Northwestern Federal District Research Articles

Методика расчета эффективности профилактических осмотров и диспансеризации определённых групп взрослого населения при выявлении злокачественных новообразований.

One of the objectives of the Federal Project «Fighting Cancer» is to achieve «The proportion of malignant neoplasms detected at early stages, Percentage.» One method to achieve the set goals is to improve the efficiency of preventive medical examinations and screenings of certain adult population groups. The study aims to provide a methodological rationale for calculating the efficiency indicators of preventive medical examinations and screenings of certain adult population groups in terms of detecting malignant neoplasms. Materials and methods. For conducting the study, we used normative legal documents regulating the procedures for conducting preventive medical examinations and screenings of certain adult population groups, as well as industry-specific statistical report forms № 131/o «Information on conducting preventive medical examinations and screenings of certain adult population groups» from 11 subjects of the Northwestern Federal District for the period 2017–2022. Results. According to the analysis of the indicator «The share of residents of the Russian Federation subjects undergoing PME (Preventive Medical Examination) and SCS (Screening for Certain Groups) compared to the number of residents fitting the criteria for PME and SCS», this indicator has practically not changed over the period from 2017 to 2022, being 0,41 in 2017 and 0,42 in 2022. The coverage by preventive examinations and screenings of certain population groups in the Russian Federation subject in the Northwestern Federal District from 2017 to 2022 decreased from 0,92 to 0,75 of what was due. When calculating the actual coverage by preventive examinations and screenings of certain adult population groups in the Northwestern Federal District, the indicator slightly decreased from 0,37 in 2017 to 0,32 in 2022. The «overall» contribution of preventive medical examinations and screenings of certain adult population groups in the Northwestern Federal District slightly increased from 0,11% in 2017 to 0,14% in 2022. When analysing the «crude» index of the contribution of PME and SCS in detecting malignant neoplasms from 2017 to 2022, an increase from 3,34% to 7,6% is noted. The standardised contribution of preventive examinations and screenings of certain adult population groups to the diagnosis of breast cancer malignant neoplasms increased from 3,7% in 2017 to 8,5%, and the diagnosis of malignant neoplasms of colon, rectum, and anal canal (C18-C20) for the same period increased from 4% to 7,9%. Conclusion. Regardless of which indicator is used to calculate the efficiency of conducted preventive measures, manual data entry and the formation of statistical forms 131/o must be stopped. Manual data entry can lead to data distortion and introduce significant fluctuations in indicators when comparing the same indicator among different subjects of the Russian Federation.

The State of Oncology Care in Russia: Localization Structure Features, Quality of Recording, and Survival of Cancer Patients in the Major Age Groups of the Population (population study). Part 6

Malignant neoplasms are considered among the most serious and prevalent diseases in many countries worldwide. In the course of our research, we conducted a review where we synthesized findings from five scientific articles providing detailed descriptions of age-related patterns of prevalence, structure, and survival among oncology patients. The final population-based study presents a culmination of all identified characteristics of this process, particularly regarding the role of age in the characteristics of prevalence and survival of cancer patients, which holds significant importance. The study utilized data from the International Agency for Research on Cancer (IARC), handbooks from the P. A. Herzen MNIOI and the N. N. Petrov National Medical Research Center of Oncology, as well as data from population-based cancer registries databases from the Saint Petersburg and Northwestern Federal District of Russia. Data processing was conducted using licensed software MS Excel 2013–2016 and STATISTICA 6.1. Modified Eurocare software, alongside mathematical, bibliographic, and statistical methods, was employed for survival calculations. The population-based study allowed for a detailed examination of the dynamics of age-specific indicators of morbidity, mortality, quality of initial patient management for MN, and survival rates of MN patients, consolidating vast datasets from across Russia and the Northwestern Federal District of Russia. All gathered and analyzed data indicate an enhancement in the quality of initial patient management for MN, a reduction in mortality rates, and an increase in survival rates.

