Anti-terrorist Operation Research Articles

Features of circulation of agricultural lands in Ukraine for legal entities

Land in Ukraine can be in private, communal and state ownership. The lands of Ukraine include all lands within its territory, including islands and lands occupied by water bodies, which are divided into categories according to their main purpose. Legal entities may acquire land mainly for use on the rights of lease, sublease, emphyteusis and permanent use, may have agricultural land on the right of lifelong inherited land tenure, the legal regulation of which is currently absent. In Ukraine at this stage, models of organization of relations between business partners are effectively and justifiably used through the creation of a joint holding company in a foreign jurisdiction, which further establishes the company in Ukraine. As a result of the anti-terrorist operation and the occupation of Crimea on the territory of Ukraine, the rights of thousands of people to housing, land and property, including the rights of agricultural land use, were violated. Today, land lease is the main way of doing agribusiness, lease agreements have become an important tool for absorbing weaker competitors or seizing their land. In conditions of slow growth in the cost of rent, agricultural holdings can afford a slightly higher fee, which gives them a significant advantage over farmers. However, the moratorium on land has been lifted in 2020 and the land market in Ukraine will be introduced on July 1, 2021. From this date, agricultural land will be available to individuals, ie the moratorium on the sale of agricultural land will be lifted. As for legal entities, the land market will be open for them only from January 1, 2024.

Аналіз основних методологічних засад, закладених у проєкт доктрини зі скритого управління військами (силами)

Метою статті є аналізу основних методологічних засад, закладених у проєкт Доктрини зі скритого управління військами (силами), розроблений робочою групою офіцерів Житомирського військового інституту імені С. П. Корольова спільно із Центральним управлінням охорони державної таємниці та захисту інформації Генерального штабу Збройних Сил України. Ця Доктрина є системою поглядів на порядок організації, забезпечення та контролю стану скритого управління військами (силами) під час застосування сил оборони та їх підготовки до застосування. Документ ґрунтується на досвіді управління військами (силами) під час навчань і мобілізаційних заходів, під час застосування підрозділів охорони державної таємниці та захисту інформації в процесі проведення антитерористичної операції (операції Об’єднаних сил) на сході України, а також ураховує світовий досвід ведення воєнних дій у воєнних конфліктах та досвід країн – членів і партнерів НАТО.

ЛЕТАЛЬНІ ВТРАТИ ВОЛИНЯН ПІД ЧАС ПРОВЕДЕННЯ АНТИТЕРОРИСТИЧНОЇ ОПЕРАЦІЇ НА СХОДІ УКРАЇНИ (2014 – 2018)

At a time when Ukraine continues to fight for territorial integrity, and when combat actions in the east of the country alternate with short periods of silence, all the years of modern independence and the years of formation of Ukrainian statehood are subject to revision and rethinking from the perspective of our national self-sufficiency. For these purposes, Ukrainians bite the dust in the fight against pro-Russian separatists. During the anti-terrorist operation in eastern Ukraine, two hundred and eighteen Volynians became victims of armed confrontation. More than two hundred times Volyn region was in mourning - Volynians buried their compatriots (110 Volynians were killed or died in 2014, 65 - in 2015, 29 - in 2016, 13 - in 2017, and 1 - up to 30 April 2018). We must remember the heroes who gave their lives for the territorial integrity of Ukraine. These soldiers, their sacrifice and courage are discussed in the article. The circumstances of their death, starting from the tragedy near Volnovakha, and the dynamics of mortality among Volyn’s servicemen during 2014 – early 2018 were analyzed as well as the tendency for non-combat casualties number increase was explained. In addition, information about the Volynians who were killed or died during the anti-terrorist operation in eastern Ukraine (2014 - April 2018) is summarized, the circumstances of fatal losses are clarified, and the causes of combat / non-combat losses are singled out. It was calculated that most of the deceased Volyn residents were servicemen of the 51st / 14th Guards Mechanized Brigades (76 and 20 people, respectively), the 24th Guards Mechanized Brigade – 16 soldiers, and the 24th Aidar Territorial Guard Battalion – 14 soldiers. Among the fatal losses of the Volyn region – 29 officers. 141 people from Volyn were posthumously awarded, while among them the highest award of the Hero of Ukraine was awarded to eighteen-year-old Andriy Snitko.

