Mobile medical teams during the Covid‑19 pandemic: legal aspects and implementation experience

During the pandemic of the new coronavirus infection Covid 19, the healthcare system faced serious challenges, one of which is a shortage of qualified personnel. One of the methods for solving this problem was the creation of mobile multidisciplinary mobile teams on the basis of federal medical institutions. In this article, the authors analyze the legal aspects of the functioning of mobile teams, and also give the experience of the employees of the Federal State Budgetary Educational Institution of Higher Education Bashkir State Medical University in the regions of Russia and abroad.

Ecological and hygienic problems in the Arctic territories of intensive industrial activity (review)

The Goal. To analyze the literature on the impact of high latitude climate on human health, as well as consider some aspects of adaptation to Arctic conditions and nutritional issues for the population and shift workers.Methods. Review of the articles placed in the bibliographic and abstract databases of VINITI, CyberLeninka, RSCI, Scopus, WoS, on the study of environmental and hygienic problems in the Arctic territories, where intense industrial activity is carried out. The following keywords were used: Arctic territories, adaptation, watch, food.Results. Long-term fundamental research has established that a complex of unfavorable and extreme natural and climatic factors in the Arctic causes two main syndromes in humans – “polar tension” and “northern tissue hypoxia”. Adaptation of new settlers in the Arctic territories proceeds in three stages. The duration of the shift period must have a physiological and hygienic justification and correspond to the duration of the period of stable working capacity. In high latitudes, it is especially important to develop diets and food products for various groups of the population and shift workers in relation to the specifics of their work in the Arctic regionsConclusions. Among the main environmental and hygienic problems of the Arctic territories, where intense industrial activity is carried out, it is necessary to highlight the tasks of scientific substantiation of rational modes of work and rest of workers in rotational forms of work. Also it’s necessary to define the quantitative and qualitative composition of food rations recommended for nutrition of various groups of the population, in relation to the specifics of production factors.

Comparative assessment of mortality and lethality rates of newborns at the regional level

In order to assess the mortality and lethality rates of newborns in obstetric organizations of the North-Western Federal District in 2013–2019, a comparative analysis of official statistics data was carried out. It was found that in the North-Western Federal District in the period from 2013 to 2019, there was an almost annual decrease in newborn mortality rates. The overall decrease in mortality in maternity care organizations of the Federal District (from 2,5% to 1,9%) was mainly due to a decrease in mortality in obstetric hospitals of the first and second levels (respectively from 3,2% to 1,2% and from 1,7% to 0,7%), while most children died in perinatal centers, where the mortality rate has not changed in recent years (2013 – 4,1%; 2019 – 4,0%). The study showed a decrease in mortality rates in the subjects of the Russian Federation that are part of the federal district, except for the city of St. Petersburg. The average hospital lethality rate of newborns in maternity care organizations of the North-Western Federal District during 2013–2019 was in the range of 1,9%–2,0%, did not change significantly and corresponded to the national average. However, the level of hospital lethality significantly differed in individual subjects of the district – in more than half of them, the level of hospital lethality exceeded the average, while in others it was significantly lower. Thus, the decrease in the mortality and lethality rates of newborns in maternity care organizations indicates an increase in the quality of medical care for children in the North-Western Federal District. dicates an increase in the quality of medical care for children in the North-Western Federal District.

The system of indicators of behavioral risk factors in Russia at the national and regional levels

Introduction. Behavioral risk factors are associated with 47% of all-cause mortality in Russia.The goal of this study was to assess and to select the available data sources on the burden of behavioral risk factors in Russia and its regions.Methods included collection and systematization of medical, demographic and survey which reflected the burden of behavioral risk factors in Russia.Results. The spectrum of sources of the data on behavioral risk factors among adults in Russia has significantly expanded in recent years. Rosstat agency provided regional survey data on prevalence of consumption of tobacco and other nicotine-containing products, physical activity, overweight and obesity. The survey results may underestimate alcohol and tobacco consumption due to the sensitivity of these questions. Therefore, the use of morbidity and mortality data is needed well. Detailed regional data on food product consumption in Russia are available, but the list of food groups needs to be updated to reflect current scientific knowledge. At the same time, there is no monitoring of the consumption of table salt and iodine by the Russian citizens. The data from Rosstat surveys on physical activity is available by the regions, and it provides more reliable results in comparison with the reports of sports organizations. Monitoring of behavioral risk factors among children and adolescents in Russia has yet to be organized.Conclusions. A number of data sources have been identified that can be used to assess the burden of behavioral risk factors in Russia and the regions, and ways to improve such monitoring are proposed.

