Introduction. The problem of regions with low population density in the aspect of providing medical care to patients with coronary heart disease is extremely relevant due to the insufficiently solved problems: (1) long-term transportation (evacuation) of a patient with acute forms of the disease; (2) difficulty in dispensary supervision of patients with a high risk of fatal cardiovascular events; (3) lack of up-to-date information on the somatic status of this cohort of patients. The above creates difficulties in making managerial decisions aimed at the «frugal» use of resources in the organization of medical care. The creation of the program «Monitoring the condition of patients who have had acute coronary syndrome» (hereinafter referred to as the program, the register) in the conditions of the Amur Region, characterized by a low population density, is due to the need to achieve effective prevention of repeated vascular events. Regular monitoring contributes to the early detection of signs of recurrence of coronary complications, timely correction of therapy, and reduction of the risk of re-hospitalizations due to life-threatening conditions. The maintenance of the register is regarded as an optimal tool for the dynamic assessment of the condition of patients with coronary heart disease and improving the quality of medical care provided to this category of patients. According to the researchers, the implementation of this program allows for a personalized approach to patient management and improves the efficiency of healthcare resources in the region. The purpose of the study: to evaluate the effectiveness of the organizational aspects of providing medical care to patients who have had acute coronary syndrome at the outpatient stage in the Amur Region, a region with a low population density. Research objectives: (1) to explore the possibilities of introducing a specialized program (register) for monitoring patients who have had acute coronary syndrome, in order to: early diagnosis of symptoms of complications, timely correction of therapeutic measures, and reducing the risk of repeated hospitalizations; (2) to study the impact of the register implementation on: the regularity of blood pressure and heart rate monitoring, patient involvement in the treatment process, the frequency of achieving treatment targets, and the timely identification of patients at risk for further medical interventions; (3) to analyze the systematization and structuring of patient data using a register to improve the effectiveness of management decisions on the prevention of coronary complications and the rational use of healthcare resources in the region. Materials and methods. The observation is based on data from patients who had an acute coronary syndrome and were discharged from the register. As of July 2025, 520 patients had been added to the register, and 386 of them were included in the study, with at least 4 months of follow-up at the outpatient stage. The operator collected information through an audio call, asking the patient questions according to a script. Based on the patient’s responses, the register program automatically generated an algorithm of actions for the operator. The necessary patient data was displayed in a tabular format for ease of use and efficiency. The result of this work was the presentation of statistical data on the condition of patients who were discharged from the hospital after an acute coronary event and were under remote monitoring, as well as the organization of their medical care in outpatient settings. Results. In the «register group,» the patients’ conditions were more stable. The proportion of patients who filled out a diary of their blood pressure and heart rate measurements was higher in this group. The achievement of blood pressure targets was also more successful in this group, as the program allowed for the identification of patient risks and the timely referral to a doctor for treatment adjustments. The «register group» was more likely to adhere to regular follow-up appointments, both for patients with complicated and uncomplicated disease courses. These patients were more engaged in the treatment process. Conclusion. The introduction of the register has made it possible to optimize health monitoring, monitor the patient’s condition, systematize data on the course of the disease, more precisely identify patients who require an in-person visit to a doctor for additional examination, therapy adjustment, or referral for surgical treatment, and assess the completeness, timeliness, and quality of outpatient care.

Introduction. A key factor that substantially reduces life expectancy in Russia is high mortality at working ages. The main risk factors are behavioral: tobacco and alcohol consumption, low levels of physical activity and unhealthy diet. All these factors are amenable to modification. The purpose of the study: to conduct a comprehensive analysis of mortality trends in Russia and, on this basis, to identify priority directions of demographic policy aimed at reducing mortality. Materials and methods. Mortality data were obtained from Rosstat, RosBRiS and the Human Mortality Database. Classical demographic methods were applied: life tables, decomposition of differences in life expectancy, analysis of counterfactual trajectories of life expectancy dynamics using the Lee–Carter model, and estimation of years of life lost. Results. For both men and women, diseases of the circulatory system are the leading cause of premature mortality. Among men, external causes also remain an important cause of premature death. Neoplasms are another major cause of premature mortality for both sexes at ages over 40. In 2019, Russia lost a total of 42,597,000 years of life due to premature mortality, which indicates a substantial potential for reducing mortality at almost all ages. Conclusion. Key measures of medical and demographic policy aimed at reducing mortality should include a new anti-alcohol and anti-tobacco campaign, as well as other programs targeting reductions in mortality from external causes, modifying the system for evaluating government health policies, improving support for patients with chronic diseases, implementing preventive interventions, promoting healthy nutrition and physical activity in the population and strengthening vaccine prevention.

