Significance. When forming the systemic principles for organizing medical care delivery, it is crucial to understand the risk factors that contribute to the development of this type of pathology. Purpose: to identify the key risk factors for kidney and urinary system disorders among children in the Russian Far North. Material and methods. To identify the risk factors for kidney and urinary system disorders, we conducted a survey of parents in 780 families. We developed a questionnaire with 44 questions, covering health and well-being; socio-demographic characteristics; lifestyle; ethical views; and medical literacy. The patient socio-demographic profile included: age, educational background, family structure, physical activity habits, and place of residence. To assess the impact of risk factors on kidney and urinary system disorders, the authors employed the methods of univariate and multivariate logistic regression. We used SPSS software to build predictive models for kidney and urinary system disorders using a continuous backward analysis. P ≤ 0.05 on both sides was considered statistically significant. Results. The analysis of risk factors for kidney and urinary system disorders among children in the Russian Far North shows that the risk decreases when there is a positive social and psychological atmosphere within the family (basic group 71.5%, control group 90% (p<0.001). In families with a favorable financial situation, the risk for kidney and urinary system disorders was 54.3% lower (p<0.001) than in children raised in families with financial constraints. The risk for kidney and urinary system disorders was 51.3% lower (p<0.001) if mothers worked in warm and comfortable environments and 37.5% lower (p<0.001) when mothers were not engaged in physically demanding work. The risk was 31.2% lower (p<0.001) if fathers worked in warm and comfortable environments and 21% lower (p<0.001) if fathers were not engaged in physically demanding work. It is crucial to note that the risk for kidney and urinary system disorder decreases by 62.0% (p<0.001) if parents spend extended periods of time with their children. Among children who regularly travel abroad on vacation, i.e. outside the Russian Federation, the risk for kidney and urinary system disorders decreases by 34.6% in the control group 299 (73.4%) (p <0.001). Particular attention should be paid to the presence or absence of basic amenities, since unfavorable housing and living conditions are significant in the occurrence and progression of kidney and urinary system disorders in children. Families with sick children were more likely to reside in private homes without access to sewage or hot water (p<0.001). Conclusion. The study has collected data on financial well-being of the family, substandard housing conditions, nutritional disorders, lifestyle, chronic diseases, the young age of mother at birth, maternal health during pregnancy, unfavorable antenatal period, untimely diagnosis of diseases of the genitourinary system, and the lack of adequate treatment. Keywords: disease; risk factor; children; Russian Far North

Significance. In Russia, dental services are provided by both public and private clinics, each with its own advantages and limitations. However, the factors influencing patient choice between these options remain insufficiently studied. The undertaken analysis of patient motives allows us to identify key barriers and incentives, which is essential for developing effective strategies to manage quality and improve access to dental care. Purpose. Based on the results of a patient survey conducted in public and private dental clinics, the study aims to perform a comprehensive analysis of the motives influencing the choice of medical organizations for receiving therapeutic and preventive dental services. Material and methods. In 2025, a survey was conducted among 4,905 patients of six public and nine private dental clinics in Irkutsk using a specially developed 27-question questionnaire. Results. Patients of private clinics were more likely to have incomplete higher education (48.6%), whereas public clinic patients more often had secondary (26.3%) or vocational education (36.0%). The proportion of employed (65.2%) and self-employed individuals (6.8%) was higher in private clinics, while public clinics served more retirees (16.0%) and unemployed individuals (6.3%). Emergency visits due to acute pain were more common among public clinic patients (62%), while preventive visits were more typical of private clinics (56%). In public clinics, 59.3% of treatments were covered by compulsory health insurance, whereas in private clinics, 47.6% of patients paid for services out-of-pocket. Public clinics were valued for their affordability (55.8 per 100 respondents) and quality control (22.4 per 100), but criticized for long waiting times (50.9 per 100) and low service quality (47.2 per 100). Private clinics were highly rated for advanced technologies (59.4 per 100) and service (55.8 per 100), though their main drawback was high cost (72.4 per 100). Key patient suggestions for improving dental care included lowering costs (78.6 per 100 respondents), expanding compulsory health insurance coverage (66.3 per 100), and introducing new technologies (60.1 per 100). Two-thirds of the patients (65.4%) supported expanding cooperation between the public and private dental sectors. Conclusion. Patient choice of dental clinic type is primarily influenced by their income level and social status. Public and private clinics serve different target groups and perform complementary rather than interchangeable functions. Enhancing the accessibility and quality of dental care requires a revision of financing mechanisms and the development of public-private partnerships in this sector. Keywords: sociological research; dentistry; patients; motivation; dental clinics