ДОСВІД ПІДГОТОВКИ ОФІЦЕРІВ У НАЦІОНАЛЬНІЙ АКАДЕМІЇ СУХОПУТНИХ ВІЙСЬК ІМЕНІ ГЕТЬМАНА ПЕТРА САГАЙДАЧНОГО В УМОВАХ ВІЙНИ НА СХОДІ УКРАЇНИ

This article examines the experience of training officers at the Hetman Petro Sagaidachny National Army Academy during the aggression of the Russian Federation against Ukraine (2014 - 2018). It is noted that 2014 was the most difficult year for the Ukrainian army, but it was then that a mechanism of radical changes was launched to reform and strengthen it. A significant contribution to the training of the officer corps of the Land Forces is made by the leading military university of Ukraine – National Army Academy. Experience of training cadets of this. Higher military educational institution during the years of anti-terrorist operation and Joint Forces Operation. Generalization of combat experience in the anti-terrorist operation zone is the basis of educational material. The Academy is considering new issues related to the use of troops, theory and practice of modern hybrid warfare, which is at the intersection of political and force components. Scientists study issues of information warfare, extension of the resource of armaments and military equipment in the field, improvement of shooting techniques, etc.

Combat in the ATO (Anti-Terrorist Operation) Zone in September—December 2014

The article analyzes military and political events in eastern Ukraine in September–December 2014, considers tactical miscalculations of ATO headquarters. It is noted that since September 2014, ATO forces have been significantly limited in their actions by the President and the Government of Ukraine, who justified their prohibitions by the Minsk Protocol. Despite the fact that the dubious “Minsk Memorandum” was de facto thwarted by pro-Russian terrorists in early October 2014, Ukrainian military aircraft had not been used at all since September 2014, and artillery was under constant restrictions and orders “from above” to hold fire. This enabled the LPR / DPR terrorist groups to rearrange for further aggressive actions, and, under the Kremlin leadership, to create two “army corps” from separate gangs, modelled on modern corps of the Russian Armed Forces. It is argued that since the beginning of the armed confrontation in the spring of 2014 in eastern Ukraine, pro-Russian groups have included a significant number of militants from the Northern Caucasus, controlled by R. Kadyrov. Separate assault units were formed from “Kadyrov soldiers”; such groups, in particular, operated in the Donetsk International Airport area in October–November 2014. It is noted that as a result of the fighting on December 4, 2014 in Grozny (Russian Federation), significant forces of Kadyrov’s terrorist groups were urgently withdrawn from Ukraine to the territory of the Russian Federation (North Caucasus). This significantly weakened the DPR forces, especially in the positions near the Donetsk International Airport, the regrouping and rotation of pro-Russian terrorists lasting for several days. Despite this, the then top Ukrainian officials did not take advantage of the temporary predicament of the aggressor country. Moreover, a ceasefire was declared at the meeting of the National Security and Defense Council, although at that time a tense situation persisted along the entire confrontation line, and violent clashes took place in the area of the Donetsk International Airport. Thus, the lull was beneficial to the terrorist group for the urgent rotation of Kadyrov’s militants, who were spreading to the North Caucasus. It is noted that the analysis of the events of 2014 is extremely relevant due to the possible escalation of the armed aggression of the Kremlin regime.

Аналіз результатів різних видів периопераційної аналгезії та інтраопераційної анестезіологічної підтримки при хірургічних втручаннях у постраждалих з бойовою травмою грудної клітки

