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Introduction: Chronic obstructive pulmonary disease (COPD), usually in advanced stages, is associated with high mortality, being the third leading cause of death worldwide. In the Netherlands, care delivery to patients with COPD has become a focus of the regional medical community, since the COPD death rates in this country are higher than the European Union average. However, between 2011 and 2021, the number of people with COPD (under follow-u by general practitioners) decreased. The experience of this country is interesting, as a large set of measures to improve the situation has been developed and implemented in this region. The purpose of the study was to analyze the experience of the Netherlands in organizing medical care for COPD in primary care settings., Material and Methods: The search for scientific literature sources was carried out using the PubMed database and Google system. The search time horizon equaled to 5 years., Results: In the Netherlands, in the system of care delivery to patients with COPD, primary care settings are heavily burdened. The article summarizes approaches to identify COPD risk factors, summarizes current clinical recommendations as of December 2022, and highlights findings of the study on medical digital platforms with the potential to organize continuous monitoring of patients. The paper exemplifies criteria for assessing the treatment quality in specialized care settings, including primary care., Discussion: It is assumed that the most effective measure to further improve efficacy of COPD treatment is the introduction of remote digital medical devices. A possible integration of the updated standards and quality indicators into digital services will further strengthen the concept of continuous automated remote monitoring of COPD patients. Evidence-based selection and introduction of effective digital solutions into current practice will improve quality of care delivery to patients.

Research in the field of public health at the global, national, regional and organizational levels continue to be relevant, attracting attention of the researchers who find new aspects of various problems and issues for consideration and analysis in this area. The paper presents results of a scientometric analytical study of the publication landscape for 2019-2021 in the field of public health, using the analytical platform SciVal, the data source for which is the international scientific database Scopus. The study shows positive dynamics and steady growth in most scientometric indicators in the subject area under consideration during the study period. A structural-functional and semantic-linguistic analysis of the top-50 keywords was also carried out, which showed that their ranking position significantly depends on the choice of one of two indicators: either by the number of publications or by relevance. Publications on public health are characterized by a polythematic distribution, providing researchers with the opportunity to make a wide choice in conducting scientific research in the branches of medical science they are interested in, taking into account scientometric indicators characterizing the publication landscape in these areas.

The article presents an overview of foreign sources devoted to the problems of population aging as a significant phenomenon that has become the most important medical and socio-demographic challenge in the world. The review provides global data on this problem and shows the need for elaborating and implementing active aging strategies, optimizing opportunities for health, participation and safety in order to improve the life quality as people age. The paper employs the method of content analysis of scientific publications retrieved in PubMed database by keywords - «aging», «population aging», «demographic trend», «longevity», and «life expectancy». Scientific publications for the period 2018-2023, WHO and UN materials, statistical data, and popular scientific publications have been studied. The purpose of the review was to analyze trends and global nature of aging based on scientific publications and open sources, and to highlight the most promising areas of the demographic policy on the older adults. In the time of rapid demographic changes, it is extremely important to use all available opportunities that maximize healthy aging with the participation of the older adults. We should remember that aging is a natural process and it is better to accept it, both psychologically and physically, rather than ignore. Healthy aging should become and has become the main principle of life, suggesting a longer healthy life of the older adults, who, in turn, should understand how to accept and implement this principle in their lives.

Performance of varies surgical manipulations (SM) is a key skill in surgery. To develop such skills simulation trainings (ST) are used, followed by a training transfer, which is the ultimate goal of ST However, this training goal is not always achievable - the share of doctors using laparoscopic intracorporal suturing after the training ranges from 43.8% to 72.2%. Therefore, to improve training transfer it is necessity to evaluate effectiveness of such training programs. Current methods evaluate training results either outside real practice or in practice but in small groups due to high cost and efforts consumed. The paper presents a new method to evaluate effectiveness of SM simulation training programs in general population of the trainees, evaluate additional effects of the training and analyze personal factors affecting the training results. The method is based on a survey of the ST program participants, and tested at the Training and Accreditation Center «Medical Simulation Center of the Botkin Hospital» within the program on laparoscopic intracorporal suturing. The rate of training transfer added up to 88.9%. The suggested method makes it possible to evaluate effectiveness of SM simulation training in general population of the trainees, analyze factors affecting the training results and use findings for improving ST programs and methods in general. The method can be recommended for a large-scale implementation in simulation training programs.

