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In the Russian Federation, comprehensive rehabilitation and abilitation of the disabled is actively developing effected by the UN Convention on the Rights of the Disabled. In 2018-2019, the quantitative indicators of comprehensive rehabilitation and abilitation were studied in 85 regions of Russia. In 36 regions (42/4%) formation of system of comprehensive rehabilitation and abilitation was necessary. The remaining 49 regions required improving their systems of comprehensive rehabilitation and abilitation (57.6%, respectively). The study results demonstrated that significant increase in rehabilitation organizations (from 12.0% in 2018 to 100.0% in 2021) to be included in regional system of comprehensive rehabilitation and abilitation is expected. In the Republic of Dagestan, the final rating of comprehensive rehabilitation and abilitation system was from 6.5 to 7.6 points that indicates the need to organize and to improve comprehensive rehabilitation and abilitation system in the region. The experience of the Sverdlovsk Oblast and the Perm Krai where pilot project on comprehensive rehabilitation and abilitation system was carried out proved that one of the effective mechanisms of organizing comprehensive rehabilitation and abilitation system is development of state regional program by the authorities with involvement of all interested players and public organizations.Комплексная реабилитация и абилитация инвалидов в РФ активно развивается под влиянием Конвенции о правах инвалидов ООН. Изучены количественные показатели оценки этой системы в 2018 и 2019 гг. во всех 85 субъектах РФ. Необходимость ее формирования выявлена в 36 регионах страны, что составило 42,4% всех субъектов РФ. В остальных 49 субъектах РФ (57,6%) существует необходимость ее совершенствования. В РФ предполагается существенный рост числа реабилитационных организаций, подлежащих включению в региональную систему комплексной реабилитации и абилитации инвалидов: с 12% в 2018 г. до 100,0% в 2023 г. В Республике Дагестан итоговый показатель оценки системы составил 6,5 и 7,6 балла (2018 и 2019 гг. соответственно), что указывает на необходимость ее формирования и совершенствования в регионе. Опыт субъектов РФ, в которых был проведен пилотный проект по системе комплексной реабилитации и абилитации инвалидов (Свердловская область и Пермский край), показал, что одним из эффективных механизмов формирования этой системы является разработка органами власти государственной региональной программы с привлечением всех заинтересованных органов власти и общественных организаций.

Experimental fuel rods were tested in the PV-2 loop facility of the MIR reactor under conditions close to operation of full-size fuel rods in a PWR core. In the tests, the external condition of the cladding of the experimental fuel rods and structural elements of FA was evaluated visually; the thickness of the oxide film on the outer surface of the cladding of some fuel rods was measured. At the completion of the tests, all fuel rods remained tight, and no defects were found on the surface of the cladding and structural elements of FA. The thickness of the oxide film on the surface of the fuel rods made from the alloy E-110 (ultrapure), E-125 did not exceed 10 μm with average fuel burnup 32 MW·days/kg.

Introduction. Cerebral palsy (CP) is one of the most common neurological causes of childhood disability. In patients with cerebral palsy, the underlying disease is often complicated by secondary orthopedic disorders, for the prevention of which orthopedic methods of treatment, including orthoses and other technical means of rehabilitation (TMR) are widely used. Funding for orthosis is carried out from the Federal budget on the basis of an individual program of rehabilitation and habilitation (IPRH) of a disabled child. IPRH, in turn, is filled in taking into account the appointments of the attending physician of the orthopedist. Purpose. To analyze the compliance of recommendations on orthosis, initially introduced in the IPRH, and clinical recommendations of the medical and technical commission (MTC) of the rehabilitation Center for disabled children with spastic forms of cerebral palsy. Materials and methods. Conducted a prospective analysis of IPRH and MTK findings was made in a group of 63 disabled children aged 2 to 17 years, formed by random sampling. All patients were divided into 5 groups depending on the level of motor activity in accordance with the classification of GMFCS. Results. There were statistically significant differences (p < 0.05) between the number of orthoses initially introduced into the IPRH and the recommended MTK with a fluctuation of the visibility index depending on the group (GMFCS) from 38.9% to 56.0%. Summary. All groups noted the need for orthopedic equipment recommended by the MTC and not included primarily in the IPRH, which suggests the need for a multidisciplinary approach to the selection of TMR, including orthoses for children with spastic forms of cerebral palsy. The level of motor activity is an important expert factor in the formation of IPRH recommendations: with a decrease in the level of motor activity, the number and range of orthoses required for the patient increases. The maximum number of orthoses is recommended for additional introduction in IPRH, noted in patients in groups 3 and 5 of GMFCS.

