Problems of Social Hygiene,
Public Health and History of Medicine

As coronavirus quarantine period is increasing, concerns are growing about its possible impact on international migrants and students. The article discusses the basics of quarantine concept and its impact during COVID-19 pandemic. The purpose of study is to develop scale to determine relationship between such factors as financial stability, living condition, educational condition, social life and physiological reactions with psychological stability and life satisfaction of international students in Russia. The focus is done on international students of Russian universities. The questionnaires (n=300) were distributed among target respondents using the convenience random sampling technique. The analysis of survey results established relationship between the factors mentioned above and international students’ psychological stability and life satisfaction. The study results proved that the original scale applied in this study is reliable and valid to assess level of life satisfaction. Therefore, policy makers should resolve related problems, including financial incentives, availability of such products as food and hygiene products through applying proper and sufficient information about the situation. using distance learning technologies, communication tools to insure positive impact on life satisfaction of international students. Moreover, the study results can provide to prospect researchers in the field of life satisfaction and psychological stability reliable and useful information.

The demographic processes significantly affect society demographic burden. The geopolitical position of Russia with predominance of rural territories determines the need in developing specific model of medical and demographic policy in rural territories. The situation with population health and health care support in rural areas remains difficult due to the prevailing demographic, economic, territorial, medical, social and organizational and managerial factors of rural life. Purpose of study. To develop proposals improving health care in rural areas based on results of analysis of medical and demographic indices of incidence and accessibility of medical care to rural residents. Methods: statistical, direct observation, analytical.Results. The current medical and demographic situation in the country determined the output of Law No. 350-FZ on raising the retirement age in Russia, which was signed on October 3, 2018 by Vladimir Putin. Increasing the retirement age requires development of set of measures protecting population health of pre-retirement age. The article presents analysis of urban and rural population health in the Russian Federation in age-gender dependence (the younger than able-bodied, the able-bodied and the older than able-bodied groups of population). A comparative analysis of medical and demographic indices of urban and rural population in dynamics in 2005-2018 is presented. The article also presents analysis of total and primary morbidity of total urban and rural population in the Russian Federation according classes of diseases (2018) and in dynamics (2010-2018). It is established that decreasing of indices of general and primary morbidity is the result of reduced detection, deterioration of preventive and dispensary activities in rural areas and limited availability of medical care in rural settlements. The need for medical and social care of the able-bodied human potential in rural areas and the development of programs for their health conservation is substantiated. To overcome aftermaths of demographic crisis in rural areas, it is necessary to modernize demographic and economic policy in rural areas. The tasks of the municipal and Federal authorities are to provide not only declarative «program» support, but also tangible resources, as well as practices to implement strategic tasks in rural areas. The article presents proposals for overcoming the medical and demographic crisis in rural areas.

The article presents the results of analysis of regional characteristics of age-gender structure of population from point of view of reproduction of subsequent generations as exemplified by the Republic of Sakha (Yakutia). The stable population growth was established, as opposed to decreasing of this indicator in the Far Eastern Federal District and its unstable dynamics throughout country as a whole. There is increasing of burden on the able-bodied population with decreasing in its number and increasing percentage of population older than able-bodied age. In long-term dynamics, the study established decreasing of number of children aged 0-4 years and adolescents aged 15-17 years. While since 2015 there was increasing in number of girls (potential mothers) aged 5-9 and 10-14 years. The reduction of number of women of reproductive age with the volatility of number of women of childbearing age is alarming, resulting in lesser stability of demographic indices of population reproduction.

The early detection of tuberculosis is one of the priority targets in the system of anti-tuberculosis care of population, regardless of epidemiological and socio-economic conditions. The effectiveness of these activities depends on system of organization, methods of detection, quality of planning and implementing preventive examinations for tuberculosis among population. Despite decreasing of morbidity and mortality from tuberculosis in the Irkutsk oblast, it belongs to the territories with high prevalence of tuberculosis. Until 2011, the increasing of incidence of tuberculosis in the Irkutsk region occurred mainly due to increasing of effectiveness of measures of active detection of tuberculosis in population. In 2012-2019, the incidence rate tends to decrease while maintaining appropriate level of efficiency of active detection of disease. In context of improving epidemiological situation of tuberculosis, it is necessary to focus organizational efforts on active detection of tuberculosis mainly in risk groups, with simultaneous increasing of detection of disease in population by referral to medical organizations of primary medical care.

The study objective is to develop classification and to characterize main business processes (production relationships) arising during development of export of medical services in the Russian Federation. Methods. The study was based on information derived from publications off- and on-line, analysis and evaluation of regulatory legal acts, structuring processes of interaction between elements of organizational system. Results. The classification and characteristics of 59 major external business processes arising in process of developing the export of medical services as part of interaction of subject pairs represented by government organizations, business structures and foreign citizens are proposed. The individual regulating documents also were considered. Interpretation. The proposed structured forms of interaction between subjects participating in export of medical services will help developing new or improving existing regulatory legal acts needed for effective implementation of this process.

