[The Childhood Decade in Russia: legal securing of health care applying information technologies].

In conditions of impetuous development of national digital technologies and necessity for their legal regulation, significance and possibilities of their implementation in protecting health of rising generation during childhood decade in Russia are demonstrated. The conceptual apparatus related to discussed problem is considered. The emphasis is made on preventive aspect of intersectoral state protection of health care and rights of children and adolescents aged 0-17 years. The scale of problem is especially impressive considering number of contingent over 30 million people and interests of about 24 million of family members with children. The purpose of the study is applying analytical method, content analysis and SWOT analysis to monitor main problems of intersectoral health care and rights of rising generation in Russia in conditions of implementation of information technologies; to evaluate application of legislation in force in context of their role and effect during the Decade of Children (2018-2027); to demonstrate significance of the institution of the Commissioner for rights of child under the President of the Russian Federation.

[The evolution of criteria of selection of citizen with mental disorders to Military Force].

The article presents the analysis of changes in official requirements to health of youths with mental disorders (the Regulation on military medical examination in version of 1995, 2003, 2013). The sections I and II of articles 14-20 of the Schedule of Diseases of this Regulation are considered from the point of view of the category of fitness for military service on conscription. The set of measures of leveling consequences of mitigation of requirements to health of future servicemen for particular nosologies is proposed.

[The nutrition of population of Russia from public health position: international recommendation practice].

The Member States of the United Nations, while planning and implementing concrete measures to protect citizens health, nutrition included, experience need in sharing best practices and in coordinated recommendations, relevant to common actual challenges. The article analyzes and systematizes main official documents of the leading international organizations in the field of population nutrition from the standpoint of public health and health care in dynamics more than over 70 years. The particular emphasis is made on their implementation to adolescents and youths aged 10-24 years, who need risk approach application in resolving their urgent nutritional problems, in relationship with influencing environmental factors, lifestyle, bad habits, physical activity, etc. The policies, programs and other documents that are currently implementing in the area of numerous problems associated with malnutrition, promote adoption of their own commitments, which must be relevant, achievable, specific, time-bound, measurable. In this regard, adopted and implemented leading national documents in this area are analyzed. The practicability of implementation of the UN and WHO recommendations with their adaptation to multiple-aspect specifics of the country, as well as need in prolonging research in this area are demonstrated.

[The transformation of sources providing medical information in male youths of military age in decade dynamics].

In 2021, according to results of survey of citizens of military age, 71.5% of respondents considered their state of health as satisfactory or poor. The negative dynamics was noted by 41.6% and 64.4% stated about absence of chronic diseases. At that, according to Rosstat data, up to 72% of young males have chronic pathology of various organs and systems that indicates insufficient information about health status of respondents. The analysis was applied concerning ways of obtaining medical information by young males aged 17-20 years in the Moscow Oblast in 2012 (n=423), 2017 (n=568) and 2021 (n=814). The sampling of young males participating in survey was 1,805 respondents. It was established that in in the Moscow region main share of medical-oriented information is drawn by young males aged 17-20 years from the Internet and social networks (more than 72%). The medical and pedagogical personnel provide only 4.4% of this information. Over the past 10 years, the role of schools and polyclinics in the formation of healthy lifestyle has decreased by more than in 6 times.

[MONITORING OF OFFICIAL REQUIREMENTS TO THE STATE OF HEALTH OF CITIZENS OF MILITARY AGE WITH DISEASES OF THE NERVOUS SYSTEM].

the article provides an analysis of changes in official requirements for the state of health of young men with diseases of the nervous system (Regulations on military medical examination as amended from 1995, 2003, 2013). Columns I and II of articles 21-28 of the Schedule of Diseases of this Provision are considered from the point of view of the category of fitness for military service on conscription. A set of measures is proposed to reduce the consequences of changing the requirements for the functional state of the nervous system of the health of future conscripted servicemen.

[The medical rehabilitation: planning work load and number of positions].

