Diagnosis Of Situation Research Articles

Hybrid cardiovascular imaging. A clinical consensus statement of the european association of nuclear medicine (EANM) and the european association of cardiovascular imaging (EACVI) of the ESC.

Hybrid imaging consists of a combination of two or more imaging modalities, which equally contribute to image information. To date, hybrid cardiovascular imaging can be performed by either merging images acquired on different scanners, or with truly hybrid PET/CT and PET/MR scanners. The European Association of Nuclear Medicine (EANM), and the European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology (ESC) aim to review clinical situations that may benefit from the use of hybrid cardiac imaging and provide advice on acquisition protocols providing the most relevant information to reach diagnosis in various clinical situations.

GIS integration for spatial analysis of urban expansion in Tisaleo canton (Ecuador).

Political or economic interests have led to an empirical zonal delimitation, and the deficient use of Geographic Information Systems does not allow the specific characterisation of the territories. This article aims to determine the spatial analysis of the urban expansion areas of the canton of Tisaleo by integrating Geographic Information Systems, using a quantitative research method. The main components analysed are: the situational diagnosis of the canton through the characterisation of its biophysical component, its human settlements and the public system of facilities and social services that support it. Based on this information, an interrelation of the data collected is carried out to complement a spatial analysis with GIS software (ArcGis/QGis, ESRI, 2018). The results show that in the canton of Tisaleo there are areas suitable for urban growth, but their limits are overdimensioned, i.e. they include areas that do not have the aptitude to be urbanised, as well as rural areas that have the characteristics to be considered urban.

Familial hypercholesterolaemia with high triglycerides: A diagnostic challenge.

Combined or mixed hyperlipidaemia is characterised by hypercholesterolaemia together with high triglyceride concentrations. It is found in approximately 1 in 100 people in the United Kingdom. Most cases are secondary to an underlying condition such as the metabolic syndrome, diabetes mellitus (especially poorly controlled) or individuals with a high alcohol intake. Mixed hyperlipidaemia is also a feature of some primary hyperlipidaemia conditions such familial combined hyperlipidaemia (FCH) or type III hyperlipidaemia (dysbetalipoproteinaemia). One differential diagnosis for mixed hyperlipidaemia that can easily be overlooked is a patient with an underlying diagnosis of familial hypercholesterolaemia (FH) who also has a hypertriglyceridaemia due to any other cause. Those patients may have very high total and low-density lipoprotein cholesterol concentrations (LDL-C) with a moderately elevated triglyceride concentration. In this article, we report 4 cases of familial hypercholesterolaemia, confirmed by genetic testing, in patients initially presenting with hypertriglyceridaemia in addition to high total cholesterol and LDL-C. This article discusses the diagnostic challenges associated with this presentation and highlights the key role of directly measuring LDL-C to aid diagnosis in these specific situations.

Conceptualizing Global Trends

Numerous publications contain high-quality descriptions of causes, processes, and effects of global trends. However, very few of these publications are theoretically guided or aim at theory building. This is a handicap preventing most publications on global trends from developing high-quality explanations and prognostications. This article contains an attempt at developing a conceptual framework for resolving the issue. The attempt is based on the paradigm of social interaction and includes arguments in favor of four global trends: upgrading the rationality of organizations, individualization, spread of instrumental activism, and homogenization of culture. The decomposition of the trends makes it possible to identify their structures and dynamics. The analyzed examples usually refer to constructive processes and effects. In reality, the global trends are internally controversial and bring about both constructive and destructive processes and effects. The most challenging task for future studies concerns the interplay of the internal dynamics of each global trend with the dynamics of the configuration of global trends. The conceptualization of the dynamic configuration of interacting global trends is the core of the diagnosis of the global situation.

Current status of wastewater treatment through large-scale treatment wetlands in the State of Veracruz, Mexico

The use of treatment wetlands has increased globally in the last twenty years. In the State of Veracruz, Mexico, CONAGUA has only registered six wetland-based treatment plants. However, recent research has revealed the existence of additional wetland treatment systems in operation that were not listed in the CONAGUA inventory. The main objective of this study is to diagnose the current situation of wastewater treatment in the State of Veracruz, Mexico, and identify the large-scale treatment wetlands that exist in the region. The study will focus on the design and implementation characteristics of these wetlands. The research is qualitative and descriptive, based on publications between 2000 and 2023 from Google Scholar and databases published by CONAGUA. The information review process used a content analysis technique to identify the geographical location of the wetlands, their installation area, the type of wetland, the type and volume of treated water, the vegetation used, and the year of installation. The results identified 12 large-scale treatment wetlands currently in operation in the State of Veracruz, Mexico, which have different design characteristics. The main variations are in the type of plants used. Some of these wetlands have been in operation for periods ranging from 1 to 17 years, but there is no updated information regarding their current functioning. Thus, future research is suggested to focus on the situational diagnosis of these systems years after their installation.

