[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.

[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.

[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 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.

[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.

[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 «uncontrolled» 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.

[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 the work of the «Healthy Moscow» 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.

[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.

[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, «perestroika». 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.

[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 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.

[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.

[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.

[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.

[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.

[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.

[FEATURES OF NUTRITION OF ADOLESCENTS IN THE TWENTIES OF THE XXI CENTURY AS A HEALTH RISK FACTOR]

Adolescence is considered a vulnerable period of life due to the influence of factors that potentially contribute to the formation of unhealthy eating behavior. At the same time, the role and importance of healthy nutrition, as well as the process of forming habits and skills of good nutrition, are especially important for adolescence and adolescence, taking into account their fertility potential.Significant factors influencing the formation and changes in the eating behavior of adolescents and youth are indicators of the economic and social development of the country, place of residence, the level of income of the population, including family income, the level of education of parents, the opportunity to engage in physical education and sports, advertising pressure, including including television and on the Internet, the state of society and industry, the degree of psychological well-being in the family and school environment, the level of complexity of personal and communication problems of young people. In order to improve eating behavior and health, reduce the consumption of unhealthy foods among adolescents and young people, systemic actions are needed that target various eating habits. It is important that the activities take into account the emotional, socio-economic and cultural aspects of the life of young people in different countries.

[ADULTS NEUROGENESIS AS A RESERVE FOR HEALTH PRESERVATION]

The article presents scientific evidence that new neurons from progenitor cells throughout life in almost all animals with a nervous system are an integral component of neuronal ontogenesis and plasticity.It has been shown that there are neural stem cells in the brain that give rise to adult neurogenesis, occurring primarily in the dentate gyrus, a subregion of the hippocampus important for learning, memory, and emotion. With age, there is a decrease in adult neurogenesis, which is associated with a decrease in cognitive functions. Newly formed neurons and «immature» neurons together constitute a potential reservoir of young cells («brain reserve») that can be used to prevent aging and/or delay the onset/reduce the impact of neurological disorders.The possibility of using neurogenic processes for therapeutic purposes to reduce pain and improve the quality of life of patients is implied.

[Modern features of fertility in lowand middle-income countries, including in the context of the COVID-19 pandemic]

The main issues in the problem of fertility in countries with low and middle incomes of the population are the high prevalence of complications and maternal deaths during childbirth, as well as the high incidence of such indicators of the birth of an infant with low growth and weight indicators for their gestational age, malnutrition of pregnant women and mothers, frequent abortions, short intervals between births due to the educational status of the mother and the financial wealth of households, high prevalence of teenage motherhood, low availability of cesarean section, high cost of educating children as a factor in fertility. The impact of the COVID-19 pandemic on fertility in low- and middle-income countries has been most pronounced due to disruptions in the health care system, a surge in domestic violence, teenage pregnancy and female genital mutilation.

[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-pandemic» 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.

[THE ISSUE OF THE IMPACT OF RADIOACTIVE SUBSTANCES ON PUBLIC HEALTH AND COUNTERMEASURES FOR RADIATION EXPOSURE AS A GLOBAL PROBLEM]

The widespread use in today's world of radioactive sources d in energy, medicine, engineering and construction, for contaminant tracking and food sterilization increases the likelihood of accidental exposure. The use of ionizing radiation and radioactive elements can directly or indirectly cause life-threatening complications, such as oncopathology, radiation burns, and impaired immunity. Pollution of the environment with radioactive elements and depletion of the ozone layer also contribute to an increase in the level of radiation exposure. To protect the health of the population living in contaminated areas and consuming locally produced products, it is necessary to organize a system for monitoring radioactive damage, as well as special anti-radiation protective measures in the field of agriculture and forestry, hunting and fishing, and providing the population with food. The purpose of the study is to analyze modern scientific data on the effect of ionizing radiation on reproductive function and modern approaches aimed at correcting its violations. Bibliographic, information-analytical methods and methods of comparative analysis were used.

