


Vol 69, No 2 (2025)
- Year: 2025
- Published: 15.04.2025
- Articles: 17
- URL: https://gynecology.orscience.ru/0044-197X/issue/view/13087
HEALTH CARE ORGANIZATION
Identification of demand and expectations from the creation of a web portal and mobile application to inform business entities on their compliance with mandatory requirements of sanitary legislation
Abstract
Introduction. Business is important for ensuring social stability of the country’s economy. To increase the pace of economic development, control and supervisory activities in relation to business have been reduced. However, one of the mechanisms for achieving sanitary and epidemiological well-being for many years has been control and supervisory activities. This requires the introduction of new formats of preventive work using preventive measures and ensuring access of economic entities to reliable information on sanitary and epidemiological norms and rules.Purpose. Determining the demand and expectations from the creation of a web portal and mobile application for informing business entities on compliance with mandatory requirements of sanitary legislation, considering the specifics of various sectors of economic activity.Materials and methods. Qualitative and quantitative analysis of the degree of demand from the business community for the creation of specialized information resources to ensure sanitary and epidemiological well-being in institutions.Results. The study showed many entrepreneurs and business leaders to have difficulty finding reliable and up-to-date information on sanitary and epidemiological issues. When searching for information, they often come across unofficial sources that are full of unreliable information and advertise their services for commercial purposes. Most respondents noted that the emergence of a specialized web portal and mobile application of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing will have a positive impact on the work and simplify the process of interaction between the business community and representatives of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing bodies and institutions.Research limitations. The research materials are limited to the results of qualitative and quantitative analytics among entrepreneurs operating during the period of spread of the new coronavirus infection (COVID-19) over the territory of the Russian Federation.Conclusion. The conducted comprehensive study showed the emergence of a specialized web portal and mobile application for ensuring sanitary and epidemiological well-being in institutions will to simplify the process of interaction between the business community and representatives of of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing bodies and institutions. The conducted study also made it possible to form a list of the main goals that must be achieved when creating specialized information resources.Compliance with ethical standards. The study does not require the presentation of the conclusion of the biomedical ethics committee or other documents.Contribution of the authors: Simkalova L.M. — approval of the final version of the article, concept and design of the study, editing; Delitsyn D.A. — concept and design of the study, writing the text, processing data, editing, compiling the list of references, responsibility for the integrity of all parts of the article.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare that there is no conflict of interest.Received: January 15, 2025 / Accepted: February 19,2025 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):105-110



Medical triage of victims in emergency situations: skills in medical specialists of non-staff mobile medical units of civil defense
Abstract
Introduction. The most important element of the system of medical and evacuation support for victims in emergency situations (ES) is medical triage. Scientific works indicate significant shortcomings in the possession of medical triage skills in outpatient and polyclinic doctors.Purpose of the study. To evaluate the possibilities of involving surgical doctors from the Moscow Municipal Emergency Stationary Complex (ESC) in work in an unofficial mobile medical unit (MMU) of civil defense in the elimination of medical and sanitary consequences of large-scale emergencies in peacetime and wartime.Materials and methods. Using the timing of medical triage of simulated victims in emergencies by triage teams of ESC surgical doctors, there was detected average time spent on medical triage of one victim of moderate (severe) severity admitted to the MMU. An analysis of the adopted triage decisions regarding victims was conducted in accordance with the data of the simulation coupons. A comparative analysis of the capabilities of the triage teams of ESC doctors and city polyclinics was conducted.Results. The capacity of two ESC teams per hour of work will be 54 cases, for 12 hours — 648 patients. A comparative analysis of the capacity of two ESC teams of doctors for 12 hours of work showed their efficiency to be of 1.8 times higher, compared to the work of three teams of doctors of municipal polyclinics. 10.0% of incorrect sorting decisions were identified, which did not affect the quality of medical sorting.Research limitations. The study materials are limited to the results of scientific research of the Moscow Territorial Scientific and Practical Center for Disaster Medicine, obtained in 2024 during the research tactical and special exercise based on the Municipal Clinical Hospital No. 15 named after O.M. Filatov.Conclusion. The results of the study demonstrated the high potential of the ESC physician teams. Triage decisions on the evacuation of victims to specialized hospitals with the provision of medical care by ambulance teams during its implementation are justified practical decisions. It is advisable to consider the managerial model of the MMU with the inclusion of two triage teams of ESC physicians in the structure.Compliance with ethical standards. This study does not require a conclusion from the Local Ethics Committee.Contribution of the authors: Pervukhin N.N. — collection of primary data, statistical analysis and generalization of the obtained results, writing the first version of the article; Gumenyuk S.A. — formation of relevance, methodological support, editing of the article text; Vechorko V.I. — development of the concept and design of the study, collection of primary data, editing the text of the article. All co-authors — approve the final version of the article and are responsible for the integrity of all parts of the article.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare the absence of any conflicts of interest regarding the publication of this paper.Received: January 21, 2025 / Accepted: February 19, 2025 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):111-116



