Problems of Social Hygiene, Public Health and History of Medicine
Chief Editor
- Khabriev Ramil Usmanovich - Academician of the Russian Academy of Sciences, DSc in Medicine, DSc in Pharmaceutics, Professor.
Journal founders
- FSSBI «N.A. Semashko National Research Institute of Public Health»
- FSBSI Central Research Institute of Organization and Informatization of Health Care of the Ministry of Health of the Russian Federation
Periodicity
- Since 1993.
- Every 2 months, 6 issues per year
Subscription indexes of the journal
- Catalog "Rospechat" - 73302
Indexing
- Scopus
- Experta Medica Abstract Journals
- Index Medicus
- Index to Dental Literature
- Chemical Abstracts
- Current Digest of the Russian Press
- EBSCOhost
- International Nursing Index
- PubMed
- RSCI
Mission of the journal
- to develop the human potential of the Russian science, to combine the efforts of various categories of researchers, pedagogical and scientific intelligentsia, to create and support a single space for scientific communication in the fields of fundamental and applied science in medicine and healthcare, to create conditions for openness and accessibility of the latest scientific achievements to practical workers, students, teachers and everyone who is involved in the development of the Russian and foreign healthcare and medicine.
The journal is intended to familiarize the Russian and foreign scientific and scientific-pedagogical community, as well as doctoral students, graduate students, undergraduates, practicing specialists and other interested people with new scientific results that are significant in various fields of fundamental and applied science.
The purpose of the journal is to popularize and disseminate relevant and advanced knowledge in the development of healthcare and medicine to a wide range of interested citizens.
The objectives of the journal:
- improving the subject matter and content of the journal, ensuring the unity of the theory and practice of scientific research, the relevance and significance of the published information for the development of scientific and applied knowledge;
- ensuring a positive image of the Journal and the Russian science in general, promoting an increase in the feedback from authors and readers;
- ensuring the objectivity and the information content of the published materials, increasing the readership;
- increasing the efficiency of the publication of scientific articles, as well as the electronic and printing quality of the published Journal.
The journal is registered with the Federal Service for Supervision of Communications, Information Technology and Mass Media (Roskomnadzor) (certificate PI No. FS 77 - 77004 dated 11.10.2019).
Current Issue
Vol 30 (2022): Special Issue
- Year: 2022
- Articles: 41
- URL: https://journal-nriph.ru/journal/issue/view/54
Articles
EVOLUTION OF APPROACHES IN THE TREATMENT OF CLOSED INJURY OF THE LIVER AND SPLEEN
Abstract
The article analyzes the main aspects of the development of various approaches and methods in the provision of medical care to patients with closed abdominal trauma with damage to the liver and spleen. The most important stages of improving approaches, the impact of scientific and technological progress on the introduction of modern technologies in this area of surgery are described. The modern views of various authors on the existing problem are considered.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):937-942
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CORPORATE CULTURE IN A MEDICAL ORGANIZATION: THE ETHNO-CONFESSIONAL AFFILIATION OF PATIENTS
Abstract
The purpose of the article is to study approaches to the development of corporate culture of healthcare workers in terms of forming a tolerant attitude towards patients belonging to various ethno-cultural and confessional groups. Among the measures of managerial influence is the further development of the foundations of the corporate culture of employees of medical organizations, which can contribute to solving the problem of attracting patients belonging to a variety of national and religious groups. The results of the analysis (systematization of scientific literature and sociological survey in the form of interviews conducted by the authors of the article) of the main problems, the solution of which is associated with the development of corporate culture, showed that the attitude of patients and medical personnel to euthanasia, termination of pregnancy, death (including suicide); methods of reproduction of life (artificial conception, surrogacy); obstacles to religious rituals during the treatment of patients.This article presents conclusions on the analysis of these problems and possible approaches to their solution: the authors propose measures for the formation of new competencies in corporate culture (as a set of formal and informal requirements in a medical organization imposed on its employees) aimed at preventing and overcoming conflict situations arising from misunderstandings in relationships between patients and medical staff.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):943-948
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SELF-PRESERVING BEHAVIOR OF YOUNG MUSCOVITES: ATTITUDES, PRACTICES, PROBLEMS OF IMPLEMENTATION
Abstract
The self-preserving behavior of young people is of particular interest, since the prospects for the reproduction of the population and the development of the economy depend on it. The article presents the results of a sociological study of the self-preservation behavior of young residents of Moscow, many of whom came from Russian regions. There were studied the ideas of young people about the role of lifestyle in ensuring health and longevity, the meaning and obligatory nature of take care of health, the influence of primary socialization and the current social environment, as well as models of behavior in terms of combining work and rest, eating habits, physical activity, seeking medical help. It is shown that the majority of young people living in the capital are aware of the value of health, consider taking care of it the norm and duty of every person, and see the lifestyle as the key factor in health and longevity. The parental families of the majority of respondents do not have pronounced self-preservation practices, while the current social environment treats health care with understanding. Basically, the respondents deny bad habits, have a good psycho-emotional status. However, not everyone can afford quality food and regular meals. Young people often sleep much less than they should, do not often go in for sports and are in the fresh air. The medical activity of young people is controversial. The majority of respondents express their willingness to undergo regular medical examinations and screening examinations. At the same time, almost half of young people carry disease on the legs, explaining this by their unwillingness to miss classes, lose wages and annoy the employer. Due to the unsatisfactory according to young people accessibility and quality of free medical care, they have to self-medicate or go to private clinics, the cost of which services two-thirds of the respondents considered very tangible. Thus, the self-preserving attitudes that young residents of Moscow have in many respects run into problems of a material nature.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):949-955
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SOME ASPECTS OF LEGISLATIVE SUPPORT FOR THE DEVELOPMENT OF MEDICAL TOURISM IN THE RUSSIAN FEDERATION
Abstract
