Vol 28, No 1 (2020)

Full Issue

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Articles
The role of actual demographic trends in improving state health policy
Alexandrova O.Y., Smbatyan S.M., Vasilieva T.P., Kostanyan A.A., Stasevich N.Y.
Abstract
The decreasing of demographic security level is a global social economic trend in both developed and developing economies. Hence there is an urgent need in improving state social policy, including health care. The key target of this study is to evaluate the role of modern demographic trends in improving state social economic policy in health care. The study characterizes demography role in developing state health care strategy and to assesses world demographic trends that permitted to formulate potential barriers and obstacles in achieving stable level of demographic security. The distinctive features of modern demographic trends in Russia were identified and used as a background in developing prospective ways of improving state health policy in Russia with specific focusing on identified identified predicaments in national demographic development. The interdisciplinary analysis was applied in the field of theory and practice of health demography as a new scientific area as well as systemic and economic analysis. The most important result of the study was the established need in assessing relationship between current national demographic situation and economic efficiency and social economic consequences for whole society that actualized retrieval and elaboration of relevant social economic indices of life quality within the framework of health demography.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):5-11
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The experience of development of partnership between science and health care institutions in resolving issues of circulatory system diseases
Artamonova G.V., Kryuchkov D.V., Danilchenko Y.V., Makarov S.A., Kusch O.V., Barbarash O.L., Barbarash L.S.
Abstract
In Russia, the process of clustering institutions at the regional level is evolved. The analysis of scientific publications revealed only several examples of efficiently functioning medical clusters. As a rule, the publications present problems or projects and perspectives of development of medical clusters. At that, no information is available concerning organizational mechanisms integration of institutions.Purpose of the study is to evaluate the results of partnership between institutions of science and practice in resolving strategic health problems related to diseases of blood circulatory system.Materials and methods. The study applied such methods as monographic approach, data derivation, statistical technique, logical and system analysis.Results. The partnership between scientific and educational institutions and practical health care organizations was analyzed on the example of the system of medical care of circulatory system diseases organized in the Kemerovo region. The effective functioning of such a partnership is based on seven integration principles. Thus, the number of treated patients increased by 7.1% from 2011 to 2018. At the same time, the number of beds decreased by 9.2%. As a result, bed turnover increased by 18.1% over this period. The work of X-ray surgery service almost doubled the rate of percutaneous coronary interventions in case of acute coronary syndrome (from 22.0% in 2011 to 42.7% in 2018).The main organizational basics of successful cooperation of institutions are succession and interdependency in work of physians and departments, joint environments of quality management, knowledge management and personnel training, shared management of research and medical activity, common production and information environment, corporate culture and traditions.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):12-17
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The increasing of awareness of patients and medical personnel of security issues: the results of questionnaire survey within the framework of the World Patient Safety Day in the Russian Federation
Ivanov I.V., Berseneva E.A., Minulin I.B., Schesyul A.G., Scheblykina A.A.
Abstract
The specially developed questionnaires on the basis of the WHO materials developed for the World Patient Safety Day were applied in sociological survey of patients and medical workers. The sampling included 3946 respondents (1747 patients and 2199 medical workers). The study was carried out to establish awareness about course of treatment and medications taken, communication with the attending physician and nurse, involvement in decision-making regarding treatment and care provided, clinical decision-making, interaction with patients, informing patients on prescribed drugs and their possible adverse reactions.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):18-22
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The psychological characteristics of interaction between patient and physician of traumatology department
Litvinova L.V., Ayrapetov G.A., Konovalov E.A., Abakarova E.G., Arutiunyan V.V.
