Клинические аспекты медико-социальной экспертизы при туберкулезе у взрослых

The military commissariat requests information characterizing their state of health in order to study the state of health of citizens subject to conscription before the next conscription of citizens for military service. An interdepartmental request for this informations provision to medical organizations and institutions of medical and social expertise is encouraging to be issued in the form of an electronic document using a unified system of interdepartmental electronic interaction, taking into account the trends in the development of the public administration system. Interdepartmental interaction optimization through creation of an electronic interaction mechanism will allow military commissariats to promptly exchange information in real-time characterizing the citizens state of health subject to conscription for military service with medical organizations of the state and municipal health care system, and federal state institutions of medical and social expertise. The direct connection of the military commissariat to the state information system in the field of healthcare of the subject of the Russian Federation by means of cryptographic protection of information will contribute to improving the quality as well as deceasing the medical examination time of citizens subject to conscription, thus improving the efficiency of providing medical services to citizens in medical organizations. The public administration system was successfully reoriented to provide state and municipal services in a remote format during the unstable epidemiological situation caused by the pandemic of a new coronavirus infection. Optimization of interdepartmental electronic interaction will allow military commissariats to take additional preventive measures to avoid infection and avert the spread of a new coronavirus infection during the recruitment campaign. Modern digital technologies and solutions are able to provide a qualitative leap in the organization of conscription of citizens for military service, which can be implemented without significant financial costs in the short term. However, there is a growing need to involve a proper number of participants of the military command and other state authorities in solving this complex problem.

Relevance. A significant level of morbidity significantly exacerbates the medical and social significance of oncopathology, leading to high mortality and disability of the population. In terms of the prevalence of disability, malignant tumors occupy the second rank after the circulatory system. The increase in advanced stages of malignant tumors associated with problems in early detection of the oncological process leads to a heavier disability group. Objective:. To analyze the prevalence and age structure of disability of the adult population due to malignant neoplasms in the Republic of North Ossetia-Alania. Materials and methods. Primary disability due to malignant neoplasms in 2020-2022 was studied using the accounting and reporting form No. 7-sobes. A comparative analysis of the structure and indicator of disability due to malignant neoplasms in the Republic of North Ossetia-Alania, the North Caucasus Federal District, and the Russian Federation was carried out. Results. The age structure of malignancy disability shows stable growth dynamics in all age groups, especially noticeable among young people. At the same time, the indicators of disability for malignant neoplasms among people of retirement age prevail over similar indicators among middle-aged and young people. In the structure of disability, taking into account the classes of diseases among IDPs due to malignant neoplasms, disability group I in 2022 amounted to 40.9%, group II 35.1%, group III 13.3%. The significant prevalence of disability group I among those recognized as disabled for the first time is prolonged during the study period, thus confirming the high relevance of the problem of malignant neoplasms. During the spread of the COVID-19 coronavirus epidemic, the growth dynamics of the disabled of the I disability group in 2021 and 2022 is noted. There was no significant impact on the indicators of disability groups II and III in this period.The indicators of primary disability due to malignant neoplasms in the Republic of North Ossetia-Alania are lower than in the Russian Federation and the North Caucasus Federal District, but have the same upward trend. Conclusion. The data obtained indicate a negative dynamics in the growth of disability indicators for malignant neoplasms and an aggravation of the degree of disability. In the current situation, the analysis of indicators and the age structure of disability due to malignant neoplasms in dynamics makes it possible to identify the priorities of medical and social expertise and becomes important when developing age-oriented, differentiated rehabilitation programs for the disabled. Given the high correlation between the severity of disability and the neglect of the oncological process, early diagnosis and adequate treatment tactics for patients with malignant neoplasms will undoubtedly contribute to improving disability indicators, allowing timely medical and social examination.

Myasthenia gravis, as a disease associated with impaired neuromuscular transmission and manifested by muscle weakness and fatigue, necessarily leads to the disability of patients. There were analyzed terms and the factors influencing upon disability in 52 patients with myasthenia, 67 per cent of whom had a disability group. The duration of the disease from the beginning to the referral to the examination in the Bureau of the Medical and Social Expertise was revealed to amount in average of 2.68 ± 0.44 years. Out of factors influencing upon more earlier disability there were noted primary or early generalization of the process, severe crisis course and pronounced severity according to MGFA, poor compensation on anticholinesterase drugs, inadequate therapy. There was noted the positive effect of thymectomy on the consequent course of the disease, only 2 out of the 18 operated patients showed its further progression.

The has been studied the analyzes of primary, repeated and general disability due to diseases of the locomotive system in the Russian Federation on appeals to the Bureau of Medical and Social Expertise.

Federal Bureau of Medical and Social Expertise, Moscow This article highlights the problematic issues of medico-social institutions licensing, the procedure of licensing, licensing requirements, a set of required licensing documents, issues of staff, training and retraining of specialists in the field of medical and social expertise.

