Problems of Social Hygiene,
Public Health and History of Medicine

The article develops a research agenda for cross-sectoral collaboration on the issues of public health. The aspects of this collaboration are not scientifically founded during the COVID-19 pandemic.The aim of the research is to study the inventory of the sectors involved in public health in the Russian Federation during the COVID-19 pandemic and to put in perspective their importance.An anonymous survey of 49 experts - health service managers was made. The respondents were asked to identify the inventory of the sectors involved in public health and to voice their opinion on their importance during the COVID-19 pandemic. The results of the survey were compared to the results obtained before the pandemic.The results of the study suggest that 23 sectors should always be involved in public health both during the COVID-19 pandemic and without it. The sectors are of relatively equal importance. However, the sectors of the inventory are ranked differently in the order of importance during the pandemic and without it. A statistically significant difference in the analysed characteristic feature is noted.The article develops a research agenda for further studies and provide implications for health-service managers.

Aim of the study - determination of approaches to the formation of the rating of the constituent entities of the Russian Federation, reflecting the state of medical care in various profiles (the effectiveness and quality of medical care in various profiles). The study included a comprehensive analysis of the structure and content of the reports based on the results of national medical research centers field events using classification and grouping methods. Assessment of the advantages and disadvantages of the used variants of the methodology for forming the subject rating of the Russian Federation used the method of selective SWOT analysis of methodologies published in the form of scientific articles. Further, based on the results obtained, the main requirements for building a rating system for subjects of the Russian Federation based on the indicators of efficiency (performance) and the quality of medical care were formulated. The possibility of applying international experience in building benchmarking systems in the Russian Federation is analyzed and requirements are formulated for building a subject rating system of the Russian Federation, taking into account the peculiarities of the domestic healthcare system. There are 3 main methodological approaches to the formation of the subject rating of the Russian Federation: a quantitative score rating assessment of quantitative indicators without weight coefficients, a qualitative rating assessment of the effectiveness of medical care in a profile without weight coefficients, and a mixed score-rating assessment of quantitative and qualitative indicators using weight coefficients determined only by an expert method. It has been established that many of the existing approaches to the formation of the subject rating of the Russian Federation are based on a combination of a point rating and weight coefficients established by an expert method. Since different indicators have different contributions to the final integral value of the subject rating of the Russian Federation, it is advisable to conduct another study to establish weight coefficients for indicators.

The article analyzes the current state of the medical service market of the Russian Federation, including: an assessment of the volume of paid medical services to the population, monetary expenses of households to pay for medical services, expenses of the consolidated budget of the Russian Federation for healthcare, investments in the fixed assets in healthcare, the volume of the pharmaceutical market in Russia and the imports of medicines and medical equipment.The rating of the largest non-governmental medical organizations in Russia in terms of revenue, the number of branches, the cost of initial admission and the number of patients was presented, the total revenue of the top 20 non-governmental medical organizations was analyzed.Negative trends affecting the current state of the medical service market were studied, the risks from the imposition of the sanctions and opportunities for further development of the medical services market were determined; measures of state support for health care in the context of sanctions were discussed.The conclusion presents perspectives for the development of the medical service market in the context of the sanctions imposed on the Russian Federation by the European Union, the United States and other states in connection with the special military operation in Ukraine.

The analysis of homeostasis as a tool for restraining, saving, security and rehabilitation technologies which ensures the sustainable functioning of the human organism through the cultivation of health-saving and rehabilitation technologies, as well as health programs, preventive (anti-alcohol, anti-nicotine, drug addicts) and recreational activities, upbringing of health culture and also environmental, medical treatment practices and correctional technologies. The cyclic mechanism of homeostasis is described, which works on the principle of alternating modes of behavior of the social system - structures for generating order and structures for maintaining order. The functioning stability of the human organism is relative and has the nature of a dynamic balance, fluctuating around a certain average value and constantly deviating from it either in the direction of positive, strengthening changes, or in the direction of negative and destructive ones.

The purpose of the study: to establish gender and age characteristics of the prevalence and risk of developing hypertension (AH) among outpatients living in the city of Tambov, according to electronic medical records (EMR).The information from the EMC of 47,113 people aged 20-99 living in Tambov was used. The prevalence rate (per 100 people) and the relative risk of developing (RR) hypertension in different sex and age groups were calculated.The prevalence of hypertension among people aged 20-99 was 45.7 cases, in women it is higher than in men by 23% (50.1 vs 38.4 cases). With age, there is an increase in the prevalence of hypertension from 1.7% in 20-24 to 86.8% in 70-74 years old people. In the transition from a smaller age group to a larger one, the increase in the prevalence of hypertension among the female cohort averaged 22.5%, among the male cohort - an average of 17.2%. The RR for the development of hypertension among the female cohort aged 20-99 years is 1.2 times higher compared to the male cohort of the same age. At the age of 25-34, the OR for the development of hypertension prevails among the male cohort, at 45-89 years old - among the female cohort.The high level and established differences in the prevalence and risk of developing hypertension determine the need to develop recommendations for hypertension screening among the population, stratification into risk groups, prevention and treatment, focused on different age and gender groups.

