Vol 31, No 4 (2023)
- Year: 2023
- Articles: 26
- URL: https://journal-nriph.ru/journal/issue/view/85
Articles
THE CERTAIN ISSUES OF SUPPORTING NON-BARRIERNESS OF OBJECTS AND SERVICES FOR NOT MOBILE CITIZEN
Abstract
The article presents analysis of establishing conditions to adapt the environment and to remove barriers for not mobile citizen (the disabled with disorders of musculoskeletal system). In the process of analysis of possibilities to organize non-barrier environment for not mobile citizen the national and foreign normative legal acts, international conventions, materials of national and foreign experts, Internet sources were used. The analysis of current international regulation of non-barrier urban environment for not mobile citizen demonstrates gradual transition from medical concept of disability to social one. The disabled society model surmises that people are disabled to the extent that the environment prevents them from fulfilling their needs and receiving necessary services. The importance of development of municipal and regional quality standards of accessibility of the environment and services for the disabled increases. It is necessary to eliminate informational, communicative and other barriers for this contingent of citizens. The consequences of impact of the COVID-19 pandemic on paradigm alteration in the field of strategy of adaptation of municipalities to needs of not mobile citizen are analyzed. The analysis of interaction between non-barrier environment and not mobile citizen permits to consider this process as an element of their post-medical rehabilitation. Only application of integrated intersectoral approach can positively effect on solution of problems in this area.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):570-577
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THE ANALYSIS OF PROBLEMS OF SUPPORTING LONG-TERM NURSING OF INDIVIDUALS WHO LOST THEIR ABILITY TO SELF-CARE IN RUSSIA
Abstract
The article considers the issues of social assistance of long-term care of individuals who lost ability to self-care. The comparative analysis of established practices of social assistance of long-term care, of legal and financial support of family members implementing such a care in Russia and European countries is presented. The study was carried out using comparative jurisprudence methodology. The analysis of legislative acts of the European countries revealed possibility of including particular legal provisions concerning financing of long-term care and implementing contractual forms of regulation of employment of family members providing such care, in the Russian social welfare system. The study demonstrated inadequate efficiency of the Russian systems of legal protection and social assistance both individuals seeking long-term care and individuals implementing it, as compared with similar systems in the European countries. To improve these systems, it is necessary to recognize legislatively the care of relative who lost the ability of self-serve as labor function liable to payment based on minimum wage rate. To fix legislatively retention of workplace for caregiver for entire period of caring and/or grant him unpaid vacation for long period. It is necessary to adjust both amount of benefits for care of family member who lost ability to self-care and procedure of calculation of amount of pension benefit of caregiver. The study results can contribute to widening scientific and practical professional discussion in the field of public health, health care organization and social work concerning problems of optimization of means and modes of supporting longterm care of persons who lost ability to self-care. The study results can serve as ground for making amendments to national legislation to harmonize legal support of social welfare system and to improve protection of rights of family members caring relative who lost ability to self-care in conditions of forced loss of income.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):578-586
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THE PREVENTION AND CORRECTION OF COGNITIVE DISORDERS IN CITIZEN OF ELDERLY AGE IN CONDITIONS OF STATIONARY INSTITUTION OF SOCIAL SUPPORT
Abstract
The article presents results of research study intended for identifying degree of cognitive impairment in elderly citizen residing in conditions of institution of stationary social support. The study was conducted in a multidisciplinary rehabilitation institution of social services. The obtained results confirmed necessity to organize primary preventive work and permitted to test program of correctional classes with elderly people having cognitive impairments. The comparative analysis of results of primary and control diagnostics testifies that efficiency of corrective impact depends on degree of cognitive impairment and beginning time of correctional work. The early correction of cognitive abnormality of light and moderate degree is the most successful. It actualizes issues of timely diagnosis of cognitive abnormalities in elderly people and necessity to develop activities of primary prevention of dementia.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):587-593
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THE ASSESSMENT OF RISK FACTORS OF DEVELOPMENT OF EXTRA BODY MASS IN CHILDREN OF SCHOOL AGE
