The research object of the study is represented by the adult working age population of the Russian Federation. The aim of the study is to develop proposals for improving preventive work with the population based on investigating medical and demographic indicators and analysis of morbidity among the adult working age population of the Russian Federation. The study relied on using analytical methods, statistical methods, and direct observation. We used data provided by Rosstat and the Russian research Institute of Health, the RF Ministry of Health, over the period 2014–2023 and data taken from federal and branch statistical reports. Over five years (2019–2023), the working-age population increased from 82 to 85 million. The mortality rate of the population of the Russian Federation decreased after a sharp rise in the year of COVID-19 (2019) and in 2023 the indicator became lower than in 2019, amounting to 1206.2 ‰00. At the same time, the mortality rate of the working-age population decreased after a sharp increase in 2020, but in 2023 it remained slightly higher than in the pre-COVID period, which determines the importance of preserving the health of the country's human resources. In the structure of newly identified morbidity of the adult working-age population of the Russian Federation (in 2023), the class of respiratory diseases is in the first place (more than 40 %), followed by injuries, poisoning and some other consequences of exposure to external causes, diseases of the genitourinary system, diseases of the skin and subcutaneous tissue, etc. Analysis of the primary and general morbidity of the adult working-age population in the Russian Federation in dynamics in the pre-COVID year (2019) and the years of the pandemic (2020-2023) revealed an increase in certain diseases caused or complicated by COVID-19, which require rehabilitation, more intensive preventive work and mass health examinations with wider coverage. In conclusion, we propose some organization forms of preventive work with the population, including working age population.
The aim of this study was to estimate the risk of modified clinical course of viral respiratory diseases (influenza, ARVI, COVID-19) due to environmental exposures and effects of lifestyle factors considering regional peculiarities in the Russian Federation. The study relied on using data from federal statistical reports issued in 2010–2019 for 82 Russian regions. ARVI and influenza incidence was analyzed. A set of social and hygienic determinants (SHD) was represented by 112 indicators grouped in 7 domains. Multiple linear regression was used to estimate contributions made by unmanageable weather and climatic factors (UV-radiation intensity, humidity, air temperature, wind speed, deviation from average long-term temperature levels). An artificial neural network (multilayer perceptron) was used to assess effects produced by other environmental and lifestyle factors. Risk was calculated as a product of disease likelihood (Δp), determined by SHD, disease severity (g) and coefficient of modified disease duration (w). Approximately 60 % of actually registered annual ARVI and influenza incidence was found to be caused by combined effects of the analyzed factors. Weather and climatic factors had more stable and considerable effect on this incidence relative to other environmental exposures. A four-level scale for risk classification was created based on its calculated values over 2012–2019 (minimal, permissible, alerting, and high) together with outlining relevant risk management activities. Scenario calculations allowed revealing the most significant factors for decreasing ARVI and influenza incidence. If ranked in the descending order, they were quality of the public healthcare system, lifestyle, sociodemographic indicators, background incidence rates, economic indicators, and sanitary-epidemiological indicators (0.52, 0.49, 0.45, 0.32, 0.28 and 0.21 cases per 100 thousand people respectively). An increase in the number of vaccinated people was found to make the greatest contribution to incidence decline among all manageable factors (on average, 0.8 cases per 100 thousand people). The developed methodical approach based on a cascade of mathematical models, makes it possible to quantify contributions made by manageable and unmanageable factors to modified course of respiratory epidemics (ARVI and influenza). The study results and the risk scale can be used for substantiating targeted preventive and anti-epidemic activities, regional specificity taken in account.
