Vol 23, No 1 (2024)

BACKGROUND: The coronavirus epidemic has stimulated large-scale structural and socio-economic changes throughout the world and led to increased attention to the problem of health in general. But has the epidemic affected the change in the attitude of people of different ages to their health, the perception of various parameters of subjective well-being? The article presents a comparative analysis of a number of assessments (about the level of happiness, satisfaction with income, healthcare, safety, communication, life, attitude towards people, etc.) of respondents from Europe and Central Asia for the period 2006–2021.

AIM: The goal is to assess changes that have occurred over a 15-year time interval in relation to health and social determinants of well-being, to determine possible directions for changing the current situation.

METHODS: To achieve this goal, the results of the tenth wave of the international comparative European Social Survey, conducted in 2021 (32 countries), were used in comparison with data from the third wave, conducted in 2006 (25 countries). The impact of the pandemic on the health of children and adolescents aged 11–15 years was based on materials from the international Health Behavior in School-Aged Children 2021–2022 in 44 countries in Europe and Central Asia.

RESULTS: Despite the difficulties, dictated by the coronavirus, over the period 2006–2021 in most European countries stability in the perception of the world of work and the healthcare institution has been maintained, the psychological situation related to the safety of living has improved, and life satisfaction has increased. According to most of the parameters considered, Russians are outsiders among European countries; however, Russians’ responses to 7 indicators of health and well-being (out of 12) show positive changes. The results of studies of the health of children and adolescents during the pandemic and post-pandemic periods indicate significant negative consequences, mainly related to mental health.

CONCLUSION: It is necessary to increase the attention of Russian government bodies to the health and well-being of Russians, first of all, to children and adolescents.

BACKGROUND: Education in a higher educational institution is critical for students due to the vulnerability of the young body and the exposure of young men and women to the impact of adverse factors that contribute to health disorders. The solution to the problem of the observed deterioration of the health of students of medical higher educational institutions is currently very acute, since this problem is directly related to the health of future health workers and determines the future of the country.

AIM: To assess the health status of students of the Institute of Clinical Medicine named after N.V. Sklifosovsky of Sechenov University on the example of graduates of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) in a comparative aspect with graduates of other educational institutions.

METHODS: A single-stage selective comparative study of the morbidity rate of students of the N.V. Sklifosovsky Institute of Clinical Medicine of Sechenov University was carried out. The data of the registration form «No 025/у» 1–6-year students for the period from 2018 to 2024 (n=2229, including 414 graduates of the Pre-University) were used. Data analysis was performed using Pearson's χ² test with Yates correction. The significance level was set as p <0.05. Numerical data are presented with absolute and relative values.

RESULTS: It was shown that the number of students assigned to the first and second health groups among Pre-University graduates was higher overall, and the number of those assigned to the third health group was lower compared to their peers who were not Pre-University graduates (p <0.01). An increase in the overall morbidity of students by the sixth year was noted, but to a lesser extent among Pre-University graduates (p <0.001). All students have more frequent eye and apparatus diseases. The second and third places were occupied by diseases of the nervous system and diseases of the respiratory organs. Diseases of the musculoskeletal system and connective tissue were less common.

CONCLUSION: The lower morbidity rate among the graduates of the Pre-University is presumably due to the promotion of a healthy lifestyle and rejection of harmful habits during the pre-professional education phase. The data obtained show the need to strengthen work on the identification and prevention of factors of educational environment, reducing the effectiveness of medical and educational measures for the formation of health status of students at the stage of pre-specific education.

BACKGROUND: In modern Russia, there is a decline in the birth rate, a decline in women’s reproductive health, and a high rate of complicated pregnancy and childbirth. The causes of unfavorable course and outcome of pregnancy are multifactorial. The contribution of medical factors to the course of the gestational process and the condition of the newborn is often not determinant in the course and outcome of pregnancy. One of the factors influencing the course of pregnancy is health-relevant quality of life.

AIM: The aim of the study was to analyze the influence of certain characteristics of the medical and social profile on the health-relevant quality of life of pregnant women with complicated pregnancy.

METHODS: 153 pregnant women with complicated pregnancy were included in the study. Cohort one-stage sociological study of quality of life was realized by questionnaire survey method. The study of health-relevant quality of life of pregnant women with complicated pregnancy was conducted using the World Health Organization Quality of Life-100 questionnaire.

RESULTS: When assessing the quality of life of pregnant women, there is a decrease in the average values of quality of life indicators in the spheres and subspheres of the questionnaire, determined by the somatic condition of respondents. A statistically significant dependence of the decrease in the mean values of the quality of life indicators of respondents in the age group of 30–39 years compared to respondents aged 20–29 years has been established. The evidence of the influence of the level of education on the quality of life of women with pathologic course of pregnancy is presented. In a comparative analysis of the quality of life of respondents whose professional activity is not associated with physical exertion and respondents who perform physical labor of varying degrees of severity, the greatest decrease in the average quality of life indicators is noted in the group of respondents engaged in heavy physical labor. There are higher quality of life indicators of respondents who are officially married.

CONCLUSION: The conducted study provides evidence of somatic and social determinacy of health-relevant quality of life in pregnant women with complicated pregnancy. The established limitations of the quality of life allow objectifying personalized medical and social assistance to pregnant women, aimed at improving their quality of life and pregnancy outcome.

