Problems of Social Hygiene,
Public Health and History of Medicine

The article considers actual topic concerning acquisition by migrant associations of certain importance in the public sphere of different countries. The analysis demonstrated that these public structures begin to act as actors of intersectorial cooperation within the framework of state policy in the fields of migration and health care. It is substantiated that various institutions of civil society remained in shadow of state and commercial structures for a long time. Only recently, Russian socially oriented noncommercial organizations acquired status of suppliers of social services, including medical social care of population. At that, they became a subject of cooperation in order to provide medical social care to population, which is provided not only to Russian citizens within the framework of mandatory medical insurance, but also to migrants. It is proved that during the pandemic, many noncommercial organizations expanded scope of cooperation with government, business and public structures of medical and social profile. Some noncommercial organizations that were originally organized as associations of migrants and had character of diasporas are now legitimate NGOs. Such organizational and functional changes can be interpreted as a result of development in the field of care of migrants and their integration into the Russian noncommercial sector. As a consequence of transnational commitment of migrants themselves and their interest in development of their native countries. Also, as a result of institutional integration, and consequence of spreading of COVID-19 and intensification of need in medical and social care to countrymen and their families. It is concluded that institutional changes allow NGOs to establish more open relations with associations of migrants of various origins, as well as to attract additional resources for planning, financing and implementing projects that are strategically important both for survival of organizations themselves and for helping migrants in pandemic conditions.

The study examines cohort of people with suicidal behavior in the light of gender and age differences. The archive materials of the Kaluga Regional Psychiatric Hospital for the period of 2017-2018 were studied. The allocated 435 cases of hospitalizations with suicidal behavior are allocated to admissions with suicidal ideation and hospitalizations with suicidal attempt and self-harm with specified suicidal intentions. The data obtained was processed using the Microsoft Excel software applying the Yule's coefficient of association and Pearson's contingency coefficient, Pearson's χ2 test and Student's t-test. The results of study established no differences in suicidal manifestations adjusted for gender, but allow to distinguish risk age intervals. Thus, mean age in the group of admission with suicidal ideation was in the range of 29.8-35.2 years and 36.0-41.4 years in the group of suicidal attempt. In the age cohort of 5-19 years, probability of admission with suicidal ideation was higher than with suicidal attempt and self-harm. On the contrary, in the age range of 25-44 years, admission with suicidal attempt and self-harm prevailed. This information complements scientific evidence and points out directions for further research concerning prevention of mortality from external causes (suicide) in this area of public health theory.

The article is devoted to conceptualization of current scientific experience of studying disorders associated with information technologies. Over the past decades, prevalence of information technologies in world modern society occurs with such intensity that detailed study of influence of this factor on health is significantly lagged behind. In the last decade, a number of pathological conditions associated with application of modern information technologies, in particular psychological and psychiatric profile, was described. The new concepts of Internet addiction, gambling, problematic use of technologies, etc., describing individual response of patients, are introduced. At that, lack of fundamental understanding of both etiology and pathogenesis of described conditions due to multiform specifics, high comorbidity and active evolution of digital society.The article attempts to fill this gap and to approach issue on population scale, namely to evaluate from perspective of epidemiological method characteristics of occurrence, spread and termination of pathogenic effects. The analysis of existing studies suggests that causation of emerging disorders is related not only to addictive behavior and prolonged exposure to information flow, but also to different pathogenicity of its particular components, causing various clinical forms of health disorders in individual with different levels of susceptibility. The pattern of new unique pathogen with specific propagation in human population is described - indirectly through digital environment - and capable of replication within specific ecological niche, i.e. digital pathogen tropic to bio-substrates of higher nervous activity. At that, the duration of contact with digital environment is considered as necessary but insufficient cause of development of pathological process that corresponds to empirical data. The most important property of digital pathogen propagation is its ability to replicate in anthropogenic abiotic digital environment, which is conditioned by its nature, mechanisms of accumulation and distribution.It is also noteworthy that basic principles of dissemination of information flows in social networks largely repeat principles of propagation of infectious pathogens in nature and are characterized by unique mechanism and ways of its transmission.It is concluded that in modern conditions there is a need to study problem of pathology associated with digital environment at population level from position of epidemiological method. The important aspects are joint efforts in studying and classifying new pathogen at interdisciplinary level and developing preventive measures.

