[The professional burnout of medical workers and its determining factors].

The study was carried out using survey technique applied to sampling of workers of the first three polyclinics of Moscow. The method was based on international questionnaire Maslach Burnout Inventory (MBI) that permitted to consider characteristics of activity of medical professionals. The analysis of results of study demonstrated that overall prevalence of burnout among doctors is 17%,among nursing personnel - 21%, among non-medical personnel - 19%. The average age of workers with professional burnout is 34-49 years. Among workers with burnout more than half of them had higher education and 30% had specialized secondary education. The workers consider as main factors of professional burnout necessity to spend most of working time at the computer (up to 92%), unrealistic expectations of patients from received medical care (up to 88%), deficiency of time for reception of patients and personal life. The majority of employees had an average (35%) and low (43%) level of reduction in personal achievements that testifies well-being of work environment. The conclusion is made that in polyclinic section of Moscow health care there are no serious conflicts in collectives and existing conflicts are within limits of working relationships.

[Management solutions using digital technologies in the Healthy Moscow pavilions].

The digital transformation of healthcare is an integral part of the priorities in modern healthcare. A striking example of the practical implementation of compliance with the basic principles of digital healthcare is the Healthy Moscow project, which has been implemented since 2021, which has become a real breakthrough in Russia in ensuring accessibility and convenience in providing medical care to the population. The aim of the project is the early prevention of chronic non-communicable diseases, the formation of a healthy lifestyle and the improvement of the well-being of Moscow residents, as well as the development of a conscious attitude to taking care of their health. Pavilions in the park areas of Moscow are an integral part of the modern medical infrastructure, providing convenient conditions for obtaining medical advice and information. The article provides information on the types of digital technologies and basic equipment that the pavilions (large and small) are equipped with as part of the Healthy Moscow project, it is shown that the introduction of digital healthcare technologies is one of the key tasks of the national strategy of Russia, which contributes significantly contribution to the successful implementation of the Healthy Moscow project.

[The child and adolescent hypertension as a world-wide problem: prevalence, risk factors including neonatal ones].

The children hypertension is a serious threat to population health because uncontrolled children hypertension can result in exponential increasing of cardiovascular and cerebrovascular diseases, progression of kidney failure and premature death in adulthood. The main risk factors for primary children and adolescent hypertension are considered as cardiovascular biomarkers (fibro-blast growth), obesity, especially central obesity, overweight, low birth weight, high sodium intake, sedentary lifestyle, lack of physical activity, socioeconomic and ethnic factors, as well as family anamnesis. The special place in studying children hypertension is occupied by problem of neonatal hypertension. The most common causes of neonatal hypertension are umbilical catheter-related thrombosis, renal parenchymal disease and chronic lung disease (bronchopulmonary dysplasia), as well as low birth weight, post-menstrual age and some other maternal factors, as well as medications (inotropic medicines, caffeine) and regulation of fluid intake.

[The molecular genetic aspects of basal cell carcinoma from the position of population health preservation].

The exploration of molecular genetic mechanisms that underlie carcinogenesis, hereditary factors of various oncological diseases, including basal cell carcinoma, the most common type of skin cancer is especially actual and significant for target strategies of public health. The diagnosis of basal cell carcinoma is based on complex clinical, radiologic and genetic examination data. The further research in the field of somatic or hereditary mutations in genes associated with basal cell carcinoma, including Patched 1 (PTCH1), Patched 2 (PTCH2), Smoothed (SMO) continue to be topical. The strategies of primary prevention of basal cell carcinoma, discussions of complex issues of decision-making concerning treatment at primary health care level, training courses and development of guidelines for general practitioners and interdisciplinary recommendations for effective early diagnosis and comprehensive care of basal cell carcinoma are to be suggested.

[Features of the state of health, including physical development, of adolescent girls living in the middle and high mountains of the Kyrgyz Republic].

Adolescent girls aged 15-18 are in an active process of growth and development, as evidenced by the dynamics of changes in height and weight indicators. Low values of average growth indicators were determined among girls in Batken, on average 2 cm less than the average indicators of girls in Bishkek, however, the statistical analysis performed did not confirm the reliability of these differences. In 84.3% of the surveyed adolescent girls living in Naryn, iron deficiency anemia was detected. Kidney and urinary tract diseases (31.4%) took the first place in the structure of diseases among girls in Batken. Diffuse enlargement of the thyroid gland was found in 13% of women living in highlands. Inflammatory diseases of the genitourinary system are two or more times more common among girls in the middle and high mountains than in Bishkek: vulvitis in 8.7-11.4% of cases against 4.1% of cases, urogenital diseases in 6.5-17.4 versus 3.9 respectively. This indicates the need to introduce specific preventive programs for girls living in the middle and high mountains.

