[SATISFACTION OF THE RESIDENTS OF THE CIRCUMPOLAR REGION WITH THE STATE HEALTHCARE SYSTEM, DEPENDING ON THE LEVEL OF THEIR HEALTH LITERACY].

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

[The application of the David back concept mechanotherapy in patients survived after myocardium infarction].

The medical rehabilitation in all areas of medicine is developing actively and rapidly. In cardiology, medical rehabilitation contributes to prevention of recurrent myocardial infarction and other complications in patients with myocardial infarction. The study evaluated impact of anaerobic exercise and strength rehabilitation program on hemodynamics in patients with myocardial infarction using the David back concept mechanotherapy method.

[The rehabilitation, health path, mechanotherapy in recuperation of functional reserves of organism].

The article presents historical essays concerning each method of rehabilitation, period of its revision depending on time and pathological etiology of each disease, application of rehabilitation (health path, mechanotherapy), different modes of choosing each method of rehabilitation. The term "rehabilitation" became widespread after adoption of the Federal Law No. 181 of November 24, 1995 "On social protection of disabled people in the Russian Federation". This is the set of measures targeted to recuperation of functional reserves of organism, improving quality of life, maintaining working capacity of patient, one's integration into society, reducing incapacitating states impact to support people with impaired functions to adapt to new conditions of life in society. The rehabilitation and habilitation are processes targeting to ensure that the disabled could be able to achieve and maintain optimal levels of physical, sensory, intellectual, psychological and/or social functioning. The rehabilitation covers wide range of activities, including rehabilitative medical care, physiotherapy, psychotherapy, logopedics and ergotherapy and supportive services too. The disabled are to have access to both general medical services and appropriate rehabilitation services.

[Effectiveness of medical rehabilitation of elderly patients who have suffered a myocardial infarction.]

At all stages of recovery after myocardial infarction (MI), the expansion of physical activity of elderly patients is one of the most important components. Of course, certain restrictions can reduce the load on the myocardium, reduce its oxygen needs and create conditions for early healing. Subsequently, depending on the dynamics and indicators of the cardiovascular system, the elderly patient is transferred from one stage of activity to another, the level of blood pressure, the number of heartbeats, the presence of arrhythmia, electrocardiogram data, EchoCG data, as well as individual load tolerance are evaluated. To date, there is a huge selection of optimal options for selecting methods of medical rehabilitation for elderly patients who have suffered a MI, and one of them is mechanotherapy. The mechanical therapy program of the David Back Concept complex - strength training is a set of simulators for working on the back muscles. The medical and diagnostic complex is designed for the diagnosis, treatment and prevention of pathologies of the musculoskeletal system, as well as for the rehabilitation of patients after surgical interventions and spinal injuries. Medical rehabilitation of elderly patients with coronary heart disease and after a MI through mechanotherapy, the program of the David Back Concept complex, provides for the restoration of their physical and social status to an optimally achievable level, determined by the capabilities of adaptive mechanisms.

[Early diagnosis of stress-induced hypertension in young employees of state law enforcement agencies].

Psychoemotional stress is one of the leading cardiovascular risk factors. The aim of this study was to explore manifestations of arterial hypertension (AH) in young men employed in the stress associatedfield works. Material and methods. A total of 68 young men, exposed to job stress (JS) of different severity during 1 to 5 years were surveyed. The control group was formed of persons whose daily work was unrelated to operational activities. The study included ambulatory monitoring (AM) blood pressure (BP) on different days of the week, comparing the results of the office and DMBP determination and assessment of resistance to a variety of diagnostic loads. Results. The study revealed an increase of AMBP indicators during the working day and their normalization at weekend. The comparison of the results of office and ambulatory determination of BP demonstrated that different forms of stressful AH (stable, isolated office and latent) occurred significantly more often than in the control group. These changes almost completely disappeared at weekends. The tolerance ofpsychoemotional testing was much worse than that of traditional exercises. It is proposed to more extensively use AMBP during regular medical examinations of young men exposed to JS in order to establish a timely differential diagnosis of various forms of stressful hypertension.

