[Dialogues with neural networks about the present and future of medical professions: risks and prospects].

The article examines the risks to social perception of health professions in the context of the growing popularity of generative textual and visual neural networks. The article is consistent with the growing body of research that tends to see more risks of this technology, including for healthcare. The second focus of the article - the stereotypes about health professions - is critical, as they have been associated with negative outcomes for the healthcare system. The study primarily focuses on the perception of nursing professionals as most stereotyped by the public. Using uploads from the chatGPT, Kandinsky, and Shedevrum networks, the author has investigated the neural network's embedded perceptions of the nursing profession. Reproduction of certain stereotypes has been identified in all neural networks; the appearance stereotypes (gender, age, race, uniform) are more often shared by visual neural networks, while the function stereotypes (lack of autonomy, dependence on colleagues) - by text networks. Actually, we can assume the risks of a vicious circle, when the network is trained on the largely stereotypical data, and products based on its output increase the scale of stereotypical representations during subsequent training of the neural network. Developers' efforts to avoid reproducing stereotypes are acknowledged, however, the uploads show that they are not fully successful. To prevent the spread of perceptual distortions in neural networks, it is recommended to promote their sociohumanistic evaluation. A «prompt-experiment¼ is proposed as a mechanism for identifying such risks.

The specifics of interaction with patients and their relatives as a factor of emotional condition of oncologists.

The paper considers issue of professional burnout of oncologists through the prism of their relationship with patients and their close relatives. The study was carried out using direct and online sociological survey method. The sample included 534 specialists being in constant contact with cancer patients. The results revealed pronounced prevalence of such main burnout domains as emotional exhaustion (55%), depersonalization (19%), reduction of professional achievements (22%). The most common methods of dealing with stress were recreation, sports, communication with immediate relatives, hobbies, walking (7-20%), 4% used alcohol. The high frequency of patient requests to oncologist for psychological support (88%) was established as well as difficulties in communication between doctor and patient because available communication skills are not always sufficient for 76% of oncologists. The majority of respondents support idea of patient need for psychological support and its effectiveness for their treatment and physical and emotional conditions. The similar trends were found in case of close relatives of patients. At the same time some oncologists expressed negative, stigmatizing attitudes towards patients in need of psychological support that requires additional educational work. In oncologists, even when need for psychological support is expressed by patient, willingness to seek it is low: a third of respondents are "rather not ready" to see psychologist even if they had this opportunity. The results meet data of other researches data and reveal that interaction with patients and their relatives is one of the main factors affecting the emotional state of oncologists. Based on study results as well as on publication analysis, comprehensive solution was proposed to implement psychological oncologic service in Russia, which, on one hand, will allow to provide support to cancer patients and their relatives, and on the other hand, will conduct specific training for oncologists concerning skills of psychologically safe communication with patients and coping with negative experiences.

[HOSPITAL EMPLOYEES IN THE COVID-19 PANDEMIC: WORKING CONDITIONS, LOYALTY AND EMOTIONAL STATE].

The spread of the new coronavirus infection (COVID-19) required dramatic changes in the healthcare system, the work of medical workers under extreme stress and an increased threat of infection. In order to formulate general recommendations for preventive work with employees in emergency conditions, a study was carried out of the current nature of work, the emotional state of medical workers and staff loyalty. In a multidisciplinary hospital in Moscow (City Clinical Hospital N 52) in the fall of 2020, a survey of hospital employees (595 people) was carried out according to the author's questionnaire with the additional use of the methodology for measuring the burnout syndrome index (MBI) and loyalty index (eNPS). A number of changes in the nature of work of medical workers were revealed, which had a significant impact on their emotional state, such as changes in the usual functionality, place and mode of work. Despite the negative aspects of working conditions, during the pandemic, the employee loyalty index remained quite high (eNPS = 24), doctors were the most loyal, and junior and middle staff were the least loyal. The assessment of the organizational aspects of the work as a whole was also quite high. The close connection between psychoemotional factors and the loyalty of the organization's employees was confirmed. The study made it possible to offer general recommendations for the development of preventive algorithms for working with employees in case of emergency.

[THE ASSESSMENT OF THE RESEARCH POTENTIAL OF THE AMBULATORY-POLYCLINICAL INSTITUTIONS OF THE MOSCOW HEALTHCARE SYSTEM].

Scientific research and their inclusion in the health care system is an important part of modern medical science. To study the readiness of primary care physicians as well as administration staff to introduce a research component into the national health care system, "The Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department" conducted an online survey of two groups of respondents - physicians of primary care settings (n = 593) and heads of outpatient clinics in Moscow (n = 168) in 2021. The results of the study show the insufficient involvement of primary care doctors in research activities in their working places: more than half do not consider scientific activities as a priority, motivating it by the lack of conditions, practical skills, age and health status as well as high level of employment, although they do not reject it in the future. Heads of Moscow primary health care settings demonstrate similar answers. According to their opinion, research activities are poorly represented in organizations of this type, and most likely the situation will not be changed in the near future; about half do not have sufficient information about the number of employees engaged in scientific work and are rarely familiar with their topics (often extensive, represented by various fields of medicine); about one third of managers reported participating in research projects of Moscow City Department of Health. The study made it possible to identify barriers that prevent the introduction of research components into the activities of Moscow primary health care organizations, which should be taken into account when making managerial decisions.

[Moscow population awareness of stroke and educational policy (survey results)].