Prospects for the implementation of artificial intelligence and computer vision technologies in laboratory medicine (literature review)
Abstract
Laboratory diagnostics plays one of the leading roles in modern medicine, providing doctors of clinical specialties with data for timely diagnosis, selection of tactics and methods of treatment. To ensure high efficiency and increase the accuracy of research, artificial intelligence technologies have recently been actively introduced into the practice of the laboratory service: computer vision, machine learning, deep learning, neural networks, data bank analysis. In laboratory diagnostics, these technologies are successfully used to automate and improve technological processes, including processing reaction results, cytomorphological images, and analysis of the obtained data. One of the promising areas for the implementation of artificial intelligence in laboratory diagnostics is the development of technologies for phenotyping blood groups using widely used monoclonal antibodies as reagents and computer vision technology on wearable devices. At the same time, there are often no ready-made solutions on the market for including intelligent software systems in the daily work of the laboratory. The review considers various examples of the use of technological systems based on artificial intelligence in laboratory diagnostics. The paper also presents a bibliometric analysis of scientific literature on the spread of computer vision, machine learning, and artificial intelligence technologies in medical laboratories based on publications from the Pubmed database over the past 20 years. In addition, the review discusses the prospects and limitations of using artificial intelligence and computer vision in medical laboratories and assesses the benefits of introducing the blood group phenotyping method into clinical practice using artificial intelligence technology on mobile devices.Contribution of the authors: Tregub P.P. — research concept and design, writing the text, compiling of the list of literature, statistical data processing;Zhemchugin D.E., Zubanov P.S. — writing the text, compiling of the list of literature, editing; Goldberg A.S., Godkov M.A., Akimkin V.G. — writing the text, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: February 21, 2025 / Accepted: March 11, 2025 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):117-122



