ISSN 2414-1143


2017. N 1

Historical, cultural and economic aspects of medicine and healthcare development of Black sea region countries

Chernysheva I., Belova L. Historical records on medical culture of northern Black sea region people / annotation

Chernysheva Irina – Ph.D.of philosophy, associate professor of history and cultural studies. Volgograd state medical university. Volgograd, Russian Federation
Belova Lyubov – Ph.D. of history, associate professor of history and cultural studies. Volgograd state medical university. Volgograd, Russian Federation

The authors cover peculiarities of people medical culture, inhabiting the territories of the Northern Black sea region. These territories represent a certain scientific interest, as through many centuries migration processes took place there. Medical culture enrichment of separate people occurred in consequence of numerous tribes interaction, having various healing traditions. Curative, phylactic, hygienic customs of people, lived in the distinguished region, their religious ideas, and behavior samples, aimed at preservation, maintenance and promotion of health, available disease prevention techniques for the medicine of that time are appeared to be the medical culture constituent part. The medical culture analysis is provided on the ground of written, archaeological, anthropological sources and paleopathology data. The works of antique authors, containing facts about methods and ways of treatment, information about healers, about hygiene level, about region climate conditions influence to people health status are considered to be the written sources, analyzed by authors. Archaeological and anthropological sources contain the valued material about health status, undergone traumas and diseases. With the help of them one can trace the life mode influence to emersion and development of these or those diseases and peculiarities of their treatment. Medical treatment tradition is considered in the context of medical culture and it is interpreted by authors as social, political, cultural and economic power, the part of cultural genesis general process and one of the person sociocultural adjustment mechanisms. People medical culture is represented as an essential component of the world culture.

Key words: historical sources, medical culture, healing, anthropology, the Scythians, the Sarmatians

Andreeva A., Zolotova A., Samburov G. Outstanding graduateof the Crimean university – professor A. Mazhbits / annotation

Andreeva Anna – director of the museum complex. North state medical university. Arkhangelsk, Russian Federation.
Zolotova Anastasia – manager of medical workers union of Arkhangelsk region. Ark-hangelsk, Russian Federation.
Samburov Gleb – specialist of the museum complex. North state medical university. Arkhangelsk, Russian Federation.

Notable alumni of the Crimean University, an obstetrician-gynecologist, urologist, Doctor of Medical Sciences, Professor Alexander Mazhbits made a great contribution to the history of medicine of the USSR, being the author of over 120 scientific works and 7 books, many scientific inventions and publications on obstetric and gynecological urology and its history, he was a creator of the textbook "Operative urogynecology", inventor and prominent scientist.Scientific activity Mazhbits began in 1925 in the Leningrad Research Institute of Obstetrics and Gynecology, where he worked almost all his life. During summers A.M. Mazhbits was a gynecologist at the resorts of Crimea, consultant gynecologist of the resort of Sochi-Matsesta and consisted in commissions for the selection of gynecological patients. During the Great Patriotic War Lieutenant-Colonel of the Medical Service of the USSR A.Mazhbits made an important contribution to the health of the wounded and sick women, was the main army gynecologist of the air defense forces of the Leningrad Military District. Professor A.Mazhbitswithin 1953-1959 worked in the Arkhangelsk State Medical Institute (now - the North-State Medical University), where he retained his personal business, thanks to which it was possible to establish little-known facts of his biography.

Key words: urology, gynecology, balneotherapy, Crimean university

Zhbannikova M., Milenkaya K. Beginning of medicine history study in Turkey: education and publications / annotation

Zhbannikova Marina – lecturer of National history dpt. Institute of history and international relations of Southern federal university; assistant of history and philosophy dpt. Rostov state medical university; scientific worker of the branch of Moscow university of S. Vitte. Rostov-on-Don, Russian Federation.
Milenkaya Kseniya – leading archeograph. State archive of Rostov region. Rostov-on-Don, Russian Federation.

