Moscow Health Research Articles

Aspects of Healthcare Staffing With Specialists in Healthcare Organization and Public Health in Moscow

Introduction. How many public health and healthcare organization professionals a health facility has on staff has a significant impact on the integration of all functional units, the ability to successfully address pressing issues, and the quality and safety of medical care.
 Purpose. The goal was to conduct a comparative analysis of staffing dynamics in health facilities with public health specialists in Moscow and Russia from 2017 to 2021.
 Materials and methods. Statistical, logical, and analytical methods were used. Data on the number of public health specialists in Moscow and Russia, workforce density and quantity of health facilities were obtained from statistical data of the Central Research Institute of Organization and Informatization of Healthcare of the Ministry of Health of the Russian Federation from 2017 to 2021. The demand for chief physicians, deputy chief physicians, methodologists, and medical statisticians was identified based on job vacancies on job search websites (HeadHunter (hh.ru), SuperJob.ru, zarplata.ru, careerist.ru) at the beginning of 2023.
 Result. It was shown that there remained a negative trend in Moscow, Russia, between 2017 and 2021 in the number of heads of medical organizations and their deputies. Conversely, over the five-year period the number of methodologists have increased, and the number of medical statisticians remained virtually the same. There are open positions for experts in healthcare organization and public health in the Moscow healthcare system, despite the established network of academic and educational institutions for the training of medical specialists.

Mini-invasive technologies in the treatment of a bronchogenic cyst in a 7-month old child

Introduction. Bronchogenic cysts is a rare congenital malformation of the tracheal tree that develops because of violated differentiation of the foregut on week 5–8 of embryogenesis. This disease is often complicated with respiratory failure due to trachea compression; heart failure may develop as well due to of heart and large main vessels compression. One of the most serious complications is erosion of the vessel wall and massive bleeding from main vessels.Clinical observation. A 7-month-old child with cough and stridor was admitted to the surgical thoracic department of National Medical Research Center for Children’s Health in Moscow. Examination revealed a bronchogenic cyst which caused compression stenosis of the trachea. The patient successfully survived thoracoscopy. This technology promoted adequate visualization of the formation and of the adjacent anatomical structures what allowed to isolate the formation in a precise manner. So, the cyst was completely removed without any pathological immature tissue left. In this particular case, there was a high risk of perforation of the trachea posterior wall at surgery and at early postoperative period. Such complication could require intraoperative conversion with circular resection of the trachea using high-frequency jet ventilation with Twin Stream apparatus, or the patient had to be transferred to extracorporeal membrane oxygenation so as to provide an adequate surgical intervention.Conclusion. In a multidisciplinary medical center, there has been performed a successful surgical treatment of a 7-month-old child with a large bronchogenic cyst that compressed the trachea using minimally invasive modern technologies.

CENTER FOR PUBLIC HEALTH AND MEDICAL PREVENTION IN MOSCOW: ISSUES OF FORMATION AND DEVELOPMENT PROSPECTS

The authors have identified the priorities of the CPHMC based on the results of the Center's work in 2021 and the trends in the development of public health in Moscow. Along with this, the preferred directions for the development of the public health system in the city of Moscow are highlighted. Scientific research in the areas of work of the Center for Medical Health Care allows using reliable and up-to-date scientific information in the work of health care in Moscow, which makes it possible to improve not only the quality, but also the volume of work performed, projects of management decisions in the field of public health. As part of the activities of the CPHMC, it is planned to expand the range of activities related to the formation of the health of labor collectives and to draw the attention of employers to corporate public health programs to the maximum.

