The concept of socially conditioned human diseases. The main forms of "diseases of civilization" and their essence
© MUZHANOVA V.K.
SOCIALLY CONDITIONED DISEASES IN THE REPUBLIC
VC. Muzhanova Ministry of Health of the Republic of Buryatia, Minister - Doctor of Medical Sciences V.V. Kozhevnikov;
Republican Medical Information and Analytical Center, head. - Director, Ph.D. B.S. Budaev.
Summary. The problem of socially conditioned diseases in the Republic of Buryatia is determined by the high incidence of tuberculosis, HIV infection and venereal diseases. In this regard, there is a problem of timely detection of socially conditioned diseases in the primary health care of the republic. The financing of primary health care includes the provision of care for socially determined diseases, the implementation of preventive measures and the early detection of socially determined diseases, which are one of the important tasks of municipal health care.
Key words: socially conditioned diseases, primary health care, primary health care, early detection.
Socio-economic changes in society cause the growth and spread of socially conditioned diseases, which include a number of infectious diseases (tuberculosis, sexually transmitted infections, HIV infection, hepatitis) and other diseases (alcoholism, drug addiction, substance abuse). The social component of the latter poses a danger to society as a whole. Since the beginning of the 90s of the XX century, the process of the spread of socially determined infectious diseases has been observed in Russia (1). The economic instability of the society, chronic stress, alcoholism of the population led to a rapid
spread of HIV infection, tuberculosis, sexually transmitted infections.
One of the most pressing problems at present is the high incidence of tuberculosis and mortality from it. According to WHO forecasts, tuberculosis will remain one of the leading causes of morbidity and mortality in the world in the next 10 years. At the end of the 80s. the incidence of tuberculosis began to rise in most regions of Russia, the incidence rate in the Russian Federation increased by 2.6 times from 34.0 per 100 thousand population in 1991 to 86.3 in 2003. There is a high incidence among people of working age, increasing proportion of women among the sick. The increase in the incidence rate was accompanied by severe changes in the structure of patients. Among newly diagnosed patients with pulmonary tuberculosis, the number of patients with acutely progressive and widespread forms has increased. Among newly diagnosed extrapulmonary tuberculosis, the proportion of lesions of peripheral lymph nodes has increased, and the number of cases of tuberculosis of rare localizations has increased. In the structure of mortality of the population of the Russian Federation, tuberculosis among infectious diseases is 85%, and the problem of mortality from tuberculosis in working age is especially acute (1).
In the Republic of Buryatia, the epidemiological situation of tuberculosis remains extremely tense. The incidence rate in different years exceeds the federal average by 1.7-2.8 times and does not tend to decrease. Every year 1200-1400 patients are registered in the republic with the diagnosis of tuberculosis established for the first time in their lives. Since 1995 to 2006 the incidence changed in waves and amounted to 2006 in 2006. - 173.6 (RF 2005 - 82.8). Also exceeds the federal average level of mortality from tuberculosis in different years by 17-26%, which in 1999-2005. remained at the level of 21.0-25.2 (RF - 21.8). A particularly unfavorable situation in the republic has developed in terms of the incidence of tuberculosis among children. Morbidity rate in children diagnosed for the first time in their lives
active tuberculosis exceeds the average federal level by 2-3 times. The highest incidence rate was observed in 1999 - 75.2 (RF - 17.9), the figure in 2005 was 41.2 per 100 thousand population (RF - 17.0).
Another urgent problem of socially conditioned diseases is the spread of HIV infection. Prior to 1996, relatively few cases of HIV infection were registered in Russia. However, since 1996, the incidence of AIDS began to grow exponentially: by January 1, 2000, 25,470 cases of HIV infection were registered in Russia, and by December 1, 2007, there were already 407,508. and teenagers. The epidemiological situation of HIV infection in the Republic of Buryatia has worsened since 1999. of the last century, several cases of HIV infection were registered in the republic - the incidence in 1998 was 0.76 per 100 thousand of us. By 2006, there was a 31-fold increase in the incidence - the figure was 23.9 per 100,000 population. The prevalence of HIV infection over the same period increased by 321 times, which in 2006 amounted to 276.5, exceeding the figure for the Russian Federation by 6.9% (228.8), and for the Siberian Federal District - by 9.0% (224.3). There is a trend of rejuvenation of the disease. Nearly 50% of HIV patients in Russia are young people under the age of 25 (1). In the Republic of Buryatia, 80% of HIV-infected people are aged 15 to 30 years. The tension of the epidemiological situation of HIV infection in the Republic of Buryatia is supported by the extremely unfavorable situation in the neighboring Irkutsk region, where the frequency of HIV infection in 2005 exceeded the figure for the Siberian Federal District by 3.6 times (Irkutsk Region - 805.8, Siberian Federal District -224, 3) and in 3.5 - in the Russian Federation (228.8).
HIV-infected pregnant women are a particular problem. Over the past 3 years, the number of children born to HIV-infected women has increased dramatically in Russia (1). In the Republic of Buryatia, the number of HIV-infected pregnant women increased by 2 over 5 years (51 and 105)
times, and they accounted for 55.7% of the total number of all identified HIV-infected women. Only 44.5% of registered HIV-infected women in 2005 terminated their pregnancy, and only 25% of HIV-infected women underwent complete chemoprophylaxis of the vertical route of HIV infection in a timely manner.
According to the forecasts of the Russian Academy of Medical Sciences, in the coming years, the annual increase in the number of newly infected with HIV by 30% is expected in Russia. Basically, the sexual route of transmission of the infection remains by way of spread. In Russia, sexual transmission of HIV infection was 49.5% in 2003 (1), in Buryatia - 65.1% in 2005. years has increased by 37.5%. In the early 1990s, the Republic of Buryatia had the lowest incidence of syphilis and recorded only a few cases per year. The peak incidence was observed in 1996 - 4779 (454.8 per 100 thousand population) patients were registered, which exceeded the federal average by 78.6% (RF - 254.6). In the next 10 years, the incidence decreased by 3.7 times - the figure in 2006 was 107.6 per 100 thousand people (RF - 72.0). But even the achieved results show that the indicators are high and the incidence of syphilis in the republic exceeds the average federal level by 50-70%.
Socially conditioned diseases are common in the same population groups, they often come into contact with each other, thereby aggravating the course and their treatment. According to WHO, more than 3 million people in the world are simultaneously infected with TB and HIV pathogens
(1). The HIV epidemic is considered to be the leading cause of the resurgence of tuberculosis in industrialized countries and its marked increase in third world countries. Tuberculosis is one of the most virulent of all opportunistic infections in HIV-infected people and develops earlier than others. Usually more than 50% of cases develop tuberculosis within a few months after primary HIV infection.
infections. On the other hand, tuberculosis contributes to the progression of latent HIV infection and the development of AIDS (4). In the Republic of Buryatia, over the past 3 years, the incidence of tuberculosis among HIV-infected people has increased by 1.4 times. The incidence rate of tuberculosis among HIV-infected people in 2005 was 3,333.3 per 100,000 people, which is 19 times higher than the incidence rate of the entire population.
In 1991, in Russia, out of 531.0 thousand patients with sexually transmitted infections (STIs), 12 were identified as HIV-infected (2.3 per 100 thousand), and in 1999 out of 1739.9 thousand - 822 ( 47.2 per 100 thousand) (1). In the Republic of Buryatia during 2000-2004. 52 times increased the number of cases of HIV infection among patients diagnosed with STIs for the first time in their lives. The prevalence of socially conditioned diseases among the population is approximately the same and was in 2002 in the Russian Federation: tuberculosis - 388.6, syphilis and gonorrhea - 306.3, HIV infection - 258.1 per 100 thousand population (1).
Early detection of socially conditioned diseases in primary health care is one of the most important health problems. About 17-25% of the population of the Russian Federation, i.e. every 4-6th inhabitant of Russia can be classified as a risk group for tuberculosis (3). All these people seek medical help, first of all, in polyclinics of the general medical network, and among them 70-75% of all newly diagnosed TB patients are registered. It is among them that it is necessary to sharply improve diagnostics. Thus, among people with concomitant diseases who are under dispensary observation, tuberculosis is detected late, mainly when they return to polyclinics with complaints or in general somatic hospitals. Among certain social groups (unemployed, pensioners, the disabled), only 1/3 of TB patients are detected during preventive examinations. Despite the decrease in the volume of preventive programs, fluorographic examination remains the most accessible to the population.
Since it is impossible to quickly increase the coverage of the population with fluorographic examinations, in order to establish the maximum number of patients, it is necessary to optimally form contingents for fluorographic examinations.
