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 article presents results of quantitative sociological surveys based on original on-line questionnaire that allows to assess professional competence of otorhinolaryngologists in prescribing antibiotics to patients with acute and chronic rhinosinusitis. The professional potential of otorhinolaryngologists within the framework of national security strategy in the field of public health. The pilot approbation was carried out in February-December 2023 by means of quantitative sociological on-line survey of 627 otorhinolaryngologists from 32 subjects of the Russian Federation. The results of sociological survey permit to obtain valuable data to detect problematic aspects of activity of physician. To standardize survey data processing, automated system of collection and processing of information was developed. The proposed evaluation algorithm was successfully adapted for other profiles of medical care and taken as basis of methodology of studying professional potential of specialists of different profiles.

The purpose of the study is to consider social immunity as integral component of social health. It is determined that scientists recognize importance of natural, anthropogenic and social conditions of human residence for preservation and improvement of health. At that, most often life-style, professional activities, nutrition, physical activity and ecology are considered. However, it is noted that no less important for human health, especially for its social component, are influences of social environment, as well as stability and resistance of social subject itself to negative impacts of alien socio-cultural systems. It is indicated that non-medical influences have daily impact on human social health. They originate from wide spectrum of social institutions that shape everyday life (authorities, family, education, sport, employment, culture). It is established that social immunity is a component of social health. It consists in human ability to recognize and to resist negative impacts coming from alien socio-cultural environment as an attempt of intrusion of alien images, norms, goals, values. The conclusion is made that social immunity acts as component of social health of every individual and thus it serves to ensure demographic security of entire country.

The article considers state of nutrition of population of the USSR during post-war recovery period in 1949-1954 after cancellation of standardized distribution of food cards and implementation of currency reform in 1948.The constant annual increase of quantity and quality of ingested food up to end of studied period is demonstrated. The explanations are given to contradictory assessments by various researchers of efficiency of measures implemented by authorities to improve dietary intake of citizens. It is established that characteristic given by authors, in many respects, is determined by time of study, availability of declassified archives, timeserving to dominated in those years of total negative attitude to Stalinism, proclaimed by N. S. Khrushchev. It is emphasized that administrative command method applied in establishing organization of diet of working population, for all its shortcomings, judging by results, allowed people with every following year to buy more food, was at the same time rather effective. The expectations of population related to hope of better life after devastating war, were reinforced annually by decreasing of prices of consumer goods and increasing of incomes of majority of population, having fair character. The people bringing maximal benefit to society - researchers, physicians, teachers - had more opportunities to consume balanced food. At the same time, even low-paid workers could afford oneself to buy high-calorie products. Despite constant improvement of nutrition structure, content of macro- and micro-nutrients in food did not meet requirements for saturating organism with full-fledged ingredients (proteins, carbohydrates, fats, vitamins). It is proved that Soviet model of development as exemplified by its implementation in sphere of nutrition of population was accepted by society in 1940s-1950s and requires further investigation and pondering to applied best Soviet practices nowadays.

In Russia, increases morbidity of myocardial infarction. The statistics of recent years demonstrate failure in meeting target indicators of national programs on reducing number of deaths from this disease. At that, able-bodied population is in high risk zone and their professional activity is under influence of large combination of risk factors of myocardial infarction. This risk area covers profession of seafarer that is characterized by irregular work schedule, high levels of stress and mental tension, low physical activity or, contrariwise, increased working loads, unbalanced diet, isotherm stress and interaction with harmful substances. Besides that, situation is aggravated by limited set of first medical aid measures at exacerbation of disease in view of remoteness from hospitalization centers. Thus, considering high mortality rate from myocardial infarction, it is extremely important for ship crews to have full and timely information about diagnostic, symptomatic and prevention of this disease. The article examines statistics data of morbidity and mortality of myocardial infarction in population of the Russian Federation on the basis of Rosstat data and target indicators of the National project "Health Care". The risk factors of myocardial infarction established by INTERHEART studies are analyzed. The specifics of work conditions of crew members of marine vessels are established. The collection of professional modifying risk factors was selected. The recommendations for their correction were developed to enhance efficiency of primary preventive measures and to decrease morbidity and mortality among seafarers.

The purpose of the study is to analyze demand in medical care at diseases of circulatory system in women in age groups of 50-64 years old. The database of cases of medical care support of population age groups 50-64 years (the database of calls of Territorial Foundation of Mandatory Medical Insurance of the Moscow region) was used as primary information source. After correlation analysis of dependencies between indicators of demand in modeling, four indicators were left, three of them were volumetric and one frequency. Three blocks were used as basic causes included in Class IX "Diseases of the circulatory system" (ICD-10 version 2014-2016): 1. I10-I15 (Hypertensive diseases [Diseases characterized by high blood pressure]); 2. I20-I25 (Coronary heart disease); 3. I60-I69 (Cerebrovascular diseases). The study demonstrated that dynamics of frequency and volume indicators of medical care demand among women in age groups of 50-64 years testifies that in age range of 50-60 years there is linear or close to linear increase of demand, after which trend of increasing demand changed to downward one. The data obtained testify that age (as variable) explains considerable proportion of all fluctuations of volume of medical care in demand in women of 50-64 years. This result can be considered quite satisfactory for applying proposed model in planning volumes of medical care. It is noted that decreasing of demand increase rate is observed at age of termination of employment of majority of female population.

