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Analysis of the structure of the information field of perception of risk factors for non-communicable diseases 非传染性疾病风险因素感知信息领域结构分析
Pub Date : 2024-07-01 DOI: 10.21045/2782-1676-2024-4-2-41-51
V. Buzin
When studying the attitude of the population to saving their own health, the question of the connection between abstract knowledge about the harm caused to health by risk factors and a real understanding of the harm caused by these factors to their own health remains poorly understood.The purpose of this work is to analyze the structure of the information field of the population’s attitude to the impact of FR on health.Materials and methods. The material for the analysis was the results of a sociological survey in three pilot regions of the Russian Federation – Tula Region, Stavropol Territory and the Republic of Crimea. The questionnaire consisted of 33 questions concerning risk factors and their impact on the human body and a block of questions concerning sources of medical information and trust in them. The sample size was 1,718 respondents. The following methods were used: descriptive statistics and the sociological method of questioning. Statistical data processing and reweighing were carried out in the statistical data processing package SPSS22.0. In general, the sampling error in the study does not exceed 1.99% for a confidence level of p<0.1.Results. The study showed that abstract knowledge about the harm of a particular FR in almost all FR is quite high, since it is precisely on them that the efforts of the medical community have been directed in recent decades. Moreover, the highest values are expected to have such factors as tobacco use, alcohol consumption, elevated blood sugar (glucose) and high blood pressure. The level of knowledge of the harm of FR, to which the medical community paid less attention, was expected to be lower. The lowest value is such a FR as a low iodine content in salt, which is consumed in food. An assessment of the relationship of variables such as abstract knowledge of harm about FR and understanding of their harm to one’s body using a two-way T-criterion showed that these variables are completely independent of each other at the significance level p<0.001. This result made us look more closely at the factor structure of the studied field of reality and put forward the assumption of independence of knowledge about the harm caused to the human body by FR and behavioral patterns in relation to FR. As a result of factor analysis of 73 variables, 9 factors were identified: the first and most powerful factor (10.33%) – knowledge of the effect of FR on one’s own health; the second most powerful factor (8.71%) – knowledge of the harm of FR; the third highlighted factor (5.46%) – trust in information sources, which included both trust in the media and trust in TV presenters, popular personalities and trust in the leaders of the region and the city; the fourth highlighted factor (4.67%) is the gender characteristics of the control of the FR by the population; the fifth highlighted factor (4.59%) is the sources of information about the FR; the sixth highlighted factor (4.30%) – age–related features of FR control; the se
在研究居民对挽救自身健康的态度时,人们对风险因素对健康造成危害的抽象认识与对这些因素对自身健康造成危害的真正理解之间的联系问题仍然知之甚少。分析材料是在俄罗斯联邦三个试点地区--图拉州、斯塔夫罗波尔边疆区和克里米亚共和国--进行的社会学调查的结果。调查问卷包括 33 个有关风险因素及其对人体影响的问题,以及一组有关医疗信息来源及其信任度的问题。样本容量为 1 718 名受访者。采用了以下方法:描述性统计和社会学提问法。统计数据的处理和再权衡在统计数据处理软件包 SPSS22.0 中进行。一般来说,在置信度为 p<0.1 的情况下,本研究的抽样误差不超过 1.99%。研究结果表明,几乎所有联邦登记处对特定联邦登记处危害的抽象认识都相当高,因为近几十年来医学界的努力正是针对这些联邦登记处。此外,烟草使用、饮酒、血糖(葡萄糖)升高和高血压等因素的预期值最高。而医学界关注较少的对 FR 危害的认识水平预计较低。最低值是食盐中碘含量低这样的 FR。使用双向 T 标准对有关食品污染物危害的抽象知识和对其对人体危害的理解等变量之间的关系进行的评估表明,这些变量之间是完全独立的,显著性水平为 p<0.001。这一结果使我们对所研究的现实领域的因子结构有了更深入的了解,并提出了关于 "FR 对人体危害的认识 "和 "与 FR 有关的行为模式 "具有独立性的假设。在对 73 个变量进行因子分析后,确定了 9 个因子:第一个也是最有力的因子(10.33%)--对阻燃剂对自身健康影响的了解;第二个最有力的因子(8.71%)--对阻燃剂危害的了解;第三个突出因子(5.46%)--对信息来源的信任,包括对媒体的信任和对电视主持人、名人的信任,以及对地区和城市领导的信任;第四个突出因子(4.67%)--居民的性别特征。第六个突出因素(4.30%)--与年龄有关的 FR 控制特征;第七个突出因素(3.32%)--使用小工具控制 FR 和锻炼;第八个突出因素(3.00%)--对作为信息来源的卫生工作者的信任;第九个突出因素(2.59%)--吸烟和饮酒。在本次研究框架内,受访者对阻燃剂对自身健康影响的评估结果明显低于对这些阻燃剂有害影响的抽象认识。对所研究领域的因素结构进行的分析表明,根据 "本身的知识 "和 "为自己的知识 "这 两种知识形式对知识进行划分是正确的。通过分析,可以提出一些提高人口预防工作有效性的条件,包括扩大人口预防的影响: 必须更积极地让最重要的人口来源--医务工作者、科学医务工作者和卫生管理人员--参 与进来;在预防措施中更充分地考虑受众的性别和年龄特征;在使用大众媒体之前,应分析目 标受众对大众媒体的信任程度;必须首先检查信息本身是否易记。预防措施应改变特定人群对 FR 和 HLS 的个人理解,而不仅仅局限于对它们的一般认识。这项研究还让我们确定了进一步研究民众对联邦登记处及其自身健康的态度的方向,这是一项跨学科的任务,需要医学和普通心理学、人格心理学和动机心理学专家以及社会学家的参与。
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引用次数: 0
