The influence of the psychosocial stress on oral health status in the conditions of being in Ukraine during the prolonged state of martial law.

OBJECTIVE: Aim: To study the presence of clinical and biochemical correlations between psycho-emotional stress, level of cortisol and periodontal oral health status of the patients in Ukraine during prolonged martial law. PATIENTS AND METHODS: Materials and Methods: The comprehensive clinical and laboratory study covered 49 persons, including 20 patients with Gingivitis (40.8%) and 29 with Periodontitis (59.2%). Biochemical blood test was performed to determine the level of "stress hormone" - cortisol. Patients filled out the questionnaire by the method of V. Zung (low mood-subdepression scale) to determine psycho-emotional state in the conditions of prolonged martial law in Ukraine. RESULTS: Results: The research results showed that in the conditions of martial law in Ukraine, "stabilization" and "improvement" of the process of patients with Gingivitis was established in 50%, with Periodontitis - only in 41.4% of patients. In 54% of patients, a significant deterioration of clinical indices was established, compared to the indicators before the war. In patients with Periodontitis, РВІ index was 1.33 (0.62-1.43) score, which was not statistically significantly different from the initial level (p>0.05). Biochemical blood tests revealed an increased level of the hormone cortisol in 18% of patients. According to the method by V. Zung scale of mental states, the majority of patients (87%) showed low mood and emotional instability within the medium level (range 2 and 3). Correlation was identified, according to the Spearman coefficient (R=0.39, р<0.05), between scale assessments by V.Zung and the blood level of cortisol. CONCLUSION: Conclusions: Psycho-emotional stress is one of the leading pathogenetic factors in the deterioration of oral health status and the development of periodontal diseases, especially in people in Ukraine during prolonged martial law. Indicators of method by V. Zung scale of mental states and the level of cortisol are optimal markers of the need to correct the psycho-emotional state. For patients with increased levels of stress and fear, it is necessary to create special treatment-prevention schemes, taking into account greater attention to motivation to maintain the health of the oral cavity, as well as more frequent hygiene procedures.

Dynamics of components of physical and mental health of law enforcement officers during the period of martial law.

OBJECTIVE: Aim: To investigate the dynamics of law enforcement officers' physical and mental health components while performing their duties during the war in Ukraine. PATIENTS AND METHODS: Materials and Methods: The research, which was conducted in 2022-2024, involved 114 law enforcement officers (male) from the Kharkiv oblast (Ukraine) of different ages: under 30 (n = 35), under 40 (n = 41), over 40 (n = 38). To test law enforcement officers' physical and mental health indicators, we used 3 methods: 1) "Fatigue-Monotony-Oversaturation-Stress"; 2) "Well-being-Activity-Mood"; 3) "Assessment of Nervous and Emotional Stress". RESULTS: Results: The negative dynamics of most components of the physical and mental health of law enforcement officers of all three groups while performing their duties during the martial law were revealed. The most pronounced significant changes occurred in such components as "Fatigue", "Oversaturation", "Stress", "Well-being", "Mood", "Nervous and Emotional Stress". The most pronounced negative changes in most components occurred in law enforcement officers over 40 years old, which is due to both the age characteristics of the subjects and their length of service. CONCLUSION: Conclusions: The research confirms the high complexity and extremity of law enforcement officers' service activities during the martial law, as well as the high requirements for law enforcement officers' readiness to perform tasks in the context of a significant expansion of the National Police's powers. The results obtained also necessitate the search for effective ways to preserve and maintain the physical and mental health of law enforcement officers.

The impact of strength loads on the health status and physical readiness of female cadets.

OBJECTIVE: Aim: To investigate the impact of kettlebell strength training on the health and physical readiness of female cadets during martial law training. PATIENTS AND METHODS: Materials and Methods: The research involved 60 female cadets, 30 each in the experimental (EG) and the control (CG) groups. The EG cadets were engaged in kettlebell exercises during the hours of their sporting and mass participation activities, while the CG cadets were engaged according to the traditional methodology. The health status was assessed by anthropometry and cardiovascular system indicators; physical readiness - by the results of 100 meter run, push-ups, and 1 km run. RESULTS: Results: It was found that at the end of the research, most indicators of health and physical readiness in female cadets engaged in kettlebell exercises were significantly better than those who were engaged in physical exercises according to the traditional methodology. The most pronounced effect of strength loads was found on the development of strength qualities, stabilization of body weight, and improvement of the functional capabilities of the cardiovascular system. In the 4th semester, the female cadets of the EG showed significantly better than in the CG indicators of BMI, SI, heart rate recovery time, LPH, results in push-ups, and 1 km run. CONCLUSION: Conclusions: It is proved that strength loads in exercises with kettlebells, having several positive features, effectively impact the state of health and development of motor skills in female cadets, as well as contribute to the formation of an aesthetic physique and weight loss.

