The education strategy for public health in Russia started
to change and it is planned that in 2004-2005 finally MPH degree will be
officially recognized in Russia. Concept of SPH as a place for training
PH-specialists has been repeatedly discussed at the level of Ministry of Health
and was supported during Collegium of Ministry in Winter 2002. After visit to
the US Schools of Public Health and discussions Workgroup on education in
Public health around Baltic Sea agreed to start work on standardization of
training programs with five major PH areas crucial for training: epidemiology,
biostatistics, management and health administration, behavioral sciences and
prevention, environmental health. St.Petersburg SPH has included all those
disciplines in the curriculum and this is significantly different from PH
training in the past.
St.Petersburg School was also invited and played important
role in creating new PH curriculum for medical schools in Russian Federation
(project finalized 2003).
School of Public Health has organizational independence
still heavily depending on MAPS. Presently relations between SPH and MAPS are
more of traditional College and University relations than the customary Russian
relation between Academy and its Colleges. Though Academy is still main
employer for faculty and owner of buildings and infrastructure, School is given
freedom in selecting faculty for conducting training (with compensation),
freedom of creating curriculum (with only final approval by MAPS Methodological
Council selecting themes for training. School also possess own operational
budget which is different from usual system of subaccounts for MAPS colleges
and departments. School Director is at the same time Dean of the MAPS College
of Public Health. The overall structure consist of Executive Director (and
Board of Trustees), financial department and course managers who are employed
for organizing and running the courses.
The curriculum for the School has been developed in 2000,
its testing started in Winter School of 2001. Major amendment was made in 2002
(incorporation of STD prevention modules) and smaller amendments in 2003. All
core modules has been tested at least once by March 2003.
Certificate system is heavily depends on decisions of
Russian Government. Due to this fact and after detailed analysis of existing
approved training programs it was decided that use of existing system will be
more appropriate. All students are issued MAPS certificates of completion the
course. All students are entered into database holding information on courses
passed and number of hours trained.
This will form a basis for credit system. First students got School certificate
of basic training completion in December 2003.
During last three years three persons graduated from
Hadassah University Brown School of Public Health with MPH degree and are used
as junior faculty at the school. One person graduated from Boston School of
Public Health MPH-program. Five persons were on a long-time non-certificate
training in Sweden (more than one month duration. 2 persons were on monthly training in Finland. Also numerous
short-term training has been organized for School faculty, mostly in Finland (CINDI
Winter School, North Karelia visitors program, HIV prevention, etc.) but also
in Sweden (Nordic School training course, PH education in Sweden, STD
prevention), Norway (STD prevention) and the US (D-learning in PH, PH training
organization). Informal evaluation show more profound effect of short-term
training on school activityb than MPH-level courses. In general, MPH-level
courses were good for forming future faculty of the school but, judging by
students feedback, less important for ongoing school operation due to short or
non-existent pedagogical experience of MPH. Also some of them has been diverted
to work for different international agencies or left country. Out of 6 persons
trained as MPH abroad, one left MAPS to work for TACIS and then WHO, second
emigrated to the UK. Of four left two are actively participated in training
during 2003 whereas two were more involved in other projects.
Short-term training for established faculty was more
fruitful in terms of involving people in SPH training. Out of “core” faculty
involved in majority of courses (about 10 persons), all has been trained on
short courses abroad, only two outside of the current project. Also visits of
MAPS faculty is influencing work of their departmentsb even if the department
not constantly involved in School activity (for example, departemnts of
Dermatovenerology, Adolescent Health)
Physcial facilities were improved with help of MAPS funds.
During 2000-2003 training took place in filial number 2 located far north of
the city. This was due to MAPS hostel location. In 2003 filial number 1 has
benn restored, where a new hostel has been opened. Now it is possible to
conduct training in place where all informational resources of the school are
located (computer class, E-library, paper-based library and HTA laboratory). At
present, according to the agreement with MAPS School has access to 40-seats
conference-hall, three 15-seats training rooms, three administrative rooms
(director, HTA-lab), computer class (8 computers), computer library (5
computers) and 86-beds hostel. If needed, School can use other MAPS facilities
including 300-seats conference hall (used during second summer school),
50-seats international conference hall (used for Schools in 2001-2003), 30-seats
training room of Family Medicine Department (recently restored, used for LFA
training course) and another 25-seats training room (used for STD courses) and
others. In general, physical facilities are not a problem for the School at
present, owing its tight connections with MAPS.
The sponsor money were used extensively for purchasing
presentation and training equipment for the facilities. OSI has sponsored
purchase of 4 computers for E-library and provision of Internet access (with
match from MAPS). Finnish funds were used for purchase computer equipment
including portable equipment for lecture delivery (notebooks and palm-sized
computers, helping provide quality training outside of MAPS main base). Swedish
funds were used for purchasing LCD projector and additional computer for
E-library. DFID funds were used for overhead projector and some other
presentation equipment. Totally funds from four agencies were used to purchase
equipment that is now used for School activity - USAID, DFID, OSI and SEEC/STAKES.