The problem of payment for short-term treatment in an inpatient emergency department: analysis and simulation modeling 住院急诊科短期治疗的付费问题:分析和模拟模型
Pub Date : 2024-07-01 DOI: 10.21045/2782-1676-2024-4-2-52-60
V. Teplov, V. V. Stozharov, E. A. Tsebrovskaya, A. A. Korshunova, V. V. Burykina, K. R. Enikeeva, S. Bagnenko
The purpose of the study: to conduct a clinical and economic analysis of the treatment effectiveness of the patients with a therapeutic profile, depending on the presence of an inpatient emergency department in the structure of the medical organization. Materials and methods. With the help of a retrospective analysis of 474 cases of hypertension worsening during the year, patients length of stay in the hospital, the amount of bills issued depending on the length of stay and the compliance of the conducted volume of examination with the requirements of the criteria for the quality of medical care were studied. Subsequently, using simulation modeling, a comparative analysis of the redistribution of patient flows was performed in order to identify optimal economic and logistical solutions. Results. When comparing the length of stay of patients, it was revealed that in 63.9% of cases, discharge occurred from dynamic observation beds during the first day. The analysis of compliance with the criteria for the quality of medical care showed that in the inpatient emergency department, almost the entire required amount of diagnosis and treatment is performed in a minimum period of time. If there is an inpatient emergency department in the hospital structure, the work model becomes significantly more intensive, but underfunded. Conclusion. The capabilities of inpatient emergency departments ensure short-term treatment of patients in compliance with the quality criteria of specialized care, while maintaining a large throughput compared to the therapeutic department. Based on the results obtained, the payment of cases should not be accompanied by the use of a sign of interruption of the case.
研究目的:根据医疗组织结构中是否设有住院急诊科,对具有治疗特征的患者的治疗效果进行临床和经济分析。材料和方法。在对当年 474 例高血压恶化病例进行回顾性分析的帮助下,研究了患者的住院时间、根据住院时间开具的账单金额以及所进行的检查量是否符合医疗质量标准的要求。随后,利用模拟模型对病人流量的重新分配进行了比较分析,以确定最佳的经济和后勤解决方案。研究结果在比较病人的住院时间时发现,63.9%的病例在第一天就从动态观察床出院了。对医疗质量标准遵守情况的分析表明,在急诊住院部,几乎所有必要的诊断和治疗都是在最短的时间内完成的。如果医院结构中设有住院急诊科,工作模式就会大大加强,但资金不足。结论与治疗科室相比,住院急诊科的能力可确保在符合专业护理质量标准的情况下对病人进行短期治疗,同时保持较大的吞吐量。根据得出的结果,在支付病例费用的同时,不应使用中断病例的标志。
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引用次数: 0
Key trends in the development of global public health: 2021–2023 全球公共卫生发展的主要趋势:2021-2023 年
Pub Date : 2024-07-01 DOI: 10.21045/2782-1676-2024-4-2-4-17
L. A. Tsvetkova, F. A. Kurakov, R. L. Karmina
The purpose of the study was to create a list of key thematic trends in the subject area “public health” that had taken shape by the end of 2023. Achieving the goal involved solving two tasks: a review of foreign publications devoted to the analysis of key topics in public health in 2021–2023; and the generation and analysis of a sample of the most cited publications in the internationalized public health segment over the same period.Materials and methods. The formation of a collection of foreign publications devoted to the analysis of trends in the subject area “public health” for the period 2021–2023 was carried out using the PubMed search engine and the query (“TREND*”) AND (“PUBLIC HEALTH”). 59 most relevant publications were selected for review. To create a collection of highly cited publications in the internationalized segment in the field of public health, recorded in research fronts based on the results of 2023, the Clarivate analytical resource – Essential Science Indicators (ESI) was used.Research results. Integration of the results of two stages of the study (expert assessments and the thematic landscape of a sample of the most cited publications in the field of public health) revealed a complete coincidence of 7 out of 10 trends in the development of public health at the present stage. The frontiers of the thematic area under study included the following thematic areas: the sustainability of national health systems (1), the increase in the number of mental disorders (2), the increase in the use of psychoactive substances (3), the impact of climate change on morbidity (4), the impact of environmental pollution on morbidity (5), healthy eating and food safety (6), aging population (7), sexual and reproductive health disorders (8), road traffic injuries (9), digital transformation of health (10), cancer (11), diseases of the cardiovascular system (12), an increase in infectious morbidity (13).