The paper examines the importance of health as a part of human capital, the role of which is that only a healthy person can work efficiently and with full potential; a healthy person can work more efficiently; a healthy person can work productively and thus contribute more to the development of the country's economy; an unhealthy person becomes a burden for both the organization and in general for the country.

The development of telemedicine and the provision of medical care using remote technologies requires appropriate competencies and skills from medical specialists, the formation of which is an important task of adapting educational systems to modern challenges and responding to requests from both medical staff and patients. Based on the analysis of foreign scientific publications, the paper considers the assessment of the need to train medical workers in remote work with patients and the prospects for the introduction of telemedicine consultations into everyday professional practice. It is concluded that having more knowledge about which aspects of medicine are best combined with telemedicine, it is important to train future medical professionals in the use of these technologies and the provision of these types of medical care. Doctors should not only be trained in the use of telemedicine, but also learn how to do it professionally, safely and on the basis of evidence.

The article discusses issues reflecting the importance of intergenerational sports as an institution influencing the formation of social values, civic identity, health-saving attitudes, etc. The paper defines the main and specific functions of sport as a social institution. Based on the author's sociological research, the results are presented reflecting the attitude of participants of intergenerational sports groups to certain types of social impact that sports activities and events held in mixed age groups have.

The phenomenon of déjà vu (DV) is of interest, occurring in 97% of healthy individuals, while DV can be a manifestation of a number of pathologies, such as Charles Bonnet syndrome, depression, schizophrenia, or temporal lobe epilepsy. Most cases of DV type epiphenomena are associated with hippocampal sclerosis, while up to 90% of patients with mesial temporal sclerosis are drug resistant. Despite the success of pharmacotherapy, the frequency of «uncontrolled» epilepsy in industrialized countries that adhere to modern standards of treatment is from 30 to 40%, and this percentage is higher among patients with symptomatic and cryptogenic forms than among patients with idiopathic epilepsy (respectively: 40% and 26%). In turn, when studying the DV phenomenon and choosing a therapy strategy, it is necessary to establish its origin, determine its clinical significance (whether it is initially pathological or not), and the need for treatment. During the analysis of exome data, a search was made for substitutions in genes associated with arteriovenous malformations, both with autosomal dominant and autosomal recessive types of inheritance. The genes KRIT1, RASA1, IL6, FAM58A, GLML, EPHB4, CCM2, and ELMO2 were analyzed especially carefully. The analysis of genetic data is of great importance in the aspect of preventing cerebrovascular accidents, at the same time, in order to obtain reliable and significant results, in addition to time and financial costs, examination of relatives is also required. Meanwhile, this fact does not mean that every patient needs to conduct a genetic study. The paper presents detailed instructions for supplementing anamnestic information, as well as the results of personalized instrumental and laboratory diagnostics, which made it possible to carry out timely correction of therapy and achieve a prolonged positive effect.

Economic and social losses due to epidemics of non-communicable diseases have put prevention and control of them on the first line in the field of sustainable development of the United Nations. The tasks of combating NCDs and risk factors within the framework of the Sustainable Development Goals require targeted actions on the part of States in the field of policy and legislation and provision of health systems with appropriate resources. In the Russian Federation, such work is being implemented within the framework of the national project "Healthcare", federal programs to combat oncological and cardiovascular diseases. Each subject takes into account the peculiarities of economic development, staffing, implementation of informatization processes, etc. The rapid pace of transformation of Moscow healthcare, its unique institutional structure allowed to form the basis for the effective development of a system of proactive dispensary monitoring of patients suffering from chronic diseases. The authors describe the process of formation of preventive work and organization of dynamic dispensary observation in Moscow. The paper presents in detail the organizational, administrative and technological resources used to create a unique system of dynamic dispensary observation. In addition, the article illustrates the personalized subsystem of dynamic dispensary observation in EMIAS and the institute of "physician assistant". The introduction of a proactive dispensary monitoring system will reduce premature mortality and disability among residents of the city. Moscow through an individual monitoring program and motivation for the responsible attitude of metropolitan patients to their health.

