Introduction; Worldwide, young women and men suffer a disproportionate share of reproductive health problems, such as unplanned pregnancies, sexually transmitted diseases, including HIV/AIDS, and other serious reproductive health problems. Youth Reproductive Health Service is a special gift from the youth age group, young people all over the world are in need of much better education and health care related to reproduction.
Methodology; This cross-sectional community based descriptive study was conducted in West Hararghe, Gumbi Bordade woreda Arba Bordade Health Center, with the main objectives of assessing youth reproductive health service preferences and utilization. Based on probability proportionate to the population size of kebele, the lottery method was used to identify the study population by interviewing 239 youth selected by systematic sampling using per-structured questionnaires
Result-. A total of 239 youth aged 15-24, 221 responded to the structured questionnaire, out of which 114 (51.6%) were male, with a male to female ratio of 1.14:1. Among the study participants, 140 (63.3%) were aged 15-19, and 38 (17.2%) were married. In the assessment of utilization and preference of the health institution, 96(43.4%) of the respondents preferred to be served in governmental health institution and 69 (31.2%) of the youth indicated the need to rearrange in the existing health institution having separate youth health institution, and 93(42.1%) of the them preferred to be served by young and of the same sex.
Conclusions: -A high figure of the youth not served in the existing health institution for their reproductive health needs, even those who used to be served, they claimed that the existing health institutions were inconvenient and unattractive. Almost half of the respondents preferred the need for rearrangement of youth reproductive health institutions separately, and also to be served by young and the same sex health providers. Family health service, sexual education, partner relation guidance, information and education on STD/HIV AIDS and to having an information center were preferred by almost by all respondents.
Conceptual Field tests were attempted on sandy soils with three trimming frameworks at India for a very long time during 2011-2013. The trials were executed in split plot plan by relegating h2o dissolvable phosphorus composts in primary plot and suggest ed portion of phosphorus in sub-plot with three replications. The most extreme practical yield of rice, child corn and Chickpea were recorded with the utilization of . The most extreme efficient yield of progressive harvests - wheat, mustard and groundnut were recorded with the application of treatment. Practically comparable patterns were seen as far as side-reaction yield, supplement take-up and leftover soil richness status. Every one of the degrees of in compound manures were discovered to be similarly successful for grain yield, straw yield, supplement take-up, and leftover soil richness.
The socio-political activity of youth is an indicator of the processes taking place in modern society. Since the young generation is the main mobilization resource of society, which determines the future of the state. This article is devoted to youth policy, international legal documents developed by the UN, the growing relevance of this issue in connection with the deepening of globalization processes and the ensuing dangers and challenges covering all countries, the solutions of which are impossible without the active participation of young people, a question that is always one of the priority tasks of the international community and in particular the UN. The international legal documents regulating the youth sphere are considered, since this issue has been an object of state policy in more than 130 countries of the world since the middle of the 20th century. In the way in which the state organizes its youth policy, two models stand out - European and Anglo-Saxon. The European model is based on the leading role of the state in the field of youth policy. This model also clearly defines priorities, goals, objectives and expected results. The Anglo-Saxon model is characterized by an approach to support exclusively voluntary activity and youth organizations without the systematic participation of government bodies in the implementation of youth policy. The article analyzes the experience of youth policy in Japan and Uzbekistan, notes the similarities and features of approaches to solving problems and problems of this topic. It is noted that the socio-political system of Japan, unlike most developed countries of the world, for decades allows the government of this country to avoid major social upheavals and crises of social institutions. This, in turn, proves the effectiveness of government measures aimed at solving youth problems in Japanese society. Japan’s policy in this area has its own specifics, based on a combination of traditional preventive measures with innovative ones, which allows us to consider about its universality. The article comprehensively surveys the new course taken by Uzbekistan to increase the role of youth in the socio-political life of society. In this regard, emphasis is placed on the comprehensive support of youth initiatives, both from the state and from youth organizations. Based on this, it can be argued that an open dialogue with youth has become a strategic direction at a new stage in the development of Uzbekistan. In this strategy, a key place is given to increasing the social activity of youth, their involvement in the processes of formation of a modern, democratic state.
