Aim: to conduct a hygienic assessment of new architectural and planning solutions of psychiatric health care facility buildings in Ukraine and give a comparative description of the sanitary standards of the latter in the EU. The study was conducted based on the analysis of State Building Norms (SBN) B.2.2-10:2019 “Buildings and structures. Health care facilities” (draft, final revision), scientific sources of domestic and foreign scientists. A survey of the chief physicians of psychiatric hospitals of Ukraine concerning safe sanitary and hygienic, anti-epidemic conditions for the functioning of psychiatric health care facilities was conducted. We consider it necessary to present more carefully architectural and planning solutions in the relevant section of SBN B.2.2-10:2019 (draft, final revision) or to use the opportunity specified in the introduction to these Norms, and to supplement them with the Manual on the design of psychiatric health care facilities, taking into account the experience of the European Union. To create an appropriate “therapeutic environment” in new domestic mental health care facilities, it is necessary to implement European requirements in the design of these facilities with the involvement of multidisciplinary groups: (from architects to nurses, from construction contractors to patients) and supplement SBN B.2.2-10:2019 “Buildings and structures. Health care Facilities” of Ukraine with a guide for designing facilities of a new type of “Mental Health Centers” as in the Republic of Poland. We have developed and sent to the chief physicians of psychiatric hospitals of Ukraine «Questionnaire for scientific sanitary and epidemiological assessment of the conditions of placement of a psychiatric health care facility”. Based on the analysis of the block of questions on sanitary and antiepidemic and sanitary and hygienic parameters that characterize the buildings of domestic psychiatric hospitals, the location of medical structures and auxiliary units on the land plot, i.e. the design of buildings is determined. In particular, 50% of psychiatric hospitals are housed in combined buildings, 25% have a pavilion system (separate buildings), 12.5% each have a centralized system (all in one building) and a block system. The number of stories of psychiatric hospitals up to 2 is 50%, up to 3 – 37.5% and up to 5 stories in those which have been under construction since 1960 – 12.5%. Analysis of the questionnaire block on the conditions of stay, treatment, rehabilitation of the mentally ill revealed the possibility of organizing occupational therapy in 12.5% of psychiatric hospitals, where special workshops are equipped and patients can acquire professional skills. Physiotherapy rooms are equipped in 50% of psychiatric hospitals. Low provision of patients with furniture was revealed: 25% of patients partially have proper desk, 75% do not have it; 50% are provided with proper chairs; 62.8% use proper bedside tables and 25% – closets for storing personal clothes.
The article analyzed the lifestyle and physical development of Ukrainian adolescents and their parents and estimated the familial aggregation and heritability of body mass index and physical activity. 408 nuclear families were examined (1216 people with complete information). Anthropometric measures such as weight, height were measured following standardized procedures of WHO. Questionnaires were used to estimate the levels of physical activity. The method of genetic epidemiology research was used to explore heritability (h2) and family aggregation (ρ). Analysis was performed using the software product S.A.G.E. The study showed that 12.0±1.6% of children were overweight or obese, 6.4±1.2% were underweight and 81.6±1.9% with normal weight. It was found that among adolescents aged 12-15 years, 17.5±3.1% of boys and 32.7±2.9% of girls were physically inactive. Body mass index values higher than 25.0 kg/m2 were found in 34.3±2.4 mothers and in 70.6±2.3% of fathers. The proportion of physically inactive persons was 45.7±2.5% among mothers and 51.1±2.7% among fathers. Heritability values were significant for both body mass index (h2 =0.41±0.09; p<0.001) and physical activity (h2 =0.23±0.07; p<0.001). Significant familial correlations were obtained between parents-offspring for physical activity (ρ=0.20±0.04; p<0.001) and body mass index (ρ=0.25±0.03; p<0.001). The study estimated that the familial correlations for physical activity between mother-son and mother-daughter pairs were higher than in father-son and father-daughter pairs. The highest is the mother-daughter aggregation (ρ = 0.29 ± 0.06; p <0.001), the lowest is the father-son (ρ=0.19±0.08; p<0.05) by body mass index. As physical inactivity and overweight increase the risk of non-communicable diseases development, the data obtained should be taken into account while planning preventive measures.
The article presents the results of studying the legal regulation of the right to reproductive health in Ukraine. The issue becomes relevant due to the growth of negative medical and demographic trends of negative natural growth, population aging, the spread of destructive behavioral stereotypes and poverty of the population of Ukraine, combined with environmental degradation and insufficient physical, territorial and economic availability of quality medical services. In such circumstances, the search for ways to overcome the identified trends, intensify the processes of population reproduction, strengthening its reproductive and labor potential becomes a priority. The aim of the study was a retrospective analysis of the legislative provision of reproductive health, reproductive rights and family planning, maternity protection as the basis for the formation of reproductive health in Ukraine. The materials for the study were domestic and foreign legal framework of legislative and policy documents of the UN, WHO, the World Medical Assembly and the World Bank on the problem. The research methods were: system analysis, bibliosemantic, content analysis. Results. The current norms of international legislation in the field of reproductive health are analyzed, starting with the Charter of Human Rights (Universal Declaration of Human Rights, 1948; International Covenant on Economic, Social and Cultural Rights, 1966; International Covenant on Civil and Political Rights ", 1966; Convention on the Rights of the Child, 1989), a number of treaties and protocols," International Convention on the Elimination of All Forms of Racial Discrimination ", 1961, revised in 1994. ; "Convention relating to the Status of Refugees", 1951, revised in 2002), numerous documents (declarations, covenants, agreements) relevant to the formation of reproductive health, determined the rights of every person and child to life, liberty, security, the highest attainable standard of physical and mental health, affordable health care, gender equality. Resolutions, regulations and declarations developed and approved by the World Medical Assembly (WMA), most of which have been ratified by Ukraine and adapted to the realities of the domestic legal framework in the current post-Soviet legal framework, have also been studied. During the years of independence in Ukraine there was an improvement of legislative regulation of the right to reproductive health in accordance with modern international standards and concepts, most initiatives for the development of this rule in Ukraine had international origins, especially regarding the legal right of every citizen families, opportunities for equal access to medical services in case of reproductive dysfunction, including the need for assisted reproductive technologies. The issues of legislative provision of women's health care before, during and after childbirth, prevention of sexually transmitted infections, reduction of abortions in combination with the program of actions with consolidation of the right of men and women to inform about the range of modern safe and means, contraception, infertility prevention and the possibility of using modern assisted reproductive technologies of family planning, were considered separately. Conclusions. The study concludes that domestic national legislation generally complies with the provisions of international legal acts of a universal nature, the legislative and regulatory framework in the field of reproductive health meets the established principles of public policy and European legislative initiatives ratified by Ukraine. Unstable financing of planned measures affects their effectiveness; state control over the implementation of legislation in this area is ineffective. The current moratorium on the planning and approval of national programs complicates the implementation of previously planned measures. The level of public awareness about the causes of reproductive problems, legislative reproductive rights and ways to prevent diseases remains low. Legal nihilism, combined with the spread of destructive behavioral stereotypes in society, contributes to the deterioration of reproductive health and the health of the general population. Key words: preservation and strengthening of reproductive health, family planning, normative-legal provision.
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