(2). There is an insufficient volume and low quality of examination of children in the general medical network if they are suspected of having tuberculosis. Thus, sputum examination for Mycobacterium tuberculosis is not carried out, contacts with patients with tuberculosis were not performed. Among children with a tuberculin test bend, only in 16.3% of cases a laboratory examination is performed (5).
In the organization of timely diagnosis of STIs, there are many related problems in laboratory screening, the work of obstetric and gynecological services and outpatient specialists. In Buryatia, despite the high proportion of patients with syphilis actively diagnosed in 2005 (66.8%), the detection of this infection in the outpatient network decreased by 1.4 times over 5 years: in 2000 -12, 3%, in 2004 - 8.9%. Latent and late forms of the disease have become more frequent. The proportion of latent syphilis has increased over 10 years in
4.2 times and amounted to 57.2% in 2005. The presence of patients with syphilis with a long period of infection indicates the emergence of diagnostically difficult cases occurring among somatic pathology. The unfavorable epidemiological situation of the last decade requires a more thorough study of errors in the detection of infectious forms of syphilis.
In order to stabilize the epidemiological situation associated with social diseases in the Republic of Buryatia, reduce premature mortality, morbidity, disability of the population and increase life expectancy, the Government of the Republic of Buryatia dated September 16, 2003 No. 293 approved the republican target program "Prevention and control of diseases social character” for 2004-2007. However, limitations in the financing of the program did not allow to fully implement the planned activities and receive
effective effect of their implementation. Out of a total need of the program of 196.4 million rubles, in 2005, 26.9 million rubles were allocated, which amounted to 13.7%. At the same time, the allocated funds are used for the development of specialized services at the regional level. There is a practice of developing their own municipal programs, for the implementation of which financial resources are also allocated insufficiently. Significant financial support in 2005 was provided at the expense of the federal budget to obtain vaccines, drugs, test systems, laboratory equipment, reagent kits in the amount of 28.7 million rubles. rubles.
President of the Russian Federation V.V. Putin in his Address to the Federal Assembly on May 26, 2004 and on April 25, 2005, the task was set to improve the quality of medical care for the population of the country, which began its implementation as part of the implementation of the priority national project "Health" in 2006-2007. The main objective of the project is the priority of primary health care. The key figure in providing it to the population should be the district doctor, a general (family) practice doctor responsible for the health of the patient as a whole. As part of the implementation of the priority national project "Health" in 2006. outpatient clinics of the Russian Federation received modern diagnostic equipment in the amount of 22,652 units in the amount of 14,296.9 million rubles. To the Republic of Buryatia for 2006-2007 received 606 units totaling
256.2 million rubles, incl. 73 ultrasound machines, 84 sets of laboratory equipment, 63 units. X-ray equipment, etc. As a result, the availability of modern diagnostic equipment in municipal polyclinics has increased, instrumental examinations have become more accessible for the population.
The problem of the effectiveness of the primary network for the early detection of diseases is becoming more important in connection with the division of powers of the executive branch and the revision of the profiles and volumes of medical care provided at the municipal level.
This problem is especially relevant for the constituent entities of the Russian Federation in the light of the entry into force on 01.01.2005 of the Federal Law of 08.22.2004 No. 122-FZ. In accordance with this law, the delimitation of powers between federal state authorities, state authorities of the constituent entities of the Russian Federation and local governments has changed the system of health care financing at the regional and municipal levels. But in this law, the organization and financing of specialized medical care, including anti-tuberculosis, dermatovenerological, in municipal healthcare organizations did not fall within the powers of local governments (6). Also, in accordance with the order of the Ministry of Health and Social Development of the Russian Federation of October 13, 2005 No. 633 “On the organization of medical care”, the provision of medical care for socially conditioned diseases is not reflected in the primary health care section. But the Decree of the Government of the Russian Federation of December 30, 2006 No. 885 approved
funding from local budgets for primary health care for sexually transmitted diseases and tuberculosis.
Thus, the implementation of preventive measures for socially conditioned diseases, their early detection remains one of the important tasks of municipal health care. The significance of this problem for the Republic of Buryatia is determined by the high incidence of socially conditioned diseases. In 2007, the Government of the Republic of Buryatia adopted the "Program for the socio-economic development of the Republic of Buryatia for 2008-2010 and for the period up to 2017". In the Health Development section, one of the objectives of the program is the prevention and control of socially conditioned diseases, the indicator of the effectiveness of which is the reduction of their level.
SOCIAL DISEASES IN REPUBLIC OF BURYATIA
Medical information-analytical center of the Republic of Buryatia
The problem of social diseases in Buryatia Republic is determined by high levels of tuberculosis morbidity, AIDS, venereal diseases. In this connection the problem of timely revelation of social diseases in primary link of public health of republic takes place. Financing of primary medical-sanitary help includes giving the first aid in social diseases, prophylactic measures and early discovery of these diseases.
Literature
1. Starodubov V.I., Mikhailova Yu.V., Son I.M. Problems of integration of socially conditioned diseases // Medico-social problems of socially conditioned diseases: tr. Ross. scientific-practical. conf. - Moscow: RIO TsNIIOIZ, 2004. - P.4-11.
2. Son I.M., Litvinov V.I., Starodubov V.I. and other Epidemiology of tuberculosis. - Moscow, 2003. - 283 p.
3. Shilova M.V. Detection and diagnosis of tuberculosis in institutions of the general medical network // Ch. doctor. - 2005. - No. 3. - S. 6-16.
4. Kopylova I.F. Tuberculosis and HIV infection // Clinical issues, diagnosis, treatment and prevention of HIV infection and opportunistic diseases: Mat. scientific-practical. conferences. - Kemerovo, 2003. - S.31-39.
5. Tinarskaya N.I. Prevention of tuberculosis in newly infected children // Tuberculosis - a problem of public health: tr. scientific-pract. conferences - Kemerovo, 2002. - S.97-98.
6. Gerasimenko N.F., Aleksandrova O.Yu. New in the Russian legislation in the field of health care // Ch. doctor. - 2005. - No. 6. - P.5-17.
SMOLENSKY HUMANITARIAN UNIVERSITY
Compiled by:
Doctor of Medical Sciences, Professor Kozlov S.B., Candidate of Medical Sciences, Associate Professor Khalepo O.V.
Fundamentals of social medicine
Teaching aid
(for part-time students enrolled in the specialty 040101 (350500) Social work)
Smolensk, 2008
PROGRAM (CONTENT) OF THE EDUCATIONAL DISCIPLINE
Section I. Social and genetic foundations of health
Topic 1. Introduction. Basic concepts and categories of social medicine.
The history of the formation of social medicine as a science and academic discipline. Social medicine as a science about the laws of public health, ways to preserve and strengthen it. Interdisciplinary nature of social medicine. The study of social, psychological, and environmental factors that affect health and morbidity. The relationship between medicine and society.
The most effective ways and means of overcoming diseases, raising the level of public health.
The activities of social workers aimed at maintaining and strengthening health.
Definition of "health". Health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (definition by the World Health Organization).
Factors affecting the preservation and promotion of health: lifestyle, heredity, environment and others.
A systematic approach to solving health problems. Interdisciplinary aspects of health: general scientific, socio-hygienic, medical and biological, psychological, pedagogical, economic, legal, technological, theological.
Patterns and trends in the formation and manifestation of a person's attitude to health. Ways and means of forming an adequate attitude of the individual to health at different stages of her life path. Health science: state and prospects.
Topic 3. Social conditioning of health
Social well-being as a component of health. Social factors affecting individual and public health.
Factors and risk groups of diseases. Socio-hygienic monitoring. The social essence of the most common and significant diseases: alcoholism, drug addiction, substance abuse, mental, cardiovascular, oncological, infectious diseases, AIDS.
The main directions of the social policy of the state, contributing to the preservation and strengthening of the health of the population at the stage of reforms: business assistance to socially vulnerable groups, reform of organizational structures and sources of financing of health care, social protection of the population, normalization of the demographic situation. Medicine and health. The place of healthcare institutions in the protection of public health.
Topic 4. Genetic conditioning of health
Genetic factors as general biological constants. Genotype as a set of genes, healthy and pathologically altered, received from parents. Mutations are changes in genes that occur throughout an individual's lifetime.
Groups of diseases caused by genetic risk. Chromosomal and gene hereditary diseases (Down's disease, hemophilia and others).
Hereditary diseases arising under the influence of external factors (gout, mental disorders, and others).
Diseases with hereditary predisposition (hypertension and peptic ulcer, eczema, tuberculosis and others).
