Bulletin of Semashko National Research Institute of Public Health

The article examines step by step the introduction of information technologies into the obstetrics system of the Tver region. A comprehensive analysis is provided of the connection between the digitalization of care provided and the reduction of mortality rates, improving the quality of care provided and increasing public awareness. The problems arising when introducing information technologies at the regional level are analyzed.

Introduction. Workplace stress is a considerable risk factor for the development of chronic non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, and obesity. Annual global economic losses due to workplace stress exceed 8 trillion dollars. This study aimed to assess the stress levels among employees in the energy sector of the Ural Federal District, working under acceptable and harmful labour conditions, and to analyse their satisfaction with personal and professional life. Materials and methods. In 2022—2023, 4653 employees from the energy sector were surveyed. The questionnaire included questions about stressful situations, personal and professional life satisfaction. Data were analyzed using statistical methods, including Student's t-test and Pearson's χ²-test. Results. Significant differences in stress levels and life satisfaction were found between groups working under acceptable and harmful conditions. Employees in harmful conditions more often reported complete satisfaction with personal and professional life (73.85% and 63.53% respectively in 2023), but also experienced more difficulties in coping with stress. In acceptable conditions, satisfaction levels decreased, while the frequency of stress remained high. Among different types of activities, the highest satisfaction was observed among operational staff, although a negative trend was noted in their assessments in 2023. Conclusion. Working conditions and type of activity significantly affect stress levels and life satisfaction. To reduce stress and improve employee well-being, it is recommended to implement stress management programs, improve working conditions, and regularly monitor stress and satisfaction levels. Limitations. The study is limited by geographical and sectoral factors, as it covers only employees in the energy sector of the Ural Federal District. Ethics. The study was carried out in compliance with the principles of the Declaration of Helsinki of the World Medical Assembly, adopted in 1964.

The issues of planning and financing medical care are inextricably linked to its accessibility and quality at all levels of the healthcare system. The availability of reliable and sufficient information on resource provision and its utilization directly affects the quality of managerial decisions, including those concerning the efficiency of medical organizations. Objective: To conduct an analytical review of the legal and regulatory framework regarding the planning and financing of medical care, as well as the formation of statistical and financial reporting by public medical organizations. Materials and Methods: Content analysis of regulatory legal acts and other documents concerning the regulation of planning and financing medical care at the federal level and the level of the constituent entities of the Russian Federation, as well as federal requirements for maintaining statistical and financial reporting at the level of medical organizations. Results: The conducted content analysis revealed that the planning and financing of medical care, as well as the principles and requirements for reporting in public medical organizations, are governed by a large number of regulatory documents of various statuses and levels. This complicates the process of monitoring and assessing the effectiveness of financial activities of medical organizations and hinders the search for ways to enhance their financial sustainability, including at the federal level where the basic planning and allocation of healthcare system resources take place. Conclusion: There is a need to develop new approaches for creating clear and comprehensible evaluation indicators and a methodology for federal level monitoring of the financial condition and performance efficiency of public medical organizations.

Improving the quality of life of people with disabilities is directly related to the introduction of a multiprofessional approach, which determines the participation of specialists of various profiles, including specialists in social work, in health protection, including the provision of various types of medical and social assistance. The development of professional social work in Russia over the past thirty years has allowed them to expand the scope of their professional activities, one of which is the field of health protection. Professional social work in healthcare, in particular, in medical organizations, can be considered as a separate specific area of its activity — medical and social work. To date, theoretical, methodological, legal and organizational foundations of medical and social work have been developed, and personnel are being trained in the system of higher and secondary vocational education. At the same time, the country has only local experience of their participation in providing medical and social assistance to people with mental disorders, addicted to psychoactive substances, in need of palliative care, since issues remain unresolved related to both the «narrow» understanding of the essence of medical and social work by the medical community, awareness by doctors of the needs for such specialists, the introduction, for example, of a team method of work in medical organizations of specialists of various profiles, as well as issues of interdepartmental interaction between organizations and specialists of health and social protection systems, patients and recipients of social services in organizations that need an integrated approach to providing them with various types of medical, social and other assistance.

