Health Сare of the Russian Federation

Introduction. The staffing problem in healthcare remains relevant, especially within the system of primary healthcare services, which necessitates a comprehensive assessment of human resources and the development of measures to improve staffing in the primary healthcare sector.Purpose. To examine the expert opinions of healthcare managers to identify the main directions for improving the staffing of medical institutions that provide primary healthcare services.Materials and methods. The study utilized expert evaluation methods, as well as statistical and analytical approaches. The research materials include the results of a remote expert survey involving thirty experts — healthcare managers who met established selection criteria and competency requirements.Results. Experts note the significant workload on medical personnel working within the primary healthcare care (PHC) system as one of the key issues related to human resources in primary healthcare. According to the experts, particular attention should be given to training specialists in educational institutions with a focus on the needs of practical healthcare. As the most significant measures of social support for medical workers, experts highlight the need for housing provision and financial compensation.Key aspects for strengthening the human resource potential of rural healthcare include addressing housing issues for medical workers, developing infrastructure, and enhancing the material and technical base of medical institutions.Research limitations. The research materials are limited to the results of individual expert surveys.Conclusions. The use of expert evaluation methods in addressing staffing issues in primary healthcare is appropriate and allows assessing the problem based on the opinions of experienced experts, facilitating subsequent management decisions.Compliance with ethical standards. The protocol for the sociological study was approved by the Ethics Committee for Sociological Research in Public Health at the Russian Research Institute of Health (conclusion No. 8/2024 dated May 8, 2024).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.Funding. 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 9, 2025 / Accepted: February 19, 2025 / Published: June 30, 2025

Introduction. Today, in a large city, private medical institutions providing primary health care are a full-fledged alternative to public clinics.Purpose: to study and compare the medical and social characteristics of patients receiving primary health care in public and private outpatient medical institutions.Materials and methods. The study was conducted in medical institutions providing medical care on an outpatient basis and functioning in the system of the City Health Department or in the private healthcare sector of the city of Moscow. The study used the method of copying data, statistical and analytical research methods.Results. Patients of public and private outpatient medical institutions are mostly women who go to the polyclinic for examination and treatment, which includes general blood and urine tests, biochemical blood tests, ultrasound, radiography, consultations of medical specialists of the 1st and 2nd levels. At the same time, more polymorbid patients from older age groups are observed in the public health sector. The private health care sector caters mainly to able-bodied working contingent who do not have serious health problems, for whom non-therapeutic diseases and examinations are the reason for contacting.Research limitations. The main limitation of the study is its conduction in a single city.Conclusion. The medical and social characteristics of patients determine their objective needs and subjective expectations in the field of health care, so they can be important for improving primary health care in public and private outpatient medical institutions, the formation and development of continuity and partnerships in their work. All this should contribute to improving the availability and quality of primary health care, as well as satisfaction, of such socially significant categories of the population as elderly patients and people of working age.Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), protocol No. 12-22 dated 02.06.2022.Contribution of the authors: Volnukhin A.V. — research concept and design, writing the text, compilation of the list of literature; Morozova T.E., Skvirskaya G.P. — writing the text, editing; Reze A.G., Samokhina E.O., Zaugolnikova T.V. — collection and processing of material; Gurjar M.V., Gertsog A.A. — statistical data processing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Funding. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: October 5, 2023 / Revised: November 13, 2023 / Accepted: December 20, 2023 / Published: June 30, 2025

