Category: Nevin Manimala

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):848-854. doi: 10.32687/0869-866X-2024-32-4-848-854.

ABSTRACT

The approaches to analysis of medical personnel of stomatological service continue to be based on principles formed in relation to state health care system that makes it difficult to objectively assess situation due to increasing proportion of specialists employed in its private sector. The study, targeted to comprehensive comparative analysis of stomatological medical personnel of state and private medical organizations in the Irkutsk Oblast, for the first time made it possible to assess provision of population of large region and its municipalities with stomatologists, considering specialists employed in private medical organizations, in dynamics and in context of separate specialties. The decrease in provision of population with stomatologists in state medical organizations by 12.3% in 2019-2023 against the background of its increase in private ones by 14.5% was revealed. In 2023, 50.5% of stomatologists were concentrated in private sector of stomatological service and 30.8% in state sector. Yet another 18.7% combined their work in medical organizations of both types. The stomatologists employed in private sector of stomatological service were mainly concentrated in metropolises, especially in regional center, where their provision exceeds average regional level by 2.6 times.

PMID:39158886 | DOI:10.32687/0869-866X-2024-32-4-848-854

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):815-821. doi: 10.32687/0869-866X-2024-32-4-815-821.

ABSTRACT

In Russia, increases morbidity of myocardial infarction. The statistics of recent years demonstrate failure in meeting target indicators of national programs on reducing number of deaths from this disease. At that, able-bodied population is in high risk zone and their professional activity is under influence of large combination of risk factors of myocardial infarction. This risk area covers profession of seafarer that is characterized by irregular work schedule, high levels of stress and mental tension, low physical activity or, contrariwise, increased working loads, unbalanced diet, isotherm stress and interaction with harmful substances. Besides that, situation is aggravated by limited set of first medical aid measures at exacerbation of disease in view of remoteness from hospitalization centers. Thus, considering high mortality rate from myocardial infarction, it is extremely important for ship crews to have full and timely information about diagnostic, symptomatic and prevention of this disease. The article examines statistics data of morbidity and mortality of myocardial infarction in population of the Russian Federation on the basis of Rosstat data and target indicators of the National project “Health Care”. The risk factors of myocardial infarction established by INTERHEART studies are analyzed. The specifics of work conditions of crew members of marine vessels are established. The collection of professional modifying risk factors was selected. The recommendations for their correction were developed to enhance efficiency of primary preventive measures and to decrease morbidity and mortality among seafarers.

PMID:39158881 | DOI:10.32687/0869-866X-2024-32-4-815-821

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):791-797. doi: 10.32687/0869-866X-2024-32-4-791-797.

ABSTRACT

The article considers social, demographic and professional factors determining choice by general practitioners and district therapists of place of employment and their professional motivation. The special questionnaire was developed to be applied in sociological survey. The sampling included general practitioners and district therapists of outpatient medical organizations of the Health Department and the private health care sector of Moscow. The final analysis included 399 questionnaires. It is established that possibility of job combining depends on number of children physician has. The significance of conditions for career growth increases with physician age and availability of adult children. The opportunities for research and education activities are of great value for physicians of private health sector who obtained higher education in Russia and having adult children. The preferred management style of line manager and model of communication with patient are affected by level of workload, working conditions and income level. The preferences regarding type of organizational culture are affected by place of birth. For physicians who graduated from Russian universities, significant factor of non-material incitement is possibility of additional rest. The physicians of older age working in private health sector more often consider career advancement as professional development goal. The factors influencing choice of place of employment and professional motivation in general practitioners and district therapists are summarized. The proposals for attracting, retaining and stimulating physicians are formulated.

PMID:39158877 | DOI:10.32687/0869-866X-2024-32-4-791-797

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):762-771. doi: 10.32687/0869-866X-2024-32-4-762-771.

ABSTRACT

The article presents updated information concerning satisfaction of patients with quality of medical care in public and private health care institutions in Russia. The purpose of the study is to explore satisfaction with medical services in different groups of Russian population using representative sampling and considering various aspects of medical care quality. The statistical analysis on the basis of data of telephone survey “The National Monitoring of Public Health” (2022) was applied. The respondents were asked about four aspects of medical care quality: explanation of health condition and treatment, involvement into desision making concerning treatment, trust to medical workers, readiness for another visit. The most patients of public and private medical institutions were satisfied with all aspects of medical care quality. The level of satisfaction varies in different groups: it was lower in less healthy patients and patients with unmet demands in medical care. No significant differences in satisfaction of patients were established in relation to socio-demographic characteristics (except place of residence). Most patients were satisfied with two aspects of medical care quality at once. However, 1-9% and 8-14% of patients of private and public clinics were satisfied with one aspect and dissatisfied with another. Despite dominance of patient satisfaction nation-wide, behaviors in some patient groups requires more detailed study to develop measures promoting their further involvement into health care system.

