Headache service quality evaluation: implementation of quality indicators in primary care in Europe
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01.12.2021 |
Lenz B.
Katsarava Z.
Gil-Gouveia R.
Karelis G.
Kaynarkaya B.
Meksa L.
Oliveira E.
Palavra F.
Rosendo I.
Sahin M.
Silva B.
Uludüz D.
Ural Y.Z.
Varsberga-Apsite I.
Zengin S.T.
Zvaune L.
Steiner T.J.
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Journal of Headache and Pain |
10.1186/s10194-021-01236-4 |
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Background: Lifting The Burden (LTB) and European Headache Federation (EHF) have developed a set of headache service quality indicators, successfully tested in specialist headache centres. Their intended application includes all levels of care. Here we assess their implementation in primary care. Methods: We included 28 primary-care clinics in Germany (4), Turkey (4), Latvia (5) and Portugal (15). To implement the indicators, we interviewed 111 doctors, 92 nurses and medical assistants, 70 secretaries, 27 service managers and 493 patients, using the questionnaires developed by LTB and EHF. In addition, we evaluated 675 patients’ records. Enquiries were in nine domains: diagnosis, individualized management, referral pathways, patient education and reassurance, convenience and comfort, patient satisfaction, equity and efficiency of headache care, outcome assessment and safety. Results: The principal finding was that Implementation proved feasible and practical in primary care. In the process, we identified significant quality deficits. Almost everywhere, histories of headache, especially temporal profiles, were captured and/or assessed inaccurately. A substantial proportion (20%) of patients received non-specific ICD codes such as R51 (“headache”) rather than specific headache diagnoses. Headache-related disability and quality of life were not part of routine clinical enquiry. Headache diaries and calendars were not in use. Waiting times were long (e.g., about 60 min in Germany). Nevertheless, most patients (> 85%) expressed satisfaction with their care. Almost all the participating clinics provided equitable and easy access to treatment, and follow-up for most headache patients, without unnecessary barriers. Conclusions: The study demonstrated that headache service quality indicators can be used in primary care, proving both practical and fit for purpose. It also uncovered quality deficits leading to suboptimal treatment, often due to a lack of knowledge among the general practitioners. There were failures of process also. These findings signal the need for additional training in headache diagnosis and management in primary care, where most headache patients are necessarily treated. More generally, they underline the importance of headache service quality evaluation in primary care, not only to identify-quality failings but also to guide improvements. This study also demonstrated that patients’ satisfaction is not, on its own, a good indicator of service quality.
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Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance
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01.12.2021 |
Sacco S.
Lampl C.
Maassen van den Brink A.
Caponnetto V.
Braschinsky M.
Ducros A.
Little P.
Pozo-Rosich P.
Reuter U.
Ruiz de la Torre E.
Sanchez Del Rio M.
Sinclair A.J.
Martelletti P.
Katsarava Z.
Cakciri G.
Djamandi P.
Grabova S.
Halili G.
Kruja J.
Kuqo A.
Naco D.
Quka A.
Stefanidhi L.
Vyshka G.
Zekja I.
Bruera O.
Gómez D.
Guitian B.
Roma J.C.
Chen I.L.
Bashirova S.
Linkov M.
Van Den Abbeele D.
Vanderschueren G.
Araujo R.
Arruda R.
Catharino A.
Ciriaco J.
Dalla Corte A.
Dornas R.
Felsenfeld B.
Fonseca Taufner A.
Fragoso Y.
Hurtado R.
Isoni Martins D.
Londero R.
Melo L.
Mignoni K.S.
Sgobbi De Souza P.V.
Souza M.N.
Osman S.
Baltzer V.
Pacheco Mosquera L.F.
Dubroja I.
Hucika Z.
Lisak M.
Lovrencic-Huzjan A.
Lušic I.
Mahovic Lakusic D.
Mikulenka P.
Rehulka P.
Amin F.M.
Antic S.
Fakhril-Din Z.
