PROPHYLACTORIUM

PROPHYLACTORIUM, a complex of therapeutic and preventive institutions including a therapeutic nutrition dining room (diet dining room), night sanatorium, day sanatorium, physiotherapy department, sports ground, solarium—usually included as an important component in individual dispensaries (e.g., tuberculosis dispensary), dispensary associations, or outpatient clinic associations, forming a single dispensary. The composition of this complex may vary depending on the nature of the medical institution of which it is a part and on the local production and living conditions of the categories of workers served. History. The P. is a product of Soviet medicine. In prerevolutionary Russia there was not a single P., and the very concept of 'prophylactorium' appeared only after the October Revolution. The first prophylactoria were organized at tuberculosis dispensaries. P.'s at general medical institutions and at single dispensaries were first organized in Moscow, Leningrad, and then they began to open in other large cities and industrial centers. For details and literature—see Dietary Dining Rooms, Sanatorium, Solarium, Physical Culture, Tuberculosis, Dispensary, Dispensarization. A P. may consist only of a diet dining room and sanatorium or of a sanatorium and physiotherapeutic department and sports ground, etc., in various combinations of these elements; however, the therapeutic nutrition dining room is most often an essential component of the prophylactorium.—The P. makes it possible to provide workers with the necessary qualified therapeutic and preventive care without removing them from production, and the application of appropriate therapeutic forces of nature in natural and transformed form and the provision of necessary dietary nutrition occupy the most important place in the work of the P. Both are provided in combination with a certain rest regime in night and day sanatoriums, while mass service of workers by the P. for the types of assistance mentioned is provided on an outpatient basis. If the provision of therapeutic and preventive assistance in the P. is associated with the need to shorten the working day, then the associated decrease in workers' earnings is compensated accordingly by the insurance fund.—The P. is organized at a dispensary, polyclinic, or hospital at the most powerful therapeutic and preventive institutions that have the necessary premises, equipment, and medical personnel. The P. usually serves not only patients receiving treatment at this medical institution, but also patients of an entire district or area of a city or several districts, from which contingents of patients in need of P. assistance are directed by other medical institutions and especially by health posts at enterprises in the manner established by the health department. P.'s are also organized at large enterprises; here they function in close connection with the health post, which directs their work; in these cases the P. usually consists of a diet dining room or diet department in the general factory dining room, sports ground, hydrotherapy installations (mostly showers, occasionally a pool), solarium, aerarium; the factory P. provides assistance during the lunch break, during breaks caused by the course of the technological process, or during special breaks for rest. P.'s are usually organized in large cities, industrial centers, in large district centers with a working population, at large enterprises; in the future, it is planned to develop P.'s at large rural medical-sanitary institutions serving state farms and collective farms. In the Soviet healthcare system, the P. occupies a prominent place, since with relatively small expenditures while keeping the worker at the workplace, it helps reduce morbidity and injury, prevent diseases, improve the work and rest regime at the workplace, spread sanitary-hygienic knowledge and skills, and in particular reduce the burden on stationary and sanatorium-resort treatment institutions, where treatment costs significantly more than in the P., not to mention the removal from production associated with hospital treatment, which in many cases is excessive and entails unnecessary losses for the national economy. Selection of appropriate contingents for the P. is carried out taking into account not only medical but also social indications, usually through special commissions ('kotyby', labor and living conditions improvement commissions, assistance commissions), in which participate: the chief physician of this medical institution where the P. is located, heads of the P. or its corresponding component (diet dining room, physiotherapeutic department), heads of health posts of corresponding enterprises, and representatives of factory committees of the latter. Selection is also carried out through institutions conducting dispensarization.