“Health in All Policies” Approach and Health Impact Assessment in Russia and the world

This study presents analysis of the international and Russian experience of implementation of “health in all policies” approach into legislation, as well as of health impact assessment. Certain steps towards the implementation of this approach have already been made in Russia, however, in general, there is still a lot to be done. It was revealed that the current system regulatory impact assessment (RIA) in Russia has a narrow focus and is focused on protecting the interests of business, which does not correspond to the well-established world practice, which presupposes complex RIA, including the impact of regulation on public health. Recommendations for strengthening the principle of “health by all policies” in Russian legislation and the introduction of the practice of assessing the regulatory impact on public health in Russia are presented.

Climate change in Russia – problems of public health

Climate change and the accompanying social risks have already become one of the main problems of the world community. An increase in the frequency and duration of natural disasters (floods, typhoons, mudflows, etc.) lead to significant loss of life. Heat waves have caused excess mortality among the urban population, especially among Russian megacities. WHO initiated the development of national adaptation plans, and Russia has accumulated some experience in developing a regional action plan using the example of the Arkhangelsk region. and a local plan in Moscow. The National Adaptation Plan of the Russian Federation provides for the participation of the Ministry of Health, but there is no intersectoral interaction, the best practices of other countries have not been sufficiently studied.

How to achieve the UN Sustainable Development Goals in the field of noncommunicable diseases by 2030, according to research in 49 countries

Goal. To analyze chronic noncommunicable diseases (NCD) mortality dynamics and associated efforts to reach UN sustainable development goals (SDG) in the area of NCD “by 2030, reduce by one third premature mortality from NCD through prevention and treatment“.Methods. WHO statistics, based on the unified mortality and cause -of- death reports of Member-States countries along with the latest information from global WHO programmes, were used to evaluate NCD mortality trends in 49 countries in 2000, 2010 and 2016 and make comparisons and assessments of different types of community -based, country-wide interventions. Only countries with multiple years of national death registration data and high completeness and quality of cause-of-death assignments were included in the analysis. Cardiovascular disease (CVD) ischemic heart disease (IHD) and stroke, chronic respiratory disease (CRD) bronchial asthma and chronic obstructive pulmonary disease (COPD) lung cancer and diabetes mortality were analysed in 36 high income countries (HIC) and 13 middle income countries (MIC).Results. The most visible decline was achieved for bronchial asthma 54%, stroke 43% IHD 30% and COPD 29%. Lung cancer and diabetes mortality decline were not statistically significant. Prevalence of tobacco smoking gradually declined in 84% of countries, 55% of countries demonstrated declining prevalence of raised blood pressure. Obesity prevalence was increasing in all countries. CVD and CRD mortality were higher in MIC. HIC better implemented tobacco and diet reduction measures. Same concerns NCD management approach. Air pollution level was higher in MIC.Conclusions. NCD mortality decline is associated with multiple WHO global life style modifications campaigns, global coordinated prevention and control programmes for hypertension, asthma and COPD and WHO developed “best buy” approach. In order to achieve better results in lung cancer mortality together with early detection, more efforts should be concentrated on early diagnosis, strengthening tobacco cessation, clean air and diet actions. Diet and physical activities along with adequate management and patient education remain key elements to improve diabetes prognosis by the year 2030. Air pollution control could also facilitate achievement of the UN SDG 3.4.

Dialetics of the relationship of public and individual health

In the article the phenomenon of health as integral notion is revealed from philosophic positions. Universal characteristics, inherent to health, in particular, its attributive, axiological and praxiological meaning, are highlighted. The evolution of representations about health is manifested in the historical context.The aim of the study. On the basis of fundamental dialectic categories to show the relationship of public and individual health from biosocial point of view.Methods. The basic dialectic principles, such as unity of quantity and quality, subjective and objective, unique, specific and common are being used.Results. Similar and differential features between public and individual health, reflected different correlation of quantitative and qualitative manifestations, objective conditions and subjective stimuluses, common, specific and unique characteristics are revealed.Conclusions. The fundamental dialectic categories may serve as a methodological basis in the analysis of the relationship of public and individual health. They advance integral understanding of health and its ontological meaning in the individual and societal experience.

