[specifics of professional stress of medical workers in the post-COVID period].

The purpose of the study is to determine the specifics of occupational stress among medical workers in the post-COVID period. Material and methods. The study involved 620 medical workers who worked and are working in the red zone. Questionnaires for susceptibility to stress at work, assessments of occupational maladaptation, occupational stress, occupational stress test, occupational stress scale, K. Pearson's correlation criterion and the Chaddok-Snedekor scale were used. Results. The study has identified the following specific features of occupational stress among medical workers in the post-COVID period: above the average level of sings of somatovegetative disorders (26.05); average level of the general indicator for assessing professional maladaptation (67.66), signs of sleep and wakefulness cycle disturbance (8.36), signs of feeling tired (5.96), signs of decreased motivation for activity (4.25), signs of decreased general activity (5.87), signs of deteriorated well-being (22.18), signs of emotional shifts (7.31), stress at work (9.25), stressful impact of professional activity on a specialist (995), stressful conditions and neuroses (24.91); below the average level of occupational stress (2.37), signs of characteristics of social interaction (6.82), signs of characteristics of individual mental processes (3.04). A noticeable relationship was established between the sign of somatovegetative disorders and the stressful impact of professional activity on a specialist (0.636), and the general indicator of assessing professional maladaptation (0.598), and stress conditions and neuroses (0.582), and the sign of deteriorated well-being (0.573), and stress at work (0.569), signs of disturbed sleep and wakefulness cycle (0.555), emotional shifts (0.542), feelings of fatigue (0.531), decreased overall activity (0.525) and motivation for activity (0.519).

[PUBLIC AWARENESS ABOUT INTELLECTUAL DISABILITY, ITS CAUSES AND EFFECTIVENESS OF INTERVENTIONS BY SPECIALISTS].

The purpose of the study is to analyze perception of the adult population about intellectual disability (ID), its causes and effectiveness of specialist interventions. MATERIAL AND METHODS: 1119 people were interviewed (men - 441, women - 678) aged 18 to 85 years (mean age - 34.3 ± 14.5 years). Urban residents - 851 people (76.1%), rural dwellers - 268 (23.9%). Each respondent was offered one vignette describing a sick child aged 8-10 with ID: typical, dyslalic, bradypsychic and dysphoric. Mathematical and statistical processing included descriptive statistics and calculation of the χ2 distribution. RESULTS: 49.1% of the respondents have correctly recognized ID in vignettes. Out of the incorrect answers, various psychological characteristics prevailed (25.3%) of the child; negative character traits with pessimistic assessments (23.2%); illness, including mental disorders (18.6%); defects in education and upbringing (15.6%). The respondents most often (38.5%) suggested assistance by psychologists, especially to patients with a bradypsychic variant of ID, a speech therapist - with a dyslalic one, teachers - with a typical one, psychiatrists - with a dysphoric one. 85.3% of the respondents expected improvement in the child's condition after the specialist intervention. The probable causes of ID included improper upbringing and disharmonious family relations, more often in case of a typical variant, hereditary burden and early childhood diseases - in dyslalic, alcohol consumption, poverty - in dysphoric, all of the above - in case of a bradypsychic variant. CONCLUSION: The study has identified an insufficient level of public awareness of ID, reflecting its delayed diagnosis in children, peculiarities of the "channels" for seeking assistance with excessively high expectations of the condition improvements.

[FUNCTIONAL DIAGNOSTICS FOR THE NEEDS OF MEDICAL AND SOCIAL EXAMINATION OF THE RUSSIAN FEDERATION].

The problems of licensing and licensing control of medical activities in the Russian Federation are related to the fundamental responsibility of healthcare - to comply with federal standards of safety, quality and accessibility. The introduction of special diagnostic equipment into the activities of the institutions of medical and social expertise of the Russian Federation and the obligation to use it for expert needs from 2022 has become the time to answer the questions: what are the safety and quality requirements when carrying out work using special diagnostic equipment; whether the organizational and managerial schemes of the activities of institutions of medical and social expertise should change; whether this is a new level of development of medical and social expertise or an expansion of the competencies of functional diagnostics; Are we standing at the origins of a new type of medical activity, and is there much new in this? Answers to these questions should not be expected from the future, putting at risk, in a period of uncertainty and searching for solutions, the life and health of patients, but it is advisable to look in the history of domestic medicine and science, their best practices, adapting them to the strict compliance with the legal field of our country today today.

[THE HISTORY OF THE TRANSFORMATION OF THE CONCEPT OF HEALTH].