[The natality and mortality of population in various social economic regions of the Far North]

The issues of improving demographic situation in Russia at large and in its particular subjects are of special actuality. Therefore, the study was carried out concerning actual characteristics of population natural movement with consideration of regional specifics of the northern and eastern territories of the country. Nowadays, in Far North regions, Arctic and Sub-Arctic territories, Far East territories that occupy almost 2/3 of the area of the Russian Federation reside less than 10% of total population. By virtue of immense industrial and resource potential of these regions, the issue of natural population increase in the northern and arctic territories is of strategic importance for the Russian Federation. The entire territory of the Republic of Sakha (Yakutia) is included in the Far North regions. The demographic situation in this territory is determined both by processes of national level and specific climatic, economic and other conditions specific for northern and arctic territories. The study was carried out to comparatively analyze indices of population natural movement in various social economic regions of the Republic of Sakha (Yakutia) such as arctic, agricultural and industrial, including Yakutsk. It was established that most unfavorable demographic situation from point of view of processes of population natural reproduction is observed in industrial regions, where lowest natality indices are observed at high mortality rates. The highest natality indices were noted in agricultural regions. The highest mortality indices were specific for Arctic and industrial regions and the lowest ones for Yakutsk. Since 2014, occurs slowdown of natural population increase in all groups of regions, while in industrial areas in 2006 and 2020, natural population loss was recorded. The revealed differences in medical and demographic indices are a basis of implementation of regional programs targeted to development of social economic living conditions and improvement of demographic policy in regions of the Far North.

[The characteristics of reproductive demographic processes in economically developed countries in conditions of COVID-19 pandemic: international publications review]

The article presents current trends in reproductive demographic process economically developed countries. Today, the total fertility rate in all European countries is below the minimum required to ensure population reproduction in long term - 2.1 children per woman during her life. According statistic data, 4.167 million children were born in the EU in 2019 that corresponds to 9.3 births per 1000 of population. In the EU, 1.53 children went to one woman in 2019 (in 2018 - 1.54). The lowest total fertility rates in 2019 were registered in Malta (1.14), Spain (1.23) and Italy (1.27). In the United States, fall of rate of childless women with higher education disputes well-established observation of positive relationship between education and childlessness. The infertility affects approximately 8-12% of couples worldwide, at that in developed countries, up to 15% of all couples are infertile. In connection with the problem of birth rate reduction in developed countries, researchers highlight such problems as increasing of average age of mothers at delivery (30-35 years and older) and intervals between labors, development of subsidiary reproductive technologies, pregnancy outcomes, newborns health in short and long perspective. The global COVID-19 pandemic resulted in resources deficiency, complexities with medical services support related to reproductive health, risks for maternal and perinatal outcomes in pregnant women with COVID-19. However, actually still there is no complete picture of pandemic impact on global indices of reproductive demographic process.

[The physical development of children of school age (7-17 years) in the Kirghiz Republic]

The article presents the results of comparative analysis of indices of physical development of school-age children residing in various regions of the Republic of Kyrgyzstan. The statistically significant relationship between body length and body mass of examined children from territories of their residence was established. The children from Bishkek had significantly higher values as compared to children from villages of highlands and the south and the north of the country as well. The statistically significant dependence of body length and body mass of examined children on gender was revealed, explained by higher anthropometric indices in boys, as compared with girls in age categories of 7-8 years and 15-17 years. The multivariate variance analysis established that territorial factor statistically significant affected anthropometric indices in all studied age categories. At that, input of this factor into indices dispersion did not exceed 10%. The input of sex assignment to variance of body height and body mass in children under age of 14 years was insignificant. However, in the age of 15 years and older effect of this factor on anthropometric indices increased significantly, reaching its maximum by the age of 17 years and significantly predominating over influence of territorial factor.