The state of cancer care in Russia: liver cancer – (C22). Age-related characteristics of morbidity and mortality, quality of registration, effectiveness of patient treatment. (clinical population study). Part 1

A clinical-population study was conducted to identify patterns in the dynamics of incidence, mortality, and patient accounting for liver cancer in Russia, as well as the specifics of changes in the structure of affected individuals by detailed localization and age. Over an 11-year period, the incidence of liver cancer in Russia increased by 24.4%, while mortality rose by 9.6%. Special attention was paid to the nature of changes in age-specific incidence and mortality rates for the population of Russia with liver cancer. The aim of the study was to investigate the dynamics of key parameters of incidence, mortality, and the quality of primary patient accounting for liver cancer at the population level in Russia and the Northwestern Federal District of the Russian Federation. The study results confirmed the severity of the problem of this pathology and the challenges associated with the timely detection and provision of adequate care to patients with liver cancer. In some territories, the mortality rate from liver cancer exceeded the number of newly diagnosed patients by 2–3 times. The impact of the coronavirus infection pandemic on the quality of registration of liver cancer patients was also assessed. The study also presented modern possibilities for early diagnosis and treatment of patients with liver cancer.

Parasitic <i>Cyathocephalus Truncatus</i> cestodes as an indicator of localization of self-naturalized populations of American char (<i>Salvelinus Fontinalis</i>) in the Strelka River basin

The Northwestern Federal District holds a leading position in the commercial fish farming of the country. In particular, the Leningrad Region occupies the second place among producers of commercial fish in the region, the fisheries complex of which includes 200 enterprises. The main object of aquaculture is rainbow trout (97.1%). Parasitic diseases often occur in fish farms. To make a diagnosis, a comprehensive examination is carried out, including the collection of epizootological data, a clinical examination, a diagnostic autopsy and laboratory tests. This article describes a case of cyatocephalosis epizootics in an operating fish farming. The causative agent of the disease is Cyathocephalus truncatus cestode, belonging to the order Pseudophyllidea, family. Cyathocephalidae. It parasitizes the pyloric appendages of mainly salmonid fish. The development of C. truncatus occurs with the participation of one intermediate host, which are crustaceans: Rivulogammarus pulex, R. spinicaudatum, Pontogammarus bosniacus, Pontopereia hoi, Pallasea quadrispinosa. To determine the causes of infection of rainbow trout juveniles, an assessment of the infestation of final and intermediate hosts, the seasonality of invasion in 2021-2022, as well as control catches of the head pond and Mill Creek belonging to the Strelka River basin was performed. During the study, 16 individuals of different ages of American char were caught, 6 of them were subjected to a partial parasitological autopsy for infection with cyatocephalosis. As a result of the study, C. truncatus cestodes were exposed in all individuals in an amount from 2 to 5. Consequently, the absence of cases of progenesis in procercoids of intermediate hosts of gammarid crustaceans, infection with parasitic cestode of both final and intermediate hosts allowed us to conclude that the final hosts of the parasite, salmon-like fish species, are present in the enterprise's water supply system. Thus, the parasitic cestode contributed to the self-naturalization of the American char population, the reproduction and cultivation of which in this water source ended in the 1970s, and has been considered lost until now.

Regional features of glaze ice events frequency in the north of the European territory of Russia in the current changing climate

Recently, the interest in society in observing and forecasting dangerous meteorological phenomena in the cold period of the year has noticeably grown. In this work, we study the phenomenon of glaze ice in the north of the European territory of Russia in the North-Western Federal District. Here glaze ice (icing) is less frequent than other forms of ice accretion, but its characteristics most often exceed the criteria of dangerous meteorological phenomena. It is a great danger for various areas of the economy, ship navigation, causing an increase in traumatism of the population and damage to infrastructure. In accordance with the aim of the work, the spatial and temporal variability of the frequency of glaze ice accretion on the territory of the North-Western Federal District in the period 1986–2022 is investigated. The results are obtained on the basis of instrumental observations of meteorological stations. Using statistical analysis, the features of mean yearly frequency at each meteorological station were studied. To assess the direction of annual changes in the glaze ice frequency, the linear trend coefficient was calculated for each meteorological station. The least squares method was used for this purpose. It is shown that the maximum number of days with glaze ice occurs in the central part of the North-Western Federal District. This can be attributed to the more frequent movement of Atlantic and southern cyclones to high latitudes and their precipitation, especially at the atmospheric fronts and in the warm sectors of the cyclones, at air temperatures near zero and below. What makes the spatial distribution of glaze ice frequency even more uneven is the presence of uplands in the European territory of Russia. More precipitation falls on their windward slopes, and the temperature decreases with altitude. The findings show that in recent decades there has been an increase in the frequency of the glaze ice phenomenon in the region. At the same time, the interannual variability remains relatively constant. Taking into account the positive trend in the number of glaze ice events and increasing air temperature and precipitation, it is necessary to develop measures to deal with this hazardous phenomenon and minimize damage from it.

