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Vol 68, No 5 (2024)
HEALTH CARE ORGANIZATION
Multidisciplinary models of primary health care for patients with chronic non-communicable diseases
Abstract
Introduction. Chronic non-communicable diseases (CNCD) requires a variety of strategies from different perspectives and at different levels, including individual and country-specific. Comprehensive patient-oriented and proactive approaches play an important role in the provision of multidisciplinary teams of medical care to patients with established CNCD.
The purpose of this study is to present the Moscow experience in managing multidisciplinary teams for the treatment of CND patients, using the example of arterial hypertension in the framework of a pilot project in the outpatient clinics of the Troitsk and Novomoskovsky administrative districts (TiNAO; were attached to the territory of Moscow in 2012).
Materials and methods. The study was conducted in two stages: at the first, a literature review was carried out, at the second, the stages of launching a pilot project on the management of multidisciplinary teams for the treatment patients with CNCD, using the example of arterial hypertension in the outpatient clinic of TinAO, were developed and discussed.
Results. The research analyzes approaches to the use of multidisciplinary teams in the world. Based on the analyzed current regulatory documents, adjustments were made to the foreign model for its possible adaptation to Moscow polyclinics, focusing on proactive dispensary dynamic monitoring.
Research limitations. The results of the conducted research are based on operational data from Moscow and can be applied only to the formation of management decisions in Moscow.
Conclusion. According to the results of the pilot project testing, an increase in the level of coverage of the attached population with medical care, accessibility of narrow specialists and provision of equal opportunities for obtaining medical care for Muscovites was noted.
Compliance with ethical standards. This type of research does not require an examination by the local ethics committee.
Contribution of the authors:
Starshinin A.V. — scientific guidance;
Kamynina N.N. — concept and design of research, formulation and development of the main theses of the article, editing;
Burkovskaya Yu.V. — collection and processing of material, statistical data processing;
Timofeeva A.S. — collection and processing of material, writing the text, compiling a list of references.
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 sponsorship.
Conflict of interest. The authors declare that there is no conflict of interest.
Received: May 14, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
349-355
Use of digital technologies in the activity of medical institutions
Abstract
Introduction. Significant transformations are taking place in modern medicine: digitalization and re-equipment, changing standards of care — all this requires the availability of new IT competencies for medical professionals. The involvement of “non-doctors” (IT specialists) compensates for the needs of medical institutions, but qualitative changes in the training process of modern medical workers are necessary to solve the problem.
The purpose is to study the needs for new competencies for medical professionals (IT doctors) and the need to attract “non-doctors” in modern conditions of digitalization of medicine.
Materials and methods. The study is based on the analysis of secondary information obtained from the Federal Statistical Observation Form No. 30 and digital resources, as well as on the results of a mass questionnaire survey conducted in medical institutions of the Moscow Department of Health (n = 1499).
Results. “Non-doctors” with IT competencies are increasingly in demand. The survey showed that certain functions of medical specialists can already be “transferred” to non-medical personnel, whose growth rate has exceeded 60% over the past 10 years. However, the training system provides the necessary IT competencies to a greater extent in technical specialties and to a lesser extent in medical ones.
Research limitations. The analysis uses statistical data and the results of a mass questionnaire survey in medical institutions of the Moscow Healthcare Department, which is a representative sample for approximating the results for the entire general population.
Conclusion. In the near future, it is necessary to train doctors according to new standards. The modernization of the training system taking into account new IT competencies in medicine and the development of the LongLife Learning (LLL) training system are becoming a reality. The increasing involvement of “non-doctors” to solve high-tech problems, the development of hardware and software complexes is undeniable. However, it is necessary to adapt them to the specifics of the industry development.
Compliance with ethical standards. The study was approved by the Ethical Committee for the Examination of Research in the field of public health, organization and sociology of healthcare at the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department (Protocol No. 03-01/EC/2023 dated 03/14/2023).
