Peer-rewieved journal "Health care of the Russian Federation"
Federal Scientific Center of Hygiene named after F.F. Erisman
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In memory of a teacher, colleague and friend. On the 90th anniversary of the birth of academician of RAMS Anatoly Ivanovich Potapov
22 августа 2025 г. исполняется 90 лет со дня рождения Анатолия Ивановича Потапова — крупного организатора отечественного здравоохранения, видного российского учёного, академика РАМН, профессора, заслуженного деятеля науки Российской Федерации, почётного профессора Сибирского медицинского университета, Калифорнийского, Лионского, Венского университетов, Воронежской и Ивановской государственных медицинских академий, директора ФБУН «Федеральный научный центр гигиены им. Ф.Ф. Эрисмана» Роспотребнадзора в 1990–2013 гг. Более четверти века А.И. Потапов был главным редактором журнала «Здравоохранение Российской Федерации».
Features of staffing of medical institutions of the state healthcare system in the Russian Federation and the Republic of Belarus
Introduction. The shortage of medical personnel is a global problem. But it is the personnel that ultimately determines the effectiveness of all transformations in the industry. In many ways, the personnel situation in the country’s healthcare is determined by the specifics of legal regulation of issues of training, selection, and retention of medical personnel. The purpose of the study: to identify the features of staffing of medical institutions of the state healthcare system of the Russian Federation and the Republic of Belarus. Materials and methods. The study is based on a retrospective analysis of the staffing of medical institutions of state health care systems of the Russian Federation, subjects of the Russian Federation and the Republic of Belarus based on official statistical data for the period of 2018–2023. Methods of analytical, comparative analysis, statistical. Results. Disproportions and imbalances in the staffing of primary care in both countries were revealed; the ratio of doctors and mid-level medical personnel did not correspond to the WHO recommendation, a comparable level of the coefficient of part-time work of doctors, classification of anesthesiology and resuscitation as a shortage specialty. In the Republic of Belarus, higher indicators of provision with medical personnel with positive trend, staffing of full-time medical positions were noted. Research limitations. The research materials are limited to the results of the analysis of data from the federal statistical observation form N 30 for Russia, the state statistical reporting forms 1-institution (Ministry of Health) and 1-ambulance (Ministry of Health) for the Republic of Belarus. Conclusion. The results of the study indicate the need for stricter government regulation of issues of uniform provision of regions with medical personnel, their attraction and retention. Compliance with ethical standards. This type of research does not require review by a local ethics committee. Contribution of the authors: Starodubov V.I. — research concept, read and approved the final version of the submitted manuscript; Rugol L.V. — wrote the article, statistical processing of data, compilation of a list of references; Menshikova L.I. — design of the study, processing of material, revised the article for important intellectual content; Semenov A.V. — collection and processing of material. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interests. The authors declare the absence of any conflicts of interest regarding the publication of this paper. Received: February 18, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Study of the opinion of the heads of executive bodies of the subjects of the Russian Federation in the sphere of healthcare on issues of management of risks impeding the development of the material and technical base of medical institutions
Introduction. The heads of executive authorities of the subjects of the Russian Federation (EASRF) in the field of health protection should be directly involved in the development of a risk management strategy aimed at updating and strengthening the material and technical component of medical institutions, thereby ensuring their effective functioning and stable development in the regions of the Russian Federation, including at all levels of management. Purpose of the study. To study the opinion of the heads of the EASRF on risk management issues that hinder the development of the material and technical base of medical institutions. Materials and methods. Seventy heads of the EASRF were interviewed. Research methods: sociological, mathematical, survey (questionnaire), analytical, content analysis, factor analysis, graphical analysis, descriptive statistics. Data processing was carried out using the licensed software SPSS 22.0. Results: Heads of the EASRF of the Russian Federation were found to be aware of the factors (risks) that reduce the effectiveness of measures aimed at developing the material and technical base of medical institutions, and related to the violation of the deadlines for the preparation of design estimates (97.17%), an increase in the cost of