Анализ особенностей половозрастного состава населения ХМАО-Югры за 2018-2019 гг.

Purpose of the study: assessment of the level and structure of the incidence of the population to determine the main categories of diseases most common in the Khanty-Mansi Autonomous Okrug-Yugra, as well as making a territorial comparison of the incidence of the population. Materials and research methods: statistical materials from the annual collection “Health of the population of the Khanty-Mansi Autonomous Okrug-Yugra and the activities of medical organizations” and data of statistical reporting on the incidence of the population from the Medstat program were used, in particular, the primary morbidity of the population of the Khanty-Mansi Autonomous Okrug-Yugra in different age groups, the general incidence the population of different age groups of the Khanty-Mansi Autonomous Okrug-Yugra. The analysis used indicators such as primary morbidity, general morbidity, one-year mortality (died within the first year from the date of diagnosis) in malignant neoplasms. Results. The primary morbidity of the population in the Khanty-Mansi Autonomous Okrug-Yugra tends to grow in all age groups. The indicators of primary morbidity of the population of the Khanty-Mansi Autonomous Okrug-Yugra in 2018 are 17.1% higher than in the Russian Federation and 12.2% higher than in the Ural Federal District. In the structure of primary morbidity, the first place is taken by diseases of the respiratory system, the second place in the structure of the primary morbidity of people over working age is taken by diseases of the circulatory system, and the third place is by diseases of the genitourinary system. The overall incidence rate of the entire population is 1896 per 1000 population. In 2018, 41.2 cases of tuberculosis per 100 thousand of the population were detected for the first time in the Khanty-Mansi Autonomous Okrug-Yugra (in the Ural Federal District – 61.6, in the Russian Federation – 44.4 per 100 thousand of the population). This pathology tends to decrease and compared with 2017 decreased by 10.2% (the Russian Federation decreased by 8.1%, the Ural Federal District – 2.1%). The number of patients with newly diagnosed HIV infection in 2018 decreased by 1.5% compared to 2017 and amounted to 82.3 per 100 thousand population, which is higher than in the Russian Federation (58.5), but lower. than in the Ural Federal District (108.2) per 100 thousand population. Since 2012, there has been a tendency towards an increase in the incidence of malignant neoplasms, but the detection rate of malignant neoplasms at stages III-IV has not changed since 2015 and is 39.5%, which is higher than in the Russian Federation (38.5%). Conclusion: the primary morbidity in the Khanty-Mansi Autonomous Okrug-Yugra in 2018 is 17.1% higher than in the Russian Federation. In the first place are diseases of the respiratory system (48.4%, of which in children – 66.4, and in persons of older working age – 22.2%). In second place in children is infectious pathology, and in people of working age – diseases of the genitourinary system. The second place in morbidity in older people of working age is diseases of the circulatory system. The district has a high level of infectious and parasitic diseases. The number of patients with newly diagnosed tuberculosis is lower than in the Ural Federal District and the Russian Federation. The number of patients with HIV infection is higher than in the Russian Federation, but lower than in the Ural Federal District. There is a tendency towards an increase in the number of malignant neoplasms. The number of neoplasms is lower than in the Ural Federal District and the Russian Federation. In the Khanty-Mansi Autonomous Okrug-Yugra, there is a positive trend in the reduction of socially significant diseases, such as tuberculosis, HIV infection, STIs, alcoholism, drug addiction, injuries and an increase in overall morbidity, including malignant neoplasms, which indicates the availability of medical care, health literacy of the population and carrying out appropriate preventive work.

