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Vol 68, No 6 (2024)
HEALTH CARE ORGANIZATION
Methods for complex population health evaluation in relation to environmental factors based on use of integral indices. Descriptive review (Report 1)
Abstract
Introduction. Structural changes detected in indices of population health and risks created by changes in priority environmental factors resulted in natural necessity to create integral valuations of population health that can be predicted under various circumstances.
The purpose of the study was the description of the population health indices used in its complex evaluations.
Materials and methods. This paper is a narrative review of available research literature. Relevant literature sources were sought in reference databases (SCOPUS, WoS), and PubMed search system without any limitations as regards time of publication. Two groups of indices were analyzed: one-dimensional ones and those based on mortality tables.
Results. Advantages and drawbacks typical for each measure types were established as regards a possibility to perform intergroup or inter-population evaluations; taking into account complexity and interrelations between various factors; use of contemporary concepts of health taking into account the expressed social orientations. Despite many available methodological developments in the sphere, integral population health indices are still being developed, among other things, due to interdisciplinary approaches, use of the complex systems theory, and up-to-date opportunities provided by computational systems.
Limitations include the lack of any strictly determined search strategy. The research results are considered qualitative (descriptive) with some elements of comparison and do not provide any quantitative estimations.
Conclusions. The results obtained by analysis of the accomplished literature allowed establishing the most relevant integral measures of population health among one-dimensional ones and those based on LEB assessment techniques and estimating whether their structural components were well-grounded. A conclusion was also made that any health evaluations, life expectancy, and life quality have certain social orientation and their multidimensional components should be taken into account in all their complexity. It is necessary to determine whether resources are allocated justly given the established burden of disease in specific population groups.
Compliance with ethical standards. The study does not require the approval of a biomedical ethics committee of other documents (the study was performed using publicly available official statistics).
Contribution of the authors:
Onishchenko G.G. — study concept and design, editing, approval of the final version of the article;
Zaitseva N.V. — study concept and design, editing, approval of the final version of the article;
Kleyn S.V. — editing, writing the text, approval of the final version of the article;
Glukhikh M.V. — editing, writing the text, approval of the final version of the article, collection and processing material, writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: September 12, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
449-458
Emergency stationary complexes (flagship centers) — a new system for managing emergency and specialized medical care. Experience of the flagship center of the O.M. Filatov Hospital in Moscow
Abstract
Introduction. In light of modern challenges, the demands on one of the most complex and labour — intensive areas of medicine — emergency care — are constantly growing. around the world emergency hospitals are faced with an increasing flow of patients, overcrowded departments, and a shortage of material and human resources.
The purpose of the work was to study the current state of providing emergency and specialized medical care and to provide a preliminary assessment of the effectiveness of the medical care system reform through the example of the emergency hospital complex of the O.M. Filatov Municipal Clinical Hospital No. 15 of the Moscow Health Department.
Materials and methods. The work used an analysis of domestic and foreign literature.
There was studied the real experience of leading emergency centers (Germany, USA, Great Britain, etc.).
Results. An analysis of the world experience of emergency centers showed the vast majority of hospitals, in general, to experience similar problems: a growing volume of patient admissions and, accordingly, a high workload of the hospital, high financial costs, a shortage of qualified personnel. For an objective analysis of the hospital load, it is necessary to take into account not only the number of hospitalizations, but also the ratio between the severity of cases, the capacity of the hospital departments and the hospital resources.
Research limitations. The approach to providing medical care described in the article is new to Russian healthcare, and therefore it is not possible to conduct a comparative analysis with its use in other regions of the Russian Federation.
Conclusion. Thus, emergency inpatient complexes allow providing to patients with varying degrees of the severity specialized medical care at a modern level, to carry out rapid and accurate diagnostics, improve patient routing, as a result of which material and time resources are saved and the quality and availability of medical care is increased.
Compliance with ethical standards. the study does not require the submission of a conclusion of the biomedical ethics committee or other documents.