Moeller-Hansen J.
Munksgaard S.
Nan A.M.
Pellesi L.
Schytz H.
Vides M.
Braschinsky K.
Krikmann Ü.
Roos C.
Cauchie A.
Christian L.
Guégan-Massardier E.
Demarquay G.
Gilles G.
Mawet J.
Kuhn E.
Lanteri Minet M.
Bustuchina Vlaicu M.
Moisset X.
Muresan M.
Najjar-Ravan M.
Giraud P.
Simonin S.
De Gaalon S.
Chakhava G.
Demuria M.
Gegelashvili G.
Kapanadze N.
Antonakakis A.
Gaul C.
Förderreuther S.
Huhn J.I.
Ibragimov S.
Kamm K.
Raffaelli B.
Czaniera R.
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Journal of Headache and Pain |
10.1186/s10194-021-01252-4 |
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Background: New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods: We conducted a web-questionnaire-based cross-sectional international study involving physicians with interest in headache care. Results: There were 277 questionnaires available for analysis. A relevant proportion of participants reported that patients with resistant and refractory migraine were frequently seen in their clinical practice (49.5% for resistant and 28.9% for refractory migraine); percentages were higher when considering only those working in specialized headache centers (75% and 46% respectively). However, many physicians reported low or moderate confidence in managing resistant (8.1% and 43.3%, respectively) and refractory (20.7% and 48.4%, respectively) migraine patients; confidence in treating resistant and refractory migraine patients was different according to the level of care and to the number of patients visited per week. Patients with resistant and refractory migraine were infrequently referred to more specialized centers (12% and 19%, respectively); also in this case, figures were different according to the level of care. Conclusions: This report highlights the clinical relevance of difficult-to-treat migraine and the presence of unmet needs in this field. There is the need of more evidence regarding the management of those patients and clear guidance referring to the organization of care and available opportunities.
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Structured Q1 headache services as the solution to the ill-health burden of headache: 1. Rationale and description
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01.12.2021 |
Steiner T.J.
Jensen R.
Katsarava Z.
Stovner L.J.
Uluduz D.
Adarmouch L.
Al Jumah M.
Al Khathaami A.M.
Ashina M.
Braschinsky M.
Broner S.
Eliasson J.H.
Gil-Gouveia R.
Gómez-Galván J.B.
Gudmundsson L.S.
Herekar A.A.
Kawatu N.
Kissani N.
Kulkarni G.B.
Lebedeva E.R.
Leonardi M.
Linde M.
Luvsannorov O.
Maiga Y.
Milanov I.
Mitsikostas D.D.
Musayev T.
Olesen J.
Osipova V.
Paemeleire K.
Peres M.F.P.
Quispe G.
Rao G.N.
Risal A.
de la Torre E.R.
Saylor D.
Togha M.
Yu S.Y.
Zebenigus M.
Zewde Y.Z.
Zidverc-Trajković J.
Tinelli M.
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Journal of Headache and Pain |
10.1186/s10194-021-01265-z |
1 |
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In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.
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Mortality of patients with rheumatoid arthritis requiring intensive care: a single-center retrospective study
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01.11.2019 |
Haviv-Yadid Y.
Segal Y.
Dagan A.
Sharif K.
Bragazzi N.
Watad A.
Amital H.
Shoenfeld Y.
Shovman O.
