Problems of Social Hygiene, Public Health and History of Medicine

Главный редактор

  • Хабриев Рамил Усманович –  академик РАН, доктор медицинских, доктор фармацевтических наук, профессор.

Учредители журнала

  • ФГБНУ Национальный НИИ Общественного здоровья имени Н.А. Семашко
  • ФГБНУ Центральный НИИ организации и информатизации здравоохранения Министерства здравоохранения Российской Федерации

Периодичность

  • С 1993 года.
  • Каждые 2 месяца, 6 номеров в год

Подписные индексы журнала

  • Каталог «Роспечать» — 73302

Индексация

  • Scopus
  • Experta Medica Abstract Journals
  • Index Medicus
  • Index to Dental Literature
  • Chemical Abstracts
  • Current Digest of the Russian Press
  • EBSCOhost
  • International Nursing Index
  • PubMed
  • РИНЦ

Миссия журнала

— состоит в развитии человеческого потенциала российской науки, в объединении усилий различных категорий исследователей, педагогической и научной интеллигенции, в создании и поддержке единого пространства научной коммуникации в областях фундаментальной и прикладной науки по медицине и здравоохранению. В создании условий открытости и доступности новейших достижений науки практическим работникам, студентам, преподавателям и всем, кто занимается развитием российского и зарубежного здравоохранения и медицины. 

Журнал предназначен для ознакомления российской и зарубежной научной и научно-педагогической общественности, а также докторантов, аспирантов, магистрантов, практикующих специалистов и других заинтересованных лиц с новыми научными результатами, имеющими значение в различных областях фундаментальной и прикладной науки.

Цель журнала состоит в популяризации и распространении актуальных и передовых знаний в области развития здравоохранения и медицины широким кругам заинтересованных граждан.

Задачи журнала:

  • совершенствование тематики и содержания журнала, обеспечение единства теории и практики научных исследований, актуальности и значимости публикуемой информации для развития научных и прикладных знаний;
  • обеспечение позитивного имиджа Журнала и российской науки в целом, содействие увеличению обратной связи с авторами и читателями;
  • обеспечение объективности и информативности публикуемых материалов, увеличение авторской и читательской аудитории;
  • повышение оперативности издания научных статей, электронного и полиграфического качества издаваемого Журнала.

Журнал зарегистрирован в Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор) (свидетельство ПИ № ФС 77 - 77004 от 11.10.2019).

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Current Issue

Vol 29, No 2 (2021)

