Publications by authors named "O Makarenko"

35 Publications

[STATE PROCUREMENTS: STUDYING THE IMPLEMENTATION OF NATIONAL POLICIES IN TERMS OF PANDEMIC COVID-19].

Georgian Med News 2021 Mar(312):157-163

3Donetsk Law Institute of the Ministry of Internal Affairs of Ukraine, Kryvyi Rih, Ukraine.

This article aims to analyse the implementation of public procurement procedures in the context of national governments' fight against the COVID-19 pandemic and find solutions for adapting those public procurement procedures that are currently used in the healthcare sector to new challenges. For this above purpose, we have applied both theoretical methods such as analysis, synthesis, generalization, and empirical methods such as observation, etc. The research has yielded the following findings: 1) there are no one-size-fits-all solutions in the national governments' fight against the COVID-19 pandemic through the public procurement mechanism, except that national policies in this field intend to speed up the organisation of the public procurement procedures, which would shorten the time for the delivery of medical goods to healthcare facilities; 2) due to the current emergency conditions caused by the COVID-19 pandemic, public procurements of medical supplies are taking place under the non-competitive procedure, i. e. with direct contracting of a specific vendor, which essentially increases corruption risks and allows for subjective decision making; 3) amid the increased corruption risks, there is a need to assign high priority to strengthening the public control (monitoring), as well as the governmental control over medical procurements; 4) saving of public funds as the underlying principle of some national public procurement systems becomes irrelevant in the face of such threats as the global COVID-19 pandemic; 5) it is quite difficult to speak of another principle - effective use of public funds - because we are now dealing with an emergency and the actors (both the government and the expert community) lack understanding of how things might potentially develop in the future. Thus, the authors offer the following solutions: 1) create temporary specialized bodies, with the cross-agency powers, at the national and regional levels, that would take on such functions as: coordination of procurements; needs analysis of particular areas in medical supplies; management of potential vendors. These measures may help make medical procurements as effective as possible in these current conditions; 2) develop special procedures (mechanisms), by national governments, for conducting checks of public procurements in the healthcare sector that are made as part of the response measures against the COVID-19 pandemic, because those check algorithms that are in place today cannot take into account the realities of this particular emergency situation and the conditions in which those procurements are made.
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March 2021

PERIPHERAL NERVE LESIONS AFTER A MECHANICALLY INDUCED LIMB ISCHEMIA.

Georgian Med News 2021 Jan(310):165-169

Interregional Academy of Personnel Management, Ukraine.

The article describes the results of studying the changes in peripheral nerves of a limb after a mechanically induced ischemia. It assessed myelinated nerve fibers in sciatic and tibial nerves after 6 hours of ischemia, simulated by a tourniquet on the level of a tibial, knee, and a lower third of a femur. Fasciculi of the sciatic nerve have shown no changes in the density of nerve fibers in 5th, 15th, and 30th days after the simulated ischemia, but we revealed the deformed fibers with the different thickness of myelin sheath. In a tibial nerve, myelin loss and deformations occurred on the 5th and 15th day, and atrophy of nerve fibers - on the 15th and 30th days. Neurolemmocytes of the injured myelin nerve fibers demonstrate the signs of dystrophic processes and autophagy. After the insertion of platelet-rich plasma, concentrated bone marrow aspirate, and homogenized adipose tissue in the ischemically damaged muscles, not a significant difference appeared between the extent of damage to the nerve. Consequently, the structural signs of the damage to peripheral nerves depend more on the level of injury to a limb than on therapy with autologous cellular technologies.
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January 2021

CORRELATION OF BLOOD BIOCHEMICAL INDICATORS WITH THE LEVEL OF KNEE JOINT DAMAGE IN THE MODEL OF THE POSTTRAUMATIC OSTEOARTHRITIS.

Georgian Med News 2020 Dec(309):135-141

4Nizhyn Gogol State University; Ukraine.

The aim of the study was to assess the dependence of blood biochemical parameters with the degree of osteoarthritis of the knee joint and therapy. In experiments, osteoarthritis was simulated in rabbits (n=25) and after 75 days changes in the level of peroxidation products, activity of leukocyte enzymes were studied and the results were compared with the degree of knee joint injury, as well as taking into account the application of a concentrate of bone marrow aspirate, mechanically homogenized adipose tissue and platelet rich plasma. Analysis of the results confirmed the assumption of a direct relationship between the level of peroxidation products (diene conjugates, TBA-reactive products, products of oxidative modification of proteins), ceruloplasmin, and proinflammatory activity of leukocytes (by the activity of elastase and myeloperoxidase) with the level of morphological changes in the articular cartilage, capsule and meniscus of the knee joint. Based on histological analysis, it was concluded that the application of a concentrate of bone marrow aspirate and homogenized adipose tissue activated the processes of reorganization and regeneration of the synovial membrane and menisci of the joint, which correlated with the indicators of myeloperoxidase activity, the level of TBA-reactive products and ceruloplasmin. The action of platelet rich plasma was characterized by a correlation between leukocyte enzymes and lipid and protein oxidation products in blood serum. The results of the study suggest that the bone marrow aspirate concentrate has a greater therapeutic potential compaired to the platelet rich plasma and cell suspension obtained from adipose tissue.
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December 2020

Violence, HIV Risks, and Polysubstance Use Among HIV-Positive People Who Inject Drugs in Ukraine.

AIDS Behav 2021 Jul 1;25(7):2120-2130. Epub 2021 Jan 1.

Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, MA, USA.

Violence experience has been consistently associated with HIV risks and substance use behaviors. Although many studies have focused on intimate partner violence (IPV), the role of violence at a structural level (i.e., police abuse) remains relevant for people who inject drugs. This study evaluated the association of IPV and police-perpetrated violence experiences with HIV risk behaviors and substance use in a cohort of HIV-positive people who inject drugs in Ukraine. We also evaluated possible moderation effects of gender and socioeconomic status in the links between violence exposure and HIV risk and polysubstance use behaviors. Data came from the Providence/Boston-CFAR-Ukraine Study involving 191 HIV-positive people who inject drugs conducted at seven addiction treatment facilities in Ukraine. Results from logistic regressions suggest that people who inject drugs and experienced IPV had higher odds of polysubstance use than those who did not experience IPV. Verbal violence and sexual violence perpetrated by police were associated with increased odds of inconsistent condom use. The odds of engaging in polysubstance use were lower for women in relation to police physical abuse. We found no evidence supporting socioeconomic status moderations. Violence experiences were associated with substance use and sexual HIV risk behaviors in this cohort of HIV-positive people who inject drugs in Ukraine. Trauma-informed prevention approaches that consider both individual and structural violence could improve this population's HIV risks.
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http://dx.doi.org/10.1007/s10461-020-03142-3DOI Listing
July 2021

Corruption and strengthening anti-corruption efforts in healthcare during the pandemic of Covid-19.

Med Leg J 2021 Mar 17;89(1):25-28. Epub 2020 Dec 17.

Department of Administrative and Legal Disciplines, Donetsk Law Institute, Donetsk, Ukraine.

The Covid-19 pandemic has created the opportunity for corruption to flourish in healthcare sectors around the world. Challenges include misuse and mismanagement of resources and corruption, which require scrutiny and attention. This article deals with such corruption during the pandemic, involving public procurement of goods and services for the treatment of diseases, falsification of public contracts and kickbacks, embezzlement of healthcare funds, opacity in governance, misuse of power, nepotism and favouritism in the management, petty corruption in the level of service, fraud and theft or embezzlement of medicines and medical devices.
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http://dx.doi.org/10.1177/0025817220971925DOI Listing
March 2021