bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of Housing Development in Nigeria
Authors: Walter Mboto Helen , Ekpo Nkamare Stephen , Onyam Edom Edom , Chike Emefiele Charles
Published: May 2023

The purpose of the study was to examine factors of mortgage that affect housing development in Nigeria. The specific objectives were to; examine the effect of interest rate, mortgage bank deposit, mortgage investment on housing development. Data for this study were sourced from secondary data and were extracted from the Central Bank of Nigeria (CBN) Statistical Bulletin and the National Bureau of Statistics, Nigeria. Data obtained were tabulated, analyzed and tested using the ordinary least square multiple regression statistical techniques. Based on the result, the findings revealed thus; there was a significant effect of mortgage loans on housing development; there was a significant effect of interest loans on housing development; there was a significant effect of mortgage investment on housing development, and there was a significant effect of mortgage bank deposit on housing development. The study recommended mortgage institutions should develop strategies to mobilize more deposits and ensure effective allocation of housing funds particularly for the low income earners. And finally government should create enabling environments to encourage private housing sector participation in long-term housing finance by providing infrastructure, enhancing soundness and competitiveness of mortgage institutions and assuring property rights.
Research on the Improvement of the Fine System in the Context of the Revision of China’s Anti-Monopoly Law
Authors: Chen Zhilei
Published: May 2023

As an essential component of implementing the Anti-monopoly Law, the fine system suffers from fundamental issues related to uncertainty and insufficient deterrence. These flaws give rise to significant weaknesses and arbitrary enforcement of the law. Even with the recent implementation of the amended Anti-monopoly Law, the fine system has undergone significant changes but is still unable to provide specific solutions to the inherent issues concerning fines under the Anti-monopoly Law. Given the above situation, there is an urgent need to focus on ways to improve the fines from a design perspective. This paper aims to explore various paths and strategies to enhance the fines system under the Anti-monopoly Law through a comprehensive examination of relevant factors. By doing so, it will be possible to identify the means to overcome the defects of the current fines system and restructure it in a way that is more efficient, transparent, and fair.
Review of American Education Reform: Achievements and Challenges
Authors: Jorge William
Published: May 2023

American education reform has been a topic of continuous discussion and debate for several decades. After World War II, the country has witnessed significant transformations in its educational system, with several rounds of reforms aimed at improving the quality of education for students. This paper presents a review of the direction of American education reform, including its history, progress, challenges, and emerging trends. The paper also discusses the characteristics that emerged during the reform process, including the speed and pace of reform, the focus on adult and vocational education, and the achievements and challenges faced by the American education system.
Promoting the Construction of the Ideological and Political Teaching Materials from the Perspective of the Three-wide Education
Authors: Wang Yuting , Jing Wenjian , Huang Xiuhong , Zhou Qin , Zhang Hui
Published: May 2023

Excellent teaching materials can enhance the overall education level of the country, promote the quality of education, and achieve the fundamental tasks of establishing moral education. This paper involves issues of teaching materials construction in colleges and universities based on the background of three-wide education. Firstly, the five stages of development of three-wide education and some national documents on teaching materials from 2016 to 2022 are summarized. Secondly, the problems of teaching materials construction in the work are analyzed. Thirdly, the ideas of further promoting the construction of teaching materials and implements the initiatives of teaching materials use and management are discussed in hoping to help deepen the subsequent work in the background of the three-wide education.
Exploring the Feasibility and Effectiveness of Youth-Aging in Reality TV Programs Using Virtual Reality Technology
Authors: Wang Ziming
Published: May 2023

This paper explores the feasibility and effectiveness of using virtual reality (VR) technology to attract young viewers to TV programs. The aging audience of TV programs is causing difficulties for the industry, and VR technology can create a new virtual space and a rich sensory experience to engage younger audiences. VR can also create new program forms, increase audience participation, and enhance the sense of belonging. From the perspective of program effect, VR can produce more modern programs, enhance entertainment value, and improve real-time performance. Studies show that the use of VR technology in TV programs attracts more young viewers, improves ratings, and increases user satisfaction. The paper concludes that the application of VR technology is crucial in the process of TV program youth and has great potential for future development. It can create a novel program experience, increase audience participation and satisfaction, attract more young viewers, expand the market space, and enhance the social influence of TV programs.
Severe anemia (hemoglobin 4 gdL) in man without chronic disease
Authors: Al-harbi Daliah , Khalid Mohamed
Published: May 2023

We present a case of a male patient 46-year-old presented to the emergency department with a complaint of vomiting, cough, shivering and abdominal pain and a heart rate of approximately 97 beats per minute, and orthostatic blood pressure of 130/70 mm Hg upon standing. We report the lowest hemoglobin 4.0 g/dL was discovered by our laboratory.

