卷 66, 编号 3 (2022)

Introduction. The problem of the necessary number of highly qualified medical personnel does not allow providing the population with affordable and high-quality medical care and making possible to widely use innovative technologies in practical healthcare.

The purpose of this study is to analyze the availability of human resources in healthcare in Russia and in the world, and events and positive experience of personnel planning in modern conditions.

Material and methods. In the course of this study, statistical data, information materials of domestic and foreign literature sources in the Pubmed, Scopus, CyberLeninka, RSCI, eLibrary databases, periodicals, including electronic resources in the Internet, were analyzed. We used such methods as: statistical, study and generalization of experience, content analysis.

Results. The analysis of the availability of medical personnel in the world and in Russia revealed the gain of provision with medical staff in China, New Zealand, Norway, Germany, Hungary, Mexico, Korea. The level of provision of doctors in the Russian Federation for the period from 2000 to 2019 increased by 4%, and the provision of secondary medical personnel — by 5.6%, the number of doctors working in non-governmental institutions has almost doubled.

Limitations. Based on the results of this study, it is possible to establish only statistical, but not causal relationships; the restriction turned out to be important in comparative analysis with the indicators of similar studies.

Discussion. The relevance of the problem of personnel planning in healthcare is characteristic of both developed and developing countries. It is necessary to study the foreign experience of personnel planning, regulatory and legal support of this area, pay attention to the professional training of medical personnel. 

Conclusion. To improve the provision of medical personnel, it is necessary to adequately change approaches to remuneration, training and advanced training of personnel; to maintain the number and staffing at the level of medical institutions in the subjects.

Contribution of the authors:
Karpova O.B. — collection and processing of material, statistical processing of material, research concept and design, writing of text.
Zagoruychenko A.A. — collection and processing of the material, concept and research design, writing and editing text.
The co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study did not have financial support.

Conflict of interest. The authors declare that there is no conflict of interest.

Received: August 25, 2021
Accepted: November 17, 2021
Published: June 28, 2022

Introduction. Quality management closely relates to the search for the most effective tools for the development of institutions. Understanding the immanent focus of commercial structures on continuous quality improvement, public sector medical institutions need to pay more attention to modern mechanisms for the formation of competitive advantages.

Purpose. Analysis of the experience of applying the criteria of self-assessment of the Award of the Government of the Russian Federation in the field of quality in a medical management.

Material and methods. Analysis of open sources of literature of scientific electronic libraries, regulatory documents and information Internet resources of the laureates of the Award of the Russian Federation in 2015–2019. Some aspects are considered on the example of the Research Institute of Complex Problems of Cardiovascular Diseases in Kemerovo.

Results. In 2019, the number of participants in the competition for the Government Award of the Russian Federation in the field of quality increased significantly by more than 200 institutions of various profiles. In the course of the study, the management of the institutions’ activities was found to be based on the requirements of the international standard ISO 9001-2015 for most of the laureate institutions. The article presents the author’s vision of the significance of the Government Award in the field of quality in the development of the management system of a medical institution and illustrates options for the development of a medical institution.

Limitations. The study used data from 56 Prizewinners of the Russian Federation; the clinic has 160 beds, which provides about 8000 patients per year.

Conclusions. The award can be used by medical organizations for the purpose of self-assessment of internal processes for compliance with international quality standards, increasing competitiveness and attractiveness for the consumer.

Contribution of the authors:
Artamonova G.V. — research concept and design, writing a text.
Popsuyko A.N. — research concept and design, writing a text.
Batsina E.A. — the collection and processing of the material, editing.
Danilchenko Ya.V. — the collection and processing of the material.
Karas D.V. — 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 no conflict of interest.

Received: April 06, 2020
Accepted: May 19, 2020
Published: June 28, 2022

The purpose of the study is to identify the reasons for the low availability of helth care to the population of municipal districts of the Saratov region.