Abstract
The global problems of children health include overweight and obesity and associated high risks of disability, premature death and complications of mental health in adult age. Purpose of the study is to identify alimentary and social risk factors of development of extra body mass in children and adolescents 7–17 years old residing in industrial center of the Eastern Siberia. The average age of studied group of children was 10.95 years. The sampling survey and anthropometric examination of children of school-age was carried out with participation of their parents (legal representatives). The results were evaluated by parametric statistical methods. The analysis testifies predominantly fat-based dietary model in children with normal and extra body weight. It is established that diet of children is inadequate in fish, curds, cultured milk food, meat, vegetables, fruits and drinking water. And 51,67–61,90% of children never consumed seafood. The most significant factors associated with extra body mass and obesity in children and adolescents were status of working mother and her specialized secondary education, high body mass index of father, satisfactory family income, high body mass index of mother. The results of study can be useful for correcting and elaborating further strategies of development of healthy diet in institutions of general education.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):594-599
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THE IMPROVEMENT OF COGNITIVE REHABILITATION OF PERSONS OF OLDER AND SENILE AGE
Abstract
The article presents results of study of patients of elderly age within the framework of pilot project on the basis of the geriatric department of the State Budget Institution of the Rostov Oblast “The Hospital for War Veterans”. The specially questionnaire was developed with participation of the charitable foundation “Memory of Generations” and the public movement “Medics-Volunteers”. The social hygienic characteristics of studied contingent was analyzed. The statistical processing of obtained data was carried out considering subjective status of patients.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):600-604
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IS POSSIBLE TO DECREASE THE RISK OF DEVELOPMENT OF UNDESIRABLE EFFECTS OF MEDICATIONS APPLYING COMPUTER TECHNOLOGIES? (A REVIEW)
Abstract
The article presents overview of modern concepts about application of artificial intelligence (AI) in pharmacotherapy to decrease risk of developing undesirable side effects of medications. The possibilities of applying AI in selection of optimal medicine or combination of medicines and prediction of treatment results are considered. The choice of the best medicine for patient usually requires integration of data of results of comprehensive examination of patient considering success of genetics and/or proteomics as well as data about chemical descriptors of compounds of medications. The prognosis of medication interactions is often based on indicators of similarity assuming that medications with analogous structures or targets will have comparable behavior or may impede each other. The optimization of scheme of dosage of medicines is implemented applying mathematical models to interpret pharmacokinetic and pharmacodynamic data.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):605-612
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THE CERTAIN ASPECTS OF ORGANIZATION OF MEDICAL CARE OF WOMEN IN PERIOD OF PREGNANCY AND DELIVERY IN THE REPUBLIC OF BASHKORTOSTAN
Abstract
Health protection of women of reproductive age is a priority direction of state policy. In protection of reproductive health of women no small importance is played by development of organization of primary medical sanitary care and specialized medical care of women during pregnancy and delivery. The study was carried out in the Republic of Bashkortostan and covered period of 2017—2021. It was established that the number of women of fertility age decreased up to 3,9% that became one of causes of reduction of birth rate from 12.1‰ to 9.8‰ respectively. At that, the level of maternal mortality increased up to 8.9 times (from 4.1 to 36.8 per 100,000 born alive). In 2021, out of 37,775 women who completed their pregnancy, 99.3% were examined by therapist and only 92.2% passed such an examination prior to 12 weeks of their pregnancy. On the gestation period of 11—4 weeks, 91.3 % of pregnant women were subjected to ultrasound examination of fetus with detection of maternal serum markers and 94.4% of pregnant women were examined at the 19—21 weeks of pregnancy. Among pregnant women, rate of diseases and pathological conditions that preceded or developed during pregnancy slightly increased. Increasing of morbidity of anemia, diseases of endocrine system, including diabetes mellitus, was noted. The deterioration of particular indicators of organization of medical care of women according to profile “obstetrics and gynecology” occurred during period of COVID-19 pandemic. The implementation of three-level system of organization of medical care resulted in significant reduction of number of obstetric and gynecological hospital beds.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):613-618