Emergency department management of anemic and severe fatigue patients is common (1, 2). We report the lowest hemoglobin of which we are aware, at 4 g/dL, in a patient without chronic disease.
The Effect of Cooperative Learning Model Implementation on Student Learning Understanding On Thematic Learning in Elementary School Literature Studies
Authors: Friska Sonia Yulia
Published: May 2023

This research is based on the lack of understanding of student learning in learning in primary schools. It is affected by the inappropriate use of teaching model, teaching management and the low of students’ critical thinking skills. The formulation of the problem in this study is what points that appear related to the effect of the applicaton of cooperative learning models on students understanding of learning in thematic learning based on previous studies.The type of research used by the researches was literature study, it examined 13 journals and 1 thesis. This study aims to find out what points that appear related to the effect of the application of cooperative learning models to the understanding of student learning in thematic learning based on previous studies. After studying 13 journals and 1 thesis, it was found that 3 points were made as a result of research, cooperative learning model can increase student cooperation in  a study group, cooperative learning model can increase student communication skills, cooperative learning models can improve students’ learning achievement. Based on the 3 points above, the result of the study indicates that there is an influence of the application of the cooperative learning model towards students’ understanding of learning in the thematic learning in elementary schools.
Rancang Bangun Sistem Absensi Berbasis Face Id di Bank Mandiri Sungai Rumbai dengan Bahasa Pemograman Python
Authors: Ade Burma
Published: May 2023

Bank Mandiri Sungai Rumbai is still implementing manual attendance. Then the author has a Face ID-based attendance plan that is more effective during a pandemic like today. Face ID attendance is expected to be useful and can improve employee discipline. The methodology used by the author is the waterfall methodology, this methodology is in the form of an overview, design and manufacture by uniting several separate parts into a unified whole to clarify the form of a system. using the PyCharm application with the Python programming language, where the initial stage of this attendance information system enters the employee's Name and ID, then trains (Training) the employee's face and finally takes attendance (Attendance) by the employee.
Pendampingan Pembelajaran Metode Qiro'ati Bagi Anak-Anak Pondok Alif Lam Mim
Authors: Teguh Handoyo  , Ana Chonitsa  , Adinda Riski Amalia  , Siti Salamah  , Inayah Priyatun  , Ayu Febrianti  , Elsa Tiara  , Rifani Raniasati  , M. Maskur Musa  , Amma Chorida Adila  , Hendri Hermawan Adinugraha
Published: May 2023

Learning to read the Qur'an has the meaning of an effort made by the ustadz or cleric to his students to understand the procedures for reading the Qur'an as a whole with correct and precise readings. Community service activities through mentoring learning the qiro'ati method for children at the Alif Lam Mim Islamic boarding school aim to ensure that the teaching carried out can run well in accordance with Islamic religious guidance as desired by Allah SWT and Rasulullah SAW through His revelations and treatises. The research that has been carried out aims to determine the process of Qiro'ati Method Learning Assistance for the Children of Pondok Alif Lam Mim. The approach used in this community service activity includes the qiro'ati method, lectures, and questions and answers. The results of this study indicate that community service activities carried out with qiro'ati learning mentoring for Alif Lam Mim Islamic boarding school children are as follows: first, adding insight and knowledge to students about the science of recitation and the qiro'ati method. Second, fostering the spirit of students in improving the science of recitation, and third helping educators in implementing the qiro'ati method in learning to read the Qur'an at the Alif Lam Mim Islamic Boarding School.
Mengelola Keuangan Usaha Kecil Dengan Berbasis Aplikasi
Authors: Euis Widanengsih  , Fajar Agustini  , Henny Destiana  , Win Kurniadi
Published: May 2023

