Problems of Social Hygiene,
Public Health and History of Medicine

Recreation and sports environment is an essential part of the urban space, which is the most important factor in improving and maintaining health of the citizens, contributing to better mental health, cognitive functions, lower overall mortality, higher life expectancy, lower morbidity and mortality from cardiovascular diseases, prevalence of obesity and type 2 diabetes, better pregnancy and birth outcomes. Recreation and sports environment of the urban space includes the city's greenery, recreational areas, areas for physical activities and sports, and waterfront areas. This study uses a correlation analysis to analyze the impact of the city recreation and sports environment on health of the working and post working population. The study was conducted in 2019 on the example of large and huge urban cities of the Moscow region populated with more than 125,000 people. Based on the correlation analysis results, the authors have demonstrated the impact of the overall set of all sports facilities, sports structures, flat sports structures, swimming pools, sports halls, and public green spaces in cities on health of the post working population. The study has also shown the impact of swimming pools, the overall set of all types of sports facilities, sports structures, flat sports structures, sports halls, and public green spaces in cities on health of the working age population. The authors come to the conclusion that development and ongoing support and maintenance of the city recreation and sports environment serve as an important objective of the city administrations, resulting in the improved physical activity of the citizens and lower morbidity among the urban population.

Background. Despite implemented measures and general favourable trend, number of patients with myocardial infarction remains high, younger people are increasingly becoming ill and dying. The study purpose: to estimate age-sex mortality dynamics from acute and recurrent myocardial infarction in adults in Moscow compared to Russia’s average in 2007—2021 to reveal patterns of mortality change within the implementation period of state prevention programs. Material and methods. Standardized adult mortality rates for Moscow and Russia, mean expected age at death within interval 20—85 years and gain in life expectancy when eliminating this cause calculated and analyzed. Results: Moscow morbidity rates for acute and recurrent myocardial infarction are twice lower than Russia’s, there are higher reduction rates for both diseases — by 16% and 58% respectively. During study period, mortality from myocardial infarction in men was by 45% higher than in women. In 2007 Moscow male-female difference estimated 3% and in 15 years it became 32% due to faster female mortality reduction. Whereas Russia’s average age of death from myocardial infarction in 2021 returned to 2010—2011 levels, then in Moscow during 2020—2021 female rates returned to 2008’s and male rates fall out the study period. Conclusions. Since implementation of the first programs on reducing mortality from chronic non-infectious diseases during the 15 years period morbidity and mortality rates from myocardial infarction reduced in Russia and Moscow in all ages. Acute and recurrent myocardial infarction have rejuvenated both in men and women as a negative effect of the pandemic.

Introduction. For a better understanding of issues related to health-preserving activities for the benefit of city population, theoretical knowledge about the attitude and readiness of all interested parties for intersectoral cooperation is needed. The purpose of the study is to analyze readiness of the participants of health-preserving activities for intersectoral cooperation in Moscow. Material and methods. In 2023, a one-time, one-time study of intersectoral responsibility, commitment and awareness, as well as satisfaction with individual health care (original test cards) was conducted among different participants in the health care of the population of the city of Moscow (n = 1007). From among them, participants were identified -workers of «medical» infrastructure facilities of urban space, participants-workers of other facilities (sports, culture, industry, waste disposal, transport, food, trade, education and others) and the population as a participant in intersectoral health saving. Results. The research based on the original integrated assessment methodology shows insufficient readiness for intersectoral cooperation to implement health-saving activities for the benefit of Moscow population. Immature intersectoral responsibility, literacy, motivation for teamwork noted among the participants of the unified health-preserving city space determines the lack of internal conviction that it is necessary to deal with both own health, and health of other members of the urban community. Conclusion. The data obtained can form basis for new methodological approaches to prioritize control measures to improve intersectoral cooperation between the participants of health-preserving activities in the metropolis.

