The application experience of focused ultrasound heart examination in patients with COVID-19 in Prone-position.

Aim of the study. To study the experience of using focused transthoracic echocardiography in patients with COVID-19 in prone position (fEchoPr) in intensive care units (ICU). Materials and methods. The retrospective observational study included 53 patients (period from 15 April to 31 December 2020). Inclusion criteria: confirmed diagnosis of COVID-19, availability of fEchoPr data, outcome certainty (discharge/death). We analyzed electronic medical records. The fEchoPr was performed in patients in the prone position with a bolster under the left side of the chest and left arm raised ('swimmer's position'). We assessed the systolic function of the right ventricle (RV) (tricuspid annular plane systolic excursion (TAPSE)), RV size, RV/LV ratio, systolic function of the left ventricle (LV) (left ventricular outflow tract velocity time integral. (LVOT VTI)), and pulmonary hypertension (PH) (tricuspid regurgitation peak gradient (PGTR). Depending on the results, the patients were divided into 2 groups: informative (+fEchoPr) and non-informative (-fEchoPr) examinations. Results. There was no statistically significant difference in the groups (+fEcho n = 35 vs -fEcho n = 18) by age (65.6 +/- 15.3 vs 60.2 +/- 15.8, p > 0.05), by gender (male: 23 (65.7%) vs 14 (77.8%), p > 0.05), by body mass index (31.3 +/- 5.3 kg/m2 vs 29.5 +/- 5.4 kg/m2, p > 0.05), by mechanical ventilation support (24 (68.6%) vs 17 (94.4%), p = 0.074), by NEWS scale indicators (6.9 +/- 3.7 vs 8.5 +/- 3.5 points), by mortality (82.8% vs 94.4%, p > 0.05). Correlation analysis revealed a moderate inverse relationship between being on mechanical ventilation and the informative value of the study (Spearman's r = -0.30 at p = 0.033). In the +fEchoPr group, the correct measurement of TAPSE and RV/LV was carried out in 100%: a decrease in RV systolic function was recorded in 5 patients (14%), expansion of the RV in 13 patients (37%). Signs of PH were detected in 11 patients (31%), PGTR could not be measured in 10 patients (28%). LV systolic dysfunction was detected in 7 patients (20%). No pathology was detected in 16 patients (46%). One patient was diagnosed with infective endocarditis of native mitral valve, which was later confirmed by autopsy. Conclusion. In 66% of cases, fEchoPr examinations were informative, especially in terms of assessing the state of the right heart. fEchoPr examination is an affordable, valid and reproducible method to assess and monitor the state of the heart in ICU patients.Copyright © 2021 VIDAR Publishing House. All Rights Reserved.

Health-Creating Higher Education Environment in Preparing Qualified Personnel

The transition to the E-learning format due to the current international epidemiological situation is stressful to all participants of the educational process that has a negative impact on their physical and mental health. This fact is the reason why purposeful formation of a health-creating university educational environment, which includes not only health resource saving, but health resource creating, is crucial. This approach makes it possible to avoid high resource consumption (leading to unavoidable depletion of body resources) which is associated with the risk of social and psychological maladaptation of educational process participants. This paper presents the results of the study including full-time and part-time students' perception of their E-learning experience during the pandemic. The research shows that students whose adaptation to the changing environment (transition to E-learning) was difficult demonstrate the following signs of social and psychological maladaptation: the feeling of social isolation, the educational satisfaction level reduction, the difficulties of self-organization, the health level reduction. It was revealed that the part-time educational environment requires more adaptation resources to cope with the situation of its transformation. The data obtained can be used in creating and managing the pedagogical and psychological support of the educational process of E-learning aimed at the prevention of social and psychological maladaptation. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The application experience of focused ultrasound heart examination in patients with COVID-19 in Prone-position

Aim of the study. To study the experience of using focused transthoracic echocardiography in patients with COVID-19 in prone position (fEchoPr) in intensive care units (ICU). Materials and methods. The retrospective observational study included 53 patients (period from 15 April to 31 December 2020). Inclusion criteria: confirmed diagnosis of COVID-19, availability of fEchoPr data, outcome certainty (discharge/death). We analyzed electronic medical records. The fEchoPr was performed in patients in the prone position with a bolster under the left side of the chest and left arm raised ('swimmer's position'). We assessed the systolic function of the right ventricle (RV) (tricuspid annular plane systolic excursion (TAPSE)), RV size, RV/LV ratio, systolic function of the left ventricle (LV) (left ventricular outflow tract velocity time integral. (LVOT VTI)), and pulmonary hypertension (PH) (tricuspid regurgitation peak gradient (PGTR). Depending on the results, the patients were divided into 2 groups: informative (+fEchoPr) and non-informative (-fEchoPr) examinations. Results. There was no statistically significant difference in the groups (+fEcho n = 35 vs -fEcho n = 18) by age (65.6 ± 15.3 vs 60.2 ± 15.8, p >0.05), by gender (male: 23 (65.7%) vs 14 (77.8%), p >0.05), by body mass index (31.3 ± 5.3 kg/m2 vs 29.5 ± 5.4 kg/m2, p >0.05), by mechanical ventilation support (24 (68.6%) vs 17 (94.4%), p = 0.074), by NEWS scale indicators (6.9 ± 3.7 vs 8.5 ± 3.5 points), by mortality (82.8% vs 94.4%, p >0.05). Correlation analysis revealed a moderate inverse relationship between being on mechanical ventilation and the informative value of the study (Spearman's r = −0.30 at p = 0.033). In the +fEchoPr group, the correct measurement of TAPSE and RV/LV was carried out in 100%: a decrease in RV systolic function was recorded in 5 patients (14%), expansion of the RV in 13 patients (37%). Signs of PH were detected in 11 patients (31%), PGTR could not be measured in 10 patients (28%). LV systolic dysfunction was detected in 7 patients (20%). No pathology was detected in 16 patients (46%). One patient was diagnosed with infective endocarditis of native mitral valve, which was later confirmed by autopsy. Conclusion. In 66% of cases, fEchoPr examinations were informative, especially in terms of assessing the state of the right heart. fEchoPr examination is an affordable, valid and reproducible method to assess and monitor the state of the heart in ICU patients. © 2021 VIDAR Publishing House. All Rights Reserved.

