EMERGENCE OF PEDIATRICS - RETROSPECTIVE AND CONTEMPORARY ANALYSIS

Pediatrics are a specialty that deals with the care of the health of children and young people. The development of pediatrics is a process that has happened during the long period of history. Pediatrics is a science for the human body starting from birth to adolescence. As science began its development in the 16th century. The word "pediatric" comes from two Greek words: pais - child and ἰατρός - healing. So pediatrics are separated as a specialty precisely because the child's health problems are different from those of the adults. The path of development of pediatrics and affirmation and as an independent science is long and is made thanks to the contribution of doctors who lay the foundations of pediatrics and child health. Objective: To study the path of pediatrics to the present day, through retrospection and modern analysis.Methods: Literary analysis and documentary method - the thesis of the path of pediatrics have been studied through retrospective and modern analysis

Loan and Grant Support for Students in the Context of the Diversification of Funding Sources for Higher Education

[full article and abstract in English] This paper considers the mechanism of direct state support for students in European countries using loans and grants: their functions, forms, schemes, and conditions for provision. The peculiarities of the state preferential educational loan in Ukraine and the reasons for its curtailment since 2011 are determined. Nowadays, it is established that the main form of state support for Ukrainian students who receive higher education in public procurement comes with academic and social scholarships, whereas students who receive higher education under a contract of preferential state lending yet after the curtailment of the program are deprived of any state support. The necessity of restoring the program of preferential state lending for students and the directions of its improvement, such as the establishment of an interest rate on a loan based on the level of inflation, the establishment of a minimum amount of annual payments on a loan as a percentage of the minimum salary, the distribution of the risk of non-repayment of a loan between the state, the borrower and his parent, are all substantiated. This is done taking into account the financial capabilities of the Ukrainian state and the high levels of hidden income. We consider the establishment of conditions needed for the development of a system of commercial educational loans, by providing for the provision of a state guarantee on it and partial state subsidy of interest rates. We consider the areas of improvement of scholarship support of students and substantiate the necessity of introducing education at least for orphans, children deprived of parental care, and disabled children