这项研究的目的是编制一份到 2023 年底 "公共卫生 "主题领域形成的主要专题趋势清单。实现这一目标需要完成两项任务:对 2021-2023 年专门分析公共卫生关键主题的外国出版物进行审查;生成并分析同期国际化公共卫生领域被引用次数最多的出版物样本。利用 PubMed 搜索引擎和查询("TREND*")和("PUBLIC HEALTH"),收集了专门分析 2021-2023 年期间 "公共卫生 "主题领域趋势的外国出版物。选择了 59 篇最相关的出版物进行审查。为了收集公共卫生领域国际化部分的高引用率出版物,并根据 2023 年的结果记录在研究前沿,使用了 Clarivate 分析资源--基本科学指标(ESI)。综合两个阶段的研究成果(专家评估和公共卫生领域被引用次数最多的出版物样本的主题景观)发现,现阶段公共卫生发展的 10 个趋势中有 7 个完全吻合。所研究的专题领域的前沿包括以下专题领域:国家卫生系统的可持续性(1)、精神疾病数量的增加(2)、精神活性物质使用的增加 (3)、气候变化对发病率的影响(4)、环境污染对发病率的影响(5)、健康饮食和食品安全(6)、人口老龄化(7)、性健康和生殖健康疾病(8)、道路交通 伤害(9)、卫生数字化转型(10)、癌症(11)、心血管系统疾病(12)、传染病发病率上升 (13)。
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引用次数: 0
The impact of tobacco consumption on the individual and population risk of non-communicable diseases in the Russian Federation 烟草消费对俄罗斯联邦个人和人口非传染性疾病风险的影响
Pub Date : 2024-07-01 DOI: 10.21045/2782-1676-2024-4-2-18-31
O. Salagay, N. S. Antonov, G. M. Sakharova, N. M. Stadnik
The aim of the study was to assess the individual and population risks of 20 non-communicable diseases (NCD) among the adult population of the Russian Federation.Materials and methods. The study used a database of Selective monitoring of the health status of the population conducted by Rosstat in 2023. To estimate the association of tobacco consumption with NCD, two groups were analyzed: current tobacco users and people who have never used tobacco. The prevalence of tobacco use and nicotine dependence were calculated. The relationship between tobacco consumption and development of disease was assessed using individual relative risk (RR), as well as age-adjusted RR (RRv) and nicotine dependence-adjusted RR (RRn). The impact of tobacco consumption on public health was assessed using population attributive risk.Results. The prevalence of tobacco/nicotine consumption in 2023 was 21.3% among the adults, 35.0% among men and 10.2% among women. Nicotine dependence of moderate and higher degree was detected in 16.7% of the total adult population, 28.9% of men and 6.9% of women. When assessing RRv, tobacco was identified as a risk factor for only five diseases. RRn assessment revealed 13 diseases for which tobacco was a risk factor with a dose-dependent effect. For most of these diseases, RR in women was higher than in men.Conclusion. Tobacco is a strong risk factor for the most of NCD. In the population in 2013, at least 3–11% of additional cases of NCD was associated with tobacco that could be prevented by tackle of the tobacco consumption.
该研究旨在评估俄罗斯联邦成年人口中 20 种非传染性疾病(NCD)的个人和人群风险。研究使用了俄罗斯国家统计局于 2023 年开展的人口健康状况选择性监测数据库。为估算烟草消费与非传染性疾病的关系,对两组人群进行了分析:目前的烟草使用者和从未使用过烟草的人群。对烟草使用率和尼古丁依赖性进行了计算。使用个体相对风险 (RR)、年龄调整 RR (RRv) 和尼古丁依赖调整 RR (RRn) 评估烟草消费与疾病发生之间的关系。烟草消费对公共卫生的影响采用人群归因风险进行评估。2023 年成年人的烟草/尼古丁消费流行率为 21.3%,其中男性为 35.0%,女性为 10.2%。中度及以上尼古丁依赖者占成年总人口的 16.7%,其中男性占 28.9%,女性占 6.9%。在评估 RRv 时,烟草仅被确定为 5 种疾病的风险因素。RRn评估显示,有13种疾病的烟草风险因素具有剂量依赖性。在大多数疾病中,女性的 RR 均高于男性。烟草是大多数非传染性疾病的强风险因素。在2013年的人口中,至少有3-11%的非传染性疾病新增病例与烟草有关,而这些病例是可以通过解决烟草消费问题来预防的。
{"title":"The impact of tobacco consumption on the individual and population risk of non-communicable diseases in the Russian Federation","authors":"O. Salagay, N. S. Antonov, G. M. Sakharova, N. M. Stadnik","doi":"10.21045/2782-1676-2024-4-2-18-31","DOIUrl":"https://doi.org/10.21045/2782-1676-2024-4-2-18-31","url":null,"abstract":"The aim of the study was to assess the individual and population risks of 20 non-communicable diseases (NCD) among the adult population of the Russian Federation.Materials and methods. The study used a database of Selective monitoring of the health status of the population conducted by Rosstat in 2023. To estimate the association of tobacco consumption with NCD, two groups were analyzed: current tobacco users and people who have never used tobacco. The prevalence of tobacco use and nicotine dependence were calculated. The relationship between tobacco consumption and development of disease was assessed using individual relative risk (RR), as well as age-adjusted RR (RRv) and nicotine dependence-adjusted RR (RRn). The impact of tobacco consumption on public health was assessed using population attributive risk.Results. The prevalence of tobacco/nicotine consumption in 2023 was 21.3% among the adults, 35.0% among men and 10.2% among women. Nicotine dependence of moderate and higher degree was detected in 16.7% of the total adult population, 28.9% of men and 6.9% of women. When assessing RRv, tobacco was identified as a risk factor for only five diseases. RRn assessment revealed 13 diseases for which tobacco was a risk factor with a dose-dependent effect. For most of these diseases, RR in women was higher than in men.Conclusion. Tobacco is a strong risk factor for the most of NCD. In the population in 2013, at least 3–11% of additional cases of NCD was associated with tobacco that could be prevented by tackle of the tobacco consumption.","PeriodicalId":507323,"journal":{"name":"Public Health","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of organizational and legal measures and new practices to against HIV infection in the Novosibirsk region 新西伯利亚州预防艾滋病毒感染的组织措施、法律措施和新做法的有效性
Pub Date : 2024-07-01 DOI: 10.21045/2782-1676-2024-4-2-61-68
D. V. Kapustin, L. Pozdnyakova, E. I. Krasnova, N. I. Khokhlova, A. K. Tsoi, N. I. Shulgina, Yu. A. Stashevskay
