Suchergebnisse

The article considers the problem of legal regulation of the use of assisted reproductive technologies. The works of scientists on this topic are analyzed, as well as the legislation is investigated, without which a full understanding of this topic would be impossible. In conditions of the demographic crisis the question of assistance in sterile marriage arises. A birth rate and demographic processes require new developments, with that the area of medicine manage well, however the legal aspects of application of programs of assisted reproductive technology requires of attention. Reproductive rights are the part of natural rights, which have to be settled and legally provided. Assisted reproductive technology is the one of the significant human achievements and this is an effective mechanism of resolving of the problem of infertility. The "social infertility", which is caused by not medical rate but the absence of the partner is being resolved by means of using ART. ART in practice is ahead of the formation of a legal framework in this area. The current regulatory legal acts in Ukraine regarding assisted reproductive technologies are generally aimed at securing the right to use ART and regulating the medical side of this issue, leaving the legal aspect without due attention. The problem of protecting reproductive health and the reproductive rights of a person and a citizen, including the right to use ART, is the most important area of state policy, and it is the state that is charged with the duty of its proper legal support. The legal basis of ART requires subsequent development and improvement. Individuals, who require medical services from the specialized institutions, which embody the ART methods, must find the actual state of Ukrainian legislation in this area, which would have unconditional feature and exact mechanism of its legal unequivocal application. ; У статті розглядається проблема правового регулювання застосування допоміжних репродуктивних технологій. Проаналізовано праці науковців із даної теми, а також досліджено законодавство, без чого повне розуміння даної теми було б неможливим. В умовах демографічної кризи гостро постає питання допомоги у випадку безплідного шлюбу. Стан народжуваності та демографічні процеси вимагають нових розробок, із чим успішно справляється галузь медицини, однак потребують уваги правові аспекти застосування програм допоміжних репродуктивних технологій. Репродуктивні права є частиною природних прав, які повинні бути врегульованими та забезпеченими нормативно. Допоміжні репродуктивні технології є одним із вагомих досягнень людства та дієвим механізмом вирішення проблеми безплідності. За допомогою застосування ДРТ вирішується так зване «соціальне безпліддя», що викликане не медичними показниками, а відсутністю партнера. ДРТ на практиці випереджає формування правової бази в цій галузі. Чинні нормативно-правові акти в Україні стосовно допоміжних репродуктивних технологій загалом спрямовані на закріплення права на застосування ДРТ та регулювання медичної сторони даного питання, залишаючи юридичний аспект без належної уваги. Проблема охорони репродуктивного здоров'я та репродуктивних прав людини й громадянина, включно із правом на використання ДРТ, являє собою найважливіший напрям державної політики, і саме на державу покладено обов'язок її належного юридичного забезпечення. Правова база ДРТ потребує подальшого розвитку та вдосконалення. Особи, що потребують медичних послуг у спеціалізованих установах, які втілюють методи ДРТ, мають знати актуальний стан українського законодавства в цій галузі, яке б мало беззаперечний характер та чіткий механізм його правового беззастережного застосування.

En diciembre del 2019, se ha reportado el brote de una de neumonía letal atípica con en la ciudad Wuhan (China); se identificò el agente causal al Coronavirus 2 del Síndrome Respiratorio Agudo grave (COVID-19). En una situación sin precedentes el 11 de marzo 2020 a tan solo 101 días de su reporte inicial; la Organización Mundial de la Salud, calificó como una pandemia mundial COVID- 19 ya en estos momentos los casos confirmados superaban los 118 000 a nivel mundial esparcido en 114 países y se registraban 4,291 fallecidos. Con más de 80 mil casos, 2267 muertes y solo 1031 camas de UCI para 33 millones de habitantes, Perú es uno de los países latinoamericanos con mayor impacto de la pandemia COVID-19 a pesar de las primeras medidas tomadas por el gobierno. A través de una declaración de emergencia nacional, el gobierno peruano estableció una cuarentena a partir del 16 de marzo 3 que se extendió hasta setiembre, sin embargo, a la fecha aún no hay estabilización y reducción en el número de nuevos casos y muertes. Por tal motivo en la región Loreto, viéndose con el personal de salud agotado y la mayorá enferma y en proceso de recuperación, DIRESA solicitó personal voluntario con conocimiento médico para el apoyo en la atención de pacientes en el Hospital Regional Loreto el cual venía atendiendo aproximadamente 300 pacientes hopitalizados. Ante ello un grupo humano de egresados de la Facultad de Medicina Humana de la Universidad Nacional de la Amazonía Peruana decidieron afrontar esta responsabilidad, los mismos que a pesar del miedo demostraron capacidad, entrega y responsabilidad en lo requerido por dicho nosocomio. ; In December 2019, an outbreak of an atypical lethal pneumonia was reported in the city of Wuhan (China); The causal agent of the Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) was identified. In an unprecedented situation on March 11, 2020 just 101 days after its initial report; The World Health Organization, classified as a global pandemic COVID-19 and at this time the confirmed cases exceeded 118,000 worldwide spread in 114 countries and there were 4,291 deaths. With more than 80 thousand cases, 2267 deaths and only 1031 ICU beds for 33 million inhabitants, Peru is one of the Latin American countries with the greatest impact of the COVID-19 pandemic despite the first measures taken by the government. Through a declaration of national emergency, the Peruvian government established a quarantine as of March 16, 3 that lasted until September, however, to date there is still no stabilization and reduction in the number of new cases and deaths. For this reason, in the Loreto region, seeing the health personnel exhausted and the majority sick and in the process of recovery, DIRESA requested volunteer personnel with medical knowledge to support the care of patients at the Loreto Regional Hospital, which had been treating approximately 300 hospitalized patients. Faced with this, a group of graduates from the Faculty of Human Medicine of the National University of the Peruvian Amazon decided to face this responsibility, the same ones that despite fear demonstrated capacity, dedication and responsibility in what is required by said hospital. ; Trabajo de suficiencia profesional