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Clinical Rheumatology |
10.1007/s10067-019-04651-w |
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© 2019, International League of Associations for Rheumatology (ILAR). Background: Patients with rheumatoid arthritis (RA) are at a high risk for life-threatening conditions requiring admission to the intensive care unit (ICU), but the data regarding the outcomes of these patients is limited. The present study investigated the clinical characteristics and outcomes of RA patients admitted to an ICU. Methods: This retrospective cohort study included RA patients admitted to the general ICU of the Sheba Medical Center during 2002–2018. The main outcome was 30-day mortality. Using Student’s t test, χ2, and multivariable analyses, we compared the demographic, clinical, and laboratory parameters of the survivors and the non-survivors. Figures with p value < 0.05 were considered statistically significant. Results: Forty-three RA patients were admitted to the ICU during the study period (mean age, 64.0 ± 13.1 years; 74.4% female). The leading causes of ICU admission were infection (72.1%), respiratory failure (72.1%), renal failure (60.5%), and septic shock (55.8%). The 30-day mortality rate was 34.9%, with infection (9/15, 60%) as the most frequent cause. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were 19.7 ± 12.5 and 7.0 ± 4.5, respectively. Multivariable analysis showed that heart failure (p = 0.023), liver failure (p = 0.012), SOFA score (p = 0.007), and vasopressor treatment in ICU (p = 0.039) were significantly associated with overall mortality. SOFA score was linked with overall mortality (area under the curve (AUC) = 0.781 ± 0.085, p = 0.003) and mortality from respiratory failure (AUC = 0.861 ± 0.075, p = 0.002), while APACHE II score was only correlated with mortality from infection (AUC = 0.735 ± 0.082, p = 0.032). Conclusions: Our study demonstrated a relatively high mortality rate among RA patients who were admitted to the general ICU. RA patients with risk factors such as heart failure, liver failure, elevated SOFA score, and vasopressor treatment in ICU should be promptly identified and treated accordingly.Key Points• The 30-day mortality rate of patients with RA that were admitted to the general ICU of a tertiary hospital was 34.9%.• The most common causes of ICU admission among patients with RA were infections and respiratory failure. Infections were the most common cause of death among these patients.• Patients with RA that present to the ICU with heart failure, liver failure, elevated SOFA score, and/or require vasopressor treatment in ICU should be promptly identified and treated accordingly.
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Interaction of health and religion in the modern world ways of rapprochement
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01.10.2019 |
Osadchuk M.
Osadchuk A.
Korzhenkov N.
Trushin M.
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European Journal of Science and Theology |
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0 |
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© 2019, Ecozone, OAIMDD. All rights reserved. Spirituality is the fourth aspect of health, along with the physical, mental and social ones. At the same time, religiosity is a private manifestation of spirituality. The purpose of the study is to find out the relationship between health care on the one hand, and spirituality, religious life, a subjective feeling of happiness and good health indicators, on the other. A review of literary sources shows that positive values, beliefs, and the power of faith contribute to health and happiness. Religious participation and spiritual practices have a positive effect on the survival of the sick, low disease incidence, prolonged remissions of chronic diseases, lower anxiety and depression level, healthy lifestyle and compliance. At the same time, better results in treating patients are achieved when doctors and patients have common spiritual and/or religious attitudes.
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The development of territorial program of mandatory medical insurance: calculation of standards of out-patient care volume
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01.09.2019 |
Stolbov A.
Madianova V.
Allenov A.
Kobiatckaia E.
Leesovskii D.
Orlov S.
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Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny |
10.32687/0869-866X-2019-27-5-813-816 |
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The article presents technique of calculation of the planned volume of outpatient care consumed by population of the subject of the Russian Federation considering demographic structure and level of morbidity. The formulas are presented developed for calculating financial costs of outpatient care and treatment in day hospital to be included into of mandatory health insurance program.
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A novel low-cost approach for the semi-quantitative analysis of carbohydrate-deficient transferrin (CDT) based on fluorescence resonance energy transfer (FRET)
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01.08.2019 |
Musile G.
De Palo E.
Savchuk S.
Shestakova K.
Bortolotti F.
Tagliaro F.