Abstract
The actual conditions of “physician-patient” interaction in hospital department presents high requirements to quality and rate of provided services. The development of conflicts because of misunderstanding of behavior motivation of physician and patient in hospital department determined purpose of actual study. The standardized psychological questionnaire “Big Five” and Myers-Briggs questionnaire were used to obtain needed data. The study results were statistically processed using Student's test. The statistical analysis established in physicians and patients’ reliable difference in indices of “attachment - isolation” (p=0.035), prevalence in physicians of mental processes (p=0.001) and sensuous component in social interaction of patients (p=0.025). The physician of orthopedic department seeks to keep exact logical sequence of actions. The patients fully rely on their feelings in their decision making. The established hypersensitivity of patients and inner strive to move “not according plan” results in disagreements concerning therapeutic strategy and failure in strict applications of all physician recommendations that frequently becomes a cause of uncoordinated actions and conflict situations.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):23-28
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The social economical losses because of mortality due to alcohol-associated causes
Budaev B.S., Mikheev A.S., Tarmaeva I.Y., Khamnaeva N.I., Bogdanova O.G.
Abstract
The evaluation of social economic losses based on the analysis of mortality of alcohol-associated causes in the Republic of Buryatia was carried out. It is established that in the Republic in 1993-2017 the average mortality due to alcohol-associated causes made up to 3.52% of total population mortality. This indicator is significantly higher among died individuals of able-bodied age, reaching 6.98±0.11% in this cohort. The economic damage due to direct alcohol-associated causes of death of individuals of able-bodied age made up to 4,123.9 million rubles, including 2038.3 million rubles in male population and 319.3 million rubles in female population, considering employment of analyzed population cohort. The social and economic damage due to population premature mortality in the Republic of Buryatia and directly related to alcohol consumption was calculated on the basis of potential demography principle. In average, the annual social losses made up to 80,248.37 man-years not survived till the end of able-bodied age. In total, the concomitant economic losses for the mentioned above period made up to 4.1 billion rubles. The obtained data testify both high level of alcoholization of population of the Republic of Buryatia and necessity of the activation of activities targeted to primary prevention.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):29-33
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The role of family doctor in early detection of glaucoma
Salikhova K.M.
Abstract
The purpose of the study is to assess medical efficiency of family doctors involved in early detection of glaucoma.Materials and methods. The prospective observation was carried on in polyclinic No.3 (the basis institution of the University Department of family medicine) to provide experimental evidence of role of family physician in medical care of ophthalmic patients.The sampling included 1000 patients visited polyclinic for the first time. In total the cohort was formed from 250 patients of therapist (family physician), 250 patients of neurologist, 250 patients of dentist and 250 patients of other physicians.All patients initially passed Maklakov’s eye tonometry prior to visiting medical specialists. After tonometry, all patients have been observed by ophthalmologist and in the process of treatment also by therapist, neurologist, dentist and other medical specialists.The results. The percentage of patients with intraocular pressure <12, 12-16, 17-21, 22-26, 27-31, l32 mm/Hg in the right and the left eye correspondingly made up to 41.6±1.6 and 42.1±1.6%; 30.0±1.5 and 31.4±1.5; 18.4±1.2 and 16.2±1.2%; 5.6±0.7 and 5.2±0.7%; 2.4±0.5 and 2.9±0.5%; 2.4±0.5 and 2.2±0.5%. It is clear that, at of Among patients, visited polyclinics for the first time, in 10,5±0,97% an increase in intraocular pressure of more than 21 mm / Hg in the right and 10.3 ± 0.96% in the left eye was established.The percentage of patients with visual acuity l6/18; 6/18-6/60; 6/60-3/6 and <3/60 in the right and left eye made up to 72.3±1.4 and 76.7±1.3%; 22.4±1.3 and 18.4±1.2%; 4.4±0.7 and 3.8±0.6% 0.9±0.3 and 1.1±0.3%. The third category of visual impairment (visual acuity <3/60) was established шт small group of patients. The second category of visual impairment (visual acuity 3/60-6/60) was established in relatively larger group of patients.Out of 100 observed patients, visited polyclinic for the first time in 2016, number of undiagnosed diseases and firstly diagnosed due to active participation of family physician included 4.6±0.7 cases of myopia, 3.8±0.6 cases of hyperopia, 2.2±0.5 astigmatism cases, 1.4±0.4 cataract cases, 2.3±0.5 cases of glaucoma, 0.1±0.1 cases of diabetic retinopathy, 4.4±0.7 cases of other eye diseases.Conclusions. The family physician using professional knowledge and skills, can implement diagnostic and therapeutic measures during observation of patients with opthalmologic pathology. The family physician, while observing patients aged 40 years and older, can for the first time diagnose 18.8±1.2 % of eye diseases, including 4.6±0.7 cases of myopia, 3.8±0.6 cases of hyperopia, 2.2±0.5 astigmatism cases, 1.4±0.4 cataract cases, 2.3±0.5 cases of glaucoma, 0.1±0.1 cases of diabetic retinopathy, 4.4±0.7 cases of other eye diseases.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):34-38
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The characteristics of morbidity of breast cancer in the Kabarda-Balkar Republic
Badoeva Z.A., Eshtrekova A.M., Alikova Z.R., Kozyreva F.U.
