Problems of Social Hygiene,
Public Health and History of Medicine

The current anti-narcotic policy in the Russian Federation is implemented as a multi-level management system that includes strategic, tactical and operational contours of decision-making. The purpose of the study is to develop methodological approaches to systemic evaluation of efficiency of implementation of anti-narcotic policy in the Russian Federation at strategic, tactical and operational levels from position of cybernetic approach. On the basis of the S. Beer's Viable System Model (VSM) and the W. R. Ashby's law of requisite diversity, the cybernetic model RAS-VI (Resilience-Adaptability-Synergy-Diversity Index) is proposed. The model is intended to diagnose viability of regional anti-narcotic systems. Within the framework of the study were marked out key indicators (resilience, adaptability, synergy, diversity). The formulas for their calculation and criteria of interpretation were propose that permits to quantitatively assess integrity and adaptability of interdepartmental mechanisms of prevention. The theoretical foundation of the model is based on cybernetic principles of self-regulation, feedback and recursion and as well on concept of digital double of anti-narcotic system. The practical application of the RAS-VI model facilitates transition from normative descriptive to system analytical management of anti-narcotic policy in conditions of digital transformation of health care.

The purpose of the study is to comprehensively assess health status of the pre-levy youth aged 15–18, behavioral risk factors, attitudes toward military service and level of health literacy in the context of the pre-levy training system in the Republic of Uzbekistan. The cross-sectional study was carried out in September and December 2024 among 386 youth of pre-levy age (15–18 years) studying in institutions of general education of Bukhara. The adapted version of the WHO European Office Health Behavior of Schoolchildren (HBSC) questionnaire was applied with additional sections on pre-levy training that included 65 questions. The Statistical processing was performed using methods of descriptive statistics, Pearson's χ² test, Fisher's exact test and Spearman's correlation analysis. The high prevalence of alcohol use was established for 89.1% of pre-levy conscripts, tobacco smoking for 42.5% (including those who tried it), and marijuana smoking in 15.5%. Among respondents, 21.2% of youths rated their health as “rather poor” or “poor”. The statistically significant associations are found between tobacco smoking and the number of smoking friends (χ²=28.76, p<0.001; OSH=4.21), alcohol consumption and age (χ²=9.21, p=0.027), marijuana use and religious affiliation (χ²=7.95, p=0.019). The counter-indications to service were found in 21.8% of draftees. The most common pathologies were scoliosis and other musculo-skeletal disorders (35.2%) and impairments of vision (32.1%). Less than half of draftees (42.5%) received full course of vaccination before service. The pre-levy youth of Bukhara region are characterized by high prevalence of behavioral risk factors, especially alcohol consumption. The “peer effect” is dominant factor in development of tobacco smoking. The systemic gaps in medical support of pre-levy training were identified. The obtained data require development of targeted prevention programs focusing on group behavior of adolescents and enhancement intersectoral cooperation in pre-levy training system.

The pregnancy that occurred due to in vitro fertilization is characterized by higher risk of development of gestational diabetes mellitus. The purpose of the study was to investigate course and outcomes of pregnancy resulted from in vitro fertilization in women with gestational diabetes mellitus, depending on time of its manifestation. The analysis of course of pregnancy, childbirth and condition of newborns in 179 women with gestational diabetes mellitus under pregnancy resulted from in vitro fertilization was carried out. It is established that early manifestation of gestational diabetes mellitus is associated with older age of pregnant women, higher rate of birth of large fetus in anamnesis, higher body mass index, more frequent prescription of insulin therapy to treat gestational diabetes mellitus, higher rate of development of early threatened miscarriage, isthmic cervical insufficiency, anemia, chronic arterial hypertension, gestational arterial hypertension, moderate preeclampsia, severe preeclampsia, premature normally placed placenta detachment, fetal growth retardation, chronic intrauterine fetal hypoxia, diabetic fetopathy, prenatal rupture of amniotic fluid, premature birth, more frequent birth of large fetus, development of fetal renal pyelectasia. The female patients with late manifestation of gestational diabetes mellitus had higher level of fasting plasma glycemia, frequent development of placenta previa, polyhydramnios, pathological and insufficient gain of body mass during pregnancy, dis-coordination of labor and clinically narrow pelvis during labor, more frequent operative delivery and early delivery. The gestational diabetes mellitus, developed both in early and late periods, complicates the course and childbirth under pregnancy resulted from in vitro fertilization, adversely affects state of the newborn. The study in depth is needed to establish possible mechanisms of development of gestational diabetes mellitus in this cohort of women with implementation of screening examinations and determination of further tactics of management of pregnancy depending on time of its manifestation.