Full Issue

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Articles
The characteristics of population mortality of the Russian Federation, the Central Federal Okrug and City of Moscow in 2020
Shchepin V.O., Khabriev R.U.
Abstract
To preserve the country's population is among one of the most vital tasks over the period of existence of the new Russia and constitutes the subject of national security. The article presents the results of analysis of population mortality rate of the Russian Federation, the Central Federal Okrug and City of Moscow during the first eight months of 2020 towards to concurrent period of 2019. In January-March 2020, the population total mortality rate, retaining prevalent trends of number of preceding years, decreased in the Russian Federation by 3.8%, in the Central Federal Okrug by 3.0% and in City of Moscow by 3.9%. However, since April-May the situation has changed dramatically and, according to the results of January-August, mortality by this time has increased, and its growth made up to 6.5% in the Russian Federation, 7.8% in the Central Federal Okrug and 15.6% in the City of Moscow. In May 2020, the gain of absolute number of the deceased in the Russian Federation by months (towards to concurrent month of 2019) made up to 11.9%, in June to 18.6%, in July to 19.7% and in August to 9.6%. In Moscow, the peak values of this increase were noted in May - 57.2% and in June - 41.6% In the conditions of new coronavirus infection pandemic, the share of COVID-19, as main cause of death (ICD-10 codes U07.1 and U07.2), in the structure of total mortality in April-August consisted 3.2% and in the structure of excess deaths in May-August - 28.6%. The increase of mortality and continued decrease of birth rate resulted in increasing of natural population loss by 1.5 times and more and reached such values as -3.6 in the Russian Federation, -4.9 in the Central Federal Okrug and -1.6 in the City of Moscow (per 1000 of population). The process of depopulation of the Russian nation not only retained, but significantly has become significantly aggravated.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):189-193
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The COVID-19 implications: the role of stress and stigmatization
Mironova K., Lipai T.P.
Abstract
At all levels of society, almost polarizing attitudes towards coronavirus are manifested, ranging from panic and empty store shelves to complete denying the existence of coronavirus problem. The wave of coronavirus parties and as well as demonstrations against restrictive measures related to infection swept the world. In addition, protests against arrivals from COVID risk areas are known. Stigma and fear can severely impede efforts to manage the spread of COVID outbreak. The predisposing factors in development of COVID stigma are lack of knowledge, rapid virus spreading, relatively higher mortality and absence of effective treatment. Meanwhile, at the level of society, particular processes are taking place, when not only infected ones, but also healthy members of society become subject to stigmatization, that can be determined as “probably” infected. The article supplements information to improve actual knowledge among specialists concerning various approaches and methods of preventing mental disorders due to stress epidemiological situation in the world.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):194-196
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The impact of natural climatic factors on level of population morbidity in Russia
Lukyanets A.S., Bragin A.D.
Abstract
The article considers the influence of natural and climatic factors on population health. According to expert judgments, natural and climatic factors are among causes of unwell feeling of significant part of Russians. The purpose of the study is to determine in what limits and in what way the climate affects citizen health. The various natural and climatic factors were analyzed in the context of their differentiation by regions and the level of impact on human organism. It is determined that natural and climatic factors cause the development of chronic diseases in Russia. On the basis of data comparative analysis concerning nature of acquired diseases and migration level it is concluded that chronic diseases of population can contribute into process of “climate migration”.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):197-202
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The impact of COVID-19 pandemic on medical tourism development
Ananchenkova P.I.
Abstract
The COVID-19 pandemic impacted tourist business on global scale dramatically. The medical tourism always was considered as the most stable and the least subjected to external circumstances. However, spreading of coronavirus infection shortened both number of arrivals and volume of medical services provided within the framework of their export. The article presents data reflecting COVID-19 pandemic impact on development of medical tourism market.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):203-205
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The trends and perspectives of development of medical tourism
Zakharova E.N., Gisina O.G., Kalnitskaya O.V.
Abstract
The article demonstrates that over the past few years medical tourism market goes through significant changes . This especially relates to regional economy and its aspects in the field of tourism. The article presents an important conclusion that nowadays the top-priority factor in the development of medical tourism is a number of crisis points in provision of health tourism services both in the regions of Russia and in the capital region that are related to pandemic and its consequences. The article considers complex of factors related just to epidemiological crisis and its consequences? including economic and social factors related to health-preserving technologies of medical tourism industry. The actual condition of tourism industry, as a branch of the Russian economy,demonstrates that it was among the first ones hit by the pandemic. The article emphasizes that due to emerging problematic trends during epidemics and their aftermaths the possibilities of providing medical tourism services and their concentration in the country, costs and conditions are changing that undoubtedly impact the economic component and health ecology aspects. The conclusion is made that among main conditions of adjustment of medical tourism industry to the new economic conditions are to be truly multidimensional and structured directions and tools that can be applied to look for way out of difficult situations when sales of medical services have fallen to zero, and companies are forced to work out on solutions emerging problems and to make plans of operational way out of existing crisis.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):206-212
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The attitude of the youth to vaccine prevention of influenza in conditions of COVID-19 pandemic
Besschetnova O.V., Volkova O.A., Aliev S.I., Besschetnova O.V.
Abstract
The article considers the problem of attitude of the youth to vaccine prevention of influenza. The study was organized on the basis of qualitative research methods (focus groups) of students of two universities in the Central and Volga Federal Okrugs. The data about attitudes towards vaccination and refusal motivation was obtained. The need in increasing awareness of the youth about vaccine prevention as an actual health-preserving technology was substantiated.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):213-219
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The comparative analysis of population attitude to vaccination against COVID-19 infection in foreign countries and in Russia
