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Readiness of medical graduates to self-guided work in primary health care organizations 医学毕业生在基层医疗机构自主工作的准备情况
Q3 Social Sciences Pub Date : 2024-01-28 DOI: 10.15829/1728-8800-2023-3829
Zh. L. Varakina, N. Y. Shkerskaya, V. R. Losev, E. V. Zimina, L. I. Menshikova
Aim. To study the opinion of senior medical students about their readiness for self-guided practice in primary health care organizations.Material and methods. In 2023, a continuous cross- sectional social study was conducted among 5th and 6th year students of the Northern State Medical University (Arkhangelsk), of which 137 were from pediatric faculty (5th year — 70, 6th year — 65), 266 — general medicine faculty (5th year — 140, 6th year — 126).Results. An insufficient level of readiness of medical graduates for self-guided practice in primary health care facilities was revealed. Only 19,0%, after passing the primary accreditation, aim to immediately work as a local pediatrician and a local general practitioner, while 44,2% are not ready to begin independent practical activity. The main work direction of a local physician is considered to be prevention by 67,2% and 28,6% of senior pediatric and general medicine students, respectively. More than 75% of graduates are ready to work independently in a medical information system, but 15,1% of respondents are not sure that they will be able to independently make an electronic sick note, while 41% — a referral for disability examination, and about a third of graduates — fill out a statistical electronic form.Conclusion. The study results confirm the need to strengthen the practice in the training of medical students and introduce a mentoring system in primary health care facilities.
目的研究高年级医学生对在基层医疗机构进行自我指导实践的准备情况的看法。2023年,对北方国立医科大学(阿尔汉格尔斯克)5、6年级学生进行了连续性横断面社会调查,其中137人来自儿科系(5年级-70人,6年级-65人),266人来自全科医学系(5年级-140人,6年级-126人)。结果表明,医学毕业生在初级医疗机构的自我指导实践方面准备不足。只有 19.0%的毕业生在通过初级鉴定后打算立即担任当地儿科医生和全科医生,而 44.2%的毕业生尚未做好开始独立实践活动的准备。分别有 67.2% 和 28.6% 的儿科和全科高年级学生认为当地医生的主要工作方向是预防。75%以上的毕业生已做好在医疗信息系统中独立工作的准备,但15.1%的受访者不确定自己是否能独立制作电子病历,41%的受访者不确定自己是否能独立制作电子病历,41%的受访者不确定自己是否能独立制作残疾检查转诊单,约三分之一的毕业生不确定自己是否能独立填写统计电子表格。研究结果证实,有必要加强医科学生的培训实践,并在初级卫生保健机构引入导师制度。
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引用次数: 0
Digital health literacy in primary care: a key driver of patient satisfaction in the era of digital transformation in healthcare 初级保健中的数字健康知识:医疗保健数字化转型时代患者满意度的关键驱动因素
Q3 Social Sciences Pub Date : 2024-01-28 DOI: 10.15829/1728-8800-2023-3835
D. V. Voshev, I. M. Son, N. A. Vosheva, S. Orlov, K. Mezhidov, R. Shepel, O. Drapkina
Aim. To analyze digital technologies in the primary health care system, as well as studying the impact of digital health literacy on patient satisfaction with the services provided.Material and methods. A study assessing patients' opinions on the digitalization of primary care in Russia was conducted from June to September 2023 among 1004 participants from 42 regions. A questionnaire with 33 questions was used, of which the 8 most relevant ones were selected for the article, aimed at assessing the satisfaction and personal experience of patients in using digital technologies. Data was collected through Yandex Forms. Data analysis included synthesis of results, classification and content analysis of literature.Results. The study examined the impact of digitalization on primary care patient satisfaction. Analysis of digital technologies in the primary health care system made it possible to establish that the target audience has a positive attitude towards the introduction of innovations. The patients also aimed at using them and are ready to seek new digital medical services. At the same time, it is important for patients to increase the effectiveness of personal interaction with the physicians. In order to improve digital innovation, development of practical guidelines for the updating and further implementation of digital tools is needed.Conclusion. The study confirmed that digital health literacy plays an important role in improving primary care patient satisfaction. Based on the data obtained, it is necessary to develop and implement educational programs for patients and medical professionals aimed at increasing the level of digital literacy and optimizing the use of digital tools in me dicine.
