The greatest contribution to the development of gerontopsychology, the actual psychological concept of old age, was made by Erik Erikson’s theory of the eight stages of personality development. Each stage of the life cycle is characterized by a specific task that is put forward by society, and each stage has a specific goal in achieving one or another socially valuable quality (65).
The eighth stage of the life path - old age - is characterized by the achievement of a new, completed form of ego identity. A person who has shown concern for people and has adapted to the successes and disappointments inherent in life, in the parent of children and the creator of things and ideas, acquires the highest level of personal integrity. E. Erickson notes several components of this state of mind: this is an ever-increasing personal confidence in one’s commitment to order and meaningfulness; this is the acceptance of one’s life path as the only one that is due and does not need to be replaced; this is a new, different from the previous, love for your parents; it is a sympathetic attitude towards the principles of past times and various activities as they manifested themselves in human culture. The task of an elderly person, according to Erikson, is to achieve the integrity of the development of one’s Self (Ego), confidence in the meaning of life, as well as harmony, understood as the essential quality of life of an individual and the entire Universe. Harmony is opposed to disharmony, perceived as a violation of integrity, which plunges a person into a state of despair and despondency. The implementation of this task leads a person to “a sense of identity with himself and the duration of his individual existence as a certain value, which, even if necessary, should not be subjected to any changes.” Despair can only occur when one realizes failure in life and lacks time to correct mistakes. Despair and dissatisfaction with oneself in an elderly person often manifest themselves through condemnation of the actions of others, especially young people. According to E. Erikson, achieving a sense of fullness of life, fulfilled duty, and wisdom is possible in old age only if the previous stages have been positively completed. If the most important tasks of previous ages were not realized, old age is accompanied by disappointment, despair and fear of death (65).
E. Erikson's theory aroused great interest among psychologists and was later expanded by R. Peck (120). R. Peck believed that in order to achieve “successful old age,” a person must solve three main tasks, covering three dimensions of his personality.
Firstly, this is differentiation, this is transcendence versus absorption in roles. In the course of professional activity, a person is absorbed in the role dictated by the profession. Elderly people, in connection with retirement, must determine for themselves a whole set of meaningful activities so that their time is completely filled with various types of activities. If people define themselves only in terms of their work or family, then retirement, changing jobs, or children leaving home will cause a surge of negative emotions that the individual may not be able to cope with.
Second, there is transcendence of the body versus preoccupation with the body, a dimension that has to do with the individual's ability to avoid becoming overly focused on the increasing ailments, pains, and physical ailments that accompany aging. According to R. Peck, old people should learn to cope with deteriorating health, distract themselves from painful sensations and enjoy life primarily through human relationships. This will allow them to “step” beyond their preoccupation with their body.
Finally, ego transcendence versus ego preoccupation is a dimension of particular importance in old age. Old people must understand that although death is inevitable and may not be too far away, it will be easier for them if they realize that they have contributed to the future through the raising of their children, through their deeds and ideas. People should not indulge in thoughts of death (or, as R. Peck puts it, should not plunge into “ego night”). According to E. Erikson's theory, people who face old age without fear and despair transcend the imminent prospect of their own death through participation in the younger generation - a legacy that will outlive them (120).
Like Erikson's stages, none of Peck's dimensions are limited to middle age or old age. Decisions made early in life act as the building blocks from which all adult decisions are made, and middle-aged people are already beginning to resolve the problems of coming old age (29).
4. Approaches to periodization of the second half of a person’s life
Age periods occurring in the middle and end of the life cycle are more difficult to characterize: individual-typical differences increase with age. Personal development at each stage of maturity depends on the life plan and its implementation, “the roads that we choose.” Along with the content, the boundaries of the periods also become less defined. When analyzing the development of a mature personality, one should proceed not so much from general patterns, but from development options.
At the same time, there are periodizations of adult development. They reflect ideas, sometimes completely different, about a holistic life path, tasks to be solved, experiences and crises. The age range of periods is most often determined as follows. The boundary of youth and youth is set at about 20-23 years, youth and maturity - 28-30 years, sometimes it is pushed back to 35 years, the boundary of maturity and old age - approximately 60-70 years. Some periodizations highlight decrepitude. The final boundary of life is especially difficult to define. According to modern statistics, in developed Western countries it is 84 years for women and 77 years for men. But individual differences are so great that some centenarians extend their final age to 100 years or more.
Consider, as an example, two different periodizations of the development of a mature personality: S. Bühler and R. Gould, D. Levinson, D. Weillant.
Highlighting five phases of the human life cycle, S. Bühler focuses on maturity - the time of flourishing; After 50 years, aging begins, coloring life in gloomy tones.
The periodization of American psychologists R. Gould, D. Levinson, and D. Vaillant is more optimistic. In a person's adult life, they emphasize two crises - 30 and 40 years; the rest of the time, including in old age, peace of mind sets in.
| Age | Psychological content of the age period |
| 16-22 years | The time of growing up, the desire for independence, uncertainty. Leaving the parental home |
| 23-28 years old | Awareness of oneself as an adult with his rights and responsibilities, the formation of ideas about his future life and work. Meeting your life partner and getting married |
| 29-32 years | Transition period: previous ideas about life are not entirely correct. Sometimes life is rebuilt |
| 33-39 years old | “Storm and Drang”, as if the return of adolescence. Family happiness often loses its charm, all efforts are put into work, what has been achieved seems insufficient |
| 40-42 years | Explosion in midlife: the impression that life is being wasted, youth is lost |
| 43-50 years | New balance. Attachment to family |
| After 50 years | Family life and children's successes are a source of constant satisfaction. Questions about the meaning of life, the value of what has been done |
Social problems of food hygiene
Normalization of the population's nutrition is a major socio-economic and political problem, the relevance of which is increasing due to the progressive increase in the human population, currently approaching 4 billion. Moreover, every week it increases by approximately 1 million 200 thousand and, according to reasonable forecasts , will exceed 6 billion people by the year 2000.
