Problems of Social Hygiene, Public Health and History of Medicine
Problemy Sotsialnoi Gigieny, Zdravookhraneniya, i Istorii Meditsiny Launch year 1994 Founders FSSBI «N.A. Semashko National Research Institute of Public Health» Central Research Institute of Organization and Informatization of the Ministry of Health of the Russian Federation Frequency 6 issues per year About The journal covers theoretical issues of social hygiene, ways to develop healthy lifestyle behaviors, health- and social care delivery models, economic issues, job engineering, health statistics, and the history of medicine and public health. The journal publishes articles on the best practices of сenters for hygiene and epidemiology, methods and results in the study of living conditions and health status, the current state of public health, the work of healthcare providers abroad, designing healthcare facilities, and the development of medicine and healthcare. The journal also disseminates information on historic dates, the work of scientific societies, conferences, and meetings. The journal is intended for heads of public health bodies and healthcare institutions, researchers, educators, and other professionals working in the fields of social hygiene, public health management, health statistics, and the history of medicine. Indexing Scopus Experta Medica Abstract Journals Index Medicus Index to Dental Literature Chemical Abstracts Current Digest of the Russian Press EBSCOhost International Nursing Index PubMed Russian Science Citation Index Publication standarts The journal is following publishing and journal best practices of these organizations: Association of science editors and publishers (ASEP) (http://rasep.ru) Committee on Publication Ethics (COPE) (publicationethics.org) International Committee of Medical Journal Editors (ICMJE) (www.icmje.org) <a class="daria-goto-anchor" href="http://www.councilscienceeditors.org/resource-library/editorial-policies/" target="_blank" rel="noopener noreferrer" data-vdir-href="https://mail.yandex.ru/re.jsx?uid=1130000013745094&c=LIZA&cv=13.1.103&mid=162692536538764359&h=a,mU2ZHqFI0VUX7Aaw3wvNng&l=aHR0cDovL3d3dy5jb3VuY2lsc2NpZW5jZWVkaXRvcnMub3JnL3Jlc291cmNlLWxpYnJhcnkvZWRpdG9yaWFsLXBvbGljaWVzLw" data-orig-href="http://www.councilscienceeditors.org/resource-library/editorial-policies/">Council of Scientific Editors (CSE) (www.councilscienceeditors.org) National Information Standards Organization (NISO) (www.niso.org/workrooms/piej)
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MODERN TRENDS IN DIGITAL TRANSFORMATION OF DOMESTIC AND FOREIGN HEALTHCARE
The relevance of this study is due to the fact that the Government of the Russian Federation has approved a strategic direction in the field of digital transformation of healthcare until 2030, contributing to the achievement of technological sovereignty and ensuring conditions for the development of the country's healthcare sector. In this context, an overview of the current situation in the field of digital healthcare at the national and international levels was conducted. The authors analyzed the regulatory documents of the Russian Federation and scientific publications (RSCI, PubMed), selecting 22 domestic and 6 foreign works (2023—2024) on the digital transformation of healthcare. Based on PRISMA, an assessment of the quality of research was carried out, new analytical data on current trends and prospects for the development of digital healthcare were obtained. This review includes an analysis of the practical implementation of digital healthcare initiatives and a critical examination of the formation and effectiveness of the relevant regulatory framework in the country. The current main scientific and practical directions of the digital transformation of domestic healthcare were also considered. In addition, the results of the study of current priority trends in the digital development of foreign healthcare are presented. This allowed us to form a holistic view of the achievements and challenges facing the healthcare system in the era of digitalization.
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Mathematical Tools for Prioritizing Health Technologies: Focus on Implementing Multicriteria Decision Analysis Models
MCDA (Multicriteria Decision Analysis methods) allow for a comprehensive assessment of healthcare technologies based on diverse criteria. The study analyzes the main MCDA methods and the specifics of their application for prioritizing medical technologies. The materials are obtained from the PubMed database and the Google system. A generalized MCDA algorithm is presented, and frequently used models are highlighted: the weighted sum method (WSM), the theory of multicriteria utility (MAUT), and the analytical hierarchical process (AHP). The MCDA support software tools are considered. Special attention is paid to promising hybrid methods (AHP-TOPSIS) and models for dealing with uncertainties (fuzzy AHP and TOPSIS). Effective implementation of MCDA requires the development of medical informatics, but the key role belongs to the human factor — experts who determine the analysis strategy, the quality of the source data and the interpretation of the results. Automated systems and artificial intelligence need mandatory monitoring and validation by specialists when used for management decisions in healthcare.