Material and methods. For the study, official data from the Federal State Statistics Service, the Central Research Institute for the Management and Informatization of Healthcare of the Ministry of Health of the Russian Federation and the Unified Interdepartmental Information and Statistical System for 2014–2019 were taken. The optimal volumes of health care in inpatient and outpatient settings were calculated in accordance with the orders of the Ministry of Health of the Russian Federation and the Decrees of the Government of the Russian Federation.

Results. During the study in the region, the reasons for the low availability of health care to residents of municipal districts were identified: lack of human resources in municipal medical organizations, low population density of municipal districts, low recommended staffing standards for specialists in accordance with the Procedures for organizing medical care.

Limitations. The main demographic indicators, indicators of resource provision and performance indicators of medical institutions in the Saratov region for 2014–2019 were studied. A comparative analysis of the cost of training programs for highly qualified personnel in the residency of the Saratov State Medical University named after V.I. Razumovsky of general practitioners and the most demanded specialties in municipal outpatient medical organizations in the region.

Conclusion. As a result of the study, the reasons for the low availability of health care to the population of the municipal districts of the region were identified and possible ways to overcome them were proposed.

Compliance with ethical standards. The study does not require the submission of the opinion of the biomedical ethics committee.

Contribution of the authors:
Sazanova G.Yu. — concept of the study, approval of the final version of the article.
Ponomarev A.D. — concept of the study, work with literary sources, editing of the article.
Mirieva I.D. — editing of the article.
Puzakov K.K. — collection and processing of material, writing text.
Yuranova Yu.V. — writing text.
Nezhibovskaya N.R. — writing text.
The co-authors responsibility for the integrity of all parts of the article. 

Acknowledgment. The work was carried out in accordance with the Research and Development Institute of 01.09.2021 No. 121090200094-8 “Creation of conditions for the use of modern organizational technologies in the provision of medical care to patients with socially significant diseases”.

Conflict of interests. The authors declare no conflict of interest.

Received: March 26, 2021
Accepted: April 21, 2021
Published: June 28, 2022

Introduction. The quality of life of navy mariners has a significant impact on the readiness to perform military tasks, which determines the relevance of studying the factors that negatively affect it.

The purpose of the study is to assess the impact of a new coronavirus infection COVID-19 on the quality of life in navy mariners.

Material and methods. During the period from June to July 2021, 265 navy mariners were interviewed on a WHOQOL-BREF questionnaire. The quality of life in this study is considered as a summary indicator of a person’s perception of his physical, mental, emotional and social functioning. There was carried out the calculation of relative values, arithmetic mean with a 95% confidence interval. Comparative analysis using the Mann–Whitney test, correlation and regression analysis were used.

Results. 115 respondents (43.4%) noted the past COVID-19, the non-sick soldiers made up the comparison group (n = 150). Asymptomatic form was found in 15.7%, mild form — 48.7%, moderate — 32.2% and severe form — 3.5% in the general structure. In the postcovid period, asthenic syndrome (53.9%), dyspnea (38.3%), sleep disorders (17.4%), joint pain (15.7%) were noted most often. Significant differences (p = 0.041) were found in the assessment of the social well-being of the comparison group and the sick navy mariners. A significant effect of the severity of the disease was established on the assessment of the microsocial support sphere (p = 0.035), and dyspnoe — on the assessment of the self-perception sphere (p = 0.018) and microsocial support (p = 0.007).

Limitations of the study. The volume of the sample population of 265 persons represented by the personnel of submarines under construction and under repair; climatogeographic features of the region; cross-sectional nature of the study.

Conclusion. The new coronavirus infection has a significant impact on various areas of the quality of life of navy mariners, which makes it important to conduct full rehabilitation after COVID-19, psychological support for servicemen in submarine crews during the pandemic, conduct preventive vaccinations, improve the quality of medical examinations.

Compliance with ethical standards: all interviewees received full information about the study and signed informed consent. Study approved by Northern State Medical University’s local ethics committee.

