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 FACTORS AND BARRIERS AFFECTING HEALTH OF MIGRANTS AND MODES OF ITS AMELIORATION
The article considers international experience in studying health of migrants. The most common diseases in migrant community are described. The factors determining their prevalence are established. The barriers restricting medical care provision to displaced persons, including social economic, cultural, and communicative ones, are described. The ways to improve organization of medical care of migrants are proposed. The proposed measures will help to develop benevolent environment for migrants and will contribute to their successful integration into new country of residence.
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THE SOCIAL PATHOLOGY AS THEORETICAL CONSTRUCT: RUSSIAN VIEW AND GERMAN KNOWLEDGE (1910–1930)
The theory of social pathology originated in Germany in early 20th century, owing to Alfred Grotjahn, the founder of scientific school of social hygiene. Both German and Russian social hygienists ran into problem of definition of concept “social pathology” and its scientific methods and theory. The ideas of Grotjahn on social pathology were largely introduced in the Imperial Russia due to energetic activities of L. B. Granovsky, member of the Pirogov Society. In the 1920s, the Soviet social hygienists explored social pathology from both practical and theoretical points of view. The Soviet academic literature developed theoretical approach to social pathology based on work of Benno Hayes, follower of Grotjahn. The theory of Chajes in sphere of social pathology differed from original theory of Grotjahn. In Russia, the German concept of social pathology was adapted under the influence of the Soviet ideology and the Marxist understanding of history. In the University clinic, on the basis of ideas of Grotjahn, practical approach was realized that received support from N. A. Semashko, the People's Commissar of Health Care. Within the framework of this approach attempts were made to examine relationship between etiology of diseases and impact of environment.
The structure of morbidity of digestive organs in Kyrgyzstan (according data of appealability to department of gastroenterology and hepatology of the national center of maternity and childhood care)
The state of health of children represents serious medical social problem. The data of official statistics and special studies everywhere register increasing of general morbidity and disability, including area of digestive system, chronic forms of diseases in structure of children pathology, share of congenital development defects and genetic deviations. The study was carried out to investigate and analyze structure of morbidity of digestive system in children based on data of appealability for hospitalization in the gastroenterology and hepatology Department of the National Center of Maternity and Childhood Care (Kyrgyzstan). The data from reports of mentioned gastroenterology and hepatology Department in 2019–2024 were analyzed. It was established that across all nosological units that are subjected to hospitalization in hospital, occurs steady increasing that indicates to severity of disease. The facts of increase of morbidity of gastrointestinal tract and hepatobiliary system require further investigation and scientific research to find causal factor.
THE ISSUES OF MEDICINAL SUPPORT UNDER HIGHLY WASTEFUL NOSOLOGIES. THE ORIGINAL MEDICINAL PREPARATIONS REPRODUCED ONES AND BIO-ANALOGUES
In case of high-cost nosologies the issues of medication support are key ones at organization of necessary medical care. At that in conditions of budget deficiency availability of cheaper alternatives within the framework of one international non-patent name allows to save budget and to distribute it among larger number of patients. On the other hand in case of medication intolerance treatment with original medication may be required for vital indications. The article analyzes medicinal preparations applied in case of high-cost nosologies at the expense of the Federal budget from standpoint of availability of generic medications and bio-analogues.
The estimated expenditures on medicinal support of patients with chronic obstructive disease of lungs
The purpose of the study is to calculate amount of funds required for medicinal support of patients with chronic obstructive disease of lungs in all conditions of provision of medical care. The calculation of costs of medication support of patients with chronic obstructive disease of lungs was implemented. The standards of medical care and original methodology of calculation were applied. The sums necessary for provision of of medications according to pharmacological classes and groups of patients were calculated. The sums of necessary costs for medication support of patients with chronic obstructive disease of lungs, calculated on the basis of standards of medical care and original methodology turned to be comparable (difference is less than 10%) and made up to from 23.4 billion rubles to 25.2 billion rubles. The study revealed that differences in sums of funds required to support patients with medications of various pharmacological classes depending on type of calculation: based on standard of medical care and original methodology. The largest sums of funds required for treatment of mentioned patients fall on groups of patients C and D. The results of the study can be used in planning medical care in pulmonology, as well as in development of the Federal project “The struggle with chronic obstructive disease of lungs”.