Impact of healthcare waste management training intervention on the knowledge and practices of healthcare professionals: a quasi-experimental study in a Surgical University Hospital in Southern Tunisia
Abstract
Introduction. Healthcare professionals (HCPs) play a crucial role in healthcare waste management (HWM). Insufficient knowledge and inadequate management practices are the most important issues in the HWM process.The purpose of the study — the objective was to assess an educational program’s impact on HCP’s knowledge and practices regarding HWM.Materials and Methods. This quasi-experimental study consisted of a pretest evaluation, an intervention, and a post-test re-evaluation conducted in Habib Bourguiba University Hospital during the period of January 2nd to April 30th, 2022.Results. Overall, 134 HCPs provided complete responses. The median age was 40 years (Interquartile range = [32.00–48.75] years) and the sex ratio was 0.44. We found a significant rise in the knowledge score (KS) of participants regarding global HWM knowledge (86.8 ± 6.7 vs 58.5 ± 6.8; p < 0.001) and also in the KS for each waste category: non-infectious waste (89.6 ± 8.7 vs 68.9 ± 15.4; p = 0.005), infectious waste (90.7 ± 4.2 vs 74.3 ± 9.7; p = 0.001), sharps (89 ± 7,3 vs 72.9 ± 7.0; p < 0.001) and cytotoxic waste (80.0 ± 21.7 vs 17.2 ± 5.7; p < 0.001). We noted a significant rise in PS of participants regarding global HWM practices (93 ± 6 vs 73 ± 10; p < 0.001) and also for each item: availability of equipment in the medical treatment cart (100 ± 1 vs 71 ± 23; p < 0.001), healthcare waste segregation (78 ± 20 vs 54 ± 27; p = 0.002), information and training about HWM (100 ± 10 vs 71 ± 46; p = 0.003), and healthcare waste disposal (91 ± 14 vs 45 ± 34; p = 0.001). The KS change was significantly more important for HCPs who had no previous training in HWM during the last 3 years than other HCPs with previous training (29.8 vs 25; p = 0.042).Research limitations. It was a single-center study that could impact the generalization of the results on a national scale. Secondly, as previously noted, the participation rate was low but this fact was not an obstacle to having a positive impact on HCP’s knowledge and practices in the whole hospital.Conclusions. HWM training sessions are a promising and effective intervention to improve knowledge and practices of HCPs. It should not be a one-time activity but it should be a continuous and regular process to ensure a safe care environment and deliver quality care.Compliance with ethical standards. The study does not require submission of the opinion of the biomedical ethics committee or other documents.Contribution of the authors: Baklouti M., Trigui M., Ben Hmida M., Ben Jmaa M. — substantial contribution to the study’s conception and design, data acquisition, or data analysis and interpretation; Baklouti M., Trigui M., Ben Ayed H. — writing the article and/or revising the article for important intellectual content; Baklouti M., Trigui M., Ben Ayed H., Ben Hmida M., Ben Jmaa M., Mejdoub Y., Jedidi J., Kassis M., Yaich S. — reading and approving the final version of the submitted manuscript. All authors revised the manuscript and gave their contributions to improve the paper, read and approved the final manuscript.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: September 16, 2024 / Accepted: December 11, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):123-130



Socio-psychological factors of occupational stress in medical workers
Abstract
Introduction. The need to study the socio-psychological factors of occupational stress in medical workers is due to the need for the earliest possible profiling and identification of factors of adverse functional conditions, including occupational stress, taking into account the specifics of the professional activities of medical workers.Purpose of the study. The study of socio-psychological factors (the level of claims, conflict, and social frustration) of occupational stress in medical workers.Materials and methods. The total sample size was sixty 23–59 years 60 people. The experimental group included 30 medical specialists (doctors and nursing staff). The control group consisted of 30 non-medical specialists (psychologists, speech therapists, social workers. Research methods: the method “Integral diagnosis of occupational stress” by A.B. Leonova, the method “Assessment of the level of claims” by V.K. Gerbachevsky, the questionnaire “Level of social frustration” by L.I. Wasserman, the method “Determination of the level of conflict of an individual by D.M. Ramendik.Results. Moderate levels of both acute and chronic occupational stress were found in medical and non-medical workers, which is an argument in favour of the combined status of high stress resistance and professional adaptation. The triad of indicators including social frustration, conflict, and the level of claims, considered as the studied socio-psychological factors, are in the range of values corresponding to a moderate level.Research limitations. The possibility of applying the results obtained is limited exclusively to medical professionals (excluding junior medical staff) both with medical and non-medical education, involved in professional interaction.Conclusion. A necessary condition for the success of the professional activities in both medical and non-medical specialists is psychoprophylaxis and reduction of contextual socio-psychological risks of occupational stress among medical personnel in the presence of a prognostically unfavourable configuration of stressors, as well as the development of prevention competencies, the formation of coping skills, and increased resistance to occupational stress.Compliance with ethical standards. The study was conducted in accordance with the requirements of the Fundamentals of Legislation “On the Protection of Citizens’ Health”; all participants signed an informed consent to the examination (extract from the minutes of the meeting of the Ethics Committee No. 2 dated 10/14/2022).Contribution of the authors: Nikishina V.B. — the concept and design of the study, writing the text, editing, approval of the final version of the article; Petrash E.A. — writing the text, editing, responsibility for the integrity of all parts of the article; Starodumova A.B. — collection and processing of material, statistical data processing; Tropnikov O.L. — concept and design of the study, editing.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: June 7, 2024 / Accepted: December 11, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):131-137