Contribution of the authors:
Dybin A.S. — research concept, research design, research organization, collection of literature data, collection of material and processing of data.
Menshikova L.I. — research design, editing.
Poteryaev A.E. — research organization, editing.
Shapovalov P.Yu. — research organization, collection of material and processing of data.
Yanborisov S.P., Tumilovich O.A. — collection of material and processing of data.
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 are no clear and potential conflicts of interest in connection with the publication of this article.

Received: March 30, 2022
Accepted: April 27, 2022
Published: June 28, 2022

Introduction. The widespread use of mobile phones/smartphones and other multimedia devices in children makes the scientific community look for answers to questions about the impact of these devices on health. Currently, there are scientific studies both confirming the fact of harmful effects of mobile devices on cognitive functions in children, and refuting it.

Material and methods. In the experimental part of the research the follow-up group consisted of schoolchildren who did not use mobile phones while at school (n = 100), and the control group consisted of children who did not have restrictions on the use of mobile phones (n = 101). The research was conducted by evaluating the dynamics of work capacity, attention span during the day (Schulte test), and by means of a social survey (n = 392).

Results. The proportion of students with high and good independent work performance at the end of the school day was significantly higher among students in the school with complete restrictions on mobile communication devices. The survey found students in the unrestricted school to be more active while gadget users to be more likely to report signs of phone and problems with falling asleep. However, the differences are not significant (p > 0.05).

Limitations. The study of the assessment of the influence of mobile phones on the cognitive functions of schoolchildren aged 11–16 years was carried out on a representative sample of 201 people, which was divided into an observation group and a control group.

Conclusion. The results of the study confirm the negative impact of a distraction (mobile phones) on mental performance.

Compliance with ethical standards. The study was approved at a meeting of the ethics committee at the Novosibirsk Research Institute of Hygiene (minutes No. 6 dated November 15, 2019). The study involved children whose parents gave written informed consent.

Contribution of the authors:
Novikova I.I. — research concept and design, collection and processing of material, writing the text, statistical data processing.
Zubtsovskaya N.A. — collection and processing of material, writing the text, compilation of the list of literature, statistical data processing, editing.
Lobkis M.A. — collection and processing of material, compilation of the list of literature.
Kondrashchenko A.I. — collection and processing of material.
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: May 17, 2021
Accepted: August 24, 2021
Published: June 28, 2022

Introduction. Employees engaged in mining are exposed to several harmful (hazardous) occupation factors: dust factor, industrial noise, general and local vibration, hard labour, heating or cooling microclimate.

The paper aims at studying the influence of the length of employment in underground chrome ore mining coupled with biological (age, obesity) and behavioral (smoking) parameters on spirometric bronchial obstruction indices.

Material and methods. The study included 134 employees of a chrome ore mine having underground experience from 1 to 33 years. The comparison group comprised of 404 people who had never worked in a mine. External respiration function was evaluated using the Spirometer SP-1 (Schiller). Statistical processing was carried out using the SPSS 22. One-factor and multi-factor linear regression models were built.

Results. The construction of one-factor linear regression models of the dependence of FEV₁%, FVC% considering the selected independent factors (age, waist circumference, smoking experience, underground experience) showed a statistically significant effect on the dependent variable of all factors in the model (R² = 0.010–0.135; p = 0.026–0.0001). The variability of obstructive parameters in a multi-factor linear regression model occurs not often in terms of the studied factors (as for FEV₁%, R² = 0.163; as for FVC%, R² = 0.107). Smoking experience and waist circumference are the most significant factors leading to the decrease in these indices. Age and underground work experience are less important, but statistically significant.

Limitations. The limitation of the results of the study was that they characterize a specific set of certain working conditions and lifestyles of workers in chromium mines.

