Healthcare Products Research Articles

Comprehensive Review of EGCG Modification: Esterification Methods and Their Impacts on Biological Activities.

Epigallocatechin gallate (EGCG), the key constituent of tea polyphenols, presents challenges in terms of its lipid solubility, stability, and bioavailability because of its polyhydroxy structure. Consequently, structural modifications are imperative to enhance its efficacy. This paper comprehensively reviews the esterification techniques applied to EGCG over the past two decades and their impacts on bioactivities. Both chemical and enzymatic esterification methods involve catalysts, solvents, and hydrophobic groups as critical factors. Although the chemical method is cost-efficient, it poses challenges in purification; on the other hand, the enzymatic approach offers improved selectivity and simplified purification processes. The biological functions of EGCG are inevitably influenced by the structural changes incurred through esterification. The antioxidant capacity of EGCG derivatives can be compromised under certain conditions by reducing hydroxyl groups, while enhancing lipid solubility and stability can strengthen their antiviral, antibacterial, and anticancer properties. Additionally, esterification broadens the utility of EGCG in food applications. This review provides critical insights into developing cost-effective and environmentally sustainable selective esterification methods, as well as emphasizes the elucidation of the bioactive mechanisms of EGCG derivatives to facilitate their widespread adoption in food processing, healthcare products, and pharmaceuticals.

PUFFIn – A user friendly fast interface for calculating and visualizing the dose distribution in materials

This article describes a new graphical user interface that uses the PENELOPE Monte Carlo code to calculate dose distributions in materials. It is named PUFFIn, for the Penelope User-Friendly Fast Interface and was developed as an educational and scoping analysis tool for non-experts in radiation modeling. PUFFIn enables the user to visualize and compare the dose distributions in objects (e.g., sterilized healthcare products) irradiated with cobalt-60 gamma-rays, electron beam (E-beam) or X-rays. From such comparisons, the user can determine the most efficient product and/or packaging designs for any given radiation field – whether for conceptual or existing products and packaging.PUFFIn is distributed in a complete, self-contained package of software, including the PENELOPE radiation transport code, a standard graphics package, and a set of simple exercises. The package is available to any user at no cost and requires a minimal amount of training compared to other similar software. PUFFIn's capabilities are described, as well as validation measurements performed at Texas A&M University E-beam facility and the Aerial E-beam Facility in France.

Investigating impact of health belief and trust on technology acceptance in smartwatch usage: Turkish senior adults case

PurposeThis paper aims to investigate the influence of health beliefs and trust by senior adults as associated with the perceived ease of use and perceived usefulness, for the acceptance of smart technology with a focus on smartwatch technology.Design/methodology/approachStructural equation modeling is used to conceptualize the model using survey data collected from 243 randomly selected senior adults 60+ years of age.FindingsThis paper presents that perceived usefulness, perceived ease of use, trust and health belief are direct and indirect predictors of senior adults’ technology acceptance and intention to use smartwatch technology.Research limitations/implicationsThe study reveals the moderator effect of social influence on relation between perceived usefulness, perceived ease of use and intention to use. The authors highlight the effect of health belief and trust on perceived usefulness and perceived ease of use and the role of intention to use smartwatch technology.Practical implicationsThe authors contribute bridging developers of health technologists and senior adults as end-user perspectives. For marketing of health-care technology products, specifically smartwatch, to seniors, a focus on health beliefs and trust is essential to build, maintain and improve perceived usefulness and perceived ease of use.Originality/valueThe present study contributes empirical evidence to the literature on factors affecting the acceptance of the smartwatch technology by senior adults.

Reclaiming Agriceuticals from Sweetpotato (Ipomoea batatas [L.] Lam.) By-Products.