Introduction. The article presents the results of historical and medical research devoted to the study of the origins of Russian scientific and clinical pediatrics, its formation and development during the XVIII–XIX–XX centuries. The relevance of this study lies in the fact that it allows us to draw historical lessons from the past, which can be used to address a range of modern medical, social, and demographic issues. The previous experience and professional knowledge of prominent Russian pediatricians provide an opportunity to make breakthroughs in certain areas of child health care and plan the development of new scientific fields in ХХI century pediatrics. The purpose of the study is to establish the main stages of the development of pediatrics as a scientific and clinical discipline and medical specialty in Russia, to determine the role of the state in creating a national system of child health protection, to show achievements in the field of pediatrics and the importance of pediatric education. Materials and methods. During studying the origins of Russian pediatrics, its formation, and development, the following research methods were used: problem-chronological, system-genetic, and comparative analysis. To highlight the problem, chapters of monographs, articles from scientific journals and collections based on archival data, and other materials were studied. Results. The conducted historical and medical review suggests that in the XVIII century there was an urgent need to provide medical care to the pediatric population, but pediatrics as an independent medical discipline did not yet exist. The origin of practical pediatrics in Russia is associated with the organization of Imperial orphanages and the opening of the first children’s hospitals. Thanks to the organization of Foster homes in Russia, a system of medical and social support for children was created and the beginning of the state system of children’s healthcare in our country was laid. During the 19th and 20th centuries, scientific and clinical pediatrics and a medical specialty developed in Russia. In the Soviet Union, the system of child health protection with the priority role of the state and the organization of pediatric faculties in medical universities was recognized by WHO in 1978. It has provided the most child-oriented and accessible health care to the children’s population and has made a significant contribution to the development of world medicine. Congresses of pediatricians in the Russian Empire, as well as in the Soviet Union and post-Soviet Russia, were extremely important in the development of Russian pediatrics. They have always determined the right vector of scientific research and practical healthcare, contributed to improving the skills of pediatricians, improving the quality of medical care, and reducing child morbidity and mortality. Conclusion. By the end of the twentieth century, national pediatrics had become a modern, efficient, high-tech, highly specialized branch of clinical medicine. Russian pediatricians, who have repeatedly made world-class breakthrough discoveries, have made a significant contribution to the development of pediatrics.

Introduction. Due to temporary disability of employees, Russian Federation annually loses about 4% of GDP. A significant issue for the national economics and occupational health is the problem of presenteeism – attending work while being ill – which poses dangers to the employer’s financial well-being and the health of the country’s working population. However, the phenomenon of presenteeism remains largely unexplored worldwide. The significance of the issue of presenteeism is added by the varying results obtained through different assessment methods. Lack of understanding of their frequency, correlation and influence on the choice of approaches hinders both inter-research comparisons and the creation of unified strategies and recommendations to prevent and reduce economic loss associated with presenteeism. The purpose of the study is to systematize data on the prevalence, assessment methods, and economic burden of presenteeism and analyze their regional characteristics. Materials and methods. The systematic review was prepared in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The literature search was performed using PubMed, Scopus, and eLibrary databases. The review includes 84 original articles published in English and Russian between January 2020 and June 2025. Results. The undertaken systematic review has identified a number of key trends and methodological challenges in the research on presenteeism. There is a pronounced regional peculiarity, particularly in European studies, which focus on economic aspects and financial loss. The prevalence of the WPAI questionnaire in global research has been confirmed, while in Asian countries (especially Japan) the WFun scale, reflecting cultural peculiarities, is widely used. There is also a discrepancy in the approach to sampling: the focus on specific nosologies prevails in Western countries, whereas in China and Brazil, certain areas of employee activity are more frequently explored. The thematic analysis shows a focus on pain syndromes, while among the occupation groups, medical workers prevail. An extreme heterogeneity of quantitative result presentation turned out to be the major methodological challenge, significantly complicating comparisons and meta-analyses. This indicates an urgent need to develop uniform reporting standards to improve data validity and comparability. Conclusion. The literature review has identified significant methodological challenges in the research on presenteeism, requiring unification of approaches to its assessment and economic interpretation. The study has proposed the most significant areas for further research, including the development of consensus documents for standardizing assessment methods and data presentation, cross-validation of existing scales, unification of approaches to economic evaluation, expansion of the range of studied nosologies, and the creation of clinical recommendations and guidelines for practical applications to effectively manage presenteeism.

