Problems of Social Hygiene,
Public Health and History of Medicine

Within the framework of research project on studying job satisfaction among general practitioners in Moscow medical organizations, studies have been expanded to analyze the “Job Satisfaction” factor across 7 components characterizing job satisfaction of physicians. The new data was obtained concerning impact of different levels of the indicator on quality of interaction with patients.
The purpose of the study was to develop methodological techniques of studying factors of satisfaction with the work by general practitioners determining quality of interaction with patients and their satisfaction with provided medical care.
The method of parallel survey of primary care physicians of Moscow medical organizations (n=340) and patients (n=394) who visited physician at least once in previous 12 months was applied for one-time assessment of their opinion. The sociological survey was applied using validated Russian version of international psycho-social questionnaire COPSOQ III (Long version), adapted for health workers, and standardized international questionnaire EUROPEP to assess patient satisfaction with provided medical care (in 2022–2023). The non-parametric Kraskel-Wallis test was used to compare the groups (level of statistical significance p≤0.05).
The results of the study confirmed the reliable correlation of low quality interaction with patients on the part of the physician (p<0.0001) in comparison groups of job satisfaction by levels “Low — Normal”, “Low — High” and in the groups “Normal — High”. The compared indicators had statistically significant differences (p=0.0001).
It is demonstrated that satisfaction of general practitioners with their work is an influence factor for quality of interaction and patient satisfaction with medical care provided, determining important component in achieving patient satisfaction and improving quality of medical care in patient-oriented model of health care.

All over the world, technologies, globalization, demographic shifts, emergency situations and climate changes are altering conditions how and where people live and work. In many countries, the COVID-19 pandemic and geopolitical crises impacted population psychological health, disturbed labor markets and accelerated pace of changes in labor sphere, especially in sphere of remote work, e-commerce and automation. These changes create new difficulties or exacerbate existing problems. The modern stressful realities affect mental health of working population.
The effective solution of problems in prevention of destructive changes and maintaining mental health of employees is urgent task not only within separate organization, but also for entire sphere of work.
The purpose of the study is to investigate problem of psychological state of Russian society and analyze its socioeconomic aspects.
The empirical basis of the study was data from the official websites of the World Health Organization, the All-Russian Center for the Study of Public Opinion, and the Center for the Development of Advanced Technologies.

The relevance of humanitarian analysis of digitization of medicine is conditioned by the fact that digitization track is a general component of transformation of entire health care system, including relationships between subjects of medicine, changes in content of professional competencies of physician. The necessity of discussion and multilateral reflection of digitization processes unites developers, physicians, management staff of industry, representatives of social and humanitarian sciences.

The innovative technologies are becoming widespread in all spheres of human life, including labor protection. The AI, modern systems of monitoring and data analysis permit to develop devices with functions to determine physical conditions of workers, to track and to prevent emergency situations and to minimize occupational traumatism. The mentioned advantages of such devices are very important in working conditions at maritime industry enterprises where risk of traumatism is increased and physician providing timely qualified care is absent on shipboard. In such conditions it is more rational to prevent risks of traumatism. The list of such devices is quite wide: from sensors analyzing external environment to “intelligent” helmets and boots. With all visible advantages of implementation of innovations into labor protection, the issues of their application in order to control production efficiency of employees continue to be mixed ones. Thus, data from different studies, as well as original survey of ship crew members fixed negative attitude of personnel to such devices reasoning stress condition and increased anxiety level. Hence, it is necessary to develop a number of recommendations permitting to implement innovations into labor protection within the framework of maritime industry and to consider psychological state of workers in order to prevent development of diseases caused by high levels of stress.

The purpose of the study is to introduce into interdisciplinary research field results of media analysis of Big Data in online media concerning problem of achieving healthy and active longevity of rural residents. The media analysis permitted to record low interest of journalists to rural issues and existence of restrictions for rural residents in access to organized modes of achieving healthy and active longevity.

The modern biomedical science grants to humankind significant choice regarding reproductive function. In view of development of biomedical technologies man becomes a producer of one's own human nature that especially is manifested in area of genetic engineering and auxiliary reproductive technologies.
The article problematizes ethical social discourse on medicalization of human reproduction. The main ethical dilemmas occurring at application of procedure of and systematizes the ethical dilemmas that arise during the procedure of extra-corporal fertilization are considered. The occurring medicalization of feminine reproductive health is consequence of understanding of social life as legitimization of care of body on the part of medicine.
The researchers note dominance of biomedical approach to human reproduction. The important aspects of medicalization of female corporeality include such achievements of modern medicine as artificial insemination, extra-corporal fertilization, surrogate maternity, abortion. The main ethical dilemmas occurring during extra-corporal fertilization are related to application of technologies that suppose destruction of part of embryos. The conclusion is made about relationship between possibilities of modern bio-medicine and actualization of ethical problems in this area. The necessity of assessment from point of view both of regulative mechanisms of legislation and ethical expertise is established.

