Vol 29, No 3 (2021)

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Articles
The preconditions of occurrence and social demographic consequences of pandemics
Ryazantsev S.V., Smirnov A.V.
Abstract
The article considers the historical features of development and theoretical approaches to defining the concept of “pandemic” in social sciences. The approaches of demographic science to the study of the consequences of pandemics are outlined. The prerequisites of occurrence of major pandemics at various historical stages of humankind development are highlighted. The particular attention is paid to pandemics in the XXI century. The demographic and social economic consequences of pandemics for the countries all over the world, including the countries on post-Soviet territory, are considered. The characteristics of the COVID-19 pandemic are highlighted from the standpoint of social demographic consequences, including the impact on fertility and mortality. The key directions of pandemics control in some countries of the world are designated.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):389-397
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The organization of the system of supply and management of stock of individual protection means in conditions of COVID-19 pandemic
Boykov V.A.
Abstract
In conditions of increasing of load caused by rapid development of new coronavirus infection (COVID-19) pandemic, health care systems of various countries faced the shortage of basic resources, including individual protection means for medical personnel and population that required taking complex measures to eliminate the situation.In the Tomsk oblast, the unified system of supplying medical organizations with individual protection means was organized. The system provides centralization of management of supplies and their distribution; standardization of approaches to using, accounting, storage and utilization of protection means depending on type and conditions of medical care support; monitoring system of provision of individual protection means applying lean manufacturing tools. The implementation of the project made it possible to ensure at the initial stage of the pandemic the maintenance of individual protection means stock in every institution not less than for 7 days and subsequently not less than 30 days demand.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):398-403
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The health education of students during COVID-19 pandemic
Kabayan N.V., Kabayan O.S., Kabayan A.V.
Abstract
The article considers issues of health education in educational institutions during COVID-19 pandemic. The importance of educating health-preserving attitude and sanitary hygienic culture in students is emphasized. In the context of pandemic, the priority task is to develop in students epidemiological culture as a background of healthy behavior. The special educational programs are to be developed to support sanitary-hygienic security in in educational standards.The article determines that the need to discuss issues epidemiologically safe learning environment is due to the fact that currently a large number of students experience unstable and uncomfortable conditions that impede implementation of educational requirements. Hence, development of reluctance to visit school. Among reasons are the conditions of quarantine and self-isolation affecting their perception of society either scaring and forcing self-isolation or inducing considerations about keeping hygiene rules in conditions of pandemic crisis. The students are not aware enough or don't want to seek important sanitary hygienic basics of health promotion to establish personal parameters of anti-infection and anti-virus safety and to improve sanitary and hygienic culture.The article makes an important conclusion that the solution of the problems of implementing sanitary measures in conditions of epidemiological crisis is in planning and carrying out activities developing health promotion culture, familiarizing with epidemiological security standards, creating conditions to achieve sanitary security, to understand issues of personal epidemiological security both during and outside educational process, especially in public areas.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):404-409
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The modern methods of evaluation of implementing personalized programs of prevention of age-associated diseases
Khabriev R.U., Stasevich N.Y., Carton E.A., Zaretskaya E.G., Davydova A.V., Mikhailov A.V.
Abstract
The development of preventive programs targeting specific groups of consumers of medical social services having age-related health and lifestyle characteristics is one of the most prospective methods to improve quality of medical care of the elderly and senile patients.The previously developed by Russian and foreign scientists programs of personalized prevention of age-related diseases make it possible to organize target groups of patients seeking medical services in both state and private health care organizations to be screened for conditions of medical and social significance from the point of view of preventive medicine. This permits to achieve a real integration of various components of preventive care that improves health of elderly and senile patients in terms of morphofunctional indices of patient's physical status, quality of life, degree of independence, and, as a result, quality and scope of implementation of preventive programs for elderly population. Therefore, the development of the basics of personalized programs preventing age-related diseases in elderly population is actual.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):410-414
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The analysis and assessment of problems of medicinal support in The Russian Federation in actual conditions
Telnova E.A.
Abstract
The medication support of population is an integral part of health care system reflecting the state of social and economic sectors in conditions of national pharmaceutical market development that as opposed to markets of other goods has such specific characteristics as wide scale, large selection of assortment, science linkage, durational cycle of medication development.Lately, intensive work was implemented improving national medication supply system. The normative base passed through significant changes. The percentage of costs of medication support in total costs of health care increased. The preparation of pilot project concerning system of reimbursement of appropriated medications proceeds. However, despite all these actions, availability of medications does not improve. The components of medicinal availability can be structured as physical, spatial temporal, assortmental and infrastructural ones. The article presents overall analysis of most acute challenges in the area of medication supply. The proposals were formulated concerning development of system of medication support of population.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):415-420
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The priority directions of forming and supporting healthy life-style in megalopolis conditions
Konovalov O.E., Allenov A.M., Gorenkov R.V., Pak V.I., Arseenkova O.Y.