The problem of availability of abortion services for women in countries of world community is not only not losing its importance, but is undergoing new stage of actualization, since it has no clear understanding and is often raised in the context of solving demographic problems of aging society. At the same time, analysis reveals vulnerability of position of those using religious context in woman's self-determination regarding disposal of her own body and right to refuse compulsion to terminate her pregnancy by physiological childbirth without her psychological, social and economic readiness and public support. Referring to various testimonies and sources, we appeal to necessity of working out common criteria to ensure women's access to medical care related to procedure of abortion in order to reduce mortality from diseases associated with self-abortions menacing live and health of women. The issues considered in the study may affect various spheres of social, medical and legal field and have wide area of practical implementation. The purpose of the study is to identify causes and to establish consequences of women's limited access to abortion services, as well as legal and ethical aspects of overcoming these restrictions.

The diseases of oral cavity belong to the most widespread non-communicable pathologies, significantly affecting quality of life and the economy. In Russia, the prevalence of dental caries and periodontal diseases remains high, especially in the rural population, where availability of stomatological care is limited. In the Republic of Dagestan, the situation is complicated by natural climatic, cultural and linguistic characteristics, that determine the necessity of local evaluation of factors of stomatological health.

In the USSR, in conditions of “demographic swings” of 1930s, deterioration of living standards of population, urbanization and other causes, mother and child health care especially mattered. The article considers mother and child health care in the USSR in 1936–1941 as part of demographic policy measures targeting the improvement of qualitative and quantitative demographic indicators. The period from validity of the Resolution of the Central Executive Committee of the USSR and the Council of People's Commissars of the USSR of June 27, 1936, to the beginning of the Great Patriotic War is analyzed. The mother and child health care was integrated into all three groups of measures of motherhood and childhood support and provided the state activities directed at expanding network of medical institutions, improving medical and social assistance support, expanding network of childcare facilities and training of operating personnel. The following conclusions are made. First, despite significant expansion of network of medical and childcare facilities and significant changes in system of medical and social assistance of mothers and children, practical implementation of these measures remained difficult. By the early 1940s, implemented measures were effective only in part. Second, the ban of abortions originated numerous social, medical and legal problems that negatively impacted the demographic situation. Third, despite undertaken measures, the USSR failed to stabilize the demographic situation by the end of 1930s and by the beginning of 1940s.

The article offers systematic consideration of epistemology of psychiatry as section of medicine which examination permits to analyze dispositif of science successfully implementing conceptual theoretical constructs in everyday practice. The various versions and trends in this area are considered, from traditional history of medicine with its positive or negative models of development of psychiatry to historical epistemology and history of ideas striving to create conceptualized picture of permanent scientific revolution or explosive evolution of psychiatry. The number of key moments are marked representing crystallization points of epistemology of psychiatry as systematic form of research: 1) the question about area of knowledge that is provide space for research in this direction; 2) creation of space of reflexive thinking where internal problematization of psychiatric theory and practice will be possible, excluding development of general theory of psychiatry that is externally imposed on it as general guidelines; 3) problematization of modus of openness of psychiatry to related areas of knowledge and public practice, minimizing interference of non-professionals in professional activities of psychiatrists.

The global transformations in health care system, directed from reactive medicine to proactive and preventive model bring to the forefront issues of protection of female health. The health of woman is not only fundamental basis, but also key factor of social economic well-being of society, demographic stability and health of future generations. The traditional fragmented model of provision of obstetric gynecological care, focused mainly on treatment of already occurred pathologies and pregnancy management, demonstrates its inefficiency in the context of modern challenges: increase of chronic noncommunicable diseases, psycho-emotional loads and need of integration of reproductive health into general context of well-being of woman at all stages of her life. In the Russian Federation, the problem of modernization of obstetric gynecological service and, in particular, women consultations, is especially acute. Historically, The historically established system is often criticized for bureaucratization, insufficient focus on prevention and disparity between various levels of medical care. In this regard, emergence and implementation of new regional standards, in particular, metropolitan standard of obstetric gynecological care and Centers of Female Health is unique case requiring detailed scientific analysis and comparison with international advanced experience. The actuality of the study is conditioned by increasing need in developing new paradigm of medical care support of women, built on principles of complexity, continuity, personalization and orientation on prevention. The Centers of Female Health, integrating large spectrum of services, from screenings and diagnostics to psychological support and training programs, are considered by world community as gold standard of organization of such care.

