Public Health Journal

INFLUENCE OF FACTORS ON THE MENTAL HEALTH OF YOUNG UKRAINIANS STUDYING IN HIGHER EDUCATIONAL INSTITUTIONS IN MEDICAL SPECIALTIES IN NEW REALITIES

Inessa Gennadiyevna Bibyk — Fri, 30 May 2025 00:00:00 +0300

Topicality. Mental health is one of the most important and serious problems because it is a leading factor in labour productivity and contributes to the country’s economic development. The potential of any nation depends on youth and young professionals studying in higher educational institutions. Therefore, it was decided to conduct a study on the psycho-emotional state of student youth and develop strategies to improve mental health.Purpose of the study: to investigate the impact of different forms of education on the psycho-emotional state ofstudents studying in higher educational institutions in medical specialities during the introduction of martial law and the conduct of active hostilities on the territory of Ukraine. To study the feasibility of introducing a blended form of educationand the impact of different forms of education on the quality of knowledge obtained.The study used the following methods: bibliosemantic analysis, survey methods, sociological approach, medical-statistical methods, systematic approach and content analysis, and structural-logical analysis.Results of the study. The results of the study showed that the emotional state of Ukrainian students significantly changes depending on the form of study during the war. Students studying in full-time forms of study noted that the quality of education improved after they switched from online studying. Most surveyed students are satisfied with the quality of the education received. Namely, 86.8 ± 3.37 % and only 13.2 ± 3.37 % remain dissatisfied. The assessment of thecollected data showed that more than half of the respondents, namely 56.0 ± 4.82 %, believe that receiving education inthe form of online studying affects the quality of knowledge received, only 16.2 ± 3.67 % noted that online studying does not affect the quality of education at all, and 27.8 ± 4.47 % of respondents believe that receiving education in the form of online studying does not affect, but rather affects the quality of knowledge received. At the same time, 82.1 ± 3.83 % ofrespondents believe that the online studying format is optimal and more appropriate, and 17.9 ± 3.83 % of respondentsnote that the online studying format is unacceptable even during the introduction of martial law. According to the survey,81.7 ± 3.86 % of students noted a deterioration in their psycho-emotional state during the transition to full-time education under martial law, and only 18.3 ± 3.86 % of respondents did not feel that they had any changes in their psycho-emotional state. The transition to the education system is stressful for students primarily due to ongoing hostilities, constant air raids, and sleep disturbances due to a combination of all factors.Conclusions. The study’s results demonstrate students’ readiness to adapt to new circumstances. They also demonstrate the need to continue studying and evaluating existing psychological support programs that improve their mental health and adaptive capabilities. They also demonstrate the need to develop new support programs that meet the needs of students in stressful and emergencies.

DEMOGRAPHIC CRISIS AND PUBLIC HEALTH: CONCERNING THE ANALYSIS OF SOME RELATIONSHIP VECTORS

Ihor Vitaliyovych Hushchuk, Andriy Viktorovych Mokienko — Fri, 30 May 2025 00:00:00 +0300

The purpose of the work. Identification of medical and social problems of society and public health asdriving forces of the demographic crisis in Ukraine.Materials and methods. The work uses the results of demographic and medical and social research, which are available on the Internet.Results of the study. The paper analyzes the current demographic situation in Ukraine. It is shown that the lifestyle (improper nutrition, alcohol abuse, smoking, harmful work, stress, etc.) of ordinary Ukrainians, especially able-bodied people,is a priority factor influencing the demographic situation. The main risk factors for the occurrence of non-communicablediseases (cardiovascular diseases, cancer, diabetes and chronic lung diseases) lead to 91% of deaths in Ukraine. More than 50% of Ukrainians are currently overweight or obese. 82% of Ukrainians drink alcoholic beverages, and 26% say that they drink more alcohol now than before the war. In total, there are about 9 million active smokers in the country, which make upa third of the entire working population of the country. More than 70% of Ukrainians feel stressed or very nervous. About 80% of Ukrainian youth have chronic diseases. Every year, about 50,000 people are injured at work, 1,500 of them die, and more than 3,500 get occupational diseases. It is justified that the basis of a healthy lifestyle should be a health-preserving (preventive) paradigm. The opinions of leading demographers of the country regarding the significance of the contributionof medicine to the health of the population (30–35%) are expressed. In 2021, 17% of households (or 2.5 million families) experienced catastrophic health care costs. In 2020, public spending on health care accounted for 8% of total spending (12%for EU candidate countries, 14% EU average). The urgent need for serious changes and shifts in the financing mechanismand system of organization of the current health care system was determined.Conclusions. Post-war recovery and active development of all spheres of social life requires such mandatory components as creating conditions for a healthy lifestyle and the availability of quality medical services.

MONITORING OF THE INCIDENCE OF VIRAL HEPATITIS A AMONG THE POPULATION OF RIVNE AND LVIV REGIONS OF UKRAINE IN 2014–2023

Inna Stanislavivna Khoronzhevska, Yulia Mykolaivna Yukhymchuk — Fri, 30 May 2025 00:00:00 +0300

The article is devoted to the study of the problem of the spread of viral hepatitis A (HA). The incidence of hepatitis A in the Rivne and Lviv regions of Ukraine for 2014–2023 was analyzed.Topicality. The article highlights the incidence of HA before the full-scale invasion of Ukraine by the RussianFederation and during the period of full-scale military aggression. The aim of the study is to analyze the incidence and study the peculiarities of the spread of viral HA among the population of Rivne and Lviv regions of Ukraine during 2014–2023. Materials and methods. A retrospective epidemiological analysis of the incidence of HA in the population of Rivne and Lviv regions of Ukraine for 2014– 2023 was conducted according to statistical reporting (form No. 40-health. "Report on the work of the sanitary and epidemiological station", № 1 and No. 2 "Report on certain infections and parasitic diseases" (monthly, annual).Results of the study. It has been established that during the period of the full-scale invasion of Ukraine by the Russian Federation in 2022–2023, a 1.4-fold increase in the incidence of HA Lviv region and an increase in the risk of morbidity in Rivne region. Among the population of both regions the period 2017–2023, the most vulnerable to HA was the age group of persons of working age 25–49 years: in Rivne region, the percentage of such patients was 40.48% (85 people) of the total number of cases, in Lviv region – 46.21% (140 people), children under 14 years of age in the structure of HAincidence were 20.0% and 20.46%, respectively (42 and 62 people).Conclusions. It has been established that during the period of full-scale Russian military aggression on the territory of Ukraine in 2022–2023, there was a 1.4-fold increase in the incidence of HA the Lviv region and an increase in the risk of HA in the Rivne region, which requires strengthening of epidemiological surveillance of this infection and requires mobilization of all actions of health care workers and communities in the prevention of HA, as well as increased efforts of politicians to speed up the political solution to end Russian military aggression in Ukraine.