construction due to the identification of works not provided for by the project (95.71%); non-compliance deadlines for commissioning of health facilities completed by construction (95.71%); poor quality of design work (91.43%); the need to review decisions during construction (77.14%), poor quality of construction work (51.43%). According to the heads of the EASRF, it is necessary to increase the level of knowledge and managerial competencies in personnel of medical institutions in planning and control during the preparation and conduct of construction works (98.57%), the participation of head physicians in the development of technical specifications for the construction of medical institutions. buildings of a specific medical institution (95.71%), assigning responsibility for the preparation of technical task to the head physician and his team (54.29%). Research limitations. The study materials are limited to the results of a survey of one group of respondents (70 people), conducted from May to July 2024. Conclusions. Achieving this goal directly depends on the ability of the heads of the Federal Penitentiary Service and head physicians to manage risks that impede the proper execution of work on the design, construction, and equipping with medical and technological equipment healthcare facilities used by medical institutions in providing medical services to the population. Compliance with ethical standards. The study was approved by the Ethics Committee for the Expertise of Sociological Research in the Field of Public Health at the Federal Research Institute for Health Institution and Informatics of the Ministry of Health of the Russian Federation (Conclusion № 7a dated 08.05.2024). All respondents signed informed consent to participate in the study and gave consent to the publication of the results of the sociological survey. Contribution of the authors: Boenko E.А. — collection and processing of material, writing of text, compilation of bibliography, responsibility for the integrity of all parts of the article; Khodakova О.V. — research concept and design, approval of the final version of the manuscript; Shikina I.B. — research concept and design, collection and processing of material, statistical data processing, editing, approval of the final version of the manuscript. Funding. The study had no sponsorship. Conflict of interest. The authors declare the absence of any conflicts of interest regarding the publication of this paper. Received: December 12, 2024 / Accepted: February 19, 2025 / Published: September 12, 2025
A model of regional resource and managerial interaction for the development of export of medical services
Introduction. The export of medical services, implemented in seventy regions of the Russian Federation, in conditions of limited financing requires involvement in existing regional development programs. The analysis of scientific research by Russian and foreign scientists has revealed a gap in the methodology for assessing the level of realization of exports of medical services (EMS) in the regional resource and managerial potential. The task of the study was to develop a model for a comprehensive assessment of the realization of the resource and organizational potential of the export of medical services of the subject. Materials and methods. During the research, the methods of bibliographic and information search of sources in document databases, as well as semantic search of sources on the Internet were used. The analysis of normative legal acts and methodological documents is carried out. The methods of system analysis, information and mathematical modeling were used. Results. As a result of the study of the first three stages of the research, 39 factors of regional resource and managerial potential were identified, combined into 9 groups. Based on the identified factors, a comprehensive model was developed to assess the feasibility of the resource and managerial potential of the subject EMS. Limitations of the study. The study considered no additional factors specific to special economic zones. Also, approved programs and established development institutions at the level of individual regions were not taken into account. Conclusion. The qualitative and quantitative analysis of the region’s involvement in the development of EMS revealed the main factors of resource and managerial potential in the field of healthcare, foreign trade, tourism, national and humanitarian regional policy, as well as the involvement of scientific and academic circles. The constructed model of a comprehensive assessment of the realization of the EMS resource and managerial potential in the region allows 70 subjects participating in the federal project “Development of export of medical services” to conduct a primary assessment of the level of inclusion of exports of medical services in existing regional development programs. Compliance with ethical standards. Research does not require the submission of a biomedical ethics committee opinion or other documents. Contribution of the authors: Chernyshev E.V. — the idea of the study, the concept and design of the study, the collection and processing of the material, the writing of the text, compiling a list of references; Petrova G.D. — editing, responsibility for the integrity of all parts of the article, approving the final version of the article. Funding. The study had no sponsorship. Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article. Received: September 2, 2024 / Accepted: December 11,2024 / Published: September 12, 2025