目的分析初级卫生保健系统中的数字技术,并研究数字卫生知识对患者对所提供服务的满意度的影响。2023 年 6 月至 9 月,对来自 42 个地区的 1004 名参与者进行了一项研究,以评估患者对俄罗斯初级医疗数字化的看法。该研究使用了一份包含 33 个问题的调查问卷,其中 8 个最相关的问题被选入文章,旨在评估患者在使用数字技术方面的满意度和个人经验。数据通过 Yandex 表格收集。数据分析包括结果综合、分类和文献内容分析。研究探讨了数字化对初级保健患者满意度的影响。通过分析初级医疗系统中的数字化技术,可以确定目标受众对引入创新持积极态度。患者的目标也是使用这些技术,并愿意寻求新的数字化医疗服务。同时,对于患者来说,提高与医生的个人互动效率也很重要。为了改进数字创新,有必要为数字工具的更新和进一步实施制定实用指南。研究证实,数字健康知识在提高初级保健患者满意度方面发挥着重要作用。根据所获得的数据,有必要为患者和医疗专业人员制定和实施教育计划,以提高数字素养水平,优化数字工具在医疗中的使用。
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引用次数: 0
Problematic issues and development of classifications of the main parameters of quality and adherence to pharmacotherapy. Part II: physician adherence to clinical guidelines and official drug labels 药物治疗质量和依从性主要参数的问题和分类发展。第二部分:医生遵守临床指南和官方药品标签的情况
Q3 Social Sciences Pub Date : 2024-01-23 DOI: 10.15829/1728-8800-2024-3920
Yy. V. Lukina, N. Kutishenko, S. Martsevich, O. Drapkina
The second publication is presented, devoted to the classification of the main parameters of quality and adherence to pharmacotherapy. Despite the fact that patients play a central role in the problem of medical adherence, the role of attending physicians is extremely significant both in prescribing/non-prescribing proven effective and safe therapy, and in influencing patient medical adherence. This led to the identification of a special commitment type — the physician adherence to the basic principles of rational treatment. Collection, analysis and systematization of information, as well as the related development of a classification of physician adherence/non-adherence were the aim of this review and analytical work. We searched data using keywords among Russian and English-­language sources. When compiling the classification, categories of adherence/non-adherence were identified in accordance with the implementation by physicians of the main provisions of clinical guidelines for long-term therapy for patients with non-communicable diseases (NCDs), as well as following official drug labels reflecting data on clinical pharmacology, the main side effects, drug-drug interactions. The classification of physician adherence/non-adherence to implementing the principles of rational treatment of patients with NCDs can be used in the development of electronic medical decision support systems for providing therapy with proven effectiveness and safety in specific clinical situations. In addition, on the basis of the developed classification, checklists for monitoring by healthcare specialists of the implementation of the rational treatment of patients with chronic NCDs should be created.
第二份出版物专门介绍了药物治疗质量和依从性主要参数的分类。尽管患者在坚持用药问题上起着核心作用,但主治医生在开具/不开具行之有效的安全疗法处方以及影响患者坚持用药方面的作用都极为重要。因此,我们确定了一种特殊的承诺类型--医生坚持合理治疗的基本原则。收集、分析和系统化信息,以及制定相关的医生依从性/非依从性分类是本次回顾和分析工作的目的。我们使用关键词搜索了俄语和英语资料来源中的数据。在编制分类时,根据医生对非传染性疾病(NCDs)患者长期治疗临床指南主要规定的执行情况,以及根据反映临床药理学、主要副作用、药物间相互作用等数据的官方药物标签,确定了依从/不依从的类别。对医生遵守/不遵守非传染性疾病患者合理治疗原则的情况进行分类,可用于开发电子医疗决策支持系统,以便在特定临床情况下提供经证实有效和安全的治疗。此外,还应在已制定的分类基础上创建检查表,供医疗专家监测慢性非传染性疾病患者合理治疗的实施情况。
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引用次数: 0
Gut microbiota at different stages of cardiovascular disease continuum 心血管疾病不同阶段的肠道微生物群
Q3 Social Sciences Pub Date : 2024-01-02 DOI: 10.15829/1728-8800-2023-3751
A. Yafarova, E. D. Dementyeva, O. A. Zlobovskaya, A. R. Kiselev, A. Sheptulina, G. A. Ashniev, L. M. Zhamalov, V. Makarov, S. Yudin, O. Drapkina
Aim. To study the relationship of gut microbiota (GM) composition with clinical and paraclinical characteristics of patients with coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF).Material and methods. The study included 64 patients (men, 71,9%) with CAD, 33 (men, 87,9%) with HFrEF and 38 (men, 63,2%) with various cardiovascular risk factors (control group). GM composition was assessed using real-time polymerase chain reaction and next- generation sequencing. To identify correlations of GM composition with clinical and paraclinical characteristics, the Spearman rank correlation coefficient (ρ) was calculated. Generalized linear models (QuasiPoisson, overdispersion) with covariates (age, body mass index) were used to compare groups by phylotype.Results. The relative abundance of Bacillota phylotypes is significantly higher in patients with CAD and HFrEF compared to controls (p<0,001). The Bacillota/Bacteroidota dysbiosis ratio was also significantly higher in patients with CAD and HFrEF than in the control group (p<0,001). According to correlation analysis, the relative representation of methanogenic archaea Methanomassiliicoccaceae, Methanomethylophilaceae (ρ=0,49, p<0,0003) directly correlated with ventricular arrhythmias in patients with HFrEF.Conclusion. Patients with CAD and HFrEF differ significantly from the control group in GM composition at the phylotype level. In the study groups, Bacillota/Bacteroidota dysbiosis ratio was also significantly higher than in the control group. The relative abundance of the archaea Methanomassiliicoccaceae and Methanomethylophilaceae is associated with episodes of ventricular tachycardia/ventricular fibrillation.