Vosheva N.A., Kamynina N.N., Korotkova E.O., Voshev D.V.
Abstract
The COVID-19 vaccination is considered as decisive factor in termination of pandemic. Hence, the vaccine development and clinical trials are carried on in an accelerated rate. At that, success of any mass immunization program, including its global application, directly depends on population willingness to be vaccinated. The purpose of the study is to investigate opinions about COVID-19 vaccination in various countries and to identify factors contributing to or hindering to increasing commitment to immunization. Methods and materials. The search of relevant data was implemented through such bibliographic databases as eLIBRARY.RU, PubMed, MEDLINE, Scopus and Google Scholar. Moreover, the primary research data concerning opinions of Russians about coronavirus infection vaccination was analyzed. Results. The cross-country study of opinions about COVID-19 vaccination permitted to identify main factors impacting degree of readiness to mass immunization, including fear and personal perceptions of risk of COVID-19 infection, attitudes to influenza vaccination and fear of vaccination, mainly due to disinformation about efficiency, efficacy and safety of the vaccine. Conclusion. The conclusion was made that public opinion surveys implemented in various countries are important because they provide priceless information for implementing public policy targeted to improve health care support, in particular to develop effective vaccination campaigns against COVID-19, identifying high-risk groups, socially and economically vulnerable individuals for whom vaccination is to be paramount and free, and also setting vaccination fees for other groups based on their readiness to pay.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):220-226
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The analysis of health condition of individuals aged 40 years and older and going in for sports
Khabriev R.U., Cherkasov S.N., Grigoriev G.Y., Fedyaeva A.V.
Abstract
The attitude to high physical loads on organism in the middle and older age groups is ambiguous, from optimistic to completely pessimistic, associated with possibility of development pathological processes because of high physical activity. The purpose of the study is to evaluate health status of people aged 40 years and older involved in sports . The health data was obtained through interviewing athletes aged 40 years and older competing in track and field events at distances of 10 kilometers or more. In total, 1800 questionnaires were distributed, and 1649 completed questionnaires were returned. The analysis of health status was implemented on the basis of self-rated health and objective characteristics (medical care appealability, acute diseases incidence, chronic diseases availability, fact of medication intake). The very high level of health self-rate was established in individuals involved in sports, that persisted along age increasing. No gender differences were revealed (4.00-4.07 for males and 3.89-4.08 for females). According to survey results, less than half of male respondents consulted physician during a year. The level of appealability was stable in all age groups surveyed. The average rate of acute diseases per year in athletes of older age groups did not exceed 1.16 diseases per year and was slightly higher in females. With age, the indicator tended to decrease in males and to increase in females. The prevalence rate of chronic diseases was low in both males and females and with age it tended to increase in males and remained almost stable in females. The rate of regular medication intake was lower than rate of chronic diseases, this difference was especially significant in females. According to respondents, sport activities, despite heavy loads and age, contribute to organism health enhancement. This opinion was specific for more than 90% of athletes, regardless of their gender. In the oldest age group (60 years and older) 94.3% of respondents expressed reported that their health improved after starting running. However, sufficient number of athletes are concerned about potential risk of training that is the reason to organize system of medical monitoring of athletes, especially in older age groups.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):227-231
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The health issues in self-appraisal of workers of industrial production and social sector
Zudin A.B., Vvedensky A.I.
Abstract
The article considers issues of health, safety and well-being of working citizens in such sectors of economy having great importance for every state such as production and social sphere. The problem of health preservation and working place safety is actual for working population all around the world, going beyond interests of individual citizens and their families and playing primary role in issues of labor safety and productivity, competitiveness and development of enterprises, stability of national economy sectors. The actuality of the study is conditioned by the fact that human resources and labor market are key institutional factors impacting the level of state socioeconomic development and determining health status of working citizens. In Russia, the issues of support by employers safe working conditions in various spheres of national economy to contribute to preservation of their employees health, to occupational diseases prevention ultimately determine both labor productivity at particular enterprise and development and stability of national economy as a whole. The study of self-assessment of health status of workers in industrial production and social sphere was carried out on the basis of results of survey implemented in September 2020 among medical personnel of the Municipal Hospital No. 11 of the city of Ryazan and employees of the oil refining plant - JSC Ryazan Oil Refinery. The analysis of the study results permitted to conclude that, in answering question about health status assessment, workers of social sphere consider themselves to be healthier than workers in industrial production.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):232-237
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The hospital medical care support of individuals older than able-bodied age in The Russian Federation
Shlyafer S.I.
Abstract
The growth of population older than working age with specific age characteristics and problems inevitably results in increasing number of their visits to physicians both in out-patient and in-patient organizations. The purpose of the study is to evaluate indices of hospital medical care of patients older than working age based on the beds profile in the Russian Federation during 2012-2019. The comprehensive study was organized to investigate dynamics of the main indices of inpatient medical care of people older than working age residing at specialized hospital beds (hospitalization rate, hospital mortality, average length of stay in bed). The forms of the Federal statistical observation form № 47 and 30 for the Russian Federation in 2012-2019 were used. The statistical and analytical research methods were applied. During these 8 years, the hospitalization rate of patients older than working age increased up to 4.5% (from 27.36 to 28.6 per 100 of population of corresponding age), the hospital mortality rate - from 3.42% to 3.95%The average length of bed stay of patients decreased from 13.4 to 10.85 days that may be associated with intensification of treatment and diagnostic process. The rates of hospitalization of patients older than working age as compared with adults of able-bodied age were higher by 1.5-8.9 times for certain types of specialized medical care (ophthalmology, palliative care, nursing, cardiology, cardiac surgery, radiology, neurology, vascular surgery, oncology).
