This paper presents the second part of descriptive reviews on methodological tools for the comprehensive assessment of public health, focusing on index-based indicators and measures of population health burden and health-related quality of life. The manuscript is centered on instruments for assessing health losses and the multidimensional evaluation of health determinants, continuing the analysis of metrics of achieved health status.

The purpose of the study is to describe the principles of construction, methodological features, fields of application, advantages, and limitations of integral indicators focused on the assessment of disease burden (DALY, QALY) and multidimensional composite indices.

The analysis of the scientific literature was conducted using the method of «snowball» based on scientific articles indexed in bibliographic databases including Scopus, Web of Science, PubMed. Priority was given to conceptually foundational documents describing the methodology for indicator development. In addition, reviews and reports from international organizations (WHO, OECD, UN) were analyzed.

DALY (Disability-Adjusted Life Years) was shown to be «gold standard» for monitoring inequalities and gaps in population health status, with identification of the most significant risk factors. QALY (Quality-Adjusted Life Years), based on subjective health state utility assessments, enables comparison of the effectiveness of heterogeneous medical technologies within pharmacoeconomic evaluations. Composite indices, such as the Human Development Index and the English Health Index provide a comprehensive cross-sectoral and interagency assessment by integrating social, economic, and environmental determinants into a single metric.

Research limitations. The review is narrative (descriptive), without strict systematization search strategy by study type, publication date, or source.

Conclusion. The choice of a specific assessment tool should be determined by the research objectives, the availability and quality of input data, and the required level of detail for supporting decision-making, including in the field of sanitary and epidemiological well-being.

Contribution of the authors:
Glukhikh M.V., Ukhabov V.М. — editing, writing the text, approval of the final version of the article;
Onishchenko G.G. — study concept and design, editing, approval of the final version of the article;
Klein S.D. — editing, writing the text, approval of the final version of the article, collection and processing material, writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: February 12, 2026 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. In recent years, there has been a marked increase in the incidence of diabetes mellitus (DM) in Russia, which places a heavy burden on the healthcare system.

The purpose: to consider the incidence of DM, including type 1 and type 2, as well as the contribution of active detection methods to the formation of its structure in Russia in the trend over the period from 2015 to 2024.

Materials and methods. Statistical data from form No. 12 and Rosstat on the population for 2015–2024. To analyze the incidence rates of diabetes, including type 1 and type 2, in the trend 2015–2024, dynamic range indicators and the Fisher criterion were used, the differences were significant at < 0.05.

Results. In Russia, the incidence of DM and diabetes type 2 increased markedly in 2015–2024 and reached 310.7 and 292.6 per 100,000 population in 2024. In the structure of the incidence of diabetes, the proportion of diabetes type 2 reached 92.2, and diabetes type 1 — 6.1%. In the structure of newly diagnosed patients with diabetes in 2024, the proportion of patients who were actively identified increased to 31.7% due to an increase in the proportion of patients identified during medical examinations to 27.6%.

Research limitations. Statistical information provides a sufficient sample for the study.

Conclusion. Currently, to analyze the incidence of diabetes in the Russian population, there is a need to develop a new federal statistical observation reporting form containing detailed information on newly diagnosed patients with diabetes.

Compliance with ethical standards. The conclusion of the biomedical ethics committee was not required for this study (the study was based on publicly available official statistics).

Contribution of the authors:
Starodubov V.I. — research concept;
Tsybikova E.B. — research design, text writing, bibliography;
Samoilova Yu.G. — concept and editing;
Kotlovskiy M.Yu. — collection and processing of material.
All co-authors are responsible for approving the final version of the article and ensuring the integrity of all parts of the article.

Funding. The research was not granted any sponsor support.

Conflict of interest. The authors declare no competing interests.

