How stress affects health. The effect of stress on the human body at the physiological level

Throughout life, we are constantly faced with stress. Stress is a natural physical and mental response to both good and bad experiences that can be extremely beneficial to your health and safety. Your body responds to stress by releasing hormones into your bloodstream, increasing your heart rate and breathing faster. As a result, the brain receives more oxygen and gives you the opportunity to respond to the problem in the most appropriate way. In the short term, stress helps you deal with difficult situations.

Stress can be caused by the burden of daily duties at work and at home. Negative events, such as divorce or the death of a loved one, also cause stress. So is physical illness. Traumatic stress caused by war, disaster, or a criminal attack can keep you stressed for much longer than it takes to survive. Well, chronic stress can lead to the appearance of various symptoms and affect general state health and your well-being.

Let's look at what the impact of stress exerts on various body systems.

Effects of stress on the central nervous and endocrine systems

Central nervous system(CNS) is responsible for the fight-or-flight response. The central nervous system instantly tells what to do to all other parts of the body, directing all resources to solve the problem. In the brain, the hypothalamus comes into play, telling the adrenal glands to release adrenaline and cortisol.

When the feeling of fear passes, the central nervous system tells all systems that it is possible to return to normal mode. If the central nervous system itself fails to return to normal mode or the stress factor has not disappeared, this will affect your health.

Symptoms of chronic stress include irritability, anxiety, and depression. You may suffer from headaches or insomnia. Chronic stress can lead to overeating or undereating, alcohol or drug abuse, and social isolation.

Stress and the respiratory and cardiovascular systems

Stress hormones affect the respiratory and cardiovascular systems. During the stress response, you breathe faster to quickly distribute oxygen and blood throughout your body. If you have a respiratory condition like asthma or emphysema, stress can lead to difficulty breathing.

The heart also pumps blood faster. Stress hormones cause blood vessels to constrict, resulting in high blood pressure. All this helps to oxygenate the brain and heart so that you have more energy and strength to act.

Frequent or chronic stress makes the heart work too hard for too long, increasing the risk of developing hypertension as well as problems with the blood vessels and heart. In this case, you are more likely to have a stroke or heart attack.

The hormone estrogen gives premenopausal women some protection against stress-related heart disease.

The effect of stress on the digestive system

Under stress, the liver produces extra sugar (glucose) to give you an energy boost. Unused blood sugar will be reabsorbed by body tissues. If you are under chronic stress, your body may not have time to normalize blood sugar and then you are at increased risk of developing type 2 diabetes.

A sharp increase in hormone levels, rapid breathing and heart rate can lead to digestive disorders. You will most likely suffer from heartburn and acid reflux. Stress is not the cause of ulcers, the bacterium "Helicobacter pylori" is to blame. However, stress can aggravate an already existing ulcer.

You may experience nausea, vomiting, and abdominal pain. The effect of stress on the movement of food through the digestive tract can lead to diarrhea or constipation.

Muscular system and stress

Under stress, muscles tense up to protect themselves from damage. It is quite possible that you have already noticed that you tense up in difficult situations, and when the stress factor disappears, you relax. If you are constantly under stress, your muscles have no opportunity to relax. Tight muscles can cause headaches, pain in the back, shoulders, and other parts of the body. Pain can force you to start using painkillers, which can lead to an unhealthy addiction.

Sex drive and the reproductive system

Stress drains the resources of the body and mind. It is not uncommon for people under chronic stress to lose interest in sex. However, during times of stress, the male body can produce more of the male sex hormone testosterone, which can increase sexual arousal for a short time.

In women, stress can affect the menstrual cycle. Menstruation can become irregular, or even completely disappear, it can be more difficult and painful. The physical symptoms of menopause may be more intense in a state of chronic stress.

If stress continues for a long time, testosterone levels begin to drop. This can affect sperm production and lead to erectile dysfunction or impotence. The chronic effects of stress can make the urethra, prostate, and testes more susceptible to infection.

Immune response to stress

Stress stimulates the immune system. If the stress is short-term, then it will benefit the immune system. It helps prevent infectious diseases and heal wounds. However, over time, cortisol compromises the immune system by suppressing histamine secretion and the inflammatory response. People in a state of chronic stress are more susceptible to viral and colds. This increases the risk of developing concomitant diseases and infections. Stress can also prolong the recovery period after an illness or injury.

