Bulletin of Semashko National Research Institute of Public Health

The analysis of the primary morbidity of the child population of the districts (uluses) included in the Vilyui group (Verkhnevilyuisky, Vilyuisky, Mirninsky, Nyurbinsky and Suntar) was carried out. First, we analyzed the morbidity data in general and by disease classes in the indicated districts (uluses) in a comparative aspect with all administrative-territorial entities of the republic. At the same time, the levels of morbidity for certain classes of diseases were revealed in dynamics for the periods under consideration. It was found that in terms of the incidence of the child population as a whole, the Nyurbinsky and Verkhnevilyuisky uluses had a relatively better position. In Mirny district has relatively high levels of primary morbidity are noted in 11 classes of diseases out of 17, while in Verkhnevilyuysky — none.

The scientific team of the N.A.Semashko National Research Institute of Public Health conducted structuring and digitization of diagnostic criteria for the main forms of dementia, which made it possible to build a medical information system «Diagnosis and Treatment of Cognitive Disorders» (MIS) based on the 1C platform, designed to support medical decision-making in determining diagnosis and prescribing treatment to patients with cognitive disorders. Upon completion of clinical trials, it is planned to introduce MIS into the organization of the activities of memory impairment rooms.

The study of students' career expectations has recently become a relevant topic, as young doctors face numerous challenges after receiving higher medical education, especially in their endeavour to find a desirable and suitable job. In the Russian Federation, there are no studies on career expectations of dentists yet. A proper understanding of the career expectations of future graduates of dental higher education institutions is important for the use of human resources to maximise the efficiency of the health care system. This study investigates the professional career expectations of future dentists. In the course of the study, a quantitative research-survey of 327 young dentists in different regions of the Russian Federation was conducted to achieve the stated objective. The results of the study showed various components that influence career expectations of dentists, key questions were highlighted and answered. The conducted research can be a source of information for managers and decision-makers in the field of medical education management, and dental universities and faculties can make a meaningful contribution to the career development of dental students.

This paper examines the technical and technological possibility of providing citizens with information about the results of all ongoing quality checks of medical care provided to them, and also makes an attempt to study the subjective attitude of citizens to this kind of information. For this purpose, an analysis of the existing regulatory legal framework (federal laws, by-laws) was carried out, and research was conducted in the form of a survey among 50 respondents. The percentage of Russians with access to state and municipal services (not only in digital form) in the country exceeds 97%, of which more than 76% use electronic services. Among all inspections, the vast majority relate to the compulsory health insurance system, and only 0.2% of the activities are carried out at the request of citizens, with the results of the inspection subsequently provided to them. Modeling, during a social experiment, a situation where a citizen who previously had no complaints about the quality (results) of medical services provided, received control results, shows, first of all, the emergence of aggression and the desire to “punish” a medical organization, rather than resolve the issue of the impact of such a violation on his health, with determination of tactics (if necessary) for continuing treatment.

Special attention in this review is paid to risk factors for breast cancer, the features of mammography as the main method of cancer screening for diagnosing breast tumors in the age group of patients subject to preventive and medical examinations. The idea why of standard screening not suitable for young women is highlighted. A comparative analysis of existing mathematical models for assessing individual risk of developing breast cancer was carried out. The advantages and disadvantages of the selected models are noted. Based on the analysis, the need to optimize the approach for the selection of diagnostic tactics based on the assessment of risk factors was identified in order to increase the proportion of early detection of breast pathologies.

Early diagnosis plays an important role in the successful treatment of oncological diseases. The well-coordinated interaction of the radiological technician and the radiologist and the formation of the research protocol timely represent the key stages of effective medical care provision for patients. Today, a new trend prevails in healthcare management. It is management based on objective data, the implementation of which is possible by using a universal tool — dashboard.
Purpose. The purpose of our research was to study the effectiveness of using the analytical panel as a tool for monitoring the timeliness of the preparation of research protocols in radiation diagnostics.
Material and methods. The work of the radiology departments was constantly monitored with help of the developed analytical panel «Oncology CT, MRI, MMG». Among other analyzed parameters, the proportion of the results of radiation examinations sent for expert review and the proportion of the results of preventive mammography classified as BI-RADS 3 were evaluated. When deviations were detected, intervention was carried out (two types of management actions). The results of the interventions were evaluated after 1 year.
Results. In comparison with the data of 2022, in 2023 there was a decrease in the percentage of studies not sent to the second reading: for CT of the kidneys and urinary tract from 27.5% to 0%, for MRI of the prostate from 32.13% to 0.17%, for MMG — from 100% to 3%. According to the monitoring results, the intervention contributed to a decrease in the percentage of BI-RADS 3 in MMG protocols from 6.1% in 2022 to 4.16% in 2023.
Limitations of the study. The monitoring was carried out using the developed analytical panel «Oncology CT, MRI, MMG»
Conclusion. The implementation of the dashboard «Oncology CT, MRI, MMG» into clinical practice allowed to optimize the diagnostic process, eliminating delays in obtaining conclusions, as well as improving their quality, thanks to the double reading of images and continuous training of specialists.

