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Vol 27, No 3 (2019)

Articles
The prevention of disability as a leading priority of caring of mother and child health
Baranov A.A., Namazova-Baranova L.S., Albitckii V.I., Terletckaia R.N.
Abstract
The prevention of disability in children and support of families fostering disabled children and children with limited capacities in health are included into number of main priorities of the state social policy of the Russian Federation. Thereupon, the project “Childhood Decade” is an important stage that includes social care of disabled children and children with limited capacities in health and their integration in modern society according the Decree of the President on implementation of state policy in the field of family and children care. The underestimation of children disability is supposed to be present produced by such causes as social motivation of family, complicacy of legal official registration, harsh requirements of medical social expertise services, inadequate awareness of medical staff about criteria of disability.According the WHO European Regional Bureau, in Russia there are 250 000 children with limitations of life activity mainly caused by somatic pathology, who have no status of disabled person and no state social support. The prevention of children disability is considered as a system of measures of caring mother and child health all along childhood. The priority directions of prevention considering causes of development of disability and its structure according particular disease are marked. The data is presented related to modern technologies of decreasing genetic load on population from position of prevention of hereditary, inborn and orphan diseases. In particular studies non-infectious pathology acquiring greater significance in development of disability in children of various age groups since neonatal period is considered. The new directions of research are proposed to affect the processes of incapacitation of child on more profound pathogenic level and to develop organization of preventive activities in this area.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):216-221
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The analysis of mortality of population of able-bodied age because of external causes
Shchepin V.O., Shishkin E.V.
Abstract
The article presents analysis of mortality because of injuries, poisonings and other consequences of impact of external causes in able-bodied population of the Russian Federation. In 2016, the study identified 18 subjects of the Russian Federation, where these causes of death occupied first rank, leaving behind mortality of blood circulatory system diseases.The optimization of medical care of persons injured by external causes should be implemented by three main directions: traumatological orthopedic one with organization of traumatological centers; сombustiological one with organization of burn centers; toxicological one with organization of toxicological centers.The established differences in mortality rates between subjects of the Russian Federation testify the necessity of complex and substantive measures of organizing and developing medical care support of persons injured by external causes, considering climatic geographic features of regions, as well as availability of “endemic” zones within the territories of subjects that will make it possible to propose valid recommendations related to organization of new centers and optimization of routing of patients based on actual operating medical organizations and their structural subdivisions.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):222-226
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The personalized medicine and organization of geriatric care of population
Belushkina N.N., Chemezov A.S., Paltsev M.A.
Abstract
The article presents advisability of applying approaches of personalized medicine to solve problems of modern gerontology and geriatrics. The actuality of issue is conditioned by population aging due to rapid increasing of both percentage and absolute number of elderly people in total population of most countries. The ideology of personalized medicine or P4 medicine is targeted to developing individual preventive and therapeutic activities for specific personality. The fundamental basis of developing personalized medicine is ensured by biomarkers, specific for every patient and certain disease. The elderly people health is characterized by increased susceptibility to diseases, polymorbidity and heterogeneity in health status. The solution of actual problems in gerontology and geriatrics improvement of basic principles of health care is needed with an emphasis on prognostication, prevention and personalized approach applied to elderly patients with the purpose of ameliorating their quality of life. The development and promotion of complex inter-disciplinary programs of personalized treatment of elderly patients is required.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):227-230
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The public opinion about health care: the main factors of increasing satisfaction of population with medical care
Mihailova I.V., Siburina T.A., Son I.M., Shchepin V.O., Lindenbraten A.L., Mihailov A.I.
Abstract
The evaluation of satisfaction of population with medical care has become widespread in practice of medical institutions as an obligatory criterion of assessing quality of their functioning.The study objective is to determine degree of satisfaction of population Russia with health care and role of particular factors in its formation.The study applied questionnaire survey of residents of 9 subjects of the Russian Federation using representative sampling of 1457 observations. The Pearson contingency indicator and the Chuprov-Cramer indicator of association between two nominal variables were determined. The ranking of signs according their influence strength was carried out.The most significant role in evaluation of satisfaction with health system functioning is played by satisfaction with medical care. Among the factors characterizing consumers of medical services, self-assessment of one's health status, social status of respondents, residence demonstrate the most effect. The priority factors in formation of positive public opinion about health care are identified.It is proved that positive opinion about health care depends on quality and accessibility of popular types of medical care, organization of functioning of primary health care medical organizations according expectations of population. The level of satisfaction with health care system is lower than in case of rendered medical services.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):231-236
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The attitude to health in modern family
Markova A.I., Flores M.A.
Abstract
The purpose of survey is to identify behavioral characteristics in family life-style and intra-family educational practices in dynamics of observation as health indicator. The life-style is analyzed according the results of questionnaire survey of 297 respondents, fostering school age children. The comparative analysis of behavior of adults and children is carried out based on the results of questionnaire surveys in 2007 and 2013. The verbal affirmations concerning importance of health and observance of healthy life-style in family have no concordance with actual behavior. The deterioration of of family function in healthy generation fostering is established. About 36,7% of parents pay no attention to their children. The passivity concerning organization of comfortable domestic conditions and inadequate medical activity in children health support are manifested by parents. The responsibility of parents for health of their children decreases too. The changing of priorities in hierarchy of life values occurs. The health loses its primary value. The decreasing of health in adults and children is logical due to effect relationship between life-style and health.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):237-242
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The patients' evaluation of medical service at the out-patient level
Denisov I.N., Reze A.G., Volnuhin A.V., Azizova D.I.
Abstract
The article presents the results of questionnaire survey of patients' opinions about out-patient medical care. The survey was carried out using the Doctors' Interpersonal Skills Questionnaire during 12 months. The sampling consisted of 14.712 respondents. The lowest rates out of 11 parameters analyzed received parameters Q5 (Could the doctor reassure you?) and Q7 (Did the doctor help you to express your feelings and fears?). Such a situation was common for all medical specialties. Unexpectedly, combination of low estimate of mentioned parameters with their low correlation and resultant satisfaction with medical care was established. The resultant satisfaction with medical service by general practitioners (family doctors) was less dependent from physician's respectful attitude to patient than attention of physician to personal circumstances of patient choosing treatment. The patients of endocrinologists noted that the least input into resultant satisfaction with medical care was related to ability of physician to assist them to express their fears, and the greatest input was given to first impression from manner and mode of how physician received patient. The least input into resultant satisfaction of patients with medical services by cardiologists was made by respectful attitude of physician and the most input was attributed to way of how physician considers patient’s personal circumstances in treatment selection. The patients of gastroenterologists mentioned physician's ability to reassure patient as least input into resultant satisfaction with medical care, and attention to way of how physician considers patient’s personal circumstances in treatment selection as most input.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):243-247
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The social anamnesis, conditions of life and life-style of pregnant women with syphilitic infection
Matyskina N.V., Artiuhov I.P., Taranushenko T.E.
Abstract
The article presents the results of analysis of characteristics of social behavior, life conditions and life-style of pregnant women with syphilitic infection. The sampling included 647 female pregnant patients actually ill with syphilis or having this disease in the past that were accepted to maternity houses of Krasnoyarsk in 2004-2014. The three groups of women with syphilitic infection were organized on the basis of remoteness of diagnosis of disease and results of complex of serological reactions during pregnancy.The presented data testify late diagnostic of mentioned pathology and significant percentage of hidden forms of infection course. The characteristics of “social portrait” of women with syphilitic infection during pregnancy are early beginning of sexual life (prior to 18 years in every 5-6 woman), predominantly school education and specialized secondary education, belonging to working specialties, availability of harmful habits and chronic diseases (about 50%) non-registered marriage. The study established no reliable facts of non-adapted social behavior of pregnant women with syphilis.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):248-251
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The morbidity of diseases of skin and subcutaneous cellular tissue in population of the Republic of Bashkortostan
Muhamadeeva O.R., Sharafutdinova N.K., Pavlova M.I., Borisova M.V.
Abstract
The diseases of skin and subcutaneous tissue are an actual medical and social problem. The purpose of study was to analyze dynamics of incidence and prevalence of diseases of skin and subcutaneous tissue in population of the Republic of Bashkortostan in 2008-2017. The average rates of incidence and prevalence of these diseases in the Republic of Bashkortostan were significantly higher than relevant data in the Russian Federation and Volga federal district. In the Republic of Bashkortostan the study established increase in incidence rate of atopic dermatitis (primary morbidity increased up to 18.6%, total morbidity increased up to 20.2%) and psoriasis (total morbidity increased up to 3%). The low level of dispensary observation of patients with dermatitis in the medical organizations of the Republic of Bashkortostan was established. In 2017 full coverage with dispensary observation was established in case of children aged 0-14 years with discoid lupus erythematosus. The low level of dispensary observation of children with atopic dermatitis (42%) and adults with psoriasis (30.6%) was established. The study demonstrated necessity of further studying of total and primary morbidity of diseases of skin and subcutaneous tissue and also indices of dispensary observation of patients according nosologies and age groups, identification of corresponding risk factors, development and implementation of measures improving medical care at all stages of its rendering.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):252-256
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The regional epidemiological characteristics of craniocerebral injury in children in Russia in 2003-2014
Roshal L.M., Valiullina S.A., Sharova E.A.
Abstract
The craniocerebral injury is a global problem of health care and society. The fatal and incapacitating aftermaths developed because of this type of trauma result in significant social and economic losses. To develop effective measures of decreasing these losses epidemiological studies are needed to be implemented considering gender, age, regional and other characteristics.The purpose of study was to analyze regional and epidemiological characteristics of craniocerebral injury in children population of Russia.The study was based on data of state statistic reports in Russia and in its regions in 2003-2004.During analyzed period, dynamics of children morbidity of craniocerebral injury are characterized by its maximal level reached in 2010 (6.3 per 1,000 of children population) and by its decreasing to initial level (5.4% per 1,000 of children population) in 2014.The two-fold increase of percentage of children of the first year of life in mortality of craniocerebral injury was established against the background of stable decrease of craniocerebral injury mortality among children aged from 0 to 17 years. In 2014, every ninth child who died because of head trauma did not survived age of 1 year.In Russia, decreasing of level of hospitalization of children with craniocerebral injury was established. At that, indices of hospitalized morbidity of children of the first year of life increased up to 30%.The actual statistical reporting in Russian Federation provides no full measure evaluation of true levels of mortality, morbidity and hospitalized morbidity. this condition occurs due to limitations of including additional nosological forms in state statistic reporting and to specificity of main disease codification or leading causes of death. The study established significant regional specificity of craniocerebral injury in children that determines necessity of development effective measures considering established epidemiological characteristics.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):257-261
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The regional characteristics of endocrine pathology in the Perm kraii
Demicheva T.P., Shilova S.P.