Screening or its synonym medical check-up is the result of a health indicator, representing results of a medical examination and an effective tool of disease prevention. The concept of the term screening in European countries implies active detection of a disease or a premorbidity in people who are considered or consider themselves healthy. Medical check-up is a set of measures that includes preventive medical examination and additional methods of examinations conducted in order to assess the state of health and carried out in relation to certain groups of the population. The study and analysis of the international screening model and experience of its implementation, its role in the system of primary health care, including rehabilitation, is very important in terms of shaping public health at the international level. The article discusses regional trends in screening (medical check-up) and issues related to the conceptual and methodological aspects of medical check-up organization in the context of public health and prevention of risk factors. The data were searched in Scopus Web of Science, MedLine, the Cochrane Library, PubMed.

Residents of a megalopolis are constantly exposed to urban stress — the combined effects of a number of different extreme factors and living conditions of the urban environment. Urban stress of a megalopolis resident has an extreme complex multifactorial effect on his body and psyche. The features of the existing subspecies of urban stress (ecological, psychological, social, informational, professional, related to the pandemic), as well as the main stress factors causing them, are considered. The medical and social features of urban stress are described. The consequences of exposure to urban stress, directly related to human health disorders, include the so-called «urban stress diseases» or «diseases of civilization», primarily psychosomatic diseases. It is determined that urban stress is a multifactorial complex of stress factors affecting the physical and mental health of megalopolis residents. Due to the fact that an increasing number of megalopolis residents are experiencing the negative impact of an aggressive urban environment, it is necessary both to formalize stress factors in order to possibly correct them to improve the quality of life of citizens, and to develop appropriate optimizing medical and social recommendations. Modern organizational and medical and social measures aimed at reducing the negative impact of urban stress on the health of megalopolis residents are considered. It is proposed to minimize the negative impact of extreme urban stress factors on the physical and mental health of megalopolis residents by using therapeutic and preventive strategies to increase their stress resistance. There are a number of different organizations and departments in Moscow that provide psychological and psychotherapeutic support. Also, in order to determine the level of the body's reserves and stress resistance, it is possible to undergo a comprehensive examination both in the nearest polyclinic and in the nearest park within the framework of the Healthy Moscow program.

Purpose of the study: to determine the main threats to the health of the population of Moscow based on the analysis of the medical and demographic situation in Moscow and the Russian Federation in the context of the COVID-19 pandemic, in order to develop management decisions at the regional level.

The digital transformation of healthcare is an integral part of the priorities in modern healthcare. A striking example of the practical implementation of compliance with the basic principles of digital healthcare is the Healthy Moscow project, which has been implemented since 2021, which has become a real breakthrough in Russia in ensuring accessibility and convenience in providing medical care to the population. The aim of the project is the early prevention of chronic non-communicable diseases, the formation of a healthy lifestyle and the improvement of the well-being of Moscow residents, as well as the development of a conscious attitude to taking care of their health. Pavilions in the park areas of Moscow are an integral part of the modern medical infrastructure, providing convenient conditions for obtaining medical advice and information. The article provides information on the types of digital technologies and basic equipment that the pavilions (large and small) are equipped with as part of the Healthy Moscow project, it is shown that the introduction of digital healthcare technologies is one of the key tasks of the national strategy of Russia, which contributes significantly contribution to the successful implementation of the Healthy Moscow project.

The purpose of the study is to analyze perception of the adult population about intellectual disability (ID), its causes and effectiveness of specialist interventions. Material and methods. 1119 people were interviewed (men — 441, women — 678) aged 18 to 85 years (mean age — 34.3 ± 14.5 years). Urban residents — 851 people (76.1%), rural dwellers — 268 (23.9%). Each respondent was offered one vignette describing a sick child aged 8—10 with ID: typical, dyslalic, bradypsychic and dysphoric. Mathematical and statistical processing included descriptive statistics and calculation of the χ2 distribution. Results. 49.1% of the respondents have correctly recognized ID in vignettes. Out of the incorrect answers, various psychological characteristics prevailed (25.3%) of the child; negative character traits with pessimistic assessments (23.2%); illness, including mental disorders (18.6%); defects in education and upbringing (15.6%). The respondents most often (38.5%) suggested assistance by psychologists, especially to patients with a bradypsychic variant of ID, a speech therapist — with a dyslalic one, teachers — with a typical one, psychiatrists — with a dysphoric one. 85.3% of the respondents expected improvement in the child's condition after the specialist intervention. The probable causes of ID included improper upbringing and disharmonious family relations, more often in case of a typical variant, hereditary burden and early childhood diseases — in dyslalic, alcohol consumption, poverty — in dysphoric, all of the above — in case of a bradypsychic variant. Conclusion. The study has identified an insufficient level of public awareness of ID, reflecting its delayed diagnosis in children, peculiarities of the “channels” for seeking assistance with excessively high expectations of the condition improvements.