Exploring strategies to rapidly identify false positives in high-sensitivity cardiac troponin I assay: A prospective study

BackgroundCardiac troponin is the pivotal biomarker of myocardial injury, playing a central role in the diagnosis of acute coronary syndrome and various clinical situations. Nevertheless, challenges arise when patients exhibit elevated cardiac troponin levels in the absence of evident cardiac origin, as evidenced by extensive cardiac exploration, which suggests the presence of an interfering factor. Despite the high performance of high-sensitive cardiac troponin immunoassays, these tests remain susceptible to interferences that may lead to false-positives. MethodsIn the period between July 2021 and July 2024, 8129 patients were hospitalized in the cardiology departments of Bordeaux University Hospital with positive results for high-sensitivity cardiac troponin I. Among them, 15 patients were suspected of having false-positive results, based on clinical and biological observations. ResultsIn this subpopulation, we evaluated prospectively various techniques, including serial dilutions, antibody-binding tubes, and alternative immunoassays (for cardiac troponin I and T) with the objective of identifying any potential analytical interference in their high-sensitive cardiac troponin I measurements. Our investigations revealed that 12 out of 15 suspected cases exhibited an interference on the high-sensitive cardiac troponin I assay. ConclusionIn conclusion, we propose an original algorithm designed to identify high-sensitive cardiac troponin I false-positives. This algorithm can help clinicians to make prompt and informed decisions about patient care, and to avoid erroneous clinical interventions that may result from such interferences.

Metodologia da problematização e uso do fluxograma descritor na reorganização do processo de trabalho em vigilância sanitária

Introduction: The field of work in Health Surveillance in the Unified Health System (SUS) has undergone considerable strategic reformulations in recent years, marked, above all, by the increase in technological and informational aspects in the routine of the work process. Although they represent advances and potential benefits, different obstacles have been mentioned by the sector’s work teams, which weigh on the training of workers to understand these transformations. Objective: To report the experience of developing a flowchart that describes the work process in health surveillance in a health district in Recife/PE. Method: The problematization methodology was used to guide the preparation and execution of the study. The methodology was carried out through collaborative practice and construction, involving professionals from the health surveillance sector, proposing the situational diagnosis of the work and the demands presented by the teams, associated with the role of the resident health professional as facilitator and driver of operationalization of the action described. Results: The construction and implementation of the descriptor flowchart in the reality of the health surveillance service enabled the reorganization of the work process and alignment between professionals, guided by teamwork in a collaborative and situational way. Conclusions: The proposal presents a pragmatic and pedagogical nature, by using the horizons of observation, action, and intervention directed to the field of work management in health surveillance, in order to seek the resolution of obstacles and critical formative knots that sometimes interfere in the full exercise of programmatic activities of the work field.

Emergency Department Applications of Inflammatory Markers: A Narrative Review

AbstractThis is a narrative review of the role and applications of inflammatory markers in emergency departments, emphasizing their significance in rapid and accurate assessment of patients with urgent health concerns. The markers discussed include C-reactive protein (CRP), white blood cell count, erythrocyte sedimentation rate (ESR), procalcitonin, and serum amyloid A (SAA). Each of these markers has certain physiological roles. CRP serves as a crucial acute-phase reactant in response to inflammatory signals, while white blood cell count plays a vital role in immune response. ESR acts as a nonspecific marker of inflammation, with procalcitonin being elevated in bacterial infections, whereas SAA responds to inflammation and infection. These markers have several roles in the emergency departments. CRP plays a key role as an infection marker and is used in monitoring inflammatory conditions and tissue damage. White blood cell count is highlighted for its utility in evaluating various conditions, including infections, inflammations, autoimmune diseases, and sepsis. ESR is a diagnostic tool in emergency settings for assessing and monitoring inflammatory conditions. Procalcitonin's diagnostic specificity for bacterial infections is underscored, aiding in prompt and accurate diagnosis in emergency situations. SAA, as an acute-phase protein, has a role in inflammation and, infection responses, with applications in evaluating infections, monitoring inflammatory diseases, diagnosing and monitoring sepsis, and assessing other inflammation-related conditions. In conclusion, SAA has diverse applications in emergency departments, offering valuable insights into infection detection, monitoring chronic inflammatory diseases, diagnosing sepsis, evaluating inflammation-related conditions, and providing rapid insights in emergency scenarios. The importance of these inflammatory markers in enhancing diagnostic accuracy, guiding treatment decisions, and optimizing patient care in critical situations is emphasized throughout the review.