The purpose of the study is to assess rate of hospitalization of children of early age in tertiary-level specialized ophthalmology center and its regional variability. The hospitalization records of children under 3 years of age for 2020–2024 were retrospectively analyzed. No exclusion criteria were applied. All children were comprehensively examined and treated surgically. The patients were assorted according to model of organization of ophthalmological care. The ophthalmology offices providing primary-level ophthalmic services are available in all cities and districts under Republican jurisdiction. The differences in hospitalization rates across cities and districts were evaluated using Pearson’s chi-square test (p ≤0.05). The overall hospitalization rate among children under age of 1 year, aged 1–2 years, and 2–3 years were 69.4±8.2, 73.3±8.5, and 1.2±0.6 per 10,000, respectively. The difference in hospitalization rates between children aged under 1 year and aged 1–2 years was not statistically significant (P>0.05). The hospitalizations among children aged 2–3 years were at low level (1.2±0.6 per 10,000, P=0.001). The gender differences were insignificant (32.8±2.0 per 10,000 in boys vs. 38.6±2.3 per 10,000 in girls, P=0.05). In separate age groups, gender differences in hospitalization rates persisted but had no statistical significance (P>0.05). The regional variability in hospitalization is affected by territorial proximity to ophthalmological care of tertiary-level, capacity of local ophthalmology services and population awareness of importance of timely medical consultation.

The achievement of high life-quality is priority task of public social policy. The organization and provision of medical care and disease prevention directly affect objective indicators of life-quality of population and their subjective assessments. The regional health care systems frequently have no required infrastructure, material and technical equipment and qualified personnel in needed fullness that have an effect on quality of medical care support. As a result, the population experiences upon oneself health care “deficiencies” negatively affecting quality of life. The purpose of the study was to investigate subjective assessments of life-quality as related to quality of medical care of residents of Kursk as the Oblast center of frontier region with high geopolitical risks. This article is based on the results of sociological survey carried out in July 2025 using the snowball sampling method (N = 517). The research hypothesis consisted in assumption that subjective well-being of citizen and life-quality assessments are related to assessments of quality of health care organization and medical care support. The results demonstrate moderate deterioration in life-quality of residents and relationship between this phenomenon and changes in health care sector. In current situation, systemic approach is needed to organize medical care that considers regional specifics, geopolitical situation, personnel supply and capabilities of health care system. The aspiration to achieve satisfaction of population with with life-quality is to be based on opinions and needs of the residents themselves.

In Russia, the population preservation and health promotion are defined as national development goal, and within its framework life expectancy is to increase up to 78 years by 2030. In national normative legal acts considerable attention is paid not only to issues of medical care support but also to importance of making system to maintain and to promote health. In 2025, the WHO adopted the Global strategy of traditional medicine for the period up to 2034. The strategy defines concepts of "traditional medicine", "complementary medicine" and "integrative medicine". When considering integrative medicine exactly as comprehensive approach supporting health it is essential to understand whether there are opportunities to improve and to maintain population health. The study permitted to comprehensively analyze indicators both characterizing performance of health care system (financial support and infrastructure conditions) and public health (index of universal health care services coverage; non-communicable disease mortality rate; probability to die at the age from 30 to 70 years from any cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases; and life expectancy at birth) in countries with no application of regulated methods of integrative medicine and in countries with implemented system of integrative medicine. The obtained data testify availability of potential to enhance public health under application of methods of integrative medicine.

The article analyses the medical blogosphere as a special digital space where new models of communication between physician and patient are formed. The relevance of research is conditioned by increasing role of digital media in health care, spreading of practices of independent search of medical information by patients and intensification of influence of social platforms on confidence and reputation of physician and decision-making regarding health. It is demonstrated that medical blogosphere performs simultaneously informational, educational, navigational and reputational functions. At the same time, the given space is associated with significant risks: dissemination of unreliable information, blurring of professional boundaries, threats to confidentiality and decreasing of quality of medical communication under absence of professional moderation. The thesis is substantiated that blogosphere does not replace clinical interaction, but becomes an important communicative contour that precedes, accompanies and continues full-time reception. The conclusion is made about necessity of institutionalization of professional presence of physicians in digital sphere, development of digital and media literacy in patients and elaboration of ethical standards of medical blogging.