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):238-244
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The features of temperament and levels of activation of central nervous system of female students with various condition of reproductive health
Alimbaeva M.A., Lisova N.A., Spiridonova M.S., Shilova O.I., Shilov S.N.
Abstract
The article demonstrates the relationship between temperamental features and functional state of central nervous system in female students various regimen of reproductive system functioning. The sampling included 115 female students of Krasnoyarsk with different status of menstrual function, including 51 female students with normal gonadotropic and prolactin type of anovulation and 64 female students with ovulatory menstrual cycle. The questionnaire DOTS-R was applied to establish the temperament characteristics. The functional condition of the central nervous system was studied using method of simple and complex visual-motor reaction by means of device “Psychophysiologist”. The results of the study demonstrated that girls with “calm” and “rigid” types of temperament have features of functional state of the central nervous system that can condition predisposition to menstrual cycle disorders. The particular features of functional state of the central nervous system in female students with anovulatory cycle were established: decreasing of level of activation of the central nervous system in individuals with “intense” and “unstable” types of temperament and workability of girls of “adequate” type. The application of complex reproductive health evaluation to female students to establish personalty temperamental features will input into forming of risk groups relating to development of menstrual cycle disorders in female students.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):245-249
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The disability due to industrial injuries and occupational diseases in the Arkhangelsk Oblast
Bedareva V.E., Menshikova L.I., Varakina Z.L., Kravtsova L.N.
Abstract
The article presents analysis of primary disability in the Northern Region as compared with The Russian Federation. The dynamics and structure of disability due to occupational injuries and diseases is presented. In 2008-2018, in the Arkhangelsk Oblast the level of disability for the analyzed group of causes decreased up to 9.3 times. The proportion of population of able-bodied age makes 83.4%. The occupational injuries input the largest contribution to disability structure.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):250-253
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“The effect of healthy worker” in various areas of occupational medicine: the publications review
Trubetskov A.D., Zhyrov K.S.
Abstract
The article considers “the effect of healthy worker” as a source of systematic errors that makes epidemiological studies in occupational medicine less reliable and this is a significant problem. It is very important to analyze the professions and work conditions under which the phenomenon of self-selection and artificial «health improvement» of working population is to be expected.The scientific publications from open databases and other sources, discussing effect of self-selection under various work conditions and in various professions were analyzed. The data related to effect of healthy worker during labor activity in conditions of contact with industrial dust, allergens, radiation, physical load is discussed. In development of self-selection, psycho-emotional intense work is of greatest importance. In many specialties, this effect plays an essential role in the formation of rate of arterial hypertension. The substantial staff turnover and self-selection are associated with shift and night work, disorders of sleep-wake rhythm in various specialties.The underestimation of the effect of healthy worker may result in underestimation of the degree of harmfulness of work. On the contrary, its analysis will permit to obtain more accurate data on the impact of occupational work conditions on human organism and to develop methods of professional selection and recommendations on diseases prevention.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):254-259
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The dynamics of life-span of citizen of the Russian Federation: the sociological aspect
Fomicheva T.V.
Abstract
The article considers the results of sociological study that was carried out to determine vector of dynamics of indices regulating duration of life of the Russian population, including the expected one. The method of secondary analysis of statistical and sociological information data was applied. Results. Against the background of decreasing of birth rate, “aging of population”, migration inflows and transformation of value systems the reduction of population size in The Russian Federation (natural loss) dominates, though life expectancy itself is slightly increasing. The high value of indicator of «death external causes» is established. The trend of steady decreasing of infant mortality in Russia over the past 27 years is marked. The groups of factors affecting life expectancy of the Russian population is identified. The main characteristics are revealed that are fundamentally important to ensure higher life expectancy of Russians. One of the demographic behavior models in modern Russia is described. The approaches to solve demographic problems in the Russian Federation, proposed by state bodies on the basis of policy documents (Concept of demographic development of the Russian Federation for the period up to 2025, etc.) are considered. The importance of health-preserving projects (such as “Moscow longevity”, etc.), is determined.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):260-264
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The age gender structure of the disabled due to cerebral vascular diseases in Moscow in 2014-2018
Puzin S.N., Gribova E.P., Memetov S.S., Sharkunov N.P., Chandirli S.A., Kim V.V.
Abstract
The article presents the dynamics of disability due to cerebrovascular diseases in 2014-2018 in Moscow. The age gender analysis of the disabled in this category was carried out. It was established that 30% of total population of the disabled due to cerebrovascular diseases accounted for the share of those who were recognized as disabled for the first time in the structure of total population. The most frequently disabled persons are those who are older than able-bodied age. In total structure of the disabled due to cerebrovascular diseases, women predominate.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):265-269
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The normative legal regulation of medical care support of rare (orphan) diseases in adult population of The Russian Federation
Vasilieva T.P., Komarov I.A., Aleksandrova O.Y., Zinchenko R.A.
Abstract
The article considers the results of legal regulation analysis of medical care support including medication maintenance of adult patients suffering from rare diseases exemplified by life-threatened and chronic progressed rare (orphan) diseases resulting in life expectancy decrease and or disability (“List-24”). Materials and methods. Law database was analyzed in terms of current orders of medical care provision, standards of medical care, and clinical guidelines for rare diseases from “List-24” regarding to adult patients. Results. It is concluded that there are no determined rules of medical care provision to adult population in case of rare diseases from “List-24”. There are standards of medical care on 6 rare diseases (25% of total diseases amount) from this list for adult patients. However, based on content analysis data of approved standards it was established that there are only 3 from 11 standards (27.28%) for primary medical care support, 4 standards (33.34%) for medical care provision in planned condition, and only 1 standard (9.09%) had appropriate legal basis for its development (clinical guidelines availability). Nevertheless, there is negative prognosis for this the only standard due to legal necessity of all clinical guidelines revision till the end of 2021. Conclusion. Revision and creation of clinical guidelines and standards of medical care afterwards are needed for adult patients treatment with rare diseases from “List-24”. The conclusion was made in terms of medical care standardization improvement for adult patients suffering from rare diseases from “List-24” based on its alignment with current legal regulation.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):270-277
