Introduction: Specialized inpatient care leads in treatment of cancer cases. Its financing is based on the model of  statistical clinical groups, the analysis of which helps assess service effectiveness, enhance care quality and accessibility, and optimize resources.

Objective: To conduct a structural analysis of specialized medical care provided to breast cancer patients at the Tomsk Regional Oncology Dispensary in 2020–2024 by statistical clinical groups.

Materials and methods: The study was conducted using depersonalized data on breast cancer patients treated at the regional oncology dispensary. We analyzed the number of hospitalized patients, their distribution by age, department, and statistical clinical group code, and the dynamics of the cost-intensity coefficient within groups.

Results: During the study period, the majority of hospitalized cases were women aged 55–64 (32.5 ± 3.5 %) and 65–74 (27.5 ± 1.1 %). Most patients (76.8 % in 2024) were treated in the Oncology Department, with the highest number of completed cases (14,083; 80.7 %) involving drug therapy. In day hospitals, Level 4 Drug Therapy prevailed. In the round-the-clock inpatient department, Level 1 Mastectomy was most common among patients aged 55 years and older (1,294 cases; 24.8 %), while Level 1 Drug Therapy dominated in those under 54 years of age (958 cases; 23.5 %). The relative cost-intensity coefficient declined for most drug therapy statistical clinical groups by 2024, except for those of Levels 10–11 in day hospitals and Levels 11–13 in 24-hour hospitals, demonstrating an increase.

Conclusion: The study results highlight the importance of optimizing age- and cost-aware resource planning to improve clinical economic standards, develop differentiated approaches to funding, forecast departmental workloads, and support data-driven healthcare management.

Introduction: Commitment to a healthy lifestyle and quitting tobacco and e-cigarette smoking remains an important problem of the modern society. The article examines behavioral characteristics associated with smoking and the attitude towards smoking of various categories of people.

Objective: To determine behavioral characteristics inconsistent with a healthy lifestyle, including tobacco consumption and e-cigarette use.

Materials and methods: The study is based on data of the survey “Selective Observation of the Health Status of the Population” conducted in 2024 by the Federal Service for State Statistics of the Russian Federation (Rosstat) in all constituent entities of the country involving 98,961 people aged 15 and over (42 % of men and 58 % of women).

Residents of Moscow made up 6.8 % and those of the Moscow Region – 4.2 % of the respondents (6,743 and 4,114 people, respectively).

Results: In 2024, 10 % of Russian people and 7 % of Moscow citizens were strongly committed to a healthy lifestyle. In the capital, 29 % of men and 10 % of women were chronic tobacco smokers while 5 % of men and 3 % of women were occasional smokers. No differences in e-cigarette use were noted between men and women: 9 % smoked electronic cigarettes daily (4 % of men and 3 % of women did this periodically). Almost 14 % of the Muscovites tried to quit smoking. Of those who wanted to quit smoking, 59 % received advice from a doctor or other health worker about the importance of quitting smoking.

Conclusions: Smokers are much more loyal to health risks of smoking, which can be an obstacle to quitting smoking. The resource of involving healthcare professionals able to support patients willing to quit smoking in resolving the problem is not fully utilized.

Introduction: Attitude towards health plays the key role in maintaining and strengthening women’s health, the most important element of which is the value-based motivational component. At the same time, it is critical to understand the specifics of forming health attitude in the urban and rural settings.

Objective: To identify features of the value-based component of health attitude in women living in areas with different levels of urbanization.

Materials and methods: The empirical basis of the study conducted in spring 2025 was the data of a formalized survey of 1,637 residents of the Nizhny Novgorod Region aged 18 years and older. The sample was created by river sampling allowing verification of the territorial affiliation of the respondents. The data were analyzed using the IBM SPSS Statisticssoftware.

Results: We established differences in health attitude between women living in the regional center and rural areas.