The phenomenon of ‘metabolically healthy obesity’ is of great interest to researchers around the world. This is determined by two complementary standpoints: 1) the investigated obesity phenotype, under exposure to additional risk factors, may represent an intermediate state leading to ‘metabolic unhealthiness’; and 2) if this is true, this phenotype is a research object for searching triggers of diseases prevention. Due to absence of biochemically substantiated changes, groups of analyzed pre-nosologic states were divided per body mass index as an integral sign of metabolism effectiveness. This was made allowing for the obviously multi-level structure of metabolic processes where the physiological optimum as the main target is maintained at the cellular level and compensation for growing deviations requires involvement of the managing nuerohumoral system, vegetative regulation included. This is manifested through changes in structures that support metabolic homeostasis. The aim of this study was to estimate the reserve and stability of regulatory metabolic systems within analyzing potential cardiometabolic risks for people with ‘metabolically healthy obesity’. A single-time cross-sectional study was conducted on a continuous sample of 34 healthy volunteers aged 18 to 43 years with body mass index of 18.5 to 30.0 kg/m2 and a verified diagnosis of ‘healthy’. Using standard laboratory methods, biochemical blood tests were performed one hour after a standardized meal, and insulin and cortisol levels were additionally determined in blood plasma. Standardized food load was used as a universal irritant in estimating changes in the metabolic status as a health measure. This allowed us to reveal the maximum involvement of metabolic regulators or the system ‘tension’. We analyzed strength of statistical relationships between analyzed indicators. The analysis clearly showed that ‘higher’ levels of metabolic regulations steadily became more and more involved in healthy volunteers as their body weight grew and hyperinsulinemia occurred. This involvement grew from the first cellular level that induced a strictly identified specific response aimed at achieving a justified physiological effect and determined point control through the organ level where local interactions became more tensed to the body level where physiological responses occurred with their orientation at long-term effects. When control over metabolism regulation goes to the nuerohumoral system in hyperinsulinemia presence, this means a certain functional mark in evolution of ‘metabolically healthy obesity’. This process is the key link in an individual risk trajectory since it marks the transition from compensated pseudo-health to a phase when prenosologic disorders are formed quite actively. Personalized risk stratification and timely preventive interventions should rely on revealing and estimating this process.
The aim of this study was to assess dose thresholds and their uncertainties for different severity degrees of acute radiation syndrome (ARS) and to establish relative risk (RR) of transition from preceding ARS severity degree to a higher one. The study objects were represented by 104 individuals with ARS developed after Chernobyl disaster at the Chernobyl nuclear power plant in 1986 with literature available data on ARS severity degree and verified external g-β-radiation doses. Empirical dose distributions in each group of ARS severity degree were approximated by the distribution function based on Weibull model; dose thresholds (D0) and their uncertainties (U, %) were calculated by pairwise examination of distribution functions for the study groups; RR of transition from preceding ARS severity degree to a higher one were calculated by using fourfold tables. The calculation results were presented in the paper in pairs in accordance with the ARS severity degrees: Groups I–II (D0 = 1.95 Gy; U = 9.38 %; RR = 3.05), Groups II–III (D0 = 3.96 Gy; U = 4.63 %; RR = 5.93), Groups III–IV (D0 = 6.13 Gy; U = 6.81 %; RR = 8.82). The study findings have not only scientific but also practical significance as they make it possible to predict ARS severity degrees more accurately if data are available on external radiation exposure doses after a radiation accident. It is also proposed to correct the regulated dose range for IV severity degree of bone marrow ARS syndrome based on these findings.
Research objects were represented by bream, zander, and sabrefish as valuable commercial fish species from the Gorky Reservoir. The aim of the study was to determine the elemental composition of the muscle tissue and gonads of fish from the Gorky Reservoir and to assess the human health risks associated with consuming this fish. Fish was caught by trawl at the stations in the reservoir. Muscle tissue and gonads were selected for analysis, weighed, and frozen at -18 °C until analysis. In the laboratory, the tissues were dried at 60 °C to constant mass, ground in a laboratory mill, and then ashed in a muffle furnace at 550 °C. Cd, Pb, Al, Co, Ni, Zn, Cu, Li, Cr, and V were determined in the samples using an Agilent 7500 inductively coupled plasma mass spectrometer (ICP-MS) (USA), and Mn, Fe, and Mg were determined using a KVANT 2-AT spectrophotometer (Kortec Ltd., Moscow, Russian Federation). Potassium content was determined using flame emission spectrometry. Fish consumption was calculated based on FAO data, taking into account the mass fraction of meat and gonads. Assessment of the associated human health risks involved calculating the hazard coefficient, the cumulative risk, the chronic daily intake of metals, the cancer risk, and the total cancer risk. Elevated contents of several metals were found in sabrefish tissues relative to bream and zander. This may be due to a wider feeding spectrum of this species. The obtained values of the daily intake of metals from the tissues of the examined fish did not exceed the permissible daily intake and the recommended daily allowance for the adult population. The values of the target hazard quotient and the total hazard index for all elements did not exceed the permissible threshold. The value of the total target cancer risk caused by consuming bream meat exceeded permissible levels. Non-carcinogenic and carcinogenic risk indicators were higher for consumption of consuming bream tissues relative to zander and sabrefish tissues. Our findings can be used for informing the population about potential health risks caused by consumption of local commercial fish species caught in the Gorky Reservoir.
