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 HEALTH PRESERVATION OF POPULATION: THE SOCIOLOGICAL ANALYSIS OF DETERMINANTS OF HEALTHY LIFE-STYLE
The article defines health care as priority of preventive medicine. The high natality in Dagestan is supported by traditional values, influence of tribal and community structures, low level of urbanization and religious and ethno-cultural characteristics of nations. The purpose of the study is to analyze determinants affecting individual health and to formulate practical recommendations promoting healthy life-style. The research methods included anonymous survey of 478 patients of polyclinics of Makhachkala in 2023–2024 and subsequent statistical processing using the Statistica 6.0 software.
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THE ZEMSKY DOCTOR: THE RESULTS OF IMPLEMENTATION IN THE REPUBLIC OF INGUSHETIA
The article considers issues of implementation of the Federal programs “Zemsky Doctor” and “Zemsky Feldsher” in the Republic of Ingushetia in 2012–2025. The analysis of dynamics of involvement of medical specialists in rural medical institutions of the region, the structure of employed personnel by specialties and territorial distribution was applied. It is noted that programs became the key tool to resolve issues of personnel deficiency in rural health care of the Republic. It permitted to recruit 384 specialists over thirteen-year period of implementation. It is established that the largest number of physicians is employed in the Nazranovsky district and among the specialties predominate therapists, pediatricians, anesthesiologists–resuscitators and endocrinologists. It is determined that financial motivation of 1 million rubles for physicians and 500 thousand rubles for paramedical personnel combined with modernization of medical infrastructure ensures stable recruitment of personnel to hard-to-reach territories. The conclusion is made that the program demonstrates high efficiency in the conditions of the Republic of Ingushetia, contributing into increase of accessibility and quality of medical care of rural population. The recommendation is made to continue implementation of the program until 2030 to consolidate the achieved results.
THE PUBLICATION OF “THE SHORT REPORT ON SANITARY ORGANIZATIONS OVER GUBERNIAS OF THE FAR EAST AND THE PROJECT OF ESTABLISHMENT OF NEW ORGANIZATIONS IN CURRENT [1924] YEAR” WITH SCIENTIFIC COMMENTARIES
The article presents the publication of the archival document which is stored in the funds of the State Archive of the Khabarovsk Krai, and is accompanied by scientific commentaries. In the text of the document from 1924 the question is about difficult legacy inherited by the Soviet medicine. The heads of the Department of the Health Care of the Far Eastern Revolutionary Committee, responsible for social engineering and implementation of the principles of the new medicine, wrote about inherited from their predecessors devastation and desolation and reported about immediate tasks of their work.
THE PRE-SOVIET HEALTH CARE OF THE FAR EAST OF XX CENTURY: THE ARCHIVE MYSTIFICATIONS
The article compares the claims made by M. I. Barsukov and D. V. Pisarev, the authors of “The short report on sanitary organizations over Gubernias of the Far East and the project of establishment of new organizations in current [1924] year” with the results of carried out historical reconstruction of the pre-Soviet health care of the Far East of the 20th century. The reconstruction revealed a complex landscape of the medical sanitary infrastructure of the given region. Because of the comparison the gaps were uncovered in the Bolshevik narrative of the past, zones of the default, the exaggerations and the deliberate distortions of reality in the archival text, which has the status of office work document.
THE INDICATORS OF MORBIDITY, MORTALITY, ONE-YEAR LETHALITY AND DESOLATION OF PATIENTS WITH CERVICAL CANCER IN THE OSH OBLAST OF THE KYRGYZ REPUBLIC
The purpose of the study is to evaluate morbidity, mortality, one-year lethality, and desolation of patients with cervical cancer in the Osh Oblast of the Kyrgyz Republic. The data about patients with cervical cancer in 2010–2023 was included in the study. The average value of morbidity of cervical cancer in the Osh region of the Kyrgyz Republic (over 14 years) made up to 10,3 ±3,6%000. The growth rate of indicator of morbidity of cervical cancer was 51,2%. The increase in mortality from cervical cancer was unsatisfactory in terms of the onco-gynecological service from 0.3%000 in 2010 to 5.3%000 in 2023. The growth rate was very high, exceeding 1 600%. The improvement and refinement of comprehensive therapy of patients with cervical cancer was evidenced by decrease of one-year mortality from 41.0% to 13.0%. The rate of decline was 68.3%. The positive trend is also observed in the rate of desolation of patients with cervical cancer, which decreased from 62.0% to 24.0%, as result of increased number of patients with early stages of the disease in the Osh region. The rate of desolation of patients with cervical cancer was 61.3%. The results of the study can be used to formulate proposals improving the organization of medical care support for patients with cervical cancer, as well as for formation of regional projects or departmental target programs.