The article presents the analysis of disability on the cardiovascular diseases, according to the Bureau of Medical and Social Expertise in the Nizhny Novgorod region in dynamics for 2003-2013. The article analyzed the number of persons recognized as disabled according the Bureau of Medical and Social Expertise, calculated accumulated contingent disabled due to cardiovascular diseases according to the pension fund. The years of life lost due to disability in dynamics were calculated for 2004-2013 years.

The need to develop methods for assessing the quality of educational programs of higher professional education is currently becoming relevant, which causes the need to form a Fund of assessment tools (FOS) that have a structure, composition and integrity. Develop test tasks for the current FOS certification that provide assessment of the progress of residents development of sections and topics of the discipline (module) Medical and social expertise.

Substantiation. The article presents the structure and medical and social aspects of the primary disablement of the adult population of the Altai Region due to schizophrenia for the period from 2015 to 2019. Purpose of the study: to investigate the structure of primary disablement of the adult population of the Altai Region due to schizophrenia (by sex, age, place of residence, the main types, and degree of impairment of body functions and life limitations) and present the medical and social characteristics of patients first recognized as disabled. Material and methods. During the study, statistical data of the Federal State Institution «Main Bureau of Medical and Social Expert Examination for the Altai Region» of the Ministry of Labor and Social Protection of the Russian Federation were used. The material of the study included reporting forms No. 7‑sobes (n=5), protocols for conducting medical and social expert examination in the federal state institution of medical and social expert examination (n=745), and forms No. 088 / u of medical organizations (n=745). The research period was 2015‑2019. Research methods: documentary, data copying, statistical, and analytical methods. Results. The study has indicated that in the structure of primary disablement of the adult population of the Altai Region due to schizophrenia, urban residents predominate, while men prevail in the gender category. More than 90.0 % of the patients first recognized as disabled due to schizophrenia are citizens of working age. The vast majority of the patients did not work at the time of examination, while having a professional education. More than half of the patients,mostly men, were not married, had no children, and lived with their parents. In more than 90.0 % of the patients, the paranoid type of schizophrenia led to disability, and the main maladapting syndrome involved emotional and volitional disorders. More than 60.0 % of the patients had persistent moderate impairment of body functions; life limitations were more frequently detected in the following categories: the ability to work, the ability to communicate, and the ability to control one»s behavior. More often, patients with schizophrenia obtained the third group of disability during the initial examination. Conclusion. The results of the study can be a scientific and practical basis for planning and effective implementation of comprehensive rehabilitation of disabled patients with this pathology.

Dolly Ntseane and Kholisani Solo’s book Social Protection in Botswana: Socio-Economic and Legal Perspectives is a careful, well-regarded study of social protection in Botswana, anchored in its historical and socio-economic context. The book reviews existing international, regional and local legal instruments on social protection and their suitability for application in Botswana. This includes United Nations instruments that offer policy guidance that is supplementary to local instruments. The latter part of the book offers practical recommendations to improve Botswana’s social protection regime, and these will be of great use to policy-makers, administrators and those implementing social protection programmes.

In the framework of this study, the main scientific schools and their doctrines aimed at identifying and solving the main problems of organizational and legal support of medico – social expertise in the Russian Federation are characterized in the context of increasing the level of objectivity of the evaluation of life activity restrictions of persons with disabilities and appointed (recommended) measures to overcome difficulties. Based on the analysis of the works of a number of scientific groups considering current legislation, the article argues that one of the main directions of improving the efficiency and quality of organizational and legal support of medico- social expertise in the Russian Federation is to strengthen public control. It is obvious that such control can increase the level of objectivity of the assessment of restrictions of life activity of disabled people, the main appointed (recommended) measures for their overcoming, and also other assessments in case of increase of "transparency" of carrying out expertise, and measures previous to it and, the main thing - the subsequent actions. For this purpose, it is proposed to amend paragraph 18 of article 5.1 ("Federal Register of Disabled Persons") of the Law on social protection of disabled persons, to specify (in terms of listing the type of diseases) some subordinate normative legal acts.

The medical social expertise is considered as recognition of a person as the disabled and specification, in accordance with established procedure, of needs of examined person in social protection measures, including rehabilitation, based on evaluation of disabilities caused by persistent dysfunction of organism. The main normative legal acts governing activities of institutions of medical social expertise are the Federal Law of November 24, 1995 "On social protection of disabled people in the Russian Federation", the Decree of the Government of the Russian Federation of February 20, 2006 № 95 "On the procedure and conditions for recognition disabled person". Because of COVID-19 pandemic conditions, the normative legal base has undergone a number of changes. In particular, on 09.04. 2020, the Resolution of the Government of the Russian Federation № 467 "On the temporary procedure for recognizing a person as disabled" came into force. The actual article considers the features of this temporarily order related to the repeated medical and social examination and its results as of 2020. The qualitative analysis of permitted to get patterns of increasing and decreasing (improvement or deterioration) of particular statistical indices.