The impact of stress on human health is very well studied by scientists. This is primarily manifested in the development of many stress-dependent diseases of internal organs:

coronary disease hearts,
atherosclerosis,
hypertension,
diabetes,
peptic ulcer,
bronchial asthma,
neuroses, etc.

Nervous stress can affect a person's health in the following ways:

can play the role of a leading pathogenic factor and lead to diseases that are related to, in particular to;
may participate in the occurrence and development of somatic disorders as one of several different external and internal factors that have a pathogenic effect on the body;
various mental factors can adversely affect the course of any disease.

In addition to the nature of the provoking factor itself, it is worth mentioning the factors that affect the severity and nature of pathological reactions. These include three characteristics:

stressful event;
an individual exposed to stress;
social environment.

Stress and heart disease

Cardiac ischemia

The influence of stress on the occurrence and development of coronary heart disease, the main enemy of human health, has been studied the most. According to the American cardiologist G.I. Rassek, out of 100 patients with coronary heart disease under the age of 40 years, 91% were subjected to prolonged emotional stress associated with increased responsibility at work, compared with 20% in the control group of healthy individuals. Besides:

70% of patients with coronary heart disease,
lack of physical activity was present in 58%,
excess fat intake - in 53%,
— in 26%,
hereditary predisposition to coronary heart disease - in 67%.

Of the neuropsychic factors contributing to the emergence and progression of coronary heart disease, the main ones are the characteristics social position patients and their changes, excessive nervous stress (overload at work, chronic conflict situations, life changes). Extremely important for the onset and progression of coronary heart disease is the way an individual responds to various external and internal problems, including:

life dissatisfaction,
sense of anxiety,
depression
neurotic disorders,
emotional exhaustion,
insomnia.

In addition, the individual style of external expression with manifestations of aggressiveness, rivalry, irritability, and haste is important. Type A behavior is especially predisposing to coronary disease (read). Type A behavior increases the risk of coronary heart disease, according to some reports, by about 60%.

The mechanisms of the damaging effect of stress on the heart muscle with the development of coronary heart disease are currently well understood (diagram above). Among them, the most important are:

atherosclerosis of the coronary arteries,
non-coronary adrenergic myocardial damage,
increased blood clotting,
coronary thrombosis,
decrease in myocardial resistance to hypoxia and ischemia, etc.

Atherosclerosis

Prolonged tension of the central nervous system and, as a result, stress can contribute to the development of atherosclerosis of the coronary arteries of the heart and other vessels.

This was evidenced by the message of the Czech doctor F. Blaga, which appeared in the press in 1958. As a prisoner of the Dachau concentration camp during the Second World War, he performed several thousand autopsies of dead prisoners and found that many of them, even under the age of 30, had pronounced signs of atherosclerosis. It was found that the severity of atherosclerosis was directly proportional to the length of time people spent in the camp. At the same time, the daily ration of prisoners contained no more than 5 grams of fat.

Mechanisms of development of atherosclerosis

Taking into account the experimental and clinical data, the main mechanisms for the development of neurogenic atherosclerosis can be presented as follows.

Psychoemotional stress is accompanied by activation of the pituitary-adrenal and sympathetic-adrenal systems, which leads to hyperlipidemia. With the cessation of nervous excitation or with prolonged excitation, the level of 11-hydroxycorticosteroids in the blood decreases, which causes the development of pathological permeability of the walls of the arteries and the deposition of blood plasma lipids in them.

However, it should be noted that positive in the experiment on animals do not lead to the development of atherosclerosis.

stress and pressure

The negative impact of psycho-emotional stress on the occurrence and course of hypertension has been repeatedly proven. Long-lasting increase blood pressure noted after stress, namely:

after prolonged psycho-emotional stress,
after participating in hostilities,
with the threat of unemployment
in the conditions of long and excessive requirements for information processing.

Numerous studies have pointed to a clear predominance of high blood pressure among the population of large industrial centers compared with rural areas. People who have moved to large cities from rural areas fall ill and have pressure problems just as often and even more often than locals, and they often need an appointment.

There is evidence of the highest prevalence of hypertension among managers and administrative workers, engineering and technical staff, and researchers. Great importance in the occurrence of hypertension is given to the nature of the relationship between family members and the situation in the team. According to various researchers, 64-88% of those suffering from high blood pressure before the onset of hypertension had significant stresses of psycho-emotional genesis.

