Medical and Social Expert Evaluation and Rehabilitation

ISSN: 1560-9537 (Print) ISSN: 2412-2092 (Online)

Mediko-Sotsyal’naya Ekspretiza i Reabilitatsiya
Launch Year: 1998
Frequency: 4 issues per year

Subscripition:
«Rospechat» – 47281
«Pressa Rossii» – 27883

The journal is intended for practitioners and specialists involved in disability issues.

It covers the following topics: theoretical and practical aspects of prevention and prevalence of disability; medical and social evaluation; medical, vocational, and social rehabilitation of people with disabilities; legal, regulatory, and economic issues relating to disability; the training of, and refresher courses for, specialists from institutions for medical and social evaluation; and rehabilitation of people with disabilities.

The journal disseminates information on the current state and future of Russia’s social policy for people with disabilities, the practices of Russian regional and territorial agencies working in the field of social protection, and modern approaches to solving the problems of disabled people in other countries. Special attention is devoted to original research focused on new promising methods of diagnosis and treatment of disabling conditions.

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Vol 24, No 1 (2021)

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Expertise and rehabilitation

Social and pedagogical rehabilitation infrastructure for children with autism spectrum disorder on the example of the Northwestern Federal District
Malkova S., Vladimirova O., Lorer V., Kogan Z., Goryainov I., Goryainova M.
Abstract

Goal. A study of the rehabilitation infrastructure of the social and pedagogical spectrum of the Northwestern Federal District for children with autism spectrum disorder (ASD).

Materials and methods. The indicators of the level of disability of children with ASD were calculated and analyzed on the basis of data from the state statistical reporting in the Northwestern Federal District for 2018. Based on the information provided by the portal of the Federal Resource Center for the Organization of Comprehensive Support for Children with Autism Spectrum Disorders (FRC) a review of social and psychological and pedagogical services was carried out, indicators of the provision of children with organizations providing assistance to people with ASD, the structure of organizations by departments were studied (education, social protection of the population, non-profit organizations, excluding health care and culture and sports).

Results. In 2018, 5770 children were registered in the Northwestern Federal District, for the first time and repeatedly recognized as disabled due to mental disorders and behavioral disorders, of which 684 are disabled children with autism spectrum disorders, which amounted to 3.3% of the total disability of the child population on appeal to the bureau of medical and social expertise in the Northwestern Federal District. Rehabilitation measures/services for children with these disorders are provided in 205 organizations: mainly educational institutions - 94%, as well as social protection - 4%, non-profit organizations - 2%. Five regional resource centers have been organized: four of which are in the field of education - in the Leningrad, Murmansk, Pskov regions and the Komi Republic, one - in the field of social protection - in the Novgorod region. In the field of education, organizations implement adapted educational programs in accordance with Federal state educational standards and provide a range of medical and social rehabilitation services for children with ASD, depending on the type of organization (pre-school educational organizations, general education organizations, educational centers and others). In the field of social protection, organizations (rehabilitation centers and others) mainly provide assistance according to the standard for the provision of social services, including social, socio-medical, socio-psychological, socio-pedagogical, socio-labour, socio-legal services. Non-profit organizations located in St. Petersburg and Arkhangelsk provide social-psychological, social-pedagogical and social-labor services to children with ASD.

Conclusion. The results of the study showed that a social and pedagogical rehabilitation infrastructure was created for children with ASD in the Northwestern Federal District in 2018 (healthcare institutions were not studied). Children with ASD and their families can receive services in organizations of various departmental affiliation, which are represented in all constituent entities of the Russian Federation that are part of the Northwestern Federal District, but are concentrated mainly in urban areas, which limits children in obtaining services directly near their places of residence. A system has been created to inform specialists and parents about the rehabilitation infrastructure for children with ASD, which is presented by the FRC portal, at the same time, the need for the organization to submit data to the portal is optional. Services for children with ASD are aimed at solving issues of psychological, pedagogical, social and vocational rehabilitation, including career guidance work with adolescents and, as a result, at the social adaptation of a child with ASD and his integration into society.

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):5-12
pages 5-12 views
Assessment of the functional state of the brain by neuroenergy mapping as a way to optimize neurological rehabilitation
Pradkhan P., Shunenkov D.A., Vorontsova V.S.
Abstract

Neurological rehabilitation of patients with brain injuries is a complex interdisciplinary system aimed at restoring and producing compensatory mechanisms, as well as psychological and social readaptation of patients. An important issue is a personalized rehabilitation program for each individual patient. One method that can help solve this problem is neuroenergy mapping.