The article presents the results of analysis of normative legal documents and their changes related to planning of volume of medical care in "medical rehabilitation" profile. The calculation of planned normative number of beds of this profile from 2014 to 2021 is presented according to the number of bed-days and planned beds turnover. The number of arithmetic errors in planned indices of specialized medical care in hospital conditions for medical rehabilitation is demonstrated in the letters of the Minzdrav of Russia related to formation and economic validation of territorial program of state guarantees. So, significant decrease (by 44%) in recommended volumes in 2021 contradicts data presented in the Decree of the Government the Russian Federation. The violations of nomenclatures of positions of medical workers, double standard of the number of positions for day-and-night work are defects of vast majority of Orders about Procedures of provision of medical care that may testify severe problems in actual health planning. At the same time, such changes in Orders on Procedures of organizing medical rehabilitation as division into adults and children, alterations of set of units, staging in provision of medical care and corresponding staff standards, increasing of standard number of positions should result in improvement of quality of medical rehabilitation, including its implementation at early stages and expanding possibilities of rehabilitation without hospitalization related to organization of day hospital.

[The changes of official requirements to health conditions of the male youths of military age with blood circulation diseases in 1995-2021].

The article presents results of analysis of changes of official requirements to health of male youths with diseases of circulatory organs (Regulation of military medical expertise, revision of 1995, 2003, 2013). The sections I and II of the Articles 42-48 of the Schedule of diseases of this Regulation are considered from the point of view of category of physical fitness for military service on conscription. The complex of measures is proposed to level consequences of mitigation of requirements to health status of future servicemen for particular nosology.

[The modern approaches to rating of medical organizations on the basis of strategy of sustainable development of health care institution].

The article analyzes modern approaches to medical organizations rating based on national and foreign literature, The groups of indices that are responsible for effectiveness of medical organizations from point of view of consumers of medical services and health care administration are established. According analyzed publications, rating values consider effectiveness of single processes rather than organization in whole. This served as a basis for scientific search of evaluation system that can reflect performance of medical organization contributing to its sustainable development. In 2012-2018, the Novosibirsk State Medical University carried out a study of potential of sustainable development of health care organizations. On the basis of legal analysis, sociological and expert research of opinions of administrators the key directions of activity contributing to improving efficiency of medical organizations functioning were identified. The article presents original approach to comparative assessment of health care organizations providing different types of medical care to population based on concept of sustainable development using the T. L. Saati hierarchy analysis methodology. The strategy of sustainable development supposes achievement of long-term goals of medical organizations, including not only indices of patient satisfaction with quality of medical care and organization of safe environment for their stay in health care facility, but also optimization of all processes, rational resource support, monitoring and analysis of internal environment of organization for continuous activity improvement, staff training, implementation of organizational innovations, etc. It is established that medical organizations implementing strategy of sustainable development demonstrated the best results in resource management, increasing of consumer satisfaction with quality and safety of medical care, optimization of processes to increase the number of treated patients, etc. Thus, health care institutions with clear-cut plan of actions and set of management practices to achieve long-term goals acquire ability to improve medical social indices and, as a result, population health indices.

[State policy of development of resort business in Russia: legal and organizational aspects, including those in an emergency]. / Gosudarstvennaya politika razvitiya kurortnogo dela v Rossii: pravovye i organizatsionnye aspekty realizatsii, v tom chisle v ekstremal'noi situatsii.