Introduction. Loss of pregnancy remains an extremely acute public health problem today. Live birth accounts for only 30% of gestational outcomes, all other pregnancies that occur end in reproductive losses: 30% – implantation, 30% – postimplantation, 10% – spontaneous miscarriages. In conditions of declining birth rates, reducing reproductive losses is the most important element of the state’s demographic policy.Аim. Тo assess the reproductive health of women of fertile age in the Tyumen region, registered in antenatal clinics and other medical institutions in connection with pregnancy, as well as the risks associated with an increase in the frequency of diseases endemic for the West Siberian region.Materials and methods. The study used data from federal statistical observation. Statistical analysis of the data was carried out using the statistical program Statistica (version 13.0). Quantitative features are described by absolute and relative (percent) indicators. The difference is considered significant at p < 0.05. Results. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. The incidence of HIV and hepatitis C among pregnant women for five years and for each of the given nosologies exceeds 1% of the number of patients admitted under the supervision of health care facilities. At the same time, since 2018, the incidence of ectopic pregnancy associated with HIV has significantly increased (p >< 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 0.05.Results. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. The incidence of HIV and hepatitis C among pregnant women for five years and for each of the given nosologies exceeds 1% of the number of patients admitted under the supervision of health care facilities. At the same time, since 2018, the incidence of ectopic pregnancy associated with HIV has significantly increased (p < 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 000.1). These data also indicate an increased risk of spontaneous abortion in HIV-infected pregnant women (p < 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control. Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate. >< 000.1). From 2016 to 2019, there has been a steady increase in the incidence of ectopic pregnancies and spontaneous abortion in primary pregnant women. The situation has improved somewhat in 2020. Noteworthy is the high share of medical abortion in birth control.Сonclusions. Despite the increase in the number of women of reproductive age, fertility rates are declining both in the Tyumen region and in the Ural Federal District, as well as in Russia as a whole. The 5-year dynamics of registered pregnancies in the Tyumen region correlates with the dynamics of the birth rate.

Despite of significant advances in the development of healthcare as well as the introduction of new safe diagnosis and treatment technologies of various diseases, the problem of preventing health care-associated infections (HAIs) does not lose its relevance.
 The article presents an data analysis of officially registered HAIs cases within medical organizations of Ural and Siberian Federal Districts. The analysis was carried out on the basis of data from Federal Statistical Observation Forms No. 2 "Information on infectious and parasitic diseases", No. 23-17 "Information on outbreaks of infectious diseases" and additional request materials "Information on medical manipulations and contingents treated" for 2021 and in dynamics for 7 years (2015-2021) in comparison with indicators for whole Russian Federation.
 Statistical data were provided by the Departments of Rospotrebnadzor from Irkutsk, Kemerovo, Kurgan, Novosibirsk, Omsk, Sverdlovsk, Tomsk, Tyumen, Chelyabinsk regions; Altai, Transbaikal, Krasnoyarsk Territory; republics of Altai, Buryatia, Tyva, Khakassia; Khanty-Mansi Autonomous Okrug Yugra, Yamalo-Nenets Autonomous Okrug. Data for Russian Federation were provided by Federal Center for Hygiene and Epidemiology of Rospotrebnadzor according the duties of Ural-Siberian Scientific and Methodological Center for the Prevention of Health Care-associated Infections.
 Based on the analysis results the rating assessment of HAIs detection and registration quality in subjects of Ural and Siberian Federal Districts and the ranking of subjects taking into account the HAIs epidemiological surveillance system functioning activity was carried out. The information presented in the article is intended for employees of Rospotrebnadzor bodies and organizations, medical organizations, educational organizations, executive authorities in the field of healthcare.

