No 3 (2024)

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Общественное здоровье и организация здравоохранения
Primary morbidity in the child population of the Vilyui group of districts for 1995—2021
Timofeev L.F., Savvina N.V., Krivoshapkin V.G., Timofeev A.L.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Methodology for constructing the indicator «Immunisation (vaccination) adherence index (%)» based on sociological survey data
Kaunina D.V.
Abstract

This article is devoted to the methodology of constructing the structure of the index of population adherence to immunisation (vaccination) according to the data of a sociological survey using the author's methodology «Algorithm for assessing the level of population ADHERENCE TO VACCINE PROPHYLAXIS». Objective: to propose a methodology for calculating the indicator «Index of adherence to immunisation (vaccination), IАI (%)» using mathematical modelling.
Materials and мethods. The data of sociological survey of respondents using the author's methodology were used in mathematical modelling.
Results and discussion. The IАI design includes such indicators as the proportion of respondents with low, medium and high levels of adherence. The IАI can serve as a tool for ranking or clustering the constituent entities of the Russian Federation, medical organisations and their structural subdivisions by the degree of risk of reduced vaccination coverage. The calculation of the IАI indicator is an important indicator of the level of adherence of the population to immunisation.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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An innovative approach to the management of a key geriatric pathology — dementia
Yakushin M.A., Karpova O.V., Vorobeva A.V., Pershin A.V., Gabrielyan A.R., Kudrin A.P., Yakushina T.I.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Prevention of the development of burnout syndrome of nursing staff in relation to the level of emotional intelligence
Allenov A.M., Sidorenko M.A., Genatulin M.A., Lvova D.P.
Abstract

Emotional burnout syndrome is a pathological condition included in the ICD—10 under the heading Z.73.0: overwork is a state of exhaustion of vital forces. According to the literature, the profession of a nurse is characterized by a high risk of CMEA formation, which over time can deepen and lead to serious changes in behavior, feelings and thinking, further increasing the risk of alcoholism, drug addiction, serious mental illness, and in rare cases even suicide. Studies show that 87.6% of nurses have a history of CMEA, while the diagnosis is not found in their outpatient records. The above confirms the highest importance of the problem of emotional burnout of nursing staff, being a serious threat, the cause of a decrease in the quality of medical activity, an increase in the number of professional mistakes and formal performance of official duties. The article presents the results of an original study of the severity of the development of emotional burnout syndrome, as well as the level of emotional intelligence of the secondary medical staff of the outpatient clinic in Moscow. A statistically significant relationship between the level of emotional intelligence and the severity of the development of emotional burnout syndrome was reliably assessed and revealed. The results made it possible to develop scientifically sound proposals for the prevention of burnout syndrome of secondary medical personnel of primary health care.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Russian dentists: professional career expectations and prospects
Khaniev A.A., Ardavova A.A.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Evaluation of the activity of institutions providing medical support of sports training in the Republic of Belarus
Malyovanaya I.A., Moroz I.N.
Abstract

The article analyzes the activities of institutions that provide medical support for sports training. The scope and directions of work of a sports medicine doctor depending on the level of medical support of sports training are described. The need to organize a multilevel system of medical support of sports training is substantiated.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Social aspects of implementing patient feedback in systems used for quality control and safety of medical activities
Roshchin D.O., Laktanov P.V.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Researching of possibilities for conduction of the first level of the rehabilitation of patients with acute cerebrovascular accident in medical organizations of the Russian Federation
A. Magomedova Z.A., Gurkov G.A., Artikulova I.N., Musaev G.K.
Abstract

The relevance of medical rehabilitation at all stages is due to the high prevalence of cardiovascular diseases, including acute cerebrovascular accident. The article examines the possibilities of providing medical care in the field of medical rehabilitation at the first stage to patients with acute cerebrovascular accident in the Republic of Dagestan. The bed capacity of intensive care units with dedicated beds for this category of patients, neurological departments for patients with acute cerebrovascular accident, the equipping of these departments with equipment and methodological aids, as well as staffing, in accordance with the procedures for providing medical rehabilitation assistance to adults, were analyzed. The study showed that the possibility of conducting the first stage of medical rehabilitation in medical institutions of the Republic of Dagestan is present, but does not fully correspond to the procedure for providing care. Firstly, there are not enough beds available both in intensive care units and insufficient number of beds in neurological departments for patients with stroke. In addition, a significant problem that needs to be solved is the personnel shortage of both doctors and paramedical personnel. It is also necessary to standardize and equip early medical rehabilitation departments.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Cancer screening in patients at risk for breast cancer under 40 years of age. Literature review
A. Komissarova V.A., Safontsev I.P., Zukov R.A.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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COVID-19 and chronic non-infectious diseases in the patients with fatal outcome according to the Federal Register in Tomsk region
Naydenova N.E., Ilyinskikh E.N., Nagaytsev A.V., Stasyuk N.A., Amonotidi A.V.
Abstract