All the above examples indicate that psycho-emotional stress associated with an abundance of information a large number interpersonal contacts, and especially with a change in life stereotypes, for a significant part of people, especially for those with a hereditary predisposition to hypertension, do not pass without a trace. They end with the appearance and progression of increased blood pressure.

Stress and diabetes

Nervous stress, leading to the activation of the pituitary gland, cortical and medulla of the adrenal glands, thus affects the state of human health, which contributes to an increase in blood sugar levels. This stimulates the pancreas, which in some people may be accompanied by the depletion of its functionality, namely the deficiency, and ultimately the development of diabetes. The diagram above shows the main stages in the development of diabetes mellitus under the influence of nervous stress.

The role of stress in the occurrence and progression of neurotic disorders, in particular neuroses, is especially important. As a result of one of the studies, it was found that the prevalence of neurosis is 11.5%, including among women - 17.2%, among men - 5.7%. Neurotic disorders were observed more often in urban residents (15.4%) and less often in representatives of the rural group (7.3%). The trend towards an increase in the frequency of neuroses in the process of urbanization, which is noted everywhere, is due to personal and social factors which are characterized by an increase in psycho-emotional tension.

in 56% of the examined patients, the disease is associated with family and domestic psychotraumas,

32% have industrial conflicts,

in 12% - with intense mental work and with overstrain.

The occurrence of neuroses is significantly influenced by additional factors:

type of higher nervous activity,
biorhythm disorder,
many others, asthenizing the nervous system.

IN last years work began to appear linking the emergence oncological diseases, in particular cancer, from stress. Animal experiments have revealed the influence of a person's emotional status on genetic variability.

Neuropsychic stress causes a sharp change in the hormonal status in the body, in particular an increase in the level of corticosteroids. A number of experiments have shown that these hormones cause inhibition of DNA replication and repair synthesis, as well as chromatin fragmentation in somatic cells, which is mediated by the action of hormones. Stress can lead to an increase in the frequency of mutations and, as a result, to cancer.

Stress, apparently, plays the role of a link between the environment and the genetic apparatus. Abrupt changes in the environment, causing neuropsychic stress in humans, ultimately lead to a redistribution of recombination events, the emergence of offspring with an altered spectrum of combinational variability. Thus, the environment, through a stress reaction, generates variability in the offspring of persons who do not have individual adaptation to it. Stress can significantly affect the detection of hidden genetic diversity and modulate recombination and mutation processes. This original hypothesis complements our understanding of evolutionary development. The above data on the effect of neuropsychic stress on genetic variability largely substantiate the previously expressed opinion about the possibility of developing cancer under the influence of stress.

You can boast of excellent health and the ability to resist any disease as much as you like, but not to experience stress even once in your life?! Such people simply do not exist! Negativity, conflict situations, reasons for nervous strain in life modern man, alas, enough. A is a natural reaction of the body to such factors.

Everyone knows the negative impact of stress on human health, both mental and physiological. No wonder they say that all diseases arise from nerves, but what exactly can this manifest itself in?

Psycho-emotional state

splash negative emotions regardless of the reasons that caused it, it introduces an imbalance in the usual measured way of life. Stress affects a person's behavior in society, affects his mental capacity, reduce performance. With isolated cases, the body can cope. In this case, stress is not so dangerous and does not lead to serious consequences. But if the nervous tension lasts for a long time, a person is constantly stressed, then this can cause various psycho-emotional disorders and nervous disorders.

Common effects of stress are:

imbalance;
causeless mood swings;
neuroses;
emotional instability;
memory impairment, impaired attention;
anger;
increased fatigue.

In such a state, the quality of human life deteriorates significantly. Simply put, it becomes much more difficult for him to live, since any action is given with great difficulty and requires incredible mental strength. Often, against the background of stress, insomnia, irritability, intolerance, can occur.

The most disappointing post-stress state is severe prolonged depression, apathy towards everything around. The consequence of this may be a complete loss of interest in life, suicidal behavior, obsessive thoughts about suicide.

