Bulletin of Semashko National Research Institute of Public Health
Semashko National Research Institute of Public Health publishes the Scientific Journal «Bulletin of Semashko National Research Institute of Public Health»
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«Generation Z» in medicine: the problem of burnout in the early stages of professional activity
Modern medicine is experiencing an influx of a younger generation, often referred to as “Generation Z” — people born between 1997 and 2010. This is the first generation to grow up in the era of the Internet, smartphones and mobile applications, which has shaped their unique perception of the world. Representatives of this generation are characterized by different views on privacy, trust and interaction in the digital space. They attach great importance to personal well-being, including financial stability, healthy eating, physical activity, quality sleep and stress management methods. Modern conditions of the healthcare system are associated with an increased risk of developing burnout syndrome among medical workers, including at the beginning of their professional activity, among residents of various specializations. It is estimated that up to 60% of residents face this condition, which causes justified concern about the well-being of young specialists and the stability of the healthcare system itself.
Copyright (c) 2025 ФГБНУ Национальный НИИ Общественного здоровья имени Н.А. Семашко https://creativecommons.org/licenses/by-nc-nd/4.0
Perinatal outcomes in women with gestational diabetes mellitus in Ivanovo from 2014 to 2024
Gestational diabetes mellitus (GDM) is a common chronic disease that complicates the course of pregnancy and childbirth. A retrospective study was carried out. An analysis of the course of pregnancy, childbirth and the condition of newborns of 2665 women with GDM observed on the basis of antenatal clinics in Ivanovo in the period from 2014 to 2024 was carried out. complications and outcomes of pregnancy, such as early and late threatened miscarriage, vomiting of pregnant women, premature abruption of the normally located placenta, placental insufficiency, pathological weight gain, diabetic fetopathy, prenatal rupture of amniotic fluid, premature birth, the condition of the fetus improves according to the Apgar scale. By 2024, women with GDM have increased indicators such as isthmic cervical insufficiency, anemia, hypertensive disorders, fetal growth retardation, insufficient weight gain during pregnancy, a double contour of the head, a clinically narrow pelvis during childbirth, and congenital malformations of the fetus. Timely diagnosis of GDM and pregnancy complications, continuity of specialized medical care will reduce the incidence of adverse pregnancy complications and improve perinatal outcomes.
Provision of anti-tuberculosis services and medical organizations providing primary health care during periodic examinations of the population for tuberculosis
The aim of the study was to study the joint activities of anti-tuberculosis organizations and medical organizations providing primary health care in organizing and conducting periodic examinations aimed at the early detection of tuberculosis among the population. Materials and methods. An anonymous voluntary survey was conducted among 160 district general practitioners (respondents) working in 17 state budgetary medical organizations of the Kaluga Region. A special questionnaire containing 19 open and closed questions (containing a list of answer options) was developed to collect data. Results. The survey results showed that almost half of the respondents did not know about the procedure and frequency of examinations aimed at the early detection of TB among the assigned population and about the high-risk groups for TB living in the territory of medical service, and only less than 30% of them kept a permanent record of the assigned population covered by examinations. The supervisory work of district TB doctors aimed at early detection of TB was assessed negatively by 66.3% of respondents, who noted that this activity was presented either in the form of lectures (50.6% of respondents) or was devoted to assessing the coverage of examinations of the assigned population (36.3% of respondents). The analysis of newly diagnosed cases of TB, relapses of TB and cases of death from TB was noted by only 29.3% of respondents, and regular verification of lists of patients with active TB and those removed from the dispensary register due to recovery — by 25.6% of respondents. Conclusion. The results of the study allowed us to identify gaps in the joint work of the anti-tuberculosis service and organizations providing primary health care, dedicated to the organization and conduct of periodic examinations aimed at early detection of TB among the population.