The primary prevention of a significant number of diseases today is based on the principles of a healthy lifestyle which are the most important conditions for maintaining and strengthening the health of the population. At the same time, one of the main tasks is to optimize the nutritional status, preserve and improve the health of certain groups of the population and, above all, children and adolescents. The purpose of the work is a hygienic assessment of the characteristics of the nutritional status and nutritional health of young students and the scientific substantiation of recommendations for their optimization. It has been established that the insufficient level of knowledge of the basics of a healthy lifestyle and the existing shortcomings in the organization of nutrition of adolescents, as well as economic factors, lead to an inadequate nutritional status of students in secondary professional education, which is expressed in the low energy value of the diet, its imbalance and lack of diversity, as well as its low provision with macronutrients, vitamins and minerals. There is a significant increase in the incidence of diseases of the digestive system from junior to senior years, which allows us to consider college education as a risk factor for diseases of this class.

In the context of improving cancer prevention programs, it becomes relevant to justify the introduction of regional HPV cervical cancer screening programs based on a study of the prevalence of human papillomavirus infection and cervical cancer.Aim: to identify the main patterns of the prevalence of human papillomavirus infection and cervical cancer in Bashkortostan and the Kaliningrad region for the scientific substantiation of the criteria for the adoption of regional screening programs.A prospective analytical cohort single-stage observational examination of 3428 women of the Republic of Bashkortostan and 1246 women of the Kaliningrad region was carried out, as well as a retrospective observational analytical study of cervical cancer incidence in Bashkiria and the Kaliningrad region according to the official statistics from 2011 to 2020 compared to Russian indicators.In Bashkortostan and the Kaliningrad region, HPV DNA was detected in 48.7% and 54.2% of women of reproductive age, respectively, of which HPV of high oncogenic risk (HPV HR) was 51.7 ± 6.2%, and 23.4% were found to have PCM . In the Kaliningrad region, HPV DNA was detected in 47.2% of the women under study, HPV VR - 31.1%, in 25.5% accompanied by cervix uteri diseases. An increase in the incidence is noted in the Kaliningrad region by 38.6% over 10 years, with an annual increase of 3.8%. In Bashkortostan, the growth is demonstrated by 31.8% with an annual increase of 3%, which is significantly higher than in the Russian Federation (13.3%, р=0.001). For 10 years, the prevalence of cervical cancer has increased in the Kaliningrad region by 10.1%, with an average annual increase of 1.1%. In Bashkortostan, the prevalence of CSM increased by 4.7% with an annual increase of 0.3%.The high prevalence of HPV infection among women of reproductive age, the unfavorable dynamics of indicators of cervical HPV-associated oncopathology in remote regions of the Russian Federation (Bashkiria and the Kaliningrad region) is a scientifically based criterion for the reorganization of regional cervical screening programs. The implementation of Organized screening with primary HPV examination with mandatory separate genotyping of types 16 and 18 and the remaining 12 types of HPV HRC in a complex will enhance the effectiveness of ongoing preventive measures and meet international standards.

The article provides an analysis of changes in official requirements for the state of health of young men with diseases of the nervous system (Regulations on military medical examination as amended from 1995, 2003, 2013). Columns I and II of articles 21-28 of the Schedule of Diseases of this Provision are considered from the point of view of the category of fitness for military service on conscription. A set of measures is proposed to reduce the consequences of changing the requirements for the functional state of the nervous system of the health of future conscripted servicemen.

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the ‘healthy’ citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of ‘healthy’ people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

For the purposes of this work, children with disabilities include disabled children or children aged 0 to 8 years who are not recognized as disabled in the prescribed manner, but who have temporary or permanent deviations in physical and (or) mental development (hereinafter - children with disabilities).The legislative basis for the implementation of the rights and opportunities of children with disabilities and their families is constituted by constitutional provisions that enshrine state guarantees for the protection of childhood, motherhood, paternity, family (part 1 of article 38, paragraph "g.1" of part 1 of article 72 of the Constitution of the Russian Federation).An early start of comprehensive care for children with disabilities contributes to the maximum possible achievements in the development of the child, maintaining his health, as well as successful socialization and inclusion of the child in the educational environment with subsequent integration into society.The research material was the international treaties and regulatory legal acts of the Russian Federation on providing early assistance to children with disabilities.The work used a set of methods of scientific knowledge, including general scientific methods: analysis, synthesis, induction, deduction, special: comparative, formal legal, etc.Legislative consolidation of the institution of providing early assistance to children with disabilities can be carried out by amending the existing legislative acts or by adopting a separate regulatory legal act of the legislative level that establishes the legal basis for providing early assistance.This article outlines the directions for improving legal regulation in terms of legislative consolidation of the institution of providing early assistance to children with disabilities by amending the current legislative acts of the federal level.

