Bulletin of Semashko National Research Institute of Public Health

The article presents the results of the author's survey on the problem of reproductive losses of the population on the basis of the OGBUZ «Magadan maternity hospital». At the first stage, risk factors for reproductive losses were identified in patients with a burdened obstetric history, including psychological, material condition and direct anamnesis data. The analysis of the subsequent results of the survey of 400 women with a high risk of reproductive losses revealed low levels of provision of women with components of medical and genetic care. Low satisfaction with the provision of preferential drugs, information tools for the prevention of reproductive losses has been established. Measures of a medical and managerial nature have been identified that contribute to improving medical and genetic services for women in the direction of preventing reproductive losses: increasing social and information security; preferential and gratuitous medical and genetic examinations, medical preparations and vitamin complexes.

The article provides an analysis of the scientific literature, showing that modern research is mainly focused on the role of immunity and microorganisms in the pathogenesis of rosacea. To elucidate the common pathogenetic mechanisms and genetic factors between rosacea and skin cancer, studies in various populations with detailed clinical data, genetic analysis and a longer follow-up period are relevant. Assessment of the quality of life of patients with rosacea is of great interest for clinical practice. It is emphasized that there is an urgent need for global research to develop a modern comprehensive treatment for rosacea, and this pathology, as a chronic inflammatory skin disease, requires active treatment during exacerbations and preventive strategies to limit relapses.

One of the fundamental principles of public health is the collaboration of prevention and treatment of diseases, especially socially significant ones, including infections, such as TB. Preventive measures to reduce the TB spread include its early detection (screening), among key risk groups too. The study aim, provided by using information-analytical and statistical methods, based on own materials, national and foreign publications, data obtained from federal statistical observation forms, is to know the effectiveness of various TB and LTBI screening methods, among vulnerable groups. The study results show that in Russia, along with improvement in the epidemic situation, periodic CXR examinations continue to be the main TB screening method. Effective and modern TB screening methods are used extremely rarely: MGM (6,2%), IGRA-tests for LTBI screening among key risk groups are used non-systemically, mainly among children, along with national ART. Meanwhile, with equal rates of population screening coverage and share of new TB cases found by screening, its detection rate in regions with a high TB incidence is significantly prevailing in regions with a low once (95,0% CI: -0,12 — -3,11, p<0,02). The obtained data indicate the need for a differentiated approach to provide TB screening measures: in regions with a high TB incidence, to maintain mass CXR screening; in areas with low incidence rates, active TB screening should be carried out only among vulnerable groups, including usage of MGM, ATR and IGRA-tests for LTBI screening, and passive TB screening should be organized among those who seek medical care.

Dispensary observation (DO) helps prevent the development of severe forms of the disease and reduce the frequency of relapses. Purpose: to assess the main indicators of DO of the adult population with chronic dermatoses: psoriasis, atopic dermatitis and eczema in the Republic of Bashkortostan (RB). Materials: data of the reporting form No. 12 for 2021 in general for RB and separately for two polyclinics: the city polyclinic and the polyclinic as part of the Central District Hospital (CDH), outpatient cards of patients with analyzed chronic dermatoses who are under DO of both polyclinics. Results: insufficient coverage of DO of patients with psoriasis, eczema and atopic dermatitis in RB was noted, however, this indicator increased relative to the same indicator in 2021. In the polyclinic at the CDH, the coverage of the population with DO is lower, but the indicator of the timeliness of being taken for DO is higher than in the city polyclinic. Between polyclinics, various reasons for withdrawing patients from DO were identified, in some cases being the result of an error in the preparation of medical documents. In the city polyclinic, the coverage of patients with outpatient and inpatient treatment is less, but more with sanatorium-resort treatment than in the polyclinic at CDH. Conclusion: a comprehensive analysis of DO indicators of patients with psoriasis, eczema and atopic dermatitis in RB revealed significant differences between groups of patients living in urban and rural areas, which are due to a number of reasons. It is necessary to further identify and study these causes, as well as assess their impact on the statistical indicators of medical organizations in order to develop measures aimed at correcting them and improving the quality of medical care for the population with chronic dermatosis.