Development of the concept of career longevity for Russian economic sectors based on the literature review and best practices
Введение. В условиях демографических изменений и увеличения продолжительности жизни актуальной становится проблема профессионального долголетия. Исследование направлено на систематизацию знаний о факторах, влияющих на продолжительность активной профессиональной деятельности, и разработку концепции профессионального долголетия для российских отраслей. Целью исследования было проанализировать существующую литературу, выявить факторы, способствующие профессиональному долголетию, дать определение профессионального долголетия и предложить рекомендации для поддержки работников предпенсионного и пенсионного возраста. Материалы и методы. Использовался комплексный подход, включающий анализ научной литературы, данные опросов сотрудников предпенсионного возраста (опросник «РИА ЭЙДЖ»), статистический анализ и экспертные интервью. Эти методы позволили изучить влияние условий труда, здоровья и мотивации на профессиональную активность. Результаты. Дано определение профессионального долголетия. Выявлены основные эргономические и психологические факторы, влияющие на профессиональное долголетие, в частности шум, физические нагрузки и уровень стресса. Предложены меры по улучшению условий труда, внедрению инновационных технологий и программ поддержки здоровья. Ограничения. Недостаточное представление о долгосрочной эффективности предложенных мер. Кроме того, данные основаны на ограниченной выборке и могут быть неприменимы ко всем экономическим отраслям. Заключение. Профессиональное долголетие требует комплексного подхода, включающего меры по сохранению здоровья, повышению мотивации и созданию комфортных условий труда. Корпоративные и государственные инициативы должны учитывать экономические и демографические особенности. Этика. Исследование проведено с соблюдением норм Хельсинской декларации Всемирной Медицинской Ассоциации, принятой в 1964 г.
Ensuring professional activity of a social worker and a social specialist in the system of providing medical care to patients with mental disorders: analysis of the regulatory framework and organizational technologies
The organization of medical and social services in Russia is associated with difficulties due to differences in the nature of medical and social work in social protection institutions and healthcare institutions, which requires its adaptation taking into account the specifics of the contingent with mental disorders and their need for social assistance. The purpose of the study is to analyze the current regulatory framework and organizational technologies for providing social assistance to patients with mental disorders with the development of recommendations for their improvement. The analysis of the professional standard of a social worker and organizational technologies for providing medical care to patients with mental disorders, taking into account the needs of patients in receiving medical and social services, made it possible to revise and adapt the labor functions of a social worker working in a psychiatrist's office. As a result, methodological approaches to the formation of job descriptions for a social worker and a social worker were developed by adapting professional standards to the Procedure for Providing Medical Care for Mental Disorders and Behavioral Disorders. This work algorithm helps to increase the effectiveness of dispensary observation, accessibility and quality of social and medical rehabilitation care for patients with mental disorders.
Work standardization of medical staff at different levels of the medical provision of sports training
The article presents the results of the developed and scientifically based work standards of sports medicine doctors at different levels of medical provision of sports training in the Republic of Belarus. Studies of the structure and the time amount spent by a sports medicine doctor have been conducted, a classifier (dictionary) of activities and work operations of a sports medicine doctor has been developed, and an analysis of the structure of working time consumption has been performed depending on the level of medical provision of sports training, typical areas of activity of institutions and the structure of the assigned sports contingent. The need for the number of regular posts of sports medicine doctors at different levels of medical provision has been identified.