Sweetpotato (SP, Ipomoea batatas [L.] Lam.) is a globally significant food crop known for its high nutritional and functional values. Although the contents and compositions of bioactive constituents vary among SP varieties, sweetpotato by-products (SPBs), including aerial parts, storage root peels, and wastes generated from starch processing, are considered as excellent sources of polyphenols (e.g., chlorogenic acid, caffeoylquinic acid, and dicaffeoylquinic acid), lutein, functional carbohydrates (e.g., pectin, polysaccharides, and resin glycosides) or proteins (e.g., polyphenol oxidase, β-amylase, and sporamins). This review summarises the health benefits of these ingredients specifically derived from SPBs in vitro and/or in vivo, such as anti-obesity, anti-cancer, antioxidant, cardioprotective, and anti-diabetic, evidencing their potential to regenerate value-added bio-products in the fields of food and nutraceutical. Accordingly, conventional and novel technologies have been developed and sometimes combined for the pretreatment and extraction processes aimed at optimising the recovery efficiency of bioactive ingredients from SPBs while ensuring sustainability. However, so far, advanced extraction technologies have not been extensively applied for recovering bioactive compounds from SPBs except for SP leaves. Furthermore, the incorporation of reclaimed bioactive ingredients from SPBs into foods or other healthcare products remains limited. This review also briefly discusses current challenges faced by the SPB recycling industry while suggesting that more efforts should be made to facilitate the transition from scientific advances to commercialisation for reutilising and valorising SPBs.

Getting it right with discrete choice experiments: Are we hot or cold?

Discrete Choice Experiments (DCEs) are widely employed survey-based methods to assess preferences for healthcare services and products. While they offer an experimental way to represent health-related decisions, the stylized representation of scenarios in DCEs may overlook contextual factors that could influence decision-making. The aim of this paper was to evaluate the predictive validity of preferences elicited through a DCE in decisions likely influenced by a hot-cold empathy gap, and compare it to another commonly used method, a direct-elicitation question. We focused on preferences for pain-relief modalities, especially for an epidural during childbirth - a context where direct-elicitation questions have shown a preference for or intention to have a natural birth (representing the “cold” state), yet individuals often opt for an epidural during labor (representing the “hot” state). Leveraging a unique dataset collected from 248 individuals, we incorporated both the stated preferences collected through a survey administered upon hospital admission for childbirth and the actual pain-relief modality usage data documented in medical records. The DCE allowed for the evaluation of scenarios outside of those expected by respondents to simulate decision-making during childbirth. When we compared the predicted epidural use with the actual epidural use during labor, we observed a choice concordance of 71-60%, depending on the model specification. The concordance rate between the predicted and actual choices increased to 77-76% when accounting for the initial use of other ineffective modalities. In contrast, the direct-elicitation choices, relying solely on respondents’ baseline expectations, yielded a lower concordance rate of 58% with actual epidural use. These findings highlight the flexibility of the DCE method in simulating complex decision contexts, including those involving hot-cold empathy gaps. The DCE proves valuable in assessing nuanced preferences, providing a more accurate representation of the decision-making processes in healthcare scenarios.

Effect of clinical engagement on value, standardisation, decision-making and savings in NHS product procurement.

UK healthcare expenditure is now £193.8 billion a year. The procurement function is seen as central to driving efficiencies within the NHS. This comes with an increasing onus on clinicians, including nurses and allied health professionals, to accept procurement outcomes to realise efficiency savings, with or without prior engagement. This empirical study seeks to examine whether clinical engagement in the procurement of healthcare products in the NHS is necessary to achieve value, savings and standardisation; it will thereby address a gap in the research. A multi-method qualitative case study design was used, which included a survey and eight semi-structured interviews. Results identified three factors that influence the achievement of value, savings and standardisation around clinical engagement: micro-level processes for clinical engagement; clinical stakeholders and clinical procurement professionals as experts at the centre of procurement activity; and clinical value in standardisation. A shift away from standardisation to resilience was identified, resulting from current market supply pressures. This research brings empirically derived findings to address gaps in research, supports the benefit of clinical engagement through specific forums for collaboration at a trust level and provides a clinical/expert impact/preference matrix as a resource for procurement professionals to facilitate clinical engagement.

Navigating equity in global access to genome therapy expanding access to potentially transformative therapies and benefiting those in need requires global policy changes.