Currently, student families are a demographic resource for the state, and at the same time, they are the most vulnerable population group due to their young age and incomplete maturity. Unfavorable influencing factors are associated with the risk of declining reproductive potential and, as a consequence, the deterioration of the demographic situation in the country. A comprehensive assessment of risk factors for reproductive health disorders, taking into account age and future occupation, can become a tool for organizing medical and preventive measures. The study involved 200 students from medical and non-medical educational institutions and focused on assessing impacts of certain groups of risk factors leading to a decline in reproductive potential. Four groups of factors were studied: social, characterizing healthy lifestyle, psychological health, and reproductive literacy. Family was shown to have a significant role in formation of future reproductive behavior; the study revealed health disorders affecting reproductive potential among students. Differences were observed depending on the identified groups according to the following parameters: "closeness of relationship with parents" (p < 0.001); "attitude towards abortion" (p < 0.001); awareness of the "Pearl Index" concept (p < 0.001*). A different level of reproductive literacy was established, with medical university students being more reproductively literate. The study involved assessment of risk factors affecting the reproductive potential of student youth. According to our findings, each of the studied groups requires correction of lifestyle and influencing risk factors to increase reproductive potential.
The article focuses on establishing risks of side reactions caused by using aqueous extract of Picea abies mega-strobiles for three months and provides histological results for internal organs obtained in an experiment. The aim of this study was to establish safety of aqueous extract of Picea abies mega-strobiles by estimating its effect on various organs and tissues of experimental animals in a sub-chronic toxicity test. Picea abies mega-strobiles were harvested on the territory of the Perm region in the Russian Federation in a fir tree forest with green moss and grass cover. Dry aqueous extract was obtained according to the original patented method. An experiment was conducted using white outbred Wistar rats of both sexes. The analyzed extract was administered daily for three months. Distilled water was administered in the control animal group as equivalent stress exposure. The element structure of bone samples was established using x-ray fluorescence with an energy-dispersion x-ray fluorescent spectrometer. Heart, kidneys, stomach and small intestine were extracted from the experimental animals for microscopic examination. Chronic oral administration of aqueous extract of Picea abies mega-strobiles into healthy inflammation-free rats did not cause any changes in their behavior, mucosa or fur as confirmed by comparative analysis of the indicators between the test and control animal groups, the latter not exposed to the extract. Histology of the gastrointestinal organs (stomach and small intestine) did not find any differences between the test and control groups; no differences were found between male and female rats in the test group either. The experiment did not establish any toxic effects produced on the heart or kidneys by aqueous extract of Picea abies mega-strobiles. The results obtained by analyzing rats’ stomach and small intestine as well as heart and kidneys indicate absence of any significant differences between the test and control group. The analysis of the bone element structure revealed a trend for growing levels of calcium and phosphor in rat bones in the test group (exposed to aqueous extract of Picea abies mega-strobiles). These findings make it possible to conclude that use of aqueous extract of Picea abies mega-strobiles at the dose of 12 mg/kg for 12 weeks did not cause any significant impairment either in mucosa, fur, or internal organs of experimental animals.
Prostate cancer (PC) is one of the most common malignant neoplasms in men worldwide. In Russia, this type of cancer ranks second in the structure of male mortality, while the country is in the top 10 in terms of mortality from this disease. Studying the risk factors for PC development is of particular importance for developing effective preventive measures. The aim of this study was to conduct a comprehensive analysis of current scientific data on influence of medical and social factors on prostate cancer development and to identify the main determinants of the disease risk. This study included a systematic review of the scientific literature from leading international and domestic databases. The following databases were used: PubMed/MEDLINE; Scopus; Web of Science; eLibrary; Cochrane Library. This study was based on the results of large population-based and sociohygienic studies that included analysis of data on influence exerted by various factors on prostate cancer development. The search period was 2005–2025. The research methodology is based on a systematic review of scientific literature. The study identified key risk factors for PC development, including unfavorable dietary habits (excessive consumption of red meat, lack of vegetables); low physical activity; smoking and alcohol abuse; overweight and obesity; exposure to occupational hazards; environmental factors; effects of ionizing radiation. Most PC cases were established to develop due to combined effects of genetic and environmental factors. The results of various studies demonstrate some inconsistency, indicating the need for further research in the area of prostate cancer prevention. Development of comprehensive measures to reduce the impact of modifiable risk factors is of particular importance. The study results may serve as a basis for improving prevention and early detection programs for prostate cancer as well as for developing targeted measures to reduce the incidence of the disease.