—The working hours of the P. are set taking into account the working hours of the enterprise so as to facilitate workers' ability to use the P. without being removed from production (night sanatorium for serving workers of day shifts, day sanatorium for workers of evening shifts, diet dining room with working hours corresponding to breaks in the work of different shifts, etc.). In newly built dispensaries, polyclinics, etc., all parts of the P. are located in a special part of the building with proper isolation of the dining room, sanatorium premises; the physiotherapeutic department of the P. (electro-, X-ray-, helio-, hydro-, mechanotherapy) is arranged so that it is accessible from within from the polyclinic side and from the street side for serving patients directed by other medical institutions and health posts of enterprises. The physiotherapeutic department of the P. may also be located in a separate building; the same applies to the therapeutic nutrition dining room. Where the P. is located on the territory of a hospital, the physiotherapeutic department also serves patients of inpatient departments at certain hours; in this case, the diet dining room can also serve at certain hours certain categories of inpatients. Staffing of the P. is established for all its components in accordance with the volume of work of each component according to established norms for medical personnel provision. II. Should be distinguished from the labor P., which treats women engaged in prostitution suffering from venereal diseases and accustoms them to work by organizing training for them in special workshops (see Venereal Diseases, Prostitution).l. gorfin. PROFILE. Anthropometric profile- a computational or graphical method for showing the degree of deviation of an individual or type in several characteristics from a conventional basic type. Let e.g. the basic type be the type of hot shop metalworkers in Moscow aged 30-39 years. Anthropometrically this type is characterized by certain average values (M) and quadratic deviations σ (see Variational Statistics) of a series of characteristics such as height, weight, etc. The question is how to characterize two individuals (J₁ and J₂), having the same values of these characteristics. This characteristic will be the differences between the average and individual values of the separate characteristics (D=M-J), expressed in comparable conventional units, e.g. in fractions of quadratic deviations (σ), and presented in their relationship. The above calculations are presented in the following table: ---Relative deviation in the direction of - m ^v direction* 5 1 005 &0 S 1 0 1,'5 Height Weight Chest circumference Shoulder transverse diameter Leg length !----1 \ \ _ч > \ < Figure 1. Anthropometric profile of two individuals (curves). The base (line)-metalworkers of hot shops in Moscow 3 0-3 9 years. Profile expressed in fractions of quadratic deviation. Characteristic Value basic type first individual second individual a Their a D, d₂ a 167,1 66,0 91,t 38,5 89,3 5,1 5,9 4,2 1,6 4,2 162,8 58,9 87,6 36,9 86,1 -4,3 -7,1 -3,8 -1,6 -2,9 -0,8 -1,2 -0,9 -1,0 -0,7 166,0 69,5 94,8 38,8 88,6 +3,5 +3,4 + 0,3 -0,7 -0,2 +0,6 + 0,8 + 0,4 -0,3 Weight......... Chest circumference ... I Shoulder transverse diameter . . From the table it is clear that for the first individual, a relatively small weight is particularly characteristic, for the second, a relatively large chest circumference. For graphical characterization, through arbitrary but equal intervals, parallel lines are drawn, each of which denotes variations of one characteristic—height, weight, etc. These parallels intersect at right angles with several other parallels, also at arbitrary but equal distances. The central of the perpendiculars (Ж) denotes the average values of the characteristics, the others represent relative deviation. Instead of quadratic deviation, other parameters can also be used, e.g. the range of physiological variability of the characteristic from minimum to maximum. Having determined the relative deviation, the found values are plotted on a grid. The line connecting the points found for a given individual represents the 'profile', graphically expressing the relationship of characteristics (fig. 1). In practical work, when preparing an individual card, ready-made grids are often used, in which the individual values of characteristics are distributed according to relative deviation and printed. It only remains to connect the points characteristic of the individual. Values of relative deviation are grouped into normal, small, very small, etc., variants.

Martin's classification is well-known, but others exist. Theoretically, the method of relative deviations in the described form is not without flaws. In the presence of correlation between sizes and their unequal variability (in different groups), P. distorts the relationship of traits. P. constructed in the described way for characterizing the connection between growth and weight are not sufficiently reliable. More precise results are obtained if, as a basis, one uses not the general average of the given type (M), but the average corresponding to the growth of the given individual. Just as P. of individual deviations are constructed, P. of type deviations or type difference can also be obtained.