Studying of psycholinguistic features of doctors' professional communication under war conditions.

OBJECTIVE: Aim: Studying of psycholinguistic features of doctors' communication competence in Ukraine under war conditions. PATIENTS AND METHODS: Materials and Methods: Bibliosemantic method; method of system analysis, comparison and generalization; empirical methods - direct observation of the doctors' and patients' living language, typology of empirical data according to socio-demographic indicators. RESULTS: Results: Within the study, 286 dialogues were collected. With voluntary consent, they were recorded in video and audio formats in compliance with ethical, bioethical, and legal norms. Next, initial typology of dialogues, their lexical and semantic analysis with identification of typical positive and negative communicative strategies were carried out. With the help of the ≪Textanz≫ specialized computer software, 48 dialogues were subjected to the content analysis procedure for two separate ≪Doctors≫ and ≪Patients≫ samples. CONCLUSION: Conclusions: The results of the analysis of ≪Doctor-Patient≫ dialogues enabled identifying and describing psycholinguistic markers of typical physiological, mental, social, and spiritual states of individuals seeking medical help under martial law. Thus, the markers of positive emotional states (optimism, confidence, empathy, etc.) and affective, negative emotional processes (anxiety, fear, anger, aggression, sadness, depression, etc.) were identified.

Dental treatment of children under general anesthesia during the period of matrial law.

OBJECTIVE: Aim: To summarize the experience of providing dental medical care under general anesthesia to children from different regions of Ukraine during the martial law, taking into account the factors affecting the choice of optimal conditions for dental treatment. PATIENTS AND METHODS: Materials and Methods: Dental treatment under general anesthesia of 1,258 children from different regions of Ukraine has been performed since March 2022. The condition of the teeth (df, df+DMF, DMF) and hygienic state of the oral cavity (OHI-S) were determined. The level of awareness of parents regarding the preservation of children's dental health was studied through a questionnaire. RESULTS: Results: An unsatisfactory oral hygiene, a high level of caries were found in the vast majority of children. The highest df was observed in the group of children aged 3 to 6 years (7.14±0.33), which is significantly higher than in the group of children under 3 years of age (4.32±1.04, p≤0.05). The worst oral hygiene was observed in children aged 6-12 years (OHI-S 2.62±0.32). An insufficient level of awareness of parents and children regarding dental health was revealed. A total of 1,712 operations under general anesthesia were performed. The majority of patients could not regularly appear for follow-up examinations due to the forced departure from the country. CONCLUSION: Conclusions: The organization of dental treatment under general anesthesia allows solving a number of problems of dental care for children during the war.

State Regulation of Ensuring the Quality Medical Care During Martial Law in Ukraine: Lessons for the International Community.

Background: Nowadays, the quality of medical care and health care measures is considered the main target function of the health care system and at the same time the determining criterion for its activities. Objective: The article examines state regulation of medical care quality post- COVID and during martial law, identifying improvement areas. It emphasizes state roles in healthcare standardization, continuous feedback monitoring, and studying patient satisfaction. Interrelationships among Ukraine's state regulation mechanisms are determined, highlighting the need to enhance tools such as criteria and quality indicators for medical care assurance. Methods: The authors of this article utilize various scientific methods, including analysis, synthesis, induction, and deduction, as well as historical and legal, formal legal, and comparative legal methods to examine the state regulation of ensuring the quality of medical care during martial law in Ukraine. Results: The article considered the interrelationships of mechanisms and instruments of state regulation of quality assurance of medical care in Ukraine. Conclusions: The state should enhance medical care quality regulation, drawing on international experiences from the EU and the USA and adapting best practices to national circumstances. The resilience of the healthcare system depends on effective quality assurance, ensuring preparedness, stability, and ongoing improvement prospects.