Abstract
The activities related to formation and maintenance of healthy life-style of population are to be carried out in accordance with the Strategy of prevention of chronic non-communicable diseases. The purpose of the study is to analyze current trends in the formation of healthy life-style of Moscow residents and to determine priority areas of its maintenance.Materials and methods. The analysis of the lifestyle of the Moscow population in conditions of actual infrastructure of urban environment was carried out as exemplified by two administrative Okrugs. According to dispenasarization data the prevalence risk factors of chronic non-communicable diseases. in Moscow residents was investigated. The Results. It is demonstrated that in actual conditions, the population is be provided with recommendations concerning development of stress resistance, proper diet and physical activity enhancement using really existing integrated prevention space. The specialists involved into issues of citizens following healthy life-style in their professional activities are to rely on the results of both study of characteristics of self-preservation behavior of population and analysis of the state of prevention infrastructure in particular municipality.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):421-425
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The analysis of achievement of prognostic indices of the Concept of the Federal system of training of citizen to military service
Sogiyaynen A.A., Chicherin L.P., Shchepin V.O.
Abstract
The article analyzes the achievement of the prognostic indices of the Concept of the federal system of training citizens for military service for the period up to 2020 (to reduce the number of citizens who do not meet the requirements of military service due to health and physical conditions; to increase the rate of fitness for military service of citizens who have arrived at draft commissions; to ensure the availability of the first sports category or sports rank for citizens who are subject to military service draft). The causes and factors preventing the achievement of the target values of the Concept are considered. The set of measures targeting to improve medical support of the youth of military draft age is proposed.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):426-429
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The factors of birth of second child in contemporary Russia: The analysis of sociological survey results
Rostovskaya T.K., Arkhangelskiy V.N., Kuchmaeva O.V., Sudin S.A.
Abstract
The article considers the factors determining the orientation of Russians in relation to the birth of second child in single-child families. The analysis is based on the sociological survey data of the first wave of the All-Russian survey “The Demographic Well-being of Russia”, carried out at the turn of 2019 - in the beginning of 2020 by the research team headed by Professor Rostovskaya T. K. The emphasis on the determination of namely second births is determined by the fact that it is just this determination that has social psychological and social economic character, while the dynamics of indices of first births is primarily associated with changes in nuptiality. Moreover, the two children continues to be the modal value of the ideal, the desired and the expected number of children in Russia and in the most other economically developed countries. The conclusions of the study are based on the distribution of respondents according a number of characteristics that stand as factors of second births. The analysis demonstrated that a more expressed orientation to the birth of second child occurs with relatively greater value of two children, perception of it as a factor contributing to marriage consolidation, significantly greater first of all in women. The importance of such motives for the birth of second child as strong desire in male spouse and desire to have an infant in the family again is emphasized. Besides, the results of the study demonstrated that high valuation of the standard of living promotes the formation of intention to have second child, without any delaying of its birth, but only among those ones who want to have one. It is established that the second births rate is effected by both the demographic factors (age and marital status), social factors (education level, the number of children in families of parents and friends, the nearest environment) and social psychological factors, motives of second child birth and the system of values of Russians. In the context of implementation of the strategy of family demographic policy, it is important that probability of second births is effected primarily by the improvement of quality of medical institutions functioning, development of personal services and provision of preferential credits depending on the number of children in family.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):430-436
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The analysis of failures of intra-familial relationships in families with children suffering of diabetes mellitus
Rudakova D.A., Volodin B.Y., Petrov D.S., Novikov V.V., Filimonov A.P.
Abstract
The article presents the results of study of in-family (child-parents) relationships in families with children suffering with diagnosed diabetes mellitus type I. The purpose of study is to investigate the disorders of family relationships in families of such kind. The established disorders allow to develop psychotherapeutic measures both for children and their parents. Materials and methods. The study covered 30 families with children of primary school age (7-10 years old) with diabetes mellitus. The families with children with severe concomitant diseases and broken families were excluded of the sampling. The control group consisted of 30 relevant families with healthy children. The in-family relationships were explored using a number of psychological tests applied to children and their mothers. The results. In mothers of the studied families prevailed authoritarian type of upbringing, which was expressed in tendency to hyper-protect and to over-control. The phobia of losing child and the tendency to reject it were also established. The children suffered from high level of anxiety. They had more positive attitude to mother than to father. The conclusion. The established disorders of in-family relationships in families with children with diabetes mellitus can serve as targets for psychotherapeutic activities both with children and their parents.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):437-441
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The food habits of women as a factor of development of maternal obesity
Amlaev K.R., Dahkilgova K.T., Khripunova A.A., Kuz'mina E.M., Plotnikova N.S., Majarov V.N.