Conceptual approaches to the interpretation of the concepts of «society», «community», «population» in the formation of the methodology of public health as a medical and social resource
For further theoretical development of the methodology of public health as a medical and social resource of society, it is extremely important to identify the existing foreign and domestic science conceptual approaches to the interpretation of the theoretical concepts of «society», «community», «population», «population» and their relationship. The aim of the study: to define the theoretical concept «society», its relationship with the concepts of «community», «population», «population» taking into account the existing foreign and domestic science conceptual approaches to the interpretation of these theoretical concepts in order to further take them into account in the development of more effective strategies to improve public health as a medical and social resource of society, ensuring national security. Material and methods. Desk study: the WHO recommendations «Closing the gap in a generation: health equity through action on the social determinants of health» and GOST R ISO 31000—2019 standard were used as a methodological approach. The authors analysed scientific articles on the subject of the study published in scientific databases: PUBMED and eLIBRARY. The search was carried out using the keywords «society», «community», «population», «population» in the keywords of the publication. Subsequent analysis of the obtained list of papers was performed using manual sorting. The total number of analysed scientific articles on the subject of the study was 61, with 31 articles in PUBMED and 29 in eLIBRARY. Results. There are many different interpretations of the concepts of «society» and «community», «population», «population». The main problem in defining these terms is the lack of unity of terminology, unity of interpretation of concepts, correlation with the concept of public health as a medical and social resource of society. The authors from the point of view of system analysis give their definition of the concept of «society» and its main structural elements and links and show its relationship with the concept of «community», explaining that the concepts of «society» and «community» have both common features and specific differences. They are interrelated and complement each other, creating a multi-level structure of social interactions. Conclusion. The main problem in defining the theoretical terms «society», «community» is the lack of unity of terminology, unity of interpretation of concepts. The system approach allows us to study society as a complex, multi-layered structure consisting of various elements that interact with each other. The authors have defined the concept of «society» and «community» and developed a scheme showing the main parts of society as a system.
Using digital technologies in diagnostics and treatment of children with oncological and hematological diseases: experience Dmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology
The introduction of digital technologies in pediatric oncology and hematology allows to reduce the waiting time of patients, improve the accuracy of diagnosis and treatment, and increase the level of comfort and satisfaction of patients and their parents, which is confirmed by the analysis of the experience of using digital technologies of the Dmitry Rogachev National Medical Research Center for Pediatric Hematology and Oncology of the Ministry of Health of the Russian Federation, which play a significant role in improving the quality of medical care for children with oncological and hematological diseases. For example, telemedicine consultations allow for remote monitoring of patients without leaving home. Gaining access to advanced diagnostic and treatment technologies is especially important for children with oncological and hematological diseases who may have a weakened immune system. Using our own analytical tools for data analysis (such as an electronic system for assessing the quality of specialized medical care) allows us to identify key points in the regional service and ensure continuity of specialized medical care. They provide doctors with prompt access to complete and up-to-date information about patients, which helps make informed clinical decisions and effectively optimize workflows. These platforms thus serve as a key tool for continuous and coordinated patient care across all stages of treatment.
Radiologist productivity metrics under centralized radiological care
Economically developed countries face an increasing healthcare burden due to the growing number of diagnostic procedures. Compounding this issue, personnel shortages persist. Centralizing radiological care and transitioning to automation allow radiologists to focus on the analysis and interpretation of imaging findings. Assessing radiologist productivity within a centralized system, such as the Moscow Reference Center for Radiology, is necessary. Goal: to evaluate radiologist productivity within a centralized radiological care system. Materials and Methods: data from August 2020 to July 2024 were analyzed. The data were extracted from the Unified Radiological Information Service of the Unified Medical Information and Analytical System of Moscow. The database included anonymized radiologist identifiers, dates of employment, contractual working hours, hours worked, completed radiological reports (broken down by imaging modality), total completed reports, planned versus executed workload (in standardized units and percentages), and audit results. Labor effort, labor hours per unit, output, and productivity metrics were calculated. Results: the Moscow Reference Center demonstrated a consistent and stable increase in labor productivity. From 2020 to 2024, this rate nearly doubled, increasing from 782.02 to 1325.20. In 2020, the average labor hours per unit per radiologist was 12.57, decreasing to 8.77 by 2024. The average labor effort was 92.34 in 2022 and increased to 196.07 in 2024. In 2020, it was 8.57, increasing to 11.07 in 2021. The output indicator was calculated. In 2020, it was 8.57, increasing to 11.07 in 2021. A plateau was observed in subsequent periods. Conclusion: modifying working conditions and activities enhances radiologist productivity while reducing labor hours per unit. A centralized approach to radiological care proved more effective compared to distributing resources across primary care facilities.
