Problems of Social Hygiene,
Public Health and History of Medicine

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 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 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 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 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.

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 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 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.

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.

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 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 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 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 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.