Development of systemic approaches to management of the regional prevalence (literature review)
Managing the territorial prevalence in the population, especially the economically active part of it, requires an integrated approach based on the principles of primary health care (PHC) and interdepartmental cooperation. Key influencing factors include legislation, ethical standards, diagnostic methods, health monitoring, education, and coordination between government agencies, employers, and medical institutions. The main elements on which the possibility of managing employee morbidity depends on the point of view of the impact on the health of employees (the working population of working age) are analyzed according to publicly available texts in the Russian Science Citation Index, on the PubMed portal. The legislative framework, including International Labour Organization Conventions No. 155 and No. 161 in the field of occupational safety and health) and national standards, sets minimum standards for occupational safety, but workers’ health issues go beyond occupational diseases and require integration with PHC systems. Ethical aspects such as confidentiality and protection of workers’ rights complicate the collection of data necessary for effective management of prevalence. Modern diagnostic and monitoring methods, including biomonitoring and digital technologies, make it possible to identify risks at an early stage, but their implementation requires a balance between efficiency and respect for workers’ rights. Education that increases health literacy and risk awareness plays an important role. Conclusion. To improve the management system, it is necessary to establish interaction between health and occupational safety information systems, ensure data protection and develop targeted prevention programs. Only coordinated efforts by all stakeholders will make it possible to create a sustainable system that promotes the preservation of the health of the able-bodied population and the socio-economic development of the regions. Funding. This article was prepared by the author within the framework of the research work «Scientific substantiation of approaches to transforming the activities of outpatient and polyclinic institutions subordinate to the Department of Health of the City of Moscow» (no. according to EGISU: 123032100061-9). Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article. Received: April 4, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Analysis of the medical and social effectiveness of the implementation of the model of comprehensive support for children with autism spectrum disorders
Introduction. Since 2019, the public project “Mental Health” having been implemented in the Volga Federal District (VFD), comprehensive assistance measures were implemented for children with autism spectrum disorders (ASD). Purpose of the study is to evaluate the medical and social effectiveness of measures implemented during the managerial experiment on early detection and support of ASD children at the regional level. Materials and methods. The research is based on an managerial experiment to introduce a model of comprehensive care for ASD children. Statistical processing and comparative analysis of data obtained from the regions of the VFD within the framework of annual monitoring for 2019-2022 was carried out using parametric and nonparametric analysis methods. Results. From 2019 to 2022, in the regions of the VFD, the overall prevalence of ASD increased more than doubled and amounted to 0.19% of the child population. In 2022, the average prevalence of ASD among children in regions implementing comprehensive measures to help ASD children was 0.23%, which is statistically significantly higher than the average for regions not participating in the Project (0.09%). From 2020 to 2022 the proportion of children with disabilities due to ASD decreased from 56.6% to 43.18%. By the end of 2022 ranged the indicators of child disability due to ASD from 0.5 to 1.2 per 1000 children depending on the date of entry of the regions of the VFD into the Project. Research limitations. The study was carried out on the basis of aggregated summary information without using primary data. Conclusions. The study showed the effectiveness of the managerial model of comprehensive support of ASD children. Indicators characterizing the prevalence of ASD among the child population and disability of children due to ASD correlate with managerial measures implemented in the regions for the early detection of mental development disorders that can be considered as criteria for evaluating their effectiveness. Compliance with ethical standards. This study does not require the conclusion of a biomedical ethics committee or other documents. Contribution of the authors: Karyakin N.N. — research concept and design, editing; Gvozd U.Yu. — research concept and design, writing the text, statistical data processing, compilation of the list of literature; Balandina O.V. — collection and processing of material. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: May 16, 2024 / Accepted: December 11, 2024 / Published: September 12, 2025