PROBLEMS OF SOCIALLY SIGNIFICANT DISEASES
Management of tuberculosis detection in target groups at increased risk of tuberculosis
Abstract
Introduction. In Russia, periodic examinations (screening) are carried out annually for the early detection of tuberculosis among the population. Screening should cover all population groups of the constituent entities of the Russian Federation, and first of all, those that belong to the high-risk groups for TB.Materials and methods. The proportion of people who had not undergone screening for ≥ 2 years was determined. Information on one hundred sixty two cases involved in screening, but had previously avoided it for ≥ 2 years, was studied. The structure of chest diseases detected during screening in 143 people who had not undergone examinations for ≥ 2 years was studied.Results. In the Kaluga Region over 2018–2022, a high level of population coverage with tuberculosis screening was registered, amounting to an average of 68.8%. The proportion of the population who had not been screened for ≥ 2 years ranged from 3.3 to 7.9%, averaging 5.88 ± 1.06%. The population of one therapeutic area in 2015–2022 ranged from 1876 to 1901 people, averaging 1892.75 ± 3.06 people, while the proportion of people who had not been screened for ≥ 2 years ranged from 8.3 to 9.3%, averaging 8.89 ± 0.13%. Over the course of 3.5 months of work, the district phthisiatrician managed to attract 143 people to undergo screening, which amounted to 88.3% of their total number.Research limitations. The study was carried out in a short period of time among the population of one therapeutic area.Conclusion. A new approach to managing screening in medical institutions providing primary health care for individuals who have avoided screening for ≥ 2 years is proposed.Compliance with ethical standards: the study does not require the submission of a biomedical ethics committee opinion or other documents. Contribution of the authors: Lapshina I.S. — research concept and design, writing the text, compilation of the list of literature, statistical data processing; Tsybikova E.B. — writing the text, statistical data processing, editing; Kryuchenkov M.V. — collection and processing of material. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: October 22, 2023 / Accepted: March 19, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):138-143



TOPICAL ISSUES OF HYGIENE
Peculiarities of the immune status in children with nervous system pathology combined with excessive contamination of biological media with aluminum
Abstract
Introduction. Diseases of the nervous system (NS) occupy a leading place in the structure of child prevalence. The environmental conditions create a growing number of stress-inducing factors able of affecting the child body. Aluminum and its compounds are a good example here, it, in turn, is the most common element on Earth. The increase in the volume of pollution of environmental objects with these chemical pollutants, aspects of its toxic properties in relation to the immune and nervous systems, are attracting more and more attention. However, despite the problem being obvious and urgent to be solved, the pathway of adverse effects produced by aluminum on the immune and nervous system still remains unclear.Materials and methods. We examined sixty six 4–7 years children living in an area affected by emissions from aluminum production. The observation group consisted of children (n = 39) suffering from a nervous disease. The comparison group consisted of a child population (n = 27) without pathology of the nervous system. Immunological exploration was conducted by using flow cytometry, radioallergosorbent tests, and ELISA tests.Results. We comparatively analyzed cell differentiation clusters in the groups of the examined children; as a result, we identified authentically excessive expression of receptors, which were pathogenetically linked to nervous system pathology, in the test group (butyrophilin, toll-like receptor): BTN3/CD277rel., CD284, HLA-DRrel./abs. We also identified elevated aluminum concentration in biological media, elevated IgG specific to aluminum and HCE in blood serum (p < 0.05). These findings allow recommending these indicators as priority ones for children with diagnosed ‘disorder of autonomic nervous system, unspecified, G.90.9’ associated with elevated aluminum contamination in biological media.Research limitations. Children without any nervous system pathology did not participated in the study.Conclusion. We established children with disorder of autonomic nervous system (G.90.9) and elevated aluminum contamination in biological media to have elevated expression of cell differentiation clusters (CD277, CD284) and the late activation marker (HLA-DR) in their blood. This was combined with non-specific (elevated levels of neuron-specific enolase marker) and specific (IgG specific to aluminum) signs of autoimmune aggression, which was not identified in children without elevated contamination of their biological media with aluminum.Compliance with ethical standards. The study was accomplished in conformity with the WMA Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects (1964, 2013). The study was approved by the Local Ethics Committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies. All the participants provided their voluntary consent to participation in the study.Contribution of the authors: Zaitseva N.V., Dolgikh О.V. Lanin D.V. — study concept an design, editing; Alikina I.N. — study concept an design, data collection and analysis, writing and editing the text; Starkova К.G. — data collection and analysis; Kirichenko L.V. — editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: September 15, 2023 / Revised: December 9, 2024 / Accepted: December 11, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):144-149