At the same time, such a sharp increase in population is not accompanied by a corresponding increase in the production of food resources. The latter is all the more alarming because already, according to UNESCO, about 66% of the world's inhabitants are constantly undernourished.
It is also estimated that the population of developing (former colonial) countries has 1/3 less calories in their daily diet, almost 2 times less protein and about 5 times less animal protein than residents of developed countries.
One of the main consequences of quantitative insufficiency and qualitative inferiority of food is the development of such a specific disease as kwashiorkor, which causes the death of hundreds of thousands of children. This disease is characterized by extremely low protein digestibility, stunted growth, dystrophy, changes in the skin, severe liver damage, symptoms of cretinism, etc.
However, an analysis of the circumstances causing the shortage of food resources in many countries of the world allows us to conclude that population growth does not play a decisive role. Moreover, the current level of science and technology is quite sufficient to ensure an abundance of food for all humanity, the main obstacle is the capitalist system itself.
This once again confirms the validity of V.I. Lenin’s statements that the main cause of hunger on Earth is social inequality and the polarity of wealth distribution under capitalism.
As a result, food production has never actually reached its full capacity, since entrepreneurs are only interested in the profits they make, and not in meeting the basic needs of humanity. It was this circumstance that ultimately led to the creation of that extremely difficult and serious situation when a sharp increase in population growth rates exceeds the quantitative indicators of the increase in food resources.
Thus, one of the most important problems of our time is to find the most effective methods for progressively increasing food reserves for the current and future inhabitants of our planet. This equally applies to particularly advantageous methods of food production, new sources of nutrients, the biological value of certain food products, rational methods of storing them, etc.
When solving all these issues, it is necessary, first of all, to keep in mind the elimination of the global protein deficiency, since more than half of humanity is in a state of high-quality protein starvation. At the same time, in the current century, the basis of the population’s nutrition will be traditional food products of natural origin, to satisfy the demand for which it is quite possible with the appropriate intensification of agricultural production.
In conclusion, it should be emphasized that in a socialist society there is every opportunity for a radical solution to the food problem, both in terms of quantitative and qualitative indicators of planned food production. According to the successful expression of A. A. Pokrovsky, the entire sphere of food production can be defined as the main preventive workshop of the health industry.
“Hygiene”, V.A. Pokrovsky
In the same section:
The importance of nutrition for public health
It must be emphasized that nutritional conditions can obviously have a certain influence on the development of not only an individual, but also several generations. According to some researchers, these conditions even contribute to the formation of a certain type of neuropsychic organization. “Good nutrition,” wrote G.V. Khlopin, is the basis of public health, since it increases the body’s resistance to pathogens...
Food hygiene assessment
When hygienic assessment of the population's nutrition, it is necessary to pay special attention to the content of those nutrients whose chemical structures are not synthesized by the body's enzyme systems. These substances, called essential nutritional factors, are necessary for the normal course of metabolic processes, and these include some amino and polyunsaturated fatty acids, vitamins and mineral elements. Along with the concept...
Basic principles of food rationing for the population
The most important task of food hygiene is the study of quantitative and qualitative indicators of a person’s diet, taking into account the various conditions of his life and activity. Thus, when determining the appropriate standards, it is necessary to proceed from the data of a detailed study of the body’s energy expenditure, indicators of protein, fat, carbohydrate, vitamin, mineral and water metabolism. At the same time, the need for the specified...
Energy assessment of diet
Since in the process of nutrition the body, first of all, receives the energy necessary for life processes, its energy value, or calorie content, is an integral quantitative measure for assessing the food consumed. As is known, energy costs consist of costs for basal metabolism, the specific dynamic action of nutrients and muscle work. For the adult working population, the most important...
Daily caloric intake
Known differences in daily caloric intake depend on the living conditions of the population, and in cities with developed public services there is a decrease in the body’s energy expenditure due to the presence of water supply, sewerage, central heating, public transport systems, etc. This explains the large value of the corresponding indicators recommended for rural residents. Finally, when estimating calories...
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LECTURE 2
Social and hygienic problems of the most common socially significant diseases (tuberculosis, alcoholism, substance abuse, cancer, etc.)
Social hygiene studies problems characterizing the health of the population (morbidity of various population groups, demographic processes, disability, physical development), and problems of organizing health care. The results of social and hygienic research play a big role in preventing morbidity and reducing mortality in the country's population.
The most relevant study is: 1) the dependence of people’s health on the method of production and environmental factors; 2) general morbidity and its connection with the environment, including infectious morbidity; morbidity with temporary disability; social diseases, i.e. diseases with a pronounced social nature (tuberculosis, venereal diseases, trachoma, alcoholism, injuries, occupational diseases, some cardiovascular and neuropsychiatric diseases, etc.). Factors in the social environment that influence the health of the population include work, housing, nutrition, recreation, physical education and sports. The social environment is also characterized by the state of medical care to the population - its volume and quality.
