bluuebunny/crossref_metadata_2025 huggingface dataset:
Public health in Kosovo after five difficult years of independence
Authors: Jerliu Naim , Ramadani Naser , Mone Iris , Brand Helmut
Published: May 2023

Kosovo is undergoing a rapid process of transformation to an independent state,which was formally proclaimed in 2008, after almost a decade under United Nationsadministration. Regarding the health status, five years after independence, compared with other European countries, post-war transitional Kosovo is still characterized by higher mortality rates including traditional public health problems pertinent to infant mortality and maternal deaths. In parallel, however, Kosovo is undergoing a rapid process of epidemiological transition characterized by an aging trend which is inevitably coupled with high cardiovascular and cancer mortality and morbidity along with an excess mortality in external causes of death and injuries among the adult population. Adoption of the new Health Law in December 2012 by the Kosovo Assembly aims the transition from centralized health care system established under emergency conditions of the post-war period towards a contemporary modern health care system with a clear purchaser-provider split based on a high transparency and accountability of the health care providers and their contractors. The health care reform, leading eventually to significant changes within the health sector in Kosovo, consists of two main pillars: (i) structural and functional reorganization of the health care system through establishment of Kosovo Health Service (an autonomous and non-for-profit public enterprise at central level of the health care sector), and; (ii) establishment for the first time of the public health insurance system with a Health Insurance Fund as its main body. Nevertheless, five years after declaration of independence, Kosovo, the newest state in Europe consisting of the youngest population, is currently facing a particularly difficult socioeconomic and political transition and is additionally struggling and mainstreaming all energies and efforts in order to get full international recognition.
Learning from the pandemic, building increased international cooperation
Authors: Lopes Henrique , Middleton John
Published: May 2023

The COVID-19 pandemic highlighted a fragile preparation by countries and regions for epidemic events, exposing exacerbated nationalisms in pandemic mitigation and control actions. Both conditions decisively compromise the effectiveness and efficiency of pandemic control capacity. It is important to develop frameworks that help overcome frailties in response to epidemics.
Based on a thematic literature review and discussions with multiple national and international entities an attempt was made to build a tool for responding to future epidemics, the Pandemic Preparation Framework (2PF).
The proposed 2PF tool is aligned with the Sendai Framework for Disaster Risk Reduction and with international bodies, such as the European Health Emergency Preparedness and Response Authority (HERA). It aims to be a framework for operationalizing these agreements.
The response to pandemics must be based essentially on international action and closer collaboration between countries and regions.
Improving the health status of sex workers in Europe: a policy brief with recommendations
Authors: Ravenswaaij Hilde van , Rojas Daniela , Sharjeel Muhammed , Slaats Puck , Andelic Petra , Paric Martina
Published: May 2023

Context:  Although the United Nations and the European Union are set to improve life on earth through the Sustainable Development Goals (SDG) Framework, sex workers have not been included in this Framework, thereby further increasing various issues, which affect this group, such as discrimination, stigma, and poor mental- and physical health. The COVID-19 pandemic has exacerbated the already existing disadvantages of sex workers, highlighting the need for a systematic change to sustainably improve the empowerment and health status of sex workers throughout the European Union.
Policy Options: The aim of this policy brief is to propose recommendations, which can contribute to the sustainable improvement of the health status and empowerment of sex workers throughout the EU. Policy options include a bottom-up approach with use of community-based organizations and public-private partnerships, targeting inclusion of sex workers, the organization of workshops, and the distribution of toolkits.
Recommendations:

Inclusion of sex workers in the SDG Framework;
Organization of community-based workshops by and for sex workers;
Distribution of culture-personalized toolkits by and to sex workers.
Increasing influenza vaccination rates among healthcare workers by focusing on workplace and patient safety
Authors: Bruin Jeanine de , Machado Matilde , Marie Nabbe , Saccà Riccardo , Verhoeven Jeske , Clemens Timo
Published: May 2023

Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety.
Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered.  Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge.
Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake.
Acknowledgments:  We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process
How are excellence and trust for using artificial intelligence ensured? Evaluation of its current use in EU healthcare
Authors: Bimczok Simon Paul , Godynyuk Elizabeth Alexandra , Pierey Joris , Roppel Malin Siv , Scholz Mirjam Lisa
Published: May 2023