The purpose of the study: to study the effectiveness of organizational and legal measures and new practices to against HIV infection introduced in the Novosibirsk region in 2019–2022.Materials and methods. The study was conducted on the basis of the State Medical Institution of the NGO «City Infectious Clinical Hospital No. 1», a division of the Center for the Prevention and Control of AIDS.Results. By Order of the Ministry of Health of the Novosibirsk Region No. 3429 of 10/15/2019, mandatory HIV screening was provided for all hospitalized with unknown HIV status during the year, which significantly increased the coverage of HIV screening. In 2019–2022, an AIDS Center information system was introduced for all patients with HIV infection admitted to inpatient treatment: 6,938 notifications were sent to the AIDS Center. Of the 2,717 patients who required measures to increase the level of adherence and involvement in ART, 18.9% of patients resumed ART after the measures taken; 36.5% started taking ART for the first time. The order of the State Medical Institution of the Infectious Clinical Hospital № 247 «On the organization of family support in the department «Center for the Prevention and Control of AIDS» dated 02.08.2021 provides the principle of monitoring the whole family with one doctor, which improves the adherence of children and parents to ART. For 4 months of functioning of family support, the share of parents receiving ART and having a high commitment increased from 15.5% to 77.3%. Among 45 children who had a previously determined level of HIV RNA viral load on the background of ART, 20% (9 abs.) registered an undetectable level of viral load for 3 months, and 13.3% (6 abs.) – for 2 months.Conclusion. The organizational and legal measures implemented in 2019–2022 in the Novosibirsk region and new practices to combat HIV infection have shown high efficiency: the coverage of dispensary observation of patients with HIV infection increased from 79.3% to 86.5%, and the coverage of antiretroviral therapy – from 74.5% to 85.2%.
研究目的:研究 2019-2022 年新西伯利亚州预防艾滋病毒感染的组织、法律措施和新做法的有效性。研究在非政府组织 "市第一传染病临床医院 "国家医疗机构(艾滋病预防与控制中心下属机构)的基础上进行。根据新西伯利亚州卫生部2019年10月15日第3429号命令,本年度对所有艾滋病毒感染状况不明的住院病人进行强制性艾滋病毒筛查,这大大提高了艾滋病毒筛查的覆盖率。2019-2022年,针对所有住院治疗的艾滋病毒感染者引入了艾滋病中心信息系统:向艾滋病中心发送了 6938 份通知。在需要采取措施提高抗逆转录病毒疗法依从性和参与程度的 2 717 名患者中,18.9%的患者在采取措施后恢复了抗逆转录病毒疗法;36.5%的患者首次开始服用抗逆转录病毒疗法。2021 年 8 月 2 日国家传染病临床医院第 247 号 "关于在'艾滋病预防和控制中心'部门组织家庭支持" 的命令规定了由一名医生对整个家庭进行监测的原则,这提高了儿童和父母坚持抗逆转录病毒疗法的程度。在家庭支助运作的 4 个月中,接受抗逆转录病毒疗法并做出高度承诺的父母比例从 15.5%增至 77.3%。在抗逆转录病毒疗法背景下,45 名儿童的艾滋病毒 RNA 病毒载量水平先前已确定,其中 20%(9 例)的病毒载量在 3 个月内检测不到,13.3%(6 例)的病毒载量在 2 个月内检测不到。新西伯利亚州 2019-2022 年实施的组织和法律措施以及抗击艾滋病毒感染的新做法显示出很高的效 率:对艾滋病毒感染者进行诊室观察的覆盖率从 79.3%增至 86.5%,抗逆转录病毒疗法的覆盖率从 74.5% 增至 85.2%。
{"title":"Effectiveness of organizational and legal measures and new practices to against HIV infection in the Novosibirsk region","authors":"D. V. Kapustin, L. Pozdnyakova, E. I. Krasnova, N. I. Khokhlova, A. K. Tsoi, N. I. Shulgina, Yu. A. Stashevskay","doi":"10.21045/2782-1676-2024-4-2-61-68","DOIUrl":"https://doi.org/10.21045/2782-1676-2024-4-2-61-68","url":null,"abstract":"The purpose of the study: to study the effectiveness of organizational and legal measures and new practices to against HIV infection introduced in the Novosibirsk region in 2019–2022.Materials and methods. The study was conducted on the basis of the State Medical Institution of the NGO «City Infectious Clinical Hospital No. 1», a division of the Center for the Prevention and Control of AIDS.Results. By Order of the Ministry of Health of the Novosibirsk Region No. 3429 of 10/15/2019, mandatory HIV screening was provided for all hospitalized with unknown HIV status during the year, which significantly increased the coverage of HIV screening. In 2019–2022, an AIDS Center information system was introduced for all patients with HIV infection admitted to inpatient treatment: 6,938 notifications were sent to the AIDS Center. Of the 2,717 patients who required measures to increase the level of adherence and involvement in ART, 18.9% of patients resumed ART after the measures taken; 36.5% started taking ART for the first time. The order of the State Medical Institution of the Infectious Clinical Hospital № 247 «On the organization of family support in the department «Center for the Prevention and Control of AIDS» dated 02.08.2021 provides the principle of monitoring the whole family with one doctor, which improves the adherence of children and parents to ART. For 4 months of functioning of family support, the share of parents receiving ART and having a high commitment increased from 15.5% to 77.3%. Among 45 children who had a previously determined level of HIV RNA viral load on the background of ART, 20% (9 abs.) registered an undetectable level of viral load for 3 months, and 13.3% (6 abs.) – for 2 months.Conclusion. The organizational and legal measures implemented in 2019–2022 in the Novosibirsk region and new practices to combat HIV infection have shown high efficiency: the coverage of dispensary observation of patients with HIV infection increased from 79.3% to 86.5%, and the coverage of antiretroviral therapy – from 74.5% to 85.2%.","PeriodicalId":507323,"journal":{"name":"Public Health","volume":"11 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Features of the procedure for assessing the ability to drive a vehicle of drivers previously deprived of their rights for driving a vehicle while intoxicated: a qualitative study 曾因醉酒驾驶车辆而被剥夺权利的驾驶员驾驶车辆能力评估程序的特点:定性研究
