Organization Of Services Research Articles

Working with people living with motor neurone disease and the impact on professionals’ emotional and psychological well-being: A scoping review

Background: Integrated multidisciplinary care is required to manage the progressive and debilitating symptoms associated with motor neurone disease. Professionals can find providing the level of care required by this population clinically and emotionally challenging. To support those working with these patients it is important to understand the experience of the entire multidisciplinary team involved and the impact of working with motor neurone disease on their emotional and psychological well-being. Aim: To identify what is known about (1) healthcare professionals’ experience of working with motor neurone disease and (2) the impact of this work on their emotional and psychological well-being. Design: Scoping review. Review protocol registered on Open Science Framework. Sources: Five electronic databases were searched in January 2023 and 2024. Grey literature and hand searches were completed. Results: Fifty-one sources published between 1990 and 2023 were included. A total of 1692 healthcare professionals are represented. Three main categories were identified: (1) The demands of providing motor neurone disease care. (2) Factors influencing professionals’ ability to provide desired levels of care. (3) The emotional impact of working with motor neurone disease. Subcategories are depicted within these. Conclusion: Positive experiences included job satisfaction, enhanced perspective and receiving gratitude, while negative implications such as stress, emotional exhaustion and burnout also featured. The demands of motor neurone disease patient care, the organisation of services and resources required to meet patient and family needs and the emotional burden for professionals involved, warrant greater recognition in clinical practice, guidelines and future research.

Cardiovascular mortality rate between 2018 and 2022 in Kyrgyz Republic

Abstract Background Cardiovascular diseases (CVD) are the number one cause of death in low- and middle-income countries (LMICs), including Kyrgyz Republic. According to official statistics, CVD ranks first in the structure of overall mortality, accounting for more than half (52.1% according to 2022 data) of all deaths. Purpose to analyze the cardiovascular mortality rate in the Kyrgyz Republic, from 2018 to 2022. Methods Medical and statistical information on mortality from CVD in the population was obtained from the Centre for Electronic Health (CEH) of the Ministry of Health. To conduct a comparative analysis, relative indicators per 100 thousand population were calculated. A retrospective epidemiological study of mortality from CVD including different nosological forms over period for 2018–2022 was conducted, calculating the rate of increase (decrease). An analysis of the epidemiological situation of the disease in nine administrative-territorial units of the Kyrgyz Republic was also carried out with the calculation of the average 5-year mortality ratefor the period from 2018 to 2022. Results Despite the decrease in morbidity, a high proportion of mortality from CVD remains in all years, more than 50%. In terms of the percentage indicator for recent years, all this time it has maintained the highest position, in contrast to diseases of other organs and systems. In the last decade, from 2012 until 2020, there was a gradual decrease in the mortality rate. Since 2020, we have seen a sharp increase in the CVD mortality rate per 100 thousand population by 19.6% compared to 2018, by 19.4% since 2019, which is associated with the influence of Covid-19 pandemic, in 2021 this indicator amounted to 297.6 cases, in 2022 - 234.5. The main contribution to population death from CVD is made by coronary heart disease (65.90%), including acute myocardial infarction, cerebrovascular diseases (21.4%), arterial hypertension (5.9%). If we analyze the mortality rate from CVD by nine administrative-territorial units, the highest rates in 2022 are observed in the Chui and Talas regions, 291.9 and 266.3 per 100 thousand population respectively; the lowest in the Osh region (207.3), Osh city (196.1) and Bishkek (208.6), which is explained by the better organization of health services in these areas. Conclusion CVD remains the main cause of mortality in the population of the Kyrgyz Republic. Although over the past year there has been a good decline in this indicator, in almost all regions, particularly the greatest successes have been achieved in Naryn and Issyk-Kul regions. In connection with the above, there is requirement for a clear identification of priorities when determining the strategy of treatment and preventive interventions. It is necessary to create an effective National system of care for patients with CVD with a focus on emergency cardiac care and prevention issues.

