Bulletin of Semashko National Research Institute of Public Health

Despite the wide range of suicide prevention measures, the main condition for their implementation is scientifically based effectiveness. Means restriction is one of the most effective intervention, according to Zalsman et al., 2017. The aim of this study is to analyze methods and other forensic parameters of suicides on the example of the Kaluga Regional Forensic Bureau materials. Methods: descriptive statistics, linear regression analysis and a number of statistical criteria were used. During the period from 2012 to 2018, the number of suicides was 409 cases, 85.8% male with male to female ratio 6.03:1. The structure of suicides was as follows: hanging (90%), firearms (4.7%), cutting/piercing with sharp object (3.9%), selfpoisoning (0.7%), jumping from a height (0.5%), fire (0.2%). Hanging prevailed in both men and women: 89.2% and 96.5%, respectively. The data obtained objectify the official statistics of suicide mortality in the region and are an important addition to epidemiological studies in this area.

Laboratory medicine is a leading topic of healthcare research. However, even in a global perspective, only a few researchers consider laboratory diagnostics as an integral part of the entire health care system. It is relevant to systematize data on the development of laboratory diagnostics in the Russian Federation in order to analyze the improvement of organization and management, and introduce the principles of value-oriented healthcare. There is a selective review. The search for scientific publications made in the Russian-language bibliographic database of the Russian Science Citation Index (Russia). The search depth was 20 years, and included original and discussion papers, as well as reviews published in peer-reviewed scientific journals. The laboratory service is an important component of the healthcare system in the Russian Federation. Numerous studies are devoted to improving its organization. For this purpose, both international approaches and original decisions are used. Nevertheless, many issues of effective organization of the service remain unresolved. While their relevance is constantly increasing at the background of increasing demands for the volume, availability and quality of laboratory tests. In administrative divisions of the Russian Federation, various organizational approaches and models implemented, but their choice often does not have a scientific and methodological justification. The model of centralization has the largest evidence base, but it is not the only one, and often it is fundamentally not realizable. Practice-oriented methods for choosing a best model of laboratory services in a specific administrative division (also as a system of criteria for an objective assessment of the model's applicability in specific conditions) should be create in further research.

Employee commitment is a topic that gets undeservedly little attention. There is a wealth of research on employee motivation and satisfaction that is directly related to and directly affects commitment. However, there is no common understanding of what exactly influences the loyalty of employees of the organization, and what is commitment in general. In the context of healthcare organization, this topic is considered even less often. At the same time, commitment is what unites the organization and the employee directly. In an effort to combine methods of increasing adherence, the authors identified four main areas, each of which takes into account both internal and external factors affecting adherence: reducing distance and changing corporate culture, increasing the functional flexibility of personnel, creating opportunities for career and professional growth. involvement of personnel in management. The authors have consistently proven the value of these techniques for enhancing employee commitment.

The paper is devoted to the experience of teaching the History of Medicine at Peoples' Friendship University of Russia under conditions of a new coronavirus infection pandemic, and to the discussion on positive and negative aspects of distance education in medicine, which during the COVID-19 pandemic became the main and sometimes the only form of education. Among them are the following: a noticeable decrease in the university entrants' knowledge; loss of live communication between the teacher and the student; the difficulty to involve all students of the group into an active discussion of the topic in the on-line format; the complexity of an objective assessment of the real knowledge of students; a multiple increase in the teacher's extracurricular work, which spills out far beyond the normative load; a significant increase in the time that the teacher spends on preparing e-learning materials, checking students' written works and daily correspondence with numerous students in e-mail format; weakening of ethical and educational aspects of the teaching process, as well as professional and emotional "burnout". Thus, distance learning cannot replace full-time education - it is only an addition to the traditional full-time (live) education that has been proven for centuries.

The article analyzes the activities of officials and doctors of the Moscow Mariinsky educational institutions and hospitals, as well as the patroness of these institutions, the Empress Maria Feodorovna, to prevent epidemics in late 1812-early 1813, after the withdrawal of Napoleon's army from the city. The hospital wards, as well as the rooms of the women's institutes and the foundling house, which were empty after the evacuation of the institutes and some of the inmates, required serious disinfection and repair, as they were occupied by French patients and wounded for more than a month. Up to 2.5 thousand of them died and were buried near the walls of the foundling house. After the onset of frost, the Moscow authorities had to reburial them. Disinfection of the premises of the foundling house and women's institutes was carried out until the middle of the summer of 1813. The preventive measures taken made it possible to prevent an outbreak of infectious diseases in Moscow.