Introduction. In modern conditions, the main factor in preserving the people in Russia is a decline in mortality and gain in life expectancy, which is especially important for the territories of Siberia and requires detailed study.The purpose: to study the trend in life expectancy in the population of the Krasnoyarsk Territory, the impact on it changes in mortality at certain ages and from leading causes, and elimination reserves.Materials and methods. Age-specific mortality rates from the Russian Fertility and Mortality Database were used. Methods: indirect (demographic) method of constructing mortality tables to calculate life expectancy; E.M. Andreev method to calculate the components of differences and elimination reserves of life expectancy corresponding to individual ages and causes of death.Results. Life expectancy in men in the Krasnoyarsk Territory for 1990–2021.on average was by 2.0 years lower in women than in the Russian Federation. Until 2019, the gain (declinee) of the indicator was largely due to changes in mortality in working age (especially among men), from diseases of the circulatory system and external causes. More than 80% reduction in the indicator for 2019–2021 was associated with mortality from COVID-19. The life expectancy reserve in 2021 was 13.49 years for men and 9.42 for women. The most significant reserves are associated with the elimination in mortality from COVID-19, diseases of the circulatory system, external causes, and neoplasms.Research limitations. Territorial and temporal: the study was conducted for the population of the Krasnoyarsk Territory, 1990–2021. The estimated life expectancy reserve is higher than the real one.Conclusion. When planning the activities of the healthcare system, developing social and demographic programs, in which special attention must be paid to the territories in the east of the country, including the Krasnoyarsk Territory, it is important to know what impact changes in mortality (at what ages and from what causes) have on the trend in life expectancy life, what reserves exist to increase it.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: Baran O.I. — concept and design of the study, collection and statistical processing of material, compilation of a list of references, writing the text; Kutumova O.Yu. — research concept and design, editing; Babenko A.I. — research concept and design, editing. All authors — are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Funding. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: May 14, 2024 / Accepted: October 3, 2024 / Published: June 30, 2025

Introduction. Smartphones (SP) of health-care-workers and trainees could be easily and quickly contaminated by pathogens.The purpose of the study. To evaluate effectiveness of the disinfection with 70% isopropyl alcohol (IPA) on SP contamination, identify the prevalence of bacterial contamination of SP used by health sciences students at Sfax, Southern Tunisia and to delineate its associated factors.Materials and Methods. It was a prospective, pre-post quasi-experimental study in the Institute of Nursing Sciences of Sfax to assess SP’ contamination before and after disinfection with 70% IPA conducted between September and November 2021 among 100 trainees in the clinical services of the two University Hospital Centers of Sfax, Southern Tunisia (Habib Bourguiba Hospital and Hedi Chaker Hospital) and who were carrying SP during their internship. Results. A total of 100 enrollees were included in the survey. The mean age was 20.37 ± 0.7 years. There were 58 (58%) females giving a male-to-female ratio of 0.72. The contamination rate of SP was of 62% among participants. Associated factors of SP contaminations were the 3rd year level (OR = 2.6; p = 0.049), working at a pediatric ward (OR = 2.7; p = 0.042), working at intensive care unit (OR = 3.2; p = 0.018) and working at Habib Bourguiba University Hospital (OR = 2.5; p = 0.026). Isolated germs were coagulase negative Staphylococci (79%), followed by Bacillus spp. (42%), Micrococcus spp. (29%), Corynebacterium spp. (11.3%) and gram-negative-bacilli of the environment (6.4%). Disinfection with 70% IPA had proven to be effective, as it had allowed a reduction rate of 96.25% of the growth of germs.Research limitations. It included the cross-sectional design, through which it was possible to assess only the association between facts, but not to confirm causal relationships and temporality.Conclusions. High level of bacterial contamination of trainees’ SP was observed causing high risk for pathogens spread. The surface spread method using 70% IPA seem to be simple, effective and riskless for SP disinfection.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: Nouha Ketata, Yosra Mejdoub, Imen Turki, Jihen Jdidi, Sourour Yaich — research concept and design, data collection, processing, and analysis, writing, and editing; Salma Maalej, Maissa Ben Jmaa, Salma Smaoui, Mouna Baklouti, Ferièle Messadi-Akrout — research concept and design, data collection, processing, and analysis. All co-authors – approval of the final version of the article, responsibility for the integrity of all parts of the article.Funding. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: August 29, 2023 / Accepted: March 19, 2024 / Published: June 30, 2025