V. Bunak. Psychological Profile-a method of quantitative research of intelligence, proposed and developed by Rossolimo. According to the author's intention, this method should be a system of tests that would capture, as much as possible, all spheres of mental activity and at the same time allow for a quantitative characterization of the mental processes being studied. In addition to intellectual functions, to which the largest number of tests is devoted, the profile method also captures volitional processes. Originally intended for the study of children in normal and pathological cases, the method was later modified and improved and began to be applied to adults, and then was widely used in the professional selection of adolescents. The author himself considers the P. p. method suitable for the following purposes: 1) for solving general psychological questions (by means of a complete profile or its individual components); 2) for developing the question of types of mental individualities; 3) for the comparative study of profiles of the same individual under different conditions; 4) for research in the field of personality development at different periods of its life; 5) for solving a number of questions of pedagogical psychology; 6) for developing the doctrine of mental retardation; 7) for facilitating the research and diagnosis of many pathological forms and symptoms from the field of mental activity; and finally 8) for clinical and forensic psychiatric research of such mentally ill persons, as well as malingerers, where methods that are as objective as possible and experimentally verified are especially needed. The essence of the method is reduced to the study of mental functions identified by the author by means of tasks or tests selected by him. These tasks are very simple, elementary, and for their solution almost no educational qualification is required; one only needs to know the names of months, days of the week, and be able to count to ten. By means of these tasks, the author intended to reveal the so-called primary, or natural, mind, which in its subsequent dynamic development "absorbs" those cultural benefits that are given to the individual by the social environment surrounding it, influencing its formation (for criticism of these positions, see below). Three groups of processes are studied: a) attention and will, together constituting the mental tone, b) accuracy and stability of perception (memory), and c) associative or higher processes. This is the general division of the system, which is then broken down into the study of individual mental functions, the author dividing each of them into a whole series of separate properties and using different material for testing. The detailed scheme, reduced to the study of 11 mental functions, has the following form: A. Mental tone. I. Attention: studied in relation to 1) stability a) with selection, b) with distraction, 2) volume or distribution of attention. II. Will: determined by its ability to resist 1) automatism and 2) suggestibility. B. Memory. III. Accuracy of visual perceptions: 1) in subsequent recognition, 2) in simultaneous judgment and 3) in subsequent reproduction. IV. Stability of perceptions: 1) of meaningless linear figures, 2) of meaningless colored figures, 3) of pictures (1-3-by means of recognition), 4) of objects with subsequent enumeration. V. Accuracy of perception with respect to elements of speech: 1) auditory perception of syllables, 2) auditory perception of words, 3) auditory perception of words by association with syllables, 4) auditory perception of sentences. VI. Accuracy of perception of numbers: 1) auditory perception of numbers, 2) visual perception of number of figures, 3) visual perception of number of signs. Note: memory tests are spoken or shown 3 times. The strength of memory (retention) is determined by means of immediate reproduction and by reproduction after an hour; the percentage ratio to what was initially retained in memory is calculated. C. Higher processes. VII. Comprehension: 1) simple, i.e., comprehension of correctly drawn pictures or visual absurdities, 2) combinatorial, i.e., series of pictures connected by a common content. VIII. Combinatorial ability: composing 1) pictures of specific content and drawings cut into parts, 2) complex figures from their constituent elements. IX. Ingenuity-ability to solve simple mechanical puzzles. X. Imagination: ability to complete in imagination the missing parts in drawings, words, and sentences. XI. Observational ability, i.e., ability to find the hidden meaning or peculiarities of an object. The entire research scheme, due to the division of tests by individual functions and the identification of separate aspects in each function, thus reduces in its most complete form to 26 groups of tests, with 10 experiments in each group. Thus, the entire research includes 260 tasks. The evaluation of each task is always alternative, i.e., a + sign is given for a positive solution of the task and a - sign for the absence of solution or incorrect solution. Further, the level of development, or the state of a particular function, or rather of one or another of its aspects, is determined by the number of correctly solved tasks. Thus, the maximum level is determined by the number 10, representing the total number of tasks offered for testing a particular property. Due to the discovered unequal difficulty of tests for individual processes, the author, in order to equalize as much as possible the evaluation results of individual