Factors Affecting Colorectal Cancer Screening in Primary Care Physician Practices in Ukraine.

PURPOSE: This study aims to identify the factors influencing colorectal cancer (CRC) screening practices, along with the barriers and facilitators from the perspective of primary care physicians (PCPs) in Ukraine. Considering health care system challenges, including those posed by the ongoing war, this research seeks to inform improvements in CRC screening and outcomes in Ukraine and other low- and middle-income countries (LMICs). METHODS: A survey was designed and distributed electronically to Ukrainian PCPs, focusing on CRC screening practices, beliefs, and barriers. The survey incorporated questions adapted from established cancer screening surveys and frameworks. Complete responses were collected from 740 PCPs. Sample statistics were computed, and population-level perceptions and associations with CRC screening practices were estimated by standardizing responses to national PCP demographics. RESULTS: The majority of respondents were women (91%) and specialized in family medicine (84%). Respondents believed in the effectiveness of colonoscopy for reducing CRC mortality (80%), with 75% of PCPs referring patients for this screening modality. Major barriers identified include inadequate training of PCPs in screening and lack of resources. Respondents reported high utilization of fecal occult blood test and colonoscopy for screening when these tests were said to be available in their practices. Self-reported familiarity with CRC screening guidelines and participation in educational workshops were positively associated with screening referrals. CONCLUSION: The study highlights the role of access to CRC screening tests and awareness of screening guidelines in enhancing CRC screening practices among Ukrainian PCPs. Addressing training and resource barriers, alongside public health interventions targeting patient-related barriers, is essential. These findings offer valuable insights for LMICs facing similar challenges, emphasizing the need for tailored strategies to improve cancer screening in these health care settings.

Adverse pregnancy outcomes associated with endometriosis in Ukraine: results a multicenter study.

OBJECTIVE: Aim: To estimate pregnancy outcomes associated with endometriosis in Ukraine. PATIENTS AND METHODS: Materials and Methods: We performed the multicentre prospective cohort study during the period from January 1st, 2019 to December 31st, 2021. The study included pregnant women aged ≥18 years hospitalized in 17 hospitals from 15 regions of Ukraine. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Results: Of the 27,558 women, 990 (3,6%) reported a diagnosis of endometriosis before pregnancy. In 990 deliveries, women with endometriosis had a higher risk of hypertension in pregnancy (OR 1.2, 95% CI 1.0-1.3), preeclampsia (OR 1.4, 95% CI 1.3-1.5), severe preeclampsia (OR 1.7, 95% CI 1.5-2.3), hemorrhage in pregnancy (OR 2.3, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), birth before 34 weeks (OR 3.2, 95% CI 2.8-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). CONCLUSION: Conclusions: Pregnant women with endometriosis are at elevated risk for serious and important adverse maternal, fetal and neonatal outcomes. The magnitude of these complications calls for more intensive antenatal care of pregnant women with endometriosis.

Condition of oral tissues in children with congenital cleft lip and palate.

OBJECTIVE: Aim: To study the condition of oral tissues in children with congenital complete cleft lip, alveolar process, hard and soft palate. PATIENTS AND METHODS: Materials and Methods: From the examined 470 children National Specialized Children's Hospital "OKHMATDYT" (Kyiv, Ukraine) with congenital cleft lip and palate was analyzed: 302 patients aged 8-18 years were subject to in-depth analysis for clinical and radiological - 192 with unilateral and 110 with bilateral complete cleft lip, alveolar process, hard and soft palate. RESULTS: Results: The average value of primary adention in patients with unilateral and bilateral complete combined cleft is 69.53%, but in females this indicator is higher and in unilateral cleft 92.18% for female against 53.17% for male. In females with unilateral cleft retention - 40.62% and overcomplete - 10,93%. The same high indicators in bilateral cleft: retention - 36.58% and overcomplete - 12.19%. Retention and overcomplete have higher values for men - 44.93% and 23.19%, respectively. Chewing efficiency in females with bilateral cleft as a result of primary dentition is below 80%. Affected by caries - 90.73% in both groups. Inflammatory processes in the periodontal tissues are revealed (80,75%): chronic catarrhal gingivitis, chronic hypertrophic gingivitis, chronic generalized periodontitis. Manifestations of atopic and angular cheilitis in 39.09% and 23.63% with bilateral cleft lip and palate, glossitis in 29.09%. CONCLUSION: Conclusions: Patients with congenital complete cleft lip, alveolar process, hard and soft palate have high rates of adentia, retention, overcomplete dentition and a wide range of diseases of the oral cavity, which negatively affects surgical and orthodontic rehabilitation.

