Vol 29, No 5 (2021)

Full Issue

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Articles
COVID-19 as a catalyst of development of telemedicine services to rural population
Khabreev R.U., Bakirova E.A., Berseneva E.A., Savostina E.A.
Abstract
The paper presents a review of publications concerning issues of development of telemedicine in rural health care of the USA during in conditions of COVID-19 pandemic and expediency of extensive application of telemedicine technologies during “post-COVID” period. The issues, aspects, prospects and required conditions for extensive diffusion of telemedicine services to the rural population are considered.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1029-1033
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The resource support of medical organizations providing medical care in twenty-four-hour hospital under new corona-virus infection COVID-19
Orlov S.A., Khalfin R.A., Aleksandrova O.Y., Stolbov A.P.
Abstract
The article considers, on the basis of application of modern information analytical systems, the sequential stages of analysis and evaluation of indices of resource support of medical organizations and technological process of medical care provision. The results of the study permit to discover particular patterns of the course of disease in different gender and age groups,in terms of clinical manifestations and results of instrumental and diagnostic tests. The dependence of results and outcomes of treatment on set and quality of resources of medical organizations is established. The prognostic indices of functioning of medical organization under various alternatives of patients' flows organization as associated with hospitalization level.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1034-1039
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The image of the Russian health care in information field during second wave of COVID-19
Sharkova I.V.
Abstract
The article presents the results of restudy of the Russian health care information field, carried out during the second wave of COVID-19 in the mass media database “Medialogia” and in the search engine “Yandex” from October 1, 2020 to January 31, 2021. The comparative analysis of the results of the study with previous measurements taken from December 1, 2019 to May 15, 2020 was implemented. The results of the study are a portion of panel study of the Russian health care system image and can be used hereinafter by interested structures with the view of its adjustment.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1040-1046
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The social demographic aspects of vaccination of population of Russia in the context of COVID-19 pandemic
Ryazantsev S.V., Khramova M.N., Smirnov A.V.
Abstract
The pandemic of the new corona-virus infection COVID-19 will be over only when population immunity will be developed. This condition can be achieved by both vaccination and surviving disease in natural way. The WHO recommends the first mode for achieving population immunity, since immune response to vaccine is similar to that one developed while surviving natural infection, but with minimal risks to health and life. The article presents the results of sociological survey organized with purpose of studying the attitude of Russians to vaccination against COVID-19 infection. The results of the survey demonstrated that at present, 22% of respondents are ready to be vaccinated i.e. they responded positively to the corresponding question. The following main factors determining population attitude to vaccination were identified. First, there is statistically significant correlation between vaccination readiness and education level: respondents with higher level of education are more likely to be vaccinated against COVID-19. Secondly, in general, the population is quite positive about the response of the National health care to the corona-virus pandemic. However, the percentage of population that is positive about vaccination can be higher if it would be possible to apply foreign-made vaccines in Russia. Thirdly, still there is large percentage of population believing that vaccination with medications that have not passed long-term clinical trials can result in health negative consequences. Fourthly, the majority of respondents experienced various manifestations of the pandemic on themselves: either they have been ill themselves, or their relatives and friends were ill or died and almost all of them somehow limited their common mobility.The survey results did not established statistically significant differences in distribution of responses among males and females. We assume that in order to develop positive attitude of population to vaccination, and specifically to Russian-made vaccines, more extensive information campaign is needed to be implemented. Also, significant increase of percentage of vaccinated population can be achieved if clearly defined requirements for availability of COVID-19 vaccination would be adopted on the international level. Actually, this is key condition for restoring international mobility and removing restrictions in national economies.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1047-1056
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The institution of licensing and application of procedures of medical care support during COVID-19 pandemic
Roshchin D.O.
Abstract
The article presents the analysis of procedures of medical care support as implemented in case of patients with new coronavirus infection in Russia (“infectious diseases” profile), including their requirements as the main licensing requirement. The analysis of the results of public control of compliance with the requirements.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1057-1059
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The economic analysis of provision of medical services via medical insurance in Russia
Andriyanova A.A., Andriyanova L.S., Kornienko M.V.