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THE ACTUAL SPEECH MODULES FOR COLLECTING ANAMNESIS AS A FOUNDATION OF PREVENTIVE THINKING OF PHYSICIAN
Abstract
The article presents information about results of implementation of program of additional education of general practitioners within the framework of cognitive-behavioral prevention of iron deficiency in women. The prospective analysis of level of corresponding awareness and skills of physicians from sample (n=120) and control (n=120) groups before and after training established statistically significant differences in favor of physicians who were trained within the framework of experimental work program that confirms the effectiveness of the last one.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):619-623
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THE TELEMEDICINE AND DIGITAL TECHNOLOGIES IN EDUCATION PROGRAMS OF TRAINING MEDICAL PERSONNEL OF HIGHER QUALIFICATION
Abstract
The article considers application of telemedicine and digital technologies in educational programs of training medical personnel in residency and graduate school for the Russian health care system. The possibilities of telemedicine and digital technologies that currently are in use for remote medical care, consultations of medical workers by qualified medical specialists and for training and re-training of medical personnel are investigated. The key topics of modern health care are improvement of system of training medical manpower, personalization of medical care in health care, individualization of professional orientation in the process of continuing medical education and current methods of information environment management in health care sector. The conclusion is made that owing to new technologies,such innovations as telemedicine, artificial intelligence, medical decision-making systems, remote platforms of patient health monitoring and other modern inventions are implemented into health care. The purpose of the study is to examine impact of transformational processes in higher medical education in epoch of digitization.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):625-631
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THE FORMATION OF ORGANIZATIONAL STRUCTURES COORDINATING MANPOWER POLICY IN HEALTH CARE OF THE SUBJECT OF THE RUSSIAN FEDERATION
Abstract
Nowadays, development of organizational structures coordinating personnel policy in health care of the Subjects of the Russian Federation is relevant. The purpose of the study was to investigate feasibility, scientifically substantiate and implement at the level of the subject of the Russian Federation measures developing organizational structures to coordinate participants of personnel policy in health care. According to 88.5% of interrogated experts, insufficient interaction between participants of personnel policy in health care is a significant cause of problems of medical personnel in the Irkutsk Oblast. About 81.1% of respondents consider overall efficiency of interaction between participants as low. The survey permitted to study main directions and degree of interaction between participants of personnel policy in Oblast health care. At that, 82.8% of respondents indicated that intensification of low interaction requires development of special organizational structure. The obtained results permitted to formulate proposals concerning organization in the Irkutsk Oblast of Medical Council under the Governor and in its structure working group on personnel policy in health care. The corresponding methodological support was developed.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):633-638
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THE DETERMINANTS OF VACCINATION AGAINST THE NEW CORONAVIRUS INFECTION (COVID-19) OF RESIDENTS OF THE CIRCUMPOLAR REGION OF RUSSIA
Abstract
The maintenance of health of residents of the Northern Regions of Russia, including those living in the Arctic zone of the country, is a condition of its advance development in XXI century. The percentage of Russian citizen vaccinated against the new coronavirus infection (COVID-19) does not exceed 50% after beginning of implementation of vaccination program. It can be conditioned by lower level of both of credence of citizen to health care system and health literacy. Purpose of the study is to establish determinants of vaccination of population against COVID-19 in circumpolar region of Russia as exemplified by the Arkhangelsk Oblast. The sociological survey was carried out using the interview technique of patients of medical organizations (n=433) and conditionally healthy residents of the Arkhangelsk Oblast (n=139). To evaluate the level of general health literacy the Russian version of questionnaire HLS19 — Q22-RU was applied. The most of conditionally healthy respondents and consumers of medical services looked for information about methods of prevention and treatment (80.4% and 58.2% correspondingly), had an experience of vaccination against COVID-19 (79% and 56.3% correspondingly). The relative chances of conditionally healthy respondents, women, and respondents having no children and no credence to national health care system to independently look for information related to COVID-19 is higher at 2.94, 2.08, 1.55 and 1.48—1.57 times correspondingly. The relative chances of conditionally healthy respondents having no children in family and assessing one's economic status as “higher than average” to be vaccinated against COVID-19 is higher at 4.02, 1.52, 1.53 times correspondingly. Availability of experience of vaccination against COVID-19 is conditioned by higher level of general health literacy. In the Arkhangelsk Oblast and other circumpolar regions of Russia the programs of increasing loyalty of citizen to measures of population prevention, including vaccine prevention, is to be implemented with consideration of established determinants of of vaccinations against COVID-19.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):519-526
