Problems of Social Hygiene,
Public Health and History of Medicine

The article presents dynamic indicators of the medical demographic process in the Republic of Tatarstan in 1990–2023: number of births and deaths per 1000 population, age-specific fertility rates and fertility rate prognosis, infant and maternal mortality, life expectancy, primary morbidity, genitourinary morbidity. The trends in this area are analyzed considering two periods: pre-COVID period (1990–2019) and COVID-19 pandemic and its consequences (2020–2023). The study of long-term trends in the field of demography has scientific and practical basis and can be applied in developing methods to evaluate population reproductive potential and to build prognostic estimates in demographic sphere. The obtained results and conclusions can be applied, expanded and specified as methodical apparatus for studying demographic processes at the regional level.

The concept of identification of goods implies establishment of its consumer qualities related to purpose, material of production, origin and other characteristics The specificity of customs identification is establishment of correspondence of moving good to data in accompanying documentation and to declared classification code according to Unified Commodity Nomenclature of the Eurasian Economic Union If category of good is complicated from point of view of customs classification then problems can occur related to custom control of reliability of declared data The negative legal practice of customs authorities related to passed classification decisions indicates on insufficiently investigated issue of identification of goods in customs purpose Within the framework of analysis of customs classifier it was established that pharmaceutical production is complicated category from point of view of customs identification as pharmaceutical production The neglect of such characteristics of good as material, purpose, area of application often originates conditions for inconsistent identification of pharmaceutical production in customs purpose The material characteristics of good established separately indicating to application with medical purposes and presence of good in pharmacopoeia doesn't prove labeling of production as pharmaceutical one The development of separate document establishing order of identification of pharmaceutical production is proposed

The article investigates content of competence and role of medical lawyer at resolving legal disputes in health care. The problem of legal protection of subjects of medical legal relationships is considered. The contradictions occurring in judicial practice related to application of legislation and interpretation of law in this area are revealed. The specifics of medical disputes are determined. The tendency of increasing level of conflict relationships in health care is noted. The necessity of special training of medical lawyer having profound knowledge of jurisprudence and medicine with purpose to ensure rights of citizens to qualified legal assistance is substantiated. The content of legal communicative competence of medical lawyer is demonstrated through criteria and indicators assessing level of formation of given component of personal professional qualities of specialist. The attention is paid to such alternative form of resolving legal disputes in health care as mediation, its advantages and as well as to status and role of mediator in process of reconciling medical legal conflict. The purpose of the study is to form new knowledge about importance of medical lawyer in system of relationships developing in regard of issues of protection of health of citizens. And also to apply substantive analysis of legal communicative competence of specialist resolving legal disputes and conflicts in the health care.

The article examines monthly cash payments to the disabled that are established and disbursed by territorial body of the Pension and Social Insurance Fund of the Russian Federation. The purpose of the study is to identify significance of these payments and to develop recommendations to increase income of the disabled at the expense of system of proposed measures. The actuality of the study is conditioned by necessity of improving social security of the disabled in modern conditions. To resolve mentioned problem, original approach was applied, based on generalization and systematization of both Russian and foreign experiences and on application of results of sociological survey of the disabled. The methods of scientific abstraction, systemic approach, analysis of legislative base and publications, economic statistical analysis and sociological survey were applied. The results demonstrated necessity to develop such measures as organization of conditions for remote work of the disabled of able-bodied age, improvement of employment procedures in small and medium-sized enterprises, enhancing efficiency of vocational training of the disabled with various diseases, quarterly indexation of monthly cash payments to compensate inflation level, revision of cost of social services in natural form (medications, specialized products of diet therapy for disabled children, sanatorium treatment to prevent main diseases, free travel on commuter trains). The conclusion is derived about necessity of applying comprehensive approach in enhancing social security of the disabled considering both modern Russian and foreign experience and surmising adjustment of legislative base.