Globalization processes significantly increase in the modern world, the scientists more often deviate from regional researches to more extensive territorial researches, comprising not only the region of their habitation. Black Sea region - the territory, which originally was a centre of a highly developed culture, science and medicine. An attempt to give historiographic review of researches, produced mainly in Istanbul in the period from the end of XIX century, when the first publications appeared according to the theme ofTurkish medical history, and to the first part of ХХ century is undertaken in the given writing, dedicated to medicine history in Turkey. The subject matter is formation, historical evolution and the modern state of medicine history in Turkey, predominantly published in Istanbul. The problems of medicine history teaching touched upon in Turkey, connected with language and linguistic peculiarities, creation of dictionaries, which helped to use the basic medical terms and conceptions. It is shown how medicine history education in Turkish language and also history of development and formation of this process were important for the students and listeners. The emersion of Turkish books on medical history, as of Turkish authors (for instance, MekhmetEminFekhmi), so the translated writings (Huseyin Ramsey – “Tarih-iTıb”) is very significant. It is interesting that even the workers of various Istanbul hospitals could be the authors of the books. The first years of ХХ century were marked by the works, where the researches of medical historical societies (RysaTahsin – “Mirat-iMektebiTıbbiye”) were described. The works on Turkish medicine history were actively developed in 20-s of ХХ century under conditions of young Turkish republic formation. The challenges in the given work are: to generally consider the biographies of outstanding Turkish medicine historians and their writings, wrote in the first part of ХХ century, which contributed to Turkish science.

Key words: Medicine history, Turkey, Turkish historical society, Turkish medical historical society, Kyrymly Aziz, Mekhmet Emin Fekhmi, Rysa Tahsin, Galip Ata, Sukheil Unver

Milenkaya K., Zhbannikova M. Educational and organizational peculiarities of pharmaceutics development in Turkish Republic / annotation

Milenkaya Kseniya – leading archeograph. State archive of Rostov region. Rostov-on-Don, Russian Federation.
Zhbannikova Marina – lecturer of National history dpt. Institute of history and international relations of Southern federal university; assistant of history and philosophy dpt. Rostov state medical university; scientific worker of the branch of Moscow university of S. Vitte. Rostov-on-Don, Russian Federation.

More often historians began to address to various aspects of the medicine history, the regional peculiarities of its formation and development. However, there are practically no articles, dedicated to medicine development in Turkey, and particularly, concerning Turkish pharmaceutics in Russia. We considered some aspects of pharmaceutical branch formation in Turkish republic from 1923 to the present time. The role and tools of state support in creation of innovative pharmaceutical production, including the training of highly skilled Turkish specialists is defined. One comes to the conclusion that high import dependency of domestic market medications and medical goods appears to be unacceptable from the point of view of national security. The given problem was solved in a complex. Secondly, university reform was conducted, directed to secular education improvement, including pharmaceutical one. Lecturers, who did not prove scientific character of their work, were practically almost removed from Istanbul university, and new foreign lecturers were invited, mainly from Germany, whose works on pharmaceutics and related sciences passed scientific approbation. The history of basic professional pharmacological associations and societies are touched upon in the article. The challenges and activities of professional pharmaceutical associations are disclosed.

Key words: Turkish republic, pharmaceutical education, pharmacies in Turkey, Turkish pharmaceutical associations, pharmaceutical industry

Sklyarova E. Crimean war and establishing of public health system in Great Britain / annotation

Sklyarova Elena – candidate of history, associate professor. Rostov state medical university. Rostov-on-Don, Russian Federation.