SummaryIntroduction. The actual problem of up-to-date military surgery is to determine theplace and role of various methods of anesthesia in the care of victims with combat chesttrauma. We have clarified and improved the indications and contraindications for theuse of methods of anesthesia and intraoperative support in providing care to thiscategory of wounded and injured.Aim of the work: improving the results of treatment of wounded in the chest due tomultimodal anesthetic support and differentiated use of videothoracoscopic technologiesfor providing medical care based on the analysis of the results of treatment of 103victims with combat chest trauma received in the area of antiterrorist operation (ATO) /environmental protection at the II-IV levels of medical care in the period from 2014 to2019.Results. The proportion of chest injuries in the general structure of combat surgicaltrauma is 7.5–11.7%. fragmentation wounds prevail (48.2%) by the mechanism ofoccurrence, non-penetrating wounds prevail (38.9%) by the nature of the injury, chestinjuries - by the type of injury (40.3%), according to the severity of injury – mild injuries(42.7%) and moderate ones (37.9%).A multimodal approach to anesthetic management and differentiated use ofvideothoracoscopic techniques in patients with combat wounds and chest trauma wasdeveloped and implemented. This made it possible to carry out selective ventilation in53 (81.6%) cases without complications, to differentiate the type and volume of surgicalintervention, which allows us to achieve reliable hemostasis of wounds, aerostasis of thelungs, removal of foreign bodies from the chest organs, thorough debridement of thepleural cavity and prevent the development of early and late postoperative complications associated with anesthesia and ventilation of the lungs.Conclusions.1. The proportion of chest injuries in the general structure of combat surgicaltrauma is 7.5–-11.7%. fragmentation wounds prevail (48.2%) by the mechanism ofoccurrence, non-penetrating wounds prevail (38.9%) by the nature of the injury, chestinjuries – by the type of injury (40.3%), according to the severity of injury – mildinjuries (42.7%) and moderate ones (37.9%).2. Selective ventilation of the lungs in treatment of the patients with combat woundsand chest injuries is indicated when there is a threat of transbronchial ingress ofpathological contents (blood, pus, necrotic masses, foreign bodies, etc.) into thecontralateral lung, the presence of bronchial air leakage due to trauma of a largebronchus or a pulmonary defect tissue, the need for selective lavage of the lungs withthe threat or occurrence of recurrent pulmonary hemorrhage.3. Absolute contraindications to selective ventilation of the lungs in combat woundsand chest trauma are the discrepancy between the lumen of the main bronchi and thediameter of the endotracheal tube and pathological processes of the airways revealedduring intubation or bronchoscopy, accompanied by their stenosis or occlusion (tumors,cicatricial stenosis, exogenous deformation, bifurcation etc.). It is advisable to referoperations from the posterior thoracotomy access to relative contraindications (due tothe possible displacement of the mediastinum and rotational occlusion of theendotracheal tube when the victim is turned to the pronation position).4. Transfer of an injured person with a combat wound or chest trauma fromselective ventilation to two-lung ventilation is indicated in case of a progressivedecrease in the perfusion index and / or arterial oxygen saturation, which cannot becorrected or instability of the patient’s hemodynamic parameters

Терапія ран від’ємним тиском в лікуванні вогнепальних ран м’яких тканин кінцівок

SummaryPurpose – to analyze the results of the treatment of wounded with soft tissuegunshot wounds of extremities using negative pressure wound therapy.Materials and methods. The total number of patients studied with combat surgicaltrauma was 52 people, allocated to groups depending on the treatment performed. Thefirst group (n=27) included wounded with soft tissue defects after combat surgicaltrauma treated by the method of wound therapy with negative pressure. The secondgroup (n=25) included wounded with soft tissue defects as a consequence of combatsurgical trauma treated with traditional methods (staged surgical treatments, dailydressings with antiseptic solutions, ointment dressings).Results and discussion. A comparative analysis of the results of the treatment of52 wounded anti-terrorist operation (ATO) participants with bullet and shrapnelwounds of soft tissues of extremities who were admitted to the National Military MedicalClinical Center «Main Military Clinical Hospital» during the hostilities in easternUkraine during 2016–2018 was carried out. Of these, 27 wounded were treated usingvacuum therapy. The course of vacuum therapy ranged from 7 to 15 days of constantexposure, the average duration of applying one dressing was from 1 to 3 days. Theduration of hospital stay, peculiarities of clinical manifestations, dynamics of microbialcontamination of wounds, and cellular composition in wound prints were assessed.Vacuum therapy accelerated the cleaning of wounds and the beginning of tissueregeneration, promoted epithelialization of wounds.The data obtained indicate a significant improvement in the course of the woundprocess; during treatment using the method of vacuum therapy, it was possible to carryout the plastic stages of wound closure almost 1.5–2 times faster than using the method.The method reduces the number of planned necrectomies, increases the rate ofelimination of purulent microflora in group 1 almost twice, which ensures woundpreparation before closure.In addition, the installation of a vacuum dressing for a period of 3 days greatlysimplifies patient care, reduces the pain and traumatic factor of daily dressings, and atthe same time is the prevention of intra-hospital infection due to the absence ofcontamination from the wound.Conclusions:1. A protracted course of the disease is observed with traditional treatment ofgunshot wounds of soft tissues of the extremities with a pronounced general reaction toinflammation, which is characterized by an average length of hospital stay of up to(24.8±3.09) bed-days.2. The clinical effect of negative pressure wound therapy in the treatment of surgicalinfection of soft tissues is based on the enhancement of microcirculatory bloodcirculation in the inflammation focus, which leads to the normalization of localmetabolic processes and activation of local sanitation and regenerative reactions.3. With the simultaneous use of low-dose vacuum and antibacterial therapy, asynergistic interaction is observed due to their total antibacterial effect, as well as theability of vacuum therapy to influence the concentration of the antibacterial drug in thepathological focus.4. Negative pressure wound therapy is an effective method of treating soft tissuegunshot wounds, which allows to reduce by 2.5 times the number of repeated operations(mainly staged surgical treatments), thereby reducing the length of hospital stay by 1.7times to (17,8 ± 2.7) bed-days