Context: Artificial intelligence (AI) could be a key driver in different healthcare dossiers, ranging from preventive to diagnostic and treatment purposes. The establishment of the Artificial Intelligence High-Level Expert Group in the European Commission, as well as their White Paper, show first attempts of creating policies in the domain of artificial intelligence in the EU. Despite these policy approaches, there is a need for a coherent regulatory framework that enables the efficient use of AI in the field of health. The aim of this policy brief is to evaluate current legislative gaps in terms of the introduction of AI in healthcare, focusing on the domains of Data Protection, Liability & Transparency, as well as Robustness & Accuracy.
Policy Options: This policy brief identified a high degree of eHealth infrastructure fragmentation on member state level and limited action towards a structured and coherent framework for AI in healthcare, under the domains of Data Protection, Liability & Transparency, and Robustness & Accuracy.
Recommendations: A unified approach at EU-level, based on proposed recommendations and merged into the form of a Directive, is advised. The development of the Health-AI-Directive will bring progress and improvement to legal certainty in the European AI-landscape. The introduction of the Health-AI-Directive is recommended to ensure trust and excellence in the use of AI in healthcare.
Incorporating sustainability into food-based dietary guidelines by “Traffic Light Ecolabelling”
Authors: Asselt Evelien van , Elamin Abdullah , Sánchez Clara González , Kalesi Anastasia , Majoor Elodie
Published: May 2023

Context: Food-Based Dietary Guidelines (FBDGs) are science-based recommendations in the form of guidelines for healthy eating. They provide information and advice on foods and dietary patterns to consumers to promote the overall health and prevent chronic disease. As of now, these FBDGs lack information about the sustainability of food products. Consumer food choices have a large impact on human and planetary health and wellbeing, as the production and processing of diets make up between 20% and 30% of the total greenhouse gas emission of consumable goods in the European Union (EU). A plethora of different ecolabels exist to aid consumers in making sustainable choices when purchasing items, both food and non-food products. These ecolabels make it easier for consumers to choose eco-friendly product alternatives, with the aim of lowering the environmental impact of the products a consumer buys. While the growth of ecolabels may be interpreted as a sign of success, label overload and gaps in the understanding might result in confusion for consumers, resulting in the limit of use of these already existing ecolabels. Therefore, this policy brief proposes the development of a universal, understandable ecolabel for food products, to enable consumers to make better informed decisions.
Policy Options: Three policy options are examined. Firstly, a hypothetical ‘do nothing’ scenario is considered, in which food ecolabels are not used. As a second alternative, the use of carbon footprint labelling is examined. Lastly, the implementation of a “traffic light” colour pattern label that uses the colours green, orange and red to demonstrate low, medium and high environmental impact, respectively, is examined.
Recommendations: In order to determine the best policy option, the three proposed policy options are compared using five evaluation criteria (time of implementation, cost of implementation, ease of implementation, consumer friendliness and positive environmental impact). The traffic light ecolabel had the highest overall score, and it is thus recommended that this food ecolabel should be used. Lastly, it is recommended that the ecolabel is incorporated into the already existing EU ecolabel, in an effort to increase consumer knowledge and understanding of this novel ecolabel.
THE POPULATION'S HEALTH: COULD SOUTH EASTERN EUROPE DO BETTER?
Authors: Bozikov Jadranka
Published: May 2023

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The population's health: Could South Eastern Europe do better?
Authors: Božikov Jadranka
Published: May 2023

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Health of the Slovenian population: Where do we stand?
Authors: Zaletel-Kragelj Lijana , Batista Kaja , Bertoncelj Marusa , Brlek Aljaz , Carli Tanja , Grasek Manja , Horvat Martina , Kebler Ines , Mavric Ana , Mozetic Matija , Opresnik Denis , Rozic Mirjam , Strmsek Anja , Sivec Nastja , Smarcan Vesna , Vurzer Blaz , Zadravec Kristina , Zaletel Rok , Kukec Andreja , Erzen Ivan
Published: May 2023