Clinical and economic efficiency of endovascular left atrial appendage closure for patients with contraindication to anticoagulant
Study Objective. The aim of this study was to evaluate the cost-effectiveness of percutaneous occlusion of the left atrial appendage (LAA) compared with standard stroke prevention in patients with atrial fibrillation (AF) and contraindications to oral anticoagulants (OAC) from the point of view of the Russian healthcare system. Materials and Methods: We analyzed the data of 134 patients admitted to NMIC Cardiology from 2014 to 2022, of whom 74 patients underwent ULP closure and 60 patients did not receive prophylactic treatment. Treatment costs and quality of life (QALY) scores were evaluated over 3 years. Data on complication rates, survival and complication-free survival, and direct treatment costs including hospitalisation, therapy, autopsy and funeral costs were used. Results: Over 3 years, survival was 86.5% with LAAO versus 66.3% without prophylaxis; complication-free survival was 71.6% versus 40.0%, respectively; and the incidence of ischaemic stroke was 4.1% versus 30.0%, respectively. The mean 3-year cost per patient was 461,015 RUB for LAAO and 101,365 RUB without prophylaxis; total QALYs were 2.119 and 1.665, respectively; CER was 217,563 RUB/QALY (LAAO) and 60,880 RUB/QALY (no prophylaxis). Incremental estimates after excluding non-medical costs were: ICERQALY = 826,850 RUB per QALY gained, ICER per additional survivor = 1,858,366 RUB, and ICER per additional complication-free survivor = 1,187,943 RUB. One-way sensitivity analysis (±15% on key cost and survival parameters) confirmed robustness relative to a hypothetical willingness-to-pay threshold; nevertheless, interpretation is made against a suboptimal comparator, warranting caution when extrapolating to populations in whom OAC remains feasible. Conclusions: From the perspective of the Russian healthcare system, LAAO in patients with AF and documented absolute contraindications to OAC shows clinical benefit with an acceptable incremental cost over a 3-year horizon; however, because the comparison was made against a guideline-suboptimal strategy and given the constraints of a retrospective design and sample size, prospective economic evaluations and randomized clinical trials in the target population are needed to definitively confirm the technology’s economic value
Reasons for late diagnosis of rheumatic diseases in patients over 18 years old
Introduction: According to data from the V. A. Nasonova Research Institute of Rheumatology, 75% of patients suffering from rheumatic diseases become disabled before retirement age [1]. Early diagnosis of rheumatic diseases is often challenging for many specialists [2]. Frequently, the reasons for late diagnosis include a lack of awareness among doctors about the symptoms of the diseases, the variety of their clinical manifestations, as well as patients' delayed requests for medical assistance. This study analyzed questionnaires from 100 patients over 18 years old with confirmed rheumatic diseases. Objective of the study: To identify subjective reasons affecting the timing of diagnosis in patients with rheumatic diseases in outpatient settings, according to the patients themselves, using the examples of spondyloarthritis and rheumatoid arthritis. Materials and methods: The study included 100 patients aged 18 to 91 years who were under the care of a rheumatologist with a confirmed rheumatic diagnosis and who voluntarily agreed to participate in this study. The average duration of the disease from the onset of the first symptoms to the visit to the rheumatologist and the establishment of the rheumatological diagnosis was calculated, along with the percentage of referrals to related specialists and the reasons for the delayed detection of rheumatic diseases and late visits to the rheumatologist, according to the patients themselves. Results: The average duration of the disease from the onset of the first symptoms to the visit to the rheumatologist and the establishment of the rheumatological diagnosis was 6.88 ± 1.8 years. According to patients, the reasons for the late detection of rheumatic diseases are: personal oversight 39%, oversight by physicians 80%, lack of opportunity to visit a rheumatologist 1% (multiple responses were allowed).