CLINICAL REHABILITATION MANAGEMENT OF PERSONS WITH LATERAL EPICONDYLITIS OF THE ELBOW JOINT

O. V. Bessarabova, T. M. Zhavoronkova, H.M. Strakolist, N. V. Bohdanovska — Fri, 30 May 2025 00:00:00 +0300

Topicality. The article deals with lateral epicondylitis, as an inflammatory-degenerative disease affecting thetendons of the muscles of the lateral side of the forearm. Most patients are mostly able-bodied people aged 35–50 who lead an active lifestyle and regularly do sports. Pain and limitation of functional capabilities of the limb (most often leading)causes discomfort and significantly reduces the quality of life. It is noted that the repetition of the same movements can lead to an excessive load on the tendons of the elbow, causing tissue injury, and subsequently to degenerative processes.The disease has a chronic course, in which periods of remission alternate with exacerbations, in which, in addition to pain, the patient feels muscle weakness and functional limitations. The standard algorithm of rehabilitation managementis a long-term multi-stage drug, physiotherapeutic and, sometimes, surgical intervention. The request for a quick recoveryof the functional state, relief from pain and return to normal professional and sports life has become extremely urgent.The purpose of the study was to analyze modern methods of diagnosing functional disorders of the upper limb in patients with lateral epicondylitis and to develop a complex rehabilitation program of physical therapy for people withlateral epicondylitis of the elbow joint.Materials and methods: analysis and generalization of modern scientific literary sources, instrumental research methods (surveys, questionnaires, testing, PRTEE questionnaire, VAS pain scale, hand dynamometry, manual muscle testing, specific tests of Cozen, Mill, Maudsley) and methods of mathematical statistics.Research results. It is shown that the author’s rehabilitation program involving modern methods of intervention, suchas deep friction massage according to Cyriax, mobilization with movement according to Mulligan and kinesiological taping, had a high efficiency in restoring the affected limb in a short period of time, which meets the modern demand of working-age people with lateral epicondylitis. Already after the rehabilitation management, the patients of the main group noted a significant reduction in pain and improved functionality of the affected limb. Conclusions. The analysis of the obtained indicators in the main group indicated a significant decrease in the average indicators of pain intensity according to the VAS scale from 6.3 points to 1.7 points; the results of dynamometry also indicated an increase in hand strength from 35.8 kg at the beginning to 48.8 kg at the end of the study. There is also an increase in the strength of the extensors of theinjured limb according to MMT indicators from 2.63 points at the beginning of the study to 4.8 points at the end. The average value of the PRTEE questionnaire was 31.2 points, while at the beginning of the study this indicator was 79.7 points. Thus, after calculating the reliable value for each parameter, we obtained statistically significant results (p<0.05).Patients also noted the comfort of taking the course, because the interventions did not take much time and did notcause significant discomfort. The favorable evaluation from the study participants also allows us to recommend the program for use in rehabilitation facilities, because the patient-centered approach is the leading one for the modern fieldof health care.

SCIENTIFIC- EVIDENCE-BASED APPROACH TO BIOMECHANICAL ASPECTS OF MUSCULOSKOLE ACTIVITY: AN ANALYTICAL REVIEW OF THE SCIENTIFIC LITERATURE

Fri, 30 May 2025 00:00:00 +0300

Topicality. Modern rehabilitation is based on the principles of evidence-based medicine, where biomechanicalanalysis plays a key role in the development of individualized physical therapy programs. Objective assessment methods, such as 3D motion analysis, electromyography, etc., provide accurate diagnosis of functional disorders and recoverydynamics monitoring. The relevance of the topic is determined by the necessity to implement evidence-based approachesinto clinical practice in order to enhance the effectiveness of rehabilitation measures and improve patients’ quality of life.The aim of this study is to develop a comprehensive understanding of a scientifically grounded approach to thebiomechanical aspects of the musculoskeletal system, contributing to a deeper comprehension of movement mechanisms and overall body function.Materials and Methods. Scientific and evidence-based approach to the biomechanical aspects of the musculoskeletal system. To achieve this objective, we conducted a bibliosemantic analysis of literature sources available in Scopus (ScienceDirect), focusing on the most relevant and up-to-date research pertaining to the topic.Research results. The analysis of contemporary scientific literature confirms that an evidence-based approach to biomechanics significantly enhances the effectiveness of physical therapy. The application of technologies such as 3D motion analysis and digital diagnostics enables objective assessment of the condition of the musculoskeletal system. The individualization of rehabilitation programs based on biomechanical parameters helps to reduce the risk of re-injuryand accelerates recovery. The body mass center and its position are crucial for balance, particularly in cases involving amputation or deformity. Biomechanics as a science is an important tool in the development of modern methods oftreatment, orthotics and prosthetics. The human motor function subjects to the laws of mechanics, and each part of the body has its own center of gravity, which affects the overall balance. Through biomechanical analysis, it is possible not only to identify pathologies but also to develop effective strategies for their correction within physiotherapy practices.Conclusions. Human biomechanics is fundamental to understanding the mechanisms of movement, balance, and adaptation of the musculoskeletal system during physical activity and rehabilitation. With the aid of modern technologiessuch as 3D motion analysis and digital diagnostics, clinicians can accurately evaluate the functional state of a patientand tailor therapeutic interventions accordingly. In-depth knowledge of anatomical features, the center of mass, andlocomotion mechanisms can enhance treatment outcomes and improve quality of life.

DEFINING THE CONCEPTS OF NORM AND PATHOLOGY IN PHYSICAL THERAPY FOR PATIENTS WITH HYPERMOBILITY

Ye. A. Voroniuk, Yu. V. Antonova-Rafi — Fri, 30 May 2025 00:00:00 +0300

Topicality. Joint hypermobility is a common phenomenon among various populations, including performingartists who develop excessive joint range of motion through specific training, as well as patients with connective tissue pathologies. This article aims to define the concepts of “norm” and “pathology” in physical therapy for patients with hypermobility. Based on an analysis of current literature and experimental research, criteria for differential diagnosis wereproposed, taking into account the patient’s personal norms depending on age, gender, and profession. Special attention is given to identifying signs of pathological processes and developing individualized rehabilitation programs tailored tothe patient’s personal indicators. The findings highlight the importance of a personalized approach to improving patients’ quality of life and preserving their professional performance. Research aim. To define the concepts of “norm” and “pathology” in physical therapy for patients with hypermobility by analyzing personal indicators, considering age, gender, and professional activity, to develop criteria for differentialdiagnosis and individualized rehabilitation programs.Materials and methods. The study included 24 participants divided into four groups: circus artists with and withouthypermobility syndrome, and office workers with and without hypermobility syndrome. Grip strength was assessed using a hand dynamometer, and joint mobility was measured with a goniometer. The Beighton scale was used for hypermobility screening, along with an analysis of complications (pain, inflammation, dislocations). All results were analyzed consideringparticipants’ personal norms.The results. The study revealed significant variability in joint mobility and grip strength among patients withhypermobility syndrome, emphasizing the need to consider personal norms in physical therapy. The use of the Beightonscale and the statistical approach enabled the identification of pathological processes and differentiation between norm and pathology. Analysis showed that complications in performers with excessive joint mobility did not affect their professional activities when properly accounted for in therapeutic plans. These findings highlight the importance of apersonalized approach to diagnosis and rehabilitation.Conclusions. The findings highlight the importance of a personalized approach to physical therapy for patients with hypermobility. Identifying personal norms, utilizing modern diagnostic tools, and considering professional specifics enable effective differentiation between norm and pathology, improving patients’ quality of life and maintaining theirprofessional activity.

