Health Sphere Research Articles

Strategy Selection of Healthcare Sector Development and Risk Management of its Implementation

Introduction. The topic of this study is the necessity to implement all stages of strategic planning for health sphere development, such as analysis of the internal and external environment, selection of a specific strategy for further development, and identification and management of risks associated with the implementation of the chosen strategy.
 Aim and tasks. The purpose of the study is to justify a comprehensive strategy for health sphere development based on the results of SWOT analysis, the characteristics of its main components, the identification of fundamental and specific risks of its implementation, and the development of their minimization directions.
 Results. The study offers an application of recovery, restructuring, and reengineering strategies based on a SWOT analysis of the health sector in Ukraine. It offers cost management and risk management strategies as additional strategies. This study analyzes the fundamental and specific risks of health sector strategic development based on expert assessments. It determines that socio-political (weighted score of 7.28 points), personnel (7.94 points), and production and financial risks (7.67 points) pose the greatest threat in 2023. In addition, social and political risks tend to increase during the next two years to 7.67 points, personnel risks to 8.12 points, and production and financial risks could decrease to 6.39 points.
 Conclusions. The strategy of functioning of socio-economic system could be chosen under both favorable and unfavorable external and internal conditions; the implementation of the recovery strategy is appropriate for solving the problem of unsatisfactory regulatory and legal support for functioning of industry; restructuring strategy envisages the implementation of organizational, economic, technological and social transformations aimed at improving quality of medical services and managing the assets of medical institutions; the implementation of reengineering strategy creates the necessary prerequisites for a fundamental rethinking of essence, tasks, techniques and methods of marketing activity of medical institutions in general, as well as the development of effective solutions for the formation and implementation of their assortment, communication and service policy in particular.

APPLICATION OF SIMULATION TECHNOLOGIES AND CASE-METHOD IN PROFESSIONAL TRAINING OF FUTURE DENTISTS

Implementation of innovative learning and teaching methods based on modern pedagogical technologies is essential for further eff ective development of higher stomatological education. At the current stage of development of the public health sphere, more and more attention is paid to patient safety, ethical issues, increasing responsibility of medical staff , high level of professional qualifi cation and rapid evolution of procedures and methods. The above requires adaptation of educational programs and the use of all the educational instruments and technologies available in professional training of future dentists. Objective of the study was to conduct a theoretical analysis of scientifi c psychological- pedagogical, methodological and medical publications, educational- methodological activity of the Department concerning application of pedagogical technologies in the process of professional training of future dentists. Material and methods. Psychological-p edagogical, methodological literature, materials of scientifi c-p ractical conferences, and educational- methodological activity of the Department were analyzed. To achieve the goal, specify the essence and peculiarities of application of modern pedagogical technologies in the educational process the following theoretical methods were used: analysis, synthesis, substantiation, comparison, systematization, pedagogical modeling, and theoretical prognosis. Conclusions. Application of simulation educational technologies and case-method in training of future dentists promotes formation of abilities and practical skills, professional competence, personal development, ability to possess optimal behavior and diff er in the eff ectiveness of actions in various clinical situations. Simulation training allows you repeatedly and accurately reproduce important scenarios and algorithms of actions, and provides the opportunity to adapt the educational situation for every student. Application of modern pedagogical technologies in learning and teaching the academic discipline «Surgical Dentistry» provides controlling, teaching and educational functions. Controlling function includes assessment of student knowledge and skills, teaching function requires certain level of knowledge achieved, and educational function provides formation of essential individual qualities by learners. Eff ective organization of independent and classroom activities of students by the teacher promotes development of clinical thinking, which is an integral basis for the formation of qualifi ed and successful doctors.

