Problems of Social Hygiene, Public Health and History of Medicine
Problemy Sotsialnoi Gigieny, Zdravookhraneniya, i Istorii Meditsiny Launch year 1994 Founders FSSBI «N.A. Semashko National Research Institute of Public Health» Central Research Institute of Organization and Informatization of the Ministry of Health of the Russian Federation Frequency 6 issues per year About The journal covers theoretical issues of social hygiene, ways to develop healthy lifestyle behaviors, health- and social care delivery models, economic issues, job engineering, health statistics, and the history of medicine and public health. The journal publishes articles on the best practices of сenters for hygiene and epidemiology, methods and results in the study of living conditions and health status, the current state of public health, the work of healthcare providers abroad, designing healthcare facilities, and the development of medicine and healthcare. The journal also disseminates information on historic dates, the work of scientific societies, conferences, and meetings. The journal is intended for heads of public health bodies and healthcare institutions, researchers, educators, and other professionals working in the fields of social hygiene, public health management, health statistics, and the history of medicine. Indexing Scopus Experta Medica Abstract Journals Index Medicus Index to Dental Literature Chemical Abstracts Current Digest of the Russian Press EBSCOhost International Nursing Index PubMed Russian Science Citation Index Publication standarts The journal is following publishing and journal best practices of these organizations: Association of science editors and publishers (ASEP) (http://rasep.ru) Committee on Publication Ethics (COPE) (publicationethics.org) International Committee of Medical Journal Editors (ICMJE) (www.icmje.org) <a class="daria-goto-anchor" href="http://www.councilscienceeditors.org/resource-library/editorial-policies/" target="_blank" rel="noopener noreferrer" data-vdir-href="https://mail.yandex.ru/re.jsx?uid=1130000013745094&c=LIZA&cv=13.1.103&mid=162692536538764359&h=a,mU2ZHqFI0VUX7Aaw3wvNng&l=aHR0cDovL3d3dy5jb3VuY2lsc2NpZW5jZWVkaXRvcnMub3JnL3Jlc291cmNlLWxpYnJhcnkvZWRpdG9yaWFsLXBvbGljaWVzLw" data-orig-href="http://www.councilscienceeditors.org/resource-library/editorial-policies/">Council of Scientific Editors (CSE) (www.councilscienceeditors.org) National Information Standards Organization (NISO) (www.niso.org/workrooms/piej)
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THE HISTORY OF RUSSIAN PHARMACEUTICAL INFORMATION MARKET. REPORT IV: REGULATION OF INFORMATIONAL FIELD
In the series of original articles is analyzed formation of pharmaceutical information market in Russia. It emerged from two sources: fragments of the Soviet system of circulation of pharmaceutical information and as result of consequences of business projects. The informational segment, being “sectoral” or “internal” for pharmaceutical market, formed over time infrastructure of production, distribution, storage and consumption of its goods. Initially considered as auxiliary one, it turned out into autonomous market with its own rules of the game, leading players and prices for services. The fourth report deals with formal rules of market of pharmaceutical information, history of achievement of agreements regarding official and marketing information about medications.
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THE SOCIAL ECONOMIC DETERMINANTS OF INNER EXIT TOURISM: ANALYSIS OF CONSUMER BEHAVIOR OF PATIENTS IN CONDITIONS OF INTER-REGIONAL MOBILITY
The purpose of the study is to explore both social economic and demographic characteristics of patients seeking medical care at the Stavropol Kray Consultative Diagnostic Center from other regions and motivation of their satisfaction, contentment and barriers for inner exit tourism. The survey was carried out covering 297 patients arrived to the Center from other regions of the Russian Federation in 2024. The technique of descriptive statistics and the Pearson χ² criterion were applied. It is established that women made up 62% of respondents. Their average age made up to 31–45 years. The main reasons to address from outside of region of residence were absence of specialists of required profile (32.7%), inefficiency of treatment of younger residents (32.3%) and inaccessibility of modern diagnostic resources (25.6%). The high level of satisfaction with provided medical services was reported by 87.2% of patients. The conclusion. The study results permit to conclude that development of inner exit tourism is related to level of accessibility and quality of medical services and information distribution for population. The recommendations concerning development of system of inter-regional medical mobility are proposed.
