Legal problems of the corruption prevention in state and municipal health care institutions

The purpose of the research: to investigate the problems of legal regulation of the corruption prevention in health care institutions, outline ways of their solution. Materials and methods: normative-legal base of Ukraine, method of analysis, method of synthesis, comparative-legal method. Results: The issues of the corruption prevention, including its prevention in health care institutions, are regulated by a number of normative legal acts, in particular the Law of Ukraine "About Corruption Prevention", the Code of Ukraine on Administrative Offenses, and the Criminal Code of Ukraine. However, a number of norms are collisional, therefore they need legal improvement. Conclusions: One of the main problems of the corruption prevention is the formation of a unified normative approach to the legal regulation of the health care institutions financing, which is to bring in compliance all other normative legal acts regulating these issues with the Constitution of Ukraine or changing the Constitution. The requirements of the Criminal Code of Ukraine, the Labor Code of Ukraine, and the Civil Code of Ukraine require alignment with the Law of Ukraine "About Corruption Prevention". It is necessary to legislatively define mechanisms for the protection of the rights of officials, in particular the right to extract information about a person from the Unified State Register of persons who committed corruption or corruption-related offenses in the event of the expiration of the period provided for by the Code of Ukraine on Administrative Offenses and the Labor Code of Ukraine after the end of which the person is considered to be not attracted to a certain type of responsibility. The urgent need is to increase social standards for health workers. The need for significant improvement of the notion and settlement of the conflict of interests in accordance with the current legislation is dictated by the threat of bringing this legal institution to the point of absurdity. And, of course, strengthening legal education and legal work with patients and health care providers, maximizing the openness of information is an effective prevention of corruption manifestations

Prospective development of legal education in the field of health care as a guarantee of medical reform implementation in Ukraine

The purpose of the research: explore legal issues and the need for professional growth of health care workers towards the formation of legal competencies in the context of medical reform in Ukraine, identify promising ways for the development of legal education in health care. Materials and methods: normative-legal base of Ukraine, method of analysis, method of synthesis, comparative-legal and structural-functional methods. Results. The need for further development of legal education for healthcare workers stems from a detailed analysis of the regulatory and legal acts of Ukraine regulating medical and pharmaceutical activities, in particular, the Constitution of Ukraine, the Criminal Code of Ukraine, the Code of Ukraine on Administrative Offenses, the Laws of Ukraine “Fundamentals of the Legislation of Ukraine on Health Care”, “On State Financial Guarantees of Medical Care of the Population”, “On Amendments to Certain Legislative Acts of Ukraine regarding the improvement of legislation on the activities of health care institutions”, “On the prevention of corruption”, the decree of the Cabinet of Ministers of Ukraine “On approval of the competition for the position of head of state, municipal health care institutions”, order of the Ministry of Health of Ukraine from 31.10.2018 № 1977 “On Amendments to the Handbook of qualification characteristics of workers occupations”. Issue 78 “Health” and many others. Societies of public authorities, researchers, educators, medical, pharmaceutical workers and patients need to comprehend deeply the processes of modern transformation in the health sector, its legal regulation and the associated innovative approach to the competence matrix of the modern health worker, to develop a unified approach to the development of methods and forms of legal education in health care. Conclusions. In order to improve the effectiveness of legal education, it is necessary to develop and approve by the Resolution of the Cabinet of Ministers of Ukraine the National Concept for the Development of Legal Education in Healthcare, which should cover all subjects of legal relations in health care, including public authorities and local government, to provide the development of departments and pharmaceutical-legal and medical-legal teaching not only in medical and pharmaceutical, but also legal higher education institutions; a significant legal component of the training of health managers in master's programs; a mandatory component of medical, pharmaceutical and legal education for professionals and specialists in the field of health care at various levels and specialties. Anti-corruption education in the framework of continuing professional development of specialists should be a mandatory separate area of legal education

Principle of patient's autonomy: problems of legal regulation in Ukraine

The purpose of the research: to study the content of the principle of patient autonomy, the problem of its legal regulation in accordance with the legislation of Ukraine, outline the ways of their solution. Materials and methods: the regulatory and legal framework of Ukraine, the method of analysis, the method of synthesis, the comparative legal method. Results: The normative legal acts of Ukraine, in particular the Law of Ukraine “Fundamentals of Ukrainian legislation on health care”, the Civil Code of Ukraine, enshrined the principle of patient autonomy. However, a number of norms are conflict-related, so they need legal improvement. Conclusions: The structure of the patient's autonomy principle includes the concept of informed consent and such basic rights of the patient as the right to choose a doctor, methods of treatment, and health facilities. At present, legislation that regulates the issue of consent of patients between 14 and 18 years of age, the refusal of medical intervention, the provision of complete information on the patient's health status, the right to choose a doctor and a health care institution, requires more precise changes, requires more precise regulation of the consent of the parents (or one from the parents) of the child to medical intervention

Synchronization of chaotic oscillator time scales

This paper deals with the chaotic oscillator synchronization. A new approach to detect the synchronized behaviour of chaotic oscillators has been proposed. This approach is based on the analysis of different time scales in the time series generated by the coupled chaotic oscillators. It has been shown that complete synchronization, phase synchronization, lag synchronization and generalized synchronization are the particular cases of the synchronized behavior called as "time--scale synchronization". The quantitative measure of chaotic oscillator synchronous behavior has been proposed. This approach has been applied for the coupled Rossler systems.Comment: 29 pages, 11 figures, published in JETP. 100, 4 (2005) 784-79