[The dynamics of alterations and prognostic models of levels of morbidity of urban and rural population of the subject of the Russian Federation]

The article presents data of analytical study of morbidity indices of urban and rural population of the Republic of Tatarstan. The dynamics of population morbidity rate in the Republic of Tatarstan is characterized by steady trend of decreasing of indicator and is described by polynomial trend in both absolute and relative indices. The highest rates of increase in population morbidity were mainly observed until 2010. The maximal periods of decreasing or slowdown of rate increasing were characteristic in 2011-2019. In the structure of population morbidity, the highest percentage fell on diseases of respiratory and circulatory systems, injuries, poisoning and some other consequences of external causes impact that was typical both for the Republic of Tatarstan in whole and its rural territories. In general, morbidity rate of urban population was higher than that of rural population. This difference was statistically significant, but growth rate of number of cases in rural territories outstripped growth rate of number of cases in urban territories and was higher than in the Republic of Tatarstan in whole, but was not statistically significant. The medium-term prognosis of dynamics of population morbidity rate in the Republic of Tatarstan in whole demonstrated that, all other things being equal and taking into account current trends, decrease in number of registered patients with diagnosis established for the first time in life can be expected to 2874.2 thousand of population by 2024 (that is less as compared with 2019 level by 242.4 thousand of population, or by 7.8%) and number of registered patients with diagnosis established for the first time in life to 70217.8 per 100 thousand of population (which is less as compared with 2019 level by 9680.8 per 100 thousand of population, or by 12.1%).

[The analytical review of normative and organizational support of functioning of perinatal service in The Russian Federation in 2000-2020]

The formation of code of normative legal documents ensuring activities of perinatal service is one of the most important, basic organizational technologies that determine activities of obstetrics and childhood services, contributing to increasing of natality, decreasing of maternal and infant morbidity, and maternal and childhood health care in general. The article presents analysis of formation of normative legal base that regulates functioning of perinatal service in the Russian Federation in 2000-2020. Actually, there is no objective prerequisites for fundamental alterations in the three-level system of medical care of women during pregnancy, labor, postpartum period and newborns. However, the regulatory adjustment of the system, improvement and refinement of models of profile patients' routing, development of medical care of pregnant women, parturient women and puerpera will proceed.

[Deficient micronutrient status of the population of various countries as a risk factor in COVID-19]

The article provides an overview of scientific information on the modern features of the micronutrient status of the population of different countries of the world. It is emphasized that in conditions of epidemiological risk, it is necessary to take into account the provision of micronutrients for various social groups of the population: children, elderly people with a low socio-economic status, as well as those with chronic diseases. As a result of the analysis, it is determined that the deficient micronutrient status contributes not only to a high risk of the body's susceptibility to infectious agents, but also negatively affects the course and outcome of an infectious disease. The authors' studies confirm that in infectious diseases and in the early stages of COVID-19, a protective immune response is responsible for the elimination of the virus, therefore, the use of trace elements and vitamins in the treatment of COVID-19 is an immunoprotection strategy, the effectiveness and safety of which there is sufficient clinical data.

[EXPERIENCE OF FORMING OPERATIONAL AREAS OF OPERATION OF THE CHILDREN'S POLYCLINIC DURING THE PANDEMIC COVID-19]