Introduction. In modern medical education, there is a lack of practical experience among students, which reduces their readiness for real work in the healthcare system. The purpose of the study: assessment of the interest of senior students of a medical university in the introduction of new formats of practical classes, including interaction with medical organizations of the region and holding a teleconference with international participation. Materials and methods. The object of research is the interest of senior students in new formats of classes. The unit of observation is a senior student (3–5 courses) of the medical, pediatric and dental faculties of the Federal State Budgetary Educational Institution of Higher Education Kemerovo State Medical University of the Ministry of Health of the Russian Federation. The sample set included 399 students of the medical, pediatric and dental faculties of the Federal State Budgetary Educational Institution of Higher Education Kemerovo State Medical University of the Ministry of Health of the Russian Federation. The methods used were scientific literature analysis, questionnaires (twice: before and after the implementation of new learning formats), and summarization of the information obtained. The developed questionnaires included questions aimed at studying students’ interest in practical skills and assessing their satisfaction. Results. Analysis of the questionnaires revealed a high interest of students in obtaining practical knowledge (91.7%). The greatest interest was attracted by the work of the chief physician (40%) and his deputies (16.7%). After the introduction of new training formats, 98.1% of students rated the visit to medical organizations as useful and interesting. 96.8% of respondents positively rated the teleconference format, however, some technical difficulties were noted when connecting. Conclusion. The introduction of innovative training formats, such as meetings with heads of medical organizations and teleconferences with experts, contributes to the improvement of students’ practical competencies and requires a revision of educational programs with a focus on practical orientation.

Introduction. The safety of local anesthetics in dentistry is directly determined by the quality of drug supply management, including monitoring the movement of medications, taking into account the patient’s allergy history, and reducing the risk of adverse reactions. However, most dental clinics lack automated systems for personalized drug accounting. The purpose of the study was to improve the drug supply system using local anesthetics as an example through the implementation of automated personalized accounting. Materials and methods. The study was conducted at the Regional Dental Polyclinic (Perm Krai) in 2022–2023. The processes of anesthetic movement were analyzed, followed by an audit, implementation of the Unified State Information System in Healthcare (EGISZ PC), economic assessment, and a survey of 87 dentists. Results. The introduction of personalized accounting made it possible to ensure accurate documentation of each ampoule, reduce the risk of errors, improve anesthetic selection, reduce the consumption of local anesthetics by 34%, and decrease expenditures by 28%. Conclusion. The implementation of an automated system and a personalized approach ensured quality control and safety in the use of anesthetics and improved the economic performance of the dental medical organization.

Introduction. Recently, there has been a tendency for management to place excessive demands on medical workers with a low level of equipment in the regions. This is especially relevant for emergency medical workers. Such practices do not allow them to show initiative and independence, which can provoke risks of increasing situational anxiety rates and, as a result, lead to a less effective model of emergency care for the population. It should be noted that improving the work of emergency care directly affects the development of medical institutions as a whole, stimulating their modernization and improving the qualifications of personnel. The purpose of the study: to determine the correlation links between the process of formation of situational anxiety and the attitude of the management in combination with satisfaction with the equipment for medical staff of mobile general emergency medical teams in the city of Ufa. Materials and methods. The material of our study was the results of a comprehensive survey of 528 medical workers of the emergency medical care of the city of Ufa. The author’s questionnaire was compiled taking into account the identification of basic characteristics of the employee’s personality and special indicators of professional activity. The analysis of situational anxiety was carried out according to standardized methods. Correlation analysis was carried out according to the main methods of mathematical statistics. Results. The distribution boundaries of the social indicators under research for emergency medical staff in Ufa showed a positive attitude on the part of management (74.81% vs 10.29%). Low satisfaction with the equipment of general mobile teams was shown by 32.35% of respondents, compared to the number noting high equipment (25.00%). It was revealed that a negative attitude on the part of management and low satisfaction with equipment for emergency medical workers in Ufa sharply increases the indicators of situational anxiety after a shift (AUC0.870 vs 0.116 and AUC0.761 vs 0.303, respectively). Conclusion. The research will allow creating algorithms for optimizing processes, reducing response time, increasing diagnostic accuracy and treatment efficiency at the pre-hospital stage. Improving the efficiency of emergency medical personnel means saving resources, which contributes to wider coverage of the population with high-quality medical care and, as a result, improving the health of the population throughout the country. Thus, the study contributes to the strategy for strengthening the health of Russians at all levels.