Tuberculosis of the Skin: Modern Clinical and Epidemiological Features and the Necessity of a Multidisciplinary Approach for Timely Diagnosis and Comprehensive Therapy (Review)

The seriousness of the global significance of tuberculosis, an infection that is both old and new, was discussed extensively at the UN General Assembly meeting in New York in the summer of 2023. This seemingly purely medical issue received widespread attention for the public's understanding of the corresponding «Political Declarations on Tuberculosis» and the agreement on key issues related to combating tuberculosis. It was emphasized that the sphere of public health encompasses the unequivocal preservation of human health as the primary objective in the social development of any specific state. This clearly includes measures aimed at preventing the occurrence of tuberculosis and other infectious diseases.Objective — to conduct an analysis of professional publications of recent years regarding the modern clinical and epidemiological features of the clinical course of skin tuberculosis and to determine organizational measures to ensure the sanitary and epidemiological well-being of the public health of the population of Ukraine in wartime conditions and the conduct of active hostilities. And also to remind doctors of various specialties about the significant diversity of modern clinical manifestations of various forms of skin tuberculosis. Materials and methods. Official documents and scientific publications related to public health policy, approaches to overcoming the tuberculosis epidemic, incidence dynamics and forms of skin tuberculosis in Ukraine were analyzed. Results and discussion. The content of the analyzed professional publications indisputably proves that the problem of tuberculosis has gone far beyond the scope of the purely medical field and has acquired the status of national significance. A modern approach to improving the state of public health requires the constant coordination of the efforts of different people, who at the same time have a wide range of professional skills in many different disciplines, as well as the ability to work fruitfully with others in joint multiprofessional teams to achieve a common goal — to overcome the tuberculosis epidemic. Conclusions. Analysis of scientific publications of recent years on the problem of skin tuberculosis indicates an urgent need to consider this disease in the state Public Health system as a general infectious disease of the whole organism, in which pulmonary and formally extrapulmonary (skin) lesions are pathogenetically linked in a single chain of pathological changes. This requires an interdisciplinary ap­proach and systematic methodological cooperation of phthisis doctors, dermatovenerologists and family doctors in the aspect of timely diagnosis and complex therapy of this infection.

144 Personality’s association with the concordance of subjective and objective cholesterol measures: findings from the Irish longitudinal study on ageing (TILDA)

Abstract Background With Cardiovascular Disease (CVD) as a leading cause of death in older adults, examining risk factors for CVD is crucial. High cholesterol, often addressable by lifestyle changes and medication, is a main contributor to CVD. Despite a large portion of Ireland’s (and the world’s) population having high cholesterol, this chronic illness goes undiagnosed or untreated. Personality’s demonstrated associations with overall health, self-reported health, and health behaviours makes it a key facet to examine alongside cholesterol. Methods Through secondary analysis of data from Waves 1 and 3 of TILDA, this research explores the intricate relationships between personality, subjective (self-reported cholesterol), and objective (bloods-measured) cholesterol. The 5 domains of personality were first cross-sectionally and longitudinally examined in relation to each manner of cholesterol measure. Overall concordance between subjective and objective results was examined. Finally, personality’s association with levels of concordance was analysed. These analyses were conducted using bivariate analyses and multinomial logistic regression. Results Various personality traits were univariately associated with cholesterol, with associations varying by cholesterol measure. Neuroticism was higher in participants with high subjective cholesterol, and extraversion, openness, agreeableness, and conscientiousness were higher in those with high objective cholesterol. Overall agreement between objective and subjective high cholesterol was low and only partially explained by personality traits. While substantial percentage of participants improved their bloods-measured cholesterol over time, openness was the only trait that predicted any change in cholesterol status. Conclusion These findings demonstrate univariate effects of personality traits on cholesterol levels. There is also evidence of discordance between subjective and objective cholesterol levels, suggesting a vast amount of the population goes undiagnosed and untreated for high cholesterol. This study’s unique findings have crucial implications for the public health sphere, demonstrating the importance of diversifying healthcare approaches and laying the groundwork for exploring personality’s associations with other cardiometabolic risk factors.

MĀORI EXPERT VIEWS OF ANTIMICROBIAL RESISTANCE USING A ONE HEALTH APPROACH: A QUALITATIVE STUDY

Māori experience disproportionately worse outcomes from infectious diseases compared to non-Māori, and antimicrobial resistance (AMR) contributes to these inequities. The aim of the study reported in this article was to gain insight into Māori experts’ perspectives on AMR using a One Health approach, which incorporates understandings of human, animal and environmental health. Qualitative methods were applied and were guided by principles of Kaupapa Māori research. Four themes were identified: (1) the importance of AMR education for Māori, (2) the connection of mātauranga Māori and AMR, (3) colonisation and its negative impacts on hauora Māori and (4) collaboration across spheres of health as a priority for Māori. Overall, the findings show a need for greater recognition of an approach to AMR that is grounded in te ao Māori. This focus should be a priority for government agencies and healthcare providers across Aotearoa New Zealand in order to work towards health equity for Māori in tackling AMR.