目的研究冠状动脉疾病(CAD)和射血分数降低型心力衰竭(HFrEF)患者的肠道微生物群(GM)组成与临床和辅助临床特征的关系。研究对象包括 64 名(男性,71.9%)冠状动脉疾病患者、33 名(男性,87.9%)射血分数降低性心力衰竭患者和 38 名(男性,63.2%)具有各种心血管风险因素的患者(对照组)。采用实时聚合酶链式反应和新一代测序技术对基因改造成分进行了评估。为了确定基因组成分与临床和准临床特征的相关性,计算了斯皮尔曼秩相关系数(ρ)。使用带有协变量(年龄、体重指数)的广义线性模型(QuasiPoisson,过度分散)对各组进行系统型比较。与对照组相比,CAD 和 HFrEF 患者的芽孢杆菌系统型相对丰度明显更高(P<0.001)。CAD 和 HFrEF 患者的芽生菌群/类菌群菌群失调比率也明显高于对照组(p<0,001)。根据相关性分析,甲烷化古细菌甲烷菌科(Methanomassiliicoccaceae)和嗜甲烷菌科(Methanomethylophilaceae)的相对代表性(ρ=0,49,p<0,0003)与高频率心衰患者的室性心律失常直接相关。在系统型水平上,CAD 和 HFrEF 患者的基因组组成与对照组有显著差异。在研究组中,芽孢杆菌群/类杆菌群菌群失调比例也明显高于对照组。古细菌甲壳质球菌科(Methanomassiliicoccaceae)和嗜甲壳质球菌科(Methanomethylophilaceae)的相对丰度与室性心动过速/室颤的发作有关。
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引用次数: 0
Creation of a biosample collection from patients after myocardial infarction in the Khanty­ Mansi Autonomous Okrug — Yugra 在汉特-曼西民族自治区-尤格拉建立心肌梗塞患者生物样本采集系统
Q3 Social Sciences Pub Date : 2023-12-10 DOI: 10.15829/1728-8800-2023-3805
A. V. Morozkina, A. Vorobev, M. Y. Donnikov, L. V. Kovalenko, M. L. Safronova, A. K. Gapurova, K. Y. Nikolaev
Aim. Creation of a sample collection of whole blood, leukocyte suspension, genomic deoxyribonucleic acid from patients with myocardial infarction for fundamental and applied research in medicine.Materials and methods. The collection, transportation and processing of biomaterial samples in the biobank of the Medical Institute of Surgut State University were carried out according to standard methods using recommendations, standard operating procedures and national guidelines for biobanking.Results. As of September 1, 2023, the collection has collected 744 aliquots of whole blood and leukocyte suspension and isolated 108 samples of genomic deoxyribonucleic acid from 108 donors after myocardial infarction. Aliquots of samples from the biobank collection are actively used for a number of molecular genetic studies (genotyping, massively parallel sequencing).Conclusion. This biosample collection on the basis of Surgut State University provides current and future research projects in cardiology with high-quality biomaterial.