THE ANTINOMIANISM AS A METHODOLOGICAL BASIS OF THE SOVIET PHILOSOPHY OF PSYCHIATRY
The article has as its object to analyze, on the basis of materials of various textbooks, articles, reports and dissertations of the Soviet period, a number of problematic topics discussed in National theory of psychiatry. And on the basis of implemented analysis to point out inherent antinomianism of methodological approaches, key concepts and therapeutic practices. The article systematically analyses a number of antinomic oppositions such as biological and social, the norm and the pathology, the health and the illness, the physician and the patient. Within these framework, on the one hand, is manifested the initial antinomianism of subject of psychiatry subject in general i.e. the human being as bio-social entity and on the other hand, the specific methodological directive exactly adopted by the Soviet theoretical psychiatry and entirely conditioned by the Marxist conceptions of human essence as the totality of social relations. The conclusion. The number of deductions is made. The debatable assumption is expressed that opens perspective for further studies: despite persistent criticism and permanent attempts to distance from the Western tradition, development of the Soviet philosophy of psychiatry in many respects was determined by similar range of problems and by attempt to resolve analogous methodological difficulties.
THE SOCIAL POLICY OF ST. PETERSBURG IN THE FIELD OF HEALTH CARE
The article presents results of systematic consideration of characteristics of implementation of St. Petersburg social policy in the field of health care as an important institution of economic policy. The key direction of development of St. Petersburg are sectors oriented on human needs, including health care, which requires large-scale investments in human resources. The comprehensive analysis of publications of Russian and foreign scientists was implemented. The methodological framework is represented by systemic and situational approach. The methods of structural and functional research, of scientific abstraction, of induction and deduction, of economical statistical information gathering were applied. The results of overview of studies in the field of social policy and health care permitted to establish characteristics of social policy of St. Petersburg policy in the field of health care and to determine its prospective directions. Thus, for Russian society one of the key tasks is promotion of positive agenda of development of the individual, the society and the state, based primarily on human potential. St. Petersburg acquires image of a region of social well-being. So, the task to preserve and to enhance it is on the agenda. One of the most important functions of the state is to provide public services (goods), first of all qualitative and accessible health care.
THE PERSONAL SELF-ACTUALIZATION OF INDIVIDUAL IN RELATIONSHIP WITH ONE'S SELF-EVALUATION AS A FACTOR OF PSYCHOLOGICAL HEALTH OF SOCIETY
The psychological health of society is a phenomenon, attracting lately attention of researchers from various scientific fields. The sociologists, political scientists, philosophers and psychologists discuss the issues determining psychological health of both nation and individual. The summarizing of these studies inputs into marking out two main approaches to psychological health of the society and the individual. The first one is holistic, according to which psychological health of a person is determined by social structures — external factors, under conditioning influence of which from without the person becomes psychologically healthy and happy. The second one is personal-individualistic, according to which the psychological health of person is primarily associated with the inner “life world” of person, one's deep “I Am” and “the Self”. Exactly their disclosure from within of person into external life leads to the psychological health of human personality and one's happiness. The article theoretically and empirically substantiate the second approach. The empirical part of the study consisted of the results of questionnaire survey carried out at the Nikolai Linde Institute of Emotional-Image Therapy covering post-graduate students undergoing additional professional education in March-April 2025 (n=57). All respondents had higher education in psychology. The following psychological research methods were applied: the T. V. Dembo and S. Ya. Rubinshtein technique of studying personality self-esteem; the O. I. Motkova method of studying self-esteem of personality; the E. Shostrom questionnaire for diagnosing self-actualization of personality (adapted by A. V. Lazukin and N. F. Kalina). On the basis of the results of theoretical and empirical study it is proved that self-actualization and self-esteem positively affect each other. The increasing of person's self-actualization increases one's self-esteem. Therefore, the actualization of “the Self” of person improves one's psychological health.