THE SOCIOLOGICAL STUDY ON INVESTIGATION OF PREFERENCES IN RECEIVING INFORMATION BY PATIENTS WITH BRONCHI OBSTRUCTIVE DISEASES OF LUNGS
The article presents results of examination of satisfaction of patients with bronchoobstructive diseases by receiving information about disease, preferred topics for discussion and sources of information. The data was compared with opinions of health care specialists. The questionnaire survey was carried out among both physicians treating patients with diagnosis of “asthma” and “chronic obstructive pulmonary disease” (COPD), and patients with the same diagnoses. The overwhelming majority of patients during visit of physician are lacking time to receive information about their illness, including about its treatment. The schools for patients are not visited by 89% of patients. At that, most of them are aged 45 years and older and have diagnosis of COPD. The additional information is searched in Internet by 92% of patients. At that, level of trust to such sources is low. The results of questionnaire survey of physicians confirmed data received from patients: lacking time for answers and questions, low attendance of patient schools. The obtained results can be used in development of educational projects for patients, taking into account their preferences in receiving information.
The Development of Algorithm of Intellectual System of Supporting Decision-Making in Mammographic Diagnostics of Breast Cancer Based on Convolutional Neuronic Network
The article considers issues of training models of convolutional neuronic network (CNN) for automated identification of point functions of visualization to discern mammography pictures belonging to negative, false benign and malignant cases, targeting to improve interpretation of results of mammographic examination. On the basis of automated deep training (application of CNN) the approach is proposed, that permits to detect small differences in mammographic pictures to diagnose true positive and false positive results. The information base for training CNN is represented by digital base (open resource for methods of intellectual studying of analysis of mammographic pictures) of data of mammography screening of the Massachusetts General Hospital and the Winston-Salem Medical College, the USA. The share of false positive results according trained model in the total number of examined patients from different age groups made up from 22% to 32%. To compare, share of false positive results based on decoding of mammographic picture by medical specialist varied from 34% to 53%. The trained model based on the CNN can be used for mammographic pictures of any database. The predictive accuracy of model depends, among other things, on volume of training sample. Therefore, formation of open database of results of mammographic examinations with accurately established diagnosis will permit later on to broadly apply possibilities of deep training in medical practice. The study has great potential to incorporate deep training of CNN into clinical practice of screening of breast cancer and to improve interpretation of mammographic pictures.
The input of professor G. A. Miterev into development of national medical science and his pedagogical activity
G. A. Miterev, similar to the Soviet health care organizers N. A. Semashko and Z. P. Solovyov, while being the USSR People's Commissar of Health Care (1939–1946), began to build his own academic career. In 1945, he defended doctoral thesis. He headed the Department of Hygiene of the Moscow Pharmaceutical Institute of the USSR Ministry of Health Care in 1951–1967. G. A. Miterev is the author of more than 70 scientific works. However, his main merit in development of National medical science became not so much as his work as professor, as his organizational activity as the USSR People's Commissar of Health Care, related to establishment of the USSR Academy of Medical Sciences.
THE ACTUAL ISSUES OF SERVICING MEDICAL EQUIPMENT IN CONDITION OF SANCTIONS
The concept of servicing maintenance implies implementation of routine technical inspection, checkup and carrying out of repair work applying spare parts and accessories. In conditions of increasing sanctions' pressure, organization of supplies of component parts and accessories became complicated. As a result, delivery time and cost of such component parts increased. Because of the fact that most of medical equipment on balance sheet of medical institutions is imported, current situation affected process of servicing maintenance of medical equipment used in routine medical services in hospitals and polyclinics. Actually, main regulations of technical servicing of medical devices are established by single state standard specifying category of medical device that includes such types of goods as medical technique and medical equipment. Along with this, above-mentioned document contains enumeration of works related to servicing maintenance: unscheduled and periodic technical maintenance and diagnostics, control of technical condition, installation, dismantling, tooling, repair work. From numbered enumeration of realizing works follows that their implementation requires usage of complementary depot units and accessories, which, according to requirements of legislation in action, are to be provided from foreign builder. Consequently, such an order, in view of established circumstances, is significantly burdened by measures of sanctions' impact. Whereas, vast majority of different medical institutions run into problems of organization of servicing maintenance of medical equipment on the balance sheet. Such a situation requires permission at legislative level, since at present time carrying out servicing maintenance is allowed only with consideration of usage of original components. Therefore, establishment of separate procedure of usage of analog component parts would be a constructive solution of revealed problematic aspect.