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THE INFLUENCE OF GENDER, AGE AND LENGTH OF SERVICE ON EDUCATIONAL PREFERENCES OF GENERAL PRACTITIONERS IN RUSSIA
Abstract
In conditions of active development of medical and pharmaceutical sciences and dynamically changing work environment the education of physician is to be both continuous and personalized. Purpose of the study. To investigate effect of gender, age and work experience on educational needs and on preferences of forms and methods of training in the system of continuing medical education of Russian general practitioners. The research bases were Chairs occupied with issues of personnel training for general medical practice in Moscow, Belgorod and Kemerovo. The sociological, statistical and analytical research methodologies were applied. The overall analysis covered 402 questionnaires for general practitioners. The sampling of respondents included 19.1% of men, 80.9% of women; 52.4% were aged 36—55 (60) years, 29.3% — 24—35 years and 18.3% — 56 (61) years and older; 45.0% had experience in general medical practice up to 2 years, 16.3% — 3—4 years, 27.0% — 5—6 years, 11.7% — 7 or more years. The results of comparative analysis of opinions of physicians of both genders and various age with different time of experience concerning level of significance for practice of various areas of competence within the framework of specialty and their preferences regarding organizational forms, training methods and its duration are presented. It is established that gender, age and length of service had no significant effect on the studied parameters. However, certain characteristics associated with these factors are identified. The further study of possible influence of other internal and external factors can contribute in the future into formulation of scientifically grounded approach to choosing personalized trajectory of education of general practitioner.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):639-644
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THE BRIEF CHARACTERISTIC OF CERTAIN ASPECTS OF FUNCTIONING OF HEALTH CARE SYSTEMS OF IRAN AND THE UNITED ARAB EMIRATES (A REVIEW)
Abstract
The article presents review of publications and national reports concerning various aspects of functioning of health care systems of Iran and the UAE. It is noted that the state in these countries plays different role in supporting population with medical care. It is larger and more significant in Iran than in the UAE. At that, private medical organizations dominate in health care of both countries in area of out-patient care (in the UAE it expressed more intensively). The analysis of medical insurance demonstrated that in the UAE insurance systems and accessibility of medical care for citizens and expatriates differ significantly. It is emphasized that quality and accessibility of medical care in Iran was impacted by international sanctions that in the first place affected provision of patients with imported medicines. The characteristics of these health care systems include the transfer of functions of provision of medical and educational services to medical universities in Iran and implementation of mandatory private health insurance in the UAE.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):645-650
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THE MEDICAL REPRESENTATIVES, OR DEBATES OF 2010S ABOUT PROMOTION OF MEDICATIONS
Abstract
The article considers the issue of the restrictions imposed by the government in the 2010s into process of introducing and promoting medications at the market by means of medical representatives. The government decided to formalize relationships of pharmaceutical manufacturers with consumers of medications. On the one hand, such a trend was occurring all over the world and was stimulated by social attacks at Big Pharma under slogan “the conflict of interests”. On the other hand, at the Russian pharmaceutical market, the restrictions of direct contacts of pharmaceutical manufacturers with physicians and and pharmaceutists were supported above all by national manufacturers of medicines. In the course of competition, vast army of Russian medical representatives was stigmatized that made many medics either to leave pharmaceutical market or to limit themselves to formal duties.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):651-657
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THE TEMPTATION OF RUSSIAN PHARMA. REPORT II: THE IMPLEMENTATION OF THE PROGRAM OF ADDITIONAL MEDICINAL SUPPORT
Abstract