Abstract
The article presents the results of analysis of diet habits of women in the Stavropol Krai. The study was carried out using single-stage structured interview quantitative survey. The respondent was guaranteed anonymity and the purpose of survey was explained. The questionnaire was targeted to identify diet habits of respondents and to establish their dependence with place of residence, infant feeding schedule, body mass index. The statistical data processing was performed using SPSS v. 24 software.The study demonstrated that majority of respondents feed in a fractional and varied way. The population often pays attention to the storage life of products while buying them. But only 12.5% respondents always control the caloric content of food. The obese women are more attentive to the energy value of food (pm0.001), as well as women feeding infant in a natural way (p=0.002). The respondents consume sweets and regularly add sugar to their drinks. Almost half of women assume that they need to lose weight and 37% tried to lose weight through dieting and 30% of respondents used various medications for weight loss. At that, only 21.2% of respondents were able to achieve the desired weight.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):442-445
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The medical demographic and social characteristics of women that discontinued observation and infertility treatment
Osmanov E.M., Prokopov A.Y., Manyakov R.R., Garaeva A.S.
Abstract
The recovering of reproductive health of women is one of prospective means to stabilize fertility. The purpose of the study is to investigate medical, demographic and social risk factors of discontinuing screening and treatment of infertility in women of the Tambov Oblast. The materials and methods. The comparative data analysis of women who discontinued infertility screening and treatment prior to referral to auxiliary reproductive technologies (n = 239) and women who were factually referred to these technologies (n = 206). The results of the study. The risk factors for women of discontinuing screening and treatment of infertility included age (OR = 1.070; 95% CI 1,035-1,105; p <0.001), residence in rural areas (OR = 2.059; 95% CI 1.592-2.663; p < 0.001), secondary education (OR = 2.593; 95% CI 1.767-3.805; p < 0.01), low level of financial security (OR = 2.524; 95% CI 1,720-3,703; p <0.01), secondary nature of infertility (OR = 1.587; 95% CI 1.065-2.364; p =0.023), occurrence of sexually transmitted diseases in anamnesis (OR = 2.736; 95% CI 1,722-4,346; p<0.01). Discussion. The study results demonstrate that the most effective measures improving compliance of women to screening and treatment of infertility are the reorientation of medical care to the second-level regional centers from the regional center that will bring medical care, including active detection of infertility at younger age, more comprehensive regular preventive examinations and health education to preserve reproductive health, closer to remote areas. The conclusions. The medical, demographic and social risk factors of discontinuing testing and treatment of infertility in women are established to be applied in improving the organization of medical care for this category of patients.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):446-450
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The contemporary world trends in epidemiology of gonococcal infection: The publications review
Ufimtseva M.A., Voroshilina E.S., Komarov A.A., Gurkovskaya E.P., Bochkarev Y.M., Vishnevskaya I.F.
Abstract
The gonorrhea is a sexually transmitted infection caused by Neisseria gonorrhoeae. N. gonorrhoeae being tropic to columnar epithelium, primarily infects mucosa of urogenital system, rectum, pharynx and conjunctiva. According the WHO, in 2016 about 87 million of new cases of gonorrhea were registered in the age group of 15-49 years old. The number of new gonorrhea cases increases steadily in many countries. The significant contribution into propagation of infection is made by males practicing sex with males, migrants, commercial sex workers, ethnic minorities. The undetected cervical gonococcus infection can result in such severe complications as inflammatory diseases of organs of small pelvis and infertility that directly impacts the reproductive losses of population. The anorectal and and pharyngeal gonorrhea very often takes asymptomatic course that complicates diagnostic and effects the statistical picture of morbidity. The apprehension of world trends in epidemiology of gonococcal infection can become a key point in implementation and development of national and international programs of prevention of propagation of this disease. The review of national and world publications concerning actual clinical epidemiological characteristics of gonococcus infection was implemented through such on-line search systems as PubMed, Google Scholar, BioMed Central (95 publications in total). The conclusions are made about steady increasing of morbidity due to propagation of infection in groups of risky sexual behavior, application of modern diagnostic means and patterns of clinical course of gonorrhea. The role of sexually transmitted infections in development of infertility, inflammatory diseases of organs of small pelvis, miscarriage and reproductive losses of poplation is marked.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):451-455
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The medical social characteristics and evaluation of life quality of patients with diseases of blood circulation system
Kalininskaya A.A., Lazarev A.V., Vasil'eva T.P., Kizeev M.V., Rassoha D.V.