The article discusses the main trends in the use of telemedicine during the COVID-19 pandemic in Russia and abroad. The main attention is paid to state regulation of the provision of remote medical care: standardization, new legal norms adopted in connection with the pandemic, as well as obtaining intellectual property rights. The WHO recommendations and urgent organizational and logistical measures established by the state for the use of telemedicine in Russia, comparative assessments of the facts of the use of telemedicine in the countries of the world in support of the fight against the COVID-19 pandemic are considered. It is emphasized that currently the potential of telemedicine is not fully exploited, which requires more attention of the state. It is concluded that the policy in the direction of digitalization of healthcare gives hope for the effective use of telemedicine in emergency situations. The natural lag of regulatory norms from the pace of technological development needs further exploring by the communities of doctors and patients.

The article considers the relationship between the prevention of puerperal (postpartum) infections and the development of domestic pediatrics using the method of historical and medical analysis. The introduction of aseptics and antiseptics into the practice of combating puerperal infections, together with the progress of operative obstetrics in the early twentieth century, contributed to the emergence of large maternity hospitals and a hospital for postpartum patients in Moscow. The involvement of pediatricians in obstetric hospitals for the supervision of infants with the formation of consultations on care and feeding at them marked the beginning of systematic protection of infants in the city, a purposeful fight against infant mortality and contributed to the separation of pediatrics from obstetrics as an independent medical specialty and branch of medical science. The article presents a comparison of the features of the formation of the pediatric service in Moscow and St. Petersburg in the pre-revolutionary period in connection with the differences in the organization of obstetric care.

Designations of classic childhood infectious diseases (measles, chickenpox, rubella, mumps, diphtheria, scarlet fever, whooping cough) in the folk medicine of Russia were studied on the base of the scientific literature of the second half of the XlX-early XX century analysis. It's well known that epidemic outbreaks of these nosologies were frequent in Russia. Childhood diseases constituted a traditional sphere of folk (especially female) healing, therefore information about them is very extensive. The group of childhood infectious diseases was widely represented in folk medical terminology. The more famous and widespread the disease was, the more synonymous names it had in different regions of the country. It seems possible to distinguish two groups of folk names: “semi-official” (representing a more or less distorted corresponding medical term) and “purely folk” (usually reflecting certain aspects of the clinic and treatment of a disease).

The territory of the Lower Volga region, due to its geographical, climatic, and ethnic characteristics, was a region through which epidemic diseases from Asia penetrated into Russia. One of the factors that helps spreading of epidemics, including cholera, in this area was such magnificent a waterway as the Volga. In the 19th century, cholera became a frequent event in the cities of Volga region, one of which was Tsaritsyn. In the 19th century this city was considered to be a risk zone for living due to frequent outbreaks of infectious diseases. Over the years of constant struggle with epidemics in the Lower Volga region, practical experience has been accumulated, however, it was not always possible to prevent their development in the city, despite the anti-epidemic measures being taken. The spread of diseases was basically caused by internal migration processes taking place in this territory. The arrival of seasonal workers into Tsaritsyn every spring was often accompanyed with a new outbreak of "contagious disease." Unsanitary conditions in the city, lack of running water and sewerage systems, slums on the suburbs, low level of medical culture of the population are factors contributing to the rapid spread of epidemics. In Tsaritsyn in the 19th century, outbreaks of epidemics of cholera, plague, typhoid were often noted. At the same time Sarepta, a German colony of gernguters, near Tsaritsyn, succeeded to avoid epidemics, preserving the number of population. Due to their mentality and religious views, the gernguters created a perfect system of public health care, which was not available in Tsaritsyn.

In the mid-70s of the XIX century, one of the most ambitious experiments was carried out in clinical medicine. Hundreds of doctors were carried away by the idea of blood transfusion, looking at it as a panacea for many incurable diseases, accompanied by the depletion of the spiritual and physical forces of the body. Following the obstetric practice, military surgery seemed to be the most promising area for blood transfusion. The transience of military campaigns, coupled with mass wound casualties, became one of the main organizational and ethical problems of the military field medicine in 1850-1870. Generally, blood transfusion gave doctors the hope of bringing back to life the thousands of wounded people who were dying of blood loss on the battlefields. The use of lambs solved the problem of a shortage of healthy donated blood, allowing this idea to be put into practice. Numerous publications in the professional and public press of that time supported the interest of practicing physicians in this method. As a result, in 1874 they performed the largest number of blood transfusions, accounting for 40% of the global clinical practice that existed at that time.