The second article in series of publications considering history of implementation of the government program of additional medication support from point of view of conditions of development of pharmaceutical market in Russia. The study is carried out on the basis both of interviews of participants of pharmaceutical market and state administrators and publications in specialized editions in 2020—2022. The first experience of close interaction of pharmaceutical business with government in implementation of social policy is analyzed. The focus is made on failures in practical implementation of the program of additional medication support, in which course alliance of government and pharmaceutical business cracked.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):658-664
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THE SOURCES OF ORGANIZATION OF RECREATION AND HEALTH IMPROVEMENT IN ARTEK: THE EXPERIENCE OF THE FIRST TURNS
Abstract
The article describes historical period of becoming of Artek as children camp in the first half of the 1920s. The facts that are insufficiently covered in publications are cited. Before the opening of the first children health camp, immense regulatory and organizational work was carried out. Its experience is invaluable. The People's Commissar of Health Care Nikolai Alexandrovich Semashko and the first chief physician of Artek Fedor Fedorovich Shishmarev significantly influenced both on factual organization of institution of new format and becoming and consolidation of system of childfren health protection at its very initial stages. F. F. Shishmarev collected materials that permitted to analyze medical activities of the camp in first two years of its existence. The special attention is paid to comparative analysis of morbidity and evaluation of the results of stay of children in the camp. According to the outcomes of successfully conducted first turns of 1925—1926, the young Soviet government adopted decision to develop the given direction of activity, positioned at the junction of educational, ideological and recreational work.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):665-669
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“THE SHAKESPEARE OF MEDICINE”: WORKS AND DAYS OF JOHN HUNTER (1728—1993)
Abstract
John Hunter is rightly ranks with such most famous researchers and physicians as Galen, William Harvey and Andreas Vesalius. His role as the founder of the “experimental surgery” of the New Age and the creator of the famous Hunterian Medical Museum in London is significant for the history of medicine. His contribution into development of dentistry is incontestable. His work “The Natural history of human teeth: an explanation of their structure, use, formation, growth and diseases” (1771) was translated into many languages, but it was never published in Russian. The accuracy of description of the anatomy of teeth, jaws and mouth cavity, the view? contemporary for us, of development of the jaws and their relationship with the masseters, the introduction of such terms as “canines”, “incisors” and “anterior molars” into scientific circulation and everyday practice of dentists, the illustrations excellent by their quality and accuracy — all this is John Hunter. His works predetermined path of development of many medical directions, giving food for thought to his followers and disciples. The article reveals the facts of his biography, demonstrates significance of contribution of John Hunter into medicine in his works on anatomy, surgery, natural history of dentistry and stomatology.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):670-676
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THE REVIEW OF THE BOOK “THE DESTINY OF SCIENTIST. THE ACADEMICIAN OLEG PROKOPIEVICH SCHEPIN” BY R. V. KOROTKIH
Abstract
The review considers the book “The Destiny of Scientist. The Academician Oleg Prokopievich Schepin” by R. V. Korotkih that is based on studying of wide range of sources and publications. The author presents main periods of life and creative work of Oleg Prokopievich Schepin, the Academician of the Russian Academy of Sciences. The book by its style is notable for its simplicity and easiness. It is oriented to wide audience of readers. The purpose of the author is obvious — to share about outstanding personality being in contact with whom enriches spiritually, creatively and makes life more interesting and many-sided. Furthermore, the book reveals creative development of prominent scientist who greatly inputted into formation and consolidation of public health and health care and development of international cooperation in medicine. The author of the book, Raisa Vasilievna Korotkih, more than 20 years worked with academician O. P. Schepin and largely relied on accounts of Oleg Prokopievich himself. The author succeeded to present portrait of not only scientist, founder of eminent scientific school but great politician, organizer, health care administrator, pedagogue, leading specialist in the field of national and international health care, eminent public figure.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):677-680
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THE SOCIAL GENETIC ASPECTS OF HIGHER PREVALENCE AND PREVENTION OF BASAL CELL CARCINOMA
Abstract