The market of medical devices within the framework of the Eurasian Economic Union is regulated by special legislation that ensures formation of common market and compliance of products with all necessary requirements. This allows to ensure high level of quality of medical equipment and articles that contributes into improving safety and efficiency of medical procedures. The development of uniform requirements, considering world practices, is an important step, since it allows to guarantee high standards not only at level of single states, but also at level of the entire Union. This approach facilitates reinforcement of confidence to medical production of manufacturers from he Eurasian Economic Union countries. The article examines normative legal base regulating issues of formation and functioning of common market of medical equipment and articles within the framework of the Eurasian Economic Union. The analysis of normative legal base of the Russian Federation in section related to medical articles market was carried out. The analysis of the regulatory framework of the Russian Federation in terms of issues related to the market of medical devices was also carried out. The corresponding conclusions were made based on the study results.

The AI technologies are more and more widely implemented into modern health care. the mobile medical applications permit to monitor course of chronic diseases and form healthier behavior in patients, to reduce number of visits to medical organizations and to improve accessibility of medical care for limited mobile patients. However, actually there are number of problems limiting implementation of AI into functioning of health services. The article discusses problems associated with computer technologies themselves and medical research using them. The ethical nuances of widespread application of AI are described. The modes of overcoming existing disadvantages of computer and mobile health care are proposed.

The article considers role and specifics of professional competencies of employees of medical public organizations providing vital medical and social services to vulnerable groups of population having no access to necessary care due to financial difficulties, geographical isolation, natural disasters and other causes. It is noted that employees of such organizations have unique set of professional competencies permitting them to effectively function in conditions of limited resources and unstable circumstances. The importance of interdisciplinary interaction, cultural competence, ethicality and legal awareness of employees.

The article analyzes age dynamics of initial causes of death according to records in medical death certificates of population of older age groups. Materials and methods. The records of causes of death of 34.914 persons aged 60 years and older were used as primary source of information. The initial cause of death was determined according to the ICD-10 rules. The rate of registration by reason of death was calculated as intensive value per 100 deaths in concrete age and sex group. Each cause was coded according to the ICD-10 rules (revision 2014-2016). The belonging to group was determined by first character (letter) in four-digit code that corresponded to the Class. On the basis of analysis of structure of causes of death, the group A of causes that included five Classes of ICD-10, determined 81.4% of all deaths in population aged 60 years and older. Two Classes: "Diseases of the circulatory system" (Class IX) and "Neoplasms" (Class II) determine in all studied age groups more than a half of all deaths (from 55% to 71% of males and from 59% to 67% in females) and namely they determine mortality rate in older age groups. There are no gender differences in age characteristics of registration rate in these groups (p > 0.05), however age dynamics differ. In case of diseases of circulatory system initial cause of death is increase rate of registration at increasing of age. In case of neoplasms at increasing of age decrease of registration rate as initial cause of death is established. At that, rate of decline is higher than rate of increase that determines certain decrease of structural significance of combined contribution of these two groups of causes at increasing of age. The Group B of causes, including three Classes of ICD-10 "Respiratory diseases" (Class X), "Diseases of the digestive system" (Class XI) and "Diseases of the nervous system" (Class VI), determined in overall 11.9% of all deaths in population aged 60 years and older. The age dynamics of causes of death of population of older age groups exists for certain groups of causes and it should be considered in organizing medical care of population of older age groups.

Nowadays, the reforming of health care system in the Russian Federation is the most actual since country survives difficult economic conditions and is in need of development of new enhanced scientific and methodological approaches to various aspects of public health and health care, targeting increase of all types of efficiency in this system (medical, social, economic ones). For proper functioning of health care system, not only physicians, but also such specialists as physicists, engineers, mathematicians, biologists, chemists, lawyers, economists, psychologists, teachers and others are to be involved in process of developing new approaches. The multidisciplinary approach and effective interdisciplinary interaction can input into improvement of health care system based on needs of patients. To achieve the highest benefit for patient, development of comfortable conditions for all participants of diagnostic and treatment process, appropriate quality of medical care and maximal level of satisfaction of subjects in given system, it is necessary to consider segmentation of medical services market i.e. characteristics of consumers and providers. The systematic approach is to be applied to achieve this target, involving organizations of private and public sector of practical health care and scientific and educational organizations. it is needed to develop methods of early diagnostic, disease prevention programs and training of personnel in health care system, taking into account approaches of integrative and preventive medicine.