The aim of the study. To determine the main trends and medical and organizational prerequisites for adjusting prevention programs at the population level in the Russian Federation based on a long-term epidemiological analysis of complications of childbirth and the postpartum period. Material and methods. The authors analyzed forms No. 32 «Information on medical care for pregnant women, women in labor and women in labor», data from the collection «Main indicators of maternal and child health, activities of the child protection and obstetric services in the Russian Federation» of «Central Research Institute for the Organization of Health Informatization» of the Ministry of Health of the Russian Federation. Statistical analysis was performed using the StatTech v. 3.0.9 program (OOO «Stattech», Russia). Results. A decrease in the number of normal births in the Russian Federation, except for the North Caucasian Federal District, was established. In the Central, Ural and Siberian Federal Districts, an increase in the incidence of hypertension, which complicated childbirth and the postpartum period, is noted. A decrease in the incidence of preeclampsia has been established in the North Caucasus Federal District, while in other territories an increase in this indicator is observed, as in the country as a whole. In Russia, an increase in the incidence of premature placental abruption and a decrease in the frequency of difficult labor are observed. The incidence of placenta previa with bleeding has decreased. The frequency of bleeding due to blood clotting disorders has increased in the Northwestern Federal District. An increase in the incidence of labor dysfunction has been established in the Urals Federal District. In Russia, an increase in the incidence of grade III-V perineal rupture, uterine rupture, obstetric sepsis, diffuse postpartum infection, venous complications, and diabetes mellitus is observed. Conclusion. The study allowed us to determine the incidence trends that can be used as a methodological basis for developing preventive programs.

Purpose of the study: assessment of the features of the geographical location, climatic conditions, economic development, demographic situation, affecting the organization of medical care in the Khanty-Mansi Autonomous Okrug-Yugra. Materials and research methods: statistical materials from the annual collection “Health of the population of the Khanty-Mansi Autonomous Okrug-Ugra and the activities of medical organizations” and data of statistical reporting on the incidence of the population from the “Medstat” program were used. The analysis used indicators such as population density, the proportion of small peoples of the North, the availability of medical care, the proportion of the able-bodied population, indicators of the economic development of the Khanty-Mansi Autonomous Okrug-Yugra. Results. The conditions for the organization and provision of medical care on the territory of the Khanty-Mansi Autonomous Okrug-Yugra are determined by the geographic location of the area, equated to the regions of the Far North, the difficult climatic conditions that negatively affect human health, a significant proportion of the visiting population, poorly adapted to the conditions of the North, a combination of developed urban agglomerations (with a developed healthcare infrastructure) and sparsely populated areas, a significant length of the territory of the Khanty-Mansi Autonomous Okrug-Yugra, problems of transport infrastructure and low transport accessibility of remote areas.The above determine the need for approaches in planning medical care that are not typical for the constituent entities of the Russian Federation (for example, the territory of the Central Federal District). These approaches require increased costs for organizing a network of medical institutions and resource and staffing of medical care to the population, which is quite feasible taking into account the economic situation of the Khanty-Mansi Autonomous Okrug-Yugra. Conclusion. Factors affecting the organization and provision of medical care, and the health of the population of the Khanty-Mansi Autonomous Okrug-Yugra, should be attributed to the harsh climatic conditions, environmental factors associated with the extraction of minerals (oil and gas). Climatogeographic and social conditions are a risk factor for alcoholization of the population, the presence of natural focal diseases. Features of the economic development of the Khanty-Mansi Autonomous Okrug-Yugra requires increased costs for organizing a network of medical organizations, resource and staffing.