The article analyzes modern scientific publications that consider increasing of prevalence of basal cell carcinoma that ranks high among cases of skin cancer in all racial ethnic populations of the world, comparable with increasing prevalence of cancer of esophagus, ovaries and thyroid gland. In most countries of the world, including countries with high income level, reliable epidemiological data and national registers of basal cell carcinoma are absent. The multi-factorial etiology of basal cell carcinoma that includes environmental and genetic factors combined with social economic variables, is associated with prevalence of particular sub-types of basal cell carcinoma depending on gender, age, racial ethnic and genetic factors, as well as concomitant diseases, previous treatment and other indicators.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):527-534
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THE SYSTEMIC APPROACH TO ANALYSIS OF OPINIONS OF PATIENTS ABOUT MEDICAL SERVICE
Abstract
The purpose of the study is to adapt the Health Care Complaints Analysis Tool (HCAT) technique to analysis of complaints of patients at the level of medical organizations. The sampling of 1419 applications of patients were analyzed. All applications were entered into register and systematized and analyzed using the HCAT technique. All complaints were distributed to three problematic areas: clinical problems, organizational problems and communication problems. Each problematic area includes categories and subcategories specifying the main point of complaint. The gravity of potential harm to health and severity of factual health impact were determined. The most of complaints (77%) were related to management problems, while clinical and communication problems were found rarely (5% and 18%, respectively). The subcategory assignment appeared to be the least reliable part of the HCAT taxonomy. The management subcategories were adapted to enhance the sensitivity of detection of underlying organizational problems. The HCAT standardize approach to analysis of complaints of patients and demonstrated its applicability for systematization of complains in both inpatient and outpatient medical organizations. The final structure of classification can depend on health care institution level and conditions of medical services provision.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):535-540
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THE EVOLUTION OF CRITERIA OF SELECTION OF CITIZEN WITH MENTAL DISORDERS TO MILITARY FORCE
Abstract
The article presents the analysis of changes in official requirements to health of youths with mental disorders (the Regulation on military medical examination in version of 1995, 2003, 2013). The sections I and II of articles 14—20 of the Schedule of Diseases of this Regulation are considered from the point of view of the category of fitness for military service on conscription. The set of measures of leveling consequences of mitigation of requirements to health of future servicemen for particular nosologies is proposed.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):541-544
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THE DESIGN OF RESEARCH PROJECT OF BEHAVIORAL STRATEGIES OF WOMEN WITH BREAST CANCER EXPERIENCE
Abstract
The breast cancer can be successfully cured after its early diagnosis. Nevertheless, this disease remains one of the main causes of female mortality in Russia and in the world. The effective mode of overcoming this disease is to intensify institutional programs of prevention and treatment in context of the national health care system. The efficacy of such programs depends on social economic inequality and differences between population groups with respect to informational, financial and regional aspects. The study design includes: comprehensive approach to analysis of social economic and infrastructural conditions of organization of prevention and treatment of breast cancer; of characteristics of symbolic filling of the breast cancer phenomenon in the Russian society; of factors determining willingness and ability of women of different social status groups to be involved in prevention and treatment of breast cancer and conditions, including conditions of increasing their subjectness.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):545-549
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THE ECOLOGICAL DETERMINANCY OF DEVELOPMENT OF BRONCHIAL ASTHMA IN ADULT POPULATION (AS EXEMPLIFIED BY THE REPUBLIC OF THE NORTH OSSETIA-ALANIA)
Abstract
The intensive impact of anthropogenic factors on health causes more than 40% of all human diseases. First of all, it has to do with respiratory organs and comes out as the main determinant of development of chronic respiratory pathology. The article presents an assessment of negative impact of environmental factors on dynamics of increasing of incidence of bronchial asthma morbidity in the Republic of North Ossetia-Alania. The indicators of the general morbidity that increased up to 75.6% and for the first time detected up to 97.5% over six-year period. The results of present study correspond with the results of similar studies implemented in various territories of Russia indicating at mediation of increasing of bronchial asthma morbidity by negative impact of environment risk factors. In the Republic, over a period of many decades, contribution of the metallurgical plant producing zinc, cadmium, sulfuric acid and zinc-aluminum alloys, to atmospheric air pollution made up not less than 40%. Only two out of