ALGORITHM OF RADIOLOGICAL EXAMINATION OF PATIENTS IN THE PLANNING OF ORTHODONTIC TREATMENT OF INTERARCH RELATIONSHIP OF TEETH AND TEETH POSITION ANOMALIES.

OBJECTIVE: The aim: To increase the efficiency of diagnosis and planning of orthodontic treatment of patients with interarch relationship of teeth and teeth position anomalies by developing an optimal algorithm for radiological research using cone-beam computed tomography (CBCT), teleroentgenography (TRG), orthopantomography (OPG). PATIENTS AND METHODS: Materials and methods: 1,460 patients with interarch relationship of teeth and teeth position anomalies were examined at the Department of Radiology of the P. L. Shupyk National Healthcare University of Ukraine. The cohort of 1460 examined patients was divided by gender: 600 men (41.1%) and 860 women (58.9%) aged 6 to 18 years and 18 to 44 years. Distribution of patients was held by the number of the primary pathology signs and the number of concomitant pathology signs. RESULTS: Results: The choice of the optimal radiological examination of patients is influenced by the number of signs of the main and accompanying pathology. The risk of secondary examination of the patient with a mathematical method of choosing the optimal diagnostic technique is determined.The risk of secondary radiological examination of the patient was determined at a marginal probability of 88% (at a higher value, the model predicts a repeat visit). CONCLUSION: Conclusions: The developed diagnostic model shows that when determining the Pr-coefficient of 0.79, it is recommended to carry out OPTG and TRG. With indicators of 0.88, the recommendation is to conduct CBCT in the age groups 6-18 and 18-44 years.

ANALYSIS OF THE WORLD'S BEST PRACTICES IN TRAINING PHARMACISTS FOR PROVIDING MENTAL HEALTH CARE TO PATIENTS.

The article analyzes and systematizes international documents and research results, which reveal the experience of implementing the best practices in mental health into the educational process of training pharmacists at various levels of education. Available foreign educational programs were analyzed in terms of their form and content. According to the results of the research, it was found out that the practice of professional training of pharmacists on mental health issues is quite widespread at the world level and is presented in various scientific publications. The results of their analysis also indicate different forms of training process organization.

FINANCIAL AND ECONOMIC EFFECT FOR THE HEALTHCARE INSTITUTION FROM THE INTRODUCTION OF LOGISTICS MANAGEMENT METHODS.

OBJECTIVE: The aim: This study is to substantiate the theoretical approaches to determine the financial and economic effect for the Healthcare Institution from the introduction of logistics management methods. PATIENTS AND METHODS: Materials and methods: The work utilises a number of methods: Content Analysis, Bibliosemantic, Systematic approach and the analysis of products. CONCLUSION: Conclusions: The use of logistics management methods is substantiated: synchronization of flow processes, interactive feedback and spatio-temporal timing, as well as the need to take into account in assessing the effectiveness of health facilities not only medical and demographic indicators, but also financial and economic effect. Prospects for further research are related to the development of theoretical and methodological support for the transformation of health care management system, substantiation of methods for determining the relationship between the level of autonomy of institutions and quality of care, taking into account the risks of indirect impact due to reduced access to medical services in rural areas, reduction of the network of specialized institutions and the number of specialized specialists.

INTERACTION LINKS OF HEALTHCARE INSTITUTIONS WITHIN ONE HOSPITAL DISTRICT.

OBJECTIVE: The aim: Theoretical substantiation and determination of the main characteristics of the interaction links of medical institutions within one hospital district in the conditions of aggravation of the epidemiological situation in Ukraine on the analysis basis of the legislative base and elaboration of literary sources. PATIENTS AND METHODS: Materials and methods: In the work is used a range of methods: content analysis, bibliosemantic, systematic approach, analysis of products of activity. CONCLUSION: Conclusions: The authors propose a doctrinal definition of the term "hospital district". The key problems of the domestic healthcare sector in the context of a pandemic have also been identified. The author points out that in order to successfully reform the health care system and the effective interaction of hospitals in one hospital district, it is necessary to pay attention to funding sources and proper legal regulation, as without the latter any initiatives will have no legal force and will be ignored. health care may be ineffective.

Professional postgraduate training of family doctors - an important part and condition of the optimal paliative and hospise care system implementation in Ukraine.