Aim: Aiming at assessing the state of the Slovenian population health according to the latest available data, and comparing it with health in selected countries, the objective was to analyse the burden of disease (BoD) data available in a selected database.
Methods: The Institute for Health Metrics and Evaluation Global Burden of Disease Study (IHME-GBD) database was used. Causes of all three big IHME-GBD groups: A) communicable, maternal/neonatal conditions, and nutritional deficiencies, B) non-communicable diseases, and C) injuries, in total 18 groups of causes, were observed. Overall mortality, Disability Adjusted Life Years (DALYs), Years of Life Lost (YLLs) and Years Lived with Disability (YLDs) (all per 100.000 population), were used as indicators. Percentage of BoD generated by selected cause, and the ratios of rates in 2019 versus rates in 2014 (reference year) in Slovenia, and the ratios of rates in Slovenia versus rates in Western Europe Region countries (WERC) were analysed. Ratios >1.20 or ˂0.83 were considered as important.
Results: When considering mortality, the greatest burden was generated by cardiovascular diseases and neoplasms. In maternal/neonatal conditions, an important decrease in overall (0.68) and premature (0.68) mortality, while in nutritional deficiencies an increase in overall mortality (1.27) were observed. An increase in overall mortality was noticed also in neurological disorders (1.21), diabetes (1.21) and skin diseases (1.24). Mortality rates were higher in Slovenia than in WERC in digestive diseases, substance use, unintentional injuries and self-harm. When considering disability, the greatest burden was generated by musculoskeletal and mental disorders, and unintentional injuries. Disability rates were higher in Slovenia than in WERC in maternal/neonatal conditions, and unintentional and transport injuries.
Conclusion: In the observed five-year time span, cardiovascular diseases and neoplasms remained at the forefront. However, their burden didn’t change. Causes with burden expressed by disability, musculoskeletal and mental disorders, and unintentional injuries, which has been neglected in the past due to lack of indicators, proved to be an important problem as well. MPHPs in which a lot has to be done to reach rates in WERC, digestive diseases, substance use, and injuries, were identified.
Learning needs assessment among professional workers in community mental health centres in Slovenia: Study protocol
Authors: Kragelj Anja , Pahor Majda , Zaletel-Kragelj Lijana , Makivic Irena
Published: May 2023

Aim: This article aims to present a study protocol that represents a tool developed for a learning needs assessment. With a pilot study, based on the presented concept of a model study, we will be able to assess what mental health learning content is not yet part of formal higher education for professionals working in community mental health centres, but has been identified as necessary for inclusion. The presented tool is transferable with appropriate modifications. The goal is to conduct multiple research with the same basic tool at all levels of the educational system and in continuing professional education for all professionals who work with people.
Methods: The learning needs assessment study protocol presented uses both quantitative and qualitative research approaches. It is expected that the research will be conducted in several interrelated phases that holistically cover the needs assessment process.
Results: The pilot study will provide insight into the advantages and disadvantages of the prepared learning needs assessment tool. Through the research study, the learning needs of professionals working in community mental health centres, will be identified.
Conclusion: Professional mental health care workers must be equipped with the necessary knowledge, skills, attitudes, and values to perform their work with quality. By implementing appropriate mental health learning content in educational processes from pre-school education to higher education and further to continuing professional education, we can impact the mental health of the entire population. Since this can lead to acquiring the competencies necessary to care of one’s own mental health and that of others, it can be considered an important public health intervention.
Overview of the main incremental health care reforms introduced between 2014 and 2020 in Romania
Authors: Scintee Silvia Gabriela , Vladescu Cristian
Published: May 2023

Aim: On 2014 the Government of Romania has committed to improving health and health system through the implementation of the 2014–2020 National Health Strategy: Health for Prosperity. An official evaluation of the strategy implementation is not publicly available yet. This paper aims to provide an overview of the main incremental reforms taken during this period in Romania and to analyse the results from the perspective of the main Strategy goals.
Methods: Information was collected from legislative documents, statistical and scientific publications. The main implemented or initiated incremental reforms, during the assessed period, were assigned to five main clusters: ”governance”, “resources for health”, “coverage and access”, “organization of health care”, “quality of care” and were analysed in accordance with the aim, the type, the implementation stage and the corresponding objectives of the Strategy.
Results: The 2014–2020 National Health Strategy has definitely not reached all its objectives, but one sign of prosperity, is that based on 2019 per capita income (of $12,630) World Bank classified Romania, for the first time, as a high-income country. The health status of the population has increased in many aspects, yet Romanians’ health has still remained among the poorest in the European Union (EU).
Conclusion:  Incremental reforms might be successful, but the small steps should be taken in a holistic approach, and should be tailored to specific needs. Previous strengthening health systems resilience and plans for overcoming possible risks and obstacles might ensure successful implementation. Assessments of the reforms might draw lessons that help policymakers in shaping further health policies and designing of next strategies.
Burnout and optimism among health workers during the period of COVID-19
Authors: Theofilou Paraskevi , Platis Charalampos , Madia Konstantina , Kotsiopoulos Ioannis
Published: May 2023