Contribution of the authors:
Vechorko V.I., Zimin A.A., Obukhova E.V., Osmanov O.A., Vechorko E.V. — concept and design of the study, collection and processing of material, writing the text, compiling the list of references, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no financial support.
Conflict of interest. The authors declare no conflict of interest.
Received: September 12, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
459-463
Analysis of the provision of medical personnel in medical organizations providing primary health care in rural areas
Abstract
Introduction. The health status in the rural population plays a critical role in the development of rural areas, therefore the priority tasks for the development of healthcare are to ensure optimal accessibility of primary health care for the rural population as well as eliminating personnel shortages in medical institutions.
Purpose. To study the main trends in the provision of primary health care by medical personnel in rural areas for the period of 2018–2022.
Materials and methods. We used sanitary-statistical, analytical, and comparative analysis methods. The calculation of indices was based on data from the federal statistical observation form No. 30-village “Information about a medical institution” for the period 2018–2022, information on the size of the rural population according to Rosstat of Russia.
Results. The level of provision of the rural population with doctors providing primary health care in outpatient settings tends to decrease throughout the entire observation period. There is a natural trend towards a decrease in the staffing of full-time positions of doctors providing medical care in outpatient settings with individuals in rural areas and, accordingly, an increase in the part-time ratio. The supply of doctors to the rural population to provide primary health care in federal districts has significant differences. The highest rate of decline was noted in the level of provision of the rural population with general practitioners — the figure decreased by 22.2% in 2022 compared to the level of 2018.
Research limitations. The research materials are limited to the results of the analysis of data from the federal industrial statistical observation form No. 30-village for the Russian Federation and for individual federal districts.
Conclusions. The main trends in providing the rural population of the Russian Federation with doctors providing primary health care on an outpatient basis have been identified. The task of attracting and retaining medical personnel to work in rural areas and developing mobile forms of work for medical organizations continues to remain relevant.
Compliance with ethical standards. This study does not require the conclusion of a biomedical ethics committee or other documents.
Contribution of the authors. All authors made an equal contribution to the search and analytical work and preparation of the article, read and approved the final version before publication.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare the absence of any conflicts of interest regarding the publication of this paper.
Received: January 24, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
464-471
TOPICAL ISSUES OF HYGIENE
Assessment of risk of health from violations of mandatory sanitary and epidemiological requirements in the provision of medical services based on the results of the control and supervision activities of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor)
Abstract
Introduction. One of the main provisions of the reform of the state supervision system is the concept of a risk-oriented approach. The process of making changes to sanitary legislation goes on. However, not all changes take into account the risk criteria for health. In this regard, there are advisable amendments to the sanitary and epidemiological requirements using criteria based on risk assessment, including at objects with a high risk of harm to health.
The purpose of the study is to evaluate the risk of the health for the sanitary and epidemiological requirements when providing services to the population based on the results of the control and supervision activities of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor).
Materials and methods. A systemic analysis of the domestic and foreign experience of the substantiation of sanitary and epidemiological requirements was carried out. More than six hundred fifty units of departmental documentation of the Rospotrebnadzor, carried out during control and supervision events in medical institutions of the Perm Territory, were studied. To establish causal relationships between the frequency of disorders of sanitary and epidemiological requirements and the adverse responses from the health side, the logistics regression method has been applied.
Results. In case of violation of the sanitary and epidemiological requirements for the provision of medical services, the level of acceptable risk was shown to be formed from 2.1 ∙ 10–6 to 8.3 ∙ 10–5. Thus, with the proper execution of requirements for the provision of services in medical institutions, health safety is ensured by risk criteria.
Research limitations. The application of risk criteria for health in the sanitary and epidemiological requirements is based on Art. 1 of the Federal Law of 31.07.2020 No. 248-ФЗ «On State Control (Supervision) and Municipal Control in the Russian Federation».
Conclusion. The resulting risk levels show the exercise of the powers of Rospotrebnadzor, in the context of a risk-oriented model of supervision to provide a stable sanitary and epidemiological situation in institutions providing medical services in a specific territory.