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The mechanisms of regulation of disputes concerning inappropriate medical services support
Shmelev I.A., Sergeev V.V., Kupryakhin V.A.
Abstract
The article presents the results of comparative study of dispute resolution mechanisms related to the improper provision of medical services. On the basis of consumer model of physician-patient relationship basic options of pretrial and alternative mechanisms of settlements of disputes related to inadequate rendering of paid medical services are considered. On the basis of legal design for consumers and medical personnel the simple and evident statement of possible alternatives of mechanisms of settlement of disputes is presented. Te preferable design is consecutive application of all pretrial and alternative mechanisms of settlement of disputes. In case when there is no desirable result is the final decision is taken by court. It is concluded that the settlement of most disputes (90%) using pretrial and alternative dispute resolution mechanisms will significantly reduce time to resolve conflicts, as well as minimize unfavorable moral and economic consequences for consumers and providers of medical services.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):278-281
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The diagnostic of accessible university environment
Tanatova D.K., Korolev I.V.
Abstract
The education institutions, ensuring implementation of the rights of the disabled to higher education, adapt their environment to their needs. The universities, to organize such an accessible environment, as a rule, apply formal approach, focusing on regulatory requirements. The certification of accessible environment for the disabled is based on the same approach, when only objective indicators are considered. The opinion of those ones who have to use this environment is not taken into account. As a result, the University environment is formally considered accessible, but in practice it has many barriers that create real difficulties for disabled students. To improve the quality of the available environment, a combination of objective and subjective indicators is necessary. We need to analyze the opinions of people: employees, teachers, and students of an educational institution who use the possibilities of an accessible environment. The article offers method to diagnose availability of the University environment using specific set of indices that allow to give subjective assessment of availability of the University environment. The diagnostic method was tested on the basis of the Russian state social University, which is the flagship of inclusive education. The results of the study permitted to identify the causes of dissatisfaction with the state of accessible environment by employees, teachers and students.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):282-286
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The social health of family with disabled child during period of early childhood and school years
Vdovina M.V., Semochkina N.N.
Abstract
The purpose of the study is to compare social health of families with disabled children of early childhood and school age. The social health of family with disabled child is defined as satisfaction of family members with their position in society, their opportunities for social functioning, self-realization and interaction with social institutions that ensure their social security and support, accessibility of social environment and medical and social services. The results of original sociological surveys of parents implemented in 2017 and 2020 were applied. The emphasis is made on the peculiarities of functioning of families depending on the age of disabled child. The article demonstrates the problems of social health of families with disabled children of early childhood and families whose disabled children reached school years. The particular resources for solving these problems are discussed. The changes in social status and life strategies of parents are considered. The dynamics of medical social and other related family problems depending on the age of the «special» child is discussed. The problems of insufficient accessibility of social environment and medical and social services are revealed. The need of families with disabled children in early assistance and comprehensive support from the state services at the level of interdepartmental interaction is determined. The main directions of such support are established depending on life situation of parents and their expectations, the state of health and the degree of disability of the child. The article highlights the need to organize comprehensive support centers for families with disabled children and/or a system of personal supervision of such families involving volunteers. The main functional responsibilities of personal supervisors are defined. The practical recommendations are developed to improve the system of comprehensive support for families with disabled children.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):287-292
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The methodology of controllable medical pharmaceutical monitoring of patients: from theory to practice (publications review)
Kirshcina I.A., Soloninina A.V., Krasheninnirov A.E., Khabriev R.U.
Abstract
The preservation and promotion of health of citizens is largely determined by professional activity of both medical and pharmaceutical workers, as well as their coordinated interaction with active involvement of patient that confirms the relevance of research on improving organizational technologies for medical and pharmaceutical care of patients. The article presents an overview of international experience of controllable medical and pharmaceutical care of patient. The main interdisciplinary collaboration concepts of medical and pharmaceutical specialists from the point of view of patient health preservation is described. The main trends of professional implementation of interdisciplinary interaction in the practice of national health care are presented. The need to develop integrated medical and pharmaceutical component of pharmaceutical care of patients is justified. The definition “pharmaceutical patronage of patients” is proposed. The original methodological foundations to implement pharmaceutical patronage, including purpose, tasks and significance of the proposed service for optimizing medical and pharmaceutical care of elderly patients are discussed. It is noted that the implementation of the proposed methodology is combinatorial and variable and it may alter depending on capabilities of the pharmaceutic organization and the needs of patients. The systematized list of the main factors determining the structure and variability of functional and applied implementation of the proposed methodology in a specific territory (city, district) and / or in a specific organization is presented. It is emphasized that the key factor in implementing the methodology is the qualification of pharmaceutical specialists that justifies the need in training personnel meeting the tasks of new component of pharmaceutical care. To resolve professional tasks related to medical and pharmaceutical observation of patients, the need to introduce an additional job position with operable title «Clinical Pharmacist» into the nomenclature of positions of specialists with higher pharmaceutical education.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):293-301