«УЧРЕДИТЬ НА ЮЖНОМ БЕРЕГУ КРЫМСКОГО ПОЛУОСТРОВА В СЕЛЕНИИ ЯЛТАХ ТАМОЖЕННУЮ ЗАСТАВУ…»: К ИСТОРИИ СОЗДАНИЯ И ДЕЯТЕЛЬНОСТИ ЯЛТИНСКОЙ ТАМОЖНИ И ЮЖНОГО ОТРЯДА ТАВРИЧЕСКОЙ БРИГАДЫ ПОГРАНИЧНОЙ СТРАЖИ

The article examines the history of the creation and activities of the Yalta customs outpost (later the Yalta customs), which celebrated its 200th anniversary in 2024. Based on archival documents, some of which are being introduced into scientific circulation for the first time, as well as previously published statistical materials, collections of the customs department and other official publications of the Ministry of Finance of the Russian Empire, the main stages of interaction between customs institutions, border and quarantine guard units operating in the Taurida province are determined in the 19th century. The work of these authorities in peacetime and the features of their functioning during the Crimean (Eastern) War of 1853–1856 and the Russo-Turkish War of 1877–1878 had been analyzed. Measures aimed at optimizing the work of these units in difficult conditions of combat operations and occupation of the Crimean Peninsula by the enemy had been studied. The specifics and sources of formation of personnel of the Yalta customs outpost, units of the Taurida border guard brigade, and quarantine guard units stationed in the province had been identified. It is concluded that the organization of customs, quarantine and border services on the territory of the Taurida province, namely, on the southern coast of Crimea in the 19th century was well thought out and fully consistent with local specifics, since the peninsula was not only the center of external and internal trade operations in the Northern Black Sea region, but also the most important region in geopolitical and strategic terms. Russia, which has repeatedly faced the need to eliminate external threats while simultaneously increasing its economic potential, has taken the necessary steps to ensure the normalization of the activities of customs institutions in the region.

Process Management Framework for Health and Safety at Work (SST) Companies

Objective: This study aims to develop and implement a process management framework for Occupational Safety and Health (OSH) companies, seeking to optimize the organization and execution of services, identifying improvement opportunities throughout the customer journey, from contract closure to renewal. The proposal is to offer an adaptable model that meets industry demands and enhances the operational efficiency of companies. Theoretical Framework: The theoretical framework addresses the evolution of Regulatory Standards (NRs) since the 1970s and the importance of complying with labor laws for the safety and health of workers in Brazil. The role of eSocial, created in 2014 to unify and ensure the collection of employer information, is highlighted, as well as its function in alerting them to legal risks. Method: The methodology used was action research, as defined by Oquist (1978). The research involved mapping the operational processes of OSH companies to identify areas for improvement. The first version of the framework was developed, tested, and based on the results, improved into a second version. The improvements were based on tests and validations conducted throughout the process. Results and Discussion: The first version of the framework showed positive results but also highlighted the need for improvements, which were incorporated into the second version. Changes included the restructuring of steps and the addition of a new phase focused on the commercial process. Satisfaction surveys with internal and external clients, as well as accounting firms, indicated positive acceptance but also a lack of systemic vision among professionals, affecting the quality of the work. Research Implications: The research implications are significant for the OSH sector. The developed framework improves the organization and efficiency of service-providing companies. The study also highlights the importance of performance indicators to monitor performance and mitigate risks, such as customer loss. It is recommended that future research explore the adaptation of the framework to new technologies and automation. Originality/Value: The originality of this study lies in the creation of a process management framework specifically for OSH companies, where organization and efficiency are essential for complying with labor regulations and ensuring worker safety. The value of the work resides in its practical contribution to the sector, offering an adaptable model that can be improved based on feedback and technological advancements.