Child self-care autonomy in health (scale for parents): development, internal structure, and sex/age correlates.

Autonomy in self-care practices in the health sphere is a critical characteristic for the survival of humans throughout the life span. Notably, however, the current literature lacks psychometrically sound instruments that measure this phenomenon among children without diagnosed chronic health conditions. The purpose of the present exploratory study was to develop, test, and provide data regarding the reliability and validity of the Child Self-Care Autonomy in Health (CSAH) scale. The piloted version of the CSAH yielded an 11-item instrument designed to reflect the parent's perspective in measuring the extent of autonomy in self-care actions related to health for a child, whether diagnosed with a chronic illness or not. Data were collected through an online survey of a non-random sample of Russian-speaking parents currently residing in Russia (N = 349). The analysis focused on scale structure via principal component analysis and age/sex associations. The proposed CSAH may be of interest to social workers, health professionals, and parents seeking to ascertain schoolers' autonomy in self-care practices in the health sphere and support building a stronger self-care mindset.

Perceived Educational Needs of Substance Use Peer Support Specialists: A Qualitative Study.

The opioid crisis is an ever-growing issue nationwide. The role of peer support specialists has received widespread acceptance in the substance use and behavioral health spheres. However, there is a lack of standardization on the training required for peer support specialists to function as competent members of integrated behavioral health teams. We conducted qualitative focus groups with 14 practicing certified peer support specialists to determine their perceived educational needs. Inductive thematic analysis was used to analyze the data and six themes emerged: mental health and suicide prevention training, diversity, equity, and inclusion training, counseling skills training, family systems approach to care training, professionalism training, and taking care of self - mind, soul, and body training. To improve peer support specialists' confidence in their ability to competently perform their jobs, important topics need to be incorporated into their educational training and preparation.

ЭТАПЫ РЕАБИЛИТАЦИИ ЖЕНЩИН ПОСЛЕ РАННИХ РЕПРОДУКТИВНЫХ ПОТЕРЬ

Introduction. For all early reproductive losses, the need for restorative treatment is common. Aim. The purpose of the study is to analyze the experience of the gynecological hospital in Ryazan on a 3-stage comprehensive rehabilitation of women with early reproductive losses. Material and Methods. The development of this algorithm was carried out on the basis of an analysis of the results of research and the experience of leading research centers. A sociological survey was carried out among 128 obstetrician-gynecologists working in the gynecological department of the hospital and antenatal clinics in Ryazan. Results and discussion. The results of a sociological survey among obstetricians-gynecologists confirmed the importance of rehabilitation measures after early reproductive loss, as well as assessing the health status of women, including in terms of psycho-emotional status. At the same time, 44.8 % of respondents believed that the rehabilitation of women after early pregnancy loss should be carried out in a day hospital, 23.9% in a round-the-clock hospital, 21.6% - on an outpatient basis, 9.7% of the surveyed doctors found it difficult to answer. A description is given of the content of each of the three stages (stationary, restorative and supportive) of the developed and tested scheme of complex rehabilitation. Based on the results of the third stage, the doctor gives a comprehensive assessment of the woman’s reproductive health after the loss of pregnancy, together with the patient determines her further reproductive plan: either prescribe reliable contraception or prenatal preparation. Conclusion. Implementation The three-stage rehabilitation scheme makes it possible to provide full-scale specialized medical care for the restoration of reproductive health and psycho-emotional sphere to women with early reproductive loss, as well as to form their further reproductive plans.

The impact of aggressive behavior of patients on staff employed in psychiatric wards

Introduction: Aggression and violence in the workplace are phenomena that occur more and more often, especially towards the staff working in Psychiatric Wards. The effects of these behaviors may be disturbances in the sphere of professional, social and mental health of employees.Aim of the study: The aim of the study was to analyze the phenomenon of patient aggression, to determine the frequency of patients' aggressive behavior and to assess their impact on the staff.Material and methods: The study was conducted among the staff working in the Bielsko Psychiatry Centre. The study used the diagnostic survey method, the research tool that was used in the work was a self-questionnaire.Results: Aggression of patients was experienced by 100% of the respondents. The most common manifestations of verbal aggression are vulgar words and shouting, and physical hitting and jerking. Physicians have less contact with physical aggression than other personnel. Despite this, most staff do not intend to change their place of employment and try to solve and prevent dangerous situations and minimize aggression on the part of patients with their professional approach to the patient. After attacks of aggression, the staff most often turns to a colleague for help and does not use the help of a psychologist.Conclusions: The analysis of the obtained data showed that aggression on the part of patients is a frequent phenomenon in the work of psychiatric ward staff.