Peran Teknologi informasi dalam hal ini komputer di dunia sangatlah penting. Penyampaian informasi khususnya untuk memasarkan produk kesemua kalangan harus dibuat semenarik mungkin untuk meningkatkan omset penjulan produk. Namun sebanyak apapun pendapatan yang kita peroleh tanpa adanya perhitungan yang jelas dari setiap transaksi yang dilakukan setiap harinya, tidak akan bisa diketahui laba ruginya, Untuk itu perlunya dibuatkan laporan keuangan dari setiap transaksi penjualan yang kita lakukan agar setiap laba ruginya dapat diketahui. Menyusun atau mengelola laporan keuangan dengan berbagai aplikasi yang ditawarkan dengan berbagai kemudah banyak kita temui diplaystore. Misalnya aplikasi buku kas yang bisa kita download dari playstore. Aplikasi ini menawarkan bagaimana para usaha kecil dapat menyusun laporan keuangnya kapan saja dibutuhkan. Aplikasi ini juga mudah digunakan oleh siapa saja dan tidak memakan memori banyak dalam android. Kegiatan pelatihan menggunakan aplikasi untuk pembukuan usaha kecil dilakukan kepada ibu-ibu pemilik usaha kecil di Kelurahan Rempoa, acara dilaksanakan pada tanggal 27 Maret 2022 dengan bekerjasama dengan Lembaga Pemberdayaan Masyarakat (LPM) Rempoa. Kegiatan berjalan dengan lancar dan peserta antusias terhadap materi yang disampaikan dan berniat mengimplementasikan pada aktivitas usahanya.
Inovasi Baru Bifood Plus (Bio-Food Hewani Plus) Sebagai Upaya Pemberdayaan Masyarakat Di Desa Besar 2 Terjun, Kecamatan Pantai Cermin, Kabupaten Serdang Bedagai
Authors: Siahaan Audrey , Wastika R. Sihombing  , Danri T, Siboro  , Victor H. Sianipar
Published: May 2023

Lingkup kegiatan yang berbasis pengabdian ini adalah di Desa Besar 2 Terjun, Kecamatan Pantai Cermin, Kabupaten Serdang Bedagai kegiatan yang dilakukan yaitu dengan Pemberdayaan masyarakat Desa Besar 2, dalam upaya Mendukung Ketahanan Pangan melalui Pengolahan hasil pertanian. Memberikan pembelajaran dan pendampingan dalam meningkatkan Ketahanan Pangan melalui Pengolahan hasil pertanian. Memberikan wacana. dan penjelasan kepada masyarakat, tokoh masyarakat, dan aparatur desa di sekitar wilayah Kecamatan Pantai Cermin, Kabupaten Serdang Bedagai.
Assistance For Strengthening Farmer Group Leadership 3G-AGO Village Todo, Satar Mese North District Manggarai-Nusa Tenggara Timur
Authors: Lena Ellitan
Published: May 2023

One of the efforts that can be done is through community empowerment in agriculture, especially the horticultural agriculture sub-sector so that people can get out of this multidimensional crisis. If we look at the geographical conditions and the life of the people in Manggarai, especially in Ago Village, Todo Village, North Satarmese Subdistrict, which is agrarian, the development in the agricultural sector is very suitable to be implemented and also to support empowerment efforts carried out by the government. Therefore, farmers who are members of the 3G Farmer Group at Kampung Ago are trying to improve their Horticultural farming business in order to improve mutual welfare through the development of Organic Agriculture on our lands. Basically the group still has limitations in both Knowledge and Business Capital. Activities This community service activity was attended by leaders and members of the 3G-AGO farmer group who are practicing to develop farmer group organizations. They consist of 20 members who have officially joined this farmer group and 4 administrators. The activity will be held on Saturday 5 March 2022 and Sunday 6 March 2019 starting at 09.00 WIB until 12.00 WIB through zoom online. The participants were quite enthusiastic about participating in this training activity. At first, participants were given material according to the theme of this service. The material presented was enough to open their horizons about the importance of organizational governance and leadership. The provision of material is not only given in a lecture model, but is combined with several other methods to make it more relevant. Participants are invited to actively participate in the training process, by developing their creativity to discuss leadership and organizational issues, especially in the era of the industrial revolution 4.0. The highest effectiveness value on membership insight is due to the efforts of members who are often present and active in activities made by farmer groups so that the longer the membership period of farmer group members, coupled with a strong desire to learn and actively participate in membership activities will produce knowledge insights. and also experience in organization. All of this really requires strengthening leadership in the 3G-AGO Farmer Group, Todo Village, North Satar Mese District, Manggarai – East Nusa Tenggara.
PELATIHAN PERHITUNGAN HARGA POKOK PRODUKSI DAN PEMASARAN PADA KELOMPOK USAHA KERIPIK KHAS BANTUL YOGYAKARTA
Authors: Prakosa Adhi , Sumantika Ahsan
Published: May 2023

Kegiatan pengabdian masyarakat ini dilaksanakan di Kelompok Usaha Al Barik, Bantul DIY. Kegiatan ini bertujuan memberikan pelatihan manajemen keuangan dan pemasaran. Pembahasan tentang Harga Pokok Penjualan (HPP) dan desain dalam pemasaran dilakukan di dalam pengabdian ini, dibantu dengan kegiatan studi dunia industri yang dilakukan oleh mahasiswa Fakultas Bisnis UPY. Kelompok usaha Al Barik memiliki keunikan yaitu produk mereka yang berbeda. Usaha ini memanfaatkan potensi dari bonggol pisang yang dianggap tidak berguna, tetapi dapat diolah menjadi makanan ringan yang diminati semua kalangan. Adanya pelatihan ini diharapkan kinerja bisnis dari usaha keripik khas Bantul ini dapat semakin berkembang.
The emerging public health legislation in Ukraine
Authors: Senyuta Iryna
Published: May 2023