Stress and physical health

One way or another, stress causes a temporary disruption of the functions of the central nervous system and brain. And since all systems and organs in the human body are interconnected, this cannot affect his physical health. That is why stress is mentioned as one of the main causes of the occurrence or exacerbation of a huge number of somatic diseases. The most common consequences are:

Weakened immunity, low body resistance to viral, bacterial, infectious diseases.
muscle dystrophy.
The likelihood of cellular degeneration of tissues of the brain and spinal cord.
Increased risk of developing oncological diseases of various etiologies, etc.

Most often, due to stress, diseases of the cardiovascular system (ischemic disease, angina pectoris, etc.) and the gastrointestinal tract (,) develop. But strong nervous strains also affect the work of other systems in the most negative way. This happens due to the fact that during stress, hormones necessary for the normal functioning of the body are produced in excessive quantities. As a result, hormonal regulation gets out of control, which causes reactions that provoke the appearance of ailments, the occurrence of certain diseases, and the exacerbation of chronic diseases.

So, for example, an increased level of glucocorticoids causes a rapid breakdown of proteins and nucleic acids. The result of a deficiency of these substances is muscle dystrophy. In addition, a high concentration of glucocorticoids in the body makes it difficult for calcium to be absorbed by bone tissues, as a result of which their structure changes, becoming more porous and fragile. Stress- one of the most likely causes of the development of such a common disease today as.

Hormonal disorders caused by stress are also reflected in the state skin. An excess of some and a lack of other hormones hinder the growth of fibroblasts. Such structural changes cause thinning of the skin, resulting in its easy damage, reduced ability to heal wounds.

The negative consequences of the increased content of stress hormones in the body that exceed the permissible norms do not end there. Among the most dangerous are growth retardation, destruction of spinal cord and brain cells, reduced insulin synthesis, the development of tumor processes, and oncological diseases.

Based on the above, one conclusion follows: stress- an extremely dangerous condition, entailing serious consequences for both physical and psychological health! Therefore, you should try by all means to avoid stressful situations, emotional overstrain, depression.

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Stressful situations lie in wait for a person every day, while the reaction of each will be different. What is the effect of stress on the human body? What are the consequences of stressful situations? These questions remain relevant for many, since the harmful effects of such conditions on the body have long been proven by many medical studies.

Stress is the body's reaction to certain external stimuli. In medical psychology, it is customary to distinguish between positive and negative stress states. The positive ones are short-term stress which are inevitable and harmless. In this case, the body receives a small shake-up, a portion of adrenaline, which quickly and imperceptibly leaves.

But if excessive worries, constant doubts, fears continue for a long time, in most cases this has a serious effect on the body. Here, not only physiological states will be affected, but also mental, mental ones.

The psyche under stressful conditions

One of the first signs of stress is a mental disorder. A person begins to constantly worry, express his dissatisfaction with others, he does not like absolutely everything: family relationships, work, position, colleagues. During communication, such people are irritable, they can suddenly become aggressive, throw out their anger on others. Psychologists agree that people under stress perceive the world as an illusion. It seems to them that everything is bad for them, that they are haunted by failures, that everyone around wants to do only bad things for them.

At the initial stage, people around react with understanding to such manifestations of a person, but after a short period of time, their contacts are completely broken. A person is isolated from communication, and his subconscious mind begins to perceive his failures even more actively.

At this stage, it is extremely important to help a person, preferably professionally. He needs to be returned to communication, to be allowed to understand that the imaginary pictures of evil are only his fantasy, but in reality everything around is good.

Stressful conditions affect family relationships the most. If a child has such a state, then it seems to him that everyone around is aggressors, that no one understands him. It is these situations that can lead to suicide attempts, runaways from home, abandonment of parents.

In such situations, it is better to talk with your loved ones, find out what they feel, how they perceive the surrounding reality, what worries them. Any manifestation of stress in a person requires professional help.

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Physiological effects of stress

Socrates said many centuries ago: "All bodily diseases have one source - the soul." modern medicine has never refuted this statement. It is stressful conditions that cause various serious diseases, including fatal ones.

When applying for an appointment with a psychotherapist or psychologist, patients indicate poor health, pain in the whole body, apathy, while all tests, examinations on the apparatus will show the norm in the work of all organs.

