and 40 sets of mobile communication equipment, which were put into use after the feasibility study of the expert group and the technical group, guaranteed the competition from the hardware level. Conclusion The construction of emergency medical support mechanism in outdoor walking sports needs to pay attention to environmental characteristics, operation mode of support team, personnel and adaptability training, equipment and deployment of medical support materials, deployment and cooperation of communication and transport capacity, reasonable support plan and other factors. Medical volunteers who have been systematically trained can undertake part of outdoor medical rescue work. Pre-activity training and regular re-training of medical volunteers can ensure the safety of outdoor activities.

Relational Harm: On the Divisive Effects of Global Health Volunteering at a Hospital in Rural Zambia

ABSTRACT Drawing on ethnographic research at a hospital in rural Zambia, I show how the presence of white Christian medical volunteers from the United States damaged relations between local health workers and patients. Working from a position of economic and racial privilege, medical volunteers received praise from many patients and residents. However, these positive attitudes incited resentment among many Zambian health workers who felt that their own efforts and expertise were being undervalued or ignored. Focusing on these disrupted relationships, I argue that it is crucial to understand how global health volunteering can produce enduring forms of “relational harm”.

Perceptions of volunteers on the effectiveness of Kenya Medical Training College-run free medical camps in enhancing access to healthcare by vulnerable communities

In certain regions of Kenya, such as Nyahururu, Kabarnet, Kasikeu, and Mbooni, inadequate access to healthcare services contributes to avoidable deaths. Organizations like the Kenya Medical Training College (KMTC) address this challenge by organizing free medical camps, involving both local and international volunteer healthcare workers. This study explored the effectiveness of KMTC's free medical camps through interviews with 18 key informants, including faculty, non-faculty members, and community leaders from purposefully sampled hardship areas, namely, Nyahururu, Kabarnet, Kasikeu, and Mbooni. The study found that KMTC's free clinics offered crucial services like curative care, immunization, maternal and child health services, disease sensitization, reproductive health services, and substance abuse education. However, limitations were identified, including a shortage of medications, lack of specialized screening, follow-up care, and referral services. Resources available included community health volunteers, KMTC and hospital staff, socio-structural support, and physical infrastructure. Challenges faced by volunteers included motivation issues, inadequate facilitation, limited stakeholder involvement in planning, and perceived service comprehensiveness issues. Despite these challenges, the community acknowledged the vital role of medical camps in delivering essential services to marginalized groups. Addressing resource shortages, enhancing stakeholder engagement, improving service comprehensiveness, and boosting volunteer motivation were highlighted as crucial steps to maximize community benefits.

Implementation and mixed-methods evaluation of "Walk with a Doc" program at Stony Brook.

Walking groups run by trained individuals, lasting under an hour in a natural environment, may be a cost-effective way by which to encourage sustainable changes in physical activity as well as foster companionship and a shared experience of wellness among participants. Walk with a Doc (WWaD) is a national program that provides a platform for medical professionals, including physicians and medical students, to deliver a short talk on a health topic prior to walking side by side with patients and community members. To evaluate the WWaD Chapter at Stony Brook following implementation, a questionnaire was designed utilizing a mixed-methods approach (i.e.,containing qualitative and quantitative items) and administered to all attendees monthly prior to the health discussion. The aim of the questionnaire was fourfold: first, to obtain participant demographics; second, to obtain information on attendees' own perceptions of their health status and the role exercise plays in their health; third, to gain data on physical activity levels, including lengths of exercise sessions and types of activities performed; and fourth, to learn more about attendees' motivations and goals for participating in the walks. We received an IRB exemption. Physician and medical student volunteers were recruited from Stony Brook University Hospital, a suburban tertiary care center, to oversee program logistics. WWaD was scheduled to take place on the third Sunday of every month for 1 h at Heritage Park in Mount Sinai, New York. The event was advertised by volunteers to colleagues, peers, patients, and community members utilizing word of mouth, printed flyers, emails to listservs, and social media outlets. Each month, a physician volunteer oversaw a brief discussion (approximately 10 min in length). Over the course of the 5 month evaluation period, 91individuals participated in the walks, including repeat attendees. After excluding duplicate or incomplete entries, data from 30 participants were included in this analysis. The majority of participants were female (n=24) with a mean age of 50 years (range, 23-98 years). Feedback on WWaD program elements was largely positive. Participants commended the monthly speakers for "informative talks" (n=6) on "interesting topics" (n=4), with plans to review the supplemental information in educational pamphlets following the walk (n=4). The brochures were also deemed "helpful." Overwhelmingly, patients referred to the community gathering and team building aspects of WWaD as the "most enjoyable" aspect of the program (n=8) and a key driver for participation. This mixed-methods study of the WWaD chapter at Stony Brook contributes to a growing body of evidence highlighting the value of walking groups as effective avenues for collaboration in producing accessible healthy behavior.