Topic 5. Individual and public health
Health individual and public: definition, relationship, differences. Morbidity. Types of morbidity. Level and structure of morbidity. Hospitalized morbidity: structure, main indicators. The incidence of infectious and non-communicable diseases. Morbidity with temporary and permanent disability.
The incidence of certain age-sex and social groups of the population. Traumatism, its characteristics and social significance.
Disability. Causes of disability, prevalence.
Physical development. Definition, main and additional features. Factors affecting the level of physical development.
Comprehensive assessment of the health status of the population. Health groups, their characteristics.
Topic 6. Demographic indicators in assessing the health of the population
Use of the most important demographic indicators in health assessment. Sources of obtaining information about the health of the population.
Indicators of birth rate, death rate and natural increase of the population. Their dynamics. Comparative characteristics with the corresponding indicators of other countries.
Mortality rates as the most important criteria in assessing the health status of the population. General mortality. maternal mortality. Infant and child mortality. Causes. Medico-social significance. Factors influencing birth and death rates. Average life expectancy. Comparative life expectancy in different countries.
Aggravation of the demographic situation in modern Russia.
Topic 7. Scientific and technological progress and its impact on health
Achievements of science and technology in the treatment of diseases. The use of modern science and technology in the diagnosis of diseases: medical technology, apparatus, equipment, medical supplies.
Development and production of medicines as an achievement of scientific and technological progress (STP) at various stages of the development of society.
Integration of physics, chemistry, biology and mathematics in solving general biological problems.
Improvement of living and working conditions, production of material goods. The impact of the development of scientific and technical progress on the human environment. Zones of ecological disaster. Diseases associated with technological progress. Development of environmentally friendly technologies.
Topic 8. Physical culture and recreation
Physical activity and health. Physical inactivity as a risk factor for diseases. Forms and methods of physical culture lessons. Physical exercises, main types and their classification. Walking and running. Aerobic training. Principles of health training; its main types: rhythmic gymnastics, general physical training, shaping. Non-traditional methods of physical education: yoga, ancient martial and health systems.
Organization of physical culture and health-improving work. Physical culture and health groups. Medical control and self-control. Health schools. Children's and youth clubs of physical training, clubs of lovers of physical culture (by interests).
The concept of "recreation". Recreational areas. Recreational services. The concept of the "health industry".
Features of the development of physical culture and recreation in the conditions of new economic relations.
Topic 9. Modern approaches to health promotion and disease prevention
Protecting the health of citizens as a set of measures of a political, economic, legal, social, cultural and medical nature. Basic principles of public health protection.
The concept of causes and risk factors for health. Informing the population about health problems.
Preventive programs and their effectiveness in combating premature mortality.
Principles of individual approach in mass prevention. Selective screening (screening). Socio-hygienic monitoring.
Ensuring the necessary quality of life as the most common goal in the field of public health. Ways to improve the quality of life.
Participation of the population in solving health problems. His motivation for leading a lifestyle that promotes disease prevention and health promotion.
Topic 10. Legal mechanism for ensuring public health
Formation of the organizational and economic foundations of the legal mechanism for ensuring public health.
Tasks of the legislation of the Russian Federation on the protection of the health of citizens. The state of the legal framework for the protection of public health in Russia.
Competence of legislative and executive authorities in the field of health protection. Health financing. Organization of public health protection. The rights of citizens in the field of health protection. The rights of certain groups of the population in the field of health protection.
The rights of citizens in the provision of medical and social assistance. Guarantees for the implementation of medical and social assistance to citizens. Responsibility for causing harm to the health of citizens.
Prospects for the development of the legislation of the Russian Federation in the field of public health protection.
Section II. Organization of medical and social assistance to the population
Topic 1. Health care systems in Russia
The concepts of “health care” and “health care”.
State health care system. State guarantees to the population in the provision of medical care. Principles of operation of the state health care system. Organizational basis of activity. Governing bodies. Public health institutions. State health programs.
Municipal and private healthcare systems in the Russian Federation: state, prospects, legal framework.
Innovative structures in healthcare. Sources of financing for health systems.
Topic 2. Organization of medical and preventive care for the population
The main types of medical and preventive institutions. Primary health care system. Polyclinic: structure, principles and methods of work.
Hospital: structure and organization of work. Multidisciplinary and specialized hospital.
Public ambulance service. rehabilitation institutions.
Organization of drug supply.
Features of the organization of medical and preventive care for certain groups of the population. Medical and sanitary department. Health center. Maternity hospital. Women's consultation. Children Hospital.
Organization of trauma care.
Features of the organization of medical care for patients with infectious, venereal, mental, oncological diseases.
Health management. Features in the period of economic and social reforms.
Place and role of social work specialists in healthcare institutions.
Topic 3. Organization of medical and social work
The place and role of social work in the provision of medical and social assistance. The main functions of a social work specialist involved in the provision of medical and social assistance.
Medico-social work as a new type of multidisciplinary professional activity of a medical, psychological-pedagogical and socio-legal nature.
The state of social work in the health care of the Russian Federation. The state of medical and social work in social service institutions
systems of social protection of the population.
Topic 4. Drug supply
Organization of drug supply of the population. Features of drug provision of inpatients and outpatients. Pharmacy institution: structure and functions.
Practical ways to achieve health for all. Ensuring equity for all is achieving health for all. Health promotion and disease prevention. Active participation of a well-informed and motivated population. Intersectoral collaboration in the implementation of policies that promote public health and reduce risk factors. Meeting the basic health needs of the population by providing services as close as possible to where they live and work.
Solving the common problems of achieving health for all through international cooperation.
Section III. Formation of a healthy lifestyle
Topic 1. The concept and essence of a healthy lifestyle. The impact of lifestyle on health
Definition of the concepts “lifestyle”, “healthy lifestyle”. A systematic approach to assessing lifestyle. Lifestyle and living conditions, their relationship.
The place of lifestyle in the structure of the causes of modern human pathology.
Risk factors for diseases associated with lifestyle. Physical inactivity. Unbalanced nutrition. Harmful working conditions. Stress. Smoking. Drug consumption. Drug abuse. Low educational and cultural level. High level of urbanization.
The essence of a healthy lifestyle.
A healthy lifestyle as the basis for disease prevention, preservation and promotion of health.
Ways to form a healthy lifestyle.
Participation of social workers in the formation of a healthy lifestyle at the individual and group level.
Topic 2. Culture and health
Culture, medicine and health: basic definitions.
Hygienic education and a healthy lifestyle as part of the general human culture. The dependence of lifestyle on social status, profession, religion, national traditions.
Culture, labor, consumption, communication.
Folk hygiene. Folk customs and rituals associated with rhythm in life and work, choosing a place of settlement, safe water supply, rational nutrition, clothing and footwear, childcare, using a bath, etc.
Art and health. The impact of art on the emotional sphere of a person.
Psychotherapeutic and psychohygienic effect of exposure to works of art. Music and health. Television and cinema. Medico-social assessment of television series.
Literature and health. Features of the perception of fiction. Fashion and health. The difference between fashion and style and tradition. Fashion for clothes, shoes,
hats. Fashion for sports, exercise. Trendy diets and their
possible consequences. “Fashion diseases”: “corded liver”, “denim dermatitis”, etc. Fashion for bad habits. Fashion for health.
Topic 3. Social and medical aspects of a healthy lifestyle
Balanced diet. Basic principles. Organization, content, forms and means of hygienic education on rational nutrition.
Physical activity. Significance for strengthening, maintaining and restoring health. Essence of health-improving influence of motor activity.
Personal and communal hygiene.
Mode of work and rest. Alternate activities.
Rejection of bad habits: smoking, alcohol abuse.
Sexual culture. Physiological, psychological and social aspects of sexual life. Sexual culture and family planning.
Topic 4. Formation of environmentally competent behavior
Ecological conditionality of health. Environmental factors and health: air, water, flora, fauna, climatic phenomena.
Public awareness of the state of the environment. Timeliness and reliability of such information. The ability to use it as a preventive measure by a social worker.
Pollution of atmospheric air and drinking water as a serious health hazard. Acid rain and toxic fogs: the behavior of the population and the actions of specialists.
Knowledge of the main sources of air pollution and the choice of an acceptable behavioral solution, taking into account age, health status and other characteristics.
Harmful substances in water and food: the ability to determine at home, make the right decision about further use, knowledge of methods for processing and cleaning products.
Unorganized recreation, unknown terrain, questionable body of water are possible health consequences. Environmentally conscious behaviour.
