Vol 66, No 1 (2022)

Introduction. Tasks are to execute a study of the preparedness of government and health systems for a pandemic to develop proposals for their modernization. The author proceeds from the hypothesis that epidemic and pandemic diseases will threaten society in the foreseeable future, and therefore it is necessary to develop preventive strategies for states to be prepared for new threats. The article summarizes the experience of government and public health in a pandemic of coronavirus infection. 

Purpose. To examine pandemic preparedness of public administration and health systems and develop proposals for their modernization. 

Material and methods. There was made an expert analysis of the problematic issues of public administration in the implementation of preventive and anti-epidemic measures using statistical materials and publications of domestic and foreign authors. The study applied information and legal databases, documents of the World Health Organization, health authorities of countries in conditions of coronavirus infection pandemic, analytical, informational, statistical methods of research. 

Results. Measures are proposed to modernize states’ preparedness for possible pandemics (epidemics) for the medium and long term. 

Conclusion. The author has proposed an algorithm for the activities of the government in preparedness to combat a pandemic (epidemic). It is necessary to introduce the principles of “double” (including epidemics) use of premises, buildings and structures and “double” (including epidemics) education of specialists in the field of veterinary medicine and biology, as well as paramedical personnel.

Introduction. During the COVID-19 pandemic, there was quarantine, limited contacts, and an increased burden on the healthcare system in the last two years. These problems have led to a rethinking and transformation of patients’ readiness for the digitalisation of healthcare.

Purpose. to form a patient profile, ready to use digital technologies and artificial intelligence methods in medical care during the COVID-19 pandemic, based on technological competence and digital literacy skills analysis.

Material and methods. The sociological survey of patients was used through the remote distribution of links to the Google form on the Internet. The survey consists of 11 blocks, including an assessment of attitudes towards digital technologies and artificial intelligence in healthcare.

Results. The average age of respondents was 41.8 ± 0.7 years, mostly female 225 (74%) in the group of patients ready to use electronic wearable devices to monitor and control their health. One hundred thirty-one people (43.1 %) regularly monitor their blood pressure levels. One hundred thirty-seven people (45%) assess their health as good and 133 (43.7%) satisfactory. 256 (84.2%) respondents mostly work full-time. Ones do physical exercises regularly in 34.2% (n = 104) cases and rarely in 48,7% (n = 148). Only 164 respondents (29.4%) consider it possible to use artificial intelligence methods in providing medical care, preventing the development of diseases and promoting a healthy lifestyle, against 256 people (45.9%), the remaining 137 people (24.6%) found it difficult to answer. Women (49.7%) were more often against artificial intelligence methods than men (33.6%).

Conclusion. It is necessary to consider the patient’s profile characteristics, who is ready to use digital technologies and artificial intelligence methods in medical care when developing effective programs to increase the level and pace of healthcare’s digitalisation in the region.

Introduction. The study’s relevance is determined by the necessity to develop an effective organizing tool that provides management of the rehabilitation process after joint arthroplasty. 

Purpose. Study of online communication possibilities in managing the process of patients’ rehabilitation after joint arthroplasty in their motivation to maintain labour activity. 

Material and methods. In 2019–2020 with the System of interactive personalized monitoring and feedback (SMF) developed as a web application it was conducted a medical and sociological study which included 93 patients underwent hip and knee arthroplasty six months before.. 

Results. It is revealed an unsatisfactory assessment of rehabilitation provided at the place of patients’ residence (34.4% noted the absence of rehabilitation measures, 12.9% noted a formal extension of disability certificate). Expected results of rehabilitation are associated with overcoming pain and limitation in movements (49.5%) and a return to previous professional duties (32.3%). 77.4% of patients expressed interest in using the online service for communication with a qualified specialist. Significant functions of online service for respondents are: monitoring the rehabilitation process and individual recommendations (50.5%); receiving online consultation (41.9%). 95.7% of patients confirmed their readiness to follow online recommendations regarding rehabilitation. 