Abstract
The increasing of longevity and quality of life and population health are considered as the most important component of human development index. The diseases of blood circulation system have leading rank in morbidity, disability and mortality of population of Russia representing one of the most actual problems of health care.The diseases of circulatory system negatively effect on physical and mental health, emotional conditions and social components of life activities. All the mentioned results related to cardiovascular diseases can be detected and measured through evaluation of indices of life quality of patients.In Russia, the directive documents and national programs concerning health care modernization were adopted to rectify the unfavorable medical demographic situation on national level through decreasing of mortality, morbidity and disability due to diseases of circulation system.The purpose of the study is to analyze social hygienic characteristic and life quality of patients with diseases of circulation system during 5 years prospective cross-sectional medical statistical study in the Nizhni Novgorod Oblast at the base of the “Specialized Cardio-surgery Clinical Hospital” of Nizhni Novgorod. The study included all patients with certain corresponding criteria of involvement being at hospital treatment in the pilot medical organization. The sampling included 420 patients. The life quality inventory SF-36 and questionnaire were applied to respondents during their first and control (5 years later) visits. The questionnaire covered social and working status, presence of risk factors of cardiovascular diseases.The study demonstrated that among respondents made no control of cholesterol level 40.3%, arterial blood pressure - 16% that determines necessity of amelioration of sanitary education activities of population. The low level of income (less than 6000 rubles per one member of family) was marked by 42% of respondents. At that, 77% had financial problems with medications purchasing that testifies necessity in co-financing with the state. The results of the study testify the positive impact of implementation of target programs of prevention of cardiovascular diseases on the life quality of patients in the pilot subject of The Russian Federation.The original technique of sociological surveys and evaluation of life quality of patients can be applied at the regional level in development of managerial decision making.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):456-461
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The effect of digital mass media on mental health of children and youth
Besschetnova O.V., Volkova O.A., Aliev S.I., Ananchenkova P.I., Drobysheva L.N.
Abstract
The article considers the impact of digital media on mental health of children and the youth based on the analysis of studies of national and foreign researchers. On the one hand, the application of information technologies by children and the youth is related to requirements of actual reality that allows them to be active and independent in virtual space and contributes to development of special skills and abilities, exchange of knowledge and experience, broadens scope of interests. On the other hand, the information media establish conditions of high risk for health.The article presents the results of an empirical study, carried out in 2019 at the Balashov Institute of the Saratov State University. The questionnaire survey was applied to sampling of 386 respondents to identify the relationship between the amount of time spent online by young people and the feeling of loneliness. The study discovered that the higher is the user Internet activity that is not accompanied by sense of satisfaction, the higher is the level of frustration and loneliness.The problem areas are identified that make it difficult to ensure the effective safety of users and the timely identification of threats to their mental health: the shortage and fragmentation of scientific research; the ambiguity of opinions of expert community regarding the impact of digital technologies on the development of children and adolescents; the complexity of social control of online users due to their social demographic and sociocultural heterogeneity; the conflict of interests between providers, business structures, advertisers and other subjects of virtual reality and underage users; low level of internet literacy of parents and teachers. All these factors hinder the development of adequate technologies of early detection, prevention and support of victims of cyberaggression or cybercrimes.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):462-467
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The social factors increasing healthy life longevity (according sociological surveys materials)
Tanatova D.K., Yudina T.N., Vdovina M.V.
Abstract
The article discusses the main social factors that can positively effect on increasing the longevity of healthy life in the elderly. The main principles are based on the results of applied studies carried out by the authors in Moscow, Kursk, Velikiy Novgorod and Simferopol in 2019-2020. The respondents were both the elderly themselves and the specialists providing them social services support. The emphasis is made on the factors of healthy lifestyle of the elderly and first of all on feasible physical activity and productive creative activity. The considerable attention was paid to internal resources of the elderly person (general condition of physical and mental health and ability to maintain it, capacity for self-care and physical activity, positive frame of mind, personal persuasion in the need to properly use the opportunities available to elderly people). The following external factors are distinguish - constructive relationship with closest relatives, development of infrastructure for leisure activities, physical exercises and sport activities, accessibility for the retired of health care institutions. Among the means of maintaining active and healthy longevity of the elderly are marked informing about possibilities of using their potentials, appropriate consultations, provision of technical means of rehabilitation, involvement into constructive activities, giving positive examples and persuasion. The importance of individual approach to each retired is emphasized, taking into account their physical capabilities, health status and chronic diseases. The types of “activities” are marked useful for physical and spiritual health of elderly person, available to them at home that is especially actual in conditions of self-isolation due to prevention of coronavirus infection.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):468-473
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The effect of medical social and social economic factors on development of disability in children
Fisenko A.P., Terletskaya R.N., Vinyarskaya I.V., Antonova E.V.
