[The methodological approaches to evaluation of effect of tuberculosis as socially significant infection on decreasing of public health quality]

The study reveals main methodological approaches in monitoring and evaluating role of socially significant infectious diseases in reducing quality of public health in the Russian Federation. The article proposes at population level the grouping of main risk factors affecting quality of public health, exemplified by epidemiology of tuberculosis. The purpose of the study is to develop methodology of exploration of impact of socially significant infections on decreasing of quality of public health exemplified by epidemiology of tuberculosis as infectious disease that is well studied in medical social aspects and having fully functioning TB control and high level monitoring system. The informational analytical methodology was applied conjointly with critical analysis of national and foreign publications, normative legal acts, selected through scientific search systems PubMed, Medline, www.base-search.net, www.refseek.com, E-library, CiberLeninka, "Garant" and "ConsultantPlus". The depth of search was limited by 15 years and more. The data from the federal statistical observation form No. 8 "Information about diseases with active tuberculosis" for 2021 was also evaluated. For the first time, the grouping of main risk factors of socially significant infections , affecting decrease of quality of public health at population level are proposed. The mentioned factors are grouped as epidemiological; social economic (including economic damage caused directly by tuberculosis); demographic; behavioral; biomedical (presence of diseases not associated with tuberculosis, but reducing immunity); climatic geographical, etc. The further analysis and listing of specific indicators of each group of factors is required in order to monitor and quickly assess impact of socially significant infectious diseases on public health in the Russian Federation and its Subjects. The analysis of scientific literature demonstrated that, despite breadth of studying tuberculosis risk factors, they are non-systematized and fragmented. The methodological approaches to studying impact of socially significant infectious diseases on public health in foreign countries and in the Russian Federation, are practically absent. The compilation and actualization of listing of indicative indicators for each group of factors with the choice of statistical methods of their calculation, evaluation and interpretation will permit to develop methodological approaches to monitoring and assessing role of tuberculosis (hereinafter - HIV infection, parenteral viral hepatitis, etc.) in altering quality of public health in the Russian Federation with development of rapidly updated database of selected indicators at the level of each Subject of the Russian Federation.

[Methodical approach to the construction of the index of doctors' confidence in their activities]

INTRODUCTION

The COVID-19 pandemic has demonstrated the importance of developing a state policy to increase the attractiveness of a doctor's work and counteract professional burnout. The trust of doctors in their work determines the state of human resources in the field of healthcare. The development of an approach to the organization of monitoring the trust of doctors will allow identifying organizations at an early stage in which there is a decrease in the confidence of doctors in their activities. The purpose of the study is to develop and test a methodological approach to calculating the index of trust of doctors.

MATERIALS AND METHODS

To construct the index, a list of statements was developed that are applicable for a comprehensive assessment of the doctor's activities. The approbation of the developed approach was carried out as part of a pilot sociological study in which 346 doctors from different regions of Russia took part. The significance of the statements used in the assessment was confirmed by binary probit regression.

RESULTS

The analysis made it possible to calculate the index of doctors' trust for the obtained sample, equal to 62,5%. The results of the study can be used to assess the attitude of doctors to their activities both at the regional level and at the level of individual organizations. The Ministry of Health of the Russian Federation can use the results obtained to develop approaches to increasing the attractiveness of the medical profession to increase the public health of Russia.

[New conceptions in complex management of spine trauma patients including reconstructive microsurgery and succeeding rehabilitation]

This work is been based upon the experience of performing 100 reconstructive microsurgical operations with transplantation of combined vascular-neural autografts, in 24 cases--with introduction cellular material into zone of transplantation. The complex approach aimed to creating optimal conditions for the functional regeneration of the spinal cord (SC), including neurosurgical methods restoring anatomical integrity of the organ and also multicomponent and staging rehabilitation of patients has been developed. On the base of complex approach during a postoperative period there has been put synchronous multifactorial action, consisting of functional multichannel electrical pacing of muscles simultaneously participating in tumble. The patient concentrates all his attention on the trial to tumble with paralized extremities by himself. At that the series and the site of application of these electrical impulses forms the algorithm of this tumble. Synchronism of produced afferent and efferent impulses creates new possibilities in activating of regenerating processes in the damaged area of the spinal cord. As a result of treatment within the bounds of the developed program the authors get clinically and electrophysiologically proved certain improvement that they can not only predict but guarantee patients of this group. Presented here results of the complex treatment of patients with trauma of the spinal cord within the framework of research international program confidently testify advantages of the new approach to solving of this problem. For the first time in history of medicine there is created close cooperation and regular continuity between molecular biology, neurosurgery and rehabilitation. This scientific alliance permits in proper time to keep a close watch, quickly correct and improve every stage of treatment. The effect of implement of innovations is been summarized at the each next stage of proposed complex treatment and eventually significantly elevates an ultimate result of medical rehabilitation of invalids with trauma of the spinal cord.