In the context of a shortage of personnel, both doctors and paramedical personnel, in primary health care, medical and diagnostic work is mainly carried out, while preventive measures are implemented less purposefully. The creation of a separate dispensary observation room for adult patients with chronic non-communicable diseases can greatly improve the work of dispensary observation and reduce the burden on primary health care doctors.
The purpose of the study: to evaluate the effectiveness of the dispensary observation of adult patients with chronic non-communicable adult diseases in the preventive work of polyclinics.
Materials and methods: data from BI reports, the Unified Medical Information and Analytical System of the Moscow Region, based on the indicators of the central polyclinic department of the state budgetary institution of the Moscow Region «Lyubertsy Regional Hospital».
Methods: statistical, analytical, observation.
Results: Structural, organizational and educational measures were taken to improve the efficiency of dispensary observation of patients with non-communicable diseases. The work of the HNIZ office was organized with the allocation of the rate of the paramedic and the definition of his functional duties. An algorithm for examining patients depending on the nosology has been developed. Speech modules have been developed for calling and inviting patients for dispensary observation, interaction has been established between the offices of general practitioners and narrow specialists, the prevention office, the prescription office and the observation office for patients with chronic non-infectious cases.
Conclusions: The organization of a dispensary observation room for patients with chronic non-communicable diseases has increased the coverage of this category of patients. The availability of dispensary observation and medical examination for patients has increased due to the organization of the «green corridor». The workload on general practitioners and narrow specialists has decreased. The number of visits to the polyclinic by patients has decreased due to the active use of telemedicine consultations for making appointments with doctors based on the results of examinations. Prioritization of dispensary observation of patients with chronic non-communicable diseases has been introduced. The coverage and quality of medical examination and dispensary observation of this category of patients has increased.

The article presents a fragment of a medical and social study of the incidence of cervical cancer (CC) in the female population of the Omsk region. The aim of the study was to study the primary incidence of malignant neoplasms of the cervix among residents of the Omsk region, as well as to analyze short-term trends.

Currently, information technologies are increasingly used in the provision of medical services. In Russia, the use of telemedicine is already a reality. With the help of remote technologies, assistance was provided during the Pandemic. However, the attitude of society to medical innovations is different. The purpose of the article is to study the attitude / level of trust in the possibilities of using telemedicine technologies in the gender aspect. In the article, the authors set and solve two main tasks in the article: to assess the prevalence of telemedicine technologies in the Russian practice of medical care, as well as to study the attitude and assess the level of confidence in these innovations, taking into account gender differences in the perception of IT in medicine. The article uses the «classic» design of the study in the format of analyzing secondary and obtaining primary data based on the author's sociological survey. The results showed that, in general, men trust telemedicine to a lesser extent than women. However, the older generation of men are not so skeptical than those aged 30 to 49 years. 57% of men agree to get an online appointment with a therapist. There are only a third of them among women, which also confirms the gender difference in the perception of TM. The results obtained have theoretical and practical significance for scientists, researchers and specialists who study the peculiarities of society's attitude to innovations in everyday life, taking into account gender stereotypes, as well as for various government structures, for making balanced and effective decisions in the field of Russian healthcare development.

The relevance of the study is determined by the need to stabilize and improve the demographic situation in the country and its subjects. In order to achieve the national goals of demographic development, it is necessary to maintain the development of the socio-economic sphere of the country as a whole, as well as taking into account the specifics of its regions, including on the basis of an analysis of dynamic changes in medical and demographic indicators. After 2014 There is a trend of steady population growth in the Republic of Sakha (Yakutia), the increase in population is due to the natural increase in the population of the republic over two decades. Among the subjects of the Russian Federation, the republic ranked 34th in terms of life expectancy at birth in 2020, and 1st among the regions of the Far Eastern Federal District.

By the end of 2022, China's total population is 1.41 billion, almost 18% of the world's population. Within a few decades, the country has undergone enormous changes that are affecting the demographic picture of the world. As the rate of population growth slowed down, China’s demographic policy has shifted from the initial control of population growth so as to ensure the harmonious development of population, resources and the environment, to encouraging and stimulating the birth rate due to its reduction and population decline in the last two years. Based on statistical analysis of the National Population Census in China for 1982, 1990, 2000, 2010 and 2020, the authors describe the transformation of the family and its reproductive function, as well as their possible consequences under the dynamics of demographic policy. The average size of the Chinese family households in 2020 was 2.62. This number has been decreased by 24% and 41% compared with 2000 and 1982 respectively. A reduction is observed in the structure of households in terms of size. In 2000, the three or four-person households usually accounted for a large proportion, but in 2020, the one or two-person households have become the mode.
The main trends associated with the transformation of the Chinese household are as follows: the increasing number of small households, the growth of singles and adults living alone. The emergence of such «single society» reduces younger generations’ desire of marriage or having children. Families are more children -centered, and due to the decreasing number of children, the fertility function has weakened, the quality of other functions has been improved such as the resources and chances of education and so forth. There’s also a change of women's status in households, the status has strengthened which led to the strengthening of the role and expansion of women's rights in making family fertility decisions.

Analysis of patterns of senile comorbidity formation was carried out. A key comorbid pathology platform was identified, which is the basis for the formation of the morbidity profile of patients of older age groups. Causal relationships between individual forms of key comorbid pathology have been systematized; afferent, efferent and docking pathology is structured. Organizational solutions are proposed to optimize the procedure for preventive inspection and dispensary observation of the population of various age groups.