As Ukraine has started the legal process for a public health legislation, this narrative review attempts to: i) characterize recent legal acts (which are current as well as drafts) and international standards in the sphere of public health; ii) analyze the definitions of public health legally relevant to Ukraine, in particular: public health and public health protection; iii) discuss related definitions relevant to the health sector; iv) characterize the main subjects tasked to protect public health; v) and clarify the necessary educational innovations, which are the basis in the preparation of human resources for an efficient implementation of the public health concept. After referring to the current legislative process and a discussion of some of the concepts and terminologies available in the literature, the following understanding of the terminology is proposed here: i) ‘Public Health’ should be understood as mental and physical health of the population in a certain territory, determined by the best achievable demographic indicators, characterized by decreasing morbidity and mortality and increasing the potential to lead an active and long life; ii) the term ‘Public Health Protection’ (or, ‘Protection of Public Health’) should address a system of measures which are aimed at prevention and control of morbidity, optimization of demographic indicators, promoting a value-oriented state policy, securing biological and genetic safety and relying on joint societal efforts. It is essential that the implementation of a public health law is underpinned by adapting the postgraduate educational system to the new challenges in Ukraine.
Socio-demographic factors and selected clinical characteristics of patients with retinal vein occlusions in transitional Albania
Authors: Rustani-Batku Manushaqe , Tonuzi Ali
Published: May 2023

Aim: The aim of our study was to assess the distribution of socio-demographic factors and the clinical profile of individuals diagnosed with retinal vein occlusion (RVO) in Albania, a former communist country in South-eastern Europe which has been undergoing a rapid transition in the past decades.
Methods: This study was carried out in 2013-2016 at the Primary Health Care Centre No. 2 in Tirana municipality, which is the capital of Albania. During this timeframe, on the whole, 44 patients were diagnosed with RVO at this primary health care centre (17 women and 27 men; overall mean age: 69.5±11.5 years). The diagnosis of RVO was based on signs and symptoms indicating a quick reduction of the sight (vision), fundoscopy, fluorescein angiography and the optical coherence tomography. Data on socio-demographic factors and clinical characteristics were also gathered for each study participant.
Results: The prevalence of glaucoma was considerably higher in men than in women (67% vs. 24%, respectively, P=0.01). Diabetic retinopathy was somehow more prevalent in women than in men (18% vs. 11%, respectively), whereas an opposite finding was noted for the presence of hypertensive retinopathy (6% vs. 11%, respectively). The prevalence of cataract was higher in female patients compared with their male counterparts (18% vs. 7%, respectively, P=0.36). Both macular oedema and papillary oedema were almost equally distributed in men and in women (22% vs. 18% and 4% vs. 6%, respectively). All female patients had comorbid conditions compared to 85% of their male counterparts (P=0.15). The prevalence of hypertension was almost identical in both sexes (52% in men vs. 53% in women), whereas the prevalence of diabetes was somehow higher in men than in women (26% vs. 18%, respectively).  
Conclusion: This is one of the very few studies informing about the distribution of socio-demographic factors and selected clinical characteristics of individuals diagnosed with RVO in transitional Albania.
Approaches to the international standards application in healthcare and public health in different countries
Authors: Sarancha Vitaliy , Sulyma Vadym , Pros Nenad , Vitale Ksenija
Published: May 2023

As a result of consequent development, and guided by an increasing demand of different types of the organizations regarding structured management, the system of standardization has been established. The idea behind standardization is adjusting the characteristics of a product, process or a production cycle to make them consistent and in line with the rules regarding what is proper and acceptable.
The “standard” is a document that specifies such established set of criteria covering a broad range of topics and applicable to commissioners of health, specialists in primary care, public health staff, and social care providers, as well as the local authorities and service users. Health products, ranging from medical devices and health informatics to traditional medicines and unconventional healing tools are all in the focus of standards’ application.
Different countries have their own quality management traditions based on their history, mentality, socio-economic environment and the local regulations. Taking into consideration that community social system organization and the quality of social infrastructure are the main foundations of social relations and future prosperity, here we review the existing standardization environment in the health sector in different countries, both developed and those on a convergence path. We focused on standardization environment in the United States of America, Great Britain, Germany, Ukraine, Russian Federation, Croatia and Albania. In order to simplify comprehension, we also demonstrate the algorithm of standardization, as well as the opportunities for application of the international standards in healthcare and public health.
High level Communiqué from the InterAction Council
Authors: Lueddeke George
Published: May 2023