Этно-культуральные факторы востребованности альтернативных практик в сфере физического и психического здоровья

<p style="text-align: justify;"><strong>Objective. </strong>Study aims to investigate the ethno-cultural factors of demand for alternative practices in the sphere of health and psychological well-being among Russian youth. <br><strong>Background. </strong>The decision to seek help is critical to the health and psychological well-being of the individual and society. Turning to non-conventional practices (psychic, paranormal, etc.) to solve problems in the field of both physical and mental health and psychological well-being can be associated with potential risks. <br><strong>Study design. </strong>Quantitative cross-sectional study of adolescents and youth in several Russian regions: Saint-Petersburg and Leningradskaya region, Irkutsk, Murmansk and Tomsk regions, Kamchatka and Krasnoyarsk regions, the Republic of Sakha (Yakutia). Data collection was carried out in the form of an online survey in November-December 2020. <br><strong>Participants. </strong>The study sample consisted of 1258 adolescents and young people aged 14 years and older, of which 671 are adolescents and young people who identify themselves as indigenous peoples of the North, Siberia and the Far East of the Russian Federation. Young men constituted 33% of the sample, mean age – 22,1 years (<em>min =</em> 14, <em>max =</em> 35; <em>SD =</em> 6,26). <br><strong>Measurements. </strong>The several scales for assessing the help-seeking and related attitudes towards alternative practices, self-assessment of mental health (HBSC scale). Descriptive statistics, contingency tables to assess differences by ethnicity and gender and a logistic regression model predicting intention to future use of the services were calculated. <br><strong>Results. </strong>Young people's appeal to providers of alternative practices of help (magicians, fortune-tellers, psychics, etc.) has no ethno-cultural specifics. The youth of the indigenous peoples of the North, Siberia and the Far East significantly more often than the youth of another ethnicity turn only to shamans, who are part of the unique spiritual culture of these ethnic groups but not to any other group of practitioners. <br><strong>Conclusions. </strong>Asking for help from different representatives of alternative assistance is interconnected, which may be the result of "teenager experimentation" in different areas of life, or openness to new experience, including in relation to the search for different types of help. The second important factor of use of alternative services is the distrust of official medicine, which motivates people to use alternative types of health care (turning to shamans, fortune tellers, magicians, sorcerers, etc.).</p>

Aproximação à intimidade masculina no âmbito da saúde sexual: uma reflexão sobre práticas metodológicas no processo de investigação

Abstract When opting to use non-standardized data collection procedures, the critical analysis of research methods considering the particularities of the object of study is essential to ensure a rigorous and productive research process. This article presents some reflections about methodological options and practices that can be used to approach male intimacy, considering men’s experiences with sexual health articulated with social representations and health care utilization. Drawing on the contributions of several authors, we focus on qualitative investigation, the use of interviews for data collection and the selection of and access to participants. Concerning interviews, we highlight the possibilities and challenges of investigator-participant interaction and issues related to the specificities of interviewees and the investigator’s identity.

Mental Health among Italian Children and Adolescents during and after the SARS-CoV-2 Pandemic: A Professionals' Focus Group Study.

The SARS-CoV-2 pandemic had a negative impact on the mental health of children and adolescents. Eight focus groups and six individual hearings were conducted to gain insights from the perspectives of 97 Italian professionals from a variety of disciplines, including child and adolescent neuropsychiatrists, pediatricians, general practitioners, social workers, psychologists, teachers, school deans, non-governmental organizations, and a researcher. Urban and rural settings were represented. The present research has been promoted by the Italian Independent Authority for Children and Adolescents (Autorità Garante per l'Infanzia e l'Adolescenza, AGIA) in collaboration with the National Institute of Health (Istituto Superiore di Sanità, ISS) and the Ministry of Education and its scientific value has been supervised by a Scientific Committee. The results of the focus groups' discussions revealed increased vulnerability, with the onset of new mental health disorders in healthy individuals and those in a condition of disadvantage, migratory contexts, and with disabilities. The already critical pre-pandemic structural and operational issues of existing services have been exacerbated. In healthcare, the activation of telemedicine has been a great asset but at the same time has generated challenges and critical issues that are still unresolved. Professionals emphasized the need to pay special attention to planning integrated responses aimed at overcoming inequalities and fragmentation. The result of this initiative translates into a set of operational recommendations useful for guiding investments and policies directed toward the protection of the mental health of minors in the health, educational, and social spheres from the outset.