目的收集心肌梗塞患者的全血、白细胞悬液和基因组脱氧核糖核酸样本,用于医学基础研究和应用研究。苏尔古特国立大学医学研究所生物库中生物材料样本的采集、运输和处理均按照标准方法进行,并采用了建议、标准操作程序和国家生物库指导方针。截至 2023 年 9 月 1 日,生物库共收集了 744 份全血和白细胞悬液等分试样,并从 108 名心肌梗塞后的捐献者身上分离出 108 份基因组脱氧核糖核酸样本。生物样本库收集的等分样本被积极用于多项分子遗传学研究(基因分型、大规模平行测序)。苏尔古特国立大学的生物样本库为当前和未来的心脏病学研究项目提供了高质量的生物材料。
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引用次数: 0
From idea to implementation: the development of biobanking in Russia. The Cardiovascular Therapy and Prevention journal’s top contributing institutions: National Association of Biobanks and Biobanking Specialists (NASBIO) 从想法到实施:俄罗斯生物银行的发展。心血管治疗与预防》杂志的顶级投稿机构:国家生物库和生物库专家协会 (NASBIO)
Q3 Social Sciences Pub Date : 2023-12-10 DOI: 10.15829/1728-8800-2023-3864
A. N. Meshkov, M. S. Pokrovskaya, A. Glotov, A. Ershova, Yu. V. Rodionova, O. Drapkina
.
.
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引用次数: 0
Study of the metabolome features of patients with COVID-19 研究 COVID-19 患者的代谢组特征
Q3 Social Sciences Pub Date : 2023-12-10 DOI: 10.15829/1728-8800-2023-3711
Y. V. Russkikh, N. Sushentseva, O. Popov, S. Apalko, A. Anisenkova, S. V. Mosenko, A. Sarana, S. G. Shcherbak
Aim. To analyze the metabolomic profile of patients with coronavirus disease 2019 (COVID-19) using mass spectrometry methods and taking into account clinical and laboratory history. Studying the relationship between the severity of COVID-19 symptoms and the concentration of primary metabolites, primarily amino acids.Material and methods. The retrospective study included serum samples from a total of 935 people (445 men and 490 women) with COVID-19 from the collection of the biobank of the City Hospital № 40. A metabolomic profile was studied in all samples using chromatography-mass spectrometry. The R language was used for statistical data processing.Results. Based on the analysis, a difference in the metabolic profile of patients with COVID-19 was identified depending on the disease severity — for 52 of the 84 detected compounds, differences were observed with a significance of p<0,01. Significant differences in concentration were recorded for organic acids, amino acids and their derivatives.Conclusion. Using samples from the biobank collection, a metabolomic study of the biomaterial of patients hospitalized with a diagnosis of COVID-19 was carried out. According to the results obtained, kynurenine, phenylalanine and acetylcarnitine are associated with COVID-19 severity. Differences in the metabolomic profile were identified in patients with cytokine storm at the time of blood collection. Potential biomarkers for cytokine storm were identified.
目的利用质谱方法,结合临床和实验室病史,分析冠状病毒病 2019(COVID-19)患者的代谢组谱。研究 COVID-19 症状严重程度与主要代谢物(主要是氨基酸)浓度之间的关系。这项回顾性研究包括市立医院№40生物库收集的935名COVID-19患者(男性445人,女性490人)的血清样本。使用色谱-质谱法对所有样本进行了代谢组学分析。使用 R 语言进行数据统计处理。根据分析结果,COVID-19 患者的代谢概况因疾病严重程度不同而存在差异--在检测到的 84 种化合物中,52 种存在差异,差异显著性为 p<0.01。有机酸、氨基酸及其衍生物的浓度存在显著差异。利用生物库收集的样本,对确诊为 COVID-19 的住院患者的生物材料进行了代谢组学研究。研究结果表明,犬尿氨酸、苯丙氨酸和乙酰肉碱与 COVID-19 的严重程度有关。在采集血液时发现细胞因子风暴患者的代谢组学特征存在差异。确定了细胞因子风暴的潜在生物标志物。
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引用次数: 0
Validation of genetic risk scores for type 2 diabetes on a Russian population sample from the biobank of the National Medical Research Center for Therapy and Preventive Medicine 在国家治疗和预防医学研究中心生物库的俄罗斯人口样本中验证 2 型糖尿病遗传风险评分
Q3 Social Sciences Pub Date : 2023-12-10 DOI: 10.15829/1728-8800-20233746
A. Kiseleva, A. G. Soplenkova, V. Kutsenko, E. Sotnikova, Yu.V. Vyatkin, А. A. Zharikova, A. Ershova, M. Zaichenoka, V. Ramensky, O. Skirko, S. Smetnev, O. Kopylova, А. S. Limonova, A. Blokhina, M. S. Pokrovskaya, S. Shalnova, A. N. Meshkov, O. Drapkina
Aim. To validate and evaluate the accuracy of 14 genetic risk scores (GRSs) for type 2 diabetes (T2D), created earlier in other countries, using a Russian population sample from the biobank of the National Medical Research Center for Therapy and Preventive Medicine.Material and methods. For genetic analysis, next generation sequencing data was used on a sample from the Russian population (n=1165) based on the biobank collection. The study included 14 GRSs associated with T2D.Results. The study demonstrated that the predictive power of 12 out of 14 GRSs for T2D was replicated in the Russian population. As quality metrics, we used the area under the ROC curve, which for models including only GRS varied from 54,49 to 59,46%, and for models including GRS, sex and age — from 77,56 to 78,75%.Conclusion. For the first time in Russia, a study of 14 T2D GRSs developed on other populations was conducted. Twelve GRSs have been validated and can be used in the future to improve risk prediction and prevention of T2D in Russia.