Introduction. Increasing the commitment of minors to a healthy lifestyle in minors is one of the strategic objectives of society.The purpose of the study is to examine the commitment to a healthy lifestyle in rural students based on subjective assessment under holding preventive measures at the municipal level.Materials and methods. Changes in adherence to a healthy lifestyle in the process of carrying out preventive measures were studied based on a survey of six hundred seventeen students in 2015 and 596 in 2022 through a cumulative assessment of the main components of a healthy lifestyle in the author’s version.Results. Along with a significant increase in the proportion of people with high levels of health literacy among 5–8 grade students, the proportion of children who consume fruits and vegetables daily (OR = 0.69, 95% CI: 0.5–0.94) and have physical activity more than 1 hour per day (OR = 0.71, 95% CI: 0.52–0.95), non-smokers, non-drinkers. Against this background, the proportion of children with a high commitment to a healthy lifestyle (6 components formed) increased from 1.54 to 3.98% (p = 0.038), and close to it with 5 components formed from 3.33 to 8.22% (p = 0.038). For 9–11 grade students, these trends are less pronounced. Among children and adolescents with high and close adherence to a healthy lifestyle, there are fewer people with multiple health complaints (p = 0.009; p = 0.007) than in the group with low adherence.Research limitations. In studying the commitment to a healthy lifestyle in rural students, 1213 questionnaires were evaluated, which represents a reference sample, but the study is limited by the age of the students surveyed (grades 5–11), as well as the respondents’ residence in rural areas.Conclusion. In studying the commitment to a healthy lifestyle in rural students, 1213 questionnaires were evaluated, which represents a reference sample, but the study is limited to surveying 5–11 grade students, as well as their residence in rural areas.Compliance with ethical standards. Study approval was provided by the Local Ethics Committee of the Penza Institute for Postgraduate Medical Education — a branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation University (Minutes No. 1 of February 29, 2015). Informed consent was obtained from the parents (guardians) of the survey participants.Contribution of the authors: Vasilyev E.V. — research concept and design, writing the text, compilation of the list of literature, statistical data processing; Shulayev A.V. — writing the text, statistical data processing, editing; Vasilyev V.V. — collection and processing of material, writing the text. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Funding. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: August 25, 2023 / Revised: November 30, 2023 / Accepted: March 19, 2024 / Published: June 30, 2025

Introduction. Health-related behaviour is the actions and habits of a person that directly or indirectly affect on the state of his or her health. Although health promotion strategies often focus on individual health-related behaviors, these behaviours often co-occur.The purpose of the study is to describe the co-occurring adverse health-related behaviours of the adult population of Russia.Materials and methods. The study was carried out on a sample of one thousand eight hundred thirty eight people using statistical and regression analysis methods. The data was drawn from a public health survey carried out in 2022.Results. More than a third of the Russian population have at least two out four adverse health-related behavior modes. The association between smoking and high-risk alcohol consumption was found among both men and women. A relationship was found between smoking and inadequate physical activity only among women. Higher education, monthly income from 20 to 40 thousand roubles reduced and employment was found to increase the likelihood of having co-occurring adverse health-related behavior modes among women, and monthly income from 40 to 60 thousand roubles increased this likelihood among men.Limitations of the study include the cross-sectional nature of the data and the limited number of other health-related behaviours in the study.Conclusion. The results of the study can be used to investigate the relationship between health status and co-occurring health-related behavior modes and can also become the basis for developing strategies to reduce health risks among the adult population of Russia.Compliance with ethical standards. Study approval was provided by the Local Ethics Committee of the I.M. Sechenov First Moscow State Medical University (Sechenov University) (No 15-22 of 21.07.2022).Contribution of the authors: Rodionova T.I. — research concept and design, statistical data processing, text writing; Aleksandrova E.A. — research concept and design, statistical data processing; Davitadze A.P., Khabibullina A.R. — statistical data processing, compilation of the literature list; Svistunov A.A., Fomin V.V. — editing; Kupera A.V. — compilation of the literature list, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Funding. The study was funded by the State Strategic Academic Leadership Program «Priority-2030» (No. 075-15-2021-1324).Conflict of interest. The authors declare that there is no conflict of interest.Received: June 6, 2023 / Accepted: December 20, 2023 / Published: June 30, 2025