Here is a link to a copy of a high level Communiqué from the InterActionCouncil that may also be of interest to SEEJPH readers. 
As you may be aware, the Council brings together former world leaders (heads of government and senior officials) and focuses on issues related, among others, to global security and has been examining the role of health security over the last few years. At this year’s meeting (30-31 May), co-chaired by HE Obasanjo from Nigeria and HE Bertie Ahern from Ireland, the session on Planetary Health, coordinated by Professor John Wyn Owen, resulted in the endorsement of the “Dublin Charter for One Health”. Dr Joanna Nurse presented on the policy implications of Planetary and One Health in this session and is tasked by the InterAction Council with advancing the One Health Charter in collaboration with key partners. 
 
Below is a summary of the main actions in the Charter for One Health that may in due course help to inform trans-disciplinary research, education and practice at national, regional and global levels with a view to sustaining people and planet health and well-being. 
 
Your comments on how best to advance these key areas are requested-i.e. please let us know what is already happening, gaps and suggestions for how to advance the following: 

Strengthening multi-sector solutions for the SDGs - the One Health approach has the potential to act as a unifying theme;
Resilience to emerging threats -including AMR, disease outbreaks, climate change and environmental impacts;
Mainstreaming One Health within public health systems for UHC -including environmental health;
Strengthen One Health Governance mechanisms for systems reform;
Building leadership for One Health for future generations; 
Establish an independent accountability mechanism for advancing action on One Health.
Evidence of a higher burden of multimorbidity among female patients in Albania
Authors: Collaku Ledio , Resuli Margarita , Gjermeni Ilir , Tase Mihal
Published: May 2023

Aim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe.
Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors.    
Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0). 
Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population.
Norms in and between the philosophical ivory tower and public health practice: A heuristic model of translational ethics
Authors: Schröder-Bäck Peter , Duin Claire van , Brall Caroline , Scholtes Beatrice , Tahzib Farhang , Maeckelberghe Els
Published: May 2023

This paper draws attention to the translation of ethical norms between the theoretical discourses of philosophers and practical discourses in public health. It is suggested that five levels can be identified describing categories of a transferral process of ethical norms – a process we will refer hereto as “translational ethics”. The aim of the described process is to generate understanding regarding how ethical norms come into public health policy documents and are eventually referred to in practice. Categorizing several levels can show how ethical-philosophical concepts such as norms are transforming in meaning and scope. By subdividing the model to five levels, it is suggested that ethical concepts reduce their “content thickness” and complexity and trade this in for practicability and potential consensus in public health discourses from level to level. The model presented here is illustrated by showing how the philosophical-ethical terms “autonomy”, “dignity”, and “justice” are used at different levels of the translation process, from Kant’s and Rawls’ theories (level 1) to, in this example, WHO reports and communications (levels 4 and 5). A central role is seen for what is called “applied ethics” (level 3).
Predictive factors for patient satisfaction in public and private hospitals in Kosovo
Authors: Hoxha Rina , Kosevska Elena , Berisha Merita , Ramadani Naser , Jerliu Naim , Zhjeqi Valbona , Gashi Sanije
Published: May 2023

Aim: The objective of this study was to assess predictive factors for patient satisfaction with healthcare services as a measure of the quality of hospital care in public and private hospitals in Kosovo.
Methods: A cross-sectional study was conducted in Kosovo during 2015-2016 including a representative sample of 2585 patients older than 18 years [1010 (48.6%) males and 1069 (51.4%) females from public hospitals; and 240 (47.4%) males and 266 (52.6%) females from private hospitals]. Patient satisfaction dimensions such as satisfaction with medical care, nursing care, organization, and overall impression were the main variables measured. A risk-adjusted multivariate analysis was applied.
Results: Multiple linear regression analysis revealed as independent significant predictors of the total satisfaction of patients from public hospitals the following factors: age, length of stay in hospital in days, education, payment for additional analyzes during hospitalization and buying medications for hospital treatment. These five independent significant predictors accounted for 7.3% of the change in the total patients’ satisfaction (stepwise method - R2 = 0.073). Conversely, there were only four predictors of the total satisfaction of patients from private hospitals: length of stay in hospital in days, number of hospitalizations in the last 12 months, paying for hospitalization, and cost of hospitalization exceeds received services. Only the variables “length of hospital stay” together with “cost of hospitalization exceeds received services” as independent predictors, explained 5.3% of the variability of total satisfaction.
Conclusion: Structural and qualitative characteristics of hospitals have a significant impact on patients’ satisfaction. Age, length of stay, education, payment for additional analyzes during hospitalization and the cost of hospitalization in public hospitals and length of stay, paying for hospitalization, and cost of hospitalization in private hospitals are useful predictors for total satisfaction of patients in Kosovo.
The diabetes epidemic in Malta
Authors: Cuschieri Sarah
Published: May 2023