Self medication is a global health problem that is becoming particularly relevant in the context of digitalization and limited access to medical care. In the Russian Federation, this practice is recognized as one of the key threats to the healthcare system, which requires the development of scientifically sound strategies to minimize it. The analysis of international and Russian experience has revealed the main factors of the spread of self medication: organizational barriers (difficulties in making an appointment with a doctor), economic constraints, low medical literacy (denial of the risks of self medication), and the availability of over the counter medications. The development of antimicrobial resistance and complications of diseases is particularly dangerous. Effective measures aimed at preventing and reducing the effects of self medication include: improving regulatory regulation, introducing educational programs, developing telemedicine services, and monitoring the advertising of medicines. The results of the study emphasize the need to move to the concept of responsible self medication, taking into account international experience and Russian specifics.

Cardiovascular diseases (CVD) remain the leading cause of death and morbidity worldwide, which requires effective prevention and control strategies. Nurses occupy a key place in the primary health care system, providing early detection and management of CVD risk factors. Their contribution to preventive measures is becoming especially important against the background of the growing number of patients with cardiovascular diseases. The aim of the study is to study successful nursing strategies focused on the prevention of cardiovascular diseases and risk factors for their occurrence in the population in the context of primary health care. Materials and methods. A systematic search of publications in open databases for 2020—2025 was conducted using keywords related to nursing and CVD prevention. Results. 3 key areas of nursing interventions in the prevention of CVD have been identified: 1) early detection of risks (systematic screening, application of standardized assessment scales, step-by-step monitoring of health indicators); 2) educational programs (individual and group counseling, development of personalized recommendations for lifestyle modification, motivational support of the behavior change process); 3) usage of digital solutions (remote monitoring of the patient's condition, the use of mobile platforms to support adherence to therapy, the use of telemedicine technologies for preventive counseling). Conclusion. The participation of nurses in CVD prevention programs has proven its importance for early detection and management of cardiovascular risks. Patient education and motivation, as well as integration into teamwork with doctors, contribute to sustainable improvement of health and reduction of morbidity. The use of innovative approaches and technologies expands the possibilities of prevention.

The name of Doctor of Medical Sciences, Professor, corresponding member of the Academy of Medical Sciences of the USSR A. G. Bukrinskaya is among the leading Russian virologists of the 20th century. Based on the study of archival documents, the scientific heritage of the scientist, as well as the involvement of a few publications dedicated to A. G. Bukrinskaya, the article presents new biographical information supplemented by generalized information about her work at the D. I. Ivanovsky Institute of Virology of the Russian Academy of Medical Sciences and public activities.

The article is devoted to L. M. Starokadomsky, a Russian naval physician and polar researcher, a prominent specialist in the field of hygiene of water transport. He participated in the development of the Northern Sea Route in 1910—15, and in 1932—34 in the North-Eastern polar regions. He participated in the North-Eastern polar expeditions of the People's Commissariat of Water Transport. An island he discovered in the Severnaya Zemlya archipelago (1913) was named after him. Author of manuals on hygiene of sea transport.

Today, the actively used method of transfusion of donated blood and its components, during the Great Patriotic War, due to its novelty, was not sufficiently mastered in civilian healthcare. By the beginning of the Great Patriotic War, transfusion had not yet become widespread in the USSR. In fact, the Great Patriotic War was the first serious test for the blood service. To meet the needs of the armed forces, a wide network of blood procurement was deployed with the involvement of a large number of civilians and military personnel of the rear units. In order to save money, various types of scrap blood began to be used in civil healthcare. The activities carried out proved their effectiveness, and due to the opportunities that transfusion specialists opened up, Soviet healthcare received a powerful impetus in a number of areas.

The narrative we inherited from the Soviet history of medicine and healthcare in the USSR is largely distorted or intentionally falsified. In order not to fall into error when researching this material, it is necessary to use three mandatory techniques: referring to primary sources, the method of criticism of the source and the comparative historical method. Another important methodological issue is the study of scientific schools in medicine and the criteria for distinguishing these schools (including moral criteria). The authors conclude that it is necessary to describe the history of medicine of this period anew.

