Strengthening Of Public Health Research Articles

Problems and prospects of functional nutrition in Russia: industry and social aspect

In recent years, great importance has been attached to the preservation and strengthening of public health, the role of disease prevention and the formation of a healthy lifestyle, including the formation of a culture of healthy nutrition of the population. Prolonged improper, irrational nutrition is a factor of increased risk of developing diseases: oncological diseases, alimentary risk factors of which are the presence of carcinogenic additives in food products; diseases of the cardiovascular system; obesity; disorders of the gastrointestinal tract due to the low content of dietary fiber in food; osteoporosis is a change in the composition of bones due to the loss of calcium. The analysis of the nutrition structure of the Russian population indicates significant deviations from the recommendations on rational norms of food consumption that meet modern requirements of a healthy diet. In this paper, a matrix method of developing a formula for a fermented milk product with a high protein content is considered by enriching yogurt with vegetable components: hemp flour, jerusalem artichoke syrup and agave syrup. Using the obtained recipes, samples of fermented milk products were prepared and tasting was carried out. According to the organoleptic results, the expediency of using the matrix method of computer modeling in the development of formulations of fermented milk products is confirmed. The resulting yogurts can be recommended for use by people with diabetes and those who lead a healthy lifestyle, because the protein content in the samples has been increased to 3.7% and the introduction of sugar is excluded.

Professional Public Health Practice in Spain - Insights from the Spanish Public Health White Paper

Abstract Issue/Problem The public health professionals has gained attention during the COVID-19 pandemic. However, the weakness of Spain's public health structures has been exposed during the crisis, which is partly due to the delay in modernising institutions and the low percentage of GDP dedicated specifically to theses public health institutions. In addition, there is a lack of specific training for public health practitioners to acquire the necessary multidisciplinary competences for high quality public health practice. Description of the problem The Spanish Society of Public Health and Health Administration (SESPAS) has developed a white paper of the public health profession. The main objective is to contribute to strengthening the professional practice of public health by identifying some of its problems and agreeing on possible solutions. The specific objectives were to frame public health as a profession, to describe the socio-demographic characteristics of the people affiliated to the associations federated in SESPAS, to carry out a qualitative analysis of the discourse of public health professionals on its meaning, and developing conclusions and recommendations to address public health challenges. Results The demographic and employment data of the 3,467 people belonging to seven SESPAS societies show that, overall, about 60% are women and 40% were under 50 years of age. Undergraduate degrees were Medicine (35.9 %), Nursing (17.4 %) and Pharmacy and Veterinary Medicine (10.4 %), other life science degrees (4.3 %). Key aspects of the meaning of public health, training, employability and career and institutionalisation of public health were collected through 19 interviews and 6 focus groups. Lessons In order to agree on the conclusions and recommendations, a meeting was organised with the participation of 29 members of SESPAS. A total of 25 conclusions and 24 recommendations were drawn. Key messages • White paper is a step forward in the strengthening of public health in Spain. • Public health should develop leadership and advocacy skills for people's health from a multidisciplinary and cross-sectoral practice.

Структура питания населения России: проблемы и перспективы на примере Ростовской области

In recent years, great importance has been attached to the preservation and strengthening of public health, the role of disease prevention and the formation of a healthy lifestyle, including the formation of a culture of healthy nutrition of the population. The strategy of improving the quality of food products in the Russian Federation until 2030 is focused on ensuring proper nutrition, preventing diseases, increasing the duration and improving the quality of life of the population, stimulating the development of production and circulation in the food market. The analysis of the nutrition structure of the Russian population indicates significant deviations from the recommendations on rational norms of food consumption that meet modern requirements of a healthy diet. Prolonged improper, irrational nutrition is a factor of increased risk of developing diseases: oncological diseases, alimentary risk factors of which are the presence of carcinogenic additives in food products; diseases of the cardiovascular system; obesity; disorders of the gastrointestinal tract due to the low content of dietary fiber in food; osteoporosis is a change in the composition of bones due to the loss of calcium.