Introduction. In large cities an assessment of the impact of environmental risk factors in addition to the levels of air pollution on the morbidity of the population and the medical and demographic situation should take into account the influence of the socio-economic living conditions of the population, both availability and quality of medical care. The purpose of the work is to conduct a comparative analysis, assess the informativeness of indicators of air quality, socio-economic living conditions of the population, the availability of medical care, and identify the priority of these factors in large industrial cities of different regions of Russia. Materials and methods. A comparative analysis of indicators of the ecological situation, socio-economic conditions of living and the availability of medical care to the population in large industrial cities for the period 2008-2018 was carried out according to official statistics. Results. The criterion for choosing cities for the analysis was the population size. Large industrial cities of four Federal districts were selected as objects of research: Central (Central Federal District), Volga (Volga Federal District), Ural (Ural Federal District) and Siberian (Siberian Federal District). The main source of anthropogenic load in the Central Federal District in 50.0% of cities included in the analysis is motor transport, in 25.0% - stationary, in 25.0% the contributions of sources are comparable; in the Volga Federal District in 100.0% of cities - mobile sources; in the Ural Federal District, 50% of cities have stationary sources and 50% have mobile sources. In the Siberian Federal District, in 62.5% of the cities included in the analysis, stationary sources make the main contribution to the anthropogenic load. In cities with a population of 0.5-1 million people, the ratio of monetary income to the subsistence level and the number of doctors per 10,000 population is higher than in cities with population of 250-500 thousand. Limitations. Limited access to quantitative data and time periods. Conclusions. The indicator of anthropogenic load per inhabitant is an informative indicator of the direct impact of atmospheric air pollution on the health of the population in large cities. The ratio of the average per capita income to the subsistence minimum most objectively characterizes the level of material well-being of the population in regions with different levels of economic development. The number of doctors per 10,000 people is an indicator of the inequality of the constituent entities of the Russian Federation in terms of the level of medical provision and the availability of medical care.

The subject of this this research is the normative legal and legal acts of the government bodies of the constituent entities of the Russian Federation included into the Ural Federal District (Kurgan, Sverdlovsk, Tyumen, Chelyabinsk regions, Khanty-Mansi Autonomous Okrug, Ugra and Yamalo-Nenets Autonomous Okrug) that regulate the administrative legal mechanism for exercising the right of citizens to appeal to the government bodies in the indicated regions. Special  attention is given to the importance and need for legal regulation of the issues associated with arranging additional guarantees and exercising the right of citizens to appeal to government bodies, particularly on the level of the constituent entities of the Russian Federation included into the Ural Federal District. Based on the comprehensive analysis of the aforementioned normative legal act and legal acts, the author reveals the peculiarities of legal regulation of the administrative legal mechanism for exercising the right of citizens to appeal to government bodies in the constituent entities of the Russian Federation included into the Ural Federal District, the limits of norm-setting authorities of the listed regions of the Russian Federation, specificities of securing additional guarantees of the rights of citizens to appeal to government bodies in the corresponding regional laws, approaches towards consolidation of the categorical and conceptual apparatus, determination of parties to legal relations in the area of exercising the right of citizens to appeal to government bodies, the role of normative legal and legal acts of the constituent entities of the Russian Federation included into the Ural Federal District within the mechanism of exercising the right of citizens to appeal to government bodies. The conclusion is formulated on the prospect of the approaches of certain constituent entities of the Russian Federation towards legal regulation of the mechanism for exercising the right of citizens to appeal government. The author also makes recommendation for its improvement.

Objective: to analyze the epidemiological situation on Ixodidae tick-borne borreliosis in the Russian Federation in 2019 in comparison with the period of 2002–2018.Materials and methods. The paper uses the data contained in Form No. 2 of the state statistical reporting for 2002–2019 and information obtained by the Reference Center for Monitoring Borreliosis of the Omsk Research Institute of Natural Focal Infections from 74 constituent entities of Russia in 2019. The main research method is epidemiological one with the use of modern information technologies.Results and discussion. In Russia, 8048 cases of tick-borne borreliosis (Lyme disease – LD) were recorded (5.48 0/0000) in 2019. The actual indicators of the LD incidence for the whole country and federal districts (FD) in 2019 were within the confidence limits predicted with linear regression based on the study of the dynamics of the epidemic process in 2002–2018 in the vast majority of cases. A steady upward trend in the LD incidence was observed during 2002–2019 in the Central Federal District due to 10 out of 18 entities (Moscow, Belgorod, Lipetsk, Moscow, Bryansk, Voronezh, Kursk, Ryazan, Tambov, Tula regions); in the Southern Federal District because of the Krasnodar Territory and the Volgograd Region; in the North Caucasus Federal District – because of the Stavropol Territory. Despite the fact that a downward trend in the incidence of LD has been established over the past 18 years in the North-West, Volga and Ural Federal Districts, in some subjects of these regions a trend towards an aggravation of the epidemiological situation is observed (the Komi Republic and Chuvashia, Penza Region). In the absence of a pronounced tendency to change in the incidence rate of LD in the Siberian and Far Eastern Federal Districts, Kemerovo Region-Kuzbass, the Republic of Tuva and the Trans-Baikal Territory where a growing trend has been identified require special attention. In the Ural and Siberian Federal Districts, the share of non-erythema forms among laboratory-confirmed cases of LD was higher than in other regions, which merits further study of the genome-specific features of borrelia populations and their carriers. Effective control of the LD epidemiological situation in Russia is possible provided that the control is improved and maintained, and the capacity of preventive measures and zoological-entomological monitoring of the activity and structure of the natural foci of LD is enhanced in the entities with the long-term tendency towards increase in the incidence of the disease.