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Clinica Chimica Acta |
10.1016/j.cca.2019.06.003 |
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© 2019 Background and aim: The increase of the carbohydrate-deficient transferrin (CDT) as results of an heavy intake of alcohol for at least two weeks, is a well-known biochemical modification since the middle ‘70s. Notwithstanding the first commercial kit for the diagnosis of chronic alcohol abuse based on this biomarker was commercially accessible already thirty years ago, only expensive analytical methods are currently available for its determination. The present paper shows a new approach intrinsically sensitive and specific, based on a specific derivatization of transferrin, and not requiring sophisticated instrumentation. Methods: The proposed procedure is based on a selective chelation of terbium (III) by transferrin followed by detection using an characteristic Fluorescence Resonance Transfer Energy (FRET) phenomenon (ex 298 nm - em 550 nm). Results: The proposed procedure showed a limit of detection of 2.5 pmol/mL and a reproducibility intra-day and inter-days <15% and 20%, respectively. The results obtained analyzing 40 serum samples using the developed method, were compared with those obtained with HPLC-Vis and an R2 = 0.8854 was found. Conclusions: Considering its main features (low-cost, ease of operation, minimum need of instrumentation) the present method is suitable for application in screening contexts and in non-strictly regulated environments (e.g. clinical diagnosis) as well as in developing countries or remote areas.
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The Analysis of Actual Approaches in Evaluating Efficiency of Medical Care of Female Patients with Habitual Miscarriage
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01.07.2018 |
Vartanian E.
Gridnev O.
Belostotsky A.
Pesennikova E.
Gadaborshev M.
Kuchitz S.
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Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny |
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0 |
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The prevalence of habitual miscarriage varies depending on territories of the Russian Federation and other countries. The rate of premature delivery in the Moscow Zelenograd administrative okrug in 2013-2015 in average made up to 4.5%-4.7%. The percentage of habitual miscarriage made up to 3.6% that is a rather low indicator as compared with other Moscow okrugs and national average indices. The article considers three-level model of evaluation of medical, economic and social efficiency of obstetric gynecologic care support of population at the out-patient stage.
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The Modern Characteristics of Anti-Tuberculosis Care Support of Population of the Chechen Republic
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01.03.2018 |
Batukaieva Z.
Alekseieva V.
Kozlov V.
Mikerova M.
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Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny |
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0 |
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Despite a steady tendency of decreasing of indices of morbidity of tuberculosis of population of the Chechen Republic, the problems related to early diagnosis of tuberculosis and organization of specialized medical care of patients continue to be unresolved. The questionnaire survey of administrators of anti-tuberculosis medical organizations of the Chechen Republic was carried out with the purpose of establishing difficulties in medical care support of patients with tuberculosis and determining main directions of their overcoming. The results of study demonstrated that main problems are asocial behavior of patients, inadequate staffing of institutions with medical and paramedical personnel, absence of proper relationship with other medical organizations, inadequate level of financing. The administrators indicated as main directions of solving problems increasing of remuneration of labor of medical personnel of anti-tuberculosis medical organizations, development of social defense of patients, physicians and population, alteration of actual normative legal base according to modern social economic conditions, enhancement of preventive direction of work, optimization of manning table and standards of work load of physicians and also development of tactics of treatment and re-organization of dispensary observation of patients with tuberculosis.
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The Organization of Stomatological Care to Patients with Various Somatic Pathology
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01.03.2018 |
Grinin V.
Kovaleva L.
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Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny |
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0 |
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The article considers actual national and international publications concerning problems of organization and characteristics of stomatological care support of patients with particular types of somatic pathology. The new approaches are analyzed concerning organization of efficient stomatological care of patients with various diseases.
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Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second-line therapy after metformin monotherapy: Retrospective data for 10 256 individuals from the United Kingdom and Germany
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01.02.2018 |
Khunti K.
Godec T.
Medina J.
Garcia-Alvarez L.
Hiller J.
Gomes M.
Cid-Ruzafa J.
Charbonnel B.
Fenici P.
Hammar N.
Hashigami K.
Kosiborod M.
Nicolucci A.
Shestakova M.
Ji L.
Pocock S.