Reproductive behavior is formed and regulated under the influence of biological, economic, psychological and social factors. Global and national strategies for the protection of reproductive health and the formation of reproductive behavior have been developed and implemented. In view of the decline in the country's reproductive and demographic potential, comprehensive research is needed to develop a strategy for the formation of reproductive behavior and reproductive needs of the population. In view of the importance of health protection, starting from conception, the prevention of infectious and non-infectious diseases, including diseases of the reproductive system, preventive health strategies must include measures to strengthen the role of primary care medical services as an effective medical tool for influencing the reproductive behavior of the population.

The healthcare system is characterized by a shortage of resources and the need to manage them: a balance is constantly being sought in terms of the possibility of replacing the patient’s inpatient stay in favor of providing outpatient care. The author studies the issue of timing from the maternity hospital after an uncomplicated birth. Regulatory acts (no longer in force and currently in force) containing various requirements and instructions (as well as recommendations) regarding the length of stay of postpartum women in hospitals after childbirth were studied. More than 200 documents, including foreign ones, were analyzed. A tendency has been established to reduce the length of time a woman in labor spends in a maternity care facility (in the absence of complications of physiological labor or cesarean section), due to the improvement of social and living conditions and the development of outpatient services. At the same time, the mandatory requirements regarding the period of stay after obstetric care in a hospital must be brought into line with each other, including establishing a minimum period of stay. In addition, a unified procedure for monitoring newborns after early discharge should be approved as mandatory requirements, with subsequent monitoring of their implementation by both insurance companies and government agencies.

Morbidity among doctors of pre-retirement age is a serious problem that can have a negative impact on their performance and the quality of medical care provided. Studies show that doctors who have reached the pre-retirement age have a higher risk of developing a number of diseases, including cardiovascular diseases, diabetes and arthritis. This is due to the fact that in their work they are in daily contact with various factors of an infectious and non-infectious nature, and age-related changes reduce the capabilities of the immune system and are characterized by the accumulation of stress that accompanies professional activity.
The purpose of the study is to evaluate the results of dispensary examination and morbidity of doctors of pre—retirement age in the Republic of Tatarstan.
Materials and methods of research. The object of the study is doctors of pre—retirement age in the Republic of Tatarstan. The number of doctors of pre-retirement age, men 55—64 years old and women 50—59 years old, according to the Federal Register of Medical Workers of the Republic of Tatarstan in 2018 amounted to 3,768 people, including 1,093 men and 2,675 women. Dispensary examination was studied according to the records of preventive dispensary examination (dispensary examination) (form No. 131/y), and morbidity was studied according to the medical records of a patient receiving medical care on an outpatient basis (form No. 025/y) for 5 years by a continuous method. The processing of the material was carried out using mathematical statistics methods: the assessment of differences between two independent samples in terms of the level of any feature measured quantitatively was carried out by the Mann — Whitney criterion (with abnormal distribution), qualitative indicators — using the criterion χ2 from the StatTech software package. Intensive and average indicators and errors of the average were calculated.
Results. In the Republic of Tatarstan, only 12% of male doctors and 11% of women doctors of pre-retirement age undergo dispensary examinations annually. The primary and general morbidity of male doctors is higher than that of female doctors. During the studied five-year period, the overall morbidity of male doctors increased by 25%, and that of female doctors by 28%, and the primary morbidity by 31% and 49%, respectively.
Conclusions. Doctors of pre-retirement age, regardless of gender, demonstrate low medical activity in relation to dispensary examinations. Only slightly more than 10% of doctors of pre-retirement age in the Republic of Tatarstan undergo annual dispensary examination. At the same time, among them there is a significant growth dynamic of primary and general morbidity, in the structure of which circulatory diseases, endocrine diseases, coronavirus infection and neoplasms occupy the leading places.

Despite the widespread recognition of the merits of Meta Vasilyevna Antropova, Doctor of Medical Sciences, professor, corresponding member of the Academy of Pedagogical Sciences of the USSR (1915—2011) in the development of hygiene of children and adolescents, her biography, the main directions of her scientific activity remain unexplored to this day, rare literary publications are far from complete. This article is based on the results of the study of archival materials, literary sources and scientific heritage of M.V.Antropova is an attempt to recreate, clarify and supplement her work and scientific biography, the stages of her scientific activity. The merit of M.V.Antropova in the development and improvement of the method of natural hygienic experiment in our country, her desire to involve specialists of related medical specialties and pedagogical institutions in research activities are highlighted. The relevance and relevance of the scientific heritage of M.V.Antropova at the present time is noted.