Discussion. Lack of comprehensive rehabilitation is a significant medical and socio-economic constraint at the institutional and individual levels. Studies of organizational parameters of the rehabilitation process indicate a discrepancy between the expectations of patients and their actual state. Analysis of the results proves that it is advisable to supplement existing rehabilitation practice after providing resource-intensive medical care with the functionality of online communication. 

Conclusion. Developed online communication service is an effective tool for managing the rehabilitation 
of patients after joint replacement that is relevant for developing their labour activity motivation.

Introduction. In unstable world events, the problem of socio-psychological adaptation of the population is aggravated by a lack of magnesium in the body, which requires simplicity and accessibility of its diagnosis.

Purpose: to consider the components of socio-psychological adaptation of the adult population at various risks of magnesium deficiency based on Smart diagnostics of magnesium in the body.

Material and methods. Smart diagnostics of determining the body’s supply of magnesium in 110 people aged 18 to 70 years with the analysis of the level of components of socio-psychological adaptation and stress resistance. Two groups are selected. The Pearson χ² and Mann–Whitney criteria were applied for statistical analysis, and the agreed standardized Haberman residuals were calculated.

Results. Magnesium deficiency was detected in all respondents, with 42.7% showing a marked deficiency, while 76% were aged 18–22 years. The proportion of overweight people with a low level of magnesium deficiency is significantly lower (15.9%) than in the group with a pronounced magnesium deficiency — 29.8%. A low level of stress tolerance prevailed in the groups with different risk levels of magnesium deficiency — 8 (5–10), Uz = 0.03, p = 0.98, and the components with a high median score in the group with a pronounced magnesium deficiency were: external control, inventory, and escapism, with pronounced maladaptive. In the control group, respondents had high adaptability, self-acceptance, emotional comfort, internal control, and low maladaptive.

Conclusions. The adaptive profile of respondents with severe magnesium deficiency is characterized by significantly reduced emotional comfort, internality, desire for dominance and adaptation. Diagnosing maladaptive event, it is advisable to recommend preventive magnesium intake. The availability and non-invasiveness of the questionnaire to identify the risk of severe magnesium deficiency, along with the significance of magnesium for the normal functioning of organs and internal systems, requires more extensive use of SMART diagnostics in preventive medicine (at preventive examinations, consultations of psychologists and psychotherapists), prevention departments and health centres.

Summer rest in suburban health organisations is a formal form of summer holidays for children and adolescents.

The purpose of this work is to assess the impact of a complex of factors of health institutions on the effectiveness of children’s health. 

The methods. Medical examinations of 14,413 schoolchildren aged 8 to 14 years were collected. All health facilities were divided into three clusters depending on a comprehensive indicator characterising the compliance of the conditions and organisation of rehabilitation with hygiene requirements. The assessment results of external conditions are presented by the specific gravity of the revealed violations for individual elements and, in general, a comprehensive assessment. Comparison of the structure of violations during inspections of organisations’ sanitary and epidemiological conditions was performed according to the χ² criterion. The risks of a common healing effect were evaluated using the odds ratio (OR) indicator and its 95% confidence interval (CI). The OR calculation was performed compared to the group of the optimal level of the complex indicator of detected violations. 

Results. Contribution to the comprehensive indicator of non-compliance with requirements in medical work is from 31% to 81%, in catering from 18.3 to 54.1%, accommodation (from 15.3 to 45.5%). In 47.3% of organisations, the effectiveness of recovery was rated as high in 98.2-100% of the examined low in 3.4% of the examined. The dependence of the efficiency indicator of recovery on environmental factors is revealed.

Conclusions. There is still a need to develop a health improvement system with improved control of the effectiveness of health improvement and the study of factors contributing to improving the effectiveness of health improvement.

Introduction. At present, the process of reforming control and supervisory activities continues. Improving the compliance system is the most important area of deregulation and reducing the administrative impact on business. To effectively achieve the deregulation goals, it is necessary that this policy takes into account the peculiarities and specifics of the business and reorients the control system to reduce the administrative burden. In 2021, several new regulations came into force, including a regulatory document containing mandatory requirements for providing services to the population. The new document is a normative legal act regulating relations in sanitary legislation in terms of providing the population with services for various purposes. 