THE DYNAMIC SHIFTS IN MORBIDITY OF POPULATION SUBJECTED TO MEDICAL CARE SUPPORT IN THE N. A. SEMASHKO NORTHERN MEDICAL CLINICAL CENTER OF THE FEDERAL MEDICAL BIOLOGICAL AGENCY OF RUSSIA IN 2014–2023
The article considers results of studying dynamic shifts in morbidity of the population attached to the N. A. Semashko Northern Medical Clinical Center of the Federal Medical Biological Agency of Russia over ten-years period. The results testify increasing of morbidity of the attached contingent during studied period. In overall, the number of registered diseases increased by 4 866 cases (49.5%) as compared to the level of 2014, that is 1.5 times higher than the initial level. In quantitative terms, diseases of the eye and its appendage (2097±29), digestive organs (1671±173), circulatory system (1154±100) predominated. The analysis of gender differences testifies that percentage of neoplasms in the structure of morbidity of women (4.5%) is significantly higher than the one of men (1.4%) (p&lt;0.001). However, the rate of increase of oncological diseases was significantly higher among men (73.3%) as compared with women (20.7%)/ The rate of increase of endocrine diseases among men made up 714.0% and among women 210.3%. The study results can be used in planning the organization of medical care of population attached to the medical institution mentioned above.
THE ACTUAL TRENDS IN HEALTH CARE DEVELOPMENT
The article considers problems of development of health care system of Russia and brings out opportunities and directions of its reforming in terms of functioning efficiency. At that, special attention is paid to issues of long under-financing of the sector, applied financing models used and necessity of strengthening control of quality and safety of medical services rendering. The actual demographic problem and need in increasing level of “human capital” give medicine and health care special status, actualizing issue of efficiency. The most of the problems are identified and are working out in program and non-program activities by legislative and executive authorities as it follows from implementing national projects, state programs and Federal projects. In actual conditions of instability the key growing points in health care can be attributed to human resources, development of out-patient section, improvement of workplace ergonomics, standardization of work processes, automated patient flow management, development of day-time stay hospitals (domiciliary hospitals, nursing care, feldscher-obstetric stations), export of medical services, quantitative and qualitative development of medical trains (mobile medical teams). Since reformation process continues for decades, it is difficult to identify the very problems without addressing their solutions and marking opportunities. Therefore, the issue of problematic is to be considered comprehensively and in comparison with key indicators of program and non-program activities, as well as in comparison with global leaders.
THE PROBLEMATIC ASPECTS OF TECHNICAL REGULATION UNDER PRODUCTION IMPORT AS MENACE TO SAFETY OF CONSUMER HEALTH (BY THE EXAMPLE OF CHILDREN GOODS)
The role of technical regulation during import of production products is difficult to overestimate since it is just on quality of tests carried out regarding goods for conformity with requirements of normative documents depends safety of consumer health. Nowadays, technical regulation system is undergoing large-scale changes related to digitization and application of risk-oriented approach to selection of objects for control that undoubtedly will improve situation with falsification of test protocols. However, there is still impressive percentage of production that do not meet the regulated requirements. So, in production destined for children, after verification activities, discrepancies related to chemical, physical and toxicological parameters were found. The exceeded standards content of heavy metals, phthalates and formaldehyde can result into such irreversible negative effects on health of socially vulnerable consumers as allergic reactions, intoxications, derangement of hormonal status, disorders of kidney and digestive system. It is very important to eliminate problematic aspects of technical regulation system with purpose of non-admission to inner market production that can be unsafe for health of citizens. The article presents recommendations for improving technical regulation system both from point of view of supervisory functions and differentiation and hardening of sanctions with respect to testing laboratories.