Acrylamide is a heat-induced contaminant with potential carcinogenicity (IARC Group 2A). This study aimed to determine the occurrence and estimate the dietary exposure to acrylamide in commonly consumed processed foods in Vietnam. Representative food samples were collected from retail markets and supermarkets across major cities. Acrylamide was quantified using a validated LC-MS/MS method. Estimated daily intake (EDI) was calculated based on adult food consumption data. The margin of exposure (MOE) was derived using the European Food Safety Authority (EFSA)'s benchmark dose lower confidence limit (BMDL10) of 0.43 mg/kg bw/day for neurotoxicity and 0.17 mg/kg bw/day for carcinogenicity. Acrylamide was detected across all major food groups, with an overall mean concentration of 168 ± 109 µg/kg. The highest average concentrations were found in roasted and instant coffee (267 ± 51 µg/kg) and fried/baked potato products (181 ± 99 µg/kg). The estimated overall mean EDI for Vietnamese adults was approximately 1.36 µg/kg bw/day. The incremental lifetime cancer risk (ILCR) at the P95 percentile exceeded the 1•10-4 threshold for two food groups. The findings indicate a potential public health concern, particularly for high consumers, and suggest performing targeted risk management measures, focusing on mitigating concentrations in potato snacks, instant starch products, and fermented beverages.
The article presents a comprehensive analysis of trends and dynamics in the structure of mortality in the Kyrgyz Republic from 2018 to 2023, considering the impact of the COVID-19 pandemic and socio-demographic factors. The aim of the study was to identify patterns in changes in mortality indicators by major classes of diseases and to determine medical and social determinants influencing the level of preventable mortality. The study results may provide a basis for further risks of medical and demographic losses in the country. Official data from the Center for Electronic Health of the Ministry of Health of the Kyrgyz Republic were used as the primary source. The analysis was carried out per main classes of diseases according to ICD-10, with the calculation of time-series indicators and comparative assessment of data by regions, including the Chuy Region. The study results showed that the COVID-19 pandemic caused a sharp increase in mortality in 2020, followed by a gradual decline and stabilization of mortality rates. The main contribution to the overall mortality structure was made by diseases of the circulatory system, respiratory diseases, neoplasms, and endocrine disorders. In 2020–2021, there was a significant increase in mortality from cardiovascular and respiratory diseases, which was consistent with global trends in excess mortality during the pandemic. At the same time, pronounced regional disparities were identified, along with a persistently high level of preventable mortality among the rural population largely due to limited access to healthcare and low awareness of risk factors. The analysis confirms that mortality dynamics is determined not only by medical but also by socioeconomic and environmental factors. The findings highlight the need to improve the system for monitoring causes of death, enhance the quality of preventive and diagnostic measures, and strengthen primary healthcare. The presented data are of practical importance for specialists in public health, demography, and social policy since they help to develop effective measures for managing demographic processes. A comprehensive approach to managing medical and demographic indicators should form the basis for developing national strategies aimed at reducing preventable mortality and increasing life expectancy in the Kyrgyz Republic.