Urban residents perceived health as an instrumental value to a greater extent than women living in villages (77 % versus 69 %). Comparison of the means showed that rural women demonstrated higher internal motivation to maintain health (χ2 = 8.343 at p < 0.05) along with lower confidence in their own ability to manage it (Z = –2.485 at p < 0.05). The influence of socio-demographic factors, such as employment and the levels of income and education on the women’s value-based attitude towards health strongly depended on the place of residence. In the urban setting, employment status increased the importance of health as a resource for working capacity (ρ = –0.118 at p < 0.05), while in the villages it increased the motivation to take care of it independently (γ = –0.333 at p < 0.05).

Conclusions: Rural women perceive health as a terminal value and exhibit a proactive attitude towards it. Female city dwellers consider health to be an instrumental value, thus exhibiting a reactive attitude, which is related to externalization of responsibility and the fast pace of urban life.

Introduction: Adverse health effects of environmental factors in the urban population are the focus of many foreign and domestic studies.

Objective: To improve methodological approaches to identifying urban risk areas based on environmental indicators and prevalence rates in the child population.

Materials and methods: The territory of the Voronezh city district was chosen as the object of the research. The subject of the study was data on environmental conditions, including ambient air pollution (i.e. levels of carbon monoxide, sulfur dioxide, nitrogen oxide, nitrogen dioxide, lead, formaldehyde, total suspended particles (TSP), phenol, benzene, styrene, and soot), drinking water quality in the centralized domestic and drinking water supply system (boron, iron, manganese, fluorine nitrates, and total hardness), soil pollution in the residential area (benzo[a]pyrene, cadmium, manganese, copper, nickel, mercury, lead, and zinc), and prevalence rates in the child population in terms of medical attendance for the years 2022–2024 retrieved from statistical reports of health facilities included in the regional information fund of public health surveillance.

Results: We propose the algorithm for identifying urban risk territories based on environmental indicators and prevalence rates in the child population that includes the following stages: 1) preparation of primary data on urban territories; 2) construction of a factor – prevalence correlation matrix; 3) normalization of indicators; 4) determination of significance of each factor contributing to the prevalence rate and integral risk indicator; 5) construction of a multidimensional model of the risk indicator given the weighting coefficients; and 6) identification of territories with the highest integral risk indicator.

The priority risk factors for children’s health include the levels of carbon monoxide, nitrogen dioxide, formaldehyde, and TSP in ambient air and those of lead and zinc in soil, which is confirmed by statistically significant coefficients of paired correlation ranging from 0.61 to 0.79 and determination coefficients ranging from 36.8 to 62.3 %.

Conclusion: Based on a set of indicators, 2 out of 11 urban areas are characterized by a high level of risk (the integral risk varying from 0.88 to 1, which indicates the predominance of a combination of higher values of unfavorable statistically significant environmental factors compared with other areas).

Introduction: Adverse health effects of disadvantaged geographical conditions of the Khanty-Mansi Autonomous Okrug – Yugra are noted in the newcomer population at various stages of ontogenesis.

Objective: To establish specific morphological characteristics of girls aged 18–20 living in severe climate conditions of the Middle Ob Region.

Materials and methods: The survey involved 125 female students of the Surgut State University aged 18 to 20 years. Their anthropometric measurements were taken using a medical height gauge, scales, and a measuring tape, and further analysed using Microsoft Excel to determine the median, 25 % and 75 % quartiles. The statistical significance of differences between the age groups was assessed using the nonparametric Kruskal–Wallis test with the differences considered significant at p < 0.05.

Results: We observed stabilization of growth processes in the girls aged 18–20 years, born and living in the Middle Ob Region but belonging to the migrant population; yet, such anthropometric parameters as the body weight and circumferences increased significantly: values of the body weight ranging from 52.00 kg to 57.91 kg at the age of 18 increased to 53.10–61.30 kg at the age of 20 and those of chest circumference – from 82.00–87.00 cm to 84.50–91.00 cm, respectively. The waist-hip ratio showing distribution of adipose tissue in the 18 to 20-year-old females changed insignificantly ranging from 0.71 to 0.73 while body mass indices rose statistically.

Conclusions: Our findings provide understanding of the morphological characteristics of girls aged 18–20 years belonging to the non-native population of the Khanty-Mansi Autonomous Okrug – Yugra and can serve as objective criteria of development at the adolescent stage of ontogenesis for evaluation of adaptability of girls living in the northern region and development of appropriate health activities and preventive measures.