processes constituting the profile, introduces an equalizing addition, calculated by him from a large number of studies and compiled in a separate table, from which it is easy for a given level of each process to find the corresponding number expressing this level together with the equalizing addition added to it. The thus obtained numbers are plotted on a coordinate system, with the abscissas indicating the properties being tested and the height of the ordinate indicating the level of development of a particular mental property or the number of correctly solved tasks pertaining to this property. The line connecting all the end points of the ordinates and represents the curve called the P. p., which illuminates the "strength of psychomechanics" of the personality. Further processing of the obtained data is carried out as follows. Arithmetic means are calculated for the 11 processes mentioned above, with the percentage ratio of the height of the second reproduction to the first for all three types of memorization. All these data are also depicted graphically and form the so-called reduced profile, which allows one to form an idea of the level of a number of processes with definite psychological significance. Then the profile formula is derived, which gives an idea, on the one hand, of the average height for all 11 processes (the arithmetic mean of all 11 heights), i.e., of the "average height of the profile", which the author designates by the letter P, and on the other hand, of the average height of each of the three main groups of mental processes included in the studied "psychomechanics", namely: mental tone, consisting of the average heights of attention and will and designated by the letter t, memory, representing the arithmetic mean of accuracy and all three types of stability of perception (memorization) and designated by the letter m with the average percentage of retention (r), and finally the "higher" or "associative" processes-comprehension, combinatorial ability, ingenuity, imagination, and observational ability, designated by the letter a. The formula is thus represented in the following form: P || t + m (r%) + a. On the reduced profile, we find a reflection of the relationship of these three components, which, in the author's opinion, is very important for the final characterization of each individual profile. The duration of the research is at least 2¹/₂ hours, for which reason it is proposed to conduct it in several sessions, in any case not less than in two sessions. Evaluation of results. The absolute value of the average height according to Rossolimo with a number below 7 indicates mental deficiency. An average profile height of R₂-R₃ indicates deep imbecility. R₄ is a borderline state between imbecility and debility, R_4.5-R₅ indicates debility, R₆-R_7.9 indicates a borderline state between debility and normality, i.e., characterizes a person with intelligence within the subnormal or low normal range. All data with an average height of 7 and above indicate psychomechanics within the normal range, with the greater the height, the more gifted the individual. The highest limit of 10, as numerous studies have shown, is reached by only a few. However, the author is not satisfied with indications of the average height of the psychological profile. The diagnosis is made by the author only when taking into account the structural features of the profile, which are evaluated from the point of view of the ratios between the heights of its three components: tone, memory, and higher processes.

The joint activity of these groups characterizes the psych. activity of the personality, and the positive type, which is most favorable for successful work of the intellect and characteristic of versatile mental giftedness, is the one in which tone, memory, and higher processes reach either the same height or there is a uniform increase in the direction from tone to higher processes with the difference between two adjacent heights not exceeding one unit. Deviations from this favorable structure of the 'psychomechanics' form typical groupings, to which the author gives different diagnostic interpretations (Fig. 2). The author establishes, in addition to the most favorable positive type mentioned above (+ + +), six other types of psychomechanics, using the following terminology: hypotonic type (- +), expressing weakness of psych. tone; amnestic (Fig. 3) (- + - -) with relatively decreased memory and receptivity; demented (+ - -) with insufficiency of higher psych. processes; psychasthenic or asthenic type of P. psychol. (- - - +) with decreased psych. tone and memory compared to higher psych. processes; this type, among other things, is noted in those degrees of psych. weakness that occur in deep asthenias, simple or preceding disintegration of the personality and acquired dementia; hypotonic-demented (- - -) type with relative activity of memory and decrease of psych. tone and associative higher processes (with a low average height of the profile, this type often characterizes an imbecile personality) (Fig. 4); finally, amnestic-demented type (- - + -) with poor memory and associative processes at sufficiently good psych. tone. The method of P. psychol. has found wide application mainly in pedagogy and in the field of vocational orientation, and not only in the USSR, but with one or another corrections and changes in many places abroad. Incomplete, or partial, profile. In view of the need in certain cases for quick orientation in the 'psychomechanics' of a