Role of European Green Deal as a transformation mechanism of the state policies for the European integration of Ukraine

The authors note that the EU sets an intermediate goal: to reduce greenhouse gas emissions by 50-55% compared to the 1990 level. The European Green Deal (EGD) covers all sectors of the economy, particularly transport, energy, agriculture, construction, and industries such as steel, cement, information and communication technologies, textiles, and chemicals. The authors underlined the pandemic and response to COVID-19 in 2020 made adjustments only to the pace of implementation of the EGD. The authors clarify that the aim of the EU and, accordingly, Ukrainian transport policy is to promote more ecological vehicles. The European Green Course (EGC) covers several areas of sector reform of transport policy: changing mobility flows;shifting to cleaner modes of transport;increased requirements for standards in the transport sector;development of transport infrastructure;promotion of smart management in the transport sector digitalization.

The Psychological Hardiness of Students with a High Insomnia Index during the Covid-19 Pandemic

The combination of total uncertainty and forced self-isolation during the pandemic create a condition for stress reactions, mental and somatic disturbance of a large number of people around the world. Sleep quality has been validated as an indicator of well-being during a pandemic and a predictor of delayed risk. At this article demonstrate the interaction between psychological hardness and risk of insomnia in group of students of Herzen University during the period of remote education connected with COVID-19 pandemic. The hypothesis of the study was the assumption about the influence of hardness on the ability of students to cope with the challenge of complexity, the negative relationship of its characteristics with the index of insomnia and anxiety, as well as positive ones with the characteristics of life-meaning orientations and tolerance to uncertainty. The study show that level of psychological hardness can predict risk of insomnia and feeling of anxiety. The article demonstrate that psychological hardiness is connected with tolerance to the uncertainty. The practical significance is determined by the substantiation of indicators of potential risk and directions of development of resources for coping with the challenge of complexity in the student period. The article shows that resilience is associated with a tolerance for uncertainty. © The Authors, published by EDP Sciences, 2021.

Clinical and psychological aspects of insomnia associated with COVID-19 pandemic

Background In addition to clinical, epidemiological, and political aspects, the pandemic situation has a clinical and psychological aspect, as long as the measures taken to counteract infection inevitably cause unusual living conditions for a large number of people. Stress experience is accompanied by changes in autonomic regulation and, as a result, a number of somatic shifts. Stress markers include sleep disorders, changes in appetite, gastrointestinal disorders, headaches, chest pain, dyspnea, body pain, dizziness, numbness, fluctuations in blood pressure, sleep disorders, panic attacks, depressive and suicidal tendencies. Objective. We suggested that resilience is the predictor of successful resolution of existential crisis from the point of view of maintaining mental and somatic health, as well as gaining experience of deep self-improvement, strengthening of personality and potential for coping with life difficulties. Resilience includes coping at all levels of functioning physical, psychological, social and existential. The latter defines the perception of reality itself as a challenge of complexity that requires coping, and regulates resilience at all other levels. The indicator of sleep quality was used as an empirical criterion to evaluate coping with stress. It is both an indicator and an antistress resource for physical functioning. The hypothesis of the study was the assumption that psychological content of resilience differs in subjects with moderate severity insomnia and with no sleep disturbances during pandemic period. Design and methods. To evaluate this hypothesis during the period of self-isolation in connection with the COVID-19 pandemic (April-May 2020), an empirical study was carried out on a randomized sample of 93 subjects using clinical and psychological scales. Results. This research resulted in the identification of differences in psychological content of resilience which reflect clinical and psychological characteristics in subjects with moderate severity insomnia and with normal sleep during the pandemic. The psychological content of resilience in respondents without sleep disturbances during the pandemic can be considered as complex and mature mechanisms of personality self regulation that allow of maintaining mental and somatic health, efficiency, ability to develop. Identified features can be used as psychotherapeutic targets in patients at different stages of exposure to stress factors. © 2021 All-Russian Public Organization Antihypertensive League. All rights reserved.