Abstract
The article demonstrates that the restrictions introduced during the coronavirus pandemic affected the dynamics of mutual settlements between the territorial funds of the mandatory medical insurance (MMI, TFMMI). According to the results of the first nine months of 2020, medical institutions of a number of subjects were not able to earn even a half of the amount of sum that was presented for payment in 2019 on medical care support of patients from other regions. It was established that besides such relevant features of the Russian health care system as large territory, fragmentation of population, necessity to maintain a number of state medical institutions, there is also a number of factors that during the pandemic were most aggravated in those “weak” places in the MMI system that have been stagnating for a long time. Among them, insufficiently large listing of medical services covered by MMI, inability to provide medical services to all those in need due to shortage of equipment, working areas, qualified care, etc. It is noted that among the general trends of MMI, the Russian medical insurance system (not only that it is not a classical one), especially during the pandemic, is broken out of social insurance: two funds, structures, costs of informatization, etc. However, in Russia, even in such conditions, health care is funded through the MMI system up to 50%. The pandemic demonstrated that no private sector, no paid services, no commercial insurance companies can cover the whole spectrum of health care complicities during the pandemic crisis. Namely, the MMI system bore the brunt of the survival of medicine during the pandemic. It is concluded that namely the need in medical institutions with sufficient reserve of bed fund with MMI services can input into development of necessary stable basis for survival in difficult conditions of pandemic crisis. The proposal of the Audit Chamber of the Russian Federation of further reforming of the mandatory medical insurance system is considered reasonable and logical especially in difficult situation of struggle against COVID-19. The article also presents data concerning the state of MMI in 2020, at the height of the pandemic crisis in the regions of the Russian Federation.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1060-1065
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The accessibility of stomatological care for patients with limited capacities in conditions of COVID-19 pandemic
Kopytov A.A., Besschetnova O.V., Ovchinnikov I.V., Tkachenko P.V., Belousova N.I.
Abstract
The article considers the problem of access to stomatological care, in particular to prosthetic dentistry, for people with limited health capacities in conditions of the COVID-19 pandemic. The range of factors impeding to get quality dental services in state stomatological polyclinics and at home was established by empirical study organized in two Subjects of the Russian Federation located in the Central Federal Okrug.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1066-1070
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The psychological characteristics of food behavior of the youth in conditions of self-isolation
Petrova E.A., Babich E.G., Kuksov A.S., Tihonova V.I.
Abstract
The article presents the results of psychological study of characteristics of food behavior in young people in the conditions of forced self-isolation and COVID-19 coronavirus infection pandemic. The common research methods were applied to establish actual food disorders and intensification of their symptoms during isolation. The food behavior of each individual can be considered as network of interactions between various natural factors (physiological, psychological, economic, sociocultural ones). It is conditioned by stress level due to pandemic. The comparative analysis of study results concerning specifics of food behavior in conditions of self-isolation in young and middle-aged people demonstrated that there is significant relationship between external, emotionogenic food behavior, restrictive food behavior and age of subjects. The correlation analysis established statistical significance of a number of scales. In sample of middle-aged objects, relationships between external and emotionogenic food behavior were established. The emotionogenic condition was associated with dissatisfaction with one's own body, and body image - with restrictive food behavior. The direct statistical significance of dependence of restrictive behavior from age was revealed. In all cases, more intensive manifestation of food disorders was detected in sampling of young people that confirms hypothesis that middle-aged people are inclined to other types of food disorders as compared with young people. The severity of disorders is also less pronounced. The actuality of the analyzed problem is determined by both trends in development of scientific knowledge and existing needs of social practice.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1071-1076
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The young families during lock-down: coping strategies
Svischeva I.K., Voloshina I.G., Lazurenko N.V., Polenova M.E., Koroleva K.Y.
Abstract
The article considers the impact of lock-down and quarantine on family relationships and adaptation strategies of young families.The results demonstrate that young families demonstrate both stability during lock-down period and capacity to resist the pandemic crisis. However, isolation period revealed psychological and social problems of family relationships. The pandemic period became the most stressogenic factor for young families with children where parents combine their family responsibilities with “remote” labor activity. The current level of emotional exhaustion of young mothers depends on two components: material well-being of family and age of children. The families with two and more children and families fostering children aged less than 5 years survive most hardly period of self-isolation. The gender inequalities that are traditional for Russian families intensified in conditions of quarantine. The most common coping strategies with these conditions for young males are “escape into Internet”, loneliness, alcohol consumption and sport activities. At the same time females prefer caring of their children, housework and involvement in creative activities.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1077-1082
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The pandemic as antagonism of entropy and neg-entropy in human interaction with environment
Gazniuk L.M., Lipich T.I., Trishina T.V., Mezinov V.O.
Abstract
The article considers issue of substantiation of the anti-systemic dimension of pandemic. The combination of biocenosis, anthropocenosis and technology within the framework of systematic approach is demonstrated. The outline of structural aspects of pandemic as negative medianess, catastrophic extreme situation and antagonism of entropy and neg-entropy is presented. The analysis of constitutive character and structural aspects of anti-systemic dimension of pandemic is proposed. On the examples of pandemics of cholera, SARS, Ebola fever the occurrence of pandemic as a result of human technogenic intervention in environment is demonstrated. The concept of pandemic as specific version of anti-system is proposed. It is concluded that pandemic is a system with negative level of systemacy, that, firstly, occurs as a result of direct or indirect interference of anthropocenosis in biocenosis, resulting in mutual antagonism. Secondly, it manifests itself as mass disease. Thirdly, it is targeted to annihilation of all discrete and rigid structures, open and closed systems of anthropocenosis and biocenosis. Fourthly, it is described through negative medianess, extreme catastrophic situation and antagonism of entropy and neg-entropy.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1083-1089
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The social hygiene of labor
Gnevasheva V.A., Gorbunova N.V.
