Школа охорони здоров’я

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    Центри первинної медичної допомоги
    (РІК-У, 2022) Шевченко, Марина; Бацюра, Ганна; Klanacar, Darinka; Petric, Dragomir
    Підрозділ 3.2. з підручника для студентів, інтернів та лікарів "Сімейна медицина" за заг. ред. Лариси Матюхи [та ін.], Ужгород, 2022.
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    Unified European support framework to sustain the HIV cascade of care for people living with HIV including in displaced populations of war-struck Ukraine
    (2022) Vasylyev, Marta; Skrzat-Klapaczyńska, Agata; Bernardino, Jose ; Săndulescu, Oana; Gilles, Christine; Libois, Agnès; Curran, Adrian; Spinner, Christoph D.; Rowley, Dominic; Bickel, Markus; Aichelburg, Maximilian ; Nozza, Silvia; Wensing, Annemarie; Barber, Tristan ; Waters, Laura; Jordans, Carlijn; Bramer, Wichor; Lakatos, Botond; Tovba, Lidia; Koval, Tetyana; Kyrychenko, Tetyana; Dumchev, Kostyantyn; Buhiichyk, Vira; Smyrnov, Pavlo; Antonyak, Svitlana; Antoniak, Sergii; Vasylyeva, Tetyana ; Mazhnaya, Alyona; Kowalska, Justyna; Bhagani, Sanjay
    Ukraine is one of the countries in Europe most affected by HIV. The escalation of open war on the European continent has affected HIV care in Ukraine in an unprecedented way. Treating physicians in Europe have little experience on how to handle HIV-specific care under these circumstances. A framework is urgently needed that both defines and sets out strategies to handle the specific challenges for emergency support for people living with HIV, both those staying in Ukraine and those becoming displaced. The optimal allocation of the few available medical resources, primarily antiretroviral therapy, is necessary to best prevent individual morbidity and achieve population transmission control. Professional HIV networks play a central role to create, optimise, and execute support strategies. Through a rapid literature review we identified the key strategies needed to create a support framework, adapted to Ukraine’s HIV epidemiology. We produce a unified support framework aiming to reduce the inevitable impact on Ukraine’s HIV care cascade now, and when rebuilding it after the war.
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    The development and initial validation of the Russian version of the BASIS-24
    (2022) Madden, Lynn; Farnum, Scott; Bromberg, Daniel; Barry, Declan; Mazhnaya, Alyona; Fomenko, Tetiana; Meteliuk, Anna; Marcus, Ruthanne; Rozanova, Julia; Poklad, Iurii; Dvoriak, Sergii; Altice, Frederick
    Background: Efficient and linguistically appropriate instruments are needed to assess response to addiction treatment, including severity of addiction/mental health status. This is critical for Russian-speaking persons in Eastern Europe and Central Asia (EECA) where Medications for Opioid Use Disorder (MOUD) remain underscaled to address expanding and intertwined opioid, HIV, HCV and tuberculosis epidemics. We developed and conducted a pilot validation of a Russian version of the 24-item Behavior and Symptom Identification Scale (BASIS-24), an addiction/mental health severity instrument with six subscales, previously validated in English. Methods: Using the Mapi approach, we reviewed, translated, and back-translated the content to Russian, pilot-tested the Russian-version (BASIS-24-R) among new MOUD patients in Ukraine (N = 283). For a subset of patients (n = 44), test-rest was performed 48 h after admission to reassess reliability of BASIS-24-R. Exploratory principal component analysis (PCA) assessed underlying structure of BASIS-24-R. Results: Cronbach alpha coefficients for overall BASIS-24-R and 5 subscales exceeded 0.65; coefficient for Relationship subscale was 0.42. The Pearson correlation coefficients for overall score and all subscales on the BASIS-24-R exceeded 0.8. Each item loaded onto factors that corresponded with English BASIS-24 subscales ≥ 0.4 in PCA. Conclusion: Initial version of BASIS-24-R appears statistically valid in Russian. Use of the BASIS-24-R has potential to guide MOUD treatment delivery in the EECA region and help to align addiction treatment with HIV prevention goals in a region where HIV is concentrated in people who inject opioids and where healthcare professionals have not traditionally perceived MOUD as effective treatment, particularly for those with mental health co-morbidities.
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    The influence of the regulatory system on the study design and data management practices in clinical trials
    (2022) Yashchenko, Mariia; Yurochko, Tetiana; Soroka, Ivan
    The aim: To review real-life regulatory-dependent study design and data management practices of post marketing multicenter studies of medical devices conducted in 2021 in Ukraine and Poland. Materials and methods: This article presents the case study of 4 post marketing multicenter studies of medical devices conducted in 2021 in Ukraine and European Union. Results: The case study presented effective cross-border cooperation between Ukrainian and European actors. Despite the gaps in Ukrainian legislative framework on medical devices, complex solutions on employment of the most stringent regulatory provisions led to appropriate study design. Usage of the highly compliant electronic data capture led to fast-track study start-up and solid clinical data collection. Conclusions: Publications on real-life regulatory-dependent clinical trials conduct might be essential to innovate the regulatory system in Ukraine. The cross-border cooperation might assist the advancement of clinical trials industry in Ukraine. Gaps in medical devices regulations in Ukraine impede the context-specific clinical trials solutions for biotech industry in Ukraine. The regulatory framework and practice in Ukraine may be perceived as externally driven due to gaps in medical devices regulations, lack of capacities of domestic notified bodies and business interests of Sponsors.
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    A qualitative exploration of daily path and daily routine among people in Ukraine who inject drugs to understand associated harms
    (2022) Owczarzak, Jill; Chien, Jessie; Tobin, Karin; Mazhnaya, Alyona; Chernova, Olena; Kiriazova, Tetiana
    Background: Patterns of movement, heterogeneity of context, and individual space-time patterns affect health, and individuals’ movement throughout the landscape is shaped by addiction, meeting basic needs, and maintaining relationships. Place and social context enable or constrain behavior and individuals use social networks and daily routines to accomplish individual goals and access resources. Methods: This article explores drug use as part of daily routines and daily paths among people who inject drugs in Dnipro City, Ukraine. Between March and August 2018, we interviewed 30 people who inject drugs living in Dnipro City, Ukraine. Study participants completed a single interview that lasted between 1 and 2 hours. During the interview, participants described their daily routine and daily path using a printed map of Dnipro as a prompt. Participants were asked to draw important sites; give time estimates of arrival and departure; and annotate on the map the points, paths, and areas most prominent or important to them. Participants also described to what extent their daily routines were planned or spontaneous, how much their daily path varied over time, and how drug use shaped their daily routine. Results: We identified 3 major types of daily routine: unpredictable, predictable, and somewhat predictable. Participants with unpredictable daily routines had unreliable sources of income, inconsistent drug suppliers and drug use site, and dynamic groups of people with whom they socialized and used drugs. Participants with predictable daily routines had reliable sources of income, a regular drug dealer or stash source, and a stable group of friends or acquaintances with whom they bought and/or used drugs. Participants with somewhat predictable daily routines had some stable aspects of their daily lives, such as a steady source of income or a small group of friends with whom they used drugs, but also experienced circumstances that undermined their ability to have a routinized daily life, such as changing drug use sites or inconsistent income sources. Conclusions: Greater attention needs to be paid to the daily routines of people who use drugs to develop and tailor interventions that address the place-based and social contexts that contribute to drug-use related risks.