In December 2023, the US Food and Drug Administration and the UK Medicines and Healthcare Products Regulatory Agency granted the first regulatory approval for genome therapy for sickle cell disease. This approval brings hope to those suffering from this debilitating genetic disease. However, several barriers may hinder global patient access, including high treatment costs, obtaining informed consent for minors, inadequate public health infrastructure, and insufficient regulatory oversight. These barriers reflect the structural inequalities inherent in global health governance, where patient access often depends on social and institutional arrangements. This article addresses concerns around informed consent, treatment costs, and patient access, and proposes corresponding policy reforms. We argue that these discussions should be framed within a broader global context that considers social and institutional structures, global research priorities, and a commitment to health equity.

The Impact of Climate Change on Health Services in Low- and Middle-Income Countries: A Systematised Review and Thematic Analysis.

Aim: The aim of this study was to assess the impact of climate change on health services as categorized by the WHO's Building Blocks for creating Climate-Resilient Health Systems. Objective: The objective was to conduct a systematized review of the published literature concerning the impact of climate change, using a thematic analysis approach to address our aim and identify areas for further research. Design: A search was conducted on 8 February 2022 using the Embase and PubMed research databases. Peer-reviewed scientific studies that were published in English from 2012 to 2022, which described at least one report concerning the impact of climate change on health services in LMICs, were included. Studies were organized based on their key characteristics, which included the date of publication, objective, method, limitations, participants, and geographical focus. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the risk of bias in the included studies. Results: Twenty-three studies were included in this review. Five areas of health services which align with the WHO building blocks framework were impacted by climate change. These health service areas included: (1) Service Delivery, (2) Human Resources, (3) Health Finance, (4) Healthcare Products and Technology, and (5) Leadership and Governance. However, research concerning the impact of climate change on health information systems, which is part of the WHO building blocks framework, did not feature in our study. The climatic effects were divided into three themes: meteorological effects, extreme weather events, and general. The research in this study found that climate change had a detrimental impact on a variety of health services, with service delivery being the most frequently reported. The risk of bias varied greatly between studies. Conclusions: Climate change has negatively impacted health services in a variety of different ways, and without further actions, this problem is likely to worsen. The WHO building blocks have provided a useful lens through which to review health services. We built an aligned framework to describe our findings and to support future climate change impact assessments in this area. We propose that further research concerning the impact of climate change on health information systems would be valuable, as well as further education and responsible policy changes to help build resilience in health services affected by climate change.

A Mini-review on the Chemical Composition, Extraction and Isolation Techniques, and Pharmacological Activity of Rosmarinus officinalis L.

Abstract: Rosmarinus officinalis L. belongs to the genus Rosemary in the family Labiatae, which is a perennial evergreen subshrub. It is currently cultivated in certain areas of Yunnan, Guangxi, and Guizhou. At present, in food, cosmetics, healthcare products, and other domains, R. officinalis has a wide range of applications; it has received widespread attention, and is also a hot topic of research today. Using modern spectroscopic techniques, it has been found that the main chemical components of rosemary can be divided into two major groups, including volatile components (essential oils) and non-volatile components (diterpenes, triterpenes, flavonoids, phenolic acids, sterols, etc.). Among them, carnosic acid, carnosol, rosemary phenol, and 1,8-cineole are the main components acting as antioxidants and they are highly regarded. The main methods for extracting the active ingredients of R. officinalis include water distillation, ultrasonic-assisted microwave method, supercritical CO2 extraction method, enzyme-assisted extraction method, and microwaveassisted extraction method. Modern research has shown that rosemary has anti-inflammatory, antioxidant, antibacterial, antiviral, antitumor, hepatoprotective, hypolipidemic, immunomodulatory, antiseptic, and antithrombotic effects, and is widely used in medical applications.

Availability of Dispensing and Storage Facilities at Public and Community Pharmacies at Bahir Dar and Gondar Towns.