Compliance with ethical standards. This study does not require the conclusion of a biomedical ethics committee or other documents.
Contribution of the authors:
Shur P.Z. — research concept and design, editing;
Redko S.V., Lir D.N., Fokin V.A., Tsinker M.Yu. — collection and processing of material, writing the text, compilation of the list of literature.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: August 12, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
472-479
Reserves and limitations of the gain in life expectancy at birth for people in an industrially developed region associated with losses due to circulatory diseases
Abstract
Introduction. The current project activity of the state aimed to improve the medical and demographic situation in the country involves complex changes in many spheres of society activities including living conditions of working age population.
The purpose of study. Identification of the working environment and labour process priority factors against the background of environmental factors system, according to the measure of their influence on age-specific mortality due to circulatory system diseases and estimation potential for increasing of life expectancy at birth for the industrialized region population.
Materials and methods. Data were taken from state statistical reports issued in 2010–2019. They covered 206 indices, including factors related to workplace setting and work processes (20 items). Using a FA-ANN (factor analysis — artificial neural network) model as by 5-year age groups.
Results. We established certain influence produced on LEB in total and working age population on the example of the Perm Krai by changes in environmental according to scenario forecasts, 75.87 and 67.81 years by 2030. Influence exerted on age-specific mortality rates due to circulatory diseases and LEB by changes in some specific groups of factors was assessed using retrospective data (between (–)48.6 days and 284.5 days), in particular, positive changes in workplace settings and work processes (between 11.1 and 30.3 days within different scenarios). According to our forecast, by 2030 the maximum effect of LEB growth for the population (total and working age) is expected to be associated with changes in sociodemographic indices (435.5 days), lifestyle indices (172.2 days), sanitary-epidemiologic welfare (105.1 days).
Research limitations. The analyzed dataset, limitations of the applied model, approaches to setting scenario conditions for changes in analyzed indices.
Conclusion. Priority factors have been identified on the example of an industrially developed region (the Perm Krai). Changes in them can help use the potential of LEB growth due to targeted interdepartmental project activities including improvement of workplace settings and work processes.
Compliance with ethical standards. The study does not require the approval of a biomedical ethics committee of other documents (the study was performed using publicly available official statistics).
Contribution of the authors:
Zaitseva N.V. — research concept and design, editing, approval of the final version of the article;
Kostarev V.G. — research concept and design, editing, approval of the final version of the article;
Kleyn S.V. — editing, writing the text, approval of the final version of the article;
Kiryanov D.A. — editing, writing the text, approval of the final version of the article;
Glukhikh M.V. — statistical data processing, collection and processing material, writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: April 3, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
480-487
Awareness of the lake coast population about the prevention of alimentary-toxic paroxysmal myoglobinuria
Abstract
Introduction. The awareness of the population living in the areas of disadvantaged lakes about the prevention of alimentary-toxic paroxysmal myoglobinuria (ATPM) has not been sufficiently analyzed in the scientific medical literature.
Purpose. To determine the level of awareness of the population living in disadvantaged areas of lake coasts about the prevention of ATPM to adjust the used methods and tools of sanitary and hygienic education.
Materials and methods. a study of the level of awareness about the prevention of ATPM was carried out based on the results of a questionnaire survey of the population of the Achirsky rural settlement of the Tobolsk district of the Tyumen region.
Results. An analysis of the study of the awareness of the population of the Achirsky rural settlement living on the shores of the Andreevskoe, Portkul, Kamkul, Yakhtykul and other lakes on the prevention of Gaff disease (ATPM) of various differentiated groups by age showed that the lowest value of the awareness rate (25.23%) was observed in the age group of 61–73 years; The risk of ATPM disease was determined with an unfavourable epidemiological situation, depending on the level of education of informants. The risk was 1: 1.66 (secondary general: primary general). A study of differentiated groups by occupation revealed the highest value of the awareness rate (45.84%) among employees, and the lowest value (17.98%) among retirees.
