[Alcohol-related mortality in the assessments of hospital unit physicians and pathologists: analysis of accounting medical documents].

AIM: To make a comparative analysis of the data available in the accounting medical documents drawn up at a multidisciplinary hospital on the level and structure of alcohol-related mortality (ARM) and to evaluate the efficiency of its accounting. MATERIALS AND METHODS: Accounting medical documents, such as 453 inpatient cards (Form 003/y), 453 postmortem protocols (cards) (Form 013/H-80), and 453 death certificates (Form 106/y-08), were chosen as the basis for the study. The data of the final clinical and postmortem diagnoses in the patients who had died at hospital and their primary cause of death were comparatively analyzed. RESULTS: According to Form 003/y, ARM was 5.5%; the detection rate of alcohol-related disease (ARD) was 11% (95% confidence interval (CI), 8.3 to 14.3%); according to Form 013/H-80, ARM was 7.1% (95% CI, 4.9 to 9.8%) and the detection rate of ARD was 12.6% (95% CI, 9.7 to 16%). The consistency of the diagnoses of ARD as a main cause of death, made by hospital unit physicians and pathologists, is estimated as the mean--the Cohen's kappa coefficient (kappa) is 0.570) (p < 0.001). CONCLUSION: The results of the investigation suggest that there are 3 types of ARM, which differ in its level and structure: ARM in the assessments of hospital unit physicians; that in the assessments of pathologists, and that according to the death certificates drawn up. The consistency index for the diagnosis of ARD as a main cause of death indicates that the hospital unit physicians only determine the etiology of alcohol-related cause of death, without identifying it specifically.

[Socio-demographic status of elderly and senile age people died from alcohol-attributable states in Arkhangelsk].

To determine the characteristics of the socio-demographic status of elderly and senile age people died of alcohol-attributable states in Arkhangelsk, data from the medical certificate of death was analyzed. Data of death for persons who died in the city of Arkhangelsk in the period from 1 July 2011 to 30 June 2012 (one year) were copied out. The vast majority of alcohol conditioned deaths among men occurs in middle (working) age, 1/3 of women--over the age of 60 years. The alcohol-attributable mortality revealed the transformation of the structure of women over the age of 60 years compared with the mature age. Gender and age significantly affect the probability of death from alcohol only attribute states after 60 years. The results of the study indicate a different impact on the character of the individual sociodemographic factors on the probability of death from alcohol-attributable states in elderly and senile age.

[On the problem of registration of mortality associated with alcohol consumption among the population in the forensic medical practice].

The objective of the present study was the comparative analysis of the data obtained from the available medical documentation with a view to estimating the effectiveness of taking into account the mortality associated with alcohol consumption. The data subjected to the analysis included the age and the gender of the deceased subjects, complete forensic medical diagnoses from 1607 expert reports and acts of forensic medical expertise of the corpses (form 171/y), and information about the cause of death (item 19) from the relevant medical death certificates (form 106y/08). The mortality associated with alcohol consumption estimated based on the expert reports and acts of forensic medical expertise of the corpses (form 171/y) amounted to 6.7% (95% CI: 5.5- 8.1%); the occurrence of pathology attributable to alcohol consumption was estimated at 7.2% (95% CI: 5.9-8.5%) of the total number of deaths. It was shown that forensic medical experts do not employ in the full measure the diagnostic potential of the International Classification of Diseases (ICD-10) when having to deal with the mortality associated with alcohol consumption. The results of the study confirm the qualitative transformation of the alcohol attributable mortality structure associated with the transfer of information from the expert reports and acts of forensic medical expertise of the corpses (form 171/y) to the medical death certificates (form 106/y-08).

[The mortality because of conditions related to alcohol consumption].

The article presents the systematization of data concerning alcohol-depended mortality as a occurrence with complicated structure. It is established that grouping of alcohol-depended mortality on isolated components is conditioned by different nature of unhealthy consumption of alcohol in the development of alcohol-depended conditions as a conditional and/or supporting factor. Among other causation factors article points out the input of pattern of alcohol consumption into the value of risk of development of alcohol-attributive conditions and two-way impact of unhealthy alcohol consumption at the risk of development of particular alcohol-attributive conditions.