目的利用国家治疗和预防医学研究中心生物库中的俄罗斯人口样本,验证和评估早先在其他国家建立的14个2型糖尿病(T2D)遗传风险评分(GRS)的准确性。基因分析使用了基于生物库收集的俄罗斯人口样本(n=1165)的新一代测序数据。研究包括 14 个与 T2D 相关的 GRS。研究结果表明,14 个基因序列中的 12 个对 T2D 的预测能力在俄罗斯人群中得到了复制。作为质量指标,我们使用了 ROC 曲线下面积,仅包括 GRS 的模型下面积从 54.49% 到 59.46% 不等,包括 GRS、性别和年龄的模型下面积从 77.56% 到 78.75% 不等。俄罗斯首次对针对其他人群开发的 14 种 T2D GRS 进行了研究。12个GRS得到了验证,未来可用于改善俄罗斯T2D的风险预测和预防。
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引用次数: 0
Expert opinion on the article "Assessment of awareness of biobanking among patients and doctors: experience of the Tomsk Oblast" 关于 "评估患者和医生对生物银行的认识:托木斯克州的经验 "一文的专家意见
Q3 Social Sciences Pub Date : 2023-12-10 DOI: 10.15829/1728-8800-2023-3843
A. Ershova
.
.
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引用次数: 0
Possibilities of a biobank for serological monitoring of infectious morbidity 建立生物库对传染病发病率进行血清学监测的可能性
Q3 Social Sciences Pub Date : 2023-12-10 DOI: 10.15829/1728-8800-2023-3693
O. A. Svitich, V. Zverev, T. Solomay, T. A. Semenenko, A. Nozdracheva, T. P. Gotvyanskaya
Currently, monitoring infectious morbidity, control and forecasting the epidemic process is a topical health problem.Aim. To analyze the capabilities of the biobank for serological monitoring of infectious diseases using the Epstein- Barr virus (EBV), which is associated with infectious mononucleosis, as well as somatic pathology, including cancer.Material and methods. Using the quantitative enzyme- linked immunosorbent assay for specific antibodies to various EBV proteins, we studied blood serum samples from healthy individuals (2010, 2016, 2019, 2020, 2021 and 2022) from the collection of the N. F. Gamaleya National Center of Epidemiology and Microbiology.Results. For the first time, the intensity of EBV epidemic process among apparently healthy adult residents of the capital was assessed using samples of biological material and a biobank information database. At the time of examination, 0,8% of individuals were not infected with EBV, and 9,4% suffered reactivation of a chronic infection. There were no significant changes in detection rate of markers over the years.Conclusion. Certified collections of blood sera can be effectively used to study population immunity, the prevalence of individual infections, population protection nationwide, etc.
目前,监测传染病发病率、控制和预测流行过程是一个热门的健康问题。分析生物库利用与传染性单核细胞增多症有关的爱泼斯坦-巴氏病毒(EBV)对传染病以及包括癌症在内的体细胞病变进行血清学监测的能力。我们使用酶联免疫吸附试验定量检测各种 EBV 蛋白的特异性抗体,研究了 N. F. Gamaleya 国家流行病学和微生物学中心收集的健康人血清样本(2010 年、2016 年、2019 年、2020 年、2021 年和 2022 年)。利用生物材料样本和生物库信息数据库,首次评估了首都表面健康的成年居民中EB病毒流行过程的强度。检查结果显示,0.8% 的人未感染过 EBV,9.4% 的人慢性感染再次复发。多年来,标记物的检出率没有明显变化。经认证的血清采集可有效用于研究人群免疫、个人感染率、全国人口保护等。
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引用次数: 0
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Cardiovascular Therapy and Prevention
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