The article discusses the prospects for the development of the export of medical services and issues of regulatory regulation of medical tourism in the Russian Federation. Today, Russian legislation does not unite a number of concepts related to medical tourism and are drivers of the development of the tourism industry. The development of medical tourism has a close relationship with plans to expand the volume of incoming tourist flow and attract funds from foreign investors to Russia. At the same time, medical organizations and structures providing treatment and rehabilitation of foreign citizens note the absence of the concept of «medical tourism» in the regulatory legal framework, which acts as a significant barrier to the transformation of this process. In this regard, it is necessary to improve the current legislative framework and develop an appropriate model law.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):956-960
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EXPERIENCE IN ORGANIZING THE WORK OF THE CENTER FOR PERSONALIZED TREATMENT OF MALIGNANT NEOPLASMS (NETHERLANDS)
Abstract
Introduction. In the last decade, there has been a «breakthrough» development of scientific approaches to the assay of genomic and immune factors underlying anti-cancer treatment efficiency. The choice of antitumor therapy in practice is increasingly determined by molecular signatures, and not only by the specificity of organ tumor originated from (or by the histological properties of the tumor). An urgent and important scientific and practical task is to study the successful experience of organizing Centers for Personalized Cancer Treatment (CPCT).Aim: analysis of the 10-year experience of the Clinical Center for Personalized Cancer Treatment in the Netherlands.Materials and methods. Data were extracted from the internet databases using keywords: personalized cancer therapy / treatment, cancer, targeted therapy etc.Results. The Center's research project collects data on patients with metastatic cancer who are eligible for anticancer treatment as part of standard practice. The system accumulates various information about tumor DNA, mutations and abnormalities in DNA, treatment results (outcomes), as well as other important clinical characteristics, including individual tumor process. Registered parameters are stored in a digital database and are available for scientific research.Discussion and Conclusions. CPCT consider the possibilities for the more in-depth genomic analysis of patient DNA (including non-tumor DNA) in the future in order to improve the medical decision making regarding early diagnosis and personalized choice of anticancer therapies. Rapid progress will lead to the emergence of more advanced methods for re-evaluating biological samples accumulated in biobanks, that will facilitate the understanding the pillars of personalized anti-cancer treatment approaches as well as create an additional bases for the new drug development.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):961-965
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LITERATURE REVIEW OF GUIDELINES FOR MEDICAL DEVICES ASSESSMENT
Abstract
Background. Research on the development and implementation of new principles and methods applicable in the evaluation of medical devices (MD) will allow to accumulate new, as well as the most effective long-used and proven approaches to the clinical and economic evaluation of such an important and extensive class of medical technologies.Aims. The aim of the study is to identify and analyze developed, approved recommendations for the assessment of MD in the world and domestic practice of assessing health technologies, as well as to find and summarize the current principles, optimal proven and innovative methods for assessing MD for the draft modern recommendations for MD assessment in Moscow.Materials and methods. The sources of the study were scientific articles on the topic of MD assessment and recommendations published over the past five years.Results. A review of publications revealed disunity in the approaches to assessing MD according to international sources, as well as the lack of unified agreed recommendations in Russia. A number of problems and aspects that need to be taken into account when formulating uniform recommendations are clearly defined.Conclusion. It is obvious that there is a need to formulate and adopt clear recommendations on the assessment of medical technologies (HTA) of MD, taking into account positive international experience.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):966-971
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DEVELOPMENT OF TELEMEDICINE TECHNOLOGIES: OVERVIEW OF FOREIGN PRACTICE
Abstract
The article discusses the development of telemedicine technologies. It is noted that throughout history, technological revolutions have destroyed the workforce, creating new forms and models of work, making others obsolete and leading to broader changes in society, and digital technologies have developed faster than any innovation in recent history. By the method of content analysis of thematic publications, a review of the country practice of implementing telemedicine technologies in national health systems was carried out. It is concluded that telemedicine is an excellent tool for use in the health sector, reducing inequality and providing access to medical services. Where the construction of hospital facilities can take months, telemedicine uses improvised technologies to provide and maintain remotely
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):972-975
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EFFICIENCY OF FUNCTIONING OF HEALTH CARE SYSTEMS AS A SUBJECT OF STATE FINANCIAL CONTROL: A REVIEW OF RUSSIAN AND FOREIGN EXPERIENCE
Abstract
The predominance of the state dominant in the field of healthcare dictates the conditions of management and financing. As international practice shows, the main source of financing for the provision of medical services are state and/or public resources, which inevitably means the need to monitor the effectiveness of their spending by the state. Each country has established and effectively operates a system of state financial control, the functioning of which is based on the principles and concepts laid down in the standards of the International Organization of Supreme Bodies of Financial Control and Audit (INTOSAI). The review provides up-to-date information on the approaches of the state financial control and audit bodies of Russia and European countries to assessing the effectiveness of the functioning of national health systems. The adaptation of the experience of financial control bodies in terms of methods for assessing the effectiveness of management and functioning of national health systems makes it possible to expand the methodological tools used in the development of measures for financing and managing the Russian health system.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):976-982
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ANALYSIS OF THE STAFFING OF MEDICAL ORGANIZATIONS SUBORDINATE TO THE DEPARTMENT OF HEALTH OF THE CITY OF MOSCOW IN 2021
Abstract
An analysis was made of the structure and number of medical workers (doctors and paramedical personnel) of the Moscow healthcare system for the period 2017-2021. The analysis showed that the number of medical full-time positions over the same period increased by 13.6%, and regular positions of nursing staff by 8.9%. The provision of the population (per 10 thousand population) with doctors increased by 13.0% from 35.6 in 2017 to 40.2 in 2021. The provision of the population with nurses decreased by 2.4% from 58.4 in 2017 to 57.0 in 2021. Among medical workers, the number of individual doctors, over the same period, increased by 15.5%, and the number of individuals of paramedical personnel decreased by 3.4%. The staffing of medical rates (by positions), in general, decreased by 2.4% from 82.5 in 2017 to 80.5 in 2021, and the rates of nursing staff decreased by 9.7% from 87.4% in 2017 to 79.0% in 2021. The part-time ratio was 1.1 for medical positions and for positions of paramedical personnel. Issues related to low staffing and the coefficient of part-time employment for individual medical positions and positions of paramedical personnel require further resolution.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):983-987