In nowadays Ukrainian society, there are pretty many events at the intersection of conflict situations that require understanding, dialogue, and platforms to build connections between members of different social communities. One of the ecological ways of building dialogue is social theater.Each theater is inherently social, but we talk about free theatrical format aimed at public dialogue. In general, public dialogue is a dialogue between classes and social groups to reconcile their interests in the distribution of economic, political and cultural resources. In a specific definition, it is also the process of proclamation and converging positions so that to reach an understanding and making common decisions across different social groups.Modern forms of the social theater include playback (narrative theater), forum theater (oppressed, invisible, etc.), educational theater (medicine, pedagogy), therapeutic theater, theater in the proposed circumstances (prison theatre, Theatre of War Productions), performances (museum theater, improvisation). Mostly they are spontaneously organized by "amateur" theaters, which are founded by activists and enthusiasts. Their focus is on the dramatic events of individuals who represent invisible groups that have specific social problems.Thus, the general functions of the social theater can be divided into communicative, consolidating, cognitive, therapeutic, adaptive, rehabilitative, and creative.Judith Ackroyd talks about the dual purpose of social theater to promote changes in public opinion and behavior as well to encourage the public to the partnership. That is why it is hard to overestimate the role of social theater to get unity, cooperation, and activity. ; В связи с драматическими событиями, уходящими корнями в исторические реалии, в украинском обществе возникает много конфликтов и недопонимания, которые требуют диалога и платформ для налаживания связей между представителями различных сообществ. Одним из таких экологических способов построения диалога является социальный театр.Можно сказать, что каждый театр по своей природе является социальным, но мы говорим о свободном театральном формате, целью которого является открытый публичный диалог. В широком смысле, социальный диалог − это диалог между классами и социальными группами, которые занимают определенную позицию в социальном пространстве, в зависимости от экономических, политических и культурных ресурсов. В более узком понимании, это процесс определения собственных позиций и диспозиций разными социальными группами для достижения понимания и принятия общих решений.Современные формы социального театра включают в себя: playback (нарративный театр), форум-театр (театр «угнетенных», «невидимых» и т. д.), просветительский театр (сферы медицины, педагогики), терапевтический театр, театр в предлагаемых обстоятельствах (тюремный театр, театр военных произведений), перформансы (в музеях, на улицах и т.д.). В основном они представляют собой аматорские театры, которые основаны активистами и энтузиастами. Их фокус сосредоточен надраматических событиях людей, которые представляют уязвимые группы с определенными социальными проблемами. Джудит Акройд в своих лекциях говорит о двойной цели социального театра: способствовать изменениям общественного мнения и поведения, а также поощрять общественность к взаимодействию. Вот почему трудно переоценить роль социального театра в достижении единства, сотрудничества и активности.В целом, функции социального театра можно разделить на коммуникативные, консолидирующие, когнитивные, терапевтические, адаптивные, реабилитационные и творческие. ; У сучасному українському суспільстві відбувається забагато подій на перетині конфліктних ситуацій, що потребують порозуміння, діалогу та майданчиків для налагодження зв'язків між представниками різних соціальних спільнот. Одним із екологічних шляхів розбудови діалогу є соціальний театр. Він дає можливість групам, які не мають у суспільстві «голосу», бути почутими, подати свою версію подій, котра може відрізнятися від версії «більшості», висловити свої почуття крізь призму набутого досвіду.

Стаття присвячена дослідженню проблеми організації інклюзивної освіти в умовах загальноосвітньої школи. Обґрунтовано актуальність дослідження на основі виконаного аналізу науково-педагогічної літератури з проблеми дослідження. На основі використання комплексу дослідницьких методів охарактеризовано специфіку застосування тривимірної моделі для розвитку системи навчання дітей із особливими освітніми потребами з метою ефективного залучення до освітнього середовища. Представлено варіанти інклюзивної освіти як теоретичну конструкція у процесі її концептуалізації, проектування та імплементації у вітчизняну систему освіти загалом та освітній процес закладів загальної середньої освіти зокрема. ; Introduction of inclusive education in Ukraine presupposes, first, a change in the attitude towards people with special needs, their integration into the social space, while guaranteeing protection of their rights and comprehensive support. In this perspective, such directions in changing the educational paradigm as the provision of quality education and preparation for life in modern society of children with special educational needs are becoming substantial. After analyzing a significant amount of literature on this issue, the peculiarities of the organization of education of children with special educational needs in the general school abroad and in Ukraine were revealed. The aim of the article is to describe the main models of education of children with special educational needs in general education school. In the study the following research methods are used: general scientific (analysis, synthesis, deduction, induction, comparison, classification, generalization), which allow to argue and justify the choice of a model of teaching students with special needs in a secondary school; search and bibliographic for systematization of research sources; historiographical-interpretative for studying the state of the problem under research, comprehension of conceptual approaches to its solution and its categorical-conceptual apparatus; comparative – for the study of foreign experience of teaching students with special needs in the system of general schooling, identifying global trends in this area. Modern research in the field of pedagogy, psychology, correctional education, medicine confirms the existence of three main models of inclusive education in world practice, and in Ukraine in particular. Application of a three-dimensional model for the development of the education system for children with special educational needs will allow their effective inclusion into the educational environment, and subsequently in active social life. For the successful development of inclusive education at the state level, there must be a clear understanding of the development vector and the key principles of its construction and functioning. The options of inclusive education presented in the study are the initial theoretical construction in the process of its conceptualization, design, and implementation in the domestic education system in general and the educational process of secondary education. The inclusion of children with mental and physical disabilities in the mass education system at school age can have a significant impact on their development to increase the level of speech and communication skills, intellectual level, enriching the experience of social and educational interaction with peers. However, the level and intensity of this impact in different models are diverse. The choice of the optimal inclusion option for each child should be based on its individual characteristics, needs and potential. In turn, the possibilities for choosing the optimal model depend on the social and educational policy of the state, socio-economic conditions, the level of development of democratic processes and humanistic ideas in society.