Received: July 7, 2025 / Revised: October 13, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. Implementation of a long-term remote monitoring for rural patients’ health indicators with the diagnosed chronic heart failure (CHF) into digital healthcare practices offers significant managerial, economic, and preventative benefits for early detection of their condition aggravation. The managerial solution for this process is to expand the nursing staff functions.

Purpose of the study. To analyze differences in readiness in paramedics and nurses to participate in digital support of CHF patients living in rural areas.

Materials and methods. Diagnostic methodology: questionnaire “Readiness of medical specialists to implement remote monitoring technologies for cardiovascular parameters in CHF patients living in rural areas at the primary care level” (n = 1519). Cross-tables were used as a mathematical and statistical method for comparing two groups of respondents (nurses and paramedics) based on indicators of medical specialists’ readiness to provide care to patients using remote monitoring technologies; the significance of differences was assessed using the obtained Pearson χ² value.

Results. Nurses and paramedics rate their computer proficiency levels almost identically (15.5% and 15.4%, respectively). Respondents in both groups prefer using a phone app to communicate with patients in real time (41.9% and 39.6%, respectively). Nurses were less willing than paramedics to participate in remote digital monitoring of patients with CHF (χ² = 24.27, df = 3, p < 0.001). However, they noted the need for oversight by general practitioners and cardiologists in district hospitals and clinics.

Research limitations. This study was conducted only among mid-level medical personnel and applies to the population of rural areas.

Conclusion. The study revealed equal unwilling of the respondents (paramedics and nurses) to participate in remote monitoring on a voluntary basis (9.9% paramedics/8.5% nurses). However, 23.6% of paramedics/15.5% of nurses were willing to participate in monitoring on a compensated basis. Respondents believed the monitoring to be the responsibility of separate specialists (32.6% paramedics/43.0% nurses).

Compliance with ethical standards. The study was approved by Ethical Committee of Saratov State Medical University (Protocol No. 11, dated May 2, 2023). All participants signed informed consent to participate in the study.

Contribution of the authors:
Bogdanova T.M. — research concept and design, writing the text, compilation of the list of literature, statistical data processing;
Andrianova E.A. — writing the text, statistical data processing, editing;
Gorbunova L.A. — collection and processing of material;
Akimova O.V. — collection and processing of material;
Fedonnikov A.S. — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no clear and potential conflicts of interest in connection with the publication of this article.

Received: December 29, 2024 / Revised: February 14, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. Suicides and suicide attempts are pressing issues for healthcare systems in many countries around the world. Epidemiological monitoring for suicide and suicide attempt statistics plays an important role in managing effective activities of the healthcare system to prevent suicides.

The purpose of the study was to analyze the indicators of suicidal activity in the Sverdlovsk region for 2019-2023, as a reflection of the results of monitoring of suicidal behavior.

Materials and methods. The study used statistical data on fatal suicides of the State Autonomous Healthcare Institution of the Sverdlovsk Region “Bureau of Forensic Medical Examination” for 2019-2023; statistical data on self-harm with suicidal intent of emergency medical care (EMC) of the Sverdlovsk region for 2019-2023; data on monitoring for suicide attempts of the Ministry of Health of the Sverdlovsk Region; federal statistics data.

Results. The number of suicides in the Sverdlovsk region from 2019 to 2023 decreased by 60%: from 10 to 4 cases per 100 thousand population per year, respectively. The number of suicide attempts also decreased during this time period, but not so significantly: from 68 to 61 cases per 100 thousand population per year, respectively. This affected the changes in the ratio of suicides to suicide attempts by year: from 1:7 in 2019 to 1:14 in 2023.

Research limitations. The lack of comparisons of the results of monitoring suicidal actions in the Sverdlovsk region with similar indicators in other constituent entities of the Russian Federation.

Conclusion. The trend in the suicidal activity indicators of the population in the Sverdlovsk region from 2019 to 2023 reflects the organizational stages of monitoring and shows its effectiveness.

Compliance with ethical standards. The study did not involve human subjects, so approval of the research plan by the local ethics committee was not required.