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The role of alcoholic and narcotic substances in population mortality due to external causes and development of legal regulation of responsibility for their consumption
Shishkin E.V., Shchepin V.O.
Abstract
The study established that in the Chelyabinsk Oblast remains high percentage of violent deaths because of presence of ethyl alcohol and narcotic substances detected in blood of the perished. The increase of concentration of ethanol in blood of the dead testifies the need for inter-sectorial measures, including toughening of legal responsibility for alcohol and drugs consumption. Actually,there is no regulatory documents of the Russian Federation that fix the issue of both progression of toughening this responsibility depending on concentration of ethyl alcohol in organism of offender and responsibility scale depending on specific drug or other substance.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):302-305
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The development and enhancement of general medical practice as major condition of successful modernization of primary health care
Volnuhin A.V., Siburina T.A., Knyazev A.A.
Abstract
The need for changes in the primary health care system in the Russian Federation that is based on the principles of general medical practice is without any question. But, even after more than thirty years, there is no full-fledged reform still. The objective. To assess the state of general medical practice in the Russian Federation to identify its strengths and weaknesses, and to determine further ways of its development. The tasks. To analyze the volume and pace of development of general medical practice; to identify its impact on key demographic, medical and social indices; to assess foreign experience in this field; to elaborate proposals on intensifying process of its development in the Russian Federation. Material and methods. The analytical, sociological (n=1,573) and statistical methods were applied. The results. Since 2007, the number of general practitioners in the Russian Federation and corresponding support of the population increased. During the same time period, population size, natality, mortality, morbidity of tuberculosis, essential hypertension and cataract had positive dynamics. The morbidity of malignant neoplasms, diabetes type II, glaucoma, coronary heart disease and cerebrovascular diseases had negative dynamics. The strong negative relationship of the population's general practitioners support was established only in case of all-cause mortality and morbidity of lungs tuberculosis. The population was more satisfied with support of general practitioner than district physician. Discussion. The general practitioner support of the population of the Russian Federation continues to be insufficient and its role in public health management insignificant. The proposals are formulated to improve primary health care and its further development based on the principles of general medical practice on the basis of corresponding best international experiences and national specificity. Hence, in Russia, the national health care requires a set of measures targeted to strengthen the position of general medical practice system throughout ll territories.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):306-312
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The comparative analysis of mandatory and voluntary medical insurance in national and international practice
Abubakirov A.S., Zudin A.B.
Abstract
Nowadays, the formation and development of medical insurance system of citizens attracts attention of experts in the medical field and the insurance market. The possibilities of using foreign practice in the formation and organization of medical insurance, including improving of models of financing health care system in foreign countries and implementation of mechanisms of resource support of health care industry tested in world practice, deserve interest of researchers in order to enhance financial institutions of national system of mandatory and voluntary medical insurance. In Russia and foreign countries, the mandatory medical insurance policy allows citizens insured in mandatory medical insurance system, to undergo examination and receive treatment in medical organizations in amount established at the state level. In Russia, popularity of the voluntary medical insurance policy depends on medical care quality in the mandatory medical insurance system and volume of services guaranteed within the framework of mandatory medical insurance.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):313-315
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The verification of systemic factors of oncology care organization in the Saratov oblast
Erugina M.V., Krom I.L., Shmerkevich A.B., Eremina M.G., Balakina D.D., Vodolagin A.V.
Abstract
In Russia, the oncological diseases significantly impact public health. The study of oncological medical care organization in the Saratov Oblast, that has a number of territorial demographic and medical social characteristics, affecting oncological situation, was carried out. The purpose of the study is to verify systemic factors determining specific characteristics of the oncological medical care organization in the Saratov Oblast. Materials and methods. To elaborate objective comprehension of specific characteristics of the oncological medical care organization in the Saratov Oblast medical and sociological focus groups study was carried out, involving sampling of 12 experts oncologists and health care organizers. The results. The original guide scenario developed for the focus group study included expert discussion on trends in oncological medical care organization at the Oblast level and directions of improving continuum of oncological care. The study data analysis was implemented in accordance with specified scenario. Conclusion. The focus group study elaborated objective understanding of the specific characteristics of oncological medical care organization in the Oblast and predetermined verification and ranking of systemic factors that significantly impact the continuum of oncological care.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):316-321
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The development of management of medical organizations providing specialized primary medical sanitary care to mental patients
Ter-Israelyan A.Y., Belostotsky A.V., Grishina N.K., Solovyova N.B., Evdokimova T.E.
Abstract
Actually, in Russian health care, the organization of community-based medical care of patients with mental disorders is considered as one of requested problems to be resolved. The in-patient substituting forms of specialized primary medical and social care for mental patients create optimal conditions for treatment and rehabilitation of this group of patients without separation from familiar social environment, that in many ways reduces “personality stigmatization” and promotes returning of individual to full-fledged social life, decreasing the load on the most expensive hospital care. One of such organizational forms implemented in Moscow under the new model of provision of mental care is out-patient mental module that provides specialized primary medical and social care and is tested in conditions of basic medical organization. Hence, the purpose of the study is to develop system of indices for continuous information support of management of implemented innovations.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):322-326