[DISTRIBUTION OF BACTERIA OF THE KLEBSIELLA STRAIN IN WATER OBJECTS AND THEIR VALUE IN DEVELOPING OF THE WATER CAUSED ACUTE INTESTINAL INFECTIONS].

The wide circulation of Klebsiella bacteria in water ofwater objects of different climatic zones of Russia and various function is established. So bacteria of the Klebsiella strain are in superficial sources of the centralized water supply depending on extent of their biological and chemical pollution; underground waters at the unprotected water-bearing horizons; in drinking water at insufficiently effective system of its cleaning and disinfecting. Klebsiella circulating in water was shown to keep properties of pathogenicity and a virulence, possess resistance both to modern preparations and disinfecting agents (chlorine, an ultraviolet to radiation). Bacteria of the Klebsiella strain have high penetration in the water-bearing horizons. At strains of Klebsiella there is allocated considerable pathogenic potential (adhesive, invasive, phosphatase, lecithinase, DNA-ase, hemolytic activity) and genetic markers of pathogenicity of cnf-1. The etiologic role of bacteria of Klebsiella and an infecting (100, COE/dm3) dose emergence of acute intestinal infections (AII) is established. Detection of Klebsiella in water objects and especially in water of drinking appointment, in the absence of total coliform bacteria (TCB) contributes to the epidemic danger of water use.

[Comparative assessment of sanitary and epidemic importance of indicator coliform indices of drinking water quality].

The used methodology of the scientific substantiation of indicators is in the establishment of the conformity of laws of vital activity of indicator and pathogenic microorganisms in the real conditions of the action of the complex of factors, including disinfecting agents. In the one water sample simultaneously there were determined both the general indicator (GICB), thermotolerant (TTCB), glucose positive (GPCB) coliform bacteria, E.coli. On the base of long-term research in the various regions of the Russian Federation, as well with bearing in mind the analysis of domestic and foreign data, comparing the water quality and the incidence of intestinal infections in population it is recommended to use the index of determination of the total number glucose positive coliform bacteria (GPCB), which brings together a much broader range of bacteria of the Enterobacteriaceae family in comparison with total coliform bacteria (TCB) and thermotolerant coliform bacteria (TTCB) and warrants the absence in the test volume of water as an indicator lactose positive (E.coli, TCB, TTCB) and pathogens (salmonella) and potentially pathogenic bacteria which do not ferment lactose. Proposed index of GPCB is shown to allow to assess epidemiological risks not only more accurate, but also more efficiently without increasing the cost performance of bacteriological research.

[The importance of sanitary microbiological indices in the evaluation of epidemiological safety of water use in conditions of chemical contamination of water].

The increasing chemicalization of production and life leads to the pollution of water bodies by chemicals, the effect of which on the micro - and macro - organisms is poorly understood. This section of the study in sanitary bacteriology is becoming ever more topical and is an important task of modern hygienic science. One of complicacies of the study of the problem is related with the fact that the presence of only experimental data fails to be sufficient, as the impact of any given chemical substance on different bacteria in the experiment does not mean that under natural conditions, similar results will be obtained. One reason for this may be the inhibitory effect of the given chemical on biological properties of bacteria, while in field conditions in the water several chemicals interacting with each other can exist. In this regard, the aim of the work was to assess the indicator value of sanitary and microbiological indices of epidemic hazard of water use in conditions of chemical pollution of surface water bodies.

[The role of the vaccine prophylaxis of cervical cancer among female military personnel].

The authors presented results of the study concerning human papillomavirus infecting of military students of higher military educational institutions of the Ministry of Defence of the Russian Federation. In the Center for Obstetrics and Gynaecology of the Kirov Military-Medical Academy was performed a dynamic examination of 478 female cadets aged 17-25. The high level of high-risk HPV viruses was revealed during the examination what proves the necessity of prophylaxis enhancing with the aim to prevent gynecological diseases and reproductive health promotion. The main ways of cervical cancer prophylaxis are health education, in-depth medical examination of women with the aim to reveal and treat gynecological diseases (this medical examination should be carried out twice a year), primary prevention of cervical cancer by vaccination.

[Justification of the significance of Pseudomonas aeruginosa index in assessing the quality of drinking water].