The role of the People's Commissar of Health of the USSR, Georgy A. Miterev, as the Authorized of the State Defense Committee for anti-epidemic work, still remains a little-studied page in the history of medicine due to the closeness of most archival documents of the State Defense Committee. Georgy A. Miterev acted as the coordinator and organizer of the program to combat foci of particularly dangerous diseases. All departments of the People's Commissariat of Health of the USSR participated in the implementation of the program. The purpose of this article is to show the participation of Georgy A. Miterev in the development of important government decisions to combat the foci of particularly dangerous infections that spread among the civilian population during the Great Patriotic War in some cities in the rear of the country and in the territory liberated from the invaders.

The article describes some episodes of the last outbreak of smallpox in Moscow (Russia) at the end of 1959 and the beginning of 1960. A Muscovite, who visited India, returned home with signs of ill health, and after contacting the district polyclinic, he was sent to the Botkin Clinical Hospital. In the emergency department, he was mistakenly diagnosed with influenza and was admitted to the general ward with influenza patients. The patients in the ward shortly developed skin lesions and those gave rise to a laboratory study of the imprint preparation, in which the variola virus was detected by a specialist in smallpox and smallpox vaccine. This fact served as the basis for the formation of the headquarters, which began to organize and carry out active therapeutic actions and launched a vaccination campaign in the shortest possible time in Moscow and Moscow region. Thanks to these actions, the outbreak was soon practically eliminated.

The article is devoted to one of the prominent scientists of modern epidemiology -Doctor habil. in Biology, Professor Igor D. Drinov, who made a great theoretical and practical contribution to the prevention and organization of anti-epidemic measures against various infectious diseases, including influenza, acute respiratory diseases, particularly dangerous infections, parasitoses, HIV infection and others, both on a national scale and, especially, in the city of Moscow. Drinov I.G. is the author of a large number of scientific papers devoted to the diagnosis, prevention and evolutionary foundations of infectious pathology. In his research, professor Drinov I.D. paid great attention to the system of epidemiological surveillance of infections of various etiologies, as well as to epidemiological analysis of infectious pathology of various genesis.

The article is devoted to the contribution of Professor Natalia V. Karazhas to the study of the epidemiology of opportunistic infections. To solve the upcoming tasks, N.V. Karazhas first of all developed and put into practice methods of serological diagnosis of two opportunistic infections - cytomegalovirus and mycosis pneumocystosis, without which it is impossible to account for the incidence of these infections. Using these methods, she revealed the widespread occurrence of asymptomatic forms of pneumocystosis in Russia, primarily among patients with bronchopulmonary pathology and in persons with immuno-deficient conditions. In asymptomatic cytomegalovirus infection, the possibility of developing manifest forms against the background of immunodeficiency was revealed, and a high probability of nosocomial spread of this infection was shown. Currently, N.V. Karazhas continues to work on studying the epidemiological features of different forms of cytomegalovirus and pneumocystosis, including the combinations with HIV infection, herpesvirus infections in patients with tuberculosis are being studied, and CMI in patients with respiratory tuberculosis is being studied. In addition to her main activities, Natalia Vladimirovna created the Museum of the History of the Gamalei Institute on a voluntary basis.

The article describes the activities of Professor E.V. Rusakova, a specialist in the field of epidemiology, diagnosis and prevention of topical infections. E.V. Rusakova's research was devoted to the study of the epidemiology and prevention of various infections - both well-known (measles, diphtheria, tetanus, whooping cough, etc.) and poorly studied (mycoplasmosis, chlamydia, legionella, parenteral hepatitis, HIV infection) with extensive use of modern laboratory methods, such as serological, immunological, microbiological, virological, molecular biological). New data were obtained on the current epidemiological features of various infections, in particular, on the breadth of their spread among children and adults in different territories of the country. It paid great attention to the improvement of existing epidemiological surveillance systems and the development of surveillance for new infections, which is necessary to improve the effectiveness of measures to control infections of different etiologies.