Demographic processes and their connection with the social environment and living conditions are subjected to in-depth study: fertility, general and infant mortality, natural population growth, life expectancy and longevity issues.
Of great importance is the development of issues directly related to the organization of healthcare: treatment and preventive care for the urban and rural population - clinical examination, outpatient and inpatient care for adults and children, obstetrics; therapeutic and preventive assistance to workers of industrial enterprises; sanitary and anti-epidemic organization; issues of training, specialization and improvement of doctors, paramedics, the use of medical personnel, the scientific organization of their work. Social hygiene contains the study of issues of management, economics, planning and accounting in the field of health care: prospects for the development of health care, standards of medical care for the population and labor of medical personnel, sanitary statistics.
The peculiarity of social hygiene methods is a comprehensive solution to health-related problems, the development of measures arising from a combination of socio-economic factors affecting the health of the population. Studying the health of the population, social hygiene combines data from many sciences: housing and communal hygiene, occupational hygiene, nutrition, hygiene of children and adolescents, as well as clinical disciplines and the history of health care.
Hygienic diagnostics at the present stage
The concept of “diagnosis” (recognition) is usually associated with clinical, i.e., therapeutic medicine. Obviously, this concept can be extended to other phenomena of nature and society, including environmental factors. This was noted in his writings by the founder of hygiene in Russia, who called on doctors to diagnose the “sanitary ailments” of society, to form hygienic thinking, by which he understood the ability to diagnose and eliminate these ailments. He rightfully considered the methodology for recognizing, studying and assessing environmental conditions to be identical to that for determining and recognizing human conditions in the process of diagnosing a disease.
Modern hygienic diagnostics is a system of thinking and action aimed at studying the conditions of the natural and social environment, human health (population) and establishing the relationship between the state of the environment and health. It follows from this that hygienic diagnostics has three objects of study - environment, health and the connection between them. At present, the first object - the environment - is the most studied, the second is worse, and the third is very little studied.
In methodological and methodological terms, hygienic diagnostics differs significantly from clinical diagnostics.
The objects of hygienic prenosological diagnostics are a healthy person (population), the environment and their relationship. The object of clinical (nosological) diagnosis is a sick person and, very fragmentarily, only for informational purposes, are the conditions of his life and work. The subject of clinical diagnosis is the disease and its severity; The subject of hygienic pre-nosological diagnostics is health and its magnitude.
Hygienic prenosological diagnostics can begin with the study or, in any case, with the assessment of available data about the natural and social environment surrounding a person, and then move on to the person (population). Clinical diagnosis begins directly with the patient, who already has both complaints and symptoms. They must be linked into a logical scheme and compared with the model of the disease existing in textbooks, manuals and the model of the disease that has developed as a result of experience. Knowledge of the environment here plays a secondary role; it is almost not needed directly for diagnosis, because the result of the action of the environment is obvious, and in manifest form.
The ultimate goal of hygienic prenosological diagnostics is to establish the level and magnitude of health, clinical - to determine the disease and its severity. It follows from this that when carrying out hygienic pre-nosological diagnostics, the state of the body’s adaptive reserves must first be assessed, and then the functions and structures that may generally be intact, especially the structure. In clinical diagnostics, on the contrary, disturbances in structure, function, and, less often, the state of adaptive reserves are most often detected.
Summarizing all of the above, it should be emphasized that hygiene is a preventive science. It is at the present time that we are at that stage in the development of medical science when the question arises of revising the preventive direction of our entire health care and its deeper implementation in medical practice. Therefore, these days the words are perceived with particular relevance: “Preventive medicine is etiological, pathogenetic and social medicine at the same time; it is medicine of scientific and active multilateral influence on both the sick person and the environment.”
In all civilized countries, preventive medicine is generally recognized and the most effective. Attempts to introduce a system of medical examination of the population in our country as a method of prevention did not produce a noticeable effect. Among the reasons for the failure, along with the lack of structures and mechanisms allowing for the development of prevention, it should be noted the disinterest in carrying out this work by practical doctors, and poor training of students in medical institutes in this area of work.
The main task of prevention in current conditions should be considered not to identify early signs of diseases, but to improve the health status of those examined and the use of methods of influencing people that prevent the occurrence and development of diseases.
Environmental health is a medical and social problem
Ensuring good health of people is associated with the correct approach to solving issues of environmental protection, improving working conditions, life and recreation of the population. In recent years, the social, economic and political importance of environmental protection measures has increased significantly in the country. Evidence of this is the most difficult socio-ecological situation in a number of Russian cities (Norilsk, Novokuznetsk, Nizhny Tagil, Chelyabinsk, Angarsk, etc.). The impact of the environment on a person’s lifestyle can be considered from several perspectives: 1) impact that strengthens human health, increases his protective forces and ability to work; 2) impact that limits life activities; 3) a harmful effect on the body, as a result of which a disease occurs or the functional state of the body worsens.
Modern methodology has made it possible to formulate a fundamental position on the cause-and-effect relationships between lifestyle, environment and health of various population groups. It has been established that the basis of the adverse effects of the environment is a decrease in the nonspecific resistance of the body under the influence of adverse factors. Human interaction with the environment is an integral part of his lifestyle. Active support from legislative and government bodies and the press should contribute to the targeted implementation of health-improving activities in the process of work, household and recreational activities. Sociological and hygienic studies have shown the need to optimize the human environment in residential and public buildings (microclimate, living space, availability of amenities, possibility of privacy, etc.) and eliminate the influence of unfavorable endogenous and exogenous factors.