Contribution of the authors:
Sidenkova A.P. — material collection and processing, research concept and design, editing;
Galkin S.A. — statistical processing, writing of the text;
Serdyuk O.V. — research concept and design;
Pertsel M.G. — material collection and processing;
Klimova I.A. — material collection and processing;
Kornetov A.N. — editing, compilation of the list of literature;
Bokhan N.A. — editing.
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: April 14, 2025 / Revised: June 19, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. One of the strategic goals in the Russian Federation is to maintain reproductive health and good quality of life in women of all ages. Being the most common reasons for obstetric and gynecological hospitalization, pelvic inflammatory diseases are among the important healthcare challenges.

The purpose was to study regional incidence and prevalence rates of pelvic inflammatory diseases and to estimate their chronicity rate in the working-age women of the Ural Federal District in 2011–2019.

Materials and methods. Based on statistical data from the Russian Research Institute of Health, we calculated pelvic inflammatory disease rates in women of working age and then compared them with the Russian rates and between the constituent entities of the Ural Federal District in a pairwise manner. Using the Spearman’s rank correlation coefficient, we established the degree of correlation between the regional rates and those in the Russian Federation as a whole.

Results. We observed fold differences in disease rates between the Ural regions. In most cases, we also noted statistically significant differences between the regional and Russian morbidity rates. Pairwise comparisons mainly demonstrated significant interregional differences in disease rates. Mean values of the regional incidence and prevalence represent a statistically heterogeneous set of rates. A rising trend in the chronicity rate was identified in all constituents of the Ural Federal District.

Research limitations. The study is limited to women of working age.

Conclusions. Statistically dissimilar incidence and prevalence rates, a large number of significant differences found between the regional rates and between them and Russian rates indicate to the presence of pronounced regional patterns.

Compliance with ethical standards. Formal approval of an ethics committee is not required for this study.

Contribution of the authors:
Sakhautdinova R.R. — data collection and processing, draft manuscript preparation;
Bushueva T.V. — draft manuscript preparation, editing;
Shastin A.S. — data collection and processing, draft manuscript preparation;
Roslaya N.A. — editing;
Panov V.G. — statistical data analysis;
Milyaeva N.M. — editing;
Lavrentyeva I.V. — editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 25, 2025 / Revised: August 8, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. Performing occupational tasks for emergency medical staff is often associated with various conflict situations, unreasonable calls, and low wages. Thus, the interrelation of emotional, mental, and physical health employees directly affects the health and lives in patients.

Purpose. Identification of links between the level of conflict with and the frequency of unreasonable calls depending on salary satisfaction and indicators of stress resistance and depression risks among medical staff of emergency services.

Materials and methods. The material of the study was the data of a survey of five hundred twenty eight medical staff workers of emergency services in Ufa city. The analysis was carried out according to the author’s questionnaire using standardized methods.

Results. The range of distribution of social characteristics showed 43.3% and 36.3% to note medium and high rates of unreasonable calls; 24.8% — low satisfaction with wages; 10.5% — frequent conflicts with the staff of admission departments of hospitals. A high frequency of unreasonable calls (AUC = 0.714, p < 0.05) was revealed to increase in the frequency of conflicts (AUC = 0.827, p < 0.05) significantly reduce stress resistance; increased conflict frequency increases the risk of depression (AUC = 0.982, p < 0.05); low salary satisfaction is intercorrelated in a similar way to conflict frequency.

Research limitations. The limitations of the research can be determined: difficulty in assessing the impact of the emotional state of participants on the subjective variables of the analysis (conflict, wage satisfaction), as well as the influence of external factors (changes in legislation, economic crises) during the survey. The development of methods for taking into account these restrictions in the future will help to increase the objectivity and reliability of this kind of research.

Conclusion. This research can be used to form preventive algorithms for improving the quality and efficiency of medical services provided by emergency medical care, as well as to accelerate the development of healthcare institutions and increase the efficiency of medical staff.

