Introduction. The study is devoted to the analysis of the dynamics of the tobacco and alcohol use prevalence among the adult population during the COVID-19 pandemic.

The purpose of the study: to analyze the impact of the COVID-19 pandemic on the prevalence of tobacco and nicotine-containing products consumption among the adult population of the Russian Federation, men and women, as well as different age groups.

Materials and methods. The data source for calculations was microdata from the Sample observation of the health status of the population conducted by Rosstat in 2019–2022. The indicators characterizing the prevalence and intensity of tobacco and alcohol use by adults of different age groups, men and women, as well as their relative changes in the pre-covid (2019), covid (2020–2021) and post-covid (2022) periods were calculated by the authors.

Results. In 2019–2022, the prevalence of alcohol consumption among the adult population, men and women decreased annually. The largest relative decrease was noted in 2021 and amounted to –5.4% among the adult population, –4.3% among men and –6.1% among women. In 2022, the decline continued and amounted to –1.8%, –0.7% and –2.7%, respectively. In 2021, the maximum decrease in alcohol consumption was detected in the age groups of 15–24 years (–11.0% and –12.2%, respectively), which was replaced by significant growth in 2022. A similar trend was found in relation to the prevalence of tobacco/ nicotine use. During 2020–2021, a decrease in the intensity of alcohol and tobacco use was noted.

Conclusion. In general, the COVID-19 pandemic did not affect the general trends in reducing tobacco and alcohol use among the adult population. The changes in the dynamics of their use (decrease) were temporary and were probably related to both health concerns and restrictions imposed during the pandemic period.

Introduction. The effectiveness of the educational process depends not only on the professional competence of the teacher, but also on the physical and mental state of his health. With the best outcome, the above means that they follow a proper lifestyle (sports, balanced nutrition, sleep, disease prevention, etc.), take care of their own body, as well as the formation of health-saving behavior among students by demonstrating a personal example and spreading knowledge within the framework of this direction.

The purpose of the study is to determine the place of health in the value system of teachers.

Materials and methods. The place of the study was general education schools in Moscow and the Moscow region. The following research methods were used: analytical, sociological, statistical. The survey was conducted using a questionnaire developed by the authors; the questionnaire included 69 questions. The survey of teachers was conducted online via the resource https://docs. google.com/ from February to May 2024. 233 teachers took part in the survey.

Results. A significant part of teachers (45.1%) consider their own lifestyle healthy, however, 40.3% of respondents rarely engage in physical activity, the duration of night sleep for half of the respondents is 5–6 hours, 57.9% are unable to maintain time intervals for eating, a significant part of teachers are stressed due to work most of the time. 41.2% of respondents assess their current state of health as good; 36.5% of respondents indicated the presence of chronic diseases diagnosed by a doctor. The majority of respondents note the high importance of personal health for themselves – 39.5% of respondents consider health to be very important, and 52.8% – simply important. The majority of teachers (98.3%) believe that they are personally responsible for their health. Half of the teachers surveyed indicated that the school is responsible for shaping the lifestyle of children; 90.6% of respondents believe that there is a need to discuss issues of health and a healthy lifestyle at school.

Conclusion. The results of the study indicate a positive assessment of the state of their own health by school teachers and demonstrate its importance for this category of citizens. However, not all of the respondents lead a healthy lifestyle. To strengthen the health of teachers, a set of measures is needed aimed at reducing stress levels, promoting a healthy lifestyle and supporting school staff in seeking medical help.

Introduction. The effectiveness of screening as one of the strategies for cancer control is beyond doubt. Screening reduces the risk of diagnosing cancer at a late stage and identifies precancerous pathologies, thereby preventing the development of cancer. Potential limitations of screening include the high probability of false positives, false negatives, and overdiagnosis. The consequences are additional examinations and unnecessary and, often, excessive treatment. At the same time, interval cancers, which are characterized by an aggressive course, often do not come into view.

The purpose of the study: to explore the data on effectiveness of artificial intelligence (AI) for improving the sensitivity and specificity of cancer screening and reducing the probability of false negative and false positive results, and overdiagnosis.

Materials and methods. Review and analysis of published data on a) screening of breast cancer (BC), lung cancer (LC), prostate cancer (PC), cervical cancer (CC) and large bowel cancer (LBC); b) development and application of AI systems to improve the effectiveness of screening. The PubMed and Cochrane Library databases were searched for relevant publications.

