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Investigation of the early detection and treatment of post-traumatic stress disorder is essential to ensure the healthy development of a child. The purpose of this study was to develop and analyse effective strategies of psychological support to overcome the consequences of this disorder. For this, a survey of children who were in Ukraine during the hostilities was conducted and approaches to helping children who have experienced trauma or war were considered. According to the findings, children who lived in areas where hostilities took place testify to the detrimental impact of traumatic stress on the mental health of young people. Children in primary school may be more likely to display aggressive, withdrawn, and lonely behaviour in addition to post-traumatic stress disorder-induced anxiety. Adolescents who have experienced traumatic stress are more likely to express anxiety, irritability, aggression, and stiffness, as well as symptoms of depression. Thus, younger students who have experienced traumatic stress demonstrate aggressiveness, anxiety, secrecy, and loneliness. Preventive measures are needed to reduce the harmful effects of traumatic events on children’s mental health. Implementing interventions that prioritise early detection of trauma, psychoeducation for both children and caregivers, and the creation of a safe and supportive environment is imperative. By prioritising prevention and continuously implementing the innovation, it will be possible to better prepare for the process of overcoming the long-term effects of trauma on the well-being and mental health of citizens, including children

The relevance of the study is due to the need to find ways to ensure high-quality interaction between a doctor and a patient in the context of a medical professional's communicative tolerance. The purpose of the study was to determine the psychological characteristics of the interpersonal relationship between a doctor and his/her patients. The basis of the theoretical and methodological approach was a qualitative combination of methods of structural and functional analysis of the problem of psychological training of medical professionals and analytical research on the formation of constructive relationships between doctor and patient. Several surveys were conducted on the tolerance of healthcare professionals and their emotional well-being in the context of individual psychological characteristics. The results are presented, which reflect the methods of doctor's influence on the psychological state of the patient and his/her family. The question of how trust in a doctor and his/her professional competences is formed is highlighted. The problem of ethical principles, professional motivation of medical professionals and the specifics of their communication in the team are revealed. The subjective feelings of doctors about the work they do are revealed. The issues of modernization of medical education and digitalization of services are revealed. The conditions, components, and approaches to effective interaction between doctor and patient in the healthcare system are identified. The problems of developing diagnostic tools for assessing the psychological state of a medical professional in his/her professional activity are detailed. An experiment was conducted to substantiate the need to implement programmes to improve the communication skills of healthcare professionals, including interns and nurses. The practical value of the results of the research work is the possibility of using the outlined approach to improve the methods of improving the communication competencies of doctors in their professional activities

Since the full-scale invasion of Ukraine by Russia, many Ukrainians have fled their homes in search of safer places, thus the problem of developing convenient and effective methods of providing psychological support to the maximum number of citizens has become urgent. The research aims to develop a technology for helping internally displaced persons based on exposure therapy methods. The study sample consisted of 84 respondents who had the official status of internally displaced persons. To quantify the parameters of the stressful state, the PCL-5 post-traumatic stress disorder diagnostic tool was used, and the updated Oxford Happiness Inventory (OHI) was used to determine the emotional state. At the beginning of the study, 67% of respondents in the sample had a level of symptoms sufficient to diagnose post-traumatic stress disorder, which indicates a high level of psychological distress. The methods of trauma-focused cognitive behavioural therapy and Eye Movement Desensitisation and Reprocessing were used for psychotherapeutic procedures. The use of both methods proved to be effective in improving the overall psychological state of the respondents. The use of trauma-focused cognitive behavioural therapy led to a 9.0% reduction in symptoms of post-traumatic stress disorder and a 37.73% increase in happiness compared to the control group. The method of desensitisation and eye movement processing led to a 15.41% reduction in symptoms of post-traumatic stress disorder and a 35.30% increase in subjective indicators of happiness compared to the control group. The combined use of both methods showed the best results: after three months, there was a 19.72% reduction in post-traumatic stress disorder symptoms and a 42.54% increase in happiness scores compared to the control group. Based on the data demonstrated in this paper, the combined use of trauma-focused cognitive behavioural therapy and eye movement desensitisation and reprocessing can be recommended to reduce the severity of post-traumatic stress symptoms and improve the well-being of internally displaced persons

Children are increasingly at risk of various diseases, which has a rather negative impact on their intellectual development and can slow down social development in general, and therefore there is a need to address this issue. The main purpose of this study was to examine and analyse the state of physical, psychological, and social health of children in Ukraine based on preschool educational institutions in Mukachevo. The study used the Sensorimotor technique and the computer programme Efecton Studio 2009 to investigate preschool children’s visual-motor reactions. The Rufier-Dixon and Henchy tests were used to assess the cardiovascular and respiratory systems. It was found that every third child has problems in physical or intellectual development. It was substantiated that the tense sanitary and epidemiological situation in the country, environmental pollution, lower living standards of most families and access to medical care, insufficient physical activity, as well as environmental problems contribute to the deterioration of the psychophysical state of preschool children. It was emphasised that maintaining a healthy physical condition is an important element for the normal functioning and growth of a young organism. It was emphasised that the period of adaptation to school, which current preschoolers will go through in the future, depends considerably on the child’s health, as healthy children can better cope with mental and physical stress. It was found that most preschoolers have limited knowledge about healthy lifestyles. Only 28% of children understand what food is healthy, and 18% know the importance of eating fresh food. This indicates the need for more active work with children on healthy eating and lifestyles in general. It was found that many adults also do not have a holistic understanding of the principles of proper nutrition and do not discuss these issues with children, and therefore it is important to pay attention to adult education in the field of health and nutrition. The practical significance of the study is that all the theoretical provisions, conclusions and recommendations can be used by teachers and students of educational institutions to improve knowledge about the trends in the health status of preschoolers and schoolchildren in Ukraine, as well as by other scientists for in-depth study of the problem.