HEALTH PROGNOSIS ISSUES TAKING INTO ACCOUNT AGE AND REGIONAL CHARACTERISTICS
The paper focuses on several aspects as applied to the Russian Federation that expand the possibilities of modeling morbidity and identifying risk groups among residents of the region which currently cannot be used in an explicit way Several state information systems operate in the Russian Federation each of which was created to solve specific problems set by federal laws in the field of public health protection labor legislation and in the field of sanitary and epidemiological well-being of the population At the same time having data on the health of the population in medical information systems it is not yet possible to compare health risks with data from other information systems and conduct a comprehensive assessment of health risks for residents of the region
ALEKSANDR SEMENOVICH LURYE — NEUROSURGEON, ONCOLOGIST AND HEALTHCARE ORGANIZER
The article summarizes the activities of the famous neurosurgeon, oncologist, organizer of the surgical service A. S. Lurye and introduces into scientific circulation previously unknown documents of the «Molotov period» of the doctor's life. He graduated from the Voronezh Medical Institute and was accepted as a resident in the faculty surgical clinic of the First Moscow Medical Institute, headed by Professor N. N. Burdenko. Along with clinical work, he was actively involved in experiments in the field of fundamental medicine. In 1938, he was elected to the position of associate professor of the surgery department of the Molotov Medical Institute, where, along with medical and teaching activities, he continued research in the field of neurosurgery. His broad outlook was in demand as a consultant to hospitals in the Molotov region. With the beginning of the Great Patriotic War, he supervised surgical care for the civilian population. After returning to Moscow in 1943, A. S. Lurye headed the department of the peripheral nervous system at the Central Evacuation Hospital, on the basis of which he defended his doctoral dissertation «Surgical treatment of gunshot and blunt injuries of the brachial plexus in adults». Later, A. S. Lurye was one of the organizers of the system of oncosurgical care for the population of the Moscow region. As an innovative surgeon, he improved the Roux—Hertsen—Yudin operation and proposed a new surgical approach for esophageal tumors.
Features of the relationship between psychological defense and emotional burnout of nurses
The aim of the study was to identify the features of the relationship between psychological defense mechanisms and emotional burnout in nurses with different lengths of professional experience. The study involved 570 nurses working in inpatient departments of city clinical hospitals. Two form methods were used: the method of V. V. Boyko «Emotional Burnout» and the method of «Lifestyle Index» by L. I. Wasserman. It was revealed that nurses in stressful and crisis situations often use the mechanisms of denial intellectualization and reactive education. In the group of nurses without signs of emotional burnout syndrome which made up 50 of the total research sample a balance of all psychological defense mechanisms and the absence of their relationships with the symptoms of the phases of emotional burnout were found. In the group of nurses at the stage of developing emotional burnout positive relationships were found between the indicators of the severity of its symptoms and such destructive psychological defenses as repression and regression and negative ones — reactive formation. Nurses with pronounced signs of emotional burnout are characterized by a decrease in the frequency of using all psychological defense mechanisms their imbalance and the presence of negative relationships with the symptoms of emotional burnout. It is concluded that when organizing preventive measures it is necessary to take into account the fact of the temporary positive impact of psychological defense mechanisms on the psychoemotional states of nurses and their subsequent destructive influence manifested in the emergence and development of emotional burnout syndrome.
Educational trajectories of professional competence formation among healthcare professionals (using the example of legal competence)
The Russian Federation continues a phased reform of the higher professional education system, which focuses on the development of professional competencies among medical professionals. But the development of professional competencies should not go only by replenishing the baggage of skills with narrow-profile knowledge and skills. The competence-based model of continuing medical education implies the formation of a legal culture and the necessary level of legal literacy for a doctor. Knowledge and compliance by medical professionals with the norms of current legislation is the basis for the functioning of the healthcare system, legal literacy is the key to professional protection of their activities. The purpose of the study is to substantiate the need to develop an educational trajectory for the development of professional competencies among medical professionals (using the example of legal competence). Materials and methods. The sociological method (studying the opinion of respondents), the statistical method (evaluating the results of a sociological survey). Results. When determining the need to improve legal literacy among specialists in the field of public health and healthcare organizations, a sociological survey was conducted that revealed a lack of legal knowledge, primarily the lack of a structured understanding of the basic laws setting out the basics of the rights and obligations of subjects of medical care, and basic regulatory legal acts regulating medical activities. Conclusions. The availability of legal competencies would allow health workers to effectively master the methods of crime prevention in providing assistance, control the occurrence of conflict situations, as well as find solutions to complex ethical and legal issues. A modern doctor, and especially a healthcare organizer, must confidently navigate the legal context of his activities, legal information, and use legal knowledge in his work.
