РОЛЬ ОБЩЕСТВЕННЫХ ОРГАНИЗАЦИЙ В ОКАЗАНИИ МЕДИЦИНСКОЙ ПОМОЩИ: ПО ДАННЫМ ОПРОСА РОДИТЕЛЕЙ ДЕТЕЙ, СТРАДАЮЩИХ ОРФАННЫМИ ЗАБОЛЕВАНИЯМИ

The activities of public patient organizations are multifaceted: providing legal support to patients in order to protect their legal rights; information and educational work, conducting “schools”, providing specific types of assistance that can provide those involved in the problem. Public patient organizations are the “voice” of all patients with orphan diseases in solving their problems at the level of the highest echelons of power. From 2016-2017 years in the Reference center of congenital hereditary diseases, genetic disorders, orphan and other rare diseases of GBUZ “Morozovskaya DGKB DZM” on a specially designed questionnaire conducted a sociological study on awareness of parents of children suffering ABOUT the public patient organizations. Public organizations provide information and legal support, contact with pharmaceutical companies, participate in solving the problems of patients at the state level. Taking into account the rights and opportunities of public associations, it is necessary for doctors to inform parents about the existence of charitable organizations and their involvement in public patient organizations, as well as to participate in the work of health schools for parents.Деятельность общественных пациентских организаций многогранна: оказание юридической поддержки пациентам в целях защиты их законных прав, информационная и просветительская работа, проведение «школ», оказание специфических видов помощи, которые могут предоставить причастные к проблеме лица. Общественные пациентские организации являются «голосом» всех больных с орфанными болезнями в решении их проблем на уровне высших эшелонов власти. В 2016-2017 годы в Референс-центрах врожденных наследственных заболеваний, генетических отклонений, орфанных и других редких заболеваний ГБУЗ «Морозовской ДГКБ ДЗМ» по специально разработанной анкете проведено социологическое исследование, посвященное информированности родителей детей, страдающих орфанными болезнями, об общественных пациентских организациях. Общественные организации оказывают информационную и юридическую поддержку, контактируют с фармацевтическими компаниями, участвуют в решении проблем больных на государственном уровне. В ходе исследования выяснилось, что знает о существовании благотворительных организаций, оказывающих спонсорскую поддержку семьям с детьми, имеющими редкие заболевания, каждый четвертый респондент. Однако являются членами пациентских организаций только два респондента. Несмотря на то, что общественные объединения имеют широкие полномочия и признаны государством, более 70% респондентов не знали о наличии таких организаций. Учитывая права и возможности общественных объединений, врачам необходимо информировать родителей о существовании благотворительных организаций и приобщать их к общественным пациентским организациям, а также к участию в работе школ здоровья для родителей

КАТЕГОРИЯ МАРКЕТИНГА ОТНОШЕНИЙ В МЕДИЦИНСКИХ ОРГАНИЗАЦИЯХ

The need for intensification of health care, raises the issue of improving the efficiency of medical organizations. The article analyzes the current management technology: “marketing relationships in medical organizations”. The aim of the research was to find the correct “definition of the concept and professional fullness” of the content of relationship marketing in medical organizations. The authors defined the marketing of relations in medical organizations as “the relationship (mutual relation) of the subjects of medical care at the level of “doctor-patient”, “administration-personnel”, “relations between medical organizations and counterparts”, in order to improve the efficiency of activities and the quality of medical care, patients and medical personnel. The results are obtained on the basis of a comparative analysis of scientific literature data and authors’ own research. In the formulation of the research, methods of content analysis of bibliographic data, the sociological method and the authors’ own experience were used. Based on the results of the research, the role of the individual characteristics of patients (gender, age, occupation, relationship to the composition of patients, transport accessibility, organization of admission) in the formation of relations between consumers and providers of medical services is shown. In conclusion, based on the results of the study, the development of marketing relationships at the level of medical organizations of different ownership forms and the need to improve marketing of communications, social networks and distant forms of work with potential and real patients are justified. Conceptual bases of the marketing relationship concept in medical organizations of different ownership forms have been developed.Потребность в интенсификации деятельности здравоохранения ставит вопрос повышения эффективности работы медицинских организаций. В статье анализируется актуальная технология управления: «Маркетинг отношений в медицинских организациях». Целью исследования был поиск корректной «дефиниции понятия и профессиональной наполненности» содержания маркетинга отношений в медицинских организациях. Маркетинг отношений в медицинских организациях авторы определили как «отношения (взаимоотношения) субъектов медицинской помощи на уровне „врач - пациент“, „администрация - персонал“», «отношения между медицинскими организациями и контрагентами», с целью повышения эффективности деятельности и качества медицинской помощи, удовлетворения пациентов и медицинского персонала. На основе результатов исследований показана роль индивидуальных характеристик пациентов (пол, возраст, род занятости, отношения к составу пациентов, транспортная доступность, организация приема) в формировании отношений потребителей и производителей медицинских услуг. В заключении по результатам проведенного исследования обоснованы направления развития маркетинга отношений на уровне медицинских организаций разных форм собственности и потребности в совершенствовании маркетинга коммуникаций, включая социальные сети и дистантные формы работы с потенциальными и реальными пациентами. Разработаны концептуальные основы концепции маркетинга отношений в медицинских организациях разных форм собственности

