Introduction. Attention to socio-economic challenges is increasing at the national level. Strategic plans of innovative development of the country can be implemented only through active involvement of adolescents, the nearest labor and reproductive potential, whose health acquires special importance. The objective of our study was to develop organizational and methodological approaches to improving health care services rendered by medical workers to students of secondary vocational schools.
Materials and methods. We did a statistical analysis of health indices of adolescents in the Sverdlovsk Region for 2010–2019 and data of a sociological survey of medical workers in colleges. We also examined the system of providing medical care to students of vocational colleges and assessed its quality.
Results. The prevalence of chronic diseases in adolescents of the Sverdlovsk is growing. College students are exposed to additional learning and work-related risk factors. At the same time, the quality of health care and the level of knowledge of medical workers in colleges are poor. In order to change the situation, an Organizational Standard for Medical Care in Colleges was developed. It orders managers to organize proper medical care for students and contains standard operating procedures for healthcare workers. In addition to that, interactive learning techniques have been developed and implemented in order to improve disease prevention in adolescents.
Conclusion. The proposed set of measures aimed at regulating the work of medical personnel and increasing their level of knowledge will help improve the quality of medical care in colleges and raise awareness of health issues among students. 

Introduction. The increase in the rates of diseases of the endocrine system has been observed in the Russian Federation for many years. Unfavorable trends, including increasing growth rates and rising incidence and prevalence, are also registered in the Orenburg Region. The prevalence and structure of endocrine disorders in children and adolescents differ significantly from those in adults.
The objective of our study was to establish regional features of the structure, dynamics and rates of endocrine morbidity in the population of the Orenburg Region.
Materials and methods. We conducted correlation and regression analyses of data extracted from summary statistical reports for 2006–2019 issued by the State Budgetary Health Care Institution for the Orenburg Region “Medical Information and Analytical Center”.
Results. In 2006–2019, the incidence rate of diseases of the endocrine system increased by 1.6 and 1.7 times in the Russian Federation and the Orenburg Region, respectively. In 2019, the growth rate in the Orenburg Region was 2.6 %. We observed age-specific differences in disease growth rates: the prevalence in the adult population increased by 1.7 times while in children aged 0–14 years this increase was already by 2.4 times. The incidence rate of endocrine disorders in the population of the Russian Federation and the Volga Federal District increased by 1.2 times, and in the Orenburg Region – by 1.5 times. By 2024, there is a 95 % probability that the prevalence of diseases of the endocrine system will range from 124.3 to 143.3 % while the incidence rates might range from 20.6 to 38.6 % with the same confidence level. 
Conclusions. Our findings indicate unfavorable trends in the rates of diseases of the endocrine system among both adults and children.

Introduction. Maintaining and strengthening health of the population is a priority national task. Currently, this problem, in the context of changing social reality associated with the pandemic of COVID-19, is gaining special relevance. Previous studies have demonstrated that lifestyle and concern with own health have a major impact on human health status.
The objective of our study was to analyze self-rated health status of Russian people and their attitude to health issues, including practical attitude to medical care and self-medication.
Methods. The article is based on the results of a sociological research of behavioral practices of the population within self-preservation behavior. The main source of empirical information was the all-Russian sociological survey of the population representing various socio-demographic groups.
Results. The study reveals an increase in the positive perception of own health by the population over the past two decades. At the same time, citizens suffer from a wide range of diseases naturally affecting their self-rated health status. The situation is further aggravated by unfavorable social and psychological well-being caused, inter alia, by the pandemic and related challenges. Despite an increasing demand for qualified medical care for diseases, self-medication remains widespread and may have a negative health effect attributed to the uncontrolled drug use practiced by the respondents. Health maintenance practices of the population are largely related to the income and the lack of subspecialists, especially in rural or remote areas.
Conclusions. Our findings demonstrate the need to improve access to medical care and medical literacy of citizens and to expand incentives for self-preservation and health promotion.

