Problems of Social Hygiene,
Public Health and History of Medicine

The article is devoted to the specifics of volunteering during a pandemic. The goal of the Russian Orthodox Church is to study characteristics of volunteerism as a social phenomenon during pandemic on the the Church own experience. The specific features of volunteerism are socially useful orientation, gratuitous nature, good will, charity and care. The volunteerism of the Russian Orthodox Church is rooted in the past centuries. It is always activated when there is social demand for volunteering. This was the situation during pandemic when volunteers joined the social services with purpose of selflessly providing socially significant services to those in need. The most popular modes of assistance were hot lines, delivery of food packages, medicines, personal protective equipment, antiseptics as well as remote spiritual assistance. During the pandemic, volunteers were engaged in supplying food to the elderly and the disabled who were in self-isolation and providing medical and spiritual assistance to the sick. To illustrate, the article considers the activities of “The Orthodox Volunteers” in Belgorod.

One of possible reasons for success of Japan in confronting the COVID-19 pandemic (low mortality rates, refusal of hard lock-downs and relatively low fall in economy) is seen in record high (3-4 times higher than in most other developed countries) provision of hospital beds. Its financing was supported during first 2 decades of the XXI century by the policy of relative to GDP advanced growth of public health public expenditures based on assessment of multiplier impact of these expenditures on demand, production and employment in other sectors of the economy using the intersectoral balance method based on “input-output” tables.Purpose of the study is to analyze Japan's economic policy in managing budgetary health care costs.The comprehensive statistical, comparative and retrospective analysis of available data was applied.The study results permit to suggest that high provision of the Japan population with hospital care resources and low mortality rates in 2022 prior to development of vaccines and effective treatment schemes for COVID-19 can be explained, among other things, by long-term policy of managing health care costs using assessment of their effect on production growth, demand and employment in other economy sectors using intersectoral balance method based on regular compilation of “input-output” tables.The data obtained permits to characterize as promising approach of the Japanese government to management of health care costs using assessment of their effect on production growth, demand and employment in other sectors of the economy using intersectoral balance method based on the regular compilation of “input-output” tables. This approach permitted to increase up to 1.5 times health care costs during 2005-2018 in situation of chronic stagnation of the national economy and thus to avoid world-wide trend towards reduction of hospital bed stock and after the start of pandemic severe shortage of hospital beds. The positive experience of Japan is confirmed by encouraging results of 2 pilot projects in the EU countries on applying the intersectoral balance method to assess the multiplier effect of health care costs in 2017-2018. It is considered that using the experience of Japan in managing budgetary health care expenditures through intersectoral balance method is challenging.

The personalized medicine is based on suggestion that each person has unique characteristics at molecular, physiological, ecological and behavioral levels. In case of development of disease one is to be treated considering these unique characteristics. This belief was to some extent confirmed by application of such newest technologies as DNA sequencing, proteomics, imaging protocols and application of wireless health monitoring devices which established large inter-individual differences.The purpose of the study was to summarize and systematize the results of publications on personalized medicine and its development.The search for scientific articles was carried out, including the published in peer-reviewed journals indexed in Pubmed, WoS, Scopus and RSCI. The review covers 49 articles considering new technologies that make possible the personalized medicine possible, new experience, modes of verification and application of individualized medications as well as potential means of treating people with fertility problems and infertility.The individualization of medical practice in particular cases is probably inevitable all the more the individual approach to patient becomes more effective and cost-effective. The accessibility of modern biomedical technologies, emergence of wireless monitoring devices allows to implement “personalized” approach to early, subclinical diagnostic, individualization of treatment in order to obtain maximal efficiency and minimal toxicity of therapy, prevention of relapse of disease and its prevention. The technology of cell avatars will permit to prognose development of diseases and, possibly, life expectancy too. The personalized approach in reproductology based on genetic research will permit to eliminate a number of hereditary, orphan diseases in XXI century the same way as studies in immunology and development of vaccines made it possible to eliminate black smallpox in XX century.Conclusion. The future challenges consist not only in looking for new manifold modes of characterizing patient, but also in personalization of therapy, development of individual medication and disease prevention schemes. It is presumably that applying more relevant models based on human cell cultures will allow not only to study pharmacodynamics of medications, but also to implement personalized selection of medication therapy, considering nature of disease and comorbid background of patient.