Aim: The investigation of the level of burnout and optimism as well as the effect of socio-demographic and other factors on the above two variables among health workers during the period of covid-19.
Methods: The following two psychometric tools were used to collect the research data: the Maslach Burnout Inventory to assess burnout and the Revised Life Orientation Test (LOT-R) to assess the level of optimism.
Results: In the present study 10 men (24.4%) and 31 women (75.6%) participated. The majority of them were between 36-45 years (36.6%), married and unmarried (48.8% and 48.8% respectively), holding bachelor degree (61.0%) and with 11-25 years of work experience (53.7%). Very high levels of exhaustion and especially emotional exhaustion and depersonalization were observed with also a high degree of personal achievement. The levels of optimism were high. There were statistically significant differences between the two genders in terms of burnout (only the dimension of emotional exhaustion) with women showing higher rates. Employees aged 25-35 years and those who had 1-10 years of work seemed to have higher levels of emotional exhaustion (all differences were considered statistically significant for p<0.05). Finally, a statistically significant correlation took place between burnout and optimism (p<0.05).
Conclusions: The level of burnout among health workers seems to be high during the period of covid-19. In addition, various socio-demographic and occupational factors appear to influence burnout.
Circular health: a needed approach to promote health and prevent pandemics and other health hazards
Authors: Lirussi Flavio , Ziglio Erio
Published: May 2023

SARS-Cov-2 is a perfect example of the intimate relationship between human, animal and environmental health. Circular health goes beyond the biomedical concept of health, operating on the interface between individuals, microorganisms and ecosystems. The World Health Organization endorses this concept and stresses the importance of protecting the environment and addressing and reversing the negative impact of climate change. The application of circular health to the governance for population health is based on protection of all forms of life, interdisciplinarity, involvement of all of society, big data, artificial intelligence, and correct scientific information. It also considers a combination of health, environmental, social and economic problems caused by the synergistic interaction between the acute diseases - in this case caused by SARS-Cov-2, and a number of non-transmittable chronic pathologies. Disinformation and misuse of social media could be more dangerous for the pandemic's development than the virus itself. The adoption of circular health is an urgent necessity in restructuring development policies and making them more effective and sustainable, and protecting and promoting individual and collective health. Within public health, circular health should urgently become the mainstream approach to prevent pandemics and other health hazards. Given the many social, economic, and cultural changes undergoing in the countries of the South-Eastern European Network the conceptual and policy framework related to circular health could be of great value in further advancing progress in this part of Europe.
Legal protection of the patient's right to access medical records in Indonesia
Authors: Sudra Rano Indradi , Putra Sarsintorini , Hartini Inge
Published: May 2023

Background: Patient access rights to medical records are related to the retention period because they can only be accessed as long as they have not been destroyed. The study aims to identify the corresponding regulations to assess the legal protection of the patient's right to access her/his medical record.
Methods: Tracing and identifying primary legal sources in regulatory content related to patient rights of access. An analysis was conducted on the clarity and consistency of the contents identified.
Results: Regulations identified regarding patients' rights to access their medical records are Law number 29 of 2004, Government Regulation number 47 of 2021, and Minister of Health Regulation number 269 of 2008. The regulations governing the retention period of medical records are Law number 11 of 2008, Law number 44 of 2009, Government Regulation number 46 of 2017 and number 71 of 2019, Minister of Health Regulation number 269 of 2008, number 82 of 2013, and number 46 of 2017.
Conclusions: The condition of disharmony and inconsistency among regulations governing patient access rights and the retention period of medical records creates uncertainty for patients to access their medical records.
Assessing Reproductive Health Literacy: Terms of Sex Genital among Caregivers in Semarang city
Authors: Rimawati Eti , Kristina Tri Nur , Nugraheni Sri Achadi , Margawati Ani
Published: May 2023

Introduction: Taboos, filth, and shame are moral values ​​resulting from cultural construction that limit names, leading to inappropriate sexuality. These values will impact the practice of caregivers in communicating reproductive health to their children. This study aims to describe the terms used for the names of reproductive organs and examine the connotations built in the marking of these names.
Methods: The research design was a case report study. The sample comprised 224 caregivers to early childhood who were selected by stratified random sampling in the city of Semarang. Data analysis was carried out by description and basic quantification.
Results: Researchers found 27 language terms for the names of male and female genital organs. The name's connotation was built because of inheritance, similarity to certain animals, and texture of the organs.
Conclusion: The use of the connotation of reproductive organs in communicating to children will continue to reduce the culture of taboo and shame continuously. It is necessary to increase the ability of parents to say the correct name for the genital organs.
Albanian castles in defence of Balkan public health
Authors: Levett Jeffrey
Published: May 2023

