Vol 64, No 1 (2020)

Introduction. The analysis of reference literature as well as the routine medical practice attests to the fact that the process of making management decisions in medical organizations is underresearched. The aim is providing scientific rationale for making management decisions in medical organizations. Material and methods. An anonymous survey of 112 health managers who attended proficiency enhancement training cycle at the center of continuing professional education was conducted. The selection of experts was determined by their professional experience, expertise and opinion consistency. Results. It has been found that in the structure of management decisions systemized by their the method of their making rational ones prevail - 45.6 per cent (adaptive 36.1, intuitive - 18.3) in healthcare organizations. The significance of their steps was also evaluated and it has been defined to be the highest for problem diagnostics and final choice. The priority features (specificity and promptness) and factors (certainty and interdependence) defining quality and influencing management decision making in healthcare organizations as well as limitations (resource deficiency, statutory legal framework) and reasons (a person sees just a few options out of a large number, it’s impossible to foresee the consequences of each option, time shortage) hindering this process have been identified. It was demonstrated that of the established list of management decision making methods the quantitative one, economic analysis, diagnostics, decomposition, analogy and brainstorm are used virtually more often in healthcare organizations. The matter of planning for implementation of decisions done in just half of all cases has been estimated. Strengthening of control over execution of decisions and enhancing professional expertise for health managers as well as performance discipline have been defined to be the major ways of decision making optimization in healthcare organizations. Conclusion. The scientific rationale for the number of aspects of decision making in medical organizations is provided; it may be used for practices.

Introduction. Prematurity is a major risk factor for morbidity and mortality in infants. However, for different periods of life of premature babies, various predictors may affect survival. The purpose of the study is to assess the survival rate of deeply premature infants in the neonatal, postnatal and pediatric periods (up to 2 years), as well as to assess the risk of their disability in the future, to determine the main predictors of survival and disability. Matherial and methods. The assessment of survival of premature children in the neonatal, postnatal and pediatric (up to 2 years) periods was carried out with the use of Cox proportional hazards models. For evaluation of probability of premature children disability development multivariable binary regression was used. The empirical base of the study was the data from the examination and treatment of 277 premature born children who were hospitalized in 2013-2018, traced up to 2 years. Results. The influence of the following factors on the risk of death is statistically significant: in the neonatal period (p<0.05) - birth weight, fetal pathology and Apgar score; in the postnatal period - fetal pathology and pneumonia at birth, the volume of nursing procedures; in the pediatric period (up to 2 years) - pneumonia at birth, fetal abnormalities, the volume of primary resuscitation measures, the stay of children in a neonatal pathology unit (NPU), the factor of the male sex. The statistical modeling showed that stay in a NPU longer than the average value, the absence of infections of the urogenital system in the mother and the absence of cerebral ischemia at birth reduces the likelihood of a child developing a disability in the future. Discussion. In general, the results obtained are consistent with the studies on the issue of the survival rate of premature born children, but they let us make a detailed calculation of the odds ratio for the survival of very premature babies at different ages. Conclusion. The obtained models are important for evaluating preventive measures in the postnatal and prenatal periods of nursing of newborns.

It is known that the vibration disease takes the leading place among occupational diseases and has quite a polymorphic clinical symptomatology. An in-depth study of the pathogenesis of vibration disease to identify signs of neurovascular, neurohumoral and trophic disorders at the prenosological stage requires an integrated biomedical and biophysical studies the effects of vibration in standardized conditions. Only in a laboratory experiment can be simulated and repeatedly play the identical fully researched vibration modes and its combined effects with various other harmful for the body. The aim of the study is the principle of constructing the stand for modeling local vibration, which, with simplicity of its realization, allows you to create a simulated workplace conditions as close as possible to the practical production the process of using standard hand tools with built-in motor. Material and methods. Stand mount according to the tasks of ensuring the necessary to simulate vibration poses human operator regarding the working Panel. As vibrogenerator choose the corresponding technical characteristics standard hand tools with built-in motor (drill, punch, etc.), in a cartridge which embody the work item. Vibration sensors lock on is selected for the study areas of the body and connect to the input of the measuring instrument. Vibration load sensors are fixed on the selected areas of the body and connected to the input of the measuring device. Results. The presented measurement results have a very small scatter of parameters between operators (men and women), which indicates the absence of significant deviations of the spin axis, the center rod, from the axis of the recess in the working panel and the identity of the load on the vibration tool created by the operators. Discussion. By the approbation results the offered stand allows to reproduce conditions of a workplace and a working pose of the operator, as much as possible approached to practical production of works. Approbation of the stand clearly showed the simplicity of modeling local vibration under identical experimental conditions for all operators. Conclusions. The stand can be used for scientific research in the field of occupational medicine and industrial ecology, as well as in the educational process for laboratory work.