Further reforming of the rural health care should be proceeded with special attention to availability of medical care in countryside.The purpose of the study is to develop on the basis of analysis of accounting data and research results recommendations for improving organizational forms of medical care to country dwellers. The exploration of peopleware and main performance indicators of medical organizations in rural areas was implemented.The statistical, analytical and sociological methods were applied. The reporting forms 47, 30, 12 of Federal statistical monitoring are analyzed.Results. The provision of population with medical personnel in rural municipalities in 2010-2018 increased from 12.5 to 14.5 per 10 thousand of rural population. The provision with paramedical personnel made up to 52.3%oo and during the same years indicator decreased from 55.4 to 52.3%oo. During the analysis period, 4241 feldsher obstetric posts were reduced and in 2018 their number made up to 33,350. The number of feldshers in rural areas decreased on 18.5%. In 2005-2018 number of central district hospitals and district hospitals decreased in 2.5 times. At that, provision of beds in municipalities of rural areas decreased from 49.6 to 38.8%oo. There significant winding up of district hospitals and their restructuring into branches of central district hospitals occurred. In 2018, remained only 47 out of them equipped with 1549 beds. Unfortunately, the reporting forms of the Ministry of Health of the Russian Federation do not account branches of central district hospitals. This information is to be included in accountability of the Ministry of Health.It is necessary to expand scope of authority of local government bodies in resolving medical and social problems in rural territories.

The article considers issues reflecting characteristics of motivation of medical tourists to travel to country other than their residence placement to receive medical care. The most popular directions of medical tourism are identified as well as medical services for which travels are made.

The purpose of study was to determine attitude of the youth of the Russian Federation to physical culture and sports. The sociological research methodology was applied using both focused on-line interviews with representatives of the Russian youth as well as secondary analysis of statistical and sociological data sources of information related to the study.The study established main trends and prospects in developing physical culture and sports primarily in regions of Russia. The features of development of regional physical culture and sports in Russia, specificity of perception of physical culture and sports by young groups of Russians in regions of Russia are detected. The motivational aspects of attitudes to physical culture and sports of young Russians were singled out. The attitude to social stereotypes associated with sports was determined. The study results can be applied to innovate training courses on sociology of physical culture and sports. The conclusions of the project can be used in developing youth policy; elaboration of new programs optimizing development of physical culture and sports in Russia.

In the Russian Federation, comprehensive rehabilitation and abilitation of the disabled is actively developing effected by the UN Convention on the Rights of the Disabled. In 2018-2019, the quantitative indicators of comprehensive rehabilitation and abilitation were studied in 85 regions of Russia. In 36 regions (42/4%) formation of system of comprehensive rehabilitation and abilitation was necessary. The remaining 49 regions required improving their systems of comprehensive rehabilitation and abilitation (57.6%, respectively). The study results demonstrated that significant increase in rehabilitation organizations (from 12.0% in 2018 to 100.0% in 2021) to be included in regional system of comprehensive rehabilitation and abilitation is expected. In the Republic of Dagestan, the final rating of comprehensive rehabilitation and abilitation system was from 6.5 to 7.6 points that indicates the need to organize and to improve comprehensive rehabilitation and abilitation system in the region. The experience of the Sverdlovsk Oblast and the Perm Krai where pilot project on comprehensive rehabilitation and abilitation system was carried out proved that one of the effective mechanisms of organizing comprehensive rehabilitation and abilitation system is development of state regional program by the authorities with involvement of all interested players and public organizations.

The feminization and middle age decreasing in general practitioner profession is a worldwide trend.Purpose of the study is to explore gender and age structure, professional characteristics of general practitioners in Moscow.The retrospective analysis of personal records of students of the Chair of General Medical Practice of the Institute of Professional Education of the The I. M. Sechenov First Moscow State Medical University trained from 2016 to 2020 (n = 400).It is established that women made 80.5% out of them. The average age was 50.7 ± 0.7 years; average general professional experience - 28.8 ± 0.8 years, in general medical practice - 9.7 ± 0.3 years. The internship/residency in therapy was graduated by 84.2% of students. Up to 96.3% worked in state medical organizations. The majority (97.0%) had no academic degree. Indicators with positive dynamics: share of women, physicians with internship/residency in therapy, employees of state medical organizations, without an academic degree. Indicators with negative dynamics: age, professional experience. Differences between men and women were established for residency and professional experience in general medical practice.The average social and professional portrait of general practitioner in Moscow: woman 50 years old graduated internship/residency in therapy, professional experience of more than 20 years, with professional retraining about 10 years ago, working in state medical organization, no academic degree.The activities were proposed considering gender and age specifics, professional characteristics of general practitioners, directed to increasing efficiency and comfort of training.