[Organization of the work of the «Healthy Moscow¼ pavilions in order to conduct preventive examinations of the adult population in park areas, squares and recreation areas of the city of Moscow].

In modern conditions of global threats caused by infectious risks, the importance of programs and preventive examinations of the working-age population is increasing, which make it possible to identify groups of people at increased risk in the formation of health disorders, and to obtain objective data on the dynamics of morbidity and mortality of the population, to conduct long-term monitoring. The uniqueness of this project lies in the fact that it is based on a patient-centered approach that involves the individualization of the patient's diagnosis, professional counseling about risk factors and a healthy lifestyle, accompanying the patient until the completion of the examination, diagnosis and treatment. The organization of preventive examinations of the population within the framework of the Healthy Moscow program was the result of coordinated work and the realization of the professional potential of various services in the healthcare system, education, science and public administration. The successful experience of implementing the Healthy Moscow program can be scaled up to other cities and regions of Russia, which will contribute to the development of the country's healthcare system and improve the quality of life.

[A new approach to the epidemiological control of infectious diseases in the Russian population].

The article describes a development related to the field of public health and molecular biology, in particular, medical diagnostics. We present the Isascreen-8 portable analyzer (Registration Certificate No. RZN 2022/17322, May 24, 2022) and its application for rapid diagnostics of a new coronavirus infection with the use of commercially available sets IsoAmp SARS-CoV-2 (Lytech Co. Ltd., Russia), and also our own development TB-IZATEST (Invention Application No. 2022133809, December 22, 2022) for diagnostics of tuberculosis pathogen. The approach proposed in this article can be used for rapid detection of genetic material (DNA/RNA) of Mycobacterium tuberculosis and SARS-CoV-2 in biological samples using the method of loop isothermal amplification in less than 20 minutes, and also as a universal platform for detection of genetic material of other pathogens in a biological sample. Using the proposed approach, various research tasks for epidemiological monitoring of tuberculosis and new coronavirus infection, qualitative and quantitative analysis of bacterial and viral load in samples, including evaluation of the effectiveness of the prescribed antibiotic therapy regimen, can be solved. The advantage is that this method can be used not only in diagnostic laboratories, but also in field laboratories in the most remote regions of Russia if the mandatory sanitary and epidemiological requirements are observed. With sufficient distribution, the proposed approach could help ensure epidemiological control of the prevalence of these socially significant infections.

[Main anthropometric indicators of children and adolescents living in the Chuvash Republic in the dynamics of 137 years].

Anthropometric studies conducted in 1884, 1928, 1946, 1965 and 1999 to study the characteristics of growth and weight indicators of children living in the territory of modern Chuvashia, partly reflected the influence of the living conditions of children in certain historical periods of the country's development: revolutions, civil and domestic wars, post-war stabilization, «perestroika¼. Over the last 22-year period, from 1999 to 2021, there has been the largest increase in the growth rate of indicators of the physical development of children and adolescents, which is considered as a positive trend, a manifestation of ongoing acceleration processes. It was revealed that in modern children, physiological growth jumps in comparison with their peers in 1884, 1930, and 1999 occur earlier - in the prepubertal period.

[Comparative aspect of normative (reference) values of indicators of length and weight of children living in the region of the Far North (part 1 - body length indicators)].

PURPOSE OF THE STUDY: to analyze the differences in the normative (reference) values of the body length indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia). MATERIALS AND METHODS: Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used. RESULTS: Among boys, the highest level of statistically significant differences in body length was observed in the age groups of 12, 13 and 15-17 years, among girls - in the age groups of 13, 14 and 16 years. Higher reference values of body length indicators for boys and girls living in the industrial regions of the Republic of Sakha (Yakutia), lower - for those living in the Arctic zone of the Far North and rural areas of the Republic of Sakha (Yakutia), where the population is represented mainly by the indigenous peoples of the Far North.

[Comparative aspect of normative (reference) values of indicators of length and weight of children living in the region of the Far North. Part 2. Body weight indicators].

PURPOSE OF THE STUDY: to analyze the differences in the normative (reference) values of the body weight indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia). MATERIALS AND METHODS: Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used. RESULTS: The analysis showed that the greatest differences in this indicator were recorded in groups of children of primary school age, both among boys and girls. The highest values of reference indicators for body weight were determined in the younger age groups of boys and girls living in Yakutsk, and in older age groups - in those living in the industrial regions of the Republic of Sakha (Yakutia). The lowest values of these indicators were determined in children in rural areas of the region.

[Features of the appeal for pediatric otorhinolaryngological care in conditions of increased biological risks].