On the basis of studying of statistical data, medical documents, results of the carried-out questioning in 2012-2015 the specific weight of the patients who have transferred amputation of the lower extremity owing to complications of diabetes and the obliterating diseases of vessels of the lower extremities, their distribution for the reason and level of amputating defects is estimated. Circulation periods of citizens on primary prosthetics of the lower extremities are studied and analysed. The problems of primary prosthetics connected with presence at patients of the accompanying pathology of the blood circulatory system, breath and the musculoskeletal device are designated. The prevalence of elderly people with amputating defects of the lower extremities is revealed. Features of prosthetics for elderly people, which have decreasing of weight-bearing on safe lower extremity, physical weakness, decreasing of the cognitive functions leading to difficulty of use of technical means of rehabilitation, decrease in learning ability to skills of use of artificial limbs is characteristic are specified. Problems of early rendering the prosthetic and orthopedic help and primary prosthetics of patients after amputation of the lower extremities in the megalopolis are considered. The new technology of early primary prosthetics of the lower extremities developed by specialists of Federal Scientific Center Rehabilitation of the Disabled named after G.A. Albrecht is presented by express method. Results of introduction of modern techniques of prosthetics by express method and their value for rendering primary parotezno-ortopedicheskoyy the help in the megalopolis are discussed. This type of the help can be rendered before formation of the individual program of rehabilitation and an abilitation of disabled people in the conditions of the medical organizations when rendering out-patient and stationary medical care. Rendering early primary prosthetic and orthopedic help is feasible when healing a wound of a stump after amputation, lack of contraindications to prosthetics, high motivation of the patient. Advantages of this technology of early primary prosthetics by express method is restoration of ability of the patient to movement and self-service, decrease in dependence on assistance and leaving, prevention of emergence of some defects and diseases of a stump at uluchsheny the general condition of an organism.

The role and the place of early use of technical means of rehabilitation in the system of complex rehabilitation of patients and disabled people owing to a military trauma is considered. Need of early providing the needing persons with technical means of rehabilitation is proved during recovery treatment, including before establishment by him of disability and formation of the individual program of rehabilitation and an abilitation of disabled people. The efficiency of the developed non-plaster technology of prosthetics manufacturing techniques of artificial limbs of the lower extremities is proved by express method, options of her execution are offered. The first option of production of products on this technology consists in use of polymeric silicone covers and the water-hardening polymeric bandage directly on the patient’s stump. The second option of prosthetics is applied at some defects and diseases of a stump excluding application of silicone covers and full contact individual reception sleeves. For this purpose at production of medical and training artificial limbs of a shin and hip adjustable demountable reception sleeves from thermolayers for right-and left-side amputating defects are used. These options of prosthetics by express method are innovative, are aimed at early rendering the prosthetic and orthopedic help to patients with amputating defects. At production of artificial limbs on these technology domestic materials, modular and not modular accessories are used. The modular complete set of medical and training artificial limbs provides fast and individual setting up the scheme of construction, the individual choice of combinations of functional elements taking into account group of physical activity of the patient, a possibility of replacement of a reception sleeve and any of product elements without withdrawal of an artificial limb at the user. In need of service of a product, for example repair, replacement of the module (artificial foot, a knee) there is no requirement of urgent production of a similar design. Adjustable reception sleeves for primary artificial limbs of a shin and hip in the form of a standard series and moisture-curing bandage can add the list of products of medical appointment in laying for expansion of medical institutions during the special period.

