Problems of Social Hygiene,
Public Health and History of Medicine

The article considers issues of personal social health as resource of demographic development of the Eurasian Economic Union (EAEU) society. It is concluded that provision of not only physical and mental health but also social health (at level of individuals) has important significance for achieving public health (at society level), harmonious demographic development and long-term planning and management of demographic processes in member-states of the EAEU and in the EAEU as a whole. It is justified contemporary demographic policy is to step aside from concentration its primary attention on numerical indicators and to focus on qualitative amelioration of demographic situation. The significant direction of demographic policy development is to become focusing on guaranteeing human dignity, promoting inclusion of diverse population groups, achieving social justice, ensuring gender equity, facilitating employment and adequate labor remuneration, increasing access to medical care, improving social security and balanced various-level social interactions.

The management processes of regional projects in health care are comparable to system dynamic object. Therefore, project management in health care is to be enough flexible and adaptive to apply frequent modifications without total changes in working project.
The purpose of the study is to find best approach to creating working model of project management prototype in medical organization of the Region. The working model of project prototype is rather abstract image of designed object (management processes) functionally “geared up” for studying object and allowing adequately convey its studying properties and characteristics in dynamic.
Exactly at goal-setting stage is required deep knowledge and ability to choose proper solution for optimizing resources (temporary, material, human ones), which requires application of effective technological routes of implementing project work at output.
To solve optimization problems basics of modern project management methodology were applied based on systematic approach using principles of decomposition, hierarchy, iterativity, local optimization and complexity.
The derived analogy in approach of comparing processes of first stage of project life cycle (goal setting) in health care and in production of technical object, using principles of systemic approach permits to more clearly visualize requirements applied to purpose of the study. In a sense, it can be considered as a kind of “zero” approximation.
The “coarse” approximation became comparison of requirements applied to model of processes of functioning of project system and elements of organizational structure of project of medical organization. The conceptual filling of medical organization with project processes, taking into account properties of consistency, elements of management activity that are consistent with requirements applied to model is associated with unity of goals of their functioning and feedback loops.
The study permits to identify patterns of development of management processes of project in medical organization and to ensure increasing of accuracy of information received and to organize search for optimal project solutions for achieving universality of description of particular project operations and procedures.

The article presents results of studying self-preserving strategies of regional youth obtained during through mass survey “Life Strategies of Regional Youth” in 2023. The survey clarified issues of self-preserving dispositions, behavior models and life plans of the youth. In relation to health, groups of four types were identified based on ratio of signs of awareness of value of health and purposeful actions of preserving it. The study demonstrated positive dynamics related to increasing of the number of the youth in group of being aware type and decreasing of the number of groups with destructive attitude to their health. The important scientific result became determination of weight of stratification signs related to reproduction of inequality in issues of implementation of self-preserving strategies of the youth. Thus, settlement sign, although indicating on elements of certain inequality in opportunities, brings no sufficient weight, while economic status of the youth significantly impact not only on life plans regarding health preservation and length of life, but also on self-preserving dispositions.

The article presents comprehensive methodology to assess economic efficiency of application of HPV-testing and cytological examination under provision of medical care on “Obstetrics and Gynecology” profile. The implementation of proposed methodological approaches permitted to calculate costs and value of result of study using HPV-screening and common cytology, i.e. their economic efficiency. The higher (up to 25%) economic efficiency of HPV-screening was established.

The development of gender equality in shipping is gaining momentum. The number of female sailors is increasing every year. However, nowadays their total percentage does not exceed 2%. This category of ship crew works in same difficult conditions as males. At that, opportunities for receiving medical care on board vary. The article considers actual problematic aspect within the framework of high probability of pregnancy of female sailor during voyage. The possible causes of pregnancy pathology are considered. The lacking of necessary medications and medical equipment to provide necessary medical care is established. The practical recommendations for preventing lethal outcomes because of significant blood loss are proposed.

