Introduction: The Republic of Karelia is a part of the Northwestern Federal District and, being a sparsely populated constituent entity of the Russian Federation, is characterized by a difficult medical and demographic situation.
Objective: To assess trends in medical and demographic processes in the Republic of Karelia in 2011–2021.
Materials and methods: We analyzed official statistical data provided by the Territorial Body of the Federal State Statistics Service in the Republic of Karelia for the years 2011 to 2021. Both absolute and relative values and time series indicators were used to characterize the processes under study.
Results: A long-term depopulation process has been taking place in the region: since 2011, the size of population has decreased by 39.5 thousand people, which was mainly attributed to the rural population decline and a shrinking number of women. In 2011–2021, the natural population growth rate was negative (–2.8 and –12.1 per 1,000 population in 2011 and 2021, respectively), began to worsen in 2015 due to a decrease in the birth rate, and even aggravated during the COVID-19 pandemic of 2020–2021 owing to increased mortality rates. Diseases of the circulatory system and neoplasms were found to be the leading causes of death during the study period. In 2011–2020, the infant mortality rate ranged from 44.2 to 76.3 per 10 thousand births. We observed a regressive population age structure in the republic characterized by a decrease in the young-age to old-age population ratio from 0.70 in 2011 to 0.67 in 2021. The proportion of residents aged 60 years and older rose from 18.3 % in 2011 to 24.5 % in 2021. The share of working adults, on the opposite, decreased from 61.1 % in 2011 to 54.6 % in the year 2021. In 2020, a gradual increase in life expectancy traced in 2011–2019 turned into a decrease caused by the COVID-19 pandemic.
Conclusions: The unfavorable medical and demographic situation in the Republic of Karelia requires special attention of the scientific community and governmental structures. Applying the principle of a systematic approach to solving the problem will help improve the current situation.

Introduction: Job satisfaction of oncologists at outpatient cancer centers is an important factor that determines not only personal well-being of a doctor, but also the effectiveness of provision, quality and availability of primary specialized oncological care.
Objectives: To assess the risk of emotional burnout and to determine the level of job satisfaction of oncologists working in outpatient departments in order to propose actions to reduce the risk of job burnout and to elaborate measures promoting job satisfaction.
Materials and methods: In June–August 2022, as part of quantitative sociological surveys, 71 oncologists of Outpatient Cancer Centers located in Moscow and the Moscow and Ivanovo Regions were interviewed to assess their job satisfaction using V.A. Rozanova’s questionnaire. In addition, we conducted a qualitative sociological study consisting of six in-depth interviews with healthcare experts, including heads of federal and regional cancer clinics.
Results: We established that 21.1 % of the respondents were not satisfied with their job. Male specialists and surgeons demonstrated significantly lower job satisfaction than their colleagues. The main reasons for such dissatisfaction were the amount and fairness of wages, long working hours, disunity of actions between employees when performing collective tasks, and the leadership style of the chief. As measures to optimize the performance, the respondents emphasized better equipment of departments, impartial record of achievements of each employee for fair incentive pays, clear distribution of duties and responsibilities within implementation of collective project tasks, creation of opportunities for paid extra work, and organization of regular meals at the expense of the employer.
Conclusions: The main ways to increase job satisfaction of oncologists at outpatient cancer centers can be optimization of the incentive system that takes into account individual performance indicators, effective organization of the workflow in departments and their sufficient equipment, elaboration of personal development plans, organization of additional formal internal communication channels, an increase in the level of knowledge, skills and abilities of chief medical officers in the field of human resource management, and expansion of employee benefits based on their preferences.

Introduction: The educational process is one of the leading factors determining health of schoolchildren. Identification of pathologic afflictions among students can contribute to targeted development of health promotion activities and significantly reduce risks of diseases related to learning.
Objective: To compare prevalence rates in elementary, secondary and high school students.
Materials and methods: In January 2021 to October 2022, 498 schoolchildren passed comprehensive medical examinations. They were subdivided into three cohorts: cohort 1 consisted of 132 elementary school students (median age = 8 (7; 9) years), cohort 2 included 257 secondary school students (13 (11; 14) years), and cohort 3 comprised 109 high school students aged 16 (16; 17) years. The prevalence was assessed based on doctors’ statements; the data and statistics were analyzed using Jamovi.
Results: Diseases of the musculoskeletal and digestive systems and endocrine disorders were found to be the most prevalent among the students (68.9–87.5 per 100 examined). The highest fold difference was established between high and elementary school students for the prevalence rates of tension-type headache (32.1), chronic gastritis and duodenitis (22.9), myopia (5.1), and scoliosis (2.9). We observed a direct relationship between educational stages and the development of those diseases.
Conclusions: Our findings indicate the need of including additional examinations by neurologists and otolaryngologists at different ages in the procedure for conducting health checkups of minors. The focus, content and scope of health promotion, disease prevention, and outreach activities of pediatricians and preventive medicine physicians should be determined taking into account age-specific prevalence rates and the established association between stages of school education and certain health disorders.