OBJECTIVE: To analyze the normative and regulatory support of the state policy of development of health resort business in Russia and organizational and methodological aspects of its implementation, including those in emergency and coronavirus pandemic. MATERIAL AND METHODS: The following current methods of community hygienic and medical-organizational research were applied: analytical, statistical, best practice study, monographic, etc. Data from state and departmental official sources, statistical books, scientific publications, and other sources were studied. RESULTS: The main normative, regulatory, organizational and methodological aspects of the strategy implementation, developed in accordance with the order of the Government of the Russian Federation «On approval of the development strategy of the health-resort complex of the Russian Federation¼ dated 26.11.18 №2581-p were analyzed. Some discrepancies in the state and departmental statistics of health-resort organizations were found. The nomenclature of the health-resort area was reviewed, and the used term «health-resort treatment¼ was criticized, which does not correspond to the parts of this type of daily practice medical care, unlike the concepts «health-resort care¼ or «health-resort business¼. The article presents the author's vision of the issue of normative and organizational support of health-resort organizations in an emergency such as COVID-19 pandemic since 2020. CONCLUSIONS: It is shown that the national and local experience of coronavirus infection control contributed to the development of a considerable number of federal regulatory documents in a short time frame. The publication describes an analysis and systematic review of the most important documents, including those related to the spa resorts. Addressing the demanding challenges of further development of the country's health-resort complex largely relies on the state of its facilities and resources. However, its objective analysis is hindered by the identified significant discrepancies in the state and departmental statistic data concerning the number of functioning health-resort organizations and its change over time. As opposed to the concept of «health-resort treatment¼, the term «health-resort care¼ most accurately describes its complexity.

[The modern approaches to rating of medical organizations on the basis of sustainable development of health care institution].

The article analyzes modern approaches to the rating of medical organizations based on national and foreign publications. The study identified groups of indices that are responsible for effectiveness of health care organizations from the point of view of consumers of medical services and state boards of public health management. According analyzed publications, rating values consider effectiveness of particular processes, rather than organization as a whole. This became the basis for scientific search for assessment system that can reflect the performance of medical organization contributing into its sustainable development. In 2012-2018, the Novosibirsk State Medical University carried out the study of potential of sustainable development of health care organizations. On the basis of normative legal analysis, sociological and expert survey of opinions of managers, the key areas of activities that contributed to improving efficiency of medical organizations were identified. The article presents the original approach to comparative assessment of health care organizations that provide various types of care of population based on concept of sustainable development using the T. L. Saati hierarchy analysis methodology. The strategy of sustainable development presumes achievement of long-term goals of medical organization, including not only indices of patient satisfaction with quality of medical care and organization of safe environment for their stay in health care institution, but also optimization of all processes, rational resource support, monitoring and analysis of internal environment of organization for continuous development of functioning, personnel training, implementation of organizational innovations. The medical organizations implementing strategy of sustainable development demonstrated the best results in such areas as resource management, increasing consumer satisfaction with quality and safety of medical care, optimization of processes of increasing number of treated patients. Thus, health care organizations having clear-cut plan of actions and set of management practices to achieve long-term goals acquire ability to improve both medical social indices and population health indices.

[The actual problems of planning of obstetric-gynecologic care in The Russian Federation].

The purpose of the study was to analyze normative legal documents and their modifications in order to determine the labor standards of medical personnel in case of rendering and planning obstetric gynecological care in the Russian Federation, including standards of number of medical personnel in medical organizations and modes of operation of various types. The materials of the study were normative legal documents presented at the WEB-portal "garant.ru". The comparative analysis of actual normative legal set of documents concerning labor standards in the profile of "obstetrics and gynecology" demonstrated that the new order of Minzdrav of Russia № 1130n of 20.10.2020 introduced significant changes as compared with the current one. Its provisions contribute to reducing staffing by obstetricians-gynecologists of medical organizations providing primary health care, and to decreasing significantly the number of nurses for all types of considered medical organizations. The main drawback of the new order and the erroneousness of the orders on Procedures of Minzdrav of Russia in terms of staff support of round-the-clock functioning are demonstrated. The methodology of calculating the number of positions under different modes of operation of medical organizations are presented. The dynamics of general population morbidity in classes "Pregnancy, childbirth and complications of the postpartum period" and "Diseases of the genitourinary system" was analyzed.The corresponding trends were prognosticated for the period up to 2024. The results of the study testify the necessity to amend actual normative legal documents governing labor standards of medical personnel in case of providing obstetric gynecological and other types of medical care in the Russian Federation.