Significance. The Arctic region of Russia is one of the most labor-deficient regions in the country, which makes health protection of personnel working on a rotational basis and engaged in mineral extraction an extremely relevant task. An integral part of the occupational health and safety system is preventive medical examinations. According to the currently valid Resolution of the USSR State Committee of Labor, Secretariat of the All-Union Central Council of Trade Unions, and Ministry of Health of the USSR dated December 31, 1987 No. 794/33-82 "On Approval of Basic Provisions on the Shift Work Method of Work Organization," a medical examination by a therapist should be conducted within two to four days before departure to a remote industrial site (pre-placement examination). However, this type of medical examination is not included in the statement of work constituting medical activity at present, and there are no normative legal acts regulating implementation of pre-placement exams. Purpose. To analyze and evaluate the organization of pre-placement examinations based on opinions of medical staff of infirmaries and employees of remote industrial facilities. Material and methods. A questionnaire-based survey was carried out among 400 employees of industrial enterprises and 110 medical workers of enterprise infirmaries. The research was conducted at 19 oil and gas producing companies located within the Far North and equivalent territories. The data analysis was performed using Microsoft Office 2021 software package and processed using IBM SPSS Statistica 10.0. Results. Based on the survey results, 70.9% of the surveyed medical workers think that special training on the implementation of pre-placement medical examinations is necessary, although many of them (46.8%) have never undertaken such training. Among major problems associated with pre-placement examinations, the respondents note difficulties taking patient history of previous illnesses, insufficient time for exams, as well as issues related to unclear regulations governing the procedure. Different corporate practices of pre-placement examinations were found across various companies. Most employees (73%) undergo an examination prior to each rotation shift, while 25.25% are less frequently examined. The majority of examinations take place upon arrival or the next day after the arrival to the facility (65.7%). The level of satisfaction with the existing procedures for pre-placement examinations is high both among industrial workers (92.2%) and medical staff (80.9%), but significantly higher among industrial workers compared to medical staff (p<0.05). Possible ways to improve pre-placement examinations suggested by industrial workers include more detailed history taking and improving equipment in infirmaries. The conducted comparative analysis show that industrial workers receive less information and recommendations following their pre-placement examinations compared to what is perceived by medical professionals (p<0.05). Conclusion. Based on opinions of medical staff and employees of remote industrial facilities, the organization of pre-placement examinations has several issues, including insufficient training of medical personnel, limited access to information about previous diseases and test results of employees, insufficient time for counseling, and ambiguity concerning the procedures for conducting examinations. Different companies follow different corporate practices regarding timelines and locations for pre-placement examinations. The findings suggest further research on optimal approaches to organizing pre-placement examinations and developing improvement guidelines. Keywords: pre-placement examinations; occupational health and safety; pre-placement examination structure; organization of health care delivery at remote facilities; process standardization.