Abstract
Nowadays, the factors of labor conditions, expectations of workers about working place safety, quality of career development health integrity play an important role in distribution and exploitation of labor force. The social factors and factors of health preserving technologies gain even more importance for organization of working space. The international organizations more often fix increasing of traumatism, deterioration of quality of life of workers, including such crucial for development of labor market and society strata as the youth one. Hence it is a real threat of decreasing of human potential of nation. The article presents international estimates of understanding and calculation of main indices of labor conditions, quality of workplaces and integrity of health of workers. The problems of further investigation in this area are brought out. The characteristics of definition of the term “social hygiene of labor” are exposed as significant for describing and specifying characteristics of modern labor relations, changes in employee-employer relations for the purpose of improving work and employment conditions, as well as social protection of able-bodied population, preserving and promoting health of workers.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1090-1093
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The mortality of individuals older than able-bodied age because of consequences of external causes effect
Madyanova V.V., Kakorina E.P.
Abstract
The analysis of mortality because of external causes in persons older than able-bodied age in the Russian Federation permitted to determine their high level and significant contribution into formation of age profile of mortality of persons of older age groups. The comparison of mortality rates from injuries, poisoning, and some other consequences of external causes effect in persons older than 65 years in the Russian Federation and the European countries was carried out. The high mortality due to external causes of persons older than able-bodied age in the Russian Federation emphasizes vulnerability of this age group of population and is characterized by increased victimization.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1094-1102
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The quality of life of adolescents as integral characteristic of pre-nosologic health condition
Bulycheva E.V., Zhdanova O.M., Setko I.A.
Abstract
The purpose of the study is to establish characteristics of quality of life of adolescents and substantiate it as a reference criterion of pre-nosologic condition of health for mass screening observations of adolescent population.During puberty, in adolescents, mainly in girls, deterioration of quality of life is established. At that, minimal indices of quality of life were registered in adolescents 12 years old, that is probably conditioned by decreasing of level of functioning of central and respiratory systems against the background of vegetative balance disorders in this age group as compared with students of other age groups. The dependence of scales of mental component of quality of life of adolescents is established from following functional indices of central nervous system: stability of nervous reaction (r = 0.4) and level of functional capabilities of formed functional system (r = 0.4-0.5); physical component of quality of life of students from functional level of nervous system (r = 0.4-0.5), from integral indices of autonomic nervous system (r = -0.4-0.5); from indices of functional state of respiratory system (r = 0.4-0.6). The obtained data allows to consider quality of life as a reference diagnostic tool for assessing pre-nosologic health condition in mass screening observations of adolescent population.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1103-1110
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The family demographic policy in the context of population reproduction: the country-specific review
Rostovskaya T.K., Vasilieva E.N., Sizikova V.V., Bereza N.A.
Abstract
The purpose of the study is to systematize theoretical models of demographic family policy approved in publications included into database SCOPUS in 2019-2020 and developed using empirical data obtained by analysis of methods and practices of increasing natality in certain countries of EU, BRICS and the New World. The France, Sweden, Great Britain, Norway and Denmark are oriented to expand measures of social support of citizen and regulation of occupation of women with children with purpose to increase natality. In the countries of South-Western Asia and North Africa the measures are targeted to decreasing level of natality and to implement family planning policy.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1111-1116
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The psycho-physiological aspects of morbidity of cadets of military educational institutions
Voronin R.M., Bulatetskiy S.V.
Abstract
The purpose of the study is to determine and to estimate the psycho-physiological factors affecting morbidity of cadets of military educational institutions.The study was carried put using sampling of 79 male cadets of the Academy of the Federal Penal Service of Russia. The cluster analysis was applied to indices of morbidity and psychological characteristics of cadets. The comparative inter-group evaluation of psychological indices and indices of heart rate variability was implemented. The obtained results specify differences in groups as a result of complex impact of various factors on morbidity indices.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1117-1120
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The medical social problems and methods of diagnostic of cognitive disorders in patients taking “Spice”
Petrov D.S., Volodin B.Y., Lihoded A.A., Novikov V.V., Konovalov O.E., Pak V.I.
