UDC 614.2-082-055.2-053.31:303.62(477)

Abstract. The current challenges facing Ukrainian society require precise attention to the demographic situation, particularly to a significant decrease in the birth rate in Ukraine, which in recent years has been associated with the COVID-19 pandemic and a full-scale war on its territory.

Purpose. Identify priority areas of the development of neonatological help in Ukraine at the present stage of reforming medical care to the population by using the analysis of the results of the questionnaire for doctors, including health policymakers.

Object and methods. The material of the study was a self-developed questionnaire. The online part of the survey during 2022-2024 involved 410 respondents. The study uses the following methods: system approach and analysis, medical-statistical and sociological methods.

Results. The analysis of the key problems of the system of medical care for mothers and children determined by the respondents showed that the main issue is (and remains) the lack of financial resources to ensure the effective functioning of the health care system from state sources of funding, including mothers and children – 67.16±2.33%. When distributing by importance, respondents emphasized the importance of preparing strategic plans for the functioning of the healthcare system, both at the state and local levels, that included preparation of medical assistance for mothers and children (50,37±2,48% stated that), the highest level of that statement was found amongst people with absent experience in the specialty “Organization and management of health care,” as well as with work experience up to 10 years.

Conclusions. The formation of analytical and strategic processes for planning medical care for mothers and children, as well as further study of existing challenges and needs will allow the implementation of appropriate organizational approaches in medical care for mothers and introducing measures aimed at creating conditions for safe birth and obtaining highly qualified medical care in medical institutions.

UDC 614.23:303.62: [159.922:355.01] (477)

Introduction. The study of the population's mental health outlines a systematic analysis of the study's results on the determinants of its impact and the identification of potential determinants for building effective mechanisms to reduce their adverse effects. In Ukraine, the state of mental health of the population is affected by such global factors as full-scale military operations.

Objective. To study the role of public (social) determinants in influencing the state of mental health of the population during the war in Ukraine.

Materials and methods. The study was based on a survey of healthcare professionals to assess the level of influence of social determinants on the state of mental health of the population. The research methods used were bibliosemantic and sociological surveys, and two statistical analysis methods were a description of the study and an analysis of the facts obtained.

Results. It has been established that the critical social determinant of the impact on the state of mental health in Ukraine is the war with Russia. Based on this, the authors identified specific determinants that are closely related to this fact, namely the impact of the political situation, the effectiveness of public administration, the level of democracy, social conflicts, the organization of social protection, inflationary processes, corruption, migration processes, crime, and the organization and accessibility of the healthcare system. The assessment results showed that, according to healthcare professionals, the state of mental health is most affected by such factors as corruption (3.71±0.07 points out of 5 maximum), inflationary processes (3.58±0.07), and political situation (3.54±0.07). Respondents with less than ten years of work experience scored highest for all these factors. Social determinants: "Social conflicts in the environment," "Organization of social protection of the population," "Crime," and "Migration processes" were significantly more often mentioned by healthcare workers with up to 20 years of work experience than with more than 20 years of experience. Heads of healthcare facilities primarily pointed to the influence of such social factors as "Corruption" (3.81±0.14), "State of organization and accessibility in healthcare system" (3.74±0.13), "Political situation" and "Efficiency of public administration" (3.54±0.14 and 3.54±0.15, respectively).

Conclusions. The critical social determinants that affect the population's mental health are corruption in the state, inflationary processes, and the political situation. The correlation between the length of service and the position held regarding the level of assessment of the impact of social factors is revealed.

The monograph contains the materials of the 4th International Conference "Advanced Polymer Materials and Technologies", which was held on October 11, 2022 at the Kyiv National University of Technology and Design together with the Lviv Polytechnic National University. The monograph deals with the creation of new polymer composite materials and their processing technologies using extrusion, electroforming, 3D printing, and other methods; development of environmentally-oriented technologies and equipment for the production of polymeric materials for various purposes, including biodegradable ones. Considerable attention is paid to the creation of new polymer composite materials, in particular for environmental protection, using waste from the chemical industry. The monograph will be useful for teachers, students and graduate students, scientists and manufacturers whose activities are related to the above mentioned topics.

Introduction. A typical manifestation of anemia is a decrease in the blood's hemoglobin content, which, in combination with the changes in the color index and other indicators of the blood, allows us to assume its nature. Deficiency of vitamin B12 and folic acid in patients with diabetes mellitus requires the attention of clinicians because it can be accompanied by usual clinical manifestations, but it may also disguise itself as other diseases and be pathogenetically related to them. It is extremely important to detect anemia caused by a deficiency of vitamin B12 and folic acid in time. Therefore, clinicians need to pay attention to the problem of comprehensive assessment of the condition of patients with diabetes mellitus and to the use of reliable diagnostic methods aimed at studying the status of vitamin B12 and folic acid.
The aim of the study was to demonstrate the peculiarities of the clinical course and the patient's own experience in the diagnosis of vitamin B12 and folate deficiency anemia in a patient with diabetes mellitus.
Materials and methods. A 77-year-old woman with diabetes mellitus was under our observation; at the time of hospitalization, she complained of dizziness, general weakness, episodes of loss of consciousness, yellowing of the skin and sclera, nausea, dry mouth, discomfort in the right hypochondrium, and weight loss over the last month. To establish the diagnosis, a thorough anamnesis was collected, a complex of laboratory and instrumental studies was performed, and related specialists consulted the patient. For the diagnosis of anemia, in addition to the usual complete blood count, the content of vitamin B12 and folic acid in the blood, as well as the concentration of methylmalonic acid in the urine and the content of homocysteine in the blood were determined.
Results and discussion. During the thorough examination, hyperchromic anemia, increased blood content of vitamin B12, folic acid, and homocysteine, and an increase in the concentration of methylmalonic acid in the urine were revealed. The patient had no damage to the nervous system, and damage to the gastrointestinal tract was manifested by gastric hyperplastic polyps. The patient's clinical diagnosis was verified, and treatment was prescribed, considering vitamin B12 and folate deficiency as well as the underlying pathology. A reticulocyte crisis was noted as a result of correct tactics. As a result of the treatment, her condition improved, and she was discharged from the hospital with a recommendation to continue treatment at home. Conclusions. A comprehensive approach, taking into account the peculiarities of the clinical course, the determination of vitamin B12, folic acid, as well as methylmalonic acid and homocysteine are decisive for the differentiation and diagnosis of vitamin B12 and folate deficiency anemia in patients with diabetes mellitus.
KEYWORDS: anemia, vitamin B12 deficiency, folate deficiency, diabetes mellitus, polymorbid pathology.