The development of social work in the field of health protection (medical and social work) largely depends on the ongoing scientific research on this topic. The review presents an analysis of dissertations, which demonstrate research on various aspects of medical and social work as a professional activity. The analyzed studies cover a 25-year period from the beginning of the first dissertation work in this area. Dissertations were carried out within the framework of medical, sociological and pedagogical sciences, it is based on the interdisciplinary approach in the formation of the modern system of social work in the Russian Federation.

Medico-economic analysis in a medical organization is a set of techniques and methods for assessing the indicators of medical, industrial and financial activities, the purpose of which is to choose ways to rationally use internal resources. The main objectives of medical and economic analysis is to determine the reserves for the use of the organization's resources; introduction of effective technologies of the treatment process; assessment of the effectiveness of medical care, assessment of the effectiveness of management decisions. The combination of types of analysis, their subordination to management goals can improve the efficiency of the medical organization and its structural divisions.In the context of increasing competition in the medical services market, the importance of medical and economic analysis in medical organizations of various forms of ownership is growing. State medical institutions are no exception. Modern autonomous and budgetary healthcare institutions operate in the status of independent economic entities, while the role of the chief physician as the organizer of the medical and economic process, as well as the role of the head of the structural unit, who must analyze the results and costs, calculate the need for material and financial resources, determine efficiency of medical activity.The subject of the analysis of this article is to determine the optimal algorithm for conducting a medical and economic analysis in the context of the functioning of the structural units of a medical organization.

The article substantiates the tasks of introducing a conflict management system into the work of a private sector medical organization, reducing the number of ethical and legal conflicts that arise during the provision of medical care. The analysis of the conceptual foundations, regulatory framework and specifics of the use of conflict management tools in the context of solving organizational and managerial tasks in a private multidisciplinary clinic is presented.

The article presents a theoretical analysis of domestic and foreign experience in teaching children undergoing long-term treatment or rehabilitation in the context of medical care. The specification of educational process, its differences from the traditional classroom-lesson system, the main role of stakeholders such as administration and medical organization, teachers, children and parents and different educational technologies, as well as the basic functions of the education of children in a hospital school are analyzed.

The article deals with the issues of communication between doctors and nurses. Attention is paid to the obstacles which affect effective communication between doctors and nurses, which include the increase of the workload, the constant change of staff, the use of high-tech terminology, the previous negative experience of communication between nurses and doctors, etc. Recommendations for improving communication in a medical team are given. It is emphasized that the factors contributing to effective communication between hospitals and organizations providing primary health care are multidisciplinary medical care plans drawn up in cooperation with patients and caregivers

In a series of articles, researchers analyze the significance of the 1998 default for the development of the pharmaceutical industry and for the fates of pharmaceutical market participants. The second communication presents the results of an analysis of predictive statements and the collective memory of representatives of the pharmaceutical community. The analysis was carried out on the basis of the interviews published in pharmaceutical publications and taken by the authors of the article during 2019-2021. A total of 43 texts were used.

Eastern Siberia during the Great Patriotic War, being in the deep rear, was one of the key regions where the population and industrial enterprises were evacuated from the front-line zones and west territories of the USSR. Among the arriving population, there were many highly qualified specialists who were sent along with enterprises to resume their work, which, on the one hand, gave preconditions for the development of the region, including as a major industrial and scientific center in the future, but also created an additional burden on the civil health care system of the region "in the moment." Eastern Siberia provided the USSR with healthy human and necessary production resources, making it possible for the Soviet Army to defend the Motherland, which was the main thing in those difficult years, in the face of the sudden invasion of Nazi Germany. The archival materials that give an idea of the state of the civil health care system in the region by the beginning and in the first days of the Great Patriotic War are analyzed, and a comparative analysis of the indicators of both the Eastern Siberia region and its individual republics with the RSFSR as a whole is carried out.This study was carried out as part of the research work "State policy in the field of health protection and medical science in the Russian Empire and the USSR."

The aim of this review is to focus light on the history of the human vermiform appendix from the morphological, anatomical, surgical, classification of the origin, types, blood supply aspects in order to understand the real function and summarized this information that positively impacts the clinical decision in case of appendicitis, the most popular surgical condition. Although the characteristic features of the normal and diseased appendix had been reported for many previous centuries, it was still the most common challenge facing every single day in the operation room. The appendectomy, the commonest surgical emergency procedure, may cause little confusion for the surgeons due to highly variable situations of inside the abdominal cavity. However, the recent imaging techniques have increased the surgeon’s ability for crucial diagnosis of the diseased appendix. Besides the above-mentioned criteria, with its clinical features diagnosis and management, the author was deeply searched in many scientific databases including EMBASE, Cochrane Library, PubMed, Pubmed Central (PMC), Medline, Web of Science, and Scopus.