Abstract
In the Kabarda-Balkar Republic during last decades, stable dynamics of increasing rates of primary breast cancer morbidity is established. The gaining rate of indicator made up to 40.7% over last 10 years. The prevalence indicator of breast cancer is characterized by high growth intensity twice higher than the national level. In the structure of malignant neoplasms morbidity, breast cancer (23.3%) takes position of leading oncologic pathology. The most of patients with breast cancer (33.0%) are in the age group of 50-59 years. However, higher oncologic alertness of medical personnel concerning young women, especially 20-29 years old is required since their percentage among patients with breast cancer is increasing. Noteworthy is the low indicator of active case finding of patients with breast cancer: only 31.8% of cases is diagnosed during prevention examinations. At the early stage of development of tumor process (stage I-II), the rate of identified patients with breast cancer is lower than in the Russian Federation. Especially low is the level of early diagnosis of the disease at stage I. The data testifies existing problems of organization of oncologic medical care in the Kabarda-Balkar Republic and indicates the need of strengthening preventive measures at the primary health care level. Their effectiveness will be assessed by the level of early diagnosis of breast cancer in women and by corresponding appropriate treatment.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):39-43
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The self-preserving behavior of Russian population: dispositions and risks
Shapovalova I.S., Vangorodskaya S.A., Polukhin O.N., Peresypkin A.P., Kisilenko A.V.
Abstract
The article elaborates on research tasks determining the vector trends and key risks of actual models of self-preserving behavior of population in Russia on scale of national security level and searching the means of increasing effectiveness of regional demographic policy in area of developing effective self-preserving choices of life-style strategies. The results of sociological survey of the aspects of self-preserving behavior of residents of the central regions of the Russian Federation (the study was carried out on a quota sample, n = 1060) are analyzed. The study made it possible to answer the questions about the importance of health and to assess it identifying the groups of relative and absolute risk. The study provided following results: the importance factors affecting development of self-preserving behavioral patterns and choice trajectories among respondents, as well as motivation for health protection and for refusal to live longer. The most important factors turned out to be personal resources and family upbringing. The most powerful motivation was the desire for well-being, participation in children’s lives and self-fulfillment. The results of the study made it possible to identify self-preserving perimeter of residents of the central part of Russia. Though being aware of and understanding the importance and priority of health, almost half of the respondents waive their responsibility for their own well-being and life expectancy and at the same time displaying a clear distrust of medical institutions. Such a position of non-resource situation foregrounds all the possible risks associated with both loss of health and the failure to maintain it at satisfactory level. The results of study confirm the research hypothesis that the groups of relative and absolute risk correlate with the groups choosing external locus of control over their health. The obtained data is the basis for empirical verification of the indices of self-preserving strategies and the starting point for forecast calculations of possible risks of national demographic policy.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):44-51
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The analysis of drug abuse situation in the Khanty-Mansi Autonomous Okrug - Yugra
Novikov A.P., Gil A.Y., Khalfin R.A.
