Introduction. To enhance primary health care, new models of medical service delivery are increasingly being introduced. Variative operational models of district general practitioners implemented across Russia’s federal subjects demonstrate promising outcomes. Nevertheless, large-scale adoption is impeded by the absence of a unified system for evaluating their efficacy, necessitating harmonization and standardization.

Purpose. To develop and scientifically validate criteria for measuring the effectiveness of primary health care provision while implementing variative models of general practitioner’s operations.

Materials and methods. The study employed searches for variative models, managerial modeling, analytical techniques, and content analysis.

Results. The analysis has demonstrated variable models to contribute to the increased capacity of therapeutic units, improved access to medical services, and expanded coverage with preventive measures. Team-based work managing of general practitioners allows for more efficient distributing of job functions, reducing doctor’s workload, and increasing the number of patients served. Optimization of regulatory provisions ensures an increase in the number of attached residents, simultaneously improving the quality of provided medical care. The proposed performance evaluation criteria based on classical indicators make it possible to compare variable models. The application of these criteria will provide scientific justification for selecting the most effective model of primary health care (PHC) institution.

Research limitations. The study is restricted in that it evaluates the effectiveness of variative models solely within the scope of PHC delivery.

Conclusion. The validity of the utilized evaluation methodology is demonstrated by extant models, highlighting positive trends toward enhanced patient service quality under current Russian conditions.

Compliance with ethical standards. This type of research does not require review by a local ethics committee.

Contribution of the authors:
Khodakova O.V. — research concept and design, editing;
Miroshnichenko A.I. — collection and processing of material, writing the text, compilation of the list of literature;
Bachegova E.M., Shakhova A.M. — collection and processing of material.
All authors made an equal contribution to the search and analytical work and preparation of the article, read and approved the final version before publication.

Funding. The study had no sponsorship.

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

Received: October 13, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. Sickness absenteeism is one of the most important indicators of workers’ health. Achievement of the national goal of reducing work time and productivity losses due to health-related issues in employees determines a high importance of studying morbidity of the working-age population in the post-pandemic area.

The purpose of the study was to establish age and sex-specific characteristics of post-pandemic sickness absence from work in the Russian Federation.

Materials and methods. Based on data reported using the statistical form 16-VN, we calculated sickness absence rates for the pre-pandemic time span of 2015–2019 and the year 2023 by sex and 5-year age cohorts. We also established growth rates in 2023 compared to the pre-COVID period. To assess the statistical significance of differences, confidence intervals (CI) were constructed for the mean rate for 2015–2019.

Results. We observed significant differences in sickness absence rates between the years 2015–2019 and 2023 in all disease categories. In some cases, we noted a statistical decrease in the rate of sickness absence due to certain reasons, which may indicate an unrealized risk to health of the working population in the form of such an effect as sickness absenteeism. In the age groups of 15 to 19 and 20 to 24 years, both women and men showed the highest number of all-cause episodes of sickness absence from work and the highest growth rates for almost all ICD categories.

Research limitations. The study is limited to data for the years 2015–2019 and 2023.

Conclusions. Health authorities are advised to pay special attention to young workers when conducting medical examinations and take into account the local specifics of sickness absenteeism when implementing regional and municipal public health promotion programs. Employers are also recommended to consider sickness absenteeism in certain categories of workers when developing and implementing corporate workplace wellness programs.

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

Contribution of the authors:
Shastin A.S. — study conception and design, data collection, draft manuscript preparation;
Panov V.G. — statistical data analysis, editing.
Co-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: August 26, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. With the decline in the intensity of the tuberculosis epidemic, the number of patients has significantly decreased. Therefore, the majority of the district TB physician’s time is now devoted to measures to prevent further increases in tuberculosis incidence.

Purpose: to assess the actual time expenditures of district TB physicians in the context of declining key epidemiological indicators.

Materials and methods. The study was conducted in 2023 at the «Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Department of Health». There was used the methodology developed by the Central Research Institute of Occupational Medicine and Infection Control of the Ministry of Health of the Russian Federation. The developed flow chart recorded time measurements for various functions in the district TB physician during outpatient appointments and during outpatient work. The charts were completed for four thousand two hundred eighty eight patients. Time charts were differentiated based on the purpose of the visit, the time of the year, and type of outpatient work. A total of 107 district TB physicians (48%), out of 222 working in 189 districts serving the adult population, participated in the study.