THE PERSPECTIVES OF RUSSIA IN DEVELOPMENT OF ENTRANCE MEDICAL TOURISM FROM THE COUNTRIES OF THE PERSIAN GULF
The article is devoted to the study of the prospects of attracting medical tourists into Russia from the Persian Gulf countries. The Russian health care system has a number of competitive advantages to attract medical tourists from foreign countries: availability of highly qualified medical personnel, advanced technologies, high level of digitization of health care and possibility to provide high-tech medical care at relatively low prices for similar services. All this, in the aggregate, permits to meet the demand of the population of the Persian Gulf countries for medical care. The comparative analysis of the health care systems of the Persian Gulf countries and Russia demonstrated that Russian health care by many indicators surpasses health care systems of the Persian Gulf countries. The Russia has reputation of the country proposing the utmost modern methods of treatment by lower prices. However, and the level of qualification of medical workers, has a reputation as a country offering the most modern methods of treatment at lower prices. However, in our country, entrance medical tourism is developed insufficiently. The study of the prospects for attracting medical tourists from the Persian Gulf countries demonstrated availability of potential to develop entrance medical tourism.
The Design of Systems of Efficient Usage of Labor Potential of Workers in the Field of Health Care
The development of Russia rests in implementation of the National goals, one of which is “preservation of population, promotion of health and increase of people's well-being”. The modern development of health care is directly related to modernization and expansion of sphere of provision of medical services to population, including socially significant services. For that, qualified workers are needed as well the improvement of indicators of efficient usage of labor potential of workers in conditions of digital economics. This is the reason to design on qualitatively innovative level new systems of efficient usage of labor potential of workers in the field of health care, considering technologization of all processes in the sphere of health care.
ON IMPLEMENTATION OF THE NATIONAL PROJECT “DEMOGRAPHY” IN THE PART OF SUPPORT OF FAMILIES WITH CHILDREN
The article presents brief analysis of implementation of the National project “Demography” in 2019–2024 at the regional level including identification of problematic aspects and successful regional practices targeted to support families with children. The complex of measures directing to strengthen family values, to increase natality and to organize conditions for harmonious development of families in Russia.
THE PROGRAM OF PREVENTION AND CONTROL OF NOSOCOMIAL INFECTIONS: WORLD EXPERIENCE AND RECOMMENDATIONS FOR IMPLEMENTATION
The nosocomial infections that are related to provision of medical care continue to be one of the key problems of health care system conditioned by high morbidity, mortality and economic losses. According to the WHO, prevalence of such infections ranges from 7% to 15% among hospitalized patients. In countries with low-income this indicator can reach 20%. The article presents a review of modern data on prevalence, clinical characteristics and risk factors of nosocomial infections. The types of these infections, their economic consequences and issues related to resistance to of antimicrobial preparations are considered.
THE INFORMAL LABOR AND ECONOMIC PRACTICES IN THE HEALTH CARE SYSTEM OF THE RUSSIAN FEDERATION
This article presents the results of comprehensive analysis of informal labor and economic practices in the health care system of the Russian Federation. It is proved that informality is not a random deviation but a persistent systemic element, that is reproduced as the result of fundamental break between formal norms and real conditions of professional activity. The methodological basis of the study included content analysis of scientific publications, analysis of official Rosstat data and application of the balance method to estimate the scale of informal employment. The significant and growing percentage of informal employed in the sector, estimated by the balance method as 29.6% of the total number of workers in 2023 is established. The diversity of forms of informality, including shadow employment, informal payments between patient and physician, doctor records in official reports, activities in private and alternative sectors not regulated by legal field are systematized. The main causes of their existence are break in financing of state guarantees, disparities between expected and factual level of wage, excessive regulation and institutional contradictions. The conclusion is made that informal practices perform compensatory function, ensuring viability of the system in conditions of institutional dysfunctions but at the same time simultaneously generate serious risks for quality of medical care, principles of social justice, and legal protection of citizens. It is proposed to direct the efforts not to forceful suppression of informal practices, but to elimination of their systemic causes through harmonization of normative regulation.