THE PLACE AND ROLE OF FAMILY PLANNING IN REPRODUCTIVE HEALTH CARE: THIRTY YEARS OF RUSSIAN EXPERIENCE
The urgent problem of saving people in Russia requires an analysis of the causes and factors that hinder the expanded reproduction of the population. One of them should be considered the low level of reproductive health of the population. The family planning movement which was formed and developed in Russia in the 1990s plays an essential role in maintaining and strengthening the reproductive health of the population. An analysis of Russia's thirty year experience in this field allows us to state positive results — a decrease in maternal and infant mortality rates the prevalence of artificial abortions the formation of rational contraceptive behavior of the population. A network of medical organizations has been established that provide medical and social assistance to the population on family planning issues. However to date a number of issues remain unresolved — the development of a national concept of sexual education and youth education the development of a multiprofessional approach and interdepartmental interaction in matters of preserving and strengthening the reproductive health of the population.
Development of a methodology for calculating the need for medical staffing taking into account the regulatory framework and infrastructure indicators
The issue of calculating the personnel needs in healthcare remains key for the sustainable functioning of the medical care system and ensuring the availability of medical services. This paper provides a critical analysis of regulatory documents and methods used in the Russian Federation to assess the need for medical and paramedical personnel. Particular attention is paid to orders No. 230 and No. 974 of the Ministry of Health of the Russian Federation their applicability to various types of institutions the role of part-time job coefficients reception time standards as well as the impact of regional amendments. Approaches to calculating the need are considered from the point of view of adaptability to the actual workload and infrastructure development scenarios. The main limitations of existing approaches are presented: outdated standards lack of an updating mechanism in the context of demographic shifts and data heterogeneity. Based on a summary of sources official statistics and expert assessments a step-by-step methodology for calculating the personnel needs has been developed including elements of scenario modeling digitalization and automation of the calculation process. Explanatory charts and tables illustrate typical approaches to working with data as well as potential distortions when using incorrect coefficients. The proposed scheme is aimed at integrating personnel planning into the management practice of regional bodies and medical organizations in order to improve the validity of decisions made.
CRITERIAS FOR ASSESSING THE QUALITY OF MEDICAL SERVICES PROVIDED BY MULTIDISCIPLINARY TEAMS IN THE COUNTRIES OF THE WORLD (LITERATURE REVIEW)
The article presents an analysis of international experience in assessing the quality of medical care provided to the population through multidisciplinary teams. The main tools for assessing the quality of medical care at the primary level of health care are considered. As tools were considered models of self-evaluation of professional activity of multidisciplinary teams, the level of satisfaction of patients with the medical services provided to them, criteria included in programs for monitoring the work of team specialists. The article reflects the results of the use of quality assessment tools in primary health care organizations in a number of countries: Great Britain, Spain, Canada, China, etc. The results of foreign studies underline the importance of a multidisciplinary approach in health care that affects various aspects of quality of medical care. Assessing criteria such as patient survival, access to care, safety of health services, compliance with recommendations and patient satisfaction allows key factors to be identified, improving the delivery of health care to the public through multidisciplinary teams.
