Problems of Social Hygiene,
Public Health and History of Medicine

The purpose of the study is to identify relationship between value orientations and safety culture of workers of medical organization. The sampling consisted of 284 workers (66 men, 218 women) of medical clinic. To identify system of personal values the “Value Orientations” questionnaire by Sch. Schwartz was applied. The mean values and ranks were calculated for each value indicator. To assess safety culture the “Safety Attitudes Questionnaire” by K. N. Tsaranov et al. was applied. The data statistical processing of the data was carried out using variance analysis and correlation analysis (Pearson coefficient). The largest differences in the indicators in the group with a low level of value-intentional coherence indicator were observed in relation to values “conformity” (rank difference 2.16), “stimulation” (1.73), “universalism” (0.9), “achievement” (0.83), “independence” (0.77), “traditions” (0.61) For other values difference was less than 0.5. The largest differences in indicators in the group with high level of value-intentional coherence indicator (IVC) were observed for values “universalism” (1.01), “stimulation” (0.64), “achievement” (0.5). For the remaining values difference was less than 0.5. Assessment of safety culture revealed that below threshold of agreement (75%) were results on the scale “Recognition (understanding) of stress” in all groups of respondents. On indicator “Working conditions” below level of agreement were results of groups with low and high levels of value-intentional consistency indicator. Below threshold of agreement (75%) were results of responses to the question about the relationship with clinical pharmacologists in all groups of respondents. The value-intentional coherence index can be applied only concerning each single worker. The qualitative analysis of IVC indicator should both include its comparison at the level of normative ideals and behavioral priorities of values and to consider the spread between ranks. The values “stimulation” and “achievement” have no effect on manifestation of attitude to safety culture of medical organization. The key personal values associated with manifestations of safety culture are “power”, “autonomy” and “conformality”.

The paper presents the findings of a study conducted using a mass questionnaire survey of members of young families (n = 893). The purpose of the study is to identify what problems affecting well being are faced by members of young families. In the sample, young families are represented by two groups — families with children and families without children. It was revealed that the assessment of the significance of problems in family life is different in families with children and childless families, including the number of children in the family that affects the situation. Ratings of family problems were built according to the following criteria — self assessment of men and women and parenting experience. It is concluded that, according to a number of criteria (both material and non material), well being is formed.

The choice of specialty by graduate of medical university can be promoted by particular social, demographic and personal characteristics. Purpose of the study is to investigate demographic, social and personal characteristics of students in residency on specialty “General Medical Practice” in the Russian Federation. The sociological, statistical and analytical methods are applied. The sampling for survey consisted of 81 respondents. The specialty “General Medical Practice” is chosen mainly by women residing in city, non-married and without children. They are not characterized by participation in public life and they are characterized by the presence of hobbies (hobbies). The choice is conditioned by multidisciplinary nature of medical care and scope of professional horizons. They are attracted by treatment work and are less interested in pedagogy and science. In perspective, 80% of female respondents are going to get another specialty. More than 70% of respondents plan to work in out-patient conditions and predominantly in state sector of health care. For women, main goals of further professional training are improvement in main and adjoining specialties and career promotion. And in educational program, internal diseases are of greatest interest. The preferred forms of training are internships and e-learning. The main direction of improving educational process is increasing of scope of practical training. The comparative analysis of study results with data of previous publications was implemented. The factors influencing commitment to specialty are revealed. The proposals increasing attractiveness of general medical practice for graduates of medical universities and keeping in specialty after residency are formulated.

In the history of science, there are great scientists who, without being physicians, wrote golden pages in the History of Medicine. Such was Louis Pasteur, founder of scientific microbiology and immunology. Such was his follower Gaston Ramon (1886–1963), French veterinarian and immunologist who created 100 years ago first anatoxin for active prevention of diphtheria and later tetanus and thus opened era of anatoxins (toxoids) — vaccines based on toxin molecule devoid of toxic properties, but preserving immunogenicity and antigenic specificity. For many centuries, diphtheria (originally known as ‘croup’) was incurable contagious disease, especially among children. In XIX century, it affected in France up to 30,000 people per year and killed every second infected child. In 1888, at the Pasteur Institute (Paris), Emile Roux (1853–1933) and Alexandre Yersin (1863–1943) demonstrated for first time that symptoms of diphtheria are caused not by bacteria themselves, but by deadly toxin released by them. The long-term search for method of treatment and prevention of diphtheria did not bring the desired result. It will take many years, before Gaston Ramon in 1923 will be able to neutralize diphtheria toxin by acting on it with formalin at certain temperature and thus will receive “anatoxin”, mean of vaccination against diphtheria. The article analyzes stages of these studies, which proved high effectiveness of anatoxin and proceeded with widespread implementation of vaccination against diphtheria and later tetanus in short time in France and in Russia (with active participation of Pavel F. Zdrodovsky, 1890–1976). The separate section of the article is devoted to life story of Gaston Ramon and his activities in the Pasteur Institute. The scientist who opened the era of anatoxins did not become Nobel Prize winner, despite the fact that various organizations and scientists from many countries of the world have nominated him 155 times for the Nobel Prize in Physiology or Medicine in different years. He received recognition in France, his Motherland: Gaston Ramon is holder of the Grand Cross of the Order of the Legion of Honor and streets, colleges, lyceums, schools are named after him.