The Organization of Standard Operational Procedure on Signing Informed Consent by Patient to Participate in Clinical Study
The article determines the informed consent (IC) as free and voluntary will of subject one's desire to participate in clinical trial (CT) after receiving information about all aspects relevant to decision-making. The IC is documented by signing and dating the form of consent by the subject or one's legal representative as well as by the person giving explanatory talk. Despite standardized definitions, the procedure of implementation of all stages of the IC is not always properly followed and the information in medical literature is scanty.
THE DEMOGRAPHIC PROBLEMS OF THE UDEGEANS OF THE KHABAROVSK KRAY: THE MARRIAGE AND FAMILY ATTITUDES AND DECREASE OF NATALITY
The life activity of Russian family, regardless of region of residence and ethnicity, is largely determined by changing of patterns of demographic and reproductive behavior of population. The purpose of the study is to analyze both modern demographic, marital and familial situation and indicators characterizing the demographic and reproductive behavior of the Udegeans of the village of Gvasyugi, the Lazo District, the Khabarovsk Krai. The study utilized data from the Federal State Statistics Service, household registers, and official annual reports of the rural feldscher-obstetric station, the subsidiary №2 of village of Gvasyugi. In July 2025 the sociological survey was carried out with purpose to determine self-assessments of quality of life of the population of village of Gvasyugi, considering the current demographic situation and social economic factors. It is establish that the number of the Udegeans of the village of Gvasyugi has trend to declining at low natality and significant migration of the youth from the village to urban areas to receive education. It is determined that the majority of the Udegeans are not in registered marriages because of absence in the village of necessary social infrastructure, coupled with the out-of-the-way and remoteness of the village from the district center to obtain the necessary service on marriage registration. It is established that commitment to national traditions and positive attitude of the Udegeans to expanded reproduction in in single-ethnic or mixed families under better social economic conditions could contribute to increasing of natality, especially with third child, and overall increase of the numbers of ethnic group. It is demonstrated that the low standard of living and the absence of high-tech medical care hinder the realization of reproductive intentions within the family.
THE PRIORITIES OF STUDIES AND ELABORATIONS IN THE INTERESTS OF MEDICINE AND HEALTH CARE: THE SHOWCASE OF PRIORITIES
The Ministry of Health Care of the Russian Federation develops on systemic basis the mechanisms designed to increase effectiveness of scientific research in interests of medicine and health care by means of identifying priorities called-for in practical medicine. The list of priorities, formed on the basis of analysis of opinion of experts, is freely available in branch segment of medical science at EGISU R&D for use in planning applied scientific studies in interests of medicine and health care. The analysis of showcase of priorities demonstrates that it includes 24 priority areas and 351 priority directions of research and development. The TOP-5 priority areas include cardiology and cardiovascular surgery, neurosurgery, neurology and neuro-rehabilitation, psychiatry, surgery (including maxillofacial and dentistry), traumatology and orthopedics, infectious diseases and oncology. The key types of priorities in research and development in interests of medicine and health care are decreasing of mortality, incapacity and terms of temporary disability, increasing of life quality related to health, orphan diseases, technological trends, import substitution and market superiority (commercial availability). To transform priorities for applied scientific research from the industry segment of EGISU R&D into priority topics for fundamental and exploratory research, the Ministry of Health Care of the Russian Federation has developed special classifier adapter. The system of priorities developed by the Ministry of Health Care of the Russian Federation is designed to form thematic directions which results of research and development will be in demand by medicine and health care, ensuring National technological sovereignty and strategic leadership in these industries.
SOME ISSUES OF ORGANIZATION OF DIAGNOSTICS AND PREVENTION OF DISEASES OF THE ENT ORGANS
The issues of elaboration of organization of medical care by the profile "Otorhinolaryngology" and prevention of the ENT diseases are important from the point of view of reducing morbidity, mortality and increasing of quality and healthy life expectancy of patients.