Epidemiology of dental caries in internally displaced children during wartime in Ukraine.

OBJECTIVE: Aim: To conduct a comprehensive analysis of the oral health status of this vulnerable population in order to collect objective data that will contribute to the development of effective strategies for maintaining and improving oral health in wartime conditions. PATIENTS AND METHODS: Material and Methods: This epidemiological study was carried out within the initial 6 months of the full-scale invasion of the country. The oral health indices of 1050 internally displaced children, aged 3 to 17 years, seeking dental care at the Municipal Children Dental Clinic in Poltava, were analyzed. RESULTS: Results: The total sample comprised 620 children aged 6-11 years (mean = 8.5, SD = 0.76), with a gender distribution of 52% boys and 48% girls. The participants were divided into three age groups: Group I (6-7 years), Group II (8-9 years), and Group III (10-11 years). The average prevalence of dental caries, as measured by the dmft + DMFT index, was 76.5%, with prevalence increasing with age. Specifically, the prevalence of dental caries based on the dmft index was lower in children of Group III (66.6%) compared to Group I (79.49%). CONCLUSION: Conclusions: The analysis of the oral status among internally displaced children aged 6-11 years revealed higher dental caries prevalence and intensity compared to local children. Notably, children aged 6-7 years showed a high rate of caries in temporary teeth.

Current state of students' health and factors as well as means of its improvement.

OBJECTIVE: Aim: To assess the current state of students' health in higher educational institutions in Ukraine and identify the main measures, factors, and means of its improvement. PATIENTS AND METHODS: Materials and Methods: The research was conducted in 2022-2023 and involved 266 second-year students (82 males, 184 females) from different faculties. Research methods: analysis of literary sources, observation, questionnaire surveys, and statistical methods. RESULTS: Results: A general downward trend in the level of health among students in higher educational institutions in Ukraine has been established. The deterioration of the health of male students is particularly worrying: the number of students with good health has decreased by 34.1 % over the past 10 years, while the number of students with poor and very poor health has increased by 14.0 % and 3.7 %, respectively. It has been found that 41.5 % of male and 34.2 % of female students do not know the cause of their illness and do not know how to prevent it. Students are well aware of the value of their health but do not care about it, are too lazy to exercise and rely on medications or a doctor when they are ill. CONCLUSION: Conclusions: A student's health is his or her social and personal values, level of culture, ability to withstand heavy physical and mental stress, and ability to adapt to various external factors. Therefore, the primary task of physical education departments should be to form the interests, desires, and motives of students for physical exercise.

The effectiveness of physical therapy in the rehabilitation of patients after arthroscopy of the knee joint.

OBJECTIVE: Aim: To determine the effectiveness of physical therapy on the functional state of law enforcement officers' knee joints after surgical intervention. PATIENTS AND METHODS: Materials and Methods: The research involved law enforcement officers from different units of the National Police of Ukraine (n = 56) who had suffered knee joint injuries in the line of duty, and underwent surgical intervention and rehabilitation procedures. RESULTS: Results: It was found that 78.2 % of respondents had suffered knee joint ligament injuries as a result of falls during rapid movement, while 43.9 % were in full gear (armored protection, helmet, etc.). It was determined that after surgical intervention, the functional state of the knee joint of law enforcement officers who followed the recommendations of physical therapy specialists and systematically performed special sets of physical exercises was significantly different (p < 0.001). Worse results were noted in people who partially followed the recommendations of rehabilitation therapists and performed part of the prescribed procedures and physical exercises. CONCLUSION: Conclusions: The effectiveness of the complex use of physical rehabilitation means for restoring the functioning of the knee joint after surgical intervention, which included arthroscopy, partial menisectomy of the damaged areas, debridement, vaporization of damaged cartilage, etc. was revealed. The positive effect of physical exercises on the functional state of the knee joint was proven. The sets of exercises that are advisable to use to restore the functioning of the knee joint were determined.

Dynamics of components of physical and mental health of law enforcement officers during the period of martial law.