The article gives an idea of health and diseases in various historical epochs. Depending on the historical period, there is a different amount of information about medicine, including diseases and the concept of «Health¼. This is due to the amount of archaeological and documentary evidence. For a long time, ideas about health have been closely linked with religion. Hippocrates and other scientists of the ancient world at the heart of health determined the state of equilibrium of the four main fluids. With the development of anatomy, physiology and medicine, the development of diseases was considered as damage to anatomical structures and disruption of their functions. In the XIV-XV centuries, a direction appeared that considers the influence of social and social factors on human health. In the XIX century, the ideas of health and disease are further developed based on physiological and anatomical studies. The German Anatomical School compared the concepts of human health and pathology, linked the development of diseases with changes in cells. During the 20th century, on the one hand, medicine became more and more molecular and submicroscopic; on the other hand, global attention to people, both healthy and sick, resumed, which gave rise to synergetic, multifaceted definitions of health. The World Health Organization in 1946 formulated the definition of health as «a state of complete physical, mental and social well-being, and not just the absence of diseases or physical defects.¼ In the future, this concept was repeatedly criticized, as it considered health as an ideal and brought it closer to the concept of happiness. Today it is obvious that the concept of health is a multifactorial concept and, in addition to the medical component, is closely related to other areas of human life: sociology, ecology, cultural studies, economics, etc.

[The organizational culture of medical organizations as a factor of carrier orientations of medical personnel].

The problems of professional advancement of medical personnel, their professional formation and professional career have enduring importance in connection with development and improvement of medical care system in any society. The purpose of the study is to investigate characteristics of influence of type of organizational culture of medical organizations on career orientations of medical personnel. The study covered sampling of 7 364 employees of medical organizations. The complex of psycho-diagnostic techniques was applied that permitted to examine prevailing type of organizational culture of medical organizations (The R. Harrison questionnaire adapted by S. A. Lipatov), preferences of medical personnel in building up their professional career (E. Schein questionnaire "Carrier Anchors"), and their concepts about competitive medical worker (semantic differential - 16 opposite personality characteristics). The statistical methods included standard procedures of primary mathematical processing of empirical data (frequency and percentage distribution, calculation of mean group indices, standard deviation and dispersions), comparative analysis using Student's test (correctness of criterion application was checked by the Libya test), Spearman correlation analysis. It is established that under developed organizational culture of medical organization, its orientations towards task and personality, with team cohesion and high level of value-orientated unity of their members, medical workers have consistency of concepts concerning career and a unity of career orientations targeted to professional competence and service to other people that determines quality of medical care.

[RESEARCH OF SCIENTIFIC INTEREST TO THE CHLOROQUINE USE IN CLINICAL MEDICINE IN THE BASIS OF BIBLIOMETRIC ANALYSIS].

Interest in chloroquine, and its analog with a more favorable safety profile - hydroxychloroquine, in 2020 is certainly associated with the outbreak of a new coronavirus infection, SARS-CoV-2. The high pathogenicity and lack of specific immunity in the population caused the rapid spread of infection with an extraordinary increase in the burden on the health systems of many countries. In such conditions, it was necessary to quickly find and implement effective methods of treatment and prevention. One of the most promising candidates for this role was hydroxychloroquine, as a multi-purpose drug with a well-studied safety profile and a rich history of use. The article describes some historical stages of the study of chloroquine and its derivatives starting from the 19th century and ending in 2020. The experience of its use for the treatment of diseases such as malaria, rheumatoid arthritis, diabetes, bronchial asthma, photosensitivity and skin porphyria was reviewed. Separately, some historical aspects of its use for the treatment of viral and oncological diseases were considered. The bibliometric method used in this scientific work clearly demonstrates the dynamics of the changing interest of the scientific community in chloroquine and its derivatives. Chloroquine and its derivatives can definitely be attributed to «pharmaceutical centenarians¼ with an intense life that continues.

[The organization or personified treatment of diseases of coronary arteries considering analysis of bifurcation modifications].

The characteristics of development of vascular lines are important for development and improvement of of surgical treatment, decreasing risk of complications and development of personalized approach to treatment of patients. The purpose of the study is to reveal prevalence of different variants of development of common carotid artery bifurcation and to assess their significance for clinical medicine. The sample included 70 volunteers of average age 43.4 ± 10.7 years. The 3D reconstructions of MRI data 1.5 T Brivo 355 were evaluated. The observation data was grouped and processed using software Microsoft Excel 2007 and IBM SPSS Statistics 20. To summarize the data, 5 main variants of location of great vessels were identified. The most rare types of development and course of carotid arteries in bifurcation area were variants "II" and "III" (8.2% of all observations). The most common development options were "I" (51.4%) and "IV" (31.4%). The variants "I" and "IV" were determined relatively evenly.The variants "II" and "III" were found on the right in 60% and 66.7% correspondingly and "V" option was found on the left in 61.5%. The typical options of location of carotid arteries near the bifurcation (variants "I" and "IV"), 82.8% in total. The cases of ventral position of external carotid artery (variants "II" and "V") were established in 12.9%. The variant III was found in 4.3% of all cases. The distribution of vascular development options depending on the gender of patients was investigated. The study did not reveal significantly pronounced deviations in distribution of variants of vascular development, taking into account the age factor. The mentioned data permits to judge with confidence about necessity of developing personalized treatment of diseases of carotid arteries, considering their anatomical features of development in bifurcation area.

[ORGANIZATION OF MEDICAL REHABILITATION OF PATIENTS WITH COVID-19 IN THE POST-HOSPITAL PERIOD].