The combined effect of close contact between child patients and otorhinolaryngologists, as well as the practice of aerosol-generating procedures, justify the need to take prompt organizational measures to reduce risks in the provision of pediatric otorhinolaryngological care in conditions of increased biological risks. In the pediatric ENT community, these adaptations have resulted in: judicious distribution of care to treat the most severe conditions, minimizing the risk of long-term consequences, ensuring the safety of child patients and healthcare workers through better communication methods, changing procedural precautions, the rapid introduction of telemedicine for diagnosis and treatment of patients, as well as the development of protective protocols to limit exposure to aerosol-generating procedures or manipulations to reduce the risk of exposure to a high viral load.

[Organization of children's otorhinolaryngological care in conditions of biological risks: international experience].

The COVID-19 pandemic has spurred the introduction of new devices and technologies into the organization of otorhinolaryngological care, the development of safety measures and clinical work protocols in order to increase the safety of doctors and patients. Virtual outpatient clinics have been integrated into the pediatric and basic outpatient services, the potential of which for pediatric otolaryngology is considered quite significant. In otorhinolaryngological practice, the transition to the expanded use of telemedicine technologies (individual gadgets for examining ENT patients, including a direct access otoscope connected to an otolaryngologist's computer) was especially significant. The practice of pediatric ENT services tends to combine virtual and face-to-face visits, even after the acute phase of the COVID-19 pandemic. When organizing otorhinolaryngological care, it is necessary to pay special attention to dialogic consensus - an inclusive and reflective dialogue between a doctor and a patient.

[Comorbidity of rosacea and various pathological conditions among the population of the countries of the world, accounting for treatment and preventive measures].

Currently, there is an urgent need for global research to develop a modern comprehensive study of rosacea, including its pathogenesis, risk factors, association of rosacea subtypes with concomitant diseases. The most relevant research studies the role of immunity and microorganisms in the pathogenesis of rosacea. To elucidate the features of the comorbidity of rosacea and somatic diseases, studies in various populations with detailed clinical data and a longer follow-up period are important. At the same time, it is important to understand the relationship between the severity and severity of various clinical symptoms of rosacea, the mechanisms that regulate the progression of the process, the combination of rosacea subtypes and the course of the disease in association with other forms of pathological disorders.

[Personalized approach in the diagnostics and treatment of symptomatic epilepsy with déjà vu seizures].

The phenomenon of déjà vu (DV) is of interest, occurring in 97% of healthy individuals, while DV can be a manifestation of a number of pathologies, such as Charles Bonnet syndrome, depression, schizophrenia, or temporal lobe epilepsy. Most cases of DV type epiphenomena are associated with hippocampal sclerosis, while up to 90% of patients with mesial temporal sclerosis are drug resistant. Despite the success of pharmacotherapy, the frequency of «uncontrolled¼ epilepsy in industrialized countries that adhere to modern standards of treatment is from 30 to 40%, and this percentage is higher among patients with symptomatic and cryptogenic forms than among patients with idiopathic epilepsy (respectively: 40% and 26%). In turn, when studying the DV phenomenon and choosing a therapy strategy, it is necessary to establish its origin, determine its clinical significance (whether it is initially pathological or not), and the need for treatment. During the analysis of exome data, a search was made for substitutions in genes associated with arteriovenous malformations, both with autosomal dominant and autosomal recessive types of inheritance. The genes KRIT1, RASA1, IL6, FAM58A, GLML, EPHB4, CCM2, and ELMO2 were analyzed especially carefully. The analysis of genetic data is of great importance in the aspect of preventing cerebrovascular accidents, at the same time, in order to obtain reliable and significant results, in addition to time and financial costs, examination of relatives is also required. Meanwhile, this fact does not mean that every patient needs to conduct a genetic study. The paper presents detailed instructions for supplementing anamnestic information, as well as the results of personalized instrumental and laboratory diagnostics, which made it possible to carry out timely correction of therapy and achieve a prolonged positive effect.

[The social genetic aspects of higher prevalence and prevention of basal cell carcinoma].

The maintenance of health of residents of the Northern Regions of Russia, including those living in the Arctic zone of the cbountry, is a condition of its advance development in XXI century. The percentage of Russian citizen vaccinated against the new coronavirus infection (COVID-19) does not exceed 50% after beginning of implementation of vaccination program. It can be conditioned by lower level of both of credence of citizen to health care system and health literacy.Purpose of the study is to establish determinants of vaccination of population against COVID-19 in circumpolar region of Russia as exemplified by the Arkhangelsk Oblast.The sociological survey was carried out using the interview technique of patients of medical organizations (n=433) and conditionally healthy residents of the Arkhangelsk Oblast (n=139). To evaluate the level of general health literacy the Russian version of questionnaire HLS19 - Q22-RU was applied. The most of conditionally healthy respondents and consumers of medical services looked for information about methods of prevention and treatment (80.4% and 58.2% correspondingly), had an experience of vaccination against COVID-19 (79% and 56.3% correspondingly). The relative chances of conditionally healthy respondents, women, and respondents having no children and no credence to national health care system to independently look for information related to COVID-19 is higher at 2.94, 2.08, 1.55 and 1.48-1.57 times correspondingly. The relative chances of conditionally healthy respondents having no children in family and assessing one's economic status as "higher than average" to be vaccinated against COVID-19 is higher at 4.02, 1.52, 1.53 times correspondingly. Availability of experience of vaccination against COVID-19 is conditioned by higher level of general health literacy.In the Arkhangelsk Oblast and other circumpolar regions of Russia the programs of increasing loyalty of citizen to measures of population prevention, including vaccine prevention, is to be implemented with consideration of established determinants of of vaccinations against COVID-19.