Assessment of medical care provided to patients with obstructive lung diseases in the federal districts of the Russian Federation
Introduction. Obstructive lung diseases have a significant impact on the country’s economy. The factors that influence on the level of medical care for these patients remain poorly understood. The influence of some factors of public health determinants on the mortality rate in patients from broncho-obstructive diseases has been studied. Materials and methods. We calculated the correlation coefficient between specific factors of public health determinants, after which each pair of correlation coefficients was assigned a coefficient: for a correlation coefficient value of 0.9 or higher — 1; 0.70–0.89 — coefficient 0.9; 0.50–0.69 — coefficient 0.8; 0.30–0.49 — coefficient 0.7; less than 0.29 — 0.6. Then we calculated the total score obtained by multiplying standardized indicators of each studied factor by the coefficient, which calculation described above, for each federal district. Results. A very strong inverse correlation was found between mortality and economic factors, the number of annual treatment courses, the smoking prevalence, as well as the amount of funds spent on drug provision. A strong inverse correlation was observed with the level of funds spent on preferential drug provision. The correlation with the frequency of use of fixed triple combinations of drugs and the sum of compulsory medical insurance funds spent on drug provision was moderate. The link with availability for pulmonologists was weak, while there was no connection with availability of general practitioners. Calculation of the total scores of the studied factors revealed a substantially higher value in St. Petersburg — 29.3. Moscow and the Northwestern Federal District (excluding St. Petersburg) had totals two or more times lower than just St. Petersburg alone. The lowest total score was in the North Caucasian Federal District. Research limitations. The study is limited by the examined public health determinants. Conclusion. An integrated assessment of the quality of medical care provided to patients with obstructive lung diseases based on an analysis of public health determinants can serve a tool for the healthcare management in the federal districts of the Russian Federation. Compliance with ethical standards: the study does not require the submission of the opinion of the biomedical ethics committee or other documents. Contribution of the authors: Linnik S.A. — research concept and design, writing the text, compilation of the list of literature, statistical data processing; Avdeev S.N. — research concept and design, editing; Tumenko E.N. — research concept and design, collection and processing of material; Shvachko S.A. — collection and processing of material. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: January 16, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
The role of primary care nurses in preventive medicine: a review of foreign and domestic practices (literature review)
Chronic non-communicable diseases (NCDs), including cardiovascular pathologies, diabetes mellitus, oncological, and respiratory diseases, are closely related to behavioral risk factors, which makes prevention a key element of modern healthcare. Prevention at the primary health care level is recognized worldwide as a key tool for reducing morbidity and economic burden on health systems. The purpose of the study was to study the role of primary care nurses in the institutions of preventive care for the population in foreign countries and Russia. The search was carried out in domestic and international bibliographic databases eLIBRARY.RU, PubMed, MEDLINE, Google Scholar for 2020–2025 by keywords: "the role of nurses in preventive care", "successful preventive practices under the guidance of nurses", "effectiveness of preventive care". Nurses play a key role in the implementation of prevention programs, including educational strategies, screening and early detection of diseases, health promotion and disease prevention, as well as interaction with other healthcare professionals. The international experience of managing preventive work has been studied. The features of preventive activities of nurses in the Russian Federation (RF), including the work of pre-medical reception rooms and Health Schools, are considered. The factors influencing the effectiveness of preventive work are analyzed: managerial conditions, staff training level, material and technical support. The prospects for the development of preventive medicine, including the use of modern technologies by nurses, are discussed. Nurses were concluded to have a significant potential in reducing the incidence of chronic pathologies and optimizing the healthcare system. The need for further improvement of the management of preventive work at the primary care level is emphasized. Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, protocol dated 11.02.2025 No. 02-01/ЭК/2025. Contribution of the authors: Burkovskaya Yu.V. — concept and design of research, collection and processing of material, writing of text, compilation of a list of references, editing; Gazheva A.V. — collecting and processing material, writing text, editing; Sviridova T.B. — collecting and processing material, writing text. All authors are responsible for approving the final version of the article and for ensuring the integrity of all parts of the article. Funding. This article was prepared by the authors’ team within the framework of the research work "Scientific substantiation of approaches to transforming the activities of outpatient and polyclinic institutions subordinate to the Department of Health of the City of Moscow" (no. according to EGISU: 123032100061-9). Conflict of interest. The authors declare the absence of obvious and potential conflicts of interest in connection with the publication of this article. Received: April 1, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Prevalence of social isolation among patients with age-related macular degeneration
Introduction. Social isolation is usually studied in common somatic diseases: arterial hypertension, coronary heart disease, obesity, but is rarely considered among patients with age-related visual impairment and, in particular, with age-related macular degeneration. The purpose of the research. To study the prevalence of social isolation among patients with age-related macular degeneration. Materials and methods. The study included five hundred forty eight patients suffered from age-related macular degeneration with a disease duration from 2 to 4 years. For a comparative assessment of social isolation, there was formed a control group included 205 patients without this ophthalmopathology. A modified version of the social exclusion index was used to identify the social exclusion syndrome. Results. The prevalence of social isolation in general was 12.34 cases per 100 surveyed patients. At the same time, in the age group of 18–39 years, the prevalence of social isolation was 5.21 cases per 100 surveyed and was the lowest, and in 70–79 years the highest — 22.35 cases per 100 surveyed patients. When calculating the social isolation index, it was found that the social isolation syndrome among patients with age-related macular degeneration proceeds less favorably than without it and visual impairment significantly reduces the communicative actions of patients. Limitations. To study the prevalence of social isolation in patients with age-related macular degeneration only, to conduct a study in one regional region without comparison with other territories. Conclusion. The prevalence of social isolation among patients with age-related macular degeneration has a pronounced dependence on the age of the examined and proceeds less favorably in patients with this ophthalmology than in its absence, which indicates the importance of correcting visual deficits due to age-related macular degeneration and expanding social contacts of such patients. Compliance with ethical standards. The study was approved by the committee on Biomedical Ethics of the S.N. Fedorov National Medical Research Center "Eye Microsurgery", Tambov protocol no. 148-э, dated 09.02.2022. All participants gave informed voluntary written consent to participate in the study. Contribution of the authors: Agarkov N.M. — design development, article editing; Popova N.V. — collection of data, data processing, preparation of an article. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: October 12, 2024 / Accepted: February 19, 2025 / Published: September 12, 2025
Features of the immune and genetic profile in children with musculoskeletal pathology under exposure to biocontamination with aluminum compounds
Introduction. The musculoskeletal (MS) system stores heavy metals like aluminum, potentially causing bone defects in polluted environments. The purpose of the study is to evaluate the immune and genetic profile in children with MS diseases under exposure to aluminum biocontamination. Materials and methods. One hundred sixty six children from an aluminum province were selected to make up observation with diagnosis as 66, M85.8 «Other specified disorders of bone density and structure») and comparison (100 healthy) groups. The following iondices were estimated: CD19+ (cytofluorometry), IgG to aluminum (allergosorbent testing), osteocalcin (EIA), IgG, IgM, IgA (Mancini). PCR determined TLR4 A8595G (rs1927911) and VDR C>T (rs2228570) polymorphisms. Results. The aluminum content in blood in examined children with MS diseases was 0.0317 ± 0.0051 mg/dm³, which is 2.66 times higher than in the comparison group. IgG to aluminum in 74.5% of thr children exceeded the reference range. N-osteocalcin was reduced by 1.13 times. CD19+ hyperexpression (2.36 times), IgG increase by 1.2 times and IgA deficiency by 1.32 times were established. In the observation group against the comparison group, a significant increase was established in the frequency both of the variant allele G TLR4 and the variant allele C and