[The Arkhangelsk society of physicians--one of the first public medical organizations in Russia].

The Arkhangelsk society of physicians was officially opened in 1863. The purposes and tasks of the organization were the following: to one another with mutual education, information about important cases and news; to follow the development of medical sciences by means of journals and books subscription; to study sanitary hygienic conditions in Arkhangelskaya gubernia. The society supported in Arkhangelsk the organization of the feldsher midwife and veterinary schools (1876); the organization of the congress of physicians of Arkhangelskaya guberina (1907); the organization of spearheads to lecture the population (1911); the organization of public group "The drop of milk" $ participated in the Red Cross actions "White flower" and "Yellow flower". The activities of society played an important role in the consolidation of physicians of Arkhangelskaya guberina, promoted the enhancement of their professional qualification and the development of health care in Russian North.

[The social hygienic aspects of disability and mortality in the Archangelskaya oblast].

The article analyses the indicators of disability and mortality in Archangelskaya Oblast. The medical sociological study of the disabled patients of able-bodied age was organized based on the characteristics of working activities and labor potentials to establish the prospective of involvement of this population category into the social economic development of the region. The emphasis is made upon the specific of population mortality in Archangelskaya oblast due to the external causes impact as a priority trend in enhancing the regional policy of medical demographic development.

[The public health of Arkhangelskaya gubernia in late XIX-early XX century].

The main indicators of public health in Arkhangelskaya gubernia in late XIX-early XX centuries are discussed. Among these indicators the article deals with population number, gender structure, economic activity, birth rate and mortality. The family and cultural traditions in Pomor North are analyzed. The major characteristics of state and structure of public health system functioning during this period are given.

[Specificity of the suicidal behavior in the Arkhangelsk Region]. / Osobennosti proiavleniia suitsidal'nogo povedeniia v Arkhangel'skoi oblasti.

The paper deals with a high suicide rate in the European North. Data for the rural and urban population categories are compared. Specific features of suicide attempts and of completed suicides are accentuated for the gender and sex aspects. A set of system-making factors, which are responsible for shaping the suicidal behavior in Russia's European North, is defined; social-and-hygienic portraits of self-murders are compiled. The main trends are outlined in the field of suicidal prevention.

[Conceptual approaches to the organization of medico-social care of children]. / Kontseptual'nye podkhody k organizatsii mediko-sotsial'noi pomoshchi detiam.

Social economic crisis and decreased level of life tell on the health status of children. As primary health centers, pediatric outpatient clinics play the main role in the formation of healthy life style and rendering medicosocial care. However the existing system of organization of prophylactic care in pediatric outpatient clinics does not meet modern requirements, and problems of infant health care cannot be considered as purely medical. A draft program of restructuring local pediatric services is offered with consideration for modern social and economic problems.

[Subjective evaluation of health status and motivation for improving it in able-bodied urban population of the European North of Russia]. / Sub"ektivnaia otsenka zdorov'ia i motivatsiia na ego ukreplenie trudoposobnogo gorodskogo naseleniia Evropeiiskogo Severa Rossii.

The study was made of the awareness of capable urban population of the Arkhangelsk region about own health condition, health care system, health promotion and disease prevention. Motivation for healthy life style appeared extremely low. Subjective opinion of personal health is a valuable information of its objective condition. That is why it must be taken into consideration in objective examination of the individual.

[Social problems of transition society and health of populations of the North of the European Russia]. / Sotsial'nye problemy perekhodnogo obshchestva i zdorov'e naselenii Evropeiskogo Severa Rossii.

Dramatic changes in Russian economic life led to worse health state of population, higher children's mortality. Unfavorable influence of environmental pollution on health state is also seen in Northern regions. Governmental institutions should participate in creation of system for health care and preservation.