THE HEALTH PROTECTION OF FEMALE SAILORS IN ISSUES OF GENDER CONDITIONED VIOLENCE. PART I. THE MAGNITUDE OF THE PROBLEM AND FACTORS OF VULNERABILITY
The article considers the characteristics of manifestation of gender conditioned violence in the maritime industry, taking into account the specific of workplace of ships: isolation of the crew, prolonged cohabitation in a limited space, hierarchy, deficiency of privacy and limited access to channels of complaints and support. The typology of forms of violence that is applied to female sailors is described. The results of sociological survey carried out among female sailors (n=62) is presented. It established high prevalence of sexist jokes, significant rates of unwanted physical contacts and social isolation and low level of reporting to official authorities. The analysis demonstrate that “soft” forms of aggression contribute to lowering of the threshold of permissibility and to increasing of risk of escalation of more “hard” manifestations. The consequences include psychological traumas, decreased team unity and threats to operational security. On the basis of comparison of empirical data and normative legal base, the conclusion is made that there are gaps in institutional mechanisms of protection and that such comprehensive measures are needed as the implementation of accessible and confidential complaint procedures, training and prevention programs, expansion of medical and psychological support, increased representation of women at leadership positions and enhancement of accountability for violations.
AND IT WAS NAMED PENICILLIN-CRUSTOSIN VIEM
The article, on the basis of analysis of declassified archival documents and published sources, reveals the circumstances of identification of the strain that served as producer of the first National preparation of penicillin, named Crustozin. It is established that, since the middle of 1940s, among scientists circulated opinion about its specific affinity that differed from the one officially accepted in the USSR. The existing situation forced Professor L. I. Kursanov to take measures to protect his scientific reputation. The mode of action he choose permitted him to prove his professional competence without destroying the formed postulate.
ON THE ISSUE OF STAFF AND REGULATORY SUPPORT AND MAIN FUNCTIONS OF THE REGIONAL CENTER OF PUBLIC HEALTH AND MEDICAL PREVENTION
The article considers issues of staff and regulatory support of Regional Centers of Public Health and Medical Prevention including their basic functions. The evolution of approaches to organization of preventive activity in health care system is considered from initial health centers to modern Regional Centers of Public Health and Medical Prevention as independent medical organizations with expanded powers in field of population prevention. The particular attention is given to norms of staffing for key personnel categories, especially for physicians specializing in medical prevention. The significant discrepancies are identified between established norms of staffing and actual peopleware. Also, contradictions in norms of labor fixed in various normative documents are revealed. The analysis demonstrates that current staff requirements are not supported by available personnel resource that creates risks for sustainable implementation of prevention programs. The recommendations are formulated concerning unification and specification of norms of staff norms in order to enhance realism of staff planning and to enhance role of Regional Centers of Public Health and Medical Prevention within the public health system.
THE TRENDS OF DEVELOPMENT OF SYSTEM OF PROTECTION OF REPRODUCTIVE HEALTH OF GIRLS-ADOLESCENTS OF ST. PETERSBURG
The article presents results of comprehensive analysis of gynecological morbidity of girls-adolescents 15–17 years old in St. Petersburg in 2019–2024. It is established, on the basis of preventive examinations data, that average level of pathological affect made up to 105.04‰ and had pronounced trend to decreasing (β=−4.07; p=0.048). The comparative historical analysis demonstrated improvement of reproductive health indicators by 1.9 times as compared to basic data for 1996–1997. The characteristic of structure of gynecological morbidity of modern girls-adolescents in megalopolis is predominance of menstrual disorders (90.7% of newly diagnosed cases). At that, low medical activity of girls-adolescents continues that is proved by high percentage of newly diagnosed diseases detected only during preventive examinations (29.0%) and as well as significant prevalence of general morbidity over primary one. It is established that in St. Petersburg indicators of morbidity are 2.3–2.6 times higher than the National average indicators that is related to better accessibility of medical care and more efficient system of preventive examinations in the megalopolis. The analysis of the impact of the COVID-19 pandemic on gynecological morbidity of girls-adolescents revealed significant decreasing of appealability in 2020 and subsequent incomplete reestablishment of indicators that testifies structural changes in pattern of medical activity of girls-adolescents. The study confirms efficiency of the system of protection of reproductive health of girls-adolescents in St. Petersburg but at the same time indicates at necessity to further enhance medical activity of girls-adolescents and to develop target preventive programs.