The article presents performance indicators of the capital day hospitals for the period from 2017 to 2022. The analysis has identified a high demand for this type of medical services in Moscow. A separate analysis focused on indicators of day hospitals subordinate to the Moscow Healthcare Department deployed at outpatient (polyclinic) medical facilities, as well as institutions providing inpatient care. The bed capacity structure and number of treated diseases by pediatric and adult population have been analyzed in detail. The study has identified main trends in dynamics in a number of indicators characterizing the development of hospital-replacing forms of care delivery in Moscow in recent years. The study is based on of the Federal statistical observation form # 14 — DS «Information on day hospital performance in medical organizations».

The issues of the movement of medicines across the customs border of the Eurasian Economic Union are timely and relevant, due to the increase in the turnover of medicines in the Russian Federation. The article deals with the issues of import and export through the customs border of the Eurasian Economic Union of both registered and unregistered medicines in the Russian Federation by legal entities. In addition, the authors investigated the regulatory and legal procedure for the movement of medicines across the customs border of the Eurasian Economic Union containing narcotic and psychotropic substances. Topical issues of falsification of medicines and criminal norms of the law on combating it are touched upon. The analysis carried out in the work allowed the authors to identify the existing problems of regulatory regulation of the issue under study and propose a solution.

The article deals with the issues of human resources management of a private medical organization. The author investigates the current state of the staffing of Russian healthcare: the provision of specialists in the healthcare system, professional motivation and prospects for the development of private medicine. In recent years, a system of private medical organizations has been formed in the Russian market of medical services, which provide medical care in parallel with state medical structures. Research in the field of human resource management in healthcare of a theoretical and practical nature shows that the problem of personnel shortage in the field of medicine is urgent and needs to be solved. One of the factors of insufficient staffing of medical organizations is the underinvestment of the healthcare industry over a long period and low preparedness for emergency situations and response to them, which has worsened under the influence of the rapid spread of the coronavirus pandemic. In conclusion, it is concluded that the main task of the effective functioning of a medical organization and the provision of high-quality medical services is the management of human resources. The purpose of this study is to consider the issues of human resources management of a private medical organization.

Currently, the Eurasian Economic Union regulates all stages of the circulation of medicines, including their development, preclinical research, clinical trials, industrial production, pharmacy manufacture, sale, storage, transportation, medical use, return to the manufacturer or supplier and destruction. Legal regulation of medicines in the EEU is carried out at several levels: at the level of the legislation of the EEU and at the level of the national legislation of each of the member states. As part of the formation of a common market for medicines in the EEU countries, more than seventy regulatory legal acts were adopted. The article analyzes the regulatory framework governing the functioning of the common market of medicines of the member states of the Eurasian Economic Union, considers the registration of medicines under the uniform rules of the Union, the functioning of a unified information system and the approval of.

The review article is devoted to the healthcare system of Iceland, which demonstrates some of the best indicators of public health in the world at relatively low costs for a developed European country. The successful experience of Icelandic healthcare is important for Russia, on the one hand, due to the proximity of this country to many Russian regions in terms of climatic and geographical location, demography and territorial development. On the other hand, the success of Iceland's healthcare is closely linked to the development of a model, in many ways similar to the Soviet model of Nikolai Semashko, which Russia has abandoned. The authors believe that Iceland's experience can be used in the modernization of regional healthcare systems in Eastern Siberia, the Far East and the Arctic, as well as Russian healthcare in general.