The COVID-19 pandemic poses new challenges for the health sector, related to the organization of medical rehabilitation of patients with COVID-19. Special attention is required for patients after artificial ventilation, who have a high risk of developing physical, mental and cognitive disorders. There are acute post-ovoid syndrome lasting more than 3 weeks and chronic-lasting more than 12 weeks after discharge from the hospital. The most common symptoms are: shortness of breath, fatigue, anosmia, ageusia, myalgia, feeling of fever, tightness in the chest, tachycardia, headaches, anxiety, memory loss, sleep disorders, difficulty concentrating. The article presents the stages of rehabilitation of patients with COVID-19. Dynamic monitoring, measures for the prevention of complications, organization and methods of rehabilitation, including physiotherapy procedures and physical therapy, are considered.

[FEATURES OF THE MANIFESTATION OF REHABILITATIVE ACTIVITY IN PATIENTS WITH PRINCIPAL DISABLING PATHOLOGIES].

The article presents the results of a psychological study of patients with principal disabling pathologies that form the main structure of disability in the Russian Federation due to malignant neoplasms: diseases of the circulatory system; diseases of the musculoskeletal system and connective tissue; diseases of the endocrine system and metabolic disorders (diabetes mellitus of the first and second types). The article presents the results of studying a sample of patients by various psychological parameters, provides statistical comparisons of psychological characteristics of patients depending on the specifics of their social situation, in which patients either claim to be disabled and are under conditions of medical and social expertise, implying the possibility of changing social status, or patients of the same nosological categories, who do not claim to be disabled and who are rehabilitating on the basis of their own personal and socio-environmental resources outside of the "disabled" status. Psychological techniques are presented, the specificity of emotional and personal parameters is analyzed and characterized, including personality frustration and experience of the significance of the disease in the spheres of life, self-esteem indicators, identification characteristics, strategies that provide rehabilitation adherence, which characterize the activity of patients in the compared groups in many ways. The conceptual position that defines the activity of patients as «rehabilitative¼ has been substantiated. The results of the study revealed statistically significant differences in psychological indicators in the compared groups of patients rehabilitating outside the "disabled" status and patients claiming to be disabled. The indicators obtained in the study indicate that the personal self-regulation of patients rehabilitating outside the «disabled¼ status qualitatively differs from the self-regulation of patients claiming disability, in terms of stable self-esteem and belief in the ability to realize life in significant areas of social functioning, in the ability of perspective planning of the future, in active self-realization of social roles, active participation in interpersonal, leisure, professional, household and other spheres, high responsibility for one's health, against the background of stable emotional perception of the current social situation of the disease.

[THE PREVALENCE OF SLEEPINESS IN THE POPULATION OF ONE OF THE REGIONS OF RUSSIA].

The aim of the study was to study excessive daytime sleepiness (EDS) among the residents of Chuvashia. 2161 residents of the republic were interviewed (men - 1007, women - 1154) aged 18 to 70 (average - 36.5 ± 13.8 years old). The Epworth Sleepiness Scale and NoSAS test were used to assess the risk of obstructive sleep apnea syndrome (OSAS). Mathematical and statistical processing included descriptive statistics, one-way analysis of variance and calculation χ2-distribution. EDS was detected in 846 people (39.2%), without any gender difference and their place of residence. The respondents with EDS were older and had a larger body mass index. With age, the number of individuals with EDS rate increased, reaching the maximum in the age group of 61-70 years. EDS was more often observed in respondents with diseases, sleep disturbances, regular alcohol consumption, smokers, as well as snoring, respiratory arrest in sleep, increased blood pressure and/or treatment for it, and tiredness during the day. The probability of OSAS by NoSAS was determined in 295 people (13.7%), in 21.4% of men and 6.9% of women; EDS was present in 45.4% of the respondents with OSAS. The spread of EDS in the population makes it possible to recommend doctors of various specialties to pay attention to this act as well as to the described risk factors in patients as highly probable grounds for qualifying OSAS, its targeted diagnosis and treatment, as well as comorbid pathology.

[MODERNIZATION OF SOCIAL PROTECTION IN THE RUSSIAN FEDERATION: PROBLEMS AND PROSPECTS OF TELEMEDICINE IN THE PRACTICE OF MEDICAL-SOCIAL EXPERTISE].

One of the main duties of the Russian Federation is to respect and protect the rights and freedoms of its citizens. In addition, the Russian Federation as a social state the activities of which are designed to provide a decent life and a high level of social protection for all categories of the citizens, without exception, by regulating social, economic and other spheres of society provides social support to all segments of the population, paying special attention to certain categories of citizens which, due to life circumstances or health conditions, need social assistance and special support from the state. The main massif in the category of socially unprotected layers of the population are people with physical disabilities. Comprehensive support for the above category of citizens is carried out, among other things, based on the decision of the medical and social examination. However, the current situation has greatly complicated the on-site examination of disabled people and predetermined the correspondence order as the only possible mechanism for medical and social examination during the coronavirus pandemic. Thus, in fact, conditions close to emergency sent medical and social expertise to the path of telemedicine.