Research limitations. When studying the level of awareness of the population of the lake shores about the prevention of ATPM, an assessment of 103 questionnaires was carried out.
Conclusion. An analysis of the results of a questionnaire survey of the population of the lake shores showed: mainly the average level of awareness on the prevention of Gaff’s disease (ATPM); low level in the age group over 61 year old, non-working retirees, persons with education of 8–9 grades; indicated the need to develop information and preventive materials in Russian and Siberian-Tatar languages, search for forms of sanitary and hygienic education of the population over 61 year old, especially pensioners, the need for teacher training on ATPM prevention.
Compliance with ethical standards. The study was approved by the Ethics Committee of the Tyumen State Medical University (protocol No. 121 dated 24.05.2024). All participants gave informed voluntary written consent to participate in the study.
Contribution of the authors:
Raspopova Yu.I. — collection and processing of material;
Sharukho G.V. — collection and processing of material;
Sulkarnaeva G.A. — statistical data processing; discussion of study results, formulation of conclusions;
Bulgakova E.V. — statistical data processing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Acknowledgments. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: May 7, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
488-493
Assessment of bone metabolism in children in conditions of the strontium biogeochemical province
Abstract
Introduction. Excessive strontium entry into the body in a specific biochemical province creates elevated risks of diseases of the musculoskeletal system.
The purpose of the study. To assess the state of bone metabolism in children living in the strontium biogeochemical province.
Materials and methods. We examined by performing clinical examination of one hundred fifty six 5–10 years children (45.5% boys and 54.5% girls) (the observation group). They were exposed to strontium in drinking water in doses reaching 1.2 maximum permissible concentration. The reference group was made of 192 children (45.8% boys and 54.2% girls) who drank water conforming to hygienic requirements fixed in the sanitary legislation. We assessed strontium levels in biological media (blood and urine). Bone metabolism was examined relying on such indicators as phosphor and calcium metabolism, synthesis and resorption of bone tissues, regulation of osteoclastogenesis in blood serum, levels of hormones and vitamin D responsible for regulation of calcium metabolism.
Results. Children resided in a strontium biogeochemical province had elevated strontium levels in blood and urine. We established 2.2 times higher likelihood of deforming dorsopathy and constitutional changes for the exposed children. Also, children with strontium contamination in biological media were established to have slower formation of bone tissues that became obvious through lower N-osteocalcin levels and less active bone isozyme of alkaline phosphatase in 37.9% of cases. Resorptive processes in bones tended to be activated in the exposed children and it involved lower levels of tartrate-resistant acid phosphatase in 84.2 of cases, lower osteoprotegerin levels in 37.2%, and elevated levels of C-terminal telopeptides and Ampli-sRANKL in 40.4–43.4% of the exposed children. Likelihood of elevated bone tissue resorption was established to be 2.9 times higher for the children with strontium contamination in biological media.
Research limitations. The study included children aged 5–10 years.
Conclusion. Changes in bone metabolism in children living in a strontium biogeochemical province can facilitate early development of osteopenia and diseases of the musculoskeletal system.
Compliance with ethical standards: The clinical examination was carried out in accordance with the ethical principles of the Declaration of Helsinki (as amended in 2013) and the National Standard of the Russian Federation GOST-R 52379–2005 "Good Clinical Practice" (ICH E6 GCP), approved by the Ethics Committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies (protocol No. 3, 29.01.2013). The legal representatives of the children signed a voluntary informed consent for the examination in advance.
Contribution of the authors:
Maklakova O.A. — study concept and design, data collection and analysis, statistical analysis, writing and editing the text;
Shtina I.E. — data collection and analysis, statistical analysis, writing the text;
Valina S.L. — data collection and analysis, editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no financial support.
Conflict of interest. The authors declare no conflict of interest.