In the age of digitalization, more and more adolescents are faced with the problem of excessive internet use, making it important to predict internet addiction and associated psychosomatic disorders. The aim of this study was to identify risk factors for internet addiction and its consequences for psychosomatic health in adolescents aged 15–17 years. A comprehensive study involved 507 adolescents aged 15–17 years attending municipal budgetary general education institutions in Ivanovo. Internet addiction was assessed using S. Chen's method; personality traits were determined using the Eysenck test, and parenting methods were assessed using E. Shafer's questionnaire "Parental Behavior and Adolescents' Attitudes Toward Them". Neurotic disorders were identified in the adolescents using the author's questionnaire. Data on somatic pathology were taken from child development records (Form No. 112/u) and schoolchild medical records (Form No. 026/u). Individual physical development was assessed using the sigma deviation method relying on local age standards. Data were statistically analyzed using conventional methods of variation statistics. Risk factors for the formation of Internet addiction in adolescents included high level of neuroticism (OR = 11.1, 95 % CI: 4.2–29.1), an extroverted personality type (OR = 2.5, 95 % CI: 1.0–6.4), upbringing with weak positive interest (OR = 1.75, 95 % CI: 0.48–6.3), and parental autonomy (OR = 6.2, 95 % CI: 1.5–26.3). Internet addiction is a risk factor for neurotic disorders (hyperdynamic and asthenic syndromes (OR = 5.3, 95 % CI: 2.2–12.7), phobic syndrome (OR = 2.9, 95 % CI: 1.3–6.5), compulsive movement syndrome (OR = 3.4, 95 % CI: 1.5–7.9), diseases of the eye (OR = 3.6, 95 % CI: 1.5–8.9), digestive organs (OR = 7.3, 95 % CI: 1.9–27.3), musculoskeletal system and connective tissue (OR = 3.2, 95 % CI: 1.4–7.3), and body weight deficiency (OR = 3.1, 95 % CI: 1.1–8.9). The identified risk factors for Internet addiction and the risk factors for psychosomatic disorders in Internet addiction justify the importance of comprehensive interdisciplinary rehabilitation for adolescents as well as a system for preventing health risks of the foregoing health disorders.
This study aimed to describe the status of post-COVID-19 symptoms and their impact on the quality of life in Vietnamese people. The secondary analysis was performed on the data from a cross-sectional study conducted in Vietnam in 2022. Of the 972 participants, 76.75 % reported experiencing at least one COVID-19 symptom. Respiratory and heart symptoms and neurological symptoms were the types of symptoms that were reported the most. An increase in post-COVID-19 symptoms has an association with an increased number of problems in life quality. Pain/discomfort and anxiety/depression were the most common problems regarding the quality of life (35 % and 24.5 %, respectively). Problems with quality of life were significantly associated with all listed post-COVID-19 symptoms, in which depression and anxiety showed the highest impact. The high prevalence of post-COVID-19 symptoms and their impact on quality of life suggests that the effects of COVID-19 can persist after initial recovery, even in the long term.
The work is a systematic review focused on analyzing methods for determining specific concentration limits (SCL) for chemicals hazardous to human health. The literature search was conducted up to November 2024 in the electronic databases PubMed, Google Scholar, and CyberLeninka, and up to April 2025 in ScienceDirect and eLIBRARY.RU. Outside the scope of the systematic review, the possibility of determining SCL using alternative methods (AM) described in OECD standards was analyzed for substances cor-rosive/irritating to skin, able to cause serious eye damage/irritation, or skin sensitizers. The review included publications in Russian and English describing experimental and calculation approaches to es-tablishing SCL. Studies related to waste were excluded. Screening and assessment of publications were performed by a single author; data synthesis was descriptive. A total of 14 studies were included in the systematic review. No methods for determining SCL were identified for respiratory sensitizers and mutagens. For substances causing skin corrosion/irritation, serious eye damage/irritation, and for skin sensitizers, current regulatory practice relies on in vivo approaches and human data. To reduce the number of laboratory animals and optimize the procedure for establishing SCL for substances corrosive/irritating to skin and eyes, the author proposed a basic concentration range (BCR) designed to enable more efficient use of AM. For skin sensitizers, carcinogens, and reproductive toxicants, SCL are determined based on toxicant potency and hazard (sub)class, which may complicate the implementation of a similar approach in the EAEU. Moreover, the numerical descriptor ranges used for substance categorization are often based on expert consensus. The review did not include publications in other languages or those from paid-access databases; quantitative synthesis was not conducted due to the qualitative nature of the data. This work identified critical gaps in the existing methods for determining SCL, highlighting the need developing and validating new test systems suitable for integration into regulatory practice.