OBJECTIVE: The aim: To substantiate measures of optimization of the system of postgraduate training of GPs-Family Doctors (GP-FDs) on providing palliative and hospice care (PHC) in outpatient settings. PATIENTS AND METHODS: Materials and methods: Regulatory documents of Ukraine and International Professional Organizations; domestic and foreign literary sources; official statistics data; results of sociological research. The research methods were used: biblio-semantic, sociological (questionnaires), systemic approach and systemic analysis, and conventional medicalstatistical methods. RESULTS: Results: Based on the analysis of regulatory documents, the socio-medical importance of PHC and the importance of GP-FDs on PHC are shown. The results of the sociological survey determine: the estimated needs for PHC in Ukraine; insufficient number of inpatient beds for palliative patients (PPs); the absence of a PHC-mobile-teams service, which necessitates the involvement of GP-FDs for PHC at home. The results of the survey indicate an insufficient level of knowledge and an urgent need for special PHC education of GP-FDs. CONCLUSION: Conclusions: Multidisciplinary professional training for GP-FDs is of great importance for creating a PHC System. This will allow GP-FDs, together with social workers, NGOs to provide comprehensive PHC to PPs and their families, including medical, psychological, social and spiritual components.

Human health as a philosophic phenomenon and an important component of national security and state sovereignty potential.

OBJECTIVE: The aim: Examination of the human health problem as a philosophical phenomenon and an important component of national security and potential of the state sovereignty. PATIENTS AND METHODS: Materials and methods: The authors have analyzed scientific data (7 references) using methods of systemic approach and systemic analysis. CONCLUSION: Conclusions: The population health was always and is currently a state priority in civilized countries. Ukrainian researchers have no doubt the problem "Population health and state security and defense" needs the participation of not only medical specialists, but also of sociologists, economists, ecologists, politicians; this problem is a poly-disciplinary one. Reforms in the health care field of Ukraine are to solve an especially important and urgent task - strengthening of Ukrainian people health. The essence of concepts «national security¼ та «sovereignty of the state¼ being conditioned to a significant degree by the health state of our citizens leads to affirmation the steadfast state sovereignty to be a factor ensuring the stability and high level of national security. It is currently of the greatest importance to take into consideration all the possible configurations of future having determined strategic priorities and preparing favorable conditions for steadfast development. Currently, such development is dependent on the level of community health and quality of state government.

Bloodstream infections and antimicrobial resistance of responsible pathogens in Ukraine: results of a multicenter study (2013-2015).

OBJECTIVE: Introduction: Bloodstream infections (BSIs) are associated with high morbidity and mortality worldwide. However data of BSI from Ukraine are scarce. The aim: To obtain the first national estimates of the current incidence of BSI and antimicrobial resistance of responsible pathogens, and associated mortality in Ukraine. PATIENTS AND METHODS: Materials and methods: A retrospective multicenter cohort study was conducted at the 14 hospitals of Ukraine between January 2013 to December 2015. Definitions of BSIs were adapted from the CDC. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. RESULTS: Results: Among 20,544 patients, 3816 (18.6%) BSIs were observed. The rate of health care associated BSI was 92.4%. Death was reported in 68.4% BSI cases. The predominant pathogens were: Klebsiella pneumoniae (25.1%), Escherichia coli (17.5%), Staphylococcus aureus (9.9%), Pseudomonas aeruginosa (8.9%), and Acinetobacter spp.(8.5%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 24.8% and of methicillin-resistance in S. aureus (MRSA) 38.2%. Vancomycin resistance was observwd in 9.2% of isolated enterococci (VRE). Carbapenem resistance was identified in 33.1% of P.aeruginosa isolates and 63.2% of A. baumannii isolates. Resistance to third-generation cephalosporins was observed in 14.2% K. pneumoniae and E.coli 55% isolates. CONCLUSION: Conclusions: Healthcare-associated BSIs and antimicrobial resistance of responsible pathogens together with their associated impact on mortality, presents a significant burden to the Ukraine hospital system. Surveillance of BSIs may help to delineate the requirements for infection prevention and control.