Результати лікування комбінованих вогнепальних поранень щелепно-лицевої ділянки

SummaryIn the article, it is proposed the treatment experience of combined gunshot injuriesof soft tissues of face, neck, bones of facial region in military personnel, who took partin Anti-terrorist Operation and Joint Forces Operation (ATO/JFO) on the territory ofDonetsk and Luhansk area. The complexity of every clinical case, severity of its durationis a reason for need of individual approach while choosing terms and methods oftreatment.Combined maxillo-facial region injuries, associated with multiple gunshot fracturesof the facial bones, loss of soft tissue, are severe injuries that require long-terminpatient treatment (2–3 months) and rehabilitation. The clinical course is accompaniedby severe general and local complications that can be fatal. Therefore, to achieve apositive result of treatment, the wounded of this category are a subject for immediateevacuation to a specialized center.The high level of logistical support of the medical institution, competence,availability of special knowledge, skills and relevant experience of specialists involvedin the treatment of such wounded are crucial for their survival.Using titanium reconstructive-plates, mini-plates, mini-screws for fixation of bonefractures of jaws in early terms permits to achieve positive functional and estheticresults, critically reduce terms of treatment of patients and quantity of postsurgicalcomplications.

Аналіз основ та вироблення рекомендацій щодо початку роботи із системою доктринального забезпечення Сухопутних військ США в контексті приведення доктринального забезпечення Збройних Сил України до стандартів НАТО

Статья будет интересна для специалистов составляющих сил обороны, занимающихся их развитием и которые работают над изучением и внедрением современных стандартов и принципов ведущих стран НАТО. США является передовой страной НАТО и их вооруженные силы оказывают значительное влияние на современное состояние и перспективы этого военно-политического блока. Статья сфокусирована на доктринальном обеспечения СВ США. По своему значению, Доктрины СВ США возможно приравнять к руководящими документами уровня отдельной составляющей сил обороны. Сейчас система доктринального обеспечения Сухопутных войск США открыта и находится в свободном доступе в сети интернет. Тысячи доктринальных и других военных руководящих публикаций СВ США дают исчерпывающий перечень ответов на вопросы о современных стандартах функционирования вооруженных сил в мирное и военное время. Спектр вопросов варьируется от порядка взаимодействия между различными составляющими сил обороны до принципов здорового питания и сна отдельного военнослужащего.
 Статья написана в контексте реформы системы доктринального обеспечения Вооруженных Сил Украины. Реформа предусматривает разработку до конца 2020 года 272 новых доктринальных документов с учетом стандартов НАТО и опыта Операции Объединенных сил (Антитеррористической операции) на востоке Украины. Таким образом, перед разработчиками новых доктрин стоит задача в короткие сроки изучить и обобщить опыт ООС (АТО), требования как действующих национальных руководящих документов так и стандартам ведущих стран НАТО и подготовить на их основе такие доктринальные документы, которые позволят эффективно выполнять задачи возложенные на Вооруженные Силы Украины. Однако работа с доктринальными документами другой страны, кроме знания иностранного языка и соответствующей военной терминологии, требует понимания основ работы с доктриной соответствующего государства. Статья предоставляет минимальный набор знаний, который позволит начать уверенную работу с доктринальными публикациями СВ США и ускорить процесс их изучения.