Dynamics of socially oriented non-profit organizations development as providers of socially important services in the regions of the Northwestern Federal District of the Russian Federation

The article analyzes the dynamics of socially oriented non-profit organizations (hereinafter – SONPOs) development in the context of their role in the social service system transformation. The study is based on the data of departmental statistics for 2018–2022 for the Northwestern Federal District regions using the comparative analysis methods. The analysis revealed that in all selected federal subjects the benchmarks for the non-state providers share in the total number of social service providers have been achieved. Among them, the SONPOs share ranges from 13 to 86 %. The assessment of the SONPOs development rates for all types of socially important services contained in the official statistical information has shown that, while their number is practically unchanged, the increase in the financial support volume leads to an increase in their consumers’ number. The most noticeable expansion of the target audience is observed in the field of culture and cinematography, but in general, there is a noticeable differentiation of regions in terms of the increase rate in the socially important services volume in various spheres. The identified discrepancies in various departmental registers of SONPOs are related to their inability to adapt to new conditions and may indicate the failure to overcome barriers that prevent these organizations from participating in providing social services commissioned by the state.

Influence of development factors of manufacturing industry on the economy of the North-Western Federal District

Due to constant tightening of the sanctions policy against Russia, the stable manufacturing industry is among fundamental factors of sustainability and active growth of the country’s economy. Since the beginning of 2022, sufficient efforts have been made to neutralise the negative consequences of foreign companies leaving the market and replace imported goods and technologies with domestic ones. An urgent issue is to assess importance of stable manufacturing industry for the economy of the country and its regions. For the industrially developed North-Western macroregion, which has been seriously affected by the disruption of relations with the European Union and the United States of America, the rapid restructuring and reorientation of commodity flows is an important task, alongside with the increase in production of high value-added goods based on the resources of the macroregion. The purpose of the study was to identify how much factors of development of the manufacturing industry influence gross regional product (hereinafter referred to as GRP) per capita in the North-Western Federal District (hereinafter referred to as NWFD). The constructed econometric model made it possible to assess the most serious factors, the increase of which will allow to influence the economy of the macroregion. It is proved that the average number of employees of small enterprises has the strongest positive impact on GRP per capita in the NWFD as its increase by 1 person leads to an increase in the resulting variable by 1,055.76 rubles, all other things being equal. Thus, currently, the activation of the manufacturing industry with more employees of small business will become a driver of recovery and sustainable development of the macroregion’s economy.

Analysis of the epidemiological situation and dynamics of the incidence of sexually transmitted infections in the Russian Federation over a ten-year period (2012–2022)

Sexually transmitted infections (STIs) are socially significant diseases and require close attention due to the multifactorial causes that influence their spread. In 2012–2022, the Russian Federation maintained a downward trend in the incidence of STIs (from 267.6 to 91.3 cases per 100 thousand population), established since 1998 in all age groups. In 2022, compared to 2012, the incidence rates decreased: syphilis — by 42.7%; gonococcal infection — by 77.7%; trichomoniasis — by 75.8%; chlamydial infections — by 72.1%; anogenital herpetic infection — by 51.2%; anogenital (venereal) warts — by 36.5%. But at the same time, in 2021 and 2022, there was an increase in the incidence of syphilis and gonococcal infection: compared to 2019, the increase in the incidence of syphilis was 25.9%, and that of gonococcal infection — 5.2%. The increase in the incidence of syphilis was largely due to an increase in this indicator in the Central (from 18.1 to 37.3 cases per 100 thousand population) and Northwestern (from 14.5 to 16.2 cases per 100 thousand population) federal districts ( FO). An increase in the incidence of gonococcal infection in 2022 compared to 2019 was observed in the Central (+26.3%), Northwestern (+31.2%) and Ural (+27.6%) Federal Districts.

