Background: In the situation of economic instability, when the problem of financing welfare and other social and healthcare services is aggravated, the importance of raising funds and attracting business investors becomes particularly urgent. Results of recent studies show that a synergistic effect can be achieved by introducing a social impact bond model in collaboration of external investors and health authorities. Projects aimed at improving children’s health in order to prevent subsequent costs in healthcare have been increasingly developed and proposed recently.
Objective: To substantiate and develop a social impact bond aimed at preventing chronic noncommunicable diseases in children based on past experience.
Materials and methods: We reviewed the content of regulations on the development and implementation of social impact bonds in the Russian Federation and examined the system of providing preventive health services for the child population, including overweight and obese children.
Results: We have found that a regulatory framework for testing social impact bonds (SIB) has been already established in the Russian Federation and ten SIBs were implemented in seven constituent entities of the country in 2022. Due to a high prevalence of overweight and obesity among children in the Sverdlovsk Region and limited opportunities of implementing comprehensive, long-term preventive programs, a SIB for prevention of obesity in children aged 6 to 9 years living in the Sverdlovsk Region has been developed. The regulatory framework for the implementation of the project has been formed, the project passport approved, the targets of the social outcome set, the project implementation mechanism developed, and the participants identified.
Conclusion: The ultimate goal of social impact bonds is not so much the solution of a specific local task, but elaboration of new techniques and mechanisms for their implementation through testing, enabling replication of successful models at the municipal and regional levels, and obtaining an overall cumulative effect from sustainable positive changes

Introduction: The practice of self-medication is widespread among the population. In Russia, it exists at the level of habit, a socio-cultural norm. However, the abuse of self-medication can lead to negative consequences for the human body and the health of other people, which is a serious problem for public health. Of particular danger is the uncontrolled use of antibiotics. The use of self-treatment is the result of a number of reasons related to the beliefs of the person himself and external circumstances. In the scientific community, the topic of responsible self-treatment is being discussed, which implies reasonable health care, which does not exclude access to doctors. The need to form a responsible attitude of Russians to their health actualizes attention to the problem of self-treatment.
The objective of the study was to analyze changes in the prevalence of self-medication among the Russian population, to identify the reasons for its demand in the current conditions.
Methods: The empirical basis of the study was the all-Russian sociological survey of the population aged 18 years and older. The field stage was carried out from April 18 to April 27, 2022. The geography of the survey included 30 regions of Russia. The sample size was 1500 people. The survey method is an in-home personal interview.
Result: The results of an empirical study show that the state of health and everyday well-being of Russians cannot be called favorable, which makes it necessary for them to use various methods of treatment. Self-medication is still a common practice. Every second respondent in case of illness prefers to be treated independently, using medicines and "folk" remedies. At the same time, there is a gradual decrease in the demand for this method of treatment in favor of seeking qualified help from doctors. A significant dependence of the population on taking medications has been revealed, and the decision to use them is often made independently, which mainly concerns young people. There remains a significant number of citizens who have to refuse the necessary medical services and medicines due to lack of money or the unavailability of the necessary doctors in the area of residence, which orients them towards self-treatment. The worse respondents assess the state of the healthcare system, the less often they go to doctors and more often they treat themselves.
Conclusion: The problems noted point to the need to raise the awareness of Russians regarding self-treatment, the possible negative consequences of the uncontrolled use of drugs and non-drugs, the need to increase the general level of the health culture of the population, the responsibility of citizens in relation to their health and create conditions for obtaining affordable qualified medical care.

Introduction: The study of the prevalence of narcological disorders is an integral part of the monitoring of the drug situation allowing identification of the main trends in the situation with the use of narcotic drugs.
Objective: To analyze the level and structure of non-medical use of prescription drugs among the population of the Republic of Crimea and to assess their dynamics in 2020–2021.
Materials and methods: The subject of the study was quantitative indicators characterizing the spread of drug use disorders in the Republic of Crimea. The information base of the study included data and materials of the Federal State Statistics Service and the Ministry of Health of the Republic of Crimea. We processed data of the statistical reporting documentation for 2020–2021, Forms No. 37, Information on patients with alcoholism, drug addiction, substance abuse, and No. 11, Incidence of substance use disorders. Incidence and prevalence rates were estimated per 100 thousand population. The data were analyzed in Microsoft Excel. Results: We established an increase in the incidence of substance use disorders in the Republic of Crimea in 2020–2021 from 38.3 to 42.9 per 100 thousand population (by 12.01 % in the year 2021 compared to 2020) and an increase in the overall incidence of drug addiction and abuse from 566.5 to 578.3 per 100 thousand population (2.08 %). We noted a slight decrease in opium addiction, transition to new synthetic drugs, and an increase in the proportion of a combined use of narcotic drugs. Males aged 20 to 59 years predominate among drug users.
Conclusions: Our findings show a consistently high prevalence of non-medical use of prescription drugs among the population in the Republic of Crimea, an increase in the incidence and prevalence of drug addiction and in the number of doctor’s visits among drug abusers, and a growth of drug overdose deaths.