The relevance of the study comes from well-known facts that high-dose repeated daily administration of nitrates can induce methemoglobinemia, create elevated cancer risks, lead to endocrine diseases, cardiovascular diseases, diseases of the digestive system, negative pregnancy outcomes, and elevated formation of nitrosamines. This study investigates nitrate pollution in groundwater and its associated health risks across different age groups in northeastern Saudi Arabia. The nitrate concentrations were measured in various well types, including commercial water stations, untreated commercial stations, private domestic wells, and agricultural wells. No detectable pollution was established in 65 % of the examined wells while 18 % exhibited high levels of pollution. The highest nitrate concentrations were found in the agricultural and gardening wells, ranging from 80 to 250 mg/L, surpassing the 50 mg/L acceptable threshold. Chronic daily intake (CDI) values ranged from 0.4 to 24.3 mg/kg/day across all age groups (the safe level being 1.6 mg/kg/day). Chronic daily intake was 15 times higher than recommended safe levels for infants and up to 12 times higher for children. Hazard quotient (HQ) assessments further emphasized the unacceptable health risks, particularly for younger populations. Specifically, 55.55 % of the samples posed potential non-cancer health concerns for infants. The findings underscore the critical need for improved water management in northeastern Saudi Arabia and greater public health awareness in the region.
Relevance of the present study comes from the necessity to choose the most effective and economically feasible ways to achieve emission quotas by enterprises, to reduce ambient air pollution and to fulfill performance indicators set within the Clean Air Federal Project. The aim of this study was to test an estimation procedure per hygienic indicators using a specific example. The indicators included health risk levels, possibility and sufficiency of redistributing and offsetting emission quotas in a large industrial city. The research object was represented by large heat power stations (HPS) located in a large industrial city. They suggested offsetting emission quotas by discounting emissions from 28 low-effective coal-fueled boiler houses, which were to be liquidated. HPS plan to modernize their own facilities to increase energy production capacity. We calculated dispersion of emissions from more than 20 thousand sources overall in the city under levels of ambient air pollution established in the baseline 2017 as well as under levels established after the required quotas were achieved. The latter calculation took into account the suggested quota redistribution per sources and liquidation of low-effective coal-fueled boiler houses with their capacities being moved to facilities belonging to large heat power stations. Ambient air pollution was established to create unacceptable carcinogenic and non-carcinogenic acute and chronic health risks for the city population in the baseline 2017. The risk was assessed as ‘alerting’ and / or ‘high’ at various control points across the city. Contributions to unacceptable carcinogenic risks made by large energy-producing facilities and boiler houses to be liquidated reached 8.4 % in some areas in the city. The Project performance indicator, which is to reduce emissions of priority pollutants by not less than 20 %, is fulfilled after the set redistributed quotas have been achieved. Impacts of boiler houses, which were located diffusively across the city, have been eliminated completely (7.6 % of the achieved reduction). HPS have reduced their emissions by 12.6 % relative to 2017 due to relevant activities implemented at their facilities. When the required emission quotas are met, the analyzed facilities do not violate safe standards and do not create unacceptable health risks. In addition, spatial changes are observed in concentration fields. We have revealed a growth in a contribution made by a facility at the point of unacceptable health risks, mostly created by other pollution sources. Offset and redistribution of emission quotas between pollution sources within one given settlement seems a feasible and effective instrument for achieving conformity with safe standards set for ambient air quality and acceptable health risk levels. The procedure for offsetting and redistributing quotas between pollution sources requires developing and fixing in regulatory, legal and methodical documents. A decision on quota offset and redistribution can be and should be made only after all relevant hygienic assessments have been completed, health risk assessment included. It seems optimal to combine calculations and field data when verifying quota redistribution with the emphasis put on data obtained by instrumental measurements accomplished within environmental and social-hygienic monitoring.