Introduction. In 1990–2017, the size of population in the Belgorod Region increased by 10.9 % only as a result migration. Negative medical and demographic trends characterized by population decline caused by a decreased birth rate, increased mortality and disease incidence rates, and population aging were registered at that time. The level of primary disability due to digestive diseases dropped significantly; yet, young and middle-aged people and disability grades II and III began to prevail among primary disability cases.
Our objective was to study regional characteristics of the medical and demographic situation in the Belgorod Region from the point of view of medical and social expert examination.
Materials and methods. We analyzed data of the Federal Service for State Statistics (Rosstat) and its Belgorod Department (Belgorodstat), and the database of the unified automated vertically integrated information and analytical system (EAVI-IAS) of medical and social expertise for persons with primary disability caused by digestive disorders in the Belgorod Region in 2000–2017. We processed anonymized computerized data entered by the bureau’s medical staff. Ethical and legal principles were not violated when working with medical records. The study was carried out by a continuous method. We applied analytical, analytical graphics, and statistical (t-test, z-test, F-test) methods to data collection and processing. Digital data were processed using an IBM PC IntelCore i5-2500K and StatSoftStatistica 12.5 software package.
Results. Despite the population growth resulting from migration, we observed worsening of regional medical and demographic indices in 2010–2017. Although the incidence rates of all diseases of the digestive system decreased, the rates of incidence and mortality from diseases of the pancreas and liver rose significantly. The average age at death from diseases of the pancreas and liver indicated premature mortality. In the structure of primary disability caused by digestive disorders, diseases of the liver and pancreas ranked highest.
Conclusion. Population decline, rising digestive disease and related mortality rates dictate the need for in-depth study and practical solution of the problems of health improvement, disease prevention, treatment and rehabilitation of patients and individuals with disability due to this pathology in order to reduce premature mortality and improve the demographic situation in the region.

Background. A tendency towards an unbalanced diet is currently observed among student youth, which, along with the relative financial stability of this contingent, poses certain risks of unhealthy nutrition in modern conditions. Nutritional status of students can be considered as an important component of nutritional problem of the population and requires a comprehensive research.
Our objective was to analyze correlations between total monthly expenses, monthly food expenditures and the diet of first and second-year students of a medical university.
Materials and methods. The study included 87 junior students of the Ryazan State Medical University who gave informed consent to participate in the study. Their nutrition and physical activity were monitored during seven days in March–April 2019. In total, we analyzed 1,729 meals and 532 daily chronograms. Statistical data processing was carried out to test a number of statistical hypotheses in compliance with the conditions necessary for the application of the selected statistical criteria.
Results. We established that the diet was not balanced in the groups of junior students with monthly expenses both above and below subsistence level. Yet, the diet of students with expenditures above the subsistence level was closer to the recommended one. We found direct correlations between higher total monthly expenses of students and a greater proportion of nutrients in their diet. A direct relationship was also established between the food budget and consumption of food components, such as cholesterol and mono- and disaccharides, posing potential health risks.
Conclusion. Actions taken to improve well-being of families and student youth along supported by active promotion of healthy eating, especially among students with their large food budget, may contribute to optimizing the diet of junior students.

Introduction. The correlation between skin temperature and cutaneous blood flow is a factor that influences thermal imaging of the body in response to thermoregulation.
The objective of our study was to identify features of thermal images of young male permanent residents of the Russian North belonging to different generations.
Materials and methods. Thermography was carried out using a thermal imaging camera (FLIR SC620 thermal imager, Sweden), providing long-wave (7.5–13 μm) imaging with a thermal sensitivity of 0.1 °С. Quantitative analysis of thermovision images was performed for eight sites of the body captured from the front and back in a sitting position. We examined 90 young healthy men aged 17 to 21 years, permanently residing in the Magadan Region. Depending on the duration of adaptation to extreme conditions of the North, all subjects were divided into four groups: adapting migrants (“zero generation”) and those born in the North in the first, second and third generations.
Results. We established a significant increase in skin temperature at all measured body sites in the series from adapting migrants (“zero generation”) to the natives in the first to third generation. The maximum differences were observed for the average temperature of the forehead, abdomen, and lower back, reaching 0.97, 1.04, and 0.98 °C, respectively. It should be noted that the young men of the city of Magadan had a higher average skin temperature than those living in optimal climatic and geographical conditions of Central Russia and Eastern Europe. The smallest difference (0.43 °С) was registered for breast temperature between the migrants and representatives of the third generation.
Conclusions. Our findings prove compensatory and adaptive physiological changes occurring in the body over time to reduce adverse effects of the cold environment. This reorganization of the body is achieved through optimization of the thermoregulatory mechanism and changes in vegetative skin vasomotor responses.