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The technology of enhancement of detection of chronic renal diseases
Kotenko O.N., Serdyukovskiy S.M., Grishina N.K., Ibragimov A.I.
Abstract
The chronic kidney disease takes a special place among chronic non-communicable diseases because it is characterized by wide prevalence worldwide. However, its detection rate among Moscow adult population is 1%, though in the European countries this indicator is significantly higher and is made up on average to 6%. At the terminal stage of chronic kidney disease, quality of life of such patients decreases dramatically, that result in working capacity loss and disability. These patients often require expensive methods of programmed hemo- and peritoneal dialysis. The corresponding mortality is much higher as compared with total mortality. Among the frequent causes of hospitalization and mortality of such patients, complications of blood circulation system diseases are registered. The existing problem of low detection of kidney pathology in the population is the main cause of untimely treatment start. The rapid disease progression results in higher indices of premature mortality and increased costs of treatment of patients with this pathology. The timely diagnosis of disorders of carbohydrate and lipid metabolism permits to identify chronic kidney disease at an early stage and to start to carry out adequate treatment and prevention measures. The purpose of the study is to implement the technology of improving efficiency of detection of chronic kidney disease. Methods. The organizational experiment, analytical, mathematical and statistical research methods. Results of the study. The detection rate of chronic kidney disease amounted to 8%. Among the respondents with chronic kidney disease diagnosed, more than 80% had initial stages of disease (I-III). In this case, appropriate therapy and prevention can prolong kidney functioning and reduce velocity of disease progression. At the same time, 16.3% of patients at the late stage of diseases progression (stages IV-V) were identified.The detection rate for all stages of chronic kidney disease increases with age Conclusions. The level of detection of chronic kidney disease in the base territory is comparable with the indices established in the European countries. The need to improve quality of diagnostic and prevention of chronic kidney disease was proven. To improve overall prognosis and prevention of development of terminal renal failure is possible only in case of brigade approach to treatment including active interaction of cardiologist and nephrologist, endocrinologist and nephrologist or of all these three specialists. Scope of the results. The established higher detection rate of chronic kidney disease (8%), as compared to actual one (1%), permits to claim that with systematic improvement of diagnosis, the detection of chronic kidney disease will increase iteratively and population need for nephrologic medical care will significantly increase that will require increasing in resource support and revising of planned and normative indices for this type of medical care.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):327-330
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The role of clinical recommendations in organization of medical care support
Putilo N.V., Malichenko V.S.
Abstract
In the Russian Federation, for long time legal uncertainty existed regarding relationship between the standards of medical care and clinical guidelines in organizing medical care support. In the actual legislation, there were no official definitions of concept “clinical guidelines”. The obligation of of clinical guidelines implementation was limited by expertise of medical care quality. The article analyzes main stages of development and application of clinical guidelines regulation and their relationship with medical care standards as well. The special attention is paid to changes in regulatory legal acts establishing the clinical guidelines status and the new procedure of their development. The mechanisms of medical care quality control are evaluated. The particular attention is paid to the role of clinical guidelines in organization of population medicinal support.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):331-338
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The legislation of The Russian Federation in sphere of health protection of underage pregnant females
Mikhaylin E.S.
Abstract
The article presents legal characteristics of the legislation of the Russian Federation in the field of health protection of pregnant underage females. The legal basis for providing medical care to the underage pregnant females during pregnancy and childbirth in antenatal clinics, maternity hospitals and perinatal centers is discussed. The conclusion is made related to legal eligibility of providing medical care to this category of female patients in second-level medical institutions, except the cases of female patient with somatic pathology requiring medical care on the basis of particular clinical profiles license, THAT requires referral to third-level medical institution.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):339-342
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The pharmacological economic analysis of application of magnetic resonance contrast mediums containing gadolinium in case of multiple sclerosis
Shegay M.M., Shimanovsky D.N.
Abstract
The article considers issues of pharmacoeconomics of applying gadolinium-containing contrast medium in diagnostic of multiple sclerosis in patients. Materials and methods: The MS Excel calculator was applied to estimate costs and analyze impact on the budget under treatment of multiple sclerosis exacerbations, that were diagnosed using various gadolinium-containing contrast mediums. The direct medical costs for diagnostics with gadolinium-containing contrast medium and hospitalization due to exacerbation in accordance with mandatory medical insurance system were taken into account. The results. At the expense of reducing number of multiple sclerosis exacerbations due to the use of single-molar gadolinium-containing contrast medium (gadobutrol) as compared with semi-polar gadolinium-containing contrast medium (gadodiamide, gadoteric acid and gadoteridol) in 1000 patients it is possible to reduce financial expenses from 1,968,642 to 7,175,520 RUB. Conclusion. The cost of magnetic resonance imaging diagnostics with contrast enhancement and treatment of multiple sclerosis exacerbations increases in the series: gadobutrol < gadodiamide (Jodas Expoim) < gadodiamide (GE Health Care) < gadoteridol < gadoteric acid.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):343-346
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E comparative analysis of some indices of effectiveness of of education organizations of the Northern Caucasus Federal Okrug concerning medical personnel training within the framework of scientific educational medical claster “The Northern Caucasus”
Amlaev K.R., Koychueva S.M., Koshel V.I., Hodzhayan A.B.
Abstract
The article presents the results of comparative analysis of educational potential of participants of the scientific and educational medical cluster «North Caucasus». The differences in average unified state examination score of students of educational institutions - participants of the cluster, teaching staff with academic degrees, educational literature and other indices are examined. It is noted that the toughening of unified state examination procedure implementation and increase of number of applicants entering through target admission, resulted in certain decrease of average score of unified state examination in entrants. At the same time, measures undertaken by the cluster members targeting the improvement of the values of indices of educational organizations functioning monitored by Rosobrnadzor alter the trend in condition of educational potential of the cluster “North Caucasus” in a positive way.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):347-352
