No abstract

Introduction. Mental health is an integral part of health, and its disorders are fraught with social and economic costs for the individual and society. According to WHO, depression is the most common disease and the leading cause of disability globally; it affects 350 million people. The analysis of new data and concepts on these issues is relevant. The aim of the work is to study the problem of stress at work and mental health disorders with an analysis of the concept of allostasis and allostatic load as an integral indicator of stress. A literature search was conducted through September 2020 using the Scopus (https://www.scopus.com/home.uri) and MedLine/PubMed (https://www.ncbi.nlm.nih.gov/PubMed) scientific literature databases. Key search terms included “mental health problems,” “mental health in the workplace,” “working condition,” “anxiety,” “burnout,” and “depression. Full-text articles published in English in journals with DOIs were reviewed. There are considered work-related stressors, also called psychosocial risks. Data on the types and amounts of medico-social damage from mental health disorders in European countries and the United States are presented. The Italian experience in limiting work-related stress is reviewed in detail. There are given examples of legislation to restrict psychosocial risks at work in European countries, as well as patterns of recognition of the connection between mental disorders and work. The biomedical paradigm shift - from homeostasis to allostasis - is analyzed, and allostasis and allostatic load is described as integral indicator of chronic work stress. Despite an abundance of work on anxiety and depression, there is no unity in the literature in understanding the mechanisms and stages of mental health disorders from stress at work. It is not clear what better reflects the effects of chronic work-related stress: allostatic stress or metabolic syndrome. Stress, depression and burnout - what is the relation between them? We can discuss a logical chain: occupational risk factors - fatigue, stress - depression, burnout, health disorder, and occupational deformity. The questions of ICD-11, expected to appear in 2021, and, in particular, burnout syndrome, are outlined. The possibilities of information technologies and the Internet in preventing and treating mental health disorders are considered. Conclusions. The increasing role of stress problems in the life of modern society is noted. The methods of psychosocial risk factors limitation and mental health disorders diagnostics need to be developed. Internet-based programs for the preservation and promotion of mental health (e-MentalHealth) are promising.

Introduction. The Russian Federation has certain socio-demographic and geographical features that make it difficult to provide qualified medical care to the population. The relevance of telemedicine in modern conditions is difficult to overestimate. Telecommunications technologies have significant potential to address the challenges of providing affordable, cost-effective and high-quality health services to the population. Telemedicine uses information and communication technologies to overcome geographical barriers and increase public access to health services. On May 9, 2017, the President of the Russian Federation approved the "Strategy for the development of the information society in the Russian Federation for 2017-2030" by decree № 203. Digital healthcare is an integral part of the digital economy. The aim of study is to analyze the regulatory framework for telemedicine support of occupational pathology activities. Materials and methods. The analysis of the development of telemedicine technologies in the Russian Federation is carried out. The legal framework regulating the work of a professional pathologist using telemedicine technologies has been studied. Results. Consultation of the patient or his legal representative by the medical officer are prevention, collection, analysis of the patient's complaints and data of anamnesis, evaluation of the efficiency of diagnostic and therapeutic activities, medical monitoring of patient's condition and decision on the need for face-to-face reception (examination, consultation). The implementation of these measures using telemedicine technologies is regulated by article 36.2 of Federal Law № 323-FZ, which states that remote monitoring of the patient's health and correction of previously prescribed treatment by the attending physician can be carried out after an in-person appointment (examination, consultation). Remote surveillance is carried out on the basis of data about the patient, was with the use of medical devices intended for monitoring human body, and/or on the basis of the data entered into the unified state information system in health care, or public information system in healthcare of the Russian Federation, or medical information system or information system referred to in part 5 of article 91 of the Federal Law № 323-FZ in compliance with, established by the legislation of the Russian Federation in the field of personal data, and compliance with medical confidentiality. Conclusions. It is necessary to implement telemedicine technologies for pre-hospital consultation of patients to clarify the preliminary diagnosis, methods of examination and treatment, and advice on patient management tactics in the long-term period of the disease. The question of using technologies for patient consultation in the "patient-doctor" system remains open due to the peculiarities of diagnostic and expert work of professional pathologists, which requires the analysis of a large number of documents provided by various departments (medical organizations of different forms of ownership, the office of Rospotrebnadzor, Medical and Social Expertise (MSE), employer, etc.).