STATUS OF THE CURRENT DOMESTIC REGULATORY BASE FOR ENSURING RADIATION SAFETY AND ANTI-RADIATION PROTECTION OF MILITARY PERSONNEL DURING THE PERIOD OF MARTIAL STATUS. / СТАН ЧИННОЇ ВІТЧИЗНЯНОЇ НОРМАТИВНОЇ БАЗИ ЩОДО ЗАБЕЗПЕЧЕННЯ РАДІАЦІЙНОЇ БЕЗПЕКИ ТА ПРОТИРАДІАЦІЙНОГО ЗАХИСТУ ВІЙСЬКОВОСЛУЖБОВЦІВ НА ПЕРІОД ВОЄННОГО СТАНУ.

Prerequisite. In the conditions of a full-scale invasion, the issue of radiation safety and anti-radiation protection in the Armed Forces of Ukraine (AFU) occupies a special place, since the aggressor country violated global geopolitical international decisions, occupied civilian nuclear facilities, in the process of their liberation servicemen mayhave to act in conditions of increased radiation risk, the possibility of using tactical nuclear weapons also is not excluded. OBJECTIVE: to investigate the state of the current national regulatory framework for ensuring radiation safety and anti-radiation protection of military personnel during the period of martial law. METHODS: bibliographic, analytical, historical, systematic approach. RESULTS: The main normative document on the organization of radiation safety and anti-radiation protection of both personnel and the population in Ukraine, as well as military personnel, currently in everyday conditions and in case of radiation accidents since 1998 and until now, are the State Hygienic Standards «Radiation Safety Standards of Ukraine (NRBU-97)¼. But neither in this document, nor in the transition to NRBU-2021-P, the issue of exposure to such a category as military personnel during the performance of combat (special) tasks is considered. The system of monitoring the radiation situation in Ukraine, documents on the organization of medical support for military personnel, including the Guidelines on the Medical Support of the Armed Forces of Ukraine for a Special Period (2019)and the Guidelines on the Organization of Radiation Safety in the Armed Forces of Ukraine (2020), were analyzed.modules of radiation safety principles in the Armed Forces of Ukraine were proposed. CONCLUSION: The unsolved problem of normalization of the radiation factor in the case of man-made and socio-political emergencies can create significant problems in the organization of anti-radiation protection of troops and the population in the case of the use of nuclear weapons or radiation accidents in a special period and requires anurgent solution. It is obvious that there is a need to develop regulatory documents regarding the response and planning of continuous activities to respond to potential nuclear and radiation threats during martial law, including relationships at all levels of the management vertical and methods of communication in the event of a threat.

FEATURES OF THE PROCESS OF TRAINING IN EDUCATIONAL MEDICAL INSTITUTIONS OF UKRAINE AT THE PRESENT STAGE. PART 2. REACTION OF HIGHER EDUCATIONAL INSTITUTIONS TO DISTANCE LEARNING.

Higher education is one of the areas most affected by the Covid-19 pandemic and martial law. Against the backdrop of severe restrictions, universities faced the issue of the existing opportunities for the implementation of educational programs, the need to change the format of the educational process with the transition mainly to electronic educational technologies. Under these conditions, it was necessary to consolidate all the forces and resources of the university community. The governments of many countries have recognized the need to provide infrastructural and technological support to educational institutions. Thanks to the institutional support of the state and relevant ministries, universities managed to reduce financial losses and implement initiatives for continuous education. These measures have contributed to the sustainability of universities. In response to the COVID-19 pandemic, educational institutions all over the world have adopted different approaches and made significant changes to the education system itself in accordance with their resources and capabilities.

FEATURES OF THE PROCESS OF TRAINING IN EDUCATIONAL MEDICAL INSTITUTIONS OF UKRAINE AT THE PRESENT STAGE. PART І. ATTITUDES OF STUDENTS AND UNIVERSITY TEACHERS TOWARDS DISTANCE LEARNING.

The review article reflects the results of the assessment of data from individual research papers and personal observations, as well as data from domestic and foreign literature, as well as own opinion about the features of the training process in educational medical institutions of Ukraine at the present stage. First, the COVID-19 pandemic, and then martial law in the state, caused distance learning to become an inseparable component of modern education and contrib¬uting to the effective implementation of the educational process in general and the achievement of high quality results in medical educational institutions in particular. For the successful implementation of the e-learning system, all participants in the educational process need the help and assistance of special technical support services. Therefore, universities need to pay more attention to improving technical support of platforms and academic interaction between teachers and students [1]. Universities that have been able to provide such support have avoided many problems in the transition to distance learning. Practical and clinical skills are essential in the field of medicine, and the lack of opportunities to master and practice these skills could potentially lead to a generation of insecure doctors with limited experience of meeting and examining real patients [2]. Therefore, the task of teachers at the present stage is to do everything possible to prepare competent specialists adapted to the realities of life.