Meteorological conditions and meteorological forecast. Significance for the behavior of patients suffering from diseases of the cardiovascular system and respiratory organs.
Preventive thinking and environmentally literate behavior of decision makers. The consequences of the decisions made for the team, microdistrict, region.
Topic 5. Hygienic education as an intersectoral problem
Philosophical, sociological, socio-psychological, psychological-pedagogical, medical, legal and economic aspects of hygienic education of the population.
Hygienic education and hygienic culture. Hygienic culture as part of a general humanitarian culture. Staffing of hygienic education.
Modern “health teachers”: doctors, educators, psychologists, social workers, decision makers and other professionals.
Activities for hygienic education in medical and non-medical institutions.
Topic 6. Main directions, forms and means of hygienic education
Creation of a problem situation. Orientation of a social worker in practical situations. Knowledge necessary to solve problematic situations in hygienic education. Gap between knowledge of hygiene issues
education and the ability to apply them in practical work as the main reason for the lack of ability to act in practical situations. Mastering the generalized methods of mental activity.
The choice of the main direction, forms and means of hygienic education in practice. The leading features of situations observed in the practice of a social worker are: the quantitative composition, the homogeneity of the audience, the readiness of recipients, the extreme nature of the situation. The main types of situation and the corresponding forms and means of hygienic education.
Schemes - prescriptions of generalized methods of mental activity, the ability to use them. Orientation with the help of prescription schemes of algorithmic type.
Section IV. Sanitary and epidemiological well-being of the population
Topic 1. Sanitary and epidemiological well-being of the population as a state task
Sanitary and epidemiological well-being of the population and the basis for its provision.
Law “On Sanitary and Epidemiological Welfare of the Population” as a measure of social protection of the population, its main sections and articles. The system of sanitary and hygienic measures to ensure the sanitary and epidemiological welfare of the population.
Regional and local health promotion, disease prevention and environmental health programs. The role of social workers in their preparation and implementation.
Rights and obligations of citizens on issues of sanitary and epidemiological well-being.
Topic 2. Activities of centers for sanitary and epidemiological surveillance
Centers for State Sanitary and Epidemiological Surveillance as the main institutions exercising control over compliance with sanitary legislation.
The main activities of the centers of state sanitary and epidemiological supervision: sanitary and epidemiological monitoring, identification of the causes of diseases, accounting for morbidity, preventive sanitary and epidemiological supervision, departmental and industrial control.
Interaction of institutions of the state sanitary and epidemiological service with other services, organizations, institutions and citizens.
Formation of a hygienic culture of the population. Awareness of the population about the sanitary and epidemiological situation in the district, city, region. The role of social workers in the formation of a sanitary culture of the population.
Topic 3. The influence of environmental factors on human health
Climate and health. The impact of climatic factors on the biological rhythm of a person, seasonal morbidity, meteotropic sensitivity (air pressure, electrical state of the atmosphere, solar radiation intensity, etc.).
The concept of human biological rhythms. Desynchronosis and its adverse health effects.
City-forming factors underlying the formation of urban development. Selection of the territory, zoning of the settlement (city, village) from the point
view of the possible adverse impact of the natural environment on the health of the population. The importance of sanitary protection zones for reducing the adverse impact of urban environmental factors, their improvement.
The main sources of air pollution. Impact of chemical emissions into the atmosphere on public health. Indicators by which the quality of atmospheric air is assessed, their quantitative and normative characteristics. Acute and chronic human exposure to chemical emissions. Influence of air pollution on the climate.
Measures to combat air pollution: technical, planning, sanitary, biological.
The role of housing in providing comfortable living conditions for a person. The concept of the main characteristics of the comfort of housing. Sanitary and hygienic requirements for housing.
Drinking water supply. requirements for drinking water. Importance of drinking water supply for public health. His sources. Control.
Legislative documents to ensure the rights of citizens to favorable living conditions.
Topic 4. The impact of the conditions and nature of work on the health of workers
Dangerous and harmful production factors, their impact on the body of workers. Acute and chronic occupational diseases (poisoning). The mechanism of their investigation, Classification of labor according to the degree of harmfulness, danger, severity and tension.
Occupational health of women. Features of the female body and its adaptation to production conditions. Specific functions of women and the influence of production factors on them.
Fundamentals of legislation on labor protection and hygiene. Constitution. Labor Code (Labor Code). System of labor safety standards (SSBT). Sanitary norms and rules. Labor protection for women. Supervision and control over compliance with legislative acts in the field of labor protection and hygiene.
Occupational morbidity. Features of the establishment and confirmation of occupational diseases. Occupational disability. Loss of general and professional ability to work. Pension provision.
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From time immemorial, venereal diseases have been attributed to the number of socially caused infections, or, as they are now called, sexually transmitted diseases (STDs).
Since perestroika and the beginning of the sexual revolution, the incidence of syphilis has increased tenfold in our country.
In 1998, the incidence of syphilis for the first time exceeded the incidence of gonorrhea by more than 2 times (119.9 cases in 1998), although earlier gonorrhea significantly prevailed over syphilis.
The incidence of other forms of STDs also increased several times. From 1985 to 1999 - trichomoniasis by 2.5 times, chlamydia by 2 times, ureplasmosis by 3 times, urogenital candidiasis by 10 times. Such a high prevalence of these diseases indicates drastic negative changes in the lifestyle and living conditions, especially of the younger generation. Promiscuous sex, violations of the hygienic regime, non-compliance with healthy lifestyles, drug addiction, alcoholism are fertile ground for their spread.
Venereal diseases (from lat. Veneris - Venus, the ancient Romans had the goddess of love) - diseases united according to the principle of transmission through sexual contact. A more correct term is: diseases (or infections, diseases) sexually transmitted (STDs, STIs, STDs). Some experts classify STDs into "old" and "new".
The old ones include venereal diseases known since ancient times, and the new ones include urogenital infections detected using modern methods of examination. The "old" STIs include gonorrhea, syphilis, chancre, venereal lymphogranulomatosis, donovanosis. The last three are practically not found in Russia, so only gonorrhea and syphilis are considered “classic” sexually transmitted diseases.
The “new” STIs include HIV infection, viral hepatitis B, C and D, chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis, gardnerellosis, genital herpes, genital warts, cytomegalovirus and vaginal dysbacteriosis, as well as sexually transmitted skin diseases (scabies, pubic lice, molluscum contagiosum).
Venereology- a section of clinical medicine that studies the causes (including social), development mechanisms, manifestations, methods of diagnosis, treatment and prevention of sexually transmitted diseases. Despite the significant achievements of venereology and the fight against venereal diseases carried out in all countries, they are still widespread and continue to be a serious social and moral problem.
The social significance of venereal diseases is determined by their prevalence, danger and severity of consequences for the health of the sick, as well as the impact on the reproduction of healthy offspring.
Many gynecological diseases, infertility of men and women are often the result of venereal diseases, their complications.
STIs are transmitted through homo- and heterosexual contact: vaginal, anal and oral. The more sexual partners a person has, the higher the risk of infection.
A serious rise in venereal diseases was observed in Buryatia at the turn of the century. For example, during 2000, 2660 patients with syphilis and 1922 with gonorrhea were registered in Buryatia.
Syphilis is an infectious disease caused by a spirochete, a curl-shaped bacterium called Treponema pallidum (Treponemapallidum), which is transmitted primarily through sexual contact and is characterized by a periodic course. In 1905, F. Shaudin and E. Hoffmann discovered treponema pallidum.
Opinions about the origin of syphilis are controversial. An epidemic of syphilis devastated Europe in the last decade of the 15th century, when it was called the "great smallpox" as opposed to the "smallpox". Since the epidemic coincided with the return of Columbus from America (1493), many authorities believe that syphilis was introduced from the West Indies. It is noteworthy that, apparently, Columbus himself died of syphilitic aortitis.
According to another theory, syphilis already existed in the Old World, but it spread more widely during the wars that began shortly after Columbus returned to Europe. When soldiers of the French army wintered in Naples in 1495, they developed syphilitic ulcers in the genital area, and then their bodies began to become covered with a rash. The Italians called it a "French disease", and the French blamed the Italians for everything.
The incidence of syphilis in Buryatia is almost twice as high as in the Russian Federation as a whole, and is 121.7 per 100,000 population.
Infection with syphilis occurs from a sick person sexually or by contact. It can also be transmitted in utero from a mother with syphilis to her child.
After infection, an incubation period lasting an average of 3-4 weeks follows. In the "classic" course of a syphilitic infection, 3 clinical periods are distinguished - primary, secondary and tertiary, which successively replace each other after the incubation period.