The purpose of the study presented in this paper is to consider the attitude of senior citizens (aged 65 years and older) to telemedicine technologies and their readiness to use them.Telemedicine has become widespread in recent years, and its use will expand in the near future. Telemedicine technologies have proved to be an effective tool for solving a number of problems: providing access to medical consultations, prompt response of medical workers to patient requests, monitoring of health indicators, etc. However, the prevalence of the use of these technologies is differentiated in different age groups. Due to the fact that elderly citizens are not active users of digital gadgets, the introduction of telemedicine technologies into their daily practice of taking care of their own health is in many ways difficult.

Violation of the interconnected system of institutions for assessing the qualifications of medical specialists can be associated with two main circumstances. The first circumstance is the emergence of new institutions with duplicate tasks and organizational forms, and the second is the withdrawal from the system of an institution that performs the necessary system function. Two relatively new institutions, namely the independent assessment of qualifications (IAQ) and certification for the title of «Moscow Doctor», are considered from the point of view of these circumstances. The paper reveals that there is a convergence of the rules of the Institute of accreditation with the Institution of IAQ of qualifications, which can result in significant duplication of their activities. Therefore, it is necessary to resolve the issue of its possible unification with the Institution of accreditation while the IAQ is at the experimental stage and has not been put into practice. A certain similarity of the principles of activity can be traced in such institutions as certification for the qualification category and certification for the title of «Moscow doctor». Both of these institutions identify and rank the qualifications of specialists exceeding the basic level. The fundamental innovation of certification for the status of «Moscow Doctor» is that this institution actually introduces a qualification category that is higher than the current highest category. At the same time, this institution shows the importance of the institution of certification for a category whose existence is being questioned.

The paper presents the results of a scientometric analytical research on the study of the publication landscape formed by research institutes and scientific-practical centers subordinate to the Moscow Healthcare Department. The study was conducted using the analytical platform SciVal, the data source for which is the database Scopus, the time period was 5 years - from 2017 to 2021. The results obtained in the course of the study indicate a steady growth and positive dynamics of changes in the selected scientometric indicators, as well as a significant contribution of Moscow research institutes and scientific-practical centers to the publication flow of the Moscow Healthcare Department. For the publishing landscape of Moscow medical science, there is a wide variety of subject areas in which its publications are distributed, a significant part of which belongs to highly relevant topic clusters.

The paper highlights the issues of monitoring and assessing the state of infection control conducted over four years of research in order to prevent infections associated with the provision of medical dental care to the population of the republic. The results are presented at baseline and periodically in order to predict and scientifically substantiate preventive measures. The studies were carried out in dental organizations using the "Evaluation sheet of the state of infection control in dentistry" which included 31 criteria for seven functional and organizational blocks by the method of direct observation of existing practices, interviewing medical staff, discussion of causal relationships between processes and phenomena (qualitative assessment) and the method calculating a numerical expression of the percentage between existing and expected compliance with infection control requirements (quantification). As a result of the fourth Monitoring and Evaluation, indicators of compliance with infection control requirements showed a significant increase, both in general - by 37.2% (2.4 times compared to the baseline monitoring and evaluation), and in the functional blocks of the infection control system. The growth rate was 116.5%, the rate of increase was 16.5% (p<0.05). However, the indicators remain low, which requires further improvement of the system of measures for the prevention of infections associated with the provision of dental care to the population.

The paper presents a review of publications concerning issues of development of telemedicine in rural health care of the USA during in conditions of COVID-19 pandemic and expediency of extensive application of telemedicine technologies during "post-COVID" period. The issues, aspects, prospects and required conditions for extensive diffusion of telemedicine services to the rural population are considered.

The article is devoted to the results of a study of the problems of nursing staff performance maintenance in connection with aggressive behavior of patients. We studied the opinions of 413 nurses concerning the aggressive behavior of patients in medical organizations of the Central Federal District. The paper reveals the problems of patient aggression and its interaction with nursing staff productivity.