Abstract
The trends in economic situation requires periodic repetition of studies concerning qualitative evaluation of impact of medical, social and economic factors on population health at the regional level. The purpose of the study is to establish the relationship between the disability of children and the main medical, social and socioeconomic indices in the Russian Federation. The materials and methods. The official data on prevalence of disability in children of 0-17 years and the level of basic medical, social and socioeconomic indices were analyzed in the context of 83 subjects of the Russian Federation in 2017-2019. The demographic and epidemiological data and data on medical care support of children population were used as medical and social indices. The socioeconomic indices (unemployment rate, cash income, housing conditions and consumption of basic food products were used as the socioeconomic indices. The Spearman rank correlation method was used to determine the particular relationships. The results. It was established that the significant inter-regional variability of disability of children both in the Federal Okrugs and the subjects of The Russian Federation persists. The relationship of various degrees of intensity between the prevalence of disability of children in the subjects of the Russian Federation and many medical, social and socioeconomic factors such as demographic indices (fertility, mortality); level of primary and total morbidity of children of all age groups; medical care support (medical personnel, pediatric beds); unemployment level; average per capita cash income; percentage of population with cash incomes below cost of living; total area of residential premises that is on average per inhabitant; share of young families registered as needing housing from total number of families with children aged under 18 years; consumption of cheaper food. The conclusion. The obtained results are to be taken into account in the development of programs of preventing disability of children avoiding to place full responsibility on the health care system only.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):474-480
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On the issue of characteristics of height weight anthropometric indices in children and adolescents residing in various regions of Russia
Mingazova E.N., Lebedeva U.M., Shigaboutdinova T.N., Zhelezova P.V., Gasainieva M.M., Gureev S.A., Sadykova R.N.
Abstract
The issues of protecting the health of the children and adolescent population of Russia require detailed study of the regional characteristics of the indices of physical development, determined by anthropometric growth and weight criteria. The purpose of the study is to analyze the regional characteristics of average height and weight anthropometric indices of children of school age (7-17 years) living in various regions of the Russian Federation.The assessment of statistically significant differences in average height and weight anthropometric indices children of school age was carried out to establish the basis of developing normative indices of 10 regional “Standards of physical development of children of school age (7-17 years old)” covering such Federal Okrugs as the Central (Kostroma), North-West (St. Petersburg), North Caucasian (Makhachkala, Grozny, Vladikavkaz), Privolzhsky (Kazan, rural areas of the Republic of Tatarstan, Cheboksary ) and Far East (Yakutsk, Yuzhno-Sakhalinsk).For the first time the statistical analysis considered simultaneously the anthropometric data of the population sample of the examined children of health groups I and II (healthy and practically healthy). Namely, 41030 persons were allocated to conditional age groups: junior (7-9 years), middle (10-14 years) and senior (15-17 years old) school age. The differences in regional height and weight indices of physical development of children were statistically significant only in groups of comparison of indices of height and body weight of schoolchildren in the older age group.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):481-485
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The use of surrogate alcohol by individuals with disorders related to alcohol abuse as exemplified by the subject of The Russian Federation
Gil A.Y., Khalfin R.A., Krinitsky S.M., Nikoforov S.A., Ilchenko I.N., Kosagovskaya I.I., Fattakhova L.F.
Abstract
The purpose of the study was to describe the types of non-beverage alcohol consumed, to evaluate socio-demographic factors associated with its use and to establish effectiveness of the alcohol policy measures taken since 2005 and targeted on reducing non-beverage alcohol consumption.From December 2015 to April 2017, 302 patients of the narcological dispensary were interviewed. The prevalence of non-beverage alcohol drinking among those who reported on their non-beverage alcohol consumption status amounted to 75.8% among males and 57.7% among females. The highest prevalence of non-beverage alcohol consumption (86.9%) was identified among males employed in irregular paid work.According to multivariate analysis, the factors positively associated with the use of non-beverage alcohol were male gender (OR 2.48, 95% CI 1.14-5.43), employment on irregular paid work (or 5.0, 95% CI 2.16-11.56), unemployment in case of seeking work (or 3.55, 95% CI 1.45-8.71), unemployment in case of non-seeking work (OR 3.90, 95% CI 1.09-13.95). The types of non-beverage alcohol used for drinking included medicinal tinctures in 25, 40 and 100 ml vials, spirit cosmetic lotions, colognes, technical/medical ethanol, hygienic spirit solutions, alcohol-containing food flavor enhancers. The lower price as compared with conventional alcoholic beverages was indicated as main reason of non-beverage alcohol consumption (61.7%).The enhancement of previously introduced restrictive measures as well as the implementation of new legislative initiatives are required for more effective control of non-beverage alcohol consumption.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):486-491
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The evaluation of efficiency of the project “Home Patronage” in Moscow
Grishina N.K., Solov'yeva N.B., Golovina S.M., Atayeva N.B.