MODEL OF MOTIVATION FOR PROFESSIONAL DEVELOPMENT OF SPECIALISTS INVOLVED IN PROVIDING PRIMARY HEALTH CARE
The article presents a qualitative study of existing tools and models of motivation for professional development of specialists involved in the provision of primary health care in the global USA Canada Great Britain China and domestic practice. For more than a quarter of a century the countries of the Organization for Economic Cooperation and Development have been actively implementing motivational tools to develop the professionalization of primary health care specialists. Many countries have already formed full fledged motivational models at the state level which allows us to consider this phenomenon as an object of scientific research. The motivation model is a necessary element of all modern health care systems. For sustainable development it must be effective. The global trend is continuous education additional payments for qualifications and burnout prevention. Models of different countries have both common features and national differences. The global trend is continuous education additional payments for qualifications and burnout prevention. At the same time North American models have a pronounced decentralized nature. European countries gravitate towards centralization but strive to introduce valid performance indicators. Asian models are characterized by the presence of ultra strict state regulation with market mechanisms and digital assessment tools. The modern Russian model combines formal centralization with weak material incentives for professional development.
Development of a Comprehensive Method for Assessing Medical Workers' Satisfaction with the Infrastructure of Moscow Medical Organizations
The aim of this study was to develop a questionnaire designed to assess the satisfaction of health workers with the infrastructure of the Moscow Department of Health. The article considers modern approaches to assessing this indicator. An overview of the key infrastructure components that affect the professional well-being of staff is provided, and the importance of a comprehensive analysis of infrastructure factors to improve employee loyalty and the quality of medical services provided is emphasized. The architecture of the author's questionnaire, adapted to the specifics of Moscow healthcare, is described, providing for an assessment of satisfaction in four infrastructure domains (comfort of stay, appearance of medical organizations, technical equipment, digitalization and artificial intelligence), as well as the use of CSI and eNPS metrics to assess staff loyalty.
Nursing Practices in the Prevention of Diabetes Mellitus and Its Complications in Primary Healthcare Abroad: Review
Diabetes mellitus (DM) is a serious global health problem that requires effective prevention strategies due to its increasing prevalence and severe complications. Outpatient nurses play a key role in the prevention of diabetes, improving patients' self-care and quality of life. The aim of the study is to evaluate the effectiveness of nursing practices in reducing the risk of diabetes and concomitant pathologies in primary healthcare. A systematic review of publications (2020—2025) has been conducted, revealing the main areas of nurses' work, such as educational programs, screening, lifestyle modification, interdisciplinary collaboration, and digital technologies. These methods have proven effective in improving clinical performance, treatment adherence, and reducing the risk of complications. The introduction of such practices is promising for strengthening the prevention of diabetes and unloading the healthcare system.
Demanded areas and forms of professional development of management personnel in the capital’s healthcare system
The article presents the results of a study that included a survey of management personnel of Moscow medical organizations; interviews with heads of departments of polyclinics and with experts from the APE system; an analysis of the preliminary and subsequent questionnaires of students of the «Medical Organization Management» program. The attitudes of healthcare management personnel towards professional development, the range of areas of interest to them, and their attitude to various forms of education, including informal education, are shown. Since preparation for certification for a qualification category and special Moscow statuses can become an important step in professional development, the attitude of management personnel to these certification procedures was studied. An analysis of the results of the «entrance» and final questionnaires of students made it possible to assess the compliance of the advanced training program with the needs of managers, and the opinion of experts made it possible to clarify the most appropriate areas and formats of training.
Thematic priorities in oncology: analytical overview of publication trends and vectors of translational growth
Amid the rapid expansion of biomedical publications and the increasing complexity of the oncology research landscape, there is a growing need for a systematic analysis of thematic priorities that define global and national trajectories of scientific advancement. Oncology, as a field at the forefront of interdisciplinary innovation, spans domains from immune and cellular technologies to molecular imaging and epigenetic targets. Identifying frontier research areas that combine high scientific intensity, sustained international relevance, and translational potential is becoming a key tool for science policy and strategic planning. This study aims to map the most prominent oncology-related topics that emerged between 2021 and 2025, using data from the SciVal platform. A content-bibliometric analysis was conducted on the twenty leading thematic clusters in global oncology, followed by a comparative assessment of their representation in the Russian publication landscape. Metrics analyzed included publication output, field-weighted citation impact (FWCI), engagement dynamics, and institutional distribution. The results indicate that Russian research is contributing to several key topics, exhibiting high citation performance in niche areas such as exosomes, CAR-T therapy, radiomics, and immunotherapy for non-small cell lung cancer. However, many globally significant topics remain underrepresented in the Russian agenda, reflecting structural and human resource gaps in areas such as epigenetics, microbiome studies, precision immunomodulation, and regulated cell death mechanisms. These findings highlight both thematic gaps and institutional growth zones that require targeted support. Identifying advanced research areas positioned at the interface of scientific innovation and clinical applicability may inform the modernization of research infrastructure, the prioritization of national grant programs, and the integration of Russian research centers into global scientific consortia.