Abstract
The article presents the analysis of drug abuse situation in municipalities and districts of the Khanty-Mansi Autonomous Okrug - Yugra (KHMAO-Yugra) in 2017-2018, as well as the dynamics of changes of the drug abuse situation in KHMAO-Yugra as a whole in 2015-2018. By 2018, the drug abuse situation in the KHMAO-Yugra improved as compared with previous years of the study period and corresponded to the “tense” level, which indicates the need to continue systematic and targeted intersectoral work aimed at reducing morbidity and mortality associated with the use of drugs and psychoactive substances in this northern region of Russia.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):52-56
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The results of screening examination of pathology of hearing organs and upper respiratory tracts in HIV-infected patients
Imangazinov S.B., Aubakirov M.J., Imangazinova S.S., Ardabaeva S.N.
Abstract
Among HIV-infected patients there are individuals with masked chronic diseases that affect life quality and life-span. Their timely detection and treatment can improve life quality of HIV-infected patients. The screening examination allows to establish prevalence level, structure and features of concomitant diseases under HIV- infection to provide timely medical preventive care.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):57-60
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The prevalence of diseases of non-occupational genesis in persons with diagnosis of occupational disease
Guryev A.V., Tukov A.R., Kalinina M.I., Zubov A.V.
Abstract
The data on prevalence of diseases of non-occupational genesis in persons with occupational diseases that have stopped their labor activity are presented. The purpose of the study was to analyze prevalence of diseases of non-occupational genesis in persons with diagnose of occupational disease working at enterprises and organizations served by health care institutions of the FMBA of Russia. The study uses data from “The Industrial Register of persons with occupational diseases”. In the structure of occupational diseases of persons who stopped working the first three places are for “Injury, poisoning and certain other consequences of external causes S00-T98”, “Diseases of the respiratory system J00-J99” and “Mental and behavioral disorders F00-F99”. The most common were diseases of circulatory system, digestive system and musculoskeletal system with variations in groups of occupational diseases. The high value of “The Industrial Register of persons with occupational diseases” was confirmed. This information permits to to assess health of persons with occupational diseases.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):61-63
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The characteristics of actual curse of infectious endocarditis in cardiac surgery hospital
Griaznov D.V., Kovalev S.A., Jdanov A.I., Fursova E.A.
Abstract
The demographic and clinical data of 520 patients with infectious endocarditis treated in 2005-2017 was analyzed with the purpose to assess current trends in epidemiology and approaches to surgical correction of infectious endocarditis. The analysis established increasing of absolute number of patients with infectious endocarditis, their average age and number of female patients. The incidence of early prosthetic endocarditis and its hospital mortality decreased. The study determined increasing of number of emergency interventions, more frequent valve-preserving operations, increasing of number of interventions for perivascular lesions and more frequent application of bioprostheses.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):64-67
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The domestic violence as factor of disorder of social and mental health
Borisov S.N., Volkova O.A., Besschetnova O.V., Dolya R.Y.
Abstract
The article considers domestic violence as a factor of derangement of social and mental health of family members. There is no open access to statistical indices of cases of domestic violence. The data of population mental health is rather conditional. There is no aggregated information on social health of citizens at all. The sociological study of families of the Belgorod region was carried out in January-March 2019. The collection of primary sociological data was done using the questionnaire survey. The respondents consisted of two groups: minors and adult family members. The study established that in children-victims of violent actions, recollections remain that negatively impact their social and mental health in the present and future. Most often there is not one type of violence but whole complex. The effect of domestic violence is deterioration not only of mental and social health of victims, but physical (psychosomatic) health too. There is co-dependency of social and mental health conditions of all family members involved into violence actions. In case of domestic violence related to the elderly and disabled ones their social and mental health is deteriorating much faster than in case of similar alterations of age-related or medical causes.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):68-73
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The medical pedagogical prevention of deviant behavior in adolescents from disadvantaged family in conditions of rural school
Denisova O.A., Gudina T.V., Bukina I.A., Lekhanova O.L., Bukin D.A.