OBJECTIVE: Aim: To investigate the dynamics of law enforcement officers' physical and mental health components while performing their duties during the war in Ukraine. PATIENTS AND METHODS: Materials and Methods: The research, which was conducted in 2022-2024, involved 114 law enforcement officers (male) from the Kharkiv oblast (Ukraine) of different ages: under 30 (n = 35), under 40 (n = 41), over 40 (n = 38). To test law enforcement officers' physical and mental health indicators, we used 3 methods: 1) "Fatigue-Monotony-Oversaturation-Stress"; 2) "Well-being-Activity-Mood"; 3) "Assessment of Nervous and Emotional Stress". RESULTS: Results: The negative dynamics of most components of the physical and mental health of law enforcement officers of all three groups while performing their duties during the martial law were revealed. The most pronounced significant changes occurred in such components as "Fatigue", "Oversaturation", "Stress", "Well-being", "Mood", "Nervous and Emotional Stress". The most pronounced negative changes in most components occurred in law enforcement officers over 40 years old, which is due to both the age characteristics of the subjects and their length of service. CONCLUSION: Conclusions: The research confirms the high complexity and extremity of law enforcement officers' service activities during the martial law, as well as the high requirements for law enforcement officers' readiness to perform tasks in the context of a significant expansion of the National Police's powers. The results obtained also necessitate the search for effective ways to preserve and maintain the physical and mental health of law enforcement officers.

Health-improving effect of running for students of technical specialties.

OBJECTIVE: Aim: To study the dynamics of indicators of the functional state and health of technical specialties students during their long-term running engagement. PATIENTS AND METHODS: Materials and Methods: The research involved 112 students (59 men and 53 women) aged 17-20 years. Two groups of students were formed: group 1 included students who, in addition to compulsory academic physical education training sessions, were not engaged in any type of motor activity on their own; group 2 included students who independently were engaged in recreational running 3 times a week in extracurricular time. RESULTS: Results: It was found that during the research period, both male and female students who were independently engaged in recreational running in extracurricular time showed a significant improvement of such indicators as resting heart rate, vital capacity of the lungs, duration of breath holding during inhalation and exhalation, duration of heart rate recovery after standard exercise, level of endurance development, level of physical health. CONCLUSION: Conclusions: The positive influence of independent running with moderate intensity on the functional state and health of students of technical specialties has been proved. The low efficiency of the physical education system in Ukraine and, accordingly, the insufficient level of motor activity, indicators of functional status, and health of students who, in addition to academic physical education training sessions, did not exercise on their own, were also confirmed.

Teachers' assessment of the mental health of children with special educational needs during the war.

OBJECTIVE: Aim: To study the results of teachers' assessment of the mental health of high schoolers with special educational needs (SEN) after the 1.5 years of war in Ukraine. PATIENTS AND METHODS: Materials and Methods: Teachers' assessment of the mental health of high schoolers with SEN was conducted through an anonymous survey of teachers using the questionnaire developed by the authors. The research, conducted in 2023, involved 739 teachers working with high schoolers (ages 6-10) with SEN. RESULTS: Results: It was found that 32.3 % of high schoolers were in the combat zone or on the temporarily occupied territory; 31.7 % of high schoolers were forced to leave their homes and were temporarily displaced, 17.7 % went through a separation from their parents, 15.8 % witnessed hostilities, and 3.8 % suffered bullying from their peers. In the educational process, high schoolers with SEN most often experienced anxiety (55.2 %), "emotional swings" (48.4 %), restlessness (44.8 %), fear (37.2 %). During the 1.5 years of war, 15.4 % of high schoolers began to study worse, 12.9 % began to spend more time playing computer games and on social media. It was found that 59.9 % of teachers need more information on maintaining the mental health of high schoolers with SEN. CONCLUSION: Conclusions: The results obtained proved the negative impact of hostilities on the territory of Ukraine on the mental health of high schoolers with SEN, which necessitates the provision of adequate psychological support by teachers of such high schoolers in the educational process.

Fetal exposure to the Ukraine famine of 1932-1933 and adult type 2 diabetes mellitus.

The short-term impact of famines on death and disease is well documented, but estimating their potential long-term impact is difficult. We used the setting of the man-made Ukrainian Holodomor famine of 1932-1933 to examine the relation between prenatal famine and adult type 2 diabetes mellitus (T2DM). This ecological study included 128,225 T2DM cases diagnosed from 2000 to 2008 among 10,186,016 male and female Ukrainians born from 1930 to 1938. Individuals who were born in the first half-year of 1934, and hence exposed in early gestation to the mid-1933 peak famine period, had a greater than twofold likelihood of T2DM compared with that of unexposed controls. There was a dose-response relationship between severity of famine exposure and increase in adult T2DM risk.

The lasting effects of famine.

Early exposure to food scarcity in Ukraine increases diabetes risk in later life.

