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The article describes issues of legislative environment for medical activities in educational institutions implementing supplementary general education programs. The area of children recovery and rehabilitation (in terms of ensuring medical activities) is in regulatory deficit and requires special attention from the state system. The analysis of the procedure for providing medical care to minor children during the recovery period and organized leisure in terms of any activities in children’s centers at international and all-Russian levels (approved by the order of the Ministry of Health of Russian Federation dated June 13, 2018, № 327н) was carried out. Features of work in organizations of recreation and rehabilitation of children under conditions of new coronavirus infection are described. The assessment of previously existing and modern health legislation for atypical educational institutions is presented. Several ways on improvement of legislative environment for medical activities on recovery and rehabilitation for the full implementation of children rights on recovery, rehabilitation and supplementary education have been proposed.
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Background. Child and adolescent suicides remain one of the most painful public issues. The COVID-19 pandemic has aggravated this topic as the number of suicides among children population has increased in this period. Research and practice guidelines identify the leading role of primary care physicians in the prevention, identification, and routing of patients with suicidal behavior. At the same time, there were no studies on pediatricians’ competence in the field of suicides. Objective. The aim of the study is to study pediatricians’ competence in prevention, risk determination or and detection of suicidal behavior. Methods. Cross-sectional study was conducted with the usage of original electronic questionnaire aimed on identifying the level of pediatricians’ competence in evaluating suicidal behavior in children. Questionnaire included 18 questions. Results. We have received 208 electronic questionnaires. 97.1% of specialists have confirmed that they evaluate emotional status of their patients during admission. During admission: 86.1% of specialists have considered the characteristics of children appearance, facial expression, voice intonation, 65.4% — have asked questions about mood, 62.5% — have interviewed parents. 98.6% of specialists pay attention to the presence of self-inflicted injuries marks, 88.4% — ask about the origin of these injuries. Only 36.1% of respondents ask patients about suicidal thoughts, intentions, or actions. Only 69.3% of specialists are ready to refer their patients to psychologist, and 51.7% — to psychiatrist. Conclusion. Even though most surveyed pediatricians notice signs of suicidal intent (low mood, self-inflicted injuries), they avoid discussing the topic of suicide during admission. Increasing the competence of pediatricians should be aimed on destigmatisation in the field of mental health, increasing the knowledge level, and developing practical skills in working with children with suicidal behavior.
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Relevance. The problem of vaccine hesitancy is becoming even more urgent in the light of the coronavirus pandemic, which acted as an impetus for increasing public skepticism about vaccination. In 2019, the WHO declared vaccine hesitancy as one of the global health threats. Aims. The purpose of the research is a comprehensive analysis of the factors that cause vaccine hesitancy in Russian Federation, followed by recommendations for increasing population adherence to vaccination. Materials & Methods. Statistical, factual analysis of the research objects, as well as a qualitative and quantitative analysis of open sources data carried out. The main sources of information were anti-vaccination messages on social networks and the media, information from anti-vaccination communities on Vkontakte, official websites and social networks of relevant federal executive authorities of the Russian Federation. Results. Communication space. Social networks are the main source of dissemination of false information about vaccination. The most active platforms for the dissemination of anti-vaccination messages on social networks are Odnoklassniki and Vkontakte. Semantic analysis. Anti-vaccination rhetoric on Facebook, Instagram, Vkontakte, Odnoklassniki, Telegram, Twitter, Tik Tok, You Tube, Live Journal, the media, and forums is generally similar. As the object of anti-vaccination rhetoric, the words “vaccines”, “vaccination”, “vaccinations” most often appear in posts. Such rhetoric is more directed towards childhood vaccinations. The target audience of anti-vaccination propaganda is parents. The target audience. The sample of the target audience of the doubting population, compiled on the basis of social network Vkontakte users, amounted to 90,937 people. A significant part of the doubting population is represented by women (85%). As a result, the average age of target audience representative is 35.4 years. Major part of the audience is married – 83.1% of the total sample. Almost a third (24.1%) of the Russian audience of the anti-vaccination movement are residents of the Central Federal District. Influence groups. The activity of key influence groups members is characterized by a high level of cohesion within the anti-vaccination movement, which is manifested in mutual reposts of information, joint actions, live broadcasts and announcing the events of “comrades-in-arms”. Among the main motives for participating in the anti-vaccination movement are commercial interests in promoting services and products that are alternative to vaccination, as well as attracting the attention of the audience. It is important to