Overview of the implemented in Moscow state programs in the public health field

Introduction. Public health measures are implemented in accordance with the essential public health operations (EPHO). The EPHO tool can be used not only as a guide for assessing the potential of public health, but also to identify actions needed to strengthen and improve public health. As part of the self-assessment of the performance of operational functions of public health in Moscow, strategic documents in the interests of health and well-being implemented in Moscow (EPHO 6) were studied and a review of state programs implemented by executive authorities was conducted. Materials and methods. The study is based on the analysis of legal sources, regulatory legal acts, projects implemented by the executive authorities of Moscow, which are co-executors of the Regional Program for Strengthening Public Health. Results. State programs implemented by co-executors are an important tool that allows to combine the resources of stakeholders in addressing health promotion issues. It is possible to use the development and implementation of state programs as a search for new methods of solving tasks in the field of health promotion; coordination of goals, development of mechanisms of interdepartmental interaction for the formation of a public health system in Moscow.

Public health in Moscow in the context of the sustainable development goal “Good health and well-being”

Introduction. Management of public health requires a preliminary assessment of its current state and trends. The system of sustainable development goals offers a universal tool for evaluation of the progress in public health as a set of indicators, which characterize the fulfillment of specific objectives of the third goal (SDG 3). Using of this tool is particularly relevant for assessing the situation in 2020 that can be marked as the “era” of COVID-19. Objective. To assess the status and trends of public health in Moscow according to a number of key indicators of SDG 3 to characterize changes that occurred in 2020 during COVID-19 pandemic. Materials and methods. The main method was the analysis of data taken from open sources of the Federal State Statistics Service of the Russian Federation. Results. The key indicators, used as the criteria for assessing the achievement of SDG 3, at Moscow level have been analyzed. In 2020 compared with 2019, the following positive trends are noted: mortality of newborns and young children, acute viral hepatitis B morbidity, mortality from malignant neoplasms, suicides and road traffic injuries decreased. The negative dynamics are associated with a slight increase in mortality from circulatory and respiratory diseases. Conclusion. The COVID-19 pandemic has taken its toll on Moscow's public health. However, positive trends in many of the SDG 3 indicators demonstrate the city's strong position and potential to achieve “good health and well-being”.

Session 23 / X

Prof. V.V. Miloslavsky made a report on the Moscow institutes studying labor. Having examined the advantages and disadvantages of labor organization according to Taulor and Gilbert, the speaker outlined the work of the Central Institute of Labor with its numerous laboratories, the Institute of Professional Hygiene of the People's Commissariat for Health and the Sanitary Institute of the People's Commissariat for Health in Moscow.

Creation of Center for Public Health and Medical Prevention of Moscow as a structure for population-level prevention in metropolis

Introduction. Since 2011, Moscow has been implementing a three-level model for prevention of noncommunicable diseases. At the first (population) level, as part of interagency interaction, health authorities are developing measures to promote population's commitment to a healthy lifestyle. Aims. To provide rationale for management decision on creation of the Center for Public Health and Medical Prevention of Moscow in State Budgetary Institution “Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department”. The goal of the Center is to develop new urban policy in improving public health based on interdepartmental interaction by providing scientific, methodological and organizational support to promote population’s commitment to a healthy lifestyle. Materials and methods. Authors analyzed and assessed development issues of primary prevention at the population level using open data on the Internet, statistical databases of Rosstat and Mosgorstat. Content, statistical and documentary analyses were also used. Results. Currently, Moscow puts an emphasis on prevention, and for this purpose implemented a three-tier model for prevention of non-communicable diseases. At the population level, as part of interdepartmental interaction, it is required to develop measures aimed at improving healthcare, creating a health-preserving environment in the city, and forming a commitment to a healthy lifestyle among the population. Implementation gaps to a decree have been narrowed; and health authorities have created an institution that works towards the goal of strengthening public health in Moscow, covering the entire population of Moscow, and that interacts in the interests of healthcare with government bodies, departments, media and civil society. The current situation, including challenges due to COVID-19 pandemic, required wider participation of authorities and departments, leadership of administrative districts in strengthening public health, coordination and monitoring of all business processes to improve public health. Conclusion. It has been substantiated that public participation in preventive measures is not enough. To solve the issues one should develop and implement large-scale programs and projects to improve public health with more active involvement of authorities and departments of administrative districts, consultative and methodological support, taking into account the existing territorial characteristics of administrative and municipal districts of Moscow, including improving health quality of workers.