The article presents the experience of the city children's polyclinic No. 133 of the Moscow Department of Health in a difficult epidemiological situation associated with a new infection COVID-19. A description of the stages of the organizational work of a polyclinic in a pandemic is given, including such areas as: a) conducting lectures and webinars for doctors and nurses of a medical organization, introducing recommended methods for diagnosing and treating COVID-19, creating and observing conditions for the personal safety of employees; b) the formation of tools and a database for analytical work; creation of registers of patients and employees of the polyclinic in order to monitor and evaluate the effectiveness of work; characteristics of the structures of age-specific morbidity in children who have undergone a new coronavirus infection and community-acquired pneumonia with substantiated confirmation for them of compulsory dispensary observation and rehabilitation measures; description of the development of routing of healthy and sick children, operational identification and continuous analysis of difficulties in the work of the polyclinic during this period; c) the formation of distance technologies in treatment and prophylactic work with patients, organized group and individual exercise therapy classes, including respiratory rehabilitation gymnastics for children who have undergone a new coronavirus infection; development of an organizational algorithm for the formation of medical and nursing teams for visiting patients with COVID-19 at home and individual teams for visiting patients for patronage. The organization of this treatment and prophylactic work was approved and a confirmation was received from the Ministry of Health of the Russian Federation of the right to replicate the experience gained from the work of the polyclinic in the conditions of COVID-19.

[Public health and medical prevention centers in modern conditions of non-infectious and infectious risks]

The article provides an assessment of the validity of the formation of a new nomenclature unit within the framework of the population health protection system - the Centers for Public Health and Medical Prevention. The analysis of new directions of activity of the health care center, structural and functional transformations is carried out. The article presents a detailed description of promising areas of activity based on the use of various modern information and communication technologies, and also reflects the possibility of constructive interactions of the health care center with various social institutions. The role of government initiatives aimed at preventing non-communicable diseases, including in increasing the motivation of the population to adhere to a healthy lifestyle, is shown. The potential possibility of the developed conceptual approaches in the field of strategy and tactics of disease prevention from the point of view of protecting public health, including reproductive health, has been determined.

[Health risks of school-age children with distance learning in the first months of the spread of COVID-19]

According to the results of a sociological survey of 10,237 parents of schoolchildren during the period of emergency transfer of students to distance learning in the initial period of the spread of coronavirus infection, a low provision of children with technical teaching aids was revealed: only 18% of children had a stationary computer at home, 42% of children had a basic gadget available. available for training, there was a smartphone. At the same time, it was determined that children also use gadgets for a considerable time for personal purposes (entertainment, games): according to 17% of parents, 3-4 hours, and 8% of parents answered - more than 5 hours a day. However, most parents are not aware of the amount of time a child spends with a gadget due to their busy schedule. A significant number of parents-respondents (16.5%) pointed to difficulties that arose during distance learning in the relationship between the child and the teacher. Only 60% of the parents surveyed indicated that the child sits at the table while working with the gadget, 24% - the child is more likely to sit in an armchair or on the sofa, 16% - more often the child is in the «reclining» position on the sofa or bed. All this determines the health risks of students and indicates the need to develop skills and ways to level them. Taking into account the fact that all participants in the educational process have to face the problems that have arisen during distance learning: students, their parents and teachers, recommendations for the implementation of the general education system of medical, socio-psychological support of students and their families, operational collection data to ensure a quick response, which is possible only by means of technologically modern information systems for medical, social and psychological purposes.

[On the issue of characteristics of height weight anthropometric indices in children and adolescents residing in various regions of Russia]

The issues of protecting the health of the children and adolescent population of Russia require detailed study of the regional characteristics of the indices of physical development, determined by anthropometric growth and weight criteria. The purpose of the study is to analyze the regional characteristics of average height and weight anthropometric indices of children of school age (7-17 years) living in various regions of the Russian Federation. The assessment of statistically significant differences in average height and weight anthropometric indices children of school age was carried out to establish the basis of developing normative indices of 10 regional "Standards of physical development of children of school age (7-17 years old)" covering such Federal Okrugs as the Central (Kostroma), North-West (St. Petersburg), North Caucasian (Makhachkala, Grozny, Vladikavkaz), Privolzhsky (Kazan, rural areas of the Republic of Tatarstan, Cheboksary ) and Far East (Yakutsk, Yuzhno-Sakhalinsk). For the first time the statistical analysis considered simultaneously the anthropometric data of the population sample of the examined children of health groups I and II (healthy and practically healthy). Namely, 41030 persons were allocated to conditional age groups: junior (7-9 years), middle (10-14 years) and senior (15-17 years old) school age. The differences in regional height and weight indices of physical development of children were statistically significant only in groups of comparison of indices of height and body weight of schoolchildren in the older age group.