Results. Outpatient appointments accounted for 66.8% of their time. Outpatient visits accounted for 21.03% of their time, with the majority (37.0%) spent visiting TB hotspots and 26.8% spent visiting non-TB healthcare facilities to provide managing and methodological assistance.

Research limitations. We examined the time expenditure of district TB physicians in a city with good transportation accessibility, close proximity to healthcare facilities, and a favorable epidemiological situation.

Conclusions. On average, district TB physicians devote 21.0% of their monthly work time to outpatient work, while 66.8% of their time spent on outpatient appointments. Furthermore, the state assignment structure is based solely on outpatient visits.

Compliance with ethical standards. The conclusion of the medical ethics committee was not required to conduct this study.

Contribution of the authors:
Bezuglaya S.Yu. — collection and processing of material, statistical data processing, data analysis, writing of text;
Bogorodskaya E.M. — concept and design of the study, data analysis, writing of text, editing, approval of the final version of the article;
Odintsov V.E. — editing, approval of the final version of the article;
Afanasyeva R.R. — collection and processing of material, statistical data processing, writing of text.
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 8, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Background. In the third decade of the twenty-first century, mortality increased and its structure changed worldwide due to the outbreak of the COVID-19 pandemic. Much remains unclear about the impact of the pandemic on mortality parameters, including at the regional level.

The purpose of the study is to evaluate changes in quantitative and structural mortality rates in the context of the COVID–19 pandemic (using the Irkutsk Region as an example).

Materials and methods. The levels and structure of mortality in the Irkutsk region in 2010–2022 were analyzed. Mortality rates (by sex, age groups, and classes/groups of causes of death) were calculated using data from Federal State Statistics Service and the Demographic Research Center of the Russian Economic School. Standardized indicators were used in studies of mortality trend, and absolute data was used in the study of structures.

Results. The pandemic has interrupted the positive trend in the mortality reduction. In the Irkutsk region, the standardized mortality rate for men in 2021 increased by 25.1%, for women — by 40.6% compared to the level of 2019. The increase in mortality among men occurred by 80.0, 30.8 and 2.8% in the classes of respiratory, digestive and non–classified diseases, while among women it increased by 179.2, 37.3 and 10.9%. In 2021 the standardized mortality rates due to coronavirus infection were: 397.66⁰/₀₀₀₀ among men (42.9% higher than the average in the Russian Federation), 255.76⁰/₀₀₀₀ among women (25.8% higher). The increase in age-related mortality rates in 2020–2021 was found to occur starting from the group of the average working age (30–44 years), and at a rate increasing with increasing age.

Research limitations: population-based epidemiological study based on statistical data.

Conclusion. In the region, coronavirus infection has had an adverse impact on the course of various forms of somatic pathology, which has led to higher levels of overall mortality and mortality in certain classes and groups of diseases.

Compliance with ethical standards. This study does not require a conclusion from the Local Ethics Committee.

Contribution of the authors:
Leshchenko Ya.A. — concept and design of research, collection and processing of material, writing, editing;
Lisovtsov A.A. — collection and processing of material, statistical data processing, writing, editing.
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 study had no sponsorship.

Conflict of interest. The authors declare the absence of any conflicts of interest regarding the publication of this paper.

Received: March 26, 2025 / Revised: April 28, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. To implement a patient-centered approach in the provision of primary health care, it is necessary to take into account, among other things, the social characteristics of patients.

Purpose of the study: to study the influence of gender, age, and socio-economic status on the need in adult patients for consultative and diagnostic services provided in an outpatient setting.

Materials and methods. The study was conducted in medical institutions providing medical care on an outpatient basis and operating in the system of the municipal Department of Health or in the private healthcare sector of the city of Moscow. The study used the data copying method, statistical, and analytical research methods.

Results. In male and female patients the need for consultative and diagnostic services are comparable, with the exception of gender-specific services. However, the absence of significant differences cannot be considered true, and this issue needs further study. The key factors determining the need for consultative and diagnostic services are age and method of payment for medical care. Age determines the volume of medical care in terms of the increase in the incidence of chronic diseases and multimorbidity; method of payment for medical care — from the point of view of considering paid medical services as an alternative to free ones provided in the public health sector. Belonging to a particular social group is rather an indirect factor reflecting the age characteristics of the patient.

Research limitations. The main limitations of the study are the local nature of its conduct (Moscow) and the lack of an in-depth analysis of the connection between the need for advisory and diagnostic services and gender.

Conclusion. The predominant age of the population served and the preferred method of payment for medical care influence the necessary material and technical equipment, staffing structure and work schedule of the medical institutions, which are important for the implementation of a patient-oriented approach in terms of patient expectations.

Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University), protocol No. 12-22 dated 06/02/2022.

Contribution of the authors:
Volnukhin A.V. — research concept and design, writing the text, compilation of the list of literature;
Morozova T.E., Skvirskaya G.P. — writing the text, editing;
Reze A.G., Samokhina E.O., Zaugolnikova T.V. — collection and processing of material;
Gurjar M.V., Gertsog A.A. — statistical data processing.
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 20, 2024 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. Antimicrobial resistance (AMR) is a mounting public health threat in Indonesia, fueled by widespread non-prescription antibiotic sales and limited regulatory effectiveness.

The purpose of the study. The purpose of this study was to assess prescription adherence, patterns of antibiotic supply, and regulatory violations by analyzing 2023 data from the Indonesian Food and Drug Authority’s Jakarta Regional Office.

Materials and methods. This study analyzes 2023 inspection data from 105 Jakarta pharmacies, randomly and purposively sampled from 2,735 registered facilities, to assess prescription compliance, supply patterns, and regulatory breaches. Using a cross-sectional approach, we examined antibiotic dispensing against prescription records, documented stock levels, identified frequently supplied antibiotics, and explored the reasoning for non-prescription sales.

Results. Results revealed that 37% of antibiotics were provided without prescriptions, highlighting pervasive self-medication. Amoxicillin dominated supplies (63%), followed by Cefixime and Metronidazole, heightening resistance risks. Regulatory tools, mainly administrative reprimands, proved inadequate; notably, 20% of non-prescription antibiotics were distributed to unregulated midwives, underscoring oversight weaknesses. Fragmented education among health providers and the public further limits efforts to curb AMR.

Research limitation. The study is limited by its reliance on inspection data from a single year and region, which may not capture trends elsewhere in Indonesia or ongoing changes in pharmacy practice.

Conclusions. To address these systemic issues, we recommend stronger penalties, enhanced oversight — especially regarding midwife practices — real-time sales monitoring, integrated public education campaigns aligned with WHO guidance, and coordinated efforts across agencies to control online antibiotic sales.

Compliance with ethical standards. The study does not require submission of the opinion of the biomedical ethics committee or other documents.

Funding. The study had no sponsorship.

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

Received: June 23, 2025 / Revised: November 25, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. Feelings of loneliness are widespread among the population. The main factors contributing to this feeling include disability, old age, living alone, lack of family, close relatives, and friends, infrequent social contact, and illness.

The purpose of the study was to analyze the current state and potential use of online resources to prevent loneliness in individuals with disabilities.

Materials and methods. Seven hundred thirty two respondents were recruited for the 2024 sociological study, including 100 individuals with disabilities who completed a questionnaire and the Russell and Ferguson Diagnostic Test. Focus groups with six specialists were used to examine the potential use of online resources to prevent loneliness in individuals with disabilities.

Results. The feeling of loneliness occurs in almost all persons with disability, the degree of which largely was established to depend on the disability group. The emergence of a feeling of loneliness in persons with disability is related with poor health, low financial security, insufficient communication with people, etc. To distract themselves from the feeling of loneliness, most persons with disability study Internet resources, watch feature films, listen to music, work, take into account their health and age, walk, etc. Involving persons with disability in the development of Internet resources contributes to their social adaptation, self-development, obtaining a new specialty and employment, which in turn reduces their feeling of loneliness.

Research limitations. The study involved citizens living in Moscow and the Moscow region, and therefore the conclusions substantiated in the article can be extrapolated to residents of the Moscow region.

Conclusion. The use of Internet resources by persons with disability everyday activities is an important area of ​​​​preventing their feelings of loneliness.

Compliance with ethical standards. All patients and interviewed specialists signed informed consent to participate in this study. The study was approved by the local ethics committee of the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department (protocol dated September 2, 2024 No. 09-01/EK/2024).

Contribution of the authors:
Tregubov V.N. — concept and design of the study, writing the text, collecting and processing the material, editing;
Adamia A.V. — collecting and processing the material, statistical processing of the data, writing the text, compiling the list of references.
All co-authors — approved the final version of the article, responsible for the integrity of all parts of the article.

Funding. The study had no sponsorship.

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

Received: April 14, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. Sarcopenic obesity and visual impairment increase the risk of developing certain functional deficits and reducing social activity in everyday life. However, social activity has been virtually ignored in the elderly population with age-related macular degeneration and sarcopenic obesity.