[AWARENESS OF THE WORKING AGE POPULATION ABOUT PHYSICAL ACTIVITY AS A RISK FACTOR FOR NON-INFECTIOUS DISEASES]. / ОБІЗНАНІСТЬ НАСЕЛЕННЯ ПРАЦЕЗДАТНОГО ВІКУ ПРО ФІЗИЧНУ АКТИВНІСТЬ ЯК ФАКТОРРИЗИКУ НЕІНФЕКЦІЙНИХ ЗАХВОРЮВАНЬ

OBJECTIVE: Introduction: This publication focuses on role of physical activity in promoting and protecting health and well-being. Physical activity is a significant risk factor for noncommunicable diseases. The public's awareness of the risk factors of non-communicable diseases is an important component of their control. The aim: To estimate the level of knowledge of the working age population regarding the essence of a healthy lifestyle and risk factors for non-communicable diseases (with an emphasis on lack of physical activity and its consequences) according to qualitative and quantitative sociological research. PATIENTS AND METHODS: Materials and methods: The method of in-depth interviews (N20) and the method of personalized formal interviews (N2000) have been used. The survey among the representative sample of the population of working age was carried out according to a specially developed methodology of qualitative and quantitative research stages and data collection tools. The research was conducted in 2017 on request of the Dnipropetrovsk Regional State Administration with the financial support of the World Bank. RESULTS: Results: 90.2% of respondents are convinced of the importance of such a risk factor as hypodynamia in the onset and progression of non-communicable diseases (including cardiovascular). More than half of them consider daily exercise necessary for health. At the same time, only a third (35.1%) are engaged in physical exercises regularly. Among them, the overwhelming majority reported daily exercises (71.2%), 12.2% were engaged only on weekends. One in three considered it unnecessary to consult a physician before exercises. 55.6% of those who did not regularly engage in physical activity, the reason for this was the lack of free time, 36.1% - laziness, a quarter preferred to rest in a passive way. CONCLUSION: Conclusions:The awareness of the population of Dnipropetrovsk region about physical activity is estimated as insufficient. There is a need for the training of family medicine specialists and information work to minimize this risk factor and develop the motivation of the population to make healthy choices, using these sociological surveys.

Influence of risk factors on development of chronic obstructive pulmonary disease and legislative foundations for copd medical care in Ukraine.

OBJECTIVE: Introduction: Out of all respiratory diseases COPD is the leading cause of death and is characterized with diffuse non-reversible airway obstruction. Many various components play role in development and progression of this disease, while COPD risk factors play the most prominent role. Further progress in healthcare system development around COPD in Ukraine requires analysis of legislation, regulating pulmonological medical service in Ukraine. The aim: To analyze the influence of major risk factors on the development of chronic obstructive pulmonary disease and to determine key legislative aspects of the organization of medical care for COPD patients in Ukraine. PATIENTS AND METHODS: Materials and methods: 50 medical literature sources were systematically reviewed as the material for the research of COPD risk factors and their impact on studies disease. Also, an analysis of existing legislative acts regulating the pulmonological medical care in Ukraine, specifically, in patients with COPD, was conducted. CONCLUSION: Conclusions: There is a need to develop and implement a set of organizational and medical measures aiming at addressing the priorities of public healthcare, and specifically improvement of the quality of medical care for patients with chronic obstructive pulmonary disease in Ukraine.

[Business planningas as a tool for reforming PНС].

OBJECTIVE: Introduction: The reform of primary health care (PHC), the introduction of market mechanisms in health care, and the consequent change in the status of primary health care institutions require new approaches to the organization and management of the sector. This work is related to various aspects of health care reform: organizational, medical, social, production, financial, economic, etc. The aim of the research is to substantiate the need to apply the principles of business planning for the reform of PHC, in particular: аs a method of strategic planning and operational management of the production activities of a medical institution, аs a way of preventing and solving problems arising from the reform of the industry, аs an instrument for attracting external capital required for project implementation, аs a way of development of personal managerial qualities of the authors of the project - the head of a medical institution and his deputies. PATIENTS AND METHODS: Materials and methods: In preparing the article, the following materials and methods were used: survey methods, structural modeling, financial analysis, observation, comparison. Analysis was conducted on the basis of materials of accounting and financial reporting of medical institutions. RESULTS: Review: The practical implementation of any innovation project is much more complicated or even impossible without a well-designed business plan. The business plan is necessary not only for the justification of commercial activity, but for the implementation of non-commercial projects in order to achieve certain social outcomes. The business plan formulates the main purpose, directions of activity, ways and means of solving problems, and describes the market, production, organizational and financial aspects of future business, as well as features of management. The more dynamic and uncertain the external economic environment, the more attention should be paid to developing a strategic plan. The success of the innovation project is impossible without a clear idea of the prospects of the activity and the real plan of management. CONCLUSION: Conclusions: In this article we considered the feasibility of using the principles of business planning in the process of reforming primary health care.