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ORGANIZATIONAL AND MANAGERIAL ASPECTS OF THE DEVELOPMENT OF PROJECTS IN THE FIELD OF MEDICAL CHARITY
Abstract
The article deals with organizational and managerial problems of projects in the field of medical charity. The development of the sector of non-profit organizations in the medical field today is due to the fact that the effective activity of the state is ensured by the stable development of the social sphere. The importance of charitable projects in the field of medicine is one of the important resources aimed at increasing the availability of medical care to needy categories of citizens around the world. Accessibility of medical care is achieved due to a complex of factors, among which a significant role is given to the capabilities of medical organizations themselves. Due to the fact that financial support has its limitations, charitable projects in the medical field become a resource that allows you to regulate the availability of medical care. The activities of charitable organizations in the medical field in modern conditions require the involvement of significant resources and the formation of an organizational and managerial mechanism for the development of projects in the field of assistance to those in need. The analysis of organizational and managerial aspects of the development of projects in the field of medical charity and the development of proposals for improving the activities of charitable organizations are the purpose of this work.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):988-991
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GENE THERAPY: HISTORY OF DEVELOPMENT AND CURRENT STATE (LITERATURE REVIEW)
Abstract
The article provides a brief overview of the history of gene therapy from its inception to the present. It describes the main events that characterize the periods of history of the formation of this therapeutic direction in medicine; the basis achievements and problems of each periods. It lists the main gene therapy drugs that licensed at different times listed; innovative gene therapy technologies, which are now use in clinical practice or are still at the stage of approbation. The article is a review of publications from the Scopus and PubMed and official information from public Internet sources.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):992-997
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ANALYSIS OF THE CAUSES OF SUDDEN DEATH AMONG EMPLOYEES OF JSC «RUSSIAN RAILWAYS»
Abstract
Protecting the health of railway workers of various professional groups is an important and integral part of the work of primary health care. The incidence of circulatory diseases is a significant problem among some groups of railway workers, given the considerable number of occupational risk factors. Among the most unfavorable complications of cardiovascular disease may be sudden cardiac death.Purpose of the study - сonducting an analysis of typical risk factors for sudden death among the main occupational groups of railway workers in Russia.Materials and methods. A retrospective analysis was carried out of all cases of sudden death of employees of Russian Railways in the period from 2009 to 2021. All deceased workers were conditionally divided into 6 groups depending on the professions and positions of workers.Results. All 411 deceased patients worked on 16 railways, subordinate to 15 medical directorates of Russian Railways. 84.7% of patients felt the first symptoms during working hours and only 15.3% during non-working hours. The prevalence of cases of sudden death during working hours was noted - 81%. Among the occupational groups under consideration, death at home or outside the home was more often observed in groups I and VI, and at the workplace, from groups II to V (p < 0.001). 6.8% of those who died had high levels of ethyl alcohol in their blood, and 3 out of 4 of them died at the workplace. Among the deceased, 70.3% of the patients were smokers. 68.1% were overweight or obese. The level of total cholesterol exceeded 5 mmol/l in 20.7% of cases, and the largest number of patients (65%) had a moderate risk according to the SCORE scale.Conclusion. The study sample showed that cardiovascular diseases are the main cause of sudden death. Among the risk factors in the study group, smoking and obesity prevailed.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):998-1003
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ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS WITH RHEUMATOID ARTHRITIS IN COMPARISON WITH POPULATION NORMS IN MOSCOW
Abstract
The article is a comparative analysis of the quality of life indicators of patients with rheumatoid arthritis with similar indicators in the Moscow population. We conducted a survey of patients in the register of rheumatoid patients in Moscow using the EQ-5D-5L questionnaire and the EQ-VAS visual analog scale. The population of patients with rheumatoid arthritis, in accordance with the recommendations of EuroQoL, was divided into 6 age and sex groups. The responses of patients from each age and sex group were compared with similar groups of respondents in the Moscow population. Key differences in the quality of life of rheumatoid patients were identified in comparison with both the population norm in Moscow and similar foreign registries.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1004-1009
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CENTER FOR PUBLIC HEALTH AND MEDICAL PREVENTION IN MOSCOW: ISSUES OF FORMATION AND DEVELOPMENT PROSPECTS
Abstract
The authors have identified the priorities of the CPHMC based on the results of the Center's work in 2021 and the trends in the development of public health in Moscow. Along with this, the preferred directions for the development of the public health system in the city of Moscow are highlighted. Scientific research in the areas of work of the Center for Medical Health Care allows using reliable and up-to-date scientific information in the work of health care in Moscow, which makes it possible to improve not only the quality, but also the volume of work performed, projects of management decisions in the field of public health. As part of the activities of the CPHMC, it is planned to expand the range of activities related to the formation of the health of labor collectives and to draw the attention of employers to corporate public health programs to the maximum.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1010-1015
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MEDICAL AND SOCIAL SUPPORT OF CHRONIC PATIENTS: OLD PROBLEMS, NEW SOLUTIONS
Abstract
The purpose of the article is to study approaches to medical and social support of patients with chronic diseases in Russia and abroad in order to identify possible ways to solve emerging problems in this area of modern healthcare development. The reasons of comorbidity (polymorbidity), disadvantages of algorithms for accompanying patients with two or more chronic diseases, models of management of patients with chronic diseases and priorities of their use are considered. Based on the analysis of Russian and foreign publications, as well as the systematization of the opinions of experts interviewed during the scientific and practical expert session conducted by the authors (April 2022), conclusions are drawn about existing problems and possible ways to solve them. A proposal has been put forward to organize an information and coordination center for the support of patients with two or more chronic diseases. The purpose, tasks (and the order of their solution), the structure of the center, the need for the work of a curator leading patients (and who can perform the duties of a curator), the possibilities of integrating types of care (medical, social, psychological) to patients who need to be accompanied by specialists-representatives of organizations of very different orientation: medical, rehabilitation, social and preventive. It is shown that the increase in the number of polymorbid patients is a serious burden for modern healthcare systems around the world, and requires the search for effective approaches to solving the problem. The importance of self-preserving behavior of patients and the responsibility of the person himself for adherence to the treatment and prevention of diseases, as well as maintaining a healthy lifestyle is emphasized.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1016-1022