The Natural Reproduction of Population of Rural Territories of the Central Chernozem Region: Problems and Prospects
The article is devoted to the study of key trends in natural reproduction of rural population of the Central Chernozem Region. The main factors determining the given trends and prospects of process are established. The Rosstat data characterizing demographic situation in the Central Chernozem Region in 2020–2024 and the results of expert survey carried out in August-September 2024 (N = 32) were used as basis for analysis. The conclusion was made that scope of natural loss of population in rural areas of the Central Chernozem Region are conditioned by super-mortality during pandemic during the pandemic combined with delayed births and influence of geopolitical factor associated with the Special Military Operation. It is concluded that further prospects of natural reproduction of rural population of the Central Chernozem Region (primarily the Belgorod and Kursk regions) are in the “risk” zone. The prospects for overcoming consequences of demographic decline not only depend on stabilization of geopolitical situation but require intensification and restructuring of measures of state demographic policy, consisting in application of differentiated approach to regions, in development of targeted mortgage programs, in improvement of social, engineering, cultural and leisure, transport, communications infrastructure, in prevention of stressful social environment and self-destructive behavior of rural residents.
THE ATTITUDES OF FOREIGN STUDENTS TO THEIR FURTHER LIFE AND CAREER IN RUSSIA
The world internationalization of higher education is gaining momentum against the background of significant demographic changes in economically developed countries (aging of population, low natality) that encourage governments to attract and retain the youth from less developed regions. In these conditions, it is relevant to study migration attitudes of international students — their motives, plans and factors influencing decision to stay in Russia or leave the country after graduation. The purpose of the study is to determine value guidelines and attitudes of foreign students regarding continuation of their education, work and life in Russia and to identify key affecting factors. In 2024, the questionnaire survey of 168 foreign students-participants of the English-speaking Master program “Population and Development” in the Federal State Autonomous Educational Institution of Higher Education “The National Research University the Higher School of Economics” was carried out. The questionnaire based on the Likert Scale and further statistical analysis were applied. Additionally, official statistics data was used (VPO-1 form of the Minobrnauka of Russia). It is demonstrated that expectations of students regarding education in Russia are generally justified. The majority of respondents rates very high quality of education and life in Russia, accessibility of habitation, relatively low cost-of-living. The higher marks received accessibility of medical care and legal protection of students. At the same time, significant portion of students have no confidence in prospects of their employment in Russia. About two thirds of respondents believe that it will be difficult for them to find job after graduation that is conditioned, according their opinion, by not adequately favorable policy, mistrust of employers to foreigners and poor involvement of universities in job placement of graduates. About half of respondents feel themselves uncomfortable in Russia and plan to leave after graduation. About 40% of foreign students would like be admitted to citizenship of Russia. While the same number do not plan it.
THE DYNAMICS OF SCIENTIFIC PUBLICATIONS CONCERNING MEDICAL TOURISM IN 1945–1990: THE BIBLIOMETRIC ANALYSIS
The article considers becoming and development of concept of active longevity in state demographic policy of countries of the Commonwealth of on the basis of analysis of program documents, strategies and institutional mechanisms of the CIS member states. The special attention is paid to issues of institutionalization of approach to active longevity, as well as to of inter-state cooperation in promoting age-friendly agenda.
