Bulletin of Semashko National Research Institute of Public Health

The article discusses the issues of combating the Spanish flu (influenza virus A/H1N1 1918), which were developed at the first congresses of bacteriologists, epidemiologists and sanitary doctors of Soviet Russia. It has been established that at the first three of these Congresses there were questions about the Spanish flu in the programs. These three Congresses took place in October 1918, in April and October 1919. All took place in Moscow. To participate in the work of these congresses, the People's Commissariat of Health of Soviet Russia was able to attract part of the then domestic scientific medical elite. At the congresses, P.N. Diatroptov and E.I. Martsinovsky (Moscow), S.I. Zlatogorov (Petrograd), A.I. Berdnikov (Saratov) and others made presentation on the Spanish flu. It is shown that the resolutions adopted by these congresses were subsequently taken into account in the activities of the People's Commissariat of Health.

In the history of mankind, the "Spanish flu" ("Spanish" flu) in terms of the number of cases, deaths, was the most severe epidemic of the influenza virus. In the national history of medicine, the epidemics of "Spanish flu", cholera, typhus (1918-1921), in terms of the number of sick and dead, were one of the most tragic pages. The scientific literature on the Spanish flu epidemic is rather modest in volume due to a number of objective reasons. According to the author, in order to understand the complex of reasons why the Spanish flu epidemic was the most severe flu epidemic in the history of Russia, which claimed the lives of up to two million people (the exact number of sick and dead in 1918-1921 will never be calculated), and millions of sick people were deprived of access to medical care, it is necessary to realize the scale of the social catastrophe that took place in the country in 1917-1923. The author reveals the relationship between this social catastrophe and the Spanish flu epidemic. Military actions during the Civil War in our country were accompanied by mass mobilization into the ranks of the Red Army, a flow of volunteers into the White Army, as well as the emergence of large partisan detachments and bands, acting under various pseudo-political cover; migration of tens of millions of refugees who fled from the Soviet regime, hunger, violence, pogroms, robberies, from devastated cities and towns, villages and villages. All this contributed to the rapid spread of the Spanish flu virus and other infectious diseases. Neither the Reds nor the Whites had significant organizational and financial resources, medical personnel and public support in the fight against the Spanish flu epidemic. All the forces of the parties to the military conflict went to confrontation in the bloody Civil War. All this did not make it possible to create a unified system of counteracting the Spanish flu epidemic.

In the ancient cities of the Volga Bulgaria, they knew about the possible contamination of infectious diseases by contact, there was a quarantine system for traders arriving at the Aga Bazaar fair, travelers, and wanderers. They were isolated in hospice houses for a certain period or removed from the settlement into the forest. In 1236 the large feudal state of the Volga Bulgaria was destroyed.Plague, smallpox, measles, scarlet fever, typhus and relapsing fever, diphtheria, and trachoma were frequent epidemics on the territory of the Middle Volga. They raged unhindered from ancient times to the twentieth century. The fight against epidemics of infectious diseases began in the Soviet period. For this, infectious beds were created to isolate patients from healthy ones, infectious disease doctors were trained to carry out anti-epidemiological work. Disease prevention was carried out among the population: vaccinations, vaccinations, health education of people to combat infectious diseases.

Instability, uncertainty, risk - these words are increasingly accompanying the life of a modern person. The existing risk space transforms social reality, which causes a response to these changes on the part of people - their everyday life, social behavior is transformed, and attitudes are changing. At present, researchers pay great attention to the reactions of the population to a risk-generating environment. This problematic field has become especially relevant in the last year, when the world is faced with a new coronavirus infection, and the life of every person has changed. Within the framework of this work, the authors turn to such an aspect of human life as social health. The material analyzed by the author on the problematic field of the study allowed us to draw conclusions: in the situation with the pandemic of a new coronavirus infection, the risk caused a more careful attitude of people towards their health, made them experience a huge range of feelings and emotions, contributed to adaptation to the situation of coronavirus - people transformed their lives to a new reality , and also experienced psychological fatigue from the pandemic, and the majority of the Russian population began to turn on an information filter for negative information about the pandemic.

The COVID-19 pandemic has exacerbated many problems and outlined new challenges in the field of medical education, including improving the quality of student admission in medical universities and the formation of optimal trajectories of medical education. The paper analyzes the peculiarities of reforms in the field of secondary and higher education in France. On the example of the Faculty of Medicine of the University of Montpellier the following aspects were analyzed: the competitive selection of medical students after the successful completion of the first course based on the results of examinations and the ratings of students; the timing and learning trajectories in the main medical specialties: General Medicine (Médecine), Pharmacy (Pharmacie), Dentistry (Odontologie), Obstetrics and Gynecology (Maïeutique) during three training cycles, as well as in narrow specializations. A comparative analysis of the French and Russian traditions in the field of higher medical education was carried out.

The equivalence of the terminology for the Public Health Science and Healthcare in Russian and English for the integration of Russian Science into the World (English-speaking) Science is becoming urgent. The authors researched the most significant terms in this field. Based on the analysis made the authors present their own definitions or edited versions of definitions borrowed from other sources. It is believed that the discussion presented could promote the integration of Russian Public Health and Healthcare Research into the Global Science.

The general trend of demographic aging of the population is reflected in the medical community. The main "target" of age-related changes are cognitive functions: perception, attention, thinking, memory, mental performance. These functions are basic for medical practice. Age-related weakening of cognitive functions leads to a decrease in the therapeutic and diagnostic capabilities of a doctor, and medical errors. The article traces the influence of cognitive impairments on the level of medical competence. At the same time, the prolongation of professional medical activity is the most important measure to compensate for the shortage of medical personnel, which is observed in many countries and in Russia. After age 65, clinicians are advised to test for cognitive impairment. In case of detection of cognitive disorders, a comprehensive examination is recommended, as well as a medical and social examination to determine the rational order of work. Continuous self-education is the leading way to prevent age lag among doctors. The development of a complex of educational, methodological and health-improving measures that inhibit the influence of involutive processes is an important vector for the development of modern health care and requires comprehensive support.

The article provides an overview of the theoretical provisions that define the concepts of «medical literacy» and «insurance medical literacy» in the system of modern scientific knowledge and publications of Russian and foreign authors. The main substantive elements of the concept of «medical literacy» are determined, the author's definition of the concept of «insurance medical literacy» and its place in the system of medical literacy are given. Medical literacy is defined as a system of competencies that ensure human life, the constituent elements of which are content and behavioral competencies. Content competencies include: hygiene literacy, health literacy, preventive literacy, medical literacy, rehabilitation (restorative) literacy. It is concluded that medical literacy is a fundamental component of all efforts to achieve health and well-being in modern society. Low level of medical literacy in general and insurance literacy in particular negatively affects people's health. Despite the fact that the formation of competencies in this area of knowledge continues to grow as critical determinants of health, they are not the object of deep and large-scale scientific research and practical action in the field of public health.