Interagency programmatic approach to organize public health promotion events in Moscow

The purpose of the research is to provide a comprehensive analysis of approaches to the organization of
 events for the implementation of Moscow’s development programs, from the point of view of strengthening
 public health. Materials and methods. The methods of the study are: the integrated assessment of data of
 industry statistical reporting, the method of descriptive statistics, the method of content analysis. Approaches
 to the organization of events of the state programs of the city of Moscow, from the point of view of strengthening
 public health, are defined. It is shown that the state programs include areas related to strengthening public
 health, their implementation is carried out jointly by various departments and is of an interdepartmental nature.
 Urban planning policy and development of the territories of the city of Moscow is carried out in accordance
 with the analysis of the environmental situation, demography, and social needs of citizens. Correlation between
 the state of public health in Moscow according to the results of clinical examination and ongoing activities of
 state programs of Moscow, shows the relevance of interagency measures to enhance public health and promote
 a healthy lifestyle. Results. The results of medical examinations in 2017−2019 show that it is necessary to
 strengthen interdepartmental measures aimed at strengthening public health in the city of Moscow.

Social capital - a mixed blessing for women? A cross-sectional study of different forms of social relations and self-rated depression in Moscow.

BackgroundDepression is a major health problem worldwide, especially among women. The condition has been related to a number of factors, such as alcohol consumption, economic situation and, more recently, to social capital. However, there have been relatively few studies about the social capital-depression relationship in Eastern Europe. This paper aims to fill this gap by examining the association between different forms of social capital and self-rated depression in Moscow. Differences between men and women will also be examined, with a special focus on women.MethodsData was obtained from the Moscow Health Survey, which was conducted in 2004 with 1190 Muscovites aged 18 years or above. For depression, a single-item self-reported measure was used. Social capital was operationalised through five questions about different forms of social relations. Logistic regression analysis was undertaken to estimate the association between social capital and self-rated depression, separately for men and women.ResultsMore women (48 %) than men (36 %) reported that they had felt depressed during the last year. An association was found between social capital and reported depression only among women. Women who were divorced or widowed or who had little contact with relatives had higher odds of reporting depression than those with more family contact. Women who regularly engaged with people from different age groups outside of their families were also more likely to report depression than those with less regular contact.ConclusionsSocial capital can be a mixed blessing for women. Different forms of social relations can lead to different health outcomes, both positive and negative. Although the family is important for women’s mental health in Moscow, extra-familial relations across age groups can be mentally distressing. This suggests that even though social capital can be a valuable resource for mental health, some of its forms can be mentally deleterious to maintain, especially for women. More research is needed on both sides to social capital. A special focus should be placed on bridging social relations among women in order to better understand the complex association between social capital and depression in Russia and elsewhere.

Results and analysis of the application of a consistent targeted therapy in patients with metastatic renal cell carcinoma in Moscow (for the period from June 2005 to July 2015)

Background. This article is a personal experience of a sequential targeted therapy of tyrosine kinase inhibitors for the period from June 2005 to July 2015. Objective: evaluation of the results of the consistent application of targeted therapies in Moscow in this period. Materials and methods. A retrospective analysis of cumulative progression-free survival in 220 patients of 354 patients with mRCC were studied. Was used Statistica 10.0 program. Results. This article presents an analysis of the effectiveness of treatment and survival of patients receiving this therapy in cancer institutions Department of Health in Moscow. Conclusion. Using of targeted therapy scheme sunitinib → sorafenib, we see no significant difference sVBP compared with scheme sorafenib → sunitinib with two lines ofsequential therapy tyrosine kinase inhibitors (16.9 and 18.2 months). According to our data total progression-free survival terms as applied to the 1st line of therapy tirosine kinase inhibitors (sunitinib and sorafenib), followed by the appointment pazopanib in the 2nd line (12.5 and 14.4 months) and pazopanib in 1st line followed by the appointment tirazinkinaz inhibitors (sunitinib and sorafenib) in the 2nd line (12.50 and 11.56 months) compared to the preliminary results of a multicenter randomized trial expected SWITCH II also not statistically different.

