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Insight into the Digital Health System of Ukraine (eHealth): Trends, Definitions, Standards, and Legislative Revisions
Purpose. This article aims to provide an in-depth examination of the digital health system of Ukraine, focusing on the emerging trends, precise definitions, established standards, and recent legislative revisions that shape the practice and implementation of eHealth solutions within the country. Background. The digital health landscape in Ukraine has witnessed significant transformations, especially in the wake of the COVID-19 pandemic and subsequent military conflicts. These events have catalyzed the expansion of telemedicine services, leading to innovative approaches in healthcare delivery. The national strategy underscores the necessity for human-centric and accessible telemedicine, reinforced by technological neutrality, and harmonization with global standards. Methods. A review of the current literature, national strategies, and legal documents was conducted, alongside an analysis of data usage and service provision patterns in various Ukrainian regions. Participation in the \"Science for Safety and Sustainable Development of Ukraine\" competition facilitated project initiatives like the development of a cloud-based platform for patient-centered telerehabilitation for oncology patients. Findings. The utilization of telemedicine has significantly increased in conflict-affected regions, demonstrating the need for, and the effective deployment of, digital health strategies under crisis conditions. Private health facilities and entrepreneurs have been pivotal in the provision of telemedicine services. Legislative efforts have been geared toward framing telemedicine as an integral component of the national eHealth system, ensuring interoperability, and aligning with international standards and the Internet of Medical Things (IoMT). Interpretation. The findings underscore the resilience and adaptability of the Ukrainian healthcare system in the face of adversity. There is a clear trend towards a more integrated, patient-focused, and technologically advanced healthcare model, aligning with international trends and prioritizing public health goals over private profits. This progress, however, is contingent upon continuous development, investment in technological infrastructure, and legislative support to sustain and advance digital health initiatives.
Journal Article
The Politics of Invisibility
Before Fukushima, the most notorious large-scale nuclear accident the world had seen was Chernobyl in 1986. The fallout from Chernobyl covered vast areas in the Northern Hemisphere, especially in Europe. Belarus, at the time a Soviet republic, suffered heavily: nearly a quarter of its territory was covered with long-lasting radionuclides. Yet the damage from the massive fallout was largely imperceptible; contaminated communities looked exactly like noncontaminated ones. It could be known only through constructed representations of it. InThe Politics of Invisibility, Olga Kuchinskaya explores how we know what we know about Chernobyl, describing how the consequences of a nuclear accident were made invisible. Her analysis sheds valuable light on how we deal with other modern hazards -- toxins or global warming -- that are largely imperceptible to the human senses.Kuchinskaya describes the production of invisibility of Chernobyl's consequences in Belarus -- practices that limit public attention to radiation and make its health effects impossible to observe. Just as mitigating radiological contamination requires infrastructural solutions, she argues, the production and propagation of invisibility also involves infrastructural efforts, from redefining the scope and nature of the accident's consequences to reshaping research and protection practices. Kuchinskaya finds vast fluctuations in recognition, tracing varyingly successful efforts to conceal or reveal Chernobyl's consequences at different levels -- among affected populations, scientists, government, media, and international organizations. The production of invisibility, she argues, is a function of power relations.
eBook
Long-term effects of radiation exposure on health
Late-onset effects of exposure to ionising radiation on the human body have been identified by long-term, large-scale epidemiological studies. The cohort study of Japanese survivors of the atomic bombings of Hiroshima and Nagasaki (the Life Span Study) is thought to be the most reliable source of information about these health effects because of the size of the cohort, the exposure of a general population of both sexes and all ages, and the wide range of individually assessed doses. For this reason, the Life Span Study has become fundamental to risk assessment in the radiation protection system of the International Commission on Radiological Protection and other authorities. Radiation exposure increases the risk of cancer throughout life, so continued follow-up of survivors is essential. Overall, survivors have a clear radiation-related excess risk of cancer, and people exposed as children have a higher risk of radiation-induced cancer than those exposed at older ages. At high doses, and possibly at low doses, radiation might increase the risk of cardiovascular disease and some other non-cancer diseases. Hereditary effects in the children of atomic bomb survivors have not been detected. The dose–response relation for cancer at low doses is assumed, for purposes of radiological protection, to be linear without a threshold, but has not been shown definitively. This outstanding issue is not only a problem when dealing appropriately with potential health effects of nuclear accidents, such as at Fukushima and Chernobyl, but is of growing concern in occupational and medical exposure. Therefore, the appropriate dose–response relation for effects of low doses of radiation needs to be established.
Journal Article
Generation climate crisis, COVID-19, and Russia–Ukraine-War: global crises and mental health in adolescents
Climate change, COVID-19, and the Russia-Ukraine War are some of the great challenges of our time. These global crises affect young people in a particularly vulnerable phase of their lives. The current study aimed to assess the impact of these crises on mental health (depression, anxiety, and health-related quality of life) in secondary school students in Germany. Furthermore, we assessed known predictors of mental health, such as socio-economic factors, individual life stressors, and resilience factors (self-efficacy, expressive flexibility) as covariates. In our sample of 3998 pupils, pandemic- and climate-related distress were linked to greater depression and anxiety and reduced health-related quality of life. War-related distress was associated with greater anxiety. Critically, these associations remained significant after controlling for all covariates, supporting the incremental predictive value of the crises measures. The study reveals a significant impact of the crises on the mental health of the current generation of adolescents. As such it suggests that mental health policies should include interventions that help youth to cope with the stress caused by the crises.
Journal Article