Giardiasis in Varna district - prevalence and risk assessment

Гиардиазата е космополитна чревна протозооза, която се среща както в тропическите, така и в страните с умерен климат. На регионално ниво заболяването е изучавано в миналото, но в настоящия момент не съществува систематизирана информация относно разпространението на G. duodenalis сред различните части от населението. Целта на настоящото изследване е да установим екстензинвазията на гиардиазата в област Варна за периода 2007-2016 г. и да анализираме ефекта на различни фактори - възраст, пол, местоживеене, професия и др., върху вероятността за опаразитяване. Материал и методи: Обхванати са 55 856 лица, изследвани чрез фекална намазка, оцветена с луголов разтвор. Явленията в различните групи са представени като относителен дял. Анализът на риска е осъществен чрез χ2-тест за асоциация на Pearson, a величината на ефекта - чрез отношението на шансовете (odds ratio). Резултати и обсъждане: Сред изследвания контингент открихме 327 лица, инвазирани с G. duodenalis, a общият екстензитет от 0.58% поставя гиардиазата на второ място от всички чревни паразитози в областта. Заболяемостта по години варира между 95.93%000 за 2007 г. до 48.98%000 за 2016 г. и ако демонстрираната тенденция запази своя ход, прогнозните предвиждания посочват, че показателят ще достигне 17.36%000 за 2026 г. Гиардиазата е по-честа в детската възраст, но съотношението де-ца-възрастни е едва 2:1, a висок риск откриваме в младата активна възраст от 20-35 г. и като цяло сред възрастните мъже. В малките градове от областта вероятността за заразяване с G. duodenalis е 3,5 пъти по-висока, отколкото в гр. Варна, a в селата рискът се покачва 6-кратно. Най-висок професионален риск отчитаме при мъжете и жените, ангажирани с производството на хранителни продукти и работещите в детските заведения на областта. Въпреки сравнително високата честота, открита сред различните групи от Варненския регион, гиардиазата остава слабо познато заболяване и рядко се включва в диференциално диагностичните планове при лицата с гастроинтестинални симптоми, особено в зрялата възраст.Introduction: Giardiasis is a worldwide intestinal protozoal disease that occurs both in tropical and temperate climates. The distribution in the region has been studied in the past, but there is no current in-formation regarding the prevalence of G. duodenalis among distinct risk groups of the population. Aim: The aim of the present study is to establish the prevalence of giardiasis in Varna region in the period 2007 - 2016 and to evaluate the effect of various indicators - age, sex, place of residence, occupation, etc., on the risk of infection. Materials and Methods: For the 10-year period, a total of 55 856 individuals were tested for G. duodenalis with wet mount preparation stained with Lugol`s iodine solution. The prevalence of the disease was estimated in the separate risk groups, the risk differences were evaluated by Pearson`s χ2-test for association and the effect size was measured by the odds ratio. Results and Discussion: Three hundred twenty-seven infected with G. duodenalis persons were found in the investigated population from Varna region. The overall prevalence of 0.58% makes giardiasis the second most frequent intestinal parasitosis in the region. The established incidence ranges from 95.93 %000 in 2007 to 48.98%000 in 2016. If this negative trend is sustained, the estimated magnitude will reach 17.36%000 in 2026. Giardiasis is more common in childhood, but the children to adults ratio is barely 2:1.Even more, elevated risk is found in the young population (20-35 years) and in adult males. In small towns of the area the odds for infection with G. duodenalis are 3.5 higher than in Varna city, while in the rural areas the risk increases 6-fold. Raised prevalence and occupational risk are observed amongst workers in the food production industry and employees in childcare facilities in the region. Regardless of the relatively high frequency found among the different groups of Varna region, giardiasis remains a little-known disease and is rarely included in the differential diagnosis of gastrointestinal dysfunction especially in adult patients

Pengaruh Budaya Organisasi terhadap Keterikatan Kerja dan Organizational Citizenship Behavior (OCB)

Penelitian ini bertujuan untuk mengetahui pengaruh budaya organisasi terhadap keterikatan karyawan dan Organizational Citizenship Behavior Karyawan di Kantor Direksi PT. Perkebunan Nusantara III Medan. Metode yang digunakan dalam penelitian ini adalah metode kuantitatif. Subjek pada penelitian ini adalah 253 karyawan tetap yang bekerja di Kantor Direksi PT. Perkebunan Nusantara III Medan. Alat ukur yang digunakan adalah skala keterikatan karyawan, skala Organizational Citizenship Behavior dan skala budaya organisasi. Analisa data dilakukan dengan metode regresi sederhana. Hasil penelitian ini menunjukkan bahwa terdapat pengaruh positif antara budaya organisasi terhadap keterikatan karyawan dan Organizational Citizenship Behavior Karyawan di Kantor Direksi PT. Perkebunan Nusantara III Medan, yang berarti semakin kuat budaya organisasi terinternalisasi pada diri karyawan maka tingkat keterikatan karyawan juga semakin tinggi dan semakin sering OCB dilakukan

RARE CASE OF ASCARIASIS DETECTED BY COLONOSCOPY ON THE BACKGROUND OF ELEVATED LEVELS OF FECAL CALPROTECTIN

Introduction: The causative agents of ascariasis in humans are two species: Ascaris lumbricoides and Ascaris suum. For diagnosis, a fecal sample is most often examined. In some cases, the parasite can be identified when coming out with the intestinal passage, and very rarely up on colonoscopy. Aim to present a rare case of ascariasis where the diagnosis was made by colonoscopy on the background of elevated levels of fecal calprotectin (f-CP). Case presentation: A colonoscopy was performed on a 52-year-old female patient due to elevated f-CP. The patient had no complaints. The colonoscopy did not detect pathological changes of the intestinal mucosa, but documented larval stages of Ascaris spp. freely moving in the lumen of the large intestine. The patient was treated with albendazole. Subsequent parasitological examinations of fecal samples were negative. Discussion: In developed countries, the transmission of Ascaris lumbricoides is greatly reduced. On the background of a very limited transmission of Ascaris lumbricoides, many authors consider that most of the sporadic cases of ascariasis are due to Ascaris suum. In the case described by us, the f-CP levels normalized after the treatment, and for this reason, we cannot categorically reject the relationship between Ascaris infection and elevated f-CP levels. Conclusion: The presented clinical case is of interest due to the unusual way of diagnosi ascariasis. In the absence of clinical symptoms, and pathological changes of blood and biochemical parameters, except for elevated fecal calprotectin, inflammatory colon disease was suspected and was colonoscopy performed on this occasion