In the article there are substantiated organizational approaches to the employment of persons with disabilities in the independent movement with the use of information and communication technologies. There were evaluated activities of the employment service on the employment of people with disabilities in St. Petersburg for five years (2011-2015). There are presented data of clinical experts, social, psychological, socio-environmental characteristics of the 1120 invalids suffering from obliterating atherosclerosis of vessels of lower extremities, with disabilities in the independent movement. There was scientifically substantiated the possibility of the employment in special working conditions at home in the form of distance mode. There was recommended the algorithm for the mutual employment of specialists of the Bureau of the ITU and the employment service

Relevance The work deals with the challenging problems of improving the function and aesthetic appearance of the finger stumps using a surgical technology of osseointegration. Purpose To present preliminary results of osseointegration with the use of titanium implants and exoprostheses for finger stumps. Material and methods Osseointegration was performed in order to improve the function and aesthetic appearance of 17 phalangeal finger stumps in 8 patients at the age of 15 to 57 years who underwent treatment at the FSBI RISC for RTO of the RF ministry of health in 2014. Results Osseointegration that was assessed with clinical and radiographic methods, bench tests, and DASH scale resulted in positive short-term outcomes. Conclusion Osseointegrated finger prostheses for defects at the phalangeal level improve hand functions and appearance within a short period of time. The method of osseointegration is strategically important for management of large limb segment amputations and high levels of truncation. It is relevant to develop domestic implants that will optimize treatment terms, its results, and further prosthetic application.

Because of extensive changes in social protection laws in the Russian Federation (RF), as well as ratification of the Convention on the Rights of Persons with Disabilities, the organization of rehabilitation for disabled persons with musculoskeletal disorders has especially become relevant. Aim To improve the organizational and legal mechanisms for implementing individual programs of rehabilitation or habilitation of disabled persons with musculoskeletal system diseases in RF. Materials and Methods The authors analyzed existing international and Russian literature. The study used analytical, legal, organizational, and methodological techniques aimed at perfecting the system for rehabilitation of disabled adults and children. Results In RF, the “disabled child” category was established for the first time for more than 70,000 children (70,600 in 2013 and 72,800 in 2014) according to governmental statistics of the Institutions of Medical and Social Examination, and more than 340,000 individual rehabilitation programs for disabled children were established, including for those recognized as disabled children for the first time and for those who were rerecognized as disabled children. The disability due to diseases of the musculoskeletal system and connective tissue was established for the first time in 3,500 children and is the fifth highest ranking primary disability in RF. Conclusion The introduction of fundamentally new federal schemes of implementing individual programs of rehabilitation or habilitation requires the authorities of RF to be experienced in the field of health promotion to create the organizational and legal mechanisms for implementing such programs. Thus, the features of regional rehabilitation infrastructure, medical care and monitoring should be considered.

One of the ways to develop the economy is innovation. The purpose of the article is to identify the main trends of innovative development and develop proposals for increasing its effectiveness at the mesolevel. The authors give a characteristic of the current state of innovation activity of the Russian Federation and one of its territory - Krasnoyarsk region. The authors compared the indicators that measure the levels of innovation development both according to international and domestic statistical data. Factors based on the identified trends were identified. Regional analytical researches allowed to justify an optimum composition of the sources and tools of financing innovation. The results of empirical data allowed the authors to reveal disproportions in the structure of the innovation infrastructure. The article gives recommendations on improving of institutional support with regard of the life cycle of innovations.

According to the State Statistics a the indicators of primary disability in 2003-2015 years in Russia were studied, taking into account the population in working and over working age first time recognized as disabled persons. The necessity of medical organizations improvement during the medical and social expertise of patients in different ages was shown. The characteristics of social and medical features of the primary disability were presented that should be taken into consideration in the development of social protection programs, rehabilitation of disabled people and disability prevention, especially among elderly citizens.По данным государственной статистики проведен анализ показателей первичной инвалидности в РФ за 2003-2015 гг. с учётом численности лиц трудоспособного и старше трудоспособного возраста, впервые признанных инвалидами. Полученные результаты свидетельствуют о необходимости совершенствования деятельности медицинских организаций при направлении пациентов разных возрастных групп на освидетельствование в учреждения медико-социальной экспертизы. Выявлены характерные медико-социальные особенности первичной инвалидности, которые следует учитывать при разработке комплексных программ по социальной защите, реабилитации инвалидов и профилактике инвалидности, в том числе у лиц старших возрастных групп.