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THE AGE-RELATED FEATURES OF THE MORBIDITY OF THE POPULATION IN THE CONTEXT OF THE COVID-19 PANDEMIC
Abstract
The COVID-19 pandemic has led to changes in all medical and demographic indicators, including changes in the incidence of the population. The article provides an analysis of the age characteristics of the primary morbidity of the population in the conditions of the COVID-19 pandemic. A pattern has been determined: the highest rates of primary morbidity in the conditions of the COVID-19 pandemic (for 2020) were determined in the age group older than working age. It was in this group that the highest incidence rates of COVID-19 were established. On the contrary, a comparative analysis of the primary morbidity of children (0-14 years old) in Russia as a whole in the «pre-pandemic» year (2019) and in the conditions of the COVID-19 pandemic (2020) showed a decrease in the level of this indicator by 13.9% (from 172455.1 to 148537.7 per 100 thousand population, р < 0.05). Among the child population, 1208.3‱ cases of COVID-19 were registered. Thus, in the Central Federal District, the indicators of primary morbidity of children were lower than the general.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1023-1026
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SYSTEMIC PROBLEMS OF INSTITUTIONS FOR ASSESSING THE QUALIFICATION OF MEDICAL SPECIALISTS
Abstract
Violation of the interconnected system of institutions for assessing the qualifications of medical specialists can be associated with two main circumstances. The first circumstance is the emergence of new institutions with duplicate tasks and organizational forms, and the second is the withdrawal from the system of an institution that performs the necessary system function. Two relatively new institutions, namely the independent assessment of qualifications (IAQ) and certification for the title of «Moscow Doctor», are considered from the point of view of these circumstances. The paper reveals that there is a convergence of the rules of the Institute of accreditation with the Institution of IAQ of qualifications, which can result in significant duplication of their activities. Therefore, it is necessary to resolve the issue of its possible unification with the Institution of accreditation while the IAQ is at the experimental stage and has not been put into practice. A certain similarity of the principles of activity can be traced in such institutions as certification for the qualification category and certification for the title of «Moscow doctor». Both of these institutions identify and rank the qualifications of specialists exceeding the basic level. The fundamental innovation of certification for the status of «Moscow Doctor» is that this institution actually introduces a qualification category that is higher than the current highest category. At the same time, this institution shows the importance of the institution of certification for a category whose existence is being questioned.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1027-1032
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COVID-TECH AND DIGITAL TECHNOLOGIES IN FOREIGN AND RUSSIAN HEALTH CARE DURING THE NEW CORONAVIRUS INFECTION PANDEMIC
Abstract
The novel coronavirus infection (COVID-19) pandemic has become the biggest challenge to global and national health systems in the last 100 years. At the same time, the rapid spread of COVID-19, which required the introduction of quarantine measures, the need to maintain social distance and isolate the infected, spurred the development of information technology (IT). In healthcare, information technology has begun to play the role of support systems for various types of medical activities that have experienced a tremendous increase in workload. The use of modern information technologies in the fight against the consequences and spread of the pandemic has even acquired its own term - COVID-Tech. The article provides an overview of the achievements of COVID-Tech made in the world and in Russia since the beginning of the pandemic. Experts identify 6 main areas of application of information technologies in medicine during a pandemic: diagnostics and screening of COVID-19, search for treatment regimens for the disease and new drugs based on big data analysis, work with databases, their analysis and analytics (for example, creating maps of the spread of a pandemic virus SARS-CoV-2), monitoring social distancing, the spread of the disease, information support for the population during a global emergency, the use of telemedicine technologies in medical education and the use of robotic assistants. For each of the 6 areas, an overview of the developed technologies is presented. An assessment was made of the contribution of information technology to addressing urgent health issues during a period of increased workload.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1033-1037
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DIGITAL THERAPY TECHNOLOGIES (LITERATURE REVIEW)
Abstract
This article presents an analysis of international experience in the implementation of digital therapeutics technologies in health care. The features of digital therapeutics products: their distinction from digital health products and digital medicine are highlighted. An analysis of the global market for digital therapeutics is presented. The aspects of regulation of digital therapeutics and the barriers to its implementation are presented. The importance of digital therapeutics for the transition of health systems to a value-based management model is discussed.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1038-1043
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FEATURES OF THE USE OF ANTIBACTERIAL DRUGS IN PATIENTS WITH COVID-19
Abstract
The review traces the evolution of the section on the use of antibacterial drugs in the temporary guidelines of the Ministry of Health for the treatment of a new coronavirus infection. Diagnostic approaches that play an important role in deciding on the need and duration of antibacterial therapy are presented. Routine use of fluoroquinolones should be restricted due to the adverse safety spectrum. According to existing data, the tactic of short courses of antibacterial therapy for community-acquired pneumonia are not inferior in effectiveness to longer courses. Unjustified prescribing of antibiotics increases the cost of medical care, promotes the selection of resistant pathogens and leads to adverse side effects. Timely updating of clinical recommendations, implementation of programs to control the appointment of antibacterial agents in medical organizations and strengthening the role of the clinical pharmacology service can reduce these adverse events
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1044-1049
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WAYS TO SOLVE THE PROBLEM OF HOME PARENTERAL NUTRITION IN PATIENTS WITH SHORT BOWEL SYNDROME
Abstract