THE POSSIBILITIES OF DIGITAL RESOURCE SUPPORTING MANAGEMENT DECISION-MAKING IN ASSESSING SEVERITY AND ELIMINATION OF AFTERMATH OF CHALLENGES TO PUBLIC HEALTH AS MEDICAL SOCIAL RESOURCE MAINTAINING NATIONAL SECURITY
The article considers and classifies main challenges to public health and health care systems in the Russian Federation. The software “Challenges, version I” was used to account quantity and intensity of impact of considered challenges. The total number of challenges amounted to 118 in 2012–2024. The challenges were fell into types of impact on the population. The challenges were selected according availability of their scale, time frame and impact on strategically important components of public health. Every characteristic of challenge was assigned numeric value that was used to calculate index of challenge severity. In Russia, it was established that there are no subjects with no challenges to society. In terms of scale of distribution of challenges it was revealed that prevail national challenges manifesting on the territory of the country (45.76%). In terms of duration of challenges prevail long–term calls (39.8%). In terms of type of challenge prevail social (33.05%) and economic (22.88%) challenges. The level of average index of challenge severity increased in 2024 up to almost 4 times as compared to 2012. The study of modern challenges to public health requires a systematic approach. The application of innovative solutions and digital technologies will minimize risks and improve efficiency of health care. The information gathering about challenges plays critically important role in public health management. The monitoring of severity of challenges permits to prognosticate risks and to develop measures of response. The software “Challenges, version I” can be a typical solution for gathering and describing characteristics of challenges.
The Detection of Predisposing Factors and Causes of Disability as a Result of Glaucoma
The article presents results of identification of predisposing factors and causes of disability as a result of glaucoma in conditions of the city of Baku. The study was carried out of the basis of Polyclinic №3 of the Yasamal district of the city of Baku. The unit of observation was patient with confirmed diagnosis of glaucoma. The technique of continuous coverage was applied to collect information about 632 patients that were allocated by two groups: the disabled (150 patients) and able-bodied persons (482 patients). These groups were arranged according gender, age, clinical diagnosis, stage of pathology at the time of detection and registration by prescription of pathology. In subgroups of patients with glaucoma, depending on age, (49 years and younger, 50–59 years and 60 years and older), disability rate made up to 22.7±4.5%, 30.6±3.3% and 20.2±2.1% correspondingly. The highest risk of development of disability because of glaucoma was observed in patients 50–59 years old. Among patients with glaucoma, percentage of disability, depending on gender, was factually equal (23.9±2.1% in males and 23.4±2.8% in females). The rate of disability developed against the background of primary open-angle glaucoma (24.4±1.9%) and primary closed-angle glaucoma (23.9±5.1%) had no differences. It is established that in conditions of late detection of glaucoma rate of disability because of loss of vision is marked in 23±1.7% of patients. Among risk factors of glaucoma are age of patients, prescription of pathology, late detection. Depending on late detection and prescription of glaucoma, risk of development of disability increases up to 1.58–7.26 and 2.42–16.46 times. The reliable mode of prevention of disability because of glaucoma is its timely detection at early stages.
THE EVALUATION OF EFFICIENCY OF MECHANISM OF FUNDING AND ASSIGNING QUOTAS IN ORGANIZATION OF WORKPLACES FOR THE DISABLED
The article presents results of evaluation of efficiency of mechanisms of assigning quotas and funding of working places for the disabled in Russia. The analysis trends is applied to dynamics of resettlement of the disabled according assignment of quotas. The unstable tendencies were revealed: increasing in 2017–2019 and decreasing after 2020. The main causes of low efficiency is formal approach of employers to implementation of assignment of quotas, insufficient incentives and high costs associated with adaptation of workplaces. The shortcomings in funding, including complicacy of compensation of expenditure and limited number of setting up workplaces. It is noted that most of vacancies don't correspond to preferences of the disabled (underemployment, remote job involvement) that decreases motivation for resettlement. The measures are proposed to develop system: expansion of tax privilege for employers, flexible forms of assigning quotas, simplification of access to funding and development of supporting infrastructure. The study was based on data from Rosstat, EMISS and job portals that ensured reliability of conclusions.