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The medical nurses: the factors of professional burning-out
Kobyakova O.S., Deev I.A., Kulikov E.S., Tyufilin D.S., Pleshkov M.O., Homyakov K.V., Levko A.N., Balaganskaya M.V., Zagromova T.A.
Abstract
Nowadays, the professional burnout of paramedical personnel becomes a serious health care problem, resulting in productivity loss and medical care costs increase. The most effective mean to prevent the mentioned burnout is elimination of risk factors. The study purpose is to identify such factors (both positive or negative ones) and to quantify their contribution into development of professional burnout as exemplified by paramedical personnel in the Tomsk Oblast of Russia. The study sampling included 2,486 paramedicals as respondents. The sociological survey was carried out using questionnaire that included the Maslach Burnout Inventory tool and questions to assess corresponding factors of social, professional, economic and physical spheres of life. The study established high prevalence of high degree (29.57%) and extremely high degree (37.01%) of professional burnout in respondents. The following factors were associated with decrease in likelihood of burnout: advanced age (r = -0.089), married status (OR = 0.7; 95% CI 0.6-0, 9), higher number of children in family (r = -0.088), adequate sleep (r = -0.046), amount of time spent on sports per day (r = -0.167). The following factors were associated with increase in the likelihood of burnout: self-reported lack of sleep (OR = 2.1; 95% CI 1.8-2.5), frequent night shift work (r=0.082). The multiple linear regression analysis was applied with selection of model using the Akaike criterion: two mathematical models were formed for the integral value of professional burnout and its “Emotional exhaustion” sub-scale. The models described 15% and 20% of dispersion, respectively. The models allow both to quantify particular contributing factors to development of this syndrome and to develop programs of strengthening positive factors and mitigate negative ones. This will prevent development of professional burnout in paramedical personnel in the Tomsk Oblast.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):353-358
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Deterioration of Soviet people's health in an era of stagnation
Zatravkin S.N., Vishlenkova E.A.
Abstract
The article analyzes negative changes in the USSR population health in the era of stagnation. These changes are traced on the basis of statistical indices of physical development, morbidity of infectious and mental diseases, mortality and life expectancy. The mentioned data are compared with indices of ecological pollution, drinking water and foodstuff quality. The study results are explained by political decisions on reclamation of unsettled territories, developing of all-Union constructions, (anti)alcohol campaigns.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):359-368
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The 200 years of history of national clinic of internal diseases: the issues of periodization (the fifth and sixth stages)
Borodulin V.I., Banzelyuk E.N., Topolyanskiy A.V.
Abstract
This article completes series of three publications analyzing periodization of the history of the clinical internal medicine in Russia over the past 200 years. The discussion covers the fifth period (the second half of the 1950s - the mid-1970s), when the “landscape of diseases” changed, the differentiation of internal medicine into “narrow” specializations continued and the alterations of the state policy of the USSR in the field of health care was completed. During the sixth period (the second half of the 1970s and 1980s), the successful development of medicine in the USSR slowed down, the economic foundation of health care “failed” and indices of population health deteriorated. Ahead awaited the political and economic upheavals of the 1990s and total redesign of the internal medicine in organizational, economic and substantial aspects.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):369-372
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The international participation in organization of production of antibiotics in the USSR: “The penicillin project” of the United Nations Relief and Rehabilitation Administration (1946-1947)
Sherstneva E.V.
Abstract
On the basis of declassified materials from the Russian State Archive of Economics and State Archive of the Russian Federation, for the first time, the history of the United Nations Relief and Rehabilitation Administration (UNRRA) project for the supply of penicillin factories in the post-war years to two republics of the USSR - Ukraine and Belarus is considered. It is shown that the project initially had political significance, since the demonstration of humane intentions served to strengthen the political authority of the United States. However, despite the declaration, the Anglo-American leadership of UNRRA approached the implementation of the project formally and hardly planned its completion. This was expressed in non-compliance with requirements for completeness of equipment, violation of delivery deadlines, constant attempts to reduce and contain them, in non-supplying adequate technical documentation and specialists for setting up production. The delay in the delivery time of equipment resulted in its rapid moral obsolescence. The modernization of partially supplied factories was impeded by embargo on the export of advanced industrial equipment from the United States having strategic importance. The incompleteness of the project contributed to further split in international relations.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):373-378
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The activities of the field-doctor I. T. Voskoboynikov at Kama mills at the turn of XVIII-XIX centuries
Vasina T.A.
Abstract
The article considers the main facts of the biography of the field-doctor I. T. Voskoboynikov during his activities in the Kama mills (Izhevsk and Votkinsk ironworks) in the Vyatka Guberniya. The main stages of his service during the end of the XVIII - beginning of the XIX century are defined. The scope of medical duties and contribution to development of the social sphere of the mining department are analyzed. The article highlights the main problems of the regional health system that I. T. Voskoboynikov had to solve in the considering period. Among them were issues of full material support of Izhevsk and Votkinsk hospitals (both economic and medical parts), training and organization of smallpox vaccination. The attention is paid to the interaction of the field-doctor with the factory administration. According to the results of the study it is concluded that I. T. Voskoboynikov was one of the first field-doctors and inspectors of state mining hospitals and he stood at the origins of occupational medicine in two major industrial centers of the region. The research was based on materials from number of central and regional archives.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(2):379-384
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National research Institute of public health named after N. A. Semashko

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Phone: +7 (495) 916-29-60
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