SOCIAL AND MEDICAL DETERMINANTS OF AGING (OVERVIEW)
The relevance of this study stems from the global challenge of population aging. This review, conducted according to PRISMA methodology based on the analysis of 45 scientific articles (2019—2025), systematizes key social and medical determinants of aging. Evidence indicates that socioeconomic status (SES) is a fundamental factor: low SES increases the risk of dementia, multimorbidity, and accelerated biological aging by limiting access to healthcare and healthy lifestyle choices. Conversely, education serves as a powerful protective factor, increasing vitality indicators by 15—30% through programs like «Universities of the Third Age». Social isolation shows a significant correlation with cognitive impairment and depression, as evidenced, for example, by a 23% decrease in the Active Longevity Index (ALI) observed in rural regions of the Russian Federation. Lifestyle factors, including nutrition and physical activity, are equally critical, as is the detrimental impact of environmental pollution in accelerating aging. Among medical determinants, chronic diseases (cardiovascular disease, diabetes) and frailty/sarcopenia, affecting 52% of individuals over 80, play a leading role. Access to geriatric care remains limited (&lt; 10% in low-income countries); however, telemedicine and the integration of geriatricians into primary care settings demonstrate efficacy. Genetic and environmental factors also exert a significant, unconditional influence on aging processes. Thus, the principal determinants influencing the quality of life of older adults inform the direction of efforts aimed at developing a comprehensive policy framework to combat premature aging.
Prevention of risk factors for chronic noncommunicable diseases, effective practices, policies and approaches in the primary health care system
The relevance of this study stems from the fact that the prevention of behavioral risk factors in primary health care (PHC) is an effective measure that can reduce not only morbidity but also the burden on healthcare systems. However, the implementation of effective practices, policies, and approaches remains uneven, necessitating an examination of the best strategies, barriers, and opportunities to optimize preventive care at the PHC level. A search in the PubMed, Scopus, and WHO IRIS databases for the period 2019—2025 identified 48 relevant open-access sources. Using PRISMA guidelines, the quality of the studies was assessed, and data on current interventions implemented within PHC systems were obtained. The findings highlight the effectiveness of integrated PHC models, such as multidisciplinary teams and network-based collaboration, in reducing modifiable risk factors. Among the key successful approaches are the use of digital technologies, risk stratification, integration with local communities, and outcome-based financing. The main barriers include fragmented healthcare systems, limited resources, and low coverage of vulnerable groups. The review confirms the need to adapt effective strategies to national and regional contexts to optimize the prevention of chronic noncommunicable diseases.
«New gerontology» as a philosophy of age and meaning: a transdisciplinary approach
The article examines the concept of «new gerontology» as a philosophical and humanitarian reflection on age, aging and the meaning of life in the context of demographic transition and increasing life expectancy. The emphasis is placed on the transdisciplinary nature of modern gerontology, integrating biomedical, sociocultural and existential dimensions. It is shown that the «new gerontology» transforms the idea of old age as a deficit and decrease, offering an image of a productive, meaningful and active late age. The necessity of philosophical understanding of aging as an anthropological and axiological phenomenon is substantiated.
Peculiarities of the dynamics of the number of people with disabilities in Russia (2021—2024): analysis of key trends in younger and older age groups
The article analyzes the peculiarities of the dynamics in the number of people with disabilities in Russia between 2021 and 2024, focusing on younger (children) and older (101 years and older) age groups. The study aims to identify key trends and factors influencing changes in the number of people with disabilities in these groups. The methodology is based on statistical analysis of data from the Unified Interdepartmental Information and Statistical System (EMISS) and expert interviews. It is shown that the total number of people with disabilities demonstrates non-linear dynamics, with a sharp decrease in 2022 followed by subsequent growth. The number of children with disabilities remains stable or increases, which is associated with improved diagnostics, expansion of disability criteria, and a number of socio-economic factors. The anomalous growth in the number of people with disabilities over the age of 101 in 2024 is explained by demographic aging, improvements in the accounting system, and the possible consequences of the COVID-19 pandemic. The results have practical significance for adjusting government programs and improving the disability accounting system. The study contributes to the understanding of demographic and social processes related to disability and identifies directions for further research.
