We describe the main components that form an accessible educational environment for people with disabilities. Based on the analysis of the regulatory legal framework of education, social protection and rehabilitation of people with disabilities, as well as theoretical, procedural and medical-expert bases of disability, the characteristics of the interrelated elements of accessibility in the system of vocational education of people with disabilities is given. The main legal acts of the Russian Federation, as well as international acts regulating the provision of accessible education and employment for the disabled are considered. We reveal that vocational education of people with disabilities is at the same time an integral part of the system of vocational rehabilitation of disabled people. We also emphasize that the independent way of life of people with disabilities should be ensured through the accessibility of the physical, social, economic and cultural environment. The importance of the rehabilitation component of the accessible educational environment for the people with disabilities is highlighted. This component includes the provision of assistance to the disabled person in the development of professional educational programs, the solution of related learning problems, formation of professional, social and psychological maturity of the disabled person. The importance of technical means of rehabilitation and architectural and planning aspects in creating an accessible educational environment for the disabled is noted. Taking into account all the necessary components will allow to create a system of affordable and quality vocational education for people with disabilities.
BACKGROUND: There is a need to optimizethe continuity between the various organizations involved in the rehabilitation of the sick and disabled. The application of the International Classification of Functioning, Disabilities and Health will allow overcoming the existing barriers of interdepartmental interaction. AIMS: to create a scoring system for persistent disorders of the blood and immune system as determinants of ICF in patients with HIV infection. MATERIALS AND METHODS: A random sampling method was used to perform a retrospective analysis of 100 protocols for conducting a medical and social examination of citizens with HIV infection and AIDS. The average age of those surveyed was 39 years. Men predominated (64%). The first group of disability is set at 21%, the second ― 45%, the third group ― 25%. RESULTS: The most significant persistent disorders of body functions in patients with HIV infection were identified in the immune system (p 0.01). CONCLUSIONS: The relationship between the severity of persistent disorders of the immune system and the disability group was revealed: among the disabled of the first and second groups, severe and extremely severe problems were statistically significantly more common (p 0.01), which confirms the possibility and necessity of using the international classification of functioning in people with HIV infection/AIDS in the form of a scoring as a way to reflect the quantitative characteristics of persistent disorders of the blood and immune system, including in disabled people.
The indexes primary and secondary disability among soldiers working and retirement age because of «military trauma» in dynamics for 2015-2016. From the military in 90% of cases disability is defined in the working age. The socio- hygienic analysis of the data on primary and secondary disability, carried out on a territorial basis, points to the heterogeneous share of disability indicators among military personnel in the Federal districts of the Russian Federation. It is revealed that the North-Caucasus, southern and Central Federal districts are the leaders in the establishment of primary disability and the total number of disabled people. The heterogeneous proportion of persons with disabilities recognized as members of the armed forces in different districts determines the need to analyse the conditions and grounds on which the disability was established. The implementation of the Federal comprehensive program «Accessible environment» and sub-programs aimed at the creation of the subjects of the Russian Federation of rehabilitation centers for patients and disabled people, due to the territorial characteristics of the prevalence of primary disability and the specifics of the category of persons with disabilities. Therefore, the data of the conducted social and hygienic analysis can serve as a basis for making organizational decisions on the creation of complex rehabilitation centers for disabled people from among former servicemen in the territories of the Russian Federation.
The expert characteristics of the clinical and functional status of the military personnel for the first time recognized as disabled in 2016 because of «military trauma» are considered. It is known that the objectification of methods of expert rehabilitation diagnosis in the implementation of medical and social expertise in the establishment of disability and the development of individual programs of rehabilitation/habilitation of disabled people-one of the main objectives of the concept of «Improvement of the state system of medical and social expertise and rehabilitation of disabled people.» In accordance with this provision, clinical and expert indicators are analyzed, confirmed by the data of expert rehabilitation diagnostics, allowing to objectify the impaired functions and structures of the body of soldiers who have received a military injury, when examined in the Bureau of medical and social expertise. The main clinical and functional syndromes that have expert significance and have influenced the adoption of expert decisions in the establishment of disability groups are presented. The article describes in detail the contraindicated and shown factors of the recommended labor activity, which should be guided in the employment of disabled people from among the former soldiers. The use of evidence-based recommendations in practice makes it possible to determine the forms and conditions of employment in normal or specially created working conditions for the rational employment and socialization of servicemen who have become disabled. Referring to the updated normative legal acts, taking into account the principle of inseparability of the medical and social examination procedure from the formation of individual programs of rehabilitation/habilitation of disabled persons, the authors illustrate the possibilities of professional rehabilitation and employment of military personnel who have different groups of disability due to «military trauma».
BACKGROUND: To improve social policy, along with the study of the mechanisms of public administration, it is important to analyze the trends in the development of the social phenomenon itself -the disability of the population. The need for a systematic analysis in the planning and regulation of social protection measures for the disabled and rehabilitation in order to minimize the risks of negative socio-economic consequences causes a comprehensive study and analysis of the formation of indicators of disability in the population of the Russian Federation within the framework of long-term follow-up.AIM: identification of medical and social characteristics of the state and trends of disability in the Russian Federation and St. Petersburg for 2015-2019. MATERIALS AND METHODS:The object of the research is a set of persons who were first recognized as disabled in St. Petersburg and the Russian Federation. Sourcesforms of state statistical reporting 7-social security. Research methods: analytical, expert assessment method, statistical.RESULTS: It was found that during the study period (2014)(2015)(2016)(2017)(2018)(2019) the indicator of the level of primary disability of the adult population of the Russian Federation tended to decrease. So, in 2015 it was 58.9 per 10 thousand people, adult population, in 2019 -53.1 per 10 thousand people. The dynamics showed an uneven rate of decrease in the level of primary disability with a peak of decline in 2016.An analysis of the indicators of people recognized as disabled for the first time by age showed that over 5 years the proportion of people with disabilities of working age decreased from 46.8% in 2015 to 42.3% in 2019.A study of the need for vocational rehabilitation measures for the first time recognized as disabled, in particular, the need to create special jobs for the employment of disabled people of groups II and I, showed that the specialists of the bureau of medical and social expertise identified the need to create special jobs for 27.7% (15 977 people), and the largest share of recommendations on the need to create a special workplace was issued to disabled people of group II -89.8% (14 341 people). It was found that the share of recommendations on the creation of special jobs for persons who were repeatedly recognized as disabled was 2.6 times higher than for those who were recognized as disabled for the first time, and averaged 72.3% (41 769 people), and recommendations were drawn up mainly group II disabled people -88.4% (36 937 people). CONCLUSIONS:In modern conditions, it is relevant to plan the socio-economic costs for the implementation of programs for the social and vocational rehabilitation of disabled people, the creation of conditions for employment in specific special jobs, which is important for organizing the optimal rehabilitation resource for the constituent entities of the Russian Federation.
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