Применение функционального подхода к разработке модели психологической службы в системе общего и среднего профессионального образования

<p style="text-align: justify;"><span lang="EN-US">The article presents a theoretical overview of approaches to the functioning of psychological service models in the education system. The experience of organizing models of psychological and pedagogical assistance to participants in educational relations in three subjects of the Russian Federation (Perm Krai, Sverdlovsk Region, Yaroslavl Region), which in 2023 became the winners of the All-Russian competition of regional models of psychological service in the system of general education and secondary vocational education, is considered. The concept of a functional model is revealed, and the possibilities of its application in the organization of psychological services in the education system are presented. As part of the development of a draft functional model of psychological services in the system of general education and secondary vocational education, three functional blocks are considered, which involve the implementation of certain functions at the federal, regional, municipal and institutional levels.</span></p>

A global snapshot on health systems capacity for detection, monitoring, and management of acute kidney injury: A multinational study from the ISN-GKHA.

Acute kidney injury (AKI) is a significant cause of morbidity and mortality, especially in low and lower-middle income countries. Data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) were used to evaluate the organization of structures and services for the provision of AKI care in world countries and ISN regions. An international survey of key stakeholders (clinicians, policymakers, and patient advocates) from countries affiliated with the ISN was conducted from July to September 2022 to assess structures and services for AKI care across countries. Main findings of the study show that overall, 167 countries or jurisdictions participated in the survey, representing 97.4% of the world's population. Only 4% of countries had an AKI detection program based on national policy or guideline, and 50% of these countries used a reactive approach for AKI identification (i.e., cases managed as identified through clinical practice). Only 19% of national governments recognized AKI as a healthcare priority. Almost all countries (98% of the countries surveyed) reported capacity to provide acute hemodialysis (HD) for AKI, but in 31% of countries, peritoneal dialysis (PD) was unavailable for AKI. About half of all countries (44% of countries surveyed) provided acute dialysis (HD or PD) via public funding, but funding availability varied across ISN regions, including less than a quarter of countries in Oceania and South East Asia (17%) and Africa (24%) and highest availability in Western Europe (91%). Availability increased with the increasing country income level. Initiatives have been developed to propose and promote optimal care for AKI (including the ISN 0-by-25 initiative), but capacity for optimal AKI care remains low, particularly in low- and lower-middle-income countries. Concerted efforts by the global community are required to close these gaps, to improve AKI outcomes across the world.

Services for perinatal patients with opioid use disorder: a comprehensive Baltimore City-wide 2023 assessment

BackgroundOverdose is a leading cause of maternal mortality; in response, maternal mortality review committees have recommended expanding substance use disorder (SUD) screening, improving collaboration between obstetric and SUD treatment providers, and reducing fragmentation in systems of care. We undertook an analysis of the perinatal SUD treatment landscape in Baltimore, Maryland in order to identify barriers to treatment engagement during pregnancy and the postpartum period and guide system improvement efforts.MethodsWe conducted a survey of seven birthing hospitals, 31 prenatal care practices, and 108 SUD treatment providers in Baltimore from April-June 2023. Organizations were asked to quantify care for perinatal patients with opioid use disorder (OUD) as well as about screening, service availability, referral practices, and support needed to improve care.Results61% of the 145 contacted organizations responded. Birthing hospitals reported caring for pregnant persons with OUD with greater frequency than prenatal care practices or SUD treatment programs. Most birthing hospitals and prenatal care practices reported screening for OUD at intake, but the minority reported using validated tools. Service availability varied by type of organization and type of service. In general, prenatal care practices offered the fewest number of SUD-related services. Most SUD treatment programs that offered buprenorphine or methadone to the general population also offered these medications to pregnant patients. Withdrawal management for comorbid alcohol/benzodiazepine use disorders during pregnancy was more limited. The majority of birthing hospitals and prenatal care practices reported offering neither direct naloxone distribution nor prescriptions. Few SUD treatment programs offered tailored services for perinatal patients or for parents of young children, and many programs do not permit children onsite. Respondents reported high levels of interest in education and consultative support on SUD treatment in pregnancy within obstetric settings and on pregnancy-related medical concerns within SUD programs.ConclusionsThis project provides a comprehensive picture of services available for treatment of perinatal OUD in a major US city. Results have served as a guide for ongoing citywide system improvement efforts by our project team and offer a model for other jurisdictions hoping to strengthen services for perinatal OUD and reduce maternal mortality.