Approaches to the Algorithm of Analyzing the Results of Laboratory Testing of Micro- and Macronutrient Content of Bakery Products: Part 2

Introduction: Obtaining correct data on the chemical composition of food products is required for solving different problems, including those related to human health. It is important not only to organize the process of collecting sufficient data, but also to develop an analytical algorithm that considers different periods of data collection and types of foods. Objective: To test and adjust the algorithm for obtaining statistically correct values of average concentrations and variability of the main micro- and macronutrients in bakery products. Materials and methods: In order to test and then improve the algorithm, we used the results of laboratory testing of bakery products collected within the framework of the Federal Project on Public Health Strengthening in 2020–2021 by the laboratories of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). Results: An increase in the sample size made it possible to identify new groups of bakery products. At the same time, the data of the sample combined over two years demonstrated the best convergence. The sodium content was determined as an additional clustering feature. The implementation of the algorithm on the pooled data enabled further reduction of the coefficient of variability. Conclusion: Sequential processing of laboratory test results using the developed algorithm allowed us to update information on the chemical composition of bread currently sold by retailers and determine the presence of products that are critical in terms of their sodium content. It is of interest to expand capabilities of the algorithm in terms of automating the selection of priority indicators for clustering and, as a result, the possibility of processing similar data arrays.

Algorithm for Analyzing the Results of Laboratory Testing of Micro- and Macronutrient Composition of Milk

Introduction: The assessment of actual nutrition of the population, both at the individual and population level, strongly depends on the accuracy of data on the chemical composition of food products. Milk is an important component of a diet, and a precise estimation of micro- and macronutrients consumed with it is essential for public health assessment. Objective: To develop an algorithm for obtaining statistically accurate values of average concentrations and variability of basic micro- and macronutrients in milk. Materials and methods: To elaborate and check the algorithm, we used milk fat test results collected within the Federal Project on Public Health Strengthening by the laboratories of the Federal Service for Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in the years 2020–2021. Results: Due to numerous missing and outlying values of milk composition testing, an appropriate adjustment of the algorithm was necessary. The best separating ability was demonstrated by the approach of dividing types of milk into clusters based on their fat and calcium content. The three clusters obtained included milk with a 2.5 % fat content and the average calcium concentration of 1,144 mg/L, milk with a 3.2 % fat content and the average calcium concentration of 1,180 mg/L, and milk with both fat contents and the mean calcium level of 597 mg/L. The algorithm was validated by checking the completeness of data on the fatty acid composition and a low variability of values. Conclusion: The developed algorithm has enabled us to obtain up-to-date information on the chemical composition of milk sold by food retailers in the Russian Federation. Low-calcium milk on the market is of special concern as its average consumption fails to satisfy human physiological needs. At the same time, the content of saturated fat was below 2.2 g/100 g in the cluster of milk types with the maximum fat content, thus raising no additional health concerns. Further studies should be aimed at determining the acceptable and correct stages of data preprocessing that maintain a balance between the obtained accuracy of values and their actual reproducibility.

ПРАКТИКО-ОРИЕНТИРОВАННЫЕ РЕШЕНИЯ ДЛЯ РАДИАЦИОННОЙ МЕДИЦИНЫ

Purpose: perform a retrospective review and generalization of practice-oriented scientific research of the SBR Center in the field of radiation medicine in the period 2000-2021. Material and methods: The object of research of the SBR Center is the population of the Seversk and the personnel of the Siberian Chemical Combine (SCC). The basis for scientific research of the SBR Center is the regional medical and dosimetric register of population of the Seversk and personnel of the SCC, the bank of biological material of population of the Seversk and personnel of the SCC, as well as regular participation in the organization and conduct of periodic medical examinations of SCC personnel. Results: The assessment of morbidity and mortality from malignant neoplasms of the personnel of the nuclear industry enterprise and the population of the observation zones showed no increase in their risk during chronic technogenic exposure in the range of “small” doses. Malignant neoplasms of the digestive, respiratory, urinary and reproductive systems make the greatest contribution to the structure of oncological morbidity among the personnel of the nuclear industry enterprise and the population of the observation zones. The SBR Center was the first in the world to obtain data on the significant role of ionizing radiation in combination with traditional risk factors for the development of coronary heart disease in the increased incidence of myocardial infarction among SCC personnel. The established fact is the basis for the creation of a comprehensive program for the diagnosis and prevention of diseases of the circulatory system among the personnel of the SCC, which is being effectively implemented. The modern strategy for the prevention of non-communicable socially significant diseases developed at the SBR Center among workers at nuclear facilities and the population of observation zones (on the example of the Seversk population) includes an effective system for identifying pathological conditions, their timely correction and subsequent monitoring, which is an innovative form of work on the organization of health care and the strengthening of public health in order to increase life expectancy and ensure professional longevity. Conclusion: SBR Center performs fundamental and applied research in topical areas of radiobiology, radiation medicine, epidemiology, radiation safety and public health organization. Over the years, a significant scientific reserve has been created, a unique team has been formed, the material and technical base has been developed, and significant results have been achieved, recognized by the domestic and international scientific community.

