Introduction. Preservation and growth of the country population is the top national priority in the Russian Federation. A contemporary approach focuses on several especially urgent demographic issues that can be resolved, among other things, due to public healthcare systems becoming more efficient. The present research work is vital due to the necessity to achieve target medical and demographic parameters fixed in the national and federal projects and regional programs. These parameters include life expectancy and mortality caused by cardiovascular and oncologic diseases. The goal of this work is a development of new approaches for the complex evaluation of potential management reserves of health population indicators and the prognosis of efficiency of targeted activities performed within public healthcare systems and aimed at increasing life expectancy through reducing mortality among the population caused by cardiovascular diseases and oncologic diseases. Material and methods. The work dwells on solving a “direct” task in the “medical activities - morbidity - mortality” triple analysis system; the solution involves predicting changes in morbidity and mortality under preset, planned, or scenario changes in parameters related to the public healthcare system. We modelled cause-and-effect relations in the above system, applying mathematical statistics techniques (correlation-regression analysis and factor analysis) with the consequent medical expertise of obtained results. Results. These procedures allow assessing health losses and spot out priorities in activities performed within the public healthcare system as well as ranking managerial decisions, already taken or only planned, as per their efficiency, taking into account territories; sex and age structure of the population; diseases, their subclasses and gravity; specific activities performed within the public healthcare system (prevention, diagnostics, or treatment). We should stress that the most significant potential management reserves of reducing mortality are achieved on territories with maximum mortality levels due to reserves for the reduction in it; these reserves are manageable due to prevention and early diagnostics. Conclusion. Research techniques and results described in the present work can be used in practice to achieve target parameters fixed by national and regional priorities and to select an optimal set of activities aimed at reducing mortality among the population.
Introduction. Obesity in children makes for the earlier occurrence of cardiovascular, musculoskeletal, and endocrine system diseases.Data and methods. We examined 130 children who were distributed into two groups according to their body fat mass (BFM). Our test group included children with excess BFM fraction and our reference group was made up of children with normal body fat mass. All children were examined with bioimpedance analysis techniques. We comparatively assessed basic impedance analysis indices: fat, protein, carbohydrates, and mineral metabolism; as well as children’s vegetative status.Results. We revealed 20% of children to have overweight as their BMI while impedance analysis indicated that 40% of children had it. Children with BFM excess had a smaller phase angle and less active cellular and musculoskeletal mass combined with lower metabolic rates detected in 50% of them. Changes in body composition in the test group were accompanied by elevated contents of dextrose, sodium, total cholesterol, and hydrocortisone and prevailing influences exerted by sympathetic vegetative regulation against the reference group. Correlation analysis allowed revealing direct correlations between a BFM fraction, cholesterol, and vegetative regulation parameters. We also revealed direct correlations between hydrocortisone, atherogenic lipids and body composition that characterized fat metabolism; reserve correlations between hydrocortisone and a faction of musculoskeletal mass; between lipids in blood serum and fat-free body mass and phase angle; between a fraction of body fat mass and metabolic rate, and a fraction of musculoskeletal mass.Conclusions. Excess BFM fraction is a predictor of metabolic syndrome. Impedance analysis allows creating prevention programs aimed at correcting pathogenetic mechanisms that make for overweight occurrence.
Objective. To study the prerequisites for the development of hypertension based on the manifestation of psychovegetative dysfunction and some changes in the biochemical and functional parameters of CVS in the age aspect. Psychological adaptation of a group of underground miners in conditions of intensive labor was analyzed on the basis of indicators of psycho-vegetative status taking into account the influence of professional and psychosocial factors. In connection with the established diagnosis i.e. arterial hypertension (AH) syndrome, especially in middle-aged persons, it is of interest to study the indicators of psycho-vegetative status in the age aspect and to compare them with some changes in biochemical and functional state of cardiovascular system (CVS) in this contingent of patients. Materials and methods. The results of the study of psycho-vegetative status of 60 underground miners with AH syndrome (age 46.8 2.0 years, experience 22.0 2.4 years) using the method of psychophysiological testing as well as analysis of some clinical, functional and laboratory parameters are presented. Results. The adaptive psycho-vegetative phenotypes in a group of underground workers with AH syndrome in the age aspect were identified. Conclusions. With an increase in the length of service among labor-intensive workers, the characteristics of psycho-vegetative status change qualitatively in the form of elevated anxiety and neuro-psychical stress with a decrease in the function of attention combined with a negative relationship of these parameters with increasing age, that is accompanied by dysfunction of CVS; studying of this aspect allows identifying the prerequisites for the development of hypertension so as to form a risk group in time.
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