The analysis of literature data was carried out and performed research justifying the epidemic value of detection in water P. aeruginosa in drinking and domestic water use. The were revealed features of the vital activity of P aeruginosa in water bodies as opposed to conventional microbiological indicators. It was shown that the coliform group indices can not guarantee the epidemic safety of drinking water use in relation to P aeruginosa. The data obtained justify the need for the introduction of P aeruginosa as an additional index in monitoring the water quality of centralized and decentralized water supply.

[Harmonization of microbiologicaland parasitological indices of epidemic safety of drinking water with the international requirements].

For the purpose of harmonization of microbiological and parasitological indices and benchmarks there was performed the comparative analysis of the requirements for the quality of drinking water in respect of the epidemic safety on the basic regulations of Russia, the Directive Council of the European Union EU, WHO, the United States, Canada, Australia, Finland, Sweden, Brazil, France, Japan and China. As a result, there were revealed the priority bacteriological, virological and parasitological parameters: E. coli--indicator of recent fecal contamination, coliforms, heterotrophic bacteria colony count (Heterotrophic plate count), which is in the water legislation of the Russian Federation is characterized as total bacterial count (TBC), being an integral index of the quality of wastewater treatment technologies and hygienic condition of the water supply systems, coliphages as an indicator of viral contamination. In the Guidelines for drinking-water quality control, WHO and a set of countries there is recommended a more wide range of indicators: enterococci, Clostridium perfringens, Pseudomonas aeruginosa, enteroviruses, parasitological indices. With aim of harmonization of the requirements for the quality of drinking water in the Russian Federation with international approaches to the revision of the Sanitary Regulations and Norms (SanPin) 2.1.4.1074 into the project there are introduced priority indicator parameters of bacterial, viral and parasitic contamination of water, evidence-based guidelines.

[To a question on the impact of nanoparticles of metals present in the aquatic environment, on bacteria and continuous cell lines HEp-2 and BGM].

Promising application of nanoparticles and nanomaterials is the creation of sanitary hygienic means of new generation used for disinfection of water and indoor surfaces of mass use, furniture, sanitary technical equipment by virtue of modifying traditional materials to bring them effective biocidal properties, and for the development of methods in vitro for assessment their toxicity In this paper the possibility of the use various forms of silver, copper and aluminum as disinfectant for bacterial test organisms in the aquatic environment and assess their toxicity on biological models of continuous culture of BGM cells (a stable line of African green monkey kidney cells) and HEp-2 (Human epithelial type 2 (HEp-2) cells, derived from a human laryngeal carcinoma) is considered.

[Students' knowledge level computer testing results and individual specificity of purposeful activity vegetative support].

The vegetative correlates of individual differences in the effectiveness of the purposeful activity during computer sensory motor test and computer testing of the level of knowledge of students were studied. For the students, who reached the high results of sensory motor and training tests it was characteristic the lability of vegetative indices, which is manifested in a change in the absolute values and relationship of the characteristics of heart rate and hemodynamic in accordance with the stages of activity. These changes were specific for each of the forms of activity and connected with the results of tests. By the physiological prerequisites of the high lability of vegetative characteristics, which ensures the capability of the subject successfully to be adapted for the conditions of activity, appeared high initial values TP, power LF and HF of the ranges of spectrum.

[Significance of indicator microorganisms in the assessment of a microbial risk in the occurrence of epidemic hazard in drinking water use].

Summary. The paper provides comparative characteristics of water quality in the assessment of a risk for intestinal infections in drinking water use. It has shown that of the greatest predictive value is direct detection of potentially pathogenic microorganisms, as well as the integral indicator determined by glucose fermentation, such as glucose-positive coliform bacteria. Estimation of the per cent of nonstandard samples of water before its entering the distribution network and in the latter, including glucose-positive Escherichia coli GPEC, is recommended. The samples containing GPEC in a quantity of more than 2 CFU/100 ml should be singly taken into account.

[Improving the standard and methodological basis for bacteriological monitoring the quality of drinking water].