BACKGROUND: This study examines the main aspects of the competence-based approach of dentists in the treatment of patients with increased tooth abrasion (ITA). ITA is a serious problem that can lead to oral diseases and tooth loss. The competence-based approach in the treatment of patients with ITA plays a key role in the prevention and treatment of this disease. A study examining the knowledge of dentists in providing care to patients with ITA will reveal the level of training of specialists in this field. This will allow us to assess the need for additional training and advanced training of dentists for the effective treatment of patients with ITA. The results of the study can be used to improve the work of dental institutions and educational programs for dentists. This will improve the quality of dental care, improve the prognosis of the disease in patients with ITA and reduce the risk of complications.

AIM: To evaluate the knowledge of dentists of different specialties in providing care to patients with ITA.

METHODS: The research is based on the results of a sociological survey conducted by questioning 175 dentists of different specialties. The survey was conducted according to the questionnaire developed by us «Assessment of professional competence in the tactics of managing patients with ITA by dentists of different profiles». The questionnaire included general information about the respondent (age, specialty), questions related to ITA (concept, complaints, symptoms, prevention, treatment), assessment of the questionnaire procedure.

RESULTS: The study demonstrated a relatively low competence approach of dentists of various specialties in the prevention and treatment of patients with ITA.

CONCLUSION: The study shows the lack of interaction between dentists in the treatment of ITA. The results of the study and the high prevalence of ITA have determined the need to develop clinical recommendations for the prevention and treatment of ITA.

BACKGROUND: The advanced experience of implementing a value-based model in the practice of Moscow healthcare allowed us to identify a number of the most significant practices of its effectiveness, among which support for making an informed decision by the patient, as well as measuring satisfaction and analyzing the needs of patients were noted. In this regard, the transition of the entire national healthcare system to a value-based model requires the development of approaches to assessing the population’s compliance with such a transformation, taking into account socio-economic, demographic and psychological criteria.

AIM: To consider possible predictors of the readiness of a social group of the population older than working age to transition to a value-based model of national health care.

METHODS: A review of fundamental and modern works in the problem field was carried out. The empirical basis of the work was made up of data from the official website of the Federal Statistics Service with geographic coverage of the entire Russian Federation.

RESULTS: Analysis of data from a subjective assessment of the population's health on a national sample demonstrates the internal readiness of the population for a value-based healthcare model, despite the negative trends of aging. In age groups over 55, the majority of respondents rated it as «satisfactory», with the number of «very bad» ratings being minimal. Positive dynamics in the formation of information technology competence in the population over 65, who are experiencing difficulties in integrating into digital healthcare services, are shown. The positive dynamics of the formation of information technology competence of the population over 65 years of age, who are experiencing difficulties in integrating into digital health services, is shown.

CONCLUSION: The transition of national healthcare to a value-oriented model involves active patient involvement and the formation of patient experience in assessing the results of medical care. In this regard, it is necessary to take into account the personal socio-psychological profile of patient compliance, as possible modules of which the work demonstrates the use of subjective health assessment and assessment of the information technology competencies in the social group of people over working age, the growth of whose numbers determines demographic realities.

The capabilities of artificial intelligence (AI) and machine learning are growing at an unprecedented pace. These technologies have many useful applications, from machine translation to medical image analysis.

A large number of such applications are currently being developed, and an increasing number of such applications is expected in the long term. Unfortunately, weaknesses and other unpleasant aspects of AI have received insufficient attention. In this review, we consider a whole range of already known problems and possible risks associated with the use of innovative neural network technologies, paying special attention to the ways of preventing real dangers and potential threats in order to expand the range of stakeholders and profile experts involved in the discussion of current issues of medical AI cybersecurity, formation of responsible approach to the vulnerabilities of neural network platforms, increasing the reliability of equipment protection for its safe use, as well as the importance of legal and ethical aspects of regulating the use of AI.

Despite certain challenges described in our review, it is clear that AI will be an important element of the healthcare future. As the population continues to age and the demand for healthcare services grows, neural networks are expected to drive healthcare very soon, especially in the areas of medical image analysis, virtual assistants, drug development, treatment recommendations and patients' data processing. We would like to emphasize that while we recognize the innovative role that digital technologies and AI can and should play in strengthening the domestic healthcare system, we should not overlook the importance of timely and accurate assessment of their beneficial or negative impact on the industry to ensure such management decisions do not unnecessarily divert our attention and resources from non-digital approaches and research.

This article is a continuation of the article by Berdutin VA, Romanova TE, Romanov SV, Abaeva OP. Problematic aspects of medical artificial intelligence. Part 1. Sociology of Medicine. 2023;22(2):202–211. DOI: https://doi.org/10.17816/socm619132

This article analyses the complex moral issues that arise in the context of the use of modern genetic engineering technologies to alter genetic information in humans and other organisms. The focus is on issues of safety, justice, respect for human dignity, acceptability of gene editing, general access to gene editing technologies by population, regardless of class, race, social origin, and implications for the environment and biodiversity. The article places great emphasis on bioethical issues concerning the possible adverse effects of gene editing, such as eugenics. proper informed consent by the patient and other important bioethical dilemmas. These aspects of the issue under inquiry are of particular importance in modern society and scientific community due to the influence of such philosophical movements as transhumanism and posthumanism, which propose radical changes in humanity towards the creation of ‘superhumans’, who know neither pain, death nor suffering. In addition, the article emphasises the need for a reasoned and responsible approach to gene editing, taking into account high ethical and legal standards, to ensure that the field develops for the benefit of human beings and society.