Approaches to the Algorithm of Analyzing the Results of Laboratory Testing of Micro- and Macronutrient Content of Bakery Products: Part 1

Introduction: Data on the chemical composition of food products are important for solving many problems in medical and social spheres. The development of mechanisms for updating existing databases of the chemical composition of foodstuffs, including the need to change approaches to obtaining primary data and develop algorithms of their processing, is in demand. Objective: To develop an algorithm of obtaining statistically correct values of average concentrations and variability of the main micro– and macronutrients in bakery products. Materials and methods: To develop and test the algorithm, we used the results of testing bakery products obtained in 2020 within the Federal Project on Public Health Strengthening by the laboratories of the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). Results: A good separating power was demonstrated by k-means clustering into two groups by the fat content. An algorithm for generalization of data obtained from different laboratories is proposed due to impossibility to assess the whole aggregate of potential errors related to testing, laboratory personnel, data entry, etc. To assess the effectiveness of each stage and the algorithm as a whole, we used the value of the deviation of the resulting variability from the initial one. As a result of processing, this indicator ranged from 5 % for the carbohydrate content to 72 % for the fat content. For the contents of carbohydrates, ash, dietary fiber, vitamin B1, sodium and moisture in both clusters, statistically significant differences were obtained between the processed and original data. This result and the comparability of the obtained values of the mean and variability with the reference ones may indicate the correctness of the algorithm. There were no statistically significant differences between the obtained values of fat and protein content, but the consistency of the order of values with the reference ones was also recorded. Conclusion: The developed algorithm made it possible to obtain up-to-date information about the chemical composition of bakery products. Further research should be aimed at testing and, if necessary, adjusting the algorithm for all major food groups.

Social health as a category of sociology

The growing nature of global challenges actualizes the study of a range of issues related to the preservation and strengthening of public health as the main resource for competitiveness and national security. Various historical stages in the development of world civilization were characterized by the presence of a specific set of factors that actualize the theoretical understanding and empirical knowledge of certain elements of public health, which led to the realization of the complexity and multidimensionality of this category. The modern stage is characterized by conditions that bring to the fore the study of issues related to mental, spiritual, moral, social health, while the latter today seems to be the most in need of scientific reflection. The subject of this article is social health as one of the many elements of the structure of public health. The article is predominantly theoretical; its goal is to contribute to the discussion about the essence of the category “social health” and, accordingly, about the most effective approaches to its empirical measurement. An attempt was made to theoretically substantiate the relevance of scientific and practical understanding of the category of “social health” in the discourse of sociological concepts (anomia, “trauma” etc.), which significantly increases the practical significance of its study in terms of preventing negative trends not only in the field of protecting and strengthening public health but also in broader aspects of social development. Based on the results of the study, the author’s definition of social health is formulated, the dominant role of the sociological component in the interpretation and study of this phenomenon is substantiated. Attention is drawn to the importance of the operationalization of the concept of “social health”; on the practical significance of its empirical dimension, which is due to the specific nature of the processes of socio-cultural transformation of the Russian and global community as a whole, and, as a result, the need to search for new complex indicators and indicators that can represent their dynamics and current state representatively.