Introduction: The radiation therapy (RT) plays a tremendous role in the consistent treatment of prostate cancer (PCa). The research ideas underpinning the wide implementation of innovative digitalized continuous (nonstop) dynamic auditing are coming true. Simultaneously, there are increasing challenges in selection of RT quality indicators., Objective: to study the pivotal indicators for RT quality assurance in treatment of PCa and to highlight the breaking through developments securing the delivery of top-quality cancer care in radiation oncology units., Materials and Methods: The literature search was performed in the PubMed database and the Google system. The inquiries included such terms as: "quality of care", "quality assessment criteria", "indicators", "prostate cancer" and "radiation therapy". A logical and semantic approaches were applicated to select the relevant scientific resources., Results: In most relevant studies, the variations of the Delphi technique are used to choose the quality assessment criteria. The targeted research papers describe the development of QIs for assessing the quality of radiation therapy in patients with locally advanced PCa; a hierarchical list of QIs has been generated. The adequate registration of information has huge impact on quality assessment to draw the definitive thorough conclusions., Discussion: The further improvement of Delphi technique may form one of pillars for the development of valuable RT quality measures. Considering the math aspects and the physical nature of RT, it seems being important to include the key opinion leaders in the field of clinical oncoinformatics, radiation informatics, and specialists from technical industries in the expert committees for the selection of RT QIs.

The article is devoted to the consideration of the issues of motivation of medical personnel to work effectively in an extreme situation of a pandemic (COVID-19). The paper presents a sociological analysis of the working conditions of medical workers in the situation of the spread of a new coronavirus infection and the problems faced by medical workers in providing medical care in a pandemic. A content analysis of Russian regulatory documents regulating the requirements for the prevention, diagnosis and treatment of coronavirus was carried out. A survey was conducted by the method of a semi-formalized interview from June 15 to June 30, 2020 among employees of medical organizations. The authors analyzed the results of the study and concluded that medical workers remain the main resource in the fight against a new pandemic, and, unfortunately, one of the most vulnerable groups.

The article is devoted to the study of the process of transformation of the activities of Russian children's public organizations in the face of the threat of the spread of coronavirus infection COVID-19 and the opening of new opportunities for non-profit organizations to work in this situation. The paper uses the results of a survey conducted from March 18 to 23, 2020 by experts of the Charitable Foundation for the Development of Philanthropy, which covered 232 organizations operating in the non-profit sector. The results of the study allowed us to conclude that the period of self-isolation contributed to the stimulation of children's public organizations to actively implement information technologies in their activities, find new opportunities for remote interaction in their work, and develop online projects.

Based on the results of sociological research, the article considers the consequences of the pandemic on the social health of citizens of the Eurasian Economic Union (EAEU) states. A comparative analysis is carried out between groups of labor migrants from the EAEU states in Moscow and Russian citizens of the same age. The paper discusses the measures taken by the EАEU, for the maintenance of social health in terms of the COVID-19 pandemic crisis.

The rapid spread of the COVID-19 virus challenges governments to act in ways that are usually reserved for war or natural disasters. The pandemic has caused massive global upheaval that could last for months, or longer. Governments are taking extreme measures to limit economic shocks and human costs. The pressure on the state authorities in this situation increases. In a rapidly evolving crisis, with information coming in from all sides, citizens turn to their governments for information and guidance. They expect to be kept safe and provided with medical care in a timely manner. The purpose of this paper is to review foreign public administration practices in response to the challenges of the COVID-19 pandemic.