Abstract
The article presents the results of pilot study implemented to determine cognitive disorders in patients taking “Spice”.The purpose of research is to identify targets of psychological correction interventions to prevent cognitive deficiency in patients addicted to synthetic cannabinoids.The pilot sampling consisted of 30 patients taking “Spice”. The control group consisted of 30 healthy individuals. Along with social consequences, one of the important focuses of the study was investigation of cognitive sphere of patients. A number of pathopsychologic tests was applied. The study established that patients demonstrated disorders of various functions of memory, attention, mental pace and thinking. In particular, disorders of short-term, long-term and mediate memory and mental tempo were revealed. Also, reduced activity of attention took place. The distortion and decreasing of generalization and poor prehension occurred reliably more often as compared with control group. The established cognitive disorders in patients taking “Spice” can be considered as targets for psychological correction interventions to prevent cognitive deficiency in patients addicted to synthetic cannabinoids.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1121-1124
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The problematic aspects of medical care support of members of the crew aboard of sea-going ship
Botnaryuk M.V., Timchenko T.N., Tonkonog V.V.
Abstract
The modern requirements to business management in maritime industry are manifested not only in operative response to rapidly changing conditions of internal and external environment, but also in necessity in permanent maintenance of ship activity and health of crew members. Despite a thorough medical examination prior to starting professional activity on ship board, seamen may face the need to receive medical care during the time of contract performance. In recent years, drastic changes in procedure of first medical assistance and medical nursing on ship board. Previously, these functions were assigned to ship physician. Currently, medical care is provided by representatives of senior officers of ship crew in accordance with the requirements of international conventions. In this regard, the stated research topic is rather actual. The article describes in detail the procedure of providing medical care on ship board to crew members. Also, the key problems are established and appropriate recommendations are proposed.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1125-1131
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The phenomenon of patient aggression according opinion of medical practitioner
Deriushkin V.G., Gatsura O.A., Gatsura S.V.
Abstract
The article considers the problem of patient aggression during medical care provision. The purpose of the study was to estimate factual prevalence of patient aggressive behavior versus medical practitioners (with emphasis on primary health care) and specification of such manifestations. The anonymous survey of 508 physicians practicing in Moscow and the Moscow Region was carried out. The original questionnaire included 9 items regarding particular forms of patient aggression, its frequency and personal harm received. The feeling of personal safety at workplaces was evaluated according to 10-point scale. The study revealed that 412 respondents (81.1%) reported about episodes of patient aggressive behavior during performance of professional duties. In the year prior to the survey 66 respondents (16.0%) regularly experienced aggression from patients, 85 respondents (20.6%) recalled more than 5 such cases, 176 respondents (42.8%) - from 2 to 5 cases and 85 respondents (20.6%) - 1 case. The forms of aggression and damage suffered due to the aggressive behavior of patients were described. The physicians do not feel themselves safe at their workplaces regardless of their gender, professional experience, medical specialty and practice setting. The respondents assess their average feeling of safety in 5.4±2.5 points. The study established that 251 respondents (40.6%) considered patient aggressive behavior as manifestation of specific features developed in response to impact of present somatic disease. The study results demonstrated that physicians are exposed to aggressive actions from their patients more often than this is commonly considered and prefer to conceal such kind of incidents. The most common form of patient aggression was verbal abuse though physical aggression also took place. The application of preventive measures and management of conflict are key practical skills for any physician.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1132-1137
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The increasing of the somatic health in students using differently directed fitness
Bocharova V.I., Kondakov V.L., Kopeikina E.N., Smirnova D.E., Verzunova L.V., Shumakov I.A.
Abstract
The purpose of study is to scientifically substantiate the methodology of applying differently directed fitness tools to increase the level of somatic health, physical and mental workability of students. The experimental sampling consisted of 186 students (106 girls, 80 boys) of the Belgorod State National Research Institute and the Belgorod University of Cooperation, Economics and Law. Two groups of respondents were organized: control group (n=85; 47 girls, 38 boys) that included students involved into officially approved education program of the Chair of Physical Culture and experiment group (n=101; 59 girls, 42 boys) that included students involved into experimental program. It is established that Pilates stabilizes and topes up muscles of entire body, improves coordination abilities of students involved, improves body-build constitution, promotes reducing of back pain, improves cardio-respiratory system functioning and is the most called-for fitness direction for reducing psycho-emotional tension. The step aerobics positively effects on the cardio-respiratory system, the entire musculoskeletal system and physical workability. The level of somatic health in experiment group after the experiment improved from “below average” to “average”. In control group both before and after the experiment, the level of somatic health corresponded to “below average”. After the experiment, the physical performance indices in experiment group improved and remained at the same level in control group. In the experiment group all analyzed indices of mental workability increased and acquired measured character.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1138-1143
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The emotional burnout effect on labor efficiency of stomatologists
Aksenova E.I., Bobkova T.V., Veshkurova A.B., Lukyanova R.R., Shapiro S.A.