Medical and sociological study of public health in relation to the perception of ambient air pollution by odorous substances
Abstract
Introduction. The state of health of residents in Glazov (Udmurt Republic) was studied in relation to the perception of odours present in the ambient air. This region is part of the ten subjects of the Russian Federation with the highest level of influence of a complex of sanitary and hygienic factors on the health of the population.Material and methods. The analysis and assessment of the health status in the adult population of Glazov and the Udmurt Republic were carried out according to official data of the state forms of medical statistics (form No. 12) for 2016-2020 years. A depersonalized survey of the population in Glazov was conducted using a questionnaire specially adapted to the conditions of the city, which included questions aimed at assessing the health status in respondents (including the presence of diagnosed diseases), as well as their perception of odours present in the ambient air.Results. Based on the analysis of morbidity, the priority pathologies for this city are respiratory diseases, the average annual level of which exceeds the similar indicator for the Udmurt Republic by 1.3 times. In addition, the adult morbidity rate of digestive diseases in Glazov is almost twice higher than in the Udmurt Republic. Sociological studies have shown a pronounced connection between the proportion of persons diagnosed with these pathologies and the perception of the frequency of odours, as well as their intensity and degree of annoyance by odours present in the ambient air.Research limitations. The main limitation of the study is the incomplete correspondence of the classification of diseases in the forms of state medical statistics and in the questionnaire for the survey of the population, which makes it difficult to quantify the data obtained.Conclusion. The presence of odours in the ambient air, which can cause the “annoyance” response in the population, is one of the most important indicators of the possible presence of harmful impurities in the atmosphere, which can lead to an increase in the morbidity level in residents in the areas of placement of enterprises-sources of odours.Compliance with ethical standards. The study was approved at the meeting of the local ethical committee of the Centre for Strategic Planning of the Federal medical biological agency of Russia (Protocol No. 01/10/21 dated 25.10.2021). All participants of the sociological survey provided their voluntary informed consent to participate in the study.Contribution of the authors: Goshin M.E. — concept and design of research, collection and processing of material, statistical data processing, writing of text, compilation of a list of references; Sabirova Z.F. — collection and processing of material, editing; Budarina O.V. — collection and processing of material, editing; Skovronskaya S.A. — collection and processing of material, statistical data processing. ZAll authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study was carried out within the framework of State task No. 121090800066-9.Conflict of interest. The authors declare no conflict of interest.Received: February 29, 2024 / Accepted: May 30, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):150-157



