Bulletin of Semashko National Research Institute of Public Health

The article presents the work of female doctors who were the heads of multidisciplinary and specialized evacuation hospitals in Saratov during the Great Patriotic War. It analyzes their organizational and professional activities in providing medical care to wounded and sick soldiers of the Red Army. The study of archival materials has allowed us to reconstruct the unknown facts about the lives, work, and achievements of female doctors who were the heads of evacuation hospitals in Saratov during the Great Patriotic War and in the post-war period.

In this study, the author attempts to analyze the state of the healthcare system at the regional and municipal levels in the Amur Region. An analysis of the resource provision of the Amur Region's healthcare system for the period 2004—2024 reveals systemic challenges threatening the preservation of human capital. A decline in resources and human resources has led to disparities in access to medical care: the availability of doctors in rural areas is half that of urban areas, and variation coefficients exceed 40%, indicating an uneven distribution of resources. The identified shortages in certain medical specialties contradict the goals of the Russian Federation Healthcare Development Strategy to 2025.

The treatment of malignant neoplasms is a leading issue in global medicine. Early detection of malignant neoplasms and precancerous conditions, ensured through timely and comprehensive screening and preventive examinations, is the key to successful treatment. An analysis of the existing regulatory framework in the Russian Federation revealed inconsistencies and contradictions in certain provisions related to the lack of standardization and disparate locations for conducting necessary examinations in various regulatory acts governing preventive, screening, and routine examinations of women aimed at the prevention and early detection of malignant neoplasms of the female reproductive system, which hinders the proper implementation of these examinations. This problem can be overcome by standardizing the proposed treatment and diagnostic solutions across all existing regulatory acts, as well as revising organizational approaches in favor of conducting comprehensive diagnostic examinations aimed at the early detection and prevention of malignant neoplasms in women within a single, geographically designated structural unit of a medical organization with all the necessary logistical and personnel resources. Implementing the approach of concentrating all necessary examinations in a single location will clearly improve the accessibility of medical care, increase patient adherence to prevention and treatment, and enhance the likelihood of early detection and treatment success. This will undoubtedly improve the quality of treatment and preventive measures and lead to the preservation of women's reproductive health. Improving the organization of medical care and legal support for the prevention of gynecological oncological diseases is of high social significance, due to their inclusion among the key medical causes of reproductive health losses.

This article commemorates the 150th anniversary of the birth of V. M. Bronner, a Bolshevik physician and one of the leading organizers of the campaign against venereal diseases and of medical personnel training in the USSR. Bronner was the initiator and first director of the State Venereological Institute, the executive editor of the journal «Venerologiya i Dermatologiya», and head of the Department of Social Diseases at the People’s Commissariat of Health (Narkomzdrav). He also headed the Department of Higher Medical Education at the People’s Commissariat of Enlightenment (Narkompros), led the Bureau of Foreign Sanitary Information under Narkomzdrav, and from 1935 served as the USSR’s representative to the Health Committee of the League of Nations.

In the context of the global initiative of the World Health Organization «Decade of Healthy Aging» (2021—2030), the development of objective methods for assessing the rate of aging is becoming a priority task of modern medicine. Digital phenotyping of aging (DFS) is a promising interdisciplinary approach that makes it possible to quantify aging processes through the analysis of complex digital biomarkers. The purpose of this cross-sectional study was to structure and evaluate the significance of hemodynamic parameters of systemic hemodynamics (SRS) as key components of the aging phenotype. The study included a cohort of 905 patients aged 1 to 89 years. For a comprehensive assessment of hemodynamics, the method of noninvasive compression oscillometry was used with the registration of twenty-two parameters of the SRS. The calculated biological age (BV), determined automatically based on an algorithm that takes into account the circulatory index and the peripheral vascular resistance index, was used as an integral marker of the aging rate. As a result of the analysis, a set of statistically significant correlations was established between the negative trend of BV (excess of BV over the calendar age) and a number of hemodynamic disorders in people over 45 years of age. These included increased values of systolic, pulse, mean and lateral blood pressure, as well as high rates of cardiac energy expenditure and total peripheral vascular resistance. Separately, a U-shaped relationship between the cardiac index and the rate of aging was revealed, in which the risk of accelerated aging is associated with both hyper- and hypokinetic types of blood circulation. The data obtained expand the arsenal of predictive tools of the CFS and open up new opportunities for the formation of personalized preventive scenarios aimed at slowing the rate of aging and preventing age-associated pathology.