Importance of Vaccine Safety in Children with Chronic Conditions--Experience at the Scientific Centre for Children's Health in Moscow, Russia.

The risk of severe disease outcomes and complications of infectious diseases remains markedly increased in children and adolescents with chronic conditions. Specialized pediatric healthcare aims to improve quality of life in this high-risk group. One of the most important measures to achieve this goal is to improve immunization rates in this vulnerable population. This article aims to provide insight into models for the integration of infectious disease prevention into specialized healthcare for children with chronic conditions, by the example of the Department of Vaccines and Disease Prevention in Children with Chronic Conditions in Moscow, Russian Federation. The article highlights the importance of vaccine safety and effectiveness research in children with chronic conditions. Useful strategies for the optimization of vaccination rates in this population are presented, along with suggestions for the development of individual immunization schedules for different disease conditions.

Loneliness and health in Eastern Europe: findings from Moscow, Russia

ObjectivesTo examine which factors are associated with feeling lonely in Moscow, Russia, and to determine whether loneliness is associated with worse health. Study designCross-sectional study. MethodsData from 1190 participants were drawn from the Moscow Health Survey. Logistic regression analysis was used to examine which factors were associated with feeling lonely and whether loneliness was linked to poor health. ResultsAlmost 10% of the participants reported that they often felt lonely. Divorced and widowed individuals were significantly more likely to feel lonely, while not living alone and having greater social support reduced the risk of loneliness. Participants who felt lonely were more likely to have poor self-rated health (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.38–3.76), and have suffered from insomnia (OR: 2.43; CI: 1.56–3.77) and mental ill health (OR: 2.93; CI: 1.88–4.56). ConclusionsFeeling lonely is linked to poorer health in Moscow. More research is now needed on loneliness and the way it affects health in Eastern Europe, so that appropriate interventions can be designed and implemented to reduce loneliness and its harmful impact on population well-being in this setting.

To what extent do biomarkers account for the large social disparities in health in Moscow?

The Russian population continues to face political and economic challenges, has experienced poor general health and high mortality for decades, and has exhibited widening health disparities. The physiological factors underlying links between health and socioeconomic position in the Russian population are therefore an important topic to investigate. We used data from a population-based survey of Moscow residents aged 55 and older (n = 1495), fielded between December 2006 and June 2009, to address two questions. First, are social disparities evident across different clusters of biomarkers? Second, does biological risk mediate the link between socioeconomic status and health?Health outcomes included subscales for general health, physical function, and bodily pain. Socioeconomic status was represented by education and an index of material resources. Biological risk was measured by 20 biomarkers including cardiovascular, inflammatory, and neuroendocrine markers as well as heart rate parameters from 24-h ECG monitoring.For both sexes, the age-adjusted educational disparity in standard cardiovascular risk factors was substantial (men: standardized β = −0.16, 95% CI = −0.23 to −0.09; women: β = −0.25, CI = −0.32 to −0.18). Education differences in inflammation were also evident in both men (β = −0.17, CI = −0.25 to −0.09) and women (β = −0.09, CI = −0.17 to −0.01). Heart rate parameters differed by education only in men (β = −0.10, CI = −0.18 to −0.02). The associations between material resources and biological risk scores were generally weaker than those for education. Social disparities in neuroendocrine markers were negligible for men and women.In terms of mediating effects, biological risk accounted for more of the education gap in general health and physical function (19–36%) than in bodily pain (12–18%). Inclusion of inflammatory markers and heart rate parameters—which were important predictors of health outcomes—may explain how we accounted for more of the social disparities than previous studies.

The Winner of the Väinö Kannisto Fund Award in 2003Abstract: Health and Well-Being in Moscow and Helsinki

The Winner of the Väinö Kannisto Fund Award in 2003Abstract: Health and Well-Being in Moscow and Helsinki

Shame on you, uncle!