The state of health of scrub nurses is influenced by professional activity. The article presents an analysis of the effects of surgical smoke on the health of operating nurses, the frequency of development of chronic oropharyngeal pathology and symptoms during work in the operating unit, the load on the scrub nurse per shift is presented. The study proved the direct and strong influence of surgical smoke on the occupational morbidity of scrub nurses, at the same time, directions for a preventive solution to the problem of exposure to surgical smoke were identified and presented.

An analysis of migration processes (number/ratio of arrivals, departures and migration balance) for the period 2000—2022 was conducted. in the Republic of Sakha (Yakutia), which is one of the regions of the Federal District of Sakha (Yakutia) and 13 districts of the Arctic zone of Russian Federation. The regions with whom the most frequent migration «exchange», the age period and the educational census of the most active migrants are specified. In addition, the areas from which the most leave and those where the most arrive are identified. The presented tables show the peculiarities of migration processes depending on medical and economic zoning. It turned out that the most attractive city for moving is the capital of the republic — Yakutsk. It becomes obvious the need to strengthen the attention of the leadership of the republic and municipalities to migration processes, to create conditions for a positive balance of migration, consolidation of the population and, especially, the working age, to improve the demographic situation on the ground.

The objective of this study was to develop proposals for improving the legal framework and implementation of federal projects in healthcare at the regional level. The following key proposals were formulated and scientifically substantiated: development and approval of unified methodological approaches to the development of «core» indicators and activities of federal projects in healthcare; inclusion in federal projects of only those activities for which an assessment of clinical and economic effectiveness was carried out; development and implementation of a system for detailed analysis (monitoring) of the actual results of the implementation of federal projects over the past years; creation of a «flexible» mechanism for making changes to the federal project passport for the purpose of prompt «fine-tuning» of activities and indicators; increasing the role of «supporting» activities of federal projects (provision of patients with drugs and medical products) and activities aimed at improving the effectiveness of medical care and the efficiency of the organization of medical care. Also, in the course of this study, proposals were formulated for assessing the risks of implementing current federal projects in healthcare at the regional level for the period up to 2030.

The professional activity of health workers is characterized by the complex impact of multifactorial risks, including biological, psychosocial, ergonomic and chemical threats. Increased susceptibility of nurses to the risk of developing occupational contact dermatitis is noted, which is due to the peculiarities of their professional activity. The prevalence rate of this disease in this professional group, according to various authors, ranges from 7% to 46%. Such fluctuations can be caused by both objective factors, such as the intensity of the work process and the availability of personal protective equipment, and subjective ones, including individual characteristics of skin reactivity and compliance with hand care recommendations. A direct relationship has been found between the development of dermatological problems and a decrease in performance, which negatively affects the overall functioning of a medical organization. It is believed that nursing students are at high risk of developing occupational skin diseases. This pathology occurs in 20.9% of nursing students.

Introduction. This review article discusses the place and role of environmental determinants in public health from different perspectives. Purpose of the study. To study the role of environmental determinants in public health. Material and methods. In preparing the review, a reporting method was used for systematic reviews and meta-analysis. The search was carried out in the bibliographic databases Elibrary, PubMed, MEDLINE, Google Scholar for the keywords «environmental determinants, public health, environment, health risk factors». Results. The article deals with the categories and factors that determine the environmental determinant from the standpoint of public health. Various methods for assessing the impact of environmental determinants on public health are presented. Their strengths and weaknesses are considered. Based on the results of the analysis of methods for assessing the impact of the environmental environment on health, it was proposed to take into account the combined and combined impact of environmental factors, as well as the time factor, the characteristics of gender and age influence. Conclusion. The concept of the term “environmental determinant” and the categories of parameters that determine it differ significantly in studies. From the standpoint of a deep understanding of ecology as a science and public health, an environmental determinant is the environment surrounding a person in all its manifestations, covering all spheres of life and affecting his health. There is no single methodological approach to assessing the impact of environmental determinants on public health. Many methods have certain disadvantages and are of limited use. To assess the impact of environmental determinants on public health, it is necessary to make a purposeful choice of indicators that fully meet the goals and objectives of the study. With monitoring of environmental determinants by government in all subjects of the Russian Federation, both operational and planned impact on public health is possible, taking into account newly emerging and chronic environmental factors.