The article examines the risks to social perception of health professions in the context of the growing popularity of generative textual and visual neural networks. The article is consistent with the growing body of research that tends to see more risks of this technology, including for healthcare. The second focus of the article — the stereotypes about health professions — is critical, as they have been associated with negative outcomes for the healthcare system. The study primarily focuses on the perception of nursing professionals as most stereotyped by the public. Using uploads from the chatGPT, Kandinsky, and Shedevrum networks, the author has investigated the neural network's embedded perceptions of the nursing profession. Reproduction of certain stereotypes has been identified in all neural networks; the appearance stereotypes (gender, age, race, uniform) are more often shared by visual neural networks, while the function stereotypes (lack of autonomy, dependence on colleagues) — by text networks. Actually, we can assume the risks of a vicious circle, when the network is trained on the largely stereotypical data, and products based on its output increase the scale of stereotypical representations during subsequent training of the neural network. Developers' efforts to avoid reproducing stereotypes are acknowledged, however, the uploads show that they are not fully successful. To prevent the spread of perceptual distortions in neural networks, it is recommended to promote their sociohumanistic evaluation. A «prompt-experiment» is proposed as a mechanism for identifying such risks.

The article presents an overview of foreign sources devoted to the problems of population aging as a significant phenomenon that has become the most important medical and socio-demographic challenge in the world. The review provides global data on this problem and shows the need for elaborating and implementing active aging strategies, optimizing opportunities for health, participation and safety in order to improve the life quality as people age. The paper employs the method of content analysis of scientific publications retrieved in PubMed database by keywords — «aging», «population aging», «demographic trend», «longevity», and «life expectancy». Scientific publications for the period 2018—2023, WHO and UN materials, statistical data, and popular scientific publications have been studied. The purpose of the review was to analyze trends and global nature of aging based on scientific publications and open sources, and to highlight the most promising areas of the demographic policy on the older adults. In the time of rapid demographic changes, it is extremely important to use all available opportunities that maximize healthy aging with the participation of the older adults. We should remember that aging is a natural process and it is better to accept it, both psychologically and physically, rather than ignore. Healthy aging should become and has become the main principle of life, suggesting a longer healthy life of the older adults, who, in turn, should understand how to accept and implement this principle in their lives.

Performance of varies surgical manipulations (SM) is a key skill in surgery. To develop such skills simulation trainings (ST) are used, followed by a training transfer, which is the ultimate goal of ST However, this training goal is not always achievable — the share of doctors using laparoscopic intracorporal suturing after the training ranges from 43.8% to 72.2%. Therefore, to improve training transfer it is necessity to evaluate effectiveness of such training programs. Current methods evaluate training results either outside real practice or in practice but in small groups due to high cost and efforts consumed. The paper presents a new method to evaluate effectiveness of SM simulation training programs in general population of the trainees, evaluate additional effects of the training and analyze personal factors affecting the training results. The method is based on a survey of the ST program participants, and tested at the Training and Accreditation Center «Medical Simulation Center of the Botkin Hospital» within the program on laparoscopic intracorporal suturing. The rate of training transfer added up to 88.9%. The suggested method makes it possible to evaluate effectiveness of SM simulation training in general population of the trainees, analyze factors affecting the training results and use findings for improving ST programs and methods in general. The method can be recommended for a large-scale implementation in simulation training programs.

In order to identify the basic patterns of behavior that reflect the attitude of Russians to their health, a large corpus of relevant scientific literature was analyzed, as well as actual statistical data and the results of representative sociological studies concerning various aspects of both self-preserving and self-destructive behavior of Russians. As a result, four basic models of behavior were formed and described, which differ in a set of positive and negative attitudes and characteristic lines of behavior in relation to one’s health («a convinced healthy lifestyle person», «a beginner healthy lifestyle person», «irresponsible» and «self-destructive»). Based on the analysis of statistics and sociological information, it was concluded that even the behavioral model of a «beginner healthy lifestyle person» is implemented by a very minority of Russians. At best, the majority of the population adheres to the «irresponsible» pattern of behavior that involves refusing or reducing the consumption of alcohol and tobacco, but not assuming a rational diet, adequate sleep, physical and medical activity. Hence the task of everyone who has the opportunity to influence citizens, including medical workers, to convey to them the idea that health and longevity are achieved only through systematic and comprehensive efforts. In addition, a number of common misconceptions and unrealistic expectations related to healthy lifestyles were highlighted. Attention is drawn to the fact that subjects capable of exerting an educational impact on citizens, including medical specialists, should not only provide patients with useful knowledge, but also try to protect them from misconceptions and unfounded expectations.