The availability of various facilities that aid in providing expected services is necessary for the practice of pharmacy, which aims to make the best use of medications and other healthcare products and services. Therefore, the aim of this study was to assess the availability of dispensing and storage facilities at public and community pharmacies in Bahir Dar and Gondar towns. In Gondar and Bahir Dar towns' public and private pharmacies, a facility-based cross-sectional study was conducted from July 2023 to September 2023. All pharmacy areas that were open during data collection were included in the study. The frequency and percentage were calculated using descriptive statistics. From 239 pharmacies, 208 (87.0%) of them were open during data collection, and they are included in the study.The water supply and dispensing counter were available in the dispensing area in 79.3% and 60.1% of instances, respectively. They also had adequate room for storage (92.8%), dispensing (92.8%), and receiving (95.7%) of medicines. Additionally, about 98.1% of the facilities had shaded, ventilated, and dry areas. A therapeutic order was the most often used method (59.6%) for medication organization. Merely 1.9% of participants did not employ a strategy to arrange their medications. A refrigerator (88.0%), a refrigerator thermometer (91.3%), a spoon or spatula (81.3%), a separate storage facility (74.5%), a cold room (68.8%), a lockable cabinet (90.9%), a tablet counter (69.2%), and a fire extinguisher (safety device) (88%) were among the various storage equipment the majority of the pharmacies in the survey had. Nonetheless, air conditioning was absent from the majority (53.4%) of pharmacy facilities. Few pharmacies need to make improvements to their facilities in order to encourage convenient drug storage and dispensing practices, even though the majority of the pharmacies surveyed had all the necessary equipment and infrastructure. In addition to initiating the pharmacies to provide good practices of dispensing and storage, facility-focused initiation and regulation should be obtained to ensure full availability of the facilities.

Towards Lipid from Microalgae: Products, Biosynthesis, and Genetic Engineering.

Microalgae can convert carbon dioxide into organic matter through photosynthesis. Thus, they are considered as an environment-friendly and efficient cell chassis for biologically active metabolites. Microalgal lipids are a class of organic compounds that can be used as raw materials for food, feed, cosmetics, healthcare products, bioenergy, etc., with tremendous potential for commercialization. In this review, we summarized the commercial lipid products from eukaryotic microalgae, and updated the mechanisms of lipid synthesis in microalgae. Moreover, we reviewed the enhancement of lipids, triglycerides, polyunsaturated fatty acids, pigments, and terpenes in microalgae via environmental induction and/or metabolic engineering in the past five years. Collectively, we provided a comprehensive overview of the products, biosynthesis, induced strategies and genetic engineering in microalgal lipids. Meanwhile, the outlook has been presented for the development of microalgal lipids industries, emphasizing the significance of the accurate analysis of lipid bioactivity, as well as the high-throughput screening of microalgae with specific lipids.

Enhancing the glycerol utilization of engineered yeast increases its bisabolene production

Bisabolene is a compound commonly found in essential oils of various plants. It has a broad application in sectors such as chemical, pharmaceutical, and health-care products. This study focuses on modifying the glycerol metabolism pathway to obtain a high bisabolene-producing strain of Saccharomyces cerevisiae. To achieve this, the glycerol transporter gene PtFPS2 from Pachysolen tannophilus and the glycerol dehydrogenase gene Opgdh from Ogataea parapolymorpha were overexpressed in engineered yeast YS036, which was equipped with a GAL promoters-enhanced mevalonic acid pathway. Additionally, the glucose-inhibiting transcription factor MIG1 was knocked out to reduce glucose inhibition. The results showed that the GAL promoter transcription levels of the recombinant yeast strains increased, and the co-utilization of sucrose and glycerol was further improved in MIG1-knockout strain. Moreover, the maximum yield of bisabolene in shaking flask fermentation increased to 866.7 mg/L, an 82.2% increase compared to that of the original strain. By modifying the metabolic pathway of carbon sources, the yield of bisabolene was considerably improved. This study offers an effective strategy for enhancing the yield of terpene compounds in engineered yeast.