The purpose of the work is to identify the most optimal ways to solve the problem of home parenteral nutrition for patients with short bowel syndrome.Basics. Discussion of the current situation will help optimize the work of the Orphan Diseases Center, lead to a greater introduction of online technology, and aim at the search and implementation of new methods of treating patients in this category.Conclusion. The most optimal strategy has been proposed to improve the interaction between various specialists and patients in need of long-term parenteral nutrition.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1050-1054
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THE RESULTS OF THE ANALYSIS OF RISK FACTORS, CARDIOVASCULAR RISK, CHRONIC NON-COMMUNICABLE DISEASES IN YOUNG AND MIDDLE-AGED PATIENTS, DEPENDING ON THE EDUCATION
Abstract
Aim. To assess the frequency of risk factors (RF), total cardiovascular risk (CHR) and their association with the level of education in young and middle-aged people.Methods. Persons aged 25-59 (40.4 ± 9.2) years old took part in a one-stage comparative study; an anamnesis was taken, a physical examination was carried out, risk factors for cardiovascular diseases, cardiovascular risk were assessed according to the Systematic Coronary Risk Estimation scale in persons aged 40 years and older, according to the relative risk scale - under the age of 40, laboratory parameters.Results. Hypercholesterolemia was present in 6.1%, hyperglycemia - in 4%, obesity - in 2.5%, one risk factor - in 25.5%, 3 or more risk factors - in 30.7% of patients, the maximum number of risk factors - in men. Moderate CVR was present in 58.4%, very high - in 3.7%, low - in 31.8% of cases. Low CV risk: prevalence in women with higher education (p = 0.034), compared with women with secondary education, which was not observed in the group of men (p = 0.109). Men smoked more. Persons with higher education quit smoking 4 times more often than persons with secondary education (p = 0.001; OR = 3.98), persons with secondary education smoked 2.74 times more often (p = 0.001, OR = 2.74), than higher education. Overweight was detected in 47%: in females (p < 0.001) and males (p = 0.003), its occurrence was less common in the group with higher education. AH was present in 8.3% of patients, and the level of its control was better in those with higher education than those with secondary education (p < 0.001).Conclusion. The gender conditionality of low CVR and unidirectional trends in attitudes towards smoking in connection with the level of education were established. Purposeful consideration of the level of education, age, gender, increases the identification of risk groups for the formation of multimorbidity and high cardiovascular risk in the future.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1055-1060
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ORGANIZATION OF GENOMIC SURVEILLANCE FOR SARS-CoV-2 WITHIN THE MOSCOW CITY HEALTH DEPARTMENT
Abstract
An important goal of COVID-19 surveillance is to detect outbreaks using modern molecular epidemiology techniques based on methods to decode the full genome of the virus, since rapidly evolving RNA viruses, which include SARS-CoV-2, are constantly accumulating changes in their genomes. In addition to using these changes to identify the different virus lines spreading in the population, the availability of sequence information is very important. It will allow the identification of altered variants that may be more transmissible, cause more severe forms of disease, or be undetectable by existing diagnostic test systems. The global scientific community is particularly interested in changes in the spike protein (S-protein, Spike) because they are responsible for binding and penetration into the host cell, lead to false-negative results in diagnostic tests, and affect transmission rates, health outcomes, therapeutic interventions, and vaccine efficacy.Genomic surveillance uses next-generation sequencing (NGS) applications and makes data on the full genome of the virus available. These methods offer new means to detect variants that differ phenotypically or antigenically. This approach promotes earlier prediction as well as effective strategies to mitigate and contain outbreaks of SARS-CoV-2 and other new viruses long before they spread worldwide.Today, molecular typing of strains is playing an increasingly important role in this process, as it makes it possible to identify samples that share a common molecular «fingerprint».
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1061-1066
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Global risks of obesity in adolescent and teenage populations
Abstract
Symptoms of chronic cardiometabolic disease such as hypertension, hyperglycemia, dyslipidemia and inflammation, as well as type 2 diabetes, are becoming more common in obese adolescents. Physical inactivity, lack of sufficient physical activity among young students, the availability of sugar-containing products, sugary drinks and fast food, the high cost of healthy eating, aggressive advertising of unhealthy foods, economic difficulties, the influence of the social environment are factors in the growth of BMI and obesity among students. University students are characterized by the lack of a balanced diet, with habits such as snacking as the main meal, consumption of drinks with artificial sugar, fruit juices, and rare breakfast. Students have high consumption of unhealthy foods that contribute to weight gain and obesity: jerky, smoked sausages, hot dogs, white bread and baked goods, butter, fried foods and energy drinks, alcohol, especially by male vocational school students. Vending machines installed on student campuses provide quick access to unhealthy, sugary foods and drinks, contributing to poor nutritional status and obesity in students.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1067-1071
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FUNCTIONAL DIAGNOSTICS FOR THE NEEDS OF MEDICAL AND SOCIAL EXAMINATION OF THE RUSSIAN FEDERATION
Abstract
The problems of licensing and licensing control of medical activities in the Russian Federation are related to the fundamental responsibility of healthcare - to comply with federal standards of safety, quality and accessibility. The introduction of special diagnostic equipment into the activities of the institutions of medical and social expertise of the Russian Federation and the obligation to use it for expert needs from 2022 has become the time to answer the questions: what are the safety and quality requirements when carrying out work using special diagnostic equipment; whether the organizational and managerial schemes of the activities of institutions of medical and social expertise should change; whether this is a new level of development of medical and social expertise or an expansion of the competencies of functional diagnostics; Are we standing at the origins of a new type of medical activity, and is there much new in this? Answers to these questions should not be expected from the future, putting at risk, in a period of uncertainty and searching for solutions, the life and health of patients, but it is advisable to look in the history of domestic medicine and science, their best practices, adapting them to the strict compliance with the legal field of our country today today.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1072-1077
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FEATURES OF NUTRITION OF ADOLESCENTS IN THE TWENTIES OF THE XXI CENTURY AS A HEALTH RISK FACTOR
Abstract