Peculiarities of aeromedical evacuation of wounded and sick and ways of its improvement based on the experience of anti-terrorist operation and joint forces operation

The article is describing general principles of organization of aeromedical evacuation of the patients by helicopters directly from the battlefield area. The number and nature of casualties caused by military aggression determined the organizational and functional features of aeromedical evacuation from the zone of military conflict. The purpose of the study is to investigate demographic, clinical, chronometric and economic indicators of air medical evacuation from the zone of military conflict and between hospitals within Ukraine to create, based on their global analysis, the optimal organizational and functional model of air medical evacuation in Ukraine. Created database, which filled out from various sources. Leading syndromes grouped the diagnoses with which the patients transported. Method of analysis known as an XmR chart used to study dynamic of the aeromedical evacuation process, which is one tool from a collection of methods known as statistical process control. The aeromedical evacuation system must be able to evacuate a sufficiently large number of stable patients from anywhere on the line of contact, and be flexible to respond in the event of a relatively small number of very unstable patients in the area of hostilities who need to be evacuated quickly enough. The obtained statistics can be useful for short- and medium-term planning of the aeromedical evacuation service. The configuration and operation of aeromedical units always depends on the nature and specificity of the military conflict, but the planning of deployment and determination of requirements of means for aeromedical evacuation should always base on the analysis of previous experience.

Historical Periodization of the Anti-Terrorist Operation in Eastern Ukraine (April 14, 2014 - April 30, 2018)

Historical Periodization of the Anti-Terrorist Operation in Eastern Ukraine (April 14, 2014 - April 30, 2018)

Challenges of State Security through the Lens of ATO/JFO Literature

This article highlights the issue of national security through the lens of literature development. Since the information war has been going on against Ukraine for a long time, the instruments of influence on the consciousness of the population are constantly changing and the forms and methods of information dissemination are being improved, we decided to investigate the literary sources created during the Anti-terrorist Operation / Joint Forces Operation (further - ATO/JFO) period in order to highlight the trends of opinion formation. We used content analysis methods as a basis. The analyzed source base confirmed the thesis that fake and post-truth are artificially created and manipulative-imitation technologies that Putinists use for hybrid warfare. By imposing the post-truth era on the international community, the Kremlin regime creates a reality where emotions are dominated by facts. Thus, Russia's information strategy is based solely on the needs of the lower order.

Соціальна відповідальність громадських організацій в Україні: сучасний стан

Author uses secondary analysis of the results of empirical sociological and statistical studies to identify the main trends in the development of non-government organizations (NGOs) in Ukraine: the growing number of registered NGOs; increasing number of non-government social organizations and increasing number of implemented projects for the provision of social services to internally displaced persons, anti-terrorist operation participants and people who belong to vulnerable groups, or/and are in complicated life circumstances. The purpose of the article is to consider the current state of social responsibility of NGOs in Ukraine. The social responsibility of NGOs is defined in the paper as “a characteristic that is integrated into the activities of the NGO based on its Statute and implemented in practice by providing services on a professional basis, following international norms, to achieve socially significant goals, solving acute social problems, ensuring sustainable development of the community, the region, and the country as a whole”. To have an in-depth study of the basic principles of social responsibility of NGOs, the author conducted a content analysis of 200 websites of NGOs. Content analysis questionnaire included such indicators as annual financial report; annual non-financial report; NGO’s development strategy; information about partners, etc. The main indicators of social responsibility of NGOs are in compliance of the organization’s charter developed according to requirements of the current Ukrainian legislation and the provisions of international standards; transparent activities taking into account the interests of stakeholders, availability of annual reports (financial and non-financial), etc.