Study of doubly strange systems using stored antiprotons

Bound nuclear systems with two units of strangeness are still poorly known despite their importance for many strong interaction phenomena. Stored antiprotons beams in the GeV range represent an unparalleled factory for various hyperon-antihyperon pairs. Their outstanding large production probability in antiproton collisions will open the floodgates for a series of new studies of systems which contain two or even more units of strangeness at the P‾ANDA experiment at FAIR. For the first time, high resolution γ-spectroscopy of doubly strange ΛΛ-hypernuclei will be performed, thus complementing measurements of ground state decays of ΛΛ-hypernuclei at J-PARC or possible decays of particle unstable hypernuclei in heavy ion reactions. High resolution spectroscopy of multistrange Ξ−-atoms will be feasible and even the production of Ω−-atoms will be within reach. The latter might open the door to the |S|=3 world in strangeness nuclear physics, by the study of the hadronic Ω−-nucleus interaction. For the first time it will be possible to study the behavior of Ξ‾+ in nuclear systems under well controlled conditions

Профиль пациента в системе первичной специализированной медицинской помощи и непрерывного медицинского образования

Relevance. Improvement of quality of medical care, level of training of personnel of health care, development of market conditions of providing medical services, growth of responsibility of the population for health, requirements of the population to the primary specialized medical care (PSMC) raise. In the conditions of development of the medical organizations of different forms of ownership there is a possibility of the choice and preferences of consumers on a service component, the range of services, territorial location of the medical organizations, transport availability, to the relations of medical personnel and patients. In this situation the importance acquires knowledge of individual characteristics of consumers - patients - and quality of the continuous medical education (CME) of personnel [1, 2, 3]. Purpose by results of a medico-social research to develop and prove «the patient’s profile» - the consumer of medical services of the private and state medical organizations (MO). On the basis of knowledge of «the patient’s profile» PSMC of large city agglomeration will become possible to make the adjusting management decisions for satisfaction of need of inhabitants for PSMC taking into account health care infrastructure. Results. During the research «the patient’s profile» as the list of group characterologic and behavioural characteristics of the patients belonging to the sphere of knowledge, the relations, preferences and understanding of the PSMC system and the role in maintenance of health, medical activity, implementation of recommendations of medical personnel is developed and evidence-based. Knowledge of «the patient’s profile» is necessary for adoption of correct management decisions taking into account health care infrastructure opportunities on satisfaction of needs for medical care and improvement of continuous medical education of personnel. Methods and materials. Results of questioning of patients (a sociological method) are used, at the request for medical care, personnel of the medical organizations of different forms of ownership, the content analysis of scientific publications, the statistical and logical analysis of data. A direct object of a research were the patients who asked for medical care in network of the private and state medical organizations for adult population (a method of "copy-pair"). The reliability and substantiality of the obtained data is accepted under a condition (р < 0.05).Актуальность. Совершенствование качества медицинской помощи, уровня подготовки персонала здравоохранения, развития рыночных условий предоставления медицинских услуг, роста ответственности населения за здоровье, повышаются требования населения к первичной специализированной медицинской помощи (ПСМП). В условиях развития медицинских организаций разных форм собственности появляется возможность выбора и предпочтений потребителей по сервисной составляющей, ассортименту услуг, территориальному расположению медицинских организаций, транспортной доступности, отношениям медицинского персонала и пациентов. В этой ситуации приобретает значимость знание индивидуальных характеристик потребителей пациентов - и качества непрерывного медицинского образования (НМО) персонала [1, 2, 3]. Цель. По результатам медико-социального исследования разработать и обосновать «профиль пациента» - потребителя медицинских услуг частных и государственных медицинских организаций (МО). На основании знания «профиля пациента» ПСМП крупной городской агломерации станет возможным принимать корректирующие управленческие решения для удовлетворения потребности жителей в ПСМП с учетом инфраструктуры здравоохранения. Результаты. В ходе исследования разработан и научно обоснован «профиль пациента» как перечень групповых характерологических и поведенческих характеристик пациентов, принадлежащих к сфере знаний, отношений, предпочтений и пониманий системы ПСМП и своей роли в поддержании здоровья, медицинской активности, выполнении рекомендаций медицинского персонала. Знание «профиля пациента» необходимо для принятия корректных управленческих решений с учетом возможностей инфраструктуры здравоохранения по удовлетворению потребностей в медицинской помощи и для совершенствования непрерывного медицинского образования персонала. Методы и материалы. Использованы результаты анкетирования пациентов (социологический метод), при обращении за медицинской помощью, персонала медицинских организаций разных форм собственности, контент-анализ научных публикаций, статистический и логический анализ данных. Непосредственным объектом исследования являлись пациенты, обратившиеся за медицинской помощью в сеть частных и государственных медицинских организаций для взрослого населения (метод «копи-пара»). Достоверность и доказательность полученных данных принята при условии (р < 0,05)