THE DIGITAL PHENOTYPING OF AGING WITH APPLICATION OF HEMODYNAMIC PARAMETERS
The article presents materials of the original study on digital phenotyping of aging using expanded range of systemic hemodynamic parameters by establishing correlation with trends of biological age. The increasing of biological age with respect to actual age was considered as sign of accelerated aging. The opposite ratio was considered as manifestation of slowed aging. The relationship of accelerated aging with increasing of such key hemodynamic indicators as systolic, pulse and mean arterial pressure is confirmed. The data regarding relatively high diagnostic value of lateral arterial pressure as marker of accelerated aging were obtained. The obtained data permit to suppose that risk of accelerated aging is associated not only with high values of cardiac index but also with low ones, forming U-shaped dependence. The direct relationship between accelerated aging and decreasing of efficiency of heart functioning was established. Also inverse relationship between rate of biological aging and functional reserve of myocardium were detected. It is established that accelerated aging is associated with significant decreasing of heart energy capacity. The absolute correlation between accelerated aging and increased total peripheral vascular resistance was fixed. on the contrary, decreased value of this indicator was observed during slowed aging. The established regularities can be applied to monitor and to adjust optimal regimen of functioning.
THE FRACTAL CYBERNETIC ARCHITECTURE OF THE REGIONAL ANTI-NARCOTIC STRATEGY BASED ON MODEL ORIENTED SYSTEMIC ENGINEERING AS A TOOL OF INTERSECTORAL ADAPTIVE MANAGEMENT
This article substantiates the choice of fractal cybernetic architecture of regional anti-narcotic strategy based on the principles of the model-oriented systemic engineering. It is established that the tools of both traditional management by objectives and KPI-oriented management have predominantly reactive and fragmented patterns that reduces their efficiency in conditions of high dynamic of narcotics market and interdepartmental dissociation. The methodological basis was composed by the W. R. Ashby's Law of requisite variety and the S. Beer's model of viable system that permitted to interpret the anti-narcotic strategy as adaptive multi-level social medical system. As a result, the executable fractal cybernetic model-based systems engineering architecture was formed that incorporated goal-setting, structural, modeling, digital, and measurement loops and ensured goal traceability, coordination of interdepartmental processes and closing feedback loops. On the basis of materials from the Kabardino-Balkarian Republic, the feasibility of the architecture through the digital platform AURA-FORECAST, integration of interdepartmental data and support of management decisions in the cycle of monitoring and adjustment is demonstrated. The obtained results form the evidence-based basis of transition from reactive anti-narcotic policy to predictive and adaptive model of management in health care.
THE STATISTICAL DEMOGRAPHIC ANALYSIS OF THE MODERN RUSSIAN NATIONAL PROJECTS AND PROGRAMS ON ACTIVE LONGEVITY: THE EXPERIENCE OF THE REGIONS OF RUSSIA
The relevance of this study is conditioned by necessity of systematization and comprehensive analysis of implementation of programs of active longevity in the regions of the Russian Federation in 2023–2025 on the basis of official statistics and regional practices monitoring. The purpose of the study is to analyze efficiency of implementation of the National projects of active longevity in the regions of Russia on the basis of quantitative indicators and identification of the best regional practices. The National normative legal basis of work with persons of elderly age and statistical data and materials of the All-Russian Selection of the Best Practices of Active Longevity were investigated. The special attention was paid to psychological, economic and demographic aspects of work with the elderly generation.
THE SOCIETY REPRODUCTIVE RESOURCE AND CAUSES DETERMINING ITS LOSSES
The preservation of the population of the Russian Federation in light of the reduction of its natural reproduction in recent years becomes a priority strategic goal of national security. The public health as medical social resource of society includes such strategically important components as “labor”, “military”, “reproductive” and the reserve component that replenishes them (children and the elderly). The potential volume of the reproductive component of the medical and social resource of society is entire female and male human reserve, positioned within the limits of reproductive age (15–49 years). The actual volume of this component is smaller and consists of men and women of reproductive age, excluding persons who “unfit” to perform reproductive function because of medical and social reasons. Thus, out of reproductive resource are excluded women of reproductive age who underwent surgery of removing both ovaries and/or Fallopian tubes and/or uterus; having diseases related to medical indications for termination of pregnancy, men and women with diagnosis “infertility”, diseases that reduce possibility of occurrence of spontaneous pregnancy, having anatomical malformations of genitals that prevent the implementation of reproductive function and those who underwent medical sterilization. Both genders are to be considered for exclusion from reproductive resource because of so-called “social infertility”, including imprisonment, persistent refusal of reproduction with registered application of effective contraceptive measures. The search for factors that determine these losses of reproductive resources, as well as methodological and methodological approaches to their conservation, is the essential basis for preserving the reproductive potential of the country. The search for factors that determine the given losses of reproductive resource and methodological approaches to it preservation is the essential basis of preservation of the National reproductive potential.