Molecular characterization of Echinococcus granulosus isolates from Bulgarian human cystic echinococcosis patients

Although cystic echinococcosis (CE) is highly endemic in Bulgaria, there is still scarce information about species and/or genotypes of the Echinococcus granulosus complex that infect humans. Our study tackled the genetic diversity of E. granulosus complex in a cohort of 30 Bulgarian CE patients. Ten animal E. granulosus isolates from neighboring Greece were additionally included. Specimens were comparatively analyzed for partial sequences of five mitochondrial (mt) (cox I, nad I, rrnS, rrnL, and atp6) and three nuclear (nc) genes (act II, hbx 2, and ef-1α) using a PCR-sequencing approach. All 30 Bulgarian isolates were identified as E. granulosus sensu stricto (s.s.) and were showing identical sequences for each of the three examined partial nc gene markers. Based upon concatenated sequences from partial mtDNA markers, we detected 10 haplotypes: 6 haplotypes (H1-H6) clustering with E. granulosus s.s. (G1) and 4 haplotypes (H9-H13) grouping with E. granulosus s.s. (G3), with H1 and H10 being the most frequent in Bulgarian patients. The haplotypes H1, H4, and H11 were also present in Greek hydatid cyst samples of animal origin. In conclusion, E. granulosus s.s. (G1 and G3 genotypes) is the only causative agent found so far to cause human CE in Bulgaria. However, further studies including larger sample sizes and other additional geographic regions in Bulgaria will have to be performed to confirm our results

Патология щитовидной железы в практике педиатра

Departament of Pediatry, Nicolae Testemitanu State Medical and Pharmaceutical UniversityIt is proven that thyroid gland plays a huge role in the organism’s process of growing and development, in the health and intellectual level of population. It has implications in the body’s metabolism, genetic program and development of the nervous system, the differentiation and statural growing from conception and during people’s life. The thyroid diseases had been and still remain a major problem in pediatrics, that being explained by the evolution and clinical signs which not always has specific symptoms in the debut and even in progression. There are a lot of syndromes caused by hypothyroidism or hyperthyroidism which confuses the internists-doctors. We bring two clinical cases which we hope will help in the quick diagnosis of the thyroid gland’s pathology: the child Nicolai, 16 years old with autoimmune toxic multicystic thyroiditis and Alina 16.5 years old with secondary hypothyroidism. Diagnosis have been confirmed on the basis of clinical results, laboratory tests (T3, T4, TSH, a-TPO) and instrumental (USG, Scintigraphy).Известна ключевая роль ЩЖ для здоровья человека с момента его зачатия и на протяжении всей жизни. Гормоны ЩЖ обеспечивают реализацию генетической программы, дифференцировку тканей всех органов и систем и нормальный обмен веществ. От функционального состояния ЩЖ зависит интеллектуальный уровень населения. Болезни ЩЖ всегда представляли сложную диагностическую задачу для практических врачей – педиатров, терапевтов, невропатологов в связи с отсутствием специфической симптоматики как вначале, так и при прогрессировании заболевания с гипо- или гипертиреозом. В статье описаны два клинических случая: узловой аутоиммунный токсический тиреоидит (Николай 16 лет) и вторичный гипотиреоз (Алина 16,5 лет). Диагноз подтвержден клинически, лабораторными данными (Т3, Т4, ТSH, a-TPO), результатами УЗИ, сцинтиграфии