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):13-21
pages 13-21 views
Analysis of disability due to organic mental disorders for 2019 in the Republic of Mordovia
Kiryukhina S.V., Gulina O.V., Podsevatkin V.G., Kukina G.N., Yurasova Y.Y., Labunskiy D.A., Kolmykov V.A., Baranov D.V.
Abstract

Background. The trend of recent years is a steady increase in mental illness among the population. according to the statistics of the ministry of health of the russian federation, mental disorders were classified as socially significant diseases in russia in 2018. Thus, the absolute number of patients with a first-time diagnosis of a mental disorder who applied for counseling and treatment in the Russian Federation in 2018 was 379818, which is 3.4% more than in 2017. [20,21,22,23,24] the number of patients with a first-time diagnosis of " mental disorder (except for diseases related to the use of psychoactive substances)" taken under dispensary observation in the republic of mordovia in the same year was 35.5 per 100,000 population. In addition, mental illnesses are in third place among disabling diseases, second only to malignant neoplasms and diseases of the circulatory system. In the structure of repeated disability by class of diseases, this group of diseases is 9%, and the lion's share falls on people of working age. Thus, there is a steady increase in mental illnesses, as well as disability due to them [1], [3]. The question arises of the need to study the patterns of disability formation in order to further develop theories and concepts of ways to protect human health, prevent disability, assess the rehabilitation potential and prognosis, develop rehabilitation measures that improve social adaptation and integration of patients in the family and society.

The aim- study of the patterns of disability formation due to organic mental disorders in the Republic of Mordovia, taking into account age characteristics and severity of disability, which is important for the development of comprehensive measures for the prevention of morbidity, early diagnosis and rehabilitation of this group of people.

Materials and methods. The analysis included information from the statistical collections of Rosstat and approved forms of state statistics No. 7-sobes for 2019. The data of all first-time persons recognized as disabled due to mental disorders in the Republic of Mordovia for 2014-2019 on the basis of the ITU information base for the Republic of Mordovia are analyzed using a continuous method.

Results. Having analyzed the data of all first-time persons recognized as disabled due to mental disorders in the Republic of Mordovia for 2014-2019 on the basis of the ITU information base for the Republic of Mordovia, it was concluded that a significant place in the structure of disability is occupied by organic mental disorders. The percentage of people with organic mental disorders among those first recognized as disabled 18 years and older over the past five years is significant and stable, ranging from 20.1 (in 2017) to 25.1 (in 2014). In the structure of patients who were diagnosed with disability with this diagnosis, there is a predominance of repeated patients over primary ones (by 23.6 %), and it should be noted that this pathology is more common in men (71% of the total number of persons (or in the population) with the above diagnosis). Patients with both primary and re-recognized disabilities with a diagnosis of "Organic mental disorder" were more often assigned to the third group of disability (62% of cases among primary, 57.4% among repeated). Also, the third group of disability prevails regardless of the patient's gender. The study of age-related features of disability due to organic mental disorders in the Republic of Mordovia in 2019 showed that organic mental disorders are most often found in the working-age population. In addition, the proportion of young people (from 18 years to 44 years) is high, it is 59.2% for men, 50% for women.

Conclusions. Given the steady increase in mental illness and disability as a result of it, it is necessary to study the theories and concepts of medical and social expertise and rehabilitation of patients suffering from mental disorders. The role of fundamental and applied research in the field of medical and social expertise and medical and social rehabilitation is significant in order to create ways to protect human health, prevent disability, and develop factors that improve social adaptation and integration of patients in the family and society. in order to develop such concepts, it is necessary to study the structure of disability, the patterns of formation, and the peculiarities of the influence of age and gender factors.

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):23-29
pages 23-29 views
Organization of medical and social assistance to children with autism spectrum disorder in the Russian Federation
Malkova S.V., Vladimirova O.N., Shoshmin A., Lorer V.V.
Abstract

Goal. Analysis of the development of rehabilitation infrastructure in the Russian Federation, including organizations of various departmental affiliations and forms of ownership, providing rehabilitation services to children with autism spectrum disorders (ASD).

Methods. Analytical: the level of primary child disability due to mental and behavioral disorders, including ASD, was studied in the Russian Federation for 2017-2019. according to the official statistics of the Ministry of Labor of Russia. The work of 1,788 organizations providing rehabilitation measures to children with ASD is analyzed based on Federal Resource Center for the Organization of Comprehensive Support for Children with Autism Spectrum Disorder (as of October 2019). Rehabilitation infrastructure for children with ASD is grouped by Federal Districts and presented in the diagrams. The data of the Federal Resource Center for the Organization of Comprehensive Support for Children with Autism Spectrum Disorder (as of October 2019) were used.