given individual and the impossibility of subjecting him to a 2-3 hour examination, the author has identified from the system of P. psychol. seven of the most characteristic and responsible processes that give an approximate structure of the profile, the study of which he limits himself to in these cases. These processes are: 1) stability of attention with selection, 2) suggestibility, 3) memory of linear figures, 4) memory of words, 5) memory of numbers, 6) combining comprehension, and 7) combining from elements. This research lasts about 40 minutes. If necessary, the research can be supplemented with the remaining 19 processes and thus the partial P. is supplemented to a complete one. The processing of materials obtained by this partial P. is done according to the same rules as in the complete one. The evaluation is the same. Gize uses completely different tests for this and expresses the results not in absolute numbers but in percentage relations. Lahy in his article on the significance of the profile in professional selection and Mass research on the profile. The need for quick research of more or less significant groups of the population for various needs led to the revision of the partial profile for simultaneous research of a large number of individuals. For this purpose, all tests have been revised in such a way as to allow subjects to answer the proposed tasks exclusively in writing. Thus, attention is investigated by piercing points with certain signs forming figures located on one sheet; combining comprehension is underlining the positive or negative evaluation in descriptions of possible and impossible events, printed at the end of each of them; combining from elements is dividing the contours of figures by lines into small triangles and squares, samples of which are given on the same page, etc. The counting of results and evaluation are the same. This method has found wide application both for the professional selection of adolescents in FZU and for forming groups of the second stage. Claparade, recognizing the positive qualities of the profile, points out the varying difficulty of the tests, in view of which the same experimental evaluation of all series of tests intended for different processes is fundamentally incorrect; he therefore proposes to evaluate the results in percentage ratio. On the basis of these indications, the above-mentioned equalizing addition to the evaluation of research results was introduced. Also based on Claparade's indications, Guizet proposed a percentage P. psychol., including in it also research on orientation also points out the great scientific significance of this method. In the field of practical applications, in Lahy's opinion, the Rossolimo method makes it possible to interpret various questions of psychology, illuminate problems of pedagogy, criminal psychology and determine intellectual deficiency. Lahy, among other things, used the method of P. psychol. for vocational orientation; he believes that for each profession a special P. psychol. with specific tests can be established. He thus established, for example, the profile of a tram conductor, Gemelli-the profile of an aviator, Bartsch, having changed only a few tests, widely applies P. psychol. for the research of children in auxiliary schools. Similar application of P. has also been found in other countries. In a critical evaluation of P. psychol., one cannot overlook the historical aspect. The author proceeded from the need for objective study of psych. features of the personality by objective registration of the subject's reactions. The logical consequence of this premise is the author's recognition of the quantitative principle of evaluation of the obtained results. Thus, Rossolimo joined the spontaneously materialistic trend in psychology and the method he proposed naturally caused sharp criticism from 'pure' idealist psychologists, who considered only the method of self-observation as the only correct one; the research of the psyche by applying objective irritants was treated by them as dilettantism and in any case as a scientifically poorly grounded procedure. The introduction of quantitative evaluation into the psychological analysis of personality acquired great principled significance, all the more so as it concerned complex types of mental activity. These historical merits of the method of P. psychol. by no means remove the task of decisive criticism of the mechanical in essence theoretical foundations of this method. The author points out that the ideal method should be considered one whose results would not be affected by either age, education, or culture. Further, when under the pressure of the logic of facts the author introduces into his theory a correction for age, he here also falls into his characteristic error, adding to each age, starting from 7 to 12 years, 0.2 to the average height of the profile and thus not providing for the jump-like nature and specificity in the dynamics of the child's development. He also does not take into account the plasticity of the mechanisms of higher nervous activity, assuming that from 12 years of age any development of intellectual abilities stops and therefore removes the need for further corrections for age in the technique of P. psychol. Furthermore, the typical standards of P. psychol., established by the author, are as if outside of time and space, since they are not differentiated from the point of view of various concrete-historical conditions in which the individual grows, acts, and is educated.