Most often, the complaints of all patients are identical, they indicate such sensations:

Constant pain that intensifies during crucial moments at work, at home.
Chronic insomnia, or a constant feeling of lack of sleep. At the same time, people feel pathological fatigue, they want to be constantly in bed.
There is a rapid heartbeat, which the patient emphasizes Special attention. Diseases of the cardiovascular system may develop. If the patient has chronic diseases, they become aggravated, and the symptoms are more pronounced. In statistics, there are cases when stress causes a stroke or heart attack.
People point to a decrease in attentiveness, the inability to perform their professional duties due to a decrease in working capacity, any work causes instant overwork.
It reacts very quickly to the state of the gastrointestinal tract. Causeless intestinal disorders may begin, which turn into prolonged constipation. Many point to constant nausea, lack of appetite. If there are chronic ulcerative diseases, they become aggravated.
90% of all malignant tumors appeared after the strongest traumatic stress.
People who are under stress are more likely to be attacked by viruses and bacteria, so the immune system is weakened.

Interesting fact: American scientists are engaged in research stressful conditions people since 1929, they noticed that with a long-term condition in the patient's blood, the number of leukocytes decreases significantly. Namely, these cells play important role in the formation of the body's immune defense and protect against oncological formations.

The hormonal background changes, problems begin with many important organs: the thyroid gland, genital and internal organs.
Cases have been established when such conditions led to degeneration of the brain and spinal cord, muscle dystrophy.

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Features of children's stress

Modern medicine records a lot of facts of the development of stress in children, and their age is very different: from 6-7 years to 18. The main causes of stress in children are:

divorces of parents (this is one of the most common causes, stress from which children cannot survive even in adulthood);
separate residence from parents;
the birth of another child in the family;
experienced fears;
death of close relatives;
pain during a visit to a particular doctor;
conflict situations at school, at home;
watching various programs that do not meet age restrictions.

The parents of each child need to be very attentive and observant, since the state of stress and the whims of the child are very similar in their manifestations. And here you need not to miss the moment and turn to a specialist for help in order to adult life such states did not develop into phobias, panic and did not affect the life of the child.

Ministry of Education and Science of the Russian Federation

Yaroslavl State Pedagogical University

them. K.D. Ushinsky

Department of Health Protection and Fundamentals of Medical Knowledge

Abstract on the topic:

Stress and human health

Performed

Gromova Natalya Olegovna

Faculty of IPP

924 group, 2 course.

Yaroslavl 2009

1.Introduction………………………………………………….2

2. Types of stressful events…………………………………4

3. The impact of stress on health…………………………………………………………………………………………………………………………………………………………

4. Stress coping skills……………………………....9

5. Stress and hardening of the body…………………………….11

6.Conclusion……………………………………………....12

7. List of used literature…………………..13

1. Introduction.

IN modern life stress plays a significant role. They affect a person's behavior, his performance, health, relationships with others and in the family.

Stress is a state of excessively strong and prolonged psychological stress that occurs in a person when his nervous system receives an emotional overload.

Stress is present in the life of every person, since the presence of stress impulses in all areas human life and activities, no doubt. Today's dynamic society creates stress for many of us. We constantly feel the need to do more and more in less and less time. Noise and air pollution, congestion traffic, crime and overwork at work increasingly fill everyday life. Finally, sometimes events occur that cause especially severe stress such as the death of a relative or a natural disaster.

Stress can have direct and indirect effects on health. It is the cause of many diseases, and therefore causes significant harm to human health, while health is one of the conditions for success in any activity. Exposure to stress can lead to painful emotions such as anxiety or depression. It can also cause physical illness, both mild and severe. But the reactions of people to stressful events are significantly different: some people have serious psychological or physiological problems in a stressful situation, while others in the same stressful situation do not experience any problems and perceive it as interesting, finding new tasks for themselves in it. This means that the very occurrence and experience of stress depends not so much on objective as on subjective factors, on the characteristics of the person himself: his assessment of the situation, comparing his strengths and abilities with what is required of him, etc.

Stress can be caused by both positive and negative events. Distress is a negative manifestation of stress. Translated from English, stress is pressure, pressure, tension, and distress is grief, unhappiness, malaise, need.

The founder of the science of stress was Hans Hugo Bruno Selye. According to G. Selye, stress is a non-specific (i.e., the same for various influences) response of the body to any requirement presented to it, which helps it to adapt to the difficulty that has arisen, to cope with it. Any surprise that disrupts the usual course of life can be a cause of stress. At the same time, as G. Selye notes, it does not matter whether the situation we are faced with is pleasant or unpleasant. What matters is the intensity of the need for adjustment or adaptation.