MAPPING THE NEED FOR A CIRCULAR ECONOMY FOR FUTURE ECONOMIC BENEFITS: POTENTIALS AND PROJECTIONS FOR SMALL AND MEDIUM-SIZED ENTERPRISES IN NORTH MACEDONIA

The circular economy, a concept based on the principles of designing waste and pollution, keeping products and materials in use for a longer time, and regenerating natural systems is still in its infancy in the Western Balkans, especially in many analyses related to the development and future projections of small and medium enterprises. Over the years, there has been a steady increase in per capita waste generation in the region, with the municipal waste recycling rate among economies being very low, while resource intensity as a measure of resource efficiency has remained relatively high. In addition, enterprises in the region are rarely aware of the opportunities of a circular economy, such as reduced environmental impact, more sustainable use, and conservation of natural resources, lower production costs, increased innovation, increased competitiveness, greater resistance to external shocks through reduced dependence on resources or the creation of new markets and jobs. Of particular importance is the identification of key economic sectors that should be directly involved in the process of circular economic transformation. In addition, it is important in the European framework, to map of the good practices that could be transferred to the economy in the Republic of North Macedonia, when it comes to the circular economy. In the framework of this paper, through the application of a methodological framework of content analysis, comparison, synthesis, and generalization, a diagnosis of the current situation regarding a circular economy in North Macedonia will be presented, as well as the identification of priority sectors/areas as the main key for the future perspectives of the circular economy within these society frameworks. It requires the involvement of all key stakeholders, including government institutions, the private sector, civil society, and academia, to apply a comprehensive approach in setting a future roadmap for a circular economy and encouraging a circular transition for the greater benefit of society of the Republic of North Macedonia, with special reference to improving the future of small and medium enterprises.

Artificial Intelligence Recognition Model Using Liquid-Based Cytology Images to Discriminate Malignancy and Histological Types of Non-Small-Cell Lung Cancer

Introduction: Artificial intelligence image recognition has applications in clinical practice. The purpose of this study was to develop an automated image classification model for lung cancer cytology using a deep learning convolutional neural network (DCNN). Methods: Liquid-based cytology samples from 8 normal parenchymal (N), 22 adenocarcinoma (ADC), and 15 squamous cell carcinoma (SQCC) surgical specimens were prepared, and 45 Papanicolaou-stained slides were scanned using whole-slide imaging. The final dataset of 9,141 patches consisted of 2,737 N, 4,756 ADC, and 1,648 SQCC samples. Densenet-121 was used as the DCNN to classify N versus malignant (ADC+SQCC) and ADC versus SQCC images. AdamW optimizer and 5-fold cross-validation were used in the training. Results: For malignancy prediction, the sensitivity, specificity, and accuracy were 0.97, 0.85, and 0.94, respectively, in the patch-level classification, and 0.92, 0.88, and 0.91, respectively, in the case-level classification. For SQCC prediction, the sensitivity, specificity, and accuracy were 0.86, 0.91, and 0.90, respectively, in the patch-level classification and 0.73, 0.82, and 0.78, respectively, in the case-level classification. Conclusion: The DCNN model performed excellently in predicting malignancy and histological types of lung cancer. This model may be useful for predicting cytopathological diagnosis in clinical situations by reinforcing training.