The study of life quality was carried out covering 432 children aged 6-17 years with diseases of musculoskeletal system on the basis of the cardio-rheumatological department of the Republican Children Clinical Hospital and children polyclinics of the Republic of North Ossetia-Alania. The Russian version of the SF-36 questionnaire was applied which included 11 questions. The physical and emotional state was studied in 4 age groups: 6-8 years old (8.56%), 9-11 years old (20.14%), 12-14 years old (35.65%), 15-17 years old (35. 65%). The average age of children was 13.06±3.9 years. The significant influence of rheumatic diseases on parameters of life-quality of patients was established: physical and psychological state of children suffers, social adaptation is disturbed. According to the study results, the most problematic age group are children aged 15-17 years, who characterize their condition as mediocre (35.1%). Particular attention should be paid to the fact that there was no improvement in health state during a year among significant proportion of patients (65.3%). The obtained results testify limitation of physical state of health in 78.5% of cases, the most noticeable in age group of 15-17 years. The direct correlation between increase in pain syndrome and age of patient is established. In all age groups, there is decrease in emotional state, which increases with age. The indices of physical component of health in all age groups are significantly lower than the mental one. There are no significant gender differences in respondents assessment of life quality. The indices of life quality of children are generally characterized as low and do not reach 50 points on 100-point scale.The identified problematic age groups require increased attention from pediatric service of the Republic. The anxiety is caused by increase of negative symptoms in older age groups. The study results indicates both low efficiency of specialized rheumatological care of children and need for increased attention to dispensary work with this group of patients at early stages of disease.

The article deals with the problem of abortions among minors, which has extremely important socio-demographic significance and affects interests of the state, society, family and, above all, interests of young woman herself. The purpose of the study is to investigate and to analyze situation with abortions among minors in the Russian Federation. It is noted that maximal prevention of abortions among minors is a task of particular importance, requiring extensive educational and explanatory measures, improving the life-style, key direction in health protection strategy not only of adolescents and the youth, but also of population as a whole.The study identified the range of problems young mothers face. The conclusion is made that program to support them should be targeted to both minors themselves, their families, sphere of education, medicine, social protection of population and mass media. At the same time, social, economic, legal, medical, psychological and pedagogical consequences of these phenomena require significant state financial expenditures to eliminate them.The study substantiated that only integrated approach and application of modern means of education and medical prevention in solving problem of sexual education and education of adolescents will allow to obtain positive results. And if it is successfully implemented, it will result in strengthening health of entire nation of the Republic, significantly reducing increased threat of sexually transmitted diseases, early abortions, young motherhood, etc.

The use of various harmful substances for fumigation and preservation of goods during their transportation in containers to preserve it for longer time are widely used in sea transportations. In the context of increasing demand for carriage of goods in containers by sea, issue of customs officials safety, who are, as part of their duty customs inspection, the first to open container treated with fumigants, is becoming increasingly relevant. The results of analysis established absence of clear legal regulation of issues related to ensuring security of customs officials authorized to conduct customs inspections, both at international and national levels. In this regard, detailed analysis of main fumigants that customs inspector may encounter in his professional work is presented in this article. The risks of negative effect of fumigants on inspector health are studied and appropriate conclusions and recommendations regarding the legal and technical regulation of this question are formulated.

The paper considers issue of professional burnout of oncologists through the prism of their relationship with patients and their close relatives. The study was carried out using direct and online sociological survey method. The sample included 534 specialists being in constant contact with cancer patients. The results revealed pronounced prevalence of such main burnout domains as emotional exhaustion (55%), depersonalization (19%), reduction of professional achievements (22%). The most common methods of dealing with stress were recreation, sports, communication with immediate relatives, hobbies, walking (7-20%), 4% used alcohol. The high frequency of patient requests to oncologist for psychological support (88%) was established as well as difficulties in communication between doctor and patient because available communication skills are not always sufficient for 76% of oncologists. The majority of respondents support idea of patient need for psychological support and its effectiveness for their treatment and physical and emotional conditions. The similar trends were found in case of close relatives of patients. At the same time some oncologists expressed negative, stigmatizing attitudes towards patients in need of psychological support that requires additional educational work. In oncologists, even when need for psychological support is expressed by patient, willingness to seek it is low: a third of respondents are “rather not ready” to see psychologist even if they had this opportunity. The results meet data of other researches data and reveal that interaction with patients and their relatives is one of the main factors affecting the emotional state of oncologists. Based on study results as well as on publication analysis, comprehensive solution was proposed to implement psychological oncologic service in Russia, which, on one hand, will allow to provide support to cancer patients and their relatives, and on the other hand, will conduct specific training for oncologists concerning skills of psychologically safe communication with patients and coping with negative experiences.

The article is devoted to the issue of studying attitude of students to their own health, to healthy lifestyle, to regional health care system. The results of sociological survey carried out in February-April 2021 are presented. The factors and conditions contributing to preservation and strengthening of youth health were identified. The conclusions and recommendations concerning formation of value orientations for healthy lifestyle of students were formulated.