17 computers were purchased from 1998 to 2003 and several pieces of other
presentation equipment (LCD projectors, camcorders for training video footage
and other projection devices). Of this amount 30% of computer equipment has
been purchased with SweFi support, and 22% of presentation equipment. The
possibility to purchase equipment was very important as Ministry of Health is
capable to provide money for faculty salary and cover room costs but is not
providing money for purchasing small presentation and computer equipment.
During this period MAPS with help of SwiFin financing has
set up Internet access by leased line for main building and filial number 1,
where E-library is located.
The physical facilities now are much better that were at the
beginning of the project and they are better equipped.
Curriculum developed, field-tested and all programs are
passed through Methodological Council of the College of Public Health
(Currcicular Committee). Last program has been passed in January, 2003.
Totally in 2001-2003 21 course has been organized. They are
presented in table below.
|
|
|
|
|
|
|
Partners |
|
|
N/ Donor |
Name of the course |
Approximate dates |
Duration |
Target audience |
Number of people |
Russian |
International |
|
2001 |
|
|
|
|
|
|
|
|
Family in public health |
February 19 - March 2 |
108 hours |
Family physicians, PH specialists |
50 |
|
National Public Health Institute (Finland) Finnish Centre for Health Promotion (Finalnd) Karolinski Institute (Sweden) SEEC (Sweden) Hadassah University (Israel) |
|
|
2 OSI STAKES |
Health promotion and Disease prevention |
May 14 – 25 |
108 hours |
PH specialists, physicians, general practitioners |
33 |
Moscow Institute for preventive Medicne |
University of Tampere (Finalnd) SEEC (Sweden) STAKES (Finland) |
|
3 SEEC STAKES |
Epidemiological basis of the Public Health |
June 18 – 29 |
108 hours |
Postgraduate fellows, research workers, residents, PH
specialists |
49 |
Socmedeconominform (Moscow) |
University of Tulane (USA), SBU (Sweden), Karolinski Institute (Sweden), the Hospital District
of Helsinki and Uusimaa (Finland), STAKES (Finland), SEEC (Sweden) |
|
4 Task Force, STAKES, SEEC |
Prevention of STD in general practice. Part I |
October 29- December 2 |
36 hours |
PH specialists, general practitioners |
21 |
Institute of Sociology (Petersburg) Unit of Skin and Venereal Diseases (Petersburg) |
National Public Health Institute (Finland) Stockholm County Government (Sweden) |
|
5 OSI SEEC |
Evidence-based medcine and health technology
assessment |
November 26 - December 7 |
108 hours |
Nordic & Baltic BRIMHealth students |
15 |
Evidence-CPR, Moscow Medical Academy |
Duodecum (Finland) SBU (Sweden) Karolinska Institute (Sweden) |
|
2002 |
|
|
|
|
|
|
|
|
1 MAPS |
Methodology of medical
science. Basics of EBM |
February 4- March 3 |
144 hours |
Postgraduate fellows,
research workers, residents |
11 |
Evidence-CPR |
|
|
2 SEEC STAKES |
Health Economics and
Management |
February, 11 -22 |
108 hours |
Chief physicians |
63 |
Moscow Medical Academy |
University of Tulane
(USA), SBU (Sweden), National Board of Health & Welfare (Sweden),
Karolinski Institute, University of Tampere (Finland), STAKES (Finland), SEEC
(Sweden) |
|
3 STAKES Norway |
STD prevention II |
May 13- 21 |
72 hours |
General Practitioners |
17 |
- |
STAKES (Finland) |
|
4 SEEC STAKES |
Inequity and Health |
June 17-19 |
27 hours |
General practitioners,
sociologists, faculty |
60 |
|
SEEC (Sweden) |
|
5 STAKES SEEC |
Statistical software.