the CC genotype VDR, by by 1.9 times and 1.4–2.6 times accordingly. Research limitations. The study sample was limited to children aged 3–6 years living in a zone exposed to aluminum production emissions; for the observation group, diagnosis M85.8. Conclusion. We established activation in the B-lymphocytes→reagins system, CD19+→IgG→specific IgG to aluminum compartments, which may indicate that immunity participoates in the formation of MS pathology. The presence of variant alleles and genotypes of candidate genes VDR C>T (rs2228570), TLR4 A8595G (rs1927911) increases the risk of metabolic and immune disorders associated with bone tissue by 1.2–1.6 times. Compliance with ethical standards: The study was approved by the Ethics Committee of the Federal Scientific Center for Medical and Preventive Technologies for Population Health Risk Management (protocol No. 2 dated March 13, 2024). Parents or guardians of all children signed voluntary informed consent to participate in the study. Contribution of the authors: Zaitseva N.V. — study concept and design, writing the text, editing; Shirinkina A.S. — collecting and processing material, writing text, editing, compiling a list of references, statistical data processing; Dolgikh O.V — study concept and design, writing the text, editing; Kazakova O.A. — data analysis, writing the text. All authors have approved of the final version of the article and bear full responsibility for the integrity of all its parts. Funding. The study was not sponsored. Competing interests. The authors declare no competing interests. Received: March 17, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
On the issue of justification of criteria of health risk in sanitary epidemiological requirements directed at the prevention of infections associated with provision of medical care (literature review)
In the problem of studying hospital microflora, there has arisen a need to standardize the impact of microbiological agents and develop minimum permissible levels of exposure as health risk criteria that allow optimizing the provision of anti-epidemic protection in medical institutions. The proposed indicators, criteria, and norms of control of the hospital environment are indicative, since it is extremely difficult to establish the dependence between the number of microorganisms in the air, at the objects of the hospital environment, and the incidence of patients, due to the lack of threshold levels, reference substitutions, and minimal infected doses of microbial agents. System analysis of scientific literature performed using the databases Web of Science, Scopus, The Cochrane Library, MedLine, PubMed, CyberLeninka, eLibrary.RU, showed that the effect of the microbiological factor, most likely, should be considered threshold-free, taking into account the extensive list of criteria for evaluating the epidemic situation that are not standardized and do not imply a quantitative assessment of microbiological risk. The priority area of ​​optimization of antiepidemic measures, taking into account the methodological basis for analysis of health risk, is the development of requirements for the permissible content of microbial agents in the air of the hospital environment and flushing from surfaces. The subsequent establishment of indicative indicators of the assessment of the nosocomial environment will contribute to the fulfillment of mandatory requirements by medical institutions on the one hand, and on the other hand, the exercise of the powers of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor). In this regard, the scientific search in the field of ensuring the safety of the hospital environment should be focused on the problem of developing parameters for the dependence of the incidence of the care-associated infection and the exposition of microbiological agents based on the establishment of the minimum valid levels of exposure and the levels of acceptable health from the effects of hospital strains. Contribution of the authors: Zaitseva N.V., Shur P.Z. — research concept and design, editing; Redko S.V., Fokin V.A., Suvorov D.V. — collection and processing of material, writing the text, compilation of the list of literature. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: February 17, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Occupational stress and the risks of cardiovascular diseases development in chemical industry workers