Crimean War of 1853 – 1856 is a factor of important socio-political and socio-medical reforms. Study of these cases is characterized as interdisciplinary. At the edge of Crimean War Great Britain press highlighted aspiration of the empire to capture rus-sian territories of Black sea region, also reforms and work of E.Chadwick, founder of public health system, were criticized, he was wanted to be away from members of par-liament and London oligarchs due to his extreme reforms and British corruption. The article represents several effects of Crimean War, its meaning for establishing of public health system in Great Britain, reforms and pioneering work of Edwin Chadwick, Flo-rence Nightingale, also brought up issues of urbanization, pauperism, migration, corruption, health care of cities and army. Developing ideas of utilitarianism and benthamism, E.Chadwick proved advantage of establishing of public health system, centralization of cities administration, anticorruption efforts. His undue dismissal was passing during Crimean War, preparation for abolition of serfdom and keeping of autocracy in Russia. In this period innovation seemed inconsistent to British people considering century principles for local government and nonintervention to domestic affairs of kingdom. Russia and its Black sea regions, which have become war objective for British Empire, were named as corrupted country by English press. But corruption in Great Britain, unique position of members of parliament and London oligarchs have become reasons for dismissal of founder of public health system in Great Britain. After Crimean War in cities there was a problem of social assistance for widows, street children, families with many children, epidemics. Issues of mortality, healthcare of cities and army also became an object of parliamentary debates, requiring constant interference of the government, establishing of social policy. Fresh impetus and acceptance of establishing of public health system, as well as a social policy in Great Britain have become evident in period of Crimean War after successful public activity of sister of Mercy F.Nightingale, who addressing the House with reports on morbidity level in army, highlighting existence of these social problems and peacetime in Great Britain and Black Sea regions.

Key words: Crimean War, public health, corruption, E. Chadwick, F. Nightingale, social policy, urbanization

Conroy M. Health care in the Black sea region in late imperial Russia and in World War I / annotation

Conroy Mary Schaefer – Ph.D., emeritus professor. University of Colorado at Denver, USA.

There is a prevailing myth that before the revolutions of 1917 and the advent of Soviet power, Imperial Russia did not produce factory-prepared medicines, requiring most or all such medicines to be imported. This article refutes that misconception, do-cumenting from printed and archival sources that some 300 chemical, factories and some 100 pharmaceutical factories operated in Russia in 1913 and that some zemstvos used only domestic medicines. It is emphasized that before the 20th century the vast majority of medicines were based on botanicals. This was true even after the discovery of sulfa drugs and antibiotics because some botanically based medicines were (and are now) superior to synthetics. Such was the case with quinine for malaria, endemic and epidemic throughout Imperial Russia and the Soviet Union. The article explains the reasons why Russia imported the new chemically synthesized medicines, the so-called “magic bullets,” despite having prerequisites for production such as outstanding chemists and a large petroleum industry. It is underlined that the Russian pharmaceutical industry grew more robust during World War I because of synergy from many quarters and because the fetters on the industry were removed. The importance of the Black Sea Region is highlighted in the development of the Russian pharmaceutical industry before and during World War I.

Key words: Pharmaceutical Production, Russia, World War I, Black Sea Region, iodine

Drobotya N., Chaplygina E., Kamalova O., Sklyarova E. Contribution of researchers of Rostov state medical universityto health development of Black Sea region / annotation

Drobotya Natalya – Ph.D. of medical study, professor. Rostov state medical university. Rostov-on-Don, Russian Federation.
Chaplygina Elena – Ph.D. of medicine, professor. Rostov state medical university. Rostov-on-Don, Russian Federation.
Kamalova Olga – candidate of philosophy, associate professor. Rostov state medical university. Rostov-on-Don, Russian Federation.
Sklyarova Elena – candidate of history, associate professor. Rostov state medical university. Rostov-on-Don, Russian Federation.