Potential health and economic impact of achieving Kenya’s overweight and obesity reduction target: a modelling study

IntroductionKenya has adopted the WHO target of halting the rise of overweight, including obesity, by 2025. This paper assesses the potential impact of achieving the set target on health, healthcare...

The economic and fiscal impact of incremental use of cell-based quadrivalent influenza vaccine for the prevention of seasonal influenza among healthcare workers in Italy

BackgroundSeasonal influenza has a significant impact on public health, generating substantial direct healthcare costs, production losses and fiscal effects. Understanding these consequences is crucial to effective decision-making and the development of preventive strategies. This study aimed to evaluate the economic and the fiscal impact of implementing an incremental strategy for seasonal influenza prevention using the cell-based quadrivalent influenza vaccine (QIVc) among healthcare workers (HCWs) in Italy.MethodsTo estimate the economic impact of implementing this strategy, we performed a cost analysis that considered direct healthcare costs, productivity losses and fiscal impact. The analysis considered a 3-year time horizon. A deterministic sensitivity analysis was also conducted.ResultsAssuming a vaccination coverage rate of 30% among HCWs, the analysis considered a total of 203 018 vaccinated subjects. On analysing the overall differential impact (including direct costs, indirect costs and fiscal impact), implementing QIVc vaccination as a preventative measure against influenza among HCWs in Italy would yield societal resource savings of €23 638.78 in the first year, €47 277.56 in the second year, and €70 916.35 in the third year, resulting in total resource savings of €141 832.69.ConclusionsThe study demonstrated that implementing the incremental use of QIVc as part of a preventive strategy for seasonal influenza among HCWs in Italy could yield positive economic outcomes, especially in terms of indirect costs and fiscal impact. The resources saved could be utilized to fund further public health interventions. Policy-makers should consider these findings when making decisions regarding influenza prevention strategies targeting HCWs.

THE IMPACT OF BIG DATA ON HEALTHCARE PRODUCT DEVELOPMENT: A THEORETICAL AND ANALYTICAL REVIEW

The intersection of big data and healthcare product development has catalyzed transformative shifts in the industry, revolutionizing how medical solutions are conceptualized, designed, and deployed. This theoretical and analytical review explores the profound impact of big data on healthcare product development, elucidating its implications across various facets of the healthcare landscape. Utilizing big data analytics, healthcare stakeholders can harness vast volumes of structured and unstructured data to derive actionable insights. These insights inform evidence-based decision-making processes, driving innovation in product development pipelines. By analyzing real-time patient data, trends, and treatment outcomes, developers gain invaluable insights into disease progression, treatment efficacy, and patient preferences, thus facilitating the creation of tailored, patient-centric solutions. Moreover, big data analytics play a pivotal role in improving patient outcomes and quality of care. Through predictive analytics and machine learning algorithms, healthcare providers can identify at-risk populations, predict disease outbreaks, and personalize treatment plans. This proactive approach enhances preventive care strategies and minimizes healthcare costs by averting complications and hospital readmissions. However, the integration of big data into healthcare product development is not without challenges. Data privacy and security concerns necessitate robust frameworks to safeguard sensitive patient information. Moreover, regulatory compliance frameworks must evolve to accommodate the complexities of big data analytics while ensuring patient safety and data integrity. Despite these challenges, the potential of big data in healthcare product development is vast. By leveraging big data analytics, stakeholders can bridge gaps in healthcare access and equity, tailor interventions to underserved populations, and optimize resource allocation. In conclusion, this review underscores the transformative impact of big data on healthcare product development. By embracing data-driven approaches, stakeholders can drive innovation, enhance patient outcomes, and navigate the evolving healthcare landscape with agility and efficacy.
 Keywords: Big Data, Healthcare Product Development, Innovation, Patient Outcomes, Data Analytics, Regulatory Compliance.