The article notes that the number of citizens who apply for paid medical services is growing all over the world. The main reasons for this growth are: an increase in the level of well-being of the population; an increase in the areas of care for their own health; the inability to get the necessary assistance in state (free) structures that provide medical care; the complete absence of a number of medical services in free polyclinics, etc. The paper also presents data on the conduct of the study, which determines that on the basis of surveys and statistical data, as well as when studying reviews, it can be noted that in their significant part, consumers of medical services note that, first of all, the poor quality of public medical services prompted them to turn to paid services, but a number of respondents note that public free services in the field of medicine, especially recently, have significantly increased the level of quality. It is also concluded that from the point of view of consumers, one of the main advantages of purchasing services in commercial medical institutions is the ability to visit a doctor without waiting lists and guaranteed on the day of the appointment. Among the general trends in the paid medical services market, we can mention measures to consolidate the format and expand the areas of multi-specialty in private clinics, as well as to create conditions and factors, especially in the situation of a pandemic crisis, to provide high-quality medical services, including overcoming the consequences of the coronavirus epidemic and preventing its spread in the network of medical institutions. Statistical data and conclusions on the main areas of multidisciplinary research in the current state of paid medical services in the context of the pandemic crisis are presented. The review of new directions of providing medical services on a daily basis under the influence of the current state of the pandemic is made.

The paper presents information reflecting assessment of quality of life of patients of otorhinolaryngological departments of the Togliatti, Samara oblast, who were admitted for planned surgical treatment and had no severe comorbidity. The study examined dynamics of quality of life of patients against the background of treatment. The SF-36 questionnaire was applied to assess the quality of life. The study established portrait of operated patients in otorhinolaryngological departments. It was found that planned otorhinolaryngological surgical treatment in specialized in-patient departments of Togliatti generally had positive effect on quality of life of patients. It was also found that there were no statistically significant changes in the indicators "pain intensity" and "viability".

The efficiency of health care and the quality of medical care can be improved by implementing modern management methods and technologies. It requires modern and high-quality training of medical management personnel. Qualified personnel are the key factor in the organization and transformation of the health system. Human resources ultimately ensure the efficiency and effectiveness of the entire health sector. Requirements to economic management methods are changing and increasing, and specialists with skills in managing medical organizations at different levels of the healthcare system are becoming in demand. At the level of the constituent entities of the Russian Federation, the role of medical personnel who possess strategic methods of healthcare management is increasing. Available training programs in leading higher educational institutions of medical profile do not fully fulfill these tasks due to limited time, a large volume of lecture material, and frequent changes in the conditions and tasks of health care. These problems can be solved by optimizing training programs for retraining and advanced training of health care organizers, introducing active training methods such as business games, case methods, and project activities into the curriculum. The paper describes the system of training students for training courses in the field of healthcare and public health through planning and implementation, project management in the context of military educational organizations of the Ministry of Defense of the Russian Federation, the statistical analysis of the training effectiveness, the factors that influence the success of development programs.

The current state of demand for medical information in the media has a high practical significance for the mass audience. Medicine is a science-intensive, rapidly developing field. In this regard, it is necessary to systematically inform the public about the achievements of medicine - in science, technology and industry, explaining the essence and possible consequences of a scientific discovery, popularizing methods of treatment of a particular disease, introducing society to innovative technological processes in the medical field, achievements and developments of the medical and pharmaceutical industry. The paper reviews the experience of media coverage of medical issues in the aspect of familiarity with innovations and technologies in the context of historical development both in our country and abroad. It also describes the presentation of medical topics in modern media - in periodicals, on radio, on television - in popular science programs or TV movies, in electronic sources. In addition, the article analyzes the genre diversity of the presentation of medical topics. The paper provides information about the media coverage of the main directions of the national project "Health" and its innovative directions.

An important area of medical media is the preservation of health and a healthy lifestyle, the preservation and maintenance of adaptive properties of the body - the basis of content strategies of a large number of modern Russian media. To a greater or lesser extent and by virtue of their professional duties, it is the publications of doctors or interviews with them, as well as official research published in public and non-professional media, that popularize medical knowledge. The article focuses on the fact that the functions of popularizing health and a healthy lifestyle are inherent in the media, both special and for a wide range of the population. In addition to mass media that publish articles on preventive medicine and medicine of innovations and introduction of medical technologies, there are a number of mass media that cover medical knowledge for the population, in order to familiarize society with the achievements of medicine in the direction of maintaining health, maintaining a healthy lifestyle. This paper also concludes that all publications, all materials of Internet portals and messages, both in non-specialized and specialized media, most of the medical topics have a message of interpretation of the popularization of medical topics related to the preservation, maintenance of health and maintaining a healthy lifestyle. Popularization of medical knowledge in the media is an important direction for medical professionals and the public.