Received: April 4, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
494-499
Features of the genetic profile in children with dorsopathy complicated by dorsalgia in conditions of contamination of biological media with lead
Abstract
Introduction. The high prevalence of pathologies of the musculoskeletal system in children, in particular dorsopathies complicated by pain syndrome (dorsalgia), is one of the leading health problems. Environmental pollution with heavy metals makes a significant contribution to the formation of pathology. Lead is the most common and dangerous of industrial toxicants, it has a negative effect on the immature bone and nervous system in children, pathologies in which, left without due attention, affect the quality of life and performance in the future.
The purpose of the study. Evaluation of the features of single nucleotide substitutions of the methionine synthase (MTR) gene and dopamine receptor (DRD2) in schoolchildren with dorsopathy complicated by dorsalgia under conditions of contamination of the biological medium with lead.
Materials and methods. The study involved 7–11 years seventy eight schoolchildren with dorsopathy living in an industrially developed region. The observation group (n = 26) differed from the comparison group (n = 52) in the presence of dorsalgia. The blood lead content was studied by inductively coupled plasma mass spectrometry. Polymorphic variants of the DRD2 (rs1800497) and MTR (rs1805087) genes were identified by real-time PCR.
Results. Schoolchildren with dorsopathy and dorsalgia are characterized by an increased blood lead content relative to the background level and values of the comparison group, an increased frequency of the T-allele of the dopamine receptor gene DRD2 (rs1800497), G-allele and AG genotype of the methionine synthase gene MTR (rs1805087), and are also accompanied by excessive levels of dopamine and ionized calcium.
Research limitations. Using a small sample size.
Conclusion. In children with dorsopathy and dorsalgia syndrome features of polymorphism of candidate genes DRD2 (rs1800497) and MTR (rs1805087) associated with impaired detoxification processes, integrity and density of bone tissue cause the risk (RR = 1.73–1.77; 95% CI: 1.23–2.53) of pathology of the musculoskeletal system, accompanied by contamination of biological media with lead, changes in the indices of homeostasis that modify the development of this pathology.
Compliance with ethical standards. The study was approved by the ethics committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies (Protocol No. 11 of 14/03/2023). All patients were informed about the purpose of the study, and voluntary informed consent was obtained.
Contribution of the authors:
Otavina E.A. — the collection and processing of material, statistical processing, writing the text;
Dolgikh O.V. — concept, study design, editing, responsibility for the integrity of all parts of the article.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Conflict of interest. The authors declare no conflict of interest.
Acknowledgment. The study had no sponsorship.
Received: April 4, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
500-504
CHILDREN AND ADOLESCENTS’ HEALTH
Polymorphisms 836A>G of the MMP9 gene and -174G/C of the IL-6 gene associated with a high risk of allergic pathology in children
Abstract
Introduction. The high level of allergic diseases among the child population requires for research to develop modern approaches to the diagnosis and prevention of atopic processes with the detection of specific highly sensitive biomarkers of immunoregulation, including genetic ones, with a detailed analysis of individual etiopathogenetic links in the development of the disease.
Materials and methods. The children’s population of secondary school age in the Perm region was examined: 65 children with allergic pathology and 55 relatively healthy children. Markers of hypersensitivity were studied using enzyme-linked immunosorbent assay. SNP genotyping was performed using real-time PCR.
Results. Children with manifestations of allergy showed an increase in the allergization index by 1.4 times, in blood eosinophils – by 2.3 times, and total IgE concentration by 12.6 times relative to the group of healthy children (p < 0.001). Significant associations with the development of allergic diseases of candidate genes polymorphisms 836G*MMP9 (OR = 2.09; 95% CI = 1.10–3.99) and -174G*IL-6 (OR = 2.25; 95% CI = 1.20–4.25) was revealed. A comparative analysis of the combination of alleles of candidate immunoregulatory genes 836G*MMP9/-174G*IL-6 with alternative allelic combinations showed its significant association with an increased risk of developing allergic pathology (RR = 2.08; 95% CI = 1.27–3.41), activation of allergic inflammation markers: total IgE and blood eosinophils (on average 4.5 and 1.8 times) for children with allergic pathology (p = 0.003–0.014).