ASV (Amplicon Sequence Variant) taxonomic affiliation analysis of <i>Cryptosporidium scrofarum</i> species in pigs in the Vologda Region, the Northwestern Federal District of the Russian Federation

The purpose of the research is isolation, identification, and analysis of ASV (Amplicon Sequence Variant) types of Cryptosporidia spp. in pigs in the Vologda Region of the Russian Federation.Materials and methods. The research has been conducted in the Russian Federation for the first time. The research was conducted on pig farms in the Vologda Region of the Northwestern Federal District of the Russian Federation from January to October 2023. Feces were taken from piglets of various age groups, as well as milking sows. The samples were studied using the equipment of the resource center “Genomic Technologies, Proteomics and Cell Biology” of ARRIAM. Species of the genus Cryptosporidia were identified in fecal samples using high-throughput sequencing of 18S rRNA gene fragment amplicon libraries as obtained from nested PCR followed by “denoising”, sequence combining, and restoring the original phylotypes (ASV, (Amplicon Sequence Variant)).Results and discussion. Cryptosporidia spp. species were identified in each age group studied. As a result of high-throughput sequencing of the libraries using the Illumina technology, 20 to 100 thousand nucleotide sequences (reads) were obtained for each sample after processing of which a total of 2,372 ASVs were identified. The analysis of the ASV taxonomic affiliation performed with phylogenetic analysis supplemented by an analysis using the blastn algorithm in the GenBank database showed that, in total, 10 ASVs were only present in all studied samples that had high similarity to sequences deposited in the GenBank as 18S rRNA gene fragments of Cryptosporidium scrofarum. Eight ASV types were unique and did not repeat from farm to farm. Probably, these sequences belong to local populations of C. scrofarum subspecies. Of interest is the discovery of a unique Cryptosporidium sequence of ASV8 type which is only 91.47% similar to the closest relative of the genus, which may indicate a rather distant taxonomic relationship. This type of nucleotide sequence can be further described as a new species. All identified unique ASV nucleotide sequences were deposited in GenBank.

Влияние заболеваемости женщин в период беременности, родов и послеродовой период на показатели использования коечного фонда отделений патологии беременности.

P u r p o s e : assessment of the impact of morbidity in women during pregnancy, childbirth and the postpartum period on the utilization of bed capacity in pregnancy pathology departments. Materials and methods. Based on official statistics, a comparative statistical analysis of the incidence rates of women of fertile age with the XV class of diseases ICD‑10 «Pregnancy, childbirth and the postpartum period» and indicators of the use of bed capacity in pregnancy pathology departments of St. Petersburg with indicators for the Russian Federation and the Northwestern Federal District in dynamics for 2017 was carried out. 2022. To assess the relationship between indicators, the nonparametric Spearman rank correlation method was used. Statistical data processing was carried out using the MS Office‑2016 and StatSoft-Statistica 10.0 software packages. Results. In 2017–2022, there were significant differences in the level and dynamics of the incidence of class XV diseases in women of fertile age in the metropolis and from the indicators for the Russian Federation and the Northwestern Federal District. With multidirectional dynamics of these indicators, almost the entire study period, the incidence rate of women in St. Petersburg was lower than the national and district averages, and over six years the incidence rate decreased by 30.8%. The work of pregnancy pathology beds, the average length of stay of patients on them in the metropolis were higher than the Russian and regional averages, and the turnover of beds was higher. It was revealed that in Russia and the Northwestern Federal District, the morbidity of pregnant women, women in labor and postpartum had virtually no effect on the average occupancy of a pregnancy pathology bed per year and its average downtime, and in the metropolis, with a decrease in morbidity rates, bed occupancy moderately decreased and its downtime increased. At the same time, the impact of the incidence of class XV diseases in women on the average length of stay of patients in pregnancy pathology beds in the country as a whole and in the Northwestern Federal District was more significant than in the metropolis. At the same time, the impact of morbidity among pregnant women, women in labor and postpartum in the city on the turnover of beds in this profile was less significant than on the indicators in the federal district. It was found that the decrease in morbidity had a moderately pronounced effect on reducing the length of stay of women in the city’s pregnancy pathology departments and increasing the turnover of beds. Conclusion. There are differences in the level and dynamics of morbidity indicators for pregnant women, parturients and postpartum women and indicators of the use of obstetric beds for the pathology of pregnancy in the metropolis from these indicators in Russia and the Northwestern Federal District. The incidence of women during this period has a moderate impact on the average bed occupancy per year, the average length of stay on a bed, bed turnover and the average bed idle time. The impact of a decrease in morbidity on the use of pregnancy pathology beds in the metropolis differed from Russia and the Northwestern Federal District, which was expressed in the strength and significance of the connection.