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The role of Diabetes mellitus comorbidity on Tuberculosis treatment outcomes in Nepal: A prospective cohort study
Authors: Mahato Roshan Kumar , Laohasiriwong Wongsa , Koju Rajendra
Published: May 2023

Aim: The Objective of this study was to assess the effect of Diabetes Mellitus (DM) on treatment outcomes of tuberculosis (TB) patients in the Central Development Region of Nepal.
Methods: A prospective cohort study was conducted in central Nepal. The study population of n=408 was consecutively recruited from treatment centers of all 19 districts of central Nepal. The TB cases (n=306) and TB with DM (n=102) cases were followed up for the estimation of blood glucose level, HbA1c level, and sputum examination on 2, 5, and 6 months after TB treatment started. The Generalized Estimating Equation (GEE) was performed to identify the risk ratio among TB and TB with DM cases on treatment outcome.
Results: Our study identified that the magnitude of treatment failure among the tuberculosis cases was 19.7% (95% CI: 17.44-21.95). The GEE analysis observed that factors associated with the treatment failure had uncontrolled DM (HbA1C ≥7 %) (adj.RR=5.24, 95% CI: 2.58-10.62, P value <0.001), aged ≥ 45 (adj.RR= 6.13, 95% CI: 2.55-14.76, P value <0.001), had inadequate financial status (adj.RR= 2.33, 95% CI: 1.07-5.06, P value 0.033) and had prior TB (adj.RR=2.33, 95% CI: 1.09-4.97, P value 0.028) respectively. 
Conclusion: The prevalence of worsening TB treatment among patients with TB and DM was significantly higher than those who had TB only. Poor glycaemic control, increasing age, inadequate financial status, and previous history of tuberculosis were strong predictors of worsening tuberculosis treatment outcomes.
Effect of safety and hygiene practices on lung function among Indonesian farmers exposed to pesticides
Authors: Mahawati Eni
Published: May 2023

Aim: This study aimed to detect lung function impairment in farmers exposed to pesticides related to safety and hygiene practices in pesticide application.
Methods: This was a cross-sectional study with respondents are 200 farmers who were exposed to pesticides in Grobogan, the main agricultural center in Central Java, Indonesia, which has 95.75% agricultural workers. Data were collected by a questionnaire-based interview, observation, and spirometry measurement. Chi-square and Multinomial Regression were used for the statistical test.
Results: The survey results of all respondents showed that 12% had restriction lung function, 32% had obstruction lung function, and 56% had normal lung function. There was a significant effect between work period, pesticide spraying hour per day, spraying against wind direction, changing clothes directly after exposure to pesticides, taking a bath directly after exposure to pesticides with "farmer's lung function" based on statistical test results. 
Conclusion: The Safety and hygiene practices of farmers exposed to pesticides could affect their lung function. It is suggested that to improve management and regulation control of pesticide application, educational programs and reinforcement of "safety and hygiene practices" in the workplace as effective approaches for preventing respiratory disorders related to pesticide exposures.
Implementation of health protocols in the workplace during the Covid-19 pandemic in Indonesia
Authors: Yuantari Catur , Rachmani Enny , Kusuma Edi Jaya , Ariyanto Amelia Devi Putri
Published: May 2023

Background: Covid-19 is a new disease for which no cure has been found; prevention of disease transmission is an alternative to reducing cases. The workplace is one of the places that have the potential for information of Covid-19 because workers will have direct contact in one place with other workers. This study aims to analyze the characteristics and availability of health protocol facilities on worker compliance in the workplace during the Covid-19 pandemic.
Methods: The research method uses quantitative methods with a cross-sectional approach. The population in this study are workers who work in formal and informal sectors in Indonesia, with a sample of 217 respondents. Data collection used a survey method and obtained as much as 217 data. For data processing, we used the Rank Spearman test.
Results: The results showed that there was a relationship between years of service (p-value 0.008; rho: 0.148), educational level (p-value 0.000; rho: 0.363), number of employees (p-value 0.000; rho: 0.488), and the availability of health protocol facilities (p-value 0.000; r: 0.498) at the workplace. As for age and the level of compliance with the application of health protocols, there was no relationship (p-value 0.044).
Discussion: The level of compliance with suitable health protocols at the workplace can help suppress the spread of Covid-19. There are still workplaces where workers do not comply with health protocols, such as workers who do not practice social distancing and lower masks to their chins when talking to colleagues.
Condemning the War in Ukraine & the Need for Peace
Authors: Houghton Frank , Rourke Lisa Scott O’
Published: May 2023