For the first time considered contribution of scientists and doctors of Don region –К. S. Agadzhanyants, Z.N. Grzhebin, М.М. Gardashyan, P.P. Kovalenko, who were working at Rostov State Medical University and made a contribution in development of medicine and health science of different Black Sea regions – Crimea, Turkey, Georgia, Romania, Bulgaria. Obtaining of knowledge and experience in medical activity, they were working and teaching not only in Warsaw and Don universities, but also in Sophia and Constantinopolitan universities, defended Crimea and Sevastopol during the Great Patriotic War.After Russian revolution in 1917 psychiatrist, neurologist, professor, doctor of medicine, graduate of the medical faculty of the Imperial Military Medical Academy of St. Petersburg K. S. Aghajanyants emigrated to Turkey for reasons of policy. Student of V. Bekhterev participated in the IX Pirogov Congress with report on the role of psychotherapy in dermatology, trained in Lisbon, Berlin, was a consultant on nerve diseases of the Southern (Caucasian) Front, worked in the Red Cross, taught at University of Constantinople and Sofia University. Doctor of Medical Sciences, Professor Z.N. Grzhebin was known in the USSR as a dermatovenereologist, he worked in Rostov-on-Don, Sochi, and Crimea. A graduate of the medical faculty of Kazan University, during the First World War, he as K.S. Aghajanyants, was on the Caucasian front, trained in Berlin. Professor Z.N. Grzhebin was a member of the board of the All-Union Society of Dermatovenerologists, dealt with problems of syphilis, skin lesions with poisonous substances, and the treatment of skin diseases in resort of Sochi-Matsesta. He took part in work of the expert commissions of the Ministry of Health of the USSR, held the posts of the dean and deputy director of Rostov Medical Institute, was head of the dermatological clinic and scientific part of the scientific research balneological institute of Sochi. Together with him worked native of present-day Turkey, the director of the Rostov Medical Institute M.M. Gardashian, whose fate was still classified in the state archives of Russia and the Rostov region after unreasonable political repression. Having headed work of Rostov Medical Institute, while holding the post of director, as well as an associate professor of the department of surgery faculty, in 1936 under his leadership a number of students of the "Fiery Release" of 1941 who during the Great Patriotic War rendered medical assistance to inhabitants of Crimea, defending Sevastopol, Rostov-on-Don, Stavropol, Novorossiysk. P.P. Kovalenko, graduate of the Fiery Release, after the war, headed the Department of General Surgery, became a Rector of Rostov Medical Institute, was first in the USSR to organize a regional tissue bank that provided donor tissues to the hospitals of Crimea and the North Caucasus, and represented the USSR in Romania in exchange of experience. Studies of the fate of doctors and Don scientists who made a significant contribution to the development of medicine and health in the regions of the Black Sea region are interdisciplinary and international. They reflect the development of the internal and foreign policy of the USSR, the difficult period of political repression, forced emigration, and the exchange of medical experience of the universities of Black Sea region.

Key words: Rostov State Medical University, Warsaw University, Sofia University, Constantinople University

Tuaeva L. Efficiency of costs for health care: problems and ways of solution / annotation

Tuaeva Lali – candidate of economics, associate professor. Vladikavkaz branch of Finance university. Vladikavkaz, Russian Federation.

The research results of infection rate and medical personnel provision in whole along Russian Federation, regions of North Caucasian federal district and Republic of North Ossetia-Alania are brought in the article. The conducted comparative analysis allowed estimating expenditure facilities efficiency to the health service, educing a row of regional problems and marking the ways of their solving. The author made a row of conclusions: 1) over a period of на 2005–2014 sickness rate of Russians in whole increased on 5,8%, along the regions of NCFD and the population infection rate on the contrary decreased on 4,6%, and in RNO-Alania - one of the seven subjects of NCFD - population sickness rate increased in 3,1 times in comparison with all-Russian indice, and in comparison with average district indice practically in 4 times; 2) under the higher sickness rate in the Republic of North Ossetia-Alania doctors provision in the region is significantly higher: thus in 2014 it comprised 70,3 of doctors per 10 000 of population, and in 2015 – 63,9 of doctors per 10 000 of population that is practically in 1,5 times more than along RF (48,9 and 48,1 accordingly) and in whole in the regions of NCFD (41,6, and 39,6 accordingly); 3) under the significantly higher doctors provision their average salary appeared to be lower than that of neighboring regions and more distant but demographically comparable subjects of the Russian Federation. The author made a conclusion on the need to optimize the staff of medical and preventive institutions in the Republic of North Ossetia-Alaniya in order to create a more efficient system for providing medical services, the types, quality and volumes of which will correspond to the level, structure of morbidity and population needs, with maintaining of beds optimal number and staff size of medical personnel.