The article presents management model, based on assessment of potentials of sustainable development of medical organizations. The model can be applied to assess efficiency of activities of obstetrics organizations in the Tver Oblast reducing maternal and infant mortality. The basis for model implementation is analysis of data from reporting documentation of obstetrics institutions in the Tver Oblast. It is established that with implementation of management model manager can set in motion leadership potential and evaluate efficiency of innovations even before they start working in the institution. The decrease in maternal and infant mortality due to introduction of new techniques was noted. The implementation of pediatric component for further decreasing of infant mortality is justified.

The marine and medical practice demonstrates that despite measures taken to ensure and preserve health of members of sea craft crew, there is still shortage of marine personnel due to resignation from profession due to illness that actualizes search for additional measures maintaining their working capacity. One of promising areas in this area is new approach in carrying out medical examinations of seafarers, during which additional medical procedures are performed to obtain better research results. Nevertheless, many foreign shipowners continue to accept medical reports without taking into account opinions of such particular specialists as cardiologist and urologist. In order to prevent assignment of crew members unsuitable for work at the sea, the article proposes measures eliminate problematic aspects in actions of seafarers and medical institutions at stage of carrying out pre-scheduled medical examination.
It is necessary to increase quality control of this procedure, including at the expense of granting permission for its implementation only to organizations included in the unified register, which is to be composed in accordance with particular criteria. It is also proposed to use statistics data of examination results to develop recommendations maintaining health of crew members, considering identified individual characteristics.

The corporate financing of programs of health preservation, physical training and sport acquires strategical significance in conditions of modern business. The investments in health of employees not only contribute into improvement of their well-being, but directly impact efficiency and competitiveness of companies. The article analyzes mechanisms of corporate financing of health preservation programs, their impact on business performance. Also statistical data and examples of successful practices are considered.

The efficient functioning of medical organizations is closely related to various external and internal factors. To minimize negative impact of these factors it is necessary to implement risk management concept. The purpose of the study is to rank risks influencing functioning of medical organizations. The A. V. Zavrazhsky typology of risks was applied. The verification of sources of danger of financial risks affecting rational use of budget and non-budget funds of medical organizations was carried out. The questionnaire was developed to assess potential risks using six-point scale. The respondents (n=256) were proposed to evaluate degree of influence of risks on quality of medical care. The sampling also included heads of regional medical organizations participating in mandatory medical insurance system and subordinated to the Minzdrav of the Saratov Oblast. The following statistical methods were applied: goodness-of-fit test, Kruskal-Wallis H-criterion, Nemeni criterion, Fligner-Killeen test, permutation test.
The financial risks (26%) occupy first place in structure of influence on efficiency of medical care, followed by general economic (24%), legal (18%), social (17%) and professional (15%) risks. The correlation between evaluation of risks, position and length of service of respondents was established. The insufficient funding at the expense of mandatory medical insurance funds is the most significant financial risk affecting quality of medical care.
The study permitted to rank risks for medical organizations in the Saratov Oblast and to identify key factors affecting their assessment. The results of the study can be used in developping effective risk management strategies in medical organizations, targeted to improve quality and efficiency of medical care.

The objective of the study is to assess degree of alcoholization in national regions in dynamics. The study provided analysis of efficiency of measures targeted to decrease alcohol consumption by population in the constituent entities of the Russian Federation based on dynamics of changes of integral indicator of “The National Rating of Sobriety of the Subjects of the Russian Federation” in 2016–2023.
The analysis of dynamics of integral indicator was carried out on the basis of data presented in the reports of like name for 2016–2023.
In 2016–2023, in 41 out of 85 Regions of the Russian Federation, decreasing of the integral indicator was established, while in 44 regions increasing of the integral indicator was detected. The three regions with the most significant increase of the integral indicator included the Republic of Ingushetia (increase in 2023 as compared to 2016 was 23.5% with average annual growth rate of 3.4%), the Altai Republic (increase of 20.6% and an average annual growth rate of 2.9%) and the Leningrad Oblast (increase of 19.5% and average annual growth rate of 2.7%). The regions with the largest decrease of the integrated indicator included the Lipetsk Oblast (decrease in 2023 as compared to 2016 was 20.9% with average annual decrease rate of 2.3%), the Tyumen Oblast (decrease 26.8% with an average annual decrease rate of 2.9%). The largest decrease of the indicator in 2023 as compared to 2016 was detected in the Krasnodar Krai — 36.8%, with average annual decrease of 3.8%. The Subjects of the Russian Federation, depending on value of level of increase of the integrated indicator in 2023 as compared to 2016, are divided into four clusters. The first cluster included 23 regions with significant dynamics of the integral indicator decrease (from -36.8% up to -5.0%), the second cluster included 18 regions with insignificant dynamics of the integral indicator decrease (from -4.9% up to 0%), the third cluster included 19 regions with insignificant dynamics of the integral indicator increase (from 0% up to 4.9%) and the fourth cluster included 25 regions with significant dynamics of the integral indicator increase (from 5.0% up to 23.5%).
Despite the successful anti-alcohol policy in the Russian Federation, some regions require systemic measures targeted to change patterns of alcohol consumption by population, with a preliminary analysis of factors determining the identified patterns. The presented data indicates that the regions have real potential to improve effectiveness of measures taken by the Subjects to decrease alcohol consumption as component of decreasing alcoholization of population.