In connection with Ukraine's accession to the WTO, the Government has been tasked to take steps to ensure a consistent transition to the new International Requirements for the Safety and Quality of Raw Materials and Foodstuffs, including on animal health control.The purpose of the research was to carry out veterinary-sanitary examination of beef in the conditions of the agro-industrial market, to improve and develop express methods of determination of beef qualities of NOR- and PSE. The following research methods were used: organoleptic, biochemical, physicochemical, microscopic, microbiological, morphological and biometric.It is theoretically substantiated and experimentally confirmed the necessity to carry out veterinary and sanitary evaluation of beef qualities of NOR, PSE and DFD obtained from black-billed bull calves aged 24-27 months after maturation.The optimal quality indicators of beef quality NOR, PSE and DFD were determined. In order to prevent the loss of meat raw materials during processing, as well as in the production of meat products, it is experimentally and theoretically substantiated the need to determine the beef qualities of NOR- and PSE by organoleptic, morphological parameters, as well as by pH and pigment content.Use patented photometric methods for express and effective determination of NOR- and PSE beef in the state veterinary laboratory on the market.It is scientifically substantiated and experimentally proved the expediency of carrying out veterinary and sanitary evaluation of beef of different enterprises of Kyiv region in accordance with the current national standards and normative legal acts of Ukraine.Thus, a reliable quantitative method for determining the total content of pigments in beef qualities of NOR- and PSE along with other methods of determining these qualities (moisture retention capacity, pH, moisture content, organoleptic) is proposed. The method has the advantage over the existing methods of determining beef NOR- and PSE in that the results have a specific, reliable quantitative value.Methodical recommendations "Veterinary-sanitary evaluation of beef using quantitative method for determination of total pigment content in NOR- and PSE-meat of cattle" approved by the Academic Council of the Faculty of Veterinary Medicine of Bilotserkiv National Agrarian University, December 5, 2018 . ; Програмою Кабінету Міністрів України № 14 від 10.01.2002 року «Здоров'я нації» щодо поліпшення стану здоров'я населення, передбачено актуальність наукового обґрунтування ветеринарно-санітарної експертизи продуктів забою тваринництва, особливо за визначенні якості м'яса (NOR, PSE і DFD) відповідно до міжнародних вимог в процесі його сортування в перші години після забою тварин для запобігання його псування під час зберігання.Проведена ветеринарно-санітарна експертиза яловичини в умовах агропромислового ринку за використання органолептичних, фізико-хімічних, біохімічних, мікроскопічних, морфологічних та біометричних методів дослідження. Удосконалені та розроблені експресні методи визначення яловичини якості NOR, PSE та DFD.Теоретично обґрунтовано та експериментально підтверджено необхідність проведення ветеринарно-санітарного оцінювання яловичини NOR, PSE та DFD (отриманої від бичків чорно-рябої породи віком 24–36 місяців) після її дозрівання. Визначено оптимальні показники якості яловичини NOR, PSE та DFD. Для запобігання втрат м'ясної сировини за її обробки та виробництва м'ясних продуктів експериментально і теоретично обґрунтована необхідність визначення яловичини NOR, PSE та DFD за органолептичними, морфологічними показниками, величиною рН і вмістом пігментів. Для експресного та ефективного визначення яловичини NOR і PSE у державній лабораторії ветеринарно-санітарній експертизи на агропродовольчому ринку використовувати запатентовані фотометричні методи визначення якості яловичини, що мають перевагу над існуючими тим, що результати мають конкретне та достовірне кількісне значення.

Latar Belakang: Penggunaan obat yang tidak rasional menjadi masalah dalam pelayanan kesehatan, baik di negara maju maupun negara berkembang. Pengobatan Infeksi Saluran Pernafasan Akut (ISPA) tidak hanya tergantung pada antibiotik, tetapi dengan terapi penunjang untuk kasus yang disebabkan oleh virus. Penelitian ini bertujuan untuk mengidentifikasi pola pengobatan pasien ISPA pada balita di rumah sakit di Bogor, Indonesia. Metode: Penelitian ini dilakukan dengan desain potong lintang menggunakan data rekam medis pasien balita dengan ISPA periode 1 Januari hingga 31 Desember 2015 di rumah sakit pemerintah dan swasta di Bogor. Analisis dilakukan dengan menggunakan uji Chi-Square. Hasil: Rekam medis yang yang dikumpulkan dari kedua rumah sakit sebanyak 105 kasus. Pola pengobatan pada pasien ISPA rawat jalan (n=32) di rumah sakit swasta adalah mukolitik (81,3%), dekongestan (56,3%), antipiretik (43,8%), dan antibiotik (6,3%). Sementara itu, rumah sakit pemerintah (n=8) menggunakan antibiotik (75%), antipiretik (50%), dan mukolitik (50%). Pola pengobatan pada rawat inap di rumah sakit swasta (n=27) adalah antibiotik (85,2%), antipiretik (63%), kortikosteroid (33,3%), dan mukolitik (25,9%), sedangkan rumah sakit pemerintah (n=38) adalah antibiotik (92,1%), antipiretik (89,5%), kortikosteroid (31,6%), dan mukolitik (71,1%). Faktor-faktor yang mempengaruhi pengobatan pada rawat jalan tidak dapat diidentifikasi karena kurangnya informasi klinis dan hasil tes laboratorium. Pemberian antibiotik pada pasien rawat inap di kedua rumah sakit tidak berhubungan dengan kadar leukosit dan suhu tubuh. Kesimpulan: Penelitian ini menunjukkan bahwa penggunaan antibiotik untuk ISPA belum sesuai dengan pedoman klinis yang pemberiannya harus didahului dengan pemeriksaan klinis dan mikrobiologis. Kepatuhan terhadap pedoman klinis sangat penting untuk mencegah terjadinya resistensi antibiotik dan mengurangi terjadinya reaksi obat yang tidak diinginkan. Kata kunci: Anak, antibiotik, infeksi saluran pernafasan akut, pengobatan Abstract Background: Irrational use of medicines has become a problem in health services, both in developed and developing countries. Treatment of Acute Respiratory Tract Infections (ARTIs) is not only dependent on antibiotics, but only with supportive treatment for cases caused by viruses. This study aimed to determine treatment patterns for children under-fives with ARTIs in hospitals in Bogor, Indonesia. Methods: A cross-sectional study was conducted using medical records of patients under-fives with ARTIs in a government and a private hospital in Bogor from January 1st to December 31st, 2015. The analysis was performed using Chi-square test. Results: There were 105 medical records collected from both hospitals. The pattern of ARTIs' outpatient treatments (n= 32) at private hospital were mucolytic (81.3%), decongestants (56.3%), antipyretic (43.8%), and antibiotics (6.3%). Meanwhile, the government hospital (n=8) used antibiotics (75%), antipyretics (50%) and mucolytic (50%). The pattern of ARTIs inpatient treatments in private hospitals (n=27) were antibiotics (85.2%), antipyretic (63%), corticosteroids (33.3%), and mucolytics (25.9%). Otherwise, the government hospital (n=38) used antibiotics (92.1%), antipyretic (89.5%), corticosteroids (31.6%) and mucolytics (71.1%). Factors affected outpatient treatment could not be traced because it lacked clinical information and laboratory test results. Meanwhile, antibiotic use for inpatients in both hospitals was not related to blood leukocytes level and body temperature. Conclusion: This study showed that antibiotics prescribing for ARTIs is still not in accordance with the clinical guidelines that must be preceded by various clinical examinations and microbiological. Adherence to clinical guidelines is important to prevent antibiotic resistance and to decrease adverse effects. Keywords: Acute respiratory tract infections, antibiotics, children, treatment