The use of modern statistical techniques has made it possible to establish that a higher level of morbidity in the population depends not only on the adverse effects of environmental factors, but also on a number of biological, socio-economic and climatic-geographical parameters, lifestyle, and social conditions. The noted features confirm the importance of the correct methodological approach to studying the influence of the environment on health. The relationship between the main characteristics of the lifestyle and health of workers and the impact of the industrial, residential and natural environment has been identified. Pollution of atmospheric air, water and soil is a factor that not only creates uncomfortable living conditions, but also largely (10–20%) determines the level of morbidity, which, in turn, affects lifestyle indicators.
There is a dependence of the incidence rates of diseases of the respiratory system, digestion, cardiovascular system, endocrine system, etc. on the level of atmospheric air pollution. It has also been proven that the mortality rate of the population increases with constant exposure to various harmful environmental factors. Among family members with a high degree of healthy active interaction with the environment, rates of temporary disability for diseases of the respiratory system, cardiovascular and nervous systems are significantly lower. At the same time, it should be noted that there has been a significant increase in the indicators of VUT among those traveling to garden plots and dachas (diseases of the musculoskeletal system, peripheral nervous system, household injuries, inflammatory diseases of the female genital organs, etc.).
In areas with high levels of air pollution, there is an increase in general morbidity, incidence of respiratory diseases, a decrease in the health index, and an increase in the proportion of people who are frequently ill. Using the method of directed selection, it is possible to select such copy-pairs of population groups that are concentrated in the zone of influence of the factor being studied or outside it and are homogeneous in terms of working conditions, social composition, and living conditions. Such a selection of groups makes it possible to assess the characteristics of lifestyle, forms of life activity, the importance of living conditions, and the influence of bad habits at the individual and family level.
Recently, much attention has been paid to the study of long-term consequences of the influence of an unfavorable environment on health - mutagenic, gonadotoxic and embryotoxic effects. The object of observation can be the entire population of a city, region (regional level), individual groups (group level), as well as a family or its individual members (family or individual level).
The development and implementation of health measures aimed at reducing the number of diseases at the regional level involves coordination of the actions of all services (medical and non-medical), environmental forecasting, and socio-ecological planning. At the group (production-collective) level, it is possible to effectively carry out operational management, planning and regulation of medical, sanitary and technical measures, and evaluate their social, economic and medical effectiveness. At this level, it is possible to identify a number of local industrial and household factors that have a significant impact on the formation of risk groups and the development of conditions that precede the disease.
The family (or individual) level makes it possible to program forms of primary prevention, professional selection, the optimal choice of “health routes”, optimize family (or individual) conditions and lifestyle, and identify the initial signs of diseases.
The problem of tuberculosis, after a period of loss of interest in it, every year attracts more and more attention from the medical community and the population. This is due to an increase in incidence and the emergence of severe forms of tuberculosis with fatal outcomes in Western Europe, the USA, and also in Russia. Meanwhile, quite recently, tuberculosis was considered an endangered disease. The timing of its elimination on Earth and, first of all, in economically developed countries was calculated; epidemiological indicators for the elimination of tuberculosis were even determined; first, it was an infection rate of no higher than 1% under the age of 14 years, then other criteria, including the annual risk of infection and, finally, the incidence rate: 1 case of identifying a patient with pulmonary tuberculosis secreting Mycobacterium tuberculosis per calendar year per person 1 million population, then 1 case per 10 million people.
In 1991, the WHO General Assembly was forced to acknowledge that tuberculosis is still a priority international and national health problem not only in developing countries, but also in economically highly developed countries. More than 8 million people worldwide fall ill with tuberculosis every year. 95% of them are residents of developing countries; 3 million die from tuberculosis every year. It can be expected that 30 million people will die from tuberculosis in the next 10 years; Meanwhile, 12 million of them could be saved with good organization of early detection and treatment of patients. WHO characterizes the current situation as a crisis in global tuberculosis policy.
Attention to tuberculosis as an infectious disease and public health problem has increased sharply due to reports of an increase in incidence in Western and especially Eastern Europe, as well as in the United States. In the USA, for example, the number of registered patients increased by 14% from 1983 to 1993. Of the 25,313 newly identified patients, the majority were people aged 25-44 years; an increase in incidence by 19% was noted in the age group from 0 to 4 years and by 40% among children from 5 to 14 years. In the countries of Central and Eastern Europe, in addition to an increase in the incidence rate, there is an increase in the mortality rate from tuberculosis, which averages 7 cases per population, which is significantly higher than the mortality rate in Western European countries (from 0.3 to 2.8 cases per population.
reasons for the increase in morbidity and mortality from tuberculosis:
deterioration in the living standards of a large group of the population, in particular deterioration in nutrition with a sharp decrease in the consumption of protein products; the presence of stress due to an unstable political situation, military clashes and wars in a number of regions;
a sharp increase in the migration of large groups to settlements that are practically out of sight of treatment and preventive institutions and are not covered by health-improving measures in general and anti-tuberculosis measures in particular;
reducing the scale of anti-tuberculosis measures, especially in terms of prevention and early detection of tuberculosis in the adult population, in particular in socially maladjusted groups and high-risk groups;
an increase in the number of patients with severe forms of the disease, especially those caused by drug-resistant mycobacteria, which complicates effective treatment and contributes to the development of irreversible chronic forms and high mortality.