The results obtained are based on the data from “Federal Register of Persons with the Novel Coronavirus Infection COVID-19.” The study included the information from 160 deceased patients hospitalized from November 2020 to January 2021 in the repurposed therapeutic departments of the respiratory hospital of Tomsk Regional Clinical Hospital. Almost half of the patients with fatal outcome from COVID-19 were multimorbid (46.3%). The most common combination of CSD and respiratory diseases was found — in 33.1% of cases. A negative correlation was revealed between the length of stay of deceased patients in the hospital and the age of the patients (rs = −0.172; p <0.05).

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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The effectiveness of radiation diagnostics management using analytical dashboards: the oncological aspect
Vasilev Y.A., Ivanova G.V., Mukhortova A.N., Filin M.E., Shulkin I.M., Vladzymyrskyy A.V.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Problems of organizing pain management for patients with malignant neoplasms in the Russian Federation
Linnik S.A., Tumenko E.E., Andreyashkina I.I., Abuzarova G.R.
Abstract

Chronic pain syndrome in patients with advanced cancer is widespread. However, the organization of pain treatment for patients on an outpatient basis with pain syndrome has not been studied in our country. Using an online survey, we conducted a survey of oncologists treating outpatient patients with cancer. It turned out that more than half of the respondents believe that the organization of care for such patients has shortcomings, including the lack of routing orders, clinical recommendations and other regulatory documents, as well as the lack of specialized pain treatment rooms and difficulties with issuing prescriptions for painkillers. At the same time, the study revealed low awareness of doctors regarding the availability of certain painkillers in pharmacies.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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On strategies for regulating reproductive behavior: medical and social aspect
Mingazova E.N., Gureev S.A., Zhelezova P.V., Nepomnyashchaya G.G.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Dynamic and prognostic indicators of morbidity in the classes of «ear and mastoid process diseases» and «respiratory diseases» among children and adolescents
Oleinik A.V.
Abstract

The article presents the results of an analysis of the indicators of primary morbidity of children 0—14 years old and adolescents 15—17 years old in the classes of « ear and mastoid process diseases» and «respiratory diseases» in the Russian Federation and in the context of the municipality of Ramenskoye, Moscow region. in the period 2011—2022, there is a tendency in the Russian Federation to reduce the level of primary morbidity of children and adolescents with ear and mastoid process diseases, as well as respiratory diseases, however, in 2020—2022. The indicator has resumed growth, which may be due to the spread of coronavirus infection and its consequences. According to the medium-term forecast, while maintaining existing trends in the studied classes of diseases, by 2027 it is possible to reduce the level of primary morbidity of children and adolescents with ear and mastoid process diseases, respiratory diseases. At the same time, there is an increase in the prevalence of chronic forms of this pathology, which is more pronounced in rural patients than in urban patients, there is an increase in the need for children and adolescents in dispensary care in connection with ENT diseases, which is more pronounced among rural children and adolescents than urban ones. All this requires the development and implementation of organizational technologies for controlling, monitoring morbidity and increasing the availability of medical care to children and adolescents in urban and rural areas.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Length of stay of a maternity patient in the materinity hospital after an uncomplicated birth
Nizamova E.R., Vasilyeva T.P.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Algorithm for calculating the economic impact of introducing neonatal screening for rare diseases
Komarov I.A., Alexandrova O.Y.
Abstract