Analysis of the resource base and competition of business tourism in Moscow

This paper analyzes the resource base in the context of the competitiveness of business tourism in Moscow. It considers the key elements that form the infrastructure of business tourism, such as the hotel sector, transport accessibility, service level and the presence of business centers. Particular attention is paid to a comparative analysis with other large cities, which helps to identify the strengths and weaknesses of Moscow’s offer. It also considers factors influencing the development of business tourism, including macroeconomic conditions, trends in event organization and digitalization of services. The importance of cooperation between government and the private sector to create an attractive environment for international business clients is emphasized. In conclusion, recommendations are formulated for optimizing the city’s resource base to increase competitiveness and improve the image of Moscow as one of the leading destinations for business tourism.

Improving organisation to improve care: ERN ReCONNET organisational reference model for systemic sclerosis patients’ care pathway

Objective: To optimise the organisation of care and encourage the adoption of good clinical practices, the RarERN Path© methodology was designed within ERN ReCONNET. The aim of our work was to report the application of RarERN Path© on systemic sclerosis within the ERN ReCONNET centres, providing a feasible and flexible organisational reference model for optimising the systemic sclerosis care pathway in different countries. Methods: RarERN Path© is a six-phase methodology which enables the creation of a reference organisational model co-designed on the basis of the expertise of different stakeholders. It foresees six phases, ranging from the map of existing patients’ care pathways and patients’ stories, to the consensus on a common organisational patient care pathways, and its key performance indicators definition. Results: The agreed reference model highlights the importance of having an organisational flow for referrals that foresees how patients may access directly the specialised unit from the different referrals. Specific specialised visits were considered as mandatory to be organised and they included cardiologist, pneumologist, gastroenterologist, psychologist, nephrologist, dermatologist, wound care specialist/nurses and other healthcare professionals (such as nurses, social workers and nutritional counselling). Moreover, specific services related to therapy were highlighted as strongly recommended to be organised, mainly represented by infusion therapy and wound care, as well as occupation therapy and physiotherapy. Conclusion: The organisational model emerged from our investigation emphasises that the organisation of specific services for systemic sclerosis treatment should be organised as a solid support for implementing the existing recommendations on systemic sclerosis management in real life.

Vaccines and vaccination in prison settings: availability and model of service delivery in 20 European countries.

Prisons, due to various risk factors, are environments that are conducive to infectious disease transmission, with significantly higher prevalence of infectious diseases within prisons compared to the general population. This underscores the importance of preventive measures, particularly vaccination. As part of the international project "Reaching the hard-to-reach: Increasing access and vaccine uptake among the prison population in Europe" (RISE-Vac), this study aimed to map the availability and delivery framework of vaccination services in prisons across Europe and beyond. A questionnaire designed to collect data on the availability and delivery model of vaccination services in prisons was validated and uploaded in SurveyMonkey in July 2023. Then, it was submitted to potential participants, with at least one representative from each European country. Potential participants emailed an invitation letter by the RISE-Vac partners and by the European Organization of Prison and Correctional Services (EUROPRIS). Twenty European countries responded. Vaccines are available in European countries, although their availability differs by country and type of vaccine. The first dose is offered to people living in prisons (PLP), mostly within one month, COVID-19 is the most widely offered vaccine. In all countries, vaccines are actively offered by healthcare workers; in most countries, there is no evaluation of vaccination status among people who work in prison. The survey shows variance in vaccine availability for PLP and staff across countries and vaccine types. Quality healthcare in prisons is not only a matter of the right to health but also a critical public health investment: enhancing vaccine uptake consistently among PLP and staff should be prioritized.

