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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">sredob</journal-id><journal-title-group><journal-title xml:lang="ru">Здоровье населения и среда обитания – ЗНиСО</journal-title><trans-title-group xml:lang="en"><trans-title>Public Health and Life Environment – PH&amp;LE</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2219-5238</issn><issn pub-type="epub">2619-0788</issn><publisher><publisher-name>ФБУЗ ФЦГиЭ Роспотребнадзора</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.35627/2219-5238/2023-31-2-32-37</article-id><article-id custom-type="elpub" pub-id-type="custom">sredob-1150</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ГИГИЕНА ТРУДА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OCCUPATIONAL HEALTH</subject></subj-group></article-categories><title-group><article-title>Показатели зрительно-моторной реакции как индикаторы утомления медицинских работников выездных бригад скорой медицинской помощи</article-title><trans-title-group xml:lang="en"><trans-title>Visual-Motor Reaction Parameters as Indicators of Fatigue in Emergency Medical Personnel</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1796-6023</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Болобонкина</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bolobonkina</surname><given-names>T. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Болобонкина Татьяна Александровна – ассистент кафедры медицины катастроф и скорой медицинской помощи</p><p>д. 9, г. Рязань, 390026</p></bio><bio xml:lang="en"><p>Tatyana A. Bolobonkina -  Assistant, Department of Disaster Medicine and Emergency Care</p><p>9 Vysokovoltnaya Street, Ryazan, 390026</p></bio><email xlink:type="simple">bolobonkina@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3038-5530</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дементьев</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dementiev</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дементьев Алексей Александрович – д.м.н., доцент, зав. кафедрой общей гигиены</p><p>д. 9, г. Рязань, 390026</p></bio><bio xml:lang="en"><p>Alexey A. Dementiev -  Dr. Sci. (Med.), Assoc. Prof., Head of the Department of General Hygiene</p><p>9 Vysokovoltnaya Street, Ryazan, 390026</p></bio><email xlink:type="simple">dementiev_a@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0599-924X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Минаева</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Minaeva</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Минаева Наталья Владимировна – к.м.н., доцент, зав. кафедрой медицины катастроф и скорой медицинской помощи</p><p>д. 9, г. Рязань, 390026</p></bio><bio xml:lang="en"><p>Natalya V. Minaeva -  Cand. Sci. (Med.), Assoc. Prof., Head of the Department of Disaster Medicine and Emergency Care</p><p>9 Vysokovoltnaya Street, Ryazan, 390026</p></bio><email xlink:type="simple">shatrnat@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Рязанский государственный медицинский университет имени академика И.П. Павлова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ryazan State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>16</day><month>02</month><year>2023</year></pub-date><volume>31</volume><issue>2</issue><fpage>32</fpage><lpage>37</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Болобонкина Т.А., Дементьев А.А., Минаева Н.В., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Болобонкина Т.А., Дементьев А.А., Минаева Н.В.</copyright-holder><copyright-holder xml:lang="en">Bolobonkina T.A., Dementiev A.A., Minaeva N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://zniso.fcgie.ru/jour/article/view/1150">https://zniso.fcgie.ru/jour/article/view/1150</self-uri><abstract><p>Введение. Факторы трудовой среды влияют на функциональное состояние центральной нервной системы работников, что проявляется изменениями сенсомоторных реакций. Профессиональные задачи медицинских работников выездных бригад скорой медицинской помощи в условиях пандемии коронавирусной инфекции определяют высокие требования к устойчивости функциональных систем организма.Цель исследования – изучение влияния профессиональной деятельности на подвижность центральных нервных процессов медицинских работников выездных бригад скорой медицинской помощи.