Abstract
Nowadays, focus of research is shifted to epidemiology of non-communicable diseases. Hence, actuality of study purpose to investigate epidemiological characteristics of endocrine diseases. The data of population appealability to medical organizations in the Perm region during last 20 years was used. The levels and structure of morbidity were calculated. The dynamic process was evaluated. The trend prognostication was proposed. In 2017, total endocrine system morbidity in the Perm region made up to 88.1 cases per 1000 population. During last 20 years, primary and total morbidity has tripled. In 2006, 2013 and 2015 maximal levels of primary morbidity are conditioned by adoption of a number of legal acts targeted to detection of pathology. The pathology of diseases of the endocrine system is determined by diabetes mellitus, thyroid diseases and obesity in 87.1% of all cases. According the data of population appealability to medical organizations, the rate of prevalence of obesity in 2017 made up to 10.6, diabetes mellitus - 26.6, thyroid diseases - 23.4 per 1000 of population. During last 20 years, incidence of diabetes mellitus increased up to 2 times, and obesity up to 4.8 times. The females suffered of obesity 1.2 times and of thyroid diseases 7.4 times more often than males.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):262-266
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The social and ethno-cultural prerequisites of suicidal behavior of adolescents in the Republic of Buryatia
Semenova N.B.
Abstract
The article considers social and ethno-cultural risk factors of suicidal behavior in Buryat adolescents. The analysis of life-style of children and adolescents in actual conditions was implemented. The immediate family and external social environment were characterized. The system of vital values was analyzed. The study demonstrated that in Buryat population the is a leading one. The system of relationship of adolescents with parents, school teachers and peers was analyzed. It is established that only 62.35 of adolescents are satisfied with these relationships.It is established that Buryat adolescents changing of life-style resulted in transformation of family and decreasing of its fostering function can be considered as risk factor of suicidal behavior. The frustration of affiliation needs i.e. need in the relationship most important for Buryat ethnos is considered as the ethno-cultural factor. The risk of suicidal behavior increases when such factors as rudeness or hardheartedness of teacher, school community turning down are added.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):267-272
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The prevention of drug substances abuse among schoolchildren
Timoshilov V.I., Lastovetckii A.G.
Abstract
The drug abuse is one of the most important medical and social problems of the youth. The problems with illegal and dangerous using of psychoactive drugs of different chemical categories by schoolchildren are caused by common social and psychological risk factors. Thus, in many research studies, all drugs and solvent substances are covered by general concept of “narcotic substances”.The study purpose is to develop an evidence database related to efficiency of common prevention measures and to development of sound recommendations of its management.The study included sociological survey of representative sampling of 445 schoolchildren aged from 14 to 17 years. The relationship between participation in preventive activities (factorial sign) and development of objective concepts about harm of drug abuse and possibilities of narcology (resulting sign) are studied using calculation of relative risk and its confidence interval.The study proves the positive effect of lecturing of specialists, psychological lessons and trainings, review of thematic video materials. The involvement of schoolchildren into development of agitation materials concerning healthy life-style and into reading of special literature is considered as effective in case of their implementation after target group received initial knowledge about problems of drug abuse and toxicomania. The study proved the negative effect of independent search of information about drugs in Internet, fabrication agitation materials about harm of drugs by adolescents, discussions based on opposite opinions and all forms of communication with patients with drug addiction. The necessity of widespread implementation of target advanced training of managers of preventive measures application.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):273-276
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The satisfaction with rendering medical services of orthodontic profile to children of junior school age
Argutina A.S., Kosiuga S.I.
Abstract
The article considers the results of complex medical sociological study including questionnaire survey of schoolchildren of junior age and their parents concerning issues of satisfaction with stomatological services. The data is presented concerning subjective opinions about quality and accessibility of stomatological care of orthodontic profile. The causes of dissatisfaction are established and ranged. The criteria of predominant visits to medical organizations of state and private forms of property. The study established demographic and financial characteristics of families, professional characteristics of parents, their subjective opinions about particular aspects of quality of life. The level of sanitary hygienic knowledge and medical activity, including issues of prevention of stomatological diseases and dental maxillary anomalies in children aged 6-11 years was determined. The summary social portrait of family fostering child-patient of children stomatological polyclinic was composed.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):277-280
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The refusal in immunodiagnostic of tuberculosis in municipal conditions
Kazykina T.N., Sterlikov S.A.
Abstract
The problem of refusal of immunodiagnostic of tuberculosis has a significant public resonance in Russia, but it is not widely covered by research.The purpose of study is to determine causes of refusal of legitimate representatives of children to carry out measures for mass immunodiagnostic of tuberculosis and to suggest possible ways of adjusting this negative phenomenon.In a cross-sectional study, the results of a questionnaire survey of 269 respondents - legal representatives of children who systematically refused to carry out immunodiagnostic of tuberculosis, are being studied.Results. The main reasons for the refusal included distrust of quality of the test (31.6%), insufficient semantic motivation (23.0%), fear of adverse reactions, complications (17.8%), negative information received from Internet (13.4%) or mass media (12.3%). Denial of the problem of tuberculosis or its displacement into a remote social environment was demonstrated by 60.6% of respondents (95% CI 54.7-66.3). Respondents are characterized by a high percentage of people (46.8%, 95% CI 40.9-52.8) who have not undergone chest X-ray examinations for more than two years, as well as individuals whose children are not vaccinated with BCG (11.9%, 95% CI 8.3-16.0). Replacement of the regulated method of detection of latent tuberculosis infection by the method chosen by the respondent will allow to examine children about half (52.4%) of the respondents. However, that will require a change in regulatory framework of the Russian Federation.The greatest part of refusals from immunodiagnostic of tuberculosis is associated with defects in sanitary education, resulting in distrust of the quality of tests and insufficient semantic motivation for implementing tests. The respondents are characterized by denial of the problem of tuberculosis. The significant percentage of respondents demonstrate risky behavior regarding the transmission of tuberculosis behavior. They have not been tested for a long time on tuberculosis, and their children are not vaccinated with BCG. The acuteness of the problem can be reduced through greater flexibility in choosing the survey technique and activation of sanitary education of population.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):281-285
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The analysis of mortinatality in the Bryansk oblast and the Russian Federation
Korsakov A.V., Pugach L.I.
Abstract
On the basis of official statistics of 1995-2014 a comparative analysis of the dynamics of stillbirths of boys and girls in the Bryansk region and the Russian Federation was carried out. The study established exceeding of rate of stillbirths in boys over stillbirths in girls at 14.4% and 9.0% correspondingly both in the Bryansk Oblast and the Russian Federation that confirms the global trend of higher risk of stillbirth in boys by approximately to 10%. In case the stillbirth rate in the Bryansk Oblast will proceed established trend the ratio of stillbirths will increase relatively to the nationwide values in 2016 - 2021 and will reach 30% in 2021. At that, the gap between indices of boys and girls will increase up to 32,8%.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):286-289
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The primary morbidity of infectious and parasitic diseases in the structure of all diseases registered for the first time in life in the Russian Federation and the Northern Caucasian Federal okrug
Odinetc A.V., Ogryzko E.V., Danishevskii K.I., Ivanova M.A., Zalevskaia O.V.
Abstract
In conditions of increased population migration, studying the situation on incidence of infectious and parasitogenic diseases is an actual problem. Particularly relevant is the analysis of newly detected incidence in the dynamics, which will allow to assess the well-being of the epidemiological situation in the region. Purpose of the study is to analyze the situation with incidence of some infectious and parasitogenic diseases and their share in the structure of other classes of diseases. The data from the Federal statistical monitoring in 2010-2017 were used related to the Russian Federation and the North Caucasus region.It is demonstrated that the incidence of diseases in the North Caucasus Federal District and the Stavropol region increased while it decreased at the National level. At that, there was a decreasing of incidence of some infectious and parasitogenic diseases both in the Russian Federation and in the North Caucasus Federal District with instability of indices in the Stavropol Krai. In the structure of primarily diagnosed diseases, infectious and parasitogenic diseases both in the the Russian Federation and in the North Caucasus Federal Okrug occupy the in the ranking table tenth point and sixth point in the Stavropol Krai.The results of the study demonstrated multi-directional trends in the dynamics of morbidity in the Russian Federation and the North Caucasus Federal Okrug. The decrease in the percentage of infectious and parasitogenic diseases testifies the improvement of epidemiological situation in overall.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):290-293
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The analysis of dynamics and structure of mortality of female and male population of reproductive age in the Republic of Chuvashia
Bogdanova T.G., Gerasimova L.I.
Abstract
Reducing mortality of working-age population is a potential reserve for preserving Russia's population and its labor force. In addition, the task of analyzing health of economically active citizens of our country is inextricably linked with the challenge of developing strategy of development of reproductive potential at the regional level. As reproductive or generative woman's age is defined precisely enough, and such unambiguous definition for men is lacking, the study used mortality rates, calculated for men and women of working age (16 - 59 years and 16 - 54 years respectively) and officially published by the Russian Federal State Statistics Service (Rosstat) as characteristics of reproductive health.The analysis of mortality rate for working age men and women in the Republic of Chuvashia as well as the structure of main causes of death are presented for 2002 - 2016 in comparison with average indicators for the Russian Federation. The mortality rate of the mentioned population category in Republic of Chuvashia since 2002 has decreased by 17.5% in all age groups except women aged 30 - 39 years. At this, the rate of mortality decreased in men during the analyzed period is higher than in women i.e. 20.5% and 19.3% respectively.As compared with 2002, the percentage of circulatory system diseases, neoplasms, digestive system diseases increased with a simultaneous decrease in the proportion of “external” causes in mortality structure of able-bodied population of the Republic of Chuvashia in 2016. Throughout the analyzed period relative mortality rates of able-bodied men are four times and higher than those of women.The analysis of dynamics characteristics in mortality level and structure among working age women and men as well as risk factors that contribute to its growth, can become the basis for developing an organizational improvement program of rendering medical care to economically active population as a component of regional strategy of increasing the level of reproductive potential.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):294-298
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On organization of palliative medical care
Kolomiichenko M.E., Kareva O.S.