Case of SAS |
July 1-5 |
36 hours |
Faculty |
12 |
|
|
|
6 OSI |
Health Economics and
Management (in English) |
November 25 - December
6 |
108 hours |
Nordic & Baltic
BRIMHealth students |
20 |
Moscow Medical Academy,
OSI, Tver Medical Academy |
University of Tulane
(USA), Karolinski Institute, University of Tampere (Finland), STAKES
(Finland), SEEC (Sweden) |
|
7 OSI STAKES SEEC |
Evidence-Based Medicine
and Health Technology Assessment |
December 9 - December
20 |
108 hours |
Physicians, faculty |
60 |
Moscow Medical Academy,
Russian Cochrane Center, |
SBU (Sweden),
Karolinska Institute (Sweden), Evidence-CPR (USA-Russia) |
|
2003 |
|
|
|
|
|
|
|
|
1 MAPS |
Good Clinical Practice |
March 25-26 |
12 hours |
Postgraduate fellows,
research workers, residents |
17 |
Evidence-CPR |
|
|
2 SEEC STAKES |
Sociology and
Psychology in Public Health |
February, 24 -March 7 |
108 hours |
Chief physicians |
25 |
Open Health Institute |
University of Chicago
(USA), STAKES (Finland), SEEC (Sweden) |
|
3 SEEC STAKES |
Public Health:
Economics, Psychology, Prevention |
June 5-19 |
108 hours |
Vyborg region chief
physicians |
28 |
|
SEEC (Sweden) |
|
4 MAPS |
Behavioral sciences and
statistics |
September 8 - October 4 |
144 hours |
Postgraduate fellows, 2
year |
44 |
|
|
|
5 OHI |
Evidence-Based medicine |
October 6,8 |
12 hours |
Faculty, Postgraduate
fellows, research workers, |
18 |
|
|
|
6 MAPS |
Introduction to
research |
October 13-17 |
36 hours |
Postgraduate fellows,
1-year |
30 |
|
|
|
7 Ott Institute |
Evidence-Based medicine
and biostotistics |
November 10, 12, 17, 19 |
24 hours |
Faculty, Postgraduate
fellows, research workers, |
17 |
|
|
|
8 OHI |
Behavioral Sciences in
Public Health (in English) |
November 24 - December
5 |
108 hours |
Nordic & Baltic
BRIMHealth students |
15 |
|
Karolinski Institute,
STAKES (Finland), SEEC (Sweden)
|
|
9 DFID |
Distiance Learning in
Family Medicine |
November 3-4 |
12 hours |
Faculty |
12 |
|
Royal College of
General Practitioners |
|
|
|
|
564 hours |
|
206 |
|
|
As is seen from the table, the number of training hours was fairly stable during those years
· 2001 468 hours - 5 courses
· 2002 603 hours - 7 courses
· 2003 564 hours - 9 courses
but the number of courses rose, which mean that average
length of the course declined and number of students per course also declined
(see table below)
|
hours |
students |
courses |
av.hours |
av.course |
|
468 |
168 |
5 |
94 |
34 |
|
603 |
243 |
7 |
86 |
35 |
|
564 |
206 |
9 |
63 |
23 |
The first years of activity showed that there is significant
interest in PH training, especially in fields of clinical epidemiology with
biostatistics (commonly known as evidence-based medicine) and prevention. But
people interested in training are usually working and for them it is very
difficult to leave working place for a long period of time. Because of this
School administration decided to cut length of training and increase
investments in Distance Learning.
The courses ran by the School in 2000-2003 could be roughly
divided into following groups:
Introduction to PH
Ø Foundation of Public Health: Economics, Psychology and
Prevention
Ø Introduction to Research (Regular MAPS course)
Management and Economics
Ø Health management and Economics
Ø Health management and Economics (English)
Ø Public Health Administration
Ø Modern principles of management
Ø Clinical Management
Epidemiology
Ø Family and Public Health (genetic, reproductive &
environmental epidemiology and epidemiology of aging)
Ø General and clinical epidemiology
Ø HTA and Evidence-based medicine (English)
Ø HTA and evidence-based medicine
Ø Evidence-Based Medicine and Health Technology Assessment
(Regular MAPS course)
Ø Social epidemiology
Biostatistics
Ø Statistics with SAS software in research
Ø Statistics for medical researchers (Regular MAPS course)
Prevention
Ø Prevention in Health Care
Ø Health promotion and disease prevention
Ø Primary prevention of STD
Ø Secondary prevention of STD
Behavioral Sciences
Ø Sociology and Psychology in Public Health
Ø Behavioral Sciences in Public Health (English)
Brief list of modules prepared 1999-2003
v
Epidemiology
Ø
Basic epidemiology
Ø
Clinical epidemiology
Ø
Special epidemiology (genetic,
reproductive, environmental)
Ø
Mathematical epidemiology
v
Biostatistics
Ø
Basic biostatistics
Ø
Introduction to epidemiological
statistical software
Ø
SAS
v
Evidence-Based medicine and health
technology assessment
v
Health economics and management
Ø
Basic economics for health care
managers
Ø
Health economics
Ø
Management in health care
v
Prevention and Health promotion
v
Behavioral Sciences in Public Health
(Sociology and Psychology)
v STD prevention
As seen from this data courses were developed and tested with positive
feedback from students and large number of students trained (617 participants
in 2001-2003).
All courses are using group works, foreign teachers, especially on the
first schools has demonstrated many methods that are used now by Russian
faculty, including buzz groups, "press-conference" training and
fishbowl (courses on health economics and management). Supervision is actively
used in training. Balint groups were repeatedly demonstrated (behavioral
sciences courses). Together with partners from UK several training seminars
were organized dedicated to modern teaching methods. The Department of Teaching
Skills is running courses on pedagogical methodology, including workshops on
Instruction System Design, Distance
Learning, Learning by Questionning, Problem-Based Learning, etc. Many of those
models are used at MAPS and in SPH, though many of them still on small scale.