The article is devoted to main aspects of interaction of parties of treatment and diagnostic process and the perspectives of development of key indicators of its effectiveness. The main issues of relationship between quality of medical care and effective interaction of parties of treatment and diagnostic process are marked. The issues of satisfaction of patients, medical and non-medical workers of medical organizations, main motivating and demotivating factors during medical activity, models of relationship between medical workers and patients are described. The main perspectives of developing criteria targeted to effective interaction of all parties of treatment and diagnostic process in professional activities of medical and non-medical workers and improving quality of medical care of population are presented. The most important criteria of satisfaction of patients, medical and non-medical workers of medical organization during medical activities are analyzed. The main problems affecting quality of medical care from the side of participants in treatment and diagnostic process are considered. Some preliminary data of development of key indicators of effective interaction between parties of treatment and diagnostic process are presented. The development of these indicators in perspective can result in new approach in health care, targeted to improving quality of medical care and establishing most comfortable environment for workers of medical organization.

The article is devoted to medical errors and complaints of patients, as well as to role that communications of interested parties plays in this. The patients complaints are often caused by lack of information, unprofessional approach (lacking of respect to patient and lack of empathy, poor communication skills, abusing of one's official position). The models of response of medical workers to mistakes made are described. The algorithm of physician's actions in case of accomplishing medical error is proposed.

The demographic situation is one of markers of well-being of society. The purpose of the study was to establish main trends in demographic process in the Vologda Oblast. The Rosstat data on the Vologda Oblast for 2008-2019 were analyzed using analytical, parametric and non-parametric statistics, descriptive statistics and prognostic estimate, calculation of intensive and extensive indicators. It is demonstrated that demographic situation in the Vologda Oblast is characterized by decreasing of fertility coefficient (-20.0%) and increasing of negative natural growth of population. In rural areas, at low fertility, high mortality of population is registered and its related mostly to suicides. The relationship of random drowning with suicides and murders (R = +0.66 and R = +0.78, respectively), random alcohol poisoning with suicides (R = +0.57) and suicides with murders (R = +0.76) is established. The strong feedback between murder and random alcohol poisoning was revealed too.

The article considers issues of health management of employees at workplace in conditions of globalization and digitalization of society, causing need to revise the labor relations. Under impact of global trends in field of digital technologies, transformation occurs concerning working environment and labor safety measures, contributing to development of new forms of interaction between employee and employer and employment models as well. The ongoing changes in society and global changes in labor market require to investigate new labor conditions, formation of system of knowledge about directions and perspectives for development of labor relations and human resources management. Nowadays, because of spreading of COVID-19 morbidity, increased attention is paid to health of employees and measures targeted to preventing morbidity are intensified. The need to work in new conditions dictates topical issues for scientific research in coming years: development of theory of new labor economy, investigation changes in paradigm of quality of labor life, well-being at workplace in conditions of digitalization of economy and formation of new employment model, digital generation of workers and new challenges in human resources management.The purpose of the study is to explore issues of health management of employees at workplace in conditions of globalization and digitalization. The implemented study permitted to conclude that problems of socio-psychological nature occurring in labor sphere in conditions of active transition to digital economy are complicated by increasing instability of labor relations and occurrence of new social economic and psychological risks at workplace that negatively effect on health and well-being of employees.

The article considers problems of financing research studies in medicine at modern stage of allocation of financial support of scientific directions. In last several years situation in the Russian science cardinally changed and process of shaping new system of management of science. The sensitive issue of national science remains problem of inadequate financing. The actuality of the study is determined by putting into effect the most severe sanctions from some states. Therefore, to achieve import independence today the priority directions are determined, and among them special place occupies medicine. During last decade, the investments in medical science increased 4.3 times. The onset of coronavirus infection clearly demonstrated existing problems in health care systems of all countries hereby process of digitization. In crisis conditions, fast and qualitative medical data exchange became a priority direction formed among participants of health care system awareness about necessity to head jointly to intelligent medicine meeting actual challenges.The purpose of the study is to investigate problems of financing scientific research in medicine. The study results permit to conclude that further progressing development of scientific research in medicine depends on financial support so it is necessary to engage and private investments into development of science in The Russian Federation.