Results. In mammography screening, AI reduces the number of abnormal interpretations of mammograms, the number of recalls, the number of biopsies with a negative result, and increases the efficacy of mammogram interpretation regardless of the characteristics of the breast (dense breast, calcifications). The use of AI in conjunction with low-dose computed tomography (LDCT) for LC screening not only improves the diagnosis of various types of LC, but also predicts the risk of developing cancer several years in advance. A systematic review and meta-analysis of 12 studies evaluating the effectiveness of AI in tandem with multiparametric magnetic resonance imaging (mpMRI) of the prostate showed high overall effectiveness in the diagnosis of clinically significant PC. The performance of the AI system – based on the multimodal data including demographics, clinical characteristics, laboratory tests and ultrasound reports of patients with PC, was better than the effectiveness of PSA tests in diagnosing clinically significant PC. The effectiveness of AI in tandem with colonoscopy, despite the use of the most advanced AI systems (deep learning system based on a convolutional neural network), remains controversial. The solution to this problem depends on what goal we are pursuing when developing and training the system? Increasing “detection rate” of adenomas, regardless of their size, and removing them, or identifying and removing only large adenomas? The successful use of AI for cytological diagnosis of cervical pathology, including all stages of cervical intraepithelial neoplasia (CIN), is encouraging. The introduction of AI systems developed and trained to interact with a cytopathologist in reading and evaluating cytological material and diagnosing CIN and CC into general practice will reduce the burden on cytopahologists and other medical personnel.

Conclusion. The analysis of published data has shown the promising results concerning the use of AI for cancer diagnostics, especially in the setting of population screening programs, which cover many thousands of people. The use of AI significantly increases the effectiveness of diagnostic tool, improves its sensitivity and specificity, and reduces the probability of false negative, false positive results and overdiagnosis. The decision to introduce into practice any of the AIs with proven effectiveness in clinical trials should be made only after its testing in a real world, at the population level. The “informed consent” forms that objectively describe all the advantages and disadvantages of the use of AI compared to current practice has to be developed.

Introduction. One of the main trends in the development of the healthcare system in the Russian Federation is a shift in the emphasis of care from inpatient to outpatient. At the beginning of 2000, this trend in healthcare was confirmed by its development. However, the position on shifting the center of medical care from the inpatient to the outpatient level is currently not confirmed, in particular, in outpatient surgery.

The purpose of the study: to analyze the work of day surgical hospitals and identify problematic issues in the development of hospital-replacement technologies in surgery at the prehospital stage and propose ways to solve them.

Materials and methods. The research materials were our own developments based on the results of the work of day surgical hospitals in the outpatient surgery clinic of the Military Medical Academy of S.M. Kirov, as well as statistical data, scientific works and publications presented in periodicals by the most authoritative representatives of domestic medicine in the field of studying the development of hospital-replacement technologies (day surgical hospitals).

Results. During the study, it was revealed that the number of surgical interventions performed at the prehospital stage has been progressively decreasing since 2005. The average bed occupancy per year in day hospitals of hospitals and clinics is lower than that of 24-hour hospital beds, which indicates the idleness of day hospital beds and their underutilization. There is a low turnover of day hospital beds. All this confirms the presence of problems and low efficiency of day hospitals. To solve problematic issues in the development of hospital-replacement technologies, the authors recommend establishing “normative indicators” for the work of day hospitals, determining the status of a day hospital bed, increasing bed turnover, establishing targeted funding for day hospitals, etc. To improve the system of providing inpatient replacement care at the prehospital stage, it is proposed to create a multidisciplinary center for inpatient replacement technologies. All clinics assigned to the multidisciplinary center for hospital-replacement technologies refer patients who cannot receive routine medical care in the clinic to the multidisciplinary center. The center selects patients who will receive care using hospital-replacement technologies. The remaining patients are sent to hospitals for treatment.

Conclusion. In order to increase the efficiency of day hospitals, it is necessary to establish standard indicators for their work. It is necessary to increase the turnover of day hospital beds. It is advisable to organize targeted funding for all day hospitals. An option for optimizing the organization of inpatient replacement care at the outpatient stage is the creation of a multidisciplinary center for inpatient replacement technologies, which will prevent the “outflow” of outpatients to hospitals and increase the efficiency of using day hospital beds.

Introduction. The trend of uniting the ambulance service in the subject of the Russian Federation has already been introduced in more than half of the regions of our country, but despite this, the arguments in favor of such centralization are still being questioned in the professional community.

The purpose of the study: to study the impact of the association in the Center of Emergency Medical Care and Disaster Medicine on the specifics of providing emergency medical care to patients in the Belgorod region in working conditions in protracted emergencies.

Materials and methods. A comparative analysis of the activities of the emergency medical service was carried out before and after the creation of the Center for Emergency Medical Care and Disaster Medicine. The obtained results were subjected to statistical processing using the Pearson χ² test.