Inclusion in Ukrainian universities from an inside perspective.

This study investigates the state of inclusivity in Ukrainian universities, focusing on the perceptions of university staff amid the country's ongoing sociopolitical transformations. Here we report on the perceptions of 820 staff members from various professional roles, including academic, management, and support positions, this research explored inclusivity through diverse lenses, encompassing work experience, interactions with students with disabilities, and self-identification with vulnerable groups. Most respondents assessed a moderate to high level of inclusivity, indicating a positive overall outlook on inclusive practices within these institutions. Notably, perceptions of inclusivity vary slightly across different professional roles, with academic staff expressing a marginally lower level of perceived inclusivity than their counterparts. However, these variations are not statistically significant, suggesting a uniform perception across staff categories. Furthermore, the study revealed that personal experience in working with students with disabilities does not substantially alter staff perceptions of inclusivity. Similarly, self-identification with vulnerable groups only marginally influences these perceptions. This suggests that while individual experiences and identities are factors in inclusivity perceptions, their impact is not profoundly different. This research contributes to understanding inclusivity in higher education, particularly within environments undergoing significant social and political changes.

[Care for Seriously Injured People in Military Conflicts]. / Schwerstverletztenversorgung in kriegerischen Auseinandersetzungen.

The current war in Ukraine has drawn public attention to the treatment of war injuries. Follow-up treatment in Germany is portrayed the clover leaf of the TraumaNetzwerke DGU, is largely based on the demands of the Federal Ministries for Defence and Health and is intended to enhance resilience in war.The present article presents the special features of the care of severely injured patients during hostilities and should provide insights into the expected results of treatment and the actual procedures. We emphasise the unpredictability of the care of the severely injured during hostilities.On the basis of a search of the literature for the deployment of the German Army in Afghanistan and for the current war in Ukraine, we present the challenges and the typical patterns of injuries. We discuss the factors that can influence the procedures and the quality of the results during hostilities and how these may differ from civil polytrauma care in Germany - which is well established and standardised.Even during deployment of the Federal Army or (as planned) NATO, care of the severely injured is under standardised conditions, as based on the algorithmic ATLS care and which is concentrated on bleeding control. The corresponding equipment and personnel are well established, well prepared and well trained.However, there may be special local conditions or special deployments that make it inevitable that emergency medical care will be more delayed than in the civil system in Germany and can only take place after protracted transport. The objective is always that soldiers in combat should be able to receive medical care that is equivalent to that received by all accident victims in Germany, whatever the time and site of the accident.

Application of haloinhalations at the sanatorium-resort stage of rehabilitation of patients after COVID-19.

BACKGROUND: After suffering from COVID-19, a large number of patients need respiratory rehabilitation. One of the methods of rehabilitation is inhalation with salt aerosols. OBJECTIVE: Our work aimed to study the effectiveness of inhalations of a dry aerosol of salt precipitated from the mineral water of the "Teplitsa multidisciplinary sanatorium", Transcarpathian region of Ukraine. MATERIAL AND METHODS: 30 male patients were examined after suffering from COVID-19. We formed two groups of patients, control and main, 15 people each. Patients in the control group received inhalation with a dry aerosol of table salt of the "Aero-M-sol". In contrast, patients in the main group received a course of inhalations with a dry aerosol of salt precipitated from the mineral water. RESULTS AND DISCUSSION: Under the influence of the rehabilitation complex in both groups, there is a performance improvement but significant changes are observed only in patients of the main group. The indicator Forced Vital Сapacity1 increased to the greatest extent, which after rehabilitation is significantly higher than in the control group (p<0.05). As a result, the Tiffeneau index significantly increases in the main group compared to the control group, reaching normal values. The main effect is associated with a decrease in obstructive complications of the respiratory tract as a result of a decrease in inflammation. The use of iodine-bromine brines (as in our case) for inhalation in the treatment of respiratory diseases has been proven to be effective, with systemic effects in the form of decreased IgE and increased IgA in the blood serum having been noticed. CONCLUSIONS: The use of haloinhalations with MW salts in the rehabilitation of patients after suffering from COVID-19 disease significantly improves the clinical condition of convalescents.

Countrywide screening supports model-based predictions of the distribution of Batrachochytrium dendrobatidis in Ukraine.