Results.  The data were obtained on the growth of the level of primary disability among children with mental and behavioral disorders, including autism, in the Russian Federation. Rehabilitation activities for children with ASD are provided by organizations of various departmental affiliations: education (91%), social protection (3%), healthcare (0.5%), culture and sports (0.6%), non-profit organizations (5%). The most developed rehabilitation infrastructure for children with ASD has developed in the education system. For coordination and methodological guidance, 23 regional resource centers for people with ASD were created, of which 87% are in the field of education, 13% in the social protection system.

Conclusion. In modern Russia, there is an increase in the disability of children with mental and behavioral disorders, including autism, in this regard, the rehabilitation infrastructure for children with ASD is intensively developing. At the same time, the network of regional resource centers needs to be developed. There is a need for a unified comprehensive approach to assessing the condition, identifying needs and implementing rehabilitation measures for children with ASD, which is applicable both in departments and at the interdepartmental level. The International Classification of Functioning, Disabilities and Health (WHO, 2001) is such a universal language for interdepartmental and interdisciplinary interaction.

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):31-38
pages 31-38 views

For the practitioner

Features of medical and social examination of persons with HIV infection - AIDS when determining disability without specifying the period of re-examination
Ugleva E.M., Karasaeva L.A., Yamshchikova T.Y., Nurova A.A., Goryainova M.V., Paikov A.Y.
Abstract

Purpose of research. Studying the features of approaches to determining the timing of disability in rehabilitation and expert diagnostics during the examination of persons with HIV infection - AIDS.

Materials and methods. The research materials were the data of Rosstat of Russia, official state statistical reporting: form 7-social security "Information on the medical and social examination of persons aged 18 years and older" for 2019. The data of our own research included the protocols of persons who were examined for HIV infection in the bureau of medical and social expertiseof (MSE) St. Petersburg and other regions: 50 patients examined in the period from 01.01.2019 to 31.12.2020, (observation group) in comparison with the analysis data of 50 protocols of examination of HIV-infected in the period 2017-2018 (control group).

Results and discussion. According to the results of the study, the disability group is determined reliably more often already during the initial examination without a re-examination period (48.64% versus 19%, c2 = 0.491 at the p < 0.01 significance level) when carrying out the MSE taking into account the Government Decree No. 339. Establishing disability for patients with HIV-AIDS without a period of re-examination during the initial examination allows them to get out of the supervision of medical and medical-social services. Taking into account that a part of the contingent of patients with HIV-AIDS has a "special mentality" and the presence of psychological and social risks, the lack of systematic monitoring of their treatment and social patronage contributes to an increase in the severity

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):39-46
pages 39-46 views

Review

History of Neuro Rehabilitation in Russia
Vorontsova V.S., Kanarskii M.M., Petrova M.V., Pryanikov I.V.
Abstract

Medical rehabilitation is a process aimed at promoting and facilitating recovery from physical injury, psychological and mental disorders and clinical illness. The history of medical rehabilitation is a fascinating journey through time, providing insight into many different areas of medicine. When modern rehabilitation emerges in the mid-twentieth century, it stems from a combination of management approaches focusing on orthopedic and biomechanical understanding of movement patterns, on mastering neuropsychological mechanisms, and on an awareness of the socio-professional dimension of everyday reality.

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):47-52
pages 47-52 views
Early rehabilitation of patients after stroke-versions and contraversions (literature review)
Marciyash A.A., Zueva S.A., Moses V.G., Moses K.B., Lishov E.V., Yelgina S.I., Rudaeva E.V.
Abstract

The article contains an overview of the main directions of medical rehabilitation in stroke. Modern views on the process of intensive and moderate early rehabilitation are presented.

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):53-60
pages 53-60 views
Comparative assessment of the quality of life in patients with chronic critical lower limb ischemia after surgical treatment (literature review)
Kosenkov A.N., Vinokurov I.A., Kiselea A.K., Udovichenko S.V.
Abstract

Today, there are several approaches to the treatment of critical lower limb ischemia (KINK). However, despite the high clinical effectiveness achieved, it is not always possible to achieve a high quality of life for the patient after surgery. This article presents modern aspects of surgical treatment of KINK and assesses the quality of life of patients depending on the type of intervention (literature review).

Medical and Social Expert Evaluation and Rehabilitation. 2021;24(1):61-67
pages 61-67 views

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