Abstract
The article considers medical and pedagogical prevention of deviant behavior of adolescents from dysfunctional families in conditions of rural school, related to the need of strengthening targeted joint interaction of medical and pedagogical institutions. The description and results of testing of diagnostic tools used to establish severity of deviant behavior of children in a selected group is discussed. The interaction of medical and educational institutions in preventing deviant behavior of adolescents from dysfunctional families in rural school is of key importance for combating prevalence of drug addiction, tobacco smoking, alcohol abuse and psychoactive substances consumption, and contributing to physical and mental health promotion of younger generation, development of healthy lifestyle. The study was organized to cover cognitive, behavioral, affective and value-motivational components. The qualitative characteristics of levels of severity of deviant behavior of adolescents from dysfunctional families were developed and proposed for practice application.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):74-82
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The problems of medical care quality in primary section of private sector of health care
Siburina T.A., Volnukhin A.V., Reze A.G.
Abstract
The efficiency of quality control of medical care in medical organizations providing medical care in out-patient conditions is inadequate. The purpose of the study is to identify main problems of ensuring quality of medical care in private medical organizations providing medical care in out-patient conditions and to develop suggestions for their elimination.The assessment of medical care quality in private medical organizations network was carried out using expertise technique (n = 1070), intra-organizational attestation (n = 47), questionnaire survey of administrative (n = 28) and medical personnel (n = 241).The total number of medical care defects made up to 4,822, and 97.3% of them were related to diagnosis and treatment. A full justification of diagnosis was recorded in 65.8% of cases. The cases of insufficient and excessive examination have been identified. The non-compliance with duration of treatment and frequency of visits have been established. The inadequate medical efficiency (67.6%) reliably effected on low compliance of patients, recorded in 18.9% of cases (p <0.05).The main problems of ensuring medical care quality are related to organization of internal control system, involvement and motivation of medical personnel and development and maintenance of necessary organizational culture.In the private health care sector, quality issues can be solved solely by means of material resources. It is necessary to improve of medical personnel management, internal quality control of medical care and management of organizational culture.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):83-87
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The main indices of development of medical services market in the Krasnodar Kray of the Russian Federation
Snegireva Y.Y., Kalnitskaya O.V., Strijak M.S.
Abstract
The article considers main indices characterizing development of medical services sector in regional market of the Krasnodar Kray. The statistical and analytical data, results of questionnaire surveys of residents, expertise results are presented. The conclusions are made concerning problems and perspectives of development of regional health care.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):88-93
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The organizational legal and methodological foundations of implementation of effective contract in functioning of medical organizations
Kuchitz S.S., Gridnev O.V., Pesennikova E.V., Gritzanchuk A.M., Vartanyan E.A.
Abstract
The article considers main concepts and clauses of contract of employment with medical personnel of state institutions of health care. The recommended examples of indices and criteria of functioning efficiency assessment based on working functions of various personnel categories on the basis of analysis of practical application of effective contract in the Russian Federation are demonstrated. The possibilities and risks related to implementation of effective contract into functioning of multi-field health care institution as a technique of stimulating the increase of quality of medical care and efficiency of functioning of institution.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):94-97
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The modern features of organization of hospital-substituting psychiatric care
Ter-Israelian A.I., Evdokimova T.E.
Abstract
The article presents results of study of issues of psychiatric care organization in mental hospital in 2015-2017. The structure, age distribution and social status of patients are analyzed on the basis of data from Psychiatric Hospital № 13 of the Moscow Health Care Department.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):98-100
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The evaluation of polyclinic rehabilitation after prosthetic arthroplasty
Sandakov Y.P., Kochubey A.V., Chernyakhovsky O.B., Kochubey V.V.
