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 specificity of the medical profession, which involves constant communication with sufferers and their loved ones; the need to quickly master rapidly developing medical technologies and the digital environment; organizational and economic changes in the healthcare system that are increasingly intensifying the work of medical workers create a risk of expanding the scope and aggravation of the problem of professional burnout. The article presents an analysis of approaches to identifying signs and classifying the stages of professional burnout among medical workers, as well as methods for preventing and relieving this syndrome in domestic and foreign practice. In addition, the results of two mass surveys of medical specialists employed in the Moscow healthcare system, conducted at five-year intervals, are presented.

Autoimmune hepatitis is a chronic, immune-mediated liver disease characterized by an increased level of immunoglobulins G and/or gamma globulins, the presence of autoantibodies and a typical histological picture. Diagnosis of autoimmune hepatitis causes difficulties due to various variants of the course, wide variability of the clinical picture, which leads to a large number of missed cases of the disease. Treatment of аutoimmune hepatitis is aimed at reducing the activity of an inadequate response of the immune system against cells of its own body and achieving complete remission of the disease. The timeliness of starting treatment is directly related to the prognosis of the disease. These features of the disease necessitate proper patient routing and shortening their path to specialists with knowledge and experience in managing this category of patients.

Modern cities all over the world have various conditions and opportunities that ensure the preservation, strengthening and improvement of the health of their inhabitants. This is especially true in relation to the so-called healthy cities. Currently, the term «healthy city» means a city dominated by a rational physical, ecological and socio-economic environment that provides the vast majority of its inhabitants with opportunities for successful effective activities and a high-quality healthy life. The article presents international documents in the field of healthy cities development (World Health Organization, European Region). The achievements in the field of improvement of healthy cities abroad, contributing to the preservation, strengthening and improvement of the health of their residents, are described.

The presented work examines the problem of ageism in the doctor-patient relationship, as well as the impact of this discrimination on the quality of medical care and the psychological state of patients. Ageism is defined as bias or discrimination based on age, which can manifest itself in various forms, including underestimation of symptoms in older patients and negative stereotypes towards younger patients. The text emphasizes that ageism violates trust between a doctor and a patient, which leads to a deterioration in communication, a decrease in the quality of diagnosis and treatment, as well as to the rejection of medical recommendations by patients. Based on the analysis of international practice, the main strategies for combating ageism were identified, such as the introduction of educational programs for medical professionals, the development of a state anti-ageist policy, the creation of an inclusive environment in medical institutions and public campaigns.

Introduction: Patients with chronic obstructive pulmonary disease (COPD) usually have a decreased quality of life (QOL). Specialized questionnaires on QOL may be more sensitive when studying individual issues of COPD therapy than general (universal) questionnaires.

Goal: Conducting a review of specific tools for assessing the quality of life of patients with COPD.

Materials and methods: The study was carried out based on the results of a search of scientific literature presented in the bibliographic databases PubMed (USA) and ELIBRARY.RU (Russia, Russian-language sources). Keywords were used to search for relevant sources: «quality of life», «COPD», «chronic obstructive pulmonary disease» etc. In order to search for information on individual questionnaires, queries containing the names of the questionnaires were used. Additional references were obtained using the search engines Google and Yandex.

Results: Based on the results of a study of the scientific literature and a search in the PubMed / Medline information base, 22 specific tests used to assess the quality of life of patients with COPD were considered. These tests demonstrate different relevance and scientific applicability in recent years. Five tests were most often used in foreign and domestic studies: St. George respiratory questionnaire (SGRQ), the COPD assessment test (CAT), the modified Medical Research Council dyspnea scale (mMRC), the chronic respiratory questionnaire (CRQ), the clinical COPD questionnaire (CCQ).

Conclusion: Further study as well as local adaptation (if so required) of some questionnaires will open up new opportunities for their wider implementation into the routine daily practice of providing medical care to patients with COPD in the regions.

The function of the upper limb impaired due to stroke limits daily activity and reduces the quality of life of patients. Cognitive motor therapy using virtual reality and biofeedback (biofeedback) technologies can optimize rehabilitation. The aim of the study was to evaluate the effectiveness of cognitive motor therapy in patients with post-stroke dysfunction of the upper limb.

Non-communicable diseases (NCDs) continue to progress against the background of an increase in risk factors and the emergence of new ones, such as postcovid syndrome. Due in part to this influence, the progression of the atherosclerotic process and deterministic cardiovascular diseases is observed. In this regard, the aggravation of NCDs remains alarming against the background of the influence of six leading risk factors «25 × 25». The article presents a review of the literature and the conceptual directions of these leading factors as dominant in the development of NCDs. The directions of secondary prevention are considered and the expediency of their early implementation is justified. The presented methodological bibliometric method made it possible to analyze the experience of a number of countries that led to a decrease in the development of NCDs. The methods of bibliographic data search included search queries on the Scopus Web of Sciense, MedLine, The Cochrane Lybrary, PubMed databases. It is noted that achieving even six goals with the correction of risk factors will reduce morbidity and mortality from such four major NCDs as cardiovascular diseases, chronic obstructive pulmonary disease, stomach cancer, diabetes mellitus by 2025 to levels close to the target of «25 × 25», reducing by 77% the gap between the growth situation or stagnation and trends in the growth of new risk factors.

Within the framework of this study, the correlation of cognitive impairment with physical and psychological health in various demographic groups was studied. The analysis is based on data collected through a survey of 320 participants, which allowed us to assess the impact of age and gender differences on cognitive functions. A comprehensive approach was applied, including a decision tree and a random forest to identify key predictors of disorders, as well as correlation and regression analysis methods to determine statistically significant links between cognitive functions and other variables such as physical activity level and psychological state. It has been found that physical limitations and psychological conditions such as anxiety and depression have a significant impact on cognitive abilities.

In the context of an aging population in megacities, it is important to maintain the health and activity of older people, improving their quality of life. To do this, it is necessary to study the factors affecting longevity, including individual health characteristics and perception of the health system (accessibility, responsiveness, effectiveness, ageism).

The purpose of the study: to identify an assessment of the quality of life of elderly Muscovites and the influence of factors related to health and the assessment of the health care system on it.

Materials and methods: a sociological survey, descriptive statistics, correlation analysis, and a z-test were used to compare the proportions of variables.

Results: an assessment of the quality of life and its components based on questionnaires showed that health is a key factor for the elderly, although its assessment was low. 47% of the elderly are committed to healthy lifestyle, of which 40% regularly exercise. 25% have bad habits, 26% are disabled, which reduces the quality of life. 18% seek medical help on a monthly basis. Those who go to doctors less often rate the quality of life higher (p m 0.001). Satisfaction with the last medical visit is higher than with the healthcare system as a whole.

Conclusion: the study revealed a link between healthy lifestyle and the quality of life of the elderly. Regular physical activity improves quality of life by reducing hypochondria and potentially offloading the healthcare system. Satisfaction with the health care system also affects the quality of life and requires an increase in the availability of medical care.

The article examines current trends and challenges related to the export of medical education in the global educational services market. The analysis of the data on the number of foreign students at medical universities leading exporting countries, including USA, UK, Australia, Canada, Germany, Russia and China. The factors influencing the choice of a country for study, such as the quality of educational programs, tuition fees, and the availability of visa and immigration procedures, are highlighted. Special attention is paid to the impact of the COVID-19 pandemic and the growth of online education on international student mobility and accreditation of medical programs. In conclusion, recommendations are proposed for exporting countries to strengthen their positions in the global medical education market.