Adolescence is considered a vulnerable period of life due to the influence of factors that potentially contribute to the formation of unhealthy eating behavior. At the same time, the role and importance of healthy nutrition, as well as the process of forming habits and skills of good nutrition, are especially important for adolescence and adolescence, taking into account their fertility potential.Significant factors influencing the formation and changes in the eating behavior of adolescents and youth are indicators of the economic and social development of the country, place of residence, the level of income of the population, including family income, the level of education of parents, the opportunity to engage in physical education and sports, advertising pressure, including including television and on the Internet, the state of society and industry, the degree of psychological well-being in the family and school environment, the level of complexity of personal and communication problems of young people. In order to improve eating behavior and health, reduce the consumption of unhealthy foods among adolescents and young people, systemic actions are needed that target various eating habits. It is important that the activities take into account the emotional, socio-economic and cultural aspects of the life of young people in different countries.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1078-1082
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POPULARIZATION OF TOURISM, HEALTHY LIFESTYLE, PHYSICAL AND SOCIAL ACTIVITY IN THE PROGRAMS OF ACTIVE LONGEVITY OF SENIOR CITIZENS
Abstract
The article presents data on sports, active forms of leisure, travel among elderly Russians. An important conclusion is made that health promotion by means of active recreation and sports among senior citizens in Russia is one of the directions of active longevity policy. An overview of charitable foundations for senior citizens of the Russian Federation and their activities in promoting an active lifestyle among elderly citizens is presented.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1083-1086
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THE DEVELOPMENT OF TELEMEDICINE TECHNOLOGIES AND THE ATTITUDE OF SENIOR CITIZENS TO THEIR USE
Abstract
The purpose of the study presented in this paper is to consider the attitude of senior citizens (aged 65 years and older) to telemedicine technologies and their readiness to use them.Telemedicine has become widespread in recent years, and its use will expand in the near future. Telemedicine technologies have proved to be an effective tool for solving a number of problems: providing access to medical consultations, prompt response of medical workers to patient requests, monitoring of health indicators, etc. However, the prevalence of the use of these technologies is differentiated in different age groups. Due to the fact that elderly citizens are not active users of digital gadgets, the introduction of telemedicine technologies into their daily practice of taking care of their own health is in many ways difficult.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1087-1090
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THE HISTORY OF THE TRANSFORMATION OF THE CONCEPT OF HEALTH
Abstract
The article gives an idea of health and diseases in various historical epochs. Depending on the historical period, there is a different amount of information about medicine, including diseases and the concept of «Health». This is due to the amount of archaeological and documentary evidence. For a long time, ideas about health have been closely linked with religion. Hippocrates and other scientists of the ancient world at the heart of health determined the state of equilibrium of the four main fluids. With the development of anatomy, physiology and medicine, the development of diseases was considered as damage to anatomical structures and disruption of their functions. In the XIV-XV centuries, a direction appeared that considers the influence of social and social factors on human health. In the XIX century, the ideas of health and disease are further developed based on physiological and anatomical studies. The German Anatomical School compared the concepts of human health and pathology, linked the development of diseases with changes in cells. During the 20th century, on the one hand, medicine became more and more molecular and submicroscopic; on the other hand, global attention to people, both healthy and sick, resumed, which gave rise to synergetic, multifaceted definitions of health. The World Health Organization in 1946 formulated the definition of health as «a state of complete physical, mental and social well-being, and not just the absence of diseases or physical defects.» In the future, this concept was repeatedly criticized, as it considered health as an ideal and brought it closer to the concept of happiness. Today it is obvious that the concept of health is a multifactorial concept and, in addition to the medical component, is closely related to other areas of human life: sociology, ecology, cultural studies, economics, etc.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1091-1096
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HOSPITAL MORBIDITY OF CHILDREN IN THE CITY OF MOSCOW DURING THE COVID-19 PANDEMIC
Abstract
The article presents information on trends in hospital morbidity of child population in Moscow, as well as morbidity of children in the first year of life. Authors used population data and information from Form No. 14 of the Federal statistical observational study “Information on the activities of the medical organization departments providing inpatient medical care” between 2014 and 2021.In addition to the general indexes, the article presents categories of diseases that were significantly affected by changes in the lifestyle of children during the COVID-19 pandemic. Significant fluctuations in the incidence of infectious diseases are worth noting as they are certainly related to both fragmentations in groups of children during the pandemic, and proper nutrition, which led to positive changes in hospital morbidity due to gastrointestinal disorders. Changes in education, social isolation, better control over hygiene by the government, society and parents has led to unprecedented positive dynamics in morbidity rates of certain diseases. It is worth noting that the COVID-19 infection during pregnancy didn’t lead to expected high increases in morbidity rates associated with diseases in the perinatal period.In addition to hospital morbidity, the article presents data on mortality in 24-hour inpatient facilities, as well as changes in the proportion of emergency admissions of patients under 18 to Moscow state hospitals.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1097-1104
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DECREASE IN PHYSICAL ACTIVITY AND WEIGHT GAIN DURING QUARANTINE COVID-19
Abstract
Despite the fact that the coronavirus pandemic has almost disappeared, its consequences will be a problem for national health systems, medical institutions and individual citizens for a long time to come. During the period of quarantine measures, which were the main form of social distancing and a measure to counteract the spread of the disease, many people practicing a healthy lifestyle, sports and just moderate physical activity were forced to significantly reduce their physical education practice. As a result, many of them faced the problem of weight gain.The article examines the quantitative and qualitative aspects of this problem through the prism of sociological research by international analytical agencies.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1105-1108
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MORTALITY OF THE ADULT POPULATION OF MOSCOW AND THE RUSSIAN FEDERATION FROM OBESITY-ASSOCIATED CAUSES
Abstract