Epidemiological Characteristics of Inflammatory Demyelinating Diseases of the Central Nervous System Including Multiple Sclerosis

Relevance. Demyelinating diseases of the central nervous system and multiple sclerosis, in particular, make their debut at a young age and can lead to profound disability and death within a few years. In the last decade, there has been an increase in the number of cases of demyelinating diseases in Russia and in the world, which necessitates an in-depth study of these pathologies. Goal. To study the dynamics and features of the formation of morbidity, prevalence and mortality from demyelinating diseases of the central nervous system, including multiple sclerosis in various population groups in the Russian Federation. Materials and methods. The study design is a descriptive retrospective epidemiological study (continuous). The data was sampled from the forms of the federal state statistical observation on the distribution of the deceased by gender, age groups and causes of death of Rosstat (FSN S-51), as well as from the statistical collections of the Federal State Budgetary Institution "Central Research Institute of the Ministry of Health of the Russian Federation "Morbidity of the population" from 2009 to 2021. Results. The analysis of the data showed that in 2009-2021 in Russia there was an increase in idiopathic inflammatory demyelinating diseases (IDD) and multiple sclerosis (MS) among the adult population and adolescents aged 15 to 17 years. There is no tendency to increase or decrease the incidence among children under 14 years of age. The highest average long–term incidence rates of IDD and MS among adults are observed in the Ufa region (7.13 ± 0.27 and 5.31 ± 0.23 per 100 thousand adults, respectively), among children under 14 - IDD in the Central Federal District (1.88 ± 0.18 per 100 thousand contingent) and MS in the Central Federal District and Volga Federal District (0.22 ± 0.07 per 100 thousand contingent). Among children from 15 to 17 years of age, the highest incidence of IDD is noted in the Northwestern Federal District (4.41 ± 1.10 per 100 thousand contingent) and the Ural Federal District (4.40 ± 1.09 per 100 thousand contingent), RS – in the Central Federal District (2.67 ± 0.51 per 100 thousand contingent). IDD and MS are the least common among all age groups in the Far Eastern Federal District. Over the period from 2000 to 2020, there has been a decrease in MS mortality in the Russian Federation by 34%, from 0.72 to 0.48 per 100,000 population. The average annual mortality rate from MS among men was 0.4 ± 0.021 cases per 100 thousand of the contingent, among women 0.5 ± 0.023 cases per 100 thousand of the contingent. Conclusion. The increase in the incidence of demyelinating diseases and MS, in particular, is an important medical and social problem. These pathologies significantly reduce the quality of life and shorten the duration of work, due to the development of persistent disability in the young population. The study showed the uneven distribution of the disease across the territories of the Russian Federation, which in the future will improve the logistics of drug delivery and the provision of medical personnel, which confirms the relevance of constant and in-depth study of the epidemiology of idiopathic inflammatory demyelinating diseases in Russia.