Contribution of the authors:
Aksenova E.I. — concept and design of the study, writing an article;
Medvedeva E.I. — concept and design of the study, writing the article, editing;
Kroshilin S.V. — collection and processing of material, statistical processing, writing an article.
All authors approval of the final version of the article, responsibility for the integrity of the article.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: May 14, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
356-363
Values in the doctor-patient interaction: understanding and cooperation
Abstract
Introduction. Cooperation between a medical professional and a patient is the main value in the work of a medical institution organization and the key to improving the quality of specialists.
The purpose of the study. Development and testing of the “secret patient” method, which allows assessing the quality of medical care in accordance with the Moscow clinics’ values from the patient’s point of view; identifying factors influencing patients’ opinions regarding the quality of medical care.
Materials and methods. The study was conducted in 2024 at two medical centers in Moscow. The following methods are: focus group, content analysis, “secret patient”, participant observation.
Results. The assessment tools include the possibility and convenience of making an appointment with a doctor on the website of a medical institution; features of communication with medical workers; characteristics of the medical institution; information about the medical institution and communications in the medical institution; additional information. All medical care’ elements correlate with the values: patient-centeredness, friendliness, teamwork, trust and mutual respect.
Research limitations. The study is limited by the absence of disease in the investigators conducting the participant observation.
Conclusion. The developed methodology for receiving feedback from the head of a medical organization from patients corresponds to the core values of Moscow clinics and can be taken into the operational activities of medical organizations. Doctors provide consultations in accordance with the clinic’ values. Mutual respect and trust must be reinforced by the adoption of appropriate values by patients. The main shortcomings present in isolated cases are associated with unequal treatment of patients and incorrect communication by nursing staff.
Compliance with ethical standards. The study was approved by the Ethics Committee for the Expertise of Research in the Field of Public Health, Organization and Sociology of Healthcare at the Research Institute for Healthcare Organization and Medical Management (protocol dated 12.03.2024 No. 9 03-01/EK/202. All participants gave informed written consent to participate in the study.
Contribution of the authors:
Nazarova I.B. — concept and design of the study, editing and approval of the final version of the article;
Nesterov R.S. — organization of the field stage of the research.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Gratitude. The authors express their gratitude to the students of Peoples’ Friendship University of Russia named after Patrice Lumumba, employees of the Charitable Foundation “Support for Social Initiatives and Public Health” for performing the role of a secret patient.
Acknowledgement. This study did not receive external funding.
Conflict of interest. The authors declare that they have no apparent or potential conflicts of interest in connection with the publication of this article.
Received: May 14, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
364-370
Labour mobility of medical specialists: attitudes and factors
Abstract
Introduction. The healthcare sector characterized by low levels of labour mobility of medical specialists.
In this regard, the purpose of the study is to identify the causes of the current scale of intra-firm and inter-firm mobility in the healthcare sector, which are associated with readiness for professional and qualification growth, as well as with external and internal employment conditions.
Materials and methods. The study was based on regulatory documents of the Ministry of Health of the Russian Federation and the Government of Moscow. Data from Rosstat and statistics of the Moscow Healthcare Department, as well as materials from expert and questionnaire surveys of Moscow medical specialists, have compiled a statistical database.
Results. The relatively small scale of inter-firm mobility of medical specialists in Moscow is largely due to the similarity of employment conditions in the public sector, which includes most healthcare institutions. This hinders the transfer of personnel to other institutions, although their specifics, such as a significant workload on staff and low wages, are unlikely to suit specialists. At the same time, a significant part of doctors and nursing staff have active attitudes towards professional and qualification growth. Such attitudes can be realized by the institute of certification for the qualification category. However, its imperfection does not allow coping with these functions.
Research limitations. Due to the scarcity of official statistics, the study was mostly based on expert and questionnaire surveys of medical specialists, which, by definition, provide mainly subjective information and limited factual data.