Abstract
The study provides an analysis of the results of the questionnaire survey of physicians in the Russian Federation with the purpose of determining the competences of medical specialists and practice of palliative care and emerging problems. This article presents and discusses the data obtained during the study.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):299-302
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The planning of values of indices of quality of resource management in medical organizations of the Moscow state medical care system
Budarin S.S., Boichenko I.I., Nikonov E.L., Elbek I.V.
Abstract
The article presents the results of planning the values of indices of resource management quality in medical organizations of the Moscow state health system, that participated i the project of implementation of the quality standard of resource management in 2016-2017. The approaches of medical organizations to assessment of resources and opportunities of increasing efficiency of management of financial and human resources are described.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):303-307
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The criteria of increasing of quality of medical care of population in conditions of anthropogenic impact
Meshkov A.V., Mingazova E.N., Sitdikov I.D., Udalov I.D.
Abstract
The assessment of medical care quality of different strata and groups of population is a priority direction of preventive medicine and public health. Nowadays, application of the riskometry theory considering external modifying factors is relevant. The registration of risk indices in the process of development of model of health preservation can be considered as a criterion of medical care quality.The purpose а study was to optimize managerial decisions in the area of increasing medical care quality related to special contingent on the basis of evaluation of carcinogenic danger and reproductive risk in conditions of anthropogenic impact. The study applied such modern research methods as social hygienic, biochemical and statistical techniques.The methodological basis of assessing reproductive risk for population in conditions of anthropogenic impact can serve as a criterion of assessing level of impact and developing management decisions in area of improving health care quality. The public health and health care organization are the fields of application of study results.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):308-311
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The re-engineering and financial cost analysis of administrative economic and managerial processes in medical organization
Tatarchenko I.P., Mendel S.A., Pozdnyakova N.V., Berseneva E.A., Mordovina A.G.
Abstract
The article presents substantiation of necessity and main directions of application of re-engineering of administrative economic and managerial processes in medical organization. The approaches to financial cost analysis of the mentioned processes are also considered. The proposed methodology is demonstrated on the example of management of industrial safety measures in medical organization.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):312-315
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The quality and safety of rendering emergency and urgent medical care in hospitals
Semenova D.A., Ivanov I.V., Repina E.A., Shvabskii O.R., Stepanova S.M., Minulin I.B., Prokofiev S.A., Shcheblykina A.A., Matushevskaya E.V., Shchesiul A.G., Tokmakova A.Y.
Abstract
The article presents the results of external auditing on the section “The organization of emergency and urgent medical care in hospital. Organization of admitting office functioning” in 30 medical organizations of the Russian Federation based on “The proposals (practical guidelines) of Roszdravnadzor for organizing internal quality control and safety of medical activity in medical organization (hospital)”. The level of compliance with requirements of the Proposals is determined. The complex and structural problems of organization of rendering of emergency and urgent medical care.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):316-319
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The organization of medical social care of patients with chronic cardiac insufficiency: the literature review
Karonova T.L., Ponomarev D.S., Grineva E.N., Simonov S.N., Mikheeva E.P., Belyaeva O.D., Krasil’nikova E.I., Nikitina I.L.
Abstract
The organization of medical social care of patients with chronic cardiac insufficiency is focused on improving life of these patients through comprehensive interaction of all levels of medical care support of population. The organization of Schools of Health on the level of out-patient medical care specifically for patients with chronic cardiac insufficiency allows to extend the period of high-quality compensation of pathological condition.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):320-322
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The organizational forms of preventive activities in population
Petunina N.A., Kalininskaia A.A., Trukhina L.V., Son I.M., Martirosyan N.S.
Abstract
The concept of health progression through treatment of patient received no justification as significant deterioration of population health in last years is an obvious evidence. The practical medicine is to be focused on both ill and healthy people. The characteristics of modern structure of morbidity and mortality in Russia force to admit priority of caring health of healthy people. In the post-Soviet period the existed then system of preventive care of schoolchildren, representatives of main professions and groups of population factually was destroyed. This kind of activities is to be restored in medical sanitary units.However, the analysis of practice of clinical examination revealed the presence of a number of organizational and methodological costs that decreases efficiency of applied resources does not allow to fully achieve established goals. The article presents analysis of dispensarization of population in the Russian Federation and evaluation of efficiency of functioning of the Health Centers. The experience of youth-friendly clinics is evaluated. The organizational structure of preventive work at the level of primary medical sanitary care and its interaction with specialized services in health care.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):323-327
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The methodology of complex social hygienic investigation of various groups of population and families (In memoriam of professor O. V. Grinina)
Sukhareva O.Y., Kicha D.I., Shmushkovich I.A., Nechaev V.S., Shestakova E.A., Stepanova S.M., Shestakova M.V.
Abstract
The article expounds main principal positions of professor O. V. Grinina scientific educational methodological school of social hygienic investigations of health of population and family. The methodological analysis of scientific works of professor O. V. Grinina and her disciples was implemented to demonstrate key positions and results of studies constituting scientific school of program methodological basics of complex social hygienic studies of population health, health care and conditions of life of families.The purpose of publication is to characterize indications of the school of complex social hygienic investigations of priority population groups and families. These issues are covered by thematic fundamental works substantiating patterns of formation and estimation of health of families, program methodological issues of complex medical social studies of family and its individual members, availability of large group за disciples developing priority issues of investigation of population health at the level of family and organization of medical care based on the principles of per family observations, general (family) medical practice.The results are demonstrated and patterns are established containing in implemented complex social hygienic per family studies of various population groups, women, children and families in 1970s-1990s. The methodological significance of valid family-focused technologies in new social economic conditions of development of society and health care and principles of curative preventive activities in conditions of mandatory medical insurance are demonstrated.The professor O. V. Grinina substantiated and developed program of medical social characteristic of family. its sections and methodology of long-term continuous monitoring of family. She also determined characteristics of health of family as a group patient, principles of work of out-patient physicians with families directly at the polyclinic district.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):328-332
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The constituent session of the USSR Academy of Medical Sciences. The first day (December 20, 1944)
Shamkhalova M.S., Gliantcev S.P., Shestakova M.V., Stochik A.A.
Abstract
The article describes and analyzes the first day of the Constituent Session of the USSR Academy of Medical Sciences held on December 20, 1944. During this meeting the People's Commissar of Health of the USSR, G. A. Miterev, academicians A. I. Abrikosov and L. A. Orbeli, the full member of the USSR Academy of Medical Sciences S. S. Yudin made their speeches devoted to organizational tasks facing the USSR Academy of Medical Sciences during the war and post-war time, as well as to questions of morphology and physiology that require priority attention. The Yudin's report was emotional, patriotic and reflected the achievements of Soviet surgery in the mid-twentieth century. Analysis of the reports demonstrated that they contained many provisions that influenced the further development of medicine and public health in the USSR.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):333-337
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The prevention of disability as a leading priority of caring of mother and child health
Ametov A.S., Baranov A.A., Abaeva F.T., Namazova-Baranova L.S., Albitckii V.I., Terletckaia R.N.
Abstract
The prevention of disability in children and support of families fostering disabled children and children with limited capacities in health are included into number of main priorities of the state social policy of the Russian Federation. Thereupon, the project “Childhood Decade” is an important stage that includes social care of disabled children and children with limited capacities in health and their integration in modern society according the Decree of the President on implementation of state policy in the field of family and children care. The underestimation of children disability is supposed to be present produced by such causes as social motivation of family, complicacy of legal official registration, harsh requirements of medical social expertise services, inadequate awareness of medical staff about criteria of disability.According the WHO European Regional Bureau, in Russia there are 250 000 children with limitations of life activity mainly caused by somatic pathology, who have no status of disabled person and no state social support. The prevention of children disability is considered as a system of measures of caring mother and child health all along childhood. The priority directions of prevention considering causes of development of disability and its structure according particular disease are marked. The data is presented related to modern technologies of decreasing genetic load on population from position of prevention of hereditary, inborn and orphan diseases. In particular studies non-infectious pathology acquiring greater significance in development of disability in children of various age groups since neonatal period is considered. The new directions of research are proposed to affect the processes of incapacitation of child on more profound pathogenic level and to develop organization of preventive activities in this area.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):216-221
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The analysis of mortality of population of able-bodied age because of external causes
Demidova T.Y., Shchepin V.O., Shishkin E.V.
Abstract
The article presents analysis of mortality because of injuries, poisonings and other consequences of impact of external causes in able-bodied population of the Russian Federation. In 2016, the study identified 18 subjects of the Russian Federation, where these causes of death occupied first rank, leaving behind mortality of blood circulatory system diseases.The optimization of medical care of persons injured by external causes should be implemented by three main directions: traumatological orthopedic one with organization of traumatological centers; сombustiological one with organization of burn centers; toxicological one with organization of toxicological centers.The established differences in mortality rates between subjects of the Russian Federation testify the necessity of complex and substantive measures of organizing and developing medical care support of persons injured by external causes, considering climatic geographic features of regions, as well as availability of “endemic” zones within the territories of subjects that will make it possible to propose valid recommendations related to organization of new centers and optimization of routing of patients based on actual operating medical organizations and their structural subdivisions.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):222-226
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The personalized medicine and organization of geriatric care of population
Kazakova I.A., Belushkina N.N., Rudenko I.B., Chemezov A.S., Paltsev M.A.
Abstract
The article presents advisability of applying approaches of personalized medicine to solve problems of modern gerontology and geriatrics. The actuality of issue is conditioned by population aging due to rapid increasing of both percentage and absolute number of elderly people in total population of most countries. The ideology of personalized medicine or P4 medicine is targeted to developing individual preventive and therapeutic activities for specific personality. The fundamental basis of developing personalized medicine is ensured by biomarkers, specific for every patient and certain disease. The elderly people health is characterized by increased susceptibility to diseases, polymorbidity and heterogeneity in health status. The solution of actual problems in gerontology and geriatrics improvement of basic principles of health care is needed with an emphasis on prognostication, prevention and personalized approach applied to elderly patients with the purpose of ameliorating their quality of life. The development and promotion of complex inter-disciplinary programs of personalized treatment of elderly patients is required.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):227-230
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The public opinion about health care: the main factors of increasing satisfaction of population with medical care
Mihailova I.V., Siburina T.A., Son I.M., Shchepin V.O., Lindenbraten A.L., Mihailov A.I.