Abstract
The article presents the results of the study of factors effecting on professional deformation of stomatologists and its relationship with their personal characteristics, labor experience and medical specialization. the information is compiled with purpose of elaborating comprehensive recommendations on diagnostics of phases of development of syndrome of emotional burnout in this category of medical specialists at the initial stages of its occurrence and proposing measures of its adjustment including social and personal prevention.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1144-1151
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The children's animated cartoon as a factor of family social health
Leontyeva T.V., Dolgorukova I.V.
Abstract
The article presents the results of the study of modern Russian animated cartoons from the point of view of their impact on family social health. The social health is formed on the basis of certain values. The destruction of the family values system negatively affects the formation of family social health. The animated cartoons are an important institutional mechanism of socialization of children, because the traditional institutions that shape values of the younger generation are largely losing their role, first of all the matter is about the institution of family. The original observation card for content analysis was applied. The analysis was applied to the animated cartoons distributed in 1992 - present time with a total time volume of 6500 minutes. The analysis of the representation of family in animated cartoons permitted to identify a typical image of family in modern Russian animated cartoons that is presented as a complete nuclear parental family where the relationship between spouses is characterized as pseudo-cooperation, raising the only child-teenager in authoritarian style. In Russian animated cartoons, only 54% of families are presented as full. The extended families are presented in 11% of animated cartoons. The quarter of all families presented in modern Russian animated cartoons, are a married couple without children, where family situations are built around the relationship of young couple that have got married recently.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1152-1155
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The organization of pre-clinical studies of bactericidal and wound healing effects of the impulse photoherapy device “Zarya”
Arkhipov V.P., Bagrov V.V., Byalovsky Y.Y., Kamrukov A.S., Kuspanalieva D.S., Maslova M.V., Odegov A.K., Davydov V.V., Voronin R.M.
Abstract
The purpose of the study is to determine therapeutic effectiveness of the pulsed high intensity optical irradiation device “Zarya” exemplified by treatment of model wounds in laboratory animals and to compare with traditional methods of wound treatment.The prototype of “Zarya” device was used whose operating principle was based on pulsed irradiation of affected areas with high intensity optical radiation in continuous spectrum generated by pulsed xenon lamp. The therapeutic effect of the “Zarya” device was compared with effectiveness of the certified medical ultraviolet irradiator based on low-pressure mercury lamp and also with known wound-healing and antibacterial medication Levomekol ointment. The mature male rats of Wistar line were used in the study. The animals were distributed to 4 groups: group 1 was irradiated by “Zarya” device, group 2 was irradiated by low-pressure mercury lamp, group 3 was treated with Levomekol ointment and group 4 was exposed to no exposure. The linear wound was modeled according to the standard method under ether anesthesia. The therapeutic procedures were applied daily during 7 days. The bactericidal effect was studied on the basis of smears from wound onto flora on the 2nd, 5th and 7th day. On the 8th day the animals were subjected to euthanasia.It was established that “Zarya” device application permits to reduce considerably both duration of therapeutic procedures and therapy course in general and also to achieve more pronounced bactericidal effect. The obtained data is supposed to be used for development of program of clinical trials.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1156-1162
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The characteristics of healthy life-style of rural senior high-school students: social technological approach
Shmarion Y.V., Nadutkina I.E., Kameneva T.N., Belikh T.V., Pronina E.D.
Abstract
The article considers one of the most actual issues of social policy of the Russian state - the rising generation health. The maintenance of health of rural senior high-school students is considered in chronotopic dimension of key factors and main parameters of healthy life-style during the most dynamic period of their growing up. The rural lifestyle has its own specifics, that are reflected in organization and implementation of healthy life-style at individual and institutional levels and acquires characteristic features at its implementation in gender context. The article presents the results of an attempt to analyze, on the basis of empirical study data, dynamics of changes of attitude to healthy life-style of rural senior high-school students in 7-11 grades of rural schools and to assess impact of main factors and changes of key parameters. The obtained data are oriented to development of health-preserving social technologies at individual and institutional levels in municipalities.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1163-1170
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The modern approaches to rating of medical organizations on the basis of sustainable development of health care institution
Bravve Y.I., Shchepin V.O., Tolstova K.S., Latukha O.A.