The One Health paradigm, emphasizes the interconnectedness of human, animal, and environmental health. Recognizing that disruptions in one domain affect others, the study underscores the importance of collaborative efforts across disciplines to address complex health issues. Herein we have highligted the challenges posed by diseases such as Bovine TB, Brucellosis, Q fever, Leptospirosis, rabies, Crimean-Congo Hemorrhagic Fever, and others. The narrative extends to global warming, environmental impacts, and the intricate relationships between climate change, agriculture, and health in low-income countries. 60% of infectious diseases are zoonotic, emphasizing the need for a One Health strategy. One Health initiative in various countries, including the Netherlands, the U.S., Kenya, Thailand, Australia, Norway, and Canada has remained successful. The study delves into the challenges faced by low-income countries, in implementing the One Health approach amidst climate-induced events, floods, and disease outbreaks. Furthermore, it highlights the significance of health education, surveillance, and prevention strategies for mitigating the impact of zoonotic diseases on public health, animal health, and the environment in low-income nations. The complex interplay of environmental changes, agricultural dynamics, and socio-economic factors underscores the need for a comprehensive and transdisciplinary approach to address zoonotic challenges effectively.
In modern abdominal surgery, one of the current areas for research continues to be the improvement of various options for plastic surgery of postoperative hernias. More than 2,100,000 operations for ventral hernia are performed annually in the world, and 42% of them are postoperative hernias. In recent years, there has been a clear trend toward the expanded use of various types of biological meshes in hernioplasty. “A pooled analysis of seven PCSTAR studies for incisional hernias using retromuscular mesh showed a hernia recurrence rate of 5.7%”[1]. The use of standard surgical interventions such as alloplasty in the onlay position does not solve the problem of early postoperative complications: seroma discharge, mesh migration, adhesive disease, high frequency of hernia recurrence, etc. At the same time, hernia repair with local tissue creates the problem of increased intra-abdominal pressure and late complications in the form of recurrent hernias. “An increase in postoperative intra-abdominal pressure leads to multiple organ failure, then abdominal compartment syndrome, and even death.” [2]. Currently, there is no consensus on the surgical approach for giant postoperative abdominal wall hernias, and therefore the need to continue to develop new technologies and improve There is no doubt about the tactics. In world practice, at present, the most relevant studies continue to be studies aimed at studying the morphological and functional aspects of recurrent postoperative ventral hernias; electron microscopy reveals ultrastructural destructive changes in skin cells, aponeurosis and muscles, which indicates morphofunctional insufficiency of abdominal wall tissues; issues of cell engineering are discussed new innovative materials, experimental studies are being carried out on animals testing the biotechnical properties, texture and elasticity of new polymers, research is being conducted on open approaches with division of the posterior component with the release of the transverse abdominis muscle and a retrograde mesh, robotic operations have begun. Modern aspects of the development of domestic healthcare include many measures aimed at improving the results of treatment of patients with postoperative ventral hernias and associated pathological conditions through the introduction of modern principles of intensive care and surgical tactics. The development strategy of New Uzbekistan for 2022-2026 in seven priority areas includes tasks to improve the quality of provision of qualified medical services to the population[3]. The implementation of these tasks, including by optimizing tactical and technical approaches to the choice of hernioplasty method, as well as the development of methods for the prevention of purulent-inflammatory complications in the field of alloplastic material, is one of the current areas of abdominal surgery and medicine in general, due to the high medical and social the significance of this pathology.