note that the most active representatives of the anti-vaccination movement, for the most part, do not have a medical education. Measures to increase adherence. The state policy in relation to increasing the population adherence to population, as well as the activities of the pro-vaccination movement representatives, play an important role in strengthening the public's confidence in immunization. As part of increasing adherence to vaccination, a wide range of methods and means of informational impact on citizens is used-separate information portals, social networking, face-to-face educational events, special projects, organization of hotlines on vaccine prevention. Conclusions. Solving the problem of vaccine hesitancy under the influence of the anti-vaccination movement activities, rhetoric in the media and social networks, distrust of the state and the healthcare system, and personal perception of vaccination risks require an integrated approach to organizing measures for increasing adherence at the federal and regional levels. The immunization system development should be carried out by changing the regulatory legal framework in order to effectively implement such activities at all levels of the country's health care system. © 2022, Numikom. All rights reserved.
ABSTRACT
The pandemic caused by the new coronavirus infection remains the topical health issue and constitutes serious threat to the entire world. Nowadays, active immunization against new type of coronavirus infection continues in Russian Federation and in all other countries. Vaccination is the crucial component in comprehensive program for COVID-19 prevention and control. Mass immunization of population can prevent both admissions and hospitalization in conditions of high incidence of COVID-19 and thereby reduce the burden on the health system. Despite the remaining complications in combating the SARS-CoV-2 pandemic, preventive vaccination is by far the most effective method for protection against this infection Clinical studies on the efficacy of various preventive vaccinations in different regions of the world are extremely relevant especially under conditions of the emergency use authorization for vaccines against new coronavirus infection, the changing epidemiological situation, and the wide variability of different types of vaccines. All countries will need continuously updated data on vaccine efficacy to address new challenges such as weakening post-vaccine protection, new SARS-CoV-2 strains, and need for other preventive measures to mitigate the pandemic.
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This review presents new publicly available data on the evolution of COVID-19 pandemic caused by SARS-CoV-2, as well as on the Delta variant. The article also covers the issues of terminology and classification of already identified virus variants, vaccination efficacy, and the use monoclonal antibodies for SARS-CoV-2 virus and new Delta variant management. The authors of all analyzed publications consider the Delta variant as the most concerning in the present situation. It is noted, there is data (according to some publications) indicating its higher transmissibility, hospitalization risk, likely more severe disease course, low efficacy of vaccines after partial vaccination (e.g. one dose of vaccine). The article also considers issues related to children returning to sport activities after COVID-19.
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Background. Anti-inflammatory therapy is used to achieve and maintain asthma control, as well as respiratory function indicators monitoring. Telemedicine technologies can be used for this purpose, and it became particularly essential during the COVID-19 pandemic. Objective. The aim of the study is to analyze efficacy of the mobile technology MedQuizBot for asthma monitoring, to estimate patient compliance to use such instruments of self-control via the bot and without it, and bot's functioning satisfaction. Methods. 6-month prospective observational comparative study in patients with asthma from 4 to 17 years old was conducted. All patients were divided into two groups: patients who have used MedQuizBot and patients who have used any other self-control tools. Patients had to enter peakflowmetry data daily and undergo asthma control tests monthly. Patients were able to communicate with their doctor remotely via the chat bot. Main study indicators: determining the efficacy of MedQuizBot in patients with asthma by estimating the compliance to self-control tools at using the bot. Secondary study indicators: estimation of patients satisfaction on using the MedQuizBot and determination of level of asthma control due to the obtained data results. Results. 41 patients have used MedQuizBot, 27 patients were in the control group. Patients who used the bot more often answered asthma control test questions. Patients over 12 years old have completed the asthma control test less often than young children: ACT was filled on average in 1.5 times, САСТ — 1.8 times. 51% of patients filled in data on peakflowmetry via the new technology, patients from control group did not start the picflowmetry diary. Patients under 12 years old, who filled up the test with their parents, has entered picflowmetry data 7 times more often than adolescents. The asthma was under control in 70% of patients. The data was entered into the system 2.5 times more often during the lockdown period due to COVID-19 pandemic and during the tree flowering season in comparison to other periods of 2020. Patients noted the usability of the MedQuizBot and agreed to use it in future. Conclusion. MedQuizBot is effective in achieving asthma control mainly during the period of need — in case of insufficient control over the disease itself (exposure to pollen allergens, acute respiratory diseases), during the limitations in medical care availability.