Factors that Affect Patient Wait Times at a Free Clinic

Abstract: Free clinics may present long wait times. A retrospective chart review was conducted at a free clinic to understand contributing factors. Three wait times (total visit time, lobby wait time, and triage time) were analyzed across 349 patients. Variables included in the models were the total number of patients, providers, and volunteers; interpreter services; social work involvement; medical complexity; new vs. returning patient; scheduled vs. walk-in appointment; transportation provision; medical volunteer training level; and on-site medications and labs. Data analysis with multiple regressions was conducted. Factors that significantly affected wait times included the level of medical complexity (p&lt;.001), medical volunteer training levels (p&lt;.001), in-house labs (p&lt;.001), in-house medications (p=.04), and new patients (p=.01). An intervention involving time benchmarks at the beginning of clinics reduced first-wave lobby wait times (p&lt;.001). Future interventions addressing these factors may reduce wait times at other clinics.

Донорское движение в Москве в 1950–1970-е гг.: по документам Центрального государственного архива города Москвы

The article is devoted to a little-studied topic in Russian research circles - the history of gratuitous blood donation in the capital under the auspices of the Moscow City Committee of the Red Cross Society (MCC RCRS) in 1950-1970s. The donor movement for several decades has come a long way from spontaneously initiated events to the formation of a sustainable community of donors with its traditional actions, support and motivation system. The work actualizes the problem of development of the sectoral sphere of volunteer efforts application - gratuitous blood donation - from the historical point of view. The systematic and planned development of the donor movement of the MCC RCRS allowed to increase the donor activity of the capital's population, to form the ideology of socially significant practice with its key principles and the culture of responsible behavior of citizens. The MCC RCRS used a wide arsenal of organizational forms of social mobilization of citizens on a voluntary basis to attract the attention of the capital's residents to the problems of regularity and gratuitousness of donations. The article describes the measures of social support of donors that proved their effectiveness in practice. The joint activity of the MCC RCRS, district committees and primary branches with blood services, health care institutions in close contact with the authorities was the key to the successful fulfillment of the planned obligations to involve Soviet citizens in the ranks of gratuitous donors of the capital in the 1950-1970s. The empirical basis of the study was formed by the archival materials of the Central State Archive of Moscow, many of which the author introduces into scientific circulation for the first time. Of particular interest is the office work documentation of the MCC RCRS (transcripts, reports, annual activity reports, orders, circulars, decisions and resolutions), diverse in nature and content. The methodological basis for a comprehensive study was the principles of systematicity, historicism, objectivity, as well as the integrated use of a wide range of sources, generally accepted in historical science, which allowed us to consider the development of the gratuitous donor movement in Moscow in the conditions of specific-historical determinism, social conditionality and consistency of its design. Taking into account the historical experience of development of gratuitous donation is relevant nowadays in the process of solving both modern and prospective problems of the Russian health care system. Besides, it is in demand by the All-Russian public movement "Medical Volunteers" and the Russian Red Cross in the conditions of implementation of volunteer programs, volunteer initiatives and projects of development of the domestic blood service.

Restoring vision, restoring hope: My experience as a medical student volunteer at a mega eye camp.

Restoring vision, restoring hope: My experience as a medical student volunteer at a mega eye camp.

Health Coaching: America's Overlooked Personalized Health Solution

Chronic diseases are on the rise in the United States, particularly in rural and underserved areas, and they are often caused by preventable factors, accounting for a significant portion of healthcare costs. The short duration of routine medical visits does not give clinicians enough time to adequately address and support changes in patients' behavior that are required to improve health outcomes. Health coaching, which focuses on holistic behavior modification, shows potential in preventing and controlling chronic diseases through individualized assistance and accountability. Motivational interviewing and continual patient involvement are critical components of health coaching, and they have proven to be highly beneficial. Despite the established success of existing programs, a more comprehensive implementation tailored to individual requirements is required. Health coaching is an underutilized but intriguing method for healthcare providers to address patient health concerns proactively and directly at the cause. This strategy focuses on those who neglect their health owing to stated time restrictions, financial worries, or a lack of health education, resulting in delayed treatment and the onset of preventable chronic disease. The adaptable design, as well as a combination of medical experts and volunteers, offers exciting possibilities for urban, suburban, and rural locations alike, and may be the answer to a long-standing problem to personalized medicine in a highly diverse healthcare environment.