The article discusses issue of possibility of influence of religious organizations on the attitude of population to issues of human organ transplantation. The attitude of followers of different religions to key issues of bioethics related to organ donation and transplantation is analyzed. It is concluded that there are no definite prohibitions on implementing this kind of medical intervention in modern religious regulations. The study of results of questionnaire survey of two groups of respondents revealed certain part of population, whose decision on the issues of posthumous organ donation would be influenced by the opinion of representative of religious organization. It is established that every tenth respondent appealed to the Orthodox priest when making decision to sign consent paper concerning posthumous exempt of organ from relatives. It is concluded that it is possible to affect the formation in certain part of population understanding of need to support organ donation and transplantation in case of active work in this direction of representatives of religious organizations.

The article defines the main trends of the market of medical anti-aging services and prospects of aesthetic medicine. The paper presents the data of research on the impact of contextual advertising in social networks on the decision of patients of middle and retirement age on the use of anti-aging cosmetology and treatment for the provision of cosmetic services of an aesthetic nature. The article presents the analysis of the main options of Internet advertising of a medical nature for anti-aging subjects, in addition, describes the methodology that is developed for commercial medical organizations, and analysis of anti-aging medical procedures in the aspect of aesthetic medicine and the search for the necessary information on anti-aging medicine in social networks. The article draws an important conclusion that an important factor affecting the medical market of aesthetic medicine services is the decrease in consumer activity and solvency of the population, which requires a revision of the price and assortment policy of clinics. The article demonstrates the results of obtaining valuable data on popular requests and effective advertising sources, conversion into circulation from different advertising channels and from different devices, the activity of consumers of medical aesthetic services during the week and day. Special attention was paid to the advertising of anti-aging aesthetic medicine in social networks.

The sociological survey of physicians and patients was carried out in the state and private sector of medical care services with the purpose of comparison of various defects of paper work and quality of provided medical services. The material of study consisted of the results of survey in state and private medical institutions of Moscow. The quality of medical paper work, satisfaction of patients with received discharge epicrisis, quality of paper work for expertise of medical commission, rate of detection of defects and breaches in medical paper work were evaluated. The study object included patients aged 18-94 years received hospital care in 2016-2017 and provided voluntary informed consent to participation in survey. The study results demonstrated that in state and private medical institutions patients in overall were satisfied both with quality of proposed services and informativeness of discharge epicrisis at discharge from hospital. A number of established defects in execution of discharge epicrisis negatively affect overall perception of applied treatment and force to apply additional efforts to visit medical institution iteratively with the purpose of elimination of defects of lexical character and lacking in documentation the results of implemented clinical instrumental analyses and consultations of adjacent specialists.

The paper provides the results of the sociological survey to ascertain the opinions of physicians and paramedical personnel on the introduction of the new pay system for labor in a federal budget institution. The findings indicate that health personnel positively responded to the introduction of the new pay system for labor, their personal interest in achieving the quality indicators of their work has increased.

The paper demonstrates the importance of healthy lifestyle in the prevention and control of diseases. The description is given of the main methods and organizational technologies used in developed countries to ensure the effective performance of general practitioners on the introduction of healthy lifestyle. The concrete examples from WHO documents, USA and Australian organizations and also some recommendations for the healthcare system of Russia are provided.

The paper is devoted to organizational issues of health care quality control in Russia as at II quarter of 2008. The analysis is made of the organization of this kind of control in the context of the RF subjects with due regard for the system approach on the basis of territorial normative acts. The peculiarities of the legal provision and the organization of health care quality control in the RF subjects permit to divide them into 4 main groups according to the complete coverage of health care quality issues in the documents, and also to assess the influence of the legal provision of these issues on health care quality and the population's opinion.

The materials of publications on the realization of the national priority project "Health" concerning, in particular, the classification of citizens by groups of health in the course of additional dispensarization, indicate quite diverse results. The paper provides a comparative analysis of the correlation between groups of health established according to the results of the additional dispensarization of working citizens in the Russian Federation at large and in municipal formation for the period of 2000-2008. To ascertain the reasons for the divergence of the indicators it is necessary to conduct a thorough study of the problem at the primary level of separate municipal health institutions.

