Introduction. The article presents the results of a study assessing the association of alcohol consumption with the development of noncommunicable diseases (NCDs). The purpose of the study: to study the individual relative (OR) and population attributive risks (PAR) of developing NCDs in alcohol consumption among the adult population of the Russian Federation (RF), including depending on gender and intensity of alcohol consumption. Materials and methods. The data source was microdata from a Sample health status observation of the population in RF in 2023. The Observation questionnaire included questions about frequency and amount of alcohol consumption, diagnosed any NCDs of respondents. The intensity of alcohol consumption was assessed using AUDIT (WHO test). The calculation of OR and PAR was carried out using stratification analysis. Results. In 2023, 49.1% of the adult population consumed alcohol during the last 12 months. The intensity of alcohol consumption was low: 98.14% of female-consumers and 87.45% of male-consumers consumed alcohol with a low risk. The OR revealed alcohol as a risk factor for 10 diseases in men and 9 in women. IR was associated with levels of alcohol consumption: at low risk level, men have an increased risk of 10 diseases, women – 5; at risky use level, men have an increased risk of 11 diseases, women –  6. Heavy alcohol consumption increases men’s risk of 12 diseases, in women –  7. In general, excessive morbidity due to alcohol consumption was associated with 16 diseases. Conclusion. Reducing the prevalence of alcohol consumption among the adult population can significantly reduce the incidence of NCDs.

Introduction. In Russia, patient-centredness is highlighted as a new and key area of Roszdravnadzor’s requirements for the organisation of internal quality control in medical organisations. In order to modernise the healthcare system in a patient-centred way, it is necessary to focus on the requirements of the patients themselves and to investigate which criteria play a key role in shaping a positive experience of interaction with healthcare organisations. The purpose of the study: to assess the key criteria of patient satisfaction with medical care in outpatient settings in the Russian Federation. Materials and methods. 1 526 respondents participated in the study. In the first stage, in-depth online interviews were conducted with 17 respondents using the Path Finder methodology. Based on the data obtained, a new questionnaire was developed to assess users’ perceptions of outpatient and polyclinic medical organisations and to identify key factors of satisfaction. In the second stage, 1 509 respondents (age 35–65 years, mean age 48.5 (± 8.3); 54.1% women) living in cities with a population >500,000 people completed the questionnaire. The study included residents of 36 Russian cities from 8 federal districts. Based on the data obtained, a Johnson’s driver analysis was performed with a quantitative assessment of the unique contribution of each factor. Results. It was shown that the key criterion influencing satisfaction with outpatient medical care is the doctor’s behaviour. This criterion consisted of readiness to immerse in the problem (18.29), individualised choice of treatment (10.99), as well as willingness to inform the patient (10.28) and communication style (8.11). Also important for respondents were the equipment of the medical organisation (5.06) and convenience of the appointment process (3.89). Such parameters as quality of repair (1.28), access to electronic maps (0.80) and availability of smartphone application (2.04) were less important for users. Conclusion. The most important criteria influencing the perception of outpatient care are the competence and behaviour of the doctor. At the same time, parameters such as the appearance of the medical organisation and some aspects of digitalisation are significantly less important for patients.

Introduction. In recent years, significant steps have been taken in our country towards the development of inclusive education, including in medical schools. At the same time, issues of overcoming infrastructural, methodological and psychologicalbarriers remain unresolved. The experience of the resource educational and methodological center for training individuals with disabilities and limited health opportunities, support from the state and public organizations aimed at creating an appropriate environment, open up prospects for further optimization of the educational process, improving the quality of training of medical specialists and their successful employment. The purpose of the study: is to demonstrate the role and practical developments of the Resource Center in ensuring the availability of medical education for individuals with disabilities. Research objectives: to present the «Atlas of medical professions available for mastering by individuals with special educational needs, taking into account impaired body functions and providing the greatest opportunity to be in demand in the modern labor market» developed by the Resource Center as a tool for career guidance and career planning, to reveal approaches to the adaptation of curricula and infrastructure, and to outline the prospects for further development of an inclusive educational environment in the healthcare system. Materials and methods. An anonymous survey was conducted among forty-five medical universities in Russia to assess the level of satisfaction with the learning environment and extracurricular opportunities. A total of 1,832 questionnaires with an average age of 20.6 years were analyzed. The survey participants were students with various disabilities. The questionnaire included 32 questions aimed at identifying the profile of respondents, their learning difficulties, needs for technical and psychological support, as well as the level of satisfaction with the learning environment and involvement in extracurricular activities. Results. Based on the analysis of the questionnaire, areas for improving the inclusive educational environment, developing adapted programs and introducing innovative approaches, such as the Atlas of Medical Professions, were proposed. Conclusion. Inclusion in the educational process allows us to form a medical workforce that better understands the needs of various patient groups, including those with disabilities. This strengthens the human dimension of medicine and helps improve the quality of medical care. Equal educational opportunities for persons with disabilities are not only a social responsibility, but also a tool that allows us to create modern, inclusive and human-oriented healthcare.