The primary period of syphilis is characterized by the appearance of erosive and ulcerative lesions in the genital area and an increase in inguinal lymph nodes. Its duration is 6-7 weeks.
Further, 2-3 months after infection or 6-7 weeks after the appearance of the primary affect (sores), a secondary period of syphilis sets in, in which various rashes on the skin and mucous membranes, hair loss, and sometimes hoarseness of voice are observed; the duration of this period without treatment (or if it is not enough) is on average 3-5 years.
Then the tertiary period of syphilis develops, in which a few nodes and ulcers appear on the body, healing with the formation of scars. With a long duration of the disease and the lack of proper treatment, damage to the internal organs and the central nervous system can be observed, which can lead to death.
Syphilis is an acutely contagious disease that poses a danger to others and damages health, and therefore requires immediate examination and treatment in a specialized institution.
Gonorrhea
Gonorrhea(from the Greek gonos + rhoia - seed + expiration) or gonorrhea (from the German tripper - drip) - a common infectious disease with pronounced manifestations in the genitourinary tract, caused by gonococcus. This is a sexually transmitted disease of a person, the causative agent of which is gonococcus (from the Greek gonos + kokkos - seed + grain), resembling a coffee bean under a microscope. It was discovered in 1879 by the German scientist Albert Neiser.Gonorrhea is one of the most common sexually transmitted infections. It accounts for a quarter of all STIs.
Manifestations of gonococcal infection can be very different - from an asymptomatic course to pelvic inflammatory disease, general blood poisoning, and even meningitis - inflammation of the meninges caused by this microbe.
However, most often gonorrhea occurs in the form of inflammation of the mucous membranes of the genitourinary organs and is accompanied by purulent discharge from the urethra in men and the cervix in women.
Diseases with a similar clinical picture have been known since ancient times. The modern name of the disease "gonorrhea" was first used by Galen, who in the 2nd century AD. erroneously interpreted discharge from the urethra of men as semen.
In men, the incidence of gonorrhea is 2 times higher than in women. This is because gonorrheal urethritis causes severe burning and pain when urinating, and men are forced to see a doctor. Women usually do not experience discomfort, and only those of them who treat themselves carefully find an increase and purulent nature of the discharge from the vagina.
Gonorrhea can be contracted through any type of sexual contact (vaginal, oral, anal sex).
Young children can become infected during the passage of the birth canal of a mother with gonorrhea. To prevent this, in the first minutes after birth, all babies are instilled into the eyes, and for girls also into the genital slit, 1% silver nitrate solution or 30% albucid solution.
Chlamydial infection
Chlamydial infection has always existed, but they learned to identify it only two decades ago. In 1990, data were published that chlamydia was found in 2/3 of couples undergoing treatment for infertility.It can live in the urethra, as well as in women in the vagina, and in men - in the prostate gland and seminal vesicles.
It has been established that trichomonads are able to absorb other pathogenic microorganisms that retain their vital functions inside their body. Therefore, with superinfection - simultaneous infection with gonorrhea and trichomoniasis, it is impossible to cure the first without getting rid of the second.
Men, having become infected, usually do not feel any changes and do not go to the doctor. But in women, trichomoniasis is usually manifested by abundant grayish-yellow foamy discharge from the vagina, severe itching and a burning sensation in the vulva, which makes them turn to a gynecologist.
Trichomonas infection can cause infertility. Bank (1966) suggested that infertility due to Trichomonas infection is due to infection of the man (sexual partner) and is not associated with the presence of Trichomonas in women. He drew attention to the fact that successful treatment of a woman does not lead to pregnancy, while after treatment of a man, his partner becomes pregnant. It is believed that these protozoa simply eat sperm.
Recently, some viral diseases of the whole body, one of the ways of transmission of which is sexual contact, have been classified as STDs. This is a herpes infection, papillomatosis, viral hepatitis B, C and D, as well as AIDS
Herpetic infection of the genital tract
Herpetic infection of the genital tract- a viral disease that tends to spread widely. For example, in the United States, this disease is epidemic in nature (there are up to half a million primary cases per year).The causative agent of herpetic infection of the genital tract is the herpes simplex virus (HerpessimplexvirusHSV). Herpetic lesions were identified already in the 1st century AD by Roman doctors who observed herpetic eruptions on the lips.
The first case of herpetic lesions of the genital tract was registered in 1700. The herpes simplex virus was first described in 1912, and was first isolated from the female genital tract in 1946. The herpes simplex virus develops intracellularly. According to various studies, 65-90% of the world's population is infected with the herpes virus.
Anogenital herpes infection (genital herpes) is a chronic relapsing viral disease, predominantly sexually transmitted, characterized by exacerbation of lesions of the skin and mucous membranes of the genital organs and the genitourinary tract.
Factors contributing to the exacerbation or manifestation of genital herpes include:
- decrease in immunological reactivity;
- hypothermia or overheating of the body;
- accompanying illnesses;
- some mental and physiological conditions (sexual contacts, menstruation);
- medical manipulations (abortion, the introduction of an intrauterine device).
Condylomas, hepatitis and other diseases
warts- anogenital warts are benign warts with localization on the genitals and in the perianal (from the Greek peri + anus - located around + anus) area - the anus.The disease is characterized by a long latent course and the possibility of the appearance of clinically significant lesions after a long period of time after infection. The causative agent of the disease in more than 90% of cases is the human papillomavirus.
Anogenital warts occur in places that are traumatized during sexual intercourse, and can be either single or multiple.
Some types of papillomaviruses have a very pronounced oncogenic effect. They cause cervical cancer in women and penile cancer in men.
Viral hepatitis B also called serum hepatitis. This name is due to the fact that infection with the hepatitis B virus can occur through the blood, and through an extremely small dose. The hepatitis B virus can be transmitted sexually, by injection with non-sterile syringes from drug addicts, from mother to fetus.
This disease, by all signs of infection and the course of the infectious process in the body, is very similar to AIDS, only liver cells - hepatocytes - are affected in it.
Viral hepatitis C has a more malignant course and can also be transmitted from a carrier of the infection to a healthy person through sexual contact. A complete cure for hepatitis B and C does not always occur, and if the virus remains in the body, then there is a very high probability of developing cirrhosis and liver cancer.
The European Association for the Study of the Liver, which includes Russia, has developed basic principles for the treatment and monitoring of patients with hepatitis C. The basis of all treatment regimens is interferon-alpha. The mechanism of action of this drug is to prevent infection of new liver cells.
The use of interferon cannot guarantee a complete recovery, however, treatment with it prevents the development of cirrhosis or liver cancer. The effectiveness of treatment is significantly increased if interferon is used in combination with ribavirin. A positive effect is achieved in 40-60% of cases.
Another group of conditions - vaginal dysbiosis is also identified with STIs, although their development occurs when local immunity is weakened.
Bacterial vaginosis develops due to the replacement of the normal microflora of the vagina, in particular H 2 0-producing lactobacilli, with a large number of obligate and facultative anaerobic conditionally pathogenic microorganisms (Bacteroides, Prevotella, Peptococcus, Mobiluncus, Gardnerellavaginalis, Mycoplasmahominis, etc.), i.e. those microbes that are normally present in small amounts.
Bacterial vaginosis is a common clinical syndrome in women of reproductive age, the incidence of which in a group of sexually active women reaches 60%.
The causes of the development of the disease remain unclear, however, there are a number of factors that affect the composition of the vaginal microflora, these are:
- therapy with antibiotics, cytostatics,
- radiation therapy;
- frequent washing of the vagina;
- malformations or anatomical defects after ruptures in childbirth, surgical interventions;
- foreign bodies in the vagina, uterus (presence for a long time of vaginal tampons or diaphragms, intrauterine devices, etc.);
- use of spermicides;
- hormonal changes during puberty, pregnancy, after childbirth and abortion;
- entry of pathogenic microorganisms gastrointestinal tracta (GIT).
The main symptoms of vaginosis are a homogeneous discharge from the genital tract, often with an unpleasant odor, especially after intercourse or during and after menstruation. With the progressive course of the disease, the discharge may acquire a yellowish-greenish color, become thicker and evenly distributed along the walls of the vagina.
In 20-30% of cases, itching and burning in the vulva, dysuria are noted. According to studies, 24-32% of women have an asymptomatic course of bacterial vaginosis.
Bacterial vaginosis can cause poor pregnancy outcomes.
Gardnerellosis is one of the varieties of bacterial vaginosis, in which microbes, gardnerella, receive the greatest reproduction. Currently, such a diagnosis does not exist, but it is still found in almost all booklets on STIs.