Conclusion. For the institute for certification of medical specialists for the qualification category to fulfill the functions assigned to it, its work should be supplemented with professional training programs by category, the additional payment for them should be increased, and categorical and job status should be linked. To curb the undesirable consequences of the outflow of personnel from the healthcare sector, it is also necessary to take measures to reduce the workload on staff and increase wages.
Compliance with ethical standards. The study was approved by the Ethics Committee for the Expertise of Research in the Field of Public Health, Organization and Sociology of Healthcare at the State Budgetary Institution “Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department” (protocol No. 03-01/EK/2023, March 14, 2023).
Contribution of the authors:
Toksanbaeva M.S. — concept and design of the study, editing, compilation of the list of references;
Kolennikova O.A. — collection and processing of material, statistical processing.
All authors — are responsible for writing the text, approving the final version of the article, and being responsible for the integrity of all parts of the article.
Acknowledgement. The study had no sponsorship.
Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: May 29, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
371-378
Analysis of appeals of the population of the Nizhny Novgorod region to the territorial health management authority during the COVID-19 pandemic
Abstract
Introduction. Appeals of the population are important indicators of the realization of patient rights. Therefore, the Ministry of Health of the Nizhny Novgorod region pays great attention to the analysis of their causes.
The purpose of this study was to study the impact of the COVID-19 pandemic on the number and reasons for written appeals from the population to the territorial health authority of the Nizhny Novgorod region regarding the medical care provided.
The materials were 37,898 citizens’ appeals over 2019–2021.
Results. The number of written appeals in 2109 was 4916, in 2020 — 14832, in 2021 — 18150. The share of complaints in the structure of appeals decreased from 10,5 ± 0,4% for 2019 to 6,0 ± 0,2% in 2020 and 4,6 ± 0,2% for 2021. Reasons for writing complaints included the quality of medical care (32,9 ± 2,1% during 2019, 34,2 ± 1,6% during 2020, 22,6 ± 1,4% during 2021); refusal to provide medical care (20,5 ± 1,8% in 2019, up to 15,7% ± 1,2% over 2020 and 11,5 ± 1,1% over 2021); violations of ethics and deontology (18,8 ± 1,7% for 2019, 15,8 ± 1,6% for 2020 and 15,3 ± 1,2% for 2021); problems with access to medical care (12,0 ± 1,4% during 2019, 15,2 ± 1,2% during 2020, 19,2 ± 1,4% during 2021 year).
Research limitations. Repeated requests were excluded.
Conclusion. The example of the Nizhny Novgorod region demonstrates the openness of the Ministry of Health, the formation of feedback channels with patients to help to effectively mobilize resources to promptly address issues of providing medical care to the population in an emergency situation.
Compliance with ethical standards. The performing of the scientific research was approved by the Local Ethics Committee of the Volga District Medical Center of the Federal Medical and Biological Agency (protocol No. 13 dated 29.12.2023).
Contribution of the authors:
Melik-Guseinov D.V. — research concept and design, collection and processing of material, writing the text;
Romanova T.E. — writing the text, statistical data processing, editing;
Abaeva O.P. — compilation of the list of literature, statistical data processing, registration.
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 24, 2023 / Revised: November 30, 2023 / Accepted: March 19, 2024 / Published: November 6, 2024
379-384
SOCIOLOGY OF MEDICINE
Wisdom of age is the main psychological geroprotector in older people (analytical review)
Abstract
The article presents an analytical review of the problem of aging from the standpoint of social and spiritual forms of human life. The intensive growth in the number of elderly people has sharply reduced the quality of public attitude towards them. The foundations of social relations between elderly people and the state, intergenerational, family, and other relations have acquired a new colouring, in connection with which the importance of wisdom in solving these problems increases. The wisdom in an elderly person is potent of keeping his inner world in a state of balance. A wise person perceives his presence in life as a paradigm of integration, which determines the coexistence of all age phases during his life. It helps to cast aside regret about past failures, unfulfilled hopes, to find a lot of good even in a far from easy life. Wisdom is the universe to which a person should come in old age. Wisdom will always find something that will please and strengthen the spiritual strength of a person, make his life positions stable, lead away from despondency and a sense of helplessness. The wisdom of age creates self-confidence in an elderly person, pride in the years lived with dignity, in the benefits created, which are used by the young. The concept of “conscious aging” is based on inner strength and spiritual stability over old age. Of course, old age is full of sorrows, but life experience gives it prudence to endure them with dignity. Wisdom serves as a support for an aging person for the normal perception of all life changes, it constantly reminds him that life does not close its doors to him.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: January 25, 2024 / Accepted: March 19, 2024 / Published: November 6, 2024
385-390
Representations of Muscovites of working age about a healthy lifestyle and observance of its principles
Abstract
Introduction. Maintaining a healthy lifestyle (HLS) is one of the key aspects of the prevention of a number of chronic infectious diseases (CID). The increase in the number of people keeping a healthy lifestyle is a predictor not only of the sanitary, but also of the socio-economic well-being of society.