Significance. According to World Health Organization, in the structure of deaths among youths, external causes and diseases of the circulatory system combined account for 72.0%. The study analyzed prevalence and incidence of diseases of the circulatory system, the 2027 forecast and the structure of incidence of diseases of the circulatory system for the period from 2014 to 2022. Purpose. To identify trends in prevalence and incidence of diseases of the circulatory system in children aged 15-17, and their forecast. Material and methods. The study used materials of the statistical reporting of the Russian Research Institute of Health on prevalence and incidence of diseases of the circulatory system in children aged 15-17 in 2014-2022 within the territory of the Russian Federation, the Volga Federal District, the Udmurt Republic and bordering regions: the Kirov Region and the Republic of Bashkortostan. Results The study found that within the territory of the Udmurt Republic, in 2014-2022, there was a tendency towards decreasing prevalence and incidence of diseases of the circulatory system in children aged 15-17 – by 15.7 and 38.1% (from 7540.2 to 6353.7 and from 1915.3 to 1185.0, respectively). The 2027 forecast is also characterized by a downward trend – a decrease by 11.6 and 6.4% (from 6353.7 to 5620.0 and from 1185.0 to 1044.4, respectively). Conclusion. The diseases identified in the structure of incidence of diseases of the circulatory system (incidence of chronic rheumatic heart diseases, prevalence and incidence of diseases characterized by high blood pressure and prevalence of other heart diseases), in comparison with the Russian Federation, the Volga Federal District, the Republic of Bashkortostan and the Kirov region require the implementation of evidence-based studies at the regional level in order to identify morbidity risk factors and to develop relevant prevention programs. Keywords: morbidity trends in children aged 15-17; diseases of the circulatory system; morbidity dynamics; chronic rheumatic heart disease; high blood pressure; other heart diseases; regional characteristics; forecast; prevention.

Significance. Conducting research on public awareness of the impact of risk factors on health makes it possible to assess the effectiveness of implemented prevention-based programs and develop population prevention measures tailored to meet needs of the target audience. Purpose: to study the public attitude towards sources of information on risk factors for chronic noncommunicable diseases and to assess the level of confidence in these sources in the pilot regions of the Russian Federation. Material and methods. A sociological population survey was conducted in three regions of the Russian Federation. The sample size is 1718 respondents. The results were processed in SPSS 22.0. Results. Television is the most popular source of information (74.1%). The Internet ranks second (54.4%). Statistically significant differences between urban and rural populations and by age were revealed in their use. Popular science books and magazines about health show the highest level of confidence (39.8%). The absolute leaders in distrust about risk factors are popular media stars (71.8%). Practicing doctors enjoy the maximum level of confidence among the population. Women are statistically significantly more likely to pay attention to information materials than men (70.1% and 61.1%, respectively). Access to information materials is statistically significantly lower among rural residents. Only a third of those who saw materials on healthy lifestyle understood and remembered them. Conclusion. Sources of information with a high level of popularity do not demonstrate a high level of confidence among the respondents. The Internet content and its development should be tailored to meet needs of the target audience. High indicators of confidence in the information received from practitioners indicate the need to strengthen the role of medical organizations in population-based prevention activities. An insufficient level of clarity and memorability of information materials requires a revision of approaches towards developing and implementing prevention propaganda campaigns for the public. Keywords: risk factors for noncommunicable disease; population prevention; provision of information to the public; awareness of risk factors; confidence in information about risk factors; healthy lifestyle

Significance. In modern conditions, there is an increase in the incidence of diseases of the endocrine system in children. Such diseases often lead to complications that worsen the quality of life of children and adolescents. Since it is impossible to fully restore health with such a pathology, improving the quality of life of children becomes an important task for doctors. Purpose. To analyze medical and social characteristics and issues of life quality of children with diseases of the endocrine under inpatient treatment. Material and methods. A special questionnaire was developed to assess medical and social characteristics of patients. The quality of life of children was assessed using the PedsQL 4.0 questionnaire. Statistical research methods were used to analyze data, and the significance level was set at p<0.05. Results. The admission of patients to the pediatric endocrinology department is planned (64.7%), however, it is characterized by a fairly high proportion of emergency hospitalizations with a diagnosis of type 1 diabetes mellitus (42.4%) and prediabetes (36.8%) (p=0.004). The predominant proportion of patients (their parents) with endocrine diseases report a low adherence to treatment - 74.7%. The quality of life of children who had episodes of treatment violation and/or low awareness of the disease was characterized by lower indicators across all scales compared with patients with a high level of treatment adherence and sufficient knowledge about the disease. Lack of knowledge about self-monitoring of targets reduced the overall quality of life score by 8.6% (p=0.003); lack of awareness about the risk factors of the disease and its complications - by 6.6% (p=0.022); Violations of the treatment regimen reduce the overall quality of life score by 9.2% (p=0.005), including violation of the regularity of medication intake - by 7.4% (p= 0.010); diet violations - by 6.1% (p=0.016); violation of exercise recommendations - by 6.4% (p=0.027). Conclusion. The problems of patients with diseases of the endocrine system identified in our study are manageable, and their correction can contribute to improving the quality of life of children by 6.0-10.0%. In this regard, an in-depth counseling of patients (their parents) on prevention can help improve the quality of life of children. The selection criteria for in-depth preventive consultations can include: a low level of treatment adherence and/or low awareness of the disease, as well as low overall quality of life scores. Keywords: life quality of children; PedsQL 4.0 questionnaire; endocrinology; diabetes mellitus; obesity.