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Market and welfare valuation of the economic burden of diseases attributable to air pollution exposure in the Western Balkans
Authors: Panteli Maria , Delipalla Sofia
Published: May 2023

Aim: The population in the Western Balkans is exposed to high air pollution concentrations, among the highest in Europe, causing death and disability. Research, however, on the resulting economic cost in the region is still limited. We estimate the economic cost of the adverse health effects from air pollution exposure, including fine particulate matter (ambient and household) and ambient ozone air pollution in the region.
Methods: We employ both market and welfare-oriented methods. According to the Cost-of-Illness (COI) approach, we estimate both the direct (healthcare expenditure) and indirect cost (mortality and morbidity cost). Against the shortcomings of a market-based valuation, the Willingness to Pay (WTP) approach is also used. The most recent data from the Global Burden of Disease Study 2019 are used.
Results: Under the COI approach, total economic cost is estimated at PPP$ 6.3 billion. Equivalently, it ranges from 0.8% of GDP in Croatia to 2.39% of GDP in Bosnia and Herzegovina. The WTP methodology yields a significantly higher estimate, equal to PPP$ 76.7 billion. The monetary amount associated with the disease burden of air pollution is significant.
Conclusion: Public health policies should include monitoring of the adverse health effects of air pollution. Abatement policies should aim at reducing ambient air pollution as well as the dependence on polluting household energy usage. The reduced economic cost can be accompanied by benefits associated with climate change mitigation and an overall improvement in population’s health status, an important aspect given the current COVID-19 pandemic.
Retracted: Respiratory symptoms among urban traffic policemen in Bangladesh: A cross-sectional study
Authors: Ahmed Parvez , Eaty Mahim , Alam Nazmul , Anthony Leela , Yasmin Nawzia
Published: May 2023

This article has been retractedThis article has been retracted at the request of the Editor-in-Chief.
The authors have published the same manuscript in two journals (South Eastern European Journal of Public Health) and (Journal of public health in africa). The Ediotiral office of SEEJPH have contacted the corresponding author multiple times and failed to hear back on the explanation. As dual publication of a same manuscript is a serious academic misconduct and malpractice, as per the suggestions from the Executive editor (Prof. Genc Burazeri) and founding editor (Prof. Ulrich Laaser) of "South Eastern European Journal of Public Health (SEEJPH)", we have retracted this article from the SEEJPH website.
Self-assessment of essential public health operations in Kosovo
Authors: Berisha Merita , Ramadani Naser , Basholli Florie Miftari , Jerliu Naim , Humolli Isme , Tahirukaj Ardita , Maraokuli Maria , Martin-Moreno Jose M.
Published: May 2023

Aim: The National Institute of Public Health of Kosovo (NIPHK) considered the challenge of assessing the availability and performance of critical public health services in Kosovo. To this end, support was requested from the World Health Organization (WHO) European Regional Office, through the WHO office in Pristina, for an action-oriented process. The systematic process of the self-assessment of public health operations aimed to generate sufficient empirical evidence to identify the strengths and weaknesses of the country’s health services and functions to provide recommendations for future public health actions in Kosovo.Methods: The NIPHK team followed the systematic self-assessment methodology of the Essential Public Health Operations (EPHO) model that the WHO’s regional office for Europe developed. The appraisal was conducted throughout 2018 and the first quarter of 2019 and involved a broad spectrum of public health actors. It also followed a participatory, interdisciplinary, and inter-sectoral approach. It was developed in three phases: preparation and collection of information, analysis and interpretation of the data, and critical recommendations for the Kosovo health authorities’ consideration.
Results: The assessment resulted in an overall score of 48% sufficiency for the set of public health operations (core and enablers). The most in need of development were EPHO 6, which is related to governance (only 20% of what is needed in this dimension as a whole), followed by EPHO 3, which considers vital aspects of health protection (35%), and EPHO 10, which is related to research capacities (40%). Based on the EPHO assessment results, the specialized teams developed a set of priority recommendations to strengthen the implementation of the EPHOs in Kosovo.Conclusion: The self-assessment revealed that, despite ongoing initiatives and measures to strengthen public health, the application of EPHOs has much room for improvement. We believe that decision-makers can use this method and the findings that it reveals to implement the most effective interventions to protect and promote the population’s health. In addition, the methodology and experience can be used for educational and training purposes.
Request for the retraction of the manuscript “Public health in Kosovo after five difficult years of independence” (Review article). SEEJPH 2013 by authors Jerliu N, Ramadani N, Mone I, Brand H.
Authors: Jankovic Slavenka
Published: May 2023