Shaping and its importance in the system of physical education of students of higher education institutions

The article analyzes the importance of shaping in the system of physical education of female students of higher education institutions. It is revealed that at present, there are not enough scientific developments, material base, not enough special computer programs with the method of assessment and correction of the figure. The solution to these problems is facilitated by shaping classes, which help to improve the physical perfection of female students. It is determined that shaping is one of the types of health gymnastics. The main feature of the method of shaping is that it is the most effective way to rebuild the human body through exercise, as well as improving the overall physical fitness of students in higher education. Preservation and strengthening of public health in the current state of society with its inherent socio-economic characteristics and significant demand for values is interdisciplinary and is the subject of medical, biological, pedagogical, psychological, social and a number of other basic sciences.
 The solution to these problems is facilitated by shaping classes, which help to improve the physical perfection of female students. Today, shaping belongs to health systems that use gymnastic exercises and adhere to the principle of their strict regulation. Harmonious physique is one of the main signs of human health, because it is known that the shortcomings of the physique complicate the work of internal organs. The method of shaping is largely determined by the direction of the program, an individual approach to each person depending on age, body type, their functional and physical condition. Individualization should be aimed at correcting the physique in eliminating inconsistencies with the model level within a genetically determined somatotype.

PRESERVATION AND STRENGTHENING THE HEALTH OF THE POPULATION THROUGH THE PRISM OF SUSTAINABLE DEVELOPMENT

The article reveals the essence of the category of "population health", the methodology and methods of its cognition, the main methods and techniques of the empirical and theoretical levels of research, the technology of their practical use in ensuring sustainable socio-economic development of the country. The main attention is paid to the analysis and assessment of the health status of the population – the main productive force of society, on the basis of which it is concluded that in Ukraine there is a deterioration in the corresponding characteristics. It is noted that this is primarily influenced by insufficient financial and resource support of the medical industry as a whole. Other factors that negatively affect the health of the Ukrainian population are also indicated. An important role in overcoming these negative phenomena is played by the modernization of the medical industry, the rational use of its resource potential, the formation of a civilized market of medical services. In this regard, it is emphasized that the activities of the health care system of Ukraine should be based on unified national principles, including the formation of economically viable systems for organizing medical care, taking into account the real needs of the population, the possibilities of meeting them, as well as the most appropriate allocation of resources and their effective use. The peculiarities of the current situation with the spread of coronavirus, which led to the exacerbation of existing problems, which require the search for new approaches to their solution, related to the adoption of fundamental decisions, especially at the state level are taken into account. In addition, the article provides an assessment of the main results of the ongoing reforms in the health care system of Ukraine. In the course of the study, considerable attention is paid to structural and typological features, as well as the conditions for the formation and strengthening of public health - an important factor in increasing labor productivity, developing the economy based on the principles of sustainable development. The economic, innovative and technological aspects of the development of the health care system are summarized. New approaches to further strengthening and preserving the health of the population in the context of implementing the tasks of sustainable development are substantiated.

On the issue of forming a culture of healthy lifestyle of students as an integral part of the processes of education and training

In pedagogical theory and practice, the problem of the formation of health and a healthy lifestyle (HLS) of students occupies one of the priorities, since the preservation and strengthening of public health is one of the main strategic objectives of the country's development, regulated by federal regulatory documents. The article is devoted to the formation of a healthy lifestyle culture of students as one of the priority tasks of the educational and educational activities of a medical university. The authors conducted studies to assess the commitment of students of the 2-3 courses of the medical Institute to a healthy lifestyle according to a validated methodology, within the framework of the federal priority project "Formation of a healthy lifestyle". The results of the students' self-assessment of health showed that the largest number of students surveyed assess their individual health as good (55.8% of students). At the same time, the monitoring of adherence to healthy lifestyle revealed that the proportion of students smoking and drinking alcohol was 15.8% and 21.9%. accordingly, physical activity does not meet the recommended standards in 59.6% of students. In the course of the research, the index of adherence to healthy lifestyle among students was determined primarily due to poor-quality, unbalanced nutrition, eating habits, as well as the low financial situation of a significant part of students. The assessment of the index of adherence to healthy lifestyle among students of medical educational organizations showed extremely low values. Thus, only 2.6% of students have a high index index and only 39% are satisfactory, in the sexual difference, girls have slightly better indications compared to boys. Thus, the results indicate a low culture of students' health, which determines the importance of improving the effectiveness of teaching the basics of healthy lifestyle in the framework of educational programs, the introduction of new methods and forms of training into the educational and educational process aimed at forming the competence of future doctors in the field of healthy lifestyle.