The purpose of the study is to determine the views of Muscovites of working age about HLS and compliance with its principles.
Materials and methods. The article uses the results of a sociological survey of the able-bodied population of Moscow (18–55 years women and 18–60 years men) conducted in 2022. A total of one thousand five hundred twenty two respondents took part in the survey. The maximum sampling error is ± 2.51% (CI = 95%). To obtain additional data, 12 focus group discussions were also conducted with capital residents of working age, both having and not keeping HLS.
Results. 63% of the respondents noted that they certainly or rather keep HLS, 71% of them assess their state of health as good. Different HLS practices are considered, the adherence to which is rather uniform. The study describes self-preserving and acquiescent models of attitude to one’s own health, factors of motivation to HLS, as well as images of people who do and do not follow HLS. These images can have positive and negative aspects in different population groups. Various socio-economic, infrastructural and personal barriers can hinder the gain in the number of Muscovites who lead a healthy lifestyle, and a number of approaches to work with them are proposed in this paper.
Research limitations. The study is limited to residents of the city of Moscow, which may impose restrictions on the generalization of data.
Conclusion. An increase in the share of Muscovites who keep HLS is possible by creating the most attractive conditions for conducting a healthy lifestyle in all spheres of human life at the level of the general urban environment, the level of habitat and work.
Compliance with ethical standards. The study was approved by the Ethical Committee for Expert Review of Research in Public Health, Organization and Sociology of Health Care at the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department (Minutes of 13.09.2022 No. 09-01/3102022).
Contribution of the authors:
Bogdan I.V. — general management of the research, writing the text of the article, editing;
Gornostalev M.D. — development of research methodology, conducting focus group discussions, writing the text of the article, literature review;
Chistyakova D.P. — development of research methodology, processing quantitative data, editing.
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 the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: May 29, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
391-398
PROBLEMS OF SOCIALLY SIGNIFICANT DISEASES
The system of support for medical decision-making in the formation of a rehabilitation diagnosis in the categories of the International Classification of Functioning, Disability and Health
Abstract
Introduction. Comprehensive rehabilitation of patients is a key task of the national healthcare system. To create an effective rehabilitation program, it is necessary to establish an accurate rehabilitation diagnosis. Designing an individual medical rehabilitation plan based on a biopsychosocial approach, the practical tool of which was the “International Classification of Functioning, Disability and Health” (ICF), has changed the global concept of rehabilitation. A priority in the field of digital healthcare is the introduction of medical decision support systems, one of the tasks of which is to help in diagnosis and minimize medical errors aimed at improving the quality of medical care.
The purpose of the work: to create a software system for making medical decisions in the formation of a rehabilitation diagnosis in the ICF categories.
Materials and methods. content analysis was used to study and analyze medical decision-making systems (foreign and domestic) and the ICF; scientific and methodological work was carried out on the development of software for medical decision-making systems.
Results. based on the work carried out, software has been developed to automate, systematize, and optimize the process of establishing a rehabilitation diagnosis in patients with ischemic stroke, standardize approaches to individualizing diagnosis formulation taking into account the severity of functional disorders.