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Diabetes, Obesity and Metabolism |
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6 |
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© 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. Aim: To investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second-line glucose-lowering therapies. Materials and Methods: This cohort study utilized retrospective data from 10 256 patients with T2DM who initiated second-line glucose-lowering therapy (switch from or add-on to metformin) between 2011 and 2014 in Germany and the UK. Effects of pre-specified patient characteristics on 6-month HbA1c changes were assessed using analysis of covariance. Results: Patients had a mean (standard error [SE]) baseline HbA1c of 8.68% (0.02); 28.5% of patients discontinued metformin and switched to an alternative therapy and the remainder initiated add-on therapy. Mean (SE) unadjusted 6-month HbA1c change was −1.27% (0.02). When adjusted for baseline HbA1c, 6-month changes depended markedly on the magnitude of the baseline HbA1c (HbA1c <9%, −0.45% per unit increase in HbA1c; HbA1c ≥9%, −0.87% per unit increase in HbA1c). Adjusted mean 6-month HbA1c reductions showed slight treatment differences (range, 0.92–1.09%; P <.001). Greater reductions in HbA1c were associated with second-line treatment initiation within 6 months of T2DM diagnosis (1.36% vs 1.03% [P <.001]) and advanced age (≥70 years, 1.13%; <70 years, 1.02% [P <.001]). Conclusions: Many patients with T2DM have very high HbA1c levels when initiating second-line therapy, indicating the need for earlier treatment intensification. Patient-specific factors merit consideration when making treatment decisions.
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To the biography of N.A. Semashko: On the work of the first people’s commissar of health in 1920–1925
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01.01.2018 |
Arsentyev E.
Reshetnikov V.
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History of Medicine |
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2 |
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© EV Arsentyev,. The article deals with the main turning points in the life and work of N.A. Semashko, the first People’s Commissar of Health of the RSFSR, from 1920 to 1925. The authors of the article proceed from the fact that the historical and biographical data available about Semashko are interpreted according to ideologically tinted stereotypes that were formed in the Soviet historiographic school. Based on various sources (mainly documents from the State Archives of the Russian Federation and Semashko’s family archive), as well as critical analysis of data from literature, an attempt was made to give an ideologically neutral assessment of the participation of Semashko in the organization of the sanatorium and resort sector in the RSFSR and the assistance provided to Soviet Russia from foreign public organizations. New facts were discovered about Semashko’s life, which in particular made it possible to clarify his role in helping medical personnel in Crimea during political repressions there (after the Bolsheviks established power on the peninsula). The authors of the article point out that despite the difficulties that existed at that time, in many respects, it was only due to Semashko’s authority and organizational abilities that the famous Soviet All-Russia health resort was established in Crimea. While work was carried out on the archives, data were found on the supply of humanitarian aid to the People’s Commissar of Health by US public organizations, sympathizing with Soviet Russia in the first half of the 1920s. It is concluded that the formation of Semashko’s scientific biography, which assumes an objective assessment, in particular, concerning his contribution to the organization of medical care, will make it possible in general to move on to an objective analysis of the features of the Soviet health care system and the transformation of the Soviet model (the Semashko model) into the modern Russian model of health care.
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The origin and formation of the Transbaikal health care system
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01.01.2018 |
Batoev S.