These reasons led to the loss of “controllability” of tuberculosis in conditions of a large reservoir of tuberculosis infection and high infection of the population, i.e., in the presence of carriers of persistent variants of the pathogen formed as a result of a primary tuberculosis infection and capable, under appropriate conditions, of causing reactivation of residual tuberculosis foci. The level of infection, as is known, depends on the size of the reservoir of infection, the basis of which is patients who pose an epidemiological danger, i.e., spreading mycobacteria among others. In a number of regions there is an additional reservoir of infection - cattle affected by tuberculosis.
In addition, one should keep in mind the large number of patients with contagious forms of tuberculosis in neighboring countries surrounding Russia, as well as in developing countries, which, with a high level of migration, creates conditions for migrants to become ill and transmit the infection to others. Currently, the number of sick adults has undoubtedly increased due to exogenous infection and superinfection. This is confirmed by an increase in the number of people with initial resistance of Mycobacterium tuberculosis to chemotherapy among newly identified patients.
In the current situation, the urgent task is to strengthen and expand anti-tuberculosis activities in conditions of limited and even insufficient funding. Of particular importance is the determination of their priority, taking into account their effectiveness and ability to influence the epidemiological situation and restore lost opportunities to “manage” tuberculosis infection.
Currently, tuberculosis is one of the pressing health problems around the world.
The Government of the Russian Federation pays considerable attention to the problem of tuberculosis in the country. The main goal of the measures being implemented is to reduce the incidence and mortality of the population from tuberculosis.
Thanks to the ongoing anti-tuberculosis work in recent years in the Russian Federation, it was possible to stop the growth of these indicators, but they continue to remain at a high level, and there is an increase in the spread of multidrug-resistant tuberculosis and tuberculosis combined with HIV infection. The proportion of patients with chronic forms of tuberculosis remains significant.
In 2011, in the Russian Federation, according to operational data, the incidence of active forms of tuberculosis (newly identified) among the resident population decreased by 4.7% compared to the previous year and amounted to 66.66 per 100 thousand population.
A particularly difficult situation remains in the Siberian and Far Eastern federal districts, where the incidence of tuberculosis is almost 2 times higher than the incidence in federal districts located in the European part of the country.
Despite the general downward trend in the incidence of newly diagnosed active forms of tuberculosis, the incidence among children under 17 years of age inclusive has remained virtually unchanged over the past two years and amounted to 18.5 cases per 100 thousand children in the reporting year.
The maintenance of epidemiological problems with regard to tuberculosis is facilitated by violations of legislation in the field of preventing the spread of tuberculosis: low coverage of the population with preventive examinations for early detection of the disease, deficiencies in the organization of preventive and anti-epidemic measures in the foci of tuberculosis at the place of residence of patients, conditions for infection of patients and staff that persist in anti-tuberculosis institutions .
The issues of treatment and follow-up of tuberculosis patients who evade treatment and represent a dangerous source of tuberculosis infection, including drug-resistant forms, have not been resolved.
The high infection and incidence of tuberculosis in children indicates the presence of sources of infection among the population. Tuberculosis in children is also caused by parents' refusal to give their children vaccinations and tuberculin diagnostics.
The spread of tuberculosis is facilitated by increased migration processes.
In 2011, among foreign citizens who underwent a medical examination in order to obtain a work permit in the Russian Federation, 2.6 thousand people were identified as suffering from active pulmonary tuberculosis.
In just 5 years, more than 14 thousand people with tuberculosis were identified among foreign citizens who arrived on the territory of the Russian Federation to carry out legal work activities. About 20% of the identified patients are treated annually in Russian hospitals, 9-17% leave the country, including for treatment in their country of residence. The rest remain on the territory of the Russian Federation and continue to work illegally, being a source of tuberculosis infection, the most dangerous in the places where they live and work.
The illegal stay and work activity on the territory of the Russian Federation of a significant part of foreign citizens makes it impossible to carry out anti-tuberculosis measures among this group, including preventive examinations for tuberculosis.
In accordance with the resolution of the Government of the Russian Federation, Rospotrebnadzor is authorized to make decisions on the undesirability of the stay (residence) of a foreign citizen or stateless person on the territory of the Russian Federation, if he is diagnosed with tuberculosis and it is impossible to carry out his treatment on the territory of the Russian Federation.
In 2011, to make a decision on the undesirability of staying in the Russian Federation, 1,356 cases of foreign citizens with tuberculosis were considered, and a decision was made in relation to 710 people.
According to data provided by the Rospotrebnadzor departments, in 2011, 427 foreign citizens with tuberculosis left the territory of the Russian Federation on their own, 29 people were deported.
The epidemiological situation regarding tuberculosis in institutions of the penitentiary system remains a problem. Despite a significant decrease in the incidence and mortality from tuberculosis in these institutions over the past 10 years, they remain a significant reservoir of tuberculosis infection. Today, there are 35 thousand tuberculosis patients in FSIN institutions. It should be noted that every year more than 4 thousand tuberculosis patients are identified at the level of pre-trial detention centers, which indicates low efficiency in identifying sources of infection among socially problematic individuals in the civilian healthcare sector.
One of the current components of the problem of epidemiological problems with tuberculosis in the Russian Federation is the incidence of tuberculosis in cattle.
According to Rosselkhoznadzor, in 2011, diseases of cattle tuberculosis were registered in the Kursk, Oryol, Saratov, Novosibirsk regions, the republics of Mordovia, Chechnya, and Ingushetia.