Материалы и методы. Исследование проводилось на базе городской клинической станции СМП города Рязани в 2021 году. В исследовании приняли участие 44 медицинских работника выездных бригад СМП (12 врачей, 32 фельдшера). Среди испытуемых было 12 мужчин и 32 женщины. Средний возраст работников составил 35,77 ± 3,39 года. Все сотрудники имели суточный режим труда: 24-часовая рабочая смена и период отдыха – 72 часа. Проведено исследование показателей сложной зрительно-моторной реакции медицинских работников выездных бригад: среднего времени сложной зрительно-моторной реакции, а также коэффициента точности Уиппла на аппаратно-программном комплексе «НС-ПсихоТест» с использованием блока зрительно-моторного анализа- тора. Статистическая обработка проводилась при помощи пакетов программ Microsoft Exсel 2007 с надстройкой «Анализ данных».Результаты. Рост среднего времени реакции к концу рабочей смены по сравнению с ее началом на 60,75 мс (р &lt; 0,001) свидетельствует об изменениях функционального состояния центральной нервной системы медицинских работников выездных бригад вследствие развившегося утомления. Анализ динамики показателей между началами соседних смен выявил положительные тенденции: снижение среднего времени реакции в среднем на 77,67 мс (p = 0,002) и рост коэффициента Уиппла в среднем на 0,07 (р &lt; 0,0001) у большинства обследованных после регламентированного периода отдыха, что свидетельствует об эффективности процессов восстановления функционального состояния центральной нервной системы.Выводы. К концу рабочей смены у медицинских работников выездных бригад наблюдались негативные тенденции в динамике зрительно-моторных реакций: рост среднего времени сложной зрительно-моторной реакции. Возраст до 30 лет и стаж работы 0– 5 лет являются факторами риска низкой профессиональной адаптации ввиду высоких долей испытуемых со статистически значимым увеличением среднего времени реакции в динамике рабочей смены. Стабилизация динамики междусменных показателей при сравнении в начале соседних смен свидетельствует о восстановлении функционального состояния центральной нервной системы работников за период регламентированного отдыха.</p></abstract><trans-abstract xml:lang="en"><p>Introduction: Factors of the work environment affect the functional state of the central nervous system of employees, which is manifested by changes in sensorimotor reactions. Professional tasks of emergency medical personnel during the COVID-19 pandemic determine high requirements for the stability of functional systems of the body.Objective: To study the influence of professional activities on the mobility of central nervous processes in ambulance workers.Materials and methods: The study was conducted at the Ryazan City Clinical Emergency Hospital in 2021. It included 44 ambulance workers (12 doctors and 32 paramedics), 12 men and 32 women with the mean age of 35.77 ± 3.39 years, working a 24-hour shift followed by 72 hours off. We studied parameters of the complex visual-motor reaction of the subjects including the average response times and the Whipple’s index using the “NS-Psychotest” computer complex equipped with the visual-motor analyzer. The data were analyzed using the Data Analysis ToolPak in Microsoft Excel 2007.Results: The established statistically significant increase in the average response time of ambulance employees by 60.75 ms (p &lt; 0.001) by the end of the work shift indicates changes in the functional state of the central nervous system caused by fatigue. The analysis of the dynamics of indicators between the beginnings of neighboring shifts revealed positive trends expressed by an average decrease in the response time by 77.67 ms (p = 0.002) and an increase in the Whipple’s index by 0.07 (p &lt; 0.0001) in most subjects after the regulated rest period, thus indicating the effectiveness of the processes of functional restoration of the central nervous system.Conclusions: By the end of the work shift, ambulance workers demonstrated increased average visual-motor reaction times. Age under 30 and 0–5-year work experience are risk factors for poor professional adaptation proven by a high proportion of the subjects with a statistical increase in the average reaction time during the work shift. Stabilization of the dynamics of inter-shift indicators when compared at the beginning of adjacent shifts indicates proper functional restoration of the central nervous system of emergency medical personnel during the 72-hour rest period.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>медицинские работники</kwd><kwd>скорая медицинская помощь</kwd><kwd>функциональное состояние центральной нервной системы</kwd><kwd>утомление</kwd><kwd>сложная зрительно-моторная реакция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>medical workers</kwd><kwd>ambulance service</kwd><kwd>functional state of the central nervous system</kwd><kwd>fatigue</kwd><kwd>complex visual-motor reaction</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">исследование выполнено при финансовой поддержке РФФИ в рамках научного проекта №20-313-90005</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ивашова Ю.