Research limitations. During the development and description of the software, the capabilities of medical information systems applied in the healthcare of Moscow were used.
Conclusion. The biopsychosocial approach is one of the main principles of modern rehabilitation. Digital healthcare facilitates the integration of decision support systems that improve the quality of medical care. The implementation of the developed program into digital platforms of the healthcare system will reduce time costs and unify the procedure for making a rehabilitation diagnosis and all related processes, consistently preserving the necessary information about the patient.
Compliance with ethical standards. All procedures used in this article comply with the ethical standards of the institution that carried out the work and comply with the Helsinki Declaration as amended in 2013. The study was approved by the Local Ethics S.I. Spasokukotsky Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department (Protocol No. 2, 19.04.2023).
Contribution of the authors:
Pogonchenkova I.V. — concept and design of research;
Kostenko E.V. — concept and design of research, writing text, editing;
Petrova L.V. — collection and processing of material, writing text;
Burkovskaya Yu.V. — compilation of a list of references, editing.
All authors — are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Acknowledgment. The study was supported by the Grant of the Government of Moscow No. 1503-7/23.
Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: July 1, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
399-405
Basic instruments for measuring the quality of life in patients after stroke (literature review)
Abstract
Improvements in drug therapy have led to an increase in the number of patients surviving after the acute period of the stroke. A significant proportion of stroke patients experience consequences such as impaired motor function, psychological and social disorders. This affects the quality of life (QoL) of patients. General and specialized tests are used to assess the QoL in patients after a stroke.
The purpose of the study. Systematization of information about the main questionnaires used in assessing QoL in patients after the acute period of stroke.
The search for relevant sources devoted to the topic of work was carried out in the bibliographic database Pubmed / Medline and the Google information system. The following keywords were used in the search queries: “quality of life”, “stroke”, “indicators” etc. Test names were also used as keywords.
The characteristics of a number of general and specialized questionnaires that allow analyzing QoL in patients after a stroke are considered. Key practical information about the main questionnaires used abroad is summarized. Information on their applicability in domestic studies of QoL in patients who have suffered from a stroke is presented. The instruments that are most widely used in foreign practice are noted.
The tests reviewed (general and specific) have usually acceptable psychometric properties (validity and reliability), although none are ideal or suitable for all situations. Continuing the development of comprehensive methods for assessing QoL in patients with stroke consequences at are best suited for everyday clinical practice remains one of the important tasks of medicine.
Further development and widespread introduction of promising methods of QOL analysis into regular medical practice will increase the information content of assessments of the outcomes of therapy and rehabilitation.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: May 31, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
406-411
PREVENTION OF INFECTIOUS DISEASES
Management of genomic surveillance for respiratory viral infections circulating in the territory of the city of Moscow
Abstract
Introduction. Outbreaks of respiratory viral infections have an economic impact on the healthcare system and pose a threat to public well-being. Monitoring for the incidence of acute respiratory viral infections in a metropolitan area, especially during the COVID-19 pandemic, was in dire need of an adequate tool to identify mutations and variants that evade vaccine immunity and initiate an increase in incidence. Genomic surveillance was required for a timely response.
Purpose of the study. Management of the Moscow Genomic Center for genomic surveillance for acute respiratory viral infections and COVID-19, with an assessment of the results during seasonal outbreaks in the capital.
Materials and methods. With the support of the Moscow City Health Department, management and logistics measures were developed and implemented, the NGS testing program in patient samples on a planned basis and during the period of increased incidence of acute respiratory viral infections and COVID-19, technical procedures for high-throughput sequencing were developed, the security of data exchange and biosafety of medical personnel were ensured.