MOTIVATION FACTORS FOR DOCTORS: PART 1 (CHOOSING A DOCTOR'S PROFESSION)
Modern society is facing numerous challenges in the field of healthcare, which require young people to make an informed choice of profession. In an ever-changing social and economic environment, the question of what motivates young people to choose a medical profession is becoming an increasingly relevant topic for research. This article provides an in-depth analysis of the many motivational factors that play a key role in deciding on a medical career. The work covers psychological, social and economic aspects that shape the motivation of future doctors. Psychological factors include inner aspirations and personal beliefs, such as a desire to help people, an interest in science, and an attraction to the humanities of medicine. Social aspects consider the influence of the environment, including family values and cultural expectations, which may encourage young people to choose this profession. Economic factors focus on financial expectations and career opportunities in medicine. Based on a sociological study conducted among students and applicants of medical universities, the article highlights the key motivators influencing the choice of a doctor's profession. The results of this work can serve as a basis for the development of programs aimed at attracting and retaining young people in the medical profession, which is important for the future of healthcare.
MOTIVATION FACTORS FOR DOCTORS: PART 2 (STAYING IN THE PROFESSION)
This article examines the factors influencing doctors' motivation to stay in their profession. For this purpose, a sociological survey was conducted, which was attended by 428 medical workers of various specialties working in public health institutions in Moscow and the Moscow region. The survey consisted of several key sections, including personal, professional, social, and economic aspects, which revealed both internal and external motivations shaping doctors' attitudes toward their profession. The results show that 57% of respondents chose the profession of a doctor out of a desire to help people, which highlights the altruistic nature of medical practice. However, higher workloads, economic instability, and lack of respect for the profession pose significant challenges. Despite this, a significant part of the doctors surveyed express satisfaction with their work, which indicates internal motivation and a desire for constant self-improvement. The article summarizes the popularity of professional communities, the level of financial expectations and the importance of family support, and identifies changes that could improve the working conditions of medical professionals.
NETWORKING BETWEEN MEDICAL UNIVERSITIES AND COMMERCIAL ENTERPRISES: POTENTIAL, MECHANISMS AND CHALLENGES
The article examines the forms and content of network interaction between medical universities and commercial enterprises in the context of the transformation of the scientific and educational environment. The potential of such partnerships for the development of applied medical research, innovative entrepreneurship, and healthcare staffing is analyzed. The key mechanisms of cooperation are substantiated: technological alliances, R&D clusters, incubators and educational consortia. Ethical, legal and organizational barriers to cooperation are noted. It is concluded that there is a need for regulatory and institutional support for networking as a tool for shaping the «fourth mission» of universities.
HEALTH WORKERS’ COMMITMENT TO A HEALTHY LIFESTYLE
Maintaining a healthy lifestyle is one of the main conditions for health preservation. The paper examines subjective predictors of commitment to a healthy lifestyle as assessed by health workers. The article is based on a secondary analysis of data from the study «Study of the Human Resources Potential of Moscow Healthcare» conducted in 2023 by the State Budgetary Institution «Research Institute for Healthcare Organization and Medical Management of the Moscow Department of Healthcare» — NIIOZMM. 1,449 specialists — doctors and nurses of medical organizations of the capital were surveyed. Most of the study participants (67%) answered that their lifestyle is rather healthy, a quarter (26%) — unhealthy, 6% could not give an answer. Employees with secondary specialized education are less likely to note commitment to a healthy lifestyle (59%), and those who have completed residency — more often (74%). Commitment to a healthy lifestyle is more often demonstrated by employees working in medical organizations that carry out activities to form a healthy lifestyle among the population (78%). The main predictors of refusal to lead a healthy lifestyle based on logistic regression were identified as the perceptions of health workers about the conditions that hinder health behavior: lack of confidence in the benefits of a healthy lifestyle, lack of support from others, the presence of psychological problems, stress at work and at home. On the contrary, employees committed to a healthy lifestyle consider it important for the population to trust medical organizations and health workers. They are ready to bear responsibility for the healthy lifestyle of the population along with the state and the people themselves.