Compliance with ethical standards. The study was approved by the local ethics committee of the Bashkir State Medical University of the Russian Ministry of Health (Protocol No. 1, dated January 22, 2025). All respondents provided informed consent to participate in the study.

Contribution of the authors:
Melnikov A.S. — research concept and design, writing the text, compiling the list of references, statistical data processing;
Nelyubina E.V. — writing the text, statistical data processing, editing;
Amirov A.F. — research concept and design, editing.
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: April 19, 2025 / Revised: July 10, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. The health of medical students is influenced by social, economic, and medical factors. Maintaining a healthy lifestyle is the basis for physical and mental well-being.

Purpose of the study is to assess the factors influencing the health of medical university students.

Materials and methods. The analysis of the presence of socio-economic and medical factors affecting the health status of three hundred twenty one Russian 5–6 year student of the medical university was carried out through an anonymous face-to-face survey conducted with their informed voluntary consent in 2022–2025, among which there were 78 male and 243 female students.

Results. The following social risk factors were identified: 12.8% lived in a dormitory, 41.4% did not receive a scholarship, 10.3% had loan debts, 65.1% of students combined study with work in medical institutions, with 29.6% working 3 or more times a week and having an unbalanced work and rest schedule. 48.9% of students ate irregularly but of good quality, and 18.4% rated their nutrition as irregular and of poor quality, with an insufficient amount of protein. 38.9% did not exercise, 19.9% ​​smoked tobacco products, 9.7% of students drank alcohol once a week. Analysis of medical risk factors showed 15.0% of students to have chronic somatic diseases, 38.9% were in constant psycho-emotional stress.

Research limitations. Medical university students, citizens of Russia.

Conclusion. Raising the level of knowledge about the principles of a healthy lifestyle through educational work and managing health events are the most important tasks of the medical university.

Compliance with ethical standards. This article complies with the ethical standards set forth in the Declaration of Helsinki and respects the rights and well-being of the participants. The study protocol was approved by the Ethics Committee of the N.N. Burdenko Voronezh State Medical University (Protocol No. 1, dated February 17, 2026).

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: May 7, 2025 / Revised: July 3, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. In the context of total digitalization of various spheres of human life, the problem of health in student youth is given increased attention. Therefore, the topic we have chosen is quite relevant.

Materials and methods. To obtain primary data, more than four hundred fifty Omsk 18-20 years students were tested in 2020 and 2025. The processing and analysis of the obtained dichotomous data were carried out using the George Rasch measurement model, which is a visual display of the results of observations of the importance of the studied latent property of a person and the complexity of test elements on a general logarithmic scale.

Purpose. Determination of the indicators of the student’s «health level» and the «significance» of test questions using the George Rasch measurement model.

Results. A comparison of these indicators revealed that students in 2025 are more likely to take medications without a doctor’s prescription than those in 2020. The number of colds among students has remained virtually unchanged, and meals have become more regular, though proper lunches are often replaced by fast food. The number of students participating in sports has increased, but the number of students with unhealthy habits has remained the same. The number of students in «very close to good» health in 2025 has increased significantly compared to 2020.

Research limitations. The survey is limited to a survey of Omsk students.

Conclusion. The obtained results can be used by administrative structures in the field of youth policy in the region to make management decisions to improve the health of students.

Compliance with ethical standards. The study was approved by the local ethics committee of the Federal State Budgetary Educational Institution of Higher Education «Omsk State Medical University of the Ministry of Health of the Russian Federation», protocol dated January 20, 2025.

Contribution of the authors:
Lyapin V.A. — research concept and design, writing the text, data processing, editing;
Marenko V.A. — writing the text, data processing, 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 research was funded in accordance with the state task of the Sobolev Institute of Mathematics, Siberian Branch of the Russian Academy of Sciences, project FWNF-2026-0024.

Conflict of interest. The authors declare no conflict of interest.