Medicine needs of children not addressed in the National Cancer Strategic Framework: insights from a triangulation study

Aim A better understanding of the scope of the National Cancer Strategic Framework (NCSF) could lead to improvements aiding the framework’s ultimate objective of reducing the burden of cancer. Accordingly, this report evaluates whether the 2017-2022 NCSF adequately addressed issues related to childhood cancer treatment, in particular paediatric oncology medicines. Methods To identify determinants of current access to childhood oncology medicines in South Africa, in-depth interviews were conducted with 29 stakeholders in South Africa’s public and private healthcare sectors. Key health system stakeholders included policy makers and regulators, medical insurance scheme informants, medicine suppliers, healthcare providers and civil society stakeholders. Identified barriers were categorised according to the components of the pharmaceutical value chain, and combined with a health systems approach to acknowledge the linkages of medicines with other building blocks of the health system. Identified barriers were then compared to the limitations and interventions as discussed in the 2017-2022 NCSF to identify areas for improvement in the framework. Findings Three recurrent gaps in the NCSF in relation to childhood cancers were identified, representing a range of issues throughout the pharmaceutical value chain: 1) childhood cancers are neglected compared to adult cancers, in both the policy arena and the organisation of healthcare services; 2) there are particular challenges for childhood cancers due to their rarity, thus requiring targeted interventions (e.g., regulatory incentives, tailored pricing solutions, and customised evidence requirements by decision-making bodies); and 3) children must be accompanied by a caregiver during treatment, causing several social and financial issues for their families. Conclusions There is a pressing need for a strategic cancer plan that makes proper provisions for children. Such an endeavour must commence with acknowledging the areas in which childhood cancers are different from adult cancers, and which demand targeted intervention in an update of the NCSF.

СУТЬ І СТРУКТУРА ЕКОНОМІЧНОЇ КУЛЬТУРИ МАЙБУТНІХ ТЕХНІКІВ З ТРАНСПОРТНИХ ТЕХНОЛОГІЙ ТА УПРАВЛІННЯ ПЕРЕВЕЗЕННЯМИ НА АВТОМОБІЛЬНОМУ ТРАНСПОРТІ

The relevance of the article is due to the need to define and substantiate the essence and structure of the economic culture of future technicians in transport technologies and transportation management in road transport, to reveal the content of each component of the structure of economic culture, as well as to determine the key factors that contribute to its formation in the process of professional training of future technicians in transport technologies technologies and management of road transport. The purpose of the article is to determine the essence and structure of the economic culture of future technicians in transport technologies and management of road transport. Methods: the study of scientific sources regarding the interpretation of the essence of the concept "economic culture of the culture of future technicians in transport technologies and management of transportation by road transport" - to formulate one's own views on defining the content of this phenomenon; structural-component analysis - to distinguish the components of the economic culture of future technicians in transport technologies and transportation management by road transport; generalization and systematization - and formulation of conclusions and prospects for further research. Results: the main approaches in scientific sources to the interpretation of the concept of "economic culture of future technicians in transport technologies and management of road transport" were determined; the main components of the structure of economic culture and the components of the formation of the economic culture of future technicians in transport technologies and management of road transport are characterized. Conclusions: the essence of the economic culture of future technicians in transport technologies and transportation management in road transport is an integrative formation of the personality of a specialist, reflecting a system of professionally important qualities, values, knowledge, abilities and skills in planning technologies for the organization of transportation, providing transport and warehouse services, using resource potential for development transport enterprises in market conditions; characterized by a high degree of discipline, responsibility, independence with an awareness of the priorities of economic culture in the performance of professional tasks. The component structure of the economic culture of technicians in transport technologies and transportation management in road transport includes motivational-value, innovative-cognitive, activity-technological, personal-reflexive.

