Bulletin of Semashko National Research Institute of Public Health

Culture of health care of the population is an important condition for the formation of a health-saving (preventive) urban environment. A study was conducted to assess the culture of health saving of the population living in the cities of the Central Federal District. The basis of the study is the health care system of the cities of the Central Federal District: Moscow, Yaroslavl, Ivanovo. The information and methodological basis of the study was made up of specially conducted sociological surveys on the questionnaire among 1200 city residents. It is established that there are similar violations in the parameters of the culture of health saving in different cities of the Central Federal District, with features in the parameters of "compliance with the regime of work and rest" and "information and educational activity" in the capital, due to the information saturation and higher intensity of the working life of the population. This causes, on the one hand, the possibility of developing common (universal) approaches to the formation of an optimal culture of health saving of the population, and on the other hand, the need to take into account the characteristics of individual characteristics of the population of the metropolis.

This article presents the results of the analysis of mortality rates due to vascular catastrophes, including acute disorders of cerebral circulation and acute coronary syndrome. The analysis was performed for a five-year period (2016-2020) based on the results of the Orenburg Regional Vascular Center, which is a structural subdivision of the Orenburg Regional Clinical Hospital. Despite the pandemic of the new coronavirus infection COVID-19 in the Orenburg regional Vascular Center in 2020, there was no deterioration in the mortality rate due to acute cerebral circulatory disorders, although the mortality rate due to acute coronary syndrome increased slightly. The gender composition of those who died from acute cerebrovascular accidents was characterized by the predominance of women - 58.9%. At the same time, men prevailed among those who died from acute coronary syndrome - 54.7%. In the age structure of those who died from acute vascular accidents, persons of the elderly (60-74 years old) and senile (75-90 years old) prevailed. In general, the mortality rates according to the Orenburg Regional Vascular Center were characterized by lower values compared to the average regional indicators.

The article describes a model of automatic coding of the diagnosis according to the algorithm of the International Classification of Diseases of the 10th revision from the standpoint of the process approach. The comparison of the process of traditional (manual) and automated coding of the diagnosis is carried out. The factors initiating the process, the stages of the process, the executors of the stages, the business rules governing the process, the expected result of the implementation of the stages are presented. Possible variability of the diagnosis coding process is indicated, which allows to adapt the process to the specific conditions of the medical organization. The methods of process control, the main risk factors for non-fulfillment or untimely execution of the process are displayed. The advantages of the process approach to diagnosis coding are highlighted. The model of the automated process of coding the diagnosis presented by us is typical and can be introduced into the work of medical organizations of various profiles and departmental subordination, providing equal conditions for the formation of reliable statistical data on morbidity and mortality of the population.

The influence of the level of education on the prevalence of a responsible attitude to their health of the population aged 60 years and older was studied. The study involved 888 people. The respondents lived in Moscow and in Samara. Two comparison groups were formed. The first group included respondents with higher or incomplete higher education (high level of education) (140 men and 222 women). The second comparison group included respondents with secondary or specialized secondary education (low level of education) (164 men and 362 women). Regardless of gender, the majority of respondents from older age groups consider themselves responsible for their health, but the frequency of this opinion decreases with age. Men and women with a high level of education have a greater proportion of respondents who consider themselves responsible for their health. The state is more popular among respondents with a low level of education as a responsible entity for their health, and the healthcare system is more popular among those with a high level of education.

According to the Health Department of the Kyrgyz SSR, 10.755 contagious diseases were detected in 1920, of which 65.7% (7,074) were the population of Karakol district and 34.3% (419) of Karakol. Scabies (47.4%) took the first place in the structure of contagious diseases, malaria (18.4%) took the second place, influenza (10.7%) took the third place and trachoma (5.8%) took the fourth place. In order to combat epidemics and to provide medical assistance to the indigenous population of the Turkestan Territory, in 1920, volatile medical and epidemic units and volatile antimalarial units were established in remote areas of the counties, which were assigned a certain district of the county, which was not adequately served by outpatient and inpatient medical care. Doctors of the detachments paid due attention to social diseases (tuberculosis, sexually transmitted diseases, alcoholism, trachoma, scabies), carried out vaccination. Having familiarized themselves with the sanitary condition of the districts, the detachments established the causes of diseases, took emergency measures to eliminate the causes, and carried out measures to bring the affected places into a satisfactory sanitary condition.

The article reveals the topic of the population's attitude to medicine and medical measures during the cholera epidemics in the Voronezh Province in 1892-1893 and in 1909-1910. In addition to the conclusions and results on the results of the fight against cholera, Voronezh zemstvo doctors noted cases of distrust and unusual aggressive behavior of the residents of the province in relation to doctors and anti-epidemic detachments. There are cases of pogroms of cholera barracks, attacks on medical workers of anti-epidemic detachments. The population often hid cholera cases, considering doctors and paramedics the main culprits of the spread of cholera. The article presents the main speculations and prejudices of the population of the Voronezh Province about the causes of cholera, its spread and treatment, which are typical for many regions of Russia. A comparative analysis of social assessments of medicine in the years of the emergence of cholera in the late XIX-early XX centuries and the COVID-19 pandemic allows us to see similar forms of social responses to the challenges of epidemics.

