Problems of Social Hygiene,
Public Health and History of Medicine

The article considers international experience in studying health of migrants. The most common diseases in migrant community are described. The factors determining their prevalence are established. The barriers restricting medical care provision to displaced persons, including social economic, cultural, and communicative ones, are described. The ways to improve organization of medical care of migrants are proposed. The proposed measures will help to develop benevolent environment for migrants and will contribute to their successful integration into new country of residence.

The state of health of children represents serious medical social problem. The data of official statistics and special studies everywhere register increasing of general morbidity and disability, including area of digestive system, chronic forms of diseases in structure of children pathology, share of congenital development defects and genetic deviations. The study was carried out to investigate and analyze structure of morbidity of digestive system in children based on data of appealability for hospitalization in the gastroenterology and hepatology Department of the National Center of Maternity and Childhood Care (Kyrgyzstan). The data from reports of mentioned gastroenterology and hepatology Department in 2019–2024 were analyzed. It was established that across all nosological units that are subjected to hospitalization in hospital, occurs steady increasing that indicates to severity of disease. The facts of increase of morbidity of gastrointestinal tract and hepatobiliary system require further investigation and scientific research to find causal factor.

The purpose of the study is to calculate amount of funds required for medicinal support of patients with chronic obstructive disease of lungs in all conditions of provision of medical care. The calculation of costs of medication support of patients with chronic obstructive disease of lungs was implemented. The standards of medical care and original methodology of calculation were applied. The sums necessary for provision of of medications according to pharmacological classes and groups of patients were calculated. The sums of necessary costs for medication support of patients with chronic obstructive disease of lungs, calculated on the basis of standards of medical care and original methodology turned to be comparable (difference is less than 10%) and made up to from 23.4 billion rubles to 25.2 billion rubles. The study revealed that differences in sums of funds required to support patients with medications of various pharmacological classes depending on type of calculation: based on standard of medical care and original methodology. The largest sums of funds required for treatment of mentioned patients fall on groups of patients C and D. The results of the study can be used in planning medical care in pulmonology, as well as in development of the Federal project “The struggle with chronic obstructive disease of lungs”.

The article considers issues of training models of convolutional neuronic network (CNN) for automated identification of point functions of visualization to discern mammography pictures belonging to negative, false benign and malignant cases, targeting to improve interpretation of results of mammographic examination. On the basis of automated deep training (application of CNN) the approach is proposed, that permits to detect small differences in mammographic pictures to diagnose true positive and false positive results. The information base for training CNN is represented by digital base (open resource for methods of intellectual studying of analysis of mammographic pictures) of data of mammography screening of the Massachusetts General Hospital and the Winston-Salem Medical College, the USA. The share of false positive results according trained model in the total number of examined patients from different age groups made up from 22% to 32%. To compare, share of false positive results based on decoding of mammographic picture by medical specialist varied from 34% to 53%. The trained model based on the CNN can be used for mammographic pictures of any database. The predictive accuracy of model depends, among other things, on volume of training sample. Therefore, formation of open database of results of mammographic examinations with accurately established diagnosis will permit later on to broadly apply possibilities of deep training in medical practice. The study has great potential to incorporate deep training of CNN into clinical practice of screening of breast cancer and to improve interpretation of mammographic pictures.

The concept of servicing maintenance implies implementation of routine technical inspection, checkup and carrying out of repair work applying spare parts and accessories. In conditions of increasing sanctions' pressure, organization of supplies of component parts and accessories became complicated. As a result, delivery time and cost of such component parts increased. Because of the fact that most of medical equipment on balance sheet of medical institutions is imported, current situation affected process of servicing maintenance of medical equipment used in routine medical services in hospitals and polyclinics. Actually, main regulations of technical servicing of medical devices are established by single state standard specifying category of medical device that includes such types of goods as medical technique and medical equipment. Along with this, above-mentioned document contains enumeration of works related to servicing maintenance: unscheduled and periodic technical maintenance and diagnostics, control of technical condition, installation, dismantling, tooling, repair work. From numbered enumeration of realizing works follows that their implementation requires usage of complementary depot units and accessories, which, according to requirements of legislation in action, are to be provided from foreign builder. Consequently, such an order, in view of established circumstances, is significantly burdened by measures of sanctions' impact. Whereas, vast majority of different medical institutions run into problems of organization of servicing maintenance of medical equipment on the balance sheet. Such a situation requires permission at legislative level, since at present time carrying out servicing maintenance is allowed only with consideration of usage of original components. Therefore, establishment of separate procedure of usage of analog component parts would be a constructive solution of revealed problematic aspect.