Prevention of strokes and the fight against their consequences require not only the work of the healthcare system, but also the self-preserving behavior of the population, which is largely motivated by competence in this sphere. The study of public awareness on this issue and the development of recommendations on information policy were the main objectives of the study. In October-December 2019 two surveys were conducted in Moscow, the sample of each was 800 people. The study found an increase between the waves in the number of those who think they know the signs of a stroke (up to 65%). Despite the mainly correct answers, this self-evaluation is not always backed-up by real knowledge: e.g. a stroke was sometimes confused with an ischemic heart disease, a heart attack and epilepsy. Less competency is demonstrated by men and people with primary/secondary education, younger respondents. 94% of the respondents will call an ambulance when they see signs of a stroke, 16% will begin to provide assistance on their own, and in general their actions will be correct, although there are a number of misconceptions. Among the main risk factors of a stroke the respondents consider bad habits. The population receives information about signs of a stroke mainly from relatives/friends (25%) and on the Internet (22%). The study found necessity for the right information about strokes. There is a need for some greater presentation of peer-reviewed information materials in the information field.

[The basics of health educational activities concerning vaccination in the Internet: "rational" advocates and "emotional" opponents].

The Internet and social media are becoming an influential source of information regarding health care issues, including vaccination. The profound analysis of the Russian Internet discourse on vaccination demonstrated that nowadays there is no clear-cut understanding of adequate strategy concerning informational policy in this direction. The article defines the principles of information policy for pro-vaccine attitudes spreading on the Internet. METHODS: The sampling consisted of the Muscovites Internet messages containing the keywords 'vaccine' and 'vaccinations' and their derivatives. The analyzed period of data export is the first quarter of 2019. The size of uploading was 19948 messages, the random sample of 800 messages and 280 images was taken. Veterinary and spam messages were excluded. RESULTS: The topic of vaccines in our sample is discussed more frequently by women (72%). The average age of participants is 35. The algorithms of vaccination, complications, and necessity of vaccines are the most frequently discussed issues. In our sample pro and contra vaccines messages are of equal percentage (42% and 41% respectively) and there are 17% of those who are in doubt. The key argument for contra vaccines is post-vaccination complications. The visual propaganda of vaccine supporters is aimed at the ideas of common good, rationality, scientific knowledge, they are using lots of humor, and it usually requires the context awareness. The opponents apply more personal and emotional approach. their values are family and personal experience, common sense. Their approach is more appealing to the 'common' reader. CONCLUSION: The article describes strategies for argumentation and pro and contra vaccine propaganda on the Internet. The research offers its results to the segment users concerning their rational and emotional reactions. The work strategy with each group is proposed.

[Four "Big" Stereotypes on Nurses in Mass Consciousness: on the Materials of the Moscow People Opinion Analysis in Social Media].

Staffing problems (including staff shortage) in nursing reveal the connection with the stereotypical perception of the profession. The study of stereotypes was limited to Moscow healthcare and was based on downloading messages from social media (31,613 posts), the relevance of their study is determined by the growth of social media influence on public opinion. 24% of messages about nurses in the sample contain "large" stereotypical images (excluding spam). It was studied four "large" stereotypical images of a nurse: "guardian angel", "doctor's assistant", "authoritarian nurse" and "sensual nurse", and each one has negative aspects. Authors considered the specific perception of each of the images in social media. The remaining 76% of messages do not offer an alternative image of a nurse. The conclusion offers recommendations aimed at increasing the prestige of the profession: creating a new positive image of the profession, promoting it, encouraging nurses to join public space and increasing their autonomy.

[Regulatory Support for Monitoring the Effectiveness of Medical Managers].

Authors considered the issue of regulatory support for dynamic control methodology concerning the performance efficiency of a head (head physician) of the medical organization of Moscow healthcare system. The regulatory framework for assessing the performance of managers in the public healthcare management system is described. The indicators for assessing the execution effectiveness of the state program "Development of Healthcare in the Russian Federation" and Moscow program "Development of Healthcare in Moscow (Capital Health)" are given. Authors analyzed recommendations of the federal executive authorities on the development of performance indicators of social organizations, as well as experience of their implementation by the constituent entities of the Russian Federation. Proposals to improve the system for assessing performance efficiency of head managers of medical organizations were developed.

[Creating Organizational Conditions for Healthy Lifestyle Formation Among Population].

The key role in healthy lifestyle (HLS) formation among the population belongs to medical specialists, who possess reliable scientific knowledge in this field. The effectiveness of spreading healthy living message is connected with organizational conditions: principles of segmentation and patient routing, role of non-physician staff, development of remote forms of work and staff training system. Much attention is given to healthy living attitudes among medical specialists. According to the conducted sociological study and review of foreign and national experience, the authors present practical recommendations which include organizational changes aimed at greater effectiveness of HLS promotion by healthcare professionals.

[The healthy life-style: attitude of population and priority directions].

The Moscow residents are prone to lead a healthy lifestyle (29% follow most principles of a healthy lifestyle and 56% follow some of them). During the study six main aspects of a healthy lifestyle were selected and described in detail from the perspective of Muscovites' self-assessment. Factor analysis revealed two types of behavior that characterize attitudes toward a healthy lifestyle by Muscovites: an "active healthy lifestyle" (nutrition, physical activity, work and rest regime) and a "passive healthy lifestyle" (attitudes towards smoking and alcohol). The mental health factor was examined separately. Statistical analysis of the data showed that the respondents well-being is primarily related to sport and ability to cope with stress (p<0,001). The study also identified risk groups for each aspect of a healthy lifestyle based on differences in the main socio-demographic characteristics. Additionally, the aspect of rational medical behavior was analyzed. The analysis showed that not enough attention is paid to this aspect. The results of the study can be considered in developing priority directions of work in the field of the formation of a healthy lifestyle. The specificity of the approach taken in this study is that recommendations are based on determining the main aspects of a healthy lifestyle and their interrelation, as well as discovering risk groups for each of them and their connection to health self-assessment.