The article analyzes the results of the construction, reconstruction and modernization of dairy farms and complexes in the Russian Federation based on data from National reports on the progress and results of the implementation of the State Program for the Development of Agriculture and regulation of agricultural products, raw materials and food markets. Significant differentiation between federal districts and high variability over the years in the number of established livestock farms and milk production volumes on constructed, reconstructed and modernized farms and complexes have been revealed. The number of slaughterhouses and the volume of milk production per facility indicate a predominantly average scale of production on new farms and complexes. The share of milk produced at new, reconstructed and modernized facilities in the gross milk production in agricultural organizations and farms is not significant. However, in terms of gross volumes, their share is significant and varies several times in the federal districts: in the North Caucasus Federal District - 12%, Southern Federal District -18.0%, in the Northwestern Federal District - 30%, Central Federal District – 37%, Far Eastern Federal District – 47%, Volga Federal District – 51%, Siberian Federal District – 57%, Ural Federal District – 77%, in the Russian Federation as a whole – 41%. Calculations show that milk production at existing livestock facilities has decreased in recent years, for example, in 2021: in general, in the Russian Federation - by 67.6 thousand tons, the Siberian Federal District – 43.5 thousand tons, the Ural Federal District – 51.5 thousand tons, the Volga Federal District – 100.6 thousand tons, the Southern Federal District – 4.1 thousand tons. While maintaining the pace of creation, reconstruction and modernization of farms and complexes that developed in 2013-2023, the cycle of technological modernization of dairy farming will range from 30 to 50 years. This will be a serious obstacle to the development of dairy farming according to the scenario of industries with decreasing costs. Increasing the pace of development of dairy farming requires adjusting the directions and forms of government support for the industry to accelerate the technological modernization of the main milk producers - agricultural organizations and farms with medium–scale production.