[The analysis of achievement of prognostic indices of the Concept of the Federal system of training of citizen to military service].

The article analyzes the achievement of the prognostic indices of the Concept of the federal system of training citizens for military service for the period up to 2020 (to reduce the number of citizens who do not meet the requirements of military service due to health and physical conditions; to increase the rate of fitness for military service of citizens who have arrived at draft commissions; to ensure the availability of the first sports category or sports rank for citizens who are subject to military service draft). The causes and factors preventing the achievement of the target values of the Concept are considered. The set of measures targeting to improve medical support of the youth of military draft age is proposed.

[The characteristics of population mortality of the Russian Federation, the Central Federal Okrug and City of Moscow in 2020].

To preserve the country's population is among one of the most vital tasks over the period of existence of the new Russia and constitutes the subject of national security. The article presents the results of analysis of population mortality rate of the Russian Federation, the Central Federal Okrug and City of Moscow during the first eight months of 2020 towards to concurrent period of 2019. In January-March 2020, the population total mortality rate, retaining prevalent trends of number of preceding years, decreased in the Russian Federation by 3.8%, in the Central Federal Okrug by 3.0% and in City of Moscow by 3.9%. However, since April-May the situation has changed dramatically and, according to the results of January-August, mortality by this time has increased, and its growth made up to 6.5% in the Russian Federation, 7.8% in the Central Federal Okrug and 15.6% in the City of Moscow. In May 2020, the gain of absolute number of the deceased in the Russian Federation by months (towards to concurrent month of 2019) made up to 11.9%, in June to 18.6%, in July to 19.7% and in August to 9.6%. In Moscow, the peak values of this increase were noted in May - 57.2% and in June - 41.6% In the conditions of new coronavirus infection pandemic, the share of COVID-19, as main cause of death (ICD-10 codes U07.1 and U07.2), in the structure of total mortality in April-August consisted 3.2% and in the structure of excess deaths in May-August - 28.6%. The increase of mortality and continued decrease of birth rate resulted in increasing of natural population loss by 1.5 times and more and reached such values as -3.6 in the Russian Federation, -4.9 in the Central Federal Okrug and -1.6 in the City of Moscow (per 1000 of population). The process of depopulation of the Russian nation not only retained, but significantly has become significantly aggravated.

[The role of alcoholic and narcotic substances in population mortality due to external causes and development of legal regulation of responsibility for their consumption].

The study established that in the Chelyabinsk Oblast remains high percentage of violent deaths because of presence of ethyl alcohol and narcotic substances detected in blood of the perished. The increase of concentration of ethanol in blood of the dead testifies the need for inter-sectorial measures, including toughening of legal responsibility for alcohol and drugs consumption. Actually,there is no regulatory documents of the Russian Federation that fix the issue of both progression of toughening this responsibility depending on concentration of ethyl alcohol in organism of offender and responsibility scale depending on specific drug or other substance.

[The efficiency of functioning of regional vascular center in case of acute disorder of cerebral blood circulation].

The acute stroke is one of leading causes of mortality and disability both in Russia Federation and worldwide. The specialized vascular centers and units proved to be effective in improving diagnostics, treatment and functional outcome inpatients in various countries. The purpose of article is to evaluate efficacy of regional vascular center (RVC) in Tyumen. The functioning of RVC in 2011-2017 was assessed using purposefully developed and implemented score card of medical care quality assessment in vascular centers. The epidemiological data for 2007-2017 was obtained from statistical materials of the Department of Health of Tyumen oblast. The epidemiological parameters were calculated both in absolute units by simple summing up of cases of illness and in relative units per number of population. It was established that all diagnostic and treatment procedures in RVC were implemented according actual medical standards. The significant increase of the percentage of patients hospitalized during first three hours after the onset of stroke symptoms was established. The patients receiving thrombolytic therapy was observed, with an improvement of functional status of patients upon discharge. The significant improvement of early diagnosis of cerebrovascular diseases (CVD) in the service area of RVC was demonstrated. The development and implementation of the plan of a regional vascular center placement and stroke patient routing enabled optimization of medical care accessibility to this group of patients and increased identification of CVD.