The actuality of donorship increases continuously since donors are the only source of blood to transfuse to patients in need. The medical institutions implementing hi-tech methods of treatment present increased requirements to quality and safety of blood components. The regular analysis of functioning of blood services permits to maintain and to develop productive potential.The article presents results of analysis of statistical indicators of blood service institutions of the Republic of Tatarstan, in particular Kazan, concerning procurement and safety of donor blood and its components as exemplified by three multidisciplinary hospitals with blood transfusion departments in 2017-2020. The data concerning number and structure of donors, donations, amount of procured blood and its components, applied technologies ensuring safety and quality of blood components is presented. The achieved indicators resulted from improved forms of donor propaganda, taking of donors with low risk of hemo-transmissible infections and coordinated work of medical personnel.

In 2020, the Mintrud of Russia approved a number of professional standards for specialists with secondary professional medical education. The implementation of professional standards is called to actualize outdated normative base concerning functions of medical workers, including assurance of separation of labor functions and actions of physicians and medical nurses, facilitation of development of job descriptions, and minimizing number of conflicts that occur during process of work activities at personnel functions crossing. The medical organization, focusing on requirements established by professional standards, can more competently develop personnel policy, make timely changes in staff list, establish progressive remuneration system. In this regard, it is useful to learn to what extent approved professional standards facilitate solution of practical problems of medical organizations.The article presents results of comparative analysis of three pairs of professional standards for paramedical personnel and specialists with higher education in comparable specialties. Certain contradictions and inaccuracies were esnablished too.

The article considers problems of professional burnout of medical workers. On the basis of survey of students of secondary and higher educational institutions, their positions regarding risks of professional burnout in future professional activities were determined. The study demonstrated that it is necessary to include into educational process of training physicians and specialists of secondary and junior medical personnel discipline focused on development of appropriate professional competencies to prevent risk of professional burnout and to reduce stress and psychological overload.

The article presents the materials of the 1st and 2nd sessions of the General Meeting of the USSR Academy of Medical Sciences (1944 and 1945). The comparative analysis of main tasks set at these sessions for the Soviet medical science and practical public health is implemented. It is demonstrated that if the 1st session of the USSR Academy of Medical Sciences (December 20-22, 1944) was devoted, in addition to organizational tasks, to formulation of main directions in development of fundamental (morphology, physiology, biochemistry, etc.), and practical (surgery, therapy, obstetrics, etc.) medicine, then at the 2nd session (October 28 - November 2, 1945) scientists and medical workers of the USSR were tasked to eliminate sanitary consequences of the Great Patriotic War (1941-1945) and to restore health of population of the country.

The personality of N. A. Semashko presents incontestable interest as health care official and ideologist of the Soviet health care system who contributed significantly into development of health care. Great number of studies are devoted to analysis of activities of N. A. Semashko in the Soviet period holding position of the First People's Commissar of health care of the RSFSR, initiator and head of the chair of Social hygiene of the Medical Faculty of the First Moscow State University. The studies related to pre-revolutionary period of life of N. A. Semashko are presented in less degree. The article describes, on the basis of publications and archive sources (documents from the Central State Archive of the Samara Oblast, the foundations of the Russian State Library and also the family archive of E. G. Farobina, grand-daughter of N. A. Semashko) the period of life and and activity of N. A. Semashko in the Samara Gubernia after graduating the medical faculty of the Imperial Kazan University. In 1901-1902, after short training in bacteriological laboratory of the Samara Gubernia Zemstvo Hospital and appointment to the post of sanitary and epidemiological doctor of the Zemstvo, N. A. Semashko was directly involved in elimination of epidemics of diphtheria in Orlov Guy village and of anthrax in Alexandria village of the Novouzensky Uezd. The dangerous epidemics were eliminated owing to outstanding medical knowledge, courage and organizational skills of young doctor.

The review analyzes the fundamental work of V. I. Borodulin about the history of Internal Disease Clinic in the USSR, based on the biographies of more than fifty prominent Soviet therapeutists; the research is devoted to development of main Soviet therapeutic scientific schools and formation of new scientific and educational clinical disciplines in this field in 1920s-1970s, as well as difficulties and dynamic life of therapeutic elite in the USSR in that period.