In the second half of 2011 6 new unfavorable points were identified in the Tula, Orenburg, Novosibirsk, and Nizhny Novgorod regions.
According to the Federal State Statistics Service, over the past decade, the consumption of recorded alcohol per capita in the country has steadily increased and by 2009 had increased 0.7 times (to 9.13 liters of absolute alcohol) compared to 1999 (7.9 l), and decreased compared to 2008 (from 9.8 l – 2008 to
9.13 l - 2009).
However, real per capita alcohol consumption, taking into account the turnover of alcohol-containing
of burning products, including perfumes and cosmetics, household chemicals and other types of products, in the Russian Federation is about 18 liters. These officially registered indicators do not fully reflect the real picture, since they do not take into account the volume of illegally produced products
In 2009, there was a slight decrease in the sales of alcoholic beverages
village compared to 2008. Thus, the sale of beer decreased from 1,138.2 liters to 1,024.7 liters, vodka and liquor from 181.2 liters to 166 liters, the sale of grape and fruit wines increased from 101.9 liters to 102, 5 l, sales of cognacs remained at the same level (10.6 l). Carrying out activities aimed at preventing the negative impact of alcoholic beverages on public health remains a priority. In pursuance of the resolution of the Chief State Sanitary Doctor of the Russian Federation “On the supervision of alcoholic products,” in 2010 Rospotrebnadzor specialists carried out 6,680 raid inspections of enterprises involved in the production and circulation of alcoholic products. As part of the implementation of measures to control the production and circulation of alcohol and alcoholic products, Rospotrebnadzor organizations conducted a study of 7,310 samples of these products, of which 3.18% did not meet hygienic standards for safety indicators.
In 2010, the largest number of samples of alcoholic beverages and beer was
studied in the Central Federal District (sample), while the largest share of products that do not meet hygienic standards was noted in the Ural Federal District (10.40%).
In 2010, according to research results, 1,035 batches of alcoholic beverages were rejected
drinks and beer in a volume of l. Based on the results of the inspections, 82 decisions were issued to suspend the operation of facilities engaged in the production and circulation of alcoholic beverages, 1,856 fines were imposed, and 45 cases were referred to law enforcement agencies.
In 2010, cases of alcohol-containing alcohol poisoning were registered.
duction, and of these with a fatal outcome (25.4%). The majority of poisonings occur in the adult population (18-99 years old) and account for 92.7% of the total number of poisonings with alcohol-containing products.
According to the World Health Organization, alcohol consumption
responsible for nearly 2 million deaths and 4% of illnesses worldwide each year. According to medical statistics, today 2.8 million Russians are involved in heavy, painful drunkenness, which is 2% of the total population of the country.
Literature:
1.A. G. KHOMENKO Central Research Institute of Tuberculosis of the Russian Academy of Medical Sciences, Moscow
2. “Public health and healthcare.” Medicine Publishing House. 2002
3. 3., Kozeeva hygiene. - M., 1985.
4. State report “On the sanitary and epidemiological situation in the Russian Federation in 2010”
At 16, listening to the conversations of experienced women who, at 37, no one needs with children, I wanted to ask: do you need you for yourself? But in those years it was not customary to ask adults questions.
When I was a young lady, women at 40 seemed to me dull and boring old women. They seemed like that to themselves: youth was gone, old age did not come, the alarming timelessness was colored by loud divorces - yet another unfaithful husband ran to a young woman. The young women wore short skirts and bright lipstick, laughed wildly and did not know how to cook. The ex-husbands cooked - ineptly and poorly. Ex-wives pursed their lips and mournfully shared the sad “Who needs me, at 37, with children.”
The cult of youth, to whom everything is allowed, is still thriving. It’s just that youth today is not a calendar concept, but a purely visual one. Do you look 40/30? Well done! And they’ll get you a job, and they’ll settle down with your personal life, and they’ll make friends with such people more willingly and more actively (especially on social networks, where friendship is expressed in a stingy like, and being beautiful is much easier than in reality), and they’ll hate you more intensely, and you’ll look in the mirror nicer.
Being young and beautiful today is like brushing your teeth. A question of social hygiene.
People are greeted by their clothes and escorted by their minds, says popular wisdom. My experience says that they also escort you based on your clothes; no one’s mind has given up. As well as a broad soul, and a subtle mental organization, and a deep inner world (try to imagine a kind of cadaver in three-dimensional space).
Of course, reader, this is not about you. You don’t look at the external, but pierce the inner essence. Wisdom speaks in you! And a little self-deception.
Because they communicate with a cheerful, cheerful and nice person much more willingly than with a very smart, but boring, boring and ugly person.
I, as an ugly and boring bore, have known this since childhood. Even the “I’ll let you write it off” option does not guarantee people’s love. Especially after graduation.
C-grade slobs, jokers and bon vivants suddenly make rapid careers, overtaking arrogant excellent students. C students know how to make an impression, and this impression does half the work for them in the matter of self-promotion.
Excellent students go to “How to Succeed” trainings. They (us) are taught the skill of keeping silent in time when once again you want to talk about Plutarch.
The services of stylists are no less in demand than the services of life coaches. Forgive me, reader, for the anglicism, but there is no way to translate this concept into Russian. Russian is the language of harsh survivalists, we have the word “felt boots” and a fairy tale about porridge from an ax.
Stylists teach you to wear felt boots with force. Fashionable felt boots are decorated with embroidery, lace and rhinestones.