Research limitations. The study is limited by the size of the sample examined.
Conclusion. The data obtained indicates to the risk of developing allergic pathology in children for the combination of candidate gene alleles 836G*MMP9/-174G*IL-6 (RR = 2.08; 95% CI = 1.27–3.41), so it should be recommended as a promising marker for early diagnosis, prevention and correction of atopic diseases in children.
Compliance with ethical standards. The study was carried out in accordance with the Declaration of Helsinki by the World Medical Association (revised in 2013) and approved by the Ethics Committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies (Protocol No. 9 of March 14, 2023). All legal representatives of the examined children signed a voluntary informed consent to participate in the study.
Contributions of the authors:
Starkova K.G. — concept and design of the study, collection and processing of material, statistical processing, text writing;
Dolgikh O.V. — concept and design of the study, editing, responsibility for the integrity of all parts of the article;
Legostaeva T.A. — collection and processing of material, text writing.
All authors — approval of the final version of the article.
Acknowledgment. The research was not granted any sponsor support.
Conflict of interest. The authors declare no apparent or potential competing interests related to publication of this article.
Received: August 12, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
505-510
OCCUPATIONAL MEDICINE
Workplace wellness programs as a basis for protection workforce and prolongation of work life expectancy (literature review)
Abstract
Development of the labour potential is a most important component of the economic growth in the Russian Federation. Structural modernization of the country economy in the existing critical demographical situation has made issues related to workforce protection especially acute. Studies with their focus on etiological factors that cause incidence and mortality of working age people give evidence of a close correlation between chronic non-communicable diseases and occupational activities. Employers’ losses caused by temporary disability to work, lower labour productivity, occupational injuries, and persistent disability of workers can reach 28–35%. Implementation of workplace wellness programs seems a promising trend in mitigating adverse effects produced by occupational factors on workers’ health. Workplace wellness programs are reliable investments into labour resources as well as creating a company’s positive image and increasing its competitiveness. Implementation of corporate initiatives into business activities helps to reduce overall incidence among workers; it ensures shorter period of temporary disability and decreases incidence and costs of healthcare services provided for workers by 16–48%. The review analyzes experience gained by foreign and Russian companies in developing and implementing workplace wellness programs and describes relevant principles of creating the best of them. Special attention is paid to drawbacks of workplace wellness programs and outlining future prospects in their development. Among the latter, a significant place belongs to an information-intellectual risk-based system for analysis, prediction, and prevention of occupational and work-related diseases as a solid basis for developing target activities that ensure workforce protection and prolong work life expectancy. Literature sources were searched for in relevant databases including Scopus, Web of Science, CyberLeninka, RSCI and statistical data collections over 2019–2024.
Contribution of the authors:
Ustinova О.Yu. — study concept and design, data collection and editing;
Vorobyeva А.А. — data collection, writing the text;
Leshkova I.V. — data collection and analysis, writing the text;
Gorbushina О.Yu. — data collection and analysis, writing the text.
All authors have approved the final version of the article and bear full responsibility for the integrity of all its parts.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: August 12, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
511-517
Hygienic approach to the formation of corporate programs for the preservation of the health of the able-bodied population
Abstract
Protecting the health of the working population is a priority area of state policy in the field of labour relations, ensuring safe working conditions, and preventing chronic noncommunicable diseases (CVD), which is implemented, among other things, through corporate programs to preserve and strengthen health.
The purpose of the study is to substantiate a hygienic approach to the formation of corporate programs for the preservation of the health of the able-bodied population.
Materials and methods. In carrying out this work there was used the analytical method, regulatory and legal documentation on health protection and ensuring sanitary and epidemiological well-being of the population, as well as literary sources on the subject of research of information resources such as eLIBRARY.RU, CyberLeninka over the past 5–10 years.