Real-world safety of Levetiracetam: Mining and analysis of its adverse drug reactions based on FAERS database

Levetiracetam is a relatively new and widely utilized anti-seizure medication; however, limited information is available regarding its adverse effects. This study aims to thoroughly investigate, evaluate, and present evidence on the safety profile of Levetiracetam, relying on data from the FDA Adverse Event Reporting System (FAERS) database to facilitate informed clinical decision-making. We employed various statistical measures, including Reporting Odds Ratio (ROR), Proportionate Reporting Ratio (PRR), and analysis by the Medicines and Healthcare Products Regulatory Agency (MHRA), to identify signals of adverse reactions associated with Levetiracetam. Positive signals consistent with Designated Medical Event (DME) were singled out for focused comparison and discussion. The analysis of 26,182 adverse events linked to Levetiracetam as the primary suspected drug revealed 692 positive signals spanning 22 System Organ Classes (SOCs). Nervous system disorders were the most frequently reported, followed by psychiatric disorders, and general disorders and administration site conditions. 11 positive signals consistent with Preferred Terms (PTs) in DME were identified, predominantly concentrated in 6 SOCs. Among these, rhabdomyolysis, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) exhibited relatively large values of A, ROR, and Chi-squared. Additionally, PTs related to spontaneous abortion, drug interaction, urethral atresia, ventricular septal defect, and atrial septal defect showed significant strength. The study indicates that Levetiracetam carries a potential risk of causing rhabdomyolysis, SJS, TEN, DRESS as well as spontaneous abortion. Signals related to drug interaction, urethral atresia, ventricular septal defect, and atrial septal defect warrant heightened attention in clinical use.

Regulatory requirement for Medical Devices

The safety and regulatory compliance of a widely used medical device have become a growing concern among a significant population. This has raised questions about the assessment of risks, monitoring of adverse drug reactions (ADR), and overall product safety. The efficacy and safety of such medical devices heavily rely on the regulations and guidelines set forth by regulatory agencies (RAs).
 In the pharmaceutical industry, regulatory affairs (RA) professionals play a crucial role in overseeing the lifecycle of healthcare products. They provide strategic, tactical, and operational guidance to ensure compliance with regulations, facilitating the efficient development and delivery of safe and effective healthcare products worldwide. Evaluating adherence to regulations requires a combination of expertise from the business, legal, and pharmaceutical domains.
 Regulatory authorities must thoroughly monitor medical device design, development, and manufacturing processes to guarantee that the products reaching the market are safe and effective. The certification process is intricate, involving multiple steps and the assessment of materials by competent authorities. In the United States, manufacturers must seek marketing authorization from the United States Food and Drug Administration (USFDA) through two primary application types: 510(k) and Pre-Market Application (PMA). In the European Union (EU), national authorities grant permission for the sale of medical devices, employing a third-party compliance system where notified bodies ensure quality assurance pre- and post-approval. In India, the Central Drug Standard Control Organization (CDSCO) licenses devices for sale and import under the CLAA framework.
 Conclusion
 Pharmaceutical regulatory affairs experts play a critical role in ensuring compliance with industry requirements for all pharmaceutical products. This review provides an overview of how medical devices are regulated and monitored in the EU, India, and the USA, emphasizing the importance of regulatory affairs in maintaining the safety and efficacy of healthcare products.

Societal and economic burden of migraine in Spain: results from the 2020 National Health and Wellness Survey

