Environmental competencies for healthcare management at a 2nd education level as a component of strategic management.

OBJECTIVE: Aim: To present the results of the analysis of educational standards and curricula of the second educational level of training of specialists, who may be managers of healthcare, on the content of the environmental component as an element of strategic management. PATIENTS AND METHODS: Materials and Methods: Content analysis 24 educational standards of the Ministry of Education and Science of Ukraine of Ukraine for 6 fields of knowledge and 200 master's curricula from 87 institutions of higher education of Ukraine. CONCLUSION: Conclusions: There is a distribution of basic leadership and management competencies both by types of these competencies and between specialties. The requirements for the inclusion of the environmental component in the framework documents are poorly expressed. The content of environmental issues in the curricula is insufficient.

RELATIONSHIPS BETWEEN THE SOURCE OF HEALTH INFORMATION AND THE BEHAVIOR OF MOTHERS OF CHILDREN UNDER 5 YEARS OLD: CROSS-SECTIONAL STUDY ANALYSIS.

OBJECTIVE: The aim: Is to investigate relationships between trusted sources of health information and people's behavior, including their attitudes toward vaccination and their willingness to seek medical care. PATIENTS AND METHODS: Materials and methods: The responses of 4,354 mothers of children under 5 years of age from all regions of Ukraine, who participated in the Multi-Indicator Cluster Household Survey (MICS-2012) were analyzed. The respondents were divided into separate groups using two-step cluster analysis. RESULTS: Results: 6 clusters of respondents were identified, depending on the trusted source of health information identified by them, including those who trust only physicians (50.0%), friends (15.3%), all information channels (15.2%) or do not trust anyone (6.0%). The most important statistically significant differences in the level of vaccination coverage and willingness to seek medical care were found for a group of people who do not trust any source of information about health or trust only information from the Internet. People who trust information from physicians or pharmacy workers were the most active in vaccinating and seeking medical care. CONCLUSION: Conclusions: Communication with patients who do not trust anyone through social networks seems to be a promising way to raise awareness of this group of people about health and increase the level of trust in physicians or certain medical services.

METHODS FOR COMMUNICATION PROCESSES ENHANCEMENT IN THE "PROVIDER-CONSUMER (LEARNER)" SYSTEM OF EDUCATIONAL SERVICES.

OBJECTIVE: The aim: To determine learners' (doctors) needs and draw up proposals for upgrading educational communication processes in the "provider-consumer" system of educational services. PATIENTS AND METHODS: Materials and methods: The biblio-semantic, biostatistic and sociological methods were used. 754 author questionnaires were processed. RESULTS: Results: The socio-professional characteristics of learning service consumers at Shupyk National Medical Academy of Postgraduate Education were analyzed as well as studied their proposals. Evaluating communication interactions in the "provider-consumer" system of educational services concerned determining the most comfortable organizational modes of education for a consumer, making a careful analysis of the learning service characteristics by "accessibility" and "effectiveness" criteria. The determination methodology and research results can be used by universities and colleges regardless of the educational program specialization. CONCLUSION: Conclusions: Ensuring the educational communication processes effectiveness in the "provider-consumer" system of educational services is achieved by studying learners' adaptation according to such principal criteria as organizational modes of education, the learning service accessibility and effectiveness. The learning service providers adjust customer requirements to the capabilities of a particular educational institution (personnel availability, facilities and resources etc.) and so that they ensure competitiveness.

Exposure to air pollution from traffic and childhood asthma until 12 years of age.

BACKGROUND: There are limited prospective data on long-term exposure to air pollution and effects on childhood respiratory morbidity. We investigated the development of asthma and related symptoms longitudinally over the first 12 years of life in relation to air pollution from road traffic. METHODS: The Swedish birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiological Survey) includes 4089 children who were followed up with repeated questionnaires and blood samples for up to 12 years of age. Residential, daycare, and school addresses, time-activity patterns, emission databases, and dispersion models were used to estimate individual exposure to particulate matter with aerodynamic diameter <10 µm (PM10) and nitrogen oxides (NOx) from traffic. RESULTS: Overall, the data suggested possible associations between exposure to air pollution during the first year of life and asthma and wheezing in children up to 12 years of age. Asthma risks seemed to be particularly increased in children age 8 to 12 years; the overall odds ratio was 2.0 (95% confidence interval = 1.1-3.5), and for nonallergic asthma, the odds ratio was 3.8 (0.9-16.2) for a 5th to 95th percentile increase in time-weighted average exposure to PM10 (corresponding to 7.2 µg/m). Results were similar using exposure to traffic-NOx. CONCLUSIONS: We found modest positive associations between air pollution exposure from traffic during infancy and asthma in children during the first 12 years of life, with stronger effects suggested for nonallergic asthma.

Traffic-related air pollution and development of allergic sensitization in children during the first 8 years of life.