Results. The developed hygienic approach to the formation of corporate programs makes it possible to form risk-oriented corporate programs to minimize occupational risk to the health of employees, preserve and strengthen health by ensuring safe working conditions, raising awareness of employees on the prevention of CVD and a healthy lifestyle, creating conditions for the formation of healthy lifestyle skills, correcting behavioural risk factors for diseases, medical and preventive measures for the management of medical support for employees. The development and implementation of corporate health preservation programs should be based on clear algorithms for the interaction of all stakeholders: employers, employees, regulatory authorities.
Research limitations. The study is limited by the results of the analysis of regulatory and legal documentation on health protection and ensuring sanitary and epidemiological well-being of the population and literary sources on the subject of research of information resources such as eLIBRARY.RU, CyberLeninka.
Conclusion. A hygienic approach to the formation of corporate programs will ensure the sanitary and epidemiological well-being of the able-bodied population, monitoring of working conditions, assessment and management of occupational risks to the health of employees, raising awareness of employees on the prevention of CVD and a healthy lifestyle, prevention and reduction of morbidity, disability, and premature mortality, increasing the duration of work activity.
Compliance with ethical standards. The study does not require the submission of the conclusion of the biomedical ethics committee or other documents.
Contribution of the authors:
Sukhova A.V. — concept and design of research, work with literary sources, writing text, editing;
Preobrazhenskaya E.A. — concept and design of research, work with literary sources, writing text, editing;
Lapko I.V. — concept and design of research, work with literary sources, writing text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Conflict of interest. The authors declare no conflict of interest.
Acknowledgment. The study had no sponsorship.
Received: September 2, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
518-525
Assessment of cognitive impairments in mining machine operators with different work experience at a potash fertilizer plant
Abstract
Introduction. The central nervous system in workers engaged in harmful production is subject to significant changes, manifested by impaired cognitive functions.
Purpose was to assess the relationship between changes in the cognitive functions in employees of a potash fertilizer plant and the duration of their work in harmful working conditions.
Materials and methods. There were examined thirty six machinists of mining machines employed at the enterprise for the production of potash fertilizers with harmful working conditions of class 3.3 (harmful factors — silvinite, dihydrosulfide, industrial noise, general and local vibration, microclimate, severity of the labour process). The comparison group consists of 32 employees with acceptable working conditions. Psychodiagnostics were performed using the Stroop test, tests for the level of attention and adequacy of classification and analysis operations, and measurement of the speed of motor responses.
Results. Employees with long-term work experience under conditions of exposure to production factors exceeding hygienic standards have lower cognitive function indices than people with normal working conditions. Thus, for workers with work experience of 8 years or more, the index of flexibility — rigidity of cognitive control was significantly lower by 1.2 times, indices of functional mobility and efficiency of nervous processes were lower by 1.2 to 1.4 times than for workers who worked in acceptable working conditions. At the same time, the indices in workers with up to 8 years of work experience employed in harmful and acceptable working conditions were close in value and had no significant differences. Conducting regular psychophysiological diagnostics can allow diagnosing the onset of cognitive dysfunction by minimal manifestations and timely carry out preventive measures.
Limitations. the impossibility of conducting test tests if the subjects do not have the skills to work with peripheral devices of a personal computer (computer keyboard, mouse).
Conclusions. Working in conditions exceeding hygienic standards can lead to the appearance of mild (pre-dement) cognitive impairments, the severity of which depends on the duration of work associated with exposure to harmful industrial factors.
Compliance with ethical standards. The study was approved by the ethic committee of the Federal Scientific Center for Medical and Preventive Technologies for Public Health Risk Management (protocol 1 of February 03,2022). All patients were informed about the purpose of the study, and voluntary informed consent was obtained.
Contribution of the authors:
Savinkov M.A. — collection of material, statistical processing, writing of the text;
Nosov A.E., Kostarev V.G., Ustinova O.Yu. — the concept of research, editing;
Shcherbakov A.A. — writing the text.
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no funding.
Conflict of interests. The authors declare no conflict of interests.