[On the question of the application of calcium preparations for the purpose of optimizing the diets of the population, including and for different diseases]

In recent years, there has been a particular interest in the use of calcium in order to optimize the diet of the population. It is known that calcium, indirectly affecting nervous excitability, muscle contractility, hormone secretion and blood clotting, plays an important role in the human body. However, there is an opinion about the risks of calcium supplement intake, and concerns about possible adverse consequences are becoming more pronounced. In this regard, the aim of this study was to review the scientific literature on calcium supplement intake from the standpoint of the effectiveness of fortification of food rations and the occurrence of concomitant risks. Results. The results of the analysis of numerous literature data allow us to conclude that due to the threat of calcium overdose and an increased risk of cardiovascular complications as a result of transient hypercalcemia, calcium intake from dietary sources is a priority, and calcium supplements should be prescribed only to patients with a serious risk of osteoporotic fractures and those individuals who, due to social reasons, cannot meet their daily nutritional needs. With equal effects, calcium consumption precisely from foods containing a sufficient amount of this micronutrient, in comparison with calcium supplements, provides the organism with other nutrients (proteins, amino acids, etc.), without causing risks of side effects. It can be assumed that the results of risk-benefit assessments of calcium supplements in connection with the descriptions of risks to the cardiovascular, gastrointestinal, and urinary-excretory systems cannot be considered final. In view of the above, cautious use of calcium supplements is recommended, especially considering their possible interaction with various medications, including antihypertensive drugs, calcium channel blockers, synthetic thyroid hormones, bisphosphonates and antibiotics, etc. Conclusion. Given the growing concern of the medical community about the role of calcium intake and the conflicting results of individual studies, it is clear that largescale prospective cohort studies are needed to clarify the balance of benefits and risks of calcium supplementation in different populations, especially in the elderly.

[The role of supplying population with vitamin D in conditions of COVID-19 pandemic: foreign publications review]

The overview of scientific information concerning actual characteristics of population's supply with vitamin D and its role in case of risk of development of infectious diseases and COVID-19 is presented. The analysis established that vitamin D deficiency contributes both to higher risk of susceptibility to infectious agent and to negative impact to course and outcome of disease. The significant role of vitamin D in prevention and treatment of viral diseases is established. The international research studies confirm that at infectious diseases and early stages of COVID-19 protective immune response is responsible for elimination of the virus. Therefore, using vitamin D in treatment of COVID-19 is the strategy of immune protection. The authors consider that in case of infectious risks, preventive application of vitamin D is necessary. In case of initial manifestations of COVID-19, it is appropriate to promptly achieve levels of optimal status of micro-nutrient supply.

[The Gender Age Characteristics of the Population of the Republic of Sakha (Yakutia): The Potential of Reproduction]

The article presents the results of analysis of regional characteristics of age-gender structure of population from point of view of reproduction of subsequent generations as exemplified by the Republic of Sakha (Yakutia). The stable population growth was established, as opposed to decreasing of this indicator in the Far Eastern Federal District and its unstable dynamics throughout country as a whole. There is increasing of burden on the able-bodied population with decreasing in its number and increasing percentage of population older than able-bodied age. In long-term dynamics, the study established decreasing of number of children aged 0-4 years and adolescents aged 15-17 years. While since 2015 there was increasing in number of girls (potential mothers) aged 5-9 and 10-14 years. The reduction of number of women of reproductive age with the volatility of number of women of childbearing age is alarming, resulting in lesser stability of demographic indices of population reproduction.