Specific Technologies of Aviation Rescue and Firefighting Operations over the Years

The twentieth century was a period of rapid development in aviation. It was a time of great progress in the construction of aircraft, the development of ground infrastructure and the improvement of qualifications of aviation personnel. Over the years, aviation has gone from cruise flights in simple aircraft to transatlantic flights, complex aircraft with hundreds of passengers on board. Military aviation can operate at speeds exceeding the speed of sound and in all weather conditions. The infrastructure of large airports has reached the size of cities. Over the past century, the development of aviation has been followed by changes in the organization and equipment of rescue and fire-fighting services. The public does not accept the loss of human life or large-scale material damage and environmental damage. In the search for effective extinguishing agents and methods of administering them, people began to look for ways other than field fire services. Specialized firefighting units have appeared at airports, which are designed for specific rescue and firefighting operations on aircraft and infrastructure. For many years, attempts have been made to select special rescue and firefighting technologies capable of improving the effectiveness and safety of operations. Quite quickly, the car was chosen as the means of transport for airport rescue services. But over time, the need was recognized for it to have different characteristics and equipment than a vehicle for village and town safety units. As a result of various experiments, unusual technical solutions designed to solve basic problems specific to airports were developed. Equally interesting was the path to determining the best fire extinguishing agents and their means of administration. From hand-held fire extinguishers to remote-controlled cannons administering thousands of liters or kilograms of extinguishing agents over a long distance. The publication provides information on the history and development of basic firefighting technologies specific to aviation and some pointers to the future.

Symptom vs context: lessons learned from a large-scale implementation of the Cultural Formulation Interview.

Mental health services in multicultural societies require culturally sensitive approaches to reduce health disparities. The Cultural Formulation Interview (CFI) is thought to enhance shared decision making and to facilitate culturally and contextually informed treatment. There is, however, little known regarding its implementability in large-scale psychiatric services. The current paper reports on (a) efforts to implement the CFI in a large organization for mental health services in the Netherlands, and (b) two studies that evaluated this implementation process and identified barriers to CFI adoption in clinical practice. Implementation of the CFI was facilitated by developing an online course, an advanced training of "team coaches", (digital) resources, and integrating the CFI questions into the intake format. A preliminary evaluation revealed that the CFI was administered in only 13.2% of all intakes across the entire organization, with minimal utilization of training resources. Study 1 aimed to investigate how the CFI was perceived by clinicians and stakeholders. A survey of 150 clinicians found a great lack of familiarity with the CFI and its purpose. While 67% reported partial CFI use, 50% saw no added value, and 61% deemed it relevant only for ethnic minorities. Study 2 examined which patient and clinician variables were associated with adequate CFI use (i.e., correct documentation of the CFI information in initial intake reports). The sample consisted of 112 intakes of patients conducted by ten clinicians. Regression analysis showed a significant association between clinicians' cultural competences and adequate CFI use, meaning that more culturally competent clinicians tended to generate better cultural assessments using the CFI. In addition, the CFI information was documented more adequately among patients who were unemployed at the time of assessment. In conclusion, implementation of the CFI requires a fundamental rethinking of the entire intake assessment, shifting it from a symptom-oriented approach towards a context- and person-centered one. Future trainings may benefit from embedding the CFI within a broader cultural competency training, rather than solely focusing on the CFI, which is currently the common practice.

Scaling of the infrastructure of service organizations of geophysical services

The purpose of the study is to analyse the features and scalability of the infrastructure of geophysical service organisations. The implementation of optimal strategic management through a model for any large petroleum geophysics enterprise aimed at economic growth and national interests is proposed. An approach to semantic coordination and modernisation of geographic services is proposed, where service providers share explicit knowledge of the interactions in which their services participate, and these interaction patterns are used operationally to discover and integrate geoweb services. During the research, cluster analysis was used to conduct a comparative analysis of the selected companies, the quality of possible methods of distribution of the selected population and using criteria. The volume of service geophysical services depends on the rate of increase in hydrocarbon production, which is directly related to the state’s strategy. Analysis of the competitive environment for the State-owned Enterprise Ukrgaspromgeofizika requires an assessment of the factors affecting the organisation's activities in the field of geophysical services for the gas industry. The volume of service geophysical services depends on the rate of increase in hydrocarbon production, which is directly related to the strategy of the state.