Glaucoma is the leading cause for ophthalmological disability. The disease determines the global dynamics in prevalence of the diseases of the eye and adnexa, the Kyrgyz Republic included. Such risk factors as elevated blood pressure, patient’s age, heredity, and diabetes mellitus are largely considered basic causes of loss of eyesight. It seems quite relevant to improve healthcare provided for glaucoma patients at various levels since the disease diagnostics remains an issue open for discussion so far. Glaucoma screening should be performed by primary healthcare experts. Our analysis of glaucoma patients’ health in the Kyrgyz Republic has revealed that elevated blood pressure is typical for 97.0 % of them. The risk factors for the disease include patient’s age over 40 years (93.0 %), hereditary predisposition (91.3 %) and diabetes mellitus (79.0 %). We suggest a systemic approach to improving ophthalmological healthcare for glaucoma patients. It is based on developing a network of glaucoma consulting rooms and centers together with implementing effective patient routing at every level in the public healthcare system. Regular screening among people older than 40 years and patients with concomitant diseases has been shown to be an effective instrument for diagnosing glaucoma at its early stages thereby reducing the risk of disability and loss of eye sight. The following is required to improve high-quality healthcare for glaucoma patients: a before-doctor consulting room at family medicine centers; an ophthalmology consulting room at family medicine centers; an ophthalmology consulting room in polyclinics of the National Hospital and regional hospitals, in the Republican Diagnostic Center, in the Medical center of the Kyrgyz State Medical Academy named after I.K. Akhunbaev; ophthalmological departments in the National Hospital, regional, municipal or territorial hospitals in the Kyrgyz Republic. Tonometry has been shown to be mandatory for patients aged older than 40 years and those with concomitant diseases (diabetes mellitus, coronary heart disease) within primary healthcare provision. In case glaucoma is suspected, a patient is sent to a glaucoma consulting room to be provided with regular medical check-ups, consultations, and in-depth examination. A glaucoma center is the next stage in providing high-quality healthcare; it is a coordinating link in providing ophthalmological care to glaucoma patients.
This study aims to analyze health risks in the Ijen UNESCO Global Geopark (UGG). This quantitative study was conducted in eight sites of Ijen UGG in Bondowoso Region (Gentongan water fall, Kalipait acid flow, Megasari peak, So'on solor stone, Black lava plalangan, Blawan hot spring, Wurung crater, and Paltuding). Health risk was the main variable composed by four criteria, namely, sanitation risk, operational risk, visitor safety risk, and natural disaster risk. Health risk was categorized into high (score: ≥ 217), moderate (score: 74–216), low (score: 73–144), and no risk (score: ≤ 72). The data were analyzed descriptively. The environmental sanitation risk assessment found deficiencies in clean water, suboptimal waste management, and a shortage of appeal boards. Operational risks involved shortages of health facilities, signage, and warnings. Visitor safety risks were related to dangerous trail conditions, while natural disaster risks were related to potential fires, floods, and flash floods. The environmental health risk exhibited the highest sanitation risk at the Kalipait Site, the highest operational risk at Gentongan Waterfall, and dangerous visitor safety risk at Gentongan and Kalipait Waterfall. The highest natural disaster risk was identified at the Kalipait geosite. Nevertheless, the highest health risks were established in the Kalipait Acid flow (score: 259), Gentongan Waterfall (score: 246), and Megasari Peak (score: 223). Based on the risk evaluation in Ijen UGG, the majority of Geosites are safe, but those at risk need infrastructure im-provements and community participation. Mitigation and education efforts need to be enhanced to minimize the identified risks. To improve visitor safety, it is necessary to implement public education programs and to train officers how to handle emergency conditions.
The increasing prevalence of metabolic syndrome is driving the search for simple, non-invasive, and cost-effective methods for identifying individuals at risk for its development that allow for the implementation of preventive and personalized medicine principles in managing the risk of cardiometabolic disorders among the working population at minimal cost. The aim of the study is to develop risk predictive models for cardiometabolic disorders in metallurgists. The study focused on the results of periodic medical examinations of workers at a metallurgical plant over the previous five years. Metabolic syndrome was diagnosed in compliance with the criteria of the International Diabetes Federation. The body roundness index (BRI) was calculated. The Shapiro-Wilk test was used to assess the normality of the distribution of the studied parameters. Either the paired Student's t-test or the Wilcoxon signed-rank test (with Bonferroni correction) was applied to determine the statistical significance of differences between means and medians for dependent samples. One-way repeated measures analysis of variance (ANOVA) was used for parameters with a normal distribution across all time point. The Friedman test was employed for parameters with non-normal distributions. A heatmap-based approach was used to visualize correlations between predictors while Cox regression was applied to identify independent predictors of hypertension and metabolic syndrome. The proportional hazards assumption was verified through the visual analysis of Log-Minus-Log (LML) plots. To assess the quality of the models, we constructed ROC curves and calculated the area under the curve (AUC). Using Cox regression with time-varying covariates allowed us to account for the dynamics of changes in workers’ health. Cox regression analysis revealed that the fasting blood glucose level was the strongest independent predictor of the metabolic syndrome over 5 years of observation. As a predictor of metabolic syndrome, BRI demonstrated the best results across all parameters, including an optimal balance between sensitivity and specificity, as well as overall accuracy. The ROC curve comparison showed that the body roundness index is the most accurate tool for predicting the risk of metabolic syndrome in the occupational group under study. The resulting models can be recommended for establishing risk groups among industrial workers exposed to occupational hazards for further development and implementation of personalized preventive medicine programs aimed at early detection and treatment of cardiometabolic disorders.