[The modern technologies of vitaminization in diseases prevention: publications review]

The article presents review of publications and official documents of international state, departmental and public organizations related to implementation of targeted programs of enrichment of vitamins and minerals with food rations and food products, including application of up-to-date technologies. The data is presented about practical implementation of developments in the field of problems of modern molecular nutrition, nutrigenomics, investigating effect of human nutrition on gene expression, and as well as on bioinformation approaches of nutrigenomics, intestinal microbiota metagenome, gene regulation or gene expression in a microbiome.

[Cartographical analysis of the status of indicators of total morbidity and mortality of population in subjects of the Russian Federation for 10 years]

Over the years, at the level of constituent entities of the Russian Federation, various indicators and criteria for assessing the effectiveness of regional health care have been used. Providing well-grounded scientific and methodological recommendations on the use of instruments for measuring the ratio of indicators of general morbidity and total mortality at the federal level to health authorities helps in their motivation to achieve the target (expected) results expressed in terms of public health. An analysis of the correlation of indicators of general morbidity and mortality makes it possible to timely find resources in those areas that contribute to achieving the maximum efficiency of medical organizations. The article presents indicators of the general morbidity and general mortality of the population in the constituent entities of the Russian Federation, as well as the values ​​of the ratios of these indicators for the period 2008-2017. Correlation and cartographic analyzes of indicators of general morbidity and general mortality were carried out.

[To the question of the international experience of vitaminization food and food as population health technologies]

The article provides an overview of official documents and scientific literature on the development of a policy of enrichment of vitamins and minerals with diets of the population at the level of international organizations in various countries and in the world as a whole. International programs on micronutrient fortification of food products are considered from the standpoint of protecting public health. The article focuses on the availability and effectiveness of ways to improve the vitamin and mineral status of various social groups.

[The analysis of indices of population morbidity at the level of region]

The article presents the results of the analysis of indices of morbidity of children and adults in the Kostroma Oblast in 2000-2017. The main trends and changes during analyzed period are established. The high morbidity in such classes of diseases as respiratory diseases, injuries and poisoning, complications of pregnancy, childbirth and postpartum period are determined. The morbidity population in the Kostroma Oblast in the main classes of diseases increased by 14.3% in 2000-2017. The children morbidity in age group 0-14 years remains high.

[Features of demographic trends and infant mortality in the Republic of Dagestan]

The article analyzes the regional characteristics of the demographic development of the Republic of Dagestan, presents the results of the analysis of infant mortality rates in the republic, gives a structure of the causes of infant mortality, identifies the main indicators of natural growth and population decline. The results of the study showed that in Dagestan infant mortality is one of the highest among the subjects of Russia in 2018 - 8.3 ‰ per 1000 live births (national average - 5.1 ‰, North-Western Federal District - 6.8 ‰); the main cause of death in infants under 1 year of age in Dagestan are individual conditions that occur during the perinatal period.

[Professional satisfaction of the medical staff of the scientific and practical dental complex]

A survey of dentists and managing clinics-branches of the scientific and practical dental complex showed a high level of professional satisfaction. The main advantages in the activities of rapidly developing network-type dental clinics that actively implement the most advanced, unique technologies and tools have been identified. The main motivational factors that positively affect the result of staff activities, as well as reduce their degree of professional satisfaction, are identified. Moreover, according to the results of respondents' answers, approaches were identified to improve the motivating component in personnel management, as well as to level existing problems within the team. Studying the opinions of medical personnel (doctors and managers) will help the administration to analyze the potential of the personnel potential of clinics and will contribute to the development of plans to improve the organization of staff work and network development.