Significance. Over the past two decades, Russia has experienced a series of economic crises during which many individuals faced financial stress caused by debt, declining income, and fear of job loss. During the same period, the country has tightened its tobacco control policies, which were expected to reduce the prevalence of smoking. However, the effect of stress associated with crises on tobacco consumption remains unclear. At the same time, monitoring the population addictive behaviors during crisis periods is essential for developing public health protection tools and minimizing the adverse consequences of tobacco use for both smokers and society as a whole. Purpose. To assess the impact of economic crises, financial stress, and tobacco control policies on the prevalence of smoking among employed Russians. Material and methods. This study uses data from the Russian Longitudinal Monitoring Survey of the National Research University "Higher School of Economics", covering the period from 2000 to 2023. Statistical and econometric methods were employed, including binary choice models with fixed effects, to estimate the impact of different levels of financial stress and periods of economic crisis on smoking probability while controlling for individual-specific and temporal factors. Results. Cigarette consumption was found to be associated with financial stress, but this relationship varied depending on the level of stress, individual characteristics, and specific contextual factors such as the presence of crises and the stringency of tobacco control policies. Moderate and high levels of stress among men were associated with a reduction in smoking, whereas among women, a decrease in smoking was observed only under moderate stress. During the period of lenient tobacco control in 2008-2009, the number of cigarette consumers increased; the tightening of tobacco restrictions during the 2014-2015 crisis was accompanied by a significant decline in smoking prevalence; in 2020, despite the crisis, smoking prevalence remained stable under a moderate excise policy. Conclusion. The study confirms the need for an adaptive approach to tobacco control policy that considers the economic context and gender differences in the perception of financial stress. A reduction in smoking prevalence during economic crises is likely to be more effective when strict tobacco control measures are combined with social and psychological support for those who wish to quit smoking. It is recommended to develop gender-sensitive smoking cessation programs, expand educational and awareness campaigns, and integrate stress management and smoking cessation services. Scope of application. The results can be used to improve tobacco control policies during economic crises in order to decrease smoking prevalence among working men and women. Keywords: financial stress; economic crisis; anti-smoking policy; smoking prevalence; cigarette consumption.

Significance. Primary health care is the basis for providing accessible and high-quality medical care, especially in the territories of the Russian Federation remote from regional and district centers. The availability of primary health care in them is determined, among other things, by the activities of the zemstvo doctor. Over the past decade of the Zemstvo Doctor program, it is important to study the experience of its implementation, identify the main problems and achievements for its improvement and updating in accordance with modern realities. Purpose. Тo summarize the experience of implementing the Zemsky Doctor program based on data from regional studies, regulatory legal acts and open sources, to substantiate proposals in the area of ​​organizational, regulatory, motivational and personnel approaches to its improvement. Materials and methods. A search of literary sources was conducted in the scientific electronic library eLIBRARY for 2013–2024 using the keywords: “Zemsky Doctor” program, rural doctor. Materials from the reference legal system “Consultant Plus” and the “Garant” system were used. The analysis included data from 55 sources, 35 of which were included in the list of references. Results. The results of the ten-year implementation of the "Zemsky Doctor" program have shown that along with significant positive effects, there are a number of similar problems in its implementation: there are no directive programs for adapting students to work in rural areas; current guarantees and social support measures are not effective enough to attract and retain them, which can also serve as an obstacle to the desire of university graduates to leave for remote areas with insufficient infrastructure without the opportunity to rely on the experience of colleagues and build a trajectory of career and professional growth. Gaining unique professional and personal experience, high demand for medical workers are positive factors influencing the decision to work in rural areas. Conclusion. The Zemsky Doctor program has had a positive impact on increasing the provision of rural medical institutions with qualified personnel; the experience of its implementation in the regions has revealed problems and achievements, which has made it possible to justify the need for its updating and develop a number of proposals for its improvement in a number of areas. Keywords: "Zemsky Doctor" program, rural doctor, personnel policy, motivation of specialists, social support measures