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History of Medicine |
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0 |
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© SD Batoev. The current continuing outflow of valuable production forces and intellectual resources from Transbaikal has a negative impact on the socio-economic development of this border area. A retrospective analysis of the health care system provided to the Russian population living in remote areas demonstrates that not all formative stages of the health care system in Transbaikal were completed without problems. The Russian Empire implemented a state policy on the demographic and socio-cultural integration of Transbaikal for the purpose of rational economic development, effective consolidation of the territory and provision of border security. The pre-revolutionary government, facing significant financial shortages and an unfavorable socio-economic and political situation from the mid 18th century, carried out continuous work to create the foundations for the Transbaikal public health system. However, social issues were not a priority with regard to all population groups living on the outskirts of the Russian Empire, therefore many projects and decisions were implemented with significant delays or in a reduced format. In addition, it is necessary to take into account an objective point restraining the introduction of the central authorities’ solution: a new type of medical care was being promoted, to which the indigenous and newly arrived people of Transbaikal had to grow accustomed. At the same time, by the beginning of the 20th century, the heterogeneous population of Transbaikal, which traditionally used folk methods as well as Tibetan medicine, gradually began to understand the advantages of official medicine and science-based hygiene for improving and preserving human potential, which is the basis of the physical and intellectual development of any nation, and to master their leading principles. From the beginning of November 1920, under the conditions found in the Far Eastern Republic, measures were taken for the first time to organize free and preventive medicine for all population groups on the territory of Transbaikal, which marked the beginning of positive changes in the sphere of health care in terms of ensuring the real availability of medical care. Thus, the long process if creating a treatment and prevention system in pre-revolutionary Transbaikal took place within the framework of the all-Russian model of state medical care. It was continuous in nature and had a number of significant differences from the health care system established in European Russia.
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Training of dentists in public healthcare in accordance with professional standards
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01.01.2018 |
Tregubov V.
Kuznetsova M.
Orlova A.
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Stomatologiia |
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0 |
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For the purpose of studying the possibility of labor functions development for public health and healthcare during training in the educational organizations the comparative analysis of provisions of the professional standard with the materials stated in textbooks and national manuals of the corresponding profile was carried out. It was found that in the development of Federal state educational standards of higher education in dentistry (specialization level), updating educational methodological publications on dentistry and public health, the formation of a unified database of evaluation tools for accreditation of specialists and obtaining or confirming qualification categories, it is necessary to take into account the content of labor functions of the professional standard in each discipline.
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The echo of the Khabarovsk trials: The ussr and the allegation campaign against the USA of using biological warfare during the Korean war (1950–1953)
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01.01.2018 |
Romanova V.
Shulatov Y.
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History of Medicine |
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0 |
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© VV Romanova, YA Shulatov. During the Korean War (1950–1953), China and North Korea accused the US of waging bacteriological warfare, including the use of biological weapons developed Japanese war criminals from Unit 731, who had been convicted during the Khabarovsk Trials in 1949. The Soviet Union did not immediately join in the allegation campaign against the Allies, with the Soviet Foreign Ministry initially taking a restrained stance. However, with Moscow’s backing and active involvement in international orga-nisations and the media, a powerful propaganda campaign was unleashed against American-led UN troops in Korea, as well as the political leadership of the US. The campaign was markedly political in nature and it involved many prominent individuals, including public figures from Western countries. An extensive action plan was developed, although its implementation was incoherent, which was a reflection of both the lack of evidence and a rapidly changing international environment. The article demonstrates how the Soviet stance on the use of biological warfare during the Korean War changed and reveals how the extensive campaign was launched amid the Cold War.
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Features of the formation of the health care system in Transbaikal during the period of the Far Eastern Republic
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01.01.2018 |
Batoev S.
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History of Medicine |
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0 |
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© SD Batoev. The formation of the health care system in Transbaikal after the revolution of 1917–1918 had a number of essential features that will be covered in this paper. In 1919, the organization of medical care in Transbaikal retained its pre-revolutionary structure. In connection with the tense political situation in eastern Russia and the serious danger of a military conflict with Japan, in the spring of 1920, a buffer state was created – the Far Eastern Republic (FER). The FER Ministry of Health was established within the framework of the administrative territorial unit. During this period, the Ministry of Health had to fight epidemics, organize medical and sanitary assistance for the population and provide medical support for the People’s Revolutionary Army. Throughout the FER’s territory, free access to all types of medical care (outpatient, inpatient, sanatorium and dental) was introduced for all working groups of the population. From that point on, the state medical authorities consolidated and directed all the FER’s medical and sanitary and veterinary affairs. The Ministry of Health consisted of a civilian and military administrative unit, a medical and veterinary council and local health institutions for the indigenous population. The institutions were involved in the organization of health care and conducted medical and preventive activities and statistical studies. Despite Soviet Russia’s comprehensive assistance, the FER’s economic situation remained dire and unstable. The deficit of skilled health workers and medical institutions prevented the improvement of the health care situation. Radical changes in the public health system became possible only after the accession of Transbaikal to the RSFSR. In the territory of Transbaikal during the existence of the FER (from the spring of 1920 to the end of 1922), the formation of a health care system aimed at providing all segments of the region’s population with access to qualified medical care was an ongoing process.