THE MEDICAL SOCIAL ASPECTS OF TRAUMATISM RELATED TO APPLICATION OF TOOLS OF INDIVIDUAL MOBILITY IN MEGALOPOLIS OF MOSCOW
In Moscow, implementation of means of personal mobility became a solution of the "last mile" problem by reducing costs of transposition. However, their popularity augments traumatism and is accompanied by increasing of traffic accidents. The purpose of the study is to identify medical social characteristics of traumatism at traffic accidents involving means of personal mobility. The means of personal mobility, resolving "last mile" problem become source of health risk because of lacking of safety culture, corresponding municipal infrastructure and legal gaps. The comprehensive approach to injury prevention is minimizing risks, contributes to increasing of safety of urban mobility.
THE RESOURCE SUPPORT AND MANPOWER POTENTIAL OF THE HEALTH CARE SYSTEM OF THE KYRGYZSTAN STATE
The health care system of the Kyrgyz state, in conditions of market and transition economy, underwent significant changes, including reform of primary health care and peopleware. However, becoming of the primary care system over past three decades regarding provision of full-fledged accessibility of health care system to population brought no significant changes into situation both in whole country and Bishkek. The purpose of the study was to analyze problems of training medical personnel to provide primary health care organizations and to develop ways to solve them. The study uses data from the National Statistical Committee of the Kyrgyz Republic and the database of the Republican Center for Electronic Health. The estimated indicators of the population provision with medical personnel in the country and Bishkek during the sovereign period of the country were evaluated. The obtained materials were processed using statistical and analytical methods. In the post-Soviet period, fundamental health care reforms took place. The Semashko model underwent complete restructuring with emphasis on development of primary health care that resulted in decreasing of the number of medical organizations, especially district hospitals. However, ratio between sectors of primary, secondary and hospital had no changes against the background of reduction of the number of physicians in health care system, especially at primary level that affected quality of medical services for population. The medical education system constantly undergoes transformation without consideration of world practices and does not meet needs of health care due to absence of mechanisms of intersectoral cooperation under planning of medical personnel training. The current resource situation of the healthcare system associated with the optimization of medical organizations and human resources, shows a deterioration in the availability of medical care to the population both in the whole country and in the metropolitan area. The reforms implemented over the past three decades were insufficient, as there was a lack of sustainable planning policies by organizations to strengthen the primary care system and priorities for training medical personnel and sustainable financing of the health sector. The modern resource condition of health care system related to optimization of medical organizations and human resources potential points out to deterioration of accessibility of medical care of population on national level and in conditions of metropolitan city. The implemented reforms turned out incomplete since there were no sustainable policy of planning primary health care system and priorities in medical humn resources training. Also sustainable financing of health care system was absent. The primary health care and its human resources support are be considered as main subsystem of state health care that plays leading role in facilitating and accessing medical care in interests of health of country's citizens. At that, effective mechanisms of intersectoral cooperation on sufficient investment are to be created to optimize primary health care and entire health care system, taking into account regional characteristics and the needs of population.
THE METHODOLOGICAL FOUNDATIONS OF EVALUATION OF RESOURCE READINESS OF MEDICAL ORGANIZATIONS THE REGION TO EMERGENCY SITUATIONS AND GLOBAL CHALLENGES
In view of escalation of geopolitical conflicts, biological and technological disasters, the necessity of systematic approach to evaluation of resource readiness of medical organizations becomes priority task in ensuring firmness of health care system. The international and national experience demonstrates that overload of health care system under emergency situations frequently is conditioned by insufficient resource support and ineffective coordination. The purpose of the study is formalization of methodological principles of assessment of readiness of regional medical infrastructure for various types of emergency situations considering scenarios of geopolitical, biological, and technological menaces. Based on the study results, step-by-step algorithm of assessment was developed, covering 5 key resource components of health care system. The algorithm of assessment of readiness of medical organizations and health care system is proposed that considers normative requirements, intensity of flows of victims and characteristics of different phases of development of emergency situations. The algorithm permits to identify “bottlenecks”, to rank medical organizations by readiness level and to form adaptive plan of actions eliminating occurring problems. The proposed methodological approach can be applied by regional and Federal health authorities under development of strategies of reacting to emergency situations, resource planning and enhancing firmness of health care system.