The purpose of the study is to analyze changes occurred, against the background of social challenges, in functioning of the Chair of Social Hygiene since its establishment in 1922 at the Faculty of Medicine of the I Moscow State University to the present time at the N. A. Semashko Chair of Public Health and Health Care at the Sechenov University. The historical method was applied to analyze the documents from the Moscow Central State Archive, the N. A. Semashko Chair of Public Health and Health Care and published materials from eLibrary.ru and the Central Scientific Medical Library for 100-year period.

The exploration of molecular genetic mechanisms that underlie carcinogenesis, hereditary factors of various oncological diseases, including basal cell carcinoma, the most common type of skin cancer is especially actual and significant for target strategies of public health. The diagnosis of basal cell carcinoma is based on complex clinical, radiologic and genetic examination data. The further research in the field of somatic or hereditary mutations in genes associated with basal cell carcinoma, including Patched 1 (PTCH1), Patched 2 (PTCH2), Smoothed (SMO) continue to be topical. The strategies of primary prevention of basal cell carcinoma, discussions of complex issues of decision making concerning treatment at primary health care level, training courses and development of guidelines for general practitioners and interdisciplinary recommendations for effective early diagnosis and comprehensive care of basal cell carcinoma are to be suggested.

In Russia, one of signs of organizational formation of national stomatology as independent scientific and clinical medical discipline in the end of the XIX — early XX century, became emergence of profile societies. The most important role in this process played Gilyar Ivanovich Vilga, one of founders of the Moscow Odontology Society in 1899 and its chairman since 1900. He was one of initiators of organization of the Russian Dentistry Union and and unchallenged chairman since 1906. The article describes his public activity targeted to consolidation of all specialists in dentistry in Russia, to improvement of positioning of dental corporation, to perfection and prosperity of national dentiatry.

The more active implementation of innovative medical technologies, digital transformation in medical sphere, sanction restrictions resulted in complication of already existed problems in medical law and raised new questions. The necessity in improving medical legislation is obvious. The number of lawsuits concerning medical organizations and medical workers is invariably increasing. Hence request of adoption of normative legal regulations and decisions supporting effective functioning of industry and protection of rights and interests of medical organizations and medical workers. The purpose of the research is to study and to analyze current issues of ensuring rights of medical workers as one of the main aspects of modernization of modern medical law. The main normative legal acts of modern medical law were studied. The analysis, comparison, generalization and systematization of published statistical data, judicial practice, national and foreign sources of scientific publications, devoted to topical issues of modernization of legislation regulating health care and rights of health workers were implemented. The content analysis was applied to acts regulating legal responsibility and protection of rights of medical workers. The protection of rights of physicians in system of medical care of population at the present stage was investigated. A number of problems related to legal regulation of activities of health workers was established. The proposals for its improvement was summarized. The legal regulation of medical care support by multitude of normative acts makes actual issues of systematization of normative documentation. the assignment of independent sector of medical law where legal status of medical worker is to become its main institute.

The shortage of blood donors is significant problem of Russian health care. The potential of involving new blood donors can be found, in particular, in activities on popularization of blood donor practices among students. The empirical study was carried out in 2022 to determine attitude of students and their willingness to take part in practices of blood donorship. The online survey of university students was implemented based on representative quota sampling of 1 135 respondents with gender, educational status and place of residence controlled. The results demonstrate complicated picture of motives and factors predetermining personal strategies and experiences of participation in blood donorship. The contradiction between positive attitude to blood donorship declared by students and passive behavioral practices was revealed. The motivation for blood donorship, mainly individual, is assessed as personal choice of student. The motivation based on altruism and desire to provide effective help is determinative. However, such obstacles of implementing blood donorship practices as insufficient information about possibilities and consequences of blood donorship, distrust of health care system, fear of blood collection procedure, lack of remuneration.

The task of increasing staffing of physicians in primary health care level is resolving by accreditation of medical workers. The sociological assessment of motives of employment and professional adaptation of graduates of medical university who started to work as district therapists and pediatricians after undergoing primary accreditation was carried out. Only about 7% of graduates initially wished to work as district physicians. The most frequent reasons of employment were to get additional points for admission to residency (18%) and need in financial resources (18%). The analysis of professional plans of respondents testifies intention of every second to leave primary medical care to work in specialty received in residency. The seven out of ten respondents noted insufficient scope of necessary clinical knowledge and practical skills, lacking of effective measures for professional adaptation, including internship and supervision.

The article covers aspects of morphological, anatomical, embryological, histological aspects and origin, types, blood supply, innervation, lymph drainage of human vermiform appendix. The purpose of the study is to understand real function and to summarize this information for positive impact on clinical decision in case of appendicitis. Although characteristic features of normal and diseased appendix have been reported for many previous centuries, it still the most common challenge facing every day in operation room. The appendectomy, commonest surgical emergency procedure, may cause little confusion in surgeons due to highly variable situations of it inside the abdominal cavity. However, the recent imaging techniques have increased ability of surgeon for crucial diagnosis of the diseased appendix.