Problems of Social Hygiene,
Public Health and History of Medicine

The development of telemedicine and the provision of medical care using remote technologies requires appropriate competencies and skills from medical specialists, the formation of which is an important task of adapting educational systems to modern challenges and responding to requests from both medical staff and patients. Based on the analysis of foreign scientific publications, the paper considers the assessment of the need to train medical workers in remote work with patients and the prospects for the introduction of telemedicine consultations into everyday professional practice. It is concluded that having more knowledge about which aspects of medicine are best combined with telemedicine, it is important to train future medical professionals in the use of these technologies and the provision of these types of medical care. Doctors should not only be trained in the use of telemedicine, but also learn how to do it professionally, safely and on the basis of evidence.

The article discusses the psychological and pedagogical foundations of the general educational process in a medical educational institution and the formation of professional training of a modern doctor who is able not only to conduct medical and diagnostic activities, but also to provide psychological and pedagogical assistance. The reorientation of the doctor's activity taking place in modern society from the position of treating diseases to the self-preserving behavior of patients, which aims to preserve human health by preventing the development of diseases and pathologies, involves the involvement of medical specialists in the educational process. The relevance of the topic of the article is due to the need for the formation of psychological and pedagogical competencies of medical specialists receiving higher medical education, despite the complexity and diversity of the doctor's activities. Despite the fact that a sufficient number of legislative and social programs have been implemented by state structures in recent years, which aim to popularize a healthy lifestyle among the residents of our country and reject negative factors, the main obstacle to educating citizens to health-saving behavior is the weak motivation of doctors to use psychological and pedagogical competencies in professional activities. It is obvious that medical diagnostic activity at the present stage of development requires special training from graduates of medical educational institutions, including the basics of a psychological and pedagogical nature. The purpose of the study is to consider the psychological and pedagogical readiness of a doctor after graduation from a medical school for professional activity, to assess professional and business communications in a doctor-patient relationship and the ability to perceive differences between patients of a social, ethnic and cultural nature.

The beginning of the 18th century in the history of the Russian state and society was marked by the beginning of large- scale transformations initiated by Peter I. As a result of these reforms, the patriarchal Moscow kingdom turned into a “regular” Russian empire, the political, legal and administrative structure of which differed significantly from what it was before. It is no coincidence that Peter is often referred to as a «revolutionary on the throne.» In his actions, Peter was guided by the idea of the “common good” and the ideas of the “regular” state and Polizeistaat. He drew them in Western Europe, in the countries of the Protestant circle — Prussia, Denmark, Sweden. One of the leading ideas of the Polizeistaat doctrine was the state's active policy to form a welfare society, which was supposed to be achieved through the active intervention of the authorities in the daily life of citizens, its regulation and regulation through various regulations, instructions and instructions. A regular, properly organized police force was one of the most important instruments of such intervention, which had as its ultimate goal the creation of conditions for the growth of the well-being of subjects and their number. This growth in the number of subject population was also achieved through the creation of a system of measures to prevent epidemics and their consequences. In this article, the authors, relying on the materials of the Petrine legislation, reconstruct the course of the gradual formation of sanitary legislation in Petrine Russia

The article presents the results of a study of the labor strategies of youth included in the personnel reproduction of regional health care. The authors of the article consider the results of a complex sociological study of graduates of educational medical organizations and specialized medical classes (focus group studies, target survey; n = 1027). The research made it possible to answer questions about the dynamics of professional motivation of young people, to determine labor strategies and reasons for choosing in life planning. The article proposes a factor model of decision-making when choosing a workplace by graduates of medical specialties, gives an assessment of existing workplaces in the regional health care system, conducts an audit of the need for stimulating measures to retain and secure young personnel in the medical industry. The results of the research made it possible to determine the risks of youth labor strategies as a personnel reserve of medicine and to propose directions for their leveling and correction of the situation. An important result of scientific research can be considered the proposed diagnostic complex itself, which makes it possible to establish the dynamics of indicators during subsequent measurements (motivational transformation, change in migration aspirations and labor choice) and to determine the effectiveness of the measures and decisions taken. The result and scientific result of the article is the conclusion about the lack of orientation to the key problems of the implementation of labor strategies by graduates of educational medical organizations from the branch administration system, early pre-professional burnout of young personnel, the problem of regional public opinion regarding the prestige of the medical profession and effective labor strategies of future doctors.