THE INFLUENCE OF PHYSICAL THERAPY ON THE AMPLITUDE OF MOVEMENTS IN THE LUMBAR SPINE IN PATIENTS WITH OSTEOCHONDROSIS

U. P. Hevko, D. V. Popovych, V. I. Boiko, K. V. Myndziv, A. V. Havrulenko — Fri, 30 May 2025 00:00:00 +0300

Topicality. Osteochondrosis of the lumbar spine is one of the most common degenerative-dystrophic diseasesof the musculoskeletal system, which is accompanied by pain, limitation of mobility and a decrease in the quality of life of patients. The use of physical therapy methods is one of the most effective ways to restore spinal function and improve thegeneral condition of patients. Physical therapy helps reduce pain syndrome, increase range of motion, improve musclestrength and stability. The purpose of this study is to study the effect of physical therapy on the range of motion in thelumbar spine in patients with osteochondrosis. The goal of the work is to assess the effect of physical therapy on the range of motion in the lumbar spine in patientswith osteochondrosis of the lumbar spine. Materials and methods. The effect of physical therapy on the mobility of the lumbar spine in patients withosteochondrosis was evaluated. 2 research groups of patients were formed: the main group – 13 people aged 38–45 years, with a diagnosis of osteochondrosis of the lumbar spine and working with a physical therapist according to an individual rehabilitation program, and a control group – 13 people, aged 38–45 years with the same diagnosis, which received only drug therapy.Research results and their discussion. Statistically significant differences (main effect: p<0.05) were found only inthe study group between PI and P2 measurement by 0.9 points, between PI and P3 by 1.1 points and between PI and P4 by 1.4 points.In addition, the comparison of the Schober test in four measurements (PI, P2, P3, P4) between the study group and thecontrol group was analyzed, we observed a statistically significant increase in the range of motion of the lumbar spine inthe group of patients who engaged in physical therapy compared to the control group.Conclusions. The use of physical therapy is an effective method of reducing pain and increasing the mobility of thelumbar spine.

FEATURES OF STUDENT YOUTH HEALTH IN WAR CONDITIONS

A. Yu. Hilman, O. S. Marchenko, H. V. Stadnikov — Fri, 30 May 2025 00:00:00 +0300

Topicality. The study of university students’ health provides critical insights into the components of well-being–physical, mental, and social–and highlights potential issues that require targeted interventions and preventive strategies.Objective. The aim of this research is to empirically assess the indicators of physical, mental, and social health, as well as students’ self-perceived health status. Materials and Methods. The study was based on a combination of theoretical and empirical approaches, descriptivestatistics methods as well. Empirical methods included a set of validated psychodiagnostic tools and self-report measures (The Methodology (Voitenko V.),the Sstudent Health Questionnaire (Dushanina S.), the WAM (well-being, activity, mood) method, Self-assessment of Psychophysiological State (Kokun O.), the Somatic Symptoms Scale (Chaban O., Haustova O., et al.), the Giessen Subjective Complaints List (GBB-8), the Mental Health Continuum – Short Form (MHC-SF) by Keyes C. (adapted by Nosenko E. & Chetveryk-Burchak A.), the Individual Psychological Health Model (Kozlov A.), the Ryff’s Psychological Well-Being Scales (PWB), UCLA Loneliness and Social Isolation Scale (Russell, Peplau, & Ferguson), the Subjective Loneliness Scale (Dukhnovsky S.), the Patient Health Self-Assessment Questionnaire (Chaban O., Haustova O., et al.)). Results. The article considers the assessment of physical, mental, and social health indicators, describes the physicalhealth status of university students within the realities of contemporary educational settings. An empirical study isoutlined, focusing on main groups of indicators, including physical, mental, and social health, along with students’self-evaluation of their well-being. Both objective and subjective health indicators were analyzed, revealing concerningtendencies in the deterioration of physical well-being over the course of academic training, accompanied by an increasein chronic complaints and absenteeism. Empirical data indicate that the psychophysiological state of students is generally within a satisfactory or sufficient range. The average intensity of somatic symptoms is identified, with the exhaustion scaleprevailing. The mental health state is found to be noticeably suppressed, predominantly shaped by intellectual and self-identity dimensions. Students exhibit well-defined life goals and self-awareness, along with a somewhat expressed sense of loneliness, instances of social isolation, and anxiety. The paper underscores the significance of incorporating physicalactivity into the everyday lives of students. Conclusions. The findings of the study contribute to revising current approaches to physical education in highereducation institutions, enhancing the implementation of health-promotion programs, and strengthening support for students’ mental well-being.

THE ROLE OF THE MEDICAL AND SOCIAL SUPPORT SYSTEM FOR MENTAL HEALTH IN WARTIME

A. M. Horvat — Fri, 30 May 2025 00:00:00 +0300

Topicality. The war leads to serious psychological trauma, which can have long-lasting and profoundconsequences for the physical and emotional well-being of the affected individuals. This often results in complex and exhausting recovery processes that require time and specialized assistance. The rehabilitation process is multifaceted,necessitating a comprehensive approach that takes into account the need for special attention to mental health, ensuring proper support. In this context, the established system of medical and social support plays a crucial role, as it is capableof providing timely and effective psychological assistance to restore the normal functioning of the affected individuals.The purpose of the article is to clarify the role of the medical and social support system for the mental health of the population in wartime conditions and to assess the initiatives implemented to improve its psychosocial support.Materials and methods. The article uses methods of content analysis, statistical analysis, and comparative analysis.Research results. The article emphasizes the serious psychological issues among the population resulting from the war in Ukraine, manifesting in mental health disorders. It highlights the creation of new support programs, the expansion of access to psychosocial services, and the strengthening of cooperation between state and non-governmental organizations.The importance of providing comprehensive assistance to the affected individuals is underscored, which includes the workof psychologists, psychotherapists, general practitioners, as well as medication and rehabilitation measures. The articlealso draws attention to the active development of various channels for psychological support during the war, significantly improving access to assistance for different categories of individuals.Conclusions. The medical and social support system for mental health is crucial in ensuring the emotional stability ofthe population in wartime, and the coordination of its state and non-governmental structural units allows for effective and prompt responses to crisis situations. A number of important initiatives have been implemented to provide psychological support and assistance; however, issues remain regarding the further development of specialized services, the restorationof damaged or destroyed infrastructure, and ensuring access to psychological assistance for all population categories,especially in areas most affected by hostilities.

SENSORY AND MOTOR DІSORDERS ІN THE CASE OF PERІPHERAL NEUROPATHY ІNDUCED BY CHEMOTHERAPY ІN CANCER PATІENTS – ІNDІCATІONS FOR PHYSІCAL THERAPY

A. M. Hrynkіv, O.A. Bas, F. V. Muzyka, M. Ya. Hrynkіv, Ya. V. Shparyk — Fri, 30 May 2025 00:00:00 +0300

Topіcalіty. Chemotherapy іnvolves the use of drugs of synthetіc or natural orіgіn (cytostatіcs). Chemotherapy- іnduced perіpheral neuropathy (CІPN) occurs іn 30–40% of patіents as a severe, long-term sіde effect.The goal. Based on a lіterature revіew, descrіbe the symptoms and dіsorders, and justіfy the reasons for the use of physіcal therapy іn cancer patіents іn the case of CІPN.Research methods. Comprehensіve study and analysіs of scіentіfіc papers іn the scіentіfіc databases Scopus, Pub-Med, Google Scholar, etc.Research results. Symptoms of CІPN lead to functіonal dіffіcultіes that іmpaіr daіly and socіal actіvіty, patіents experіence problems wіth movement, balance, and coordіnatіon, become more prone to іnjurіes, and have a hіgher rіsk of falls. Dependіng on the nature of the damaged nerve fіbers, three groups of symptoms of CІPN are dіstіnguіshed: sensory, motor and autonomіc, the manіfestatіons of whіch depend on the type of chemotherapeutіc drug. Chemotherapeutіc drugs that have a neurotoxіc effect on the perіpheral nervous system іnclude platіnum compounds, taxanes and vіnca alkaloіds, proteasome іnhіbіtors and epothіlones.Sensory symptoms may іnclude numbness, tіnglіng, allodynіa, hyperalgesіa, paresthesіa, dysesthesіa, shootіng paіn, change or loss of vіbratіon and joіnt posіtіon sensatіon, gaіt and balance dіsorders, sensory ataxіa. Іn severe cases, complete loss of sensіtіvіty іs possіble. Symptoms usually begіn dіstally and move more proxіmally, and the feet are usually affected fіrst. Sensory neuropathy of death іs manіfested by sensory paresthesіa accordіng to the “stockіngs and gloves” pattern. Motor symptoms manіfest as perіpheral weakness, deterіoratіon of fіne and gross motor skіlls.Most symptoms persіst, are not amenable to treatment and іn many cases are іrreversіble, turnіng іnto chronіc condіtіons.Conclusіons. Physіcal therapy іs recommended as an alternatіve non-drug method of preventіon and reductіon of adverse symptoms and manіfestatіons of CІPN durіng and after treatment. From a rehabіlіtatіon and clіnіcal poіnt of vіew, the symptoms and severіty of perіpheral neuropathy are objectіvely assessed by conductіng clіnіcal examіnatіons, as well as subjectіve measurements, such as questіonnaіres and scales.

EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN UKRAINE: GENERAL TRENDS

Fri, 30 May 2025 00:00:00 +0300

Topicality. Excess mortality and depopulation processes in Ukraine continue to reach alarming proportions.Alongside population aging, cardiovascular diseases (CVDs) occupy leading positions in the structure of population morbidity, posing a complex challenge for society and the effectiveness of the healthcare system. Identifying risk factors, ensuring control, and implementing preventive measures could mitigate the incidence of CVDs and reduce excessive population mortality.Objective. To study and analyze the trends in the development of cardiovascular diseases in Ukraine.Materials and methods. A retrospective analysis of hospital morbidity rates due to cardiovascular system diseasesamong the population of Ukraine was conducted for the period between 2014 and 2023. The morbidity analysis due to cardiovascular system diseases was carried out using absolute numbers, intensive rates (per 1,000 population), extensive values, and dynamic series indicators. The methods of a systematic approach, structural and logical, and medical and statistical analyses were used in the study.Research results. Over the past decade, cardiovascular diseases have ranked first in terms of the number of registeredcases, medical consultations, and as a leading of death among the population of Ukraine. The dynamics of the hospital morbidity rates of circulatory system diseases in Ukraine remain relatively high and show a tendency to increase, particularly during 2021–2023.The total number of CVD cases, according to the records of all medical institutions, has annually exceeded 20 million in recent years. Among these, 41.7 % on average occur in males nationwide. Notably, 36.3 % of such cases in Ukraine are observed in the working-age population. Hypertensive disease is less frequently diagnosed in males, averaging 39.56 %in Ukraine, whereas ischemic heart disease is more prevalent among women, with an average of 61.14 % in Ukraine.Acute and recurrent myocardial infarction in Ukraine is more frequently registered in men (59.28 %), including large-focal transmural myocardial infarction (61.81 %).Conclusions. The identified trends and risk factors for cardiovascular diseases should be used in the development of a national strategy to reduce the mortality through effective prevention and treatment programs.

ECOLOGICAL AND HYGIENIC ASSESSMENT OF THE STATE OF WATER SUPPLY OF THE POPULATION OF NIKOPOL OF DNIPROPETROVSK REGION FOR 2019–2024

I. V. Hushchuk, A. V. Mokienko, R. M. Gurak — Fri, 30 May 2025 00:00:00 +0300

Topicality. After the Kakhovka hydroelectric power station in Nikopol (Dnipropetrovsk region), thecentralized water supply of drinking water ceased, which forced the search for alternative sources of water, including the use of wells. The analysis of literature data showed the limited information on the water supply of this city for 2019–2024.The purpose of the work is ecological and hygienic assessment of the state of water supply of the population ofNikopol of Dnipropetrovsk region for 2019–2024.Methods of research sanitary-hygienic, bibliometric, analytical.Results of the study. It is shown that water in the sections of the Kakhovka reservoir water intake in 2019 – the first half of 2023 was low-mineralized, moderately rigid, neutral. The inconsistency of water quality is established by the normative requirements for HSC, color, turbidity, permanganate oxidation, CSK, nitrite, copper, manganese and zinc nitrogen content. Water drinking from the centralized water supply system did not meet the regulatory requirements forcolor, turbidity, permanganate oxidation, chloroform, iron. In water from decentralized sources there were exceeding the standards for turbidity, color, taste, total rigidity, dry residue, content of sulfates, chlorides, iron. Monitoring of physicochemical indicators of water quality of non-centralized water supply in 2023– 2024 showed significant deviationsfrom the standards for artesian water, which the population is forced to use as drinking, by dry residue, rigidity, sulfates,chlorides, ammonium. The water of the reservoirs did not meet the regulatory requirements for the indicators of HCC,dry residue, sulfates, chlorides.Conclusions. It is recognized as necessary purification of artesian water in Nikopol by the method of reverse osmosisand the restoration of the system of centralized economic and drinking water supply.

EPIDEMIOLOGICAL FEATURES OF THE SPREAD AND DIAGNOSIS OF INFLUENZA AND ACUTE RESPIRATORY VIRAL INFECTIONS IN VOLYN AND MYKOLAIV REGIONS (2020–2022)

O. R. Dmytrotsa, N. V. Yanko, I. V. Hushchuk, O. V. Korhzyk, I. M. Kasianchuk — Fri, 30 May 2025 00:00:00 +0300

Topicality. Influenza and acute respiratory viral infections (ARVI) remain the predominant infectious diseases in Ukraine, accounting for up to 90 % of all infectious morbidity annually. Despite their prevalence and potentialfor severe complications, vaccination coverage remains critically low. Studying regional epidemiological characteristics,particularly in the contrasting climates of Volyn and Mykolaiv regions, provides insights into the influence of environmentaland socio-demographic factors on the dynamics of respiratory infections and aids in improving preventive strategies.The goal – to analyze the regional peculiarities of the spread and diagnosis of influenza and acute respiratory viral infections in Volyn and Mykolaiv regions in 2020–2022.Materials and Methods. An epidemiological analysis of official statistics from the Center for Public Health (CPH) on the incidence of influenza and ARVI in Ukraine, Volyn and Mykolaiv regions (2020–2022) was used. Intensity indicators, epidemic thresholds, age structure, hospitalization rates, and vaccination coverage were taken into account. A comparative analysis of laboratory monitoring data from the regional centers for disease control and prevention (RDCP) using PCR, ELISA, and ELISA to detect pathogens was conducted. Comparison of regional data allowed us to identify thepeculiarities of the epidemic process.Research results. In 2020–2022, influenza and ARVI remained the leading infectious pathology in Ukraine, accounting for up to 90% of infectious morbidity. Volyn region had higher rates of reported cases, while Mykolaiv region had a higher proportion of laboratory-confirmed cases. It was found that climatic conditions affect seasonality: epidemics start earlier in Volyn compared to Mykolaiv region. The COVID-19 pandemic and military events have led to a change in the structure of pathogens, an increase in the proportion of SARS-CoV-2, and in 2021–2022, the return of influenza A(H1N1)pdm09 and B. Diagnostics was based mainly on PCR, supplemented by ELISA and MFA in Mykolaiv. Vaccination coverage in both regionsremained critically low. The results emphasize the feasibility of a regionalized approach to surveillance and prevention.Conclusions. Influenza and ARVI remain the main infectious diseases in Ukraine, accounting for up to 90 % of cases each year. In 2020–2022, the incidence rate was consistently high. The COVID-19 pandemic has changed the seasonal dynamics: in 2020–2021, SARS-CoV-2 dominated, and in 2021–2022, influenza partially returned. More cases were registered in Volyn region, while Mykolaiv region had a higher percentage of laboratory-confirmed cases. The influence of climatic differences was identified: epidemics start earlier in Volyn and later in Mykolaiv, which should be taken into account when planning prevention. PCR remained the main diagnostic method, with ELISA and MFA used additionally in the south. The pathogens identified included SARS-CoV-2, influenza A(H1N1)pdm09, H3N2, and B/Victoria. Low vaccination rates require increased access to vaccinations and education. The study confirmed the effectiveness of aregionalized approach to controlling respiratory infections.