This dissertation research to a certain extent serves to fulfill the tasks approved by the Decree of the President of the Republic of Uzbekistan “On comprehensive measures to radically improve the healthcare system of the Republic of Uzbekistan” No. UP-5590 dated December 17, 2018, the Resolutions of the President of the Republic of Uzbekistan “On measures to transform the surgical service, improving the quality and expanding the scale of surgical operations in the regions" for No. PP-5254 dated October 4, 2021 and "On additional measures to ensure public health by further increasing the efficiency of medical prevention work" for No. PP-4891 dated November 12, 2020, and as well as other regulatory documents adopted in this area. Compliance of the research with the priority directions of development of science and technology of the republic. The dissertation research was carried out in accordance with the priority direction of development of science and technology of the VI Republic “Medicine and Pharmacology”. Review of foreign scientific research on the topic of the dissertation.[4] Research work aimed at improving the quality of therapeutic and preventive care for patients with ventral hernias, carried out by many leading scientific centers and higher educational institutions in the world, including the Department of Surgical and Perioperative Sciences, Umeå University, Umeå (Sweden), Department of Surgery, Kingston General Hospital, 76 Stuart Street, Kingston (Sweden). nada), Department of Surgery, Helsinki University Hospital, Helsinki ( Finland), Service de chirurgie digestive et oncologique, CHU d'Amiens (France), Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa (USA), Department of Surgery, Howard University College of Medicine, Washington (USA) , Yong Loo Lin School of Medicine, National University of Singapore (Singapore), Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA; University of Calgary, Calgary (Canada), Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia (USA), Brigham and Women's/Faulkner Hospital, Harvard Medical School, Boston (USA) , Department of Surgical Sciences, Uppsala University Hospital, Uppsala (Sweden), Department of Surgery, University of Texas Health Sciences Center at Houston, Houston (USA), Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam (Netherlands), Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka (Japan), National Medical Research Center for Surgery named after A.V. Vishnevsky" (Russia), Republican Scientific Center for Emergency Medical Care (Uzbekistan), Tashkent Medical Academy (Uzbekistan), Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov (Uzbekistan).
As a result of studies conducted around the world to increase the effectiveness of alloplasty for postoperative ventral hernias and reduce the risk of complications in the postoperative period, a number of scientific results were obtained, including: it was determined that patients who underwent reconstruction of the abdominal wall have an increased risk of postoperative respiratory failure, understanding the epidemiology of this complication can improve prevention (the Division of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health & Science University, USA); It has been proven that the larger the hernia, the higher the risk of early surgical complications, including such as respiratory decompensation, since hernias often increase in size over time, delaying surgery can lead to an increase in the size of the hernia and, therefore, a greater risk of complications (CentreforDigestiveDiseases, KarolinskaUniversityHospital, Stockholm, Sweden); it has been shown that the ratio of the hernia volume to the volume of the abdominal cavity <20% is an independent factor in tension-free closure, which justifies the interest in preoperative volumetry to adapt the tactics of surgical care (Servicedechirurgiegénérale, digestiveetendocrinienne, CHU LyonSud, HospicescivilsdeLyon, France); It has been determined that in patients undergoing elective laparoscopic hernia repair, predictors of mortality are older age and certain concomitant diseases: congestive heart failure, pulmonary circulatory disorders, coagulopathy, liver disease, metastatic cancer, neurological disorders and paralysis (Department of Surgery, College of Medicine, University of Oklahoma, Tulsa , USA); Older age, ascites, preoperative renal and pulmonary insufficiency have been found to be independent predictors of 30-day mortality, and in the presence of these risk factors, conservative treatment should be seriously considered (Department of Surgery, University of Kentucky College of Medicine, Lexington, USA); The American College of Surgeons (ACS) Universal Surgical Risk Calculator has been shown to accurately predict thirty-day outcomes, including major complications: venous thromboembolism, medical morbidity, surgical site infection, unplanned reoperation, mortality, and length of hospital stay (Department of Plastic Surgery, Brown University and Rhode Island Hospital, Providence, USA). At the present time in the world, the most relevant research in surgery continues to be the development of new methods of hernioplasty for large and giant ventral hernias, each of which has its own pros and cons depending on the complexity of implementation, the risk of postoperative complications and relapse, large randomized clinical trials are being conducted, comparing existing methods of traditional hernioplasty with laparoscopic access and robotic surgery, which has become increasingly widespread in the last 10 years, a search is being made for new synthetic and biological materials developed for the production and use of composite meshes that have the necessary strength and the ability to prevent fatal local complications in a contaminated environment. However, despite technical advances in this field, no modern hernia repair method or prosthesis meets all the requirements. One of the key problems is that existing synthetic endoprostheses do not have sufficient elasticity, resistance to infection, high mechanical strength and integrity over a long period of time. Further research into these clinical aspects will undoubtedly improve the current understanding of the capabilities of biocompatible endoprostheses and will make it possible to develop an optimal method for their placement during allohernioplasty. The degree of knowledge of the problem. The current period of development of abdominal surgery is characterized by an emphasis on the problems of the effectiveness of introducing new installation methods and techniques for attaching bioprostheses, options for various suture materials to determine the most promising directions for the development of these technologies [5]. Researchers led by BittnerR.