Introduction. It is relevant to determine periods of adaptation of local and non-resident students coming from other Russian regions to learning conditions. The objective of our study was to measure duration of cadets’ adaptation to the learning environment as assessed by the incidence of respiratory diseases in view of synergistic effects of health risk factors in the Kaliningrad enclave.
Materials and methods. We conducted a retrospective analysis of the incidence of respiratory diseases in cadets of two military universities (n = 3,381, n = 2,013) by cohorts (local and non-resident students) for five academic years in general and by year.
Results. The proportion of respiratory diseases in university cadets was as high as 70.9 ± 2.0 and 52.1 ± 1.1 % in Universities 1 and 2, respectively. The share of respiratory diseases in the first and fifth-year students was 72.3 and 59.9 % in University 1, and 60.3 and 38.1 % in University 2, respectively. The respiratory disease incidence in non-resident cadets was 1.8 and 1.2 times higher than that in locals: 1,102.6 ± 6.2 versus 617.7 ± 24.5 ‰ and 477.6 ± 14.1 versus 388.2 ± 16.1 ‰ (p = 0.001) in Universities 1 and 2, respectively. We found differences in the rates of acute sinusitis, acute tonsillitis, upper respiratory tract infections and influenza, community-acquired pneumonia, and lower respiratory tract infections between local and non-resident cadets. In the second university, differences in the incidence of acute sinusitis and upper respiratory tract infections were still observed in third-year students while in the first university they were still pronounced in cadets during the fourth year of study. We suppose that they might be attributed to learning conditions, ratios of local to non-resident cadets, differences in living conditions and nutrition between the students.
Conclusion. Duration of the period of adaptation of military university cadets to conditions of learning is influenced by a synergistic effect of adverse environmental factors. Adaptation of non-resident cadets lasts longer due to acclimatization to weather and climate conditions of the enclave. The incidence of respiratory diseases proves the differences in learning conditions between the universities.

Introduction. A contemporary man lives and acts in conditions of increasing intensity and duration of synergistic effects of numerous adverse environmental factors causing a rapid depletion of his physiological reserves. It has been proven that functional indices of the cardiovascular system are a universal indicator of compensatory and adaptive activities of the organism.
The purpose of the study was to assess functional capacity of the cardiorespiratory system in young people, depending on social status and level of education.
Materials and methods. The study included 1,978 young people aged 18–25 years, with different social status and educational level. Functional capacities were assessed by physiometric properties and estimated indices.
Results. We established that blood pressure values were significantly higher in young men compared to women and in students compared to working youth. We also found an inverse correlation between the prevalence of hypertension and the level of education of working young adults. Average group values of the Robinson index were assessed as moderate for men and good for women. Functional capacities of the cardiovascular system in students were generally lower than those among working youth. The group average of the vital capacity index in young men and women was higher and significantly higher than the average value, respectively. Statistically higher values of this index were observed among female students compared to working young women.
Conclusions. Our assessment of functional capacities of the cardiorespiratory system showed that the young women had a greater ability to respond to combined effects of adverse environmental factors adequately and securely. This ability enabled them to spend their body reserves more economically and resist diseases. The energy potential of the cardiovascular system of working youth was higher than that of students. The latter, on the other hand, demonstrated higher capacities of the respiratory system. A higher level of education among working young adults was associated with better functional capacities and adaptive reserves of the circulatory system.

