Growing Burden of Non-Communicable Diseases in the Emerging Health Markets: The Case of BRICS

Serbia, as the largest market of the Western Balkans, has entered socioeconomic transition with substantial delay compared to most of Eastern Europe. Its health system reform efforts were bold during the past 15 years, but their results were inconsistent in various areas. The two waves of global recession that hit Balkan economies ultimately reflected to the financial situation of healthcare. Serious difficulties in providing accessible medical care to the citizens became a reality. A large part of the unbearable expenses actually belongs to the overt prescription of pharmaceuticals and various laboratory and imaging diagnostic procedures requested by physicians. Therefore, a broad national survey was conducted at all levels of the healthcare system hierarchy to distinguish the ability of cost containment strategies to reshape clinician's mindsets and decision-making in practice. Assessment of healthcare professionals' judgment on economic consequences of prescribed medical interventions and evaluation of responsiveness of healthcare professionals to policy measures targeted at increasing cost-consciousness. Cross-sectional study. A nationwide cross-sectional survey was conducted through a hierarchy of medical facilities across diverse geographical regions before and after policy action, from January 2010 to April 2013. In the middle of the observed period, the National Health Insurance Fund (RFZO) adopted severe cost-containment measures. Independently, pharmacoeconomic guidelines targeted at prescribers were disseminated. Administration in large hospitals and community pharmacies was forced to restrict access to high budget-impact medical care. Economic Awareness of Healthcare Professionals Questionnaire-29 (EAHPQ-29), developed in Serbian language, was used in face-to-face interviews. The questionnaire documented clinician's attitudes on: Clinical-Decision-Making-between-Alternative-Interventions (CDMAI), Quality-of-Health-Care (QHC), and Cost-Containment-Policy (CCP). The authors randomly and anonymously recruited 2000 healthcare experts, with a total of 1487 responding; after eliminating incomplete surveys, 649 participants were considered before and 651 after policy intervention. Dentists (1.195±0.560) had a higher mean CDMAI score compared to physicians (1.017±0.453). The surgical group compared to the internist group had a higher total EAHPQ-29 score, CCP score and CDMAI score. Policy intervention had a statistically significant negative impact on the QHC score (F=4.958; df=1; p=0.027). There was no substantial impact of policy interventions on professional behavior and judgment with regard to the CDMAI, CCP, and total EAHPQ-29 scores. Although cost savings were forcibly imposed in practice, the effects on clinical decision-making were modest. Clinicians' perceptions of quality of medical care were explained in a less effective manner due to the severely constrained resources allocated to the providers. This pioneering effort in the Balkans exposes the inefficiency of current policies to expand clinicians' cost consciousness.

Sea buckthorn (Hippophae rhamnoides L., Elaeagnaceae.) is a thorny shrub that has small, yellow to dark orange, soft, juicy berries. Due to hydrophilic and lipophilic ingredients, berries have been used as food and medicine. Sea buckthorn (SB) oil derived from berries is a source of valuable ingredients for cosmeceuticals. The unique combination of SB oil ingredients, in qualitative and quantitative aspects, provides multiple benefits of SB oil for internal and external use. Externally, SB oil can be applied in both healthy and damaged skin (burns or skin damage of different etiology), as it has good wound healing properties. Due to the well-balanced content of fatty acids, carotenoids, and vitamins, SB oil may be incorporated in cosmeceuticals for dry, flaky, burned, irritated, or rapidly ageing skin. There have been more than 100 ingredients identified in SB oil, some of which are rare in the plant kingdom (e.g., the ratio of palmitoleic to γ-linolenic acid). This review discusses facts related to the origin and properties of SB oil that make it suitable for cosmeceutical formulation.

The New and Old Europe: East-West Split in Pharmaceutical Spending

Background and Objectives: Workplace burnout syndrome is often as sociated with particular aspects of certain job positions, especially those that entail working with people with special needs. The burnout syndrome in healthcare jobs is a serious problem that has grown into an epidemic among healthcare workers and associates. The aim of this research is to assess the presence of stress and burnout syndrome at work with healthcare workers, expert workers, professional associates, and associates in social service institutions in Belgrade. Materials and Methods: This research was conducted in the form of a cross-sectional study of a representative sample in social institutions in Belgrade. It was conducted from March to the end of June of 2023. The sample of the study had 491 participants. The questionnaires used were a structured instrument with social–demographic and social–economic characteristics, workplace characteristics, lifestyle characteristics, and the following questionnaires: DASS-21, Copenhagen, Brief Resilience Scale, and Brief Resilient Coping Scale. Results: The end results indicate the following to be significant risk factors for the occurrence of workplace burnout syndrome: overtime (OR = 2.62; CI = 1.50–4.56), BRS average score (OR = 0.28; CI = 0.17–0.44), DASS21 D heightened depression (OR = 2.09; CI = 1.1–4.04), DASS21 A heightened anxiety (OR = 2.38; CI = 1.34–4.21), and DASS21 S heightened stress (OR = 2.08; CI = 1.11–3.89). The only protective risk factor that stood out was the self-assessment of health levels (OR = 0.60; CI = 0.42–0.85). Conclusion: Overtime is a significant factor associated with workplace burnout. Apart from it, other significant factors associated with workplace burnout were heightened depression, anxiety, and stress levels.