EFFECTIVENESS OF TELEREHABILITATION IN PHYSICAL THERAPY: POSSIBILITIES OF REMOTE RECOVERY AFTER SURGERY AND INJURIES

M.М. Dub, О. І. Nikolenko, I. V. Mezentseva — Fri, 30 May 2025 00:00:00 +0300

Topicality. Quick technological progress has allowed healthcare professionals to evolve and offer care in innovative methods. Leveraging technology for remote recuperation after surgery or injury offers numerous advantages for both medical staff and patients; it holds significant promise for ensuring access to excellent recovery support. Thanks totechnologies like mobile apps, devices, video calls, and interactive platforms, patients can receive useful help throughout all rehabilitation phases. This not only cuts expenses and eases access to medical aid, but also accelerates and improvesthe effectiveness of the recovery journey.The goal of the work is to explore the possibilities of remote recovery from surgery and injuries through tele-rehabilitation in physical therapy. Materials and methods. This research utilizes publications from both local and international scientists specializing in physical and rehabilitation medicine, biometrics, and digital technologies, focusing on how synchronous technologies are implemented to monitor patients with diverse medical conditions.The methodology relies on standard scientific approaches, encompassing analysis, comparison, logical reasoning and structuring, as well as the techniques of induction, deduction, synthesis, generalization, and a systematic perspective.Research results. The role of TV rehabilitation in physical therapy is characterized. The technical means and platforms for conducting TV rehabilitation programs are determined. The advantages and disadvantages of telerehabilitation aredetermined. The comparison of traditional physical therapy with telerehabilitation is carried out. The directions of integration of telerehabilitation into traditional medicine are presented. The directions of improvement of the processof remote rehabilitation in physical therapy are determined and the key criteria for evaluating the effectiveness oftelerehabilitation are presented.Conclusions. Studies emphasize the importance of tele-rehabilitation in physical rehabilitation, which opens up newperspectives for effective patient recovery and improvement of the rehabilitation process. Prospects for further research are to evaluate the use of TV rehabilitation methods for different groups of patients.

ENDOTHELIAL DYSFUNCTION AND ITS ROLE IN THE DEVELOPMENT OF GESTATIONAL DIABETES (LITERATURE REVIEW)

L. V. Dubyk, N. V. Chernetska, Y. V. Tsysar — Fri, 30 May 2025 00:00:00 +0300

Topicality. Gestational diabetes mellitus (GDM) is a carbohydrate metabolism disorder that is first diagnosed during pregnancy and usually resolves after childbirth. The prevalence of GDM varies depending on the population, diagnostic criteria, and risk factors. According to the WHO and IADPSG (International Association of Diabetes and Pregnancy Study Groups) criteria, the prevalence can reach 10–18 %. In Ukraine and European countries, this rateranges from 5 % to 12 %.In recent years, the investigation of the relationship between gestational diabetes and endothelial dysfunction has become increasingly relevant, as it may improve the management of this condition.The goal. To conduct a comprehensive analysis and summarize the literature to identify the main mechanisms of gestational diabetes development under conditions of endothelial dysfunction. Materials and Methods. A systematic literature search was conducted. The data were grouped by thematic areas foranalysis and synthesis of current knowledge.Results. A high blood glucose level leads to increased production of free radicals, which damage the endothelium and reduce nitric oxide (NO) synthesis, a key factor in vascular relaxation. In GDM, insulin resistance develops, impairing itsability to stimulate NO production, thereby enhancing vasoconstriction and endothelial dysfunction. Studies have shownthat ET-1 may contribute to the development of insulin resistance, which is a key pathogenic mechanism of gestational diabetes. Additionally, inflammation and activation of pro-inflammatory cytokines occur. Women with GDM exhibit elevated levels of inflammatory factors (IL-6, TNF-α), which contribute to endothelial damage and vascular dysfunction.Conclusion. Thus, gestational diabetes not only increases the risk of complications during pregnancy but also has long-term consequences due to endothelial dysfunction. This pressing issue holds significant clinical relevance and warrantscomprehensive, in-depth research to better understand its underlying mechanisms and potential therapeutic approaches.

THE EFFICACY OF AEROBIC TRAINING IN PHYSICAL THERAPY FOR PARKINSON’S DISEASE: DIAGNOSTIC CRITERIA AND CLINICAL OUTCOMES

I. V. Kalonova, N. V. Bohdanovska, N.V. Pozmohova — Fri, 30 May 2025 00:00:00 +0300

Topicality. Parkinson’s disease (PD) is one of the most common neurodegenerative disorders of the central nervous system. Even with optimal medical care, patients with PD experience progressive deterioration in functional activity, ability to perform daily tasks, and social participation. Consequently, an increasing number of scientific studiesemphasize the importance of integrating physical therapy into rehabilitation programs, particularly for addressing motor and non-motor impairments in the early stages of the disease.The goal of the work is to evaluate contemporary evidence-based approaches to the application of aerobic training in physical therapy for Parkinson’s disease. Materials and methods. Theoretical analysis and synthesis of modern scientific and methodological literature.Research results. The analysis of studies conducted over the past 15 years has identified key areas of physical therapy supported by a high level of evidence, which contribute to improved functional outcomes and quality of life in patients with PD. These include aerobic exercises, strength training, balance exercises, gait training, methods utilizingbiofeedback, and community-based group activities. When selecting an intervention method, it is essential to focus onaddressing specific activities in the impaired domains of each patient. The primary recommendation for physical activity in Parkinson’s disease is aerobic exercise, the therapeutic effects of which are associated with neuroplasticity in the striopallidal system and increased dopamine release. Research results demonstrate the diversity of physical interventions based on aerobic exercises and their positive impact on motor, cognitive, and functional indicators in patients with PD.Conclusions. Addressing the challenge of enhancing the efficacy of physical therapy for Parkinson’s disease requires further research aimed at optimizing rehabilitation protocols and evaluating the long-term effects of physical therapy.

SCIENTIFIC AND THEORETICAL FRAMEWORK FOR RESEARCHING STATE AND PUBLIC HEALTHCARE GOVERNANCE MECHANISMS

O. S. Kiian — Fri, 30 May 2025 00:00:00 +0300

Topicality. In the context of reforming Ukraine’s healthcare system and post-war reconstruction, the study ofstate and public healthcare management mechanisms becomes particularly relevant, as the effectiveness of the healthcaresystem directly depends on the rational organization of management processes at all levels.The goal of the work is to provide theoretical justification for state and public healthcare management mechanisms inthe context of current challenges and needs of Ukraine’s post-war reconstruction.Materials and methods. The methodological basis of the research is a comprehensive approach that combines: systemanalysis – for studying the healthcare system as a holistic management object; comparative analysis – for comparing different scientific approaches and studying international experience; abstract-logical method – for theoreticalgeneralization and formulation of conclusions. The research materials included statistical data from the Ministry ofHealth of Ukraine, analytical materials from WHO, particularly the «WHO Cooperation Strategy with Ukraine for the period up to 2030,” scientific works on state and public healthcare management, as well as the author’s own research materials on management mechanisms in the medical field.Research results. Modern approaches to defining basic concepts in the field were analyzed: «public administration,” «public management,” «healthcare system.” The peculiarities of state and public management mechanisms in thehealthcare system were investigated, their structural components and functional characteristics were determined.The necessity of implementing strategic management and strengthening intersectoral cooperation was identified. The transformation from state-centric to collaborative management model was substantiated. Directions for improvingmanagement mechanisms were proposed, taking into account international experience and national characteristics. Conclusions. It was established that the effectiveness of state and public healthcare management depends on the rational organization of management processes and coordination of efforts of all stakeholders. In the context of post-war reconstruction, it is necessary to focus on modernizing healthcare facilities, implementing new methodologies forassessing the quality of medical services, and ensuring systematic development of the industry.