Regional aspects of improving the organization of primary health care for patients with type 1 and type 2 diabetes mellitus (on the example of the Saratov region)
The aim of the study was to substantiate a set of measures aimed at increasing the availability of primary health care for patients with diabetes at the regional level. A comparative analysis of resource provision (personnel potential and hospital beds) in medical organizations (MO) providing primary health care and specialized medical care to patients with type 1 and type 2 diabetes was conducted for the period 2014—2023. A comparative analysis of the economic efficiency of providing medical care to patients with diabetes living in the region was conducted before and after the start of operation of the interdistrict center. Analytical and statistical research methods, as well as the method of organizational experiment were used. When processing and analyzing the material for comparing populations by quantitative characteristics, Student's T test (t) was used. To compare populations by qualitative characteristics, McNemar's criterion (χ2) was used. The reliability of the analyzed data was determined at a value of p &lt; 0.05. After the creation of the interdistrict center, by 2024, the average distance for a trip to an endocrinologist consultation was reduced by 70% with a decrease in the cost of these trips per patient by 66%, the number of face to face consultations in the regional endocrinology center by 38% compared to data for 2018. The creation of an interdistrict center with a concentration of primary specialized medical care on its basis, a change in the routing of patients with diabetes mellitus with the provision of primary health care by general practitioners and district therapists and the use of telemedicine technologies between all participants in the process (specialist, primary care physician and patient) helps to increase the availability of medical care for this category of patients living in rural areas of the region.
Risk factors prevalence in patients with chronic critical limb ischemia and comorbidity of ischemic cardiovascular diseases with indications for multivessel revascularization
Chronic critical limb ischemia (CCLI) is an unfavorable process in patients with obliterating diseases of the arteries of the lower extremities and is accompanied by a high risk of fatal outcomes, limb amputation and disability. Objective. To analyze the prevalence of risk factors in patients with CCLI and comorbidity of ischemic cardiovascular diseases (CVD) with indications for multivessel revascularization, to evaluate their prognostic significance and information content. Materials and methods. A retrospective multicenter research (2018—2024) was performed, big data on medical services in patients (n=782): the group А (n = 657) — patients with CCLI 3—4 st., average age — 74±3.1 years, men 72.8%. The group В (n=125) — patients without CVD and risk factors CVD, average age 44±1.05 years, men — 65.6%. The anamnestic (≥12 months before the development of CCLI) prevalence, information content and prognostic significance of smoking, alcohol consumption, intermittent claudication, hypertension, diabetes, hypercholesterolemia, hyperhomocysteinemia, chronic heart failure, history of myocardial infarction, level of daily physical activity, compliance to medication, self-monitoring of hemodynamic parameters, primary care of cardiologist or cardiovascular surgeon were studied. In patients of group B, the risks of developing CCLI within 12 months in the absence of intermittent claudication were research. The analytical period is 12 months. The following methods: content analysis, statistical, systematization, comparative analysis, mathematical. Results. In patients of group А established a high prevalence and significant prognostic significance and informativeness of Kullback for most of the risk factors of CLLI. In patients of group B, there was no risk of developing CCILI. Conclusion. The results of the research determine the need for personalized multifactorial analysis of the CVD at the primary health care level in all patients over 50 years old for correct the risk factors of CCLI.
A new type of structural unit of a multidisciplinary medical organization is a center for the implementation of innovative technologies of a medical organization
The objective of the study is to develop a regulation on a new type of structural unit of a multidisciplinary medical organization — a center for the implementation of innovative technologies in a medical organization. This structural unit can be created either on a functional basis or allocated as a separate structural unit with its own staffing schedule if the medical organization has appropriate financial support from income-generating activities, since the employees of this structural unit are not directly involved in the provision of medical care, and, therefore, their remuneration cannot be made from compulsory health insurance. It is recommended to allocate the following functions to the employees of the Center for the Implementation of Innovative Technologies in a Medical Organization: implementing a standard operating procedure for searching and selecting innovative medical technologies for implementation in a multidisciplinary medical organization; drawing up proposals for the implementation of an innovative method (innovative medical technology) in a multidisciplinary medical organization using a standardized form, etc. Thus, in the course of this study, a regulation was developed on a new type of structural unit of a multidisciplinary medical organization — a center for the implementation of innovative technologies in a medical organization, which can be used in practice in the form of a standard operating procedure approved by a local regulatory act of the medical organization.