Background. Currently, obesity is considered one of the most significant health problems, representing a common chronic disease leading to the development of severe comorbidities, accompanied by the loss of disability-adjusted life years and high mortality. Due to the fact that obesity is one of the leading risk factors for a number of non-communicable diseases, such as diseases of the circulatory system, diseases of the endocrine system and malignant neoplasms.Aims: assessment of adult mortality dynamics from obesity-associated causes in Moscow compared to the Russian Federation in 2011-2020.Materials and methods: data from the analytic package FAISS (internal use program): standardized mortality rates for population of Moscow and the Russian Federation as a whole.Results. Over the 10-year period under study, mortality in the class of diseases of the circulatory system and malignant neoplasms was decreasing, while mortality from diseases of the endocrine system was increasing. Adult mortality from the diseases of the circulatory system in Moscow reduced by 12%, in the Russian Federation - by 25%. It should be noted, that mortality rate in Moscow (302.5 per 100,000) is significantly (by 34%) lower than in Russia (460.3), at the same time, the rate of mortality reduction over a 10-year period is equal and amounts to 23-25%. Myocardial infarction is the most serious obesity-associated disease characterized by high mortality in the class of the diseases of the circulatory system, it has a declining trend in Moscow and in the Russian Federation as a whole. Adult mortality from the diseases of the endocrine system in Moscow increased by 3 times, and in the Russian Federation - by almost 5 times, while the annual increase during the first year of the pandemic was 88% in Moscow and 24% in Russia. In Moscow, more than a half (66%) of deaths from endocrine causes belongs to non-insulin-dependent diabetes mellitus, in the Russian Federation - about 80%. Compared to the Russia’s average, in Moscow mortality rates from neoplasms are lower by 8%, but at the same time, the decline happens at a similar rate (11-12%).Conclusions. Despite the impact of the COVID-19 pandemic, Moscow demonstrates slowdown of growth of mortality rates from obesity-associated diseases compared to the Russian Federation, which could have been positively affected by prevention programs of noncommunicable diseases and promotion of healthy lifestyles.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1109-1115
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STATUS FOR A FEMALE DOCTOR IN MODERN UROLOGY. THE RESULTS OF A WOMEN UROLOGISTS SURVEY IN RUSSIA
Abstract
Introduction. In recent years, the role of women in medicine, particularly in surgical practice, has increasingly become a subject for discussion. Traditionally, male doctors have dominated in surgical specialties, especially in urology. Slow rhythm of changes in the structure of the specialty remains the problem relevant, despite the optimistic perspectives of the world urological community gender heterogeneity.Materials and methods. We have conducted an anonymous survey. Respondents were asked to complete a survey, which included questions from the survey of the European Association of Urology. The sample included 63 women, who were divided into two groups.Results. Despite the opinion of both groups about the lack of a separation into «female» and «male» specialties, there are concerns about a conflict with stereotypes and ideas about the impossibility of women working in a surgical specialty. Respondents of both groups had more than 70% assurance that in order to achieve professional success, a female surgeon needs more efforts than a male surgeon. In the question of the future status after 10 years, the student population in more than 60% noted the option «operating urologist» and less than 10% of respondents chose the «researcher». At the same time, the ratio among female-doctors has 41 and 33%, respectively. Among female students, in most cases, indicated the lack of such a dilemma (family/career). Female doctors have a ratio of 50:50, respectively. In the question about pay, more than 75% of respondents were confident about receiving equal pay, similar to male doctors.Conclusion. The increasing number of female urologists across the world is a nowadays reality. Rejection of existing stereotypes, elements of gender discrimination from colleagues and patients, mentoring, awareness-building - will help attract young female doctors to the urological specialty. These aspects will be the first step in changing of the current urology.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1116-1120
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PUBLICATION LANDSCAPE OF THE MOSCOW MEDICINE SCIENCE
Abstract
The paper presents the results of a scientometric analytical research on the study of the publication landscape formed by research institutes and scientific-practical centers subordinate to the Moscow Healthcare Department. The study was conducted using the analytical platform SciVal, the data source for which is the database Scopus, the time period was 5 years - from 2017 to 2021. The results obtained in the course of the study indicate a steady growth and positive dynamics of changes in the selected scientometric indicators, as well as a significant contribution of Moscow research institutes and scientific-practical centers to the publication flow of the Moscow Healthcare Department. For the publishing landscape of Moscow medical science, there is a wide variety of subject areas in which its publications are distributed, a significant part of which belongs to highly relevant topic clusters.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1121-1126
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THE INFRASTRUCTURAL POTENTIAL OF THE MOSCOW HEALTHCARE SYSTEM IN THE CONTEXT OF FINANCING THE STATE PROGRAM “DEVELOPMENT OF HEALTHCARE IN MOSCOW”
Abstract
Introduction. The resource provision of the capital's healthcare system in general and each medical organization in particular is the leading structural component that increases the availability and quality of medical care Reproduction and maintenance of citizens' health can be viewed from the perspective of combining the fundamental triad of resources - human, logistical and financial - in order to achieve the final product - the implementation of medical care to the population. One of the independent types of resource provision in most socio-economic systems, including healthcare, includes financial resources - a form that forms the infrastructure of medical organizations (medical equipment, equipment, devices, etc.) that can be used not only to carry out medical activities directly related to treatment and prevention, but also to conduct scientific research in various subject areas of medical science.Materials and methods. Information from the Moscow Government Portal «Open Budget of the City of Moscow» and the official website of the Mayor of Moscow were used to conduct the study. After data collection and aggregation, statistical, comparative and graphical analysis methods were used for their processing in order to construct dynamic time series.Results and discussion. In the course of the study, the study of the main regulatory documents regulating the healthcare sector at the federal level and at the level of the city of Moscow was carried out. The study describes the current state of the capital's healthcare sector in terms of the regulatory framework and funding allocated for the development, expansion and modernization of the capital's healthcare infrastructure, as well as the features and main results of the purchase of medical equipment and equipment under life cycle contracts.Conclusion. Information on financing, on purchased medical equipment, devices and equipment, on the number and parameters of the functioning of the capital's healthcare infrastructure will allow analyzing and improving the work of medical organizations, implementing operational and predictive management in order to improve the quality, effectiveness and efficiency of the healthcare sector of the city of Moscow.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1127-1134
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Modern features of fertility in lowand middle-income countries, including in the context of the COVID-19 pandemic
Abstract