Abstract
The evaluation of satisfaction of population with medical care has become widespread in practice of medical institutions as an obligatory criterion of assessing quality of their functioning.The study objective is to determine degree of satisfaction of population Russia with health care and role of particular factors in its formation.The study applied questionnaire survey of residents of 9 subjects of the Russian Federation using representative sampling of 1457 observations. The Pearson contingency indicator and the Chuprov-Cramer indicator of association between two nominal variables were determined. The ranking of signs according their influence strength was carried out.The most significant role in evaluation of satisfaction with health system functioning is played by satisfaction with medical care. Among the factors characterizing consumers of medical services, self-assessment of one's health status, social status of respondents, residence demonstrate the most effect. The priority factors in formation of positive public opinion about health care are identified.It is proved that positive opinion about health care depends on quality and accessibility of popular types of medical care, organization of functioning of primary health care medical organizations according expectations of population. The level of satisfaction with health care system is lower than in case of rendered medical services.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):231-236
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The attitude to health in modern family
Markova A.I., Flores M.A.
Abstract
The purpose of survey is to identify behavioral characteristics in family life-style and intra-family educational practices in dynamics of observation as health indicator. The life-style is analyzed according the results of questionnaire survey of 297 respondents, fostering school age children. The comparative analysis of behavior of adults and children is carried out based on the results of questionnaire surveys in 2007 and 2013. The verbal affirmations concerning importance of health and observance of healthy life-style in family have no concordance with actual behavior. The deterioration of of family function in healthy generation fostering is established. About 36,7% of parents pay no attention to their children. The passivity concerning organization of comfortable domestic conditions and inadequate medical activity in children health support are manifested by parents. The responsibility of parents for health of their children decreases too. The changing of priorities in hierarchy of life values occurs. The health loses its primary value. The decreasing of health in adults and children is logical due to effect relationship between life-style and health.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):237-242
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The patients' evaluation of medical service at the out-patient level
Denisov I.N., Reze A.G., Volnuhin A.V., Azizova D.I.
Abstract
The article presents the results of questionnaire survey of patients' opinions about out-patient medical care. The survey was carried out using the Doctors' Interpersonal Skills Questionnaire during 12 months. The sampling consisted of 14.712 respondents. The lowest rates out of 11 parameters analyzed received parameters Q5 (Could the doctor reassure you?) and Q7 (Did the doctor help you to express your feelings and fears?). Such a situation was common for all medical specialties. Unexpectedly, combination of low estimate of mentioned parameters with their low correlation and resultant satisfaction with medical care was established. The resultant satisfaction with medical service by general practitioners (family doctors) was less dependent from physician's respectful attitude to patient than attention of physician to personal circumstances of patient choosing treatment. The patients of endocrinologists noted that the least input into resultant satisfaction with medical care was related to ability of physician to assist them to express their fears, and the greatest input was given to first impression from manner and mode of how physician received patient. The least input into resultant satisfaction of patients with medical services by cardiologists was made by respectful attitude of physician and the most input was attributed to way of how physician considers patient’s personal circumstances in treatment selection. The patients of gastroenterologists mentioned physician's ability to reassure patient as least input into resultant satisfaction with medical care, and attention to way of how physician considers patient’s personal circumstances in treatment selection as most input.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):243-247
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The social anamnesis, conditions of life and life-style of pregnant women with syphilitic infection
Matyskina N.V., Artiuhov I.P., Taranushenko T.E.
Abstract
The article presents the results of analysis of characteristics of social behavior, life conditions and life-style of pregnant women with syphilitic infection. The sampling included 647 female pregnant patients actually ill with syphilis or having this disease in the past that were accepted to maternity houses of Krasnoyarsk in 2004-2014. The three groups of women with syphilitic infection were organized on the basis of remoteness of diagnosis of disease and results of complex of serological reactions during pregnancy.The presented data testify late diagnostic of mentioned pathology and significant percentage of hidden forms of infection course. The characteristics of “social portrait” of women with syphilitic infection during pregnancy are early beginning of sexual life (prior to 18 years in every 5-6 woman), predominantly school education and specialized secondary education, belonging to working specialties, availability of harmful habits and chronic diseases (about 50%) non-registered marriage. The study established no reliable facts of non-adapted social behavior of pregnant women with syphilis.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):248-251
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The morbidity of diseases of skin and subcutaneous cellular tissue in population of the Republic of Bashkortostan
Muhamadeeva O.R., Sharafutdinova N.K., Pavlova M.I., Borisova M.V.
Abstract
The diseases of skin and subcutaneous tissue are an actual medical and social problem. The purpose of study was to analyze dynamics of incidence and prevalence of diseases of skin and subcutaneous tissue in population of the Republic of Bashkortostan in 2008-2017. The average rates of incidence and prevalence of these diseases in the Republic of Bashkortostan were significantly higher than relevant data in the Russian Federation and Volga federal district. In the Republic of Bashkortostan the study established increase in incidence rate of atopic dermatitis (primary morbidity increased up to 18.6%, total morbidity increased up to 20.2%) and psoriasis (total morbidity increased up to 3%). The low level of dispensary observation of patients with dermatitis in the medical organizations of the Republic of Bashkortostan was established. In 2017 full coverage with dispensary observation was established in case of children aged 0-14 years with discoid lupus erythematosus. The low level of dispensary observation of children with atopic dermatitis (42%) and adults with psoriasis (30.6%) was established. The study demonstrated necessity of further studying of total and primary morbidity of diseases of skin and subcutaneous tissue and also indices of dispensary observation of patients according nosologies and age groups, identification of corresponding risk factors, development and implementation of measures improving medical care at all stages of its rendering.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):252-256
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The regional epidemiological characteristics of craniocerebral injury in children in Russia in 2003-2014
Roshal L.M., Valiullina S.A., Sharova E.A.
Abstract
The craniocerebral injury is a global problem of health care and society. The fatal and incapacitating aftermaths developed because of this type of trauma result in significant social and economic losses. To develop effective measures of decreasing these losses epidemiological studies are needed to be implemented considering gender, age, regional and other characteristics.The purpose of study was to analyze regional and epidemiological characteristics of craniocerebral injury in children population of Russia.The study was based on data of state statistic reports in Russia and in its regions in 2003-2004.During analyzed period, dynamics of children morbidity of craniocerebral injury are characterized by its maximal level reached in 2010 (6.3 per 1,000 of children population) and by its decreasing to initial level (5.4% per 1,000 of children population) in 2014.The two-fold increase of percentage of children of the first year of life in mortality of craniocerebral injury was established against the background of stable decrease of craniocerebral injury mortality among children aged from 0 to 17 years. In 2014, every ninth child who died because of head trauma did not survived age of 1 year.In Russia, decreasing of level of hospitalization of children with craniocerebral injury was established. At that, indices of hospitalized morbidity of children of the first year of life increased up to 30%.The actual statistical reporting in Russian Federation provides no full measure evaluation of true levels of mortality, morbidity and hospitalized morbidity. this condition occurs due to limitations of including additional nosological forms in state statistic reporting and to specificity of main disease codification or leading causes of death. The study established significant regional specificity of craniocerebral injury in children that determines necessity of development effective measures considering established epidemiological characteristics.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):257-261
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The regional characteristics of endocrine pathology in the Perm kraii
Demicheva T.P., Shilova S.P.
Abstract
Nowadays, focus of research is shifted to epidemiology of non-communicable diseases. Hence, actuality of study purpose to investigate epidemiological characteristics of endocrine diseases. The data of population appealability to medical organizations in the Perm region during last 20 years was used. The levels and structure of morbidity were calculated. The dynamic process was evaluated. The trend prognostication was proposed. In 2017, total endocrine system morbidity in the Perm region made up to 88.1 cases per 1000 population. During last 20 years, primary and total morbidity has tripled. In 2006, 2013 and 2015 maximal levels of primary morbidity are conditioned by adoption of a number of legal acts targeted to detection of pathology. The pathology of diseases of the endocrine system is determined by diabetes mellitus, thyroid diseases and obesity in 87.1% of all cases. According the data of population appealability to medical organizations, the rate of prevalence of obesity in 2017 made up to 10.6, diabetes mellitus - 26.6, thyroid diseases - 23.4 per 1000 of population. During last 20 years, incidence of diabetes mellitus increased up to 2 times, and obesity up to 4.8 times. The females suffered of obesity 1.2 times and of thyroid diseases 7.4 times more often than males.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):262-266
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The social and ethno-cultural prerequisites of suicidal behavior of adolescents in the Republic of Buryatia
Semenova N.B.
Abstract
The article considers social and ethno-cultural risk factors of suicidal behavior in Buryat adolescents. The analysis of life-style of children and adolescents in actual conditions was implemented. The immediate family and external social environment were characterized. The system of vital values was analyzed. The study demonstrated that in Buryat population the is a leading one. The system of relationship of adolescents with parents, school teachers and peers was analyzed. It is established that only 62.35 of adolescents are satisfied with these relationships.It is established that Buryat adolescents changing of life-style resulted in transformation of family and decreasing of its fostering function can be considered as risk factor of suicidal behavior. The frustration of affiliation needs i.e. need in the relationship most important for Buryat ethnos is considered as the ethno-cultural factor. The risk of suicidal behavior increases when such factors as rudeness or hardheartedness of teacher, school community turning down are added.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):267-272
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The prevention of drug substances abuse among schoolchildren
Timoshilov V.I., Lastovetckii A.G.