THE REVIEW OF THE ARTICLE “THE EFFICIENCY OF X-RAY ENDOVASCULAR CARE IN DECREASING OF POPULATION MORTALITY FROM ACUTE CORONARY SYNDROME AND ACUTE DISORDER OF CEREBRAL CIRCULATION”
The assessment of the article “The efficiency of X-Ray endovascular care in decreasing of population mortality from acute coronary syndrome and acute disorder of cerebral circulation” (published in the Journal “The Problems of Social Hygiene, Health Care and History of Medicine” 2024;32(3):420–6) revealed that the title of the article does not correspond to its content. The authors broke the rules of both application of correlation analysis and work with intensive statistical indicators that turned out to be significantly distorted.
THE REVIEW OF THE MONOGRAPH BY S. N. ZATRAVKIN, E. A. VISHLENKOVA AND F. V. GENIN “THE ONE'S GAME: THE HISTORY OF PHARMACEUTICAL MARKET IN RUSSIA” (MOSCOW: SHIKO; 2025. 480 p.)
This review presents analysis of the monograph on the history of pharmaceutical market in Russia. The study meet a historiography lack minutely exploring the becoming of pharmaceutical market in Russia at the turn of the XX–XXI centuries from collapse of the Soviet system up to establishment of new industry. The authors, applying interdisciplinary approach and unique source base that included dozens of interviews with key insiders, analyze not only the formal institutional development but also the informal institutions that formed industry in the period of “drug famine” of the 1990s.
THE INFORMAL EMPLOYMENT AS FACTOR OF FISCAL LOSSES AND STRUCTURAL DEFICIENCY IN THE MANDATORY MEDICAL INSURANCE SYSTEM OF RUSSIA
The purpose of the study is to analyze the impact of informal employment on formation of structural deficiency of mandatory medical insurance in Russia. The methodology is based on the balance sheet method for estimating informal employment by comparing Rosstat data on average annual and average listed number of employees across economic sectors in 2023, followed by calculation of fiscal losses using established mandatory medical insurance contribution rate of 5.1%. The study revealed direct budget losses of the Federal mandatory medical insurance Fund at the rate of 127.1 billion RUB annually, with highest concentration in trade (36.4 billion RUB), construction (19.3 billion RUB) and manufacturing (15.8 billion RUB). It is established that structural deficiency of the Federal mandatory medical insurance Fund and chronic under-financing of health care (4.5% of GDP) against in average of over 9% in OECD countries are directly related to scale of informal sector. The conclusions testify the necessity of comprehensive reformation of the system? including diversification of sources of the Federal mandatory medical insurance Fund, measures of legalization of labor relations and restoration of confidence to institutions of social insurance as conditions of financial sustainability.
THE TEN-YEAR DYNAMICS OF PREVALENCE AND OPINION OF PARENTS ABOUT FACTORS OF SUBJECTIVE PSYCHOLOGICAL PROBLEMS IN BELORUSSIAN ADOLESCENTS
The purpose of the study is to establish prevalence of separate components of subjective psychological problems among adolescents aged 15–18 years, to identify dynamics of the prevalence of factors of psychological problems over the past decade and to characterize perception by parents of children aged 10–14 years the crisis psychological situations of their child in the Republic of Belarus. The data of surveys of representative Republican samples of adolescents of age of 15–18 years carried out in 2022–2023 (n=1254) and in 2010–2011 (n=949) were analyzed. The following factors were considered: self-assessment of health, emotional psychological characteristics of personality of adolescents as parameters of subjective psychological well-being/problematic condition. The results of survey of the Republican representative sample of parents of adolescents aged 10–14 years (n=1230) that was carried out in 2022–2023 were used to analyze opinions of parents about crisis psychological situations in life of their child. The study confirms the widespread prevalence in adolescent environment of indicators of condition of subjective psychological problems, the intensity of which increases in the interim of 15–18 years as they are becoming adult. The "risk groups" of condition of subjective psychological problems subjective disadvantage are individuals residing in rural areas and male youths. As regarding male youths, the tendency was revealed concerning deterioration of self-assessment of health and an increase of prevalence of factors of condition of subjective psychological problems during 2010–2023. According opinions of of adolescents themselves and their parents, extremely low demand for help from school psychologists, pedagogues and other workers of social psychological services of educational institutions in cases of crisis psychological situation of adolescent remained during 2010–2023.
