THE SITUATION WITH STAFFING IN PEDIATRIC SERVICES OF THE REPUBLIC OF SAKHA (YAKUTIA).

INTRODUCTION: At present, the public health in the Republic of Sakha (Yakutia) (RS(Y)) is a powerful state structure with an extensive network of prevention and treatment facilities. Since medical service density is the most generalized criterion of the medical service level, its analysis represents special interest to any regional system of public health. AIM: To analyze the dynamics of availability of doctors of all fields, of pediatricians, including pediatric surgeons, pediatric endocrinologists, and pediatric oncologists in 1995-2013. MATERIALS AND METHODS: The analysis is done to reveal the dynamics of availability of doctors: of all fields, pediatricians, including pediatric surgeons, pediatric endocrinologists, and pediatric oncologists to the population of Yakutia in 1995-2013. A statistical and comparative analysis of the data has done. RESULTS: As a whole, in the studied period, RS(Y) witnessed an increase in the availability of doctors of the pediatric profile to the child population. Both in the Russian Federation and in the RS(Y) in particular, the increased availability of pediatricians was mainly due to the reduction of the child population and, to a lesser degree, to an increase in the number of doctors. CONCLUSIONS: The survey revealed the increased availability of pediatricians in RS(Y) only in densely populated areas and the continuing lack of pediatric services in the areas with low population density.

REGIONAL TRENDS IN THE WORKING-AGE POPULATION MORTALITY RATE IN THE REPUBLIC OF SAKHA (YAKUTIA) IN 1990-2012.

Regions of the Russian Federation differ in climatic-geographic, medical-demographic and social-economic situations. One of the regions with distinct peculiarities is the Republic of Sakha (Yakutia). Ranking first by the territory (3,103.2 thousand sq x km), Yakutia is on the 81th place by the population density among regions of the Russian Federation (0.3 people per 1 km2).Yakutia is one of the most isolated and inaccessible regions of the world: 90% of the territory lacks all-the-year-round transportation. Regions of the republic, as well, differ significantly in the climatic conditions and the levels of social-economic development, which influences the population health indicators, including mortality. This survey aimed to study the trends of mortality in the working-age population in different groups of regions. To do this, basing on the statistical data, we compared the levels, trends and structure of mortality in 1990-2012. It was established that the different groups of regions show a significant variation in the working-age population mortality, depending on the social-economic conditions. Since 2000, the Arctic group of regions has demonstrated higher mortality in working-age men and women, especially of cardiovascular and digestive system diseases, and external causes. Lying beyond the Arctic Circle, these regions have severe conditions and a relatively low level of social-economic development. As for the rural regions, despite the relatively favourabe situation, they also show a high level of mortality of external causes. The industrial regions are characterized by higher social-economic development, better transport infrastructure, a satisfactory material base of medical institutions. They also have sufficient resources of health institutions, including the staff and modern equipment for treatment and diagnostics, as well as, which is critical, the full range of medical specialists. Thus, these regions demonstrate lower population mortality; however, there is still mortality of infectious diseases, neoplasms, and respiratory diseases.

SIMULATION OF GENERAL ANESTHESIA ON THE "SIMMAN 3G" AND ITS EFFICIENCY.

In recent years in medical educational process new innovative technologies are widely used with computer simulation, providing the reality of medical intervations and procedures. Practice-training teaching with using of simulation allows to improve the efficiency of learning material at the expense of creating imaginary professional activity and leading barring material to practical activity. The arm of the investigation is evaluation of the students training efficiency at the Medical Institute on the topic "General Anesthesia with using a modern simulation "SimMan 3 G". The material of the investigation is the results, carried out on the basis of the Centre of Practical skills and medical virtual educational technologies (Simulation Centre) at the Medical Institute of NEFU by M.K. Ammosov. The Object of the investigation was made up by 55 students of the third (3) course of the Faculty of General Medicine of the Medical Institute of NEFU. The investigation was hold during practical trainings (April-May 2014) of the General Surgery Department on the topic "General Anesthesia". A simulation practical course "General Anesthesia" consisted of 12 academic hours. Practical training was carried out using instruments, equipments and facilities to install anesthesia on the SimMan 3G with shooting the process and further discussions of the results. The methods of the investigations were the appreciation of students background knowledge before and after practical training (by 5 points scale) and the analysis of the results. The results of the investigation showed that before the practical course only 23 students (41.8%) had dot positive marks: "Good"--7 students (12.7%) and "Satisfactory"--16 (29.1%) students. The rest 22 (58.2%) students had bad results. The practical trainings using real instruments, equipments and facilities with imitation of installation of preparations for introductory anesthesia, main analgesics and muscle relaxants showed a patients reaction on the virtual trainer SimMan 3 G. Students were divided into anesthetic team, co-assisting of an anesthesiologist, an assistant and nurses anesthetist, who conducted general anesthesia (the mask anesthesia, intravenous anesthesia, endotracheal anesthesia). After finishing the practical course 16 students (29.1%) got 5 marks (Excellent), 35 students (63.6%)--4 (Good) and 4 students (7.3%)--3 mark (Satisfactory).