Cases of social innovations implemented in the public health sector

Subject. The article discusses medical and demographic processes in Russia and Finland. Objectives. I evaluate cases of social innovations implemented for the preservation and strengthening of public health in Finland under the auspices of The Global Burden of Disease Study. Methods. Methodologically, the study relies upon the ideology of the GDB Project, which rests on the DALY (the Disability Adjusted Life Year). Results. I analyzed the morbidity and mortality rates, DALY in Russia and Finland, determined what mainly triggers the risk (environmental, behavioral, metabolic) fueling some public health degradation. The article provides the insight into the efficiency of some social innovations implemented in Finland and suggests what should be done to outline medical and demographic programs in Russia. Conclusions and Relevance. The medical and demographic situation in Russia requires new tools to find innovative solutions for the social policy and, inter alia, the use of the GBD technique, which proved to be effective. Referring to evidence from Finland, demographic challenges in Russian can be handled through a systems approach, i.e. socio-economic actions, improvement of the healthcare and social security, wellness propaganda.

The effects of the addition of starter cultures and stevioside on technological low-fat fermented sherbet ice-cream without sugar.

The maintenance and strengthening of public health and the prevention of diseases associated with the malnutrition of children and adults is an urgent and acute problem facing the population of the whole world. Diabetes type 2 has become a serious problem for modern medicine. This disease is widespread throughout the world among children and adolescents. There are substantial grounds to believe that this global incidence is related to obesity and physical inactivity. There is a diverse assortment of ice-creams and frozen desserts available all around the world. Even with the development of the ice-cream industry, frozen desserts for people suffering from diabetes type I and II have not been sufficiently developed. Therefore, this study aims to select low-calorie components for use in the manufacture of sherbet ice-cream without sucrose in their composition, with a low glycemic index and with a high content of protein and vitamins. Tо develop the technology and formulation of the product, a combination of appropriate starter cultures and their ratios were determined. The most suitable fruit mix with a low glycemic index was chosen to maintain the product with properties desirable to consumers. Combined starter cultures, consisting of CHN-22 and St-Body 1 at a ratio of 7:3 were selected experimentally. The best thixotropic properties were shown by the test samples with a titratable acidity of 60–65°Т at a fermentation temperature of 33 ±1°C. The fruit mixture for the sherbet ice-cream was made from fruits and berries recommended for people with diabetes, including cherries, blueberries and lingonberries at a ratio of 3:4:3, respectively. The part of the mixture that was inserted into the sherbet ice-cream was evaluated as 25% of the weight of the final mixture. Stevioside and syrup of Jerusalem artichoke were selected at amounts of 0.05% and 7.5% by weight of the mixture respectively. The resulting sherbet was not inferior in sweetness to the control sample with 21% sucrose. The shelf life of the low-fat fermented sherbet ice-cream without sugar was obtained according to the results of research on organoleptic, physicochemical and microbiological properties and was substantiated as 3 months at 18°С. The presented production procedure enables the manufacture of a low-fat, sugar-free product with preventive and therapeutic properties for people who suffer from diabetes and obesity. Studies were conducted on the influence of the introduced starter cultures and sweeteners on the organoleptic, physicochemical and rheological parameters of the developed low-fat frozen sherbet. Starter cultures and doses of stevioside which had a favorable effect on the indicators of the finished product were selected.