The paper provides the results of the examination and treatment of 1500 patients with cerebro-vascular pathology on the basis of an urban polyclinic. The use of the complex therapy (medicaments, physiotherapy, massage, acupuncture, therapeutic physical training) under conditions of the day hospital allows achieving the proper clinical effect.

Diseases of the respiratory system are in the lead of general mortality of population, they tend to increase, particularly with regard to pneumonias, chronic obstructive pulmonary diseases, bronchial asthma and others. The paper surveys the structure and levels of mortality from diseases of the respiratory system, sex and age indices with special reference to the working age, the mortality dynamics since 2000, levels of mortality by regions with special reference to subjects with the minimum and maximum levels both for the total and by the main nosologies (pneumonia, diseases of the lower respiratory tract, bronchial asthma); an attempt is made to carry out the correlation analysis of the level of mortality from diseases by the main nosologies.

Implementation of system of credits and score-rating of students' knowledge at the medical faculty of Peoples' Friendship University of Russia is considered. Estimation of maximum possible rating for each discipline is conventionally based on mode of "one credit--36 study hours of student--36 scores". System of numerical score elaborated at Course of history of medicine considers attendance of lectures and studies, activity of student during study hours and self-instruction (term papers included), contribution of student into chair research, interim testing and test passing. Total score of discipline determines rating of student for study class, university year and faculty. Tables of score estimation, its relationship with conventional system of scores are discussed. Examples of evaluation of student's knowledge using score-rating system are presented.

Analyzed in the paper are volumes and structure of surgery in 1993-2002. It is shown that the fluctuating and mismatching nature of surgical up trend observed both in hospitals and outpatient clinics contradicts the redistribution of scope of medical care in favor of its primary stage, which is not supported up to now by an appropriate personnel policy.

The timely restructuring of healthcare at water transport is an issue of special importance under the social-and-economic conditions of today. The paper mirrors positive and negative aspects of the present state medical care provided to those occupied at water transport system of the North-West Okrug of the Russian Federation. The virtually identical standard of medical care rendered to the discussed category of employees is observed in other Okrugs of Russia. A model of medical care for seamen for the at-sea and on-shore conditions is put forward. In order to preserve and to promote the discussed sphere of healthcare it is necessary to preserve the positive traditions of the past and, jointly with the interested branches, departments and public and other organizations, to apply the modern methods healthcare organization, i.e. to reorganize some of the sectors, to introduce a strict Register of institutions and organizations preoccupied with medical are at water transport and to develop and to introduce new technologies in all spheres of medical care within the branch.

Described in the paper is the activity of the Russian national children's recreation facility "Orlenok", where up to 16 000 children (mainly teenagers) come annually for recreation and recovery. Information on history, evolution as well on the structure of health-improving, preventive and educational measures is presented. The major provisions and stages of the Concept of development of "Orlenok"--a recreational, methodological, medical and cultural facility--are defined. The recreational facility is regarded as an experimental center, where pilot projects targeted at health improvement and prevention of diseases among the growing generation are tested.

The paper deals with issues associated with the management of personnel resources at the regional level (Chita Region); it also analyses the specific staffing and structure of medical personnel and occupational retraining of experts. Disproportion in the distribution of medical experts within the region as well as disparity between the total quantity of medical staff and numbers of experts in different fields were demonstrated by the analysis.

The structure and functions of voluntary medical insurance (VMI) as observed in Orenburg Region are analyzed in the paper. The held marketing research pointed at problematic aspects of VMI as well as at short-comings in information support; besides, potential sectors of the market of medical services were defined, which are rendered on the basis of VMI contracts--they should be considered in the development of complex and individual VMI programs for the purpose of meeting, as full as possible, the demands of potential consumers as well as for the purpose of optimizing the financial and price policy of insurance medical organizations (IMO) in the market etc. Data that were obtained in the course of complex multi-field research served as a basis for elaborating advanced programs for the promotion of VMI in the territory of Orenburg Region as well as for working out proposals targeted at optimizing the VMI performance in the market of medical services.