PMID:39158873 | DOI:10.32687/0869-866X-2024-32-4-762-771

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):755-761. doi: 10.32687/0869-866X-2024-32-4-755-761.

ABSTRACT

The article presents results of analysis of morbidity rates in children aged 15-17 years in the Russian Federation, the Volga Federal Okrug, the Udmurt Republic, the Kirov Oblast and the Republic of Bashkortostan in 2014-2022. According to research data, in the Russian Federation there is an increase of general and primarily detected (primary) morbidity by 24.0% (from 229,468.3 to 231,505.5) and by 22.3% (from 143,109.3 to 149,143.8), respectively. In the morbidity structure, the greatest increase was noted for such diseases as obesity (24.0 and 27.8%, respectively), diabetes mellitus (30.9 and 32.8%, respectively) and diabetes mellitus type I (31.9 and 30.8%, respectively). The data of statistical reports on general and primarily detected (primary) morbidity of the Central Research Institute for Health Organization and Informatics of Minzdrav of Russia were used. The study established general and primarily detected morbidity in the Russian Federation. However, forecast for 2027, as compared with 2014, is marked by decline of total morbidity by 8.3% and primarily detected (primary) morbidity by 5.2%. Due to the unfavorable forecast for morbidity in the Russian Federation for 2027, further scientific studies are needed concerning children aged 15-17 years in order to develop preventive measures at population, group and individual levels, considering regional characteristics.

PMID:39158872 | DOI:10.32687/0869-866X-2024-32-4-755-761

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):748-754. doi: 10.32687/0869-866X-2024-32-4-748-754.

ABSTRACT

The article presents results of sociological analysis of social health of modern student youth. The empirical basis of study was composed with results of monitoring study of student youth carried out by sociological laboratory of the Department of Sociology and Social Technologies. Within a framework of sociological monitoring, were evaluated such components of social health of student youth as relationships with friends and relatives, relationships in student community, inter-ethnic relations in University and region, participation in public life, social well-being, active life position and family practices and values. It is established that modern possibilities of living conditions allow each person to organize one’s life-style in such a way as to develop synergetic effect for social health, combining achieved standards of organization of everyday life and fashion for healthy lifestyle. It is namely such synergistic effect can be enhanced and induced in social environment. The main role at that is played by namely large multi-generational family.

PMID:39158871 | DOI:10.32687/0869-866X-2024-32-4-748-754

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Jul;32(4):740-747. doi: 10.32687/0869-866X-2024-32-4-740-747.

ABSTRACT

The suicide is serious public health problem with far-reaching social, emotional and economic consequences. The world trend is significant input of both suicide itself and suicide-like attempts into external causes of mortality, tangible challenge to health life, especially in the youngest population. The WHO estimates that currently more than 700,000 suicides occur worldwide yearly, and each one deeply affect others persons. Russia takes one the first places in the world with its rate of teenage suicides. The suicide of adolescents aged 10-24 years is actual social demographic problem. The process of rapid physical, cognitive and psycho-social growth of this contingent affect feelings, thinking, decision-making and interaction with outside world, causing development of behavioral models corresponding to individual specific of responses to impacting environmental factors. Purpose of the study is, on basis of results of mental health monitoring from analytical materials on population suicidal behavior with emphasis on children and adolescent contingent, to present general conception of suicide as social phenomenon, to make brief historical excursus into becoming and development of problem; to discuss min terminology applied; to present corresponding statistics and to reveal difficulties in obtaining information.

PMID:39158870 | DOI:10.32687/0869-866X-2024-32-4-740-747

Artif Organs. 2024 Aug 19. doi: 10.1111/aor.14841. Online ahead of print.

ABSTRACT

BACKGROUND: Ex vivo machine perfusion (EVMP) has been established to extend viability of donor organs. However, EVMP protocols are inconsistent. We hypothesize that there is a significant relationship between specific parameters during EVMP and perfusion outcomes.

METHODS: A meta-analysis of literature was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement. The search encompassed articles published before July 25, 2023. PubMed, Embase, and CENTRAL databases were screened using search terms “ex-vivo,” “ex-situ,” “machine,” and “perfusion.” Weight gain, an indicator of organ viability, was chosen to compare outcomes. Extracted variables included perfused organ, warm and cold ischemia time before perfusion, perfusion duration, perfusate flow, pressure, temperature, perfusate composition (presence of cellular or acellular oxygen carrier, colloids, and other supplements) and percent weight change. Data were analyzed using SPSS statistical software.