The world internationalization of higher education is gaining momentum against the background of significant demographic changes in economically developed countries (aging of population, low natality) that encourage governments to attract and retain the youth from less developed regions. In these conditions, it is relevant to study migration attitudes of international students — their motives, plans and factors influencing decision to stay in Russia or leave the country after graduation. The purpose of the study is to determine value guidelines and attitudes of foreign students regarding continuation of their education, work and life in Russia and to identify key affecting factors. In 2024, the questionnaire survey of 168 foreign students-participants of the English-speaking Master program “Population and Development” in the Federal State Autonomous Educational Institution of Higher Education “The National Research University the Higher School of Economics” was carried out. The questionnaire based on the Likert Scale and further statistical analysis were applied. Additionally, official statistics data was used (VPO-1 form of the Minobrnauka of Russia). It is demonstrated that expectations of students regarding education in Russia are generally justified. The majority of respondents rates very high quality of education and life in Russia, accessibility of habitation, relatively low cost-of-living. The higher marks received accessibility of medical care and legal protection of students. At the same time, significant portion of students have no confidence in prospects of their employment in Russia. About two thirds of respondents believe that it will be difficult for them to find job after graduation that is conditioned, according their opinion, by not adequately favorable policy, mistrust of employers to foreigners and poor involvement of universities in job placement of graduates. About half of respondents feel themselves uncomfortable in Russia and plan to leave after graduation. About 40% of foreign students would like be admitted to citizenship of Russia. While the same number do not plan it.

The article considers and classifies main challenges to public health and health care systems in the Russian Federation. The software “Challenges, version I” was used to account quantity and intensity of impact of considered challenges. The total number of challenges amounted to 118 in 2012–2024. The challenges were fell into types of impact on the population. The challenges were selected according availability of their scale, time frame and impact on strategically important components of public health. Every characteristic of challenge was assigned numeric value that was used to calculate index of challenge severity. In Russia, it was established that there are no subjects with no challenges to society. In terms of scale of distribution of challenges it was revealed that prevail national challenges manifesting on the territory of the country (45.76%). In terms of duration of challenges prevail long–term calls (39.8%). In terms of type of challenge prevail social (33.05%) and economic (22.88%) challenges. The level of average index of challenge severity increased in 2024 up to almost 4 times as compared to 2012. The study of modern challenges to public health requires a systematic approach. The application of innovative solutions and digital technologies will minimize risks and improve efficiency of health care. The information gathering about challenges plays critically important role in public health management. The monitoring of severity of challenges permits to prognosticate risks and to develop measures of response. The software “Challenges, version I” can be a typical solution for gathering and describing characteristics of challenges.

The article presents results of evaluation of efficiency of mechanisms of assigning quotas and funding of working places for the disabled in Russia. The analysis trends is applied to dynamics of resettlement of the disabled according assignment of quotas. The unstable tendencies were revealed: increasing in 2017–2019 and decreasing after 2020. The main causes of low efficiency is formal approach of employers to implementation of assignment of quotas, insufficient incentives and high costs associated with adaptation of workplaces. The shortcomings in funding, including complicacy of compensation of expenditure and limited number of setting up workplaces. It is noted that most of vacancies don't correspond to preferences of the disabled (underemployment, remote job involvement) that decreases motivation for resettlement. The measures are proposed to develop system: expansion of tax privilege for employers, flexible forms of assigning quotas, simplification of access to funding and development of supporting infrastructure. The study was based on data from Rosstat, EMISS and job portals that ensured reliability of conclusions.

For any ship owner, the medication support of vessels of merchant shipping is one of prime tasks of organization of due medical care of crew members. The ship's first aid kit contains various medications, including medicines containing narcotic, psychotropic, drastic and toxic substances. The amount of medicines needed on board depends on duration of voyage, destination, the number of crew and nature of cargo. The ship, at call in any country, undergoes procedure of customs clearance and control both of ship itself and medications on board. The article considers modern aspects of customs clearance and control of medications. The degree of responsibility of ship owner and crew members for unreliable declaration is determined. The recommendations preventing illegal transfer of medications on ship's board are formulated.