Abstract
The study considers quality of assessing functioning, limitation of vital activity and patient participation in outpatient stage of rehabilitation according traumatology and orthopedics profile. The sampling included 712 out-patient records of patients with complete endoprosthesis replacement of hip (299 or 42%) and knee (413 or 58%) joints. The study analyzed application of the Haris, Leken and Rankin scales, hospital anxiety and depression scale (HADS), quality of life questionnaire (EQ-5D), recommended as mandatory examination tools in case of rehabilitation after endoprosthesis replacement. The statistical data processing was performed using software IBM SPSS Statistics version 23. It is established that Harris and Leken scales, hospital anxiety and depression scale (HADS) were not applied to any patient. The functional structural deformation of joint and/or limb with detailed elaboration of degrees and centimeters is described in 10% of medical records, but it completely matches data from hospital case records. At completion of rehabilitation cycle, 55.9% of all primary complaints are repeated in final diaries. What is regarded 39.3% of primary complaints, there is no information about their elimination. In 25.9% of patients in their final diaries the complaints are present that were not indicated after primary and subsequent examinations. The evaluation according both modified Rankin scale (13.1% of patients) and the quality of life questionnaire (EQ-5D) (6.9% of patients) was implemented only in case of referral to medical social expertise examination. The out-patient rehabilitation cycle was uncompleted in 26% of patients.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):101-105
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The Russian characteristics of organization of motivational and stimulating systems of labor remuneration in non-state health care institutions
Kovaleva I.P., Shuliko E.V., Strijak M.S.
Abstract
The article considers topical aspects of formation of motivational and stimulating component of remuneration in non-state health care institutions. This organizational legal type of medical organization presupposes specific characteristics of financial economic functioning and processes of organization of remuneration fund. In Russia, state and municipal medical organizations provide own sources of motivational component, that much more depend on implementation of mandatory medical insurance territorial programs. In case of non-state clinics quite different sources of employees’ incentives of improving quality and productivity of labor exist. The non-state health care institutions occupy in-between position with their financial opportunities between state (municipal) and private structures. Most non-state health care institutions are of departmental subordination. The article deals with issues of development of motivational and incentive mechanisms as exemplified by JSC “Russian Railways”. The empirical research permitted to specify in detail algorithm of process of organization of remuneration fund with designation of system of indicators for bonuses distribution. The specific characteristics of development of motivational and incentive systems of remuneration fund in non-state health care institutions are identified.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):106-113
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The experience of application of standard values of condition of laboratory services in the subjects of the Russian Federation
Zolatorev P.N., Cherkasov S.N.
Abstract
The article presents information to assess possibility of using on-line questionnaires to obtain statistic data concerning activities of laboratory services in the region. The sets of standardized statistical indicators were obtained for assessing performance of such regional services as the structure of laboratory research; comparative standardized values of availability of examinations per 1000 of population; comparative standardized values of equipment support in the regions of the Russian Federation and employment rates and staffing with medical personnel of laboratories.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):114-118
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The analysis of process of decentralization of the system of management of medical data of patients with application of cloud technologies
Polyanin A.V., Dokukina I.A.
Abstract
Actually, the opportunity exists to obtain admittance to various data. The article presents the essence of approach to development of decentralized prototype of system managing medical records of patient using blockchain technology. The global analysis of cloud technologies using various experience of their implementation is given. The scientific novelty of study consists in step-by-step application of genuine prototype of patient medical data management system using blockchain technology. It is scientifically justified that applying cloud technologies in medicine permits to improve safety and integrity of medical data of patient and to support linking uncoordinated databases into one whole, making interaction of patients and physicians much more effective and comfortable.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):119-127
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The comparative analysis of training of paramedical personnel on the territory of the subjects of the Russian Federation of the Siberian Federal Okrug
Gaydarov G.M., Makarov S.V.