THE PRECISION APPROACH IN CONTEMPORARY NEUROSURGICAL PRACTICE: A REVIEW
The review was based on analysis of 180 sources from databases PubMed, eLibrary, Cohrane Library, MEDLINE for 2015–2025 using keywords "precision medicine", "personalized medicine", "neuro-oncology", "oncology", "cranio-cerebral injury", "neuro-trauma", "neuro-proteomics" and "AI". The purpose of the study was to demonstrate, on the basis of analysis of publications on precision medicine application in neurosurgery, the significance and perspectives of mentioned approach in modern neurosurgical practice. The methods of precision medicine, digital revolution and progress in multi-modal Big Data processing permit to better understand of tumor genesis, their clinical heterogeneity, functional effects and causes underlying their resistance to treatment. The precision medicine methods provide valuable information on pathophysiological mechanisms underlying neuro-trauma through analysis of complex protein interactions and changes. The future of precision medicine in neurosurgical practice is in permanent enhancement of AI and machine learning, permitting rapid and accurate decision-making based on comprehensive molecular data. The future of neurosurgery lies in harmonious integration of such interdisciplinary approaches as precision medicine and clinical neurosurgery to discover new possibilities of targeted and personalized therapy.
THE MEDICAL DEMOGRAPHIC CHARACTERISTICS OF HEALTH OF INDIGENOUS SMALLER PEOPLES OF THE SOUTH OF THE FAR EAST OF RUSSIA
The transformation of social political system in the late 19th and early 20th centuries significantly deteriorated quality of life of indigenous peoples of the North and the Far East, lowering income levels and health indicators and marginalizing population. The indigenous smaller peoples are extremely vulnerable group of ethnic minorities in medical demographic terms. The purpose of the study is to analyze modern medical demographic situation and indicators characterizing health level of the Udege and the Nanai people residing village of Krasny Yar of the Pozharsky municipality of Primorsky Krai to take effective measures improving current medical demographic situation. The statistical and mathematical methods were applied in the study. In June 2025, sociological survey was carried out to identify self-assessments of quality of life of the population of village of Krasny Yar that included questions about nutrition quality. It is concluded that causes of deterioration of health of indigenous peoples of the Pozharsky municipality depend on medical biological and social economic factors. The main medical biological determinants include genetic ones determining characteristics of body functioning. The social economic factors include low level of living as a result of absence of work, change in ethnic identity under influence of mixed marriages, miscegenation, inaccessibility of highly qualified medical care. It is demonstrated that low income level of families is the main cause of poor nutrition. The active integration and assimilation processes, primarily related to alien population (Russians) resulted in destruction of traditional way of life and deterioration of health that affected decreasing of natality.
THE ROLE OF THE SAILORS TRADE UNION IN ENSURING HEALTH-PRESERVING ENVIRONMENT FOR FEMALE SAILORS
The article considers functions and practical directions of activities of the Russian Sailors Trade Union in ensuring health-preserving environment for female sailors in the maritime industry. The analysis was applied to role of trade unions in protecting labor rights with emphasis on specific features of maritime environment, conditioned by global character of employment, multi-nationality of crews and complexity of jurisdictions. The article presents review of international initiatives concerning gender inclusion, in particular priorities of the International Transport Workers Federation and recommendations of the International Labor Organization and also reflects practical implementation of these initiatives through activities of the Russian Sailors Trade Union. On the basis of normative documents, collective agreements, trade union practices and empirical data key directions of trade union activities are examined. The study identified main barriers to efficiency of trade union measures, including insufficient representation of women in trade union structures, persistent gender stereotypes and “culture of concealment” and difficulties of cross-border jurisdiction. The following practical recommendations were formulated to strengthen the role of the Russian Sailors Trade Union: active involvement of women in leadership and membership, strengthening gender-sensitive provisions in collective agreements and development of international cooperation for unification of standards and practices exchange. The study results substantiate conclusion that at purposeful strategy and coordination of actions, the trade union is capable to act as central subject of health-preservation of female sailors promoting their safety, health care and and professional firmness.