Known for unpredictable outcomes and potential patient safety issues, medical tourism is a term that refers to travel outside the country (region) of residence to receive medical care. The article presents a review of the literature reflecting the results of scientific research on medical and non-medical risks of tourists traveling abroad to receive medical care. The review is based on the content analysis of foreign publications in scientific and peer-reviewed journals.

Increasing interest in society in topics related to medicine and health is due to the current trend to consider physical, mental and social well-being as a basic human need. In the context of modern life, health is perceived as one of the most important values of an individual and society as a whole, therefore, medical discourse today plays a special role in culture, covering not only the professional expert and scientific community, but also the widest audience — the audience of the media. The media play a key role as a source of medical information and its targeted and targeted distribution. In this article, the medical discourse is analyzed in terms of its formation as a social activity and the role of modern mass media in it. The aim of the study is to analyze the demand for medical discourse in society and the features of its mediatization, which is the most important factor in the value-semantic dynamics of society and its way of life. The main empirical material is publications in the magazine “Zdorovie”, the most popular Russian publication about a healthy lifestyle, medicine, practices for the treatment and prevention of diseases, the art of preserving beauty and vitality. The discourse of the popular scientific magazine “Zdorovie” as a very important segment of the value-semantic space of modern media is represented by a set of genres aimed at disseminating theoretical and practical medical knowledge, experience and providing medical services, taking into account the characteristics of medical subjects. dis-course, their information needs and problem-thematic requests, goal-setting attitudes, the degree and nature of interest, as well as the level of professional, general cultural and communicative competencies.

The health of the population is the highest value, therefore, an effectively functioning system of protecting the health of citizens is the most important priority of regional socio demographic policy and national security. The purpose of the study is to consider the most important priority of socio demographic policy — capital management of public health in the regions of the Russian Federation. The relevance of the research topic is due to the fact that currently the conditions of the domestic health care system are extremely complex. Health capital management is a key socio demographic task on a global scale, which ensures well being both from the perspective of current socio economic development, which is measured by the efficiency of the use of human capital, and from the point of view of the long term effect of improving people's lives.

In modern conditions of sanctions policy, the issue of import of various categories of goods is subject to special control and attention from the state. This aspect may be due, on the one hand, to the introduction of retaliatory measures related to the prohibitions and restrictions imposed on the import of certain goods, and, on the other hand, to the development of a special approach to customs clearance of products, manifested in the simplification of requirements for the provision of accompanying documents. Of course, such a category of goods as medical devices, being the most important from the point of view of its intended purpose, requires close attention from the state, especially due to the fact that a significant amount of medical devices and their corresponding accessories are imported from third countries. The article discusses in detail the basic requirements for documents that must be accompanied by imported medical devices, examines the key aspects of customs clearance of this category of goods, and highlights problematic issues related to the import of medical device accessories, on the basis of which proposals were formulated for their settlement.

The work is devoted to the consideration of digital technologies as a tool that transformed entrepreneurship and helped save many new and established enterprises from bankruptcy during the spread of the COVID-19 pandemic. The practice of entrepreneurship in the Kazan period has shown that digital transformation allows to increase productivity and innovation in business models, value creation processes and interaction with customers and partners. In fact, digital entrepreneurship as a consideration of how digital technologies shape entrepreneurial activity seems to be blurring traditional entrepreneurial boundaries and expanding the entrepreneur's opportunities in the market, democratizing the ability to start, adapt or wind down enterprises.

Adolescent girls aged 15—18 are in an active process of growth and development, as evidenced by the dynamics of changes in height and weight indicators. Low values of average growth indicators were determined among girls in Batken, on average 2 cm less than the average indicators of girls in Bishkek, however, the statistical analysis performed did not confirm the reliability of these differences. In 84.3% of the surveyed adolescent girls living in Naryn, iron deficiency anemia was detected. Kidney and urinary tract diseases (31.4%) took the first place in the structure of diseases among girls in Batken. Diffuse enlargement of the thyroid gland was found in 13% of women living in highlands. Inflammatory diseases of the genitourinary system are two or more times more common among girls in the middle and high mountains than in Bishkek: vulvitis in 8.7—11.4% of cases against 4.1% of cases, urogenital diseases in 6.5—17.4 versus 3.9 respectively. This indicates the need to introduce specific preventive programs for girls living in the middle and high mountains.