Nutritionists teach how to cook porridge correctly: for at least 20 minutes, instant oatmeal is equivalent to a bun, rinse the ax in filtered water.
Helping professions are becoming increasingly important. There is a huge demand for attractiveness in society.
Sometimes this demand goes beyond all boundaries and turns into fascism. Women torture themselves with diets because after size 50 there is no life. There are no clothes in stores either. It is impossible to find shoes that fit a full foot.
Slender women accuse fat women of laziness and lack of will.
The young trample on the egos of the aged.
The athletic ones inspect the loose ones with disgust.
Women in leopard print leggings basically despise everyone.
At a cosmetics store, my face is carefully examined by a consultant. Silent. He examines again. I understand that we probably need to think through the repertoire of the funeral orchestra.
“Well,” says the consultant, “a dense tone won’t work with your wrinkles. You need fluid, concealer, highlighter, misty powder, paint over green bruises under the eyes with pink, blue bruises with yellow, remove pigmentation with peelings.”
“These are freckles,” I say.
“Grhm,” the consultant smiles skeptically. She was trained not to argue with women under 40. “You also need a base for the shadows, otherwise the shadows will collect in the folds of the eyelid, this is normal at your age, don’t worry. And contouring. The shape of the face decides everything!”
The list of makeup products for creating a naturally youthful look was a couple of sheets, for a total of 50 thousand. This is if you save money.
If you save money, then a cosmetologist is cheaper. “Beauty injections,” as punitive cosmetology is often called, can prolong youth for a long time. It is not accepted in society to admit to cosmetic procedures.
Beauty injections are a special type of fraud: it’s time, woman, to think about grandchildren, but you are still eager to join the closed club of those laughing loudly. We’ve lived and had enough, it’s time to give up our place to a young, unfamiliar tribe. Peers are also despised. Carry your years with dignity! For them, a good-looking woman is worse than any young woman. He works in contrast, rides into heaven on someone else’s hump. And in general, the king is not real!
Someone else's appearance concerns both the young, slender and beautiful, and representatives of the other camp. There are no indifferent people. Everyone blames everyone, filled with a sense of righteous indignation.
Righteous indignation is generally a very nice feeling: you can express rage, and it seems like it’s not gossip or condemnation, but a fight for a just cause. There is a reason to unite with like-minded people, hold hands, sing hymns, shout slogans. Burn another witch at the stake of cyberbullying (and sometimes not cyber).
At 16, listening to the conversations of experienced women who, at 37, no one needs with children, I wanted to ask: do you need you for yourself? But in those years it was not customary to ask adults questions.
Now I’m 37 myself, I’m an adult matron with children. And I have a question. All the same.
Do we need ourselves? Or is our value measured by appraisers at the gender auction? As much as a stranger (or auntie) says, will they write?
Then go and guess whether such a lot is needed, not needed, and if needed, then who needs it. When will this someone come and take responsibility, because how long can you endure, really? Isn't it time to start losing weight? Or smear your face with highlighter? Spending your beautiful moment, and then another and another, until there are too many moments - for what?
Current problems studied by modern social hygiene:
Study of the theoretical and organizational foundations of healthcare
Studying the influence of social conditions and lifestyle on public health
Development of criteria for assessing public health
Development of scientific forecasts in the field of public health protection
Research on population issues and their links to public health
Study of urbanization processes study of human ecology
Study of the social, economic and medical significance of healthcare as a social system and the development of rational ways for its development
Study of the legal and ethical foundations of health care
Studying the needs of the population for medical care and its options in outpatient clinics and hospitals
Development of sanitary and epidemiological aspects of health care
Development of socio-economic and medical prevention measures
Development of a set of programs to reduce and eliminate the most common and severe diseases (tuberculosis, diabetes, AIDS)
Development of issues of planning and management of treatment and preventive care for the population.
Development of problems of health care economics and its financing
Development of activities to promote and implement a healthy lifestyle, hygiene training and education
Development of measures and actions in case of natural disasters and other extreme situations
Health“is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO).
3health– individual and social value of the highest rank; it cannot be replaced or supplanted by any other value or interest without significant damage to the fullness of the individual’s existence.
Health deficit imposes serious restrictions on the possibilities of individual and social functioning.
Population health is assessed by a set of demographic indicators: birth rate, morbidity, average life expectancy, level of physical development, mortality. The level of physical development and functional capabilities of the human body are displayed in digital indicators - health indices.
The main factors influencing the health of the nation:
Working conditions, nature and level of remuneration, work and rest schedule;
The level of employment-unemployment ratio, potential and actual threat of loss of job and social status;
Occupational hazards, i.e. exposure to harmful agents associated with the technology and/or organization of this type of activity;
Level and quality of food;
Living conditions;
Features of lifestyle;
Bad habits (or addictions: alcohol, drugs, food, etc.);
State of the environment;
Level and quality of healthcare development and sanitary condition of the territory.
Social hygiene and healthcare organization as a science and subject of teaching. ON THE. Semashko and Z.P. Soloviev - organizers of the first departments of social hygiene in Russia.
Social hygiene and health care organization is the science of public health and healthcare, and the social problems of medicine. Its main tasks are studying the patterns of influence of socio-economic conditions, factors and lifestyles of people on the health of the population, as well as its individual groups and theoretical justification for an effective system of state and public measures, ways and methods aimed at eliminating the influence of harmful environmental factors, ensuring a high level of health for all members of society, increasing the period of their active creative longevity.