Introduction: To improve the reliability of predictive models of workers’ health risk, it is necessary to take into account individual characteristics of workers, especially their age and health status. Fatigability should be used to identify and assess vulnerability of an employee to effects of external factors.
Objective: To study quantitative patterns of the relationship between the health status of workers and their fatigability and vulnerability to occupational risk factors.
Materials and methods: The study was conducted in 2016–2021 and involved 751 industrial workers, 750 healthcare professionals, 193 educators, and 229 public catering employees, who underwent a medical examination and a standardized medical and environmental survey at the North-West Public Health Research Center in St. Petersburg. We assessed vulnerability of employees to such occupational factors as the workload, effort-reward imbalance, noise, microclimate, air quality, and lack of free (nonworking) time. We also assessed and compared the relative risk of vulnerability for workers with/without health disorders.
Results: We established increased vulnerability to occupational risk factors in the workers with chronic diseases and health deterioration observed during the previous year. Occupational factors were ranked by the criterion of vulnerability (fatigability) for those with the impaired health status.
Conclusions: Health impairments of the employees revealed in the course of periodic medical examinations induce a 1.2–2.5-fold increase in the frequency of vulnerability to most occupational risk factors. Deteriorating health causes a fold increase in the frequency of vulnerability to all occupational factors considered. All workers’ health disorders under study cause a 1.3 to 12-fold increase in vulnerability to the workload.

Introduction: Factors of the work environment affect the functional state of the central nervous system of employees, which is manifested by changes in sensorimotor reactions. Professional tasks of emergency medical personnel during the COVID-19 pandemic determine high requirements for the stability of functional systems of the body.
Objective: To study the influence of professional activities on the mobility of central nervous processes in ambulance workers.
Materials and methods: The study was conducted at the Ryazan City Clinical Emergency Hospital in 2021. It included 44 ambulance workers (12 doctors and 32 paramedics), 12 men and 32 women with the mean age of 35.77 ± 3.39 years, working a 24-hour shift followed by 72 hours off. We studied parameters of the complex visual-motor reaction of the subjects including the average response times and the Whipple’s index using the “NS-Psychotest” computer complex equipped with the visual-motor analyzer. The data were analyzed using the Data Analysis ToolPak in Microsoft Excel 2007.
Results: The established statistically significant increase in the average response time of ambulance employees by 60.75 ms (p < 0.001) by the end of the work shift indicates changes in the functional state of the central nervous system caused by fatigue. The analysis of the dynamics of indicators between the beginnings of neighboring shifts revealed positive trends expressed by an average decrease in the response time by 77.67 ms (p = 0.002) and an increase in the Whipple’s index by 0.07 (p < 0.0001) in most subjects after the regulated rest period, thus indicating the effectiveness of the processes of functional restoration of the central nervous system.
Conclusions: By the end of the work shift, ambulance workers demonstrated increased average visual-motor reaction times. Age under 30 and 0–5-year work experience are risk factors for poor professional adaptation proven by a high proportion of the subjects with a statistical increase in the average reaction time during the work shift. Stabilization of the dynamics of inter-shift indicators when compared at the beginning of adjacent shifts indicates proper functional restoration of the central nervous system of emergency medical personnel during the 72-hour rest period.