А., Устинова О.Ю., Власова Е.М., Шляпников Д.М. Влияние ночных смен на функциональное состояние вегетативной нервной системы у работников с вредными условиями труда // Медицина труда и промышленная экология. 2018. № 10. С. 54–58. doi:10.31089/1026-9428-2018-10-54-58</mixed-citation><mixed-citation xml:lang="en">Ivashova YuA, Ustinova OYu, Vlasova EM, Shlyapnikov DM. Influence of night shift work on functional state of autonomous nervous system in workers exposed to occupational hazards. Meditsina Truda i Promyshlennaya Ekologiya. 2018;(10):54-58. (In Russ.) doi: 10.31089/1026-9428-2018-10-54-58</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Patterson PD, Weaver MD, Markosyan MA, et al. Impact of shift duration on alertness among air-medical emergency care clinician shift workers. Am J Ind Med. 2019;62(4):325-336. doi: 10.1002/ajim.22956</mixed-citation><mixed-citation xml:lang="en">Patterson PD, Weaver MD, Markosyan MA, et al. Impact of shift duration on alertness among air-medical emergency care clinician shift workers. Am J Ind Med. 2019;62(4):325-336. doi: 10.1002/ajim.22956</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Губарева Л.И., Пономарева Т.Ю., Ермолова Л.С. Особенности функционирования центральной нервной системы у работников газотранспортной системы с разной степенью адаптации к условиям профессиональной среды // Медицинский вестник Северного Кавказа. 2016. Т. 11. № 4. С. 573–576. doi: 10.14300/mnnc.2016.11137</mixed-citation><mixed-citation xml:lang="en">Gubareva LI, Ponomareva TYu, Ermolova LS. Central nervous system function in gas transportation system stuff with various degree of adaptation to the professional environment. Meditsinskiy Vestnik Severnogo Kavkaza. 2016;11(4):573-576. (In Russ.) doi: 10.14300/mnnc.2016.11137</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Кылосов А.А., Деньмухомедова Д.А., Шахмирова А.Ш., Сборцева Т.В. Влияние утомления от однократной тренировочной нагрузки на быстроту зрительно-моторной реакции волейболисток // Вестник Сургутского государственного педагогического университета. 2018. №4 (55). С. 85–90</mixed-citation><mixed-citation xml:lang="en">Kylosov AA, Denmukhamedova DA, Shakhmirova ASh, Sbortseva TV. Influence of tiredness from single training load on the quickness of visuomotor reaction of female volleyball players. Vestnik Surgutskogo Gosudarstvennogo Pedagogicheskogo Universiteta. 2018;(4(55)):85–90. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Milas GP, Issaris V, Zareifopoulos N. Burnout for medical professionals during the COVID-19 pandemic in Greece; the role of primary care. Hosp Pract (1995). 2022;50(2):102-103. doi: 10.1080/21548331.2022.2045133</mixed-citation><mixed-citation xml:lang="en">Milas GP, Issaris V, Zareifopoulos N. Burnout for medical professionals during the COVID-19 pandemic in Greece; the role of primary care. Hosp Pract (1995). 2022;50(2):102-103. doi: 10.1080/21548331.2022.2045133</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Rabinerson D, Markovitch L, Gabbay-Ben-Ziv R. [Shift work and its health hazards.] Harefuah. 2016;155(7):394-397. (In Hebrew.)</mixed-citation><mixed-citation xml:lang="en">Rabinerson D, Markovitch L, Gabbay-Ben-Ziv R. [Shift work and its health hazards.] Harefuah. 2016;155(7):394-397. (In Hebrew.)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Ненахов И.Г., Степкин Ю.И., Якимова И.А. Оценка специфики сенсомоторных реакций сотрудников аккредитованного испытательного лабораторного центра в процессе профессиональной деятельности // Анализ риска здоровью. 2018. № 1. С. 59–65. doi: 10.21668/health.risk/2018.1.07</mixed-citation><mixed-citation xml:lang="en">Nenakhov IG, Styopkin YuI, Yakimova IA. Assessment of sensorimotor reactions peculiarities detected in certified test laboratory center staff during their occupational activities. Health Risk Analysis. 2018;(1):59-65. (In Russ.) doi: 10.21668/health.risk/2018.1.07</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Deng S, Yang N, Li S, Wang W, Yan H, Li H. Doctors’ job satisfaction and its relationships with doctor–patient relationship and work–family conflict in China: A structural equation modeling. Inquiry. 2018;55:46958018790831. doi: 10.1177/0046958018790831</mixed-citation><mixed-citation xml:lang="en">Deng S, Yang N, Li S, Wang W, Yan H, Li H. Doctors’ job satisfaction and its relationships with doctor–patient relationship and work–family conflict in China: A structural equation modeling. Inquiry. 