Conclusion. A small part of the impact on the obstruction indices of underground work experience might be due to the use of modern engineering systems to eliminate the harmful effects of occupation factors, as well as personal respiratory protection from dust exposure.

Compliance with ethical standards: The study program was approved by the ethics committee of the FBSI «Federal Scientific Center for Medical and Preventive Health Risk Management Technologies» (protocol No. 16 dated February 05, 2018). All patients were informed about the purpose of the study, and voluntary informed consent was obtained.

Contribution:
Nosov A.E. — concept, research design, collection of material, statistical processing, text writing.
Vlasova E.M. — concept, text writing.
Ustinova O.Yu. — concept, editing.
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: October 29, 2020
Accepted: March 03, 2021
Published: June 28, 2022

Introduction. The study of the remote effects (embryotoxicity, teratogenicity and reproductive toxicity) of new technical products on the mammalian body is the scientific basis for the safe use of pesticides.

The purpose of the study is to study the effect of a new technical product of the benzoyl urea class on the development of remote effects in warm-blooded animals (rats).

Material and methods. The evaluation of embryotoxic and teratogenic effects was carried out on laboratory animals (rats, males and females). Doses were studied: 0, 1/5000, 1/2500 and 1/1250 LD50. Each group of females consisted of 15 animals with a body weight of 230–240 g at the beginning of the study. The technical product was administered orally to female rats daily during 6–20 days of pregnancy. Fertilization of females with intact males was carried out in a ratio of 2 : 1. Reproductive toxicity was studied on two generations of rats (males; 10 individuals per group and females; 20 individuals per group) at doses of 0, 1/5000, 1/2500 and 1/624 LD₅₀.

Results. Embryotoxic and teratogenic effects were not detected, significant changes in reproductive toxicity were established at the maximum dose (for parents and offspring).

Limitations. In study, there are no data on the study of organ tissues, nor have the processes of cell damage as a result of exposure to a new technical product derived from the benzoyl urea class been studied.

Conclusion. The conducted studies have confirmed that the studied product of the benzoyl urea class belongs to low-risk compounds in terms of embryotoxicity and teratogenicity; moderately dangerous in terms of its effect on the reproductive function of warm-blooded (rats).

Compliance with ethical standards. Compliance with ethical standards: The conduct of the study was approved by the commission of the Ethics Committee of the FSB FNTSG named after F.F. Erisman of Rospotrebnadzor (protocol of the meetings No. 4 at 14.03.2019).

Contribution of the authors:
Rakitskii V.N. — concept and design of the study, editing.
Chkhvirkia E.G. — writing a text, compiling a list of references, editing.
Epishina T.M. — collecting and processing material, writing text, compiling a list of references, statistical data processing.
All authors have made an equivalent contribution to the preparation of the publication (33.3%), are responsible for the integrity of all parts of the manuscript and the approval of the final version of the manuscript.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 26, 2021
Accepted: August 10, 2021
Published: June 28, 2022

The article considers the situation in the healthcare in the Republic of Uzbekistan from the point of view of the formation of preventive medicine. The results of the analysis of literature on preventive medicine in the CIS countries and far abroad are presented. According to the analytical data obtained, it was concluded that traditional orthodox medicine not only in CIS countries, but also in some countries of the far abroad, has reached a dead end, and to preserve the health of nations, qualitatively new approaches are required in the health care systems of these states.

The ways of development at the management and structural level are shown and the scientific and methodological approaches to preventive medicine as a science that combines primary prevention and valeology (the science of health) are substantiated.

For the study, data were taken from various sources of literature regarding the situation in the development of preventive medicine. The sources are: eLibrary and CyberLeninka. Methods: selective method and the method of bibliographic references.

The principles of the formation of a way of life (as opposed to promoting a healthy lifestyle), based on the aspects of the impact: the individual level, group, population, have been substantiated. The individual level implies, first of all, pre-nosological (preclinical) diagnostics of the patient’s health status with further correction of the lifestyle. In this connection, specific proposals are given that have already been introduced into practice. The system of work with the population is given by dividing it into target groups according to social and age characteristics. Each target group has its own characteristics and impact.