Background: Meat is an important source of energy, animal proteins and micronutrients in human nutrition. On the one hand, meat products and dishes are valuable sources of essential nutrients and an integral part of a healthy and nutritious diet; on the other hand, they are among the foods, the excessive consumption of which can pose risks of certain chronic non-communicable diseases (NCDs). The analysis of trends in the average consumption of meat and meat products and their contribution to the chemical composition and energy value of the diet of Russian people is important, inter alia, for substantiating appropriate prevention strategies for NCDs at the population level.
Objective: To analyze current consumption of meat and processed meats, to establish recent trends in their dietary intake, and to assess contribution of meat products to the nutritional value of the diet of Russian people.
Materials and methods: We have analyzed meat and processed meats consumption based on data collected by the Russian Federal Service for State Statistics (Rosstat) within annual selective surveys of household budgets conducted in 1985–2021 and a selective survey of the diets of the Russian population in 2018.
Results: The article presents the results of analyzing consumption dynamics for various types of meat and processed meats in the Russian Federation from 1985 to 2021 and the role of meat products in nutrition as a source of dietary risk factors for NCDs. We have established that meat and poultry are regularly consumed by 84.7 % of Russian adults while sausages and smoked processed meats are regularly present in the diet of 41.7 % and 18.8 % of them, respectively. We have also estimated the average daily intake of 56.4 g for all types of sausages, 83.3 g for frankfurters and short thick wieners, 133.9 g for semi-finished and ready-to-eat meat products, 59.1 g for meat snacks, and 47.6 g for canned meat and canned meat with vegetables. This regularity, high frequency and volume of consumption indicate that meat products make a considerable contribution to the daily average intake of calories and such critical nutrients posing risks of NCDs as fat, saturated fatty acids, and salt (sodium).
Conclusion: We have observed a significant increase in meat consumption in the Russian Federation in recent years and a change in consumption of various types of meat and processed meats. In order to reduce the exposure of the population to dietary risk factors, it is expedient not only to improve outreach programs in healthy nutrition but also to interact with manufacturers with the purpose of updating regulatory documents for processed meats, developing new low-sodium products, and stimulating voluntary implementation of front-of-pack nutrition labeling.

Introduction: Infectious diseases continue to have major health and economic costs. The epidemiological well-being of the population depends not only on availability and quality of infectious disease services, but also on proactive anti-epidemic measures.
Objective: To determine incidence and prevalence rates of infectious diseases in the population of the Orenburg Region.
Materials and methods: We used data of the Epidemiological Atlas of the Volga Federal District made by the Nizhny Novgorod Research Institute of Epidemiology and Microbiology named after Academician I.N. Blokhina, State Reports on Sanitary and Epidemiological Wellbeing of the Population of the Russian Federation for the years 2018 and 2020 and of the Orenburg Region for 2013–2020, and the collection of the Department of Medical Statistics, Medical Information and Analytical Center, for 2016–2020. We applied a descriptive epidemiological method using a retrospective epidemiological analysis for 2013–2020. Pearson’s chi-square test (χ2) was used to assess the significance of differences between the predicted and observed incidence rates. The intensity of the development of the epidemic process was determined by the long-term growth rate.
Results: We established that airborne infectious diseases ranked the highest among all infections, and their rank was unrelated to incidence rates of seasonal influenza and acute upper respiratory tract infections. Besides, the unfavorable epidemic situation was predicted only for this group of infections.
Conclusions: In the spread of infections with different transmission modes, the rising trend of the epidemic process was established only for airborne infectious diseases. Modeling of the development of epidemic processes produced similar estimates for the regional population.

Background: Residents of long-term care facilities are at higher risk of the severe course and outcomes of COVID-19. Objective: To describe the epidemiological situation and risk factors for severe COVID-19 in nursing homes in the world and Russia.
Materials and methods: We reviewed Russian and English-language papers published in March 2020 to October 2022 and found in such resources as eLIBRARY.ru, Web of Science, PubMed, Google Academy, and Scopus using the following keywords: long-term care facilities, nursing homes, COVID-19 morbidity in nursing homes, COVID-19 mortality in nursing homes, and COVID-19 risk factors in nursing homes. Availability of information on morbidity and mortality among residents and employees of long-term care facilities in Russia, Europe and the USA and about the risk factors for severe course and adverse outcomes of COVID-19 was the inclusion criterion. Of 1,013 articles initially identified, 40 publications were included in the review.
Results: The analysis of the worldwide epidemiological situation has shown that COVID-19 incidence and mortality rates in nursing homes fluctuate, and, as of October 2022, cases of the disease among residents, including multiple cases within a facility, were still registered. In most countries, the highest incidence of COVID-19 in long-term care facilities was observed in January – March 2022, while the lowest was noted in May – July 2021. The number of deaths has decreased significantly over time and remains low. Risk factors for a severe course and death from the novel coronavirus disease include age, male sex, and concomitant diseases. We established, however, that disease severity was also affected by the staff-to-resident ratio, availability of paid sick leave of the personnel, patient isolation opportunities, division of the working area, type of ownership (private), and COVID-19 incidence rates in the local community.
Conclusion: We have analyzed the epidemiological situation and risk factors for severe COVID-19 in long-term care facilities at the national and global levels. As of October 2022, the novel coronavirus disease remains a challenge for nursing facilities. The severity of the infection is influenced by personal characteristics of patients and external factors related to the residential care facility