Models of regional healthcare system functioning under different types of global challenges
The article presents models for the functioning of a regional healthcare system under emergency conditions, using the examples of biological threats and man-made disasters. The models take into account the interaction between emergency medical services, hospitals, outpatient clinics, and a coordination center, enabling the identification of problematic areas in the organization of medical care delivery processes. The article provides a set of quantitative metrics that allow for the assessment of throughput capacity, resource availability, and the flexibility of the healthcare system. The obtained results demonstrate the effectiveness of a systems-based approach to the management of medical resources in emergency situations and can serve as a foundation for the development of software products for healthcare monitoring and planning.
National and federal projects in healthcare: comparative analysis of regulatory legal acts
Проведение сравнительного анализа нормативных актов, которые определяют параметры и правила разработки и реализации государственных программ в здравоохранении является актуальной научной задачей. В ходе исследования всего было проанализировано 36 нормативных правовых актов. Осуществлялся поиск нормативных правовых актов в поисковых системах «Консультант Плюс» и «Гарант». Всего в ходе поиска было отобрано 68 документов, из которых 36 соответствовали тематике исследования. Далее мы провели контент-анализ отобранных документов на предмет извлечения положений и тезисов, непосредственно относящихся к рассматриваемой проблеме. Положения и тезисы извлекались в электронном виде и переносились в таблицу в формате Excel. Всего было извлечено для анализа 963 положения и тезисов. Тезисы были классифицированы на несколько типов: «разработка проекта», «мониторинг реализации проекта», «финансовое обеспечение проекта», «показатели проекта», «мероприятия проекта», «общие положения и тезисы», «сроки разработки», «сроки мониторинга», «контроль и надзор за реализацией проектов». Далее проводился собственно сравнительный правовой анализ по отобранным положениям и тезисам нормативных правовых актов. Осуществлялось сравнение положений и тезисов по однородным типам, которые были проставлены каждому положению и тезису. Была впервые предложена классификация тезисов и положений нормативных документов, регулирующих разработку и реализацию федеральных проектов на 9 стандартизированных типов. Также была предложена классификация самих этих документов на 4 однородные группы. Предложенные классификации позволяют применять матричный подход при разработке новых документов и дополнении уже существующих документов, поскольку позволяют визуализировать большое количество аспектов, которые необходимо учитывать при выполнении такой работы.
The application of qualitative SWOT analysis on the example of three models of organization of provision of paid medical services
The article presents methodological approaches to the development of a qualitative SWOT analysis model for use in the healthcare sector in terms of providing paid medical services in medical organizations of the Russian Federation, taking into account the studied features. The qualitative factors influencing the use of the model are studied and strategic problems in the paid medical services market are classified. A comprehensive analysis was carried out, including regression and dispersion analysis of data, including data from a survey conducted in a Moscow medical organization providing outpatient medical care, which made it possible to build a qualitative SWOT analysis model depending on both the form of ownership and the features of the structural divisions of medical organizations. The results obtained are based on the work of specialists in the field of management in healthcare and represent new opportunities for assessing internal and external factors in healthcare, in particular, in the provision of paid medical services. Thanks to a sociological study, the empirical basis of which was the data of a survey of 343 patients of the State Budgetary Healthcare Institution “GP No. 210 of the Moscow Health Department”, as well as an expert assessment, problem areas in the organization of paid medical services in the Russian Federation were identified.