In our country social hygiene scientifically substantiates public health policies. She plays a leading role in scientific substantiation preventive areas of medicine. Important sections are development of scientific foundations medical examination population as a method of activity of medical institutions, as well as analysis and evaluation techniques activities of these institutions. The development of scientific foundations of economics, planning and forecasting of healthcare, forms and methods of healthcare management is becoming increasingly important. Organizational issues have a large share in the overall complex of preventive measures. sanitary and epidemiological service, which performs the function of “protecting the health of the healthy”, as well as hygienic education of the population, the formation of a healthy lifestyle.
Nikolai Alexandrovich Semashko– doctor, Soviet party and statesman, one of the organizers of the healthcare system in the USSR,
In 1921-1949, Semashko was a professor, head of the department of social hygiene of the medical faculty of Moscow University (from 1930 - the 1st Moscow Medical Institute).
From 11.7.1918 to 25.1.1930 People's Commissar of Health of the Council of People's Commissars of the RSFSR.
From 1930 to 1936, Semashko worked at the All-Russian Central Executive Committee, holding the positions of member of the Presidium, chairman of the Children's Commission (she was entrusted with the fight against homelessness, management of treatment and preventive work in children's health institutions). In 1945-1949 - director of the Institute of School Hygiene of the Academy of Pedagogical Sciences of the RSFSR and at the same time (1947-1949) - the Institute of Health Organization and History of Medicine of the USSR Academy of Medical Sciences (since 1965, the All-Russian Research Institute of Social Hygiene and Health Organization named after Semashko). Initiator of the creation of the Central Medical Library (1918), the House of Scientists (1922) in Moscow. In 1927-1936, editor-in-chief of the Great Medical Encyclopedia. The first chairman of the Supreme Council for Physical Culture and Sports (since 1923), chairman of the All-Union Hygienic Society (1940-1949). Delegate to the 10th, 12th-16th Congresses of the All-Union Communist Party (Bolsheviks).
Zinoviy Petrovich Solovyov - doctor, one of the organizers of Soviet healthcare, Deputy People's Commissar of Healthcare of the RSFSR. In 1920-28 he headed the military sanitary service of the Red Army and the Executive Committee of the Russian Red Cross Society. On his initiative and with his active participation, the pioneer camp-sanatorium Artek and a number of children's health institutions were created in Crimea.
The leading representatives of the Russian intelligentsia in the mid-19th century - the revolutionary democrats - attached great importance to hygiene issues.
Formation of prerequisites for the emergence and development of social hygiene as a science and subject of teaching. The history of its development.
Need scientific substantiation of health and disease at the individual and, most importantly, at the group and population levels served as a prerequisite the emergence of social hygiene and health care organization. The practical embodiment of this need is the study and disclosure of the causes of the most common diseases of the population, identifying the social conditionality of health.
In the second half of the 19th century in Russia At the same time as Germany, hygiene developed. The conditions that contributed to this were basically the same as in other capitalist countries : the economic development of the country, which entered the capitalist socio-economic formation in the middle of the 19th century, the growth of industry, the increase in population in cities, the successes of natural science, the use of which made it possible to give hygienic factors an accurate expression, to study them quantitatively and qualitatively using the methods of the natural sciences. The high incidence of infectious diseases and mortality from them in Russia raised the question of improving public life in terms of hygiene and preventing these diseases. The social movement in Russia and the growth of revolutionary upsurge after the defeat in the Crimean War, the difficult sanitary and living conditions of the Russian peasantry, which determined the beginning of the revolutionary-democratic period of the Russian liberation movement, gave a special color to the development of hygiene in Russia in the second half of the 19th century and determined special original features in the activities of the majority of domestic hygienists, which sharply distinguished them from the hygienists of Western European countries.
In the second half of the 19th century, in Russia, Medical faculties of a number of universities began to create educational programs and courses for the study of public health. At Kazan University, for example, in the 60s. prof. A.V. Petrov gave lectures on public health. There in the 70s. prof. A.P. Peskov gave a course of lectures on medical geography and medical statistics. Subsequently, public health courses were introduced at the medical faculties of universities in Moscow, St. Petersburg, Kyiv, etc.
In the post-revolutionary period, the history of social hygiene in Russia dates back to the organization of the Museum of Social Hygiene in Moscow in 1918. In 1920, the museum was reorganized into a research institute for social hygiene and health care organization. Currently it is the leading center of social and hygienic science in the CIS.
From a historical perspective The roots of the term and definition of “social hygiene” are important. First in Russian literature term was used by a Russian social hygienist IN. Portugalov in the work "Issues of Public Hygiene".
Official emergence of social hygiene date back to the first decade of the 20th century and are associated with the name of a German doctor A. Grotjana. In 1903 he organized a journal of social hygiene, in 1905 he founded a scientific society of the same name, in 1920 he headed the first department of social hygiene in the history of medical education at the University of Berlin. Similar departments soon began to be organized in other university centers.
Tasks of social hygiene and health care organization as a science and subject of teaching. History of the Department of Social Hygiene of the Tyumen Medical Academy.
Social hygiene deals development scientifically based methods of prevention and elimination harmful influences of social factors and environmental conditions on health.
The objectives of social hygiene are:
1) study of the health status of the population and its individual groups in connection with the influence of environmental conditions;
2) development of principles of clinical examination and prevention of social diseases;
3) establishing a connection between the morbidity of the population and working conditions;
4) organization and conduct of recreational activities.