In conditions of global digitization of health care, characterized by widespread implementation of information technologies into medical practice, the problem of prognostication of need for qualified IT specialists capable to ensure effective functioning and development of digital infrastructure of health care becomes especially relevant. The article considers modern trends in health care development, emphasizing increased role of IT specialists in providing high-quality and efficient medical care, and also analyzes main areas of activity of IT specialists in health care. The analysis demonstrated that, despite active development of digital health care in Russia, the country to a certain extent lags behind leaders in this field in terms of saturation of health care with qualified IT specialists. The study presents prognostication of need in IT specialists in health care in 2025-2026, characterized by dominance of software developers, as well as increasing of need for data analysts, cybersecurity specialists and DevOps engineers. To meet increasing need for IT specialists in health care in Russia, it is necessary to improve education system, to develop professional retraining programs and to organize favorable conditions for work of IT specialists in health care, including competitive salaries and opportunities for professional growth.

The article presents overview of publications devoted to experience of Russian medical universities in training bachelors in “Nurse Business” course to provide specialists in medical care of minors in educational organizations. The analysis of data related to provision of general educational organizations with medical personnel was implemented. The survey of graduates and employers was carried out. The ways to solve identified problems were proposed.
The Objective was to improve training of specialists providing medical care to minors in educational organizations based on generalization of existed experience of implementing educational program of higher nursing education in Russian universities and Kazan State Medical University.
The publications in peer-reviewed scientific journals were analyzed. The data on provision of general educational organizations of the Republic of Tatarstan with medical personnel was considered. The statistical analysis of reporting forms № 30 and № 030-PO / O-17 was implemented. The chief physicians of children clinics and surveying graduates were interviewed.
The analysis of publications demonstrated that training of bachelors in “Nurse Business” course in Russian universities is carried out almost in the same way. The common problems associated with imperfection of legislative sphere, complexity of employment, despite shortage of medical personnel in general education organizations were detected. The analysis of interviews with employers demonstrated that graduates of the bachelor “Nurse Business” course own necessary professional competencies and are the best suited ones for elaborating effective model of school health care.
The generalization of existing experience of training medical personnel under program of higher nursing education made it possible to formulate main ways of improving educational process to train specialists providing medical care to minors in educational organizations.

The Ministry of Health Care archives, journal publications, interviews and memoirs testify that in 1992–2004 issue of medications quality was key one in life of Russian Pharma. The ensuring of medications safety considered not only as part of social policy, but also as rules helping to reformat the “wild bazaar” into “controlled market”. The media disputes, departmental justifications, political bills and memoirs give idea of the “price of the issue” — heat of emotions, ambitions, financial losses. Besides, subjecting to who would determine quality (and therefore assess all players in Pharma market) depended on where the center of power would be located in the market. In series of reports, authors present results of historical reconstruction of building material, architects and technologies of raising of Russian controlling and authorizing system and market rules. The third report is devoted to products of (non-) confidence in the control system: on the one hand, exemption trustworthy partners from verification procedures and certification fees and on the other hand, making punitive Pharma police.

The article is dedicated to contribution of the Academician N. N. Blokhin, his colleagues and students into organization and becoming of the Research Institute of Reconstructive Surgery, Traumatology and Orthopedics in post-war years in city of Gorky. The study was based on materials from archives of mentioned institution, on materials from the Academy of Medical Sciences of the Russian Federation, the Blokhin family archives, on materials provided by his wife Nadezhda Germanovna and on publications. The structure and main directions of activities on rehabilitation of the Red Army soldiers injured during the Great Patriotic War are presented. The examples of innovative solutions (development of the first domestic dermatome) improving methods of plastic surgery under provision of medical care to the wounded are described. The scientific potential of N. N. Blokhin realized in his numerous publications and contributions with reports at international scientific conferences is revealed. The article proves the N. N. Blokhin’s role in preparation of successor who continued to develop the institute and to support effectiveness of efficient team whose physicians and nurses presented with new life thousands of Red Army fighters returned from battlefront.