Introduction: Time zone adaptation in conditions of circadian rhythm desynchronization can negatively affect functioning of the cardiovascular, endocrine, digestive, excretory, and other body systems of fly-in fly-out oil and gas workers, which may lead to the necessity of medical attention to these employees, including by organizing medical evacuation.

Objective: To assess health effects of time-zone adaptation in oil and gas extraction employees working in rotational shifts.

Materials and methods: We conducted a retrospective observational non-randomized longitudinal clinical study of 3,819 visits of remote rotational workers to paramedic and medical health centers at production facilities of oil and gas companies, telemedicine consultations, and remote health monitoring for 2022–2024, divided into groups by the time zone of the permanent place of residence. Age, sex, occupational history, clinical and instrumental laboratory data were taken for the analysis using the Pearson’s chi-squared test for qualitative and the Mann-Whitney U test for quantitative parameters.

Results: Compared to residents of the fourth to ninth time zones, workers arriving at their shift locations from the first to third time zones more often seek medical care at paramedic and medical units at production facilities, in general, and for emergency reasons, in particular. Living in a time zone different from that of the work location between shifts is an independent risk factor for low blood oxygen (p < 0.05) and high blood pressure in the age group of 41 to 50 years (p < 0.01).

Conclusion: Health effects of time zone adaptation in fly-in fly-out oil and gas industry workers have been proven.

Introduction: The results of previous studies lack comprehensive data on the composition of industrial aerosols at modern foundries, which limits opportunities of developing targeted preventive programs in view of recent technological changes.

Objective: An in-depth characterization of the qualitative and quantitative composition of aerosols in the workplace air at various production sites of the foundry of an automotive industry plant.

Materials and methods: The study was conducted at iron and non-ferrous casting production facilities (smelting, casting, molding, core, and chipping sections). Workplace air samples were taken simultaneously at the same sites to establish the 8-hour time-weighted average concentration, fractional and chemical composition of aerosols, and concentrations of volatile organic compounds. Sampling was carried out on quartz filters and cartridges with carbon absorbent using personal samplers and on polyvinylchloride filters using an 8-stage cascade impactor to determine particle size distribution in the aerodynamic range of less than 18 μm.

Results: The workplace air at the foundry was contaminated with industrial aerosols of complex composition. At all the sites, suspended particles capable of being deposited in the respiratory system were represented by the respirable fraction and the finely dispersed (10 to 18 μm) part of the extrathoracic fraction. We found a high proportion of ultrafine particles in the smelting and casting areas. The proportion of silica dust was within 10 %. Volatile organic compounds causing irritation and sensitization, having remote mutagenic and carcinogenic effects and potential reproductive toxicity were found in the air samples.

Conclusions: Combined exposures to fibrogenic aerosols, toxic metals, and volatile organic compounds may increase the risk of respiratory diseases. The presence of an ultrafine fraction accounts for increased biological activity of the aerosol. Epidemiological studies are needed, as well as the development of comprehensive preventive programs that consider specifics of modern foundries.

Introduction: According to data from the Jakarta Health Office, infectious diseases are among the top causes of death in the city, ranking third from 2016 to 2019 and rising to first place in 2021. The ratio of COVID-19-related deaths to all reported deaths also increased in 2021 compared to 2020. Despite the importance of vaccination, the coverage in DKI Jakarta were below the target up until the last day of vaccination program.

Objective: To determine the correlation between the completeness of the COVID-19 vaccination status and the death of confirmed COVID-19 cases.

Materials and methods: This is a retrospective cohort study with 1,881 samples from Jakarta Health Office COVID-19 surveillance data from July to December 2021, analyzed using Cox regression.

Results: The crude-hazard ratio correlation between the completeness of COVID-19 vaccination status and death in confirmed cases was 3.19 (95 % CI: 2.06 to 4.94), and the hazard ratio after adjusting for age group, symptom criteria, concomitant heart disease and hypertension covariates was 3.47 (95 % CI: 2.13 to 5.67).

Conclusion: Our findings suggest that, to reduce the mortality rate in confirmed COVID-19 cases, complete and evenly distributed vaccination among all target groups is necessary.