Received: May 21, 2025 / Revised: July 1, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. The assessment of the body’s reserve capacities is updated to improve the effectiveness of preventive and personalized medicine, ensuring healthy longevity of the population.

The purpose of the research is to develop a method and assess the reserve capacities of the body in children and adolescents.

Materials and methods. The study involved students in grades 1–11 (n = 5034). We analyzed body weight, vital capacity, right and left hand strength, Stange and Genchi tests in three age groups of 7–10, 11–14, 15–17 years. We calculated vital and strength indices; distributed them according to centile intervals according to regional standards. We created a mathematical model for calculating the index — body reserve index (BRI) to determine the reserve capacities of the body (RCB).

Results. The RCB were differentiated by indices: > 0,81 — excellent; ≤0,81 — > 0,6 — good; > 0,43 — ≤0,6 — satisfactory; < 0,43 — unsatisfactory. In the groups of 15–17 years students, compared with schoolchildren aged 7–10 years, the proportion of persons with unsatisfactory and satisfactory RCB increased due to a decrease in the proportion with good and excellent — by 6,26%; most significantly due to excellent. With insignificant proportional differences in the estimated values of the criteria “unsatisfactory” and “satisfactory” RCB, as well as “good” and “excellent” in males, they decreased in the second by 4,2%, and in the third — by 5,6% relative to the first group; in females in the older group they were higher than in the first by 11,4%, in the middle group — by 14,7%, which justifies the study of this phenomenon.

Research limitations. Schoolchildren aged 7–17, I–II health groups, no acute diseases for 1 month prior to the examination.

Conclusion. The range of methods for assessing the reserve capacity of the human body has been expanded for safe research in population screening studies.

Compliance with ethical standards. The study was conducted in compliance with the ethical standards of the World Medical Association’s Declaration of Helsinki. The Ethics Committee of the Lobachevsky State University of Nizhny Novgorod approved the study, Protocol No. 4, dated October 2, 2014.

Contribution of the authors:
Kalyuzhny E.A. — concept and design of the study, writing the text, responsibility for the integrity of all parts of the article;
Rakhmanov R.S. — editing, approval of the final version of the article;
Bogomolova E.S. — collection of literature data, editing, responsibility for the integrity of all parts of the article;
Mukhina I.V. — collection, systematization and statistical processing of material;
Razgulin S.A. — participation in statistical processing of material, interpretation of results, preparation of text.

Conflict of interest. The authors declare no conflict of interest.

Funding. The study had no sponsorship.

Received: May 22, 2025 / Revised: January 28, 2026 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. Outbreaks of viral hepatitis A (HAV) remain of socio-economic importance, but the role of the water factor has not been sufficiently studied, which reduces the effectiveness of prevention. The epidemic HAV potential determines the relevance of analyzing risk factors and predicting morbidity.

Purpose to study risk factors and predict the incidence of hepatitis A based on water contamination and vaccination rates in the Russian Federation.

Materials and methods. In 2014–2023, water samples (n = 170,372) were taken from sources of centralized and non-centralized water supply, surface and wastewater in 89 regions of the Russian Federation. The studies were carried out by the serological method, statistical processing was carried out using the R software.

Results. During the studied period, the average HAV contamination was: in centralized water supply — 0.09% (95% CI 0.07–0.11), non—centralized — 0.31% (95% CI 0.17–0.53), surface reservoirs — 0.14% (95% CI 0.11–0.19), wastewater — 0.41% (95% CI 0.35–0.48). There was a tendency to decrease the proportion of positive samples in non-centralized water supply (r = –0.78; p = 0.01) and wastewater (r = –0.87; p = 0.001). The incidence of HAV has a strong direct correlation with contamination of non-centralized water supply (r = 0.75; p = 0.01) and wastewater (r = 0.70; p = 0.03), as well as a moderate correlation with the vaccination rate (r = –0.69; p = 0.047). Linear regression equations reflecting the effect of morbidity on wastewater contamination and the effect of vaccination on morbidity are obtained.