[6] (2019) state that a giant postoperative abdominal wall hernia, the maximum diameter of which exceeds 12 cm or the ratio of the volume of the hernial sac to the abdominal cavity more than 20%, is difficult to treat, with a high recurrence rate and a large number of complications. One of the most challenging problems is that after the hernia contents return to the abdominal cavity, postoperative intra-abdominal pressure will increase, leading to multiple organ failure, then abdominal compartment syndrome (ACS), and even death. There is currently no agreement on the surgical approach for these giant incisional abdominal wall hernias. To prevent recurrences, some articles recommend placing the hernia mesh in the sublayer position and or linings (KirkpatrickAW.)[7]. According to CornetteB.[8], to prevent recurrence, it is recommended to place the hernia mesh in a sublayer or underlay position, and to achieve better mesh expansion, a component separation technique (CST) may be a suitable solution, but with a significant risk of complications and recurrence. JensenKK, et al. believe that truly successful giant hernia repair requires effective bridging or augmentation that will prevent recurrence with an acceptable risk of complications[9]. Another pressing issue in abdominal surgery is that patients with incisional hernias are extremely difficult to treat due to a number of factors including obesity, previous hernia repair, previous mesh placement, domain loss, and other variables.
The approach to patients with incisional hernias has changed significantly over the past 20 years due to both advances in mesh technology and surgical approaches. Key factors for successful outcome include modification of risk factors preoperatively, such as smoking cessation and weight loss, selection of mesh appropriate for the type of hernia and planned mesh location, and wide mesh coverage beyond the hernia defect. New techniques such as transabdominal muscle release and component separation with retrograde mesh placement and robotic approaches to abdominal wall hernia are increasingly being used in these patients[10]. Recent years have seen an increase in the number of biological meshes available for abdominal wall hernia repair. Biological meshes typically consist of materials obtained from humans, pigs, or cattle. The rationale for using biological meshes is that they can act as a scaffold for the growth of natural tissues. In addition, there are absorbable synthetic meshes that have properties similar to those of biological meshes, but with theoretically less risk because they are not derived from animal or human material. The choice of mesh for a ventral hernia depends on many factors, which include both the properties of the mesh and its location, for example, whether it should be placed intraperitoneally, preperitoneally, or retrorectus. BaierKF[11](2021) believes that the guiding principle should be to avoid placing uncoated polypropylene mesh in an intraperitoneal location where it may be in direct contact with internal organs. In addition, the type of hernia defect is another risk factor, such as whether the wound is clean or dirty, and whether the repair is performed with a bridge or abutment. Lightweight or biologic meshes to bridge the defect should be avoided due to increased recurrence rates. Holihan JL [12] (2016), Hodgkinson JD [13] (2018) believe that the principle of anatomical restoration to achieve a reliable, tension-free repair with reinforced mesh reduces the incidence of early postoperative complications and late recurrence of hernia compared with bridging mesh. The analysis of the literature concerning the theoretical aspects and clinical experience of using technologies for improving modern synthetic and biological prostheses that can provide a better plastic effect, as well as methods for preventing recurrence of ventral hernias, indicates that this is one of the priority areas in modern abdominal surgery. An unresolved issue remains the choice of the optimal endoprosthesis, which is highly effective and meets international standards for such properties as biological inertness and mechanical strength, as well as the method of positioning the mesh in relation to the layers of the abdominal wall. Considering that many of the allohernioplasty methods used today are not without drawbacks, the current direction is the development of new methods of repair for giant ventral hernias and methods for the prevention of postoperative complications in conditions of a contaminated wound, with justification of their effectiveness in a clinical experimental study. The connection between the dissertation research and the research plans of the research institution where the dissertation was completed. The dissertation research was carried out within the framework of the research work plan of the State Institution “RSNPMCH named after. acad. V. Vakhidov" under the project AL-422105574 "Development of new biocompatible mesh implants made of composite materials for reconstructive surgery of abdominal and diaphragmatic hernias" (2022-2024).