Aim: The small European Mediterranean island state of Malta is a highly prevalent type 2 diabetes (T2DM) country. Over recent decades drastic environmental, cultural and ethnic changes occurred and it was considered timely to undergo a cross-sectional survey to establish up-to-date prevalence of T2DM, its socio-geographical distribution and ultimately estimating the economic burden of T2DM.
Methods: A health examination survey was conducted (2014-16) including a representative sample of the adult population stratified by 18-70 years, gender and locality (n=3,947; males n=1,997 male). The survey consisted of a socio-demographic questionnaire, various health examination measurements and blood samples for fasting blood glucose (FBG). Prevalence for T2DM (depending on medical history, medication and FBG >7mmol/L) were calculated for the general population as well as for each of the districts making up the Maltese Islands. The economic burden of T2DM for 2017 and projected burden for 2045 were calculated using secondary sources and by incorporating 2% compound interest per annum respectively.
Results: A total response rate of 47.15% was obtained, with a mean age of 48 years for males and 46 years for females. Out of the total adjusted population (n=3,947, male n=1,998), the prevalence of T2DM was of 10.31%, with 6.31% already known to have T2DM while 4% were newly diagnosed. Females were diagnosed with T2DM at an earlier age than the males. No significant geographical T2DM prevalence differences were established. The total annual diabetes health care expenditure was approximately €107,316,517.82 for 2017, while the projected expenditure for 2045 was estimated at €244,136,040.
Conclusion: Malta is a country with a high prevalence of diabetes. The females were observed to be at an earlier risk of developing undiagnosed diabetes compared to males. Although geographical location did not appear to have significant effect on T2DM distribution, this disease contributes to a high economic burden. The expected exponential increase in diabetes prevalence is subsequently expected to affect negatively the healthcare expenditure. This puts forward the recommendation for development of early screening programmes as part of preventive action strategies.
When the world depends on effective public health intervention – and public health does not deliver
Authors: Holst Jens
Published: May 2023

The COVID-19 crisis offers both special opportunities and challenges for Public Health. The initial management of the pandemic was dominated by virologists, supported by epidemiologists who did not always meet indispensable scientific requirements. Interdisciplinary and complex Public Health concerns and expertise, however, did not have tangible impact in the COVID-19 debate. Public Health is universal and goes beyond health security as social and other upstream determinants of health play a central role. As an explicitly political concept Public Health must safeguard its broad socio-political approach and obviate all tendency towards biomedical reductionism.
COVID-19 in the Gaza Strip and the West Bank under the political conflict in Palestine
Authors: Abed Yehia
Published: May 2023

COVID-19 is a serious pandemic with variation of spread, morbidity, and fatalities between countries. Palestinians are facing the epidemic, with around 2 million inhabitants under siege in the highly populated Gaza Strip for the last 14 years. The siege may be the main threat for the spread of disease among the Palestinian population. The Palestinians faced the Corona epidemic with limited facilities in their hand. However, the risk factors remain multiple, the most important are overcrowding in the Gaza Strip, poor health care facilities, and the risk of workers moving between the West Bank and Israel. Palestinian Health authorities responded directly to the pandemic and took strict closure measures to prevent rapid spread. The Palestinian strategy has focused on social spacing, personal hygiene, control of border crossings and health preparedness to deal with medical cases while continuing to provide health services to the population. The difficult economic situation is the major obstacle facing Palestinians to overcome the disease spread where workers continue their jobs inside Israel and Gaza cannot enforce low-income workers to stay at home. More is needed to ensure community engagement, support coordination among all health care providers in Palestine, and take effective steps to promote social spacing. Friendly countries and international organizations can assist and support the Palestinian population in providing laboratory diagnostic materials, providing personal protective devices, strengthening intensive care units, and supporting outreach activities and training programmes.
Health status of the populations in the Western Balkans region
Authors: Burazeri Genc , Laaser Ulrich
Published: May 2023

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How to minimize negative health effects in the European Union due to the Economic recession caused by the COVID-19 Pandemic
Authors: Satyamoorthy Adhitya , Brand Helmut , Kessel Robin van
Published: May 2023

