Problems of Social Hygiene,
Public Health and History of Medicine

The statistical data on mortality due to COVID-19 has been studied. The weekly cycle of mortality was established. Presumably, the decreased mortality on particular days of the week related to optimized treatment protocols applied on the «favorable days». If the factors reducing mortality on particular days of the week could be identified, their positive effect should be applied to other days of the week to decrease mortality among patients with COVID-19.

The overview of scientific information concerning actual characteristics of population's supply with vitamin D and its role in case of risk of development of infectious diseases and COVID-19 is presented. The analysis established that vitamin D deficiency contributes both to higher risk of susceptibility to infectious agent and to negative impact to course and outcome of disease. The significant role of vitamin D in prevention and treatment of viral diseases is established. The international research studies confirm that at infectious diseases and early stages of COVID-19 protective immune response is responsible for elimination of the virus. Therefore, using vitamin D in treatment of COVID-19 is the strategy of immune protection. The authors consider that in case of infectious risks, preventive application of vitamin D is necessary. In case of initial manifestations of COVID-19, it is appropriate to promptly achieve levels of optimal status of micro-nutrient supply.

The article presents the results of project targeted to identify specifics of transformation of domestic violence while anti-pandemic measures are in force. The sociological survey was organized on the basis of the Crisis center for women in difficult life situations (Belgorod region, Russia). The sampling consisted of 46 women aged from 20 to 45 years endured domestic violence. The primary information was collected using semi-structured interview technique. Also, semi-structured interviews of experts from among sociologists and crisis center personnel were carried out. It is established that COVID-19 pandemic significantly impacted on family relationships. The conditions of forced isolation and anti-pandemic measures observance significantly increase risk of domestic violence.

The article presents the results of analysis of indices of primary morbidity of adult population in the Russian Federation during implementation of state programs. The purpose of the study was to study the dynamics of indices of primary morbidity of adult population of Federal districts and subjects of the Russian Federation in 2006-2011 and 2012-2018. The analysis established the subjects of the Russian Federation where the mentioned indices factually remained unchanged or had negative dynamics. Also, the periods of health care reform with positive dynamics of indices of primary morbidity were determined. Besides, reforming process was not always systematic and not all planned tasks were completed that , resulted in significant discrepancies in values of indices of primary morbidity among particular subjects of the Russian Federation. This kind of analysis permits to identify specific directions of improving regional policy in health care.

One of world trends in health care social policy is self-care behavior of population as willingness of every member of society to be personally liable for maintaining one's own health and prolongation of life activity. The value of health is considered as both human, personally significant and social capital, that is a must to achieve high indices of social development and to ensure national state security. The measures of state policy of the Russian Federation are targeted to develop culture of self-care behavior of citizen of the Russian Federation that is reflected in such national projects «Health care» and «Demography» that are implemented until 2024. To assess self-care behavior, it is necessary: to determine the need for longevity and degree of its implementation in various socio-demographic groups; to assess specifics of self-care behavior in context of motives of achieving longevity; to determine feedback in various socio-demographic groups to demographic policy measures to preserve population health and to reduce mortality; to analyze popular practices of self-care behavior. The article presents results of sociological survey on subject of «demographic self-feeling of Russia» carried out by the Institute of Social Political Research of the Russian Academy of Sciences in 2020-2021, in terms of application of various practices of self-care behavior in Russia.