Introduction. The problem of comorbid pathology, which is becoming increasingly more important for internal medicine, is still little known in occupational medicine.The purpose of the study is to obtain new data on the development, prevalence, and structure of occupational comorbidity in the copper-nickel ore metallurgical processing.Materials and methods. We studied the data from the register of extracts from occupational disease and poisoning records (Order of the Ministry of Health and Social Development of Russia No. 417 dated 27.04.2012 Health of Russia dated May 28, 2001 No. 176) in the Murmansk region and Krasnoyarsk Territory for 2007-2021.Results. In 2007–2021, 24.6% of nickel industry workers with newly diagnosed occupational diseases developed comorbid pathology. Its prevalence rose from 0% in 2007–2008 to 83.3% in 2021, and the number of diseases increased by 3.17 times over this period. Two diseases were diagnosed in 66 (14.9%), three in 22 (5.0%), four in fifteen (3.4%), five in eleven (2.5%), and six in three (0.7%) of employees. The development of occupational comorbidity is associated with a rise in exposure to the combined effect of harmful production factors (primarily chemicals and the severity of labor), the imperfection of technological processes, and the working conditions of some specialists (primarily cleaners of finished products and crane operators). Respiratory and musculoskeletal diseases were the most prevalent in the structure of comorbid pathology: 31.5% and 23.0%, respectively.Research limitations. The study is limited to the study of the causes of development, prevalence and structure of comorbid occupational pathology in workers engaged in metallurgical processing of copper-nickel ore at enterprises in the Murmansk region and Krasnoyarsk territory.Conclusion. In the nickel industry workers, exposed to combination of production hazards of various natures, the development of occupational comorbidity is caused by the continued work activity of individuals with initial signs of health disorders. For its prevention, it is necessary to timely determine the compliance of the workers´ health status with the current production hazards exposure.Compliance with ethical standards. This study does not require the approval of a biomedical ethics committee, as it is based on archival materials that do not contain personal information.Contribution of the authors: Syurin S.A — concept and design of the study, collection and analysis of literary sources, writing of the text, editing; Vinnikov D.V. — collection and analysis of literary sources, writing of the text, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Funding. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.Received: December 14, 2023 / Accepted: March 29, 2024 / Published: June 30, 2025

Introduction. The desire to switch to advanced medical techniques to carry out targeted prevention, diagnosis, and treatment, improve the quality and effectiveness of medical care is largely focused on the formation of the genetic profile of the population. For the successful development of the institute of genetic certification, phased and diversified work should be carried out, including preliminary organizational and methodological measures. To date, to move in the legal field in a given direction, it is necessary to lay the foundations and structure of rationing.The purpose of the research. To develop a principled approach to the legal regulation of the process of genetic certification in Russia in the context of the development of advanced medical technologies.Materials and methods. The methodological basis of the research consists of both general and private scientific methods of cognition. A systematic approach ensures the formation of a holistic picture of intersectoral interaction in the context of the problems analyzed in the work.Results. The authors outlined the prospects for the development of genetic certification in the context of modernization of the healthcare system, emphasized the role of the named institute for personalized medicine, identified and structured the main regulatory blocks that need to be developed to effectively promote a new form of accounting and registration activities.Research limitations. The article is based on current regulations in the field of healthcare and other branches of law and twenty seven scientific sources available to the authors (Russian and foreign databases of articles, monographs, and reviews).Conclusion. The main task of forming a genetic profile of the population is to improve the life and health of citizens, in this regard, the formation of fundamental provisions on the goals and procedure for genetic certification should be carried out within the framework of health legislation. To achieve the desired balance between the urgent need to actively promote the achievements of genetic research, on the one hand, and the need to ensure the rights and freedoms of citizens, on the other, is possible through strict goal-setting of the process of genetic certification and strict observance of the principle of voluntary conduct.Compliance with ethical standards. The study does not require the conclusion of the biomedical ethics Committee or other documents.Contribution of the authors: Inyushkin A.A. — the concept of research, collection and processing of material, writing a text, editing; Kryukova E.S. — collection and processing of material; writing a text, compiling a list of references. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Funding. The research was carried out at the expense of a grant from the Russian Science Foundation No. 23-28-00720, https://rscf.ru/project/23-28-00720/Conflict of interest. The authors declare no conflict of interest.Received: April 4, 2024 / Revised: May 6, 2024 / Accepted: December 11, 2024 / Published: June 30, 2025