The purpose of the study is to improve the results of surgical treatment of large and giant postoperative ventral hernias by introducing new laser technologies and improving the tactical and technical aspects of surgical treatment. Objectives of the study: to study the structure of immediate complications after various types of prosthetic plastic surgery; to clarify the influence of obesity factors, primary or repeat hernioplasty on the incidence of immediate and long-term complications; to evaluate the role of the immediate complicated course of the postoperative period in the incidence of long-term complications of hernioplasty; to improve the technical aspects of alloplasty for large and giant postoperative ventral hernias (POVH); to improve the technique of photodynamic therapy (PDT) of the wound surface after prosthetic plastic surgery; to study in an experiment the effectiveness of using the proposed technique of alloplasty and PDT; evaluate the morphological features of the condition of tissues during prosthetic plastic surgery using the proposed method; in a comparative aspect, evaluate the clinical effectiveness of the proposed alloplasty options in the immediate and long-term periods. The object of the study was the results of allohernioplasty in 448 patients with extensive (large) and giant POVH, who were operated on at the surgical department of the 1st clinic of the Samarkand State Medical Institute in the period from 2012 to 2021, as well as experimental animals on which the effectiveness was assessed developed a technique for prosthetic repair of postoperative ventral hernias and applied the technique of photodynamic therapy.
The subject of the study is to analyze the effectiveness of the developed alloplasty of postoperative ventral hernias and intraoperative photodynamic therapy in abdominal surgery in experiments and in the clinic. Research methods. To achieve the goal of the study and solve the assigned problems, general clinical, instrumental, biotechnological, experimental, histomorphological, microbiological and statistical research methods were used. The scientific novelty of the study is as follows: it was established that the need for extensive tissue mobilization and, as a consequence, the intersection of lymphatic capillaries during implantation of the prosthesis in the onlay position, as well as the lack of sufficient resorption function of the hernial sac in the inlay position causes a high risk of the formation of clinically significant seromas; It was determined that with prosthetic hernioplasty, along with the volume of the defect, the type of plastic surgery and the degree of obesity, the most significant predictor of the risk of developing immediate complications is the factor of re-intervention in case of recurrent hernia with the presence of a “dormant infection” hidden in the remaining ligature granulomas or scar tissue; the structure and clinical features of the course of long-term complications of hernioplasty for giant and extensive hernias were clarified, taking into account the results of the immediate postoperative period, as well as the option of fixing the prosthesis, primary or repeated hernioplasty and the degree of obesity; the method of surgery for large hernias of the anterior abdominal wall has been improved, characterized by a combination of factors such as the formation of tension-free prosthetic repair, preservation of local resorptive function to prevent the development of fluid accumulations and reducing the risk of infection; the method of preventing the development or progression of wound infection during alloplasty of ventral hernias has been improved, aimed at enhancing the antibacterial effect and stimulating reparative activity through the photosensitizing and photodynamic effect of low-energy laser radiation; It was determined in an experimental model of prosthetic plastic surgery that the proposed method of fixing the prosthesis in combination with the use of the effect of photodynamic therapy through laser radiation helps to enhance reparative processes with a reduced risk of wound complications; It has been proven that all methods of antiseptic exposure and laser stimulation of the wound surface after prosthetic plastic surgery enhance preventive measures against the development of local infection, but are ineffective in the case of an already developed purulent-inflammatory process against the background of the use of alloplastic material. The practical results of the study are as follows: it has been determined that the implantation of synthetic materials for giant and extensive hernias is accompanied by a significant number of wound complications caused by both the surgical technique itself and the reaction of surrounding tissues to a foreign body, requiring improvement of tactical and technical approaches when performing hernioplasty; it was clarified that scar-degenerative changes in the tissues of the aponeurosis in giant and extensive hernias are a predisposing factor to the occurrence of post-prosthetic hernias, especially when implanting the prosthesis in the “inlay” position and, accordingly, require increasing the efficiency of their fixation and engraftment, as well as reducing the risk of developing local complications; it was determined based on the data of an experimental study that the proposed method of alloplasty for large ventral hernias makes it possible to achieve adequate reconstruction of the anterior abdominal wall, reduce the incidence of infection in the wound, and also use a smaller size of prosthetic material; it was determined that the proposed method of tension-free