Abstract
In Moscow, the improvement of primary health care home support of patients with limited mobility is implemented since 2017, through the new organizational form “The primary health care support of groups of population with limited mobility” - “Patronage at home”. In this regard, the “evaluation of performance efficiency” of this novation is of particular importance.The purpose of the study was to substantiate approaches to implementation of such an assessment applying developed with consideration of experts' opinions “The system of criteria and indices” as well as using the data of registry of patients in need of home patronage. The acquisition of information with specified mean will both allow to objectively assess in dynamics the effectiveness of functioning of new organizational form of “primary health care support of patients with limited mobility at home” in Moscow and contribute to improving its management.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):492-496
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The means of optimization of medical care support of victims of road traffic accidents at the hospital stage: The publications review
Baranov A.V., Mordovskij E.A., Lukashov A.G.
Abstract
The road traffic traumatism remains among the most actual medical social problems in Russia. The injured because of road traffic accidents suffer of predominant severe multiple and combined injuries (polytrauma) very often resulting in permanent disablement and lethal outcomes. The existing three-level system of traumatologic centers to supply specialized medical care of the injured in road traffic accidents demonstrates efficiency only on condition of observation of routing of patients. The new organizational approaches to specialized medical care to the injured at the hospital stage is needed for further decreasing of lethality and disability in group of victims of road traffic accidents.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):497-502
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The vector of integration of medical nurses-bachelors in practical health care
Snegireva T.G., Shadrina Y.E.
Abstract
The article discusses the experience of Israel, Canada, the USA and the European countries in training nurses with higher nursing education. The considerations concerning the need to change previously established standards of professionalization of graduates with higher nursing education in health care reform are analyzed. The purpose of the study is to consider a possibility of organizing a model of partnership relationship between physician and medical nurse with higher nursing education in conditions of the reform of health care system in The Russian Federation. The study was organized in two stages. At the first stage, the results of the study carried out by The Research Institute of Health Care Organization and Medical Management of the Moscow Health Care Department were analyzed. It was established that in the conditions of modern Russian health care, there is no distinct understanding among physicians how the relationship between physicians and medical nurses should be built. At the second stage, the sociological survey was carried out based on specially developed original questionnaire covering 150 physicians in Moscow medical organizations in 2019. The survey demonstrated that physicians reconsidered the role of medical nurse and would like to expand competencies of medical nurses. However, this requires to revise the legal base to allow medical nurse with higher nursing education to fill the position “The academic medical nurse - organizer of treatment process”. The results of the study demonstrated that in medical organization the majority of physicians see in the new educational training of medical nurses a prospective area of implementing the model “The organizer of treatment process - certified medical nurse with higher nursing education”. The results of study will facilitate transition of the medical nurse business to the new professional level that will permit to improve the specialty over whole career.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):503-508
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The medical social work with individuals of elderly and senile age with total loss of teeth
Arutyunov S.D., Grachev D.I., Martynenko A.V.
Abstract
The article substantiates the necessity in applying the complex approach to handle medical social problems of patients in elderly and senile age suffering of complete absence of teeth conditions the relevance of developing medical and social work with this contingent. In the complex management of patients receiving dental orthopedic care, professional social workers apply medical, psychological, pedagogical and social measures targeted to maintain their actual health. It is demonstrated that such activities can be implemented within the framework of wide network of social service organizations in cooperation with dentists.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):509-513
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The short-term prognostication of characteristics of course and optimization of tactics of medical care support of patients with epilepsy
Medvedeva Y.I., Zorin R.A., Zhadnov V.A., Burshinov A.O., Leonov G.A., Lapkin M.M.
Abstract
In clinical practice the identification of the dynamics of course of focal epilepsies on the basis of available clinical and neurophysiological indices (prognostication) is of great importance. The purpose of the study is the short-term prognostication of the course of focal frontal and temporal epilepsy.The materials and methods. The control (42 patients) and clinical (70 patients) groups were examined. The complex clinical physiological examination was carried out using electroencephalography, cognitive evoked potential, cardiac rhythm variability and the Schulte test. The cluster analysis was applied to allocate the observable patients into groups according to the dynamics of seizures frequency. The artificial neural networks technology based on physiological characteristics was applied to classify patients into groups with different course of disease.The results. The spectral characteristics of electroencephalographic signal had the greatest value for short-term prognostication of course of disease in the group of patients with focal frontal epilepsy. In patients with focal temporal epilepsy, the most significant predictors were the characteristics of cognitive evoked potential and characteristics of function of coherence of electroencephalogram. The conclusions. The developed algorithm of prognostication of unfavorable course of focal frontal epilepsy has high sensitivity, but lower specificity. Contrariwise, in case of temporal epilepsy, high specificity of the proposed algorithm is demonstrative, but its sensitivity is lower. It is recommended to apply these algorithms and to accentuate attention on characteristics of potential parameters at organization of diagnostic process in case of focal epilepsy.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):514-518
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The experience of SERVQUAL technique application in measuring satisfaction of patients with medical services quality
Danilov A.V., Son I.M., Menshikova L.I.
