The incidence of miscarriage has been increased all over the world. In this situation more often children need artificial ventilation of the lungs (AVL) and form risk group for recurrent and chronic bronchopulmonary pathology development . Interconnection of prematurity – acute pulmonary disorders – the further formation of bronchopulmonary disease is no longer in doubt. It is observed a correlation between the administration of artificial ventilation in the neonatal period and the subsequent formation of bronchopulmonary pathology. Our studies have shown that in the case of developing bronchial asthma in a child born prematurely and suffering from acute pulmonary disorders in the period of newborn birth, the risk of developing a severe variant of the disease is extremely high . The obtained data showed that asthma in such children is characterized by a severe course, often the so-called variant "difficult asthma" (with frequent exacerbations in the form of an asthmatic condition) is often observed [5, 10]. We have been followed up 27 children with bronchial asthma, whom after birth prolonged ventilation (more than 7 days) was performed due to pulmonary sickness.
The course of asthma in these children is characterized by frequent exacerbations and perscription of high doses of β2-agonists and hormonal drugs. This cohort of patients requires special care both on the part of parents and nursing staff.
The reason should be sought, analyzing the features of the ante and perinatal period of the child's development [1, 4]. Frequent causes of miscarriage are inflammatory processes of diverse nature and etiology. In the process of inflammation, the number of cytokines, oxidants, and lytic
enzymes increases in the mother's body. In immature children, control over the inflammation process is inadequate [8, 12]. Low levels of antioxidants, antiprotease and anti-inflammatory cytokines can negatively affect the balance between inflammatory and anti-inflammatory cytokines, which in turn causes persistent inflammatory reaction and damage . Chronic inflammation causes hyperreactivity of the respiratory tract, which can not but affect the development and progress of bronchial asthma in the future . It is precisely this situation that determined the relevance and purpose of our study.
Aim is to study the frequency and the features of the course of broncho-pulmonary pathology in young children who were on artificial ventilation of the lungs in the neonatal period.
Abstract
Aim. The research aims at improving the quality of rendering medical care in the urology departments of health care facilities by conducting the clinical audit with advanced study of causes of dissatisfaction of patients with the medical service provided.
Material and Methods. Sociological research included the questioning of 405 patients who were treated in the urology departments of the municipal nonprofit enterprise of the Lviv Regional Council "Clinical Emergency Hospital". The respondents estimated the quality of providing health care in the sphere of medical service, informational content, financing, the quality of diagnosis and treatment. Methods of structural-logical analysis, systemic approach and analysis, calculation of mean and relative values, calculation of satisfaction index with services provided are used in this work.
Results and Discussion. The determination of the level of respondents' satisfaction with inpatient treatment showed that, in total, that the number of dissatisfied among the interviewed were 7.16±1.28 % persons. The focus-group of such persons was singled out: patients of active working age, financially - able, mainly with higher education, most often with diagnosis of urolithiasis, who suffered from pain syndrome, with late appealing for medical care (more than 24 hours), they were operated on and waited for the quick results of treatment, even despite the positive final result of treatment. These patients demanded more attention of a doctor, were dissatisfied with the work of paramedical personnel, conflicted with ward neighbors, had claims to availability and quality of medical equipment, sanitary state of premises of the department.
Conclusions. The results of the clinical audit targeting the satisfaction of patients with medical services provided as one of the forms of receiving the patient feedback concerning the quality of medical aid, point out, on one hand, the appropriate level of availability of services, interpersonal attitudes, infrastructure, execution of technical demands as to quality and standard compliance by the staff of department. While, on the other hand, the audit results indicate the presence of dissatisfied with some certain services in the department. The focus-groups of dissatisfied make it possible to take into account the personal approaches in rendering medical aid to such categories of population, that in total will improve and increase the quality of providing medical services. Basing on the results of clinical audit, the recommendations as to the perfection of medical care management in the urology departments of health care facilities.
Abstract
The research aims at improving the quality assessment of clinical audit results in Ukraine using the complex of statistical methods and studying statistical methods in foreign reports of the clinical audit and personal experience.
Materials and Methods. The research was performed by analyzing the reports of clinical audit (n=62), held during 2021 by the Healthcare Quality Improvement Partnership. The spectrum of statistical methods was extended by the analysis of the example of a sociological survey of patients (n=405) regarding the quality assessment of medical care. The methods applied in the current study included systemic approach and analysis, structural and logical analysis, correlation and regressive analysis, calculation of relative values.
Results and Discussion. All 100% clinical audit reports, carried out by the Healthcare Quality Improvement Partnership were based on the results of the statistical calculations. The most common method of processing results is the epidemiological statistics (93.5%), ratio of chances/risks (30.6%), probability assessment by Х2 Pearson's method (21.0%). It is noteworthy that for pointing the central tendency almost in half of the cases (46.8 %) the median and the Interquartile Range were used. Complex mathematical methods such as the survival assessment by Kaplan- Meier and method multiple regression were used in 6.5 % та 4.8 % reports, accordingly.
Conclusions. Based on our own experience, we suggested implementation of standardization methods, a detailed correlation and regressive analysis, neuro networks and power analysis into the methodology (technique) of the clinical audit. Implementation of spectrum of evidentially substantiated methods of statistical analysis will allow to increase the evidence level and to deepen the statistical analysis of databases when conducting the clinical audit, аnd therefore, the quality assessment of clinical audit results will increase.
The purpose of this section is to highlight the opportunities for digitizing important processes in the healthcare system to improve the efficiency of population health management. The introduction of these digital processes will increase patient satisfaction with the healthcare system, as well as provide a holistic outlook of patient health through access to data and give patients more control over their own health. Healthcare managers will also be using the developed Internet applications to conduct clinical audits and monitor health problems in the administrative district. It is proposed to develop and use free Internet applications and computer programs, namely: 1) Drug Compatibility Test online application, which is designed primarily for students. This app is designed to test knowledge of drug compatibility and
certain aspects of diet and behavioral habits; 2) electronic individual antenatal drug passport for a promising way to predict, prevent and reduce the risk of allergic reactions; and 3) Medical Intelligence app using the artificial intelligence technologies to develop an individual educational trajectory for doctors and pharmacists.
Background We examined the human toll and the subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022.
Method We extracted and analyzed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services – all of which disrupted the lives of Ukrainians.
Results As of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/ AIDS, tuberculosis, and Coronavirus (COVID-19).
Conclusions The 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cos