repair of large hernias of the anterior abdominal wall with strengthening of the aponeurosis with a mesh implant allows maintaining physiology, reducing the number of complications, shortening treatment time and reducing the risk of hernia recurrence; It has been determined that the proposed method for preventing the development or progression of wound infection during alloplasty of ventral hernias can reduce the frequency of suppuration, shorten the treatment time and the likelihood of relapse; It has been proven that the use of the proposed tactical and technical aspects of prosthetic repair for postoperative ventral hernias can reduce the incidence of specific complications, reduce rehabilitation time and the risk of hernia recurrence. Reliability of the research results. The reliability of the results is justified by the use of objective criteria for assessing the condition of patients, modern methods of diagnosis and treatment, the correct application of methodological approaches and sets of statistical analysis, methods for solving the problems discussed in the dissertation are based on modern scientific and practical concepts and approaches to the diagnosis and surgical treatment of patients with giant postoperative hernias. Scientific and practical significance of the research results. The results obtained make a significant contribution to the expansion of irradiation of existing ideas about the structure and clinical features of complications of hernioplasty for giant and extensive ventral hernias by identifying the morphological features of the development of a purulent-inflammatory process against the background of the use of alloplastic material, studying predictors of the risk of developing immediate complications, mechanisms for enhancing reparative processes through the use of an improved method of fixing the prosthesis in together using the effect of photodynamic therapy through laser radiation, which made it possible to enhance the antibacterial effect and improve the wound healing process. The practical significance of the study is that, based on the results obtained, the tactical and technical aspects of prosthetic hernioplasty have been optimized, the features of methods of antiseptic exposure and laser stimulation of the wound surface after prosthetic repair have been revealed, enhancing preventive measures for the development of local infection, and the method of surgery for large anterior abdominal hernias has been improved walls, characterized by a combination of factors such as the formation of tension-free prosthetic plasty, preservation of local resorptive function to prevent the development of fluid accumulations, thereby reducing the risk of developing postoperative complications, reducing the frequency of unsatisfactory results, length of hospitalization and the likelihood of relapse. Implementation of research results. According to the results of a scientific study to optimize the tactical and technical aspects of surgical treatment of large and giant postoperative ventral hernias: the “method for plastic surgery of giant hernias of the anterior abdominal wall” has been improved (invention patent No. IAP 2022 0148 dated April 18, 2022). The proposed method of tension-free repair of large hernias of the anterior abdominal wall with strengthening of the aponeurosis with a mesh implant made it possible to reduce the number of complications, shorten the treatment time and reduce the risk of hernia recurrence; the “method for preventing the progression of infection during alloplasty of infected hernias” has been improved (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022). The proposed method made it possible to reduce the frequency of wound purulent-inflammatory complications and shorten the period of rehabilitation of patients after allohernioplasty; methodological recommendations “Tactical and technical aspects of prosthetic repair for large and giant postoperative ventral hernias” have been developed (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022) . The developed recommendations made it possible to optimize the tactical and technical aspects of allohernioplasty in patients with large and giant postoperative ventral hernias; The scientific results obtained were introduced into the practical activities of healthcare, in particular, in the departments of surgery of the Khorezm and Andijan regional multidisciplinary medical centers, the clinic of the Samarkand State Medical University (certificate of the Ministry of Health No. 08-32071 dated October 17, 2022). Improving the tactical and technical aspects of prosthetic repair for postoperative ventral hernias has made it possible to reduce the incidence of specific immediate complications from 40.9% to 15.6%, to reduce rehabilitation time from 8.6±2.7 to 7.1±1.5 days, and also reduce the likelihood of long-term complications from 11.7% to 3.1%. Approbation of research results. The results of this study were discussed at 8 scientific and practical conferences, including 5 international and 3 republican ones. Publication of research results. 26 scientific works have been published on the topic of the dissertation, including 9 journal articles, 4 of which in republican and 5 in foreign journals recommended by the Higher Attestation Commission of the Republic of Uzbekistan for publication of the main scientific results of doctoral dissertations. Structure and scope of the dissertation. The dissertation consists of an introduction, seven chapters, a conclusion, conclusions, practical recommendations and a list of cited literature. The volume of work is 200 pages.
