Problemy sotsial''noi gigieny i istoriia meditsiny / NII sotsial''noi gigieny, ekonomiki i upravleniia zdravookhraneniem im. N.A. Semashko RAMN, AO ''Assotsiatsiia ''Meditsinskaia literatura''最新文献

The chronic cardiac deficiency continues to be one of the leading health care problems requiring innovative solutions. The article presents mathematical algorithm to evaluate drug interactions and targeted to minimize side effects and to optimize chronic cardiac deficiency therapy. The mathematical model, elaborated using AI, is based on analysis of fully connected sub-graphs and ranking of side effects of combined application of medications. This approach permits to implement optimal selection of the safest and most effective combinations of medications. This is particularly important with regard for co-morbid conditions when patients take simultaneously several different medications. The proposed approach can significantly improve risk prediction and favor more precise selection of combined therapy. The algorithm surmises necessity for further extension and specification of model, including consideration of wider spectrum of medications and mechanism of their interaction. In the context of rapidly advancing digital medicine, models based on mathematical algorithms and machine learning can complement systems of clinical decision support. These models also can become valuable tool improving treatment of various diseases, especially in co-morbid conditions opening new horizons in medical practice.

The article covers, on the basis of archival documents, one of the little-studied aspects of the Leningrad Blockade the activities of the State Sanitary Inspectorate for supervision over output of food products at industrial enterprises of the city (19411943). The data on its structure, personnel, under controlled network of enterprises, methods of work are presented. The specificity of functioning of the State Sanitary Inspection in conditions of Blockade was autonomy from the Republican and the Union management of the sanitary service. All decisions were taken from local daily needs and in contact with city authorities. One of the main tasks of sanitary food physicians in the blockaded city was to search for substitutes of food products and as much as possible to preserve and to use defective food products and at the same time to prevent surge of gastrointestinal diseases. With the purposes of that, workers of the State Sanitary Inspectorate carried on regular laboratory tests of food samples, authorized using in production certain surrogates and participated in development of the Temporary Technical Specifications for production of industrial enterprises. The study demonstrated that methods of work of the Leningrad State Sanitary Inspectorate (team approach to examinations, day-and-night duties of physicians in city and districts sanitary inspections, regular meetings with superiors and senior inspectors of food groups and economic executives) justified themselves in conditions of Blockade and deficiency of food resources.

The article presents management model, based on assessment of potentials of sustainable development of medical organizations. The model can be applied to assess efficiency of activities of obstetrics organizations in the Tver Oblast reducing maternal and infant mortality. The basis for model implementation is analysis of data from reporting documentation of obstetrics institutions in the Tver Oblast. It is established that with implementation of management model manager can set in motion leadership potential and evaluate efficiency of innovations even before they start working in the institution. The decrease in maternal and infant mortality due to introduction of new techniques was noted. The implementation of pediatric component for further decreasing of infant mortality is justified.

The tobacco smoking continues to be a significant public health problem, as it is one of the major risk factors of development of neoplastic, cardiovascular and respiratory diseases. The particular attention is attracted to prevalence of consumption of tobacco and new nicotine-containing products in medical students community. The article presents results of anonymous sociological survey of student youth of the Medical University as part of study of habit of consuming tobacco or nicotine-containing products. It is established that medical students have high commitment to smoking (50.7%). However, the most popular product among respondents was electronic cigarettes. The majority of respondents smoke less than 10 cigarettes per day and have very weak nicotine addiction according to the Fagerstrom test. The average age of smoking initiation among medical students was 16.523.7 years. According to respondents, among main reasons for starting smoking were pleasure, sense of adulthood, anxiety, and stress. The users of electronic cigarettes, electronic nicotine delivery systems and electronic non-nicotine delivery system more often than smokers of traditional cigarettes openly smoke with their families and less often tried to quit smoking. The health worker advised to quit smoking only in 19.650% of cases. Among respondents, 32.9% plan to quit smoking traditional cigarettes within next six months. 66.7% and 18.5% of respondents do not intend to give up using electronic nicotine delivery systems and electronic cigarettes in next six months.

The marine and medical practice demonstrates that despite measures taken to ensure and preserve health of members of sea craft crew, there is still shortage of marine personnel due to resignation from profession due to illness that actualizes search for additional measures maintaining their working capacity. One of promising areas in this area is new approach in carrying out medical examinations of seafarers, during which additional medical procedures are performed to obtain better research results. Nevertheless, many foreign shipowners continue to accept medical reports without taking into account opinions of such particular specialists as cardiologist and urologist. In order to prevent assignment of crew members unsuitable for work at the sea, the article proposes measures eliminate problematic aspects in actions of seafarers and medical institutions at stage of carrying out pre-scheduled medical examination.It is necessary to increase quality control of this procedure, including at the expense of granting permission for its implementation only to organizations included in the unified register, which is to be composed in accordance with particular criteria. It is also proposed to use statistics data of examination results to develop recommendations maintaining health of crew members, considering identified individual characteristics.