Results. The Moscow Genome Center was established within the structure of the Moscow City Health Department. For the period from October 2023 to April 2024, targeted NGS data (a panel of thirty two pathogens, 6528 samples were tested): SARS-COV-2 dominated the entire period, the incidence of influenza A (H3N2) increased sharply from the beginning of December and decreased sharply by the end of January. Sars-CoV-2 genetic lineage rotation: XBB lineage dominated (most represented: XBB.1.16, XBB.1.16.11) from October to the end of January, then JN lineage prevailed (most represented: JN.1, also found: JN.1.13, JN.1.18, JN.1.19, JN.1.4). Influenza A strain rotation: H3N2 (A/Massachusetts/01/2020) and H3N2 (A/Massachusetts/38/2019) dominated from December to February.
Research limitations. A targeted panel of 32 respiratory viruses most common in the Moscow population was used for NGS. Incomplete coverage of the entire viriome is a conditional limitation.
Conclusion. Representative, high-quality and continuous genetic surveillance has been managed in the capital. The Moscow Genome Center has successfully implemented the NGS Testing Program and support for the Russian Genomic Resource of Microorganisms VGARus.
Compliance with ethical standards. The study was approved by the Ethics Committee for the Expertise of Research in the Field of Public Health, Organization and Sociology of Health Care at “Research Institute for Healthcare Organization and Medical Management of the Moscow City Health Department” (protocol dated September 18, 2023, No. 09-03/EK/2023).
Patient consent. All participants gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form.
Contribution of the authors:
Latypova M.F. — material analysis, drafting and writing the text;
Komarov A.G. — study concept and design;
Migyaev O.K. — material collection and processing;
Shpakova O.G. — research implementation, obtaining results, compiling the list of references;
Venevtsev E.O. — participation in organizational activities for the creation of the Moscow Genome Center.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.
Acknowledgment. Organizational activities and logistical support of the genomic center of the State Budgetary Healthcare Institution “Moscow Scientific Practical Center for Laboratory Research Moscow City Health Department” were carried out with the support of the Moscow Department of Health.
Conflict of interest. The authors declare no obvious or potential conflicts of interest in connection with the publication of this article.
Received: May 31, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
412-418
CHILDREN AND ADOLESCENTS’ HEALTH
The trend in neurological diseases in Moscow adolescents, before and after the COVID-19 pandemic
Abstract
Introduction. During the pandemic the stress level among adolescents has increased significantly due to the uncertainty of the future, awareness for the health of their friends and family, and changes in the educational process and daily routine. In addition, increased time spent indoors, lack of physical activity, poor nutrition and sleep disorders also contribute to the deterioration of the nervous system of adolescents.
It is necessary to conduct additional research and monitoring of the incidence of the nervous system among adolescents in the post-pandemic period to assess and prevent possible negative consequences on their health.
The purpose is to analyze the trend in the incidence of diseases of the nervous system in adolescents, including gender differences, using the example of Moscow over the period before and after the Covid-19 pandemic.
Materials and methods. The following methods are applied: summary and grouping, calculation of relative and average values, dynamics series, distribution indices, analysis of statistical aggregates. The data of the federal statistical observation form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical institution” for 2016–2023 was used.
Results. Due to the COVID-19 pandemic in Moscow, there was an increase in the incidence during the “post-covid” period. In 2021–2023, the gain in the incidence of disorders of the autonomic nervous system (ANS) is twofold higher than over the five-year “pre-covid” period.
Research limitations. The study has regional (Moscow) limitations.
Conclusions. The average Moscow rates of the morbidity of the nervous system, while remaining lower than the Russian ones, are approaching them in trend. There were no significant changes in the difference between diseases in boys and girls, but in terms of episodic and paroxysmal disorders, the trend in convergence of indices was noted.
Compliance with ethical standards. The study does not require the submission of the conclusion of the biomedical ethics committee or other documents.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: May 31, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
419-424
Incidence of infectious diseases in infants under one year in the Astrakhan region in 2017-2021
Abstract
The purpose of the study. To analyze the epidemiological situation of “childhood infections” among children under 1 year old for 2017–2021 in the Astrakhan region.
Materials and methods. There were analyzed, epidemiological maps of infants with “children’s” infections as well as maps of inpatient sick infants who were treated in an infectious hospital.