The chytrid Batrachochytrium dendrobatidis (Bd) is a widespread fungus causing amphibian declines across the globe. Although data on Bd occurrence in Eastern Europe are scarce, a recent species distribution model (SDM) for Bd reported that western and north-western parts of Ukraine are highly suitable to the pathogen. We verified the SDM-predicted range of Bd in Ukraine by sampling amphibians across the country and screening for Bd using qPCR. A total of 446 amphibian samples (tissue and skin swabs) from 11 species were collected from 36 localities. We obtained qPCR-positive results for 33 samples including waterfrogs (Pelophylax esculentus complex) and fire- and yellow-bellied toads (Bombina spp.) from 8 localities. We found that Bd-positive localities had significantly higher predicted Bd habitat suitability than sites that were pathogen-free. Amplification and sequencing of the internal transcribed spacer (ITS) region of samples with the highest Bd load revealed matches with ITS haplotypes of the globally distributed BdGPL strain, and a single case of the BdASIA-2/BdBRAZIL haplotype. We found that Bd was non-randomly distributed across Ukraine, with infections present in the western and north-central forested peripheries of the country with a relatively cool, moist climate. On the other hand, our results suggest that Bd is absent or present in low abundance in the more continental central, southern and eastern regions of Ukraine, corroborating the model-predicted distribution of chytrid fungus. These areas could potentially serve as climatic refugia for Bd-susceptible amphibian hosts.

Addressing neurosurgical challenges in war conflict countries.

The Russo-Ukrainian war caused significant humanitarian and healthcare issues in the Russo-Ukrainian region, which were further aggravated by the escalation of the conflict on February 2022. Because of this ongoing confrontation between the two nations, which has its roots in geopolitical conflicts and historical events, there have been nearly 4 million refugees in only the first month, and 906 healthcare institutions have sustained significant damage. Consequently, the demand for medical services has increased, adding onto the burden of the pre-existing problems within the region's healthcare system, such as inequities, budget shortages, and corruption. With nearly 500,000 military deaths and an estimated 27,1499 civilian casualties, the war's immediate health effects are devastating. Due to inadequate disease surveillance and difficulties with immunization, the risk of infectious illnesses, particularly HIV/AIDS and tuberculosis, increased. Although there were originally few mental health problems, the long-term effects are yet unknown. Some of the indirect effects are the severe refugee situation, the burden on public infrastructure, and problems with the security of food and water. Unprecedented obstacles confronted neurosurgery in the Russo-Ukrainian region, including increased patient loads from war-related cases, resource limitations, and facility devastation. Many countries stepped up to aid in managing neurosurgeries however, the some of the problems still persisted, such as insufficient sterility and power outages. Strengthened security standards, financial incentives, telemedicine services, and cooperation with international medical organizations are the main points of recovery recommendations. Rebuilding the region's healthcare system and guaranteeing ongoing foreign support after the conflict require a comprehensive strategy that addresses both short- and long-term issues.

Explaining post-traumatic stress symptoms and sleep disturbance in Ukrainian civilians: perceived threat versus objective war exposure.

Objective: This study investigated the impact of war exposure on post-traumatic stress symptoms (PTSS) and sleep disturbance across Ukraine. Subjective and objective indicators of war exposure were modelled as predictors of these symptoms.Methods: We created two predictors: first, we used governmental and crowd-sourced data to create an objective war exposure index for each of the 21 non-occupied regions of Ukraine, based on the number of air raid alarms, explosions, and proximity to frontline; and second, we obtained self-report cross-sectional data, using convenience sampling, from a nation-wide survey (N = 991) on subjective experience of threat triggered by the war. The survey also measured the outcome variables of PTSS and sleep disturbance. Hierarchical multilevel regressions modelled the relationship of this objective war exposure index with the two outcome variables, after accounting for demographics. A final regression step modelled subjective threat as predictor of these symptoms.Results: We observed strongly elevated levels of PTSS and sleep disturbance and strong regional differences in objective and subjective war indicators. Objective war exposure predicted PTSS but not sleep disturbance, whereas subjective threat predicted both symptom domains.Conclusion: The study demonstrates the utility of objective war exposure data for predicting the prevalence of PTSS in the different regions. The results further underscore the prominent role of subjective appraisal processes in the symptomatology of PTSS and sleep disturbance, thus informing theories on trauma-related disorders. Our results can guide the allocation of mental health services by identifying highly affected regions.

Objective data on air raid alarms and explosions have been prospectively collected in Ukraine.We related those objective data to symptom reports of 991 responders in most Ukraine regions.Objective data explained symptoms of post-traumatic stress but not sleep disturbance.

Radiocaesium in mosses from the Kopacki rit Nature Park in Croatia: searching for undeclared releases from nuclear facilities in war-torn Ukraine.