Introduction. In 2020, the COVID-19 pandemic contributed to the epidemiology of respiratory tract infections. The importance of timely differential diagnosis of COVID-19 and seasonal acute respiratory diseases is hard to overestimate. Patients with the novel coronavirus disease are at risk of developing hospital-acquired pneumonia. The analysis of specific features of circulation of various strains of pathogens of nosocomial infections resistant to antibacterial chemotherapeutic agents is relevant.
Our objective was to study the etiological structure of community-acquired pneumonia during the epidemic spread of COVID-19 and to assess risks of developing healthcare-associated pneumonia.
Materials and methods. Biological specimens from 446 inpatients and outpatients diagnosed with community-acquired pneumonia in the city of Rostov-on-Don were tested. Verification of respiratory viruses, including RNA of SARS-CoV-2, M. pneumoniae, C. pneumoniae, and L. pneumophila, was performed by polymerase chain reaction in nasopharyngeal swab specimens. Bacteriological analysis of sputum was carried out using differential diagnostic media, and isolated pathogens were then identified by time-of-flight mass spectrometry on an Autoflex instrument (Bruker Daltonics GmbH, Germany) using the MALDI BioTyperR 3.0 software.
Results and discussion. In December 2020, the proportion of SARS-CoV-2 positive test results among patients diagnosed with community-acquired pneumonia was 35.6 %. The frequency of mixed viral infections in patients with a confirmed diagnosis of COVID-19 was not significantly different from that in patients tested negative (25.9 % and 26.2 %, respectively). The microbiota in pneumonia unrelated to SARS-CoV-2 was dominated by Candida fungi and plasma-coagulating staphylococci while cultures of non-fermenting gram-negative bacteria were significantly more often isolated from COVID-19 cases. Secondary infection presumably induced by environmental contamination or disease transmission from healthcare personnel was registered in 51.6 % of inpatients. Transmission of nosocomial infections between patients was not observed.

Introduction. When conducting PCR (polymerase chain reaction) testing of biospecimens for SARS-CoV-2 RNA at the beginning of the COVID-19 pandemic, the laboratory service in Russia and foreign countries encountered problems related to the accuracy of diagnostics and obtaining false negative, false positive, and dubious results.
The objective of this work was to analyze current literature on the problem of false positive and dubious results of RT-PCR testing for COVID-19.
Material and methods. We selected Russian and foreign English-language publications devoted to organization of laboratory diagnostics of the novel coronavirus disease, challenges of PCR testing for SARS and MERS, and general issues of DNA contamination in a PCR laboratory for 2012–2020. We also reviewed current regulations and guidelines for COVID-19 diagnostic testing.
Results. The analysis of factors leading to contamination of specimens with nucleic acids in the laboratories performing massive COVID-19 PCR testing during the pandemic showed that the main reasons for contamination included a large number of tests, accumulation of samples in the laboratory, and the increased amount of wastes containing amplification products. Cross-contamination occurs due to technical errors in the course of laboratory manipulations at the stages of sample preparation and inactivation, RNA isolation, and addition of cDNA/RNA or positive control samples to the reaction mixture. Pollution of laboratory working areas with amplicons arising from the opening of tubes and plates containing PCR products is the main cause of total contamination in the laboratory. Signs of cross-contamination include the increase in the proportion of positive samples with low threshold cycle values and detection of a positive signal from negative control samples at RNA isolation and amplification stages. A positive result for all samples in a round, including negative control samples, is a marker of “total contamination” in the laboratory. In addition to contamination, formation of nonspecific PCR products at late reaction cycles and nonspecific fluorescence of the reaction mixture, which occurs when reagent storage temperatures are not observed, may also lead to false positive results.
Conclusion. To prevent contamination in a PCR laboratory, strict control over the flow of test samples and medical wastes, regular analysis of the frequency of positive test results, and mandatory laboratory quality control of testing and DNA/ RNA contamination are compulsory.