The article presents results of study of problems, ways of development and improvement of organization and implementation of preventive medical social work with drug and alcohol addiction of persons serving criminal sentence in penitentiary system. In places of imprisonment use of psychoactive substances without specialist's prescription is strictly prohibited. So, addicted convicts can achieve situational remission while serving sentence. The treatment, rehabilitation and preventive work is implemented with emphasis on developing motivation for conscious refusal of using drugs and alcohol abuse to achieve stable remission to non-use. The purpose of the study was to reveal existing characteristics of organization and implementation of preventive work with drug and alcohol addiction in persons serving criminal sentence, as well as innovative aspects of this work in penitentiary system. The conclusions are made about characteristics of state of comprehensive preventive treatment and rehabilitation work with convicts of considered category with emphasis on personal changes, including social, educational and psychological aspects. The complex and person-oriented approach to preventive work with convicts with alcohol and drug addiction required implementation of such organizational measures as organization of life of convicts involved into prevention program, high-quality and regular psycho-therapeutic effect on convicts, stabilization of psycho-emotional condition of convicts undergoing prevention program both at individual and micro-group level, training and retraining of employees of medical, educational, social and psychological services, etc.

The article considers development of medical tourism as one of the significant areas of global market of services export. The historical stages of formation of medical tourism are described, starting from the end of the 19th century, as well as modern trends in its development due to economic, social and technological factors. The various approaches to definition of notion “medical tourism”, its classification and comparative characteristics with medical and wellness tourism are presented. The conclusion is made about definitive creolization of the very notion of “medical tourism”. The key factors and barriers affecting development of this industry are highlighted, including cost of medical services, quality of medical care, technological progress and communication barriers. The special attention is paid to role of accreditation, telemedicine and information communication technologies in ensuring competitiveness of countries in the medical tourism market. The forecast of further development of this sector in post-pandemic period is made. Its impact on transformation of national health systems is emphasized.

The purpose of the study was to analyze experience of patient blood management in obstetric and gynecological medical organizations, to assess compliance of Russian clinical guidelines of obstetric and gynecological bleeding with actual level of science and practice.
The methodology applied provided search for Russian and English words “patient blood management”, “gynecology”, “obstetrics”, “bleeding”, “anemia” in electronic libraries of Russia (eLibrary.ru) and the USA (pubmed.ncbi.nlm.nih.gov). The search resulted in 19 studies and 2 documents in form of clinical guidelines. It was established that patient blood management in gynecology and obstetrics is complex problem requiring both policy solution at national and regional scale. The formation of following set measures is required: physician mentality with “anemic alertness”, measures preventing and adjusting anemia and coagulopathies, technologies of “sparing” surgery, means of preventing and stopping bleeding, blood donorship, production of selective and safe blood components, evidence-based transfusion therapy, improvement of clinical guidelines, elaboration of normative base.

The archives of the Ministry of Health Care of Russia, journal publications, interviews and memoirs testify that issue of medications quality was key issue in life of Russian Pharma in 1992–2004. The support of medication safety considered not only as part of social policy, but also as rules that could be used to reformat the “wild bazaar” into “controlled market”. The media disputes, departmental justifications, political bills and memoirs give idea about “price of the issue” (heat of emotions, ambitions, financial losses). Besides, depending on who would determine quality (and thus to evaluate all players of Pharma market) depended placement of center of power in market. The authors of the study present in series of reports results of historical reconstruction of building materials, architects and technologies of construction of Russian control and authorization-based system and market rules. This report deals with practices of expertise of new and serially produced medications.

The system of effective management of deployed evacuation hospitals was adjusted by the People's Commissariat of Health Care headed by G. A. Miterev by 1942. The differentiation of functions of the People's Commissariat of Health Care and the Main Military Sanitary Directorate of the Red Army, the organization of the Directorate of Evacuation Hospitals, the Central Methodological Bureau engaged into organization of medical treatment in evacuation hospitals, the Hospital Council promoting implementation of new methods of treatment of wounded and ill persons into clinical practice, establishment of routing of the wounded and sick ones and provision of early specialized care permitted to hospitals of the People's Commissariat of Health Care to return to the ranks 57.6% of the wounded and sick.

The article considers the period of development of transfusiology in the USSR from the moment of publication of enactment of the Council of Labor and Defense of the USSR on the organization of the Institute of Blood Transfusion to the end of first year of the real clinical and research work of the Institute. At this stage of activities of the Institute of Blood Transfusion (at present the National Medical Research Center of Hematology), a number of research, clinical and organizational issues had to be resolved. Among them personnel recruitment, formation of structural units and their functions. Despite all difficulties (lack of money, internal struggle for power in institute and opposition to envious persons from outside), group of like-minded people, consisting of only five persons, turned out the mansion given to them, which was in terrible insanitary conditions, into National Center for blood transfusion and place of pilgrimage of physicians of the most progressive views. The Center performed more than 200 blood transfusions for more than 150 patients. The experimental biological base was organized. The colossal work was done to popularize blood transfusion.