The modern maritime industry is undergoing significant changes due to increasing of flow of transportations of bulk cargo in containers, increasing of share of regular voyages and tightening of requirements of safety of navigation. The line shipping is characterized by constancy of routes and strict compliance of schedule in conditions of higher intensity of ship flows and complicated work conditions. The invariable work in such conditions results in psycho-physiological disorders, chronic stress, emotional burnout, development of cardiovascular pathology and neurological and mental disorders. Hence, augmented risk of deterioration of health of crew members, reduced performance efficiency, increased likelihood of mis-actions of navigator and increased possibility of emergency conditions at the sea. In order to develop recommendations to maintain health of crew members and to increase safety of navigation, the article presents results of survey of command staff of container fleet. The analysis permitted to identify corresponding key problems and to formulate recommendations to eliminate them. The legal field regulating organization of medical examination and issues of admission to professional activities of sailors was analyzed. The differences in approaches to assessment of psycho-physiological state in different countries were identified.

The relevance of the study is determined by necessity to monitor life expectancy (LE) and healthy life expectancy (HLE) within the framework of implementation of National demographic priorities in Russia. The purpose of research is to analyze dynamics of LE and HLE in Russia in 1990–2023 and to identify their relationship with behavioral factors of health preservation.

The anti-narcotic activity is targeted to formation of unified system of comprehensive anti-narcotic preventive policy oriented on harmonization and coordination of processes between subjects of interdepartmental interaction of the Strategy. The purpose of the study was to establish optimal approach and principles in formation of synergistic effects between people, departments, civil society institutions, including public and non-profit organizations that make up social structure — state anti-narcotic Strategy in the region. The conclusion is made that characteristics of implementation of the Strategy for each subject of prevention at meso-level (region) set necessary potential for development and manifestation of synergistic effects leveling out existing patterns, with established vertical line of hierarchy of relations in health care sector. According to researchers, linearity, closure, lack of conditions for changes and transformations, “unjustified stability” impede self-organization and therefore to receive synergistic effects from interdepartmental interaction.

The article opens series of publications devoted to historical reconstruction of chronology and main vectors of formation of regulatory complexes in pharmaceutical sphere in the European countries and the North America. The Report I considers the first stage of development of legal regulation (XII– early XXth century), during which two main models took shape — the continental one, based on priority of normative acts dating from the Edict of Salerno, and the Anglo-Saxon one characterized by absence of specific legal norms of pharmaceutical activity.

The article elaborates issue of scientific substantiation of differentiated approach to implementation of project activities in medical organizations considering differences in resource support and motivational readiness of personnel. The study sampling included 100 polyclinics of the Moscow Oblast participating in implementation of the project “Polyclinic Reloading”. The checklists reflecting 100 criteria of effectiveness of the project were grouped together by 6 blocks. The evaluation of architectural and resource conditions was carried out in 224 medical organizations. The psychological questionnaire survey covered 1 598 workers of polyclinics. The expert survey covered 28 chief physicians involved in project implementation. the descriptive, correlative and dispersive statistical methods were applied. The average level of implementation of project criteria according check-list made up to 88.3%. However, only 16% of institutions achieved all target indicators. The analysis revealed significant differences among medical organizations in terms of architectural conditions and psychological readiness of personnel. According to experts, the most influential factors were insufficient equipment with facilities, staff shortage, higher workload and lower motivation of workers. The moderate correlation was established between area of buildings and attached population (rs = 0.49; p < 0.001) that indicates at absence of planned dependence between capacity and factual load. The implementation of projects requires adaptation to specific conditions in medical organization. The differentiated approach to implementation of project activity permits to consider resources, architecture and level of personnel involvement.

The main demographic challenges to the development of Russian society in modern conditions are, on the one hand, a low birth rate, on the other, aging and a high increase in mortality of the indigenous population, an increase in losses of people of working age. Purpose. Identify demographic challenges and individual aspects of the impact of migration processes on the public health of the indigenous population of the host territories. When analyzing medical and demographic indicators by regions and subjects of the Russian Federation, significant fluctuations are noted. Mitigation of demographic trends and compensation for negative imbalances in society is achieved by increasing migration. It should be borne in mind that external migration processes have a significant impact on the socio-economic situation of the host territories and various consequences on the public health of the permanent resident population. Migration flows increase the burden on the State in the field of health, education and other areas of economic and social assistance.