The purpose and objectives are to develop and implement new regulations in providing services to the population. 

Material and methods. In developing a new regulatory document, theoretical general logical methods and techniques of scientific knowledge were applied, their own experience of practical activities of the project developers in the institutions of the Rospotrebnadzor service was used. 

Results. As a result of the work, new regulations in providing services to the population were developed and implemented in the framework of the implementation of reforming public administration policies. 

Conclusion. New regulations have been introduced into the practical activities of business entities and control and supervisory bodies of Rospotrebnadzor, which will contribute to business compliance with sanitary and hygienic requirements and anti-epidemic measures in order to ensure the safety of services for the health of consumers. Methodological instructions or guidelines explaining the features of the new regulations will contribute to their early implementation into practice.

Introduction. The influence of stress factors in the social and occupational spheres of life leads to deformations of the professional plan and a decline in the vitality in health workers (indicators of beliefs about oneself as a specialist and occupational environment, resistance to stressful professional situations, endurance, satisfaction from work and its results, involvement, self-confidence, control, professional self-development).

The purpose of the study is to determine the specificity of the vitality of health care workers with occupational deformities.

Material and methods. The survey of 6830 healthcare workers was executed, including 816 cases with pronounced deformations of a professional plan. We used a burnout questionnaire and its modification, a mental burnout questionnaire, three modifications of the vitality test (in order to obtain objective information when the subjects perceive the content of the statements of the questionnaires in various contexts, taking into account the performance of diagnostic procedures by the self-assessment method) and a test for resistance to life difficulties. Mathematical and statistical data processing included descriptive statistics, K. Pearson’s correlation test and the Chaddock table.

Results. In health care workers, the dominance of depletion of the psychoemotional type is determined, determined by the above-average: deformation of the professional aspect, depletion of the psychoemotional nature, reduction components of the achievements of the personal and professional type and motivation of professional activity, as well as average: the distance of the personal and professional aspect and depersonalization criteria, affecting a tendency towards a lower average risk acceptance, reduced indicator of involvement, a decrease in the average value of resilience and resistance to life difficulties, a tendency towards an average indicator of control.

Discussion. The results of studies by foreign and domestic doctors and psychologists confirm the need for diagnostics, prevention and correction of professional deformations and increasing the resilience of healthcare workers.

Conclusion. The need for systematic diagnosis, prevention and correction of the components of deformations of the occupational plan of health workers is explained by the lowered indicators of involvement, resilience, control, risk acceptance and resilience to life’s difficulties.

Introduction. Surrogacy is a method of infertility treatment involving the conclusion of an agreement between potential parents, a surrogate mother and a medical institution. Until now, lawyers have not been able to develop a unified approach to forming the regulatory framework for surrogacy. Whether healthcare providers have developed a standard view of this problem is not clear.

The purpose is to summarise the medical community representatives’ views on the surrogacy program’s managing issues and their participants’ rights and obligations.

Material and methods. The Internet survey was conducted among medical workers of various specialisations from different regions of Russia and among future specialists (students of medical universities and interns). 7504 questionnaire was analysed. The questions concerned the indications for surrogate motherhood, the sources of its funding, the citizenship of the participants in surrogacy and their contractual obligations, the rights of the surrogate mother and the ordering parents.

Results. medical specialists assign a pivotal role to the surrogacy program’s legal aspects, despite being implemented using high-tech medical technologies. They give priority rights to a newborn child to the ordering parents. During pregnancy and childbirth, decisions regarding lifestyle, hospitalisation, and delivery methods should be made only in conjunction with specialists from the medical institution that signed the contract. As the level of professional responsibility of medical specialists grows, the share of answers about the inadmissibility of state funding of surrogacy, the implementation of surrogacy programs for foreign citizens and single men and women as genetic donors increases, and the share of answers about the admissibility of altruistic surrogacy decrease.

Conclusion. Having decided on the legal issues of managing medical care in surrogacy programs, representatives of the medical community do not consider this type of high-tech medical care a common way to solve the problem of infertility, considering it as an exclusive method of medical care for married couples with infertility of women.

Significant and anniversary dates of the history of healthcare in 2022.