РОЛЬ РАЗРАБОТКИ И ИСПОЛЬЗОВАНИЯ ПЕРЕДОВЫХ ТЕХНОЛОГИЙ В ЭКОНОМИКЕ ЗНАНИЙ РОССИИ И СЕВЕРО-ЗАПАДА

The problem of the development and use of advanced technologies posed in the article is relevant in connection with the objective needs of the development of the knowledge economy in Russia and the regions. The information base of the study was made up of official data of the Federal State Statistics Service of Advanced Production Technologies for 2020–2022, presented in the Russian Federation and in the context of the Russian Federation subjects. The key concept of the work is formed on the methodological basis of quality economics, which allows conducting interdisciplinary research of fundamental and applied importance. The ratio analysis of different advanced technologies groups in the economy of Russia and the Northwestern Federal District is carried out, the dynamics of changes in the development and use of advanced production technologies in the period characterized by the greatest instability due to internal changes and the effects of external shocks is investigated. The leading groups of advanced technologies in the country as a whole and in the region are identified, and the contribution of the Northwestern macro-region AMTs to the total number of developed and used AMTs in Russia is assessed. The conclusion is made about the decisive role of the Northwestern District in the development of the most important groups of technologies for the country: production, processing, transportation and assembly, design and engineering, technologies ofautomated identification, surveillance and/or control. The solution of the complex task of combining technological development and the formation of new standards of quality of life based on the quality economics is designated as a direction for further research.

НЕКОТОРЫЕ АСПЕКТЫ РАЗВИТИЯ РАССЕЛЕНИЯ РЕГИОНОВ СЕВЕРО-ЗАПАДНОГО ФЕДЕРАЛЬНОГО ОКРУГА

The article analyzes some aspects of the settlement pattern and urbanization development of Northwestern Federal District regions. The most important settlement pattern and urbanization development trends and special feature from the author’s point of viewtrends in these regions are described; the article addresses to some problems and perspectives of the settlement pattern and urban agglomerations development. The author submits the revealed regularities of the settlement pattern development of these regions. Some judgments may be controversial.

ИЗМЕНЕНИЕ ВОЗРАСТНОЙ СТРУКТУРЫ НАСЕЛЕНИЯ ТРУДОСПОСОБНОГО ВОЗРАСТА И ВОЗРАСТНОЙ ПРОФИЛЬ ЗАНЯТОСТИ В РЕГИОНАХ СЕВЕРО-ЗАПАДНОГО ФЕДЕРАЛЬНОГО ОКРУГА

The paper is a continuation of studies of changes in the age structure of the regions of the North-Western Federal District. Since the process of population aging affects not only the population as a whole, but also its various subgroups, the transformation of the age structure of the working age population (20–64 years), consisting of three subgroups: 20–34 years, 35–49 years and 50–64 years, is considered. Some demographic aspects of employment are also analyzed – the age structure of the employed and the age profile of employment in the regions of the North-Western Federal District. The results of the study can be used to harmonize labor market policies.

Hospital consumption of direct oral anticoagulants in regions of the Russian Federation in 2017–2022

The aim of the study was to investigate the dynamics of inpatient consumption of direct oral anticoagulants in different regions of the Russian Federation for the period from 2017 to 2022.Materials and methods. This study is a non-interventional, retrospective analysis of the electronic database records of Cursor Marketing LLC (Russia) about the announced by medical organizations and executed contracts for the purchase of direct oral anticoagulants (DOACs). The сonsumption was calculated on the basis of a DDD (defined-daily-dose) and estimated DDDTID (defined-daily-dose/1000-inhabitants/day) for each DOACs: rivaroxaban, dabigatran and apixaban. The Rosstat database available on its official website were used as a source of inhabitants data for the Russian regions.Results. A total of 57 866 records were entered into the analyzed databases of Cursor Marketing LLC (Russia) from 2017 to 2022, 47.38% of which indicated rivaroxaban as the drug being procured, 26.51% indicated dabigatran, and 26.11% indicated apixaban. Edoxaban was not procured by healthcare organizations. During the period investigated, there was an increase in the consumption of all DOACs studied, with a higher increase for apixaban (by an average of 284.6% per year), then rivaroxaban (by 144.8% per year) and, to a lesser extent, dabigatran (by 92.5% per year). The analysis of DOACs consumption in general showed that compared to 2017, the need for these drugs in medical organizations in 2022 increased by 18 times. The Urals Federal District consistently exceeds the national average in terms of DDTID consumption. Noteworthy is the consumption dynamics of the regions of the Central Federal District and the North-Western Federal District, which made it possible to achieve DDDTID values above the national average for 5 out of 6 observation years. The lowest rates of DOACs consumption were observed in the Volga Federal District, which, despite positive growth dynamics, failed to reach the national average values. A high level of consumption (>10 DDDTID) of rivaroxaban was noted for the Arkhangelsk region (2018) and the Nenets Autonomous District (in 2021), dabigatran – only for the Arkhangelsk region (in 2018). Many more regions reached high levels of the apixaban consumption, especially in 2021.Conclusion. Despite a number of limitations, the data on the volume of DOACs procurement can be used in the analysis of the consumption at both regional and national levels. When analyzing the DOACs consumption, the impact of COVID-19 pandemic and pharmacogenetic features of patients in different regions should be taken into account. During the studied period of time, a significant part of the Russian regions achieved a consumption level of rivaroxaban and apixaban, but not dabigatran, exceeding 1 DDDTID.