Introduction. Ural Federal District (UFD) has been one of the most HIV-affected areas in the Russian Federation during past 20 years. The total number of people living with HIV/AIDS (PLWH) and receiving antiretroviral therapy (ART) exceeds 100,000 (61.7% of all PLWH in the UFD), which creates opportunities for the wide spread of resistant HIV strains.Research aim was to determine the distribution of HIV-1 subtypes, evaluate the genetic heterogeneity of HIV-1 strains, and analyze the prevalence of HIV-1 drug resistance mutations (DRM) and the incidence of acquired resistance to antiretroviral drugs (ARVDs) in PLWH receiving ART in the UFD.Materials and methods. 223 patients receiving ART at stage III–IV of HIV infection living in the UFD were examined. To determine the subtypes and the DRM in the HIV-1 pol gene, molecular genetic studies were performed using the AmpliSense® HIV-Resist-Seq kit by Sanger sequencing on the Applied Biosystems 3500 Genetic Analyzer. The genetic heterogeneity was evaluated by calculating the identity of the genome region of the isolated strains in comparison with the genomes of foreign HIV strains, as well as using phylogenetic analysis.Results. In the studied group of patients, 5 subtypes of HIV-1 were identified: subtype A6 prevalence was 91.03%, that of subtype B was 2.69%, 3 recombinant subtypes (CRF03_A6B, CRF02_AG, CRF63_02A6) accounted for 6.28%. Among analyzed HIV-1 strains, 43.9% had a significant genetic similarity (identity of at least 97%) with the strains isolated from patients from neighboring countries (Belarus, Kazakhstan, Kyrgyzstan, Uzbekistan, Lithuania), 35.9% were similar to the strains isolated from patients from far-abroad countries (USA, China, South Korea, Australia, Sweden, Germany). A high heterogeneity of the circulating genetic variants of HIV-1 strains in the territory of the UFD region was established, which is an unfavorable factor for the diagnosis and treatment of HIV. The most common DRMs to both nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) were detected in 81 specimens (36.3%). NRTI resistance-forming M184V DRM was more common than any other DRM with statistical significance (p = 0,0008) and was detected in 88 specimens (39.5%).Conclusion. In the subtype structure of HIV-1, the dominant subtype was subtype A6, the most common in the countries that were formerly part of the USSR. The heterogeneity of the HIV-1 strains circulating in the UFD suggests that HIV-1 infection continues to be introduced into the UFD from populations outside the Russian Federation. The findings confirm the high prevalence of DRMs (62.8%) and secondary drug resistance of HIV-1 (60.1%) among PLWH in the territory of the UFD. At the same time, high-level resistance was detected in 56.5% of patients, which requires increasing the coverage of HIV resistance testing, including the introduction of monitoring for primary resistance, in order to optimize first-line ART regimens.

<p align="justify">В последние годы в российской Арктической зоне наблюдается беспрецедентный для постсоветского периода рост экономической активности. Но, несмотря на то, что большая часть сухопутных арктических территорий РФ административно относится к Уральскому и Сибирскому федеральным округам, эта активность проходит мимо большинства их соседей. О том, как распространить экономический эффект от реализации северных проектов за пределы Арктической зоны и вовлечь в процесс освоения Арктики научный и промышленный потенциал Урала и Сибири, шла речь на совместном совещании полномочных представителей Президента РФ в Сибирском и Уральском федеральных округах, при участии представителей науки, бизнеса и губернаторов сибирских и уральских регионов. </font>

Проанализированы количественные характеристики природных пожаров на территории Российской Федерации, произошедших в период 2018–2022 гг. Сравнение динамики относительных показателей пожаров показало, что в 2021 году на территории Свердловской области произошло в 8,75 раза, а на территории Уральского федерального округа в 25 раз больше пожаров, чем в среднем по России. Это обусловлено в основном опасными природными явлениями и климатическими особенностями. Осуществлена оценка эффективности применения беспилотных летательных аппаратов (БПЛА) для разведки природных пожаров. Проведено сравнение полученных на основе расчетов данных разведки с применением БПЛА и разведки, проведенной традиционными методами. Установлено, что время на принятие управленческих решений на месте пожара при разведке с помощью БПЛА сокращается в 4,25 раза по сравнению с этим временем при разведке традиционными методами. Natural fires in the Russian Federation occur annually. As part of this study, there was carried out an analysis of interannual fluctuations in the number of forest fires and a comparative analysis of the pyrological situation in the territories of the Sverdlovsk region, the Ural Federal District and the Russian Federation in 2018–2022. The number of natural fires that occurred on the territory of the Russian Federation, the Ural Federal District and the Sverdlovsk Region were related to the area of their territory. There was characterized a sharp increase in the number of fires in the Urals in 2021. The maximum quantity is found for the Ural Federal District, it is 0.2 fires per thousand hectares of territory; for the Sverdlovsk region this indicator reaches 0.075, while the national average does not exceed 0.01. Thus, in the Ural Federal District in 2021, the relative number of fires is 25 times higher, and for the Sverdlovsk region 8.75 times higher than the national average. The probable reasons are climatic. During this period, dangerous hydrometeorological phenomena were registered for the Urals, such as abnormally hot weather (record values), strong gusts of wind, and lack of precipitation (Report on climate features in the Russian Federation in 2021). Numerous fires dictate the need to increase the efficiency of reconnaissance and elimination of fires in the Urals. It is known that to eliminate natural fires successfully, it is necessary to conduct quick and high-quality reconnaissance. It was conducted a practical study of two methods of natural fire reconnaissance: the traditional method, widely used by fire and rescue units, and a method of using unmanned aerial vehicles. The object was the fire with two sources of fire that occurred on April 10, 2023 in the Sukholozhsky urban district of the Sverdlovsk region. The directions of fire development have been determined. For this purpose, a reconnaissance of fire sources was carried out and the possibility of using local water sources for refilling fire tankers was assessed. The results of the study demonstrated that the duration of reconnaissance using the traditional method is 17 minutes for two fire sources, and 15 minutes for reconnaissance of water sources. Using an unmanned aerial vehicle, the duration of reconnaissance is 4 minutes for two fire sources, and 7 minutes for reconnaissance of water sources. The time for making a fire elimination decision by the method of extinguishing a fire will be 17 minutes with traditional reconnaissance methods, and 4 minutes with the use of an unmanned aerial vehicle. Based on the conducted research, it was concluded that reconnaissance using unmanned aerial vehicles is 4.25 times more effective in comparison with traditional methods.