Aims: The article aims to analyze what can be learned from the last Financial Crisis from 2008 on to minimize the negative health effects in the European Union due to the Economic recession caused by the Covid-19 Pandemic.
Methods: Systematic literature reviews were conducted to analyze the interventions taken to combat the last Financial Crisis and their consequences on health. Parallel to this, a qualitative document analysis of the ongoing discussion about the measures taken or to be taken in the Covid-19 Pandemic to fight the current economic recession was conducted using institutional websites and international media.
Results: The main methods taken to combat the Financial Crisis from 2008 were, bailing out banks, austerity measures, and the European Stability Mechanism. There is evidence that the Financial crisis had negative effects on the European Health Systems in general. Austerity measures in some countries, led to an increase in psychological disorders. Overall mortality was not affected but the decrease of avoidable mortality slowed down. Various economic interventions such as bailing out essential industries e.g., the Aviation sector, cash injections, tax relief, short-work salary compensation, modified ESM, and the Pandemic Emergency Purchase Program (PEPP) were taken during the Covid-19 Pandemic to help stabilize the economy.
Conclusion: The current recession is not caused by internal failures of the financial system as it was in the financial Crisis of 2008, but by an outside event - the Covid-19 pandemic. Measures were taken by the governments and the European Union to avoid an economic crisis, and by these, the negative health effects were created during the Financial Crisis in 2008, but the lockdown phase seems to lead to similar negative health effects regarding psychological disorders and delay of planned screening and treatment.
Scenario planning: An alternative approach to European Commission for combating antimicrobial resistance by 2050
Authors: García Laura Patricia Orellana , Kaur Kiranjeet , Brand Helmut , Schröder-Bäck Peter
Published: May 2023

Aim: Antimicrobial resistance (AMR) is one of the major health challenges of the future, but the concrete impact of counteracting measures is still unclear. To study possible outcomes within the European Union, a scenario analysis for the year 2050 was performed on the possible influence of the European Commission (EC).
Methods: Scenario planning and development of strategies based on different scenarios.
Results: Rational use of antimicrobials in animals and humans, surveillance and monitoring, new antimicrobial therapies, travel and globalization, exposure to the environment, and awareness were recognized as the main driving elements. Four Scenarios were developed: An efficient and impli-cated EC sorts out AMR; An implicated but unsuccessful EC withstands AMR; AMR is managed regardless of the EC disinterest; and A neutral and inefficient EC fails to manage AMR.
Conclusion: All the strategies developed on the basis of the four scenarios probe for an increase in European Union's dedication to achieve positive outcomes. These include the development of effective legislation and international coordination.
Acknowledgment: Peter Schröder-Bäck, Helmut Brand and Kiranjeet Kaur’s contribution is co-funded through a grant of the European Commission within the Erasmus+ programme (Project: Prevent it. Project reference: 598515-EPP-1-2018-1-IN-EPPKA2-CBHE-JP).
Conflict of interests: None declared.
Pharmaceutical policies in post-communist Albania: Progress and challenges toward European Union membership
Authors: Roshi Dajana , Tresa Eni , Lafranconi Alessandra , Burazeri Genc , Czabanowska Katarzyna , Brand Helmut
Published: May 2023

Aim: Shifting from a communist regime to a democratic system has affected health system fundamentally in most of the Western Balkan countries including Albania. Albania became a European Union (EU) candidate country in 2014. Since then, one of the main concerns has been to approximate the legislation with the EU framework. The aim of this paper is to review the evolvement of pharmaceutical legislation in Albania and challenges toward achieving full approximation to the EU’s respective legislation.
 
Methods: We used qualitative techniques, especially means of conventional content analysis and two sources to collection data. First, we consulted the Albania’s National Publications Office webpage and analysed all available legislation regarding “pharmacy”, “medicine” and “pharmaceutical products” from 1994 to 2021. Then, we analysed the National Integration Plans that have been published by the Government of Albania from 2014 to 2021.
 
Results: The decrease of the price margin system goes in parallel with the increase of the pharmaceutical expenditure, including out-of-pocket expenditure on medicines and lack of adequate and sensitive reimbursement policies. The main pillars of the pharmaceutical sector in Albania are well-covered legally but not fully in concordance with the EU framework.
Conclusion: There is a need to foster laws implementation that regulate the opening of pharmacies; a detailed regulation on pharmacovigilance; and a regulation on medicinal products for paediatric use. Also, the existing legal framework should be aligned with the European one. Medicine pricing methods should go in the same line with the decrease of out-of-pocket expenditure.
Hepatitis C in several risk groups: Literature review
Authors: Rashiti-Bytyçi Albiona , Ramadani Naser , Kalaveshi Ariana , Muçaj Sefedin , Gashi Luljeta , Rashiti Premtim
Published: May 2023

Aim: The objective of this study was to assess the distribution of hepatitis C in selected risk groups such as haemodialysis patients, pregnant women, healthcare workers, HIV-HCV co-infected patients, patients with mental health diseases and piercing and tattoo procedures. Furthermore, it aimed at evidencing common transmitting routes and highlighting the importance of preventive measures among these groups.
 