The spinal muscular atrophy is neuromuscular disease caused by mutations in SMN1 gene. The clinical picture of disease is characterized by progressive muscular weakness and atrophy associated with degeneration of spine, and in severe cases by affection of motor neurons of lower bulbar cells. The spinal muscular atrophy progressing course resulting in disability and infant mortality. Actually, specific treatment is at the stage of clinical trials. However, patients are needed in permanent symptomatic arresting of manifestations and pathogenetic treatment preventing development of disease. The article presents calculations of direct medical costs for treatment in pediatric patients (0-17 years old) in Moscow with the main types of spinal muscular atrophy. It is established that the cost of specialized medical care of children with spinal muscular atrophy per single under age patient in Moscow consisted 7,131,185.84 rubles annually, including primary diagnostic, treatment and rehabilitation and medicinal treatment. In total, according to data for 2020 in Moscow, where number of children patients is 144, the cost of specialized medical care of children with spinal muscular atrophy is estimated as 1,024,580,269.16 rubles. At that, data takes into account only direct medical costs for out-patient and in-patient care of children with spinal muscular atrophy, excluding number of exacerbations of disease. Taking into account average numbers of hospitalizations per year because of illness, the cost of in-patient care of single child amounts to 7,844,304.42 rubles annually and 1,127,018,732.08 rubles for all children with spinal muscular atrophy in Moscow (according data of 2020).

The issue of preventing various diseases in children with disabilities is relevant around the world. The purpose of the study: to investigate the oral health of disabled children with hearing impairments and with visual impairments and to determine problematic issues of their dental care support. The individual face-to-face questionnaire survey was carried out covering parents (legal representatives) of students of special general education school for children with hearing and visual impairments. The analysis of results of preventive examination of students was implemented by stomatologist.Two categories of students were covered by the study: children with hearing impairment (first group) and children with visual impairment (second group), their families included. The first group consisted of 61 families with disabled children (37 boys (60.7%) and 24 girls (39.3%). The second group included 63 families with disabled children (35 boys (55.6%) and 28 girls (44.4%). The comparable structure of compared groups by age was established. The children aged 10-14 years dominated in both groups: 39.3% in the first one and 57.1% in the second one. The comparison of dental status of disabled children with various disorders of the senses was implemented according number of stomatological indices: caries activity, hygiene level, need for consultation by orthodontist. The patients with poor hygiene were significantly more common among children with visual impairment (38.1%) as compared with children with hearing impairment (3.3%). Also. 77.0% of patients with hearing impairments and 79.4% of patients with visual impairments needed advises of orthodontist. The families of 28.8% and 38.1% of patients in corresponding compared groups resorted to fee-for-service dental services. The first group characterized by statistically significantly higher percentage of dissatisfaction with quality of treatment and prevention (59.0% vs. 38.1%). The second most important problem was dissatisfaction with attitude of stomatologist to patients and their parents, which was noted in 16.4% and 28.6% of cases correspondingly. The stomatological health problems are very relevant for disabled children as they often suffer from oral diseases and have difficulties in accessing quality dental care. The prevalence of caries, especially sub- and de-compensated, in disabled children with visual and hearing impairments is significantly higher than in children population as a whole.

The article presents results of studying health of 1050 students of medical University. The prevalence and severity of otorhinolaryngological pathology among students is of priority attention. It was established that with high self-assessment of competence in health issues, only 55.4% of first-year students and 59% of last-year students mentioned importance of maintaining healthy lifestyle. The analysis of students’ morbidity permitted more than half out of them to refer to frequently sick with chill (68.1% and 68.9%respectively). The rhinosinusitis acute conditions were 6.2±0.3 cases in first-year students and 8.6±0.5 cases in graduate students and in 2017 2.8±0.2 and 3.1±0.3 cases respectively.The early start of antibacterial medication intake by respondents because of chill was established. While in one third of all cases this was implemented because of advice of pharmacy employee. It is concluded that it is necessary to develop preventive program concerning otolaryngological pathology that can be implemented on part-time classes.

The phenomenon of leadership for long time attracts attention of scientists and practitioners of various specialties, including medicine. Among numerous research publications on this topic, dissertations occupy special place, as both research and public defense are carried out in accordance with officially established rules.To achieve the research goal of studying characteristics of dissertations on leadership implemented in 1995-2019 in various scientific specialties bibliometric analysis, logical and descriptive statistics were applied. The sampling of 305 dissertations on leadership were analyzed in digital databases of scientific libraries.The analysis established that number of dissertations on leadership submitted to dissertation councils changed significantly over the analyzed period. In the structure of dissertations, predominated problems of political leadership (37.4%), formation of leadership qualities in young individuals (19.0%) and management on the basis of leadership potential (12.5%). The women, as compared to men, made up to 27.3% among authors dissertations on leadership. The main reserve of further study of phenomenon of leadership is implementation of dissertations on mentioned research themes in other scientific specialties that provide this area of research, as well as inclusion of theme of leadership in the scientific specialty 14.02.03 - public health and public health.