Abstract
The article analyzes modern approaches to the rating of medical organizations based on national and foreign publications. The study identified groups of indices that are responsible for effectiveness of health care organizations from the point of view of consumers of medical services and state boards of public health management.According analyzed publications, rating values consider effectiveness of particular processes, rather than organization as a whole. This became the basis for scientific search for assessment system that can reflect the performance of medical organization contributing into its sustainable development. In 2012-2018, the Novosibirsk State Medical University carried out the study of potential of sustainable development of health care organizations. On the basis of normative legal analysis, sociological and expert survey of opinions of managers, the key areas of activities that contributed to improving efficiency of medical organizations were identified.The article presents the original approach to comparative assessment of health care organizations that provide various types of care of population based on concept of sustainable development using the T. L. Saati hierarchy analysis methodology.The strategy of sustainable development presumes achievement of long-term goals of medical organization, including not only indices of patient satisfaction with quality of medical care and organization of safe environment for their stay in health care institution, but also optimization of all processes, rational resource support, monitoring and analysis of internal environment of organization for continuous development of functioning, personnel training, implementation of organizational innovations.The medical organizations implementing strategy of sustainable development demonstrated the best results in such areas as resource management, increasing consumer satisfaction with quality and safety of medical care, optimization of processes of increasing number of treated patients. Thus, health care organizations having clear-cut plan of actions and set of management practices to achieve long-term goals acquire ability to improve both medical social indices and population health indices.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1171-1178
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The financial mechanisms in health care system and medical services
Tishutin A.A.
Abstract
The article considers financial mechanisms applied in provision of medical services in the Russian health care system. The data concerning the structure of state financing and personal expenses of Russian citizens in health care system is presented. The financial resources in the Russian health care system are formed on the basis of mixed model consisting of personal funds of citizens (private sources of financing) and public funds allocated by budget system to implement the program of state guarantees of free medical care to citizens. Nowadays, the citizens have an opportunity to pay the cost of medical services directly when applying to medical organizations and through medical insurance organization, purchasing voluntary medical insurance policy and visiting medical organizations when insurance case occurred. The key goal of financial policy in concerning health care is the implementation of directions contributing to increase of financial sources in the system of medical services provision, population health support and improving efficiency of financial mechanisms application. The effectiveness of use of financial resources in health care determines the efficiency of impact of financial policy on national economy.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1179-1185
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The five-year dynamics of main indices of functioning of neurosurgical service of the Russian Federation
Perkhov V.I.
Abstract
The neurosurgery is one of the most innovative and hi-tech directions of scientific and clinical activity that significantly contribute into improvement of health and improvement of quality and longevity of human life. This positioning specifies actuality of implementing on regular basis the analysis of trends of its development with purpose to improve corresponding indices of its efficiency, to develop conditions for continuity of medical process, to ensure equal accessibility of specialized neurosurgical medical care to population in the Regions of the Russian Federation.The purpose of the study was to describe and to analyze indices of neurosurgical service functioning to support decision making related to development of professional partnership and ensuring for population of different regions of Russia equal access to profile specialized medical care.The data of 2015-2019 was collected from 85 Subjects of the Russian Federation contained in the forms of state statistical observation “Data on activity of divisions of medical organization providing medical care in hospital conditions” and “Data on medical organization”. The analysis of the collected data was implemented using such statistical tools as simple (unweighted) arithmetical mean values, specific weight of indices values, mean-root-square (standard) deviation from average values, coefficient of variation (mean-square distance and average value ratio). The data set considered as homogeneous if coefficient of variation did not exceed 33%.The study revealed that in the Russian Federation, at the mean, provision of beds of neurosurgical profile to population in 2015-2019 decreased from 9.22 to 8.83 beds per 100 000 of population. In 2019, intensity of hospitalization made up to 2.77±1.06 cases per 1000 of population. The average duration of treatment for five years decreased for 1 day and in 2019 made up to 8.47 days (9.96±2.3 days on beds for adults and 7.00±2.1 on beds for children). The mean annual occupancy of one bed of neurosurgical profile for adults decreased from 319.6±31.3 days in 2015 to 311.7±29.8 days in 2019 and for children from 305.4±28.3 days in 2015 to 289.0±29.1 days in 2019. The total hospital lethality of neurosurgical beds in 2019 consisted 1.22±1.19% that is 22.7% less than in 2015 (1.50±1.37%). The number of implemented surgical operations increased from 146.4 in 2015 to 179.1 thousand in 2019, i.e. for 22.4% and made up to 2.7 operations per 1000 of population. The postoperative lethality decreased from 9.63±7.07% in 2016 to 8.19±4.48% in 2019. In 2019, there were 1.91±0.61 neurosurgeons (natural persons) per 100 000 of population. The total number of established posts of neurosurgeons in 2019 made up to 4792.25 units (in 2015 - 4629.75 units) and out of them 4318 units are occupied (in 2015 - 4264 units). The occupied units covered 2923 neurosurgeons as natural persons. On average, per one neurosurgeon (natural person) in the Subjects of the Russian Federation fall 4.7±1.30 beds of neurosurgical profile (from 2.6 to 10.7), 54.7± 24.6 surgical operations on nervous system per year (from 14 to 162), 137.8±41.1 cases of neurosurgical beds hospitalization (from 60 to 300). In five years, the structure of types of surgical operations on nervous system changed insignificantly. The surgeries in case of degenerative diseases of spline prevail and their specific weight increases.In Russia, significant differentiation of the Regions in level of resource support of medical care of neurosurgical profile continue to remain. At that, the Russian neurosurgeons in average implement three times less operation per year than their respective colleagues from Western Europe. In Russia, the main portion of neurosurgical operations is implemented in case of degenerative diseases of spine while in the developed foreign countries in case of cerebral stroke that is one of the main causes of death all around the world. To ensure equal access of population of different Subjects of Russia to profile specialized medical care an integration of clinical and administrative processes (vertical integration) is needed. The important role in solution of this task belongs to National medical research centers organized in Russia on the basis of leading Federal state scientific medical organizations.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1186-1193
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The development of algorithm of preventive consideration of applications of citizen for stomatological polyclinics administrators
Amkhadova M.A., Soykher M.I., Soykher M.G., Stroganova A.G., Enikeev A.M.