THE ALL-UNION RESEARCH INSTITUTE OF PENICILLIN (1947–1952): THE EXTRACTED PAGE OF HISTORY. REPORT III: THE STALIN AWARD “FOR DEVELOPMENT AND IMPLEMENTATION INTO INDUSTRY THE METHOD OF OBTAINING MEDICAL PREPARATION”
The article, on the basis of analysis of archival materials, reveals contribution of the All-Union Research Institute for Penicillin and Other Antibiotics to development of modern technology for production of penicillin. The factors that allowed the Institute to improve key stage of production process in short period of time, despite deficiency of manpower and other resources were studied. The causes of exclusion of information about the Institute and its work on penicillin from the text of the Decree on the Stalin Prize of 1950 and from the information space in general are considered.
THE MODEL OF TELEMEDICINE CONTACT-CENTER
The article presents results of comparative analysis of modern telemedicine technologies and organizational models of their implementation in health care system. On the basis of study of national and international experience, the rationale for perspective model of geriatric telemedicine contact center is presented. Its role and place in the structure of remote medical care support in the Russian Federation is determined. The article considers key directions application of areas of telemedicine: synchronous and asynchronous tele-consultation, remote methodological support, tele-training and tele-monitoring. The elderly patient usually has difficulty with moving on long distances. Therefore, special attention is paid to development of out-of-office and home tele-monitoring using wearable devices, expert systems, and soft hardware complexes permitting to automatize processes of diagnostic and correction and to apply remote interaction as well. The original model of geriatric telemedicine contact center includes front-office for primary reception and routing of requests, counseling module with involvement of accredited experts, methodological module for supporting various categories of users and monitoring module for dynamic control of indicators of life activity. The model is primarily directed toward elderly patients with limited mobility that is conditioned by high need of this category of citizens for accessible and continuous medical care. The economic efficiency of telemedicine solutions capable to decrease treatment costs, to reduce the number of hospitalizations and to unload hospital sector. In conclusion, expediency of organization of Federal profile center instead of multiple territorial divisions to optimize resources and to ensure uniform standards of remote geriatric care on national basis is substantiated.
THE ASSESSMENT OF FACTORS AFFECTING IMAGE OF PHARMACEUTICAL ORGANIZATIONS OF SYRIA AMONG CONSUMERS
In conditions of unstable health care systems, public image of pharmaceutical organizations is key factor affecting patients trust and development of their loyalty. Despite important role of image of organizations, studies of perception of pharmaceutical organizations by consumers in such post-conflict regions like Syria are limited. The understanding of these factors permits to increase quality and trust to pharmaceutical services. The purpose of the study is to evaluate main factors affecting public image of pharmaceutical organizations in Syria on the basis on opinions of consumers and patients. The study was carried out using questionnaire method. The questionnaire was originally designed and included evaluation of external and internal factors affecting organization image, such as service quality, medication accessibility, communication, pricing policy and transparency of functioning. The questionnaire distributed online among patients and consumers from various regions of Syria. The survey gave 417 valid responses in total. The data analysis included examination of differences in perception depending on such demographic characteristics as gender, age and income level. It is established that respondents estimate highly such practical aspects of pharmaceutical organizations functioning as medications accessibility (87%), pricing fairness (72%) and service quality (73%) as main factors that form image. The communication with pharmacists and transparency of organizations functioning also played significant role. The interest to programs of loyalty programs and social activity differed depending on age, gender and income level. The females attached more importance to interpersonal interaction, while elderly persons emphasized functioning transparency. The respondents with lower income were more sensitive to pricing policy and expected from organizations more openness. The study results emphasize significance of service quality, medications accessibility and pricing policy as key factors of development of public trust and create foundation for development of target strategies improving image of pharmaceutical organizations in Syria.