THE ORGANIZATIONAL RESERVES OF DECREASING ISCHEMIC HEART DISEASE MORTALITY IN THE RUSSIAN FEDERATION
The article examines issue of identifying organizational reserves to reduce mortality of ischemic heart disease at the expense of optimization of management technologies under provision of medical care to patients with mentioned pathology. The national data from the statistical observation forms №№ 12, 14 and 30 and the “Monitoring of activities reducing mortality of ischemic heart disease” in 2016–2021 was analyzed. The co-integration of time series characterizing both mortality of ischemic heart disease and lethality of acute coronary syndrome were applied. The parameters of accessibility of medical care to patients with ischemic heart disease were analyzed. To evaluate power of impact of factors the elasticity coefficient was applied. It is established that mortality of ischemic heart disease decreased under increasing of number of both beds in Regional vascular centers (E=0.08%; R²=0.98) and primary vascular departments (E=0.31%; R²=0.98) and operations of coronary artery bypass (E=0.23%; R²=0.89). The lethality under acute coronary syndrome with ST segment elevation decreased at earlier hospitalization (E=0.5%; R²=0.97), thrombolysis (E=1.1%; R²=0.91) and per-cutaneous coronary intervention (E=1.5%; R²=0.60). The lethality at acute coronary syndrome without ST segment elevation decreased under increasing of percentage of per-cutaneous coronary intervention (E=1.7%; R²=0.72). The following reserves to decrease mortality were established: development of dispensary observation, expansion of network of vascular centers, increase of number of operations of coronary artery bypass, reduction of time of hospitalization, increase of cases of application of thrombolysis (especially at pre-admission stage) and application of per-cutaneous coronary intervention in case of acute coronary syndrome with with ST segment elevation.
The problems of customs registration and control of medications located aboard of water vessel
For any ship owner, the medication support of vessels of merchant shipping is one of prime tasks of organization of due medical care of crew members. The ship's first aid kit contains various medications, including medicines containing narcotic, psychotropic, drastic and toxic substances. The amount of medicines needed on board depends on duration of voyage, destination, the number of crew and nature of cargo. The ship, at call in any country, undergoes procedure of customs clearance and control both of ship itself and medications on board. The article considers modern aspects of customs clearance and control of medications. The degree of responsibility of ship owner and crew members for unreliable declaration is determined. The recommendations preventing illegal transfer of medications on ship's board are formulated.
The Role of Network Forms of Educational Cooperation in Development of Competences of Medical Specialists of the Future
The article presents analysis of network forms of educational cooperation in medical education as strategic resource of training competent specialists in conditions of technological and sociocultural transformations of health care. The theoretical foundations, organizational models and practices of network interaction between medical universities, scientific research institutions and industrial partners are considered. It is demonstrated that network cooperation contributes to integration of academic and clinical resources, support of flexibility of educational trajectories and formation of digital and interdisciplinary competencies. The special attention is paid to the Russian national experience and normative legal base of network education, as well as to prospects and challenges of its development. The conclusion is made about necessity of institutional support, digital infrastructure and mechanisms ensuring academic autonomy and quality in implementation of network models.
THE IMPACT OF HUMAN FACTOR ON SECURITY IN LINE SHIPPING: SUBSTANTIATION OF SYSTEM MONITORING OF PSYCHO-PHYSIOLOGICAL CONDITION OF CREW
The modern maritime industry is undergoing significant changes due to increasing of flow of transportations of bulk cargo in containers, increasing of share of regular voyages and tightening of requirements of safety of navigation. The line shipping is characterized by constancy of routes and strict compliance of schedule in conditions of higher intensity of ship flows and complicated work conditions. The invariable work in such conditions results in psycho-physiological disorders, chronic stress, emotional burnout, development of cardiovascular pathology and neurological and mental disorders. Hence, augmented risk of deterioration of health of crew members, reduced performance efficiency, increased likelihood of mis-actions of navigator and increased possibility of emergency conditions at the sea. In order to develop recommendations to maintain health of crew members and to increase safety of navigation, the article presents results of survey of command staff of container fleet. The analysis permitted to identify corresponding key problems and to formulate recommendations to eliminate them. The legal field regulating organization of medical examination and issues of admission to professional activities of sailors was analyzed. The differences in approaches to assessment of psycho-physiological state in different countries were identified.