There were two types of courses for trainers. One type were training
courses abroad in which only limited number of faculty participated and the
second were courses for faculty of the School and MAPS organized in
St.Petersburg. Among first group of courses it would be necessary to mention
the following:
Problem-Based Learning (University of Linkoping,Sweden; Helsinki
University, Finland) 2000
E-learning (CDC, Atlanta) 2001
Implementing EBM and HTA (Helsinki, 2003)
Open and Distance Education (Open University, UK) 2003
Also faculty of the School took place in many other courses and seminars,
among them
·
North Karelia Project Visitors Program
(Finland, 2000)
·
Searching for an Evidence Base for
Health Promotion (Finland, 2000)
·
3rd Nordic Health Promotion Research
Conference (Finland, 2000)
·
ASPHER conference (Aarhus, 2000)
·
INAHTA conference (Hague, 2000)
·
Round Table of the Russian public
health schools (Moscow, 2000)
·
Seminar in Kellokoski (Finland, 2000)
·
CINDI Winter School (Finland, 2001)
·
The WONCA conference (Finland, 2001)
·
Course on research of local health
policy and health promotion (Finland, 2001)
·
Summer School on Public Health
(Cheljabinsk, 2001)
·
The Seventh International Congress of
Behavioural Medicine (Finland, 2002)
·
Development of PH training in NIS
(Jerusalem, 2002)
·
First International and Baltic Course
on Women, Work, and Health (Latvia, 2002)
·
The 2002 Conference of the European
Society of General Practice /Family Medicine - WONCA Region Europe (London,
2002)
·
Summer School on Public Health (Tver,
2002)
·
Logical Framework Project Planning
Course (St.Petersburg, 2002)
·
INAHTA conference (Canmore, 2003)
·
Summer School on Public Health
(Moscow, 2003)
·
Advocacy in Public Health (Tbilisi,
2003)
·
ASPHER conference (Granada, 2003)
Some courses were organized at MAPS and faculty has been trained on them.
Out of persons most actively participating in the training (having more than
288 credit-hours) 45% were young school faculty. One course was organized
specially for faculty of the school (Statistics summer course, 2002). All
faculty of MAPS obliged to train at courses on teaching methodology, delivered
by Department of Teaching Skills, which chair is Executive Director of the
School.
The development of distance education started in 2001. Prior to each
course, material related to the course were published on the website of the
school. The first study materials were uploaded on the website before the
Winter School in 2001. The materials dealt with family psychology, a child’s
development, violence against women, environmental epidemiology and public
health methods. An enquiry among the students showed that many of them had got
the material and read it before the course.
As a part of the advanced course in Health Promotion in May, a
comprehensive set of material was given to the students on the website of the
school. The material consisted of Russian translations of British Medical
Journal articles on prevention, a number of Russian articles and abstracts on
the same topic, as well as a large article on the public health reform. In 2001
the development of distant learning also involved a study on content mediation
on the Internet (text formats, recording of lectures etc.) by IREX/USAID
funding. Our project has also contributed to getting modern information
technology equipment for the school.
2002 witnessed creation and testing of the first distance education
course "Role of barrier contraception methods in STD/HIV prevention".
The work on the project has started in October 2001, when first data of needs
assessment has been obtained. A subject matter expert groups has been formed
(including chief dermatovenerologist of St.Petersburg, Director of largest
youth STD prevention clinics (Youth health center), general practitioners,
etc.). Three meetings has been organized in November 2001 - February 2002.
Course material has been selected and translated (about 200 pages). Also
collection of illustrative material for the site has been made (graphs,
original photos of commercial sex workers in St.Petersburg, etc.)
The discussions of the structure of the course lead team to believe that
participants should not be persuaded that STD are serious problem for the
public health in Russia, but they need to have data to persuade others and they
need to have tools for rough forecasting of the epidemic situation.
Correspondingly the basics of mathematical epidemiology have to be included in
the training curriculum. The data that
are needed for the epidemics forecasting are existing situation with STD and
sexual behavior data. The data on STD incidence for the last 10 years has been
collected from Bureau of Medical Statistics of St.Petersburg and from project
EpiNorth database. The data were collected in such a way that allowed comparison
with other regions of North-West of Russia and Nordic neighbors. The data on sexual behavior has been taken
mostly from Russia Longitudinal Monitoring Study (RLMS) and additionally
results of survey of sexual behavior made by MAPS researchers were introduced
into presentation dedicated to the role of sexual networks in STD spread.
Additional information that describes behavior of risk group (commercial sex
workers and students) has been found and included in materials for
study.Detailed description of application of principles of mathematical
epidemiology for STD forecasting is presented as separate part of the course
completed with Excel worksheet for modeling experiments.
Course structure
Correspondingly at present course consists of five basic parts (detailed
description of the course structure is in Appendix)
I. Introduction
II. Introduction into the needs for prevention
III. Barrier methods for prevention
IV. Signs, symptoms and treatment of STDs (elective)
V. Information on STD prevention in Internet
By-product of the project: methodology of workload estimation for
D-learning courses, basing on the experience changes to the Ministry of Health
order on D-learning has been proposed (August 2002)
Some facts about the course
·
Total size of the site - 22 MB (with
exclusion of the MESH dictionary downloadable files), number of files - more
than 1,000
·
Number of pages with information
(equivalent to printed pages) - 1085
·
Number of
pictures/graphs/illustrations - more than 170
·
Number of MCQ tests created for the
project - 157
Software developed
·
MS-DOS based program for the off-line
knowledge testing
·
VB Script based applets for on-line
examination after compulsory modules
·
JavaScript-based pages for on-line
self-assessment during study
·
Excel worksheet demonstrating
approaches to the modeling epidemic spread
2003
During 2003 School has started to prepare a new distance learning project
on control of communicable diseases for PHC professionals (CME courses) and
general public. (Task Force PHC 002).