Youth Tourism has been acknowledged as one of the most perspective sectors of Tourism world, furthermore its trend is showing the high potential possessing for tourism development with the growing rate of student and young people travels. Clearly, in light of a plethora of opportunities and factors youth travellers are willing to spend their free time and weekends by travelling or going to off-beaten track or having trips on new places. As the development of transport, cheap and comfortable hostels, online booking systems together with different kinds of purposes is going to its highest point, travelling has become common for young people. Besides, there are particular factors which have played an indispensable role in urging Youth Tourism to develop significantly. Furthermore, the state and progress of youth tourism largely depends on the state of the methodology and modern practice of learning the theory of youth tourism. The development of Youth Tourism in Uzbekistan is primarily due to the fact that tourism activities are primarily associated with tourism and its legal regulation, as legal and theoretical foundations are considered to be most important to develop any field. This article examines the concepts of youth travel and tourism issued by other scholars and research organization, their approach and methodology and the importance of theoretical aspects of youth tourism. The purpose of this study is to clarify conceptual aspects of Youth travel and tourism in the case of Uzbekistan considering the characteristics and specialties of the country. The approaches were studied to point the main aspects of the travel and tourism activities, as well as, the legal basis of the category.
Youth Tourism has been acknowledged as one of the most perspective sectors of Tourism world, furthermore its trend is showing the high potential possessing for tourism development with the growing rate of student and young people travels. Clearly, in light of a plethora of opportunities and factors youth travellers are willing to spend their free time and weekends by travelling or going to off-beaten track or having trips on new places. As the development of transport, cheap and comfortable hostels, online booking systems together with different kinds of purposes is going to its highest point, travelling has become common for young people. Besides, there are particular factors which have played an indispensable role in urging Youth Tourism to develop significantly. Furthermore, the state and progress of youth tourism largely depends on the state of the methodology and modern practice of learning the theory of youth tourism. The development of Youth Tourism in Uzbekistan is primarily due to the fact that tourism activities are primarily associated with tourism and its legal regulation, as legal and theoretical foundations are considered to be most important to develop any field. This article examines the concepts of youth travel and tourism issued by other scholars and research organization, their approach and methodology and the importance of theoretical aspects of youth tourism. The purpose of this study is to clarify conceptual aspects of Youth travel and tourism in the case of Uzbekistan considering the characteristics and specialties of the country. The approaches were studied to point the main aspects of the travel and tourism activities, as well as, the legal basis of the category.
Health care management system financing plays a vital role in ensuring the availability and accessibility of quality health care services. However, numerous challenges and constraints exist that can hinder the effective financing and sustainability of health care systems. Understanding and addressing these challenges is essential for improving health care financing mechanisms and achieving better health outcomes (124, 125) Healthcare systems in suffer from neglect and underfunding, leading to severe challenges across the six World Health Organization (WHO) pillars of healthcare delivery. We conducted this study to identify the principal challenges in the health sector in and their solutions for evidence-based decisions, policy development and program prioritization
Insufficient Funding Allocation: One of the primary challenges in health care management system financing is the inadequate allocation of funds. Limited financial resources can restrict the availability of essential health care services, compromise service quality, and undermine the overall functioning of the health care system. Insufficient funding allocation hampers infrastructure development, workforce capacity building, and the procurement of medical supplies and equipment (126).