The Problems of Implementation of Normative Legal Documents Concerning Labor of Otorhinolaryngologists
The article presents analysis of detection of the number of medical workers required to provide medical care in accordance with normative legal documents concerning labor regulations. The system of labor norm-setting includes, alongside with labor standards, work content. The work content is set in the form of the number of beds, the number of visits and (or) referrals, the number of diagnostic examinations. According to results of the study, it was determined that labor standards in otorhinolaryngology are to be revised due to number of erroneous provisions mentioned in the article, as well as in accordance with the recommendations of the Ministry of Labor of the Russian Federation, which are of an inter-departmentamental ones, on revision of standard industry labor standards every 5 years after their approval, as well as after changing if organization of labor and implementation of new equipment and technology.
The trends in life expectancy and behavioral factors of health maintenance in the Russian Federation
The relevance of the study is determined by necessity to monitor life expectancy (LE) and healthy life expectancy (HLE) within the framework of implementation of National demographic priorities in Russia. The purpose of research is to analyze dynamics of LE and HLE in Russia in 1990–2023 and to identify their relationship with behavioral factors of health preservation.
THE ORGANIZATION OF MEDICAL SOCIAL CARE OF PATIENTS WITH COGNITIVE DISORDERS. PART II
The characteristic of national model of organization of medical social care of patients with cognitive disorders as compared with similar models in foreign countries is given. The causes of defects in organization of medical social care and modes of their correction are analyzed. The prospective organizational technology on the basis of routing of this category of patients is presented.
THE SELF-ORGANIZATION AND SYNERGISTIC EFFECTS IN THE SYSTEM OF ANTI-NARCOTIC STATE STRATEGY OF THE REGION
The anti-narcotic activity is targeted to formation of unified system of comprehensive anti-narcotic preventive policy oriented on harmonization and coordination of processes between subjects of interdepartmental interaction of the Strategy. The purpose of the study was to establish optimal approach and principles in formation of synergistic effects between people, departments, civil society institutions, including public and non-profit organizations that make up social structure — state anti-narcotic Strategy in the region. The conclusion is made that characteristics of implementation of the Strategy for each subject of prevention at meso-level (region) set necessary potential for development and manifestation of synergistic effects leveling out existing patterns, with established vertical line of hierarchy of relations in health care sector. According to researchers, linearity, closure, lack of conditions for changes and transformations, “unjustified stability” impede self-organization and therefore to receive synergistic effects from interdepartmental interaction.
THE THREATS OF LOSS OF LABOR POTENTIAL OF ADULT ABLE-BODIED POPULATION OF RUSSIA AND PROCEDURE OF THEIR ESTIMATION
The article substantiates actuality of calculation of threats of loss of labor potential of adult able-bodied population of Russia. The technical modes of their calculation are presented. The calculated indicators are ranked. The availability of publications concerning loss of vital and labor potential of different age groups of population in Russia points to necessity in methodological development of calculation of threats of loss of labor potential of adult able-bodied population of the Russian Federation. The developed technique of calculating loss of labor potential is based on report data of Rosstat, statistical materials of the Federal State Budget Institution “The Central Research Institute for Health Organization and Informatics” of the Minzdrav of Russia. Also data from the Order of the Ministry of Labor and Social Protection of Russia from August 27, 2019 №. 585n “On classifications and criteria applied under implementation of medical social expertise of citizens by Federal state institutions of medical social expertise”. The stages of calculation of morbidity (general) of adult able-bodied population according to selected from the Order №585n nosological forms relevant to the IV degree of severity of “disorders of functions of organism caused by diseases, consequences of traumas or defects” (it corresponds to group I of disability), determining risks of complete loss of labor potential. The study demonstrated that the greatest threat of loss of labor potential of the adult able-bodied population is associated with hypertensive disease, ischemic heart disease, malignant neoplasms, diabetes mellitus, arthrosis, obesity, asthma and asthmatic status and other diseases. The results of the study can be used at the Federal and regional levels in formation of management decisions targeted to prevent loss of labor potential of population of the Russian Federation.
The history of pharmaceutical law. Report I. Regulatory norms in sphere of pharmacy from XII to turn of XX centuries
The article opens series of publications devoted to historical reconstruction of chronology and main vectors of formation of regulatory complexes in pharmaceutical sphere in the European countries and the North America. The Report I considers the first stage of development of legal regulation (XII– early XXth century), during which two main models took shape — the continental one, based on priority of normative acts dating from the Edict of Salerno, and the Anglo-Saxon one characterized by absence of specific legal norms of pharmaceutical activity.