Pub Date : 2024-07-01 DOI: 10.21045/2782-1676-2024-4-2-32-40
A. Masyakin, I. A. Bedina, E. Y. Kharitonenkova, A. S. Sazonova, I. Bedina
Objective: identification of significant factors influencing the decision of a psychiatrist-narcologist to allow a driver to drive a vehicle (vehicle) during a medical examination related to the restoration of the right to drive a vehicle. Materials and methods. A series of in-depth interviews with psychiatrists and narcologists was conducted to study the existing problems they face when conducting a medical examination of vehicle drivers related to the restoration of the right to drive a vehicle. Results. When conducting an examination of drivers who were previously deprived of their rights for driving a vehicle while intoxicated, psychiatrists and narcologists tend to be subjective. The degree of perceived risk from making a wrong decision based on the results of this procedure is lower in comparison with an erroneous conclusion when obtaining a certificate for a weapon. Despite the possibility of atracting additional resources when assessing the suitability of drivers, psychiatrists and narcologists tend to avoid making decisions on their own and delegate the conclusion to other specialists. The specifics of the organization of this procedure may have a negative impact on the attitude of the examinee to the doctor (the phenomenon of discrediting the status of a doctor). Conclusion. It is necessary to develop additional diagnostic criteria to the current ones, which must be met by a driver “going through” the procedure for restoring a driver’s license. This is primarily applicable in situations where the laboratory diagnostic method gives a negative result, but the patient’s condition, however, raises doubts among the specialist. There is a need to create a unified algorithm for the examination route map if additional diagnostically significant examination of the patient is necessary.
目的:确定影响精神科-麻醉科医生在与恢复驾驶车辆权利有关的体检中决定是否允许驾驶车辆(车辆)的重要因素。材料和方法对精神科医生和麻醉科医生进行了一系列深入访谈,以研究他们在对车辆驾驶员进行与恢复驾驶车辆权利有关的体检时所面临的现有问题。结果。在对曾因醉酒驾驶车辆而被剥夺权利的驾驶员进行体检时,精神科医生和麻醉科医生倾向于主观臆断。与获得武器证书时的错误结论相比,根据这一程序的结果做出错误决定的风险程度较低。尽管在评估驾驶员是否合适时有可能获得额外的资源,但精神科医生和麻醉科医生倾向于避免自己做出决定,而是将结论委托给其他专家。这一程序的具体组织方式可能会对受检者对医生的态度产生负面影响(抹黑医生身份的现象)。结论有必要在现有诊断标准的基础上制定额外的诊断标准,驾驶员 "通过 "恢复驾驶执照的程序 时必须满足这些标准。这主要适用于实验室诊断方法得出阴性结果,但病人的情况却引起专家怀疑的情况。如果有必要对患者进行诊断意义重大的额外检查,则有必要制定统一的检查路线图算法。
{"title":"Features of the procedure for assessing the ability to drive a vehicle of drivers previously deprived of their rights for driving a vehicle while intoxicated: a qualitative study","authors":"A. Masyakin, I. A. Bedina, E. Y. Kharitonenkova, A. S. Sazonova, I. Bedina","doi":"10.21045/2782-1676-2024-4-2-32-40","DOIUrl":"https://doi.org/10.21045/2782-1676-2024-4-2-32-40","url":null,"abstract":"Objective: identification of significant factors influencing the decision of a psychiatrist-narcologist to allow a driver to drive a vehicle (vehicle) during a medical examination related to the restoration of the right to drive a vehicle. Materials and methods. A series of in-depth interviews with psychiatrists and narcologists was conducted to study the existing problems they face when conducting a medical examination of vehicle drivers related to the restoration of the right to drive a vehicle. Results. When conducting an examination of drivers who were previously deprived of their rights for driving a vehicle while intoxicated, psychiatrists and narcologists tend to be subjective. The degree of perceived risk from making a wrong decision based on the results of this procedure is lower in comparison with an erroneous conclusion when obtaining a certificate for a weapon. Despite the possibility of atracting additional resources when assessing the suitability of drivers, psychiatrists and narcologists tend to avoid making decisions on their own and delegate the conclusion to other specialists. The specifics of the organization of this procedure may have a negative impact on the attitude of the examinee to the doctor (the phenomenon of discrediting the status of a doctor). Conclusion. It is necessary to develop additional diagnostic criteria to the current ones, which must be met by a driver “going through” the procedure for restoring a driver’s license. This is primarily applicable in situations where the laboratory diagnostic method gives a negative result, but the patient’s condition, however, raises doubts among the specialist. There is a need to create a unified algorithm for the examination route map if additional diagnostically significant examination of the patient is necessary.","PeriodicalId":507323,"journal":{"name":"Public Health","volume":"288 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of public health infrastructure and medical prevention in the Russian Federation in the period 2013–2022 2013-2022 年期间俄罗斯联邦公共卫生基础设施和医疗预防分析
Pub Date : 2024-03-18 DOI: 10.21045/2782-1676-2024-4-1-4-17
O. Salagay, E. I. Borichevskaya