The package is dedicated to the comprehensive planning of STD/HIV
prevention efforts based on understanding politics and sociology of STD
epidemics. Course is developing themes raised and discussed in DE-course
DProf-01 mentioned above. In Summer 2003 the project has been presented to the
specialists from Open University in UK (world leading provider of open and
distance education). They have recommended changes in evaluation structure of
the course as previously adopted model was too time-consuming during
development phase and allowed less than optimal interaction at the
implementation phase. As a result emphasis has been changed in evaluation from
exclusively MCQ-based approach to short papers and essay-type evaluation.
Also materials structure has been changed and all materials has been
divided into three parts:
·
Introductory Readings
·
Core Material
·
Advanced Reading
Introductory reading contains materials for understanding basic concepts
and important things that will follow. It is either not evaluated or evaluated
by short papers. Core materials is a main topic of the module. It is evaluated
by combination of MCQs and essay. Advanced Reading is an additional information
designed to help students understand basic concepts and applications more
thoroughly. It is evaluated by means of essays and short papers.
It is difficult to estimate volume of materials shortly reviewed so we
will report only data on relations between amount of materials thoroughly
reviewed (read by course developers) - from monographs and amount of it decided
to be useful and underwent translation:
Total amount reviewed 12525 pages in 32 books. Hours necessary for
reading was 1253 or 7 person-months of worktime. Of this amount selected for
translation was 842 pages or 7 percent. Total amount of pages translated (at
3500 characters per page - average textbook page) - 433. Equivalent to the 842
printed pages (at 1800 characters per page).
Amount of information retrieved in Russian language for the use during
the course (in printed pages)
Core part - 408 pages. Major components of training materials include
handbooks on dealing with marginalized population (drug users, commercial sex
workers), participatory evaluation and using LFA for planning projects
(abridged Tempus handbook)
Newspaper and magazines clippings (HIV/AIDS, STD and prostitution in mass
media) published originally in Russian: 451 pages
The analysis of technological aspects of DE has been continued in 2003.
The following resources for distance learning at the end-user level were
analyzed: content delivery by internet with rich multimedia, delivery by
internet mostly HTML-based text, WAP-oriented delivery. Also different modes of
access were studied: dial-up connections, leased line access, HSCSD mobile
access, GPRS mobile access and CSD mobile access. All methods of access are
available inside metropolitan St.Petersburg. To test adequacy of WAP access a
WAP-site with concise information on STD treatment was set up. It was found
that WAP access functioned well with English-language information. The problems
with Cyrillic, found previously were solved and additional WAP-site has been
created, with Cyrillic support. GPRS and HSCSD performed well under conditions
of download of test materials. The download of HTML pages performed well under
GPRS and the DE-site has also functioned well.
At present the School has two modules for Distance Learning up and
running. One course is completed and another one will be completed in first
quarter of 2004. More courses are planned and material is collected for them.
The center has been organized in 2000 based on Center for Scientific
Medical Information. Computer class has been set up, equipped (with help of OSI
funds), and Internet connection has been established (in 2001, MAPS funds and
SEEC financing). In 2002-2003 access to the electronic resources was mostly
financed through OSI-sponsored projects and SEEC-supported projects with
support (in 2002) through Task Force projects. Most electronic media has been
purchased with SEEC funds. STAKES funds are used for purchasing some of the
equipment.
The Division for Scientific Medical Information subscribes to different
paper-based and electronic bibliographical sources. Among them
Information publications:
"Bulletin of international scientific meetings and conferences"
(VINITI), "All exhibitions", "Scientific information".
Series 1 (VINITI), "Scientific and technical libraries",
"Informational technologies in health care", "Informational
resources of Russia"
Journals:
Bulletin of new medical technologies, Practical physician, New medical
journal, Russian medical journal, Scientific and practical aspects of
environment protection, Disaster Medicine, New knowledge, BYTE, PC Magazine/RE,
PC World/RE, World of Internet, Home Computer
Electronic full-text sources are
Elibrary
eIFLDIrect (EBSCO)
Cambridge University Press E-library
Integrum-Techno
Cochrane library of systematic reviews
which provide access to the full-text texts of journals published by
Kluver Publishing, Springer Verlag, EBSCO, Silver Platter and some other.
The paper based library from the outset was envision as resource center
for faculty and those School students that engage in research projects. In
contrast to public library the School library will contain mostly one copy of
each book, which will allow to cover wide range of themes with relatively
modest funds, taking into account high prices of books, published in English
and limited availability of books on Public Health published in Russian.
