[The social hygienic aspects of reproductive behavior of women aged 40-45 years].

In the context of forecasted decreasing of natality, actuality of studying its causes for organizational decision-making increases. The purpose of the study was to determine factors affecting reproductive behavior of women aged 40-45 years residing in areas with different natality levels in 2020-2021. The cohort, analytical, sociological methods were applied. The results of study demonstrated that in areas with high natality level most of urban women with higher education and high income resides in conditions of dormitory or mortgage flat and working in profile of their specialty. They are characterized by belated marriage that results in postponed child-bearing. The areas with low natality are characterized by dwelling of rural women with secondary or secondary specialized education. They reside in their own homes and work in other occupations than their specialty. The analysis of social status of women of different age groups will permit more selective approach in developing measures of increasing natality in modern conditions.

[The functioning of call-center in conditions of COVID-19 pandemic].

In conditions of persisting high morbidity of COVID-19, issues related to prompt and timely medical care of population remains actual ones. The purpose of the study to analyze activities of the call-center of the Ministry of Health Care of the Udmurt Republic related to organization of medical care of COVID-19 patients in the Udmurt Republic. MATERIALS AND METHODS: The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed. THE RESULTS: The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 - 128339 calls, in 2022 - 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 - 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol. CONCLUSIONS: During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

[The satisfaction of parents with quality of palliative care rendered to their children].

The pediatric palliative care (PC) is the physical, mental and spiritual care of children as well as support of their family members. The purpose of the study - to investigate satisfaction of parents of children with severe refractory diseases with availability and quality of PC in the Moscow region. The prospective cohort study was carried out using sociological survey in 2020-2021 on the basis of the "Moscow Oblast Hospice (for children)". The survey involved 300 people (63.7% of total number of patients). The most common symptoms were shortness of breath (41.8%), impaired concentration (36.4%) and constipation (36.4%). The most common psychological symptoms were anxiety (29.1%) and sleep disorders (17.8%). The parents rated availability of PC at 7.0 (5.0; 8.0) points out of 10.0, territorial accessibility of PC at 7.0 (5.0; 8.0) points, the quality of PC received at 8.0 (6.0; 9.0) points. Almost two-thirds of respondents rated volume of PC provided as limited and only 31.0% as sufficient. The number of palliative beds in hospitals was assessed by 71.7% as limited, and by 17.0% as sufficient. According to respondents, PC provision service requires, first of all, improvement of funding (80.2%) and organization of new hospices (55.7%). The majority of children received medical assistance (99.3%). Only 23.7% received psychological, 12.2% pedagogical, 24.5% social and 4.3% legal support. The research, identification of needs, targeted care based on individual approach can support children and their family members, reduce discomfort and suffering. Support of children receiving PC and their families are key components of qualitative and affordable PC in pediatrics.

[The common morbidity of children population in conditions of propagation of new coronavirus infection COVID-19 in 2017-2019].

The health of children population is one of the indicators of the social and epidemiological well-being of society. The purpose of the study was to study main trends of propagation of various classes of diseases in children population in conditions of propagation of the new coronavirus infection. The data of Rosstat for the Udmurt Republic covering the pre-COVID period (2017-2019) and the period of COVID-19 propagation (2020-2021). The analytical method, descriptive statistics technique, the calculation of intensive and extensive indicators were applied. It is established that in 2017-2019, general morbidity of the children population aged 0-7 years decreased by 8.7%, while in conditions of higher propagation of COVID-19 (2020-2021) there was an increase by 11.0 %. In the children population aged 0-14 years, general morbidity decreased by 10%, and hereinafter it increased on 12.1%. At that, in the pre-COVID period in children population aged from 0 to 17 years, morbidity rate decreased for 14 classes of diseases, for 15 classes in children population aged from 0 to 14 years. During the period of higher propagation of COVID-19 morbidity rate for only 5 classes of diseases decreased in both age groups of children population.

[The characteristics of medical demographic indices in the Jewish autonomous oblast].

The research in the field of regional trends and risk factors related to population morbidity is considered as background of management decision-making in health care. The article presents the results of analysis of medical demographic indices and population health status in the Jewish Autonomous Oblast in 2000-2019. It is established that in in the Jewish Autonomous Oblast population size reduced by 35 100 people to 2019. The negative migration dispositions facilitate losses of population size from 0.5% to 1.23% annually. The gradual increase of number of the elderly brought to ratio working/non-working people 100 to 128. The infant mortality rate decreased from 20.2 in 2000 to 9.2 per 1000 newborns in 2019 and continues to decrease. The total morbidity increase (diagnosed for the first time) of cardiovascular diseases and neoplasms is probably related to preventive measures efficiency. In the structure of malignant neoplasms leading positions are taken by tumors of bronchopulmonary system, skin affections and breast cancer. In the Jewish Autonomous Oblast, mortality of cardiovascular diseases comprised 807.32±22.87 per 100 000 of population. In the last decade, this most important indicator decreased up to 2.12%. The mortality of malignant neoplasms made up to 217.31±15.25 per 100 000 of population. The mortality due to consolidated causes "Traumas, poisonings and some other consequences of external causes exposure" made up to 16.19±3.28 per 100 000 of population. In 2019, the average life interval made up to 68.8 years, having increased by 6.2 years since 2000. The evaluation of medical demographic indices and population health status demonstrate necessity of adjusting medical organizational measures targeting to improve medical care of population considering regional characteristics.