Key words: health service, region, efficiency, doctors provision, socioeconomic development

Gurieva L. Analysis of population mortality causes in republic of North Ossetia Alania / annotation

Gurieva Lira – Ph.D. of economics, professor. Vladikavkaz branch of Finance university. Vladikavkaz, Russian Federation.

The article is dedicated to research of the most significant death reasons of the Republic of North Ossetia-Alania population, to which one can refer high infant mortality and death growth of oncological diseases. Particularly, it is educed that infant mortality grew in 1,4 times for 2000-2014 in the region. It is shown that infants before one year old die from two groups of reasons in North Ossetia: from congenital anomalies, from individual conditions, appearing in perinatal period, and from the health state of mother, breeding a child. Fixed level is observed according to the first group of indice, but the index of “infant mortality from separate states, appearing in perinatal period” grew in 2,4 times in 2000-1014.The analysis of adult population mortality educed high and steadily growing intensity of deaths from morbid growths. Death intensity from this reason is generally high in Russian and in all regions of the North-Caucasian federal district, however, the number of registered sick people with firstly made diagnosis of malignant neoplasms grew to 17,1 % for ten years in the Republic of North Ossetia-Alania. The conclusion is made about the fact that decrease of mortality level continues to be priority aim of socioeconomic policy of Russian Federation and its regions.

Key words: population mortality, infant mortality, reasons classes of population mortality

Israelsen D., Kulumbekova M. Pharmacy merchandising in consumer behavior system / annotation

Dwight Israelsen – Ph.D. of economics, professor. Director of cooperative academic programs. Utah State University, USA.
Kulumbekova Marina – Ph.D. of economics, professor. North-Ossetian state university of K. Khetagurov. Vladikavkaz, Russian Federation.

The results of pharmaceutical merchandising as an element of consumer behavior regulation model atpharmaceutical market are given in the article. The following five aspects can be referred to pharmaceutical merchandising: 1) salesroom (format, pharmacy model, zones planning); 2) laying out (planning, formation and shopwindows design). Different variants of laying out are possible, depending on goals, which are set in front of it: “attractive”, “to lay out all assortment”, “little-known medications should be laid out” and etc.; 3) commercial (location and accessibility of information for a consumer in the pharmacy). It should be mentioned that the famous merchandising rule does not work for medications, stating that the decision about purchase in 70 % of cases is accepted at the sale points; 4) shopwindows assortment (priority formation in laying out on the economic analysis basis). Particularly, under ABC-analysis all received medication titles are arranged into several groups: A group characterizes high-turnover medications (in demand), they comprise 10% of assortment and give 80% of commodity circulation; В group - medium-turnover, 15% ofcommodity items fall on their interest – provide 15 % ofcommodity circulation; low-turnover goods of pharmaceutical assortment are included into group C (about 75% of commodity items – comprise 5% from commodity circulations. Additionally, nowadays, group D – acute –turnover commodity groups are emphasized under the analysis of pharmaceutical assortment in many pharmaceutical organizations; 5) integration of “merchandising pharmaceutical companies” (determination of principles and formats of effective “pharmacy reaction” to “merchandising from outside”). In this particular case one can speak about purchase of “popular places at shopwindows”. However, the problem is not in the fact that this phenomenon is not popular.

Key words: consumer behavior, sales promotion, pharmaceutical merchandising system

Kulumbekova M. Research of medical products purchase motivation factors / annotation

Kulumbekova Marina – Ph.D. of economics, professor. North-Ossetian state university of K. Khetagurov. Vladikavkaz, Russian Federation.