Abstract
The drug abuse is one of the most important medical and social problems of the youth. The problems with illegal and dangerous using of psychoactive drugs of different chemical categories by schoolchildren are caused by common social and psychological risk factors. Thus, in many research studies, all drugs and solvent substances are covered by general concept of “narcotic substances”.The study purpose is to develop an evidence database related to efficiency of common prevention measures and to development of sound recommendations of its management.The study included sociological survey of representative sampling of 445 schoolchildren aged from 14 to 17 years. The relationship between participation in preventive activities (factorial sign) and development of objective concepts about harm of drug abuse and possibilities of narcology (resulting sign) are studied using calculation of relative risk and its confidence interval.The study proves the positive effect of lecturing of specialists, psychological lessons and trainings, review of thematic video materials. The involvement of schoolchildren into development of agitation materials concerning healthy life-style and into reading of special literature is considered as effective in case of their implementation after target group received initial knowledge about problems of drug abuse and toxicomania. The study proved the negative effect of independent search of information about drugs in Internet, fabrication agitation materials about harm of drugs by adolescents, discussions based on opposite opinions and all forms of communication with patients with drug addiction. The necessity of widespread implementation of target advanced training of managers of preventive measures application.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):273-276
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The satisfaction with rendering medical services of orthodontic profile to children of junior school age
Argutina A.S., Kosiuga S.I.
Abstract
The article considers the results of complex medical sociological study including questionnaire survey of schoolchildren of junior age and their parents concerning issues of satisfaction with stomatological services. The data is presented concerning subjective opinions about quality and accessibility of stomatological care of orthodontic profile. The causes of dissatisfaction are established and ranged. The criteria of predominant visits to medical organizations of state and private forms of property. The study established demographic and financial characteristics of families, professional characteristics of parents, their subjective opinions about particular aspects of quality of life. The level of sanitary hygienic knowledge and medical activity, including issues of prevention of stomatological diseases and dental maxillary anomalies in children aged 6-11 years was determined. The summary social portrait of family fostering child-patient of children stomatological polyclinic was composed.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):277-280
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The refusal in immunodiagnostic of tuberculosis in municipal conditions
Kazykina T.N., Sterlikov S.A.
Abstract
The problem of refusal of immunodiagnostic of tuberculosis has a significant public resonance in Russia, but it is not widely covered by research.The purpose of study is to determine causes of refusal of legitimate representatives of children to carry out measures for mass immunodiagnostic of tuberculosis and to suggest possible ways of adjusting this negative phenomenon.In a cross-sectional study, the results of a questionnaire survey of 269 respondents - legal representatives of children who systematically refused to carry out immunodiagnostic of tuberculosis, are being studied.Results. The main reasons for the refusal included distrust of quality of the test (31.6%), insufficient semantic motivation (23.0%), fear of adverse reactions, complications (17.8%), negative information received from Internet (13.4%) or mass media (12.3%). Denial of the problem of tuberculosis or its displacement into a remote social environment was demonstrated by 60.6% of respondents (95% CI 54.7-66.3). Respondents are characterized by a high percentage of people (46.8%, 95% CI 40.9-52.8) who have not undergone chest X-ray examinations for more than two years, as well as individuals whose children are not vaccinated with BCG (11.9%, 95% CI 8.3-16.0). Replacement of the regulated method of detection of latent tuberculosis infection by the method chosen by the respondent will allow to examine children about half (52.4%) of the respondents. However, that will require a change in regulatory framework of the Russian Federation.The greatest part of refusals from immunodiagnostic of tuberculosis is associated with defects in sanitary education, resulting in distrust of the quality of tests and insufficient semantic motivation for implementing tests. The respondents are characterized by denial of the problem of tuberculosis. The significant percentage of respondents demonstrate risky behavior regarding the transmission of tuberculosis behavior. They have not been tested for a long time on tuberculosis, and their children are not vaccinated with BCG. The acuteness of the problem can be reduced through greater flexibility in choosing the survey technique and activation of sanitary education of population.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):281-285
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The analysis of mortinatality in the Bryansk oblast and the Russian Federation
Korsakov A.V., Pugach L.I.
Abstract
On the basis of official statistics of 1995-2014 a comparative analysis of the dynamics of stillbirths of boys and girls in the Bryansk region and the Russian Federation was carried out. The study established exceeding of rate of stillbirths in boys over stillbirths in girls at 14.4% and 9.0% correspondingly both in the Bryansk Oblast and the Russian Federation that confirms the global trend of higher risk of stillbirth in boys by approximately to 10%. In case the stillbirth rate in the Bryansk Oblast will proceed established trend the ratio of stillbirths will increase relatively to the nationwide values in 2016 - 2021 and will reach 30% in 2021. At that, the gap between indices of boys and girls will increase up to 32,8%.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):286-289
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The primary morbidity of infectious and parasitic diseases in the structure of all diseases registered for the first time in life in the Russian Federation and the Northern Caucasian Federal okrug
Odinetc A.V., Ogryzko E.V., Danishevskii K.I., Ivanova M.A., Zalevskaia O.V.
Abstract
In conditions of increased population migration, studying the situation on incidence of infectious and parasitogenic diseases is an actual problem. Particularly relevant is the analysis of newly detected incidence in the dynamics, which will allow to assess the well-being of the epidemiological situation in the region. Purpose of the study is to analyze the situation with incidence of some infectious and parasitogenic diseases and their share in the structure of other classes of diseases. The data from the Federal statistical monitoring in 2010-2017 were used related to the Russian Federation and the North Caucasus region.It is demonstrated that the incidence of diseases in the North Caucasus Federal District and the Stavropol region increased while it decreased at the National level. At that, there was a decreasing of incidence of some infectious and parasitogenic diseases both in the Russian Federation and in the North Caucasus Federal District with instability of indices in the Stavropol Krai. In the structure of primarily diagnosed diseases, infectious and parasitogenic diseases both in the the Russian Federation and in the North Caucasus Federal Okrug occupy the in the ranking table tenth point and sixth point in the Stavropol Krai.The results of the study demonstrated multi-directional trends in the dynamics of morbidity in the Russian Federation and the North Caucasus Federal Okrug. The decrease in the percentage of infectious and parasitogenic diseases testifies the improvement of epidemiological situation in overall.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):290-293
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The analysis of dynamics and structure of mortality of female and male population of reproductive age in the Republic of Chuvashia
Bogdanova T.G., Gerasimova L.I.
Abstract
Reducing mortality of working-age population is a potential reserve for preserving Russia's population and its labor force. In addition, the task of analyzing health of economically active citizens of our country is inextricably linked with the challenge of developing strategy of development of reproductive potential at the regional level. As reproductive or generative woman's age is defined precisely enough, and such unambiguous definition for men is lacking, the study used mortality rates, calculated for men and women of working age (16 - 59 years and 16 - 54 years respectively) and officially published by the Russian Federal State Statistics Service (Rosstat) as characteristics of reproductive health.The analysis of mortality rate for working age men and women in the Republic of Chuvashia as well as the structure of main causes of death are presented for 2002 - 2016 in comparison with average indicators for the Russian Federation. The mortality rate of the mentioned population category in Republic of Chuvashia since 2002 has decreased by 17.5% in all age groups except women aged 30 - 39 years. At this, the rate of mortality decreased in men during the analyzed period is higher than in women i.e. 20.5% and 19.3% respectively.As compared with 2002, the percentage of circulatory system diseases, neoplasms, digestive system diseases increased with a simultaneous decrease in the proportion of “external” causes in mortality structure of able-bodied population of the Republic of Chuvashia in 2016. Throughout the analyzed period relative mortality rates of able-bodied men are four times and higher than those of women.The analysis of dynamics characteristics in mortality level and structure among working age women and men as well as risk factors that contribute to its growth, can become the basis for developing an organizational improvement program of rendering medical care to economically active population as a component of regional strategy of increasing the level of reproductive potential.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):294-298
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On organization of palliative medical care
Kolomiichenko M.E., Kareva O.S.
Abstract
The study provides an analysis of the results of the questionnaire survey of physicians in the Russian Federation with the purpose of determining the competences of medical specialists and practice of palliative care and emerging problems. This article presents and discusses the data obtained during the study.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):299-302
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The planning of values of indices of quality of resource management in medical organizations of the Moscow state medical care system
Budarin S.S., Boichenko I.I., Nikonov E.L., Elbek I.V.
Abstract
The article presents the results of planning the values of indices of resource management quality in medical organizations of the Moscow state health system, that participated i the project of implementation of the quality standard of resource management in 2016-2017. The approaches of medical organizations to assessment of resources and opportunities of increasing efficiency of management of financial and human resources are described.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):303-307
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The criteria of increasing of quality of medical care of population in conditions of anthropogenic impact
Meshkov A.V., Mingazova E.N., Sitdikov I.D., Udalov I.D.
Abstract
The assessment of medical care quality of different strata and groups of population is a priority direction of preventive medicine and public health. Nowadays, application of the riskometry theory considering external modifying factors is relevant. The registration of risk indices in the process of development of model of health preservation can be considered as a criterion of medical care quality.The purpose а study was to optimize managerial decisions in the area of increasing medical care quality related to special contingent on the basis of evaluation of carcinogenic danger and reproductive risk in conditions of anthropogenic impact. The study applied such modern research methods as social hygienic, biochemical and statistical techniques.The methodological basis of assessing reproductive risk for population in conditions of anthropogenic impact can serve as a criterion of assessing level of impact and developing management decisions in area of improving health care quality. The public health and health care organization are the fields of application of study results.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):308-311
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The re-engineering and financial cost analysis of administrative economic and managerial processes in medical organization
Mendel S.A., Berseneva E.A.
Abstract
The article presents substantiation of necessity and main directions of application of re-engineering of administrative economic and managerial processes in medical organization. The approaches to financial cost analysis of the mentioned processes are also considered. The proposed methodology is demonstrated on the example of management of industrial safety measures in medical organization.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):312-315
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The quality and safety of rendering emergency and urgent medical care in hospitals
Ivanov I.V., Shvabskii O.R., Minulin I.B., Shcheblykina A.A., Shchesiul A.G.
Abstract
The article presents the results of external auditing on the section “The organization of emergency and urgent medical care in hospital. Organization of admitting office functioning” in 30 medical organizations of the Russian Federation based on “The proposals (practical guidelines) of Roszdravnadzor for organizing internal quality control and safety of medical activity in medical organization (hospital)”. The level of compliance with requirements of the Proposals is determined. The complex and structural problems of organization of rendering of emergency and urgent medical care.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):316-319
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The organization of medical social care of patients with chronic cardiac insufficiency: the literature review
Ponomarev D.S., Simonov S.N.