The article discusses some aspects of information and communication technologies in medicine. In view of the COVID-19 pandemic, special attention is paid to development of telemedicine. The informational computer technologies are especially relevant where there is shortage of medical personnel. Taking into account that by the year 2035 there will be shortage of 12.9 million medical workers worldwide due to aging of population, increase in prevalence of non-communicable diseases, migration and turnover of medical personnel, remote consultations of patients are becoming increasingly relevant. The examples of information and communication technologies in health care that proved their effectiveness are given.

The primary health care represent the most common segment of medical care in many countries and provides prevention and treatment of diseases, dynamic monitoring of patients with chronic diseases and medical rehabilitation. There is substantial shortage of health personnel to meet health needs all over the world, especially in primary health care. The COVID-19 pandemic exacerbated this problem. It changed workload in primary health care and demonstrated need for new organizational solutions to increase access to primary health care.One of the new transformations in general practice can be redistribution of medical work in primary health care. In this research, five options for organizational models of primary home care were identified. We used “performer (doctor / nurse)”, “payment method for the home visit”, “frequency of patient visits per week” as indices.There is lack of unified approach in the way how home visits are organized so optimal organizational model of primary home medical care is needed. This will increase access of most demanded type of medical care and ensure rational use of human resources at the primary health care level, especially during COVID-19 pandemic.

In the modern conditions of the coronavirus pandemic, the issue of transportation of immunobiological drugs is particularly actual, since control measures in this direction provide for supply of vaccines to different states, that naturally involves duration of transportation and compliance with certain established temperature regime at all stages of logistics chain, violation of which results in loss of pharmaceutical properties by drugs. The analysis demonstrated that currently transportation of immunobiological drugs is carried out within the framework of cold chain approach, which establishes mandatory compliance with temperature range of storage and transportation. Thus, the most important issue is control of compliance with temperature regime, which requires appropriate technical equipment at all levels of cold chain, ensuring fixation of detected violations.

Nowadays, process of aging of population covers all countries of the world. In current conditions, an important moment is increasing medical activity of elderly population and old persons. The purpose of the study is to investigate social hygienic characteristics of medical activity and satisfaction with geriatric care of the elderly residents of Mongolia.The sociological survey of 726 residents of Mongolia older than able-bodied age, 75 out of which were in nursing homes, was carried out using specially designed questionnaire that included questions on assessing medical activity and satisfaction with geriatric care.The negative correlation was established between good assessment of one's own health and age of respondents. The study revealed that 90.9% of respondents noted presence of chronic pathology, but only 21.1% of them were registered in dispensary. In age group under 65 years, 75.8% of persons capable to serving themselves made up 75.8% and in age group 75 years and older only 48.1%. The analysis established that 50.2% of elderly and senile persons consulted geriatrician, while 48.3% of those who did not consult this specialist were unaware of its existence. The number of cases of respondents visiting geriatric doctor in place of their residence was higher in cities. The respondents who received geriatric medical care were completely satisfied with it in 52.7%. The causes of dissatisfaction with geriatric medical care in aimags (regions) were inattentive attitude of medical staff, low effectiveness of treatment and insufficient availability of free provision of medications.The identified social hygienic characteristics of medical activity and satisfaction with geriatric care of the elderly and senile residents of Mongolia should be taken into account in developing measures to improve this type of care in Mongolia.

The article considers problems of organization of medical care at railroad transport in Russia at beginning of XX century. The implemented historical reconstruction was based on materials of section of railroad medicine of Congresses of the Society of Russian Physicians in memory of N. I. Pirogov. The issues are analyzed concerning legal basis of railroad medicine, duties of services and position of railroad physicians, principles of organization of medical sanitary unit and medical care of passengers, organization of sanitary supervision of status of railroad workers and ensuring safety on railroad transport.

The previous report partially brought to light history of publishing of “The letters of S. P. Botkin from Bulgaria 1877”. The original letters were abroad for many years and they were returned to the USSR in 1974 by grandchildren of S. P. Botkin, S. P. Chekhov and D. P. Chekhov, who resided in France. The circumstances of handing over of the letters to the N. A. Semashko Institute of Health Organization and Social Hygiene are presented. The letters have not been republished for 130 years, but their historical, moral and educational significance remains actual and nowadays. The modern edition of the complete manuscript, along with introductory article and detailed scientific commentary, will become a significant contribution to representation of biography of S.P Botkin, to supplementation of written sources about the Russian-Turkish war of 1877-1878, and to comprehension of centuries-old Middle Eastern geopolitics of Russia.