Integration of medical and non-medical universities in the training of personnel in innovative educational programs
The article examines the theoretical and practical foundations and models of integration of medical and non-medical universities in the context of training personnel in innovative educational programs. The article analyzes the institutional formats of cooperation, interdisciplinary approaches, resource and organizational effects of combining the efforts of universities of various profiles. It is shown that effective integration ensures the formation of new professional competencies at the intersection of medicine, biotechnology, occupational health and social sciences. The key principles of the organization of integrative programs and the directions of development of network models of higher education in healthcare are proposed.
Media and digital technologies: harm or benefit in the fight against childhood obesity? (literature review)
Childhood obesity is one of the most important public health problems, as it is associated with the development of concomitant diseases and deterioration of social, emotional and mental health. The high prevalence of overweight among children worldwide requires the development of effective prevention and treatment methods. Traditional approaches based on personal contact with specialists have limited availability. Digitalization, on the one hand, exacerbates the problem due to physical inactivity and easy access to unhealthy food, and on the other hand, opens up new opportunities due to children's receptivity to digital technologies. The purpose of this work is to systematize modern data on the impact of media and digital technologies on body mass index in children and adolescents. An analysis of PubMed/MEDLINE publications over the past five years has revealed the main digital risk factors: advertisements for harmful products, lack of movement in front of screens, eating while watching, and the psychological impact of content. At the same time, mobile apps and gaming programs have proven effective in combating obesity. Comprehensive approaches combining digital tools with face-to-face visits to doctors are particularly promising.
CRM CONCEPT AS A NEW FORMAT OF PATIENT-CENTRICITY IN MEDICAL ORGANIZATIONS OF THE FUTURE
The effectiveness of the management of medical organizations, on which the quality of medical services and the health of Russians depend, is today a cornerstone in solving and achieving strategic health-saving objectives. Russian medicine uses the most advanced technologies and digital solutions that contribute to the effective organization of the work of medical workers, allow them to realize patient-centricity and improve the quality of medical services provided. The purpose of the study is to search for approaches to creating and implementing a CRM application model as a new format for implementing patient—centricity in the Ministry of Health of the future. To achieve this goal, a range of different techniques was used: analytical, logical and systematic approaches to the analysis of secondary data. The empirical part of the study is a survey of the expert community, which allowed us to build/obtain a matrix diagram of the relationship between CRM functionality and HR management processes in the Ministry of Defense. As a result, a conceptual model of CRM implementation in the MO is proposed, which takes into account the demand from patients for the services of a particular MO, taking into account its capabilities. The results obtained within the framework of the research topic will improve the efficiency of the Ministry of Defense due to a more efficient and optimal workload of medical specialists and a more complete «understanding of needs» on the part of the population based on the implementation of CRM.
Uncertainty of Results in Clinical Diagnostic Laboratory Examination
The article examines the critical role of measurement uncertainty assessment in ensuring the reliability of the results of clinical diagnostic laboratories. A two-component measurement uncertainty model is analyzed which includes a component related to the traceability of results to the highest standards provided by the manufacturer of in vitro diagnostic systems and a component characterizing the reproducibility of measurements in a specific laboratory evaluated on the basis of in-laboratory quality control. The methodology for calculating the total measurement uncertainty is presented and its mandatory indication along with the analysis result in the format «Value ± measurement uncertainty (%)» which determines the range of possible values of the true value. The clinical importance of taking measurement uncertainty into account when interpreting laboratory data is emphasized. Using the example of the threshold value of anti-Muller hormone for deciding on the possibility of in vitro fertilization it is demonstrated how ignoring the uncertainty interval can lead to an erroneous refusal of treatment. The key challenges of the widespread introduction of measurement uncertainty into practice are noted: the need to maintain clinical diagnostic laboratories in a state of statistical manageability ensuring the reliability and completeness of data from in vitro diagnostic manufacturers modifying laboratory forms and most importantly training clinicians in the principles of interpreting results taking into account uncertainty. It is concluded that the integration of measurement uncertainty into routine laboratory reporting and clinical decision-making is a necessary condition for improving diagnostic quality minimizing errors and ensuring patient safety.