The purpose of the article is to identify areas that determine the role of international founds and organizations in promoting effective reform of the financing of the national healthcare system.The article considers prerequisites, which became a catalyst for radical reforms in the Ukrainian healthcare system, the implementation of which has been facilitated by the international funds and organizations. The legal framework necessary in regard to reformation of the medical sector and elaborated and implemented by Ukrainian authorities with the assistance of international partners have been analysed. The stages of medical reform implementation have been identified. The engagement of international funds and organisations at certain stages of medical sector reformation has been determined.Key aspects of a new financing model for the healthcare system have been highlighted. The role of international organisations in the process of transformation of a model of healthcare system financial support has been analysed, especially at the stage of reformation of the centralised procurement of medicines and medical devices for budgetary funds.Activities of several international organisations that most intensively contribute to the effective reformation of the national healthcare system have been described. The main programmes and projects implemented by international funds and organisations in the process of promoting effective reformation of the healthcare system in Ukraine have been outlined.The results of the study has been showed that the role of international organizations and funds in the process of transforming the model of financial support of the healthcare system is extremely important at each stage of reform.It is concluded that in order to reform the model of financing the healthcare system, it is necessary to achieve coherence between the actions of local authorities and political leaders at the national level with the participation of international organizations as a mediator between these sides.Keywords: healthcare system, model of healthcare financing, international organization, international fund, medical guarantee program, government-funded package, budget funds, centralized procurement, medical services, international programmes, international projects. ; Метою статті є виокремлення напрямів, котрі визначають роль міжнародних фондів та організацій у сприянні ефективному реформуванню фінансування вітчизняної системи охорони здоров'я. У дослідженні використано історичний метод, котрий дав змогу виділити передумови, що стали каталізатором радикальних реформ у сфері фінансування системи охорони здоров'я, впровадження яких супроводжуються процесом залученням міжнародних фондів та організацій. Виокремлено основні аспекти нової моделі фінансування системи охорони здоров'я; здійснено аналіз діяльності деяких міжнародних фондів, організацій та окреслено основні програми й проекти, які ними реалізовуються з метою сприяння ефективному реформуванню системи охорони здоров'я в Україні. Результати дослідження показали, що роль міжнародних організацій та фондів в процесі трансформації моделі фінансового забезпечення системи охорони здоров'я є вкрай важливою на кожному етапі реформування, а особливо на стадії переформатування централізованої закупівлі лікарських засобів та медичних виробів за бюджетні кошти. Сформульовано висновок, що для подальшого ефективного реформування моделі фінансування системи охорони здоров'я необхідно досягнути стійкої взаємоузгодженості між діями органів місцевої влади та політичними лідерами національного рівня стосовно кінцевої моделі фінансування за допомогою участі міжнародних організацій в ролі посередника між цими сторонами.Ключові слова: система охорони здоров'я, модель фінансування системи охорони здоров'я, міжнародна організація, міжнародний фонд, програма медичних гарантій, державний гарантований пакет, бюджетні кошти, централізовані закупівлі, медичні послуги, міжнародні програми, міжнародні проекти.