Abstract
The key priorities of the concept of development of health care in the Russian Federation is the population health support and increasing of availability and quality of medical care. The critical link in chain of interaction between medical organizations and residents is examination of applications of citizen. An appeal of citizen received by state authority, local self-government authority or by the official in accordance with their competence is to be a subject of mandatory proceeding. The service of non-staff chief stomatologist based on the organizational methodical office of Moscow Oblast Stomatological Polyclinic the comprehensive analysis of appeals of citizen appeals regarding provision of medical care in stomatological polyclinics of the Moscow Oblast was carried out. The analysis of summary of tasks demonstrated that in 2020, 107,511 appeals of citizens were received and 1002 tasks were related to stomatological care support that accounts 0.93% of total number of appeals. The results of analysis permitted to elaborate a set of recommendations for administrators of stomatological medical organizations to improve quality of examination of appeals of citizen.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1194-1200
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The problems of organization of medical care of crews of passenger ships in the system of inner water transport of the Russian Federation
Kosagovskaya I.I., Komarova E.V.
Abstract
The purpose of the study was to analyze organization of medical care of crews of passenger ships of inner water transport of the Russian Federation and to examine morbidity according to appeal for medical care of the crew during navigation.The analysis of organization of medical care in inner water transport covered the corresponding normative legal base of the late 1980s to present times. The search and analysis of available publications concerning issues of organization and provision of medical care to passenger river transport crews during and out of navigation was carried out. The estimation of morbidity statistics was implemented according data of medical log journal of out-patient reception of members of the crew of river cruise ship during navigation.The normative legal base of provision of medical care to crews of water river transport during navigation and on shore, and training and employment systems of ship physicians requires substantial revision. On average, 1.5 initial visits for medical assistance during navigation is for 1 crew members. The repeated visits accounted for significant proportion (48.0%) of all crew visits. The largest percentage of visits was related to rank-and-file staff (74.0%). In the structure of causes of visiting out-patient medical unit on board the first place is for injuries (22.0%), respiratory diseases follow (18.0%) and diseases of musculoskeletal system are third (11.0%).In the Russian Federation, the system of medical care support of the crews of water passenger transport requires a serious improvement. The structure of morbidity of the crew of a passenger river vessel during navigation (the prevalence of injuries, respiratory diseases, diseases of the musculoskeletal system) is determined by unfavorable factors of professional activity of sailors and dictates the specifics of training of ship physicians. It is necessary to work further the normative legal base regulating medical care of the crew during navigation and on the coast, training and employment of ship medical personnel, and developing and approval of unified quality standards for organizations (institutions) involved into medical support of inner water transport workers.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1201-1206
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The sociological aspects of medical employee turnover
Makarov S.V., Gaydarov G.M., Alekseevskaya T.I., Apkhanova N.S., Alekseeva N.Y.
Abstract
The level of development of human resources in health care is determined by a number of factors, among which an important place belongs to turnover of medical staff. The turnover, or the process of unscheduled dismissal of staff, negatively affects functioning of the organization in any field, including health care. Although the analysis of staff turnover is widely applied in various fields of activity, relatively few studies are related to problems of assessing causes of this phenomenon in health care. The purpose of the study was to assess the characteristics and causes of turnover of medical staff in state medical organizations of the Irkutsk Oblast. The detailed information about the respondents obtained in the study made it possible to get a concept of intensity and characteristics of turnover of physicians and medical nurses, and to study causes of dismissal of respondents from their previous employment as well as causes that influenced current employment and to assess content and effectiveness of measures of professional adaptation and social support of hired specialists.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1207-1213
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The improvement of medical personnel and post-graduate education within the framework of scientific educational medical cluster “The North-Caucasian”
Amlaev K.R., Koichueva S.M., Mazharov V.N., Koshael V.I., Khodzhayan A.B.