Received: August 12, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
526-532
MEDICAL STATISTICS
Analysis of the trend in obesity incidence among the working-age population
Abstract
Introduction. Obesity is one of the socially significant chronic non-communicable diseases and, according to numerous forecasts, the incidence of obesity may increase several times by 2030.
Purpose of study. To analyze the primary and general morbidity of obesity and assess its relationship with the coefficient of availability of medical staff and the incidence of coronary heart disease among the working-age population over ten years on the example of the Saratov region.
Materials and methods. Based on the data from the State Health Institution “Medical Information and Analytical Center” of Saratov, the trend indices of general and primary morbidity of obesity among the working-age population in the Saratov region over 10 years (2013–2022) were analyzed.
Results. The overall obesity incidence in Saratov increased by 6.8%, in the Saratov region — by 22.2%; the primary morbidity increased by 53.3% and 81.4%, respectively. A correlation was established between the primary and general morbidity of obesity in Saratov: r = 0.63, p = 0.04; between the general morbidity in Saratov and the Saratov region: r = 0.68, p = 0.03. In all districts of the region, no correlation was found between the indices of general and primary morbidity of obesity and coronary heart disease: r = –0.13; p = 0.45 and r = 0.3; p = 0.07, respectively. The relationship between the coefficient of availability of medical staff and the incidence of obesity has not been established.
Research limitations. The study has regional (Saratov region) and age (adult population) restrictions.
Conclusion. To find out additional reasons for the insufficient detectability of obesity, it is advisable to conduct additional studies aimed at studying the level of awareness of primary care physicians, as well as the working-age population living in the Saratov region, about the role of obesity in the development and course of other diseases. An important area of research may be the search for external objective factors that cause different levels of obesity prevalence within the same group of districts formed taking into account the coefficients of availability of medical staff.
Compliance with ethical standards. The study does not require submission the opinion of the biomedical ethics committee or other documents.
Contribution of the authors:
Dolich V.N. — writing the text;
Komleva N.E. — writing the text, editing;
Lyapina E.P. — writing the text, editing;
Mazilov S.I. — statistical data processing;
Pozdnyakov M.V. — the collection and processing of the material;
Zaikina I.V. — the collection and processing of the material;
Chekhonatskiy А.А. — the collection and processing of the material.
All coauthors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: June 26, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024
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INFORMATION
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HISTORY OF HEALTH CARE AND MEDICINE
Simferopol God-pleasing institutions during the Crimean War over 1853–1856
Abstract
This article for the first time covers previously unknown pages of the history of the Simferopol God-pleasing institutions related to the period of the Crimean War. Thanks to the search among the unique materials of the State Archive of the Republic of Crimea, memoirs of contemporaries, funds of Crimean libraries and museums of Simferopol, it was possible to restore the chronicle of the terrible war days in the fate of the hospital and revive the names of forgotten doctors. The God-pleasing institutions, the largest civilian medical institution of the Taurida province, immediately after the beginning of the war accepted wounded soldiers.
Civilian doctors of Simferopol stood alongside military doctors to accept their “battle”: with a huge number of wounded, high mortality, epidemics, shortages of medicine and food. Senior doctor Fyodor Fyodorovich Bruns, in addition to medical work, carried out special care for the sisters of mercy of the Krestovozdvizhenskaya community. Junior doctor Nikolai Vladimirovich Pleshkov worked in several hospitals, carried out special assignments of the governor on sanitary and epidemiological matters. Under the vaults of the God-pleasing institutions, the great surgeon Nikolai Ivanovich Pirogov himself worked, assisted by the first Sisters of Charity.
Contribution of the authors:
Zvereva E.E. — research concept, collection and processing of material, writing of text;
Kutia S.A. — research design, editing, compilation of reference list.
All authors approved the final version of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: August 23, 2023 / Accepted: December 20, 2023 / Published: December 28, 2024
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Регистрационный номер и дата принятия решения о регистрации СМИ: ПИ № ФС77-50668 от 13.07.2012 г.