Introduction. Extracorporeal membrane oxygenation is demanding extensive resources intensive care method and is used as a temporary measure to compensate for respiratory and/or heart failure in potentially reversible diseases and conditions, or as a “bridge” to transplantation of the affected organ (heart, lungs) or the use of long-term support (artificial ventricle or ventricles of the heart) for its function. Significant events that influenced the introduction of the technique into broad clinical practice were outbreaks of infectious diseases characterized by lung damage with the development of severe respiratory failure, including the 2009–2011 H1N1 influenza pandemic, the 2012 MERS-Cov coronavirus epidemic and the 2019–2022 SARSCov-19 new coronavirus pandemic. The purpose of the study: to analyze the use of ECMO in obstetric “near-miss” cases. Materials and methods. The data of the international registry Extracorporeal Life Support Organization (1997–2023), the Russian Society of ECMO Specialists “ROSECMO” (2011–2023) and the Russian Obstetric “Near-Miss” Registry (2021–2023) are analyzed. Results. The ELSO registry has registered 263 cases of ECMO in obstetrics, with a survival rate 70%. There are only 502 cases of ECMO in the “ROSECMO” Registry (there is no division into obstetric and general patients) with a survival rate of 85%. Cases are entered into the “ROSECMO” Registry on the initiative of the physician, on a voluntary basis. The true rate of survival and discharge of patients using the ECMO method from the hospital in Russia is unknown, judging by individual sources it is 10–13%. Russian Obstetric “Near-Miss” Registry –  103 obstetric patients with a survival rate of 32%. Conclusion. Compared with the “ROSECMO” and “ELSO” registers, the Russian Obstetric “Near-Miss” Registry contains the most complete and reliable data on the use of ECMO among obstetric patients. Unlike voluntary, and therefore subjective (mostly cases with a favorable outcome are entered) data entry into the ROSECMO and ELSO registers, data on all cases of ECMO use in obstetric practice in Russia are transferred to the Obstetric “Near-Miss” Registry. The survival rate of obstetric patients when transferred to ECMO is higher than the survival rate in the general population in the Russian Federation. There are reserves for the prevention of maternal deaths with timely and proper use of the ECMO method.

Introduction. Simulation training is a basic component of both medical school and postgraduate education, which requires modern education and healthcare systems to evaluate its effectiveness. The purpose of the study: evaluating the effectiveness of the simulation training allowed them to achieve long-term success and increase their prospects. Materials and methods. Search and analysis of world literature data on simulation training and criteria for the effectiveness of medical training was carried out. Results. Recently, there has been a rapid growth in simulation training programs, which requires the formation of criteria and indicators of their effectiveness. During our analysis of the available data, the following criteria for the effectiveness of the training were identified: frequency of attendance, compliance of the course program with its goals and objectives, simulation equipment, comfort level of participants and team work. Conclusion. Simulation training is a bridge between theoretical, fundamental knowledge and real clinical experience. The effectiveness of simulation training programs determines their rapid growth, which, in the face of an increasing number of proposals, obliges us to determine specific criteria and indicators of their effectiveness.