АНАЛІЗ РЕЗУЛЬТАТИВНОСТІ РЕФОРМИ ЄСВ 2016 РОКУ В УКРАЇНІ

In view of the need to define the areas of further improvement of the mechanism of levying single social contribution (SSC), considering the challenges and threats stemming from the increasing deficit of the Pension Fund of Ukraine, an analysis of reforms of the said contribution implemented during 2015—2017 in the context of their effect on the degree of shadowization of wage payments in the country becomes especially important.The scientific rationale for the expediency of lowering the SSC rate in order to reduce the degree of shadowization of wage payments was analyzed. The reform of SSC in Ukraine in 2016 was assessed in the context of its effect on the degree of shadowization of wage payments and unofficial employment, which gave reasons to conclude that no significant positive effects were produced by the said reform. An insignificant decline of these indicators is incomparable with the adverse consequences which this reform had for revenues of the Pension Fund of Ukraine. Calculations of tax burden on the wages paid in Ukraine in 2010—2019 were made. It was established that in 2016, tax burden on payroll fund declined to 28,58% versus 2015, but the following years saw an insignificant growth of this indicator to 30,16% in 2019. It was proved that the drastic lowering of the SSC rate did not stimulate employers to deshadowize wages. For when Ukrainian lawmakers initiated this reform, they failed to take into account a number of nontax factors in deshadowization of wage payments related, in particular, to the quality of Ukrainian legislation and regulatory policy and to the level of corruption in the country. Given that employers remain able to conceal the actual number of personnel and the amount of their wages, it will be impossible to solve the problem of unofficial employment and shadowization of wage payments only by lowering the SSC rate. An emphasis was placed on the need to apply a systemic approach to the assessment of possible consequences from future transformations of SSC and their impact on tax burden on payroll fund in terms of all its components and taking into account nontax factors in deshadowization of wage payments.З огляду на необхідність визначення напрямів подальшого вдосконалення механізму справляння єдиного соціального внеску (далі — ЄСВ) з урахуванням викликів і загроз, пов’язаних зі зростанням дефіциту Пенсійного фонду України, особливої актуальності набуває аналіз здійснених упродовж 2015—2017 років реформ зазначеного податкового платежу в контексті їхнього впливу на рівень тінізації заробітних плат у країні.Досліджено питання наукового обґрунтування доцільності зниження ставки ЄСВ з метою зменшення рівня тінізації оплати праці. Здійснено оцінку реформи ЄСВ в Україні 2016 року в контексті її впливу на рівень тінізації заробітних плат і неформальної зайнятості населення, що дало підстави для висновків про відсутність суттєвих її позитивних ефектів. Незначне зниження зазначених показників не є зіставним із негативними наслідками, які ця реформа мала для надходжень до Пенсійного фонду України. Проведено розрахунки податкового навантаження на оплату праці в Україні у 2010—2019 рр. Установлено, що 2016 року податкове навантаження на працю, порівняно з 2015-м, знизилось до рівня 28,58 %, однак у наступні роки відбулося його незначне зростання — до 30,16 % 2019 року. Обґрунтовано, що кардинальне зниження ставки ЄСВ не стало стимулом для роботодавців до детінізації заробітних плат. Адже ініціюючи реформу, вітчизняний законодавець не врахував низку неподаткових факторів детінізації заробітних плат, пов’язаних, зокрема, з якістю вітчизняного законодавства і регуляторної політики, рівнем корупції. За умов наявності в роботодавців можливості приховувати реальну кількість працівників і розмір їхніх заробітних плат, неможливо розв’язати проблему неформальної зайнятості та тінізації оплати праці лише за рахунок зниження ставки ЄСВ. Наголошено на необхідності застосування системного підходу до оцінки можливих наслідків майбутніх трансформацій ЄСВ щодо їхнього впливу на податкове навантаження на працю в розрізі усіх його складових, а також з урахуванням неподаткових факторів детінізації заробітних плат