Strategic Directions of the Capital Market Development of Georgia

The development of the capital market in Georgia is an important prerequisite for the creation of a free and competitive environment, which naturally ensures the need for capital and investments in the country. It will become effective, innovative, focused on high results and a guarantee of economic development. The purpose of the study is to study the current situation in the sector in order to identify the main problem in the sector and by analyzing the shortcomings identified as a result of comparison with the desired situation, the main problem was identified. The diagnosis of the current situation in the sector is based on the conclusions of the overview of the development of the capital market made within the framework of the financial sector assessment program developed by the World Bank, the Asian Bank and other financial institutions. The mentioned conclusions were also used to determine the main problem-causing factors and negative consequences. The purpose of the capital market development strategy in Georgia is to create the most important action mechanism for the coordinated and consistent development of the capital market. The strategy reviews the current situation in the direction of the capital market, challenges in the field and ways to overcome them. The strategy defines the strategic position and future direction of the capital market of Georgia in the coming years. The capital market strategy defines the framework for the consistent introduction of new supervisory, regulatory and legislative acts, which is important for market participants to operate in a transparent and predictable environment. Keywords: Capital market strategy; Operating in a stimulating environment for market participants; Guarantor of economic development.

Deficiency of Adenosine Deaminase 2

Adenosine deaminase 2 (ADA2) deficiency is an autosomal recessively inherited autoinflammatory disorder caused by loss-of-function mutations in the ADA2 gene. Although the pathogenesis involves the triggering of a proinflammatory cascade due to increased production of inflammatory cytokines such as tumor necrosis factor (TNF)-α and dysregulation of neutrophil extracellular trap formation resulting from an excess accumulation of extracellular adenosine, the pathogenetic mechanism still needs further clarification due to the broad clinical spectrum. In addition to the initially described vasculitis-related symptoms, hematological, immunological, and autoinflammatory symptoms are now well recognized. The diagnosis is made by demonstration of pathogenic variants of ADA2 with biallelic loss of function and identification of low plasma ADA2 catalytic activity. Currently, TNF-α inhibitors are the treatment of choice for controlling vasculitis manifestations and preventing strokes. However, in patients presenting with severe hematologic findings, TNF-α inhibitors are not the treatment of choice and hematopoietic stem cell transplantation has been shown to be successful in selected cases. Recombinant ADA2 protein and gene therapy are promising treatment modalities for the future. In conclusion, ADA2 deficiency has a broad phenotype and should be considered in the differential diagnosis of different clinical situations. In this review, we summarize the disease manifestations of ADA2 deficiency and available treatment options.

Quantification of Inorganic Waste from Estero Atascoso: Mitigation Strategies

Objective: The objective of this study was to quantify the inorganic waste of the Atascoso estuary as a mitigation strategy. Theoretical Framework: This topic presents the main concepts and theories that support the research. Highlighting the diagnosis of the current situation and dynamics of inorganic waste generation, also the quantification of inorganic waste, and for the design of a comprehensive management plan for inorganic waste using mitigation strategies; providing a solid foundation for understanding the context of the research. Method: The methodology adopted for this research includes diagnosing the current situation and generation dynamics of inorganic waste, also to quantify inorganic waste, and methodology to design a comprehensive management plan for inorganic waste using mitigation strategies. Results and Discussion: The results obtained revealed the critical situation of the estuary is due to the increase in the accumulation of garbage and the lack of environmental awareness. Therefore, it is essential that the population and the authorities act immediately to promote sustainable and responsible habits in the community. In the discussion section, these results are contextualized in light of the theoretical framework, highlighting the implications and relationships identified. This section also considers possible discrepancies and limitations of the study. Originality/Value: This study contributes to the literature through specific applicability, for a given area. The relevance and value of this research is evident in the use of mitigation strategies to promote sustainable and responsible habits in the community.

Rethinking on the epidemic situation and standardized diagnosis and treatment of low risk differentiated thyroid cancer

Thyroid cancer is a malignant tumor originating from thyroid epithelial or parafollicular epithelial cells. It is also the most common malignant tumor in the head and neck. At present, the incidence of thyroid cancer ranks ninth among all common malignant tumors, and has become one of the top ten common malignant tumors. In recent years, with the release of various guidelines, the diagnosis and treatment of thyroid cancer around the world is gradually standardized. Meanwhile, China has also begun to implement quality control of diagnosis and treatment, standardize diagnosis and treatment behavior, and promote the standardization of diagnosis and treatment of thyroid tumors nationwide, in order to ultimately improve patient's survival rate and quality of life. Based on the current changes in the diagnosis and treatment of thyroid cancer at home and abroad, the article discusses the epidemic situation, diagnosis and treatment status, new concept and progress of standardized diagnosis and treatment of thyroid cancer.