The purpose of the study was to investigate characteristics of health and psycho-emotional status according to self-assessment in young families and contingents of adolescence, residing in the Irkutsk oblast, in the second decade of XXI century. Methods. The study implemented technology of self-assessment of the level of individual health according five-point scale in groups of adolescents, students, and the families. The methodology also considered presence of chronic diseases, manifestations of painful symptoms, rate of cases of diseases during the year, number of visits to physician, causes of disease, treatment costs. The prompt diagnosis was implemented regarding psycho-emotional stress on the basis of method of O. S. Kopina et al. (2004). In families and among students, the degree of satisfaction with various aspects of life was rated. Results. The number of persons among adult family member, who rated their health status as satisfactory, was higher than among adolescents and youths by 2.0 and 1.5 times (χ2 = 11.2, p = 0.02). The highest frequency of self-assessment of health as “bad” and “very poor” was among students. Teenage-girls and student-girls were statistically significantly more likely than young boys to note morphofunctional disorders on the part of various organs and systems. In adolescent groups, 2.3% of boys and 10.9% of girls; in the groups of students - 8.9% of boys and 12.8% of girls reported pathology of reproductive system. The main reasons of visiting patients for medical care are: respiratory and digestive diseases, allergic and neurological diseases. Students and family adult members also suffered of circulatory system diseases. The family adult members experienced high level of psychoemotional stress more frequently than adolescents by 3.4 times, students - 2.9 times (χ2 = 31.3; p < 0.001), which corresponded to lower indicators of satisfaction of the family adult members with living conditions. Findings. The high frequency of morphofunctional disorders, neurotic and psychosomatic manifestations among examined individuals indicate significant prevalence of autonomic nervous system dysfunctions and latent pathological processes.

The paper presents information reflecting assessment of quality of life of patients of otorhinolaryngological departments of the Togliatti, Samara oblast, who were admitted for planned surgical treatment and had no severe comorbidity. The study examined dynamics of quality of life of patients against the background of treatment. The SF-36 questionnaire was applied to assess the quality of life. The study established portrait of operated patients in otorhinolaryngological departments. It was found that planned otorhinolaryngological surgical treatment in specialized in-patient departments of Togliatti generally had positive effect on quality of life of patients. It was also found that there were no statistically significant changes in the indicators “pain intensity” and “viability”.

The article discusses results of complex cross-sectional and anthropometric medical check up in the M. V. Lomonosov Moscow State University in 2002-2003 and 2013. The sampling covered 494 students aged 18-23 years. The check up included basic anthropometric measurements and cardiovascular parameters. The pulse pressure and Bayevsky adaptation potential were calculated. Results. The secular trend in body mass increasing was established. So, decade variations was +3.3 kg in young men (p=0.021) and +1.8 kg in girls (p=0.098). The cardiovascular system parameters degraded over ten years: occurrence of bradycardia and tachycardia increased significantly for both genders. In most observed participants in 2002-2003 the sufficient adaptation according Bayevsky was established (75.1% in young men and 71.6% in girls). Over ten years, this proportion decreased to 44.1% in young men (p=0.0000) and to 51.7% in girls (p=0.034). The percentage of adaptation failure cases increased. Conclusions. The analysis of decade dynamics demonstrated deterioration of physical development and somatic health parameters of modern youth. The established trends should be considered in planning health improving programs targeted to early prevention of cardiovascular diseases and development of adaptive capabilities of modern youth.

The article considers methodological studying of problematics of health preservation and its organizational technologies. The health preservation is considered in the context of public health policy. The necessity of complex interdisciplinary and longitudinal approach to studying this problematic is substantiated. The results of analysis of semantics of key concepts of health preservation are presented. The patient-centralized principles of activities and communication as applied to health preservation are substantiated. The differentiation between concepts of “value” and “utility” of organizational technologies of health preservation for health are discussed. The possible areas of studying positioning of health preservation in the system of personality values, including health culture, are proposed. The possible structuration of factors determining health condition and healthy life-style are proved. The scope of principles and approaches for subsequent elaboration of methods, standards, instruments and regulations of complex methodology of studying issues of health preservation and its organizational technologies are established.

