Background We examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022. Method We extracted and analysed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services – all of which disrupted the lives of Ukrainians. Results As of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/AIDS, tuberculosis, and Coronavirus (COVID-19). Conclusions The 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cost of war will impact generations of Ukrainians to come.

Aim. The medical care quality remains one of the most pressing issues of the health care system, especially at the stage of reforming of the medical sector. Medical-statistical information comprising reporting forms is the basis for analyzing the status of medical care quality and incorporating management decisions to improve it. Material and Methods. The study was performed by the means of analysis of the annual reports of the Urology Department of Municipal Non-profit Enterprise "Lviv Clinical Emergency Hospital" over a ten-year period: from 2010 to 2019. Statistical analysis included the analysis of average and relative values, as well as the calculation of indicators of the dynamic range: growth rate and absolute increase. Results and Discussion. Analysis of the use of bed stock of the Urology Department of MNELCEH during 2010-2019 showed that the average quantity of inpatient days is 251.12-340.18 days per year. Inpatient turnover was in the range of 30.28-36.55 patients per year. The indicator of surgical activity increased by 5.4 percentage points (from 33.0% in 2010 to 38.4% in 2019). There was also a positive tendency of decrease of the duration of post-surgery stay of patients at the inpatient department of the Urology Department (from 9.25 in 2010 to 8.55 in 2019). During the study period of 2010-2019, the ratio of post-surgical complications remained relatively stable and did not exceed 5.1% (the indicator is in the range of 4.38% -5.09%). The analysis of the total mortality among all treated patients was in the range of 0.06%-0.65%. Conclusion. The indicators analyzed in the annual reports make it possible to identify the main problematic issues in the work of the department. In order to provide professional specialized care, quality and rational use of property and human resources, algorithms should be developed to increase treatment of patients with malignant tumors and urolithiasis at the department, as in recent years we could observe an outflow of patients with these diagnoses to other healthcare establishments. There is a need for individual analysis of the causes of post-surgical complications and mortality. These issues can be resolved by introducing clinical audit into the work of the department

Aim. The research aims at improving the quality of rendering medical care in the urology departments of health care facilities by conducting the clinical audit with advanced study of causes of dissatisfaction of patients with the medical service provided. Material and Methods. Sociological research included the questioning of 405 patients who were treated in the urology departments of the municipal nonprofit enterprise of the Lviv Regional Council "Clinical Emergency Hospital". The respondents estimated the quality of providing health care in the sphere of medical service, informational content, financing, the quality of diagnosis and treatment. Methods of structural-logical analysis, systemic approach and analysis, calculation of mean and relative values, calculation of satisfaction index with services provided are used in this work. Results and Discussion. The determination of the level of respondents' satisfaction with inpatient treatment showed that, in total, that the number of dissatisfied among the interviewed were 7.16±1.28 % persons. The focus-group of such persons was singled out: patients of active working age, financially - able, mainly with higher education, most often with diagnosis of urolithiasis, who suffered from pain syndrome, with late appealing for medical care (more than 24 hours), they were operated on and waited for the quick results of treatment, even despite the positive final result of treatment. These patients demanded more attention of a doctor, were dissatisfied with the work of paramedical personnel, conflicted with ward neighbors, had claims to availability and quality of medical equipment, sanitary state of premises of the department. Conclusions. The results of the clinical audit targeting the satisfaction of patients with medical services provided as one of the forms of receiving the patient feedback concerning the quality of medical aid, point out, on one hand, the appropriate level of availability of services, interpersonal attitudes, infrastructure, execution of technical demands as to quality and standard compliance by the staff of department. While, on the other hand, the audit results indicate the presence of dissatisfied with some certain services in the department. The focus-groups of dissatisfied make it possible to take into account the personal approaches in rendering medical aid to such categories of population, that in total will improve and increase the quality of providing medical services. Basing on the results of clinical audit, the recommendations as to the perfection of medical care management in the urology departments of health care facilities.