Results. According to the results of the study, it was revealed that despite working in conditions of protracted emergencies of a biological, social and military nature, as a result of the merger, it was possible to significantly (p<0.05) improve the performance of 20-minute delivery of emergency medical services teams to emergency calls. Thanks to the merger, it was possible to ensure timely evacuation of victims with severe combined injuries to level 1 and 2 trauma centers, as well as patients with suspected acute coronary syndrome to the regional vascular center.

Conclusion. The creation of the Unified Center for Emergency Medical Care and Disaster Medicine made it possible to organize the effective functioning of the EMS service in the region against the backdrop of a protracted emergency of a biological, social and military nature.

Introduction. Improving palliative care requires a comprehensive assessment of the quality of its provision from the point of view of patients and their immediate environment, including an assessment of the accessible environment for people with disabilities. The Russian Federation is one of the few countries where this task is set and solved at the state level.

The purpose of the study: to analyze the dynamics of the subjective assessment of the state of the accessible environment in medical organizations providing palliative care for the period 2021–2013.

Materials and methods. The material for the analysis was the results of a sociological survey of palliative care users over 18 years of age; relatives and legal representatives of adult (over 18 years old) patients in need of primary care; relatives and legal representatives of children (under 18 years of age) in need of primary health care, conducted in 2021–2023 using personal interviews at the place of residence. The following methods were used: descriptive statistics and the sociological survey method.

Results. In 2023, compared to 2021, the study showed a significant increase in the proportion of respondents among recipients of palliative care over 18 years of age who noted subjective satisfaction with the equipment of medical organizations to receive people with disabilities. In the group of relatives of palliative care recipients over 18 years of age, compared to 2021, there is also a significant increase in the share of respondents noting subjective satisfaction with the equipment of medical organizations for receiving persons with disabilities from 82% in 2021 to 95% in 2023. This suggests that the accessible environment for persons with disabilities in medical institutions is being improved within the framework of ongoing state and regional programs. A survey of parents of children requiring palliative care also shows a steady increase in satisfaction with the accessible environment in medical institutions over the same period from 85% to 90%. A small proportion of respondents (5–10% of all respondents) indicated some shortcomings in medical organizations, mainly related to the lack of handrails, a sufficient number of wheelchairs and accompanying personnel, and the lack of information stands in Braille).

Conclusion. A survey of people in need of palliative care and their relatives and legal representatives showed that in general the situation with the modernization of medical organizations in terms of creating an accessible environment for patients with disabilities is steadily improving. The vast majority of respondents say that they are completely satisfied with the state of the accessible environment of medical organizations providing palliative care.

Introduction. Negative natural growth and aging of the population are urgent problems in the Russian Federation. The birth of children is closely related to marriage and the formation of a family, the existence of which on average lasts no more than 5 years for every third married couple according to domestic statistics. The institution of marriage in the Russian Federation is currently undergoing a crisis: a significant number of early divorces, the massive spread of officially unregistered cohabitation, voluntary refusal to have children.

The purpose of the study: to study the features of reproductive attitudes and family values in modern Russian society on the example of students of the Ural State Medical University (UGMU).

Materials and methods. A one-stage descriptive study was conducted on the basis of the Department of Obstetrics and Gynecology of UGMU in February-March 2023. The assessment of students’ reproductive attitudes was found out by anonymous questionnaire using Google-forms. In total, 111 students of the 4th-5th year of USMU took part in the study. Microsoft Excel package was used for data analysis (USA, 2016). When scoring a certain parameter, the average value and the standard deviation were indicated.

Results. Young people aged 21–22 study at the 4th-5th courses of UGMU, mostly out of wedlock – 86.5%. 4.5% already have children, including 3 or more. 16.2% do not live a sexual life at all, the rest – in 55.9% of cases use a condom as a contraceptive. In the future, 89.9% of respondents plan to enter into an official marriage under the age of 30, the male partner should be slightly older. The majority of the study participants – 62.5% – would like to have two children. In general, the younger generation has a positive attitude to the issue of adoption, ART methods.

Conclusion. The preservation of reproductive function with subsequent implementation is one of the most important life tasks for the younger generation.

Introduction. Currently, much attention is being paid to studying the level of knowledge of the country's population and improving health literacy in relation to HIV infection and parenteral viral hepatitis. With insufficient awareness of society about various aspects of social infectious diseases, morbidity increases, stigmatization of people living with HIV worsens, mortality increases and a tense situation in society is created.

The purpose of the study: to evaluate levels of awareness among population of the Zabailalsky krai of the Far Eastern Federal district in order to plan priority direction of HIV-infection an viral hepatitis preventive measures.