The purpose of the research is to assessment of social activity of patients with sarcopenic obesity and age-associated pathology of the organ of vision.

Materials and methods. To perform this study, two clinical groups were randomly selected, one of which consisted of one hundred thirty four patients with age-related macular degeneration and sarcopenic obesity. The control group consisted of 132 patients with sarcopenic obesity only. Determination of the body mass index and hand dynamometry were used to identify sarcopenic obesity. Social activity in everyday life was determined using the Lawton scale.

Results. The decrease in social activity in the compared groups is mainly due to difficulties in using transport — 0.52 ± 0.07 points with a combination of age-related macular degeneration and sarcopenic obesity compared to 0.78 ± 0.6 points (p < 0.01) in the control group. Making purchases — 0.62 ± 0.06 and 0.76 ± 0.08 points (p < 0.01) performing financial activities — 0.48 ± 0.05 and 0.61 ± 0.04 points (p < 0.001), respectively. In addition, sarcopenic obesity and age-related macular degeneration cause a statistically significant decrease in all types of social activity in everyday life with the exception of maintaining house (apartment) — 0.70 ± 0.06 points versus 0.73 ± 0.07 points (p > 0.05).

Research limitations. Study of social activity of elderly patients without comparison with other age groups.

Conclusion. The decline in social activity in elderly patients with age-related macular degeneration and sarcopenic obesity is more significant than with the impact of sarcopenic obesity alone. At the same time, the deterioration in social activity among patients with sarcopenic obesity and age-related macular degeneration occurs especially pronounced in the use of transport, making phone calls, shopping and conducting financial transactions.

Compliance with ethical standards. The study was approved by the committee on Biomedical Ethics of the S.N. Fedorov National medical research center "MNTK Eye Microsurgery", Tambov (protocol no. 842/15 dated 12/25/2024).

Contribution of the authors:
Agarkov N.M. — concept and design of the study, editing;
Kopylov A.E. — collection and processing of the material, writing 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 interests. The authors declare no conflict of interest.

Received: November 20, 2024 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. Spring water is in high demand among consumers for drinking and household purposes. High population density and industrial development cause environmental damage to the natural environment, including the groundwater of the Moscow region. At the same time, the incidence due to the water factor is increasing. The end user does not have reliable information about the quality and safety of water.

Purpose. To study the quality and safety of spring water in the Moscow region according to sanitary and hygienic indicators.

Materials and methods. The article presents the results of a large-scale two-stage (spring–summer 2024 and summer 2025) study of spring water in 14 districts of the Moscow region on sanitary, chemical, organoleptic, and microbiological indicators.

Results. Hygienic characteristics of the condition of the nearby spring areas have been compiled, and potential contaminating objects have been identified. The percentage of springs in the Moscow region has been determined, the condition of which allows the end consumer using water without pretreatment. The main deviations in sanitary and hygienic indicators and the probable causes of their occurrence have been established. A list of priority indicators and standards recommended for monitoring and sanitary-epidemiological supervision of the quality and safety of spring water is proposed.

Research limitations. The study has regional limitations (Moscow region).

Conclusion. The trend in deterioration in the quality and safety of spring water during the spring and summer periods determines the need for measures for water protection and informing the public about the ways of using water for domestic and drinking use to minimize the risks of the spread of acute intestinal infections among the population.

Compliance with ethical standards. Research does not require approval by an ethics committee.

Contribution of the authors:
Trukhina G.M. — research concept and design, analysis and statistical data processing, writing the text, compilation of the list of literature;
Mikailova O.M., Drozd N.A. — editing, statistical data processing;
Borisova N.A., Samotoina A.A. — collection and processing of material, writing the text, statistical data processing.
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: November 17, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Soil is a critical component of the environment, determining the quality of life and public health. This article provides an analytical review of the evolution of methodological approaches to the hygienic assessment of soil quality. The study was performed using an information-analytical method based on the analysis of regulatory documentation and scientific publications from databases such as Elibrary, Scopus, Web of Science, PubMed, Tekhexpert, Consultant, and others.

It considers traditional regulation-oriented methods based on comparing the content of pollutants with their maximum permissible concentrations (MPCs). There are highlighted their main limitations, associated with the failure to account for the combined effects of pollutants and actual exposure pathways. The modern methodology of health risk assessment is described in detail, including the stages of hazard identification, exposure assessment, dose-response relationship, and risk characterization. Special attention is paid to integral diagnostic methods, such as bio-testing and bioindication, which allow assessing the integral toxicity of soil. There are addressed new challenges, including the need to assess the bioavailability of pollutants, the emergence of new classes of pollutants (microplastics, pharmaceuticals, antibiotic resistance genes), and the application of GIS technologies for spatial risk analysis.