The term “regulatory guillotine” means analysis of all existing normative legal acts in order to understand their compliance with modern requirements. If these regulations meet the requirements, then the rules remain; if not, they must either be canceled and new regulation to be elaborated or corresponding changes must be implemented to current regulation. To resolve this problem, the government of the Russian Federation decided to implement the “regulatory guillotine” procedure. The main task of this procedure is to completely replace the entire array of norms that establish mandatory requirements with new ones by January 1, 2021. This will reduce administrative burden on business and increase level of security for consumers of various services. The same work is applied to the standards regulating management of quality and safety of medical activities. The article analyzes normative legal acts that regulate quality and safety management of medical activities, as well as new normative legal acts that are already accepted but still are not entered into force.

The article presents results of measures of increasing research potential of participants of the scientific and educational medical cluster «North Caucasian». The measures include both organizational measures and measures of meaningful nature, i.e. union of scientific and pedagogical workers in scientific areas and their inclusion into activities of scientific schools. The steps are undertaken within the framework of scientific and educational cluster resulted in an increasing of scope of research work and incomes received from their commercialization. The integration of medical universities and medical institutes and departments of classical universities under the Ministry of Education and Science gives synergistic effect in development of innovative products.

The article considers problematic issues in hospital-replacing out-patient mental care management on the basis of the Psychiatric Hospital № 13 in 2015-2017. The analysis covered structure of mental patients, their age and social status. Also, patients under active dispensary monitoring and compulsory continuous out-patient treatment were analyzed. The new management component - «the out-patient psychiatric module» - is proposed to be introduced into the structure of mental dispensary.

The article presents materials characterizing the state of health care system in the USSR in 1960-1980s. The main attention is paid to the complex of unresolved problems that had negative impact on capacity and quality of population medical care. The conclusions concerning factors weakening state health care system during last decades of the USSR existence are expressed and justified.

The article considers the circumstances of the beginning of teaching medical police at St.Vladimir Imperial University in Kiev that was investigated for the first time. It was established that the medical police were taught as one of academic disciplines at the Department of State Medicine Studies. It found out that the given Department began its activities in 1843 when it was organized and headed by professor Ivan Fedorovich Leonov (1809-1854). The adjunct assistant professor Ch.Ya. von Hübbenet and associate professor A. I. Slobodzinsky worked at this Department in 1847-1850 and in 1851-1856 correspondingly. In 1852, the Charter and Staff of the St. Vladimir University provided setting apart medical jurisprudence from medical police subject and teaching it as an independent faculty discipline. It is demonstrated that hereinafter the given practice didn't become widespread in the Universities of the Russian Empire. In 1853, the Department of State Medicine Studies in Kiev was headed by F. F. Mering (1822-1887).

The authors of this study discovered in annals of history the “Oath” of the Portuguese physician Amatus Lusitanus (1511-1568) and translated it into Russian for the first time. The mentioned historical document represents a sort of Code of Honor of European physician of XVI century that both took in ethical norms of Hippocrates and determined one's own rules of doctoring.The ethical principles of Amatus are akin Hippocrates’ ones and they are in parallel on seven positions. However, the “Oath” of A. Lusitanus also includes other aspects of medical ethics that are completely organic to the very personality of author and distinguish themselves by courage and novelty for its time. To mention reward of physician for one's labor, difficulties and hardships falling on representatives of medical profession, theme of glorification and exaltation of physician and and medical tolerance. Amatus Lusitanus can be considered as a precursor of initiation of tolerance in European medical ethics that he anticipated with his “Oath”.