On May 28, 2020 on the online platform of Kharkiv National Medical University in the framework of scientific and practical online conference with international participation "The problem of man in socio-humanitarian and medical discourses" successfully held a round table "Metamorphoses of the center and periphery in medical, gender and age dimensions inclusion". The focus was on the phenomenon of inclusion, in particular, with a projection on education. Inclusion was interpreted by the participants as broadly as possible – as the inclusion of any people and groups of people who are discriminated against and / or in need of certain mechanisms of adaptation in social life, as well as a theoretical model of interaction of all people in different spheres of society on the basis of equality of rights and opportunities. Attendees tried to give a nudge for an interpretation that goes beyond the traditional stereotypical identity of inclusion = disability and focused on the stereotypes that exist in education and medicine about transgender and homosexual people, people with disabilities, children with hearing impairments, children with SEN, etc. Inclusion is the recognition of the unique characteristics of each individual, the creation of a culture that seeks and strives to ensure equality of opportunities and at the same time accents and values the differences. Medical universities are forming a new culture of inclusiveness, mutual respect and tolerance among future professionals, which, in turn, should affect the equality and democracy of society as a whole, and in particular non-discrimination, security of space, equal access to health care. The discussion also focused on the educational training of the medical community, but there were revealed also gaps in the legal field of Ukraine, the unrealized potential for the development of inclusive education in educational system in general. The existing models of disability in the society are considered: charitable, medical, social, human rights defending. ; 28 травня 2020 року на онлайн-платформі Харківського національного медичного університету в рамках науково-практичної онлайн-конференції з міжнародною участю «Проблема людини у соціально-гуманітарному та медичному дискурсах» успішно пройшов круглий стіл «Метаморфози центру та периферії в медичному, гендерному і віковому вимірах інклюзії». У центрі уваги був феномен інклюзії, зокрема, з проекцією на освіту. Інклюзія трактувалася учасниками і учасницями максимально широко – як включення будь-яких людей і груп людей, що дискриміновані та/або потребують певних механізмів адаптації, в соціальне життя, а також як теоретична модель взаємодії всіх людей у різних сферах життя суспільства на засадах рівності прав і можливостей. Присутні намагалися дати поштовх такому трактуванню, що виходить за рамки традиційно-стереотипної тотожності інклюзія = інвалідність і зосередилися на проблемі стереотипів, які існують в освіті та медицині щодо трансгендерних та гомосексуальних людей, осіб з інвалідністю, дітей з порушеннями слуху, дітей з ООП та ін. Інклюзія є визнанням унікальних ознак кожної особистості, створенням культури, що прагне та докладає зусилля для забезпечення рівності можливостей та водночас акцептує та цінує відмінності. Медичні університети формують нову культуру інклюзивності, взаємоповаги та толерантності у майбутніх фахівців та фахівчинь, що, у свою чергу, має вплинути і на рівноправність та демократичність суспільства у цілому, і, зокрема, на недискримінацію, безпечність простору, рівний доступ усіх до охорони здоров'я. Дискусія також зосередилася навколо освітньої підготовки лікарської спільноти, однак були також виявлені лакуни у правовому полі України, нереалізований потенціал розвитку інклюзивної освіти у системі освіти в цілому. Розлянуто наявні у суспільстві моделі інвалідності: благодійну, медичну, соціальну, правозахисну.

AbstractBackground: Affective and anxiety disorders have a higher occurrence in older people with intellectual disability (ID) than in the general population. However, there is a lack of research into this ageing group from the point of view of their health panorama, use of medicines, healthcare utilisation and social welfare support. This thesis is part of a Swedish national population project on health, mortality, healthcare and social welfare utilisation among older people with ID.Aim: The main aim of the thesis was to investigate comorbidities, healthcare utilisation and pharmacotherapy in older people with ID, compared to older people from the general population, diagnosed with affective and/or anxiety disorders. A further aim was to investigate, within the ID group, the association between frailty factors and use of support and social services provided through Swedish disability regulations.Methods: All of the studies have a longitudinal design, based on Swedish national registries during an 11-year period. The ID cohort was a sample from the national study population, aged at least 55 years and alive at the end of 2012 (n=7,936), and a control group of the same size was matched by birth year and sex from the general population. Studies I–III investigated those in both cohorts with at least one affective disorder (n=918) and/or anxiety disorder (n=825) who visited specialist healthcare, examining diagnoses, healthcare utilisation and pharmacotherapy in these subgroups. Study IV focused on the ID group only (n=871), examining their frailty factors and use of support and social services.Results: Older people with ID were more likely to have other comorbidities, to visit inpatient healthcare and to be prescribed drugs such as anxiolytics, compared to older people in the general population with affective and/or anxiety disorders (Studies I-III). The most common psychiatric comorbidities in the ID group were unspecified or other mental disorders. Concerning somatic comorbidities, they were more likely to have neurological problems, injuries and falls (Study I). The ID group was more likely to have inpatient and unplanned healthcare visits to both psychiatric and somatic healthcare (Study II). Those with affective and/or anxiety disorders in the ID group were more likely to be prescribed anxiolytics and GABA agonists (Study III). Those having more than 12 visits to healthcare and having multimorbidity were less likely to live in residential arrangements, the opposite was found for polypharmacy and moderate or severe levels of ID compare to those without (Study IV).Conclusion: The results verify that older people with ID and with affective and/or anxiety disorders have comprehensive and complex needs for healthcare, treatment and social services, which puts exceptionally high demands on promoting healthy ageing for this target group. From the results of these studies, as well as from the increasing number of ageing people with ID in all developed countries in the world, there is an urgent need to develop specific medical guidelines for health surveillance and structured care programmes for this frail group of older people. Preventive interventions for affective and anxiety disorders need to focus on communication strategies and tools to foster healthy ageing and person-centred healthcare. Implementation of Peplau's model of the nurse client relationship and EU policy of healthy ageing may improve the quality of care.