ANALYSIS OF STAFFING OF THE MEDICAL AND GENETIC SERVICE IN UKRAINE

Aim. To study the staffing conditions of the medical-genetic service in Ukraine during the period from 2008 to 2022 and to forecast the staffing dynamics until 2026. Materials and Methods: Statistical data from healthcare institutions in Ukraine that provided medical-genetic services during the period from 2008 to 2022 were analyzed, based on reporting forms 21, 17, 49 from the City Health Center website http://medstat.gov.ua/ukr/statdan.html and http://medstat.gov.ua/ukr/statdanMMXIX.html. Single-factor linear regression models were applied for mathematical modeling, with quality assessment conducted using the coefficient of determination R². Calculations were performed using MedCalc® Statistical Software (v.22.009). Results: Compared to 2008, there was a significant reduction in the number of full-time positions of heads of offices (genetic doctors), genetic doctors, and genetic laboratory doctors in Ukraine in 2022 by -45.24%, -24.83%, and -23.39%, respectively. A significant decrease in the number of these positions was determined (p<0.05). In 2022, compared to 2008, there was also a decrease in the staffing rate of all full-time positions with occupied positions of the personnel of centers/offices. Specifically, for genetic doctors, the staffing rate in 2022 was 69.62% compared to 85.37% in 2008, and for genetic laboratory doctors, it was 57.54% compared to 94.62% in 2022 and 2008, respectively. The level of provision of geneticists (individuals) in Ukraine in 2022 was 1.99 per 1 million population, which is -16.03% less than in 2008. Furthermore, compared to 2008, the share of vacant positions for genetic doctors in 2022 increased 2-fold, and for genetic laboratory doctors almost 8-fold. According to the results of mathematical forecasting, in 2026, a further decrease in the availability of genetic doctors to the level of 1.77 per 1 million population is predicted (R²=0.88, p<0.001). Results. Compared to 2008, there was a significant reduction in the number of full-time positions of heads of offices (genetic doctors), genetic doctors, and genetic laboratory doctors in Ukraine in 2022 by -45.24%, -24.83%, and -23.39%, respectively. A significant decrease in the number of these positions was determined (p<0.05). In 2022, compared to 2008, there was also a decrease in the staffing rate of all full-time positions with occupied positions of the personnel of centers/offices. Specifically, for genetic doctors, the staffing rate in 2022 was 69.62% compared to 85.37% in 2008, and for genetic laboratory doctors, it was 57.54% compared to 94.62% in 2022 and 2008, respectively. Furthermore, in comparison with 2008, the share of vacant positions for genetic doctors in 2022 increased in 2-fold, and for genetic laboratory doctors almost in 8-fold. According to the results of mathematical forecasting, in 2026, a further decrease in the availability of genetic doctors to the level of 1.77 per 1 million population is predicted (R²=0.88, p<0.001). Conclusions. Based on the analysis of staffing of the medical-genetic service in Ukraine during the period 2008-2022, conclusions can be drawn about the reduction in the number of full-time positions and the availability of genetic doctors in the medical-genetic service in Ukraine. To ensure proper medical-genetic counseling for the population, it is necessary to develop an effective strategy for improving the organization of the medical-genetic service, capable of providing comprehensive support for patients with genetic pathologies.

Remote mental health services during the COVID-19 pandemic in Finland and the Netherlands: a qualitative study

BackgroundThe COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our study was to identify and compare the promoters and challenges of the adoption of remote mental health services experienced by service users in Finland and the Netherlands during the COVID-19 pandemic with help of the FITTE framework.MethodsThe study adopted a qualitative descriptive approach, consisting of in-depth semi-structured interviews with mental health service users in Finland (n = 12) and the Netherlands (n = 13) during the COVID-19 pandemic. Qualitative content analysis with both inductive and deductive approach was utilized, and the extended FITTE framework was applied to identify the factors related to the fit between individual, task, technology, and environment that influenced the adoption of remote services.ResultsOverall, the adoption of remote mental health services during the COVID-19 pandemic involved several promoters related to easy access to mental health services, support for mental health and well-being, and benefits of the home environment such as not having to leave outside for services and having less risk of getting the corona virus. Most of the challenges were related to lack of non-verbal communication, difficulties with expressing oneself and interpreting others, technological issues, the organization of remote services, usability and suitability of services, affinity of the health professional with the provision of remote services, and the safety and security of remote services.ConclusionsWhile remote services are accessible, support our well-being and mental health and protect us against the coronavirus, our findings also show that face-to-face contact was often indispensable when adopting mental health services. Therefore, the design of future mental health services should include both remote and face-to-face delivery. Further research should be done on blended approaches and on ways in which the challenges and development needs which emerged from this study can be tackled to improve remote mental health services.

