A new range of threats arose at the beginning of the 21st century, and the current global and national security systems could not respond effectively. Climate change threatens human health and well-being. Extreme weather events, food and water shortages, and the growth of infectious diseases increase the burden on healthcare systems. Progress in international health partnerships in 2022 has stalled and, in some cases, is reversing. The constant increase in the cost of medical services and medicines has a negative impact on the effectiveness of the functioning of national healthcare systems. Out-of-pocket healthcare costs cause financial hardship for more than 930 million people and push about 90 million into extreme poverty each year. If current trends continue, the World Health
Organization predicts that by 2030, up to 5 billion people will be unable to access or afford health services. For further advancement in global health security and to ensure better health for all in a changing world, reducing the cost and guaranteeing access for indigent patients to innovative medicines for treating a wide range of life-threatening diseases is essential. To minimize the cost and ensure access to medicines, it is proposed to create international research centers for developing innovative medicines without patent protection with centralized funding and appropriate planning for high-level interdisciplinary fundamental and applied research based on the needs of healthcare systems worldwide.
Keywords: Healthcare; cost of medicines; patent protection; research center
The multi-sided damages caused by the large-scale invasion of Russia has become a great challenge for the medical care system of Ukraine. This research is aimed at studying, analyzing and summarizing data from scientific publications, personal experience, and open sources of relevant information concerning changes that occur in the work within Ukraine’s healthcare system and the activity of medical staff due to the Russian invasion. Special attention has been paid to processes related to relocations of medical staff and health care establishments, field hospitals as an important tool during martial law, as well as for the different types of support provided by the international partners of Ukraine. Data concerning demographic shifts in Ukraine due to the 2022 Russia-Ukraine war are also presented. Moreover, SWOT analysis of changes in the system of health care in Ukraine during martial law has been performed. Keywords: health care system of Ukraine, healthcare quality, demographic shifts, internally displaced people, relocations, field hospitals.
УДК: 613.84:159.923
Aim. Establishing the type of tobacco behavior and the main motives and reasons for smoking among consumers of tobacco products.
Material and Methods. A survey involved 817 individuals aged 18-44 in the Lviv region. Various types of tobacco products were identified among the interviewees: 96 respondents were smokers of electronic nicotine delivery systems (ENDS), 93 respondents were smokers of heated tobacco products (HTPs), and 228 respondents were smokers of classic cigarettes. A sociological survey using Horn's questionnaire was conducted to determine the types of behavior of smokers.
Results and Discussion. The dominant type of smoking behavior, both among smokers of classic cigarettes or tobacco products for heating (HTP), and among users of nicotine through electronic cigarettes (ENDS) was the "Support" type, the second-ranked - "Playing with a cigarette", the third-ranked - "Thirst". The largest number of smokers by the behavioral type "Playing with a cigarette" was found among HTP smokers - 55.91±5.15 cases per 100 respondents. The "Thirst" type is most typical in smokers of classic cigarettes - 39.91±3.24 cases per 100 respondents. The "Support" type was the leading one for male smokers in the groups of classic cigarette smokers (47.09±3.81 cases per 100 men) and ENDS smokers (47.62±7.71 cases per 100 men), while for HTP smokers - "Playing with a cigarette" (54.55±7.51 cases per 100 men). In the group of female smokers in all studied groups, the "Support" type was the dominant type of behavior. At the same time, among female ENDS smokers, two types of behavior were dominant, namely - "Support" and "Playing with a cigarette" with an identical rate of 44.44±6.76 cases per 100 women.
Conclusions. Determining the types of behavior of a smoker and the main reasons and motives for smoking will allow choosing a method of smoking cessation and increasing the effectiveness of quitting tobacco and nicotine use.
Background We examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022.
Method We extracted and analysed 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 cost of war will impact generations of Ukrainians to come.
УДК 616-036.22:618.39]-037(477+477.83)
Мета. Обґрунтування прогностичної складової в процесі опрацювання моделі попередження невиношування вагітності серед жіночого населення України.
Матеріали і методи. Проведено ретроспективний епідеміологічний аналіз динаміки невиношування вагітності серед жіночого населення України та Львівської області за період з 2014по 2021 роки та здійснено прогнозування показників даної патології до 2026 року. У роботі застосовано методи системного підходу та структурно- логічного аналізу, медико- статистичного аналізу та прогнозування за допомогою експоненціального згладжування за двохпараметричним методом Холта.
Результати й обговорення. За аналізований період з 2014 по 2021 роки відмічено зростання індексу співвідношення загального показника кількості невиношування до загального числа вагітностей (випадків невиношування на 100 вагітностей) з 5,50 у 2014 році до 6,22 у 2021 році в Україні та відповідно з 3,57 до 4,72 у Львівській області. З метою прогнозування нами було обрано метод експоненціального згладжування за двохпараметричним методом Холта (Holt). На нашу думку даний показник співвідношення найменше буде залежати від впливу війни та пандемії COVID-19.
За інших незмінних умов, результати прогнозування передбачають, що у 2026 році в Україні показник співвідношення невиношування до загального числа вагітностей становитиме 6,37 випадків невиношування на 100 вагітностей, а у Львівській області 5,38 випадків невиношування на 100 вагітностей.
Висновки. Аналіз показників динаміки співвідношення невиношування до загального числа вагітностей за аналізований 8-річний період як в Україні так і у Львівській області показав тенденцію до щорічного зростання даного індексу.
Погіршення демографічної ситуації за результатами дослідження, а також ймовірний розвиток демографічної кризи у зв’язку з воєнним станом в Україні та спровокованою ним масовою міграцією жіночого населення, вимагає пошуку усіх можливих шляхів, щодо попередження невиношування та врахування цієї прогностично- негативної тенденції у розробці профілактичних програм.