The study established that nowadays in the crew are included not only men but also women, creating certain degree of psychological discomfort on shipboard. Significant part of men do not consider profession of sailor suitable for fair sex representatives. Therefore, they are not quite ready to accept current situation. This fact is confirmed by results of survey of experienced sailors and cadets of higher maritime educational institution. Considering the above mentioned and current pronounced trend of lobbying for gender equality strategy in merchant shipping, the problem of preserving psychological health of sailors is urgent and quite burning. The review of the scientific publications on this issue and results of original studies permitted to develop recommendations postulating that in order to preserve psychological health of crew in case of inclusion of female sailors it is necessary to change approach to formation of ship's crew. It is proposed to focus on psychological testing of male sailors in order to determine possible manifestation of negative attitude towards presence of woman on shipboard in order to take measures concerning development of favorable psychological climate in crew.

The article considers results of studying attractiveness the municipal service. The purpose of the study was to investigate role of municipal employees in formation of health preserving environment, transmission of healthy lifestyle and ascertain attitudes to one's own health. The object of the study was commitment of municipal employees to healthy lifestyle practices. The study sampling included 275 representatives of municipal service. The research toolkit included several blocks: questions related to personal practices of preserving behavior; participation in cultural and sport events; understanding role of ambassadors of healthy lifestyle; evaluation of measures implemented by municipality education regarding public health promotion. It is established that municipal employees, despite high workload, try to adhere to healthy lifestyle, to be an example for population and to promote propagation of healthy lifestyle ideology. The measures implemented by municipalities require participation of business and non-profit organizations representatives. The wider mass media coverage is also needed. The formation of health-preserving environment is to be based on inter-departmental cooperation.

The article presents analysis of factors affecting training quality of medical university students, based on results of sociological survey. The sampling consisted of 200 respondents, including undergraduates and graduates with minimal work experience. The main focus in made on perception of educational process by both students and the youth just started their professional career. The survey results revealed high level of student satisfaction with quality of theoretical training. However, also were confirmed opinions that there were problems associated with insufficient practical training and outdated educational materials. The interviews with graduates confirmed importance of faculty support, but revealed needs in more individualized approach to learning. The coordinated efforts are needed by both educational institutions and health care authorities to create more flexible educational environment. The proposed recommendations permit to identify key directions of work, including modernization of curricula and emphasis on practical training and improving interaction between universities and medical institutions. The study emphasize necessity of comprehensive approach to reformation of medical education that will contribute to quality of medical services and to expanding of opportunities for students of medical university.

The authors, in series of articles, analyze becoming of pharmaceutical information market in Russia It emerged from two sources fragments of the Soviet system of circulation of pharmaceutical information and as consequence of business projects The information segment, being “sectoral” or “internal” to pharmaceutical market, formed over time infrastructure of production, distribution, storage and consumption of its goods Initially, being considered as auxiliary, it turned out into autonomous market with its own rules of the game, leading players and prices for services In the Report matter is the Soviet system of supplying pharmaceutical industry with information places of its accumulation and production, information flows and their conducting system

The article presents, on the base of materials from state archives, restored for the first time the circumstances of establishment of the All-Union Scientific Research Institute on Penicillin and Other Antibiotics (actually the All-Russian Research Institute of Penicillin, VNIIP). The rationale for its organization on the basis of the Scientific Research Institute for Biological Prevention of Infections is given. The reasons for the dismissal of the former director are considered.

The preservation of dental health requires keeping the hygienic norms and timeliness of therapeutic and preventive care. To ensure availability of this care adequate supply of medical specialists is needed since health of the children population is one of important indicators of health care organization and demographic well-being. The purpose of the study was to examine main trends in dynamics of provision with pediatric dentists in the Subjects of the Russian Federation. The data of official statistical monitoring of provision with pediatric dentists in 2012–2023 was studied using analytical and statistical methods and descriptive statistics technique. The results of the study demonstrated that in Russia, in 2012–2023 the provision of pediatric dentists decreased up to 17.9%. In 2023, the 50 Subjects of the Russian Federation (in 2012 — 59 Subjects) were characterized by provision with specialists being lower than the national average level. In other Subjects level of provision was higher than the national level, especially in the Chukotka Autonomous Okrug (by 3.7 times), the Republic of Kabardino-Balkaria (by 3 times) and the Nenets Autonomous Region (by 2.8 times). In 2023, the highest provision with specialists was fixed in the Chukotka Autonomous Okrug, the Republic of Kabardino-Balkaria, the Nenets Autonomous Okrug, the Voronezh Oblast and St. Petersburg. The results of the study of provision with pediatric dentists in Russia in 2012–2023 demonstrated that negative dynamics are traced in most Federal Okrugs. The prognostic assessment revealed possibility for further decreasing of indicator, despite stabilization of situation and increasing of provision with specialists in particular Subjects of the Russian Federation.