The study aimed to assess serum Klotho protein level in type 2 diabetic patients depending on kidney function. Methods. This observational study included 72 patients with diabetes mellitus (DM) and 26 patients with acute coronary syndrome. The control group consisted of 20 healthy subjects. Depending on the presence of albuminuria and glomerular filtration rate (GFR), the diabetics were divided into the following groups: group I included the patients with normal GFR and without albuminuria (n = 25); group ІІ consisted the patients with normal GFR and albuminuria (n = 23); group III – the patients with reduced GFR and albuminuria (n = 24) and group ІV included the patients with acute coronary syndrome (n = 26). The GFR was calculated using the CKD EPI formula (KDIGO 2012). The concentration of Klotho protein was determined by enzyme-linked immunosorbent assay. Results. The development of diabetic nephropathy in type 2 diabetic patients accompanied by a significant decrease of soluble Klotho compared with the controls and the patients of the1-st group. The level of Klotho protein in the group of patients with albuminuria decreased to (490.66 ± 58.76) pg/ml (p

Abstract. The aim of the study was to assess a serum level of vascular endothelial growth factor (VEGF) in type 2 diabetic patients depending on kidney function. Methods: we examined 66 type 2 diabetic patients and 20 healthy control subjects. Depending on the presence of albuminuria and glomerular filtration rate (GFR) level, patients with diabetes mellitus (DM) were divided into the following groups: group I - patients with type 2 DM without signs of nephropathy – normal GFR without albuminuria (n = 26); group ІІ - patients with type 2 DM with normal GFR and albuminuria (n = 22); group III - patients with type 2 DM with reduced GFR and albuminuria (n = 18). ІV group - patients with acute coronary syndrome (n = 26). The concentration of the VEGF was determined by enzyme-linked immunosorbent assay. The glomerular filtration rate (GFR) was calculated using the CKD EPI formula (KDIGO 2012). Results: serum VEGF level in patients with diabetic nephropathy (DN) was significantly increased depending on kidney function. VEGF positively correlated with urine albumin and serum creatinine levels and the negative correlation with GFR was found. These findings prove the undeniable role of kidneys in the development of renocardial syndrome in patients with DN. VEGF levels positively correlated with glycosylated hemoglobin and total cholesterol, indicating an unconditional dependence of endothelial dysfunction on lipid and glucose metabolism disorders. Conclusions: Increased levels of VEGF in type 2 diabetic patients without clinical signs of kidney damage may indicate the development of subclinical renal dysfunction. Blood VEGF in patients with DN may be an integral marker of endothelial dysfunction and pathological angiogenesis. Our findings suggest that determination of serum VEGF level in patients with DN may have practical use as an early predictor of cardiac disruption, estimation of the prognosis, as well as improvement of cardionephroprotective strategy.

In this study, we assessed the impact of COVID-19 on the course of HFmrEF by determining the biomarkers furin and NT-proBNP, questionnaires (EQ-5D-5L), and cardiac ultrasound. A comprehensive examination of 72 patients with HFmrEF (main group) and 18 apparently healthy individuals (control group). The main group was divided into two subgroups depending on the history of coronavirus disease. All patients gave their consent to participate in the study. In the group of patients with a history of coronavirus infection compared to the patients without a COVID-19 history were established: significantly higher concentrations of NT-proBNP (1002.79±215.94 pg/ml and 405.37±99.06 pg/ml, respectively, p-value 0.01), uric acid (429.08±27.01 mmol/l vs. 354.44±28.75 mmol/l, p-value 0.04) and a lower furin to NT-proBNP ratio (0.87± 0.26 and 1.38 ± 1.16, p-value 0.045) in blood serum; using the EQ-5D-5L questionnaire, a significant deterioration of quality of life indicators (64.21±3.04 points vs. 72.81±1.82 points by VAS, p-value 0.02); higher indicators of LVMMi (157.39±6.14 g/m2 and 138.68±6.02 g/m2, p-value 0.03), LA dimensions (43.74±0.95 mm and 41.12±0.85 mm, p-value 0.04) and RA dimensions (40.76±1.23 mm and 37.75±0.85 mm, p-value 0.04). Coronavirus infection in patients with HFmrEF leads to disorders of intracardiac hemodynamics and persistent negative structural changes of the heart. The ratio of furin to NT-proBNP serum levels can be used to determine the impact of the HF syndrome itself on the patients' subjective assessment of their quality of life.

The aim of the present study was to establish the disorders of mineral metabolism and production of monocyte chemoattractant protein type 1 (MCP-1) and plasminogen activator inhibitor type 1 (PAI-1) in patients with diabetic nephropathy (DN) at different stages of the disease. We examined 78 patients with DN aged from 57 to 76 years. Fibroblast growth factor 23 (FGF23), MCP-1 and PAI-1 levels in blood serum were determined by ELISA. The levels of calcium and phosphorus in the serum were established by biochemical method. Our results showed the progressive elevation of FGF-23 level in serum depending on the stage of the DN (p <0.05). High levels of FGF23 were determined already in the early stages of nephropathy. FGF23 levels in DN patients twice exceeded control group level. The highest FGF23 concentrations were detected in the late stages of the disease. Hyperphosphatemia was found in the late stages of the DN when compared with controls and early preclinical stages. We found a significant increase of MCP-1 and PAI-1 levels in patients with DN. These changes may be involved in inflammatory and fibrotic processes in the kidneys. FGF23 elevation in the peripheral blood of DN patients was associated with an increase of inflammatory and fibrosis mediators MCP-1 and PAI-1. We conclude that FGF23 increase may be considered as an important risk factor of DN progression.