RELEVANCE: The human resources policy is one of the leading social and economic sectors of society. There is a vast shortage in health professionals on a global scale. This problem is aggravated every year. That’s why it is so relevant now. Public health facilities are affected most of all. They have to compete with private clinics, which provide more favorable working conditions for specialists. The health system needs qualified personnel. The global shortage of doctors due also to “optimisation” processes that have been recognized as ineffective. The human resources policy of health care is aimed primarily to increase the number of medical personnel. The state population's health depends on it. In this regard, the problem of staffing in health care is an important area of ​​analysis. PURPOSE: To analyze employment data in public health facilities in the city of Tver and to evaluate the trends in staff turnover rates. MATERIALS. The data from official reports of polyclinics No. 1, No. 2, No. 3 of City Clinical Hospital No. 7 in Tver (Russia) was analyzed. The assessment was carried out for the period from 2011 to 2020 by comparing three time periods: 2011-2014, 2015-2017, 2018-2020. In the course of its work, mathematical calculations on the validity of the investigated data were made. RESULTS. The analysis of data from polyclinic No. 1 shows a decrease in the percentage of employment among doctors by 38% (p=0.197) and among nurses by 17.5% (p=0.559). The employment of paramedical staff did not change and remained below 50% throughout the decade. There is a clear shortage of outpatient personnel. The indicators of polyclinic No. 2 indicate a stable positive dynamics of staff employment in the field. However, nursing and paramedical personnel require an increase in involvement in the specialty, because there are a large number of free positions. The indicators of polyclinic No. 3 have not changed for 10 years. This polyclinic has a minimum number of rates for the work of medical personnel. It may be due to the peculiarities of the territorial location of this medical institution. CONCLUSION: A decrease in the percentage of staff employment was noted in the polyclinics of the City Clinical Hospital No. 7 for the period 2011-2020 for various reasons. In general, the decrease in indicators was observed among doctors. The grounds for termination of employment may be: the remoteness of the workplace, low wages, high professional loads, including the additional work. It is necessary to develop the right strategy to compensate for the vacant positions of specialists. One of the main reference points can be monitoring the employment of hospital staff. This issue remains relevant in the regions of the Russian Federation.

RELEVANCE: The problem of disability among the able-bodied population is very relevant, because the number of people with a newly established disability group is increasing. Every tenth person in the world has a disability according to the United Nation. The disability is considered to be one of the medical and demographic indicators. Its monitoring underlies ensuring the protection of the health of citizens. Research on the epidemiology of disability plays an important role in preventing an increase in the number of disabled citizens. PURPOSE: To study the dynamics and structure of disability among patients of a surgical department and assessing the degree of disability among residents of the city of Tver (Russia). MATERIALS: The analysis was carried out using the data on the official reports of polyclinic No. 1 of City Clinical Hospital No. 7 in Tver for the period from 2010 to 2020. The dynamics of the frequency of registration of persons with disabilities was studied, the structure of disability by groups was analyzed. The degree of reliability of the obtained data was assessed. RESULTS: The rates of citizens with disabilities increased 3.3 times from 2010 to 2020. The dynamics was wave-like. There was a sharp rise in the number of people who received a disability group for the first time from the beginning of 2010 to the end of 2013. The indicators did not change much from 2014 to 2020. However, the dynamics of the percentage of the working population among persons with disabilities developed in inverse proportion. Those who received a disability group for the first time mainly had pathologies of the musculoskeletal system and vascular diseases. The largest number of patients received disability group III (moderate disability) each year. CONCLUSION:The tendency was illustrated through an example of the city of Tver (Russia). The data shows a decrease in the able-bodied population and an increase in social inequality. It is an urgent problem in the region.

RELEVANCE: The human resources policy is one of the leading social and economic sectors of society. There is a vast shortage in health professionals on a global scale. This problem is aggravated every year. That’s why it is so relevant now. Public health facilities are affected most of all. They have to compete with private clinics, which provide more favorable working conditions for specialists. The health system needs qualified personnel. The global shortage of doctors due also to “optimisation” processes that have been recognized as ineffective. The human resources policy of health care is aimed primarily to increase the number of medical personnel. The state population's health depends on it. In this regard, the problem of staffing in health care is an important area of ​​analysis. PURPOSE: To analyze employment data in public health facilities in the city of Tver and to evaluate the trends in staff turnover rates. MATERIALS. The data from official reports of polyclinics No. 1, No. 2, No. 3 of City Clinical Hospital No. 7 in Tver (Russia) was analyzed. The assessment was carried out for the period from 2011 to 2020 by comparing three time periods: 2011-2014, 2015-2017, 2018-2020. In the course of its work, mathematical calculations on the validity of the investigated data were made. RESULTS. The analysis of data from polyclinic No. 1 shows a decrease in the percentage of employment among doctors by 38% (p=0.197) and among nurses by 17.5% (p=0.559). The employment of paramedical staff did not change and remained below 50% throughout the decade. There is a clear shortage of outpatient personnel. The indicators of polyclinic No. 2 indicate a stable positive dynamics of staff employment in the field. However, nursing and paramedical personnel require an increase in involvement in the specialty, because there are a large number of free positions. The indicators of polyclinic No. 3 have not changed for 10 years. This polyclinic has a minimum number of rates for the work of medical personnel. It may be due to the peculiarities of the territorial location of this medical institution. CONCLUSION: A decrease in the percentage of staff employment was noted in the polyclinics of the City Clinical Hospital No. 7 for the period 2011-2020 for various reasons. In general, the decrease in indicators was observed among doctors. The grounds for termination of employment may be: the remoteness of the workplace, low wages, high professional loads, including the additional work. It is necessary to develop the right strategy to compensate for the vacant positions of specialists. One of the main reference points can be monitoring the employment of hospital staff. This issue remains relevant in the regions of the Russian Federation.

No abstract

— Relevance: Cornelia de Lange syndrome is a rare congenital disorder associated with orphan diseases and is characterized by multiple stigmas of dysembryogenesis at birth. This syndrome occurs in newborns with a frequency of 1: 30,000 to 1: 10,000; there are no gender differences in the frequency of occurrence. Cornelia de Lange syndrome is a dominantly inherited disease, but most cases are sporadic de novo, therefore, mainly children with Cornelia de Lange syndrome are born from genetically healthy parents. Purpose: Using the example of a clinical case, to demonstrate the characteristic features of the clinical picture, namely the phenotype and deviations of the neurological status in Cornelia de Lange syndrome. Materials: Girl M., born in 2018, at the age of 1 year 11 months, together with her mother, was admitted to the Center for Pediatric Neurology and Medical Rehabilitation No. 2 in Tver, Russia. The girl had the following complaints (according to the mother): the child does not walk independently, stands with legs apart, and does not speak. She has obsessive movements ("crossed out" hand movement, waves her arms, puts his right hand behind the body, shakes objects in the mouth area), lags behind in development, does not differentiate significant adults, does not speak, there is no pointing gesture. Inpatient examination and treatment was carried out at the Center for Pediatric Neurology and Medical Rehabilitation. Results: Based on the examinations, the following diagnosis was established: Cornellia de Lange syndrome, type 1. Delayed physical, static-motor and mental development. Short stature. Congenital kidney anomaly: horseshoe kidney. Sensorineural hearing loss I-II degree The priority areas in this case are: improving the patient's quality of life, stimulating the development of the mental and motor spheres, socialization with other children. Conclusion: This clinical case demonstrates the need for early diagnosis of genetic disorders in order to build correct social and medical rehabilitation.