The main strategic element of the system being formed, designed to solve preventive tasks at the regional and mu­nicipal level, has become Center for Public Health and Medical Prevention (COSiMP). The article provides an analysis of the activities of the COSiMP for the period 2013–2022 in the Russian Federation and offers recommendations for its improvement. Materials and methods. The analysis includes the structure of the COSiMP; material and technical equipment; dynamics of personnel training in the context of individual categories, sociological research, number and staffing, funds received for preventive work with the population, circulation of publications published by the COSiMP; mass work and advisory and recreational activities of the Center. The data on the activities of the COSiMP were an­alyzed according to the reporting form No. 70 for the period 2013–2022. The specifics of the COSiMP activity were assessed by calculating the median value of the indicator for the corresponding year, as well as the percentage of changes in this indicator against another period. Results. The total number of structural divisions in the COSiMP has changed slightly: from 560 in 2013 to 547 in 2022. After the reform of the medical prevention system carried out by the Ministry of Health of Russia in 2020, public health and medical prevention centers with a fundamentally different structure were formed in the regions. During the period 2013–2022, a slight increase in full-time positions in the CSIMP was revealed from 3720 to 3771, respectively. From 2013 to 2022, the number of trained students increased by 31.7%, but the number of trained physicians decreased by 45.3%. Conclusion. During the studied period, the COSiMP underwent serious changes. The growth in the number of programs and projects implemented by the Cen­ters, the impressive volume of mass work carried out shows the demand for these medical organizations. However, the statistical form used to collect the necessary information about the activities of the COSiMP has been de-actual­ized to date and does not comply with the main provisions of the acts regulating the activities of these organizations.
正在形成的旨在解决地区和市级预防任务的系统的主要战略要素已成为公共卫生和医疗预防中心(COSiMP)。文章对 COSiMP 在 2013-2022 年期间在俄罗斯联邦开展的活动进行了分析,并提出了改进建议。材料和方法。分析内容包括:COSiMP 的结构;物质和技术装备;个人类别、社会学研究、数量和人员编制方面的人员培训动态;用于人口预防工作的资金;COSiMP 出版物的发行量;中心的群众工作、咨询和娱乐活动。根据第 70 号报告表对 COSiMP 2013-2022 年期间的活动数据进行了分析。通过计算相应年份的指标中值以及该指标与其他时期相比的变化百分比,对 COSiMP 活动的具体情况进行了评估。结果。COSiMP 的结构部门总数略有变化:从 2013 年的 560 个增至 2022 年的 547 个。俄罗斯卫生部于 2020 年对医疗预防系统进行改革后,各地区成立了结构截然不同的公共卫生和医疗预防中心。2013-2022 年间,俄联邦卫生和医疗预防中心的全职岗位数略有增加,分别从 3720 个增至 3771 个。从 2013 年到 2022 年,受训学生人数增加了 31.7%,但受训医生人数减少了 45.3%。结论在研究期间,COSiMP发生了严重变化。各中心实施的方案和项目数量增加,开展的群众工作数量可观,表明了对这些医疗组织的需求。然而,用于收集有关 COSiMP 活动的必要信息的统计表格至今仍未生效,不符合规范这些组织活动的法案的主要规定。
{"title":"Analysis of public health infrastructure and medical prevention in the Russian Federation in the period 2013–2022","authors":"O. Salagay, E. I. Borichevskaya","doi":"10.21045/2782-1676-2024-4-1-4-17","DOIUrl":"https://doi.org/10.21045/2782-1676-2024-4-1-4-17","url":null,"abstract":"The main strategic element of the system being formed, designed to solve preventive tasks at the regional and mu­nicipal level, has become Center for Public Health and Medical Prevention (COSiMP). The article provides an analysis of the activities of the COSiMP for the period 2013–2022 in the Russian Federation and offers recommendations for its improvement. Materials and methods. The analysis includes the structure of the COSiMP; material and technical equipment; dynamics of personnel training in the context of individual categories, sociological research, number and staffing, funds received for preventive work with the population, circulation of publications published by the COSiMP; mass work and advisory and recreational activities of the Center. The data on the activities of the COSiMP were an­alyzed according to the reporting form No. 70 for the period 2013–2022. The specifics of the COSiMP activity were assessed by calculating the median value of the indicator for the corresponding year, as well as the percentage of changes in this indicator against another period. Results. The total number of structural divisions in the COSiMP has changed slightly: from 560 in 2013 to 547 in 2022. After the reform of the medical prevention system carried out by the Ministry of Health of Russia in 2020, public health and medical prevention centers with a fundamentally different structure were formed in the regions. During the period 2013–2022, a slight increase in full-time positions in the CSIMP was revealed from 3720 to 3771, respectively. From 2013 to 2022, the number of trained students increased by 31.7%, but the number of trained physicians decreased by 45.3%. Conclusion. During the studied period, the COSiMP underwent serious changes. The growth in the number of programs and projects implemented by the Cen­ters, the impressive volume of mass work carried out shows the demand for these medical organizations. However, the statistical form used to collect the necessary information about the activities of the COSiMP has been de-actual­ized to date and does not comply with the main provisions of the acts regulating the activities of these organizations.","PeriodicalId":507323,"journal":{"name":"Public Health","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sociological analysis of the functioning of early assistance services for children under 3 years in the Krasnoyarsk Krai 对克拉斯诺亚尔斯克边疆区 3 岁以下儿童早期援助服务功能的社会学分析
Pub Date : 2024-03-18 DOI: 10.21045/2782-1676-2024-4-1-30-42
O. S. Shmeleva, D. O. Trufanov, O. M. Matveeva