Assessing changes in the pattern of healthcare-associated infectious agents in intensive care units during a novel coronavirus infection pandemic (COVID-19)

Introduction. The novel coronavirus infection (COVID-19) pandemic has been a major challenge to the global healthcare system, affecting more than 32 million patients worldwide. Unprecedented anti-epidemic measures carried out in hospitals allowed clinicians to hope for a decrease of hospital infection, however, the pandemic exacerbated the problem of the spread and circulation of multidrug-resistant bacteria in hospitals. The goal of study to conduct a comparative assessment of changes in the microbial landscape and the level of antibiotic resistance of the main pathogens of lower respiratory tract infections in ICU patients who were in different epidemiological conditions during the COVID-19 pandemic in comparison with the “pre-Covid” period. Materials and methods. A multicenter retrospective observational cohort study was conducted, which included the ICU of 4 hospitals in Yekaterinburg, which were in different epidemiological situations during the COVID-19 pandemic, as well as a comparative analysis of the length of stay of patients in the ICU, the frequency and duration of mechanical ventilation, the resuscitation mortality rate, and also the results of microbiological examination of sputum with an assessment of the structure of pathogens and the level of their antibiotic resistance. Results. The structure of pathogens in sputum in ICU patients of the “green zone” has not fundamentally changed. In the “red zone” there was an increase in the number of documented infections of the lower respiratory tract and blood flow, while hospitals showed differences in changes in the microbial landscape. The microbiological situation in the ICU of the “red zone” was characterized by a decrease in the number of isolated strains of Enterobacterales and non-fermenting Gram-negative bacteria by the end of the pandemic, as well as a significant increase fungi in sputum. In hospitals, where there was an alternation of periods of work in the “red” and “green” zones, there was a decrease of Enterobacterales, an increase in non-fermenting Gram-negative bacteria and a fungi. Among the microflora isolated by bacteriological methods in patients with COVID-19, gram-negative bacteria and fungi predominated, mainly Klebsiella pneumonia, Acinetobacter baumanii and fungi of the Candida spp. A significant increase in the proportion of fungi in sputum was noted in ICU patients in infectious diseases hospitals during the pandemic period. An increase in the level of antibiotic resistance of the main pathogens of lower respiratory tract infections was revealed with the appearance of multi-resistant and extremely resistant strains of Klebsiella pneumoniae and Acinetobacter baumanii. Discussion. Changes in the microbial landscape may indirectly reflect the features of immune damage in patients with a new coronavirus infection COVID-19, which, combined with the severity of the disease and the characteristics of its therapy, led to an increase in complications in the form of a secondary bacterial infection. The reasons for the increase in HAI cases include: an increase in the number of patients with severe comorbidities in an artificial closed ecosystem - the “red zone”; features of the methods of treatment (glucocorticosteroids, genetically engineered biological products - IL-6 inhibitors, etc.); high frequency of unreasonable use of antibacterial drugs; increase in the duration ofuse of various invasive devices and mechanical ventilation; changing the structure and practice of staffing hospitals, increasing the number of inexperienced medical workers and volunteers; inadequate hand hygiene, use of unsuitable individual protection means with a lack of developed methods for their processing in the new conditions. Conclusion. The results obtained indicate the importance of the work of a multidisciplinary with a microbiologist, epidemiologist, clinical pharmacologist in order to improve the quality of care for patients, especially in a difficult epidemiological situation. Surveillance over the spread of HAI pathogens should be attributed to the most progressive form of anti-epidemic activity. Microbiological monitoring and its results can serve as the basis for making managerial decisions to combat and prevent hospital infections. It is the main method for assessing the etiology, phenotype, mechanisms of resistance to antimicrobial drugs, allows you to identify epidemiological relationships between diseases, reasonably prescribe antibiotic therapy, and conduct targeted purchases of drugs (antibiotics) for the needs of this hospital.

Medical clowning in hospitals: practices, training and perception

Previous studies on medical clowning focused on patients, while research remains inadequate concerning clowning itself: training programmes and prerequisite requirements, clowning methods, deontology and accepted practices. Diverse approaches and paradigms...