Experience of Employment of People with Disabilities in Ukraine (Anti-Terrorist Operation Veterans as a Case Study)

The article elaborates theoretical approaches to the study of the phenomenon of disability, taking into account the concept of masculinity. Two strategies of interaction between masculinity and disability are distinguished: “the fight” against disability and the acceptance of disability. It is difficult for men with disabilities to implement such norms of masculinity in society as strength and the ideal body, because of physical and certain social barriers that impede access to education, work, and power. Employment of people with disabilities in Ukraine is problematic. In particular, employers are not ready to recruit people with disabilities to work because they are not perceived as potential employees. This happens due to the fact that in society there is a stereotypical view that a person with a disability cannot perform the job properly. It should also be noted that employment problems are preceded by problems with the access to education, and the lack of education in turn reduces the chances of employment. The study of the employment experience of male veterans of the Anti-Terrorist Operation (ATO) with disabilities in Ukraine is based on the constructivist paradigm. Disability in this study is seen as socially constructed. The experience of employing people with disabilities has been explored to understand, first and foremost, disability in society. The empirical part of the study was conducted through semi-structured in-depth interviews. The attitudes of veterans to their own disability were clarified, and the barriers to employment and ways of finding employment among veterans with disabilities were identified and typified. Institutional barriers to employment include: health expert commission, public employment service and employers. Individual barriers to employment include: excessive family care, lack of motivation, and psychological rehabilitation. In addition, two ways in which veterans found employment were identified: personal contacts and civic organizations involved in veterans’ affairs. Disabled veterans have the motivation to do useful things for the community that has emerged just after returning from the ATO area. This motivation is to engage in various initiatives and projects that support veterans, promote community development, and carry the “public good”. Manuscript received 01.03.2020

Perception of Post-traumatic Stress Disorder in Ukraine: a Dispositive Analysis of a News Website Censor.net

The war in Eastern Ukraine has been happening for more than five years. Many veterans of this conflict are suffering from PTSD (post-traumatic stress disorder). Despite the existence of effective PTSD treatment, they do not seek help. The main reason for not seeking help is stigma. The most common view is that the main reason for stigma is the military culture. The military culture is recognized as a discourse in this article. One of the important ways of studying discourses is media analysis. The method of dispositive analysis by Siegfried Jager and Florentine Maier, which is a type of critical discourse analysis, was used to examine discourses about PTSD among veterans of the Anti-Terrorist Operation (ATO) and Joint Forces Operation (JFO) on the news website Censor.net. A thematic analysis of 46 articles from this website, which contain at least one mention of the word ‘PTSD’, was conducted. This examination was enhanced by a rhetoric review of the articles which were typical for the most frequent themes emerged in the data. The results suggest that there are at least three ways of understanding PTSD in Ukrainian society. PTSD as a way of understanding and explaining all the war and postwar experience among veterans; PTSD as a way how volunteers and other people who help veterans treat veterans; and as a complex phenomenon as it is understood by foreign and Ukrainian mental health professionals. All these attempts to understand the essence of PTSD may define how it will be treated in Ukrainian society. For veterans, PTSD is a state of mind and a way how they feel about the political situation in Ukraine. With such a mindset, they will unlikely seek help. For volunteers, it is a condition of all veterans who return from war. From this point of view, all veterans must pass rehabilitation. For mental health professionals, PTSD is a unique war experience, and this view also differs from the way how veterans feel about and experience PTSD. Manuscript received 29.02.2020