Introduction. The ecosystem approach to the organization of business processes in the pharmaceutical market meets the prevailing trends, so the growth index of e-commerce in the retail sector of medicines for 5 years amounted to 1.87. The market distribution sector of medicines in the Russian Federation is characterized by a shift in corporate governance towards marketing cooperation based on aggregation electronic trading platforms (AETPS). Development of territorial pharmaceutical ecosystems (TFE) As a new integrative tool for managing the pharmaceutical development – production – distribution cycle, in order to achieve the target model of PHARMA 2030 at the territorial level, it requires the development of regulatory mechanisms for managing the supply of medicines. Objective: characteristics of integration processes in the industrial, wholesale and retail sectors of the pharmaceutical market to assess the potential competitiveness of territorial pharmaceutical ecosystems. Material and methods. The primary data for the analysis were: volumes of wholesale commodity residues of medicines produced in the Ural Federal District (461 registration certificates; proprietary Price and Distribution Test data for 230 trade names of LP EMIS data 2021–2022; Alpharm data 2021–2022; Datainsight 2022. In the course of the study, a structural analysis of the pharmaceutical market, a functional analysis of participants in the pharmaceutical product chain, and a marketing analysis were carried out. Results. It was found that the dynamics of the AETP segment development corresponds to the outstripping growth of highly integrated platforms: the short-term growth index of 5-pl AETP (Uteca) is 164%, 4-pl (Eapteca) is 55%, 3pl-AETP (averaged) is 36.5%. The absence of formal mechanisms of regional protectionism for the sale of finished dosage forms of local manufacturers in the Ural Federal District has been revealed. We have obtained the results of evaluating the effect of ecosystem integration of certain types of pharmaceutical market participants. For manufacturers of medicinal products, it was determined that the median coefficient of penetration of the local assortment of medicinal products into the pharmaceutical market in the context of ATX groups of level 2 is 0.67, which indicates a significant diversification of the assortment portfolio and the possibility of its aggregation without a barrier of internal competition. In the wholesale drugs sector, the potential for saving margins on medicines has been identified when implementing the scenario of localization of supplies in production regions in low and medium-low price ranges (30 – 550 rubles/unit), varying between 53–67%. It was found that the median share of regional distribution in the Ural Federal District (in packages) is 20.72%. It has been established that the Ural Federal District is one of the leaders in terms of the share of omnichannel consumers in the pharmaceutical market (63%), which is a significant incentive for the integration of organizations in the retail sector of the pharmaceutical market into the ecosystem 5pl platform. Conclusion. Situational analysis of the morphology of cooperative interactions in the pharmaceutical market allowed us to identify the prerequisites for the formation of ecosystem-organized management structures in the pharmaceutical market system – territorial pharmaceutical ecosystems. We have systematized incentives for ecosystem determination of medicines supplies, and found that: an additional channel for the market distribution of the industrial range of medicicnes in the Urals is not associated with a barrier to internal competition of pharmaceutical plants; the inclusion of regional suppliers in TFE will allow to form additional competitiveness in the “buyer's market” in conditions of market dominance of federal suppliers; the omnichannel approach to the distribution of the retail range of TFE in pharmacy organizations has a high projected conversion rate. A detailed assessment of integration processes in certain sectors of the pharmaceutical market did not reveal critical barriers to the introduction of TFE.