Abstract
The implementation of system of quality control conforming to requirements of interstate ISO 9001 standards in in the medical organization, the important role is assigned to indicator of satisfaction of patients with quality of medical care as a feedback channel. The study purpose was to investigate satisfaction of patients with quality of medical services in medical organization rendering hospital medical care on the basis of SERVQUAL technique. The analysis of results of survey of 339 patients treated in the twenty-four-hour department of municipal hospital demonstrated rather high rating of perception of quality of rendered medical services that made up to 4.47 points according five-point scale. The application of GAP analysis technique allowed to reveal gaps between expected and real quality of received medical services by means of SQL index quality. The highest points were received for such criteria as “Sympathy” (0.61 points), “Responsiveness” (0.20 points). The satisfactory results were in case of criteria “Materiality” (-0.38 points), “Reliability (-0.43 points). The lowest points were received for criteria “Persuasiveness, confidence” (-0.69 points) that reflects inadequate orientation of hospital personnel to settle problems of patients. The study demonstrated that applying the SERVQUAL technique in assessment of quality of medical services allows to reveal the most significant factors determining satisfaction of patients. The results of survey based on the SERVQUAL technique and processed by GAP analysis are to be considered in management decision making concerning choice of correcting and preventive actions in quality management of rendering medical services at the regional level.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):519-524
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The development of prototype of “ideal” model of competences of executive manager in health care
Abramov A.Y., Kicha D.I., Komissarov E.E., Rukodayny O.V., Goloshchapov-Aksenov R.S.
Abstract
The formation of a prototype of the organizational functional model of competences of the “ideal” health care manager and availability of objective assessment of its activities are of considerable practical interest. In any medical organization there is a need for trained, experienced and motivated administrators - managers capable effectively achieve their goals. This need can be met by developing and improving managerial competencies in managers at all levels. The competences of manager can be developed on the basis of organizational functional model and in accordance with personal responsibilities, work status, goals of medical organizations and professional standard.The purpose of the study. was to develop a prototype of “ideal” organizational functional model of competencies of administrator - health care manager.Materials and methods. On the basis of data content analysis, evaluation of experimental results and logical and comparative technique a prototype of the “ideal” organizational functional model of health care manager was developed and tested. The development of model of administrators competences was based on comparative parameters of the professional standard “The specialist of health care and public health,” personal managership of administrators of medical organizations, in accordance with the work status and objectives proposed in the course of the study organized in the Chelyabinsk Regional Children's Clinical Hospital (n = 26).The results. The analysis of the factors affecting quality of management functions performed by managers, presented in t professional publications and based on the results of competence model testing, permitted to conclude that the requirements of the professional standard “The specialist of Health Organization and Public Health” are not sufficient to completely assess the activities of administrator - manager. To improve comprehensiveness of assessment of managers and the development of “ideal” model of executive manager competence the listing of requirements in the professional standard is to be supplemented with “The necessity of satisfaction with own work”, “The necessity of conscious motivation to work at managerial position”, “The necessity of abilities to perform management activities”.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):525-530
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The evaluation of personnel progression in state medical organizations of the Irkutsk Oblast
Makarov S.V., Gaydarov G.M., Alekseevskaya T.I., Apkhanova N.S., Alekseeva N.Y.
Abstract
The medical personnel reallocation is the most important resource to ensure sustainable functioning and development of medical organizations and health care system as a whole. The purpose of the study was to assess reallocation of medical personnel of state medical organizations in the subject of the Russian Federation exemplified by the Irkutsk Oblast in 2015-2019. The study permitted to test approaches to application of methods for analysis of reallocation of medical personnel in respect of physicians. The results contribute to development of measures targeted to prevent and to reduce the medical personnel turnover and to increase efficiency of human resources management in health care.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):531-536
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The sociological aspects of scientific pedagogic activities of medical university lecturer
Koichueva S.M.
Abstract
The research activity of Medical University lecturers is related to pedagogical and medical activities. Nowadays, more attention is paid namely to scientific component in activities of the faculty. The article presents the results of the survey of the faculty of the Medical University concerning various aspects of their scientific activities. It is established that the younger generation of Medical University lecturers lose interest to scientific activities due to material and moral incentives lacking. Yet another reason of low activity of lecturers according their opinion is poor knowledge of foreign languages.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):537-541
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The epidemic process of whooping cough at contemporary stage in the Republic of Kyrgyzstan
Niiazalieva M.S., Isakova J.T., Dzhumalieva G.A., Toygombaeva V.S., Mergenov A.E., Joldoshbekov E.J.