In the field of human health, it is important to make medical services affordable in all respects, high quality and financially affordable for the population. In the provision of medical services, the organization of the relationship between the medical institution, the doctor and the patient, the creation of the necessary conditions for the treatment of patients in the medical institution is organized in different ways. One of the most effective of these methods in modern medicine today is health insurance. Through health insurance, the insurance company takes all organizational (financially hospitalized, highly qualified doctors) financial measures related to the treatment of the insured person (patient) in the event of an insured event, and as a result the insured person has access to qualified and quality medical care. Today, there are no clear approaches to the role of health insurance in legal regulation and jurisprudence, which area of insurance it is: life insurance and general insurance. This at the same time creates a number of problems and gaps in the legal regulation of the interpretation of the essence of the health insurance contract and its application. Therefore, it is important to determine the essence of health insurance, its content and specifics as a legal relationship, and thus create a legal basis for health insurance.
Social Pediatrics is a global, holistic, and multidisciplinary approach to child health, considering the health of the child in the context of their society, environment, school, and family. Social pediatrics integrates the physical, mental and social aspects of a child’s health and development, as well as care, prevention, health promotion, and quality of life. Social pediatrics operates in three areas: children’s health problems caused by social causes, the social consequences of child health problems, and the protection of child health in society. Thus, social pediatrics includes medical treatment, health promotion, disease prevention, and rehabilitation of children. The integration of social pediatrics into curricula implies the development of social partnerships of medical universities with mahallas.
This article examines how social and health inequalities shape the health impacts of climate change, and what the implications are for climate change adaptation and health care provision. Exposure to heat and cold, air pollution, pollen, food safety risks, disruptions to access to and functioning of health services and facilities, emerging infections and flooding are examined as the key impacts of climate change influencing health outcomes. Health education and public preparedness measures that take into account differential exposure, sensitivity and adaptive capacity of different groups help address health and social inequalities to do with climate change.
The article deals with the conception and features of prevention of crimes committed by youth. The author formulated corresponding proposals and recommendations on prevention of crimes committed by youth
Атипичный гемолитико-уремический синдром (аГУС) – ультраредкое генетически детерминированное заболевание, обусловленное неконтролируемой активацией альтернативного пути комплемента. Органом мишенью при аГУС являются почки из-за высокой чувствительности к активации и дисрегуляции комплемента за счет фенестрированной архитектуры эндотелия клубочков, отсутствия поверхностно связанных регуляторов комплемента в гломерулярной базальной мембране и высокой зависимости эндотелиальных клеток клубочков от фактора роста эндотелия сосудов. В 20% случаев у пациентов с аГУС могут диагностироваться внепочечные симптомы, которые могут быть как проявлениями, так и осложнениями заболевания.
This article examines the role of insurance
in the country's health care system, ensuring the provision of high-quality medical care to insured persons, and covering medical expenses by an insurance company. Consequently, as in the case of all types of insurance, the health insurance contract does not provide for the possibility of preliminary determination of the insured event and providing a list of all events that may occur.
Such a two-sided approach to the legal nature of health insurance, in turn, shows the need for a scientific and practical interpretation of the insured event and its application in health insurance. Of course, this is due to the fact that health insurance is voluntary or compulsory.
This article is devoted to the problem of health saving in elementary school, which is topical today. Despite the fact that health is the most important aspect of human life, the problem of health saving in elementary school, to date, is not given due attention. The modern education system is a serious load for a junior schoolboy and becomes a bright contributing factor for the deterioration of children's health. The article notes that the identification of criteria of health-saving potential of the school lesson, as well as extracurricular and extracurricular activities and the construction of the educational process on the basis of the principles of ensuring and protecting health is a priority in the development of education in the junior school level. The purpose of this article is to focus attention on the problem of saving the health of students and educating them in the field of healthy lifestyle in modern schools and to solve this problem through the active application of health-saving technologies in the classroom. Pedagogical design of health-saving education of junior schoolchildren and application of health-saving technologies in the pedagogical process can help teachers to keep students' high efficiency, delay fatigue and exclude overwork at lessons.