© 2020 – IOS Press and the authors. ; [Background]: Previous studies suggest that Dickkopf-1 (DKK1), an inhibitor of Wnt signaling, plays a role in amyloid-induced toxicity and hence Alzheimer's disease (AD). However, the effect of DKK1 expression on protein expression, and whether such proteins are altered in disease, is unknown. [Objective]: We aim to test whether DKK1 induced protein signature obtained in vitro were associated with markers of AD pathology as used in the amyloid/tau/neurodegeneration (ATN) framework as well as with clinical outcomes. [Methods]: We first overexpressed DKK1 in HEK293A cells and quantified 1,128 proteins in cell lysates using aptamer capture arrays (SomaScan) to obtain a protein signature induced by DKK1. We then used the same assay to measure the DKK1-signature proteins in human plasma in two large cohorts, EMIF (n = 785) and ANM (n = 677). [Results]: We identified a 100-protein signature induced by DKK1 in vitro. Subsets of proteins, along with age and apolipoprotein E ɛ4 genotype distinguished amyloid pathology (A + T–N–, A+T+N–, A+T–N+, and A+T+N+) from no AD pathology (A–T–N–) with an area under the curve of 0.72, 0.81, 0.88, and 0.85, respectively. Furthermore, we found that some signature proteins (e.g., Complement C3 and albumin) were associated with cognitive score and AD diagnosis in both cohorts. [Conclusions]: Our results add further evidence for a role of DKK regulation of Wnt signaling in AD and suggest that DKK1 induced signature proteins obtained in vitro could reflect theATNframework as well as predict disease severity and progression in vivo. ; This research was conducted as part of the EMIF-AD project which has received support from the Innovative Medicines Initiative Joint Undertaking under EMIF grant agreement n° 115372, resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies' in-kind contribution. The DESCRIPA study was funded by the European Commission within the 5th framework program (QLRT-2001-2455). The EDAR study was funded by the European Commission within the 5th framework program (contract # 37670). The Leuven cohort was funded by the Stichting voor Alzheimer Onderzoek (grant numbers #11020, #13007 and #15005). The Lausanne cohort study was supported by a grant from the Swiss National Research Foundation to JP (SNF 320030_141179). RV is a senior clinical investigator of the Flemish Research Foundation (FWO). JS is currently an employee of UCB, Braine-l'Alleud, Belgium. The San Sebastian GAP study is partially funded by the Department of Health of the Basque Government (allocation 17.0.1.08.12.0000.2.454.01.41142.001.H). We acknowledge the contribution of the personnel of the Genomic Service Facility at the VIB-U Antwerp Center for Molecular Neurology. The research at VIB-CMN is funded in part by the University of Antwerp Research Fund. FB is supported by the NIHR biomedical research centre at UCLH. RD is supported by Health Data Research UK, the National Institute for Health Research (NIHR) Biomedical Research Centre at South London, Maudsley NHS Foundation Trust, King's College London and the NIHR University College London Hospitals Biomedical Research Centre. LS is funded by DPUK through MRC (grant no. MR/L023784/2) and the UK Medical Research Council Award to the University of Oxford (grant no. MC_PC_17215). Also support was received from the NIHR Biomedical Research Centre at Oxford Health NHS Foundation Trust.

Social programs as an initiative aimed at improving the quality of life of the population always represent a great challenge for the planning of governments highlighting the great requirement of resources for their execution, in this area they will always be limited and in order to maximize the possibilities to reach the established goals the conception of strategic alliance arises that for this work is centered between the state and the academy. The Ministry of Economic and Social Inclusion (MIES), promotes actions to give greater prominence and participation to the youth population in the generation of public policies. In 2015, the "Leónidas Proaño" mission was implemented to link university students to institutional services to execute their pre-professional practices. The Azogues Headquarters Academic Health and Welfare Unit, in response to the requirements of District 1 of the MIES Azogues, planned the execution of the project Intervention in health of children and families of the Growing Up with Our Children Program, with the objective of contributing to improve the health condition of the children who attend this program. Among the participants are students of Medicine, Nursing, Biopharmacy, teachers of UCACUE, Educators, children from 0 to 60 months and parents of the Growing Up with Our Children program. The value of associating has allowed us to project a greater visibility of activities related to society, among which are: 2313 children evaluated in their nutritional status, development, hemoglobin tests and co-parasitic exams. Additionally, parents and / or representatives have received health education in complementary feeding, infection prevention and infection. ; Los programas sociales, como iniciativa orientada a mejorar la calidad de vida de la población, representan siempre un gran desafío para la planificación de los gobiernos, destacando el gran requerimiento de recursos para su ejecución, que, en este ámbito, siempre resultarán limitados. Con la finalidad de maximizar las posibilidades de alcanzar las metas establecidas, surge la concepción de alianza estratégica que para este trabajo se centre entre el estado y la academia. El Ministerio de Inclusión Económica y Social (MIES), impulsa acciones para dar mayor protagonismo y participación a la población juvenil en la generación de las políticas públicas. En el año 2015 se implementó la misión "Leónidas Proaño", para vincular a los estudiantes universitarios a los servicios institucionales para ejecutar sus prácticas pre-profesionales. La Unidad Académica de Salud y Bienestar de la Sede Azogues, en respuesta a los requerimientos del Distrito 1 del MIES Azogues, planificó la ejecución del proyecto Intervención en salud de niños, niñas y familias del Programa Creciendo con Nuestros Hijos, con el objetivo de contribuir a mejorar la condición de salud de los niños y niñas que asisten a este programa. Entre los participantes se cuentan estudiantes de Medicina, Enfermería, Biofarmacia, docentes de la UCACUE, educadoras, niños de 0 a 60 meses y padres de familia del programa Creciendo con nuestros Hijos. El valor de asociarse ha permitido proyectar una mayor visibilidad de actividades de vinculación con la sociedad entre los que se destacan: 2313 niños evaluados en su estado nutricional, desarrollo, pruebas de hemoglobina y exámenes copro-parasitarios. Adicionalmente los padres y/o representantes han recibido educación para la salud en alimentación complementaria, prevención de infecciones y de infecciones.