НАДЕЖНОСТЬ ТРАКТОРОВ БЕЛАРУСЬ И ОРГАНИЗАЦИЯ ТЕХНИЧЕСКОГО СЕРВИСА В УСЛОВИЯХ АЗЕРБАЙДЖАНСКОЙ РЕСПУБЛИКИ

The article analyzes typical failures of Belarusian tractors by brand and component. It has been established that over the past 17 years, the production of tractors has increased by 3.28 times. Observations of more than 100 units of Belarusian tractors operating in different climatic conditions of the Republic of Azerbaijan were carried out for the effective organization of technical service, taking into account the nature of the distribution of faults. It was found that 73.2% of malfunctions occur in Belarus tractors - 892, 15.9% - in Belarus - 1221, 10.9% - in Belarus - 82.1. It has been established that 64.6% of Belarusian tractor failures occur in engines, 29.3% in transmissions, and 6.1% in hydraulic systems. Operational and technological assessment was carried out on the fields of the republic. A decrease in the efficiency of using equipment was revealed as a consequence of the fact that due to an insufficient technical service network, its efficiency decreases, costs and time to eliminate failures increase and, accordingly, the intensity and frequency of their occurrence increases. The methodology for determining the density of tractors depending on their number and area of farmland was developed to optimize the development and placement of technical service centers (TSC) for tractors in Belarus. Equipment density is characterized by the amount of equipment per 1 km2 of farmland. The average distance they travel to the central heating station depends on the density of tractors. A nomogram for determining the average moving distance of equipment to the central heating system based on the number of equipment and the density of their distribution has been developed. Thus, the effective organization of technical services in the republic helps to ensure a minimum level of prices for services with high quality.

Managing hypertension in rural Gambia and Kenya: Protocol for a qualitative study exploring the experiences of patients, health care workers, and decision-makers

Background Hypertension is the single leading risk factor for premature death in Sub-Saharan Africa (SSA). Prevalence is high, but awareness, treatment, and control are low. Community-centred interventions show promise for effective hypertension management, but embedding such interventions sustainably requires a good understanding of the wider context within which they are being introduced. This study aims to conduct a systematic health system assessment exploring the micro (patients/carers), meso (health care workers and facilities), and macro (broader system) contexts in rural Gambia and Kenya. Methods This study will utilise various qualitative approaches. We will conduct (i) focus group discussions with people living with hypertensive to map a ‘typical’ patient journey through health systems, and (ii) in-depth interviews with patients and family carers, health care workers, decision-makers, and NCD partners to explore their experiences of managing hypertension and assess the capacity and readiness of the health systems to strengthen hypertension management. We will also review national guidelines and policy documents to map the organisation of services and guidance on hypertension management. We will use thematic analysis to analyse data, guided by the cumulative complexity model, and theories of organisational readiness and dissemination of innovations. Expected findings This study will describe the current context for the management of hypertension from the perspective of those involved in seeking (patients), delivering (health care workers) and overseeing (decision-makers) health services in rural Gambia and Kenya. It will juxtapose what should be happening according to health system guidance and what is happening in practice, drawing on the experiences of study participants. It will outline the various barriers to and facilitators of hypertension management, as perceived by patients, providers, and decision-makers, and the conditions that would need to be in place for effective and sustainable implementation of a community-centred intervention to improve the management of hypertension in rural settings.

Situation on childhood tuberculosis for 10 years and the organization of pediatric tB service in St. petersburg

Situation on childhood tuberculosis for 10 years and the organization of pediatric tB service in St. petersburg