Early Detection of Substance Abuse and Prevention of Mental Deviations Among Minor Students

Background: the reduction in the premature mortality as a result of non-contagious diseases by way of the improvement measures to be adopted with the purpose of prevention and treatment of the substance abuse and general health care activities were outlined by the United Nations Organization as the primary objectives as far back as 2015 in order to work towards sustainable development (the objective № 3 “Promotion of healthy lifestyle and furtherance of wellbeing of individuals of all ages” in 2030 perspective). There is a high risks for the Russian Federation of transnational drugs expansion developing [1]. Concurrently, in order to build a national dependence prevention system, Decree № 581н as of 06.10.2014 “On the Preventive Medical Screening to be made at educational establishments” was issued by the Ministry of Health of the Russian Federation. Purpose: the research was supposed to focus on Preventive Medical Screening as a measure of prevention of illegal usage of substances and mental disorders among minor students and on the optimization of such preventive medical screening. Materials and methods: the findings are based on the posthoc analysis of the data of the Federal statistical survey form and of the research and information reports (n = 491 280 students). The results: the findings of the preventive medical screening made across the Russian Federation and in Moscow over the years 2016–2018 show the increase of minor students involved into such preventive medical screening, as well as the decrease of those who might use psychoactive drugs. The same findings show that the majority of the illegal drug users were students of secondary vocational schools. The findings can be called a trend across the Russian Federation and in Moscow. Conclusions: non-medical usage of substances among minor students can be a serious threat to the mental health of the youth. There are suggestions for improvement prevention of mental disorders among students at the results of the research. These include methodology of Brief Motivational Consulting at a time of preventive medical screening and the ways of increase effectivity toxicology screening in different educational organizations offering to add in preventive medical screening cotinine (it’s metabolite of nicotine) screening for students of primary school; it’s have to systematically update and expand types of screening tools for substances in preventive medical screening in all educations organizations. © 2021, Medicinskoe Informacionnoe agentstvo. All rights reserved

Preventive medical examinations of students in the system of early detection of illegal use of psychoactive substances