[Main directions of activity of the institute of the Commissioner for the Rights of the Child in assistance of protection of health and formation of the environment of "safe childhood" from positions of public health]

In a rapidly changing world, legal protection of children from the standpoint of public health, namely from the standpoint of protecting the health of the child population from the adverse effects of various factors, including social ones, is of particular importance, thereby complementing the concept of "safe childhood" in terms of risk management safety of a child's life and his health. Despite the fact that the institution of the Commissioner for the Rights of the Child in Russia was established more than ten years ago and is active in promoting the protection of children's health, many medical workers, specialists in healthcare and preventive medicine, unfortunately, are not fully aware of functions of this state structure and, accordingly, do not use its resource capabilities in the implementation of key installations of national projects. The aim of this work was to analyze the types of activities of the institution of the Presidential Commissioner for the Rights of the Child to identify and present the modern features of his human rights and operational-organizational assistance in protecting health and creating an environment for "safe childhood" from the standpoint of public health.

[Main indicators of morbidity and expected long life of the population of the northern region of Russia]

This article analyzes the main indicators of the incidence and life expectancy of the population of the Republic of Sakha (Yakutia) over a twenty-year period. An increase in the incidence rate of the population was revealed that exceeded the average for the country and the Far Eastern Federal District, including for oncological diseases, the level of which increased several times in the republic. The value of the indicator of life expectancy in the republic approached the average Russian level, while 20 years ago a much lower indicator was determined. In the dynamics of indicators of the morbidity of the population and life expectancy over a twenty-year period, a polynomial trend has been outlined. For example, the incidence of neoplasms and diseases of the circulatory system showed a sharp increase in 2004, followed by a decrease, for diseases of the digestive system - similarly, an increase in 2001 and a subsequent decrease. This aspect requires an additional detailed study of the causes of such changes in order to be able to predict them in the future.

[The characteristics of medical demographic development of the Republic of Dagestan]

The issues of assessing medical and demographic processes and improving public health are very actual in Russia. The article analyzes the current state and regional characteristics of medical and demographic development using the example of the Republic of Dagestan. The positive tendency of the main fertility indicators was determined, including the analysis of the age structure of the population and population size alterations.

[Current indicators of fertility and mortality of population in the region of central Russia]

The article analyzes the indicators of population reproduction on the example of the Kostroma region, presents the dynamics of the main medical and demographic indicators of the region: age structure of the population, mortality, fertility, migration, marriage and divorce rates, as well as the starting positions for overcoming reproductive and demographic disadvantages.

[The organization of diet therapy from positions of development of patient-oriented health care]

The article discusses the problematic issues of the organization of medical nutrition of sick people both in medical organizations and outside of their stay, reflecting the current understanding of the organization of therapeutic nutrition as the main structural element of the patient-oriented health care system. The authors declare the need for an evidence-based assessment of the effectiveness of personalized diet therapy and the use of specialized enrichment of patients 'diet. The article presents the rationale for the correctness of using for this purpose a proven methodology for assessing the effectiveness of alternative technologies in healthcare. The integral efficiency indicator used in this methodology includes the calculation of the social satisfaction coefficient, which is proposed to be used by one of the levers of control from public organizations of patients, and above all their flagship All-Russian Union of Patients.

[The criteria of increasing of quality of medical care of population in conditions of anthropogenic impact]

The assessment of medical care quality of different strata and groups of population is a priority direction of preventive medicine and public health. Nowadays, application of the riskometry theory considering external modifying factors is relevant. The registration of risk indices in the process of development of model of health preservation can be considered as a criterion of medical care quality. The purpose а study was to optimize managerial decisions in the area of increasing medical care quality related to special contingent on the basis of evaluation of carcinogenic danger and reproductive risk in conditions of anthropogenic impact. The study applied such modern research methods as social hygienic, biochemical and statistical techniques. The methodological basis of assessing reproductive risk for population in conditions of anthropogenic impact can serve as a criterion of assessing level of impact and developing management decisions in area of improving health care quality. The public health and health care organization are the fields of application of study results.

[The Analysis of Advantages of Network Structures in Stomatology]

The article analyzes and highlights particular advantages of network structures in health care as exemplified by the network of stomatological clinics «PresiDent». Various approaches to establishment of principles of organization of network structures are proposed.