[The analysis of mortality of population of able-bodied age because of external causes].

The article presents analysis of mortality because of injuries, poisonings and other consequences of impact of external causes in able-bodied population of the Russian Federation. In 2016, the study identified 18 subjects of the Russian Federation, where these causes of death occupied first rank, leaving behind mortality of blood circulatory system diseases. The optimization of medical care of persons injured by external causes should be implemented by three main directions: traumatological orthopedic one with organization of traumatological centers; сombustiological one with organization of burn centers; toxicological one with organization of toxicological centers. The established differences in mortality rates between subjects of the Russian Federation testify the necessity of complex and substantive measures of organizing and developing medical care support of persons injured by external causes, considering climatic geographic features of regions, as well as availability of "endemic" zones within the territories of subjects that will make it possible to propose valid recommendations related to organization of new centers and optimization of routing of patients based on actual operating medical organizations and their structural subdivisions.

[The public opinion about health care: the main factors of increasing satisfaction of population with medical care].

The evaluation of satisfaction of population with medical care has become widespread in practice of medical institutions as an obligatory criterion of assessing quality of their functioning. The study objective is to determine degree of satisfaction of population Russia with health care and role of particular factors in its formation. The study applied questionnaire survey of residents of 9 subjects of the Russian Federation using representative sampling of 1457 observations. The Pearson contingency indicator and the Chuprov-Cramer indicator of association between two nominal variables were determined. The ranking of signs according their influence strength was carried out. The most significant role in evaluation of satisfaction with health system functioning is played by satisfaction with medical care. Among the factors characterizing consumers of medical services, self-assessment of one's health status, social status of respondents, residence demonstrate the most effect. The priority factors in formation of positive public opinion about health care are identified. It is proved that positive opinion about health care depends on quality and accessibility of popular types of medical care, organization of functioning of primary health care medical organizations according expectations of population. The level of satisfaction with health care system is lower than in case of rendered medical services.

[The state and problems of pharmaceutical support of preferential categories of citizen].

The Federal program of supplementary preferential pharmaceutical support of particular categories of citizen functions since 2005. During this period, it seriously impacted on quality of pharmaceutical support, accessibility of medications, development of pharmaceutical market in general. The article presents analysis of state of pharmaceutical support of particular categories of citizen during 2017-2018. The established problems requiring solution are discussed too. It is established that in majority of cases the problems with pharmaceutical support have organizational specificity. The health care authorities allow decreasing of volumes including shortcomings in purchase and logistic of deliver, untimely holding of auctions, inconsistent compiling of applications and insufficient control of trade stock management. The problems with accessibility of pharmaceuticals occur because of inefficient application of already bought items. The open access data of official web-site of Minzdrav of Russia and Roszdravnadzor were used for analysis and preparation of article.

[The regional characteristics of quality of life of citizen of military age].

The article presents the analysis of characteristics of quality of life of citizen of military age in the Moscow oblast and the Primorskiy Krai of the Russian Federation in the light of comprehensive approach to evaluation of the contingent with the regard to regional characteristics and multi-factorial mode of development of mental and physical health. The comparative study was carried out applying the questionnaire MOSSF-36 (physical functioning, role activity, general health condition, live activity, mental health) to contingent of young people of military age. The differences in indices of quality of life are considered depending on regions of Russia and in 5 years dynamics.

[The Morbidity of Infectious Diseases in the USSR. Report I. 1919-1949].

The article presents the analysis of elicited and systematized indices of morbidity of acutely contagious diseases in the Empire of Russia and the USSR in 1887-1949. The firmly established in scientific literature opinion about stable epidemic well-being set in the USSR in 1930-1940s is disproved. It is established that in the USSR during this period occurred increasing of morbidity of infectious diseases. The main causes of this occurrence are demonstrated.