The article provides brief information about Dr. V. D. Chenykaev's medical and social activities in the fight against famine in 1921—1922 and the establishment of Russia's first rural TB dispensary in the village of Turki, Saratov Province. It highlights his four-year medical, diagnostic, preventive, and educational work, as well as the contributions of the dispensary's medical staff, from 1923 to 1927, in combating tuberculosis among the rural population of the region.

This study was conducted to characterize functional gastrointestinal disorders (FGIDs) among Generation Z representatives in terms of their prevalence patterns and risk factors. According to foreign studies, the prevalence of such disorders affects more than 40% of the global population, which allows classifying them as global medico-social problems. FGIDs are widespread among youth, accounting for nearly half of visits to gastroenterologists. Based on the results of 14 studies conducted in Europe, North and Latin America, the global prevalence of FGIDs among adolescents is 23%, meaning that every fourth representative of this generation exhibits corresponding clinical manifestations. The main forms of FGIDs are functional constipation (12%), followed by functional dyspepsia (5%) and irritable bowel syndrome (3%). Recent studies indicate that patients with FGIDs are characterized by a high degree of comorbid psychological and psychiatric disorders. Modern scientific literature identifies the main risk factors for FGIDs in Generation Z as unbalanced nutrition, unhealthy eating habits, insufficient water intake, uncontrolled use of drugs promoted as «digestive improvers,» as well as anxiety, insomnia, impaired intestinal barrier regulation, suboptimal body mass index (BMI), low physical activity, and living in dormitories or boarding schools.

The article presents the results of analysis of dynamics of indicators of life expectancy and healthy life expectancy according key causes. In various world regions there is general trend of increasing life expectancy of population. The general characteristics and specific differences of indicator increasing related to national socio-economic and organizational characteristics of health care of different countries.

In the context of persistent risks of biological, man-made, and geopolitical emergencies that increase the vulnerability of primary healthcare, there is a particular urgency for a standardized assessment of its preparedness. Such an assessment must allow for the benchmarking of results and their translation into specific management decisions. The aim of this cross-sectional analytical study was to evaluate the preparedness of the Moscow Region state primary healthcare organizations for global challenges, based on surveys of healthcare professionals and department heads. Data from 147 department heads and 486 healthcare workers were analyzed. Methodological approaches included psychometric validation of the research instruments (Cronbach's alpha, factor analysis), non-parametric and robust inferential analysis, IRT modeling (Rasch model), latent class analysis (LCA), territorial clustering assessment, and ROC/AUC verification. The average preparedness index was 0.812±0.167 for department heads and 0.709±0.277 for healthcare professionals, revealing a pronounced polarization of profiles. The most deficient areas were resource-intensive and organizationally complex components: human resource reserves and staff rotation, prevention of psycho-emotional burnout, laboratory capacity redundancy, stable communication channels, and regular interagency drills. A significant gap was identified between the existence of formal regulations and the practical application of skills. The findings substantiate the necessity of transitioning from documentary to verifiable preparedness, prioritizing measurable reserves, scenario-based exercises, and targeted measures to mitigate inter-territorial heterogeneity.

The article examines the features of family-marital behavior in older adults and its dependence on economic, social, and psychological factors. The study found that economic dependence and the fear of loneliness are key factors preventing elderly individuals from divorcing, with traditional marital unions dominating despite the rise of civil unions. Age significantly impacts the likelihood of being married, reducing the probability of remarriage. Financial stability lowers the risk of divorce, while difficult financial conditions increase the likelihood of divorce. The presence of children has a weak influence on divorce, but families with multiple children are less likely to break up. Education and employment have a minor impact on the marital status of the elderly. Economic dependency and social norms continue to influence decisions about divorce and remarriage. These factors should be considered in social and medical support programs for the elderly.