QUALIFICATION ISSUES OF OLDER MEDICAL SPECIALISTS
The relevance of employing older medical professionals is driven by the need to address the workforce shortage in the healthcare sector. The qualifications of these specialists are significantly influenced by their work experience in their specialty, which correlates with age-related characteristics. The study utilized statistics from the Moscow Department of Healthcare and data from surveys with specialists working within the Moscow healthcare system. The primary focus was on the qualifications of physicians. The study examined physicians' proficiency in both hard and soft professional skills and found that, in most cases, older physicians outperform younger and mid-career professionals in acquiring hard skills. In terms of soft skills, older physicians lead in competencies such as patient communication and teamwork. Overall, it can be concluded that the qualifications of older physicians often surpass those of other age groups. However, they do face age-related limitations, such as reduced activity levels and weaker cognitive functions, which must be taken into account in continuing medical education programs and work schedules. With proper organization of labour and additional training, the performance of older physicians can be as successful as that of their middle-aged colleagues.
Specificity of negative emotional automanifestations of health workers as a prerequisite for professional deformations (burnout)
The average degree of accumulation of charges of emotional-energetic nature of self-direction was determined in healthcare workers (8.75), which is characterized by: an above-average indicator of the tendency to reproduce experiences of an unreacted plan (7.58), an average degree of tendency of a personality type to a mood of a reduced vector (7.02) and a tendency to reactions of a disorganizing emotional nature (7.16), a below-average level of emotional excitability of an uncontrollable aspect (4.25) and a tendency to behavior of an affective nature (3.97); the following were established: a high relationship between the tendency to reproduce experiences of an unreacted plan and the accumulation of charges of an emotional-energetic nature of self-direction (0.829), the tendency of a personality type to a mood of a reduced vector (0.765) and to reactions of a disorganizing emotional nature (0.793); a noticeable connection between the accumulation of charges of an emotional-energetic nature of auto-direction and the tendency of a personality type to a mood of a reduced vector (0.624).
Standardized Operating Procedure «Model of Short-Term Motivational Intervention During Preventive Medical Examinations of Students for Early Detection of Narcotic Drugs and Psychotropic Substances Use»
Introduction. The use of psychoactive substances (PAS) remains one of the key factors contributing to the development of non-communicable diseases and posing a threat to the national security of the Russian Federation. Preventive measures remain the most effective in minimizing negative impacts on public health, as supported by scientific research and enshrined in the *State Anti-Drug Policy Strategy of the Russian Federation until 2030* (Presidential Decree No. 733 of 23.11.2020). Objective. To assess the effectiveness of implementing the standardized operational procedure (SOP) «Model of Short-Term Motivational Intervention During Preventive Medical Examinations of Students for Early Detection of Illicit Use of Narcotic Drugs and Psychotropic Substances». Materials and methods. The study materials included: original research on preventive medical examinations; methodological guidelines on short-term motivational intervention developed by the authors; data from the study «Improving Measures for Preventing Addictive Behavior Among Adolescents and Youth in the Russian Federation»; results of a randomized controlled trial comparing the SOP and traditional examination approaches. The findings were analyzed using parametric and non-parametric statistical methods. Conclusion. The SOP, integrated into a preventive informational conversation between a psychiatrist-narcologist and a student, improves screening quality and enhances the detection of risk factors for non-medical PAS use, while also strengthening motivation, personal responsibility for health, and commitment to a healthy lifestyle.
ASPECTS OF FORMING A CAREER TRAJECTORY FOR A MEDICAL SPECIALIST
Elimination of personnel shortage in healthcare has been one of the key tasks for several years. The reasons for the shortage of specialists have long been studied, but the situation is not changing as fast as we would like. The solution to the problem of shortage of medical workers, first of all, is the creation of suitable working conditions and opportunities for self-realization of healthcare personnel, while it is important to start the formation of a personnel reserve by attracting schoolchildren to the profession, then maintaining interest in the profession during training, and also promoting the adaptation and professional development of young specialists when they are employed. The purpose of this study is to identify the role of mentoring at each stage of the career trajectory of a young specialist. The information basis of the study is the data of sociological studies devoted to identifying modern challenges in the development of human resources in the healthcare system and organizational aspects of mentoring, in 2023—2024 in medical organizations subordinate to the Department of Health of the City of Moscow. The present study proposes to use a model of a “seamless” career trajectory for a health worker through a mentoring system.