The article describes a development related to the field of public health and molecular biology, in particular, medical diagnostics. We present the Isascreen-8 portable analyzer (Registration Certificate No. RZN 2022/17322, May 24, 2022) and its application for rapid diagnostics of a new coronavirus infection with the use of commercially available sets IsoAmp SARS-CoV-2 (Lytech Co. Ltd., Russia), and also our own development TB-IZATEST (Invention Application No. 2022133809, December 22, 2022) for diagnostics of tuberculosis pathogen. The approach proposed in this article can be used for rapid detection of genetic material (DNA/RNA) of Mycobacterium tuberculosis and SARS-CoV-2 in biological samples using the method of loop isothermal amplification in less than 20 minutes, and also as a universal platform for detection of genetic material of other pathogens in a biological sample. Using the proposed approach, various research tasks for epidemiological monitoring of tuberculosis and new coronavirus infection, qualitative and quantitative analysis of bacterial and viral load in samples, including evaluation of the effectiveness of the prescribed antibiotic therapy regimen, can be solved. The advantage is that this method can be used not only in diagnostic laboratories, but also in field laboratories in the most remote regions of Russia if the mandatory sanitary and epidemiological requirements are observed. With sufficient distribution, the proposed approach could help ensure epidemiological control of the prevalence of these socially significant infections.

Anthropometric studies conducted in 1884, 1928, 1946, 1965 and 1999 to study the characteristics of growth and weight indicators of children living in the territory of modern Chuvashia, partly reflected the influence of the living conditions of children in certain historical periods of the country's development: revolutions, civil and domestic wars, post-war stabilization, «perestroika». Over the last 22-year period, from 1999 to 2021, there has been the largest increase in the growth rate of indicators of the physical development of children and adolescents, which is considered as a positive trend, a manifestation of ongoing acceleration processes. It was revealed that in modern children, physiological growth jumps in comparison with their peers in 1884, 1930, and 1999 occur earlier — in the prepubertal period.

Purpose of the study: to analyze the differences in the normative (reference) values of the body length indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia). Materials and methods. Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used. Results. Among boys, the highest level of statistically significant differences in body length was observed in the age groups of 12, 13 and 15—17 years, among girls — in the age groups of 13, 14 and 16 years. Higher reference values of body length indicators for boys and girls living in the industrial regions of the Republic of Sakha (Yakutia), lower — for those living in the Arctic zone of the Far North and rural areas of the Republic of Sakha (Yakutia), where the population is represented mainly by the indigenous peoples of the Far North.

The combined effect of close contact between child patients and otorhinolaryngologists, as well as the practice of aerosol-generating procedures, justify the need to take prompt organizational measures to reduce risks in the provision of pediatric otorhinolaryngological care in conditions of increased biological risks. In the pediatric ENT community, these adaptations have resulted in: judicious distribution of care to treat the most severe conditions, minimizing the risk of long-term consequences, ensuring the safety of child patients and healthcare workers through better communication methods, changing procedural precautions, the rapid introduction of telemedicine for diagnosis and treatment of patients, as well as the development of protective protocols to limit exposure to aerosol-generating procedures or manipulations to reduce the risk of exposure to a high viral load.

Currently, there is an urgent need for global research to develop a modern comprehensive study of rosacea, including its pathogenesis, risk factors, association of rosacea subtypes with concomitant diseases. The most relevant research studies the role of immunity and microorganisms in the pathogenesis of rosacea. To elucidate the features of the comorbidity of rosacea and somatic diseases, studies in various populations with detailed clinical data and a longer follow up period are important. At the same time, it is important to understand the relationship between the severity and severity of various clinical symptoms of rosacea, the mechanisms that regulate the progression of the process, the combination of rosacea subtypes and the course of the disease in association with other forms of pathological disorders.