The results of the study. The main complaints of the majority of patients were fever — 87.8% and exanthema syndrome — 84.6%. In rare cases, patients showed catarrhal phenomena of the upper respiratory tract — 13.2%. Dyspeptic phenomena were observed in 15.9% of children. In rare cases, patients had angina — 0.5% and lymphadenopathy — 8.9%. Conjunctivitis and scleritis were observed in 9.6% of infants, including twelve cases with whooping cough, four with chickenpox and 58 with measles. The phenomena of meningitis were observed in one child — 0.1% with chickenpox. Lesions of the lower respiratory tract in the form of bronchitis — in 18.5% of infants, including two infants with chickenpox, 117 infants with whooping cough and 24 infants with measles.
Research limitations. Epidemiological maps of infants with “childhood” infections identified in them were studied, during which data on the structure of the incidence of measles, scarlet fever, whooping cough and chickenpox were analyzed.
Conclusions. The leading place in the incidence in infants falls on chickenpox, group outbreaks of which were repeatedly recorded over 2017 and 2018. There is a decrease in the incidence of infections such as scarlet fever and whooping cough among infants under the age of 1 year. During 2020–2021, against the background of general well-being, there is an increase in the number of cases of measles among children of different age groups, including among infants under the age of 1 year. The main complaints were fever and exanthema syndrome.
Compliance with ethical standards. The conducted research requires no the submission of the conclusion of the biomedical ethics committee or other documents, since all work was carried out with documents, and not with the patients themselves.
Contribution of the authors:
Larina N.S. — collection and processing of material;
Zakaev K.Yu. — approval of the final version of the article;
Kurbangalieva A.R. — material processing;
Kasatkin D.N. — approval of the final version of the article;
Arakelyan R.S. — text writing, statistical data processing, editing, research concept and design, compilation of a list of references, statistical data processing;
Khabirova E.R. — material processing.
Acknowledgment. The study had no sponsorship.
Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: May 10, 2023 / Accepted: October 18, 2023 / Published: November 6, 2024
425-430
PROBLEMS OF MEDICAL EDUCATION
Characteristics of medical student education during the COVID-19 pandemic
Abstract
Introduction. After the last pandemic, the university community faced a number of issues related to the management and conduct of training, so improving the quality of education and training of medical students is relevant. The transition to distance learning on various platforms with all kinds of media support, on the one hand, made it possible not to interrupt the educational process during a difficult period of social restrictions, and on the other hand, created a load and stressed both students and teachers of educational institutions.
Purpose. To assess the impact of changes on the educational process of medical students during the COVID-19 pandemic, including the implementation of distance learning technologies and the use of online platforms, and to identify the need for social support measures to reduce academic burnout and improve students’ psychological resilience.
Materials and methods. A comparative observational study was conducted at the Urology Clinic of the Russian University of Medicine, which used an anonymous Internet survey. Two hundred forty eight 4th year medical students were interviewed from 2020 to 2021 and 501 respondents from 2021 to 2022.
Results. Two groups of students were compared, distributed according to a time criterion. The most frequent area of application of social networks in the educational process was consultation with teachers and search for information for educational activities. In relation to distance learning, positive responses were received from 170 respondents (68.55%) in group 1 and 342 (68.26%) in group 2, and negative responses from 68 (27.42%) and 127 (25.35%) respondents, respectively.
Research limitations. A narrow focus on the sample of medical students, which does not reflect the diversity of opinions and experiences in the wider population, as well as conducting research during the COVID-19 pandemic.
Conclusions. Given the changes in educational activities against the background of the coronavirus pandemic, as well as the lack of regulated norms, rules, and support for students and teachers during this period, comprehensive coverage and development of distance learning methods are necessary.
Compliance with ethical standards. The study was carried out in accordance with the Declaration of Helsinki (revised in Fortaleza, Brazil, in October 2013).
