Vol 62, No 4 (2018)

The study established impacting of regional activities of social economic incentives of medical personnel on the process of employment in medical institutions of rural area. The analysis of Federal and regional legislation regulating process of incentives of physicians to employment in rural health care system was implemented. The study material was based on the results of implementation of activities of social economic incentives of medical personnel to join rural medical institutions applied in the territory of the Nizhny Novgorod region in 2006-2017. The comparative analysis was implemented concerning normative base of activities of social economic support of physicians including assessment of quality and scope of material preferences and also analysis of effect of types of material incentives on amount of input of specialists in rural health care. The comparative characteristics are presented concerning regional activities of supporting rural medical personnel with ready-made accommodation and vehicles and also assessment of federal activities related to granting rural physicians with single compensation payment of one million rubles. The implemented study demonstrated that problem of recruitment of medical personnel in general and in rural health care in particular is an extremely complicated task. The Federal and regional health authorities were engaged in development of alternatives of solution of this problem until now. It is established that a significant importance in decision making related to employment in rural medical institutions is attached to implementing programs of social economic support. It is derived that measures of social economic support related to granting ready-made accommodation within the framework of regional activities favored more active involvement and long-term assignment of medical personnel in rural area than granting with single compensation payment of one million rubles.

The support of high level of life quality of population presupposes organization of efficient health care system both in general and in particular regions. The state health care investments permitted to implement large-scale state programs, including the priority National Project "Health" and regional programs of health care modernization. All this promoted positive alterations in demographic policy and health attitude in population and increasing of average life-span. However, problem of establishing characteristics and trends in alterations of demographic policy, population health, level of morbidity of main classes of diseases and assessment of efficiency of health care system in conditions of concrete region continues to be rather actual one and significant for practice. The statistical data was used for analyzing main demographic indices of the Kaluga region with the purpose to characterize actual demographic situation as one of the factors of social economic development of the region. The analysis of primary morbidity according visits to medical institutions and mortality of population of the oblast was implemented. The distribution of population of Kaluga region according age groups was demonstrated, characterizing decreasing of number of able-bodied population against the background of increasing of number of population older than able-bodied age. The dynamics of development of health care system in the Kaluga region during 2010-2016 was presented and analyzed.

The article presents the results of analysis of functioning of the family health center in Samara during 2014-2016. During analyzed period, number of visits of adults and adults with children increased up to 23.33% and 17.13% correspondingly. In 2016, in overall 6429 examinations had been applied, including 5088 examinations of children younger than 17 years, 1341 examinations of adults. During three-year period, increasing of number of cared children aged 6-14 years with detected risk factors and with prevailing of functional deviations in cardio-vascular system was observed. The decreasing of function of external breath and risk of development of stomatological diseases were observed too. The activities of personnel of the family health center in the first place is targeted to early diagnostic of detected disorders of health and appointment of consultations of medical specialists. Te personnel, in case of necessity, presents recommendations concerning life-style changing. Also, the plan of activities of the family health center includes a progressive increasing of number of children from health group I with possible transfer of children from health group II to health group I after implementation of individual plans of healthy life-style management.

The article presents the results of evaluation of post-natal deviations in offspring of individuals underwent irradiation exposure at work that testify necessity of supporting radiation security of personnel of reproductive age. Purpose of study. To analyze endocrine metabolic disorders in children of female workers of nuclear industry having cumulated pre-conceptive doses of external gamma-radiation. Material and methods. The retrospective analysis was carried out concerning data of medical documentation of 1190 children prior to age of 15 years old. Out of them, 238 children were offspring of mothers underwent radiation exposure at work. The methods of non-parametric statistics were applied. The factorial analysis method of principal components was applied to establish latent factors. Results. The range of pre-conceptive doses of external gamma-radiation of gonads of mothers made up to 0,09-3523,7 mGy and average absorbed dose on gonads made up to 373,6 ± 34,2 mGy. In the groups, no significant differences in rate of endocrine metabolic pathology were established. In the structure of class "Diseases of endocrine system, nutrition disorders and metabolic imbalance" prevalence of rickets and malnutrition of children of early age were established. In the group of offspring of radiation exposed mothers, a statistically reliable exceeding of both thyroid pathology in general and iodine-deficiency conditions was established with main input of sub-group of girls. There was no evidence of autoimmune endocrine pathology and malignant neoplasms of thyroid gland in the examined groups. The factorial analysis in the group of offspring of female workers of nuclear industry marked out five factors characterizing feeding of infant of the first year of life (dispersion 25.5%), obstetrical anamnesis of mothers (dispersion 11.1%), harmful habits of mothers (dispersion 9.8%), anthropometric status of newborns (dispersion 7.3%) and pre-conceptive irradiation of mothers (dispersion 6.2%). The higher factorial load of variable "dose on gonads" (0.8) is demonstrated. Conclusion. The presented characteristics can be used for early detection of endocrine metabolic disorders in offspring of irradiation exposed mothers in case of dispensary observation.

The article considers, including clinical medicine, the situation with innovative activities as one of leading mechanisms determining national scientific technical potential, efficiency and stability in economy and its competitiveness. The data related to inadequate level of innovative activities and necessity of its enhancement are reflected. The leading factors related to innovative activities are established. The emphasis is made on factors negatively impacting innovative activities. The significant role is played by imperfection of legal base and lacking of corresponding attitude to this problem of administrative structures on all levels of state administrations, first of all administrators of medical institutions. They also are insufficiently aware of expediency and necessity of implementation of theoretical and practical developed designs into clinical medicine. The approaches are proposed to elimination of similar shortcomings and ways of stimulation of innovative activities and also criteria product is to conform. The necessity is emphasized to provide possibility of advancement of scientific technical ideas to contingent involved into invention and innovation activities.