Introduction: The number of mental and behavioral disorders in juvenile convicts tends to increase and worsen, since this contingent often has a burdened heredity and is prone to development of chronic diseases, and is also committed to the abuse of psychoactive substances.
Objective: To study mental health and mental characteristics of minor convicts incarcerated in juvenile corrections of the Federal Penitentiary Service of Russia based on long-term data of statistical analysis and psychological testing.
Materials and methods: We used forms of departmental statistical observation to study mental health of juvenile convicts. Psychological characteristics of 122 juvenile male convicts aged 15–17 years were assessed in 2021 using the Eysenck Personality Questionnaire and Leonhard–Shmishek Test and then compared with those observed in a similar age and sex group of adolescents. To establish specifics of the incidence in the juvenile convicts, we also compared their disease rates with those registered and sex-adjusted in teenagers aged 15–17 years. We calculated extensive and intensive indicators, 95 % confidence intervals, and statistical significance of differences using the t-tests and the χ-square test.
Results: The incidence of mental and behavioral disorders in juvenile convicts incarcerated in juvenile corrections was 10.9 times higher than the standardized incidence in 15 to 17-year-old adolescents (14,050.6 ± 3,881.3 and 1,290.4 ± 427.9, respectively; p < 0.01). We established a low proportion of melancholics (2.9 % (95 % CI: 0.9–7.2), p < 0.05) and the predominance of stable types of temperament in those convicts.
Conclusions: The incidence of mental and behavioral disorders in juvenile convicts incarcerated in juvenile corrections is 11 times higher than the sex-standardized incidence in their 15 to 17-year-old peers. Hyperthymic and excitable types of personality accentuation prevail in them with a pronounced tendency to stable types of temperament.

Introduction: One of the promising ways to improve the quality of life and life expectancy of the population is harmonization of the drinking regimen aimed at reducing the risk of the negative impact of increased levels of drinking water components and correcting the deficiency of a number of essential microelements.
Objective: To conduct a questionnaire-based survey of young people living in the Altai Region and adjacent territories to determine the proportion of males and females who consume bottled water, taking into account added essential trace elements, duration of regular use, and the approximate volume of general water consumption.
Materials and methods: The study involved 2,068 people, including 1,534 women and 534 men with the mean age of 20.7 ± 2.3 years and 20.6 ± 2.1 years, respectively. The survey was conducted during the second half of 2022 and the results were analyzed in January 2023.
Results: The statistical frequency analysis showed that the structure of bottled water consumption in the young men did not differ from that in the whole sample and the women. The majority of young people (82.0 to 83.5 %) of both sexes actively used bottled water for drinking purposes, and 8.5 to 12.2 % of them consciously chose bottled water with added essential trace elements. The median time of constant bottled water consumption among all the respondents was 5 years with the first and third quartiles of 1 and 10 years, respectively. A statistical relationship was established between sex and the volume of water consumption: the young women were prone to consume less while a large proportion of young men was found to consume more water than required for optimal hydration.
Conclusions: Ensuring proper drinking regimen is an important task for health maintenance of young people, which should be addressed through creation of specialized health schools on the basis of regional centers for prevention of non-communicable diseases and/or disease prevention departments (offices) of medical institutions.

Introduction: Stability of physicochemical parameters of body fluids reflects the degree of influence of environmental factors on the body.
Objective: To assess the body response to snowmelt water consumption for drinking purposes in military personnel serving in the Arctic based on blood parameters.
Material and methods: The study was conducted in summer 2022. We took snowmelt water samples for chemical analysis and venous samples from 51 servicemen for a complete blood count and electrolyte measurements.
Results: Snowmelt testing showed that the levels of iron were 1.2–1.6, copper – 22.2, zinc – 52.1, sodium – 11.6 to 21.9, magnesium – 5.7 to 29.1, and calcium – 9.0 to 34.1 times lower than reference concentrations. Potassium levels were negligible. The length of service of the study subjects in the Arctic above the 76th parallel North was 5.7 ± 0.3 years. Blood test results showed low or lower normal values of erythrocyte count in 39.2 %, hematocrit – in 19.6 %, and mean hemoglobin – in 13.7 % of the military personnel. A high mean corpuscular volume was detected in 17.6 % of them. The proportion of stab neutrophils in the sample was 0.55 ± 0.04 % with the normal range of 1 to 6 %. The electrolyte imbalance was evidenced by high serum potassium levels in 21.6 %, a lack of ionized calcium and magnesium in 29.4 % and 17.6 %, respectively, and sodium, phosphorus, and chlorine levels at the lower limit of the normal range in 29.4 to 47.1 % of the examined.
Conclusions: Snowmelt water contains low concentrations of inorganic chemicals. Its long-term daily consumption for drinking purposes leads to electrolyte imbalance in the body, such as hypotonic water overload, and is likely to affect nonspecific resistance.