Significance. In Russia, the vaccination of children against meningococcal disease is included in immunization schedule with limitations, the vaccination is recommended just in cases of outbreaks caused by meningococcal serogroups A or C. As far as the disease is more dangerous for children rather than adults, in some countries the vaccination is recommended for all children. It is recommended by some researchers to expand vaccination programmes for children in Russia. This study is focused on determining factors affecting parents’ willingness to vaccinate their children. The main part of this study is based on data from a survey of parents in the Perm agglomeration. Purpose: to determine factors affecting parents’ willingness to vaccinate their children against meningococcal disease. Material and methods. Data was gathered through a survey. Logistic regression was used for determining factors affecting parents’ willingness to vaccinate children. Results. There are three main factors which have a significantly positive influence on parents’ willingness to vaccinate children. Firstly, an increase of 30% in willingness to vaccinate children was observed for those parents who got vaccination recommendations from relatives. Secondly, parents with higher medical education are 40% more likely to vaccinate children compared to those who have other types of higher education. Thirdly, an 82% drop of vaccine price from current market price can increase the probability of vaccination but just for 7,3%. A switch to free vaccination from current market price vaccination can increase the probability of vaccination on 26,6%. Potential vaccination rates are lower if vaccination is available only in private medical centers or only in municipal polyclinics compared to a case where vaccination is available in both these types of medical organizations. Conclusions. Free vaccination in both types of medical organizations — private centers and municipal polyclinics — is necessary when there is a need for rapid growth of vaccination rates. Stimulating discussions among friends and relatives about meningococcal vaccination is also important for increasing parents’ willingness to vaccinate children. Moreover, informing parents about benefits from meningococcal vaccination and side effects of particular vaccines is also considerable, as well as giving them provaccination recommendations from trustworthy doctors and other experts. Scope of application. The results obtained are to be taken into account while developing measures for increasing vaccination rates. Keywords: Perm Region; willingness to pay for vaccines; willingness to vaccinate; meningococcal disease

Significance. Optimization of resource provision of healthcare includes the efficient use of financial, human and material and technical resources. The introduction of effective financing mechanisms, advanced training of medical workers, updating the material and technical base of medical organizations and optimization of logistics processes ensure the availability and quality of medical care with limited financial capabilities. In these conditions, the role of assessing the financial and economic condition of medical organizations increases. Purpose: to substantiate the list of indicators reflecting the financial condition of state-owned medical organizations participating in the implementation of the territorial compulsory medical insurance program. Materials and methods. An analytical review of the literature using the method of content analysis devoted to the issues of financial sustainability of medical organizations was conducted. Research methods: analytical, content analysis, generalizations. Results. The authors conducted a study of scientific literature devoted to issues of effective management of the financial condition of medical organizations, the choice of indicators reflecting financial stability in the conditions of activity in the compulsory medical insurance system. Conclusion. As a result of the study, a list of indicators for assessing the financial condition of a medical organization was formed, aimed at identifying problem areas and substantiating the most effective solutions to improve the financial stability of the organization. Keywords: financial stability of a medical organization; accounts payable; compulsory medical insurance; subsidies; financial dependence