Stress is a common and common occurrence. We all experience it at times - maybe as a feeling of emptyness in the back of our stomach when we get up, imagining ourselves in a new place, or as increased irritability or insomnia during an exam session. Minor stresses are inevitable and harmless. It is excessive stress that creates problems for individuals. Stress is an integral part of human existence, you just need to learn to distinguish between an acceptable degree of stress and too big stress. Zero stress is impossible.

Thus:

The purpose of this work:

Learn how to deal with stress.

Tasks of this work:

Answer a series of questions:

1. What is stress?

2.How does it occur?

3.How does it affect the human body?

4. How to deal with it?

2. Types of stressful events.

Stress can be caused by countless events. Among them are major changes that affect many people, such as war, accidents at nuclear power plants or earthquakes. These include serious changes in a person's private life, for example, moving to a new place, changing jobs, getting married, losing a friend, a serious illness. Everyday difficulties - losing your wallet, traffic jam, disagreement with a professor, etc. - can also be sources of stress. Finally, the source of stress may be within the individual in the form of conflicting motives and desires.

Events experienced as stressful usually fall into one or more of the following categories:

1. Traumatic events that go beyond the normal scope of human experience ( natural disasters, floods and earthquakes; man-made disasters such as wars and nuclear explosions; catastrophic accidents - for example, crashes of cars and planes; incidents of physical abuse).

2. Uncontrollable and unpredictable events (death of a loved one, dismissal from work and serious illness, as well as the rejection of a friend

accept your apologies for some oversight).

3. Events that exceed our capabilities and self-understanding (marriage, session time).

4. Internal conflicts (confrontation of motives: independence versus dependence, closeness versus isolation, cooperation versus competition, impulsive expressiveness versus moral norms).

3. Impact of stress on health.

Stressful situations cause a wide variety of emotional reactions - from mild excitement (if the event requires a certain amount of stress, but it can be dealt with) to the usual emotions of anxiety, anger, despondency and depression. If the stressful situation does not stop, emotions can follow one another depending on the success of our attempts to overcome this situation. The following are the most common reactions to stress:

Psychological reactions(anxiety, anger and aggression, apathy and depression, cognitive impairment).

Physiological reactions ( increased metabolic rate, increased heart rate, dilated pupils, increased blood pressure, increased respiration, muscle tension, release of endorphins and adrenocorticotropic hormones, release of increased amounts of sugar from the liver).

In 1978, Hans Selye described this complex of bodily reactions and called them the "general adaptation syndrome". In it, he identified three phases:
1. Anxiety reaction - preparation of the body for subsequent actions.

2. Resistance - the situation is dragging on. Outwardly, it looks like calmness, fitness, but the body continues to use reserves.

3. Exhaustion - consequences.

The consequences of stress can be psychosomatic diseases (angina pectoris, asthma, gastritis, ulcers), at the psychological level, behavioral disorganization (abnormal behavior), aggressive reactions, suicides, etc. can occur. Trying to adapt to the constant presence of a source of stress can deplete the body's resources and increase its susceptibility to disease. Chronic stress leads to physical disorders such as increased blood pressure(hypertension) and heart disease. It can also impair the immune system, reducing the body's ability to fight off invading bacteria and viruses.

The direct impact of stress on health. The physiological response of the body to a source of stress can directly negative impact on physical health if it lasts for a long time. Prolonged overexcitation of the sympathetic or adrenocortical system can cause damage to the arteries and organ systems. Stress directly affects the ability of the immune system to fight diseases.

Cardiac ischemia. Chronic overexcitation caused by constant stress, may contribute to coronary heart disease (CHD). This disease occurs when the blood vessels supplying the muscles of the heart are narrowed or clogged (by a progressive buildup of a dense fatty substance called plaque), blocking the flow to the heart. nutrients and oxygen. This causes pain called angina pectoris (angina pectoris) that spreads through the chest and arm. The complete cessation of oxygen supply to the heart causes myocardial infarction - a heart attack.

Ischemic heart disease is the leading cause of death and chronic disease. People with high stress at work are exposed to increased risk IHD, especially if the work has increased requirements (in terms of workload, responsibility and role conflicts), but is poorly regulated (the worker practically cannot influence the speed, content and working conditions).

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