Introduction. The development of digitalization in healthcare based on digital information technologies has ensured the growth of patient-oriented systems for the prevention of chronic non-communicable diseases. In this aspect, patient-oriented systems act as a means of managing the health in each person and an innovative tool for digital disease prevention. With digital prevention of the disease we understand the field of digital health, focused on the use of information and communication technologies, namely digital devices and applications, to solve problems of preventive care for the population.The purpose of the article is to systematize publications devoted to patient-oriented systems for the prevention of chronic non-communicable diseases and to present their multidimensional classification.The selection of publications was carried out using search engines and information resources elibrary.ru, ScienceDirect, BMJ, MEDLINE/PubMed, Elsevier, Springer, MDPI, Sage Journals, JMIR for the period from 2013 to 2023. As a result of expert analysis, fifty four publications were included in the review. Definitions of the concepts “Digital Prevention”, “Patient-oriented Systems” are given, a multidimensional classification of reports in the field of patient-oriented systems is given: by main purpose (28%), by content (13%), by digital technologies used (39%), by type of tasks being solved in the field of disease prevention (41%). We also analyzed reports that used artificial intelligence technologies within patient-oriented systems (13%) and ready-to-use digital solutions (20%).Conclusion. The results will contribute to further research, optimal implementation and effective use of digital technologies in the form of patient-oriented systems to improve the results of preventive measures for patients with chronic non-communicable diseases and the development of digital disease prevention.Contribution of the authors: Afanasieva T.V. — concept and design of the study, search and synthesis of publications, writing the text, compiling a list of references; Zamashkin Iu.S. — text writing, processing and analysis of publications, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Conflict of interest. The authors declare no conflict of interest.Funding. This research was performed within the framework of the state task in the field of scientific activity of the Ministry of Science and Higher Education of the Russian Federation, project “Models, methods, and algorithms of artificial intelligence in the problems of economics for the analysis and style transfer of multidimensional datasets, time series forecasting, and recommendation systems design”, grant no. FSSW-2023-0004.Received: October 4, 2023/ Accepted: December 20, 2023 / Published: June 30, 2025

The article is devoted to the study of sanitary and preventive activities in the Voronezh province over 1896–1906. In the historical literature, the period under the study of the work of the Sanitary Department of the Voronezh Provincial Zemstvo has not received adequate coverage. Therefore, the chronological scope of the article is limited to these ten years. Based on archival documents from the depositories of the Voronezh region, historical materials on the management and implementation of sanitary and preventive measures by the sanitary department of the Voronezh Provincial Zemstvo durinng late 19th and early 20th centuries have been analyzed. The authors calculated numerically and percentages of the main epidemic and infectious diseases of the population of the Voronezh province for the period from 1896 to 1906, and provided information on the overall incidence. The article reveals the fruitful activities of the heads of the sanitary department, N.I. Tezyakov and A.I. Shingarev, in the formation and development of the sanitary and preventive direction in the Voronezh province. The persistence of the officials of the Sanitary Department, seeking support and resources from the authorities, deserves attention. The importance of continuity in personnel rotation in healthcare management in the Voronezh province is noted. The origin of scientifically based measures in carrying out sanitary and preventive work has been established. At the beginning of the activity of the Sanitary Department of the Voronezh Provincial Zemstvo, its work consisted in managing sanitary and preventive measures aimed at eliminating and preventing epidemics. The materials on the results of the first sanitary inspections are presented. The epidemiological situation was determined by the geographical location of the Voronezh province, the state of the environment, in particular, the presence of huge swampy areas, affecting the incidence of the population. As a result of comprehensive measures to improve sanitation in the Voronezh province, including disinfection with disinfectants, isolation of patients, quarantines, vaccination and revaccination, it was possible to reduce the number of epidemics and minimize infectious diseases. Throughout 1897–1906, the Sanitary Department of the Voronezh Provincial Zemstvo became the founding institution of the sanitary and preventive medicine in the region.Contribution of the authors: Serebryany R.S. — concept and design of research, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article; Malikova A.A. — idea of the study, collection and processing of material, writing text, compiling a list of literature.Funding. The study had no sponsor support.Conflict of interests. The author declares absence of conflict of interests.Received: June 18, 2024 / Accepted: October 3, 2024 / Published: June 30, 2025