This article considers, initially, the mobility of doctors throughout the world from a bibliographic database collection and identifies the lack of information regarding Brazilian doctors. The aim is to analyze aspects that determine the emigration of Brazilian doctors to the United States of America. The methodology is based on bibliographic research using the keywords brain drain, medical migration, physicians migration, data migration physicians; identification of articles related to the emigration of doctors throughout the world; elaboration and validation of the questionnaire "Emigration Motives"; identification of doctors that emigrated, using the "snowball" technique; sending of the questionnaire by e-mail to the doctors that emigrated to the USA; tabulation of the forwarded answers; Skype interviews aiming at the validation and illustration of the results obtained in the questionnaire. Initially, the doctors choose to emigrate for personal motives (family, professional opportunities, and, in general, absence of language barriers); when established in the USA, they experience a new way of life that makes them stay (better work condition, quality of life, family and general opportunities); external motives become the cause for staying in the USA (insecurity, professional, political and economic scenarios). The conclusion is that an emigrational process of Brazilian doctors to the USA exists and, at first, the reason to emigrate is not well defined; salary is not mentioned as a primary reason; the presence of the family eases the stay in the country; the proficiency in the English language is fundamental and necessary to restart the professional life as a recently graduated in medicine since there isn't an university degree or medical specialty degree validation. ; Este artigo aborda a mobilidade de médicos pelo mundo a partir de levantamento bibliográfico em base de dados e identifica a escassez de informações referentes aos médicos brasileiros. O objetivo é analisar aspectos que determinam a emigração de médicos brasileiros para os EUA. A metodologia baseia-se em pesquisa bibliográfica, utilizando as palavras-chave "brain drain", "medical migration", "physicians migration", "data migration physicians"; identificação de artigos relacionados à emigração de médicos pelo mundo; elaboração e validação do questionário "Motivos de Emigração"; identificação de médicos que emigraram utilizando a técnica "bola de neve" ; envio do questionário por e-mail aos médicos que emigraram para os EUA; tabulação das respostas encaminhadas; realização de entrevistas por Skype com a finalidade de corroborar e exemplificar os resultados obtidos nos questionários. Inicialmente, os médicos escolhem emigrar por motivos pessoais (família, oportunidades profissionais e, em geral, facilidade do idioma); ao se estabelecerem nos EUA vivenciam uma nova forma de vida, o que os faz permanecer (melhores condições de trabalho, qualidade de vida, família e oportunidades em geral); as causas do não retorno ao Brasil passam a ter motivos externos (insegurança, cenários profissional, político e econômico). Conclui-se que existe um processo emigratório de médicos brasileiros para os EUA e, a princípio, a motivação de emigrar não é bem determinada; o salário não é citado como questão primordial; a presença da família facilita a permanência no país; a fluência na língua inglesa é fundamental; e é necessário recomeçar a vida profissional como um recémformado em medicina, pois não existe processo de validação de diploma ou de especialidades.

In response to an epidemic of opioid overdose deaths attributed to prescription and illicit opioid use, distribution of the opioid antagonist naloxone has been identified in Canada and abroad as a key emergency measure to effectively prevent rising mortality (1,2). The current environmental scan was produced in order to better understand current practices and programs aimed to distribute naloxone for use in suspected opioid overdose, to assess uptake of these programs across Canadian provinces and territories (P/Ts), and to understand barriers related to knowledge and evidence in the use of naloxone, as well as operational obstacles to achieving widespread population coverage. Publicly funded take-home naloxone (THN) programs have been rolled out across every province and territory in Canada in response to the current opioid crisis. All publicly funded THN programs offer naloxone free of charge to those at risk of opioid overdose, while the majority of these programs also target any person who self-identifies as being at risk of witnessing an opioid overdose (including friends or family of people who use drugs). All provinces offer kits with the injectable formulation of naloxone as part of their publicly-funded program, while three P/Ts (Ontario, Quebec, and the Northwest Territories) also offer the nasal naloxone spray. Nasal naloxone spray is also available to clients of Veterans Affairs Canada, and through the NonInsured Health Benefits (NIHB) Program (benefits for First Nations individuals who present a valid status card and personal health number to confirm their eligibility). In most P/Ts, naloxone is made available through a number of different sites and organisations, including community pharmacies, shelters, medical centres, and treatment service centres, although some jurisdictions are limited in their ability to distribute naloxone due to geographical considerations and regulations related to provincial drug scheduling. While population access to naloxone has improved substantially across the country, there remain some jurisdiction-specific operational, geographic, knowledge/evidence, and policy barriers to access. Importantly, there are several unanswered questions regarding the safety and effectiveness of different naloxone routes of administration, dosing, and the extent of training needed to effectively respond to an overdose and administer naloxone. Evidence regarding the benefit of distributing naloxone broadly (as opposed to only specific at-risk populations) is needed. There are also ethical considerations including how to collect robust health data while protecting low-barrier access environments and respecting patient anonymity, and whether it is appropriate to provide naloxone kits to minors. Additional considerations include identifying the most effective overdose response strategy more generally (outlining actions to take beyond administering naloxone, such as chest compressions, rescue breaths, calling 911, etc., and the order to take them in), as well as in the development of program evaluation practices and performance indicators. Consolidating existing evidence, suggesting areas for future research, and building consensus among stakeholders may help improve naloxone access and ensure equitable outcomes in Canada. Finally, there is continued recognition of the complex social, political, and legal solutions needed to address the state of the opioid crisis in Canada, as well as for the need to address continued stigma around drug use, integrate harm reduction practices, and support a holistic model of care in order to best confront the upstream factors leading to overdose, addiction, and substance use. ; Medicine, Faculty of ; Non UBC ; Population and Public Health (SPPH), School of ; Unreviewed ; Faculty ; Researcher