The withdrawal of traditional foreign suppliers and subsequent legalization of parallel importation, called upon to saturate market with necessary production, objectively created favorable conditions for penetration of counterfeit goods into medical sector, posing direct threat to health and life of population. In response to these challenges, the state authorities initiated launch of system of mandatory labeling for medical articles that conditioned actuality of considered topic. The article presents comprehensive analysis of phased implementation of mandatory labeling as key mechanism ensuring traceability of medical articles turnover. The article considers in detail chronology of introduction of mandatory requirements from initial registration of participants in the system “Honest Sign” and application of Data Matrix codes to step-by-step expansion of list of articles. The special attention is paid to analysis of technical aspects of labeling, including structure of identification code and practical tools for importers, such as information retrieval system for customs and logistics warehouses.

The purpose of the study was to analyze the new orders concerning labor standards for infectiologists and possibilities to implement these documents into health care practice. The analysis comparing the normative numbers of infectiologists to provide primary health and hospital care and the factual number of infectiologists revealed that the available number of infectiologists cannot fully meet the staffing standards. To improve the normative legal base on the labor of infectiologists it is proposed to align the staffing levels of infectiologists specified in simultaneously in force and having equal legal validity orders of the Minzdrav of Russia; to implement changes in the scope of infectiologists training; to ensure accessibility of statistical materials characterizing the actual number of infectiologists; distribution of bed-spaces according types of medical organizations, as well as other data necessary to make informed management decisions concerning development of medical care under infectious diseases at both the Federal and the Regional levels and in specific medical organizations.

One of basic tasks of maritime medicine is formation of system of protection of health and life of sailors. Currently, even greater importance is attached to measures minimizing high risk of morbidity, severe clinical course and mortality from infectious diseases through vaccination. The article discovers key requirements to pre-voyage medical examination of crew members. The list of mandatory vaccinations required to obtain the International Vaccination Certificate for work on international ships is established. The geographic regions with high risk to fell ill with malaria during voyage are established. The recommendational measures preventing contamination with infection are presented.

The study was carried out among residents of Ozersk, Russia's first city built near enterprise of atomic industry. The purpose of the study is to analyze structure and dynamics of population mortality in Ozersk during 1948–2021. The main attention is focused on main causes of death: diseases of cardiovascular organs, malignant neoplasms, external causes, and infectious and parasitic diseases.

The diseases of circulatory system represent one of the main problems of the population health due to corresponding high morbidity and mortality and load on health care. The purpose of the study is to evaluate direct and indirect costs of medical care under acute coronary syndrome depending on level of medical organization. The study used content-analysis, statistical and analytical methods scientific publications on the research topic, copying of data from the medical documentation of the Vologda Regional Clinical Hospital for the period 2012–2021. The significant number of publications confirm that diseases of circulatory system develop due to multitude of risk factors. Also economic and medical effectiveness of timely applied medical care of diseases of the circulatory system is proved. It is demonstrated that medical care and cardiac rehabilitation under acute coronary syndrome are the most resource-wasteful types of medical care, while prevention of development of disease allows to save human, material and financial resources. In the medium perspective, economic damage under the worst scenario of development of disease when disability is set in makes up to about 400.000 rubles and in case of death of patient, more than five million rubles. Under acute coronary syndrome, medical, social and economic efficiency of emergency medical care is higher in medical organizations of the 3rd level. However, it is more economically advantageous to implement preventive measures.

The article considers placement of methods of traditional and complementary medicine in the public health system of the Russian Federation, focusing on prevention and management of chronic non-communicable diseases. The analysis of the evidence base on key methods of traditional and complementary medicine (acupuncture, phytotherapy, homeopathy, manual therapy, osteopathy) was carried out, including differentiated estimate of level of evidence for forms of homeopathy based on the latest systematic review of meta-analyses. The legal framework of its application in Russia are explored. The corresponding collisions and barriers are identified. The following proposals concerning integrative health care model are formulated: differentiated register of methods, clinical guidelines, pilot integration into compulsory health insurance system and enhancement of research.