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In December 2019, the world became aware of an epidemic of a very severe infection caused by a new coronavirus. Later, WHO declared a pandemic. The pediatricians were ready for the worst. The novel infection was expected to promptly spread among the most vulnerable population, children. But the clinicians soon understood that the situation is unbelievable: adults develop severe disease and die, while the children remain almost excluded from the infection spreading. 9 months have passed in the “new reality”. The humankind was learning to respond to the new infection challenge by empirical search for the potential therapeutic and diagnostic solutions and conducting wide clinical studies in parallel. A few questions have been answered because of consolidated and/or isolated actions of researchers and clinicians at the national, regional, and international levels. However, most aspects of how the new coronavirus affects the humans, including children, is still unclear and our knowledge of these aspects cannot be transferred in the routine practice. This review presents latest understanding of the course of the novel coronavirus infection in children, its treatment and outcomes. © 2020 Medical Education. All rights reserved.
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Dear friends, colleagues! The number of cases of new coronaviral infection has begun to decrease over the past two months, whereas, the number of publications on the accumulated experience of diagnosis, management and rehabilitation is increasing. It allows us to share knowledge and enhance our tactics. We present updated data on SARS-CoV-19 coronavirus and the disease it causes in this review.
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The COVID-19 infection caused by the new coronavirus SARS-CoV-2 has become the real pandemic. Children account for 1-6% of all diagnosed COVID-19 cases. Generally, children have mild disease in comparison to adults, and their mortality rates are extremely low. Despite the fact that all the main efforts of the medical and political community are now focused on preventing the pandemic spread and organizing medical care for patients with moderate and severe COVID-19 course, we still have to remember to implement adequate help for patients with chronic diseases, especially for children with allergic diseases. The pandemic period coincided with natural weather period of dusting of causative plants, that led to annual escalation of both allergic rhinitis and asthma in patient group with specific sensitization to tree pollen. Leading experts of allergology (adapting to modern conditions) have created key guidelines on management of children with allergic diseases during the COVID-19 pandemic. These guidelines are based on the data and results from the Union of Pediatricians of Russia, Russian Association of Allergologists and Clinical Immunologists, European Academy of Allergy and Clinical Immunology (EAACI), European Respiratory Society (ERS), American Thoracic Society (ATS), Global Strategy for Asthma Management (GINA), Initiative on Allergic Rhinitis and its Impact on Asthma (ARIA/MACVIA).
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There is crucial question on further therapeutic tactics for the management of such patients (within the severe epidemiological situation caused by the pandemic of new coronavirus SARS-CoV-2) due to widespread application of genetically engineered biologic drugs (GEBD)in management of immune mediated inflammatory diseases. This review sums up current data on the pathogenesis of COVID-19 with the development of acute respiratory distress syndrome associated with cytokine release syndrome (cytokine storm). The effects of GEBD on COVID-19 pathogenesis and their role in management of COVID-19 severe forms of are considered. This review presents the latest guidelines of international associations/consensus and observations of doctors of various specialties on the issue of interruption/continuation of GEBD therapy and with further consequence evaluation in case of interruption of biological therapy.