Two Scenarios of Breaking Chaotic Phase Synchronization

Two types of phase synchronization (accordingly, two scenarios of breaking phase synchronization) between coupled stochastic oscillators are shown to exist depending on the discrepancy between the control parameters of interacting oscillators, as in the case of classical synchronization of periodic oscillators. If interacting stochastic oscillators are weakly detuned, the phase coherency of the attractors persists when phase synchronization breaks. Conversely, if the control parameters differ considerably, the chaotic attractor becomes phase-incoherent under the conditions of phase synchronization break.Comment: 8 pages, 7 figure

Double Entropic Stochastic Resonance

We demonstrate the appearance of a purely entropic stochastic resonance (ESR) occurring in a geometrically confined system, where the irregular boundaries cause entropic barriers. The interplay between a periodic input signal, a constant bias and intrinsic thermal noise leads to a resonant ESR-phenomenon in which feeble signals become amplified. This new phenomenon is characterized by the presence of two peaks in the spectral amplification at corresponding optimal values of the noise strength. The main peak is associated with the manifest stochastic resonance synchronization mechanism involving the inter-well noise-activated dynamics while a second peak relates to a regime of optimal sensitivity for intra-well dynamics. The nature of ESR, occurring when the origin of the barrier is entropic rather than energetic, offers new perspectives for novel investigations and potential applications. ESR by itself presents yet another case where one constructively can harvest noise in driven nonequilibrium systems.Comment: 6 pages, 7 figures ; Europhys. Lett., in press (2009

Effective Fokker-Planck Equation for Birhythmic Modified van der Pol Oscillator

We present an explicit solution based on the phase-amplitude approximation of the Fokker-Planck equation associated with the Langevin equation of the birhythmic modified van der Pol system. The solution enables us to derive probability distributions analytically as well as the activation energies associated to switching between the coexisting different attractors that characterize the birhythmic system. Comparing analytical and numerical results we find good agreement when the frequencies of both attractors are equal, while the predictions of the analytic estimates deteriorate when the two frequencies depart. Under the effect of noise the two states that characterize the birhythmic system can merge, inasmuch as the parameter plane of the birhythmic solutions is found to shrink when the noise intensity increases. The solution of the Fokker-Planck equation shows that in the birhythmic region, the two attractors are characterized by very different probabilities of finding the system in such a state. The probability becomes comparable only for a narrow range of the control parameters, thus the two limit cycles have properties in close analogy with the thermodynamic phases

Global stability analysis of birhythmicity in a self-sustained oscillator

We analyze global stability properties of birhythmicity in a self-sustained system with random excitations. The model is a multi-limit cycles variation of the van der Pol oscillatorintroduced to analyze enzymatic substrate reactions in brain waves. We show that the two frequencies are strongly influenced by the nonlinear coefficients $\alpha$ and $\beta$. With a random excitation, such as a Gaussian white noise, the attractor's global stability is measured by the mean escape time $\tau$ from one limit-cycle. An effective activation energy barrier is obtained by the slope of the linear part of the variation of the escape time $\tau$ versus the inverse noise-intensity 1/D. We find that the trapping barriers of the two frequencies can be very different, thus leaving the system on the same attractor for an overwhelming time. However, we also find that the system is nearly symmetric in a narrow range of the parameters.Comment: 17 pages, 8 figures, to appear on Choas, 201

Resonant enhancement of the jump rate in a double-well potential

We study the overdamped dynamics of a Brownian particle in the double-well potential under the influence of an external periodic (AC) force with zero mean. We obtain a dependence of the jump rate on the frequency of the external force. The dependence shows a maximum at a certain driving frequency. We explain the phenomenon as a switching between different time scales of the system: interwell relaxation time (the mean residence time) and the intrawell relaxation time. Dependence of the resonant peak on the system parameters, namely the amplitude of the driving force A and the noise strength (temperature) D has been explored. We observe that the effect is well pronounced when A/D > 1 and if A/D 1 the enhancement of the jump rate can be of the order of magnitude with respect to the Kramers rate.Comment: Published in J. Phys. A: Math. Gen. 37 (2004) 6043-6051; 6 figure

Zebrafish, a novel model system to study uremic toxins: The case for the sulfur amino acid lanthionine

The non-proteinogenic amino acid lanthionine is a byproduct of hydrogen sulfide biosynthesis: the third endogenous vasodilator gas, after nitric oxide and carbon monoxide. While hydrogen sulfide is decreased in uremic patients on hemodialysis, lanthionine is increased and has been proposed as a new uremic toxin, since it is able to impair hydrogen sulfide production in hepatoma cells. To characterize lanthionine as a uremic toxin, we explored its effects during the early development of the zebrafish (Danio rerio), a widely used model to study the organ and tissue alterations induced by xenobiotics. Lanthionine was employed at concentrations reproducing those previously detected in uremia. Light-induced visual motor response was also studied by means of the DanioVision system. Treatment of zebrafish embryos with lanthionine determined acute phenotypical alterations, on heart organogenesis (disproportion in cardiac chambers), increased heart beating, and arrhythmia. Lanthionine also induced locomotor alterations in zebrafish embryos. Some of these effects could be counteracted by glutathione. Lanthionine exerted acute effects on transsulfuration enzymes and the expression of genes involved in inflammation and metabolic regulation, and modified microRNA expression in a way comparable with some alterations detected in uremia. Lanthionine meets the criteria for classification as a uremic toxin. Zebrafish can be successfully used to explore uremic toxin effects