RESULTS: Overall, 44 articles were included. Red blood cell-based perfusates resulted in significantly lower weight gain compared to acellular perfusates without oxygen carriers (11.3% vs. 27.0%, p < 0.001). Hemoglobin-based oxygen carriers resulted in significantly lower weight gain compared to acellular perfusates (16.5% vs. 27%, p = 0.006). Normothermic perfusion led to the least weight gain (14.6%), significantly different from hypothermic (24.3%) and subnormothermic (25.0%) conditions (p < 0.001), with no significant difference between hypothermic and subnormothermic groups (24.3% vs. 25.0%, p = 0.952). There was a positive correlation between flow rate and weight gain (ß = 13.1, R = 0.390, p < 0.001).

CONCLUSIONS: Oxygen carriers, low flow rates, and normothermic perfusate temperature appear to improve outcomes in EVMP. These findings offer opportunities for improving organ transplantation outcomes.

PMID:39157933 | DOI:10.1111/aor.14841

Int J Gynaecol Obstet. 2024 Aug 19. doi: 10.1002/ijgo.15864. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study was to analyze the association between de novo urethral hypermobility 6 months postpartum and stress urinary incontinence (SUI) symptoms at 6 months and 12 years after first delivery. Risk factors associated with the development of postnatal urethral hypermobility were also examined.

METHODS: A longitudinal cohort study was conducted on primigravid women, after excluding those with UI before pregnancy and/or urethral hypermobility (rotational angle ≥30°) at term. At 6 months postpartum, SUI was assessed based on symptoms and introital ultrasound performed to measure rotational angle (difference between urethro-pelvic angle at rest and at maximum Valsalva). Twelve years after delivery, women were sent a questionnaire including SUI assessment and questions on parity, current age, and body mass index. Continuous variables were compared using student’s t-test and qualitative variables using chi-squared tests. A logistic regression model was constructed including variables that reached statistical significance (P < 0.05) in the univariate analysis.

RESULTS: Of the 314 women who completed the 6-month follow-up, 265 (84.4%) were successfully contacted and completed the questionnaire at 12 years and these formed the study group. In 127 women (47.9%), de novo urethral hypermobility had developed by 6 months postpartum. There was no association between urethral hypermobility and SUI symptoms 6 months postpartum (OR: 1.17; 95% CI: 0.59-2.33). Twelve years after delivery, however, SUI was reported by 110 women overall (41.5%) and nearly half of the women who developed postnatal urethral hypermobility (61/127, 48.0%).

CONCLUSION: De novo urethral hypermobility 6 months postpartum constitutes a risk factor for SUI 12 years later.

PMID:39157930 | DOI:10.1002/ijgo.15864

Cancer Med. 2024 Aug;13(16):e7458. doi: 10.1002/cam4.7458.

ABSTRACT

OBJECTIVE: This study aimed to verify if intraoperative radiotherapy (IORT) can achieve the same survival outcome as whole-breast external beam radiotherapy (EBRT) in early breast cancer after breast-conserving surgery (BCS), and to explore the suitable candidates that can safely receive IORT after BCS.

METHODS: Eligible post-BCS patients who received IORT or EBRT were included in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2018. Risk factors that affected 5-year overall survival (OS) or breast cancer specific survival (BCSS) were identified by Cox proportional hazards regression analysis. Clinical characteristics, OS, and BCSS were comparatively analyzed between the two treatment modalities.

RESULTS: The survival analysis after propensity score matching confirmed that patients who received IORT (n = 2200) had a better 5-year OS than those who received EBRT (n = 2200) (p = 0.015). However, the two groups did not differ significantly in 5-year BCSS (p = 0.381). This feature persisted even after multivariate analyses that took into account numerous clinical characteristics. Although there was no significant difference in BCSS between different subgroups of patients treated with IORT or EBRT, patients over 55 years of age, with T1, N0, non-triple negative breast cancers, hormone receptor-positive, and histologic grade II showed a better OS after receiving IORT.

CONCLUSION: In low-risk, early-stage breast cancer, IORT was not inferior to EBRT considering 5-year BCSS and OS. Considering the equivalent clinical outcome but less radiotoxicity, IORT might be a reasonable alternative to EBRT in highly selective patients undergoing BCS.

PMID:39157891 | DOI:10.1002/cam4.7458