Animal disease and its impact on the ecological environment and public health

For centuries, people have recognized the importance and engaged in ensuring interaction between the spheres of health, animal husbandry and environmental protection. About 20 years ago, the concept of "Unified Health" appeared, suggesting a holistic and intersectoral approach to the development and implementation of programs to ensure human health, as well as programs that affect animal health and the environment. The relevance of the study of animal diseases and the impact on the ecological environment and the health of the population is beyond doubt. Moreover, the problems of epidemics in protected areas with wild animals, which also cause serious impacts not only on the environment (pastures, lands, aquatic environment), but also the population can suffer – a risk to human health. The main environmental threats to human health in relatively prosperous countries are polluted air, noise and exposure to toxic substances. Despite the fact that it is extremely difficult to prove a direct relationship between the disease and environmental pollution, such cases can be found in every country. Many of the factors that determine the development of diseases can be reduced or prevented through government regulation and information campaigns among the population. Numerous studies have also shown that the loss of biodiversity increases the risk of infectious diseases among animals, as well as the risk of their transmission to humans. While broad biodiversity reduces the transmission rate of pathogens and, consequently, the risk of diseases for humans, wild animals, livestock and plants.

#6373 EFFECT ON BLOOD PRESSURE AND CARDIOVASCULAR RISK FACTORS IN PEDIATRIC PATIENTS DURING COVID-19 PANDEMIC CONFINEMENT (COBECOR STUDY)

Abstract Background and Aims Patients monitored in the cardiovascular risk (CVR) consultation usually present overweight/obesity, metabolic syndrome, tendency to hypertension (HT), poor eating habits and sedentary lifestyle, with great resistance to change, great influence of the environment and, frequently, psychosocial limitations. We asked whether home confinement for COVID-19 (March-May 2020) could have negative effects in relation to CVR in these patients. The main objective of this work is to assess this hypothesis with respect to HTN and the use of antihypertensive drugs in these patients. As a secondary objective, we assessed changes in other parameters: body mass index (BMI), level of physical activity and diet. Method Retrospective cohort study with review of 738 ambulatory blood pressure monitoring (ABPM) between 2019-2022 obtaining, after applying the exclusion criteria (no overweight/obesity, poor therapeutic compliance, underlying renal pathology or failure to perform two ABPM in the study period), a final cohort of 46 patients divided into two groups (23 each): one group exposed to home confinement (G1) with one ABPM before and after home confinement and another group not exposed to confinement (G2) with two ABPM in different periods between 2021-2022. Blood pressure (BP) percentile values, dipper pattern, variability and blood pressure load, as well as the rest of the CVR parameters were compared in both periods. Results The mean age was 13 years (13.8 G1/13.2 G2) with a mean time between the 1st and 2nd ABPM of 11 months (11.08 G1/10.95 G2) and a greater reduction in BMI in G2 than in G1 (1.05 G1/1.21 G2). Despite this, the results were not statistically significant. Nor were the results significant in terms of differences in AT or worsening of the dipper pattern (30.4% in G1 and 21.7% in G2). We did observe differences (p<0.022) in the use of antihypertensive drugs, although contrary to our initial hypothesis, with greater use of drugs in G2. Conclusion Although the low sample size, the biases inherent in the design and the lack of previous studies make the interpretability and statistical significance of some results difficult, they reinforce that the measures during confinement did not contemplate all spheres of health and the need to implement specific CVR consultations. Obesity and its associated pathologies are an important public health problem that pediatricians have the responsibility to address.

