Insurance as a Tool for Managing Risks in Agriculture

The article views the contradiction between necessity for agricultural reproduction of rational parameters for providing food security of the country and reduction of investments, primarily internal, into agrarian sphere of the economy. This condition causes the necessity for development of measures facilitating the stabilization of the sources for reproduction process in the sphere and its development. It was found that one of the most effective measures aimed at the solution of this problem is insurance. However, according to the analysis of current situation in Stavropol Krai, this tool didn’t achieve a lot of success. Taking into account the found drawbacks of the existing mechanism of agricultural insurance, the authors substantiated the necessity for unification of agricultural enterprises into societies of mutual insurance support for reproduction for the purpose of minimization of risks of reduction of profit, caused by the specifics of business in this sphere. Besides, the authors offer the mechanism for their functioning and the methodology for calculation of insurance rates, differentiated according to groups of husbandries as to the type of provided reproductional process, and developed the recommendations for increase of interest of enterprises in entering the societies of mutual insurance support for reproduction. DOI: 10.5901/mjss.2015.v6n5p22

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Three-Plane Model to Standardize Laparoscopic Right Hemicolectomy with Extended D3 Lymph Node Dissection

AIM: The purposes of this study were to create a three-plane model for laparoscopic right hemicolectomy and to compare short-term outcomes of anterior medial-to-lateral (aM-to-L) and caudal-to-cranial access by retroperitoneal tunneling (Ca-to-Cr), as described based on the three-plane model. METHODS: A three-plane model was developed to clarify the steps of an operation. Consecutive cases of right colon cancer were operated upon with an aM-to-L approach in the earlier period and then with a Ca-to-Cr approach, and postoperative outcomes were evaluated. Short-term results were compared. RESULTS: Sixty-two patients were divided into aM-to-L (n=29) and Ca-to-Cr (n=33) groups. The two groups did not differ in terms of the patients\u27 baseline characteristics. Median operative time was 220 min (IQR 190-260) for the aM-to-L group and 222.5 min (IQR 180-255) for the Ca-to-Cr group (p=0.73). Estimated blood loss was similar in both groups (p=0.13). Median length of hospital stay was 6 days (IQR 5-8) in the aM-to-L group and 7 days (IQR 6-9) in the Ca-to-Cr group (p=0.17). Median number of harvested lymph nodes was 45.5 (IQR 25-44.9) in the aM-to-L group and 30 (IQR 18-48.5) in the Ca-to-Cr group (p=0.34). CONCLUSION: The approach used to reach the superior mesenteric vessels for laparoscopic right hemicolectomy with D3 lymph node dissection does not affect the short-term outcome of the operation. The present three-plane model gives surgeons additional insight to perform this operation