Introduction. The article examines the impact of occupational stress on the risk of developing cardiovascular diseases (CVD) among workers in chemical production. The study covers two groups of employees from chemical industry enterprises with different levels of process automation — ethylbenzene-styrene (EBS) and ethylene-propylene (EP) production. The purpose — to investigate the effect of occupational stress on the development of cardiovascular diseases among workers in specific chemical industries and to develop a set of preventive measures aimed at reducing cardiovascular risk. Materials and methods. The study included an analysis of working conditions, the psychophysiological state of employees using standardized questionnaires (“DORS,” HADS, Reeder), as well as results from periodic medical examinations. Results. Operators of ethylene-propylene (EP) production, working in conditions of more pronounced exposure to harmful production factors (class of working conditions 3.2), have a higher level of anxiety, stress and fatigue, compared to operators of ethylbenzene-styrene (EBS) (class of working conditions 3.1). The operators of the EP production showed a higher prevalence of arterial hypertension (34.3% versus 27.2% among the automation center workers working under the acceptable class of working conditions), as well as a significant prevalence of subclinical anxiety (37.9% versus 21.7% among the automation center workers). The analysis of risk factors according to the SCORE scale showed a higher cardiovascular risk among the workers of this production. Limitations include the lack of consideration of individual risk factors among workers and the subjectivity of stress assessment methods. Conclusion. Based on the study results, a set of preventive measures was developed to reduce the negative impact of occupational stress on workers. The proposed measures should be incorporated into the corporate program and focus on optimizing working conditions, training in stress management techniques, and health monitoring. Compliance with ethical standards. The study was approved by the local ethical committee of the Ufa Scientific Research Institute of Occupational Medicine and Human Ecology (meeting protocol No. 01-1 dated January 22, 2025), and the Helsinki Declaration of the World Medical Association was carried out. Contribution of the authors: Karimova L.K. — the concept and design of the study, writing text; Zaydullin I.I. — writing text, statistical processing; Muldasheva N.A. — writing text; Sheenkova M.V. — editing; Gimaeva Z.F. — collection and processing of material; Ryabova J.V. — compiling a bibliography. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: March 10, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Implementation of a program of hygienic training for mechanical engineering workers on healthy nutrition issues within the framework of the national project “Demography”
Introduction. To implement the national project “Demography”, specialists of Federal Scientific Center of Hygiene named after F.F. Erisman, have created a training (educational) program on healthy nutrition for workers in difficult and harmful working conditions. The planned outcome of the program is to increase the educational qualification in matters of healthy nutrition in working collectives. The purpose of the study. To evaluate the effectiveness of using by engineering workers educational materials on healthy nutrition. Materials and methods. A study of the nutritional status and the state of actual nutrition in one hundred eight mechanical engineering workers aged 29 to 53 years with work experience in harmful working conditions for over 5 years was carried out; dynamic monitoring was carried out 6 months after the implementation of the training program on healthy nutrition. Results. In the initial study, the proportion of overweight or obese workers was 43.5%. The causes of the imbalance of the diet by the main food groups have been determined: vegetables, fruits, fish, cereals, including whole grain dishes and legumes, products with a high content of saturated fats of animal origin, products with a high glycemic index, added sugar, table salt. The calculation of the energy value and daily intake of macronutrients and vitamins was carried out. Dynamic monitoring 6 months after the start of preventive intervention showed that the structure of the nutritional status of the surveyed has changed for the better, the proportion of workers adhering to the principles of healthy nutrition has increased. At the same time, the insufficient effectiveness of the training program in terms of the content of polyunsaturated fatty acids, vitamins D, B1, B2, K in the nutrition of mechanical engineering workers was revealed. Limitations of research. The research materials are limited to the results of preventive counseling for 108 workers in mechanical engineering and a time interval of 6 months. Conclusion. The implementation of the key recommendations of the training program led to an increase in the number of employees adhering to the principles of healthy nutrition, which had a positive effect on the nutritional status in the surveyed cases. Compliance with ethical standards. The study was conducted in compliance with ethical standards, approved at a meeting of the local ethics committee of the FNTSG named after F.F. Erisman of Rospotrebnadzor (Protocol No. 6 of 10/23/2023). Contribution of the authors: Yatsyna I.V. — concept and design of the study, discussion of the results, editing; Sheenkova M.V. — concept and design of the study, data processing, text writing, discussion of results, statistical analysis, collection of literature data, editing; Gavrilchenko D.S. — collection and processing of material, statistical analysis, text writing, collection of literature data. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: October 18, 2024 / Revised: January 30, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Legal regulation and problems of the implementation of postmortem assisted reproductive technologies: the experience of Russia and foreign countries (analytical review)