BackgroundThe burden of migraine goes beyond the pain and associated symptoms. We aimed to describe the impact of migraine in healthcare resource utilization (HCRU), work productivity, and mood disorders, as well as its economic cost.MethodsCase–control study nested in a cross-sectional analysis of patient-reported data collected between 30/12/2019 and 20/04/2020 as part of the National Health and Wellness Survey, from respondents located in Spain. Adults (≥ 18 years old) who reported a physician diagnosis of migraine and ≥ 1 monthly headache days (MHD) in the previous 30 days were included. HCRU, health-related quality-of-life, depression scores, work and activity impairment, and the associated direct and indirect costs were assessed for four cohorts of migraine patients, according to the frequency of headache (MHD: 1–3, 4–7, 8–14, ≥ 15) and compared to a no-migraine control, matched to migraine cases by a propensity score based on demographic and clinical variables.ResultsThe survey was completed by 595 people with active migraine, of whom 461 (77.4%) experienced < 8 MHDs and 134 (22.6%) ≥ 8 MHDs, and 1,190 non-migraine matched controls. Migraine patients presented worse mental and physical health functioning (SF-12 MCS: 41.9 vs. 44.7, p < 0.001; SF-12 PCS: 48.6 vs. 51.5, p < 0.001), worse self-reported health (EQ-5D VAS: 65.8 vs. 73.5, p < 0.001), more severe depression (PHQ-9: 8.9 vs. 6.1, p < 0.001), and higher overall work impairment (WPAI: 41.4 vs. 25.5, p < 0.001). People with migraine had higher HCRU, twice higher hospitalization rates (17.0% vs. 8.3%, p < 0.001) and 1.6 higher emergency room (ER) visit rates (51.4% vs. 31.2%, p < 0.001). Having migraine translated into higher annual costs with HCRU (€894 vs. €530) and productivity losses (€8,000 vs. €4,780) per person. Respondents with more MHDs presented worse outcomes and higher costs but suffering from 1–3 MHD also increased costs by 51.3%.ConclusionsHaving migraine not only causes a massive impact on patients’ quality of life and ability to work, but it also generates considerable economic costs for society. In Spain, having migraine was associated to 1.7 higher costs per patient. The clinical and economic burden increases with the frequency of headaches but is higher than controls even in patients suffering from 1–3 MHD.Graphical

Healthcare Public Relations – A Pilot Study in Romania

Communication is a critical component in the process of providing quality healthcare services and products. The role of public relations (PR), as a strategic, proactive, and responsible type of communication, is to establish and maintain a positive reputation and relationships with the public, based on trust and mutual understanding. Given the complex approach and process of this activity, when properly applied, PR can bring benefits to all stakeholders in the healthcare sector, contributing positively to its overall realities and outcomes. This paper presents the results of an exploratory pilot study aimed at identifying the coordinates of PR in the Romanian health sector by investigating perceptions on health public relations (HPR), its potential, challenges and opportunities, and stakeholders in healthcare. It is based on qualitative research, using interviews with a mixed group of professionals from the public and private sectors (doctors, medical service coordinators, medical professors, managers, and owners of entities that provide health services and products, and strategic communication professionals working for companies in healthcare). The results are discussed alongside relevant findings provided by previously published studies. In the final part of the article, the author proposes a PR model for entities in the medical area. It emphasizes that HPR should not only be used as a tactical tool or alternative to marketing efforts, nor only intended to manage an undesirable image or deliver damage control after an inconvenient situation or crisis. Instead, HPR services are at their true potential when a strategic approach is applied proactively, based on complex research and planning, designed to engage stakeholders and motivate them towards collaborative communication and sustained effort, based on partnership, for efficient and effective results in the health sector.

Impact of water quality on reprocessing equipment: Assessment of neurosurgical instruments cleaning and biofilm formation in hospital pipes.

The presence of contamination and microorganisms at any stage of processing renders a method unsafe, leading to a high risk of cross-transmission and cross-infection. The objective of this study was to assess the cleaning quality of aspirator instruments used in neurosurgical procedures. The experimental study was conducted at the materials and sterilization center, as well as the microbiology laboratory, of a philanthropic hospital in Brazil. A study protocol was implemented, which involved the analysis of 10 samples of Yasargil aspirators with varying dimensions. The samples were subjected to protein tests to detect the presence of organic matter and microbiological analysis. Descriptive statistics were used to analyze the data. The results indicated that 40% of the instruments tested positive for protein after manual cleaning. Furthermore, after automated cleaning, samples showed an increased microbiological load, with Escherichia coli accounting for 20% and Klebsiella aerogenes for 10% of the identified microorganisms. This study provides evidence of failures in the cleaning process of healthcare products and highlights the presence of biofilm in the pipes, thereby compromising the drinking water quality standard.