The purpose of the study was to create a list of key thematic trends in the subject area “public health” that had taken shape by the end of 2023. Achieving the goal involved solving two tasks: a review of foreign publications devoted to the analysis of key topics in public health in 2021–2023; and the generation and analysis of a sample of the most cited publications in the internationalized public health segment over the same period.
Materials and methods. The formation of a collection of foreign publications devoted to the analysis of trends in the subject area “public health” for the period 2021–2023 was carried out using the PubMed search engine and the query (“TREND*”) AND (“PUBLIC HEALTH”). 59 most relevant publications were selected for review. To create a collection of highly cited publications in the internationalized segment in the field of public health, recorded in research fronts based on the results of 2023, the Clarivate analytical resource – Essential Science Indicators (ESI) was used.
Research results. Integration of the results of two stages of the study (expert assessments and the thematic landscape of a sample of the most cited publications in the field of public health) revealed a complete coincidence of 7 out of 10 trends in the development of public health at the present stage. The frontiers of the thematic area under study included the following thematic areas: the sustainability of national health systems (1), the increase in the number of mental disorders (2), the increase in the use of psychoactive substances (3), the impact of climate change on morbidity (4), the impact of environmental pollution on morbidity (5), healthy eating and food safety (6), aging population (7), sexual and reproductive health disorders (8), road traffic injuries (9), digital transformation of health (10), cancer (11), diseases of the cardiovascular system (12), an increase in infectious morbidity (13).

The aim of the study was to assess the individual and population risks of 20 non-communicable diseases (NCD) among the adult population of the Russian Federation.
Materials and methods. The study used a database of Selective monitoring of the health status of the population conducted by Rosstat in 2023. To estimate the association of tobacco consumption with NCD, two groups were analyzed: current tobacco users and people who have never used tobacco. The prevalence of tobacco use and nicotine dependence were calculated. The relationship between tobacco consumption and development of disease was assessed using individual relative risk (RR), as well as age-adjusted RR (RRv) and nicotine dependence-adjusted RR (RRn). The impact of tobacco consumption on public health was assessed using population attributive risk.
Results. The prevalence of tobacco/nicotine consumption in 2023 was 21.3% among the adults, 35.0% among men and 10.2% among women. Nicotine dependence of moderate and higher degree was detected in 16.7% of the total adult population, 28.9% of men and 6.9% of women. When assessing RRv, tobacco was identified as a risk factor for only five diseases. RRn assessment revealed 13 diseases for which tobacco was a risk factor with a dose-dependent effect. For most of these diseases, RR in women was higher than in men.
Conclusion. Tobacco is a strong risk factor for the most of NCD. In the population in 2013, at least 3–11% of additional cases of NCD was associated with tobacco that could be prevented by tackle of the tobacco consumption.

Objective: identification of significant factors influencing the decision of a psychiatrist-narcologist to allow a driver to drive a vehicle (vehicle) during a medical examination related to the restoration of the right to drive a vehicle. Materials and methods. A series of in-depth interviews with psychiatrists and narcologists was conducted to study the existing problems they face when conducting a medical examination of vehicle drivers related to the restoration of the right to drive a vehicle. Results. When conducting an examination of drivers who were previously deprived of their rights for driving a vehicle while intoxicated, psychiatrists and narcologists tend to be subjective. The degree of perceived risk from making a wrong decision based on the results of this procedure is lower in comparison with an erroneous conclusion when obtaining a certificate for a weapon. Despite the possibility of atracting additional resources when assessing the suitability of drivers, psychiatrists and narcologists tend to avoid making decisions on their own and delegate the conclusion to other specialists. The specifics of the organization of this procedure may have a negative impact on the attitude of the examinee to the doctor (the phenomenon of discrediting the status of a doctor). Conclusion. It is necessary to develop additional diagnostic criteria to the current ones, which must be met by a driver “going through” the procedure for restoring a driver’s license. This is primarily applicable in situations where the laboratory diagnostic method gives a negative result, but the patient’s condition, however, raises doubts among the specialist. There is a need to create a unified algorithm for the examination route map if additional diagnostically significant examination of the patient is necessary.