[The application of statistical programs and methods of data mathematical processing in obstetrics and gynecology].

In recent decades, evidence-based medicine acquired special importance in medicine. Therefore, proper presentation of data obtained in scientific research is extremely important. The statistical data processing, being an integral part of this process, often causes difficulties for researchers and its incorrect application results in distortion of results obtained. The purpose of the study is to comparatively analyze programs and methods of statistical data processing applied in dissertations on obstetrics and gynecology in 2011-2021, to examine trends in choosing them depending on specificity of research issue and to identify shortcomings erred by authors in choosing or describing data processing methods. The sampling for analysis included 258 abstracts of candidate's dissertations in the specialty "obstetrics and gynecology", defended in 2011-2021. The analysis covered the programs and methods of mathematical data processing. Over the past decade, significant complication of statistical processing of results of clinical trials in obstetrics and gynecology occurred in part of methods applied. The application of binary logistic regression and discriminant analysis increased most significantly over the past decade. Such sophisticated methods of statistical data processing as factor analysis, decision trees, ordinal logistic regression and neural networks began to be used too. The trend of gradual replacement of parametric methods (Student's t-test, one-way analysis of variance) by such corresponding non-parametric methods as Mann-Whitney test, Kruskal-Wallis test. The Microsoft Excel and Statistica were used most often for data processing. In recent years, the software SPSS Statistics is actively applied. However, problems in describing statistical methods used in dissertations continue to be present. In significant part of dissertations information about statistical program applied, methods of assessing of quantitative data distribution and criteria of significance of obtained results is absent. The proper application of statistical programs, methods of information processing, adequate interpretation of results as well as provision of complete information about methodological support are the key points to carry out modern research resulting in trusted attitude to scientific work and its results.

[The health of children of adolescent age delivered on time with light and large body mass].

The need to preserve and promote health of children determine one of the basic directions of development of public social policy. It is the most important strategic purpose of modern children health care, since from it depend health of the nation, increasing of life expectancy and national economic potential.Purpose of the study is to assess health status of children of adolescent age born at term with diagnosis "fetus with low birth weight for gestational age" and with large body mass. The bibliographic, information-analytical and comparative analysis methodology were applied.

[THE AGE-RELATED FEATURES OF THE MORBIDITY OF THE POPULATION IN THE CONTEXT OF THE COVID-19 PANDEMIC].

The COVID-19 pandemic has led to changes in all medical and demographic indicators, including changes in the incidence of the population. The article provides an analysis of the age characteristics of the primary morbidity of the population in the conditions of the COVID-19 pandemic. A pattern has been determined: the highest rates of primary morbidity in the conditions of the COVID-19 pandemic (for 2020) were determined in the age group older than working age. It was in this group that the highest incidence rates of COVID-19 were established. On the contrary, a comparative analysis of the primary morbidity of children (0-14 years old) in Russia as a whole in the «pre-pandemic¼ year (2019) and in the conditions of the COVID-19 pandemic (2020) showed a decrease in the level of this indicator by 13.9% (from 172455.1 to 148537.7 per 100 thousand population, р < 0.05). Among the child population, 1208.3‱ cases of COVID-19 were registered. Thus, in the Central Federal District, the indicators of primary morbidity of children were lower than the general.

[Global risks of obesity in adolescent and teenage populations].

Symptoms of chronic cardiometabolic disease such as hypertension, hyperglycemia, dyslipidemia and inflammation, as well as type 2 diabetes, are becoming more common in obese adolescents. Physical inactivity, lack of sufficient physical activity among young students, the availability of sugar-containing products, sugary drinks and fast food, the high cost of healthy eating, aggressive advertising of unhealthy foods, economic difficulties, the influence of the social environment are factors in the growth of BMI and obesity among students. University students are characterized by the lack of a balanced diet, with habits such as snacking as the main meal, consumption of drinks with artificial sugar, fruit juices, and rare breakfast. Students have high consumption of unhealthy foods that contribute to weight gain and obesity: jerky, smoked sausages, hot dogs, white bread and baked goods, butter, fried foods and energy drinks, alcohol, especially by male vocational school students. Vending machines installed on student campuses provide quick access to unhealthy, sugary foods and drinks, contributing to poor nutritional status and obesity in students.