Irritable Bowel Syndrome: What Are the Reasons for Dissatisfaction with the Treatment of Patients and Doctors? (Based on the Experience of Medical Institutions of the Northwestern Federal District of Russia)

Irritable Bowel Syndrome: What Are the Reasons for Dissatisfaction with the Treatment of Patients and Doctors? (Based on the Experience of Medical Institutions of the Northwestern Federal District of Russia)

Взаимосвязь развития региона и функ­ционирования вузов (на примере Северо-Западного федерального округа)

The role of universities in regional socio-economic systems is pivotal. However, despite the overall trend of GRP growth, regions of Russia’s Northwestern Federal District underperform on education-related measures. These include the share of education in GRP, the percentage of individuals employed in the education sector and the number of universities and students. These trends pose a substantial challenge to regional development, especially in the context of the fourth industrial revolution and the rise of the knowledge economy. The lack of attention to the education sector may stem from the gross underestimation of its contribution to regional development. By implementing their ‘third mission’, universities exert influence on the economy, politics and socially responsible industries in their home region. A better understanding of the role of universities in regional development requires a comprehensive evaluation of their performance. This study aims to evaluate the performance of regional universities and examine its impact on regional socio-economic indicators. The paper proposes a methodology for evaluating the performance of regional universities and presents the results of its application in the regions of Russia’s Northwestern Federal District. The universities of the Arkhangelsk region and St Petersburg demonstrated the highest performance levels, whilst those of the Leningrad region were the lowest. Correlation analysis showed a significant connection between universities’ performance levels and the key socio-economic indicators of regional development. Universities’ performance levels vary significantly across Russia’s Northwestern regions. The findings may interest researchers studying regional development issues and administrators of universities prioritising the implementation of the third mission. Additionally, the results can inform decisions regarding the advancement of higher education at the regional level within the Northwestern Federal District.

Geographical aspects of organizing industry exhibition activities in the Northwestern Federal District of Russia

The exhibition industry is a relatively new and dynamically developing type of economic activity. It has a great influence on the development of trade and economic relations, promotes goods, services, technologies, forms the image of the region and generally helps the development of individual sectors of the economy, regions and the country. The author sees the main task in identifying the geographical aspects of exhibition activities in the Northwestern Federal District as one of the most vulnerable in the conditions of modern sanctions policy. The article formulates the results of the study, which are based on a database created by the author of 195 exhibitions held in the Northwestern Federal District and containing comparable information about each exhibition (venue, number of domestic and foreign exhibitors, visitors, specialization, trade policy, etc.). Its analysis made it possible to determine the region’s position in the country’s industry exhibition activities; industry structure based on the comparative geographical characteristics of exhibitions in the service sector, industrial exhibitions, exhibitions of the agro-industrial complex (the leadership position of industrial exhibitions is noted in terms of the ability to influence the economy of the region), the geographical features of industry exhibition activities in the region are identified based on the ranking of the constituent entities of the Russian Federation according to the studied indicators. The calculation of the coefficients of specialization, localization and shower production in the sectoral exhibition activities of the district made it possible to develop a classification of subjects of the Russian Federation according to the level of activity of exhibition activities.