Gardnerellosis by definition is a dysbacteriosis of the vagina. Therefore, it is wrong to make such a diagnosis for men. Sometimes pathogens of gardnerellosis cause urethritis in men, which is manifested by burning and pain during urination. In this case, treatment is necessary. In other cases (when Gardnerellavaginalis is detected by accurate methods or gardnerellosis in a sexual partner), there is no need to treat men.
genital candidiasis is an infectious disease of the genitourinary system caused by yeast-like fungi of the genus Candida. A feature of this disease is a long course and a tendency to recurrence - repetition of exacerbations.
The most common forms of genital candidiasis in women include vulvovaginitis (from Latin vulvovaginitis - inflammation of the vulva and vagina), in men - balanoposthitis (from Greek balanoposthitis - inflammation of the glans penis and foreskin). It is caused by yeast-like fungi of the genus Candida.
This fungus is detected in healthy women, however, with a change in the microbiocenosis of the vagina and a violation of the barrier mechanisms of local immunity, it can acquire pathogenic properties.
Risk factors for the development of genital candidiasis include long-term antibiotic therapy, hormones, the use of immunosuppressants, radiation therapy, severe infectious diseases, pregnancy, diseases of the gastrointestinal tract and the endocrine system, in particular diabetes mellitus.
Symptoms of genital candidiasis in women: thick, white, cheesy, sometimes liquid, creamy vaginal discharge; itching in the vulva and vagina; hyperemia, swelling and dryness of the mucous membrane of the vulva and vagina, sometimes small bubbles, erosion and cracks; some patients have dysuria.
Symptoms of candidiasis of the genitals in men: moderate itching and burning in the vulva; puffiness, hyperemia, superficial peeling, whitish plaque on the glans penis and on the inner leaf of the foreskin.
For any suspicious symptoms, you should always consult a doctor, because only he can make the correct diagnosis and prescribe treatment under the control of tests among a wide variety of STIs.
The main principles of STI treatment are:
- simultaneous treatment of sexual partners,
- exclusion of unprotected sexual contacts during treatment,
- strict adherence to all medical recommendations.
It must be remembered that:
- the best sexual partner - beloved, constant and only;
- for casual sex, a condom is always used;
- having sex under the influence of alcohol or drugs reduces self-control.
: methodical manual for students of the faculty of physical education / A.V. Shelegina, I.L. Levin; GOU VPO "Kuzbass State Pedagogical Academy", Department of TiPFOFK - Novokuznetsk, 2011 -114p.
Toolkit "Fundamentals of prevention of the spread of socially significant diseases among adolescents" is intended for students of the faculty of physical education who study the discipline of specialization "Fundamentals of health-improving work in an educational institution", the Methodological manual contains theoretical material necessary for a future specialist whose professional activity is aimed at organizing preventive work in an educational institution
Introduction
According to the Ministry of Health, the epidemiological situation in Russia is becoming increasingly tense. Economic and social instability in society entails an inexorable increase in the number of diseases that are called socially significant. Diseases of this group pose a significant threat to public health, cause enormous damage to society, associated with the loss of temporary and permanent disability, the need for huge costs for prevention, treatment and rehabilitation, premature mortality, and crime.
Statistics show that socially significant diseases are widespread among adolescents. Young people are the most vulnerable group of the population, which is quickly involved in the epidemic process. The reasons for the growth of socially significant diseases among adolescents are social maladjustment, low level of hygiene knowledge, environmental conditions and early onset of sexual activity. [Korchagina G.A. et al., 2004; Ramazanov R.S., 2005; Suslin S.A., Galkin R.A., 2006].
The solution to the problem of the spread of socially significant diseases among adolescents is associated with the organization of primary prevention in educational institutions. The essence of preventive work is to expand the ideas of adolescent schoolchildren in this area, the formation of health-saving behavior strategies in risk situations associated with the possibility of infection, the onset of the disease.
The methodological manual "Fundamentals of prevention of the spread of socially significant diseases among adolescents" is intended to train specialists in the organization of preventive work in an educational institution. The manual contains detailed theoretical material on socially significant diseases, their characteristics, methods of prevention, etc. The electronic version of the manual contains a visual and illustrative block. In addition, the workbook developed for the methodological manual will help to structure knowledge, check the quality of assimilation of theoretical material.
Socially significant diseases
The concept of "socially significant diseases". Society and socially significant diseases. Human Responsibility in the Spread of Socially Significant Diseases . Classification and main characteristics of diseases.
What is meant by socially significant diseases? An elementary analysis of the phrase “socially significant” shows that the diseases of this group are of great importance for society and pose a threat to a large number of people. Referring to literary sources allows us to assert that the concept of socially significant diseases includes a number of diseases that carry the greatest threat to the well-being of the country's population. The main features included in the concept of a socially significant disease are:
The mass nature of the disease, that is, a high percentage of the spread of the disease among the population, including the presence of a significant percentage of "hidden" patients in society,
High rates of annual increase in the number of patients, diseases of this group tend to spread quite quickly,
limiting the full functioning of the patient in society in the presence of such a disease,
risk of illness to others
infectious and non-infectious.
In addition, diseases belonging to this category not only destroy the health and body of a person, but also have negative social consequences: the loss of family, friends, work, livelihood, etc. A characteristic feature of such diseases is that they take away in the bulk of the life of young people, people of working age. An important feature of socially significant diseases is that if you know how not to get sick and follow certain rules, then the disease can be prevented or stopped at an early stage of the disease.
The situation with the spread of diseases of this group has become so acute that it causes concern at the level of the government of the Russian Federation. Epidemiological observations served as the basis for compiling a list of socially significant diseases. In accordance with Article No. 41 of the Fundamentals of the Legislation of the Russian Federation on the protection of the health of citizens, the Government of the Russian Federation approved a list of diseases that are classified as socially significant. (Resolution of December 1, 2004 N 715 "On approval of the list of socially significant diseases and the list of diseases that pose a danger to others"). This list includes: a disease caused by the human immunodeficiency virus (HIV), tuberculosis, hepatitis, sexually transmitted infections, diabetes mellitus, malignant neoplasms, mental and behavioral disorders, diseases characterized by high blood pressure.
According to statistics, society shifts responsibility for health onto the shoulders of the state, medicine, schools, anyone but themselves. On the part of health care, certain preventive measures are being taken, but their volume and effectiveness directly depend on the desire of the population to live in a society that is healthy both in body and soul. Very often, people do not realize the magnitude of their health reserves, and waste it, forgetting that it is easy to lose, but difficult to restore, and sometimes, with regard to socially significant diseases, it is impossible. At the same time, each person is able to protect himself and his loved ones. To do this, it is necessary to have basic hygienic knowledge related to the prevention of socially significant diseases. In addition, in view of the specifics of diseases, a person interested in his own well-being must understand that his health to a large extent depends on the health of his environment. Therefore, one of the most important measures of the federal program to combat socially significant diseases is to increase the level of knowledge about the existing epidemiological situation, the dissemination of hygienic knowledge about the prevention of these diseases. “A society that has a significant amount of information about these diseases, about preventive measures and effective methods of treatment, can be of great help in the fight against socially significant diseases”
All this will contribute to a decrease in social significance, i.e. the achievement of such a state of affairs in relation to the disease, in which the existence of a certain disease in the country ceases to have socially significant consequences.
Today, the incidence rate is so high that, according to many epidemiologists, sociologists, hygienists, and others, in order to reduce the social significance of diseases in this group, in addition to all of the above, it is necessary to ensure:
The full functioning of the individual in society in the presence of a disease (In particular, diabetes in Japan is a common but socially insignificant disease, since drug provision and education of diabetics is organized in such a way that the average life expectancy of a diabetic patient in Japan is higher than that of an ordinary person),
Reducing the number of "hidden" patients and guaranteeing the absence of a significant number of such patients in society (by improving the quality of diagnosis in the first years, the number of officially registered patients will certainly increase, however, in the end, the social significance of the disease will be reduced due to a decrease in the number of fatal and seriously traumatic outcomes of the treatment of the disease, due to the start of treatment at an early stage, for example, cancer patients).
So, socially significant diseases are a group of diseases that pose a threat to modern society. Today, the situation with the spread of socially significant diseases is very serious, requiring the consolidation of many structures, not only state, medical, but also pedagogical. The education system has great potential in the organization of primary prevention, the essence of which is to expand hygiene knowledge among young people, the formation of health-saving behavior strategies in situations associated with the risk of infection or the onset of the development of the disease.
Let us consider a brief description of socially significant diseases included in the list approved by the Government of the Russian Federation.