MEDICAL EDUCATION
Management of the activities of the All-Russian public organization "Medical League of Russia"
Abstract
The All–Russian public organization "Medical League of Russia" is an association of experts who, since 2011, have been involved in improving the quality of medical education, including through state and professional-public accreditation procedures. The organization conducts an independent assessment of the quality of educational programs at various levels, ensuring that information about the examination results is open and accessible. Currently, the Medical League of Russia consists of one hundred ninety nine highly qualified experts. Professional and public accreditation, being a practice-oriented assessment tool, allows assessing the quality of graduate training in accordance with the requirements of the labour market. Since the establishment of the Medical League of Russia, more than 50 professional and public accreditation procedures have been carried out in educational institutions of medical and pharmaceutical profile. In 2022–2024, more than 200 educational programs were examined. The assessment system is constantly being improved: The average expert assessment of educational programs is increasing, and the number of institutions participating in the accreditation procedure is growing. The plans for further development include the legislative consolidation of mandatory professional and public accreditation for medical and pharmaceutical institutions, the introduction of automated educational quality assessment services and the development of new assessment methods. The Medical League of Russia also organizes professional competitions and contributes to improving the quality of educational services through the involvement of experts and employers in evaluating the medical education system. Contribution of the authors. All authors made an equal contribution to the search and analytical work and preparation of the article, read and approved the final version before publication.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: February 25, 2025 / Accepted: March 10, 2025 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):158-161



DISCUSSION
Paradigm of economic culture of health care
Abstract
Introduction. For effective management of the economic sphere in health care, it is important to understand the essence and patterns of development of its economic culture.Purpose of the study — to propose a methodological basis for the paradigm of the economic culture of health care.Materials and methods. The study is theoretical and methodological. In the course of the study, the following methods were used: bibliographic and scientometric analysis, historical and legal analysis, expert assessments, expert survey. Scientometric analysis of publications was carried out in the volume of databases of library systems “e-library” and “cyberleninka” with a depth of 10 years. Data processing was carried out using applied software with the calculation of average and relative values, statistical errors.Results. The analysis showed the problem points in the economic culture of health care to be: the level of economic literacy of medical workers and management personnel of medical institutions; inadequate health financing; high level of economic and reputational losses; low job satisfaction and investment activity. The potential of economic literacy of medical workers and management personnel of medical institutions in public health care is 65.5%, in private health care — 71.5%.Research limitations. In the study of economic culture, a survey of thirty experts was conducted, which is a sufficient reference sample.Conclusion. The obtained data allowed us to formulate the main provisions of the paradigm of economic culture in healthcare: formation of a new economic consciousness in the healthcare sector; formation of a current level of economic competencies; creation of investment-attractive conditions and traditions of new economic behavior in healthcare; formation of a system for forecasting and preventing the risks of reputational losses and losses of economic information based on digital technologies.Compliance with ethical standards. The study was approved by the Ethics Committee of the IvSMU of the Ministry of Health of Russia (Protocol № 3 of 09/13/2024). All respondents signed an informed consent to participate in the study.Contribution of the authors: Mushnikov D.L. — concept and design of the study, writing the text; Korsunov P.P., Yatsyna I.V. — collection and processing of the material, statistical processing, writing the text. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: March 26, 2025 / Accepted: April 7, 2025 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):162-168



