Uniformed personnel are highly exposed to occupational stress, which increases the risk of mental health problems. This study examined whether coping styles moderate the relationship between perceived stress and satisfaction with life among uniformed personnel treated for bodily distress disorder or post-traumatic stress disorder. Methods: A cross-sectional study was conducted with 183 participants (81% male, aged 30–66 years). Standardized questionnaires were administered: the Perceived Stress Scale (PSS-10), Satisfaction with Life Scale (SWLS), and Coping Inventory for Stressful Situations (CISS). Pearson correlations with 95% confidence intervals were computed, and moderation analyses were conducted using separate regression models for each coping style with bootstrap estimation (1000 samples). Gender differences were examined using t-tests with Cohen’s d. Results: Perceived stress was negatively correlated with life satisfaction (r = −0.43, 95% CI [−0.54, −0.29], moderate effect). Emotion-oriented coping correlated negatively with life satisfaction (r = −0.28, 95% CI [−0.42, −0.14]), while social diversion correlated positively (r = 0.21, 95% CI [0.07, 0.35]). Women reported higher stress (Cohen’s d = 0.60) and lower life satisfaction (Cohen’s d = −0.50) than men. Moderation analysis revealed that emotion-oriented coping significantly intensified the negative effect of stress on life satisfaction (B = −0.01, p = 0.019). Conclusions: Perceived stress strongly impairs life satisfaction in uniformed personnel, particularly among those relying on emotion-oriented coping. Targeted interventions, such as emotion regulation training, mindfulness, and cognitive restructuring, may enhance resilience and mitigate stress-related declines in well-being in this high-risk occupational group.

UDC 616.12-005.4-036.12-06:(616.12+616.61+616-056.5)]-008 

Cardio-renal metabolic syndrome (CRMs) is believed to be a holistic, systemic disorder with multiorgan dysfunction and a high number of adverse cardiovascular outcomes. It involves complex interconnection mechanisms between renal dysfunction, cardiovascular disease and metabolic disorders. Our study's feasibility was determined by several unresolved issues regarding the peculiarities of the course of CRMs. A deep understanding of the interrelationships of these conditions requires a comprehensive approach aimed at studying and evaluating risk factors and pathophysiological mechanisms. Studying the features of CRMs will allow optimising lifestyle, involving an interdisciplinary team in treatment and, in the future, developing a unified protocol for the management of such patients.
The study aimed to evaluate the clinical manifestations and characteristics of CRMs in patients with chronic coronary heart disease.
For this purpose, 113 patients with chronic coronary heart disease (CHD) were examined, chronic heart failure (CHF) I-III functional class (FC) according to the NYHA, who were diagnosed with CRMS according to the criteria: diagnosed CHD with CHF; body mass index (BMI) > 25 kg/m2; fasting glucose level > 6.1 mmol/l or previously diagnosed type 1 or type 2 diabetes mellitus (T2D) or use of hypoglycaemic therapy; glomerular filtration rate (GFR) < 80 kg/mkmol; blood creatinine above normal.
The results of the study indicate that 15.92% of patients with chronic coronary artery disease can be diagnosed with complete cardio-renal metabolic syndrome. Patients with complete CRMs were younger but had higher BMI, systolic hypertension and tachycardia, hyperlipidemia and leptin resistance, higher levels of total fibrinogen and leukocytes, leukocyte intoxication index, lipid ratios and triglycerides. The deterioration of metabolic parameters was
accompanied by activation of inflammation and endogenous intoxication, cytolysis and an increase in leptin.

Abstract
Background Disease and non-battle injuries (DNBI) often account for more military casualties than those from
combat wounds. The February 2022 Russian invasion of Ukraine has severely limited access to care in areas with
increasing patient care needs beyond combat injuries. The expansion of the draft resulted in an older military
population susceptible to musculoskeletal injuries, while trench warfare and harsh winters create conditions
conducive to cold weather injuries and infectious diseases. This study aims to assess the prevalence and scope of
DNBI in Ukraine.
Methods We conducted qualitative key informant interviews with Ukrainian military and civilian health care workers
from June 2023-February 2024 using an expanded version of the Global Trauma System Evaluation Tool which had
components focusing on DNBI. Thematic content analysis was used to derive key themes related to DNBI from
interviews.
Results We conducted 36 key informant interviews. Respondents described the wide range of DNBI that Ukrainian
soldiers are experiencing. Infectious disease, cold weather injuries, musculoskeletal injuries, sexual assault, and mental health emerged as prevalent concerns. Respondents described the critical shortage of resources and the high burden on military hospitals as barriers to the delivery of adequate care for DNBI.
Conclusions DNBI in Ukraine are directly related to the physical environment and the age and fitness of the military population. The troop shortage has resulted in soldiers with chronic illnesses returning to duty, while the physical environment limits prevention measures for weather-related injuries and infectious diseases. The complex healthcare challenges created by these factors highlight the importance of a military health system with the capacity to provide service members with the full spectrum of care beyond combat injuries.
Keywords Ukraine, Disease and Non-battle Injury, Conflict, Military Health

Introduction:
Ukraine’s health and trauma care system has been devastated by the Russian Federation’s invasion in 2022. Previous research shared insight of returned volunteers into changes in the system; however, as the war continues there is the need to understand how the observations of United States (U.S.) volunteers and Ukrainians working in healthcare in Ukraine may differ regarding perceptions of the trauma system’s current strengths and challenges.
Materials and Methods: We conducted structured interviews with U.S. healthcare or healthcare-adjacent returned volunteers and Ukrainian healthcare workers using the Ukraine Trauma System Assessment Tool Study Region Observation (TSAT SRO) Tool. Mean scores were calculated for each trauma system domain among both Ukrainian and U.S. groups. t-tests were used to determine if there were any statistical differences between these means among the 2 groups.
Results:
The overall score for the Ukraine trauma system combining scores from U.S. volunteers and Ukrainians was 1.89 out of a possible 3.00. The domains with the highest combined scores included Prehospital, Chemical, Biological, Radiological, Nuclear, and Explosive (score = 2.33), Prehospital Training (score = 2.25), and Definitive Care Facilities: Blood Product Use (score = 2.38). Domains with the lowest combined scores included Injury Prevention (score = 1.55), Definitive
Care Facilities: Disease and Non-Battle Injuries (DNBI) (score = 1.60), and Logistics and Supply (score = 1.55). U.S.
volunteers scored every domain lower compared to Ukrainian respondents. All differences between U.S. volunteers
and Ukrainian responses were statistically significant except Definitive Care Facilities: Telemedicine, Definitive Care
Facilities: Blood Product Use, and Definitive Care Facilities: DNBI.
Conclusions:
TSAT SRO component scoring from observations of U.S. volunteers and Ukrainian healthcare workers suggests the
current Ukrainian trauma system is in development. Domain scores differed between U.S. volunteers and Ukrainians; most were statistically significant, demonstrating the importance of including citizens of a nation versus only foreign healthcare workers in assessing a healthcare or trauma system