Based on the results of the work, modern hygienic diagnostics it is concluded to be a multi-level system integrating traditional and modern approaches to transition from merely stating pollution to forecasting and effectively managing soil resources.

The comprehensive application of new hygienic methods allows transiting from stating the fact of pollution to forecasting its consequences and developing evidence-based measures for managing soil resources to protect public health.

Contribution of the authors:
Ushakova O.V., Vodyanova M.A. — research concept and design, data collection and processing, text writing, manuscript preparation;
Evseeva I.S. — data collection and processing, text writing;
Yudin S.M., Kraevoy S.А. — data collection and processing, editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. The research was carried out within the framework of a State Assignment.

Conflict of interest. The authors declare no apparent or potential conflicts of interest in relation to the publication of this article.

Received: November 17, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026

Relevance. The accessibility of reliable and verified information is attracting increasing attention. The most affected category of citizens are teenagers who learn about the world through the Internet. Given current trends, there is a clear need to implement a resource aimed at providing teenagers with reliable educational information using online technologies.

Purpose. to identify the need to create an online resource for young people aimed at providing information in the field of hygienic education and prevention of STIs.

Materials and methods. The study includes the results of anonymous questionnaires provided for completion to 435 schoolchildren from the Far Eastern District. Study period. March 2023 — March 2024.

Results. Half of the surveyed schoolchildren would like to receive information about current diseases. The majority of the teenagers are likely to ask their elders questions regarding sex education, but few actually do so in practice. The largest share of respondents is formed in the “Social Network”, in particular “VKontakte”, as the most convenient way to obtain information about the prevention of STI. Only a small number of respondents were able to name the STIs symptoms. The most common answer about the sources of knowledge received on sex education was “I found the information myself”.

Research limitations. In the presented results of the study there is a given number of respondents due to the voluntary nature of the survey.

Conclusion. The collected data confirm the need and interest of respondents in obtaining reliable knowledge in the field of hygiene education.

Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the I.M. Sechenov First Moscow State Medical University (Sechenov University), protocol No. 02-23 dated 01/26/2023. 

Funding. The study had no sponsorship.

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

Received: September 23, 2024 / Revised: November 11, 2024 / Accepted: December 17, 2025 / Published: March 4, 2026

Introduction. In Russia in the 2010s, at the state level the tasks of improving the efficiency and quality of medical research and integration into the world science were set.

The purpose of our work is to study the trend in publication activity of Russian medical scientists in foreign journals in 2010–2020. The results are interesting in the context of assessing the fulfilment of the mentioned tasks.

Materials and methods. Research method — quantitative analysis of the metadata array of publications of Russian scientists in foreign scientific journals for 2010–2020. Data sources — Web of Science Core Collection (22,953 articles by Russian authors), Scopus (34,413), Medline (37,468). The combined data set is stratified by the level of scientific journals.

Results. Articles in foreign journals account for a smaller portion of the publications by Russian scientists in medicine, but this portion has been growing in recent years and exceeded 20% by 2020. The growth in the number of foreign articles was observed at all levels of the journal hierarchy, from reputable journals to weak and more questionable ones. In reputable journals, no noticeable drop in the number of articles by Russian scientists was observed in 2022 and 2023.

Research limitations. The study is limited by its data sources: only journals indexed in Scopus, Web of Science, and Medline were analyzed, excluding part of the global medical literature. Additionally, all articles with at least one author affiliated with a Russian institution were classified as Russian, which may not accurately reflect the origin of the research.

Conclusions. Russian authors began to publish their results more often in foreign journals, including leading ones. This indicates some progress in solving the mentioned problems of improving research performance. However, the growing number of Russian articles in questionable journals represents an adverse side effect of the evaluation of scientists by publications, which requires adjusting the previously used approaches to stimulating scientists to publish.

Compliance with ethical standards. The study does not require the submission of a biomedical ethics committee opinion or other documents.

Contribution of the authors:
Dyachenko E.L. — the concept and design of the study, writing a text, editing;
Agafonov Iu.G. — the collection and processing of the material, writing a text, editing;
Guba K.S. — the concept and design of the study, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Funding. The work was supported by the European University in St. Petersburg within the framework of the competition for prospective studies.

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

Received: September 2, 2024 / Revised: April 17, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026