Abstract
The comparative analysis of training of nursing staff in the territories of subjects of the Russian Federation, included in the Siberian Federal Okrug was implemented, based on data of the federal statistical monitoring of corresponding educational organizations in 2018. The analysis of calculated indices permitted to identify uncoordinated nature of provision of nursing staff and volumes of its training at the level of number of subjects of the RF on the territory of the Siberian Federal Okrug, and group them according to combination of level of the given indicators. The assessment was implemented concerning validity of manpower policy in the case of nursing staff in territories of mentioned regions. The study results permitted to determine role and place of the analyzed regions in training of nursing personnel considering groups of criteria characterizing training activities, infrastructure of educational organizations, financial economic aspects of implementation of educational process and employment of graduates with nursing education. The mentioned results are the basis for further research on issues of education of nursing staff at the level of particular subjects of the Russian Federation, analysis of indices in dynamics, factors determining level of development of manpower potential of medical organizations and other elements of scientifically grounded manpower policy in health care sector.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):128-133
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The study of rate and spectrum of frequency of mutations of gene KRAS in patients with colorectal cancer in the Republic of Kazakhstan
Smagulova K.K., Kaydarova D.R., Nasrytdinov T.S.
Abstract
The colorectal cancer is considered as the third most common malignant disease in the world. During last decade, the problem of colorectal cancer became especially urgent conditioned not only by increasing of number of metastatic tumors of colon and rectum, but also by implementation of high-tech methods of treatment that significantly improved the results of five-year survival period. Along with success of therapy, understanding of genomics of colorectal cancer and owing to extensive application of next generation sequencing, the opportunity of optimal choice of treatment options was offered.Methods. The sampling included tumor material of 332 patients diagnosed with colorectal cancer, fixed in formalin and enclosed in paraffin, and treated in oncology dispensaries and centers and in the Kazakh Research Institute of Oncology and Radiology in 2010-2014. After morphological evaluation of the material quality, the molecular genetic analysis was applied to establish mutation of the KRAS gene using polymerase chain reaction in real-time.Results. The study established that KRAS mutation rate in patients with colorectal cancer had no reliable dependency with the region of their residence, since statistical analysis of pair “region of residence - all KRAS mutations” had value of correlation coefficient rp = 0.1 (p = 0.05).Conclusions. colorectal cancer It was established that there is no reliable dependence of rate of KRAS gene mutation in patients with colorectal cancer in the region of their residence. The high rate of occurrence of mutated type of gene was detected in 3 regions (Kyzyl-Orda, North Kazakhstan and Almaty) within the range of 58.3-76.5% of cases. The wild type of KRAS gene was most frequently detected in patients from the Karaganda region (65.5%), South Kazakhstan (71.4%) and Almaty (60.7%).
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):134-138
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The formation of state institutions of health care and development of medical business in Russia in the second half of XVI century
Vorontsova E.V., Vorontsov A.L.
Abstract
The article considers historical characteristics of process of origin and formation of the health care system in Russia as process of state organizational activities. The starting point of the mentioned process is determined the period of the second half of XVI century that initiated becoming of institutional foundations of the whole health care system in Russia establishing the priority of state power initiative in becoming and development of the given processes. The significant role of foreign factor in development of medicine business in Russia during the given historical period is emphasized. The role of English medical men in popularization of European practice of medical treatment at the Tsar's court and in becoming of state institutions of health care is specially emphasized. At that, the state character of formation of health care system in Russia is stressed and is considered as national feature related to paternalistic character of the state authority itself. The specific facts of history of becoming of national health care system are considered in the context of universal historical development. On the whole, the period of governing of the Russian Tsars of second half of XVI century - Ivan VI the Terrible, Fedor Ioannovich, Boris Godunov, - is considered as unconditionally positive one in the process of becoming of the state medicine in Russia.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):139-144
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The St. Petersburg medicine of the late 1820s as seen by London physician
Lapis G.A., Raskin D.I.