The purpose of the study is a comprehensive sociological analysis of the functioning of early intervention services for children under 3 years of age in the Krasnoyarsk Territory. The tasks of the analysis include: 1) studying the structure of the early intervention service as a social organization, the functions of its elements, systemic connections and relationships between them; 2) studying the satisfaction of representatives of client families with the work of early intervention services; 3) studying the subjective perceptions of employees of early intervention services and representative’s client families about the content and meaning of the services. The authors used the methods of a sociological survey, in-depth interviews, participant observation. Based on a number of indicators, the authors concluded that early intervention services were predominantly highly effective. The article shows the problem area of the functioning of early intervention services, which lies in the difference in understanding the goals and results of working with children on the part of client families and early intervention service specialists. Specialists see as the main goal the development of functional skills by children that contribute to socialization and independence, and then the improvement, the acquisition of educational, cognitive skills. Parents often prioritize learning skills when setting class goals. This difference may reduce parental satisfaction with the results of early intervention and the effectiveness of classes. The authors revealed the dependence of the level of involvement of parents in work with children together with specialists from early intervention services on the length of service and the age of the child. The more experience and the older the child, the less parents are involved in working with children. The authors proposed a social typology of representatives of client families on the grounds of their involvement in work with children and their attitude to the results of work with a child.
本研究旨在对克拉斯诺亚尔斯克边疆区 3 岁以下儿童早期干预服务的运作情况进行全面的社会学分析。分析任务包括1) 研究作为社会组织的早期干预服务的结构、各要素的功能、系统联系以及它们之间的关系;2) 研究客户家庭代表对早期干预服务工作的满意度;3) 研究早期干预服务员工和客户家庭代表对服务内容和意义的主观看法。作者采用了社会学调查、深入访谈、参与观察等方法。根据一系列指标,作者得出结论,早期干预服务主要是非常有效的。文章指出了早期干预服务运作的问题所在,即客户家庭和早期干预服务专家对儿童工作的目标和结果的理解不同。专家们认为,主要目标是培养儿童的功能性技能,以促进其社会化和独立性,然后是提高和掌握教育、认知技能。而家长在制定班级目标时,往往把学习技能放在首位。这种差异可能会降低家长对早期干预结果和课堂效果的满意度。作者发现,家长与早期干预服务专家一起参与儿童工作的程度取决于服务时间的长短和儿童的年龄。经验越丰富、孩子年龄越大,家长参与儿童工作的程度就越低。作者根据客户家庭代表参与儿童工作的情况及其对儿童工作成果的态度,提出了客户家庭代表的社会类型。
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引用次数: 0
Social care institutions workers of the far eastern federal district awareness on HIV-infection and its significance in providing quality services and lowering self-perceived HIV risk 远东联邦区社会护理机构工作人员对艾滋病毒感染的认识及其在提供优质服务和降低自我感觉感染艾滋病毒风险方面的意义
Pub Date : 2024-03-18 DOI: 10.21045/2782-1676-2024-4-1-18-29
I. O. Taenkova, O. E. Trotsenko, L. Balakhontseva, A. A. Taenkova, E. Bazykina
Objective of the research: to reveal level of awareness and stigmatizing factors that influence service provision, to disclose self-perceived HIV risk of social care workers and a necessity of planning events targeted at increasing their competence concerning the issues of HIV-infection. Materials and methods: by the means of a structured questionnaire, a sociological research was conducted among 386 specialists of social care institutions of 6 constituent entities of the Far Eastern Federal district. Mean age of survey participants was 41.5 years, work experience – 11.2 years. Sociological (survey) and analytical research methods were utilized in the study. Results: HIV/AIDS epidemic is one of main medical and social issues of modern days. Specialists of social care institutions will inevitably meet with people living with HIV during their practice. Their insufficient awareness about HIV transmission route, stigmatization of people living with HIV cause fear and reluctance to work with such recipients of the service. Respondents rated their knowledge on the issue of HIV-infection as satisfactory in 74.7%. All participants were well aware of main routs of HIV transmission however, mother-to-child transmission was known only by 66.1% of respondents. A certain lack of knowl­edge was revealed regarding self-perceived HIV risk as well as anxiety regarding working with HIV-infected clients and high rate of alert when working with HIV-positive colleagues. However, up to 25.7% of respondents expressed their readiness to help people living with HIV. Using condoms, disposable medical instruments and personal hygiene items as well as avoiding intravenous drug use were selected by survey participants as measures of HIV-infection prevention. Conclusion: the results of the research indicate insufficient level of awareness on the issue, because of which a con­clusion can be made that there is a certain degree of stigmatization of clients living with HIV receiving social services, as well as existence of self-perceived occupational vulnerability to HIV among social workers. This reveals a necessity of further surveillance over social workers’ knowledge to define priority topics in order to increase their professional competence on the issue of HIV-infection as well as expediency of holding training seminars for specialists of social care institutions contributing to development of their practical skills in work with HIV-positive clients.