In the year 2003 School got the books primarily from two sources -
STAKES-sponsored purchases and DFID
project (development of D-learning).
At present library of the School of Public Health contains about 430
volumes (in 2001 it was about 100 books) roughly classified in the following
categories:
·
Statistics - 15% (63)
·
Basic Epidemiology - 10% (43)
·
Infections/STD/HIV - 11% (46)
·
Health management - 5% (23)
·
Psychology and sociology in public
health - 12% (52)
·
Evidence-based medicine & pharmacoepidemiology
- 7% (29)
·
Pedagogic - 6% (25)
·
Health & general economics - 4%
(18)
·
Other
Largest donors for the library are STAKES and OSI. Number of books
donated by largest donors
STAKES - 34%
OSI - 25%
USAID - 9%
DFID - 8%
SEEC - 4%
Total cost of the books already purchased for the library exceeds 35,000
USD.
The library is successfully used in courses preparation.
With project support two books has been prepared:
S.L.Plavinski Statistical Decision-making
S.L.Plavinski Short textbook of meta-analysis
Guidelines for Preventing STD in General Practice/ ed. By O.Kuznetsova
K.Raznatovsky, A.Barinova Sex without venereal diseases
Medical Postgraduate Training/ ed by N.A.Beljakov (chapters on Distance
Learning)
Presently in preparation:
book on statistical analysis
book on health economics, management and training in
health care
Many publications were prepared with partial or full support from the
project by the following School faculty: O. Kuznetsova, S.Plavinski, E,Frolova,
T.Dubikaitis, E.Rekushevskaya, N.Gurina, A.Barinova, I.Moiseeva, et others. In
2003 S.Plavinski with co-authors published article in BMJ on social
determinants of mortality in Russia.
Starting from 2003 accents in production of learning materials has been
transferred to Web-based materials. Formerly it has been used mostly as a place
for students to access and download hand-outs and other materials additional to
face-to-face training courses. After successful implementation of the first
D-learning course in 2002 the transformation of Web-site to repository and a
kind of on-line library for PH specialists took place. Supported by financing
for development of D-course on STD prevention and on development of HTA/EBM,
School started to place on-line translation of materials and redesigned the
site for better representation of PH training.
Presently the site consist of :
General information:
speeches of H.Mahler on the opening ceremony of the School of Public
Health in St.Petersburg and C.Ortendahl on receiving Honorable Doctor Degree at
SPb MAPS
short information on organizations that supported the School
Curriculum
School curriculum
PH curriculum for
physician-residents
Information about School
courses for this year
School evaluation report
(F.-K. Jorgenssen)
After that training materials are presented, separated in five major
domains of Public Health, namely: Epidemiology, Biostatistics, Management and
Health Economics, Psychology and Sociology in Public Health and Prevention. At
present two training modules - 1e (Basics of mathematical epidemiology, about 6
chapters) and 1p (Infectious agent biology and epidemics, about 14 chapters)
are placed in free access for self-training. All other materials are considered
as a help and self-education by PH specialists, faculty of other Schools and
lay persons. The following resources are now placed on site:
Epidemiology
Introduction to
epidemiological methods
Estimating the Size of
Populations at Risk for HIV
Estimating the
Prevalence of Drug Misuse on the Local Level. Capture-Recapture
Two translated
epidemiology textbooks (from free access Web-sites):
Coggon et
al., Epidemiology for the uninitiated
Dicker et al., An Introduction to Applied Epidemiology
and Biostatistics
Hand-outs from
epidemiology courses at the School
Biostatistics
Comparison of
statistical software programs (selection of articles)
Why we need to use
command-line statistical software (selection of articles)
How to select
statistical test
Statistical Evaluation
of HIV Prevention Programs
Statistical Analysis in
SAS (book chapters)
Introduction to Stata
Epidemiological tables
in Stata
Hand-outs from
statistics courses at the School
Management and Economics
Introduction to
strategic planning
Textbook on health
economics (from other site)
Textbook on
microeconomics (from other site)
Hand-outs from economics
and management courses at the School
Sociology and Psychology
Hand-outs from
behavioral sciences courses at the School
Prevention
Public Health Policy
Development
Quality Assurance and
Quality Improvement in Public Health
Preventive Program
Evaluation
Other materials include information on EBM/HTA - more than 25 articles
and book chapters, short textbook on PubMed search and Women's Health materials
(about 20 articles) and pedagogics materials, mostly on distance learning
(about 30 articles). Totally site holds translation of more than 100 different
articles and book chapters on different aspects of Public Health.
Textbooks are also available for download in on-line Library, presently there are 10 books:
3 on epidemiology (including Abramson's Making sense of data, provided by
Tver School of Public Health), 2 on biostatistics (Statistical Decision-making,
by S.Plavinski and Econometrical analysis in Stata by S.Kolenikov), 2 on
economics, 2 on prevention (STD prevention by Barinova and Raznatovski and
Contraception textbook). Also short textbook on PubMed search is placed
on-line.
All materials are provided in download-friendly format read by most
computer platforms, including palm-sized computers (iSilo or Adobe PDF).