In recent years, in the Russian Federation, the program of state guarantees of free medical care to citizens has included expanded neonatal screening, including for rare diseases. At the same time, it is important to understand the economic impact of this initiative on the state budget. On the one hand, timely detection of diseases allows for better control in their treatment. On the other hand, this will require more healthcare resources and, as a result, additional budgetary expenses. The purpose of the study is to develop an algorithm for calculating the economic impact of introducing neonatal screening for rare diseases. The regulatory documents regulating the provision of medical care, as well as neonatal screening for rare diseases, were analyzed. As an example for the development of the algorithm, a study was used to assess the socio-economic effectiveness of neonatal screening for spinal muscular atrophy in the Russian Federation, as well as examples of domestic pharmacoeconomic studies. The main types of costs that need to be assessed in the economic analysis of the consequences of introducing screening are identified. Approaches to their accounting are presented based on existing regulatory documents.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Dispenserization and morbidity of doctors of pre-retirement age in the Republic of Tatarstan
AnasA. Gilmanov A.A., Nigmatullina D.H., Vasiliev M.D., Russkikh S.V.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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История медицины
Contribution of M.V.Antropova to the development of hygiene of children and adolescents
Sarkisov A.S.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Alexander Schmidt and his scientific school: studying the physiology of blood coagulation
Sergeeva M.S.
Abstract

In the second half of the 19th century, the study of blood physiology became one of the leading experimental areas, whose relevance had been associated not only with the emergence of new research methods, but also with the growing popularity of blood transfusion in clinical practice. However, the widespread use of the blood transfusion practice was impossible without solving the problem of thrombosis. Patient safety required a detailed study of the causes of blood clotting and the search for effective methods to overcome it. A comprehensive understanding of this process was proposed by the University of Dorpat professor Alexander Schmidt, who created the enzymatic theory of thrombosis, and his students (Jakovitsky, Sachsendahl, Köhler, Birk and others), studied the formation, content and action of the fibrin enzyme in a living organism. They managed to prove the multistage nature of the blood coagulation process, to explain the mechanism of its internal regulation in a living organism and to describe the pathology of blood transfusion. Studying the contribution of Schmidt’s scientific school to improving scientific ideas about the mechanism of coagulation, the safety of blood transfusion and the methodology of experimental physiological research in general became the purpose of this article.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Nikolai Aleksandrovich Semashko, Professor of the First Department of Social Hygiene (150th anniversary of his birth)
Pashkov K.A., Topolyanskiy A.V.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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The beginning of the career path of the academician N.N.Blokhin
Koshelev A.D.
Abstract

This article is dedicated to the beginning of the surgical career path of an outstanding public figure, a world-famous scientist, and a high-profile domestic oncologist, namely Nikolay Nikolayevich Blokhin. His transformation from a resident physician into a great scientist and brilliant surgeon is described. Based on archive materials, the results of his first surgical interventions are presented for the first time. Those interventions took place when he graduated from the Gorky Medical Institute and started working in a rural hospital in the village of Diveyevo, Gorky Krai, in 1935. Readers get to follow the development of skills of N.N.Blokhin who mastered increasingly complex methods of restorative medicine by every year.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Public health in Republic of China during the «Nanking decade» (1928—1937)
Mikhel D.V., Mikhel I.V.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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About the clinical school of the “holy doctor” F.G.Yanovsky: (academy members V.N.Ivanov, V.Kh. Vasilenko and B.E.Votchal) and about the Haass tradition of christian humanism in Russian medicine
Borodulin V.I., Vasyliev K.K., Banzelyuk E.N.
Abstract

Famous physician from Kiev, member of Academy of Sciences, Feofil Gavrilovich Yanovsky, creator of a large Russian scientific medical school, undoubtedly belongs to the leaders of Russian therapeutic elite at the beginning of the 20th century. In addition to his medical and scientific achievements, F.G.Yanovsky went down in history as a «holy doctor» — because of his medical selfless devotion in the tradition of F.P.Haass. However, this tradition continued in different ways among his disciples. The article provides a comparative personal analysis of the three major representatives from the traditional composition of this school: V.I.Ivanov, V.Kh. Vasilenko and B.E.Votchal.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Self-organization of the medical science of Petrograd-Leningrad in the 1920s
Sinelnikova E.F.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Experience of Information Technologies application in teaching History of Medicine at RUDN University
Sorokina T.S., Fomicheva S.A.
Abstract

This article is devoted to successful experience of the RUDN University Department for the History of Medicine, in collaboration with the RUDN Scientific Library, in introduction of information technologies in the subject «History of Medicine” educational process. The components of the educational practice of the Department for the History of Medicine, interactive elements of online coursesand specific solutions that made it possible to overcome problems arising in application of information technologies in traditional learning process in higher education are discussed. Complex online system for assessing students' knowledge in accordance with the point-rating system adopted at RUDN University is also described in this paper. Such combination of face-to-face and online learning opportunities allows taking into account all intellectual activities of students aimed at mastering the discipline «History of Medicine».