研究目的:揭示影响服务提供的认识水平和污名化因素,揭示社会护理人员自我感觉感染艾滋 病毒的风险,以及规划旨在提高其有关艾滋病毒感染问题能力的活动的必要性。材料和方法:通过结构化问卷,对远东联邦区 6 个主体的 386 名社会护理机构专家进行了社会学研究。调查参与者的平均年龄为 41.5 岁,工作年限为 11.2 年。研究采用了社会学(调查)和分析研究方法。研究结果艾滋病毒/艾滋病是当今主要的医疗和社会问题之一。社会医疗机构的专业人员在工作中不可避免地会遇到艾滋病毒感染者。他们对艾滋病毒传播途径的认识不足,对艾滋病毒感染者的污名化,导致他们害怕并不愿意与这些服务对象打交道。74.7% 的受访者认为自己对艾滋病毒感染问题的了解程度令人满意。所有参与者都非常了解艾滋病毒的主要传播途径,但只有 66.1%的受访者知道母婴传播。受访者对自我感觉感染艾滋病病毒的风险缺乏了解,在与感染艾滋病病毒的客户共事时感到焦虑,在与艾滋病病毒呈阳性的同事共事时警惕性很高。然而,高达 25.7%的受访者表示愿意帮助艾滋病毒感染者。调查参与者选择使用安全套、一次性医疗器械和个人卫生用品以及避免静脉注射毒品作为预防艾滋病毒感染的措施。结论:研究结果表明,人们对这一问题的认识水平不够,因此可以得出结论认为,接受社 会服务的艾滋病毒感染者在一定程度上会受到鄙视,而且社会工作者自我感觉在职业上容易感染 艾滋病毒。这表明有必要进一步监测社会工作者的知识,以确定优先主题,从而提高他们在艾滋病毒感染问题上的专业能力,同时有必要为社会护理机构的专家举办培训研讨会,以促进发展他们与艾滋病毒呈阳性的客户打交道的实际技能。
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引用次数: 0
Medical and social aspects of the activities of local self-government and the medical community of Yekaterinodar in the late XIX – early XX century 叶卡捷琳堡地方自治政府和医学界在十九世纪末二十世纪初的医学和社会活动
Pub Date : 2024-03-18 DOI: 10.21045/2782-1676-2024-4-1-55-63
A. Y. Ionov, I. V. Kryuchkova, I. G. Shcherbinina, A. A. Ionova
The purpose of the study: to study the medical and social aspects of the activities of public institutions of the city of Yekaterinodar in the early twentieth century, as a reflection of global trends shaping the public health system. Materials and methods: historical-descriptive, comparative-historical, problem-chronological, biographical methods were used in the work. The article is based on published sources and archival materials available to the authors. Results.   Currently, there is no doubt that the level of public health depends not only on the activities of medical institutions, the qualifications of doctors, medical staff, but also on the timely comprehensive solution of many social issues with the participation of public and state institutions. The article presents some examples of the formation of such interaction and original solutions to urgent medical and social problems in Yekaterinodar (now Krasnodar) at the end of the XIX  –   beginning of the XX century. The issues of financing medical institutions, medical salaries and pensions, the organization of measures to combat epidemics, the formation of sanitary services, the opening of new specialized hospital departments, and services for the poorest segments of the population were touched upon. The elements of educational work, ways to solve the problem of high infant mortality and the organization of the first Consultation for infants are shown. Many doctors actively participated in the work of local city government, being “public” of the City Duma and the City Council, thereby contributing to the solution of many social and medical issues, including problems of payment for treatment, different categories of the population and “hospital arrears”. Conclusion .   Thus, without having a clear state concept and program for the development of healthcare, the city administration, together with the medical community, demonstrated the desire and possibility of jointly solving many medical and social problems of the city of Yekaterinodar. That is, during this period, the potential properties and understanding of the need for the development of the public health system and sphere were formed in the regional society.
研究目的:研究二十世纪初叶卡捷琳诺达尔市公共机构活动的医疗和社会方面,以反映形成公共卫生体系的全球趋势。材料与方法:工作中使用了历史描述法、历史比较法、问题-时间顺序法、传记法。文章以作者所掌握的公开资料和档案材料为基础。研究结果 目前,毫无疑问,公共卫生水平不仅取决于医疗机构的活动、医生和医务人员的资质,还取决于在公共和国家机构的参与下及时全面地解决许多社会问题。文章介绍了叶卡捷琳堡(现克拉斯诺达尔市)在十九世纪末二十世纪初形成这种互动和解决紧急医疗和社会问题的一些实例。其中涉及到医疗机构的资金筹措、医疗人员的工资和养老金、抗击流行病措施的组织、卫生服务的形成、开设新的专科医院科室以及为最贫困人口提供服务等问题。还介绍了教育工作的内容、解决婴儿死亡率高问题的方法以及组织第一次婴儿咨询。许多医生积极参与了当地市政府的工作,成为了市杜马和市议会的 "公众",从而为解决许多社会和医疗问题做出了贡献,其中包括治疗费用、不同类别人口和 "拖欠医院费用 "等问题。结论 . 因此,在没有明确的国家医疗卫生发展概念和计划的情况下,市政府与医疗界一起展示了共同解决叶卡捷琳诺达尔市许多医疗和社会问题的愿望和可能性。也就是说,在此期间,地区社会形成了发展公共卫生系统和领域的潜在属性和对其必要性的理解。
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