Abstract
The organization of medical social care of patients with chronic cardiac insufficiency is focused on improving life of these patients through comprehensive interaction of all levels of medical care support of population. The organization of Schools of Health on the level of out-patient medical care specifically for patients with chronic cardiac insufficiency allows to extend the period of high-quality compensation of pathological condition.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):320-322
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The organizational forms of preventive activities in population
Kalininskaia A.A., Son I.M.
Abstract
The concept of health progression through treatment of patient received no justification as significant deterioration of population health in last years is an obvious evidence. The practical medicine is to be focused on both ill and healthy people. The characteristics of modern structure of morbidity and mortality in Russia force to admit priority of caring health of healthy people. In the post-Soviet period the existed then system of preventive care of schoolchildren, representatives of main professions and groups of population factually was destroyed. This kind of activities is to be restored in medical sanitary units.However, the analysis of practice of clinical examination revealed the presence of a number of organizational and methodological costs that decreases efficiency of applied resources does not allow to fully achieve established goals. The article presents analysis of dispensarization of population in the Russian Federation and evaluation of efficiency of functioning of the Health Centers. The experience of youth-friendly clinics is evaluated. The organizational structure of preventive work at the level of primary medical sanitary care and its interaction with specialized services in health care.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):323-327
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The methodology of complex social hygienic investigation of various groups of population and families (In memoriam of professor O. V. Grinina)
Kicha D.I., Nechaev V.S., Stepanova S.M.
Abstract
The article expounds main principal positions of professor O. V. Grinina scientific educational methodological school of social hygienic investigations of health of population and family. The methodological analysis of scientific works of professor O. V. Grinina and her disciples was implemented to demonstrate key positions and results of studies constituting scientific school of program methodological basics of complex social hygienic studies of population health, health care and conditions of life of families.The purpose of publication is to characterize indications of the school of complex social hygienic investigations of priority population groups and families. These issues are covered by thematic fundamental works substantiating patterns of formation and estimation of health of families, program methodological issues of complex medical social studies of family and its individual members, availability of large group за disciples developing priority issues of investigation of population health at the level of family and organization of medical care based on the principles of per family observations, general (family) medical practice.The results are demonstrated and patterns are established containing in implemented complex social hygienic per family studies of various population groups, women, children and families in 1970s-1990s. The methodological significance of valid family-focused technologies in new social economic conditions of development of society and health care and principles of curative preventive activities in conditions of mandatory medical insurance are demonstrated.The professor O. V. Grinina substantiated and developed program of medical social characteristic of family. its sections and methodology of long-term continuous monitoring of family. She also determined characteristics of health of family as a group patient, principles of work of out-patient physicians with families directly at the polyclinic district.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):328-332
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The constituent session of the USSR Academy of Medical Sciences. The first day (December 20, 1944)
Gliantcev S.P., Stochik A.A.
Abstract
The article describes and analyzes the first day of the Constituent Session of the USSR Academy of Medical Sciences held on December 20, 1944. During this meeting the People's Commissar of Health of the USSR, G. A. Miterev, academicians A. I. Abrikosov and L. A. Orbeli, the full member of the USSR Academy of Medical Sciences S. S. Yudin made their speeches devoted to organizational tasks facing the USSR Academy of Medical Sciences during the war and post-war time, as well as to questions of morphology and physiology that require priority attention. The Yudin's report was emotional, patriotic and reflected the achievements of Soviet surgery in the mid-twentieth century. Analysis of the reports demonstrated that they contained many provisions that influenced the further development of medicine and public health in the USSR.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):333-337
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The prevention of disability as a leading priority of caring of mother and child health
Baranov A.A., Namazova-Baranova L.S., Albitckii V.I., Terletckaia R.N.
Abstract
The prevention of disability in children and support of families fostering disabled children and children with limited capacities in health are included into number of main priorities of the state social policy of the Russian Federation. Thereupon, the project “Childhood Decade” is an important stage that includes social care of disabled children and children with limited capacities in health and their integration in modern society according the Decree of the President on implementation of state policy in the field of family and children care. The underestimation of children disability is supposed to be present produced by such causes as social motivation of family, complicacy of legal official registration, harsh requirements of medical social expertise services, inadequate awareness of medical staff about criteria of disability.According the WHO European Regional Bureau, in Russia there are 250 000 children with limitations of life activity mainly caused by somatic pathology, who have no status of disabled person and no state social support. The prevention of children disability is considered as a system of measures of caring mother and child health all along childhood. The priority directions of prevention considering causes of development of disability and its structure according particular disease are marked. The data is presented related to modern technologies of decreasing genetic load on population from position of prevention of hereditary, inborn and orphan diseases. In particular studies non-infectious pathology acquiring greater significance in development of disability in children of various age groups since neonatal period is considered. The new directions of research are proposed to affect the processes of incapacitation of child on more profound pathogenic level and to develop organization of preventive activities in this area.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):216-221
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The analysis of mortality of population of able-bodied age because of external causes
Shchepin V.O., Shishkin E.V.
Abstract
The article presents analysis of mortality because of injuries, poisonings and other consequences of impact of external causes in able-bodied population of the Russian Federation. In 2016, the study identified 18 subjects of the Russian Federation, where these causes of death occupied first rank, leaving behind mortality of blood circulatory system diseases.The optimization of medical care of persons injured by external causes should be implemented by three main directions: traumatological orthopedic one with organization of traumatological centers; сombustiological one with organization of burn centers; toxicological one with organization of toxicological centers.The established differences in mortality rates between subjects of the Russian Federation testify the necessity of complex and substantive measures of organizing and developing medical care support of persons injured by external causes, considering climatic geographic features of regions, as well as availability of “endemic” zones within the territories of subjects that will make it possible to propose valid recommendations related to organization of new centers and optimization of routing of patients based on actual operating medical organizations and their structural subdivisions.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):222-226
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The personalized medicine and organization of geriatric care of population
Belushkina N.N., Chemezov A.S., Paltsev M.A.
Abstract
The article presents advisability of applying approaches of personalized medicine to solve problems of modern gerontology and geriatrics. The actuality of issue is conditioned by population aging due to rapid increasing of both percentage and absolute number of elderly people in total population of most countries. The ideology of personalized medicine or P4 medicine is targeted to developing individual preventive and therapeutic activities for specific personality. The fundamental basis of developing personalized medicine is ensured by biomarkers, specific for every patient and certain disease. The elderly people health is characterized by increased susceptibility to diseases, polymorbidity and heterogeneity in health status. The solution of actual problems in gerontology and geriatrics improvement of basic principles of health care is needed with an emphasis on prognostication, prevention and personalized approach applied to elderly patients with the purpose of ameliorating their quality of life. The development and promotion of complex inter-disciplinary programs of personalized treatment of elderly patients is required.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):227-230
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The public opinion about health care: the main factors of increasing satisfaction of population with medical care
Mihailova I.V., Siburina T.A., Son I.M., Shchepin V.O., Lindenbraten A.L., Mihailov A.I.
Abstract
The evaluation of satisfaction of population with medical care has become widespread in practice of medical institutions as an obligatory criterion of assessing quality of their functioning.The study objective is to determine degree of satisfaction of population Russia with health care and role of particular factors in its formation.The study applied questionnaire survey of residents of 9 subjects of the Russian Federation using representative sampling of 1457 observations. The Pearson contingency indicator and the Chuprov-Cramer indicator of association between two nominal variables were determined. The ranking of signs according their influence strength was carried out.The most significant role in evaluation of satisfaction with health system functioning is played by satisfaction with medical care. Among the factors characterizing consumers of medical services, self-assessment of one's health status, social status of respondents, residence demonstrate the most effect. The priority factors in formation of positive public opinion about health care are identified.It is proved that positive opinion about health care depends on quality and accessibility of popular types of medical care, organization of functioning of primary health care medical organizations according expectations of population. The level of satisfaction with health care system is lower than in case of rendered medical services.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):231-236
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The attitude to health in modern family
Markova A.I., Flores M.A.
Abstract
The purpose of survey is to identify behavioral characteristics in family life-style and intra-family educational practices in dynamics of observation as health indicator. The life-style is analyzed according the results of questionnaire survey of 297 respondents, fostering school age children. The comparative analysis of behavior of adults and children is carried out based on the results of questionnaire surveys in 2007 and 2013. The verbal affirmations concerning importance of health and observance of healthy life-style in family have no concordance with actual behavior. The deterioration of of family function in healthy generation fostering is established. About 36,7% of parents pay no attention to their children. The passivity concerning organization of comfortable domestic conditions and inadequate medical activity in children health support are manifested by parents. The responsibility of parents for health of their children decreases too. The changing of priorities in hierarchy of life values occurs. The health loses its primary value. The decreasing of health in adults and children is logical due to effect relationship between life-style and health.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):237-242
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The patients' evaluation of medical service at the out-patient level
Denisov I.N., Reze A.G., Volnuhin A.V., Azizova D.I.
Abstract
The article presents the results of questionnaire survey of patients' opinions about out-patient medical care. The survey was carried out using the Doctors' Interpersonal Skills Questionnaire during 12 months. The sampling consisted of 14.712 respondents. The lowest rates out of 11 parameters analyzed received parameters Q5 (Could the doctor reassure you?) and Q7 (Did the doctor help you to express your feelings and fears?). Such a situation was common for all medical specialties. Unexpectedly, combination of low estimate of mentioned parameters with their low correlation and resultant satisfaction with medical care was established. The resultant satisfaction with medical service by general practitioners (family doctors) was less dependent from physician's respectful attitude to patient than attention of physician to personal circumstances of patient choosing treatment. The patients of endocrinologists noted that the least input into resultant satisfaction with medical care was related to ability of physician to assist them to express their fears, and the greatest input was given to first impression from manner and mode of how physician received patient. The least input into resultant satisfaction of patients with medical services by cardiologists was made by respectful attitude of physician and the most input was attributed to way of how physician considers patient’s personal circumstances in treatment selection. The patients of gastroenterologists mentioned physician's ability to reassure patient as least input into resultant satisfaction with medical care, and attention to way of how physician considers patient’s personal circumstances in treatment selection as most input.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):243-247
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The social anamnesis, conditions of life and life-style of pregnant women with syphilitic infection
Matyskina N.V., Bondarenko I.Z., Artiuhov I.P., Shirshina I.A., Taranushenko T.E.