The invasion of Ukraine and military operations around Ukrainian nuclear power plants and other nuclear facilities have prompted us to search for radiocaesium in mosses from the Kopacki Rit Nature Park in Croatia, since mosses are known bioindicators of airborne radioactive pollution, and Kopacki Rit is a known low radiocaesium background area. Sampling was finished in August 2023, and our analysis found no elevated radiocaesium levels. Kopacki Rit therefore remains a suitable place for future detection of anthropogenic radioactive pollutants.

IMPROVEMENT OF THE MODEL OF PREVENTION OF MALIGNANT NEOPLASM OF THE GASTRIC.

The fight against malignant neoplasms is one of the most important problems of health care in Ukraine; its relevance is due to the continuous growth of oncological morbidity in the population, the complexity of timely diagnosis and treatment, high cost, as well as quite high levels of disability and mortality of such patients. Gastric cancer, which remains one of the most common and deadly neoplasms in the world, occupies one of the leading positions among cancer. Aim - scientifically substantiate and develop a model for improving the organization of prevention of malignant neoplasms of the gastric. A study of performance indicators of oncology health care facilities and a survey of respondents was conducted: 180 respondents of patients with gastric cancer and precancerous diseases of the stomach using medical-statistical, sociological methods and questionnaires. A functional and organizational model for improving the prevention of malignant neoplasms of the stomach has been scientifically substantiated and developed. The features of the proposed model were the inclusion in it, in addition to the previously existing, innovative elements (an algorithm for early diagnosis and prevention of negative consequences of malignant neoplasms of the stomach at the level of primary medical care, reminders for primary medical care doctors regarding monitoring of risk factors and predictors of malignancy of precancerous stomach diseases, the allocation of a dynamic monitoring group due to the increased risk of precancerous gastric diseases becoming oncological), as well as previously existing, but functionally changed components (optimization of the functions of the primary care physician in relation to the information provision of the patient and his relatives; monitoring of risk factors for precancerous and cancerous stomach diseases, control and accounting for the implementation of the recommendations of specialist doctors and rehabilitation specialists), the interaction between which provided the model with a qualitatively new focus on achieving its strategic goal - preventing the occurrence and progression of the development of malignant neoplasms of the gastric. The proposed functional and organizational model will lead to a positive medical and social effect for the improvement of the organization of the prevention of gastric cancer in the main areas: systematicity, comprehensiveness and preventive direction. Its implementation will lead to an increase in early detection, coverage of dynamic monitoring of patients, as well as a projected economic effect due to a decrease in the specific weight of neglected forms of gastric cancer, improvement in survival and reduction in mortality.

PROTECTION OF CONFIDENTIAL MEDICAL INFORMATION IN UKRAINE: PROBLEMS OF LEGAL REGULATION.

The aim of the article is to analyze the legal aspects and mechanisms of confidential medical information protection about an individual in the health care sphere in Ukraine. During the scientific research, various methods of cognition of legal phenomena were used. Among the general scientific approaches, the dialectical method was primarily used, which allowed to identify trends in the development of patient information rights and formulate proposals for improving legislation in the field of medical data protection. The formal-legal method was used to provide a comprehensive characterization of the EU (European Union) and Ukrainian legislation in the sphere of confidential medical information protection. Additionally, general scientific logical methods (analysis and synthesis, comparison and analogy, abstraction, and modeling) were used in order to study the problems of information relations in the medical field and establish legal liability for violation of the confidentiality of such information. The definitions of medical data, medical information, confidential medical data, and medical confidentiality have been researched and compared. The article identified the legitimate grounds for disclosing confidential medical information about an individual in the healthcare sector. Authors revealed the gaps in Ukrainian legislation regarding the confidential medical data protection by healthcare professionals and electronic medical systems regulators. The necessity of expanding the list of subjects responsible for preserving confidential medical information has been substantiated. The study explored the case law of the European Court of Human Rights in the field of the medical data confidentiality violation. It has been outlined the potential judicial remedies and liability for violating the right to personal medical information confidentiality of an individual in the healthcare sector. The legal grounds and cases of possible lawful disclosure of confidential medical information have been analyzed. Attention has been drawn to the insufficient regulation of access to medical confidentiality during martial law. It has been emphasized that the mechanism for protecting the violated right to confidentiality of medical information involves appealing to the Ukrainian Parliament Commissioner for Human Rights or to the court. The increasing role of international legal acts in ensuring the protection of medical data in the European Union and Ukraine has been highlighted.