DISCUSSIONS
Prevention of medical errors is a comprehensive aspect of the practical medicine
Abstract
The prevention of medical errors is more effective when we fully understand the problem and its context.The purpose of the publication is to discuss the connection of the problem and medical science, and to recall other leading aspects of medical malpractice theory.Materials and methods. Knowledge on the problem of medical errors is still insufficiently systematized and extended enough. Working in this direction may be more appropriate nowadays than studying the specific issues of the problems by specific evidentiary methods. So, the material for this paper was based on literature sources, own observations and discussion of the problem on professional websites. The scientific analysis was carried out by general logical and axiomatic methods. Conclusions on the aspects of the problem given in the article first of all need understanding of their content rather than confirmation.Results. Each failure of the diagnosis and treatment process must be analyzed. A scientific approach makes failure analysis effective. Practice improves on analysis, and analysis is at the heart of the science. Irrational attitude to mistakes can slow down the development of the science. Modern medicine is developing in the direction of identifying and controlling the individual characteristics of each patient. It is the unknown and uncontrolled individual features that often cause diagnostic and curative errors.The key terms such as “mistake”, “guilt”, “punishment”, “experience” must be differentiated into subtypes with different meanings, so that when they are used during a discussion, we can correctly understand each other. As a doctor’s work experience increases, the structure of the causes of his errors also changes, which is shown in specific examples.Conclusion. Error analysis not only promotes good practice, but also stimulates the development of the medical science. It was necessary to protect doctors from unjust accusations, but it was more important to expose them to errors and teach them how to deal with their own and others’ mistakes. Understanding mistakes is the best way to prevent it.Contribution of the authors: Makhambetchin M.M. — concept and design of the study, writing the text, compilation of the list of literature; Shakeev K.T., Turgunov Ye.M. — writing the text, editing; Lokhvitskiy S.V. — editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: August 3, 2023 / Revised: November 09, 2023 / Accepted: January 17, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):169-174



HISTORY OF HEALTH CARE AND MEDICINE
Otto von Bismarck or Karl Marx: financing medical guarantees for the population by contributions from salaries or by turnover tax?
Abstract
The article examines the circumstances that allowed the Soviet Union rapid creating the world’s first universal health coverage (UHC) system in the 1920s and 1930s, ahead of most developed OECD countries. At the same time, while OECD countries created their UHC systems in the context of rapid economic growth during the so-called “golden age of capitalism” (1945–1975), the achievement of UHC in the USSR occurred in extremely unfavourable economic conditions. Analyzing the success of healthcare in the USSR, the authors conclude the refusal to finance it from taxation of the wage fund (the so-called Bismarck system) to be in favour of the innovative Soviet tax on the turnover of enterprises, the authors found the source of ideas for which in the works of K. Marx and W. Rathenau, played an important role. The authors see prospects for using the Soviet tax innovation in the 21st century.Contribution of the authors: Ragozin A.V. — research concept, writing the text, compilation of the list of literature; Grishin V.V. — statistical data processing; Dudnik A.I. — editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The article was prepared based on the results of research carried out at the expense of budgetary funds under a state assignment for the Financial University.Conflict of interest. The authors declare no conflict of interest.Received: December 3, 2024 / Accepted: February 19, 2025 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):175-181



Healthcare in Dagestan during the Great Patriotic War
Abstract
The article examines specific features of the medical service in Dagestan during the Great Patriotic War based on a wide range of published and newly introduced documents. The health care system in Dagestan suffered from serious changes during the significant events in the Soviet history, which had an essential impact on the state of the medical service in the region. The authors examine the specifics of the transformations in the field of managing care to the military and civilian population. Dagestan was a deep rear area at the beginning of the war, so evacuation hospitals were established here, its workload increased as the front line approached, and as a result, the work of hospitals consisted of serving the seriously wounded combatants moving from sanitary trains from the front and from other hospitals which were in the frontline or in enemy-occupied territory. According to mobilization in this period, Dagestan suffered from an acute shortage of qualified medical personnel, diagnostic equipment, care products, instruments and medications. For this reason, the medical service extra suffered in rural areas, and the system of emergency and urgent care to the civilian population was almost destroyed throughout the region. The article pays specific attention to the scientific work conducted by medical workers during the war. The authors conclude that Dagestan was characterized by trends in the transformation of the health care system of the entire country, and the imbalance in providing medical care exclusively to wounded combatants led to a deterioration in the quality of medical care for the civilian population.Contribution of the authors. All co-authors made an equal contribution to the research and preparation of the article for publication.Acknowledgement. The study was carried out within the framework of the Fundamental Research Program of the National Research University “Higher School of Economics”.Conflict of interest. The authors declare no conflict of interest.Received: September 11, 2024 / Revised: November 29, 2024 / Accepted: December 11, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):182-186