Introduction. Acute cerebrovascular accidents are among the leading causes of death and disability in the population. The study of regional features of the incidence of acute disorders of cerebral circulation in the context of a pandemic of a new coronavirus infection COVID-19 is an urgent task. Purpose - to conduct a comparative analysis of the primary incidence of acute disorders of cerebral circulation, including transient ischemic attacks, in the adult population of Russia, the Urals Federal District and the constituent entities of the Russian Federation as part of the Urals Federal District. Materials and methods. A comparative analysis of the primary incidence of acute cerebrovascular accidents in the adult population in the Urals Federal District and in individual subjects of the district during the 2020 pandemic was carried out relative to the average long-term indicators for 2015-2019. Transient transient cerebral ischemic attacks, intracerebral and other intracranial hemorrhages, cerebral infarctions and strokes not specified as hemorrhage or infarction were taken into account. Average long-term levels of primary morbidity, standard deviation, coefficient of variation were calculated. Statistical data analysis was carried out using Microsoft Excel software products. Results. During the COVID-19 pandemic, the levels of primary incidence of certain acute cerebrovascular accidents in the Russian Federation and the Urals Federal District as a whole decreased compared to the long-term averages of 2015-2019. Conclusions. Indicators of primary morbidity of the adult population of the Ural Federal District with certain acute cerebrovascular accidents, including transient ischemic attacks, in different subjects of the district have pronounced regional features. Regional peculiarities of morbidity should be taken into account when planning the volume and financial parameters of territorial programs for the provision of free medical care to citizens. Significant differences in morbidity rates should be in the focus of attention of the chief neurologists of the Ministry of Health of the Russian Federation and the constituent entities of the Russian Federation.

Background: Achievement of the national goals to increase life expectancy and ensure sustained population growth in the Russian Federation largely depends on the health status and mortality rates in the working-age population. Health risk management for this cohort is impossible without effective disease incidence data, the lack of which impedes the development and implementation of optimal solutions in health maintenance. Objective: To assess rates and features of disease incidence in the working-age population of the Ural Federal District. Materials and methods: We acquired data on disease incidence in the Russian Federation from statistical yearbooks published on the website of the Federal Research Institute for Health Organization and Informatics of the Russian Ministry of Health and on the size of the working-age population from the Federal State Statistics Service. We estimated age-specific incidence rates (per 100,000) in the working-age population of the Russian Federation, the Ural Federal District and its administrative territories for 2015–2019 using MS Excel. The statistical data analysis was performed using the Statistica 10 software. The incidence structure by ICD-10 disease categories was determined. Results: We were first to establish absolute and relative incidence rates, incidence structure by ICD-10 disease categories, and regional features of disease incidence in the working-age population residing in the Ural Federal District. We found significant differences between district and federal average incidence rates. Conclusions: The incidence in the Ural Federal District was significantly higher than the national average. Incidence rates differed significantly between certain territories of the district. Incidence rates in the working-age population shall be included in the system of public health monitoring and taken into account when developing local programs of governmental guarantees of free medical services to citizens.