Introduction. For managers of medical organizations and pathologists, information about payment for pathological studies is important. However, its comparative analysis is difficult due to the cumbersome nature and different structure of the relevant Tariff Agreements in the RF regions. The purpose of the study: perform a comparative analysis of tariffs for payment for pathological studies of biopsy (surgical) material at the expense of compulsory medical insurance funds specified in the Tariff Agreements of the Irkutsk Region for the period 2021–2024, as well as the corresponding tariffs for 2024 in the RF regions the Siberian Federal District. Materials and methods. Tariff agreements of the Irkutsk region for 2021–2024, and the RF of regions of the Siberian Federal District for 2024 are analyzed. The tariffs for pathological studies were calculated taking into account differentiation coefficients. Results. Starting from 2022, the number of tariffs for pathological studies in the Tariff Agreement of the Irkutsk Region has decreased to 45, however, tariffs have appeared that take into account the category of complexity of the material, and there has also been an average threefold increase in the value of tariffs. In 2024, tariffs were indexed by another 4.5%. However, tariffs for pathological studies, taking into account the category of complexity of the material, in the Irkutsk region are the lowest among the RF regions of the Siberian Federal District. In the considered RF regions, the lists and values   of these tariffs differ significantly. Conclusion. Pathological services of the RF regions of the Siberian Federal District operate in very different economic conditions and use different approaches to paying for pathological studies using compulsory medical insurance funds.

Introduction. When carrying out a complex of resuscitation measures, it is extremely important to develop and hone practical skills and well-coordinated work of specialists in a team. The purpose of the study: to evaluate the effectiveness of the training program for providing intensive care to a full-term newborn baby in the delivery room according to the principles of the modified 5 “O” system based on modeling clinical situations among neonatologists, anesthesiologists-resuscitators of the republics of Tajikistan, Kyrgyzstan and Uzbekistan within the framework of the program: “Ways to reduce maternal and infant mortality”. Materials and methods. Among neonatologists, anesthesiologists and resuscitators of the republics of Tajikistan, Kyrgyzstan and Uzbekistan within the framework of the training course (36 hours) “Resuscitation and stabilization of newborns in the delivery room” based on the training program developed according to the principles of the modified 5 “O” system (training, practical skills development, processing and analysis of the results, awareness, feedback communication) at the beginning (PRE) and at the end of the training course (POST) testing, assessment of the sequence, correctness of the implementation of practical skills, a given scenario, debriefing and receiving feedback were carried out. Results. The results of testing before (PRE) and after (POST) training demonstrate an increase in the number of correct answers by 26% (PRE56±6.4 and POST 82±5.2%; p<0.05). In the initial assessment of the effectiveness of the practical part of the training (according to the checklist), students demonstrated a significant increase in performance –  by 36% (PRE42±5.6 and POST 78±3.8%; p<0.05). The time from birth to the start of respiratory support has practically decreased to the recommended 30 seconds (PRE67±12.4 s, POST 38±5.8 s; p<0.05), the time before the start of chest compression (PRE180±19.8 s, POST 104±12.4 s; p<0.05), time before administration of drugs PRE824±32.5 s, POST 362±21.6 s; p<0.05). Conclusion. Practice-oriented training programs and modeling of clinical situations in the provision of intensive care to a full-term newborn in the delivery room are safe, effective and useful for improving doctors’ teamwork skills.

Introduction. A significant event in 2024 is the 150th anniversary of the birth of an outstanding healthcare organizer, politician, scientist and teacher in the field of social hygiene –  Nikolai Aleksandrovich Semashko. The purpose of the study: based on the analysis of works published by N. A. Semashko, to identify the main organizational directions for improving the medical and diagnostic work of doctors in the first half of the twentieth century. Materials and methods. The study of N. A. Semashko’s views on the organization of medical and diagnostic work of a doctor was carried out using analytical and logical methods based on his published scientific works, the search for which was carried out in the Central Scientific Medical Library, the Russian State Library, electronic scientific libraries eLibrary and CyberLeninka for the period from 1918 to 1949. Results. In the course of the study, it was established that Nikolai Aleksandrovich paid close attention to improving the organization of medical and diagnostic work when forming a new healthcare system in our country. Based on his university education, experience as a district zemstvo doctor and his extraordinary abilities, he successfully achieved the development of effective directions of medical and preventive measures not only in the activities of hospitals, clinics, dispensaries, sanatoriums, but also performed by medical personnel at factories, plants and in rural areas. At the same time, N. A. Semashko considered the doctor to be the key figure in the implementation of medical and diagnostic work, who must know his duties and perform them efficiently. Along with this, he considered it important that society, in turn, knew the rights and duties of the doctor and understood the limits of its demands on him. Conclusion. Most of the directions for organizing the medical and diagnostic work of doctors substantiated by N. A. Semashko remain relevant to this day, and therefore they should be developed in the modern conditions of health care.