eight rural municipal districts are relatively environmentally problem-free today. In rural areas, more than 50% of atmospheric air pollutants is related to carbon oxide. Nowadays, along with industrial emissions into atmospheric air and their accumulation, increases importance of motor transport in environmental pollution. The cars account for 50–70% of all harmful emissions. The presence of harmful substances contained in exhaust gases exceeds permissible standards by 2–3 times. According to the data of systematic analysis of urban air quality, most of the year citizens breathe atmospheric air not meeting normative requirements. The actual situation favors development of bronchial asthma. In the Republic, its morbidity has not decreased for many decades. To improve indicators of bronchial asthma morbidity can be achieved by leveling harmful effects of environment through identification of main sources of environmental troubles. The priority is both to decrease industrial emissions that pollute atmosphere and to transit to more ecologically safe modern power supplies of motor transport facilities.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):550-554
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THE DEVELOPMENT OF MEDICAL TOURISM IN CONDITIONS OF GLOBALIZATION HEALTH CARE
Abstract
The article considers impact of process of health care globalization on development of medical tourism. The main trends in health care that drastically changes the situation in conditions of COVID-19 pandemic and implementation of digitization are presented. The normative legal base in force regulating medical services export is analyzed. The study of conditions of development of medical tourism in Russia is carried out. The directions of development of medical services export in modern conditions are considered. The enumeration of issues of global health care is formed. It is accepted to consider health care sector as a part of economics that is most isolated and attached to place of rendering and consumption of services. The outbreak of COVID-19 pandemic and active implementation of digital technologies into processes of organization of health care and medical care provision launched transformation and urged globalization. The conclusion is drew that actual society exists in epoch of globalization and digitization of health care sector. Nowadays, borders of states are not insurmountable obstacle for patients in need of high-tech medical care. The world market of medical tourism demonstrates trend to continuous growth and development permitting largest medical clusters to compete for attention of patients. The purpose of the study is in considering directions of development of medical tourism under the influence of process of health care globalization in modern society.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):555-561
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THE SUPPORT OF HEALTH MAINTENANCE OF UNDER AGE TRAINEES ON SHIPBOARD
Abstract
The international conventions and national state educational standards specify mandatory practical training on shipboard for acquiring through programs of secondary professional education professional habits and skills by students of swimming specialties. For cadets, specified temporary regime of work and rest is established. Other items concerning organization of labor activity, apply to them same rights and obligations as to regular members of crew as declared in ship's role. Since during internship the age of cadets does not exceed 18 years, occurrence of possible disorders of their mental health is urgent concern and high-risk factor for shipowner. The article describes in detail rules of organizing practical training of cadets on shipboard. The responsible persons are identified. The responsibilities of shipowner in relation to trainees are revealed. The current problematic aspects are marked and appropriate preventive measures are proposed.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):562-569
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THE ASSESSMENT OF EFFICIENCY OF IMPLEMENTATION OF THE FEDERAL PROJECT “THE STRUGGLE WITH CARDIOVASCULAR DISEASES” DURING COVID-19 PANDEMIC
Abstract
The article presents assessment of efficiency of implementation of the Federal project “The struggle with cardiovascular diseases” during COVID-19 pandemic. It is demonstrated that over three years of implementation of the Federal project significant consolidation of medical infrastructure and volume of work of regional vascular departments and centers took place. However, these achievements resulted in no improvement of quality of medical care nor in decreasing of mortality from diseases of the circulatory system. According to results of integral assessment, there is trend of pronounced decreasing in the number of subjects of the Russian Federation with average and high indicators of project efficiency when the COVID-19 pandemic that factually resulted in occurrence of emergency situation in health care and deteriorated access of population to medical care, is factor of failure in achieving main goals of the Federal project. To confirm or refute this hypothesis further research is needed.
Problems of Social Hygiene, Public Health and History of Medicine. 2023;31(4):509-518
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