Contribution of the authors:
Sukhikh S.O. — collection and processing of material, text writing, editing;
Kazakov N.S. — statistical processing of data, compilation of the list of references;
Stroganov R.Yu. — editing;
Kupriyanov Yu.A. — collection and processing of material, text writing, editing;
Vasiliev A.O. — collection and processing of material, text writing, editing;
Bormotin A.V. — research concept and design, editing;
Bernikov A.N. — research concept and design, editing;
Malkhasyan V.A. — research concept and design, editing;
Gvasalia B.R. — research concept and design, editing;
Govorov A.V. — research concept and design, editing;
Kolontarev K.B. — research concept and design, editing;
Gvozdev M.Yu. — research concept and design, editing;
Zaitsev A.V. — research concept and design, editing;
Khodyreva L.A. — research concept and design, editing;
Dyakov V.V. — editing;
Kasyan G.R. — research concept and design, editing;
Pushkar D.Yu. — research concept and design, editing.
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 the absence of obvious and potential conflicts of interest in connection with the publication of this article.
Received: May 29, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
439-444
MEDICAL STATISTICS
Comparative analysis of the targets for reducing adult population mortality by 2024
Abstract
Introduction. Currently, in the Russian Federation there are realized national projects “Healthcare” and “Demography” aimed at reducing the mortality. For implementation at the regional level in Moscow, there have been developed regional programs with appropriate regional indicators.
The purpose of the study is to assess the degree of achievement of the targets of national, federal and regional adult mortality rates.
Materials and methods. The study is based on a comparative analysis of targets and actual statistical data.
Results. In Moscow and in Russia, there is a decrease in mortality from all causes, diseases of the circulatory system, myocardial and cerebral infarction, neoplasms. Despite the increase in the level in 2020–2021 due to the pandemic, in 2022, mortality rates returned to the pre-pandemic period and have a tendency to further decrease. Current trends point to the high achievability of targets in Moscow, while in the country, most indicators have a chance of not being achieved. In Moscow there is noted a higher cancer mortality rate i to which a significant contribution may be made by cancer patients from other Russian regions who receive medical care in federal cancer centers located in Moscow and who died on its territory.
Research limitations. Standardized mortality rates of the population were calculated in the FAISS internal use program.
Conclusion. The implementation of national, federal and regional projects has had a positive impact on the effectiveness of demographic policy to reduce mortality.
Compliance with ethical standards. This type of research does not require an examination by the local ethics committee.
Contribution of the authors:
Savina A.A. — research concept and design, statistical processing, text writing;
Feiginova S.I. — research design, text writing, editing, translation, compilation of the list of references;
Grigorov A.A. — research concept, editing.
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 that there is no conflict of interest.
Received: May 31, 2024 / Accepted: October 3, 2024 / Published: November 6, 2024
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BOOK REVIEW
Retsenziya na monografiyu «Analiz riska zdorov'yu v strategii gosudarstvennogo sotsial'no-ekonomicheskogo razvitiya» pod obshchey redaktsiey G.G. Onishchenko, N.V. Zaytsevoy. 2-e izd., pererabotannoe i dopolnennoe. M.; Perm': izd-vo Permskogo natsional'nogo issledovatel'skogo politekhnicheskogo universiteta, 2024. 1048 s.
Abstract
Монография, представленная коллективом авторов, посвящена чрезвычайно актуальной проблеме — инновационной методологии анализа риска здоровью населения как инструменту координации правоприменительной практики системы государственного регулирования обеспечения санитарно-эпидемиологического благополучия населения и здоровья граждан России. Своевременность научного издания определяется тем, что, являясь составной частью профилактической медицины и гигиенической науки, анализ риска здоровью не только позволяет с высокой степенью достоверности оценивать текущие и прогнозные негативные изменения здоровья на индивидуальном и популяционном уровнях под действием различных по природе и сочетанию внешнесредовых факторов, но и обосновать наиболее эффективные меры, в том числе социальные, экономические, медико-профилактические, направленные на предупреждение заболеваний и создание условий, обеспечивающих сохранение здоровья населения.
438-438
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