Introduction. The growing popularity of alternative smoking methods among young people dictates the need to identify new targets for preventive intervention. The purpose of the study: determination of the degree of perceived risk among young consumers of electronic cigarettes. Materials and methods. The research was conducted using high-quality design, the main method of which was an in-depth interview. A series of 12 in-depth semi-structured interviews were conducted with respondents aged 18–35. The data collected during the surveys was analyzed at three stages of encoding (primary, axial, and selective), highlighting key categories, subcategories, and corresponding text passages. At the first stage, the main categories and their subcategories (codes) were determined. Then, with the help of a technical program, a detailed analysis was conducted, in which the corresponding subcategories were assigned to individual text fragments. Results. In general, the topics that are used in preventive communication to encourage consumers to quit smoking are relevant to ES consumers. The most significant risks associated with smoking ES, as identified by the respondents, include the risk of health harm, increased financial costs, development of dependent behavior, and loss of inner freedom. At the same time, the study also identified risks that are specific to alternative smoking methods, such as the dubious chemical composition of inhaled substances and the risk of purchasing counterfeit products. It is important for consumers to recognize the dangers of ES smoking and be prepared to abandon «unhealthy» behaviors (high involvement), confirming the need for prevention efforts related to alternative smoking. Conclusion. Communication message themes aimed at stimulating cessation of traditional smoking may improve the effectiveness of e-cigarette smoking prevention campaigns among young consumers.

Introduction. One of the most important parameters characterizing population health, is the level of disease prevalence. Children’s health, and especially adolescents, determines the health of the nation in the short term, therefore, the issues of health preservation and improvement require the utmost attention. The purpose of the study is to analyze disease prevalence in girls aged 15–17 in the Russian Federation for the period from 2020 to 2024. Materials and methods. The study used data from the annual reporting forms of the federal statistical observation No. 12 “Information on the number of diseases registered in patients residing within the catchment area of a medical organization” and No. 30 “Information on medical organization” for the period from 2020 to 2024. Statistical and analytical methods were employed. Results. Over the past five years, the rate of disease prevalence in girls aged 15–17 has increased by 15.2%. This increase was due to a rise in prevalence across almost all classes of diseases. In 2024, the structure of disease prevalence was topped by respiratory diseases (37.3%), diseases of the eye and adnexa (11.0%), and diseases of the musculoskeletal system and connective tissue (7.7%). Among individual nosologies, obesity prevalence increased by 16.5%, type 1 diabetes prevalence – by 24.2%, and type 2 diabetes – 1.5 times. Menstrual disorders lead the structure of gynecological diseases, accounting for 71%. The number of abortions tends to decrease (a 19.6% reduction). Conclusion. To achieve the goal of preserving and improving the health of girls aged 15–17 as the basis for future nation health, it is crucial to develop necessary interventions for disease treatment and follow-up of girls with chronic diseases, as well as to implement preventive measures, including utilizing modern clinical guidelines, adapting global best practices, and fostering a healthy lifestyle within families.

Introduction. Today, overweight is an important problem not only for healthcare, but also for the whole society. Many factors are involved in the development of obesity, including stress, which occurs as a response to external and internal influences. In this paper, stress is considered as one of the mechanisms for changing eating behavior and body weight. The study included medical students who experience high emotional stress associated with a busy study schedule and a large amount of studied material. The purpose of the study is to study the peculiarities of eating behavior and the emotional and psychological state of medical students, as well as to identify a possible relationship between stress levels and body mass index of students. Materials and methods. The participants’ height and body weight indicators were analyzed; 322 medical university students participated in the survey conducted with the use of the Reeder questionnaire, aimed at determining the level of psychological stress, and the Dutch Eating Behavior Questionnaire (DEBQ). The data was processed using Microsoft Excel 2019 and PASW Statistics 22 software. Results. Female students were more likely to have low body weight, while males were more likely to be overweight. At the same time, stress levels were found to be higher among females. Studying is the main stress factor for medical students and can lead to eating disorders, in particular, to a decrease in the desire to eat when irritated, while anxiety, concern and tension do not have a significant impact on a person’s attitude to food intake. Rank correlation coefficient showed no association between stress levels and BMI among students (ρ=0,013). Conclusion. A statistically significant difference was found between the level of BMI and the frequency of desire to eat when irritated. However, there was no statistically significant difference in the emotional status of respondents with low, normal and high BMI.