Research limitations. The official data on the HAV incidence in the Russian Federation for 2014–2023 were used, which ensures a representative sample.

Conclusion. The data obtained can be used to predict the incidence of HCV, assess the associated economic damage, as well as to calculate the level of wastewater contamination for planning preventive measures.

Compliance with ethical standards. This study did not require the conclusion of the biomedical ethics committee (the study was based on publicly available official statistics).

Contribution of the authors:
Badamshina G.G. — collecting material, conducting research, analyzing literature, statistical processing, analyzing data obtained and editing;
Gafarova L.F. — conducting research, analyzing literature, statistical processing, analyzing data obtained and editing;
Poptsova E.A. — conducting research, analyzing data obtained and editing;
Trukhina G.M. — collecting material, literature analysis, data analysis and editing;
Samotoina A.A. — collecting material, conducting research and editing;
Yuzlibaeva L.R. — literature analysis, analysis of obtained data;
Malinnikova E.Yu. — article editing;
Fatkhutdinova L.M. — idea and development of the concept of the article, literature analysis, analysis of the data obtained and scientific editing of the article;
Ilyinskaya O.N. — scientific and final editing of the 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: July 28, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

Introduction. Consumption of nutrients promoting the normalization of lipid metabolism allows correcting dyslipidemia, which is important for people engaged in mental work.

Purpose. An assessment of blood lipids in persons engaged in mental work that is harmful due to the intensity of the work process, when including in their diet a product made from plant materials.

Materials and methods. The study involved men aged 35.7 ± 4.9 years who had been engaged in mental labor for 10.6 ± 0.9 years. Working conditions were assessed based on indicators of work intensity. Subjects in Group 1 (n = 30) consumed a multicomponent herbal product produced using cryotechnology for 21 days; Group 2 (n = 30) served as a comparison group. Daily micronutrient intake was calculated. Blood lipid and cortisol levels were determined at baseline, on days 22, and 32.

Results. In terms of the intensity of the work process, the work is harmful (degree 3.3). When taking the product, a decrease in total cholesterol was determined (to 4.78 ± 0.63 from 5.0 ± 0.75 mmol/l (p = 0.003), an increase of 13.4% in the proportion of people with normal and a decrease of 10.0% with high cholesterol, an increase of 4.1% in the proportion of people with high high-density lipoproteins, a decrease of 11.9% in the proportion with high low-density lipoproteins; lipid atherogenicity decreased by 15.5%. In the comparison group, high high-density lipoproteins tended to decrease, low density to increase. Blood atherogenicity in the main group initially exceeded the norm in 22.2%, at the end of the observation in 6.7%, in the comparison group, respectively, in 36.7% and 53.3%. The effect on anabolic processes and stress levels was evidenced by the hormone cortisol: a decrease in 66.7% in the main group group and growth in 43.3% in the comparison group.

Research limitations. Men under 40 years of age, occupationally engaged in mental work, assessed according to the degree of harmfulness and danger as harmful level 3.3.

Conclusions. Optimization of nutrition with a natural multi-component product from plant raw materials is a method for preventing dyslipidemia and stress during long-term intense harmful mental work.

Compliance with ethical standards. The study was approved by the Ethics Committee of the Primary Medical University (Protocol No. 4, dated March 14, 2022).

Contribution of the authors:
Rakhmanov R.S. — concept and design of the study, writing the text;
Bogomolova E.S. — writing and editing the text;
Narutdinov D.A. — collection of primary material;
Razgulin S.A. — collection of literary data and compilation of the list of references;
Potekhina N.N. — participation in the preparation of the text and statistical processing of the material;
Khairov R.Sh. — statistical processing of the material.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no obvious or potential conflicts of interest in connection with the publication of this article.

Received: February 10, 2025 / Revised: May 26, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026