Journal «MEDICINA» 3/2013

Key words: doctoral staff, nursing staff, salary, licensing, shortage, Russian Federation, migration

The author carried out the analysis of a current state of the Russian legislation in the field of health protection of citizens. With the attention center – problems of creation of effective system of carrying out forensic medical examinations and researches. In his opinion corruption in the sphere of public administration, the tolerant relation to corruption manifestations from citizens involves corruption in the sphere of judicial and expert activity, the actual commercialization of activity of judicial experts, involvement of officials of judicial and expert establishments in the economic conflicts and criminal actions. Lack of effective system of carrying out judicial examinations attracts emergence of problems not only in the legal sphere, but also in all-social aspect as promotes formation in the society of legal nihilism, the disrespectful relation to the law and court, ignoring of the civil, family, labor and other duties established by the law, corruption development, encouragement of illegal and asocial type of behavior. Concrete steps on creation of conditions for high-quality improvement of a situation in the sphere of judicial and expert activity are offered.

Key words: forensic medical examination, judicial and expert activity, judicial expert, violation of the rights of patients

In the conditions of Russian Health Service modernization, the Drug Provision is one of the most serious and important issues. Despite the start of many social programs, most patients are still not being supplied of required medicaments. The availability of medicines to the population is provided primarily due to the Restrictive Drug Lists. Identification of obstacles in formation of the positive changes in medical practice, and recommendations for optimization of drug provision, within the Restrictive Lists of Drugs is an urgent task of this work and it has a high practical significance for improving quality of medical care.

Key words: the Drug Provision System, the Restrictive Drug Lists, Drug Supply Program, social groups of benefit recipients and the Clinical Economic analysis

While demographic situation in Russia is improving the changes seen are minimal and most can be explained by longer term cohort effects and serendipities. Male life expectancy is still dragging 12 years behind female, almost 20 years behind western world and 5-10 years behind the Central Asian former USSR republics. National priority programs aimed at improving healthcare system so far had little effect on this grim picture. Measures to control tobacco and alcohol are key in improving working age population health.

Key words: Demographic situation, lifespan, working age, mortality, tobacco control, alcohol control

The article presents results of the survey of 5502 persons of high HIV risk (injecting drug users and commercial sex workers) undertaken in 2006-2008 in 10 regions of Russian Federation, participating in the GLOBUS project. It was shown that sexually transmitted diseases (STD) are risk factor for HIV infection, increasing risk 1.5-2.0 times with multiplicative risk, and analyzed risk groups could be viewed as hubs of sexual networks through which STD pathogens spread, which manifests in significant number of cases being infected with several pathogens.

Key words: STD, HIV infection, GLOBUS project, risk group, pathogen

BACKGROUND: The process of industrialization of the USSR has left a legacy of widespread and often poorly controlled pollution which is widely believed to have adverse implications for health, in particular for respiratory disease among children.

OBJECTIVES: To assess the relationship between area of residence and respiratory function in junior schoolchildren in different districts of Moscow.

METHODS: A survey was conducted of 539 children aged 6-12 years who attend school and live in one of three districts of Moscow with varying ambient pollution levels. Spirometry [forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)] was assessed at school by trained school health staff. Parents of the children completed a questionnaire asking about respiratory function and factors potentially associated with it, as well as about social and other factors that could influence respiratory development and the health status of their children.

RESULTS: There was appreciable difference in the characteristics of the children from the three districts. Children from the lower pollutant districts were generally younger, had higher parental income, and were less frequently exposed to cigarette smoke at home. They were also less likely to report heavy lorry traffic in the streets outside their homes. After adjustment for age, gender and height the FVC was 7.6 per cent (3.6-11.5 per cent) lower in children from the medium pollution district and 9.9 per cent [95 per cent confidence interval (CI) 5.6-14.0 per cent] lower in children from the high pollution district compared with those in the least polluted district (p Недопустимый тэг [] 0.001 for trend). These differences were little affected by further adjustment for household income or exposure to household smoking. In contrast, FEV1 showed comparatively little variation across districts. The odds of a forced expiratory ratio (FER) Недопустимый тэг [] 5 per cent were substantially lower in the high pollution compared with the low pollution district (odds ratio 0.10, 95per cent CI 0.03-0.32 after adjustment for age, gender and height), and there was clear evidence of a trend across pollution categories (p Недопустимый тэг [] 0.001). The frequency of reported allergy was also lower in the high pollution district. FVC increased, and the probability of a low FER decreased, with household income.

CONCLUSION: Children from areas of high environmental pollution had lower lung capacity but also smaller risk of a low FER compared with those from cleaner areas. The extent to which these differences can be attributed to environmental pollution is unclear without more detailed study. However, socio-economic deprivation, which was associated with pollution, appears to be an important determinant of respiratory function although it was associated with a lower risk of an obstructive pattern of lung function tests.

Key words: Environmental factors, social factors, respiratory diseases, children, polluted areas