2018;55:46958018790831. doi: 10.1177/0046958018790831</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Шапарь В.Б., Тимченко А.В., Швыдченко В.Н. Практическая психология. Инструментарий. Ростов-на-Дону: Изд-во «Феникс», 2002. 688 с.</mixed-citation><mixed-citation xml:lang="en">Shapar VB, Timchenko AV, Shvydchenko VN. [Practical Psychology. Tools.] Rostov-on-Don: Phoenix Publ.; 2002. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Игнатова Ю.П., Макарова И.И., Яковлева К.Н., Аксенова А.В. Зрительно-моторные реакции как индикатор функционального состояния центральной нервной системы // Ульяновский Медико-Биологический Журнал. 2019. № 3. С. 38–51. doi:10.34014/2227-1848-2019-3-38-51</mixed-citation><mixed-citation xml:lang="en">Ignatova YuP, Makarova II, Yakovleva KN, Aksenova AV. Visual- motor reactions as an indicator of CNS functional state. Ul'yanovskiy Mediko-Biologicheskiy Zhurnal. 2019;(3):38-51. (In Russ.) doi: 10.34014/2227-1848-2019-3-38-51</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Bi J, Yin X, Li H, et al. Effects of monitor alarm management training on nurses’ alarm fatigue: A randomised controlled trial. J Clin Nurs. 2020;29(21-22):4203-4216. doi: 10.1111/jocn.15452</mixed-citation><mixed-citation xml:lang="en">Bi J, Yin X, Li H, et al. Effects of monitor alarm management training on nurses’ alarm fatigue: A randomised controlled trial. J Clin Nurs. 2020;29(21-22):4203-4216. doi: 10.1111/jocn.15452</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Lin MH, Huang YC, Chen WK, Wang JY. Sleepiness and injury risk in emergency medical service workers in Taiwan. PLoS One. 2020;15(2):e0229202. doi: 10.1371/journal.pone.0229202</mixed-citation><mixed-citation xml:lang="en">Lin MH, Huang YC, Chen WK, Wang JY. Sleepiness and injury risk in emergency medical service workers in Taiwan. PLoS One. 2020;15(2):e0229202. doi: 10.1371/journal.pone.0229202</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Mansukhani MP, Kolla BP, Surani S, Varon J, Ramar K. Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature. Postgrad Med. 2012;124(4):241-249. doi: 10.3810/pgm.2012.07.2583</mixed-citation><mixed-citation xml:lang="en">Mansukhani MP, Kolla BP, Surani S, Varon J, Ramar K. Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature. Postgrad Med. 2012;124(4):241-249. doi: 10.3810/pgm.2012.07.2583</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Купцова С.В., Иванова М.В., Петрушевский А.Г., Федина О.Н., Жаворонкова Л.А. ФМРТ-исследование переключения зрительного внимания у здоровых людей // Журнал высшей нервной деятельности. 2015. Т. 65. № 1. С. 61. doi: 10.7868/S0044467715010062</mixed-citation><mixed-citation xml:lang="en">Kuptsova SV, Ivanova MV, Petrushevsky AG, Fedina ON, Zhavoronkova LA. FMRI study of visual task switching in healthy individuals. Zhurnal Vysshey Nervnoy Deyatel'nosti im. I.P. Pavlova. 2015;65(1):61. (In Russ.) doi: 10.7868/S0044467715010062</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Poysophon P, Rao AL. Neurocognitive deficits associated with ADHD in athletes: A systematic review. Sports Health. 2018;10(4):317-326. doi: 10.1177/1941738117751387</mixed-citation><mixed-citation xml:lang="en">Poysophon P, Rao AL. Neurocognitive deficits associated with ADHD in athletes: A systematic review. Sports Health. 2018;10(4):317-326. doi: 10.1177/1941738117751387</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Ильясова С.Д., Куликов Р. Ф. Психоэмоциональное выгорание работников скорой медицинской помощи. Colloquium-journal. 2019. №10-3 (34). С. 35–37.</mixed-citation><mixed-citation xml:lang="en">Ilyasova SD, Kulikov RA. Psycho-emotional extinguishment of emergency medical aid workers. Colloquium-Journal. 2019;(10- 3(34)):35–37. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Moukarzel A, Michelet P, Durand AC, et al. Burnout syndrome among emergency department staff: Prevalence and associated factors. Biomed Res Int. 2019;2019:6462472. doi: 10.1155/2019/6462472</mixed-citation><mixed-citation xml:lang="en">Moukarzel A, Michelet P, Durand AC, et al. Burnout syndrome among emergency department staff: Prevalence and associated factors. Biomed Res Int. 2019;2019:6462472. doi: 10.1155/2019/6462472</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Knap M, Maciąg D, Trzeciak-Bereza E, Knap B, Czop M, Krupa S. Sleep disturbances and health consequences induced by the specificity of nurses’ work. Int J Environ Res Public Health. 