The paper presents materials to provide a scientific rationale for the microbiological parameters enhancing the efficiency of drinking water quality control from the point of view of reliability in the provision of epidemic water consumption safety (coliform bacteria being identified by the glucose index; E. coli). Based on the criterion assessment of the significance of microbial water contamination in relation to morbidity rates, the authors have been developed bacteriological standards--the absence of microorganisms in a 300-ml water sample. Evidence is provided for the epidemically significant level--more than 2 CFU of coliform bacteria in 100 ml. A rapid determination procedure has been substantiated in the experimental studies of the effects of oxidase reagents on the viability and biochemical properties of E. coli bacteria. In search for current technologies for membrane filtration, experimental rationale has been made for the possibility of using track membranes for sanitary and bacteriological water analyses.

[Buccal epithelial micronuclear test in the comprehensive assessment of children's ecological well-being in Moscow].

In the buccal epithelial micronuclear test, only the higher frequency of cells with any nuclear degenerative changes is considered to be attributable to the adverse influence of environmental factors. Comprehensive examination of 223 children of 5-7 years of age, going to kindergartens and schools has indicated that the frequency of cells with nuclear chromatin condensation and incomplete nuclear lysis decreased when ambient air contamination was increased in the territories of children's establishments and when the child's throat was contaminated with Staphylococcus aureus or the pharyngeal resident microflora inhibited. Some poor conditions of the nasal and buccal mucosae were also associated with the increase or decrease of cell frequencies. It is suggested that nuclear chromatin condensation and nuclear lysis (rather than other signs of cell degeneration and death) reflect natural cell aging. A moderate toxic effect causes epitheliocytic physiological development retardation and a more intensive effect accelerates aging of cells and induces their death.

[Comparison of the methods of evaluation of the microbiological danger of antimicrobial agents by the example of oligo- and polyguanidines].

The article contains the results of comparison of the methods of evaluation of the microbiological danger of antimicrobial agents by the example of oligo- and polyguanidines. The study demonstrates that choice of an adequate study model (a bacterial or protozoa species) and exposure time depends on the characteristics of the preparation to be tested. It shows that the microbocide activity of polyguanidines should be studied on a bacterial model using long (24 hours) exposure. The most sensitive to XG6 was a protozoa culture in short-time exposure. To evaluate the biological danger ofantimicrobial agents, it is also possible to apply techniques that allow revealing reversable physiological changes in a culture of test objects.

[EEG correlates of individual differences in performance efficiency of students during examination stress].

Performance of cognitive tests and EEG spectral power were evaluated in 39 students aged from 19-21 years in two conditions: during common educational process and immediately before examination (stress condition). Before examination, the performance was better in subjects with low level of spectral density in the delta band (in the occipital, parietal, central and frontal cortical areas) and high level of the alpha-rhythm spectral density in all the cortical areas, A decrease in performance scores before examination was correlated with an increase in the delta activity (in the right frontal and temporal cortical areas) and rise of the anxiety level (tested by Spielberger).

[Problems of epidemic safety of drinking water use by the population of Russia].

Quantitative relationships were studied between the indicators (common coliform bacteria (CCP), glucose-positive bacteria (GPB), thermoduric bacteria (TDB), coliform bacteria, enterococci, clostridia, coliphages) and the opportunistic (Pseudomonas aeruginosa, Proteus, Klebsiella) and pathogenetic (Salmonella and intestinal viruses) microorganisms at the stages of effluent purification and decontamination, in processes of self-purification in the water reservoirs and of water preparation at water-supplying stations, as well as in the association with the incidence of acute intestinal infections of bacterial and viral genesis in different climatic zones of the country. Salmonella and the opportunistic bacteria of the Enterobacteriaceae family and Pseudomonas aeruginosa were found to be highly resistant to detoxifying agents and environmental factors, adaptable, able to reproduce in pure water, to long survive in underground waters, and to accumulate when water is desalinated at the erections. The cases of intestinal infections were found in the population using the portable water of the standard quality in terms of E. coli, TDB, CCB, and enterococci. In this case only the wider integral index of GPB, which includes the indices of E. coli, TDB, CCB, as well as lactose-negative pathogenic and opportunistic species retains its sanitary significance in terms of all signs and is a reliable indicator of the potential epidemic hazard of drinking water use. Long-term studies have provided evidence for the sanitary value of coliphages as indicators of viral drinking water contamination.