FEATURES OF REHABILITATION OF PERSONS WITH KNEE OSTEOARTHRITIS IN THE SANATORIUM AND RESORT TREATMENT IN THE ROMAN BATHS IN SLOVENIA

A. A. Kotvitska, N. Yu. Seliukova, G. V. Tamozhanska, V. Arakelov, Iu. Pate — Fri, 30 May 2025 00:00:00 +0300

Topicality. Osteoarthritis (OA) most often affects the knee joint, and patients experience inflammation, pain, stiffness, muscle atrophy and functional disability. Modern methods of treating knee osteoarthritis are aimed atrelieving these symptoms by various methods, such as pharmacological and non-pharmacological ones. The main non- drug conservative treatment is balneotherapy.Aim. To evaluate the effects of balneotherapy of the springs in the Roman Baths as a therapy for the treatment ofsymptoms and signs of osteoarthritis, taking into account all possible anatomical localizations in adults and the elderly.Materials and methods. The study included adult patients of both sexes with an average age of 64.8 ± 8.9 years,diagnosed with OA of the knee joint according to the classification of the American College of Rheumatology. Patients received 30-minute thermal water treatment (36.3 °C) in a bath 5 times a week for 3 weeks and performed therapeutic exercises for 50 minutes, three times a week. All patients were randomly assigned to two groups: the tap water group and patients treated with thermal mineral water. The WOMAC index, the visual analog scale (VAS) for determining the severity of pain were determined, and the questionnaire “Your health and well-being: assessment of quality-of-life indicators” was offered.Results. In our study, no significant differences were found in the tap water group in VAS scores for pain at rest andduring movement at the end point of treatment (in 3 weeks), and in the extended period, i.e., in two months. However, themean VAS score was significantly lower (less pain) in the group of patients receiving thermal mineral water in 3 weeks and during the 2-month follow-up (P < 0.05). Patients were interviewed before and after the treatment. Our study found improvements in all parameters of the SF 36 questionnaire, both short-term and long-term. There was a significant decrease in the WOMAC scores for subscales of pain, stiffness and physical function from the baseline to three weeks and two months of the treatment (P = 0.000) in the mineral water group, as well as in comparison between groups (P = 0.000).Conclusions. The data obtained indicate that the thermal water in the Roman Baths in Slovenia leads to the treatment of symptoms and signs of OA, taking into account all possible anatomical localizations in adults and the elderly. It has also been confirmed that balneotherapy in the Roman Baths has a greater long-term impact on the quality of life of people with severe disabilities, reducing pain and stiffness in the joints and increasing mobility of the limbs.

REGIONAL AND ALL-UKRAINIAN FEATURES OF THE ORGANIZATION OF DENTAL CARE FOR CHILDREN: AN ANALYTICAL STUDY TO DEVELOP WAYS TO STRENGTHEN DENTAL PUBLIC HEALTH

L. V. Kryachkova, M. Yu. Korobko — Fri, 30 May 2025 00:00:00 +0300

Topicality. The state of dental public health in children is a serious medical and social problem, which iscaused by the high prevalence of oral diseases among children and adolescents. Such diseases not only worsen the qualityof life, but also contribute to an increased risk of developing non-communicable diseases due to common risk factors. Inaddition, they increase socio-economic inequalities in access to dental services and create a significant financial burdenon both families and the health care system as a whole.Objective: Determination of regional and national features of structural and dynamic indicators of the organizationof dental care for the child population to develop ways to strengthen dental public health.Materials and methods. The organization of dental care for children was studied according to the data of the national sectoral statistical reporting of the Ministry of Health of Ukraine on the main indicators of the activity of the dental servicefor 2018–2022. Statistical data of the Ministry of Health system presented on the website of the State Institution “Center for Public Health of the Ministry of Health of Ukraine” (http://medstat.gov.ua/ukr/statdanMMXIX.html) and information from the directories “Dental Care in Ukraine: Analysis of Main Indicators of Activity” for 2018–2022 were used.A set of descriptive and analytical statistical methods, as well as the comparative analysis method, was used. For statistical comparison of values, clarity indicators were used. Statistical processing was carried out using Microsoft Excel Microsoft Excel (https://www.microsoft.com/microsoft-365/free-office-online-for-the-web).Results. Analysis of national statistical reporting for 2018–2022 revealed a significant deterioration in the organizationof dental care for children in Ukraine. Of particular concern is the reduction in the number of pediatric dentists in statemedical institutions, which decreased by 27.3% on average, and in the Dnipropetrovsk region by 44.4%. This directly affected the decrease in the number of children visiting dentists and the quality of preventive measures.At the same time, the proportion of children in need of rehabilitation increased from 48.7% to 60.8%, while thenumber of actually sanitized patients decreased by almost 81%. The public sector is not keeping up with the growingneeds, which stimulates the transfer of patients to private clinics, where growth rates significantly exceed public ones.An increase in the share of complicated caries was also found, which is a consequence of a decrease in preventive services. At the same time, there is a shortage of high-quality statistical and epidemiological data, which indicates theneed for digitalization of accounting and monitoring of children's health.Conclusions. The identified significant negative trends in staffing, the volume of dental services provided to children, and the accessibility of dental care indicate an urgent need to increase the effectiveness of prevention of oral diseasesamong children and adolescents and increase the preventive potential of dental services and the need to develop the dental public health sector.

ANALYSIS OF THE CAUSES AND STRUCTURE OF DISABILITY GROUPS AMONG THE POPULATION OF UKRAINE BETWEEN 2014 AND 2023

Ya. V. Nahurna — Fri, 30 May 2025 00:00:00 +0300

Topicality. One third of patients worldwide require rehabilitation care at some stage of their treatment.Rehabilitation for patients who need it is often inaccessible and does not meet modern requirements due to a shortage of rehabilitation specialists and insufficient volume and quality of rehabilitation care.Objective. Epidemiological analysis and assessment of the dynamics of disability by groups and causes of disability to determine the necessary volume of rehabilitation care in planning and improving the quality and accessibility of medicalrehabilitation in Ukraine.Materials and methods. A retrospective analysis and assessment of the dynamic indicators of disability among thepopulation of Ukraine from 2014 to 2023 were conducted. Statistical data from the State Statistics Service and the Ministry of Health of Ukraine were used. The methods of a systematic approach, structural and logical, and medical and statistical analyses were used in the study.Research results. The analysis of the dynamics of absolute indicators on general and primary disability (between 2014 and 2022) indicates that in 2022-2023, there was an increase in the total number of persons with disabilities and newly recognized ones. Moreover, the increase occurred across all disability groups, with the growth rates for 2021-2023averaging: group I – 31.26 %, group II – 35.14 %, and group III – 20.81 % per year. It was found that the most significantincrease in the number of persons with disabilities in Ukraine in 2023 was due to: diseases of the musculoskeletal systemand connective tissue, which increased by 170.73 %; diseases of the nervous system – by 76.20 %; injuries, poisoning, and consequences of external forces – by 72.84 %; mental and behavioral disorders – by 31.42 %.Conclusions. The full-scale war has led to an increase in the number of persons with disabilities and a growingdemand for rehabilitation care. This, in turn, necessitates finding ways to ensure the required volume, accessibility, and quality of rehabilitation services for the population of Ukraine.

INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION AS A MEANS OF ATHLETE RECOVERY AFTER INTENSIVE TRAINING TOPICALITY

I. M. Nikolenko, O. I. Nikolenko, I.O. Mykhailova, T. O. Ostrovska — Fri, 30 May 2025 00:00:00 +0300

Topicality. The goal of the work is to analyze the role of Instrument-Assisted Soft Tissue Mobilization (IASTM) in the recovery process of athletes after intense physical exertion. Its application is multifaceted and varies depending on specific conditions and the selected type of influence. Massage plays a particularly important role in the field of sports activity, contributing significantly to the acceleration of recovery after intense physical exertion. It is widelyused not only for therapeutic purposes but also as a preventive and preparatory tool to maintain the athlete’s performanceand reduce the risk of injuries.In professional sports, a specialized branch of massage has developed, specifically aimed at solving the particularchallenges that athletes face during training and recovery phases. Of special importance is the application of sportsmassage before competitions or intensive training sessions, as it improves flexibility, reduces the likelihood of injuries, accelerates physiological recovery, and positively influences athletic performance. These factors make sports massage anessential component of comprehensive athlete preparation programs.In this context, the Instrument-Assisted Soft Tissue Mobilization (IASTM) technique has gained widespread use,particularly after intensive physical loads. This approach enhances microcirculation, activates tissue regenerationprocesses, and increases tissue mobility. The use of IASTM enables the therapist to target overstrained soft tissues by inducing controlled microtrauma and localized inflammatory responses, which in turn stimulate regenerative adaptation. This mechanism makes IASTM not only effective for recovery but also as a corrective method in rehabilitation protocols. IASTM has also shown high efficiency in the treatment of myofascial pain syndromes, adhesions in soft tissues, limitedrange of motion, and functional weakness. Its application helps to improve the condition of muscles and ligamentousstructures while restoring the full amplitude of joint movements. One of the important advantages of the method is itsversatility and the ability to integrate it into comprehensive rehabilitation strategies, such as kinesitherapy, manualtherapy, and physiotherapy. This integrative approach makes IASTM a valuable tool in the hands of physical therapistsworking with high-performance athletes. Materials and methods. Analysis of scientific opinions and views of various authors on the effective application ofinstrument-assisted soft tissue mobilization in the recovery of athletes after intense physical exertion.Research results. Instrument-Assisted Soft Tissue Mobilization (IASTM) is an effective method of athlete recovery that involves the use of specialized tools to mechanically affect soft tissues, particularly the fascia – a connective tissue sheath that serves as a framework for muscles. This technique allows for the complete relaxation of one or several muscle groups. The application of IASTM enhances blood circulation, stimulates tissue regeneration, and restores their biomechanical mobility in relation to other anatomical structures. IASTM involves the use of specialized instrumentsthat exert controlled mechanical pressure on the skin, receptors, connective tissue, and deep structures of the soft tissues. Conclusions. Instrument-Assisted Soft Tissue Mobilization is a highly effective method of recovery after intense physicalexertion, optimizing the functional state of the musculoskeletal system, accelerating tissue regeneration, and preventingthe development of chronic pathological conditions. Due to the combination of mechanical action and neurophysiological stimulation, IASTM occupies an important place among modern methods of athlete recovery and rehabilitation after injuries.

PUBLIC HEALTH AND DISABILITY: REGIONAL ASPECTS OF TERNOPIL REGION

Fri, 30 May 2025 00:00:00 +0300

Topicality. The disability rate reflects the state of public health, socio-economic development, and the effectiveness of medicine. Research at the regional level helps to identify the factors of disability growth and ways to reduce it.The goal of the work is to analyze trends in disability of the adult population of Ternopil region, to assess the impact of the public health system on its dynamics and to identify prospects for improving preventive measures.Materials and methods. To achieve the purpose of the study, the method of analysis and synthesis, as well as the methodof generalization based on scientific works, regulations and statistics covering disability and public health issues were used.Research results. The article examines the disability rate among the adult population of Ternopil region and its dynamics from 2017 to 2024. The main causes of disability, including cardiovascular diseases, oncological pathologies, trauma, andmental disorders, have been identified. The impact of the public health system on reducing disability rates has been analyzed,particularly through preventive measures, rehabilitation programs, and access to medical services. Prospects for improvingregional policies to prevent disability and enhance the quality of life of the population have been outlined. The proposed measures aim to reduce the number of new disability cases and improve the efficiency of medical and social support.Conclusions. The public health system plays an important role in reducing the level of disability in Ternopil region.Comprehensive measures aimed at prevention, diagnosis, and rehabilitation can improve the quality of life of thepopulation and reduce the socio-economic impact of disability.

THE POTENTIAL OF DIGITAL TRANSFORMATION IN PRIMARY HEALTH CARE: A COMPARATIVE ANALYSIS OF POPULAR ELECTRONIC MEDICAL SYSTEMS FOR FAMILY PHYSICIANS IN THE USA AND UKRAINE

A. А. Petrukh, T. H. Gutor — Fri, 30 May 2025 00:00:00 +0300

Actuality: Primary healthcare plays a crucial role in maintaining population health. With the advancementof digital technologies and artificial intelligence, the medical field is undergoing significant transformation, particularly in the United States. The implementation of information systems in New York and New Jersey demonstrates high efficiency in improving the quality of medical services. Meanwhile, Ukraine has substantial potential for modernizing its primaryhealthcare sector by adapting advanced digital solutions.Purpose: To study the organization of primary healthcare in New York and New Jersey compared to Ukraine, focusing on the use of modern information systems, including artificial intelligence elements, and to propose recommendations forintegrating similar practices into the Ukrainian healthcare system.Materials and Methods. The study utilizes statistical data on the number of primary care physicians, physicianworkload, average patient visit frequency, and an analysis of leading electronic medical systems in the U.S. (Epic Systems, Cerner, Allscripts) and Ukraine (Helsi, Doctor Eleks). The study was conducted using comparative analysis, a systematicapproach, and structural-logical analysis methods. Research Results. The analysis revealed that electronic health records (EHR) are widely implemented in the U.S., integrating with laboratory tests, insurance companies, and clinical decision support tools. A key advantage is the use of artificial intelligence for risk prediction, automated diagnostics, and personalized treatment. In Ukraine, informationsystems primarily focus on administrative processes and do not provide clinical decision support at the same level as their American counterparts. Conclusions. The introduction of artificial intelligence and the enhancement of information systems can significantly improve the quality of medical services in Ukraine. Specifically, it is necessary to develop medical platforms that include symptom analysis, risk prediction, and clinical decision support. Additionally, critical directions include increasingphysicians’ digital literacy and ensuring funding for healthcare innovation development.