The research aims at improving the quality assessment of clinical audit results in Ukraine using the complex of statistical methods and studying statistical methods in foreign reports of the clinical audit and personal experience. Materials and Methods. The research was performed by analyzing the reports of clinical audit (n=62), held during 2021 by the Healthcare Quality Improvement Partnership. The spectrum of statistical methods was extended by the analysis of the example of a sociological survey of patients (n=405) regarding the quality assessment of medical care. The methods applied in the current study included systemic approach and analysis, structural and logical analysis, correlation and regressive analysis, calculation of relative values. Results and Discussion. All 100% clinical audit reports, carried out by the Healthcare Quality Improvement Partnership were based on the results of the statistical calculations. The most common method of processing results is the epidemiological statistics (93.5%), ratio of chances/risks (30.6%), probability assessment by Х2 Pearson's method (21.0%). It is noteworthy that for pointing the central tendency almost in half of the cases (46.8 %) the median and the Interquartile Range were used. Complex mathematical methods such as the survival assessment by Kaplan- Meier and method multiple regression were used in 6.5 % та 4.8 % reports, accordingly. Conclusions. Based on our own experience, we suggested implementation of standardization methods, a detailed correlation and regressive analysis, neuro networks and power analysis into the methodology (technique) of the clinical audit. Implementation of spectrum of evidentially substantiated methods of statistical analysis will allow to increase the evidence level and to deepen the statistical analysis of databases when conducting the clinical audit, аnd therefore, the quality assessment of clinical audit results will increase.

Fluorine is a common element in nature; however, the difference between a beneficial dose and a toxic dose for the organisms is small. The main source of fluoride for humans is water in addition to food. The aim of this study was to estimate the degree of severity of pathological changes, namely, caries or fluorosis, in the mineralized tooth tissue of 15-year-old adolescents with respect to their hygienic and nutritional habits, and the content of fluorine in drinking water, soil and plant products. 100 adolescents aged 15 from schools in Sosniłka, L'viv region, were examined. The condition of mineralized tooth tissue was evaluated by the caries severity, expressed by the mean number D3MFT, caries frequency and value of the SIC index. Fluorine in plant material and soil were determined according to the PN-G-04543:1982 standard, and water according to the PN-EN ISO 10304 - 1: 2009+ AC: 2012 standard. Severity of caries disease expressed by the D3MFT number in the examined group of 15-year-olds was 3.39; in the group of girls - 3.08, and in the group of boys - 3.76. In the examined group, the average number of teeth with fluorosis was 7.59. Value of the SIC index among the examined population of students (n-31) was 6.26: 5.89 (n-18) for girls and 7.31 (n-13) for boys. Fluorine concentration in the water was 0.78 - 1.25(mg·dm-3). In the soil, it also did not vary across the sampled areas and amounted, on average, to 176 mg·dm-3. The biggest fluorine content noted in the dry mass of beetroots was 3.50 (mg F· kg), and the lowest - 3.34 (mg F· kg). Close to optimal fluorine content lowers caries severity and frequency of fluorosis. Optimal fluorine content in drinking water and food does not require additional diet supplementation.

Poor adherence of chronic diseases treatment is a worldwide problem, in Ukraine as well. Improving adherence also enhances patients’ safety. Consequently, interventions that target adherence must be tailored to the particular illness-related demands experienced by the patient. The aim of the research was to determine the patient’s adherence level to pharmacotherapy through «face-to-face» interview 55 patients (visitors) in a pharmacy in Lviv (Ukraine). The methods of descriptive statistics have been used during the research results’ analyzes. The main 3 categories of factors of non-adherence to pharmacotherapy in Ukraine were conducted: 1) factors related to the patient (59.7%); 2) factors related with pharmacotherapy (26.9%); 3) socio-economic factors (13.4%). We established that the most common problems of non-adherence were: missed drugs dosage’s (40.1%), contravention duration pharmacotherapy (32.9%) and contravention of frequency of taking medicines (14.6%). We established that the level of adherence declines with the increase of number prescribed drugs (r= -0.33; R= -0.35; p < 0.05), diseases of the patient (r= -0.27; R= -0.25; p< 0.05) and the cost of medicines (r= -0.17; R= -0.19; p < 0.05). However, the level of adherence does not depend on the age of the patient (r= -0.10; R= -0.12; p>0.05).