The materials from the site are
extensively used for training in Tver School of Public Health (indicated in
list of resources), Moscow Medical Academy and Cheljabinsk School of Public
Health.
In September 2003 School has joined SpyLOG Web-tracking service to better
analyze Inetrent-audience of the School Web-site.
In October-December 2003 there were more than 8300 different visitors to
the School Web-site. It has translated in 470 visitors per week and 2700
visitors per month. About 90 persons has visited site more than three times
each week, being so-called "core users".
Most visitors were from Moscow (34.3%) 14.3% were from St.Petersburg and
about 2% each were from such cities Ekaterinburg, Vladivostok, Novosibirsk,
Rostov-on-Don, Tomsk. Slightly less visitors (less than 2%) were from Irkutsk,
Nyzhnyi Novgorod, Saamara, Kazan, Perm, Krasnodar, Ufa, Krasnojarsk,
Cheljabinsk and Stavropol. This shows, that Web-site is accessible and is used
by visitors from almost all large and medium cities of Russia.
Not only Russian visitors are using the site. Russian audience comprise
about 76% of all visitors to the site, with Ukraine occupying second place
(6.7%). About 2% of visitors were from the USA and 1.9% from Kazachstan and
Belorussia each. Also there were visitors from Germany, Latvia, Kyrgisia,
Israel, Estonia, Lithuania, Moldova, Georgia, Uzbekistan, Azerbajdzhan, Sweden,
UK, France and other European countries, showing that the site is becoming
interesting for visitors from different countries, but mostly from NIS, because
of majority materials published in Russian.
In 2000-2003 the School of public Health in St.Petersburg has been active
participant of the project on development of Baltic International School of
Public Health, issuing MPH degree according to the ASPHER standards. This
project is a legacy of BRIMHealth project, but with less leading role from the
Nordic School of Public Health in Goteborg, Sweden (NHV).
The BRIMHEALTH Program (Baltic Rim Partnership for Public Health) was
started in 1993 involving Estonia, Latvia, and Lithuania. Poland and the area
of St. Petersburg joined the program in 1996. Within the framework of the
BRIMHEALTH program during 1993-1995 the first cohort of Baltic students –
public health trainers and key decision makers – were trained in the Nordic
School of Public Health, introducing the principles and ideas of the new public
health in theory and practice. Since 1995 more of the training was run in the
Baltic countries as knowledge, competence and resources were growing there.
Development of BISPH
In 2000 the preparatory work to establish the Baltic International School
of Public Health (BISPH) started. The plan was approved as “New Memorandum of
Understanding” and is now signed by the partner institutions from Estonia,
Latvia and Lithuania as well as the Ministries of Health of the Baltic States.
According to the ”New Memorandum of Understanding” the present founder
institutions of the BISPH are Kaunas Medical University, Vilnius University/
Centre of Social Medicine, Tartu University/ Department of Public Health,
Latvian School of Public Health, The Medical Academy for Postgraduate Studies
St. Petersburg and the Nordic School of Public Health. The ”New Memorandum of
Understanding” makes provision for the admission of new members, too. By a
letter dated August 27, 2001, the Jagellonian University in Poland has
expressed its interest to join the collaboration in 2002.
The working language of BISPH is English, which has the makings of the
international network for public health training around the Baltic Sea. An
example of the successful international network is the exchange of students
between the BISPH and Nordic School of Public Health, which has been
implemented already since 1997 within the framework of the BRIMHEALTH program
and will continue in the BISPH as well.
Three courses read at St.Petersburg SPH are included in the BISPH
curriculum: "Evidence-Based Meicine", "Health Management and
Economics" and "Behavioral Sciences".
The BISPH financing has ended 2003 and its future unclear, but the same
participants are now forming Network of Public Health Schools around Baltic Sea
under umbrella of Task Force for Communicable Diseases, last meeting in Oslo
has supported idea of joint application to EU funds for continuing
collaboration.