Abstract
The article presents the results of analysis of characteristics of social behavior, life conditions and life-style of pregnant women with syphilitic infection. The sampling included 647 female pregnant patients actually ill with syphilis or having this disease in the past that were accepted to maternity houses of Krasnoyarsk in 2004-2014. The three groups of women with syphilitic infection were organized on the basis of remoteness of diagnosis of disease and results of complex of serological reactions during pregnancy.The presented data testify late diagnostic of mentioned pathology and significant percentage of hidden forms of infection course. The characteristics of “social portrait” of women with syphilitic infection during pregnancy are early beginning of sexual life (prior to 18 years in every 5-6 woman), predominantly school education and specialized secondary education, belonging to working specialties, availability of harmful habits and chronic diseases (about 50%) non-registered marriage. The study established no reliable facts of non-adapted social behavior of pregnant women with syphilis.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):248-251
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The morbidity of diseases of skin and subcutaneous cellular tissue in population of the Republic of Bashkortostan
Muhamadeeva O.R., Sharafutdinova N.K., Pavlova M.I., Borisova M.V.
Abstract
The diseases of skin and subcutaneous tissue are an actual medical and social problem. The purpose of study was to analyze dynamics of incidence and prevalence of diseases of skin and subcutaneous tissue in population of the Republic of Bashkortostan in 2008-2017. The average rates of incidence and prevalence of these diseases in the Republic of Bashkortostan were significantly higher than relevant data in the Russian Federation and Volga federal district. In the Republic of Bashkortostan the study established increase in incidence rate of atopic dermatitis (primary morbidity increased up to 18.6%, total morbidity increased up to 20.2%) and psoriasis (total morbidity increased up to 3%). The low level of dispensary observation of patients with dermatitis in the medical organizations of the Republic of Bashkortostan was established. In 2017 full coverage with dispensary observation was established in case of children aged 0-14 years with discoid lupus erythematosus. The low level of dispensary observation of children with atopic dermatitis (42%) and adults with psoriasis (30.6%) was established. The study demonstrated necessity of further studying of total and primary morbidity of diseases of skin and subcutaneous tissue and also indices of dispensary observation of patients according nosologies and age groups, identification of corresponding risk factors, development and implementation of measures improving medical care at all stages of its rendering.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):252-256
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The regional epidemiological characteristics of craniocerebral injury in children in Russia in 2003-2014
Roshal L.M., Valiullina S.A., Sharova E.A.
Abstract
The craniocerebral injury is a global problem of health care and society. The fatal and incapacitating aftermaths developed because of this type of trauma result in significant social and economic losses. To develop effective measures of decreasing these losses epidemiological studies are needed to be implemented considering gender, age, regional and other characteristics.The purpose of study was to analyze regional and epidemiological characteristics of craniocerebral injury in children population of Russia.The study was based on data of state statistic reports in Russia and in its regions in 2003-2004.During analyzed period, dynamics of children morbidity of craniocerebral injury are characterized by its maximal level reached in 2010 (6.3 per 1,000 of children population) and by its decreasing to initial level (5.4% per 1,000 of children population) in 2014.The two-fold increase of percentage of children of the first year of life in mortality of craniocerebral injury was established against the background of stable decrease of craniocerebral injury mortality among children aged from 0 to 17 years. In 2014, every ninth child who died because of head trauma did not survived age of 1 year.In Russia, decreasing of level of hospitalization of children with craniocerebral injury was established. At that, indices of hospitalized morbidity of children of the first year of life increased up to 30%.The actual statistical reporting in Russian Federation provides no full measure evaluation of true levels of mortality, morbidity and hospitalized morbidity. this condition occurs due to limitations of including additional nosological forms in state statistic reporting and to specificity of main disease codification or leading causes of death. The study established significant regional specificity of craniocerebral injury in children that determines necessity of development effective measures considering established epidemiological characteristics.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):257-261
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The regional characteristics of endocrine pathology in the Perm kraii
Demicheva T.P., Laptev D.N., Shilova S.P., Filippov Y.I., Emel'yanov A.O., Kuraeva T.L.
Abstract
Nowadays, focus of research is shifted to epidemiology of non-communicable diseases. Hence, actuality of study purpose to investigate epidemiological characteristics of endocrine diseases. The data of population appealability to medical organizations in the Perm region during last 20 years was used. The levels and structure of morbidity were calculated. The dynamic process was evaluated. The trend prognostication was proposed. In 2017, total endocrine system morbidity in the Perm region made up to 88.1 cases per 1000 population. During last 20 years, primary and total morbidity has tripled. In 2006, 2013 and 2015 maximal levels of primary morbidity are conditioned by adoption of a number of legal acts targeted to detection of pathology. The pathology of diseases of the endocrine system is determined by diabetes mellitus, thyroid diseases and obesity in 87.1% of all cases. According the data of population appealability to medical organizations, the rate of prevalence of obesity in 2017 made up to 10.6, diabetes mellitus - 26.6, thyroid diseases - 23.4 per 1000 of population. During last 20 years, incidence of diabetes mellitus increased up to 2 times, and obesity up to 4.8 times. The females suffered of obesity 1.2 times and of thyroid diseases 7.4 times more often than males.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):262-266
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The social and ethno-cultural prerequisites of suicidal behavior of adolescents in the Republic of Buryatia
Semenova N.B.
Abstract
The article considers social and ethno-cultural risk factors of suicidal behavior in Buryat adolescents. The analysis of life-style of children and adolescents in actual conditions was implemented. The immediate family and external social environment were characterized. The system of vital values was analyzed. The study demonstrated that in Buryat population the is a leading one. The system of relationship of adolescents with parents, school teachers and peers was analyzed. It is established that only 62.35 of adolescents are satisfied with these relationships.It is established that Buryat adolescents changing of life-style resulted in transformation of family and decreasing of its fostering function can be considered as risk factor of suicidal behavior. The frustration of affiliation needs i.e. need in the relationship most important for Buryat ethnos is considered as the ethno-cultural factor. The risk of suicidal behavior increases when such factors as rudeness or hardheartedness of teacher, school community turning down are added.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):267-272
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The prevention of drug substances abuse among schoolchildren
Timoshilov V.I., Lastovetckii A.G.
Abstract
The drug abuse is one of the most important medical and social problems of the youth. The problems with illegal and dangerous using of psychoactive drugs of different chemical categories by schoolchildren are caused by common social and psychological risk factors. Thus, in many research studies, all drugs and solvent substances are covered by general concept of “narcotic substances”.The study purpose is to develop an evidence database related to efficiency of common prevention measures and to development of sound recommendations of its management.The study included sociological survey of representative sampling of 445 schoolchildren aged from 14 to 17 years. The relationship between participation in preventive activities (factorial sign) and development of objective concepts about harm of drug abuse and possibilities of narcology (resulting sign) are studied using calculation of relative risk and its confidence interval.The study proves the positive effect of lecturing of specialists, psychological lessons and trainings, review of thematic video materials. The involvement of schoolchildren into development of agitation materials concerning healthy life-style and into reading of special literature is considered as effective in case of their implementation after target group received initial knowledge about problems of drug abuse and toxicomania. The study proved the negative effect of independent search of information about drugs in Internet, fabrication agitation materials about harm of drugs by adolescents, discussions based on opposite opinions and all forms of communication with patients with drug addiction. The necessity of widespread implementation of target advanced training of managers of preventive measures application.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):273-276
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The satisfaction with rendering medical services of orthodontic profile to children of junior school age
Argutina A.S., Kosiuga S.I.
Abstract
The article considers the results of complex medical sociological study including questionnaire survey of schoolchildren of junior age and their parents concerning issues of satisfaction with stomatological services. The data is presented concerning subjective opinions about quality and accessibility of stomatological care of orthodontic profile. The causes of dissatisfaction are established and ranged. The criteria of predominant visits to medical organizations of state and private forms of property. The study established demographic and financial characteristics of families, professional characteristics of parents, their subjective opinions about particular aspects of quality of life. The level of sanitary hygienic knowledge and medical activity, including issues of prevention of stomatological diseases and dental maxillary anomalies in children aged 6-11 years was determined. The summary social portrait of family fostering child-patient of children stomatological polyclinic was composed.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):277-280
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The refusal in immunodiagnostic of tuberculosis in municipal conditions
Kazykina T.N., Sterlikov S.A.
Abstract
The problem of refusal of immunodiagnostic of tuberculosis has a significant public resonance in Russia, but it is not widely covered by research.The purpose of study is to determine causes of refusal of legitimate representatives of children to carry out measures for mass immunodiagnostic of tuberculosis and to suggest possible ways of adjusting this negative phenomenon.In a cross-sectional study, the results of a questionnaire survey of 269 respondents - legal representatives of children who systematically refused to carry out immunodiagnostic of tuberculosis, are being studied.Results. The main reasons for the refusal included distrust of quality of the test (31.6%), insufficient semantic motivation (23.0%), fear of adverse reactions, complications (17.8%), negative information received from Internet (13.4%) or mass media (12.3%). Denial of the problem of tuberculosis or its displacement into a remote social environment was demonstrated by 60.6% of respondents (95% CI 54.7-66.3). Respondents are characterized by a high percentage of people (46.8%, 95% CI 40.9-52.8) who have not undergone chest X-ray examinations for more than two years, as well as individuals whose children are not vaccinated with BCG (11.9%, 95% CI 8.3-16.0). Replacement of the regulated method of detection of latent tuberculosis infection by the method chosen by the respondent will allow to examine children about half (52.4%) of the respondents. However, that will require a change in regulatory framework of the Russian Federation.The greatest part of refusals from immunodiagnostic of tuberculosis is associated with defects in sanitary education, resulting in distrust of the quality of tests and insufficient semantic motivation for implementing tests. The respondents are characterized by denial of the problem of tuberculosis. The significant percentage of respondents demonstrate risky behavior regarding the transmission of tuberculosis behavior. They have not been tested for a long time on tuberculosis, and their children are not vaccinated with BCG. The acuteness of the problem can be reduced through greater flexibility in choosing the survey technique and activation of sanitary education of population.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):281-285
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The analysis of mortinatality in the Bryansk oblast and the Russian Federation
Korsakov A.V., Pugach L.I.