Introduction: Adverse human health effects of motor vehicle noise, which levels are the highest in urban areas, are considered in many foreign and domestic studies.
Objective: To establish the zone of acoustic discomfort related to motor vehicle noise on the territory of new residential complexes in the city of Voronezh.
Materials and methods: Using the “Assistant” sound level meter (accuracy class 1), we conducted 72 noise measurements at 36 monitoring points within the 20.5 hectare area of two residential complexes at distances of 7.5, 50, 100, 200, 300, 350, and 430 meters from the four-lane highway, the main local source of traffic noise. The measurements were taken in May 2023 on working days (Monday to Friday) in the daytime and at night.
Results: We have established that modern urban planning technologies and solutions used in the construction of new residential complexes are unable to eliminate the zone of acoustic discomfort. According to the results of field measurements, the equivalent noise level along the highway in the daytime exceeds permissible levels by 17.8–19.7 dBA and at night – by 22.6–25.7 dBA. The noise limit is also exceeded in the inner yard (on the playground, in the recreation area). The significant area of the study object is almost completely affected by traffic noise at the distances of up to 100 m and 200 m in the daytime and at night, respectively, which creates an unfavorable acoustic environment that has a negative impact on the local residents.
Conclusions: To reduce the area of the acoustic discomfort zone, it is recommended to take measures to reduce traffic intensity in the study area by developing the road network and public transport system, prohibiting motorcycle and freight traffic on this street, especially at nighttime, improving landscaping of the adjoining territory, and installing transparent noise barriers that will prevent noise transfer between houses to the inner territory of the residential complex and the lower floors of the buildings.

Introduction: Optimization of epidemiological and microbiological monitoring of nosocomial infections at the regional level will contribute to limiting circulation and spread of pathogens and improving preventive measures on the territory of the Russian Federation.
Objective: To determine directions of optimization of epidemiological and microbiological monitoring of healthcareassociated infections in surgery departments and intensive care units of hospitals of the Republic of North Ossetia – Alania.
Materials and methods: We carried out a retrospective epidemiological analysis of the incidence of nosocomial infections and results of microbiological monitoring conducted in surgery departments and intensive care units of ten multidisciplinary hospitals of the Republic of North Ossetia – Alania in 2015–2019. We also examined data on evaluation of preventive measures, infection control, and compliance with criteria of internal quality control and safety in health care.
Results: According to the results of routine surveillance and specially organized epidemiological and microbiological monitoring, the incidence rates of healthcare-associated infections were 0.85 and 26.4 per 1,000 inpatients in surgery departments and intensive care units of hospitals of the Republic of North Ossetia – Alania, respectively. The incidence rates of certain types of nosocomial infections were statistically different (p ≤ 0.05) depending on the type of monitoring (routine/optimized): surgical site infections – 15.9/132.8 per 1,000 surgeries, catheter-associated urinary tract infections – 8.5/69.4 per 1,000 catheter days, central line-associated bloodstream infections – 7.74/89.12 per 1,000 catheter days, and ventilator-associated pneumonia – 8.12/39.74 per 1,000 ventilator days. K. pneumoniae strains isolated from surgery and intensive care patients and exhibiting extreme resistance to antimicrobial drugs belong to sequence type 1082, possess a high pandemic potential, and are widespread in many countries. According to the results of assessing compliance with the criteria of internal quality control and safety of health care, only three of ten hospitals in the Republic of North Ossetia – Alania had the compliance rate ≥ 70 %. As for the readiness for infection prevention and control in surgery departments and intensive care units, 60 % of the hospitals demonstrated a basic level and 40 % – an intermediate level of measures taken.
Conclusions: Optimization of approaches to tracing healthcare-associated infections in the hospitals of the Republic of North Ossetia – Alania helped establish that actual incidence rates of nosocomial infections were on the average 26.4 times higher than those officially registered based on the results of routine surveillance.

Background: The active spread of Aedes albopictus mosquitoes, epidemiologically important vectors for the transmission of dangerous arboviruses, on the Black Sea coast of the Krasnodar Region necessitates prompt analysis of the results of their monitoring using modern geographic information systems.
Objective: To analyze the results of practical application of the ZikaMap web portal for tracing migration of tiger mosquitoes along the Black Sea coast of the Krasnodar Region in 2016–2022.
Materials and methods: We used Aedes albopictus migration monitoring data for 2016–2022 from the ZikaMap web portal. Mosquito counts were taken in Novorossiysk, Anapa and Tuapse districts, and Sochi with the total of 476 objects and 2,366 stationary points examined.
Results and discussion: Tiger mosquitoes were found on the territory of epidemically significant objects four times (in the years 2018–2019 and in 2021) and once (in 2017) at a distance of 500 m from them (within the flight range of the Aedes mosquito). Immediately after that, emergency local disinfestation treatment was carried out. The highest abundance of Ae. albopictus (both in absolute numbers and catch per trap per hour) during the entire study period was registered in the Central District of Sochi, with a decrease observed since 2020. Results of the annual comparative cartographic analysis for 2016–2022 indicate the expansion of the boundaries of the Ae. albopictus habitat on the territory of the Black Sea coast of the Krasnodar Region 122 km northwards and 83 km westwards.
Conclusion: It is expedient to continue developing real-time geographic information technologies in order to optimize approaches to monitoring and assessment of the current epidemic potential of natural foci of vector-borne and zoonotic infections and to improve the efficiency of response to potential worsening of the epidemic situation.