THE AGE-RELATED SHIFTS IN THE STRUCTURE OF FEMALE POPULATION OF FERTILITY AGE IN POPULATION OF SMALL TOWNS OF THE EASTERN SIBERIA AND THEIR IMPACT ON TOTAL NATALITY
The article notes that population of females of fertility age and its structure and dynamics is the basis for determination of tendencies and prognostication of total fertility. For the first time, technique of determination of shifts in demographic structure of female population of fertility age was applied. The study of dynamics of share of female population of fertility age in total number of female population in small towns revealed its decreasing. The special indicators of dynamics — mass of structural shift in female population, rate of structural shift, intensity of structural shift — demonstrated that their dynamics are taking shape in population of small towns of the Eastern Siberia differently. During 2000–2023, shifts in population affected total fertility rate. The effect of structural shifts in ratio of female population of fertility age on total fertility rate demonstrated that in 9 selected territories in 3 of them unfavorable shifts affected total fertility rate. The reliable correlation interdependence was established. The established interdependence are to be considered in generation of prognosis of population in territories of the subject of the Russian Federation.
THE DIFFERENTIAL APPROACH TO IMPLEMENTATION OF PROJECT ACTIVITY IN MEDICAL ORGANIZATIONS OF PRIMARY HEALTH CARE
The article elaborates issue of scientific substantiation of differentiated approach to implementation of project activities in medical organizations considering differences in resource support and motivational readiness of personnel. The study sampling included 100 polyclinics of the Moscow Oblast participating in implementation of the project “Polyclinic Reloading”. The checklists reflecting 100 criteria of effectiveness of the project were grouped together by 6 blocks. The evaluation of architectural and resource conditions was carried out in 224 medical organizations. The psychological questionnaire survey covered 1 598 workers of polyclinics. The expert survey covered 28 chief physicians involved in project implementation. the descriptive, correlative and dispersive statistical methods were applied. The average level of implementation of project criteria according check-list made up to 88.3%. However, only 16% of institutions achieved all target indicators. The analysis revealed significant differences among medical organizations in terms of architectural conditions and psychological readiness of personnel. According to experts, the most influential factors were insufficient equipment with facilities, staff shortage, higher workload and lower motivation of workers. The moderate correlation was established between area of buildings and attached population (rs = 0.49; p &lt; 0.001) that indicates at absence of planned dependence between capacity and factual load. The implementation of projects requires adaptation to specific conditions in medical organization. The differentiated approach to implementation of project activity permits to consider resources, architecture and level of personnel involvement.
THE HISTORY OF RUSSIAN PHARMACEUTICAL INFORMATION MARKET. REPORT II: FORMS OF PRODUCTION AND PACKAGING OF INFORMATION
In this series of articles the authors analyze becoming of pharmaceutical information market in Russia. It originated from two sources: fragments of the Soviet system of circulation of pharmaceutical information and as consequence of business projects. The information segment, being “sectoral” or “internal” for pharmaceutical market, formed with time infrastructure of production, distribution, storage and consumption of its goods. Initially, it was considered as auxiliary and then it changed into autonomous market with its own rules of game, leading players and prices for services. In Report II the question is about transformation of pharmaceutical information into commodity, about need of young market of medications in information, its packaging forms, sources and technologies of production in the 1990s.
The main demographic challenges to the development of Russian society in modern conditions are, on the one hand, a low birth rate, on the other, aging and a high increase in mortality of the indigenous population, an increase in losses of people of working age. Purpose. Identify demographic challenges and individual aspects of the impact of migration processes on the public health of the indigenous population of the host territories. When analyzing medical and demographic indicators by regions and subjects of the Russian Federation, significant fluctuations are noted. Mitigation of demographic trends and compensation for negative imbalances in society is achieved by increasing migration. It should be borne in mind that external migration processes have a significant impact on the socio-economic situation of the host territories and various consequences on the public health of the permanent resident population. Migration flows increase the burden on the State in the field of health, education and other areas of economic and social assistance.