THE FORESIGHT TECHNOLOGIES IN ANTI-NARCOTIC PREVENTION: SCENARIO MODELING AND MESO-STRATEGY IN THE KABARDINO-BALKARIA REPUBLIC
The purpose of the study is to determine directions of strategy of intersectoral interaction in preventing drug consumption in the Kabardino-Balkarian Republic based on the Foresight approach and scenario modeling of arising trends in society narcotization. The Foresight methodological tools were used (PESTLE analysis, scenario forecast, drivers and bifurcation points identification, the Popper diamond). The data base for analysis included statistical data from narcologic services, the reports of the WHO, the UNODC, the Main Directorate for Drug Control of the Ministry of Internal Affairs of the Russian Federation and expert assessments. The analysis of study results permitted to identify key trends (increase of poly-narcomania, intensification of synthetic drugs, rejuvenation of drug addicts and drug market digitization). The probable and possible scenarios of development such as inertial, optimistic, crisis and innovative ones were determined. The drivers and bifurcation points capable radically change trajectory of drug situation were identified. The necessity of transition from predominantly repressive approach to preventive and rehabilitative one, integration of digital monitoring technologies (WBE, Big Data) and development of individual plan of prevention set-back are substantiated. The conclusions are made that the Foresight analysis in the field of anti-narcotic prevention is efficient tool of proactive risk management that permits to coordinate Federal and regional strategies. For the Kabardino-Balkarian Republic, special importance acquires development of "meso-strategy" based on intersectoral cooperation, use of ethno-confessional resources and educational and cultural potential. The scenario modeling provides opportunity to be prepared for potential menaces and to develop sustainable trajectory of reducing drug risks and promoting public health by 2030.
THE CHARACTERISTICS OF MEDICAL CARE SUPPORT OF ELDER AGE GROUPS OF RURAL POPULATION: THE NECESSARY ELEMENTS OF MEDICINAL DIAGNOSTIC PROCESS UNDER KEY COMORBID PATHOLOGY
The article presents the results of comprehensive study of assessing characteristics of organization of medical care of elder age groups of rural population with purpose to substantiate the necessary elements of diagnostic and treatment process under key comorbid pathology. The set of systemic causes conditioning defects of quality of medical care support in rural medical organizations is identified. The structure of comorbid pathology in patients of elder age groups was studied. The cause-effect relationships between various forms of chronic diseases are established. The analysis of medical documentation of patients of the older age groups resulted in structuring of 77 different forms of senile pathology: 23 forms of geriatric diseases and 54 forms of geriatric syndromes. The established cause-effect relationships were classified as afferent (disease positions as causal factor) and efferent ones (disease is consequence of other pathology). All forms of geriatric pathology, for which statistically significant comorbid associations with other diseases were established, are unified into group of key comorbid pathology. On the basis of established specificity of afferent and efferent comorbid relationships, the necessary elements of treatment and diagnostic process for each of the forms of key comorbid pathology are developed.
THE KEY STRATEGIES OF EDUCATIONAL PROFESSIONAL TRAJECTORY OF SCHOOLCHILDREN IN THE FIELD OF MEDICINE
In conditions of deficiency of medical personnel and high social significance of profession, effective career guidance work with schoolchildren in the field of medicine becomes key element of future specialists training. The purpose of the study is to analyze and to identify the most effective strategy of career guidance work with students targeted to development of sustainable interest to medical profession choosing. The study used results of analysis of scientific pedagogical literature available in Med Line, Cochrane Library and eLibrary.ru databases, normative legal base in sphere of career guidance work and original experience of authors. The article presents analysis of strategies of career guidance for schoolchildren targeted to deliberated choice of profession. The main attention is paid to characteristic of the adaptation method that is used in career guidance activities among schoolchildren by teachers of the Medical Faculty of the Federal State University of Education. The article emphasizes the necessity of integrated approach and development of adaptation strategy with purpose to develop in university entrants ability to build constructive, successful relationships with new elements of educational environment of medical university.