ЗАСТОСУВАННЯ МЕТОДІВ КІНЕЗІОЛОГІЇ У ПРОГРАМІ ПСИХОЛОГІЧНОЇ РЕАБІЛІТАЦІЇ ВЕТЕРАНІВ АТО

The article considers the peculiarities of the use of kinesiology methods in the program of measures of psychological rehabilitation of participants in hostilities. In the course of psychological rehabilitation of anti-terrorist operation veterans we applied methods of the following directions of kinesiology:“Touch for Health”; “HYPERTON Х”;“One Brain / Three in one Concepts”;RESET (Rafferty Energy System of Easing the Temporomandibular Joint).The main purpose of the study was to analyze the features of psychological rehabilitation of ATO veterans through the methods of kinesiology and to determine the effectiveness of the applied program of work with veterans.The actualization of the rapid and long-term psychological recovery of a participant in hostilities prompted us to look for methods that would give appropriate results. To overcome the consequences of combat trauma after the timely provision of primary psychological assistance to the serviceman must undergo a long process of psychological rehabilitation with the involvement of a psychotherapist, and such a process can be delayed for a long time. We have chosen the methods of kinesiology as those that give fast and long-term positive results in working with participants in hostilities. Moreover, the frequency of meetings with a kinesiologist 1-2 times a month for 3-4 months. The session lasts from 40 minutes to two hours (depending on the veteran's requests).Muscle testing (also known as biological feedback or manual muscle testing) has traditionally been used for kinesiology to work effectively with veterans. After determining the "purity of the muscle", we assess the state of the body in accordance with the signal (alarm) points of the body and carry out in accordance with muscle testing correction or in accordance with methods: Healing touch or HYPERTON X. If the veteran reports barotrauma, or frequent major pains before carrying out the general correction we carry out correction of a temporomandibular joint through RESET methods and only then we start the general correction.Inclusion in the program of psychological rehabilitation of kinesiological practices significantly reduces the recovery time of veterans, helps to better absorb the psychotherapeutic effects of psychotherapists, promotes faster recovery of servicemen who were treated after injuries.We see prospects for further research in the processing of data of psychological and psychophysiological test methods, which will confirm the feasibility and effectiveness of kinesiological methods in the psychological rehabilitation of veterans.

IMPLEMENTATION THE PRINCIPLES OF RECONSTRUCTIVE SURGERY WOUNDED WITH SOFT TISSUE DEFECTS AT THE IV LEVEL OF MEDICAL CARE

Resume. The experience of providing medical care during the anti-terrorist operation in eastern Ukraine has shown that in the structure of modern combat surgical trauma gunshot wounds with soft tissue defects are 64.9-68.2%, of which 36.4-37.5% small and medium, 28.5-30.7% are large and very large defects. Goal: To improve the results of surgical care for soft tissue defects by introducing differentiated surgical tactics for wound closure to each level. Material and methods. The total amount of the study was 136 wounded with shrapnel, bullet and explosive injuries from April 2014 to September 2018. Determination of surgical tactics for closing soft tissue defects was performed on the basis of metric classification, taking into account the area, volume and anatomical areas of the lesion. Results. The combination of metric characteristics of wound defects by area, volume and location of wounds in a single classification allowed to offer a comprehensive approach to sorting the wounded by the level of medical care and determine further reconstructive surgical tactics to close soft tissue defects. Conclusions. The introduction of differentiated surgical tactics in wounded with gunshot defects of the soft tissues at the all levels of medical care improved functional results: the proportion of satisfactory increased from 46.9% to 53.7%, the relative number of unsatisfactory decreased from 18.8% to 11.6%

MULTIMODAL APPROACH IN THE RECONSTRUCTION OF FIRING DEFECTS OF THE LOWER LIMBS (CLINICAL CASE)

According connection with the global trends, manifested by an increase in the number of illegal firearms, an increase in social, political, ethnic, racial and religious conflicts, accompanied by the use of firearms, the problem of treating gunshot wounds is becoming increasingly important. It is especially acute during local and widespread hostilities, during peacekeeping missions, anti-terrorist operations, in cases of massive gunshot wounds. The aim of the work is to improve the surgical tactics in the reconstruction of severe wounded with soft tissue gunshot defects due to the multimodal scheme. Improvement of dynamic audio and thermal imaging diagnostics of the damaged anatomical area, analysis and modeling of the shape and direction of movement of the donor flap. A clinical case of closure of a bullet-through bullet wound of the left thigh (03.25.19 year) with a gunshot multi-fragment fracture of the left femoral pigtail in the middle third, damage to the superficial femoral vein and marginal damage to the superficial femoral artery was demonstrated.In the preoperative period, the first stage was dynamic digital thermography of the surface of wounds and surrounding soft tissues, which allowed thermal imaging to assess the state of damaged structures, to identify areas of preservation of blood supply. The second stage was the audio control of the identified areas of the "supply" - perforating vessels with a comparison of the blood flow velocity. The results obtained formed the basis for modeling the donor zone and monitoring its movement. The described clinical case of soft tissue defect closure consisted of three stages: The first stage - preparatory (diagnostics and cleaning) - (9 days of inpatient treatment) - repeated surgical treatment of wounds using low-frequency ultrasound (cavitation of the wound surface), controlled negative pressure (in a pulsed mode - 125 mm Hg), the imposition of secondary early sutures, due to which the wound area decreased by 35% compared to the wound area at the time of admission to the VICC of the Southern region. The second stage - the final (reconstructive) - (12 days after the injury) - plastic reconstruction of the defect of the posterior surface of the middle third of the left thigh by moving a ball-and-socket flap from the outer surface of the thigh using the Keystone technique. Conclusions: A multimodal algorithm with dynamic control of changes in the perfusion of the defect zone and surrounding structures is at the heart of the successful reconstruction of a gunshot defect in the soft tissues of the lower extremities, which reduces the treatment time by 1.5 times.