The efficiency of the work of valeocabinets (health rooms) in the primary health care sector has been determined. Rooms provide all the necessary tools and trained personnel for the active implementation of the principles of healthy lifestyle among the population. In the process of searching for literature, the selective method and the method of bibliographic references were used.

Contribution of the authors:
Irgashev Sh.B. — collection and processing of material.
Torakulov D.D. — collection and processing of material, editing, compilation of a list of references.
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 09, 2020
Accepted: January 19, 2021
Published: June 28, 2022

Introduction. The article considers the category “public health” as the main value of people’s life, an element of human potential, a resource for socio-economic development. This category acts as an integral expression of individual levels of health and characterizes the viability of societies and their reproductive potential.

The purpose of the study. The main goal of the study was to create a method for assessing the state and trend in public health of the appropriate rank, taking into account the emergent properties of the socio-ecological-economic system of the regional level. Authors create an appropriate research algorithm and test it on the example of a number of key regions of the Russian Federation.

Material and methods. The starting materials research was based on information from Federal State Statistics Service (Rosstat) and regional statistical reference books. The processing of the collected data and the subsequent calculation of the trend in public health was`made by using indicative and index approaches, the method of summary indicators and the model of randomization of uncertainty used in the case of information deficit.

Results. Based on the collected and processed materials from the republics of Sakha (Yakutia), Karelia and Komi, the regions of Arkhangelsk (with the separation of the Nenets Autonomous Okrug) and Murmansk, certain differences in the state and trend in indicators were revealed. Nevertheless, in general, a steady trend of positive growth in the state of public health was established in all named regions in 2001–2019.

Discussion. The most favourable situation has developed in the Murmansk region, the Arkhangelsk region and the Komi Republic held second — third place, the Republic of Karelia is in fourth and the Nenets Autonomous Okrug is fifth. The trend of the state and dynamics of public health connected to the difference in the habitat of the population.

Conclusion. The conclusions obtained in the article can be used in the field of health management, in particular in the development of documents for strategic spatial planning of development and territorial organization of the healthcare sector at the level of regions of the Russian Federation and municipal districts.

Contribution of the authors:
Chistobaev A.I. — research concept and design, writing and editing the text.
Dmitriev V.V. — research concept and design, writing and editing the text, statistical data processing.
Semenova Z.A. — collection and processing of material, list of literature.
Grudtcyn N.A. — collection and processing of material, writing and editing the text, list of literature.
Ogurtsov A.N. — collection and processing of material, statistical data processing.
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 15, 2021
Accepted: September 07, 2021
Published: June 28, 2022

Based on a wide range of both published and newly introduced documents, the article examines the development of the health care system in Dagestan during the 1917 revolutions and the Civil War. The health care system in Dagestan, not very developed at the beginning of the 20th century, underwent a number of serious changes during the years of radical breakdown in Russian history with a negative impact on the state of public health in the region. The author considers the specifics of the changes in mangement of health care after the February revolution. The measures proposed by the Provisional Government proved inapplicable to Dagestan. Therefore, a special provision was developed, according to which the medical and sanitary case was assigned to a special city commission. During the period under review, there was an acute shortage of qualified medical personnel in Dagestan. In order to fill this deficit, a paramedic school was established in the city of Temir-Khan-Shura at the infirmary. Despite the fact that special manuals were issued to prevent infectious diseases, and also special sanitary commissions, it was not possible to avoid the high mortality rate from typhoid and typhus. This was due to the low effectiveness of antiepidemic measures. The author comes to the conclusion that, despite the difficult political situation, all political players in the region without exception turned to transformations in the field of management, of medical care.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The author declare no conflict of interest.

Received: March 16, 2022
Accepted: April 14, 2022
Published: June 28, 2022