Abstract
The article considers the organization of postgraduate education and clinical activities within the framework of functioning of the North-Caucasian Scientific and Educational Medical Cluster. The analysis of obtained data revealed shortcomings in training of physicians at all stages of their professional career, as well as inadequately effective mechanisms of employment of graduates from medical faculties. To eliminate these shortcomings, the measures have been developed within the framework of NOMK that include computer programs for operational monitoring of public health indices, innovative technologies of education and advanced training of of physicians, exemplified by the Tutor project. The conclusion is made that scientific and educational cluster is an effective tool in area of training and retraining of physicians .
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1214-1219
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The impact of re-vaccination implementation on morbidity of mumps in the Kyrgyz Republic
Niiazalieva M.S., Isakova Z.T., Toygombaeva V.S., Aldjambaeva I.S.
Abstract
The article presents results of evaluation of long-term dynamics of morbidity of mumps in the Kyrgyz Republic (KR) in the pre-vaccination period, after the introduction of routine mass immunization in 1978 and in beginning of re-vaccination since 2015. The pronounced trend of increasing of morbidity was noted since 1970. In 1978, the morbidity increased up to 194 times as compared to 1948. The annual growth rate was made up to 7.7%. The application of vaccination significantly effected morbidity and prevalence of mumps in the Republic. In the long-term dynamics a pronounced trend of morbidity decreasing with annual decreasing rate of 7.5%.In 2015, re-vaccination of children of 6 years old was introduced in the Republic. This action resulted in morbidity decreasing during the next three years (2016, 2017 and 2018). However, in 2019, an outbreak of morbidity covering both children under 14 years and the adults was registered.The level of IgG to virus of mumps was determined by enzyme-linked immunosorbent assay using the test-system “VectoParotit-IgG” (by Vector BEST, Russia). The analysis of seroepidemiological study established the highest specific weight of seronegative individuals in the age group of 1-4 years (51.5%, 95% CI 42.9-60.1), and proportion of seropositive individuals falls on the age groups of 30 years and over (85, 4%), 10-14 years (62%), 5-9 years (61.5%), 15-19 years (60%).
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1220-1224
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The hospital care of civilian population during the first two years of the Great Patriotic War
Serebryany R.S., Kamelskikh D.V.
Abstract
The article presents, on the basis of archival documents and literature sources, the distribution and placement of hospital staff, staffing of physicians and nurses, support of population with medical personnel and medications, changes in beds stock, equipment of hospital institutions on the unoccupied territories of the USSR. An increase of workload, volume and intensity of labor of personnel of civil health care during the first two years of the Great Patriotic War was established. The unreadiness of the Narkomzdrav (the USSR People's Commissariat of Health Care) for making optimal decisions concerning the rational application of human resources in the beginning of the war is proved.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1225-1230
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The problems of military medicine at the Pirogov congresses of physicians (1887-1913)
Egorysheva I.V., Poddubny M.V.
Abstract
The article is devoted to the activities of the military medicine section of the Pirogov congresses of physicians in the late XIX - early XX centuries. A number of contributions of military physicians at the meetings of the section are analyzed. The famous surgeons N. A. Velyaminov, S. P. Kolomnin, V. I. Razumovsky, M. S. Subbotin, N. V. Sklifosovsky and others participated in the military medicine section activities. The study of the materials of the congresses provides notions about the most burning issues of military medicine of the studied period.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1231-1235
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Vladimir Nikititch Vinogradov (1882-1964): the leader of Soviet therapists
Borodulin V.I., Glyantsev S.P., Topolyanskiy A.V., Stochik A.A.
Abstract
The article reconstructs and describes, considering as a background the social political events that took place in the USSR during 1930s-1950s, the scientific biography and input into clinical medicine of professor V. N. Vinogradov (1882-1964), the prominent Soviet therapist, the Hero of Socialist Labor, the USSR State Prize winner (posthumously), the holder of five Orders of Lenin, the Honored Man of Science, the Head of the Chairs of Faculty Therapy of the I. V. Stalin Second Moscow State Medical Institute (1935-1942) and the I. M. Sechenov First Moscow Medical (1943-1964), the full member of the USSR Academy of Medical Sciences. The facts of participation of V. N. Vinogradov in the political trials on “The case of the Trotskyst block” (1938, on the side of the prosecution) and on “The case of physicians” (1952-1953, as the accused one) are presented. The issues of existence of the scientific clinical school of V. N. Vinogradov (in a sense, the united school of V. N. Vinogradov-V. G. Popov can be considered) and the phenomenon of leadership of V. N. Vinogradov among the therapeutic elite of the USSR are discussed. This phenomenon consists in dedication to the cause he served and in consecutive implementation of the priority directions of the clinic of internal diseases, developed by the teams of the departments and clinics headed by him in different years.
Problems of Social Hygiene, Public Health and History of Medicine. 2021;29(5):1236-1242
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