On Decriminalization of Offenses Related to Contamination with HIV Infection
The article considers the problem of sufficiency and adequacy of measures of criminal legal impact targeted to prevent and to suppress acts related to the spread of HIV infection. The purpose of the study is to substantiate the necessity to revise the existing in the Russian Federation views on criminalization of factors that bring to criminal account for corpus delecti related to contamination with HIV infection. According to statistical data, the spread of HIV infection for a long time has rapid character. The risks of contamination with it are present both in people's private lives and at applying for medical care that in one's time created basis for the inclusion of the Article 122 “HIV infection” in the Criminal Code of the Russian Federation. For the same reasons, the migration legislation of the Russian Federation was supplemented with the articles about mandatory medical examination for HIV infection for migrants and their deportation from the country in case of its detection. However, in the last decade, experts in the field of health care and law from various countries, including Russia, in increasing frequency express doubts about efficiency measures of criminal legal impact in achieving the goals of reducing the number of new cases of HIV infection contamination and suppressing the spread of the disease. Relying on world practice and considering low prevalence of the idea of decriminalization of HIV in our country, the compromise version of solution of the problem is proposed.
THE HISTORY OF PHARMACEUTICAL LAW. REPORT III. THE TRENDS OF GLOBALIZATION OF REGULATIVE NORMS IN XXI CENTURY
This article continues the cycle of publications on the study of history of pharmaceutical law. In the XXI century, the third stage of development of regulation of pharmaceutical sphere began. The introduction of the laws of direct action or regulations, completed the process of harmonization of European regulatory norms with American ones. The implementation of the rules of good practices of research and production of ICH into legislation of countries with developed market of medicinal products ensured unification of technical requirements to safety and quality of medications in the general pharmaceutical market.
THE SOCIOLOGICAL ASSESSMENT OF PROFESSIONAL BURNOUT IN PATHOANATOMISTS
The article considers issues of prevalence of professional burnout syndrome in pathoanatomists of the Irkutsk Oblast analyzed on the basis of the MBI-HSS questionnaire expanded with additional original questions. The professional burnout syndrome was identified in 52.1% of respondents. The leading role of emotional exhaustion in the structure of professional burnout syndrome was established under moderately expressed depersonalization. The application of the Pearson -test permitted to reveal statistically significant influence on development of professional burnout syndrome of such factors as the number of positions held by physicians (p=0.002), the size of the work body (p=0.02) and application of non-ergonomic software (p=0.04). The high risk of development of professional burnout syndrome was also associated with work in health care institutions located in large cities, predominant analysis of biopsy material, and availability of family with minor children. The research data testifies that professional burnout in pathoanatomists is primarily determined by systemic and organizational conditions of work that dictates necessity of development of comprehensive preventive measures, including workload optimization, modernization of document flow and organization of support system for specialists.
THE PROFESSIONAL OCCUPATIONAL HYGIENE: ASSESSMENT OF GENDER SEGREGATION
The article considers aspects of professional occupational hygiene from the point of view of gender segregation on labor market. It is demonstrated, on the basis of analysis of statistical data, that males and females are unevenly distributed by industries and types of harmful production factors. The males predominate in conditions related to physical load, noise, vibration, chemical and ionizing effects. The females more often are exposed to biological factors and work in conditions of high neuro-psychic stress. These revealed differences are conditioned by both social stereotypes and sectoral structure of employment. The necessity to consider gender-specific factors under development of standards of occupational safety, design of personal protective equipment and organization of medical supervision are emphasized. The results of the study can be applied in formation of gender policy in the field of occupational safety and improvement of conditions of professional environment for all workers.