The problem of researching the legal institute of assisted reproductive technologies is very relevant in Russia and abroad. The world is searching for optimal legal regulation of postmortem assistive technologies to ensure the possibility of continuing the life of citizens in future generations, including as a result of premature death. In Russia, this problem has become more urgent due to changes in legislation in 2022, which significantly limited people’s access to surrogacy, which was also used as a means to realize the posthumous birth of children. The purpose of the work. To consider the concept of «postmortem assisted reproductive technologies», to assess the implementation of mechanisms of postmortem assisted reproductive technologies in Russia and abroad. Regulatory legal acts, law enforcement practice on the implementation of postmortem assisted human reproduction, scientific literature published over 2018–2024 in the databases Scopus, Web of Science, Pubmed, CyberLeninka, eLIBRARY.RU have been studied and analyzed. Dialectical and logical methods made it possible to consider comprehensively the problems of using postmortem assisted reproductive technologies in Russia; the comparative legal method was used in the analysis of normative acts of foreign countries, the formal legal method provided the qualification of the legal facts of postmortem reproductive technologies in relation to legal norms. Conclusion. The development of legal regulation of public relations is the constitutional responsibility of public authorities, therefore, it is the State and public authorities that have the responsibility to regulate and ensure the possibility of having children from deceased men. The author’s opinion on the prospects for the development of current Russian legislation regulating postmortem assisted reproductive technologies is given. Contribution of the authors: Basova A.V. — concept and design, writing of the article, design, approval of the final version of the article; Komkova G.N. — concept and design, writing of the article, editing, approval of the final version of the article. Funding. The study had no sponsorship. Conflict of interest. The authors declare no conflict of interest. Received: February 28, 2025 / Revised: March 26, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
Contribution of academician N.N. Blokhin to the development of national reconstructive surgery
Nikolai Nikolaevich Blokhin is an outstanding public figure, a scientist of world renown; known to contemporaries as the President of the Academy of Medical Sciences of the USSR, Academician of the Academy of Sciences and the Academy of Medical Sciences of the USSR, the creator of the largest oncological research center in the world, bearing his name, an excellent oncologist. But few people know Nikolai Nikolaevich as a talented plastic surgeon, traumatologist, and orthopedist! We emphasize that at the moment his activities in the development of reconstructive surgery are practically not covered. The purpose of the study was to analyze N.N. Blokhin’s contribution to restorative and plastic surgery over the war and post-war years, while working in the so-called “Gorky period”, 1941–1952. It was established that a number of technologies used by him were “pioneer”, which had not been unused in domestic reconstructive surgery before him. The various methods used by scientists to help the wounded in wartime and peacetime are given: with multiple combined injuries, extensive focal lesions of Red Army soldiers disfigured by explosions, burns of tankers, crippled pilots. During the Great Patriotic War, N.N. Blokhin having performed several hundred surgical procedures for skin grafting with a thick flap, changed the existing one before a negative attitude towards this type of surgery. The invention in 1946, together with M.V. Kolokoltsev, of the first domestic dermatome with a disc knife confirms N.N. Blokhin’s constant desire to create innovations in medicine. The initiative of the doctor has been proven, who, despite the current instructions, took responsibility and carried out complex reconstructive operations without sending the wounded during the Great Patriotic War to the deep rear. Often repeated with dignity by Nikolai Nikolaevich: “First of all, I am a doctor!” reveals the full depth of his worldview as a doctor who fulfilled his duty, based on creative potential, determining practical achievements in reconstructive surgery for the benefit of victims in peacetime and wartime. Contribution of the authors: Serebryany R.S. — concept and design of the study, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article; Koshelev A.D. — idea of ​​the study, collection and processing of material, writing the text, compiling a list of references. Funding. The study had no sponsor support. Conflict of interests. The author declares absence of conflict of interests. Received: December 25, 2024 / Revised: February 22, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025