2022;19(16):9802. doi: 10.3390/ijerph19169802</mixed-citation><mixed-citation xml:lang="en">Knap M, Maciąg D, Trzeciak-Bereza E, Knap B, Czop M, Krupa S. Sleep disturbances and health consequences induced by the specificity of nurses’ work. Int J Environ Res Public Health. 2022;19(16):9802. doi: 10.3390/ijerph19169802</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Petitet P, Spitz G, Emir UE, Johansen-Berg H, O'Shea J. Age-related decline in cortical inhibitory tone strengthens motor memory. Neuroimage. 2021;245:118681. doi: 10.1016/j.neuroimage.2021.118681</mixed-citation><mixed-citation xml:lang="en">Petitet P, Spitz G, Emir UE, Johansen-Berg H, O'Shea J. Age-related decline in cortical inhibitory tone strengthens motor memory. Neuroimage. 2021;245:118681. doi: 10.1016/j.neuroimage.2021.118681</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Ganesan S, Magee M, Stone JE, et al. The impact of shift work on sleep, alertness and performance in healthcare workers. Sci Rep. 2019;9(1):4635. doi: 10.1038/s41598-019-40914-x</mixed-citation><mixed-citation xml:lang="en">Ganesan S, Magee M, Stone JE, et al. The impact of shift work on sleep, alertness and performance in healthcare workers. Sci Rep. 2019;9(1):4635. doi: 10.1038/s41598-019-40914-x</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Violanti JM, Owens SL, Fekedulegn D, Ma CC, Charles LE, Andrew ME. An exploration of shift work, fatigue, and gender among police officers: The BCOPS study. Workplace Health Saf. 2018;66(11):530-537. doi: 10.1177/2165079918754586</mixed-citation><mixed-citation xml:lang="en">Violanti JM, Owens SL, Fekedulegn D, Ma CC, Charles LE, Andrew ME. An exploration of shift work, fatigue, and gender among police officers: The BCOPS study. Workplace Health Saf. 2018;66(11):530-537. doi: 10.1177/2165079918754586</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Кабанова Т.Н., Дубинский А.А., Московская М.С. Стаж профессиональной деятельности как фактор, детерминирующий различия в восприятии стресса у сотрудников следственных органов // Прикладная юридическая психология 2019. № 1 (46). С. 59–68. doi: 10.33463/2072-8336.2019.1(46).059-068</mixed-citation><mixed-citation xml:lang="en">Kabanova TN, Dubinskii AA, Moskovskaya MS. [Years of professional experience as a factor determining differences in perception of stress in investigating officials.] Prikladnaya Yuridicheskaya Psikhologiya. 2019;(1):59–68. (In Russ.) doi: 10.33463/2072-8336.2019.1(46).059-068</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Zhan YX, Zhao SY, Yuan J, et al. Prevalence and influencing factors on fatigue of first-line nurses combating with COVID-19 in China: A descriptive cross-sectional study. Curr Med Sci. 2020;40(4):625-635. doi: 10.1007/s11596-020-2226-9</mixed-citation><mixed-citation xml:lang="en">Zhan YX, Zhao SY, Yuan J, et al. Prevalence and influencing factors on fatigue of first-line nurses combating with COVID-19 in China: A descriptive cross-sectional study. Curr Med Sci. 2020;40(4):625-635. doi: 10.1007/s11596-020-2226-9</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Raudenská J, Steinerová V, Javůrková A, et al. Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic. Best Pract Res Clin Anaesthesiol. 2020;34(3):553-560. doi: 10.1016/j.bpa.2020.07.008</mixed-citation><mixed-citation xml:lang="en">Raudenská J, Steinerová V, Javůrková A, et al. Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic. Best Pract Res Clin Anaesthesiol. 2020;34(3):553-560. doi:10.1016/j.bpa.2020.07.008</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Габдреева Г. Ш. Гендерные различия адаптивности личности // Филология и культура. 2016. Т. 1. № 43. С. 338–347.</mixed-citation><mixed-citation xml:lang="en">Gabdreeva GS. Gender differences in adaptability as a personality trait. Filologiya i Kul'tura. 2016;(1(43)):338-347. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Медведева Ю.И., Зорин Р.А., Жаднов В.А., Лапкин М.М. Показатели вегетативной регуляции при фокальной лобной и височной эпилепсии // Российский медико-биологический вестник им. академика И.П. Павлова. 2021. Т. 29. №1. C. 45–53. doi: 10.23888/PAVLOVJ202129145-53</mixed-citation><mixed-citation xml:lang="en">Medvedeva YuI, Zorin RA, Zhadnov VA, Lapkin MM. Parameters of autonomic regulation in patients with focal frontal and temporal epilepsy. Rossiyskiy Mediko-Biologicheskiy Vestnik im. Akademika I.P. Pavlova. 2021;29(1):45-53. (In Russ.) doi:10.23888/PAVLOVJ202129145-53</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru"></mixed-citation><mixed-citation xml:lang="en"></mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