BACKGROUND: The role of exposure to air pollution in the development of allergic sensitization remains unclear. OBJECTIVE: We sought to assess the development of sensitization until school age related to longitudinal exposure to air pollution from road traffic. METHODS: More than 2500 children in the birth cohort BAMSE (Children, Allergy, Milieu, Stockholm, Epidemiological Survey) from Stockholm, Sweden, were followed with repeated questionnaires and blood sampling until 8 years of age. Outdoor concentrations of nitrogen oxides, as a marker of exhaust particles, and particles with an aerodynamic diameter of less than 10 µm (PM(10)), mainly representing road dust, were assigned to residential, day care, and school addresses by using dispersion models. Time-weighted average exposures were linked to levels of IgE against common inhalant and food allergens at 4 and 8 years of age. RESULTS: Air pollution exposure during the first year of life was associated with an increased risk of pollen sensitization at 4 years of age (odds ratio, 1.83; 95% confidence interval, 1.02-3.28) for a 5th to 95th difference in exposure to nitrogen oxides. At 8 years, there was no general increase in the risk of sensitization; however, the risk of food sensitization was increased, particularly among children free of sensitization at 4 years of age (odds ratio, 2.30; 95% confidence interval, 1.10-4.82). Results were similar by using PM(10). No associations between air pollution exposure after the first year of life and sensitization were seen. CONCLUSION: Traffic-related air pollution exposure does not seem to increase the overall risk of sensitization to common inhalant and food allergens up to school age, but sensitization to certain allergens might be related to exposure during infancy.

COVID-19 at War: The Joint Forces Operation in Ukraine.

The ongoing pandemic disaster of coronavirus erupted with the first confirmed cases in Wuhan, China, in December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) novel coronavirus, the disease referred to as coronavirus disease 2019, or COVID-19. The World Health Organization (WHO) confirmed the outbreak and determined it a global pandemic. The current pandemic has infected nearly 300 million people and killed over 3 million. The current COVID-19 pandemic is smashing every public health barrier, guardrail, and safety measure in underdeveloped and the most developed countries alike, with peaks and troughs across time. Greatly impacted are those regions experiencing conflict and war. Morbidity and mortality increase logarithmically for those communities at risk and that lack the ability to promote basic preventative measures. States around the globe struggle to unify responses, make gains on preparedness levels, identify and symptomatically treat positive cases, and labs across the globe frantically rollout various vaccines and effective surveillance and therapeutic mechanisms. The incidence and prevalence of COVID-19 may continue to increase globally as no unified disaster response is manifested and disinformation spreads. During this failure in response, virus variants are erupting at a dizzying pace. Ungoverned spaces where nonstate actors predominate and active war zones may become the next epicenter for COVID-19 fatality rates. As the incidence rates continue to rise, hospitals in North America and Europe exceed surge capacity, and immunity post infection struggles to be adequately described. The global threat in previously high-quality, robust infrastructure health-care systems in the most developed economies are failing the challenge posed by COVID-19; how will less-developed economies and those health-care infrastructures that are destroyed by war and conflict fare until adequate vaccine penetrance in these communities or adequate treatment are established? Ukraine and other states in the Black Sea Region are under threat and are exposed to armed Russian aggression against territorial sovereignty daily. Ukraine, where Russia has been waging war since 2014, faces this specific dual threat: disaster response to violence and a deadly infectious disease. To best serve biosurveillance, aid in pandemic disaster response, and bolster health security in Europe, across the North Atlantic Treaty Alliance (NATO) and Black Sea regions, increased NATO integration, across Ukraine's disaster response structures within the Ministries of Health, Defense, and Interior must be reinforced and expanded to mitigate the COVID-19 disaster.

Placental weight and its ratio to birthweight in a Ukrainian city.

BACKGROUND: Placental weight and its ratio to birthweight have recently been reported to predict later chronic disease. These fetal growth indicators have been measured in the west for over a century with consistent results when methods of preparation were comparable. We investigated whether recent difficult conditions in the former eastern bloc have altered placental weight or its relationship to other fetal size measures from what has historically been reported. METHODS: Placentas were obtained from 1621 singleton births of at least 28 weeks gestation in a Ukrainian city during 1993-1994, using a systematic protocol. Maternal characteristics were obtained from questionnaires. Pregnancy complications and birth size measures (infant weight, length, crown-rump length, and head circumference) were abstracted from medical records. We examined relationships of placental weight and ratio to these variables. RESULTS: Placental weight ranged from 100 to 1000 g, with a mean of 470 g. Mean placental ratio was 13.9%. Placental weights increased and ratios decreased with gestational age. Larger ratios were related to larger maternal BMI. Absolute measures of infant size and placental weight were mutually positively correlated. Placental ratio, infant length, and ponderal index (PI) were nearly uncorrelated. CONCLUSIONS: Absolute and relative weights of Ukrainian placentas were similar to historical reports, as were their relationships to other infant size indicators. Placental weight ratio (PWR), ponderal index, and infant length measured different birth size dimensions. Placental availability, consistency of placental measurements, and placental ratio's reflection of an independent facet of fetal growth make the placenta a useful research tool.