THE VALUE OF FOOD BEHAVIOR OF THE MILITARY FOR IMPROVEMENT OF THE FOOD SERVICE SYSTEM IN THE ARMED FORCES AND THE NAVY OF THE RUSSIAN FEDERATION

Eating behavior is a selection of definite food subconsciously aimed at meeting physiological needs from main nutrients and energy. Genetic aspects of human metabolism as well as various environmental factors including social-psychological factors have a significant impact on the appearance and a further retention of definite food excesses of each person. Healthy lifestyle promotion (including compliance with nutrition prescription, preference to balanced daily rations cor responding with the level of daily energy needs) helps to form human eating behavior based on nutrition laws that promotes preservation and strengthening of public health (the military personnel). Formation of proper eating behavior may become an important preventive measure for preservation and strengthening of the health of the military personnel of the Armed Forces of the Russian Federation and the Navy of the Russian Federation. Increasing of daily energy needs due to introduction of new model of physical fitness in the Armed Forces of the Russian Federation exerts a considerable impact on an eating behavior in the military personnel. Correction of an eating behavior in the military draft servicemen in the Armed Forces of the Russian Federation as well as observance of the principles of healthy nutrition may be conducted by means of outreach interviews with specified cohort. Possible changes in eating behavior may be monitored using special tests and questionnaires allowing to execute its overall assessment. Dynamic assessment of eating behavior may take rightful place in the system of scientific study of lifestyle of the military and also be in active use on further improvement of food service system of the Armed Forces of the RF and the Navy of the RF. Significance of assessment of eating behavior in the military will not be irrelevant in the near future but, to the contrary, will gradually increase in connection with advances in science, promotion of food fit to personal genetic aspects and improvement of food service system of the Army Forces of the RF.

SANATION OF PATIENTS MOUTH IN DENTAL ORGANIZATIONS OF PRIVATE HEALTH CARE SYSTEM

Oral sanitation - a set of measures aimed at curing diseases of the organs and tissues of the mouth, including the treatment of dental caries, its complications, non-carious lesions and professional hygiene or preparation of the mouth for further orthodontic and orthopedic treatment. Sanation of the mouth can be considered as an indicator of the quality of medical care, as it is a planned result of the treatment of the whole body. However, this indicator is not subject to accounting and analysis in private medical organizations, as a result of which statistical data on the true situation of dental disease and the effectiveness of treatment are unreliable. We conducted a study on the activities of four private dental organizations to achieve the effectiveness of treatment of patients. Evaluation of the scope and cost of work performed, complete rehabilitation of the mouth, carried out the certificate of completion. The collection of data on the structure of dental morbidity by turnover was studied by the medical records of the dental patient. The reason for the refusal to continue treatment before the rehabilitation of the mouth was studied by interviewing (telephone survey) of patients carried out by employees of private dental organizations (medical registrars). The activities of medical organizations, regardless of ownership, should include an in-depth analysis of statistical information, which is part of the management process in health care, ensuring the strengthening of public health and the effectiveness of the health system. Statistics reveal problems, priorities and challenges for the rational use of human, financial and logistical resources. In this regard, all offices of the organization must provide statistical data on their activities to the appropriate authorities and a range of socio-economic measures aimed at the final result of the dental Wellness of the population, strengthen the health and well-being of the person through the reorganization of the mouth.

Methodological perspectives of public health research. A brief look

Research allows for the strengthening of disciplines, particularly those that draw on information from various specialties, such as public health. The objective of this report is to provide consolidated methodological perspectives to enrich public health as a science. The review highlights three key elements: the type of investigative approach, the evidence and competence approaches in the methodological context of the inquiry into collective health. It is concluded that the systematic, specific knowledge, integrated to the context and obtained in attention to the circumstances of the investigation, the object of study and the institutional location, contribute with the strengthening of public health as a multidisciplinary science, directly involved, for its competence and based on the evidence, in the decision making in matters of health by the State in areas as important as needs, services and health systems.