On the basis of quiz results of pharmaceutical production consumers of Vladikav-kaz, the author formed the basic features of consumer behavior model at the region pharmaceutical market. Thus, the basic problems, connected with clients service and establishment contact with them turned to be:insufficiency of products knowledge from the position “characterisrics- advantage-benefit”; absence of behavior experience with dissatisfied customers;inefficiency to conduct express-analysis of conducted sale.However, under the conditions of pharmaceutical networks development in the region, from one side, and necessity of alternative pharmaceutical enterprises functioning, from the other, one should emphasize priority marketing tools for the specified forms of pharmaceutical retail. Herewith, the general, in our opinion is considered to be the using of “attract-function” technology, which consists of three basic components:service constituent – accessibility of curative assistance, quality guarantee, catalogue of provided services and etc.;aesthetical constituent – pharmacy interior decoration, appearance of service personnel, design of offered goods for realization and etc.; ethical constituent – attitude to the customers and the experience to work with them. The main condition for the clients-oriented approach – necessity to develop and find balance between all three components of “attract-function”.

Key words: consumer behavior, sales promotion, strong brend, loyalty program, preferences of Vladikavkaz pharmacy visitors

Tuaeva L., Kochieva Zh. Market conditions in the health system / annotation

Tuaeva Lali – candidate of economics, associate professor. Vladikavkaz branch of Finance university. Vladikavkaz, Russian Federation.
Kochieva Zhanna – candidate of economics, associate professor. South-Ossetian research institute. Vladikavkaz, Russian Federation.

The initial position of the study, the results of which are presented in the article, is the statement that health as a specific social sphere of society has its own peculiarities, presupposing the primacy of medical results over financial ones. In this sense, market relations action sphere of in health service is limited. The concept, explaining the need for civil service or public health control is concluded in the fact that the free market (in its pure form), often considered to be a self-regulating and most effective way of achieving the enterprise rise, is simply unsuitable for the health service system due to the fact that health service, as a branch of the social economy, has a number of characteristics that violating the market operation mechanism.The development of market relations, at the moment, practically has not affected the authorities financial mechanism, where the extensive approach under financing still prevails. In modern conditions, domestic health service financing requires a thorough rethinking. Health service as a branch of the public economy has a number of characteristics, violating the market mechanism operation. There is an acute problem of used resources efficient allocation to improve the accessibility and quality of medical assistance. Its solution requires improving management practices, comparative evaluation methods of possible variants available resources distribution and choice grounding of the best of them, which is connected with economic, market, technological, social, political and other factors that need to be addressed.

Key words: health service, market, market relations, financial mechanism, free market

Volkov V. Medical support of Russian workers in the late XIX - early XX century / annotation

Volkov Vyacheslav – candidate of philosophy, associate professor. Military institute (Railway troops and military communication) of Military academy of material and technical supplement of the general A. Khrulev. St. Petersburg, Russian Federation.

The process of medical defense formation of the Russian workers in the end of XIХ – beginning of ХХ century is considered in the article. Methodologically the author proceeded from the fact that understanding extension of production costs phenomenon by capitalists, including medical support, comprises the most significant condition of capitalist labor market formation. Royal authority could not solve the problem of modern medical support system creation by reason of great bourgeoisie Russian opposition and departmental inconformity. But under the working class pressure entrepreneurs and the highest bureaucracy, finally, understood that production costs obligatory should include expenditures for the workers treatment and mainly this comprised the basic element of capitalist labor market formation.Thus, workers medical defense formation from labor capacity loss, peculiar for capitalist epoch, went long and complex way. The fact that was evident for specialists and progressive clerks already in 80-s of XIX century, could not come up to its implementation for long period by the reason of large Russian bourgeoisie opposition and departmental inconformity. But, eventually, under the working class pressure, the entrepreneurs and bureaucracy understood that production costs obligatory should include expenditures on medical defense and workers reward for their labor capacity loss and that this comprised the most important element of capitalist labor market formation. This was reflected in the law from 23 of June 1912 “About workers supplying in case of disease”, which, finally, realized the idea of state medical insurance of workers, taken as agenda some decades before it.

Key words: law, health care, treatment, workers, factory, pension benefits

Don State Technical University
Tbilisi State University
Moldavian association of international law
DANUBIUS University
Varna Free University 'Chernorizets Hrabar'