Abstract
The article considers the condition of medicine in St. Petersburg in 1827-1828 as presented in memoirs of English physician A. B. Granville about his visiting the capital of Russia. The prominent physician and naturalist, familiar with condition of medicine in main countries of Europe, he provided substantial and objective characteristic of condition of medicine and health care in Russia. This characteristic, coming from independent and competent observer, permits to correct conceptions about condition of Russian medicine during the period when the results of modernization of the Russian Empire of XVIII-early XIX centuries manifested in full measure effecting becoming of Russian school of medicine.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):145-151
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The problem of initial stage of mass production of penicillin in the USSR
Sherstneva E.V.
Abstract
The article analyzes the problems of initial stage of mass production of penicillin in the USSR on the basis of documents of the State archive of the Russian Federation. The analysis covered declassified documents of the funds of the Narkomzdrav of the USSR, the Council of Ministers of the USSR, the A. M. Gorky All-Union Institute of Experimental Medicine (VIEM). The secret correspondence of the People's Commissar of Health Care with the Government, with the Head of the Department of Biochemistry of Microbes and experimental production laboratory of VIEM Z. V. Ermolieva, with Directors of plants for organization of production of penicillin is analyzed. The transcripts of meetings and orders of the People's Commissar of Health Care are considered. It is demonstrated that development of production facilities and provision of health care with antibiotics was an extremely difficult task. Its solution was complicated by many factors such as the inaccessibility of advanced methods of deep fermentation, general technological backwardness, organizational problems associated with specificity of management and public decision-making. It is established that during 1944 the main producer of penicillin was the laboratory of VIEM and serial production of penicillin at the Karpov enterprise and plant of endocrine drugs in Moscow began only in late 1944, and amount production was were extremily not enough. In this situation, in early 1945, G. A. Miterev, the People's Commissar of Health Care, raised the question of buying plants for the production of penicillin in the United States. However, the final decision was not taken by the government. The attempt to devote part of the resources of the Central Military Sanitary Department of the Red Army for ensuring public health with antibiotic failed. In 1945, enterprises of the People's Commissariat of Meat and Dairy Industry were involved in the production of penicillin. At all enterprises of the USSR in the end of 1945, production of antibiotic was carried out by surface fermentation and liquid penicillin was produced, except for the A. Mikoyan Moscow meat-packing plant, where the production of drug in dry form was established. The outdated technologies and limited scale of production determined lower productivity of enterprises, which did not allow to cover the needs of health care even approximately.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):152-157
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The wars, epidemics and destiny of Empires of Ancient World
Lipich T.I., Polukhin O.N., Reutov N.N., Artyukh A.V., Penskoy V.V.
Abstract
The article considers the features of the impact of epidemics on the course of hostilities and the fate of the states of Antiquity. Three cases are presented as examples. The first one is related to the invasion of the Assyrian King Sennacherib in Judea and the attempt of his troops to take Jerusalem. The second case is related to the epidemic in Athens in the early years of the Peloponnesian war. The third one - with the epidemic in the Roman Empire in the 2nd half of the 2nd century AD. The analysis, based on information from extant sources, permitted to conclude that the intensity and destructive effect of epidemics in the Ancient World increased gradually. To this fact is attributed the effect of “closing” the Oikumena into a single whole. However, the degree of influence of epidemics on the fate of ancient states is greatly exaggerated by the historical tradition, which developed under the influence of emotional descriptions of the tragedies and mass deaths of people.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):158-163
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The tragedy of starving population of the central regions of Russia in 1920-1922
Gorelova L.E., Serebryanny R.S., Yaremchuk O.V.
Abstract
On the basis of archival documents and literary sources the importance of nutrition factors determining the importance of its influence on the level of demographic indicators and morbidity during the famine of the 1920s in the Samara Gubernia is demonstrated. The contribution of foreign public organizations in saving people from starvation is presented.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(1):164-168
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