Comparative analysis of the takzdorovo.ru internet portal within the framework of a communication campaign aimed at the motivation of citizens of the Russian Federation to lead a healthy lifestyle

Objective. To evaluate the results of the information and communication campaign to promote a healthy lifestyle through a comparative analysis of the use of the takzdorovo.ru Internet portal in 2018–2019.Methods. Comparative analysis of the use of the Internet portal takzdorovo.ru in 2018–2019. was carried out by analyzing the data of the Yandex.Metrica web analytics system. As a source of information on the prevalence of risk factors from 2018 to 2019 we used data from a sample observation of behavioral factors affecting the health status of the population and the compilation “Healthcare in Russia – 2019” by Rosstat, as well as data from surveys of VTsIOM and the Public Opinion Foundation.Results. The total number of visits to the Internet portal takzdorovo.ru after the information and communication campaign increased by 6,4 times. In 2018, the number of unique visitors to the Internet portal reached 449,302 people, in 2019 – 1,82 million people, an increase of 4 times. The number of page views on the site during the reporting period increased by 8,6 times. Also, a number of behavioral characteristics of users of the takzdorovo.ru Internet portal have improved, for example, attendance by time of day, from various types of devices, page viewing depth, number of failures and duration of the visit on the takzdorovo.ru Internet portal.Conclusion. Conducting a communication campaign within the framework of the federal project “Strengthening Public Health” of the national project “Demography” made it possible to attract citizens to use a reliable Internet resource about healthy lifestyles, which is filled by leading experts in the field of health protection.The conducted communication campaign has demonstrated the effectiveness of attracting the target audience to information materials on the preservation and promotion of health, and indicates the need to support and replicate this experience in order to attract and further motivate the population to lead a healthy lifestyle.

The influence of smoking on the formation of occupational lung diseases in workers who come into contact with industrial aerosols

The formation of a healthy lifestyle is one of the most important tasks of disease prevention. Among the factors that negatively affect the health of the population, smoking is of great importance. The influence of smoking on the formation of occupational diseases in workers in harmful and (or) dangerous working conditions has not been sufficiently studied. Based on the knowledge of the pathogenesis of common diseases, it can be assumed with a high degree of probability that smoking can provoke the development of occupational pathology of the respiratory organs, malignant neoplasms, vascular pathology.The aim of the work was to study the clinical manifestations of chronic bronchitis, characterizing the state of the bronchopulmonary system, in smokers and non-smokers who had long-term contact with industrial dust, as well as to analyze the literature data on the impact of smoking on the development of occupational lung diseases in workers exposed to asbestos dust.Materials and methods of research. In the clinic “Research Institute of Occupational Medicine named after Academician N.F. Izmerov”, 55 workers were examined under the influence of industrial aerosols of fibrogenic action. The group of smokers consisted of 45 people: 25 people were coal miners, 20 people were foundry workers. The group of non-smokers consisted of 10 people: 6 coal miners and 4 foundry workers. The severity of the course of professional and non-professional chronic bronchitis in patients was assessed taking into account the clinical manifestations and frequency of exacerbations of the disease, as well as taking into account the severity of respiratory disorders and gas exchange disorders.Results and discussion. In the group of smoking patients, 93,3% had occupational chronic bronchitis, 6.7% had no such pathology. In the group of non-smoking patients with and without occupational chronic bronchitis, there were equally – 50,0%. In the group of smoking patients, 55,5 of the examined patients had respiratory insufficiency of the II degree; 15,5% were diagnosed with respiratory insufficiency of the III degree; cases without respiratory function impairment (DN0 art.) were only 8,8%. In the group of non-smoking patients, grade II DN was more than three times less frequent, amounting to 20,0%, while 40,0% had grade 0 DN and 40,0% had grade I DN; grade III DN was never diagnosed in this group of patients.Conclusion. Smoking, as an independent factor, can play a significant, and in some cases, obviously, a determining role in the development and progression of chronic bronchitis in people exposed to industrial aerosols.The health risks associated with tobacco should be taken into account as an integral part of the assessment of the risks of developing occupational diseases.