METHODS FOR COMMUNICATION PROCESSES ENHANCEMENT IN THE "PROVIDER-CONSUMER (LEARNER)" SYSTEM OF EDUCATIONAL SERVICES.

OBJECTIVE: The aim: To determine learners' (doctors) needs and draw up proposals for upgrading educational communication processes in the "provider-consumer" system of educational services. PATIENTS AND METHODS: Materials and methods: The biblio-semantic, biostatistic and sociological methods were used. 754 author questionnaires were processed. RESULTS: Results: The socio-professional characteristics of learning service consumers at Shupyk National Medical Academy of Postgraduate Education were analyzed as well as studied their proposals. Evaluating communication interactions in the "provider-consumer" system of educational services concerned determining the most comfortable organizational modes of education for a consumer, making a careful analysis of the learning service characteristics by "accessibility" and "effectiveness" criteria. The determination methodology and research results can be used by universities and colleges regardless of the educational program specialization. CONCLUSION: Conclusions: Ensuring the educational communication processes effectiveness in the "provider-consumer" system of educational services is achieved by studying learners' adaptation according to such principal criteria as organizational modes of education, the learning service accessibility and effectiveness. The learning service providers adjust customer requirements to the capabilities of a particular educational institution (personnel availability, facilities and resources etc.) and so that they ensure competitiveness.

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.

Informational and psychological technologies development of educational competencies in medical e-education.

OBJECTIVE: Introduction: The article analyses systematized ideas on е-education as informational-psychological technology of educational competencies development applied to medical education. In the widest sense, е-education is interpreted as use of internet for learning. Such aspects of this informational-psychological technology, as virtual educational environment and subjects of educational process (е-student, educational technologist, librarian, teacher) are examined in the article. The aim. On the basis of the above information, one can formulate the purpose of the article, which is to present systematized representations of e-learning as an informational and psychological technology for the development of educational competencies in the process of postgraduate medical education. 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. RESULTS: Review: Features of e-education are explored as an adaptive educational technology in the process of medical education and retraining. Target-orientation is emphasized as key important principle of effective informational-psychological technology of educational competencies development. Virtual educational environment is researched as the computer-integrated е-learning, which typically includes wide set of various tools for effective delivery of e-educational content to the audience, which improves co-operation and management. The article proves that structural and contentual dimensions of е-teaching make fundamental influence on what can or can't take place within e-educational process and even on how teachers and students build their own knowledge within e-courses, build that they what do (not) know, and the process of this construction. It is mentioned that the role of content within the е-educational environment can acquire many various forms, including educational materials, reference sources, as well as any practice-related materials, like scientific articles or clinical protocols and instructions. Some most typical functions, instruments and services, usually available in a virtual educational environment, are described in the article. CONCLUSION: Conclusion is made about considerable potential of е-education as an effective informational-psychological technology of educational process in medical education.

Assessment of endothelial function in patients with initial manifestations of chronic cerebral ischemia

Introduction: Over the last decade, the number of patients with cerebrovascular diseases in Ukraine has grown by 1.5 times. This negative trend is based on the significant increase of vascular risk factors - arterial hypertension, dyslipidemia, sedentary lifestyle, excessive weight/obesity, diabetes mellitus, tobacco smoking, etc. - prevalence among the population of the country, their early development and combination of several vascular risk factors, which makes prevention of cerebrovascular diseases at their early stages a priority. The aim: Study of endothelial vasomotor function in patients with initial symptoms of chronic cerebral ischemia. Material and methods: The study included 260 patients of the main group (mean age 50.6±70.9) with initial manifestations of CCI and 30 persons of similar age of the control group. All the patients underwent a clinical neurological examination, MRI of the brain, ultrasonography with the establishment of flow-mediated endotelium-dependent dilatation (FMD) index based on the results of brachial artery compression test, as well as laboratory tests of endothelin-1 and nitrite levels. The patients were subdivided into 3 groups based on their MRI of the brain data: without structural changes of the brain (group 1), with initial vascular structural changes (group 2), with initial structural changes and mild cerebral atrophy (group 3). Results: Reliable differences of FMD index were established in the groups with different degrees of structural brain damage, and in comparison with the control group (р<0.001). Considerable downward trend of FMD index with increase of the number of existing vascular risk factors (VRF) was identified (p<0.05). An associative link with the presence of arterial hypertension (AH), its degree and FMD index (p<0.05) was established. It was shown that a thickened intima-media complex (ІМC) of common carotid arteries >0.9 mm had a significantly lower predetermination to FMD (р=0,001). Statistically significant lower FMD indices were registered in persons with endothelial vasomotor function disorder according to the biochemical markers: with endothelin level increase and nitrite level decrease (р<0.001). Conclusions: An associative link with the presence of endothelial dysfunction according to FMD index were established with different degrees of structural brain damage, with the presence of AH, with ІМC of common carotid arteries >0.9 mm, with endothelial vasomotor function disorder according to the biochemical markers: with endothelin level increase and nitrite level decrease.