Abstract
On the basis of official statistics of 1995-2014 a comparative analysis of the dynamics of stillbirths of boys and girls in the Bryansk region and the Russian Federation was carried out. The study established exceeding of rate of stillbirths in boys over stillbirths in girls at 14.4% and 9.0% correspondingly both in the Bryansk Oblast and the Russian Federation that confirms the global trend of higher risk of stillbirth in boys by approximately to 10%. In case the stillbirth rate in the Bryansk Oblast will proceed established trend the ratio of stillbirths will increase relatively to the nationwide values in 2016 - 2021 and will reach 30% in 2021. At that, the gap between indices of boys and girls will increase up to 32,8%.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):286-289
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The primary morbidity of infectious and parasitic diseases in the structure of all diseases registered for the first time in life in the Russian Federation and the Northern Caucasian Federal okrug
Odinetc A.V., Ogryzko E.V., Danishevskii K.I., Ivanova M.A., Zalevskaia O.V.
Abstract
In conditions of increased population migration, studying the situation on incidence of infectious and parasitogenic diseases is an actual problem. Particularly relevant is the analysis of newly detected incidence in the dynamics, which will allow to assess the well-being of the epidemiological situation in the region. Purpose of the study is to analyze the situation with incidence of some infectious and parasitogenic diseases and their share in the structure of other classes of diseases. The data from the Federal statistical monitoring in 2010-2017 were used related to the Russian Federation and the North Caucasus region.It is demonstrated that the incidence of diseases in the North Caucasus Federal District and the Stavropol region increased while it decreased at the National level. At that, there was a decreasing of incidence of some infectious and parasitogenic diseases both in the Russian Federation and in the North Caucasus Federal District with instability of indices in the Stavropol Krai. In the structure of primarily diagnosed diseases, infectious and parasitogenic diseases both in the the Russian Federation and in the North Caucasus Federal Okrug occupy the in the ranking table tenth point and sixth point in the Stavropol Krai.The results of the study demonstrated multi-directional trends in the dynamics of morbidity in the Russian Federation and the North Caucasus Federal Okrug. The decrease in the percentage of infectious and parasitogenic diseases testifies the improvement of epidemiological situation in overall.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):290-293
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The analysis of dynamics and structure of mortality of female and male population of reproductive age in the Republic of Chuvashia
Bogdanova T.G., Gerasimova L.I.
Abstract
Reducing mortality of working-age population is a potential reserve for preserving Russia's population and its labor force. In addition, the task of analyzing health of economically active citizens of our country is inextricably linked with the challenge of developing strategy of development of reproductive potential at the regional level. As reproductive or generative woman's age is defined precisely enough, and such unambiguous definition for men is lacking, the study used mortality rates, calculated for men and women of working age (16 - 59 years and 16 - 54 years respectively) and officially published by the Russian Federal State Statistics Service (Rosstat) as characteristics of reproductive health.The analysis of mortality rate for working age men and women in the Republic of Chuvashia as well as the structure of main causes of death are presented for 2002 - 2016 in comparison with average indicators for the Russian Federation. The mortality rate of the mentioned population category in Republic of Chuvashia since 2002 has decreased by 17.5% in all age groups except women aged 30 - 39 years. At this, the rate of mortality decreased in men during the analyzed period is higher than in women i.e. 20.5% and 19.3% respectively.As compared with 2002, the percentage of circulatory system diseases, neoplasms, digestive system diseases increased with a simultaneous decrease in the proportion of “external” causes in mortality structure of able-bodied population of the Republic of Chuvashia in 2016. Throughout the analyzed period relative mortality rates of able-bodied men are four times and higher than those of women.The analysis of dynamics characteristics in mortality level and structure among working age women and men as well as risk factors that contribute to its growth, can become the basis for developing an organizational improvement program of rendering medical care to economically active population as a component of regional strategy of increasing the level of reproductive potential.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):294-298
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On organization of palliative medical care
Kolomiichenko M.E., Kareva O.S.
Abstract
The study provides an analysis of the results of the questionnaire survey of physicians in the Russian Federation with the purpose of determining the competences of medical specialists and practice of palliative care and emerging problems. This article presents and discusses the data obtained during the study.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):299-302
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The planning of values of indices of quality of resource management in medical organizations of the Moscow state medical care system
Budarin S.S., Boichenko I.I., Nikonov E.L., Elbek I.V.
Abstract
The article presents the results of planning the values of indices of resource management quality in medical organizations of the Moscow state health system, that participated i the project of implementation of the quality standard of resource management in 2016-2017. The approaches of medical organizations to assessment of resources and opportunities of increasing efficiency of management of financial and human resources are described.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):303-307
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The criteria of increasing of quality of medical care of population in conditions of anthropogenic impact
Meshkov A.V., Mingazova E.N., Sitdikov I.D., Udalov I.D.
Abstract
The assessment of medical care quality of different strata and groups of population is a priority direction of preventive medicine and public health. Nowadays, application of the riskometry theory considering external modifying factors is relevant. The registration of risk indices in the process of development of model of health preservation can be considered as a criterion of medical care quality.The purpose а study was to optimize managerial decisions in the area of increasing medical care quality related to special contingent on the basis of evaluation of carcinogenic danger and reproductive risk in conditions of anthropogenic impact. The study applied such modern research methods as social hygienic, biochemical and statistical techniques.The methodological basis of assessing reproductive risk for population in conditions of anthropogenic impact can serve as a criterion of assessing level of impact and developing management decisions in area of improving health care quality. The public health and health care organization are the fields of application of study results.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):308-311
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The re-engineering and financial cost analysis of administrative economic and managerial processes in medical organization
Mendel S.A., Berseneva E.A.
Abstract
The article presents substantiation of necessity and main directions of application of re-engineering of administrative economic and managerial processes in medical organization. The approaches to financial cost analysis of the mentioned processes are also considered. The proposed methodology is demonstrated on the example of management of industrial safety measures in medical organization.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):312-315
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The quality and safety of rendering emergency and urgent medical care in hospitals
Ivanov I.V., Shvabskii O.R., Minulin I.B., Shcheblykina A.A., Shchesiul A.G.
Abstract
The article presents the results of external auditing on the section “The organization of emergency and urgent medical care in hospital. Organization of admitting office functioning” in 30 medical organizations of the Russian Federation based on “The proposals (practical guidelines) of Roszdravnadzor for organizing internal quality control and safety of medical activity in medical organization (hospital)”. The level of compliance with requirements of the Proposals is determined. The complex and structural problems of organization of rendering of emergency and urgent medical care.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):316-319
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The organization of medical social care of patients with chronic cardiac insufficiency: the literature review
Ponomarev D.S., Simonov S.N.
Abstract
The organization of medical social care of patients with chronic cardiac insufficiency is focused on improving life of these patients through comprehensive interaction of all levels of medical care support of population. The organization of Schools of Health on the level of out-patient medical care specifically for patients with chronic cardiac insufficiency allows to extend the period of high-quality compensation of pathological condition.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):320-322
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The organizational forms of preventive activities in population
Kalininskaia A.A., Son I.M.
Abstract
The concept of health progression through treatment of patient received no justification as significant deterioration of population health in last years is an obvious evidence. The practical medicine is to be focused on both ill and healthy people. The characteristics of modern structure of morbidity and mortality in Russia force to admit priority of caring health of healthy people. In the post-Soviet period the existed then system of preventive care of schoolchildren, representatives of main professions and groups of population factually was destroyed. This kind of activities is to be restored in medical sanitary units.However, the analysis of practice of clinical examination revealed the presence of a number of organizational and methodological costs that decreases efficiency of applied resources does not allow to fully achieve established goals. The article presents analysis of dispensarization of population in the Russian Federation and evaluation of efficiency of functioning of the Health Centers. The experience of youth-friendly clinics is evaluated. The organizational structure of preventive work at the level of primary medical sanitary care and its interaction with specialized services in health care.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):323-327
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The methodology of complex social hygienic investigation of various groups of population and families (In memoriam of professor O. V. Grinina)
Kicha D.I., Nechaev V.S., Stepanova S.M.
Abstract
The article expounds main principal positions of professor O. V. Grinina scientific educational methodological school of social hygienic investigations of health of population and family. The methodological analysis of scientific works of professor O. V. Grinina and her disciples was implemented to demonstrate key positions and results of studies constituting scientific school of program methodological basics of complex social hygienic studies of population health, health care and conditions of life of families.The purpose of publication is to characterize indications of the school of complex social hygienic investigations of priority population groups and families. These issues are covered by thematic fundamental works substantiating patterns of formation and estimation of health of families, program methodological issues of complex medical social studies of family and its individual members, availability of large group за disciples developing priority issues of investigation of population health at the level of family and organization of medical care based on the principles of per family observations, general (family) medical practice.The results are demonstrated and patterns are established containing in implemented complex social hygienic per family studies of various population groups, women, children and families in 1970s-1990s. The methodological significance of valid family-focused technologies in new social economic conditions of development of society and health care and principles of curative preventive activities in conditions of mandatory medical insurance are demonstrated.The professor O. V. Grinina substantiated and developed program of medical social characteristic of family. its sections and methodology of long-term continuous monitoring of family. She also determined characteristics of health of family as a group patient, principles of work of out-patient physicians with families directly at the polyclinic district.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):328-332
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The constituent session of the USSR Academy of Medical Sciences. The first day (December 20, 1944)
Gliantcev S.P., Stochik A.A.
Abstract
The article describes and analyzes the first day of the Constituent Session of the USSR Academy of Medical Sciences held on December 20, 1944. During this meeting the People's Commissar of Health of the USSR, G. A. Miterev, academicians A. I. Abrikosov and L. A. Orbeli, the full member of the USSR Academy of Medical Sciences S. S. Yudin made their speeches devoted to organizational tasks facing the USSR Academy of Medical Sciences during the war and post-war time, as well as to questions of morphology and physiology that require priority attention. The Yudin's report was emotional, patriotic and reflected the achievements of Soviet surgery in the mid-twentieth century. Analysis of the reports demonstrated that they contained many provisions that influenced the further development of medicine and public health in the USSR.
Problems of Social Hygiene, Public Health and History of Medicine. 2019;27(3):333-337
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