The main issues in the problem of fertility in countries with low and middle incomes of the population are the high prevalence of complications and maternal deaths during childbirth, as well as the high incidence of such indicators of the birth of an infant with low growth and weight indicators for their gestational age, malnutrition of pregnant women and mothers, frequent abortions, short intervals between births due to the educational status of the mother and the financial wealth of households, high prevalence of teenage motherhood, low availability of cesarean section, high cost of educating children as a factor in fertility. The impact of the COVID-19 pandemic on fertility in low- and middle-income countries has been most pronounced due to disruptions in the health care system, a surge in domestic violence, teenage pregnancy and female genital mutilation.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1135-1143
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ADULTS NEUROGENESIS AS A RESERVE FOR HEALTH PRESERVATION
Abstract
The article presents scientific evidence that new neurons from progenitor cells throughout life in almost all animals with a nervous system are an integral component of neuronal ontogenesis and plasticity.It has been shown that there are neural stem cells in the brain that give rise to adult neurogenesis, occurring primarily in the dentate gyrus, a subregion of the hippocampus important for learning, memory, and emotion. With age, there is a decrease in adult neurogenesis, which is associated with a decrease in cognitive functions. Newly formed neurons and «immature» neurons together constitute a potential reservoir of young cells («brain reserve») that can be used to prevent aging and/or delay the onset/reduce the impact of neurological disorders.The possibility of using neurogenic processes for therapeutic purposes to reduce pain and improve the quality of life of patients is implied.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1144-1149
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THE RUSSIAN HEALTHCARE IMAGE DURING THIRD WAVE OF COVID-19 IN THE INFO FIELD
Abstract
The article contains the results of primary research of the information field of medical tourism in Russia, conducted in the period before the COVID-19 pandemic in the Yandex search engine and the Medialogia media database from January 01, 2019 to December 31, 2019. The analysis of the results of the study with measurements of the beginning of the year and the end is carried out. The results of the study are one of the parts of the panel study of the image of medical tourism in Russia and can be used in the future by interested structures in order to adjust it.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1150-1154
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THE CONCEPT OF PATIENT AND DOCTOR DIGNITY IN THE RUSSIAN FEDERATION
Abstract
The article focuses on the problem of the dignity of doctor and patient, in the Russian Federation, their relationship in the context of the modern realities of medicine. Today there is an acute problem of decreasing patient's trust in the doctor. Despite the development of advanced technologies and the appearance of modern effective methods of treatment, which increase the effectiveness of recovery, the human interaction between the patient and the doctor takes second place. This leads to a problem of distrust of treatment methods and psychological tension, which can be a factor impeding healing. It also leads a person to endlessly change doctors in order to compare specialists' opinions, to search for information about his ailment on the Internet, up to self-diagnosis and cases of self-treatment. At the same time, there has been a significant increase in the number of cases of diminishing the dignity of the doctor. This threatens to reduce public respect for medical professionals, disappointment in their own profession, and an increase in conflict situations. Therefore, along with the use of all the medical technologies available today, it is extremely important for the doctor to observe the principles of his and the patient's dignity and not to lose the purely human connection with the patient.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1155-1161
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CROHN'S DISEASE. TO THE 90th ANNIVERSARY OF THE DESCRIPTION
Abstract
The article describes the main achievements in the study of Crohn's disease, first described as a disease of the terminal ileum, affecting mainly young people, characterized by subacute or chronic necrotizing and scarring inflammation. In subsequent years, the inflammatory disease was also detected in other parts of the gastrointestinal tract. This disease affects the entire intestine and can involve every part of the gastrointestinal tract, from the mouth to the anus. The history of the study of Crohn's disease for 90 years has made it possible to delve deeply into the pathogenesis of inflammation, but has not yet come closer to revealing its etiology. Therefore, it is impossible to talk about the possibility of recovery from CD.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1162-1166
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PERSONAL GROWTH AND PERCEIVED ABILITY TO WORK OF HEADS OF DEPARTMENTS OF MEDICAL ORGANIZATIONS
Abstract
Introduction. Despite the need for the heads of departments to implement the labor functions of a clinician and manager, the study of personal growth and perceived ability to work in this category of medical workers was not carried out.The purpose of the study: determining the relationship of personal growth and perceived ability to work of heads of departments of medical organizations, as well as the impact on self-esteem of various characteristics of this category of respondents.Methods. A correspondence survey was conducted of 216 heads of clinical departments in the section «personal growth» of the questionnaire «psychological well-being of Riff» and the questionnaire «perceived ability to work» of the Institute of Social Research of the University of Michigan. The personal growth index is the average score according to the statements of the 1st questionnaire. The index of ability to work is the sum of points for each of the statements of the 2nd questionnaire. The average length of service is 23.1 ± 8.60 years, the average age is 47.9 ± 8.08 years. 123 (56.9%) men, 117 (54.2%) worked in a hospital, 114 (52.8%) worked in the «red zone», 111 (51.4%) have a second higher education, 138 (63.89%) have a qualification category, 63 (29.1%) have an academic degree. The Spearman correlation coefficients and the Student's criterion are calculated to assess the relationship and significance of differences between indices and characteristics.Results. The personal growth index is 4.89 ± 0.818, the work ability index is 33.60 ± 4.564 points. Respondents aged 41-50 have significantly (p < 0.001) lower indices. There was no significant difference between the index of personal growth and the index of ability to work in respondents of different sexes (р = 0.864 and р = 0.951), those who worked in inpatient and outpatient settings (р = 0.834 and р = 0.848); those who worked in the «red zone» (р = 0.727 and р = 0.775), respondents with a qualification category (р = 0.543 and р = 0.404), with an academic degree (р = 0.871 and р = 0.898), with the second highest education (р = 0.443 and р = 0.588). There is an average direct correlation of personal growth indices and perceived ability to work (r = 0.6; p < 0.001).Conclusion. The relationship between personal growth indices and perceived ability to work, significantly lower indices in the group of 41-50 years and over 60 years must be taken into account to ensure the professional development of department heads.
Problems of Social Hygiene, Public Health and History of Medicine. 2022;30(s1):1167-1172
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