The article considers current regulatory framework governing provision of cancer palliative care and establishing the patients' rights. The main problems of implementation of legislation in this area are established, namely: problems of medical care quality, problems of legal regulation of voluntary informed consent, problems of implementation of right of patient to palliative care. It is noted that system of organizational and legal support of medical and social expertise in relation to oncologic patients in need of palliative care requires modernization, especially in terms of quality and availability of services provided by medical and social expertise institutions. The problem of personnel training for implementing procedure for interaction of medical organizations, social services is considered. The need for adjusting training programs to form necessary competencies in implementation of the Federal educational standards targeted to training qualified specialists to provide palliative care is emphasized.

Kingdom of Saudi Arabia presented great attentiveness for handicapped, considering their suffering specific problems, so it issued legislations and laws to facilitate respectable life for them. Within this framework, issue of current research has identified in identifying in, what does the social policies of the Kingdom of Saudi Arabia including legislation provide and achieve for handicapped in three fields rehabilitation, empowerment and integration. And analyzing these policies by using a social and legal perspective, also comparing the Saudi and Egyptian policies to determine differences between them. After applying we deduced that Kingdom undertaked efforts to achieve handicapped social and legal protection which began before the ratified international agreements, because of values and teachings of Islamic Sharia were the main basis for providing health, educational, social and rehabilitation services. ... and others, for the handicapped and other groups whom deserving of care, although those efforts still need to develop philosophy of their policies, to activate the participation of the disabled in development, to empower them ueing benefits of achieved development. On the basis of that results, a proposed plan has been developed for what can be added or made to the amendments to these texts to achieve more protection for the category of the handicapped, both legal and social, in the Saudi system.

This study provides a comparative analysis of two key taxation models in Ukraine's IT sector: the sole proprietorship (FOP - fizychna osoba-pidpryiemnets) 3rd group and the "Diia.City" special regime. The comparison examines tax criteria, administrative burden, social guarantees, and investment attractiveness. The research uniquely analyzes martial law impacts on both formats, including tax benefits and cooperation restrictions Scientific novelty lies in determining optimal conditions for combining the flexible FOP model with "Diia.City" advantages (low taxes, mobilization reservation, investment opportunities) to ensure IT industry competitiveness. Methodology includes analysis of legal acts, statistics, and expert materials. Research methodology includes analysis of normative-legal acts, official statistics, and expert analytical materials. The comparative framework encompasses tax rates for personal income tax, single tax, military levy, and unified social contribution, as well as corporate profit taxation features. Administrative aspects cover status acquisition procedures, activity volume limitations, and reporting requirements. Social guarantees evaluation includes pension and social insurance, paid leave, and protection during illness or mobilization. Results show FOP maintains relevance for freelancers with minimal tax burden (5% single tax) and flexibility but lacks social protection and scalability. "Diia.City" offers balanced conditions: 5 % personal income tax for specialists, 9 % withdrawn capital tax, gig contracts with social protection, and employee reservation opportunities. During martial law, FOPs received temporary 2 % tax rate support, while "Diia.City" demonstrated growth from ~400 residents in 2022 to ~1,520 in 2024, with tax contributions increasing from 4 to 18 billion UAH. Mobilization reservation became a significant wartime advantage. Investment analysis reveals FOP suits freelancing but limits scaling. "Diia.City" enables investor attraction through corporate structures, stock options, and IP protection. The 9 % withdrawn capital tax encourages reinvestment. Post-war recovery requires a hybrid approach maintaining both regimes. FOPs remain relevant for small projects; "Diia.City" suits business scaling and high-value product development. Recommendations include ensuring legislative stability and implementing differentiated tax rates.

A review of the available domestic and foreign literary sources is presented concerning factors affecting the working capacity of persons after coronary artery bypass grafting. It was found that in Russia, after surgical treatment of coronary heart disease, there is an increase in the number of disabled people compared to foreign data. In recent years, there has been an increase in patients undergoing coronary bypass surgery. However, this did not reduce the increasing number of disabled people after coronary artery bypass grafting, which does not correspond to the initial expectations about the cost-effectiveness of this type of surgery. According to Russian researchers, the proportion of persons with disabilities referred for surgical myocardial revascularization was 39.0-42.5%. Subsequently, this indicator increased to 64.0%. In other countries, the dynamics are different. Among patients under 60 years of age who underwent surgical treatment of coronary artery disease, more than half returned to work. In general, labour activity was restored by 67.5%, and the number of disabled persons decreased from 56.0 to 42.0%. Social and medical factors were assessed to establish the causes of disability after coronary artery bypass grafting. World experience testifies to the critical role of state social support in preserving the labour status of patients, which ultimately justifies the economic costs of surgical treatment. To assess the degree of disability after coronary artery bypass grafting, social status before surgical treatment of coronary heart disease, and the severity of comorbid pathology. To increase the economic efficiency of coronary bypass surgery, it is necessary to organize an affordable and effective rehabilitation program, uniform criteria for referring patients to medical and social expertise.