Human immunodeficiency virus (HIV) disease. Designated as the "plague" of the twentieth and now the twenty-first century, HIV infection is the most significant threat to human society. According to statistics, over the past 24 years, HIV has caused the death of more than 25 million people, becoming one of the socially significant diseases dangerous to society. HIV is spreading rapidly and is characterized by incredible variability - today more than 40,000 variants of its genome are known to science. This circumstance complicates the research of scientists in the field of finding effective drugs against this infection. At the moment, there are no drugs in the world that can completely cure an HIV patient. All drugs known to date are aimed only at supporting the resources of the human body infected with the virus. Until now, scientists studying the phenomenon of HIV cannot establish how this disease entered the human population. According to one of the most plausible hypotheses, the immune deficiency virus was obtained from monkeys, but scientists do not give an exact answer to the logical question of exactly how this happened. Only one thing is known for certain - the birthplace of HIV is in the countries of Central and West Africa. HIV infection is a long-term infectious disease of viral etiology, characterized by a long latent period, damage to the cellular link of the immune system, leading to a condition known as "acquired immunodeficiency syndrome" (AIDS). During AIDS, secondary infectious and oncological diseases develop, usually leading to death. The disease was first registered in 1981, in 1983 the causative agent, the human immunodeficiency virus, was discovered. During its existence, the disease has spread to all continents of the globe and has taken on the character of a pandemic. According to the Federal Scientific and Methodological Center for the Prevention and Control of AIDS, the number of HIV-infected people in Russia may actually reach 1 million people (which corresponds to 1% of the country's adult population).
Tuberculosis- an infectious disease that develops when tuberculosis bacteria enter the body. In this case, the main organ that is affected by the disease is the lungs. In some cases, there may be tuberculosis of the brain and its membranes, tuberculosis of the bones, joints, kidneys, genitals, eyes, intestines and other organs. 75% of tuberculosis patients are people aged 20-40 years, that is, the most able-bodied and childbearing age. Today it is proved that the vast majority of cases of tuberculosis can be cured. If the detection and treatment of tuberculosis is properly organized, which should be carried out under control and not interrupted, then patients will recover. More than 100 years ago, it was proved that tuberculosis is an infectious (contagious) disease caused by Koch's bacillus. Not only humans, but also animals and birds suffer from tuberculosis. In a living organism, tubercle bacilli find suitable nutritional conditions and temperatures and can multiply rapidly. Tuberculosis affects people of all ages and genders. With this disease, not only the lungs are affected, but also other organs: bones, eyes, skin, lymphatic, genitourinary and nervous systems, etc.
Infections transmitted primarily through sexual contact. Sexually transmitted diseases include: gonorrhea, syphilis, genital herpes, genital warts (genital warts), bacterial vaginosis, etc. In addition, viral hepatitis can be transmitted sexually, from which a large number of people die every year. To date, the incidence of STIs is steadily increasing. Recently, doctors have recorded combinations of different forms of diseases caused simultaneously by several pathogens. Therefore, for more effective treatment of the patient, it is necessary to examine for the presence of all types of STI pathogens. The social significance of sexually transmitted diseases lies in the fact that, if not properly treated, they can lead to infertility, sexual dysfunction in men, and inflammation of the internal genital organs in women. Despite the fact that 100% prevention of sexually transmitted diseases does not exist, personal hygiene and reasonable behavior in sexual life will help to avoid an unpleasant encounter with STIs.
Hepatitis(from the Greek. hepatos - liver) is the general name for inflammatory diseases of the liver. Hepatitis can be caused by certain drugs, toxins, infectious or systemic diseases. However, a significant problem for medical science and practical health care, which is becoming more and more acute epidemiological in nature, is viral hepatitis.
Widespread worldwide has included hepatitis in the list of the most dangerous socially significant diseases. This epidemiological situation is explained by the ease of spread of viral hepatitis. Even the smallest amount of infected blood, once in the human body, can lead to infection with hepatitis.
In the absence of timely treatment, the hepatitis disease progresses and passes into the chronic stage, which is more difficult to treat. According to studies, approximately 20 million people in the world fall ill with viral hepatitis every year, and if left untreated, about 10% of them become chronically ill. Hepatitis A and hepatitis E occur mainly due to poor personal hygiene, while infection with viruses B, C, D, G occurs through contact with infected blood. Due to the wide prevalence and destructive effects on the human body, hepatitis viruses pose the greatest health hazard. B and C.
Malignant neoplasms. Oncology(onco- + Greek logos doctrine, science) - a field of medicine and biology that studies the causes, development mechanisms and clinical manifestations of tumors. Oncology studies methods of diagnosis, treatment and prevention of tumors. tumor called excessive pathological growths of tissues, consisting of qualitatively changed cells of the body that have lost their differentiation. Of the terms accepted in medicine for the tumor process, the following are most often used: tumor - tumores, neoplasms - neoplasma, blastoma - blastomata, - the latter most fully reflects the essence of the process. Blastoma comes from the Greek verb blastonein, to grow. According to the nature and rate of growth, tumors are divided into benign and malignant. Most malignant neoplasms are cancerous tumors. Doctors note that the name of the disease "cancer" comes from the Latin word "cancer", since the shape of the tumor resembles a crab in its outlines. Today's doctors are seriously concerned that the incidence of cancer throughout the world is steadily increasing. This situation is caused, first of all, by the deterioration of the environment and the way of life of people. Today, the most common types of cancer doctors call lung cancer, stomach cancer and breast cancer. The social significance of malignant neoplasms lies in the fact that the diagnosis of "cancer" often sounds like a sentence for people. The lack of information about this disease and outdated ideas about methods of treatment form a myth in society about the incurability of cancer. However, society must have reliable information about the disease and remember that cancer is a curable disease. According to doctors, in the initial stages of the disease, cancer is cured in most cases, and therefore society should realize the extreme importance of early diagnosis. The danger of cancer is that for a long time it is asymptomatic. Many people turn to specialists for help only when they begin to experience physical discomfort, and this happens only in the last stages of the disease. It should be remembered that too late diagnosis significantly reduces the effectiveness of treatment. According to doctors, the main causes of cancer can be divided into external and internal. External factors include physical, chemical and biological factors. Internal causes of cancer are associated with hereditary predisposition to the disease. In particular, this applies to breast cancer in women.
Diabetes- a disease of the endocrine system, caused by absolute or relative insufficiency in the body of the hormone of the pancreas - insulin and manifested by profound disorders of carbohydrate, fat and protein metabolism. Diabetes mellitus is one of the most common diseases. Its prevalence among the population is currently 6%. Every 10-15 years the total number of patients doubles.
Mental and behavioral disorders.More than 450 million people in the world suffer from mental or neurological disorders. About a quarter of the population, both in developed and developing countries, suffer from some form of mental disorder at some time in their lives.
There are currently 120 million people in the world with depression, 37 million with Alzheimer's disease. About 50 million suffer from epilepsy and 24 from schizophrenia. At the same time, according to WHO, 41 percent of countries do not have a developed policy on mental illness, and 25 percent of countries have no legislation on this issue. Two-thirds of governments allocate no more than one per cent of the health budget to psychiatry.
Diseases characterized by high blood pressure. According to the World Health Organization, cardiovascular disease is the leading cause of death worldwide, accounting for more than half of all cases. According to recent statistical studies conducted by WHO in 34 countries, Russia today ranks first in mortality from complications of hypertension. The danger of hypertension lies in the fact that it often goes unnoticed by a person. Often, a person attributes the symptoms of hypertension to simple fatigue, not finding a reason to see a doctor in them. However, frequent headaches, dizziness, tinnitus, decreased performance, swelling of the extremities, and increased blood pressure may be symptoms of latent hypertension.
All listed socially significant diseases have risk factors and protective factors. Knowledge of these factors can play a large role in the implementation of prevention . Risk factors are associated with an increased likelihood of developing, more severe, or longer duration of severe health disorders. Protective factors are conditions that increase people's resistance to risk factors and disorders; they are defined as factors that modify, improve, or alter an individual's response to certain environmental risk factors that predispose to impaired adaptive capacity.
Topic No. 21. General characteristics of emergency situations of a social nature.
1. Circumstances of a military, economic, criminal, political and domestic nature refer to ...
a) man-made emergencies;
b) natural disasters;
c) ecological character;
d) social emergencies.
Correct answer: Mr.
2. Socially conditioned diseases include:
a) influenza, tonsillitis, pneumonia, syphilis;
b) sexually transmitted diseases, HIV infection, tuberculosis;
c) intestinal infections, colds, tuberculosis;
d) venereal diseases, intestinal diseases.