According to the State Statistics a comparative analysis of total disability in the Russian Federation in 2010-2016 years was conducted, taking into account the performance of the working-age and over working-age population. The necessity of integration policy towards the older generation and social policy in respect of disabled persons is shown: it is advisable to make adjustments to the national strategies and programs involving the duties of authorities to protect and promote the rights of disabled people, the development of preventive, rehabilitation, medical and social trends in the interests of senior citizens are involved.По данным государственной статистики проведен сравнительный анализ показателей общей инвалидности в РФ за 2010-2016 гг. с учётом показателей численности населения трудоспособного и старше трудоспособного возраста. Показана необходимость интеграции политики в отношении старшего поколения и социальной политики в отношении инвалидов: целесообразно внести коррективы в общенациональные стратегии и программы, предусматривающие обязанности органов власти по защите и поощрению прав инвалидов, предполагающие развитие профилактического, реабилитационного и медико-социального направлений в интересах граждан старшего поколения.

To study the primary disability due to cerebrovascular diseases (CVD) in St.-Petersburg for 13 years (from 2004 to 2016) according to the data of the medical-social expertise institution.Based on the official statistics, the prevalence, level and structure of primary disability due to CVD in St.-Petersburg for 13 years (from 2004 to 2016) were analyzed.With the increase in overall incidence of CVD by 1.3 times during the study period and the increase in primary morbidity due to CVD by 2 times, there was a decline by 3.1 times of indicators of primary disability. The level of primary disability in people of retirement age due to this disease during the entire observation period was significantly higher than in the working age group (4.3-fold). The structure of primary disability due to CVD in people of working age is dominated by persons with disabilities of III group, whereas among the elderly, the vast majority were people with group II disability, however, the 13-year dynamics shows that their share has decreased in 1.4 times. There was a significant difference between the indicators of primary disability due to CVD in St.-Petersburg in comparison with the Russian Federation, connected, in our opinion, with the special demographic composition of the residents of the city and a predominance of people of retirement age.Цель исследования. Изучение первичной инвалидности вследствие цереброваскулярных болезней (ЦВБ) в Санкт-Петербурге за 13 лет (с 2004 по 2016 г.) по данным учреждения медико-социальной экспертизы. Материал и методы. По данным официальной статистики проанализированы показатели численности, уровня и структуры первичной инвалидности вследствие ЦВБ в Санкт-Петербурге за 13 лет (2004-2016 гг.). Результаты и заключение. При повышении показателей общей заболеваемости при ЦВБ в 1,3 раза за исследуемый период и увеличении показателей первичной заболеваемости вследствие ЦВБ в 2 раза зафиксировано снижение показателей первичной инвалидности в 3,1 раза. Уровень первичной инвалидности среди лиц пенсионного возраста вследствие данной патологии в течение всего периода наблюдения существенно превышал аналогичный показатель в трудоспособном возрасте (в 4,3 раза). В структуре первичной инвалидности вследствие ЦВБ в трудоспособном возрасте преобладали инвалиды III группы, тогда как среди лиц пожилого возраста подавляющее большинство составляли инвалиды II группы, однако в динамике за 13 лет их удельный вес уменьшился в 1,4 раза. Зафиксировано существенное отличие показателей первичной инвалидности вследствие ЦВБ в Санкт-Петербурге по сравнению с Российской Федерацией, связанное, по нашему мнению, с особым демографическим составом жителей города и преобладанием в нем лиц старше трудоспособного возраста.

In the article the authors examined the insurance compensation injury suffered in the workplace as a result of occupational accidents and diseases, as well as the place and role of medical organizations in matters of medical and social assistance to victims in the workplace.