THE CURRENT PROBLEM OF TUBERCULOSIS IN THE RIVNE REGION

E. V. Ruban, V. Y. Melnyk — Fri, 30 May 2025 00:00:00 +0300

Topicality. Despite significant achievements in medicine regarding the treatment of tuberculosis patients inrecent years, the tuberculosis epidemic has not been eliminated and is even gaining momentum in some regions of Ukraine.The main problems of the tuberculosis epidemic in the Rivne region include the spread of drug-resistant tuberculosis, co-infection with HIV, AIDS, and COVID-19. An important issue is the inconsistency in the tuberculosis service and its financing, which depend on the country’s financial situation, as well as the deterioration of the material and technicalbase and the reduction of the human resources in the anti-tuberculosis service. Therefore, studying this problem is crucial.Aim. To study the valeological aspects of tuberculosis infection and analyze the incidence of tuberculosis in thepopulation of Ukraine and the Rivne region, in particular, to plan measures to reduce its level.Materials and methods. The research employed theoretical methods (review of literature, statistical data analysis, and generalization of laboratory research data) and laboratory methods, including bacterioscopic (smear microscopy), bacteriological (sputum culture on nutrient media, determination of the sensitivity of M. tuberculosis cultures toantimycobacterial drugs), and polymerase chain reaction (PCR) methods.Research results. The research was conducted in the clinical diagnostic laboratory of the Rivne Regional Phthisiopulmonary Medical Center from 2019 to 2023. The prevalence, morbidity, and mortality rates of tuberculosis in the Rivne region were determined. The prevalence of all forms of active tuberculosis in the region was 49.9, while the first registered incidence and its relapses were 51.3 cases per 100,000 population. The average regional mortality ratedecreased from 8.5 to 5.3 per 100000 population.Conclusions. Tuberculosis remains a social problem in the Rivne region, reflecting the socio-economic state of the country. Significant efforts are required from the state, public, and medical services to combat tuberculosis effectively. The epidemiological situation regarding tuberculosis in the Rivne region remains tense.

PHYSIOTHERAPY AS A COMPONENT OF COMPREHENSIVE REHABILITATION CARE IN CASE OF STROKE

K.A. Tymruk-Skoropad, V. A. Gryb — Fri, 30 May 2025 00:00:00 +0300

Topicality. Stroke is one of the leading causes of mortality and disability worldwide. Rehabilitation after stroke is aimed at minimising the consequences and promoting people’s independence and potential recovery offunctioning.Purpose: to theoretically analyse the effectiveness of physical therapy in the rehabilitation of patients after stroke.Materials and methods. Analysis and systematisation of theoretical data on the peculiarities of the impact of physicaltherapy interventions on the restoration of lost motor functions and the prevention of complications after stroke.Research results. This article describes a wide range of interventions based on impairments and activity limitationsfor recovery at different stages of stroke. This article focuses on rehabilitation approaches, in particular physical therapyafter stroke, to enable a person with a stroke-related impairment to achieve their optimal physical, cognitive, emotional,communicative and social functional level. Rehabilitation interventions are provided in settings such as: acute inpatient care or sub-acute care; inpatient rehabilitation units, on general or mixed rehabilitation units; outpatient or community settings such as outpatient clinics, day clinics and recreation centres; and home-based services such as supported earlydischarge and home rehabilitation. Conclusions. This article discusses the effectiveness of rehabilitation interventions in physical therapy dependingon the period of rehabilitation after stroke. The physical condition of the patient and the period after stroke do not fullyreflect the severity of the impairment. However, by establishing recommendations based on the period, it is possible to offer post-stroke care that is appropriate for each patient. Therefore, this study attempted to analyse the rehabilitationprogramme for stroke survivors and provide appropriate interventions according to the patient’s physical condition.

PHYSICAL THERAPY AFTER ISCHEMIC STROKE IN THE EARLY RECOVERY PERIOD

Fri, 30 May 2025 00:00:00 +0300

Topicality. Vascular diseases of the brain, including stroke, have been on the list of the most importantmedical and social problems in recent years, as they cause great economic damage to society, causing long-term disability and mortality.The goal of the work is to analyze the quality of physical therapy programs for patients with different stroke severityand to substantiate their impact on functional recovery.Materials and methods. The following tests and scales were used for the examination: The Barthel scale and the 10-meter gait test. The results were statistically processed using the MedStat statistical package. In all cases, the valueof 0.05 was taken as the critical level of significance. The study was conducted at the public organization “Rehabilitation Complex Agape Ukraine”. The study involved 20 patients, including 8 men and 12 women, aged 50 to 70 years. All patients had suffered an ischemic stroke: the right (7 patients) and left (13 patients) sides of the body. Rehabilitationlasted from 2 to 6 weeks. The patients had sessions 3 times a day, 5 times a week, lasting 50 minutes each.Research results. The values of the 10-meter gait test in the early period of rehabilitation of male patients with lefthemisphere brain damage compared to the initial examination showed a noticeable improvement, as the final results showed values of 80% of the norm compared to the initial 60%. Still, we did not obtain a statistically significant difference in the indicators. Instead, in the group of men with right hemisphere lesions, the values differed at the level of p˂0.05. From thebeginning of therapeutic interventions (46% of the norm), high results were achieved that corresponded to a regular coursewithout disorders; the rate was 99% of the norm. In the group of female patients with left hemisphere lesions, the values of the 10-meter test differed at the significance level of p˂0.05. The test result improved from 30% of the norm to 58%. In thegroup of patients with right hemisphere lesions, the result was achieved only up to 39% of the norm compared to the initialvalues (20% of the norm). The study found that early physical therapy positively affects the restoration of functional mobility.The highest results on the Barthel scale (90–100 points) were achieved by 8 people out of 20. It was statistically proventhat there is a significant difference between the functional state at the time of admission and discharge. Most of the studyparticipants demonstrated progress in essential aspects of functioning during the recovery period.Conclusions. Early rehabilitation has a practical effect on restoring gait function and general functional status and increasing muscle strength of the upper and lower extremities in patients who have suffered an ischemic stroke.

MONITORING OF INFLUENZA AND ARVI INCIDENCE AMONG THE POPULATION OF KIROVOHRAD REGION IN 2014–2023

I. S. Khoronzhevska, V. V. Puhyr — Fri, 30 May 2025 00:00:00 +0300

The article is devoted to the study of the problem of the spread of influenza and acute respiratory viral infections (ARVI). The incidence of influenza and ARVI in the Kirovohrad region of Ukraine for 2014–2023 is analyzed.Topicality.The article highlights the state of influenza and ARVI incidence before the full-scale invasion of the RussianFederation into the territory of Ukraine and during the period of full-scale military aggression.The purpose of the work is to analyze the incidence and study the features of the spread of influenza and SARS amongthe population of the Kirovohrad region of Ukraine during 2014–2023.Materials and methods. A retrospective epidemiological analysis of the incidence of influenza and SARS amongthe population of the Kirovohrad region of Ukraine for 2014–2023 was conducted according to statistical reportingdata (form No. 40-zdor. "Report on the work of the sanitary and epidemiological station", No. 1 and No. 2 "Report onindividual infections and parasitic diseases" (monthly, annual).Results of the study. Monitoring of influenza and acute respiratory viral infections in the Kirovohrad region for2014–2023 revealed local features of the epidemiological process, in particular, changes in dominant pathogens, theimpact of the COVID-19 pandemic on the circulation of influenza viruses. The results of the analysis emphasize the needto strengthen laboratory research in the region, increase vaccination rates, and develop targeted preventive programs adapted to regional conditions.Conclusions. It was found that the most vulnerable groups to COVID-19 are people aged 30–64 and over 65. The study highlights the importance of virological monitoring and laboratory diagnostics (in particular, the RT-PCR method), which allowed to detect the evolution of influenza strains and SARS-CoV-2. The low level of influenza vaccination (2-5%of the population) remains a critical problem, increasing the vulnerability of the region to epidemics. Military operationsfurther complicate the collection of statistical data and the implementation of preventive measures, which requires theadaptation of public health strategies in the context of an emergency.