Роль і місце Національної академії медичних наук України у наданні медичної допомоги військовослужбовцям під час АТО/ООС

Мета роботи – дослідження місця та ролі Національної академії медичних наук (НАМН) України та підпорядкованих їй науково-дослідних установ, в структурі яких є клінічні підрозділи, в системі надання медичної допомоги пораненим, ураженим, травмованим і хворим військовослужбовцям під час антитерористичної операції та операції Об’єднаних сил (АТО/ООС).
 Матеріали та методи. Використано нормативно-правові акти з питань національної безпеки держави та охорони здоров’я в Україні, публікації у відкритих наукових джерелах стосовно діяльності Національної академії медичних наук України в цілях надання медичної допомоги військовослужбовцям під час АТО/ООС. Методи дослідження – бібліографічний, статистичний, аналітичний, системного підходу. 
 Результати. НАМН України та підпорядковані їй науково-дослідні установи, в структурі яких є клінічні підрозділи, під час АТО/ООС взяли активну участь у наданні медичної допомоги пораненим, ураженим, травмованим і хворим військовослужбовцям ЗС України та інших військових формувань. Робота НАМН України щодо надання медичної допомоги військовослужбовцям була багатовекторною і велася за декількома напрямами: організаційний, безпосереднього надання медичної допомоги та наукового супроводу. Клінічні установи НАМН України під час АТО/ООС не припиняли надання високоспеціалізованої медичної допомоги цивільному населенню України, зокрема й вимушеним переселенцям з районів проведення АТО/ООС.
 Висновки. Завдяки злагодженій діяльності Президії НАМН України та підпорядкованих їй науково-дослідних установ зроблено вагомий внесок у надання високоспеціалізованої медичної допомоги пораненим, ураженим травмованим і хворим військовослужбовцям під час АТО/ООС, а також сформовано основні напрями розвитку вітчизняної військово-медичної науки: організаційний, лікувально-профілактичний та логістично-технологічний.

МЕТОДИЧНИЙ ПІДХІД ЩОДО ОБҐРУНТУВАННЯ СКЛАДУ РЕМОНТНИХ ПІДРОЗДІЛІВ ДЛЯ ВІДНОВЛЕННЯ ТЕХНІКИ ТИЛУ ОПЕРАТИВНОГО УГРУПОВАННЯ ВІЙСЬК

Analysis of wars and armed conflicts in recent years and the implementation of tasks by military units (units) in the Joint Forces operation (anti-terrorist operation) confirms that the success of tasks of mechanized, tank, assault and other military units (units) will depend on the effectiveness of troops (forces) support systems. The location of military units (units) conducting combat operations in a constant state of combat will depend on the efficiency of the support system, ie how the logistics units will deliver materials, fuel and lubricants, restore damaged samples of weapons and military equipment, etc. At the same time, the effectiveness of their operation will fully depend on the timely and high-quality restoration of rear equipment, which received combat or operational damage, repair and recovery units (units). Therefore, the article proposes a methodological approach to substantiate the composition of repair units for the restoration of rear equipment of the operational group of troops, which is based on solving the optimization problem of integer nonlinear programming to minimize costs for repair and maintenance of backup samples of rear equipment.