Materials and methods. To implement the goals and objectives of the research an analysis of population awareness levels about the issues of HIV and viral hepatitis was conducted after outreach event was performed. The questionnaire included 12 questions with a number of answers from 3 to 7 aimed at revealing awareness concerning the issues of HIV-infection and viral hepatitis. A total number of 312 people were examined. The research included sociological (questionnaire), statistical and comparative analysis.

Results. Results of the pilot study revealed a satisfactory level of population awareness on main questions concerning risks of obtaining infection and preventive measures against the diseases. However, answers on some of the questions indicated a need of additional attention during development/adjusting and implementation of different preventive measures and educational programs. Youth mean age of whom equaled 15.6 years exhibited sympathetic behavior towards HIV-infected persons more frequently compared to adult population. Not quite satisfactory levels of awareness concerning ability of HIV-infected people to create family and have children was detected among adult population (mean age – 49.0 years). Some of surveyed people expressed a will to be tested for HIV. A total number of 90.5% of examined youth wanted to be tested but no one had a chance to do it because no one offered it.

Conclusion. Taking in to account the obtained data for further development and implementation of prevention programs it is necessary to pay more attention to protection measures against HIV and hepatitis, emphasize attention on legal aspects of HIV and viral hepatitis issue as well as a necessity of regular testing to control HIV-status. Prevention work should include game-based learning to develop refusal skills to avoid risky behavior by playing out typical situations. It is necessary to continue the study and expand the number of respondents from different key groups and conduct a comparative analysis of awareness levels before and after the outreach events in order to evaluate their efficiency.

Introduction. The problem of disability of doctors is the most important indicator of public health, since doctors solve an important task of state policy aimed at maintaining public health, which determines the study and analysis of the disability status of this contingent of specialists.

The purpose of the study: analysis of factors that shape the medical and social portrait of doctors who have been diagnosed with a disability for the first time. Task. To explore the medical and social characteristics of doctors who are first recognized as disabled in the Irkutsk region in 2021–2023.

Materials and methods. Subject of the study: 400 citizens who were recognized as disabled for the first time in the Federal State Institution «Main Bureau of Medical and Social Expertise in the Irkutsk Region» in 2021–2023. Of these, 174 people are doctors. The study is selective. Selection criteria: persons recognized as disabled for the first time in the Irkutsk region in 2021–2023, working at the time of examination in their specialty. Sources: form 7-social security. Research methods: documentary, analytical, statistical.

Results. In the structure of those first recognized as disabled among doctors, women predominate by gender, while men predominate in the control group, and the average age of initial recognition as disabled in the main group is older than in the control group. Most often, the III group of disability is established in the main and control group, the most rarely – I. Three main classes of diseases form more than 75,0% of primary disability in the Irkutsk region, and disability due to malignant neoplasms in the medical contingent is found slightly more often, and due to diseases of the circulatory system – somewhat less often than in the control group. Most often, in the first-recognized person in the main and control group, restrictions on the ability to self-service, movement and work in their various combinations were revealed.

Conclusion. Among doctors from among the factors that were first recognized by people with disabilities, forming their medical and social portrait, were the female gender, the age of 55 years and older, the presence of a «light» group III of disability due to malignant neoplasms. The primary disability of doctors was most often established due to persistent disorders of the function of the blood system and the immune system, with a limitation of the ability to independently maintain, movement and work.

Introduction. The peculiarities of the culture of food consumption and the level of awareness in matters of nutrition of the working population of the Sverdlovsk region have been analyzed, the trends contributing to the formation of irrational nutrition have been noted, and recommendations for preventive work have been formulated.

The purpose of the study: to identify the peculiarities of food consumption culture and to determine the level of awareness of nutrition among the working population of the Sverdlovsk region.

Materials and methods. A quantitative method was used – an online survey using Computer Assisted WEB Interviewing (CAWI) technology with 2,500 respondents. Quota sampling by gender and age of respondents, with the definition of the territory of residence was calculated.

Results. The number of meals inappropriate to the recommendations, predominance of carbohydrate component in breakfasts and low representation of vegetables and fruits at any meal were revealed. The tendency to prepare food at home remains. A high level of awareness of working residents of the Sverdlovsk region on issues of rational nutrition was revealed – 73%, with a low level of awareness of the impact of dietary intake on the risk of chronic non-infectious diseases – 48%.

Conclusion. It is recommended to disseminate information on the relationship between nutrition and the risk of occurrence and development of chronic non-communicable diseases. Emphasis is placed on the importance of reading information on food labels to identify “hidden” sugar and salt. At the same time, the importance of informing about the norms of consumption of fruits and vegetables, fish, salt and sugar, as well as about the benefits of following the recommended dietary regimen was emphasized. The authors note the need for a deeper analysis of the reasons for the discrepancy between the criteria “know” and “apply” in the issues of rational nutrition among the working population of the Sverdlovsk region.