ENGLISH LANGUAGE AND SOCIAL LIFE INNOVATIONS (2010–2021)

The paper analyses new words and set expressions through their affiliation with different spheres of social life of the English-speaking community. The aim of the article is to analyse innovations by their distribution in the spheres of social life of the English-speaking society. The aim was reached by using both general scientific (analysis, synthesis, systematisation, classification, induction, deduction) and strictly linguistic methods (random sampling and observation method, lexico-semantic and contextual analysis, interpretation of dictionary definitions). In addition, the method of sociolinguistic analysis of the collected material was used. It aims to explore the relationship between language and society. Twelve groups of social life areas have been identified that have given a rise to entirely new innovations: innovations related to education and upbringing; innovations related to health sector; innovations related to generations; innovations related to gender aspect; innovations related to different diets, new recipes, and technologies in cooking; innovations related to sports, tourism, physical education, fitness; innovations related to environment; innovations related to COVID-19; innovations related to economy; innovations related to gadgets; innovations related to social media; innovations specified by modern information technology. The most expansive group is represented by the innovations related to the sphere of information technology, especially the social networks, which should be considered to be a new form of social communication. A certain number of new formations of economy and business denote new types and models of economic systems with the active role of ‘economy’ as the key word. Coronavirus pandemic (Covid-19) has begot dozens of new words and expressions with the words Covid/corona being the centre of innovations. Quite a number of neologisms is focused on the environmental problems, namely – the problems of climate change, global warming. Considerable number of words and expressions denote new kinds of sport, tourism, fitness. The trend to minimise the consumption of meat and other animal products, to go on different diets, to become vegetarian, the new cooking technology and technique – these factors determine the coinage of new formations, associated with the sphere of food, nutrition, culinary. Special attention is given to the denomination of new kinds and brands of such a beverage as coffee. Women liberation movement, especially the struggle for equal role in political and public life, against discrimination and sexism is evidenced in coinages based on the analogy of the expression glass ceiling, fusions with the words man and mom (mum) as the first element. Replenished is the vocabulary associated with the names and characteristics of generations, especially the new ones. The sphere of medicine and health contributes to the formation of neologisms denoting new therapies, cosmetic surgery, and treatment procedures. New formations in the sphere of education reflect changes in this sphere, new approaches and methods. Newly coined phrases characterise types of families, relations between their members. Sociolinguistic analysis is combined with the description of active ways, types and productive elements contributing to the replenishment of English vocabulary. Thus, the innovations in English in the last decade have reflected changes in almost all spheres of social life. These changes are caused by emerging problems and the need to solve them. Particular attention has been paid to the verbalisation of new forms and means of social communication in the context of the information revolution. The most active mechanisms for the formation of neologisms are telescoping (so called portmanteau words) including analogy with telescoping and pure telescoping, forming compound words, especially according to the N+(pro-)N model, affixation, abbreviations, and acronyms.

The nurse's approach in primary health care to women in climateric

The present study aims to identify the factors that interfere with the approach of nurses in Primary Health Care, in relation to women in the climacteric. This is a research with a qualitative approach, of the descriptive type, along the lines of a bibliographic review. As the result of crossing the descriptors in Health Sciences (DeCS) and searching the main databases (BVS, BDENF, LILACS, Medline, SciELO), it was possible to extract, after a detailed reading, a selection of 12 studies. In the synthesis, two themes emerged: knowledge and practices of nurses about the climacteric and health education as a care strategy for women in the climacteric. Followed by an integrated discussion of each theme, in order to respond the research objectives, it became evident the shortage of investment of a political and academic nature in the sphere of women's health, in addition to the insufficient knowledge of nurses in managing the climacteric, which culminate in few health actions aimed to the public and a lack of investment in health education.

Политический дискурс здоровья и мировоззренческие установки граждан России

Health is declared by citizens as one of the most important values, which makes it possible to address this topic within the framework of political discourse in order to achieve political goals. At the same time, the study of the manifestation and impact of the political discourse of health on the attitude of individual citizens and social groups to the sphere of health remains an understudied area of political science. A healthy lifestyle and health literacy were not included in the list of traditional values, although the topics of “health of the nation” and “health of citizens” are widely represented in public and political discourse. Political discourse, with the right emphasis, can have an impact on citizens’ attitudes towards health. It is possible to reveal this potential by determining the worldview features of the multicultural, socially differentiated population of Russia and taking them into account in the framework of political discourse and social policy. As the main methodology for studying the impact of various information channels, in which political discourse is presented, on worldview attitudes in relation to health, the concept of the sociocultural code of the health sector can be used, which opens up the possibility of developing ways for effective interaction with citizens, including the presentation of information by government officials and placement of accents, aimed at correcting the attitude of the population to their health.