The problem of preserving health of students remains an important task due to peculiarities of their studies and life. The otorhinolaryngologic pathology, in particular rhinosinusitis, occupies one of leading positions in the structure of morbidity of students. The purpose of study is to assess morbidity in students and to develop three-stage prevention program with subsequent evaluation of its effectiveness. Materials and methods: analysis of the results of comprehensive medical examination of medical students in 2015-2017, otorhinolaryngologic pathology. The three-stage prevention program was developed and implemented. The program consisted of general strengthening basic program at the first stage, medication and physiotherapy program at the second stage and complex of Strelnikova respiratory gymnastics and with natural mineral water nasal lavage at the third stage. To evaluate effectiveness of the program, sampling of 164 students suffering of rhinosinusitis was randomized at three groups that passed the first, the second, or all 3 stages respectively. Results and conclusions. The analysis of structure of morbidity in students established high prevalence of otorhinolaryngologic pathology, mainly rhinosinusitis. The proposed three-stage prevention program, implemented in the University, decreased rate of common colds and annual hospitalizations and duration of rhinosinusitis.

The integrated approach to diagnosis and dispensary monitoring of women with high risk for breast cancer, the active detection of combined pathology of endometrium are promising directions in prevention and timely diagnosis of breast and uterus malignant neoplasms. The study established that particular correction of measures of secondary prevention of breast cancer is needed, including formation of risk group and organization of dynamic monitoring of women with high risk of breast cancer development. The comprehensive examination of reproductive system organs, including evaluation of risk factors, combined use of mammography and sonography methods to examine mammary glands and condition of endometrium, can to increase accuracy of differential diagnosis and to avoid unneeded invasive interventions with mammary glands and early diagnosis of endometrial pathology.

The concept of preventable mortality makes it possible to assess health care reserves and to identify priorities of their improvement at the regional level. It was established that in the Republic of Buryatia during 2005-2019, the percentage of the first group by the levels of prevention of causes of death of the old list (Preventable) decreased by 6.1%, mainly due to injuries, poisoning and other consequences of external factors. The percentage of the second and third groups increased by 4.4% and 1.7%, respectively. The cause of increasing of preventable mortality are malignant neoplasms and diseases of respiratory system. The increase of mortality from malignant neoplasms made from11.4% i.e. from 166.3 (2005) up to 185.3 (2019) per 100 thousand of population caused by increasing of mortality of malignant neoplasms included in the first group (malignant neoplasms of lip, mouth, pharynx, esophagus, liver, intrahepatic bile ducts, larynx, trachea, bronchi, lungs, urinary bladder). The increasing of mortality from malignant neoplasms in the second group occurred due to malignant neoplasms of skin, including melanoma, breast, cervix, uterus. In this case, the lateness of seeking medical care, which is characteristic of a large part of population is to be considered. The dynamics of proportion of respiratory diseases in the structure of the third group was characterized by wave-like curve, with minimum in 2008 (45.3%), and maximum in 2014 (65.1%). At the same time, overall mortality of respiratory diseases decreased from 84.9 to 54.6 per 100 thousand of population. Taking into account the results of the study, it is appropriate to update existing regional preventive programs with emphasis on improving diagnostic of malignant neoplasms and appropriateness of regular preventive examinations of population of the Republic.

The article presents the experience of reforming primary health care in Belgorod Oblast in 2016-2019. In the process of reforming, the original organizational model of new interaction pattern “family doctor - patient - family members”, was developed and implemented. The measures were taken to strengthen material-technical base and manpower potential of primary medical care. The general practitioners offices were positioned within “step accessibility” for patients. The continuous training of family doctors was organized at the workplace. The unified regional medical information system was developed and implemented enabling corporate conference communications, remote consultations, public feedback and remote arrangement of visits of patients to physician. The differentiated approach to remuneration of medical personnel was implemented using key performance indices that permitted to increase salaries and work quality. As a result of the reforms, the percentage of patients under supervision of family doctors increased up to 13%, the number of medical emergency calls decreased up to 3.3% and the number of calls because of illness decreased up to 17%. The mortality of population older than able-bodied age began to decrease and life expectancy reached relevant 74 years in 2019.

The section of physician everyday life of the Pirogov congresses discussed not only issues related to economic and legal status of physicians. At its sessions, the need for reforming medical and sanitary legislation and expediency of organization of independent Ministry of health care were considered. Also, various ethical problems of medical activity were brought up (responsibility for non-attendance of patient, court of honor, medical secrecy). The loaded social issues such as abolition of abbacinaire and the death penalty were raised.

The article proceeds to analyze the results of the study of organizational forms of Soviet assistance to the Mongolian People’s Republic in the field of medicine and health care. The characteristics of organization and activities of the first, second, and subsequent medical sanitary expeditions of the Narkomzdrav of the RSFSR in Mongolia. The new archival documents are introduced into scientific circulation, allowing to verify critical assessment of activities of the first expedition under direction of A. A. Frantsuzov presented in in the reports of G. V. Ivitsky, the member of the expedition. The relationship between the second medical sanitary expedition staff, the Mongolian government and the Soviet physicians at Mongolian service are considered in detail. The role of medical sanitary expeditions as special form of Soviet assistance to Mongolia, allowing to resolve at the same time several tasks of local and strategic nature, and their contribution into the development of the Mongolian health care at early stages is highlighted.