Now is no longer the time for poets.

A reflection piece-on rethinking the return of a Martial Law dictator in the form of his namesake, the newly elected president of the Philippines; the gamut of conversations on (un)covered facts, post-truth, appearances, interpolations, populism, revisionism and transformations, as well as the power of (trans)national media and images entangled with participatory publics; and how might a younger generation and/or transgender poet, such as myself, who did not experience first-hand the atrocities of military rule and learned them only through dominant narratives, might create and/or open capacious spaces for empathic opacity, new understandings, and possible coalitions and resistances within a historical moment concurrent with a present and/or imagined dystopia-expressed as a suit of three poems: To write another eye; Now is no longer the time for poets; Requisite condemnation.

A view on the problem of providing oncological aid during the war in Ukraine.

Introduction: Providing oncological care in conflict conditions is a difficult test for the country's health care system, especially if aggression is carried out in violation of the main international rules of conduct of war, the treaties of the Geneva Convention, when the aggressor attacks the civilian population. Material and methods: Having conducted an analysis of the style of military operations conducted by the aggressor and the peculiarities of the territories of Ukraine, the quality of providing oncological care before the conflict, the digital transformation of the state, the use of the application Diya by the population, and the functioning of the eHealth electronic medical telecommunication information system, we identified four zones of providing oncological care during martial law. Results: Each zone is defined and the amount of consultation and diagnostics with subsequent treatment assistance to the population is presented. Conclusions: Thanks to the practical implementation of the above characteristics, with a constantly functioning Internet network throughout Ukraine with a sufficiently high level of computer literacy of the population and available online means of communication, and in addition to the high level of organization of the Ukrainian and international volunteer service, it was possible to provide a qualified level of oncological care to the population during martial law.

Contracting for Catastrophe:Legitimizing Emergency Constitutions by Drawing on Social Contract Theory.

States of emergency are declared frequently in all parts of the world. Their declaration routinely implies a suspension of basic constitutional rights. In the last half century, it has become the norm for constitutions to contain an explicit 'emergency constitution', i.e., the constitutionally safeguarded rules of operation for a state of emergency. In this paper, I ask whether inclusion of an emergency constitution can be legitimized by drawing on social contract theory. I argue that there are important arguments, both against and in favor of constitutionalized emergency provisions, and that social contract theory-as applied by economists-can be of some help when deciding whether to have, or not to have an emergency constitution. This paper introduces a novel argument for justifying emergency constitutions. It argues that they can serve as a commitment mechanism protecting both citizens and politicians from overreacting to rare but significant threats.

STATE INSTITUTION «NATIONAL RESEARCH CENTER FOR RADIATION MEDICINE OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE¼ - RESEARCH ACTIVITIES AND SCIENTIFIC ADVANCE IN 2017. / REFORMUVANNIa SYSTEMY OKhORONY ZDOROV'Ia: ROL' I MISTsE ZAKLADIV OKhORONY ZDOROV'Ia TRETYNNOGO RIVNIa PRY RADIATsIINYKh NADZVYChAINYKh SYTUATsIIaKh V UMOVAKh VOIeNNOGO STANU.

The role and place of health care facilities of the highly specialized (tertiary) level in radiation emergencies in the conditions of martial law are considered taking into account the experience of overcoming of the Chornobyl catas-trophe consequences. The classification of emergencies and the main scenarios of radiation emergencies (nuclear terrorism, radiation accidents and incidents, the use of nuclear weapons) are presented. The principles of medical preparedness and providing the highly specialized medical care in a radiological emergency are presented on the base of the Chornobyl catastrophe experience. It is determined that the tertiary health care facilities in a radiological emergency should provide as follow: development and implementation of plans and protocols of highly specialized medical care; organization, direct provision, coordination and quality control of the highly specialized medical care; aggregation and coordination of efforts of all three levels of health care facilities; integration into the radiation emergency management system, and analysis and generalization of the experience gained.