Abstract
The causes of epidemic outbreaks of pertussis infection in the Kyrgyz Republic were studied in order to optimize immunological surveillance of this infection. The object of the study was the epidemic process of whooping cough, and the subject of the study was the incidence of pertussis infection in 2009-2018 and official data on the outbreak of pertussis in 2018.To diagnose pertussis the bacteriological method was applied. The bacteriological inoculation of the samples was carried out in the laboratory of the Republican Clinical Infectious Diseases Hospital. The smear from posterior pharyngeal wall was collected from 2153 patients. The level of pertussis antibodies was determined by enzyme-linked immunosorbent assay (ELISA) using the RIDASCREEN Pertussis IgG test system (R-Biopharm, Germany) in various series.The study data testifies that despite the vaccine prevention and high inoculation coverage, the epidemic increases occurred in incidence of whooping cough in 2015 and 2018 with an intensive rate of 4.7 and 9.6 per hundred thousand of population, respectively. The evaluation of vaccination status of patients demonstrated that out of them 80.7% were non-immunized; the percentage of vaccinated patients made up to 13.1%. The analysis of the age structure testifies that the main group of the diseased consisted of children under one year of life (63.1%), the second group consisted of children aged 1-4 years (33.1%). The severe forms of infection were observed among children under one year of age (95.8%). According to the territorial distribution, the largest percentage of cases fall on Bishkek - 70% (426 cases) and Chuyskaya Oblast - 22.4% (137 cases). The sero-epidemiological study revealed high proportion of seronegative individuals in all studied groups, and the highest percentage was observed in the group of children 5-9 years old and adolescents of 15-19 years old - 62.8% and 62%, respectively.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):542-546
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The “Penicillin Project” of the he United Nations Relief and Rehabilitation Administration as a factor of aggravation of the Soviet American relations
Sherstneva E.V.
Abstract
The analysis of the declassified documents of the Russian State Archive of Economics and the State Archive of the Russian Federation made it possible to establish that the project of the United Nations Relief and Reconstruction Administration was not a priority in the USSR for supplying equipment for penicillin factories to the two Soviet republics. Of greater interest was the acquisition in the United States of expensive high-performance plant equipped with the latest machinery, albeit for cash payment. This prioritization affected time-frame and implementation progress of the UNRRA penicillin project and facilitated manipulation on part of the United States. In aggregate with distrust of the USSR in quality of the supplied equipment and the hope for alternative sources of obtaining necessary scientific and technical information, this resulted in loss of interest to this project. The turned out situation affected correspondingly on the attitude of the Soviet Government to the UNRRA missions operating on the territory of the Soviet Republics and to the leadership of the organization itself and contributed to the further exacerbation the of Soviet-American relations.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):547-552
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The last tsarist minister N. K. Kulchickiy (1856-1925): in between science and politics
Pashkov K.A., Dmitriev A.N.
Abstract
The article analyzes the scientific and political aspects of the biography of Nikolai Konstantinovich Kulchitsky (1856-1925). He was not only the last tsarist minister of education, but also the sole medico at this high position. The scientific achievements of professor histologist from Kharkov have proved to be in great demand in the XXI century not only in neuroendocrinology, but in oncology and pulmonology too. The authors analyzed the stages and conditions of the administrative career of the conservative Kulchitsky heading large educational districts during five years and two ministerial months in the beginning of 1917. He managed to do not a little for development of school hygiene and sanitation in the Kazan and Petrogad educational districts, including in conditions of the world war. The meaningful for the particular epoch the combination of medical and social aspects of activities of gifted researcher medico deserves a special attention and comprehensive study.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):553-559
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The becoming and development of departmental medical statistic in Bavaria and Prussia (1800-1871)
Gatina Z.S., Mitrofanov R.S.
Abstract
The article is devoted to the history of the emergence and functioning of departmental medical statistics in the German states in 1800-1871. The authors, on the basis of the analysis of German historiography, identify main actors, goals, methods of administration and representation of health statistics. Starting from the specifics of German terminology concerning the umbrella term “medical statistics” (“medizinische Statistik”, “Medizinalstatistik”, “sanitäre Statistik”, “Gesundheitsstatistik”), the authors elaborate in detail on the cases of the Bavarian and Prussian kingdoms. By the beginning of the XIX century, the mechanisms of building modern state were started up in these countries. In its functioning, it was primarily based on statistical surveys of people and territories. The gradual institutionalization of medical statistics, its complexification and enhancement are considered in the context of state bureaucratic system reforming. The analysis of historical research results permitted to generate cumulative picture of becoming and development of medical statistics in Bavaria and Prussia. The study of transformation of reporting forms allowed to see how the bureaucratic institutions, by means of statistical methods, sought to rate the “death” and “health” of population.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(3):560-566
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