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Public healthcare responsibilities of ophthalmologists according to professional regulations
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01.01.2018 |
Tregubov V.
Fettser E.
Siplivy V.
Orlova A.
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Vestnik Oftalmologii |
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0 |
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© 2018, Media Sfera. All rights reserved. Modern public healthcare practices are constantly being improved by the medical community, which involves approval and implementation of professional standards such as including public health activities in the responsibilities of medical specialists. To understand how well such skills can be mastered by the specialists, we have conducted a comparative analysis of ophthalmologist qualifications found in the most often used guidelines and textbooks. With logical, analytical and hypothetical analysis, books and guides published before 2018 were found to have insufficient coverage of the public health responsibilities. Improvement of the public healthcare in terms of professional standards is an important course of development for the medical field. The continued work on Russian Federal State Educational Standard (Higher Education) for Ophthalmology - index number 31.08.59 - should include actualization of educational materials with modern public health notions, development of a universal learning evaluation database for specialist accreditation, as well as evaluation tools for the obtainment and confirmation of their qualification. The professional standards for ophthalmologists should fully account for the job responsibilities they acquire. Training of ophthalmologists in the public healthcare should utilize the following textbooks published in 2018: «Organization of medical aid in the Russian Federation» under the editorship of V.A. Reshetnikova, «Healthcare and public health» under the editorship of G.N. Tsarik, and «Public health and healthcare» by V.A. Medic.
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The national cancer control program: Pediatric oncology
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01.01.2018 |
Rykov M.
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Rossiyskiy Vestnik Perinatologii i Pediatrii |
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1 |
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© The authors team, 2018.All Rights Reserved. Due to its cardinal differences from the adult oncology the children's oncology takes a special place in the national cancer control program. The article analyzes up-to-date problems and suggests their solutions. It contains statistical indicators and a three-level model of medical care for children with cancer. The tasks of the national program stated in the article reflect the author's point of view and are to be further discussed.
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120 years of outpatient service and ambulatory education in Moscow
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01.01.2018 |
Svistunov A.
Osadchuk M.
Kireeva N.
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Profilakticheskaya Meditsina |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. This article reflects the main stages of outpatient care formation in Moscow. It describes the most significant health care and health education reforms in different periods of Russian history. The article stresses the relevance of outpatient service modernization as a priority of Russian health care reform. The dominance of outpatient care and the introduction of a new three-level primary health care system into healthcare practice have demonstrated the optimal scheme of interaction of all Moscow medical institutions. The article shows the importance of consolidating the efforts of the Government of Moscow and Moscow medical universities, and the I.M. Sechenov First Moscow Medical University in particular, to solve the basic issues of prevention, early diagnosis, and treatment of diseases and to achieve the high quality of life in Muscovites.
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100th Anniversary of the Soviet maternal and child healthcare system: Successes, problems, and lessons
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01.01.2018 |
Baranov A.
Albitsky V.
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Voprosy Sovremennoi Pediatrii - Current Pediatrics |
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0 |
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© 2018 Publishing House of the Union of Pediatricians. All rights reserved. The article presents the text of the authors' report at the plenary session of the XX Congress of Pediatricians of Russia (dated February 16, 2018) dedicated to the centenary of the Soviet state mother and child welfare system. The features of its formation and development were described. The most important achievements in the field of child health care were outlined. Attention is focused on the personalities of the first facilitators of pediatric healthcare in Soviet Russia. Authors summarise the findings resulting from the history of the Soviet pediatric service.
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