When studying the attitude of the population to saving their own health, the question of the connection between abstract knowledge about the harm caused to health by risk factors and a real understanding of the harm caused by these factors to their own health remains poorly understood.
The purpose of this work is to analyze the structure of the information field of the population’s attitude to the impact of FR on health.
Materials and methods. The material for the analysis was the results of a sociological survey in three pilot regions of the Russian Federation – Tula Region, Stavropol Territory and the Republic of Crimea. The questionnaire consisted of 33 questions concerning risk factors and their impact on the human body and a block of questions concerning sources of medical information and trust in them. The sample size was 1,718 respondents. The following methods were used: descriptive statistics and the sociological method of questioning. Statistical data processing and reweighing were carried out in the statistical data processing package SPSS22.0. In general, the sampling error in the study does not exceed 1.99% for a confidence level of p<0.1.
Results. The study showed that abstract knowledge about the harm of a particular FR in almost all FR is quite high, since it is precisely on them that the efforts of the medical community have been directed in recent decades. Moreover, the highest values are expected to have such factors as tobacco use, alcohol consumption, elevated blood sugar (glucose) and high blood pressure. The level of knowledge of the harm of FR, to which the medical community paid less attention, was expected to be lower. The lowest value is such a FR as a low iodine content in salt, which is consumed in food. An assessment of the relationship of variables such as abstract knowledge of harm about FR and understanding of their harm to one’s body using a two-way T-criterion showed that these variables are completely independent of each other at the significance level p<0.001. This result made us look more closely at the factor structure of the studied field of reality and put forward the assumption of independence of knowledge about the harm caused to the human body by FR and behavioral patterns in relation to FR. As a result of factor analysis of 73 variables, 9 factors were identified: the first and most powerful factor (10.33%) – knowledge of the effect of FR on one’s own health; the second most powerful factor (8.71%) – knowledge of the harm of FR; the third highlighted factor (5.46%) – trust in information sources, which included both trust in the media and trust in TV presenters, popular personalities and trust in the leaders of the region and the city; the fourth highlighted factor (4.67%) is the gender characteristics of the control of the FR by the population; the fifth highlighted factor (4.59%) is the sources of information about the FR; the sixth highlighted factor (4.30%) – age–related features of FR control; the seventh highlighted factor (3.32%) – the use of gadgets to control FR and exercise; the eighth highlighted factor (3.00%) – trust in health workers as a source of information; the ninth highlighted factor (2.59%) – smoking and alcohol consumption.
Conclusion. The assessment of the effect of FR on the respondents’ own health in the framework of the conducted study turned out to be significantly lower than abstract knowledge about the harmful effects of these FR. The analysis of the factor structure of the studied field confirmed the validity of such a division of knowledge based on ideas about its various forms – «knowledge in itself» and «knowledge for oneself». The analysis made it possible to formulate a number of conditions for improving the effectiveness of preventive work with the population, including to increase the impact of population prevention: it is necessary to more actively involve the most important sources for the population – medical workers, scientific medical workers and health managers; more fully take into account the gender and age characteristics of audiences in preventive measures; the use of mass media should be preceded by an analysis of the level of trust in them from the target audience; the information messages themselves must first be checked for memorability. Preventive measures should change the personal meanings of specific people in relation to FR and HLS, and not be limited to stating general knowledge about them. The study also allows us to determine the directions for further research of the population’s attitude to the FR and their own health as an interdisciplinary task with the necessary involvement of specialists in medical and general psychology, personality psychology and motivation psychology, as well as sociologists.

The purpose of the study: to conduct a clinical and economic analysis of the treatment effectiveness of the patients with a therapeutic profile, depending on the presence of an inpatient emergency department in the structure of the medical organization. Materials and methods. With the help of a retrospective analysis of 474 cases of hypertension worsening during the year, patients length of stay in the hospital, the amount of bills issued depending on the length of stay and the compliance of the conducted volume of examination with the requirements of the criteria for the quality of medical care were studied. Subsequently, using simulation modeling, a comparative analysis of the redistribution of patient flows was performed in order to identify optimal economic and logistical solutions. Results. When comparing the length of stay of patients, it was revealed that in 63.9% of cases, discharge occurred from dynamic observation beds during the first day. The analysis of compliance with the criteria for the quality of medical care showed that in the inpatient emergency department, almost the entire required amount of diagnosis and treatment is performed in a minimum period of time. If there is an inpatient emergency department in the hospital structure, the work model becomes significantly more intensive, but underfunded. Conclusion. The capabilities of inpatient emergency departments ensure short-term treatment of patients in compliance with the quality criteria of specialized care, while maintaining a large throughput compared to the therapeutic department. Based on the results obtained, the payment of cases should not be accompanied by the use of a sign of interruption of the case.

The purpose of the study: to study the effectiveness of organizational and legal measures and new practices to against HIV infection introduced in the Novosibirsk region in 2019–2022.
Materials and methods. The study was conducted on the basis of the State Medical Institution of the NGO «City Infectious Clinical Hospital No. 1», a division of the Center for the Prevention and Control of AIDS.
Results. By Order of the Ministry of Health of the Novosibirsk Region No. 3429 of 10/15/2019, mandatory HIV screening was provided for all hospitalized with unknown HIV status during the year, which significantly increased the coverage of HIV screening. In 2019–2022, an AIDS Center information system was introduced for all patients with HIV infection admitted to inpatient treatment: 6,938 notifications were sent to the AIDS Center. Of the 2,717 patients who required measures to increase the level of adherence and involvement in ART, 18.9% of patients resumed ART after the measures taken; 36.5% started taking ART for the first time. The order of the State Medical Institution of the Infectious Clinical Hospital № 247 «On the organization of family support in the department «Center for the Prevention and Control of AIDS» dated 02.08.2021 provides the principle of monitoring the whole family with one doctor, which improves the adherence of children and parents to ART. For 4 months of functioning of family support, the share of parents receiving ART and having a high commitment increased from 15.5% to 77.3%. Among 45 children who had a previously determined level of HIV RNA viral load on the background of ART, 20% (9 abs.) registered an undetectable level of viral load for 3 months, and 13.3% (6 abs.) – for 2 months.
Conclusion. The organizational and legal measures implemented in 2019–2022 in the Novosibirsk region and new practices to combat HIV infection have shown high efficiency: the coverage of dispensary observation of patients with HIV infection increased from 79.3% to 86.5%, and the coverage of antiretroviral therapy – from 74.5% to 85.2%.