Methods: The literature review was conducted using online databases (Medline) with search query involving the keyword “hepatitis C” in conjunction with keywords describing risk groups such as "dialysis", or "haemodialysis", or "pregnancy", or "pregnant", or "mental health", or "tattoo", or "piercing", or "HIV", or "health professionals”.
 
Results: After assessing all the retrieved publications, 39 of them were considered for inclusion: 17 on haemodialysis patients, 7 on pregnant women, 8 on HIV-HCV co-infection and 7 publications on health professionals, patients of mental health wards and piercing and tattoo procedures. The high rate of hepatitis C is still a high problem and in some cases it is considered as a new issue, as in the case of pregnancy. Some of the transmission routes have been identified earlier, such as the HIV-HCV co-infection but some, such as piercing and tattoo, are becoming new transmission routes. Health professionals are still identified as high risk group while mental health patients are a potentially high risk group.
 
Conclusion: Even though some patients are routinely screened for hepatitis C, there are indications for performing such a routine test in other groups. In almost all of the risk groups, it is advocated to use stricter preventive measures and to disseminate knowledge on risks of hepatitis C.
 
Conflict of interest: None declared.
Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage
Authors: Ahmad Jameel Ismail , Jibril Murtala , Ahmad Barroon Isma’eel , Suleiman Abdurrahman , Inuwa Nasir Sani , Ali Abdullahi Garba , Ismail Salihu Ibrahim
Published: May 2023

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem.
Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0.
Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents.  Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare.  Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 - $6.56 and $3.28 – $6.56, respectively.
Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria.
Post Covid-19 Agenda: Maximizing human resources for health towards Universal Health Coverage in Africa
Authors: Amedari McKing I. , Ejidike Ifunanya Carista
Published: May 2023

Aim: To analyse options for maximising the capacity of human resources for health to achieve Universal Health Coverage (UHC) in Africa.
Methods: Articles were retrieved from a Pubmed search and additional snowballing was conducted to provide other relevant sources. Further utilizations were made of Campbell's modified framework of the Human Resources for Health (HRH) and Universal Health Coverage with the WHO labour market dynamics framework for Universal Health Coverage. Four sub-themes viz improved HRH performance, Labour Market Factors, Rural Health Workers Retention Factors, and Information Technology Factors were analysed.
Results: Labour market factors such as the dynamics of demand and supply of health workers determine the availability of health workers. Supportive supervision enables the health workers to improve in their performance and enhance optimised utilisation of available resources. This supervision can be more effective by complementing it with tools such as information technology that focus on improving the quality of health care, considering the growth in the number of internet and broadband users in the continent.
Conclusion: Expanding the training opportunities for health workers and also increasing the funding to human resources for health are useful policy options to consider. Cost-effective approaches such as a focus on community health committees which stimulate the demand for health services in rural communities to tackle the disproportionate distribution of health workers should be considered in the context of the uncertain economic aftermath of the covid-19 outbreak.
Sources of Funding
Nil
Acknowledgement
We express profound gratitude to Prof Flavia Senkubuge for providing technical help and writing assistance during the preparation of this manuscript. We also appreciate Dr. Aborisade Adetayo for assisting with editing of the manuscript.
Conflicts of Interest
The authors declare no conflict of interest.
Author Contributions
MIA drafted the entire manuscript. ICE provided a critical review and made substantial contributions to the design of the manuscript.
Applying innovative strategies to achieve Universal Health Coverage in the African Region
Authors: Leufak Arlette Mouako , Ndwandwe Duduzile
Published: May 2023

Universal health coverage is defined as ensuring that all people have access to needed health services of sufficient quality to be effective while ensuring that these services do not expose the user the financial hardship. Universal health coverage includes three related objectives: equity in access to health services (everyone who needs services should get them, not only those who can pay for them); the quality of health services should be good enough to improve the health of those receiving services; and people should be protected against financial risk, ensuring that the cost of using services does not put people at risk of financial harm. Africa still has a long way to go to achieve these objectives. Many barriers limit the progress of the African Region towards building the robust health systems needed for universal health coverage. Such barriers include poor infrastructure, high out-of-pocket payments and catastrophic health expenditures, shortages and inequitable distribution of qualified healthcare workers, poor quality of care delivery, high cost of quality medicines, and lack of innovative technologies appropriate to the range of settings where care is delivered, health financing and governance. This paper aims to propose innovative strategies that could be applied to improve health systems in the Africa Region, which progress towards the continent attaining universal health coverage.
Recovery and resilience plan and health: The Italian experience
Authors: Torre Giuseppe La
Published: May 2023

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