Problems of Social Hygiene,
Public Health and History of Medicine

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.