In September 2025, the 90th anniversary of the founding of the Molotov State Dental Institute — one of the first specialized institutions in the Urals — will be celebrated. Its history began with odontology courses at Perm University in 1923, followed by the opening of the first dental clinic. The Institute played a key role in training dental professionals and advancing scientific research in the field of dentistry, especially during the years of the Great Patriotic War. Under the guidance of prominent scholars, innovative methods for treating dental caries, maxillofacial injuries, and dentoalveolar deformities were developed. In 1953, the Institute was reorganized, and its foundation laid the basis for the Dental Faculty of Perm State Medical University named after academician E. A. Wagner, which to this day maintains a high standard of specialist training and scientific research in dentistry.

Aim. To evaluate the social effects of the implementation of various innovative diagnostic and treatment methods in the fields of cardiovascular surgery and neurosurgery in a regional multidisciplinary medical organization. Methods. This study is based on an organizational experiment, the purpose of which was to test and evaluate the effectiveness of a proprietary set of organizational and management technologies designed to optimize the implementation of innovative diagnostic and treatment methods in a multidisciplinary hospital. The main group (n=125) included patients who received medical care using the innovative diagnostic and treatment methods introduced as part of the experiment. The comparison group (n=68) included patients who received treatment using standard («routine») diagnostic and treatment methods for similar nosologies, comparable in clinical complexity and patient age. The total sample for the sociological study consisted of 193 people. Results. Patients' opinions on the quality of care provided varied significantly depending on the innovative method used (p=0.0031, Kruskal-Wallis test). The highest average scores were assigned to minimally invasive endovascular interventions: endovascular embolization of vessels and balloon angioplasty (5.00 points each on a 5-point scale). Cryoballoon ablation of the pulmonary vein orifices demonstrated a comparably high result (4.91 points). The integrated indicator of overall satisfaction, assessed on a 10-point scale (Figure 3), demonstrated the most pronounced and highly reliable differences between the groups (p=0.00001, Kruskal-Wallis test). The undisputed leaders were endovascular embolization of vessels (10.00 points) and balloon angioplasty (9.94 points). Patients who underwent endovascular laser coagulation (9.11 points) and radiofrequency thermal ablation (8.78 points) also expressed high satisfaction. Cryoballoon ablation, which demonstrated the best results in terms of quality of life, achieved a more moderate, but still high, score (7.30) in this parameter. Conclusion. Planning for the implementation of innovative technologies should consider not only clinical and economic benefits but also the predicted socio-psychological effectiveness, which varies significantly between different methods. For technologies with delayed clinical and functional results (for example, in spinal surgery), it is necessary to develop and integrate structured patient information programs and support during the rehabilitation period into the treatment process to enhance the positive social impact.

The Russian Ministry of Health's Order No. 202n of April 14, 2025, which substantially reforms labor regulation for medical personnel, requires scientific scrutiny of its consequences and implementation issues. The article conducts a comparative analysis of the new staffing standards with prior regulations and sector-specific standards of care.

This article presents the results of a sociological survey of patients diagnosed with malignant neoplasms to examine access to medical care for them in the Saratov Region. The following methods were used: sociological, content analysis of literary data, and analytical. To examine priority issues of access to medical care for patients with malignant neoplasms in urban and rural areas, an original questionnaire was developed. It included general and specific sections, comprising a total of 29 questions. Its validity was determined using Cronbach's α coefficient, an indicator of the internal consistency or reliability of a set of questions. Literary data confirming the challenges of patient routing for cancer patients in rural areas were analyzed. A statistically significant relationship was found between patients' place of residence and the conditions of cancer diagnosis, the location of examinations at diagnosis, and wait times for medical care. The study identified issues with patient routing when diagnosing malignant neoplasms, leading to increased delays in treatment and diagnostic procedures, and also revealed low access to medical care for rural patients. This study revealed low access to medical care for residents of rural areas of the Saratov Region based on an analysis of a survey of patients receiving specialized treatment for cancer. The study identified challenges in scheduling appointments and obtaining outpatient diagnostic tests, as well as insufficient coverage of routine medical examinations to enable timely detection of cancer. Combating the damage caused by cancer in the population requires a comprehensive approach to detecting malignant neoplasms.