THE INNOVATIVE APPROACHES TO MEDICAL EDUCATION IN THE COUNTRIES OF THE BRICS: PROJECT TRAINING AS A MODE OF PROFESSIONAL COMPETENCES FORMATION
The medical education in the BRICs countries plays key role in ensuring technological sovereignty of member countries. The article explores innovative approaches to medical education in the BRICs countries. The special attention is paid to project training as a tool to form professional competencies of future specialists. The analysis was applied to such successful practices of the BRICs countries as development of telemedicine, international cooperation and organization of joint research projects. The main challenges, including personnel deficiency and inequality member countries in fitting-out education sphere are highlighted. The article emphasizes role of medical education in ensuring technological sovereignty and proposes directions for further cooperation between the BRICs member countries. The key element of work of physician today are technologies related to long-term monitoring of patient permitting to survive the longest life. On the example of project and research activities of leading Russian and foreign universities, the model of integration of science, education and practical health care is developed to ensure training of highly qualified medical personnel. The key trends in digital transformation of education are considered, including application of AI, cloud technologies and personalized approach to solution of clinical problems in education process.
The Recommendations on Maintenance of Social Health of Sailors of Merchant Navy
The labor activity of sailor is constantly passes under permanent impact of multitude of negative factors and requires not only professionalism, but also high concentration and increased emotional resistance to various stressful situations. Among many activities targeted to to achieve these conditions the pre-voyage medical check-up of all crew members is mandatory as a tool of timely detection of health menaces. The particular attention is paid to preservation of mental and psychological health of sailor. Nevertheless, cases of suicide conditioned by conflict situations at workplace and other reasons are still recorded in the navy. In this regard, it is important that social health of sailors of merchant navy remains practically unexplored. Hence, measures preserving health will increase social immunity of sailors and will create more favorable conditions for working activity. On the basis of survey results and conclusions of researchers in this field recommendations oriented on enhancing social health of crew members of a marine vessel.
THE POTENTIAL OF STRATEGIC TECHNOLOGICAL PARTNERSHIP IN ORGANIZATION OF SOCIAL DEMOGRAPHIC STUDIES IN THE FIELD OF DEVELOPMENT OF RURAL TERRITORIES
The article presents analysis of potential of strategic technological partnership in the context of carrying out social demographic research in the field of development of rural territories in Russia. The actuality of the study lies in the fact that such partnership can support research center in improving quality of research results to increase speed of primary data collection to accelerate data processing and to optimize interaction with public authorities. It is established that important mode of searching constructive solutions is development of social technological partnerships between scientific social demographic centers public authorities and private companies. The list of key Russian scientific social demographic centers actively engaged in exploration of demographic issues and in varying degrees accomplishing social technological partnership is presented. It is defined that potential technological partners for research centers studying social demographic issues in rural areas can be IT companies software developers cloud providers owners of analytical services population survey centers public authorities municipal administrations of local governing profile non-profit organizations educational institutions telecommunication companies and communication operators. The criteria to select strategic technological partners are proposed experience of working with social demographic materials ability to provide effective solutions for data analysis and visualization readiness for long-term collaboration and joint development compliance with requirements to data protection confidentiality and scientific ethics.
THE ORGANIZATIONAL ECONOMIC SUPPORT OF FUNCTIONING OF THE IRKUTSK MUNICIPAL SMALLPOX VACCINATION DEPARTMENT IN 1887–1892
The article considers history of searching for solutions of problems of smallpox vaccination in the Irkutsk Gubernia in 1887–1892. It is demonstrated that smallpox outbreaks served as a basis for issue of the municipal Duma resolution about organization of Irkutsk smallpox vaccination room and calf barn, along with determination of costs for maintenance of smallpox vaccination cabinet. The expansion of supply of detritus to Okrugs, including the Yakutsk Oblast and the Primorye, determined necessity of reorganization of the Irkutsk smallpox vaccination department. It is noted that organization of the Commission for reorganization of the Irkutsk Vaccination Department, collaboration between city Uprava members, city physicians, sanitary physician, veterinarian permitted to organize activity of smallpox vaccination department in accordance with needs of the territory. The analysis of the minutes of the Commission and City Duma meetings demonstrate that the Commission defined the duties of physician and smallpox vaccinator and approved book of control of income and expenditure of materials for vaccination. The article demonstrates formation of costs according expenses on salaries of department personnel, requirements to calf housing conditions and the cost of their upkeep. The income and expenditure receipt for smallpox vaccination was introduced. The conclusion notes progressive role of authorities and medical Uprava in reduction of population morbidity with smallpox.