Non-medical substance use is a risk factor for the development of non-communicable diseases. Improving the prevention of sub-stance use disorders is an important area of public health action. In Russia, an anti-drug policy is being implemented, one of the directions of which is the prevention of addiction among students. Purpose of the study. To perform a comparative analysis of the results of preventive medical examinations of students conducted in Russia and Moscow in order to early identify the illegal use of psychoactive substances. Develop proposals for the prevention of non-communicable diseases based on the results of the analysis. Material and methods. The study is based on a retrospective analysis of data obtained from federal statistical observation forms No. 37. Within the framework of this study, statistical methods were used: Comparative statistical analysis of data, increase in indicators, structure of identified psychoactive substances; legal and regulatory analysis of documentation; content analysis of literature data. The database was created and data was analyzed using Microsoft Office Excel 2016. Results. During the studied period of time in Russia and Moscow, there was a decrease in the number of students participating in preventive medical examinations, while schoolchildren prevailed in the structure of participants. The facts of the illegal use of psychoactive substances were revealed mainly in secondary vocational educational organizations. The proportion of students who illegally used psychoactive substances did not exceed 1% of the total number of those surveyed. Differences in the structure of identified psychoactive substances illegally used by students in Russia and Moscow were determined. Conclusion. Preventive medical examinations of students occupy an important place in the system of early detection of illegal use of narcotic drugs and psychotropic substances. At the same time, they act as a practical tool for preventing the development of non-communicable diseases. In the course of the study, a number of necessary measures were identified: Differentiation of students by risk groups; increasing the coverage of students of higher educational institutions with preventive medical examinations; inclusion in the procedure of preventive medical examination of the elements of formation of motivation for adherence to a healthy lifestyle. © 2022, Media Sphera Publishing Group. All rights reserved

Organizational and technological algorithm of primary specialized health care at cardiovascular diseases

Aim. To develop an algorithm for primary specialized cardiovascular care with a priority of endovascular strategy. Methods. The study was conducted in 2018–2019 based on the Central Clinical Hospital “Russian Railways-Medicine” and 14 polyclinics in the regions of the Russian Federation. The subject of the study is cardiovascular surgeons (n=2), possessing the skills of endovascular care. The object of the study was patients (n=1018) attended regional polyclinics of the Russian Federation. Patients were divided into two groups: group A consisting of 673 patients with clinically significant atherosclerosis of the coronary, brachiocephalic and peripheral arteries and abdominal aortic aneurysm; group B consisting of 345 patients with chronic lower limb ischemia that does not require surgical treatment. The average age of patients in group A was 69±6.1 years, in group B — 63±7.2 years. There were 467 men in group A (69.4%), and 339 in group B (98.3%). An organizational and technological algorithm was developed to improve the primary specialized cardiovascular care. The results were assessed by the presence of outcomes (heart attack, stroke, bleeding, death), the availability of endovascular care and patient survival follow up 12 and 24 months. A content analysis of scientific publications on the issue under study has been performed. Results. An organizational and technological algorithm of primary specialized cardiovascular care has been developed, including the activities of the cardiovascular surgeon, who has the skills of endovascular care and a nurse in an outpatient clinic. The implementation of the algorithm ensured continuity, 100% availability, safety and quality of cardiovascular care using endovascular technology. Outcomes are not registered in both groups. Both patient groups showed 100% one and two-year survival. Conclusion. The developed algorithm of primary specialized cardiovascular care has provided high quality healthcare. © 2020 Author

Experimental and numerical analysis of high strain rate behavior of aluminum alloys AMg-6 and D-16

Results of experimental investigation and numerical modeling of high strain rate behavior of aluminium alloys AMg-6 and D-16 are presented. Using Split Hopkinson Pressure Bar (SHPB) parameters of Johnson-Cook's model and other models from LS-DYNA library were determined in strain rate range 10$^{2}$-10$^{4}$ s$^{ - 1}$. For verification of the models a comparison of the results of numerical modeling and model experiments was carried out. Modificated Taylor's test and modification of SHPB test for high-speed penetration were carried out as model experiments

REMOTE CLINICAL QUALITY MANAGEMENT OF ENDOVASCULAR CARE

To assess the effectiveness of remote clinical quality management of endovascular Aim care. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The Methods system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In April-December 2020 it increased up to 71.6% (p<0.001). The frequency of performing Results PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005). Remote clinical management based on telemedicine and mentoring process Conclusion technologies contributes to improving the quality of endovascular care in MI. © 2021 Angles. All rights reserved

The dynamic response of Copper 101 under high-rate loading

The initial results of an investigation into the dynamic behavior of copper C101 are presented. This study involved several experimental technicques; quasi-static, compressive Split Hopkinson Pressure Bar (SHPB), a modified Taylor test and a direct impact method. From these studies dynamic and static stress-strain curves were obtained. Numerical simulation was applied to the system using a variety plasticity models in a LS-DYNA environment. The results of the models were valicated by comparison with two selected experiments. Overall the study shows the essential need for cross-comparison of the materials parameters used and how the different techniuques yeild these fundamental parameters in differing ways