The article examines the experience of Russian psychiatrists in the study of psychopathic epidemics that spread in the Russian Empire at the late XIX century. Special attention is paid to the description of klikushestvo by N. Krainsky, as well as the hysterical epidemics of manerik and meryachenie in North-Eastern Siberia, studied by A. Tokarsky, S. Mitskevich, N. Kashin and others. These disorders were united by several similar signs: they were peculiar only to the peasant population and almost exclusively to women; the mode of their spread was socially mediated - superstitions specific to a particular locality were assimilated through imitation and auto-suggestion; their symptoms were similar in the form of seizures accompanied by shouting, motor excitements, and sometimes falls. The researchers attributed mass prejudices and beliefs to the most significant factors of psychopathic epidemics’ emergence, the spread of which was not hindered even by a high level of literacy among peasants.

The analysis of 55 medical records of patients with a diagnosis of new coronavirus infection was carried out. The examination included clinical and biochemical studies, coagulograms, determination of SARS-CoV-2 RNA by PCR, as well as IgM and IgG antibodies to the nucleocapsid protein of SARS-CoV-2 beta-coronavirus by ELISA. In the clinical picture, along with the intoxication syndrome, the manifestations of gastroenterocolitis and skin rashes are significant. Depending on the severity, erythropenia, leukopenia, thrombocytopenia and an increase in the rate of erythrocyte sedimentation are detected, which has significant differences in comparison. The study identified the clinical masks COVID-19 intestinal (23.6% of patients) and cutaneous (5.5% of patients); it was shown that the blood oxygen level is a marker of the severity of coronavirus infection, has a directly proportional relationship with the severity of the course of coronavirus infection in the groups with moderate and severe course. According to the data obtained, the most accurate and objective method of diagnosing pneumonia is chest computed tomography, while chest radiography is informative in the case of lung tissue damage of 25%. Whereas in the early stages of the disease, before the formation of pneumonia, the PCR test is informative.

The article considers actions in the field of public health aimed at informatization of the personnel of the healthcare system and in the conditions of increasing the pace of implementation of digital systems. The authors attempt to determine priorities in the process of digitalization of healthcare and the use of emerging innovative digital healthcare systems to strengthen national health systems. Digital technologies today are able to expand the rights and opportunities of citizens, provide support to medical professionals and contribute to the solution of key tasks of the national health policy. In order to accelerate the pace of the introduction of digital systems in healthcare, promote the reform of the healthcare sector and create innovative mechanisms for the provision of medical services, it is necessary for medical professionals to master digital technologies, expand their professional competencies in a digital society. It is quite obvious that now there is a transformation of methods for assessing progress in the introduction of digital healthcare, there is a search for possible mechanisms for using new technologies to strengthen health systems around the world. The relevance of the research topic is due to the importance of positive examples of the use of digital healthcare in the conditions of digitalization. The purpose of this work is to consider the current training of medical specialists and the availability of new technologies in the medical field in the context of the transition to digital systems. The conducted research allowed us to conclude that in the conditions of transition to digital systems of national health care, it is necessary to constantly develop, strengthen and monitor the level of qualification of medical personnel, developing competencies in the field of digitalization, in order to ensure the effectiveness of the activities of medical organizations at a high level.

The article deals with the issues related to the "professional burnout" of medical workers, which faced the health systems of all states especially acutely during the outbreak of the pandemic due to the spread of COVID-19 infection. Now the profession of a doctor and medical personnel, despite its increasing demand and importance in the context of the implementation of national tasks for the preservation of public health, is one of the most stressful and tense. The application of huge efforts from medical specialists was also required to resist the spread of COVID-19, which determined the relevance of the topic of this study. Currently, when the peak of the outbreak of infection has passed and its spread has slowed down, many medical personnel may face the problem of "professional burnout" due to such titanic work in the fight against the spread of the disease. The authors consider recommendations for medical professionals who are in an environment of increased psycho-emotional stress and are at risk of professional burnout. The purpose of this article is to study the concept of "professional burnout" and the causes of it among health care workers, as well as to consider recommendations for medical workers in difficult conditions of providing medical care that require a high level of mobilization and the highest dedication from doctors and paramedical personnel. Based on the results of the work, the author concludes that in difficult conditions and an increasingly complicated technical working environment, along with checking the personal qualities of a specialist, such as patience, compassion, empathy, there is also a professional test, such as the ability to make important decisions in a short time.