MATHEMATICAL MODEL FOR PREDICTING FASTING BLOOD GLUCOSE LEVEL IN DIABETES MELLITUS PATIENTS.

OBJECTIVE: The aim: To substantiate the use of data on patients' lifestyle, parameters of blood glucose, heart rate, blood pressure and bread units to build a mathematical model for predicting fasting blood glucose level in diabetes mellitus patients to improve existing measures for diabetes prevention. PATIENTS AND METHODS: Materials and methods: An open database consisting of the studied parameters of 359 people was used in the research. The linear regression method was used to predict fasting blood glucose level in diabetes mellitus patients. The statistical software IBM SPSS Statistics Version 23 was chosen for calculations. RESULTS: Results: To calculate the coefficients of the linear regression equation, stepwise elimination of parameters was chosen. The analysis of the coefficients of influence of independent variables on dependent showed that the greatest effect on the change in glucose level had value of consumed bread units. The model for women diagnosed with type 2 diabetes showed the highest accuracy. CONCLUSION: Conclusions: Mathematical modeling made it clear that any malnutrition or health disorders can lead to a significant change in glucose levels. The obtained models consist of a number of parameters, some of which might depend on the presence of concomitant diseases. Further studies should focus on the optimal combination of various parameters taking into account methods of treating comorbidities.

NATIONAL EXPERIENCE OF CREATING AND IMPLEMENTING MEDICAL STANDARDS IN CASE EVIDENCE APPEARS «LATER¼ (DURING THE COVID-19 CORONAVIRUS DISEASE PANDEMIC).

OBJECTIVE: The aim: Identification of methodological processes to accelerate the development of clinical guidelines in an emergency situation (in particular, coronavirus disease COVID-19), analysis of the practice of implementing clinical guidelines and clinical pathway. PATIENTS AND METHODS: Materials and methods: The processes of developing COVID-19 clinical guidelines are described on the websites of the developers. Implementing the patient's own clinical pathway. Survey of 117 health professionals involved in medical care at COVID-19 on management information. A retrospective pragmatic study of organizational and clinical aspects of medical care for 9,259 patients over 18 years with COVID-19 from March 18, 2020 to March 31, 2021. RESULTS: Results: Acceleration of the methodology of clinical guidelines, changes in legislation have contributed to the improvement of medical care for patients with COVID-19. Clinical pathway (CPw) professionals surveyed: 88.2% satisfied with the structure of CPw, 91.0% were in favor of local instructions and explanations, templates of registration forms, 72.7% needed on-the-job training, 78.1% needed training on medical features, 74.5% noted the positive impact of remote interaction, 61.6% required standard operating procedures. 9259 patients with suspected COVID-19 confirmed PCR in 55.2%. Among those checked, 31.2% of chest computed tomography confirmed pneumonia in 95.7% of CT; 9.3% were hospitalized; fatalities 5.5% of hospitalized or 0.5% of verified. CONCLUSION: Conclusions: Changes in the methodology of clinical guidelines, changes in legislation, education based on clinical guidelines have contributed to improving the results of management in COVID-19.

ANALYSIS OF THE EFFECTIVENESS OF THE FUNCTIONAL ORGANIZATIONAL MODEL FOR KNOWN PROPHYLAXIS OF CHRONIC NONINFECTIOUS DISEASES BASED ON THE ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS AT THE MEDICAL INSTITUTION.

OBJECTIVE: The aim: Study of the indicators of quality of life of patients served by a multidisciplinary health care institution with the functionally-organizational model of coded prevention of chronic noninfectious diseases is implemented. PATIENTS AND METHODS: Materials and methods: To evaluate the effectiveness of the model's use we used the assessment of the dynamics of QL indices, which was assessed according to the EUROHISQOL 8-item index methodology among 376 patients aged over 18 years. RESULTS: Results: Most of the respondents (61.4%) were dissatisfied to varying degrees with their state of health and, on average, evaluated their QL (56.1%). ЗThe overall assessment of the quality of life of the surveyed population was on a 20-point scale of 13.5 (3.19) points in 2017 before the introduction of the program of managed prevention of СNCDs and 14.6 (3.48) points after its three-year operation, with an increase integrated indicator on average by 1.1 (95% CI 0.59 - 1.60) points (p <0.001). Among the areas of QOL assessment, the assessments in the physical sphere and the environment increased at most (p<0.05). It is determined that the overall level of QOL of patients with NCDs is 40% due to medical and social factors that can be positively influenced by medical care using a model of managed prevention. CONCLUSION: Conclusions: The analysis of changes in the quality of life of patients of multidisciplinary institutions who have risk factors for СNCDs or suffer from chronic non-communicable diseases, showed that the introduction of a functional-organizational model of managed prevention at the health care institution level can improve integrated assessment of QOL and positively affect the overall complex of medical and social factors, including managed risk factors. This indicates the effectiveness of this model of managed prevention at the level of a multidisciplinary health care institution.

APPROACHES TO DEVELOPING AND IMPLEMENTING CLINICAL AND ORGANIZATIONAL REGULATIONS ENSURING INFECTIOUS SAFETY AND EPIDEMIOLOGICAL RESPONSE IN THE WORK PROCESS (THE CASE OF COVID-19).

OBJECTIVE: The aim: Of the work was to develop clinical and organizational regulations ensuring infectious safety and epidemiological response in the work process (the case of COVID-19) based on the current legislative acts of Ukraine to combat the spread of coronavirus disease (COVID-19), as well as on the data from international practices. PATIENTS AND METHODS: Materials and methods: The research objective was carried out in accordance with the Methodology for the development of medical and technological documents for the standardization of medical care. RESULTS: Results: The Protocol includes organizational elements to prevent the spread of coronavirus disease, such as "The development of general provisions on infectious safety and antiepidemic measures during the COVID-19 pandemic in the company's workplaces, taking into account the legislative acts of Ukraine and international practices", which include: the development of "Health Questionnaire" (epidemiological data questionnaire) for daily monitoring of the company employee health; the development of "Checklist for self-assessment of the workplace", "Checklist for self-assessment of the public space"; the development of "Analytical report on compliance with the infectious safety rules in the workplace and in the public space on the basis of self-assessment", thirteen Appendices. CONCLUSION: Conclusions: "The Protocol for infectious safety and antiepidemic measures in the work process" is a detailed instruction that provides a balance of compliance with medical standards and reasonable needs of employees and employers through the implementation of scientific evidence base in antiepidemic and infectious safety measures in the workplace.