ANTIBODIES AGAINST Leptospira spp. IN DAIRY CATTLE IN A FAMILY AGRICULTURE SYSTEM

Leptospirosis is an endemic zoonosis in Brazil responsible for numerous reproductive and economic losses to the dairy industry. Brazil ranks fifth in the world's production of cow's milk and around 23 million cows are milked every day. The northwest region of the state of São Paulo has a considerable number of family farming settlements, with dairy farming being predominant. This article reports a seroepidemiological study to detect agglutinins against Leptospira spp. in 1,004 dairy cattle kept on 64 family farms producing milk in the northwest region of São Paulo. Management and environmental data for situation diagnosis were obtained with a questionnaire. Antibodies against Leptospira spp. were investigated by the microscopic seroagglutination test (SAM) and milk and urine samples were obtained from seroreactive animals with titer ? 400. These samples were submitted to molecular tests. Of the 64 properties studied, 63 (98%) had seroreactive animals. Of the 1,004 animals, 523 (52%) were reactive. According to the molecular tests, the presence of Leptospira spp. in the urine and milk of the seroreactive animals was negative. Wetlands, presence of rodents, occurrence of abortion, presence of dogs, presence of cats and presence of horses were variables associated with the risk of infection by Leptospira spp. In addition to its importance in animal health, leptospirosis poses a risk to human health, a situation that indicates the need for improvement of sanitary conditions in rural properties.

Perspectives for the construction and applicability of the situational diagnosis of educational practices used in the school context as a way of transmitting knowledge for the prevention and coping with arboviruses

Introduction: In recent years, there has been an increase in cases of diseases transmitted by arboviruses (arboviruses) in tropical regions. In this scenario marked by the growing risk of these diseases, schools are assuming a fundamental role in the prevention, control and confrontation of these diseases. Thus, many schools have been developing new educational practices focused on the theme of arboviruses. In this context, the situational diagnosis (SD) of arbovirus education in schools is an important tool for data collection, treatment and analysis, ensuring subsequent planning for the effectiveness of future actions. This article aims to present the construction of a tool for diagnosing the teaching-learning situation related to arboviruses in the school context. Methodology: The SD will be divided into two stages: the first stage approaches the approximation with the school's profile and activities already carried out with a learning objective related to arboviruses. The second stage of the diagnosis consists of knowing possible scenarios in the school environment. Results: Based on the information collected, the situational diagnosis allows the identification of the school's strengths, those aspects that work well and contribute to the success of the students. On the other hand, it is also possible to detect the weak points, the areas that need to be improved to ensure quality education. Considerations: the situational diagnosis of educational practices for arboviruses in schools is an essential tool to strengthen health education and contribute to the prevention and control of these diseases. Through the evaluation of existing practices, it is possible to identify points of improvement and develop effective actions to protect the health of students and the school community.

PROCESSAMENTO TÉCNICO DOS ACERVOS AUDIOVISUAIS NO ARQUIVO NACIONAL

It analyzes the technical processing of these audiovisual documents at the National Archives, the main archival institution in Brazil. The general objective was to prepare an archival diagnosis on the technical processing of audiovisual archival documents at the National Archives, with three specific objectives: to conceptually discuss audiovisual documents and their insertion in the universe of archives; problematize the technical processing of audiovisual documents in archives; identify the profile of the National Archives’ audiovisual collection and its forms of entry; and map the stage of organization, level of description and digitization of the National Archives' audiovisual collection. The research contributes to improving technical treatment practices for audiovisual documents at the National Archives, providing a detailed diagnosis of the current situation. The methodology used involved the collection and analysis of documents, as well as the exploration of the National Archives Information System (SIAN) and research instruments developed by the institution's technical team. The results indicate the importance of a comprehensive and critical study on the treatment of audiovisual documents in the archival context, suggesting the need for innovative approaches to the access and preservation of audiovisual documents in archival institutions.