Nurses are exposed to a complex of unfavorable professional factors in the course of their occupational activity, stress being among the most frequent ones. It is important to form a stable psychoemotional status of future nurses already at a medical college. The aim of the study was to assess the prevalence of stress-associated behavioral factor “Internet addiction” in the lifestyle of female students attending a medical college for nurses and its relationship with formation of anxiety-depressive disorders. The risk of Internet addiction was assessed using the Chen Internet Addiction Scale. Anxiety-depressive disorders in female medical college students majoring in nursing were assessed using the Bass-Darki method for measuring aggressive and hostile reactions. Indicators of Internet addiction behavior were analyzed in female students with aggression and hostility. Minimal risk of Internet addiction was reveled in 44.2 % of the female students; 47.1 % were prone to Internet addiction; 8.7 % had pronounced and stable Internet addiction. The study showed an increase in all forms of aggressive reactions among female students with a tendency to develop Internet addiction: a high degree of hostility, which was formed from resentment and suspiciousness indicators (60.3 %), aggressiveness, and indirect aggression. The results obtained by assessing female students’ aggressive and hostile reactions showed that the risk of manifesting hostility and aggression was 1.6–1.9 times higher in the second group made of female students prone to Internet addiction against the first group, which included female students with the minimal risk of Internet addiction. Our findings give evidence that Internet addiction among female medical college students majoring in nursing is a risk factor increasing likelihood of aggression and hostility. The goal is to provide targeted training on professional values in nursing at a medical college; to create a cognitive-behavioral therapy program for hospital managers aimed at identifying sources of stress at the workplace; and to develop interpersonal skills such as teamwork, behavioral and communication skills, and effective strategies.
Overweight and obesity are a global medical and social problem. Current data indicate a significant role of the intestinal microbiome in the modulation of energy metabolism and the pathogenesis of obesity, while the regional features of the functional characteristics of a healthy microbiome remain poorly understood. The aim is to study the features of the large intestine microbiome in middle–aged men living in the Magadan region, taking into account the variability of body mass index (BMI). In the study, the qualitative and quantitative composition of the large intestine microbiome was assessed by PCR analysis in men permanently residing in the Magadan region. The participants were stratified into two groups according to the BMI value: those with normal body weight and those with overweight/obese. The analysis of the occurrence index revealed significant intergroup differences in the composition of the microbiota: Enterococcus spp. was detected more often in men with a normal BMI than in the overweight sample (by 20 %) as well as Blautia spp. (by 20 %), Streptococcus spp. (by 27 %), Ruminococcus spp. (by 23 %), and Acinetobacter spp. (by 10%); on the contrary, Prevotella spp. was detected less frequently in this group (by 20 %). Bifidobacterium spp. was found to prevail in individuals with a normal BMI, whereas overweight individuals showed an increase in the proportion of the Bacteroidetes phylum and a decrease in the Firmicutes phylum, despite the growth of Lactobacillus spp., observed against the background of a slightly lower microbiological diversity of the large intestine. The study revealed a clear association between changes in the intestinal microbiota in the two study groups and the nutritional characteristics typical for the "Western diet". The most pronounced dysbiotic disorders were observed in the overweight group, where a significant imbalance of macronutrients was detected involving deficiency of protein and dietary fiber against the excessive proportion of consumption of mono-disaccharides. The revealed differences in the microbiota composition between people with normal weight and overweight confirm the possibility to use the microbiotic profile as an additional indicator of the obesity risk. The Study findings are consistent with current ideas about the impact exerted by a diet on intestinal microbiocenosis and also emphasize the need to further study the characteristics of a healthy microbiome in order to develop personalized approaches to improving the quality of life in northern populations.