The increasing of the level of employment of citizens with established disability group is an actual task for our country in current time and in perspective. Nowadays, the indicators of level of employment of the disabled are rather low along with high level of unemployment. To increase level of participation of the disabled in employment at the state level the number of measures is implemented. The article presents evaluation of the potential employing the disabled, considering their diseases, severity of disability group, gender, age and socioeconomic characteristics. The prognosis regarding future need in workplaces for the disabled and evaluation of key trends in this issue is given. Despite the fact that the total number of the disabled decreases in recent years this does not decreases actuality of issue of their employment. Considering current trends,increase in the number of the disabled of group III as well as disabled children is prognosticated. The specificity and character of prevailing diseases causing disability in children, exacerbate the issue of expanding possibilities for social employment. The particular attention in developing program to increase employment of the disabled is be paid also to veterans of military operations, whose diseases require organization of special conditions and programs of social and psychological adaptation.

The article presents characteristic of national model of organization of medical social care of patients with cognitive disorders as compared with similar models of foreign countries. The causes of defects of organization of medical social care and modes of their correction are analyzed. On the basis of analysis, prospective organizational technology is presented, essentially based on routing of this category of patients.

The article is devoted to comparative assessment of medical social risk factors in pregnant women of late reproductive age hospitalized in the antenatal department of third-level obstetric hospital. In modern conditions of organization and management of health care, when terms of childbirth are shifted to older age groups, medical social studies of health of pregnant women aged 35 years and older are of particular importance. Considering that in conditions of demographic crisis auxiliary reproductive technologies began to be considered as reserve to increase natality, comparative evaluation of medical social risk factors in pregnant women of late reproductive age with different methods of pregnancy onset is actual topic for research. With this purpose, exon of data from medical records of prenatal department of the perinatal center was carried out. The main group consisted of pregnant women who overcame infertility by in vitro fertilization. The control group included pregnant women with spontaneously occurred pregnancy. The study revealed specificity of impact of medical social risk factors in the group of female patients of late reproductive age of perinatal center medical that is important for organization and management of health care in mentioned domain.

The struggle against drug addiction, illicit turnover of narcotic drugs and psychotropic substances remains actual and re quires searching of of new mechanisms counteracting negative social phenomenon at the level of all administration au thorities, including regional health care management. The purpose of the study was to apply approaches of systemic engineering based on models to formalize system of operat ing interdepartmental interaction of participants in counteracting abuse of narcotic drugs and psychotropic substances at the regional level. The application systems based on models of Model-Based Systems Engineering as tool is intended to facilitate unification focused on architectural methodology that embodies best practices and reflects consensus of systemic community. The attempt was undertook to identify processes of interdepartmental interaction between participants in countering drug aggression with principles of systemic engineering based on models. The concept of architecture-oriented or managed with models of systemic engineering process differs from traditional thinking oriented on documents, historically consisted of textual specifications, graphical images, tables. The formalization of processes of interdepartmental interaction using principles of systemic engineering is targeted to management of large number of constituent elements, numerous internal and external interactions, known and unfore seen dependencies between elements of system and external objects. The construction and application of architecture using taxonomy elements, as coordinated set of systemic categories is an important aspect of establishing clear communication and sequence of operations in complex system of interdepartmental interaction of team of participants of counteracting narcotism in the Subject. The application of systems based on models of Model-Based Systems Engineering will permit to adequately determine structure, behavior, rules, universal properties, information content and other key aspects of investigated object for opti mization of processes.