Apart from BISPH partners, the School of Public Health also has good
working relations with the following training institutions:
·
Karolinska Institute (Sweden)
·
Nordic School of Public Health
(Sweden)
·
University of Tampere (Finland)
·
Hadassah University Brown School of
Public Health (Israel)
·
Public Health Training Network (USA)
·
Technische Universitaet Berlin
(Germany)
·
University of Leipzig (Germany)
·
University College London (UK)
·
University of Birmingham (UK)
·
Tulane University School of Hygiene
and Tropical Medicine (USA)
Systematic reviews performed:
Effectiveness of hypolipidemic therapy (published, 2001)
Low cholesterol and aggression (published, 2002)
High blood pressure treatment (2003)
Antioxidants role in treatment of human diseases and
conditions (2003)
HTA research reports:
Analytical Hierarchy Process Incorporating
Evidence-Based Effect Measures. Abstr. of the 2001 ISTACH Meeting, -
Philadelphia, 2001.- p. 32
Use Of Data On Number Needed To Be Treated (NNT) Derived
From Randomized Controlled Trials To Aid Economic Decisions on Treatment//
Abstr. of the 2003 ISTACH Meeting, - Canmore, 2003.- p. 8
Cardiovascular epidemiology (STAKES support)
A research project on cardiovascular diseases, stroke, and cancer in the
Krasnogvardejskij district, St. Petersburg, was started in 2002, and was
continued in 2003. The project was started due to especially high morbidity and
mortality rates in the Krasnogvardejskij district caused by the above-mentioned
diseases. The partners of the St. P. School of Public Health in this project
are the Health Committee of the Krasnogvardejskij district, the St. Petersburg
Centre for Statistics, and the St. Petersburg Centre for Health Education. In 2002, surveillance of the risk factors of
the mentioned diseases was implemented; 1640 persons were questioned (There are
400,000 inhabitants in the Krasnogvardejskij district.) The results of the
screening and questionnaire were analyzed and showed high prevalence of smoking
(about 60% males and 26% of females, especially young females among whom about
32% are smoking), arterial hypertension (more than 40% - with about 30%
untreated hypertension), high alcohol consumption (in younger age groups 20%
and more consumed more than 20 g ethanol/day). More than 40% have had excessive
body weight. Patient education materials have been distributed by nurses and
physicians who will first were trained at MAPS. The research project and
intervention are used as education tools for students of the St. P. School of
Public Health.
Publications are in preparation
Other projects
Research grants for young scientist awarded in 2002 to
Irina Moiseeva to study non-pharmacological treatment of hypertension in
general practice.
Cardiovascular epidemiology (other support)
Analysis of the causes of increased mortality among Russian males in
mid-90s has been made. Some social factors responsible for this are identified.
Major publications:
S.L.Plavinski, S.I.Plavinskaya, V.Richter, F.Rassoul,
W.Schilow, A.N.Klimov. The total and HDL-cholesterol levels in populations of
St.Petersburg (Russia) and Leipzig (Germany) Nutr. Metab.Cardiovasc.Dis.- 1999,
v.9, N4, P 184-191
Plavinskya S.I., Klimov A.N., Plavinski S.L. Drop in
HDL-C level as possible cause of increased mortality in population.
St.Petersburg, Nauka Publishing, 2000, p. 139-140 [in Russian]
Plavinski S.L. Mortality and the lipid levels in Russia
in the 90s. Abstr. of the XI Lipid-Meeting Lepzig, - Lepzig, 2001.- p. 43
Plavinski S.L., Merkusheva E.V. The level of blood
cholesterol in the population of St.Petersburg. Is there any need for
concern? In: Lipoproteinmetabolismus
und aterosklerosepravention. Hrsg. von V.Richter, W.Reuter, F.Rassoul, J Thiery
- 2002, Verlag Wissenschaftlische Scripten, Zwickau.- S. 365-370
S. L Plavinski, S I Plavinskaya, and A N Klimov. Social
factors and increase in mortality in Russia in the 1990s: prospective cohort
study//BMJ - 2003; 326: 1240-1242.
S. L Plavinski, S I Plavinskaya, and A N Klimov.
Increase in mortality in Russia in the 1990s//BMJ - 2003; 327: 751.
Infectious diseases epidemiology
Most of the activity is centered on modelling STD
spread, studying risk factors of STD and sexual behaviour. Research support was
given through:
Research grants for young scientist awarded in 2001 to
Elena Rekushevskaya for her work on STD prevalence in general practice
Research grants for young scientist awarded in 2001 to
Viktoria Boeva for her work on risk factors of STD in adolescents
Research grants for young scientist awarded in 2002 to Anna Barinova for
her work "Development of diagnostic score for optimizing diagnosis and
treatment of genital chlamydia infection".
Some publications:
Plavinski S.L. The Role of HIV infection in the Russian
Federation. The role of sexually transmitted diseases (STDs). In: Being
Positive. Perspectives on HIV/AIDS in the EU's Northern Dimension and Finland's
Neighbouring Areas./ ed by Aaltonen U., Arsalo U., Sinkkonen.- STAKES, 2002.- p. 121-128
Plavinski S.L. Mathematical modelling of STD. Russian
Family Physician.- 2002.-N. 1.- с. 16-22 [in Russian]
Other publications are in preparation.
The study of caost-effectiveness of cardiovascular prevention efforts
based on RCT in Pontonnaya village in St.Petersburg has been performed. Results
are published:
Frolova E. et al. Effectiveness of CVD prevention.
Problems in Health Administration - 2003.- N 3.- 73-82 [in Russian]
Frolova E. et al. Effective correction of cardiovascular
risk factors. Economics and Health Administrations 2003 .- N 5 [in Russian]
N.Gurina has researched and prepared a report on maternal mortality in
St.Petersburg. She analyzed all causes of maternal mortality in St.Petersburg
from 1992 to 2001 (148 cases of maternal mortality and 29 cases of fatal
accidents with pregnant women). Publication:
Gurina N.A. Causes of maternal mortality in
St.Petersburg/ Development of the Schools of Public Health., Tver, 2002.– С.
70-73. [in Russian]
Other publications are in preparation