Antonina Konstantinovna Shubladze (15.04.1909–1.08.1993)
The article is devoted to one of the founders of Russian, Soviet medical epidemiology, laureate of the USSR State Prize, corresponding member of the USSR Academy of Medical Sciences, Doctor of Medical Sciences, Professor Antonina Konstantinovna Shubladze. Based on the study of archival documents and the study of published materials, her scientific biography has been supplemented, her contribution to the formation and development of domestic epidemiology has been clarified. It is indicated that in the studied literary and archival sources it was not possible to identify information confirming the information that A. K. Shubladze was a representative of the Red Cross of the USSR in England in 1945—1947.
The study of international experience in psychopharmacology and psychopharmacotherapy by Soviet scientists in the 1950s-1960s
Статья посвящена изучению советскими учеными зарубежного опыта в области психофармакологии и психофармакотерапии в 1950-е-1960-е гг. На основе анализа архивных материалов Управления внешних сношений Министерства здравоохранения СССР за 1950-е-1960-е гг. (ГА РФ. Ф. Р-8009. Оп. 34) сделан вывод о том, что ведущими направлениями заимствования подобного опыта были участие советских специалистов в зарубежных психофармакологических конференциях, а также посещение ими иностранных учреждений психофармакологического профиля. Наибольшее внимание отечественные специалисты уделяли особенностям методологии и организации зарубежных психофармакологических исследований, направленных прежде всего на поиск механизмов действия психотропных средств. Главными ориентирами для советских ученых стали Франция и США, откуда была принята идея создания в СССР специализированного психофармакологического учреждения, в деятельности которого ведущее место занимал бы междисциплинарный подход.
The activities of Z. P. Solovyov in creating the first ambulance aircraft in Russia (On the 150th anniversary of his birth)
In commemoration of the 150th anniversary of Z. P. Solovyov's birth, which the medical community celebrates in 2026, this study presents an analytical review of archival documents and published scientific literature on the role of Zinovy Petrovich in the creation of the first domestic medical aircraft.
Historical analysis of the formation and development of bioethics in Russia: the role of H. T. Engelhardt
The article discusses the history of the emergence of biomedical ethics in Russia. This discipline, being imported in post Soviet times, has not been fully developed. Among the reasons for this, the author, based on the works of H. T. Engelhardt, highlights the need to take into account the socio cultural context of assimilation of ethical principles and norms. In addition, it is found that Engelhardt's works were used to develop bioethical provisions by the Russian Orthodox Church. His ideas on the development of meaningful bioethics may become the basis for solving bioethical dilemmas of our time.
The influence of smallpox vaccination on the health of the population of the Voronezh province in the period from 1879 to 1896
The article is devoted to the history of the spread of smallpox in the Voronezh province of the second half of the 19th century. The chronological scope of the study is defined as 1879 — 1896. Beginning: 1879 — the growth of smallpox epidemics, the assumption of office of the first city sanitary doctor of Voronezh M. Ya. Kapustin, formation of the city sanitary council; end: 1896 — appointment of the first sanitary doctor N.I. to the Voronezh province. Tezyakov and the initiation of centralized preventive events in the region, smallpox vaccination. Particular attention is paid to the topic of the population’s attitude towards vaccination, the need to explain to illiterate sections of society about the benefits of vaccinations and their impact on people’s health. Based on archival documents from the depositories of the Voronezh region, materials on morbidity and mortality of the population are analyzed, data on the number of people vaccinated against smallpox from 1880 to 1896 are provided.
The article is devoted to the 200th anniversary of the birth of Nikolai Ivanovich Kashin (1825—1872), Russian physician-ethnographer, explorer of Eastern Siberia. For the first time he described the Level disease (Kashin-Bek's disease) and indicated measures of its control. His scientific works are devoted to regional pathology, prevention and treatment of helminthic diseases, endemic goitre, as well as to the issues of balneology, public hygiene, folk medicine. He paid much attention to the influence of labour conditions, everyday life of the population, influence of climatic factors on morbidity. N. I. Kashin actively participated in the creation and work of the Society of Physicians of Eastern Siberia in Irkutsk — one of the first provincial medical societies in Russia.