Correct answer: b.
3. The growth in the number of social emergencies depends on:
a) a high level of general culture;
b) stability and order in society;
c) lowering the standard of living.
Correct answer: c.
Topic No. 22. Emergency situations of a military nature.
1. Military emergencies include ...
a) careless handling of weapons, resulting in the death of people;
b) local armed conflict;
c) hostage-taking (kidnapping);
d) getting into a street shootout.
Correct answer: b.
2. Military-political conflicts, as a form of resolving internal political contradictions in society, lead to ...
a) an increase in life expectancy in the country;
b) a decrease in life expectancy in the country;
c) do not affect life expectancy.
Correct answer: b.
3. Socio-political conflicts in the form of strikes and sabotage lead to ...
a) strengthening the economy in the country;
b) weaken the country's economy;
c) do not affect the economy of the country.
Correct answer: b.
4. Military emergencies in terms of propagation speed can be:
a) moderate;
b) smoothly distributed;
c) sluggish;
d) explosive, rapid, rapidly spreading.
Correct answer: Mr.
5. Military emergencies in terms of duration of actions, as a rule, are ...
a) insignificant;
b) long-term;
c) large-scale;
d) short term.
Correct answer: in
Topic No. 23. Emergency situations of an economic nature.
1. Economic emergencies include ...
a) bribery;
b) insufficient food supply;
c) corruption;
d) misappropriation of real estate of an individual.
Correct answer: c.
2. Corruption in the country contributes to:
a) increase the economic potential in the country;
b) does not affect the economy in the country;
c) the stratification of the population.
D) the spread of infectious diseases.
Correct answer: c.
3. Economic emergencies lead to ...
a) a decrease in the social activity of the population of the country;
b) increasing the social activity of the population of the country;
c) do not affect the social activity of the population of the country.
Correct answer: a.
4. Under the conditions of an uncontrolled increase in the social anthropogenic share of consumption of the biosphere product, an emergency of ___________ nature may occur.
a) military;
b) economic;
c) criminal;
d) political.
Correct answer: b.
5. In accordance with the general classification, economic emergencies are ...
a) conflict-free;
b) conflict;
c) federal;
d) local.
Correct answer: c.
6. Creation of legal legislation and effective mechanisms for monitoring its implementation, strengthening state regulation in the economy are ...
a) the basis for ensuring national security in the foreign economic activity of the state;
b) legislative creativity;
c) the basis for ensuring national security in the internal economic activities of the state;
d) legal support of foreign economic activity of the state.
Correct answer: c.
7. Emergencies of an economic nature, according to the scale of distribution, are divided into ...
a) controlled and uncontrolled;
b) predictable and unpredictable;
c) regional, national, global;
d) local, object, local.
Correct answer: c.
Topic No. 24. Emergencies of a criminal nature.
1. If signs of an apartment robbery are found, it is necessary ...
a) run out into the street and try to catch up with the thief;
b) notify the police;
c) start cleaning the premises;
d) call the neighbors and tell them about the theft.
Correct answer: b.
2. The science of crime victims is called...
a) victimology;
b) psychology;
c) jurisprudence;
d) criminalistics.
Correct answer: a.
3. Social hazards associated with physical impact on a person include ...
a) sexually transmitted diseases;
b) theft;
c) hostage;
d) suicide.
Correct answer: c.
4. To reduce the risk of being kidnapped on the street, you need to ...
a) choose a route of movement passing through busy and lit streets;
b) don't think about it;
c) carry a gas pistol;
d) always walk with the dog.
Correct answer: a.
5. Being a hostage, you must adhere to the following rules ...
a) behave complaisantly, calmly and, if possible, peacefully, carefully monitor the behavior of criminals, but do not comply with their demands under any pretext;
b) do not lose heart, try to take away their weapons, and in case of a convenient and safe opportunity, run away;
c) if possible, fulfill the requirements of criminals, do not contradict them, do not risk the lives of others and your own, do not allow hysteria and panic;
d) not endure hardships, insults and humiliation, proudly look the criminal in the eye, act according to the principle "the best defense is an attack."
Correct answer: c.
6. Complex criminal activities carried out on a large scale by organizations that have an internal structure, receive financial profit and gain power by creating and exploiting markets for illegal goods and services are called ...
a) organized crime;
b) banditry;
c) extremism;
d) terrorism.
Correct answer: a.
7. If, upon returning home, you find that the door is ajar and unfamiliar voices are heard from the apartment, then you need ...
a) enter the apartment together with the neighbors and detain the “visitors”;
b) enter the apartment and find out what is happening;
c) close the door with a key, do not remove it from the lock and call the police;
d) enter the apartment and ask: “Who is there?”.
Correct answer: c.
8. If you are held hostage and injured, you must ...
a) dial 03 and call an ambulance;
b) since you are injured, get up and go to the exit on your own;
c) ask the terrorists to call a doctor;
d) try to move less and thereby reduce blood loss.
Correct answer: Mr.
9. The commission of actions that create a danger of death of people, causing significant property damage or the onset of other socially dangerous consequences, as well as the threat of committing these actions for the same purposes, is called ...
a) a criminal act;
b) banditry;
c) extremism;
d) terrorism.
Correct answer: b.
10. In modern conditions, when any property can become an object of profit, creating security for a home and maintaining property in it is ...
a) the case of the police;
b) the task of local authorities;
c) care of the state;
d) duty of every citizen.
Correct answer: Mr.
11. Adherence to extreme views or actions is...
a) inciting racial hatred;
b) Freemasonry;
c) extremism;
d) selfishness.
Correct answer: c.
12. Violation of public security, intimidation of the population, influence on authorities, encroachment on the life of state or public figures and other crimes that pose a threat to the state and social system of the country, complicating its international relations, is called ...
a) extremism;
b) fascism;
c) terrorism;
d) separatism.
Correct answer: c.
13. The rules that must be observed by the hostages during the release by the special services ...
a) lie on the floor, covering your head with your hands and not move;
b) if possible, help the employees of special services;
c) run towards the officers of the special services in order to quickly release them;
d) try to leave the building unnoticed or hide in a secluded place.
Correct answer: a.
14. A person who wants to use the services of a passing car should ...
a) show the money to the driver at the time of getting into the car;
b) immediately tell the driver that there is money for travel;
c) immediately give the money to the driver;
d) set aside money in advance to pay for travel.
Correct answer: Mr.
15. The most severe punishment that can be imposed on a convicted juvenile is ...
b) deprivation of the right to engage in certain activities;
c) probation;
d) imprisonment.
Correct answer: c.
16. When taken hostage, the leaders and teachers of an educational institution must ...
a) try not to contradict the criminals, to fulfill their requirements, if this is not associated with damage to the life and health of students;
b) demand immediate release from criminals;
c) provoke the bandits to an armed clash;
d) organize and arrange an escape, at least for several groups of students.
Correct answer: a.
17. Organization, preparation, implementation of a terrorist action, financing of a terrorist organization, or other assistance is ...
a) military conflict;
b) illegal actions;
c) overthrow of power;
d) terrorist activities.
Correct answer: Mr.
18. If a car slows down and passengers ask to show them the way, you should ...
a) get in the car and show the way;
b) you should come closer, tell in detail about the road and show it;
c) go next to the car, showing the way;
d) talk to the driver and passengers, standing at some distance from the car.
Correct answer: Mr.
Theme № 25. Emergencies of a political nature.
1. Political emergencies include…
a) unemployment;
b) a rally;
c) local armed conflict;
d) taking hostages.
Correct answer: b.
2. Terrorism is called politics...
a) non-intervention of opposing factions;
b) intimidation, suppression of political opponents by violent measures;
c) the contradiction of two opposing factions;
d) cooperation with opponents by various methods.
Correct answer: b.
3. According to Article 205 of the Criminal Code of the Russian Federation, a person who has committed an act of terrorism, as well as a threat to commit a terrorist act, shall be punished with imprisonment for a term of ____ years.
Correct answer: a.
Topic No. 26. Emergency situations of a family and domestic nature.
1. A family emergency includes ...
a) household gas explosion;
b) ignition of household electrical appliances;
c) conflict with neighbors;
d) an infectious disease of family members.
Correct answer: c.
2. An increase in the number of family situations is associated with the spread among the population:
a) alcoholism;
b) infectious diseases;
c) psychological incompatibility.
Correct answer: a.
3. An increase in the number of family situations is associated with the spread among the population of:
a) infectious diseases;
b) leakage of household gas;
c) drug addiction;
d) icy roads.