Perekhodya granitsy. Rossiyskiy stendap: lokalnye i globalnye smysly

Stand-up comedy is one of the brightest youth scenes of modern Russia, rapidly gaining popularity over the last decade. This genre of modern laugh culture rarely gets the attention of either foreign or domestic scholars and researchers. This article focuses on the career strategies of stand-up comedians, the peculiarities of their communication with audiences in the context of the formation of the stand-up scene in contemporary Russia in comparison with the formats of humor and laugh culture characteristic of the Soviet and post-Soviet times. The uniqueness of the Russian stand-up experience will be revealed through the analysis of characteristic style markers associated with the genre: the liminality / transboundary nature of the emerging culture, the high mobility of stand-up artists, creative collaborations, and touring exchanges within and between cities in their native regions. As a theoretical framework, the construct of youth cultural scene is used as the most adequate to the case under the study. The empirical base of the article is 15 semi-structured interviews with participants in the stand-up scene, non-participant observation of stand-up performances, and the textual analysis of blogs of stand-up comedians. The case study material was collected as part of a large-scale research project aimed at tracing the migration strategies and life plans of talented young people in the Northwestern Federal District of Russia.

Staffing of the hematology service of the Russian Federation

Introduction. As part of the implementation of the federal project Development of a network of national medical research centers and the introduction of innovative medical technologies, one of the activities of the National Medical Research Center for Hematology (Center) is the analysis of the staffi ng of medical organizations (MO) of the constituent entities of the Russian Federation (RF) by hematologists.Aim — to analyze the dynamics of staffi ng by hematologists of MO in the RF.Materials and methods. Data from the Federal State Statistics Service (Rosstat) — Federal Statistical Observation Form No. 30 “Information about a medical organization” of the constituent entities of the Russian Federation for 2012–2020, reference books of the Central Research Institute of Organization and Informatization Health of the Russian Ministry of Health in the Russian Federation, information obtained from the results of on-site events of the National Medical Research Center for Hematology, including expert assessments were used.Results. The hematological service is organized in all subjects of the RF, with the exception of the Chukotka and Nenets Autonomous Okrug, Republic of Kalmykia and Altai, as well as the Jewish Autonomous Region. As of December 31, 2021, 1,594 hematologists work in the constituent entities of the RF, of which 460 specialists are in outpatient care and 1133 specialists in hospital settings. Analysis of the availability of full-time positions of hematologists per 10,000 populations in the Russian Federation in dynamics for 2012–2020 revealed fl uctuations in the values of this indicator from 0.06 to 0.17. The largest “failure” in the provision of hematologists occurred in 2014 in almost all federal districts (FD) of the Russian Federation. Only the Urals FD maintains the stability of the indicator of availability of these specialists. Over the past 3 years, there has been an increase in the number of full-time positions of hematologists, while the staffi ng of individuals reduced due to the lack (increase) of new employees and slightly offset by an increase in the coeffi cient of internal part-time work. Thus, the highest combination coeffi cient was noted in 2020 in the Ural (1.49) and Siberian (1.45) FD, the lowest in the North-Western FD (1.09). In accordance with the legal act regulating the activities of the hematology service, the standard for calculating the positions of outpatient hematologists is 1 doctor per 200 thousand of the population, however, the provision of full-time positions for the outpatient stage of care remains not achieved (2021 — 0.92 per 200 thousand); at least 731 doctors are needed against the existing 456 specialists. The staffi ng standard of the department of hematology corresponds to one medical position per 10 beds. Compliance with regulations regarding the formation of the staffi ng table of the inpatient unit was noted in 95% of the constituent entities of the Russian Federation.Conclusion. The issues of personnel shortage of hematologists are relevant. The shortage of hematologists in the Russian Federation indicates the lack of attractiveness of remuneration and indicates the need for management decisions to be made by the Government of the Russian Federation and executive authorities of the constituent entities of the Russian Federation aimed at developing mechanisms for maintaining the human resource of hematologists in the healthcare system.