How rural doctor E. A. Zakharova earned the attention of professor N. A. Semashko
The letters of N. A. Semashko to the local rural doctor E. A. Zakharova and other documents concerning her personality, introduced into scientific circulation for the first time, allowed us to expand our understanding of the range of interests of the outstanding organizer of Soviet health care at the turn of the 1930s and 1940s, to understand what he valued most in a specialist, what kind of help he could provide to a good local doctor. The professional merits of doctor Zakharova, her organizational talent, strong willed and human qualities are noted. The range of assistance provided by N. A. Semashko is shown: from simple advice on how to start work, to a personal visit to the site with an analysis of the main points of what was seen.
From free trade to quarantine: the emergence of sanitary policy in the Amur region at the turn of the 19th and 20th centuries
This article is devoted to the study of the formation of a sanitary control system on the Russian-Chinese border in the Amur region at the turn of the 19th and 20th centuries. The author examines the complex process of forming sanitary policy in the context of rapid economic and cultural exchange caused by active migration, intensive trade, and the construction of railways in the Far East. It is emphasized that the complexity and scale of the sanitary problem forced the Russian leadership to quickly adapt new international standards of infectious disease control and initiate close cooperation with Chinese colleagues to create effective joint sanitary posts. It is noted that the consequences of the plague and cholera epidemics in the regions along the Argun, Amur, and Ussuri rivers were a catalyst for the formation of a public health system. The article reflects the complex balance between economic ties and the protection of public health, highlighting the process of forming an effective sanitary infrastructure in the Far East.
Study and use of mineral waters of the North Caucasus in the 18th — first half of the 19th century
В литературе, как правило, большое внимание уделяется изучению отдельных аспектов освоения минеральных источников Северного Кавказа. Большинство авторов концентрирует свое внимание на регионе Кавказских Минеральных Вод, который и сегодня известен своими курортами. При этом обходится вниманием период начального изучения минеральных источников, начало которому было положено еще в XVIII в. при императоре Петре Великом. Кроме того, обойдены вниманием изучение и развитие бальнеологических ресурсов Северо-Восточного Кавказа в первой половине XIX в., когда на этой территории происходили трагические события Кавказской войны. Привлекая данные литературы, а также архивные документов из российских и зарубежных архивов в статье предпринята попытка рассмотреть параллельно развитие и изучение минеральных вод Центрального и Восточного Кавказа.
Ancient Greek myths on healers and diseases
On the basis of sources of Ancient Greek epic literature (the Iliad and the Odyssey) and original works by researchers of ancient philosophy and mythology (Ya. E. Golosovker, N. A. Kuhn, and others), the functional roles of mythological heroes of Ancient Greek legends and epics in the field of healing and health care (centaur Chiron, Apollo, Asclepius, Prometheus, etc.) are analyzed, what is important for teaching of the History of Medicine and fostering moral and ethical principles of professional activity among medical students — future physicians.
Fighting the Cholera Epidemic in the Nalchik District of the Terek Region
This article examines measures to combat cholera in the Nalchik District of the Terek Region from 1892 to 1910. It analyzes the role of doctors, state surveillance services, government agencies and the clergy in organizing anti cholera measures among the population of the district.
Organization of Medical, Diagnostic and Preventive Work of Practical Health Care Bodies in the Fight against Tuberculosis in the Saratov Province in the 1920s—30s of the XX Century
The article presents the activities of the Saratov Provincial Health Department in the organization of tuberculosis dispensaries, the House of Sanitary Education and public organizations, whose work was aimed at combating and preventing tuberculosis among the residents of the Saratov province in the 20s and 30s of the twentieth century. Against the background of large-scale measures to identify contact persons (door-to-door visits) and treat tuberculosis patients, health education, improvement of living and working conditions, the dynamics of reducing the incidence among the adult and child population in the province is shown.