Currently, there is an unrealized need for modern scientifically based approaches in organizing the motivation of citizens to lead a healthy lifestyle. Improving the health status of citizens is undoubtedly the basis for ensuring the sustainable development of the Russian Federation, which is of national interest. The development and implementation of health promotion programs at the workplace are separately listed among the tasks of the Federal Project «Ukreplenie obshchestvennogo zdorov'ya» of the National Project «Demografiya». Guided by the territorial-district principle of preventive work, the Ellara Group of Companies was chosen as the base for the study, which includes a full-cycle pharmaceutical company, and also has its own Research & Development laboratory. More than 80% of the drugs produced at the enterprise are included in the list of vital and essential drugs, which explains the close interest in protecting the health of employees of this group of companies, since in modern geopolitical conditions the issue of drug sovereignty is extremely acute. At present, the corporate health protection system for employees includes a voluntary health insurance program and subscriptions to a fitness club. The article presents an analysis of the components of the health-related aspect of the lifestyle of adult citizens using grouping by place of work on the example of the Ellara Group of Companies. The influence of the gender factor on the violation of specific principles of a healthy lifestyle, the popularity of certain channels for obtaining information about a healthy lifestyle was demonstrated, which proves the need to take them into account when working to motivate, stimulate a healthy lifestyle, and develop measures to improve the corporate health protection program for employees.

This article presents an analysis of the opinion of the population on the participation of a person in the program of preventive examinations and medical examinations and his commitment to the preservation and promotion of health based on a sociological survey of 385 people in the city of Moscow.

The article presents the main stages of the scientific path of the outstanding Russian scientist, academician of the Russian Academy of Medical Sciences Mikhail Surenovich Balayan, his formation and growth at the M.P.Chumakov Research Institute of Polio and Viral Encephalitis on the basis of scientific publications, information from the mass media and numerous archival documents. The circle of his scientific interests is outlined, the results of research works on topical problems of medicine are described. The priority directions of his work are highlighted. The contribution of M.S. was noted. Balayan contributed to the development and strengthening of international cooperation of the M.P.Chumakov Research Institute of Polio and Viral Encephalitis with leading scientific organizations from around the world. Special attention is paid to M.S.Balayan's experiment with self-infection, his detection and description of a new nosological form of viral hepatitis (hepatitis E). The continuity of this feat of a scientist with a high tradition of Russian medicine, Russian doctors in the study of infectious diseases, prevention and control of epidemic processes is emphasized.

On September 21 (8), 2024, the medical community celebrates the 150th anniversary of the birth of Nikolai Alexandrovich Semashko, an outstanding organizer of healthcare and the first professor of the Department of Social Hygiene, which he created at the Medical Faculty of Moscow State University I in 1922 and which he led for 27 years until his death. The teaching staff formed by Nikolai Aleksandrovich from like-minded people successfully carried out educational, methodological and scientific work, actively participated in the development of health care in our country. The respectful and kind attitude of colleagues towards N.A.Semashko did not fade even after his death in 1949, which is largely due to the measures taken to perpetuate his memory. To this day, Sechenov University carefully preserves and strengthens the memory of the life of Nikolai Alexandrovich, his contribution to healthcare, science and medical education. At the Department of Public Health and Health. N.A.Semashko created a historical exposition about him, solemn events are held on his birthday, scientific articles on this topic are regularly published, examples from his life and work are highlighted during training sessions and at scientific and practical conferences.

The medical societies of Saratov (physico−medical and sanitary) were the first to pay attention to the consistently high incidence of social diseases (tuberculosis, venereal diseases and alcoholism) at the turn of the XIX — XX centuries, and then the zemstvo and private practitioners of the province. The active activity of the members of the Saratov sanitary society prompted in 1901 to create a committee to combat tuberculosis, thanks to which seasonal sanatoriums and outpatient clinics were opened, the production of koumiss was organized, pavilions were opened for its implementation and treatment of patients. To combat drunkenness and alcoholism, representatives of the intelligentsia organized a Society for Sober and Improved Life in 1894, and in 1904, with the joint participation of representatives of the authorities, the Physico-Medical Society and the city Committee of the Guardianship of People's Sobriety, a hospital for alcoholics was established. In 1905, by permission of the medical board of the Saratov Provincial Board, private practitioners opened private hospitals for skin, venereal and genitourinary diseases. In addition, the medical community and doctors conducted large-scale sanitary and educational work among the population of the region aimed at combating and carrying out measures to prevent social diseases.

The candidate dissertation of Yu.V. Tatarkova, carried out in order to develop and scientifically substantiate measures to improve ophthalmological care for medical students at the regional level, is reviewed. Risk approach and prediction of eye disease outcomes were performed. The created Center for the Diagnosis and Prevention of Pathology has become a model of optimization in general of health protection, medical and social support for youth and university workers of various profiles, citizens of the territory.