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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К юбилею НИИОЗММ ДЗМ: сотрудники института об актуальных проблемах здравоохранения
Corporate culture and its impact on the staffing of a medical organization
Voronov T.M., Shkrumyak A.R., Dashkova A.L.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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The modern view of foreign scientists on the problem of aging and increasing the duration of a healthy life
Turzin P.S., Derbenev D.P.
Abstract

Aging is a complex process accompanied by a progressive decrease in the activity of psychophysiological systems and body functions and an increased risk of developing age-related chronic diseases. Foreign scientists believe that in the context of unprecedented global population aging, we are faced with the need for an integrated approach to solving the interdisciplinary problem of healthy aging.
The purpose of the study was to analyze the modern understanding of the essence of the aging process and existing approaches to increasing life expectancy. Materials and methods. The paper uses the method of content analysis of scientific publications collected in the international databases Scopus, Web of Science and PubMed based on the keywords «aging» and «life expectancy» over a five-year period.
The results and their discussion. As a result of the work carried out, the modern view of foreign scientists on the aging process was clarified, which is the result of a combination of various biological processes and methods that optimize the aging process. A key tool for adapting the treatment of elderly cancer patients has been identified.
Conclusion. Aging is a multifactorial process associated with a decrease in functions and an increased risk of morbidity and mortality, which places ever-increasing demands on the healthcare infrastructure. Measures to promote healthy aging are important to maximize the quality of life of older people, increase life expectancy and minimize the burden on health systems.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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The use of ultrasound diagnostics in emergency medical care
Murmilov V.V.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Вопросы демографии
Forecast for trends in medical demographic processes: 2002—2022 (Udmurt Republic)
Kicha D.I., Bagin S.A., Rukodaynyy O.V., Goloshchapov-Aksenov R.S., Uteva A.G.
Abstract

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.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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Analysis of the medical and demographic situation in the Samara region during a pandemic
Kalininskaya A.A., Merekina M.D., Shakurov I.G., Balzamova L.A., Irineva S.V., Smirnov A.A.
Abstract

Target. The results of the analysis of medical and demographic indicators and morbidity of the population of the Samara region should be taken into account to develop management decisions on protecting the health of the population.
Materials and methods: analytical, statistical. Statistical materials of the Federal State Statistics Service and the Central Scientific Research Institute of Infectious Diseases of the Ministry of Health of Russia (2013—2022), Rosstat, Samarstat (2013—2022) were used.
Results. Over the 10 years of analysis, the mortality rate in the Samara region decreased until 2020, followed by an increase during the pandemic to 16.7‰ (2020) and a decline in 2022 to 14.2‰. In the pre-Covid year (2019), the primary morbidity rate of the population in the region was 88098.2‰00; in the next year of the pandemic (2020), the value of the indicator decreased to 81956.8‰00 and in subsequent years of the pandemic increased, amounting to (91866.1) and in 2022 (97799.2). In 2022, the primary morbidity rate as a whole increased compared to (2019) by 11%, which was associated only with respiratory diseases by 24%. At the same time, the incidence of COVID-19 increased from 1713.5‰00 in 2020 to 9894.3 (2022). In all classes of diseases, except for respiratory diseases, a decrease in primary morbidity was noted in 2022 compared to 2019. Analysis of the structure of morbidity (primary) in 2022 showed that more than half of the diseases were associated with respiratory diseases (51.2 %), in second place is the incidence of COVID-19 (10.1%), in third place are injuries, poisoning and some other consequences of external causes (6.6%), etc. The difference in primary incidence rates in the constituent entities of the Russian Federation is large — in 3.6 times.
Conclusion. It is required to develop management decisions aimed at improving organizational forms of work, strengthening preventive work with the population and rehabilitation of patients in the post-Covid period.

Bulletin of Semashko National Research Institute of Public Health. 2024;(3):
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