The article considers influence of social demographic factors on choosing mode of making appointment with physician in ambulatory polyclinic institutions of health care. The survey of population registered in medical organizations providing primary health care in out-patient conditions was carried out. The material was statistically analyzed. The relationship between choice of registration mode and such social demographic factors as gender, marital status and area of ​residence (urban/rural) was not detected. The relationship between registration mode and such social economic category as able-bodied and retired persons, employment and education level was established. These factors reflect activity of population and are have common economical origin. These factors affect digital maturity of population.The territorial planning related to health care in settlements with predominantly able-bodied population and high employment, emphasis is to be made on appointment through Internet network. In settlements with predominantly populated with persons of retired age and low employment emphasis is to be made on making appointments in person or through call center.

The development of industry of modeling and care of artificial nails, conditioned by comfort and aesthetic component for consumers is particularly dynamic. In Russia, this service is relatively new one. Therefore, most of materials are imported from other countries. However, compositions of main material of gel-lacquers from various manufacturing companies contain such harmful substances and chemical components as toluene, formaldehyde and dibutyl phthalate that negatively impact on human health and often causes various diseases and side-effects.The analysis confirmed problematic aspects in current legislation related to import foreign gel-lacquers used in nail modeling, especially in terms of compliance with technical regulation measures to ensure safety of citizens health that is one of main tasks of customs authorities. In this regard, regulatory framework governing strict procedure for import of foreign-made gel-lacquers into territory of the Russian Federation as part of the EAEU analysis was implemented. The relevant conclusions and recommendations were formulated.

The article is dedicated to contribution of the Academician N. N. Blokhin, his colleagues and students into organization and becoming of the Research Institute of Reconstructive Surgery, Traumatology and Orthopedics in post-war years in city of Gorky. The study was based on materials from archives of mentioned institution, on materials from the Academy of Medical Sciences of the Russian Federation, the Blokhin family archives, on materials provided by his wife Nadezhda Germanovna and on publications. The structure and main directions of activities on rehabilitation of the Red Army soldiers injured during the Great Patriotic War are presented. The examples of innovative solutions (development of the first domestic dermatome) improving methods of plastic surgery under provision of medical care to the wounded are described. The scientific potential of N. N. Blokhin realized in his numerous publications and contributions with reports at international scientific conferences is revealed. The article proves the N. N. Blokhins role in preparation of successor who continued to develop the institute and to support effectiveness of efficient team whose physicians and nurses presented with new life thousands of Red Army fighters returned from battlefront.

The article analyses current trends in training of young specialists carried out by higher and secondary vocational educational institutions in the Union State of Russia and Belarus today. The study permitted to substantiate existing problems in health care related to staffing and high turnover of personnel. This situation determines special significance of staffing for health care system, especially in the light of development of digitization. The on-line surveys of students in Google docs concerning their attitudes towards prospect of their further participation in RD during and after graduation were carried out. The surveys included questions concerning assessment of quality of digital technology adoption that permitted to identify most attractive areas of digital medicine development for respondents. The particular trends related to training of health care personnel in the Union State of Russia and Belarus were revealed, including increase in the number of medical graduates in the Russian Federation, while in Belarus this indicator is decreasing. In addition, the preferred areas of realization of their professional potential by medical students with knowledge of digital technologies in health care were identified.

The efficient functioning of medical organizations is closely related to various external and internal factors. To minimize negative impact of these factors it is necessary to implement risk management concept. The purpose of the study is to rank risks influencing functioning of medical organizations. The A. V. Zavrazhsky typology of risks was applied. The verification of sources of danger of financial risks affecting rational use of budget and non-budget funds of medical organizations was carried out. The questionnaire was developed to assess potential risks using six-point scale. The respondents (n=256) were proposed to evaluate degree of influence of risks on quality of medical care. The sampling also included heads of regional medical organizations participating in mandatory medical insurance system and subordinated to the Minzdrav of the Saratov Oblast. The following statistical methods were applied: goodness-of-fit test, Kruskal-Wallis H-criterion, Nemeni criterion, Fligner-Killeen test, permutation test.The financial risks (26%) occupy first place in structure of influence on efficiency of medical care, followed by general economic (24%), legal (18%), social (17%) and professional (15%) risks. The correlation between evaluation of risks, position and length of service of respondents was established. The insufficient funding at the expense of mandatory medical insurance funds is the most significant financial risk affecting quality of medical care.The study permitted to rank risks for medical organizations in the Saratov Oblast and to identify key factors affecting their assessment. The results of the study can be used in developping effective risk management strategies in medical organizations, targeted to improve quality and efficiency of medical care.