Presented in the paper are data on the health of population in Arkhangelsk Region. Specific features of morbidity are defined. Parameters of morbidity are described; its structure is evaluated and retrospectively analyzed. The key trends are displayed for the recent 5 years, they are: an increasing number of acute diseases, many of which become chronic; and growing primary disability. The regional specificity of morbidity must be taken account of in structuring of medical care.

Presented in the paper is the level and dynamic figures (for a period of 15 years) of infant mortality, i.e. one of the most important indices of population health and of quality of medical care, including all its components, as well as of perinatal mortality as observed in Leningrad Region. The main causes of infant mortality are described.; the key measures on its prevention are defined.

Described in the paper are issues related with the involution time in men and women, who are in the second period of their mature age, and with complications of the mentioned time interval affecting the life quality and its expectancy and aggravating the risk of sudden death. It was for the first time that the authors undertook a complex study of men and women of the mentioned age whose involution was physiological or complicated; they focused attention on the criterion specificity of the involution disregulations of different nature affecting the mean life expectancy and life quality in patients. The study results verify to the fact that the involution period is essentially influenced not only by endogenous but also by exogenous factors. It is pointed out as necessary to promote the primary prevention and outpatient follow-up of men and women aged above 40 for the purpose of exposing the factors of risk of involution complications and for the purpose of preventing early complications observed during the discussed life period. It is demonstrated that this would essentially improve the life quality in a significant share of the nation including patients aged above 40.

It is suggested in the paper how to finance stages of healthcare in Kazakhstan. The introduction of the Budget Code is expected to change the functioning of the financial department for the better.

The results of monitoring of bad habits (smoking) among senior schoolchildren in 23 towns of Moscow Region are dynamically described in the paper for 2000-2003. Smoking-related specific features are analyzed with respect to the age and sex differences of teenagers. A database, comprising above 25,000 entries, was created on the prevalence of smokers among city schoolchildren.

Presented in the paper are the results of monitoring of congenital defects (CD) among newborns in Nizhniy Novgorod Region in 1999-2003. All CD were subject to routine registration at maternity homes, pediatric clinics and dissection rooms of hospitals. The mean CD prevalence made, during the mentioned period, 15 cases per 1000 newborns, which is in keeping with the CD figures registered in other regions of Russia. The share of some nosological CD forms is in line with the results of the International Registry.

Analyzed in the paper are the 20-year dynamic changes of widespread chronic diseases and morphofunctional anomalies (MPO) observed in the health condition of schoolchildren at comprehensive medical check-ups. If MPO are predominant in the morbidity structure of schoolchildren, the chronic pathology is more intensive: it aggravates reaching its uttermost point by the age of senior pupils. On the basis of the obtained data the authors formulate the necessity in elaborating a variety of organizational and therapeutic-preventive measures for the treatment, prevention and follow-up of schoolchildren with MPO and pronounced chronic pathologies. It is also suggested to revise the norms and workloads for practitioners at pediatric patient-care facilities, which, according to the authors, should be made with respect to the frequency rate and structure of a detected pathology.

Results of a sociological study made among the heads of pediatric services in the city of Khabarovsk and related with different aspects of therapeutic, preventive and social care of children are discussed in the paper. It is demonstrated as necessary to transform the primary pediatric-care facilities within the national healthcare reform; suggestions are made on promoting the pediatric service.

Described in the paper is a concept of an alternative educational facility (City center for medical, psychological and social follow-up, diagnosis and consultation of schoolchildren in Yaroslavl) popularizing the healthy mode of life among pupils of general schools. The center's experts developed and tested comprehensive approaches to teaching the motivation and skills of the healthy mode of life through the comprehensive training of pupils, teachers and parents.

The paper focuses on issues related with the involution time in mature men and women, which affect negatively the life quality and life expectancy, aggravate the risk of unexpected death and worsen the morbidity and disablement. The authors convincingly demonstrate within their comprehensive case study that, apart from the genetic influence, social factors, like alcoholism in family, nicotine dependence in mother or father and family's well-being, have an essential impact on the development of the complicated involution period.