The establishment of social hygiene as an independent specialty in the USSR is inextricably linked to the name of the first People's Commissar of Health of the RSFSR. N.A.Semashko, a physician and Bolshevik, believed that improving working and recreational conditions, housing and living conditions, nutrition, and, most importantly, the proper education of Soviet people would not only prevent social diseases and improve the health of the population, but would also make it possible to create a «new man. Believing that knowledge of social hygiene is absolutely necessary for all doctors, regardless of their specialty, in 1922 he founded the first department of social hygiene in the country, which he headed until the last days of his life.

The establishment of a national health system in the Republic of China during the “Nanjing Decade” (1928—1937) is a good example of an attempt to realize ambitious public health plans with scarce resources and medical personnel. Having achieved political unification of the country after years of war and economic devastation, the Nationalist authorities in Nanjing in 1928 established the first Ministry of Health in the country's history, which was later transformed into the National Health Administration. The article shows how a group of medical reformers from the Peking Union Medical College set about establishing the institutional framework for Chinese health care, as well as pioneering the rural health care. It focuses on the main leader of Chinese health care during this period, Dr. J. Heng Liu, as well as the pioneer of rural health care, Dr. C.C.Chen, who acted as the leader of the medical part of the social experiment in Dingxing County.

Scientific societies are one of the most traditional and effective forms of science self-organization. The article is devoted to the medical societies activities in Petrograd-Leningrad during the 1920s. Based on archival materials about the activities of these scientific societies, stored in the Central State Archives of St. Petersburg, various directions and forms of their scientific and organizational work, administrative and economic activities, problems of relationships with authorities, as well as their socio-demographic and numerical composition. The author concluded that Petrograd-Leningrad medical scientific societies made a significant contribution to the development of medicine in the 1920s. Despite the different period of existence, the unequal number of members, they all pursued a common goal — the development of medical science and the active use of its latest achievements in public health practice.

culture is an integral element of the development strategy of any medical organization. The influence of corporate culture on team building goes far beyond the internal atmosphere of the organization, having a direct impact on the quality and efficiency of the medical institution as a whole. In an environment where the health and life of patients depend on the coordinated work of medical teams, the role of corporate culture is of particular importance, and the study of its impact on various aspects of the functioning of medical organizations is becoming an increasingly urgent task for both researchers and practitioners in the field of health management.

The paper investigates the role of corporate culture in team building of medical organizations, as well as the analysis of its impact on the quality of medical care and the overall efficiency of health care institutions. It is concluded that the development and maintenance of a strong corporate culture should be a priority for the heads of medical organizations seeking to improve the quality of medical care and achieve long-term success in the healthcare market.

The article examines the role of ultrasound diagnostics (ultrasound) in emergency medical care, its significant impact on the speed and accuracy of diagnosis in emergency situations. The advantages of ultrasound, such as non-invasiveness, mobility and cost-effectiveness, which make this method indispensable in critical conditions, are emphasized. The evolution of ultrasound technology is described, including the development of portable ultrasound scanners and the introduction of FAST examination protocols that allow doctors to quickly assess the condition of patients and make vital decisions. Attention is also paid to the social and economic aspects of the introduction of ultrasound into medical practice.

Medical and demographic analysis of the inter-district nature in certain regions is the basis of the organizational and methodological justification of the clinical and managerial improvement of various health subsystems. Primary medical care of the inter-district level refers to the most important component of maintaining the health of various medical and demographic groups. The research of the dynamics of medical and demographic processes includes the birth rate, incidence, mortality, the ratio of marriages and divorces, the migration of the population, as well as an assessment of the medical function of patients. On these results, it becomes possible to apply models of improving regional healthcare, developing and introducing new, more effective and affordable management technologies. The purpose of this fragment of the study was a regional medical and demographic dynamic analysis at the level of the Udmurt Republic for two decades 2002—2022 with the forecast of trends until 2030. A dynamic analysis of general and primary morbidity, mortality and maternal mortality, the intensity of divorces, marriages and migrations, and the dynamics of the population is assigned to the subject of the research. Based on the results, the development of practical recommendations was made to preserve human capital as socio-economic potential. The data of the Federal State Statistics Service and the Republican Medical Information and Analytical Center of the Ministry of Health of the Udmurt Republic for 2002—2022 were used. The forecast of medical and demographic trends was carried out using the R2 (determination coefficient). Medical and demographic analysis showed that in the region over the past 20 years, the total population, predominant due to urban age at the age of 18—65 years, has been progressively reduced. The main causes of depopulation have a progressive increase in primary and general incidence of adults, maternal incidence and mortality, and a high level of migration of young people under the age of 34 to other regions. In order to solve the problem of increasing the population of the region, based on improving public health, it is planned to introduce the competency-based model of a specialist/paramedic/general practitioner and nurses at the stage of primary health care. A prognostic analysis of the show that the result will be achieved the optimal availability and quality of primary health care, the coverage of a medical examination of up to 99% of the population, a decrease in total and maternal incidence and mortality.