The knowledge of the client/user/student, is the starting point of all organization directed to satisfy the necessities of a group of people; while it doesn't happen, it is practically impossible to design products or services that respond appropriately to the expectations of the consumers. In the specific case of the Libre University of Cali which is a company of knowledge, to know the characteristics detailedly of those who are their users, should constitute a priority because starting from them it is possible to designed appropiately the plans of strategic management. The lack of information modernized on the socioeconomic profile of the students that enrol to the different academic programs offered by the University, prevents to identify aspects so important as: socioeconomic stratum, gender, geographical origin, age, civil state, labor activity, nature of the school where they finished high school studies, free time activities and interests, current coexistence, members of their family group, the parent´s educational level, and so on. For the above-mentioned, the Libre University of Cali with the coordination of the Program of Economy with emphasis in International Business, decided to carry out an investigation directed to identify the socioeconomic profile of the students that enroled to the different academic programs in 2007/I and starting from it, to support the design and adoption of development strategies toward the future. The obtained results involved students of the following academic programs: Business Administration, Public Accounting, Law and Political Sciences, and Economy with emphasis in International Business. For different circumstances they were not involved in the study students of nursing , System Engineering and Medicine. ; El conocimiento del cliente/usuario/estudiante es el punto de partida de toda organización dirigida a satisfacer las necesidades de un grupo de personas; mientras ello no ocurra es prácticamente imposible diseñar productos o servicios que respondan adecuadamente a las expectativas de los consumidores. En el caso particular de la Universidad Libre-Seccional Cali, que es una empresa de conocimiento, conocer detalladamente las características de quienes son sus usuarios, debe constituir una prioridad comoquiera que a partir de ello se pueden diseñar apropiadamente los planes de direccionamiento estratégico. La falta de información actualizada sobre el perfil socioeconómico de los estudiantes que ingresan a los distintos programas académicos ofrecidos por la Universidad, impide identificar aspectos tan importantes como estrato socioeconómico , género, procedencia geográfica, edad, estado civil, actividad laboral, naturaleza del colegio donde terminó estudios de bachillerato, actividades e intereses en el tiempo libre, convivencia actual, tamaño del grupo familiar, nivel educativo del padre y la madre, etc. Por lo anterior, la Universidad Libre-Seccional Cali, con la coordinación del Programa de Economía con énfasis en Negocios Internacionales, decidió realizar una investigación dirigida a identificar el perfil socioeconómico de los estudiantes que ingresaron a los diferentes programas de pregrado en el 2007/I y a partir de ello soportar el diseño y adopción de estrategias de desarrollo hacia el futuro. Los resultados obtenidos involucraron estudiantes de los siguientes programas de pregrado: Administración de Empresas, Contaduría Pública, Derecho y Ciencias Políticas y Economía con énfasis en Negocios Internacionales; por distintas circunstancias no se involucraron en el estudio estudiantes de Enfermería, Ingeniería de Sistemas y Medicina.

Perencanaan dan pengadaan obat merupakan tahap yang penting dalam memenuhi kebutuhan obat-obatan di suatu pelayanan kesehatan. Dari jenis permintaan obat yang dibutuhkan di bulan Juli dari 66 jenis obat yang diminta hanya terdapat 11 jenis obat dan alkes yang diterima sesuai permintaan, sisanya sebanyak 52 jenis obat yang tidak terpenuhi sesuai yang diminta dan sebanyak 3 jenis obat yang diberi berlebih jumlahnya. Tujuan penelitian ini adalah untuk mengetahui informasi mendalam mengenai perencanaan dan pengadaan obat di Puskesmas Sario Kota Manado.Jenis penelitian ini menggunakan metode Kualitatif bertujuan untuk mendapatkan informasi yang lebih mendalam tentang proses pengadaan obat di Puskesmas Sario. Metode pengumpulan data yaitu dengan wawancara mendalam dengan Informan penelitian yang dipilih menurut tanggung jawab yang bersangkutan dengan penelitian. Informan dalam penelitian ini terdiri dari 4 (Empat) informan yang terdiri dari Kepala Puskesmas Sario, Penanggung Jawab Gudang Obat di Puskesmas Sario, Kepala Instalasi Farmasi Dinas Kesehatan Kota Manado, dan Staff Apotik di Puskesmas Sario. Hasil penelitian menunjukkan bahwa Metode untuk perencanaan dan pengadaan obat yang digunakan oleh Dinas Kesehatan Kota Manado dan Puskesmas Sario berbeda, perencanaan kebutuhan obat di Puskesmas Sario menggunakan metode Konsumsi. Sedangkan metode perencanaan dan pengadaan obat di Dinas Kesehatan Kota Manado berbeda-beda sesuai dengan tugas, pokok, dan fungsinya masing-masing. Masalah kekosongan obat di Puskesmas Sario disebabkan pendanaan yang tidak mencukupi dari pemerintah dan kurangnya respon dari PBF (Pedagang Besar Farmasi). Pengadaan obat JKN melalui e-katalog tidak dapat menyediakan sesuai dengan jumlah yang diminta, jadi ketika didistribusi ke Puskesmas mengalami kekurangan.Kata Kunci: Perencanaan, PengadaanABSTRACTMedicine planning and procurement are two important steps in fulfilling the need of medicines in a certain unit of health service. Looking at the drug demand in July,out of the 66 types of drug demanded, only 11 types of drug and medical devices met the demand. 52 types did not meet the demand while the other 3 excess the demanded amount. The objective of this research is to obtain a deeper information regarding the drug planning and procurement in Puskesmas Sario Manado. This research uses the qualitative method in order to obtain a deeper information regarding the process of drug procurement in Puskesmas Sario. The data collected by doing an interview with informants whose tasks are related to this research. The informants were chosen based on their resposibilities. There are 4 (four) informants, namely The Head of Puskesmas Sario, Penanggung Jawab Gudang Obat Puskesmas Sario, The Head of The Pharmacy Installation of Manado Health Department and a Staff of Puskesmas Ssrio Drugstore. The result of this research shows that the methods of drug planning and procurement used by both Manado Health Department and Puskesmas Sario are different to each other. The drug planning in Puskesmas Sario uses the Comsumptionmethod while the Manado Health Department uses various methods according to each officer's tasks and functions. The problem in drug supply in Puskesmas Sario is caused by the insufficient funding from the government and the lack of response from the PBF (Pedagang Besar Farmasi). The drug procurement via e-catalog is not able to provide the sufficient amount of drug demanded, causing the lack of drug distributed to the Puskesmas.Keywords: Planning, Procurement