Introduction. Ischemic stroke is a structurally complex disease based on various pathogenetic mechanisms. In view of the complexity of this pathology and its structure, the medical community has established various assessment scales based on different signs. The scales were created in order to predict possible conditions of a patient at various stages of treatment.
The objective of our research was to determine the relevance of applying the system of predicting outcomes of ischemic stroke based on neural networks to improve ischemic stroke treatment and management.
Materials and methods: We reviewed scientific and medical literature devoted to the development and use of forecasting systems based on artificial neural networks to predict outcomes of ischemic stroke and analyzed the most common assessment scales currently used in therapeutic practices.
Results. The analysis of effectiveness of available scales revealed that their main drawback was a subjective component in the assessment of a patient’s condition. The use of neural networks, in its turn, minimizes the subjective component in predicting the outcome of ischemic stroke since neural networks are capable of processing large amounts of data and can, therefore, establish implicit correlation between research objects.
Conclusion. The analysis of domestic and foreign literary sources proves that the presence of a forecasting system based on a neural network is a major advantage for a health care facility. Yet, neural networks have not fully passed clinical trials that would confirm their superiority over current methods of predicting disease outcomes, which impedes their extensive use in clinical practice.

Introduction. In modern conditions of rapid development of information and communication technologies, healthcare workers start experiencing adverse health effects of such risk factors as an uncontrolled use of electronic devices and associated physical inactivity, sleep deprivation, and impaired work/rest patterns during their professional training. Our purpose was to study subjective assessment of risks from electronic device usage by medical workers.
Methods. A specially developed questionnaire was distributed among 148 doctors, 72 nurses and paramedics, and 119 professors of medical universities. In addition to that, selective measurements of body composition were taken in homogeneous cohorts of female healthcare professionals serving as teachers of clinical departments of medical universities (33) or nurses (36) who gave an informed consent to participate in the study and filled out the questionnaire. The statistical software package Statistica 13 PL (StatSoft, USA) was used for statistical data processing.
Results. In general, the respondents gave an adequate assessment of health effects of electronic device usage. Nurses and paramedics appeared to be the least trained in issues of the safe use of electronic devices. Almost 61 % of them had varying degrees of overweight and obesity; yet, 51.4 % of nurses and paramedics rated their health as good being aware of the risks related to overweight. Medical university staff adequately assessed potential health risks and demonstrated better skills of a safe use of electronic devices in everyday life, payed more attention to their physical activity and nutrition, and were committed to developing appropriate competencies in their students.
Conclusion. Development of skills of a risk-free electronic device usage in healthcare professionals should begin in a medical school.

Introduction. The current state of the development of science and the society poses challenges to the pedagogical community and requires improvement of educational technologies to achieve a higher level of professional training of medical workers. Today, the search and development of effective teaching strategies for mastering fundamental and special professional knowledge is more relevant than ever.
Our objectives were to create a learning environment contributing to the development of communication competencies within the system of continuing education of medical workers and to test it on occupational therapists and hygienists studying in the Pacific State Medical University.
Materials and methods. First, we substantiated the hypothesis through the analysis of literary sources and legislative documents on the topic of the study. Second, we applied rapid diagnostic techniques (testing and a questionnaire-based survey) to study the level of development of communication competencies in healthcare professionals.
Results. To solve one of the study goals, we defined communication competencies of a medical practitioner as the ability not only to establish but also to maintain necessary relationships with other people, including the professional network, over the years. At the theoretical stage of our research, we substantiated the system of organizational, pedagogical and psychological conditions necessary for effective development of communication skills of a medical doctor. The practical stage involved the elaboration of individual programs of professional and self-development and their introduction into practical activities of the doctors.
Conclusion. Thus, according to the hypothesis of the study, implementation of the model of the development of communication competencies will help the medical practitioner expand professional communications enabling him to turn from a performer into a researcher and/or experimenter and master the skills of research activities, drafting projects and programs of experimental work.