[The availability and quality of the ambulatory polyclinic care].

The article deals with the results of the study of complex of medical demographic and social economic indicators of Nizhny Novgorod oblast during 1989-2010. The results are as follows. The policlinics' net reduced by 2.25 times, including by 10.6 times in rural area and by 12.6 times of ambulatories of community hospitals. The indicators of physicians' supply of oblast population decreased too especially in urban area. The annual number of visits to physicians per capita decreased by 1.36 times. The number of calls of out-patients to physicians of emergency medical care increased by 1.5 times. The morbidity with temporarily disability and primary registration as a disabled person decreased by 1.45 times, including able-bodied citizen by 1.54 times. In Nizhny Novgorod oblast, the rate of decrease of indicators of primary disability during 2006-2009 overpassed the corresponding federal indicators by 1.45 times. The population mortality increased by 1.43 times. The accessibility and quality of ambulatory polyclinic care significantly impacts on the levels of mortality and social security of population and can be used as an indicator of social risks in the region.

[The formation of social professional skills of students with limited possibilities].

The education of children and adolescents with limited possibilities is a system of economic, public, legal and individual personal measures supporting the optimal conditions to overcome this defect up to a degree of participation in public life on par with other citizen. In the Nijny Novgorod academic boarding school for the disabled the organization of activities forming the social professional skills are differentiated on terms and targets of education. The students of first course need the optimization of communication, enhancement of self-consciousness, formation of educational information perception, reasoning, involuntary memory voluntary logical memory attention, will, educational general intellectual expertise. The students of second course need more attention to making and optimization of various types of activity, activation of labor activity, forming of labor attitudes, communicative skills and enhancement of emotional and motivational sphere. The students of third course need to develop the skills of self-reliant work, motoric activity, dexterity labor skills, working discipline skills, rational attitude to group work, professional knowledge.

[The role of medical social expertise in the social protection of disabled patients].

The dynamics of disability level in the Nijegorodskaya oblast was analyzed. The decrease of number of patients admitted as disabled for the first time and its causes was revealed. The drastic decreasing of number of patients examined in 2007 brings to consider the existence of expertise barriers in outpatient and polyclinic institutions which make the expert care less accessible. The share of persons accepted as the disabled in the total number of examined decreases too. The adequate rehabilitation services net in the oblast factually don't exist. Artificial decreasing of disability rate always leads to the decrease of social protection of patients and to the increase of mortality rate in population.

[The issues of the medical social rehabilitation of the handicapped persons of able-bodied age].

Among the medical social and economic problems having important universal public significance, a particular place belongs to the issues of the disability and the organization of care of persons with limited physical and mental possibilities. The Nijhny Novgorod oblast experience of work with the handicapped persons demonstrates that in the large-scale industrial region the level of disability is rather high with the neatly marked tendency to increase. The need for the professional education and further employment assistance is quite meaningful among the handicapped persons of able-bodied age. To meet this demand is possible only on the way of the development of the system of professional rehabilitation on the oblast level. The most appropriate conditions for the professional rehabilitation of the young handicapped persons are established in the special-purpose professional specialized schools where the rehabilitation divisions are deployed. This approach allows to work effectively on the implementation of the individual programs of handicapped persons rehabilitation and in that way to provide a higher level of social security of the students (i.e. higher scholarship, free-of-charge meals and medical services). In the city of Nijhny Novgorod specialized boarding school for the handicapped persons a system of activities is developed to enhance the social adaptation including the blocks of labor and everyday life adaptation and practical work training.

[Organization of municipal medical-and-social rehabilitation of the invalids of able-bodied age-veterans of armed conflicts].

A territorial model of the organization of medical-and-social rehabilitation of labor-liable-age invalids was studied basing on the results of the experiment which enabled to test in practice the system of rehabilitation, ensuring step-by-step persistent successive complex rehabilitation process with an individual approach to each invalid according to his or her health, personality, labor ability, social environment. The efficacy of this treatment was higher than executing separate medical and professional rehabilitation of invalids.

[Several aspects of formation of occupational recommendations for health examinations and employment of the disabled]. / Nekotorye aspekty formirovaniia trudovykh rekomendatsii MSEK i trudoustroistva invalidov.

The article analyzed medical examination of 100 patients observed as disabled in 1993. The authors revealed notable drawbacks in occupational rehabilitation of the patients and the disabled individuals by Commissions of occupational medical examination and medical consultation, so inadequate occupational placement was given. Analysis of the data helped to determine the guidelines for better occupational rehabilitation of disabled people. Those guidelines are: professional training and informational supplies for Commission of occupational medical examination, use of up-to-date scientific methods to organize placement for disabled people.