Special Issue on Pacific Health

The World Health Organization (WHO) has defined a healthy island as an island that is committed to, and involved in, a process of achieving a better health and quality of life for its people and healthier physical and social environments in the context of sustainable environment. The main challenges facing island health include the increasing burden of noncommunicable diseases as well as the continuing, and sometimes reemerging, burden of communicable diseases. Human resources for heath in remote areas are always a problem, but it is even more difficult to develop and retain health workers on islands. Some remote island villages, be it in the Pacific region or elsewhere, have only the bare necessities for survival; no electricity, no proper toilets or clean drinking water. In India, for example, the Indian government brings electric power, education, and health services to rural villages. Together with UNICEF, the Indian government is attempting to bring basic health care to isolated island villages, such as those situated along the Brahmaputra River or in the Andaman archipelagoes. But the challenge of small populations, remoteness and an island environment make this difficult. Indonesia and the Philippines have the largest number of islands, countless thousands of them, and providing public health services in these remote island villages is difficult and challenging because of geography, culture, economics, and politics. In the Pacific islands, the “healthy island” concept provides a theoretical underpinning for efforts in health promotion and health protection in island countries. WHO began its healthy island initiatives in 1995. Healthy island initiatives are linked to community commitment and take various forms in several Pacific islands countries. Some initiatives focus on control of specific diseases or health problems, for example, malaria control in the Solomon Islands, environmental health and health promotion initiatives in Fiji, or on water supply and sanitation in Tonga. All these pose a challenge to the coordination of health programs and interventions and the strengthening of public health in these island countries. Binns et al, 1 in their article, discussed the issues and challenges of island health and its impact on public health and illustrated the scope of the problem of island health and how health services in islands required an integrated approach to public health and clinical services. The roles of schools of public health are highlighted in promoting healthy islands. There is a need to develop competency in knowledge and skills and in inculcating a right and positive attitude for island health with the hope of delivering island health leadership in health care. Furthermore, there is a need for intersectoral collaborations, and cooperation is a matter of necessity among Pacific island nations. 2

High HIV knowledge relates to low stigma in pharmacists and university health science students in Guyana, South America

The objective of this study was to investigate HIV knowledge and its relation to HIV stigma among health science students and pharmacists in Guyana, South America. This study also evaluated how the Public Health Strengthening in Guyana Project's (PHSGP) HIV/AIDS/STI educational initiatives influenced HIV knowledge levels among health science students at the University of Guyana. A total of 119 individuals, consisting of pharmacists (n=42) and health science students (n=77) participated in this cross-sectional study. All participants completed validated measures of HIV knowledge and HIV stigma. Overall, health science students scored high on knowledge about HIV risk factors and modes of HIV infection, but were less knowledgeable about more complex HIV treatment issues such as adherence and drug resistance. Students who had received educational HIV training had significantly higher levels of HIV knowledge than those who had not received training. Pharmacists had excellent knowledge regarding HIV risk factors and modes of infection, but had some important gaps in knowledge regarding the importance of HIV medication adherence and drug resistance. Overall, low levels of HIV stigma were endorsed, and those with higher HIV knowledge reported lower HIV stigma. Although the HIV curriculum has enhanced HIV knowledge, gaps in HIV knowledge remain, such as complex HIV treatment issues. The results of this study are discussed within the context of the challenges of HIV capacity building in resource-poor countries.

Patents, Price Regulation and Innovation in the Pharmaceutical Industry

The trade-off between property rights/price regulation and innovation depends on country characteristics and drug industry specificities. Access to drugs and innovation can be reconciled by seven ways that, among others, include: public health strengthening in the countries with the largest access problems (those among the poor with the weakest institutions); public and private aid to make attractive RD price discrimination with market segmentation; to require patent owners to choose either protection in the rich countries or protection in the poor countries (but not both). Regarding price regulation, after a review of theoretical arguments and empirical evidence, seven strategies to reconcile health and industrial considerations are outlined, including: mitigation of the medical profession dependence on the pharmaceutical industry; consideration of a drug as an input of a production process; split drug authorization from public funding decisions; establish an efficiency minimum for all health production inputs; and stop the European R&D hemorrhagia.

Reforming the reform: the greek national health system in transition

The National Health System (ESY) in Greece, which was established in 1983, is in a state of continuous crisis. This situation is caused mainly by the system's problematic administration, low productivity and inadequate Primary Health Care. These have led the re-elected PASOK government to introduce by the end of 2000 a radical reform of the health system. The 200 reform measures announced by the new Minister of Health and Welfare include changes aiming at: the decentralization of the ESY, the creation of a unified financing system for the social insurance funds, a new management structure in public hospitals, the organization of a Primary Health System in urban areas, and the strengthening of Public Health and Health Promotion. These changes are presented and discussed in this paper.