The article presents a brief descriptive overview of the human resources of healthcare in Greece, Spain and Bulgaria. It is noted that they differ in the redundancy of specialist doctors with a relative shortage of general practitioners. The medical personnel of these countries are characterized by aging, a tendency to migrate to other countries, a shortage of secondary medical personnel, an excess of the required number of dentists, which is especially pronounced in Bulgaria. In addition, the availability of medical care and the limits on the number of patients for a certain time period with one doctor, established in Greece, reduce. The salary level of doctors in these countries varies from the minimum (Greece, Bulgaria) to the maximum in Spain. At the same time, the training of medical personnel is carried out according to the Bologna system (bachelor's degree, master's degree, etc.) and is characterized by a long period (4—5 years) of preparing a doctor for independent work.

The article examines the practice of medical charity as a virtuous activity in the field of medical care. The main attention is paid to non-profit organizations that, in accordance with the legislation, have the status of non-governmental organizations or non-governmental organizations. An overview of the main activities of NGOs with an emphasis on participation in the organization and financing of medical research is presented.

The article devoted to ensuring the rights of patients and the availability of medical care in Austria, Belgium, Germany and Estonia notes the experience of creating an institute of independent ombudsmen who plays an important role in this issue. Basically, in these countries, the choice of a medical organization and a doctor is possible, and in Belgium the right to choose an insurance organization is granted. Patients in these countries are given the right to control the process of providing them with medical care, including its payment and joint decision-making with the doctor on treatment tactics. The State also ensures the patient's right to receive preventive and restorative services provided to children free of charge, and compensated for adults in 80% of cases. It is impossible not to recognize the high percentage of citizens of these countries, reaching 98%, satisfied with the medical services provided to them. However, in some countries there is an imbalance in the availability of medical care, which is expressed by high availability of family doctor services and low availability of specialist services, as in Estonia. Nevertheless, this does not cause an increase in the level of corruption in the medical spheres of these countries, which is below the European average. According to the totality of indicators of the availability of medical care, Germany is the leader among the analyzed countries.

The article is a description of the problems and reforms of the healthcare systems of Greece, Bulgaria, Spain. The range of existing problems includes the imperfection of management and financing of healthcare in these countries, which leads to a high level of co-financing of medical care by the population itself, a shortage of medical personnel and their uneven distribution within countries, the predominance of inpatient medical services, reduced availability (waiting time for medical care). In addition, Greece and Bulgaria have a high prevalence of risk factors for non-communicable diseases with weak or no screening programs. The countries listed above are implementing a number of reforms related to the management and financing of healthcare, and the availability of medical care. However, significant results of reform, with the exception of Spain, are not observed in these countries, including due to the lack of political agreement on the implementation of the necessary reforms.

The review of healthcare systems presented in the article notes the diversity of healthcare management in Greece, Spain, and Bulgaria. All these systems have more or less pronounced state subsystems with different centralization of management, the maximum level of which is represented in Bulgaria. Medical care is provided at several levels, while the provision of primary health care still requires improvement in Greece and Bulgaria. A fairly high percentage of GDP spent in these countries on healthcare does not prevent the co-financing of medical services at the expense of personal funds of citizens, including through informal payments. At the same time, in all three countries, the provision of medical care in hospitals still prevails over outpatient care.

This series of articles analyses the drug safety policy of the Russian Federation. The first report reveals the reasons behind the government's dramatic turnaround in the pharmaceutical market and pharmaceutical industry, which emerged in 2007—2008. Based on publications, author interviews and unique protocol documents from the government archive, the logic and sequence of a new regulatory agreement between the pharmaceutical business and the Russian state are revealed.

It has long been a tradition for doctors to dress professionally in white coats — a universal symbol of belonging to the medical profession. This tradition dates back to the time of Hippocrates, but during the XIX—XXI centuries, the symbolism of the white coat was criticized in connection with research on the spread of infections through tissue. Currently, many doctors refuse to use the oldest symbol of the profession, and the practice of medical activity is replete with new variants of the uniform of a medical worker (both in style and in color palette. However, it should be noted that the white coat symbolizes another important part of the medical education of students, the standard of professionalism and care, as well as a symbol of the trust they must earn from patients.

The article discusses issues reflecting the importance of intergenerational sports as an institution influencing the formation of social values, civic identity, health-saving attitudes, etc. The paper defines the main and specific functions of sport as a social institution. Based on the author's sociological research, the results are presented reflecting the attitude of participants of intergenerational sports groups to certain types of social impact that sports activities and events held in mixed age groups have.