The role of scientists of the S.M. Kirov Military Medical Academy in the formation of Russian psychophysiology and professional psychophysiological selection
Abstract
The prerequisite for the development of Russian psychophysiology was the need to regulate the activities of military personnel related to the specifics of their work.The purpose is to highlight the formation and development of psychophysiology and professional psychophysiological selection in Russia, reflecting the role of scientists at the S.M. Kirov Military Medical Academy in this process.Materials and methods. General scientific (analysis, synthesis, generalization), and special historical (historical-genetic, historical-systemic) methods are used.Results. The work of scientists from the Kirov Military Medical Academy made a decisive contribution to the development of psychophysiology in our country. In the early 1860s, I.M. Sechenov laid the theoretical foundation for psychophysiology in medicine. V.M. Bekhterev opened and headed the clinic of nervous diseases with Russia’s first Department of surgical neuropathology, managed a psychological laboratory. Pavlov’s teaching on conditioned reflexes and types of higher nervous activity was a milestone in the development of psychophysiology. L.A. Orbeli emphasized the close relationship between physiological and psychophysiological research, conducted laboratory and field studies of the activities in divers, pilots, parachutists, and other military specialists. In 1947, the Department of Experimental Psychology headed by K.K. Platonov was established at the Institute of Aviation Medicine, and in 1964, psychological selection of candidates for pilots was introduced, and psychophysiological laboratories were established. Since that time, great attention has been paid to the problems of psychophysiology at the S.M. Kirov Military Medical Academy, and G.I. Gurvich, V.I. Kopanev, V.I. Medvedev, A.A. Bochenkov, and others have worked on them. In 1997, the Department of Military Psychophysiology was established at the Military Medical Academy under the leadership of V.N. Sysoev.Conclusion. The achievements of psychophysiology are widely used in clinical practice and occupational medicine. It is necessary to develop methods of psychophysiological selection of specialists in dangerous professions, psychophysiological training aimed at preserving their health and improving the reliability and safety of professional activities, the creation and implementation in practice of methods for monitoring the functional state and its correction.Contribution of the authors: Karpenko I.V. — the concept and design of the study, writing the text; Kosachev V.E. — collecting and processing materials, writing text; Krylov N.N., Batoev S.D. — collection and processing of materials; Starostina Yu.V. — collection and processing of information. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: November 13, 2023 / Accepted: March 19, 2024 / Published: April 30, 2025
Health Сare of the Russian Federation. 2025;69(2):187-192



JUBILEES
To the 75th anniversary of Vladimir I. Starodubov
Abstract
Владимир Иванович относится к редкой категории людей, чей жизненный и профессиональный путь является отражением истории страны, истории развития и становления системы здравоохранения. За более чем 50-летний период работы Владимир Иванович прошёл путь от врача-хирурга до министра здравоохранения Российской Федерации, учёного с мировым именем, академика Российской академии наук.
Health Сare of the Russian Federation. 2025;69(2):193-195



To the 75th anniversary of Valery N. Rakitsky
Abstract
Валерий Николаевич Ракитский родился 15 мая 1950 г. во Владимире в семье служащих. В 1967 г. окончил школу № 1 в г. Собинке Владимирской области с золотой медалью, в этом же году поступил в Ивановский государственный медицинский институт. В 1973 г. окончил с отличием Киевский медицинский институт им. А.А. Богомольца. С 1973 по 1976 г. обучался в очной аспирантуре по специальности «Гигиена» во Всесоюзном научно-исследовательском институте гигиены и токсикологии пестицидов, полимерных и пластических масс Минздрава СССР. После окончания аспирантуры работал в вышеуказанном институте с 1976 по 1993 г., занимая должности младшего научного сотрудника (1976–1979 гг.), старшего научного сотрудника (1979–1988 гг.), руководителя лаборатории токсиколого-гигиенического скрининга новых пестицидов и руководителя отдела гигиены (1988–1993 гг.).
Health Сare of the Russian Federation. 2025;69(2):196-197