Nutritional therapy in celiac disease: a review of the gluten-free diet as a modulator of cardiovascular risk factors

Introduction: Celiac Disease (CD) is a chronic immune-mediated enteropathy precipitated by dietary exposure to gluten in genetically predisposed individuals. The CD has been reported as a rare disease, with an estimated prevalence of 0.3 to 2% worldwide. Objective: This study aimed to review the literature on the role of a gluten-free diet in cardiovascular risk factors in patients with celiac disease, specifically related to lipid profile, body mass index, and diabetes mellitus. Methods: This is a non-systematic literature review study, carried out from July to October 2017. Relevant publications available in the PubMed and BIREME databases were identified. The literature review included randomized controlled trials, cohort studies, casecontrol studies, and cross-sectional analyses. Results and Conclusion: CD it is a disease of special interest due to its association with other autoimmune disorders, intestinal malabsorption, with specific comorbidities, and because its main control mechanism is dietary therapy: the Gluten-Free Diet. Bearing in mind the increase in the worldwide prevalence of celiac disease and its relationship with cardiovascular risk, which may be attributable both to the pathophysiological role of the disease and to the therapeutic plan (dietary), scientific investment in this sphere of public health becomes more than necessary. The influence of gluten-free diet on the cardiovascular risk parameters studied in this review is still not entirely clear. Some studies have suggested that gluten-free diet may have a beneficial effect on the lipid profile of celiac patients, while others have shown that the diet probably does not change or induce atherosclerosis by raising the lipid profile of these patients. In addition, by altering caloric and glycemic intake, the reviewed studies demonstrated a greater tendency towards hyperglycemia and the development of insulin resistance in celiac patients on gluten-free diet. As well as there was a trend towards an increase in body mass index after the introduction of gluten-free diet. However, some authors report that based on these available data, it is not possible to state whether there is a better or worse cardiovascular risk profile after the introduction of gluten-free diet, and therefore, continuity with clinical studies is necessary.

Saccharomyces cerevisiae: Multifaceted Applications in One Health and the Achievement of Sustainable Development Goals

Saccharomyces cerevisiae (SC), a yeast with an extensive history in food and beverage fermentations, is increasingly acknowledged for its multifaceted application in promoting and benefiting all aspects of a ‘One Health’ approach, including the prevention and control of zoonoses. For instance, SC contributes to environmentally sustainable agricultural practices through the reduced use of toxic agents, thus minimizing air and soil pollution while enhancing crop quality. Additionally, this versatile yeast can improve the health of domestic and farm animals, leading to more efficient and sustainable food production, while fostering synergistic impacts across environmental, animal, and human health spheres. Moreover, SC directly applies benefits to human health by promoting improved nutrition, improving gut health through probiotics, as an alternative to antibiotics, and treating gastric disorders. By aligning with several Sustainable Development Goals (SDGs), SC is vital in advancing global health and well-being, environmental sustainability, and responsible consumption and production. This entry illustrates the numerous benefits of SC and highlights its significant impact on a global ‘One Health’ scale, promoting the achievement of SDGs through its unique characteristics and deeper understanding of its contribution to the One Health concept.

Current challenges for the use of phytotherapy: a narrative

Considering the phytotherapy increasing use, there are challenges that must be overcome to applying this therapeutic area in a comprehensive way. In order to explore the main obstacles that limit the application of phytotherapy in the health spheres, the aim of this bibliographic review is to offer a summary of the main issues on this topic. In this narrative literature review, studies about the main challenges for the use and development of phytotherapy were selected. Searches were performed in MEDLINE, PUBMED, SCIENCE DIRECT, SciELO and LILACS. In the selected studies, can be cited how main challenges the raw material and bioactive compounds obtaining, regulatory, safety and efficacy evaluation, issues related to quality control and the health professionals training and knowledge. The global acceptance about the herbal medicines and products based on medicinal plants use shows exponential growth. In order to protect users, some issues must be overcome, how regulatory standardization, health professionals adequacy training and quality assurance, efficacy and safety of the products used in phytotherapy.