THE CHILD IN THIS SOVIET poster is a Young Pioneer; his red armband indicates that he is on patrol. The Young Pioneer organization was created soon after the Russian Revolution. Just as, in the classroom, children with red armbands were responsible for keeping desks tidy and blackboards clean, so, in the street, children with red armbands were responsible for educating others, including adults, about proper behavior. This child addresses the man as “uncle,” a familiar term of address in Russia from a child to any older man. The man pretends not to hear, although knowing that he is in the wrong, for he is both smoking and littering. The Institute of Sanitary Education of the Ministry of Public Health in Moscow produced 35 000 copies of this poster in 1964. Health propaganda was a very important function of the Ministry of Public Health.1 The institute, an academic research organization with perhaps 50 to 60 staff members, produced many such posters, which were then placed in polyclinics, canteens, factories, and other public spaces. This poster notes the name of the creator of the concept, I. S. Sokoloff, and of the artist, K. K. Ivanov. It also notes the censor number ({type:entrez-nucleotide,attrs:{text:T06284,term_id:317433,term_text:T06284}}T06284) and the date (May 11, 1964) when the censor gave permission for the poster to be printed and distributed. It is perhaps ironic that 1964 was also the date of publication of the first, and most famous, US Surgeon General’s Report on Smoking and Health.2 When the American Cancer Society, the American Heart Association, the National Tuberculosis Association, and the American Public Health Association asked John F. Kennedy in 1961 to appoint a national commission on smoking and health, he was initially too preoccupied with the Cold War and civil rights to be bothered about smoking. Tobacco played an important role in the American economy, and politicians were often reluctant to treat it as a health hazard. The surgeon general, Luther L. Terry, was himself a cigarette smoker, and when he chose the 10 members of his Advisory Committee on Smoking and Health, he chose 5 who were regular smokers. Nevertheless, the group produced the first comprehensive and critical assessment to date of the relationship between smoking and health. When their groundbreaking report was ready, Surgeon General Terry released it on a Saturday in order to minimize its possible adverse effect on the stock market.3 Despite the importance of the 1964 Report on Smoking and Health, it would be many more years before an effective health education campaign against smoking could even be attempted in the United States.

A multilevel city health profile of Moscow

This report describes a multilevel city-wide profile of physical health in Moscow, examining individual and urban level factors. Objectives of the paper were to: (1) identify macro and micro risk factors for poor physical health in Moscow;(2) assess the effect of two dimensions of micro determinants — personal health habits and social connectivity, such as social cohesion, social support, and social networks; (3) examine the hypothesis that relative social inequality is a significant structural condition at the community level which influences the physical health of individuals, as a main and as a joint effect with psychosocial behaviors. A random sample of Moscow adults, with household telephones ( N=2000), was collected 17–19 September, 1991, and had a completed interview rate of 81.8%. The questionnaire replicated items from the California Alameda Study and the US Health Interview Survey. Respondents’ urban area of residence was linked to macro measures of inequality derived from the Moscow census. This report describes the baseline survey of a prospective study design. Results of this study demonstrate that the social context in a community affects the health of people living there independently from the effects of individual health lifestyle or social connectivity. The structural conditions in Moscow which significantly increased the vulnerability of specific social groups for poor physical health were identified in a hierarchical linear regression: relative social inequality in the form of income inequality; urban area poverty risks; and mean level of alcohol consumption in urban areas. The psychosocial conditions included poor diet, lack of social cohesion and social support, involvement in formal social networks in the form of professional groups. A multilevel theoretical perspective is important for defining the targets of preventive health policy by identifying the structural conditions which increase the health disadvantage of some social groups. Further research is needed in refining the concept of relative social inequality, as well as investigating whether psychosocial factors, such as social cohesion, are mediating links between sick societies and their sick citizens.

Child health in Moscow.

Child health in Moscow.