Partial Administrative Audit of the human resources area of an artisan bakery in the State of Veracruz

This audit research and development work was carried out in an artisanal bakery company in the state of Veracruz. The objective of this research was to carry out a diagnosis of the current situation of administrative management, with the aim of identifying possible deficiencies and opportunities within these organizations to propose useful strategic alternatives, maximize processes and resources. This is how a field, descriptive and documentary research is carried out; This is through instruments and interviews with owners on the management of administrative processes and surveying employees. Subsequently, a diagnosis is implemented, which allows all the information obtained through interviews and surveys to be analyzed and classified. Based on the results, it was detected that in the area of Human Resources there is a minimum of problems, since there is a stable work environment and communication between them, which leads to a good functioning and compliance in the performance of activities. An organizational, process and/or policy manual is recommended, so that staff do not lose track of the organization and improve their performance.

Internationalisation of science and technology parks and the stage of their life: The Central European perspective

Research background: A science and technology park (STP) is an important tool of innovation policy. In order to carry out new tasks in the field of internationalisation of innovative processes, parks have to incorporate completely new ones into their classic roles and activities. There is still a low level of knowledge about the factors that limit this process. The identified research gap provided the rationale for addressing the issue of the internationalisation of parks in Poland, which is an original treatment of the issue and probably one of the first such studies in Central Europe. Purpose of the article: The purpose of the article is to diagnose the stages through which the internationalisation of science and technology parks takes place in the context of the phases of the life cycle of these organisations, as well as to identify and assess the importance of obstacles limiting the internationalisation process. Methods: A critical analysis of the literature and direct research was carried out using the survey method, according to the author's questionnaire. The research was carried out in 2022 among 18 STPs in Poland (55% of all Polish parks). The diagnosis of internationalisation was made on an institutional level. Three phases of the park life cycle were defined and operationalised based on the criteria identified by J. Allen (2007): creation, consolidation and maturity phase. Ward’s agglomeration method (Ward, 1963) was utilised to group the parks based on the level of actions realised in their life cycle and their degree of internationalisation. In the identification of the number of groups, the Duda-Hart (Duda et al., 2000) Je(2)/Je(1) index-stopping rule was used. Thirteen of the most important obstacles to the internationalisation process were identified. In order to examine the internal consistency of variables describing the internationalisation of parks, Cronbach’s Alpha reliability index was calculated. In order to find out the strength and direction of the existing relationship between obstacles and the internationalisation index of the studied parks, Kendall’s τ test was used. Findings & value added: The sequential development of parks at the national level is in line with the assumptions indicated in the literature. The problem, however, is the internationalisation of parks. Not only is it characterised by a low level, but its course also does not indicate that it is the result of the successive implementation of previously assumed activities. The processes of development and internationalisation are interrelated, but this is not a significant interdependence. The problem is also indicated by the results of studies relating to obstacles to the internationalisation process. This is because the most significant ones are diagnosed only at an advanced level of internationalisation. Such an important activity of parks is undertaken without a prior in-depth diagnosis of the international situation. This can result in limited effectiveness of the activities undertaken in the direction of internationalisation and generate related problems. The results of the study provide a basis for indicating the type of activities aimed at activating parks in the international arena. Such activities should be undertaken at a higher level than the parks themselves since they do not have sufficient procedures and resources to guarantee increased internationalisation. One desirable course of action could also be the creation of cooperation networks at different territorial and entity levels.

Situational diagnosis carried out at ESF 303

The Family Health Strategy (ESF) is crucial to expanding health coverage. This study, carried out by the second term of the Medicine course at the Centro Universitário de Goiatuba, analyzed the Family Health Strategy - 303, in Goiatuba, through situational diagnosis, which assesses the health conditions of a population, allowing us to know the challenges experienced in that place and plan strategic actions for possible improvements. Goiatuba, in Goiás, has 13 Family Health Units serving 35,664 inhabitants. Data from the health unit was collected and analyzed, including interviews with the preceptor and nurses, as well as site visits. A prevalence of cases of hypertension, diabetes and schizophrenia was observed, as well as structural weaknesses such as the lack of a vaccination room, a preventive care room, problems in the dental office and the absence of a full team of collaborators. These factors hamper the efficiency of the service and the quality of care. Pamphlets were distributed and an awareness campaign on healthy lifestyles was carried out, encouraging healthy eating, physical exercise and structural improvements to the unit were suggested, such as implementing psychological counseling. The research highlighted the importance of situational diagnosis in order to understand the reality of local health and implement more effective actions aimed at serving the entire population.