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The willingness of COVID-19 vaccination and associated factors: A systematic review
Authors: Fani Tiara , Saptorini Kriswiharsi Kun , Anggreani Aprilia Diah
Published: May 2023

Aim: Vaccination is an effective approach to avoid infection and reduce morbidity and mortality of infectious diseases. However, in previous infectious disease vaccination programs, some people were hesitant to get vaccinated. To develop an effective vaccination program or policy, the government or public health officials need to understand the factors that influence the willingness of COVID-19 vaccination from the various studies.
Methods: Between 1-18 December 2020, articles were searched from PubMed and ScienceDirect with the following key terms: Willingness, Acceptance, Acceptability, COVID-19 vaccine, and COVID-19 vaccination.  Eligibility for article inclusion criteria was determined by PRISMA.
Results: 20 studies were included in this review. All studies were conducted in the early days of the COVID-19 pandemic. The willingness of COVID-19 vaccination ranged from 60-97% among the general population, 28-63% among healthcare workers, 56-65% among parents or caregivers, and 73% among factory workers. The common factors that affected the willingness of COVID-19 vaccination:  gender, age, education, individual perception about diseases and the vaccine, trust in the government, statements of public health officials and health providers.
Conclusion: Concerns about disease risk, effectiveness, and side effects are important factors associated with vaccination willingness. To avoid vaccination hesitancy in the community, public health officials need to disseminate detailed information about the vaccines like efficacy level and side effects, and continue to provide information about the risks of COVID-19 for personal health and others through various online media to avoid vaccination hesitancy.
An examination of the diversity of beer and cider products sold in Irish supermarkets in the context of health promotion advice
Authors: Houghton Frank , ’Mahony CáitlínO
Published: May 2023

Aim: Current health promotion advice relating to the consumption of beer and cider in
Ireland is very firmly based on nominal pints and half pints of beer. This study sought to determine if the assumed alcohol strength of beer and cider available in a sample of mainstream supermarkets was appropriate. This study also sought to examine if the assumed size of containers of beer and cider was accurate.
Methods: All beer and cider products in a purposive sample of Irish mainstream supermarkets was examined. Data was input into SPSS and examined. 
Results: There is a substantial level of variation in the container size and alcohol content of beer available in mainstream supermarkets in Ireland.
Discussion: Current health promotion advice in Ireland is out of date and does not enable people to easily monitor their drinking and follow healthy drinking guidelines. The obvious answer is the enactment of the Public Health (Alcohol) Act, 2018, that has already been passed requiring alcohol containers to display the number of grams of alcohol contained. However, this element of the legislation, despite being passed into law, has yet to be either enacted, or even given a date for enactment.
Developing a new generation of public health leaders
Authors: Czabanowska Katarzyna
Published: May 2023

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The COVID-19 pandemic and the right to health of people who use drugs
Authors: Eick Donata , Aubert Océane , Dempsey Kendra , Ozawa Momone , Eerd Eveline Van , Neicun Jessica
Published: May 2023

Context: According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) people who inject drugs (PWID) make up a significant part of the population that needs to be looked after to eliminate infectious diseases such as those caused by HIV and HCV. This situation has been exacerbated by the COVID-19 pandemic. As COVID-19 rapidly spread across the globe, governments implemented various prevention measures which not only caused an increase in problem drug use (PDU) because of their negative impact on mental health and socioeconomic conditions but also prompted a decrease in drug services provided. Therefore, new challenges appeared, such as increased demand for drugs and diversification of clients, and new needs. Nevertheless, in clear contradiction to what was needed, the EMCDDA’s initial reports suggested that there was a decline in European drug services both in providing treatment and harm reduction interventions. COVID-19 increased the need to access drug services, healthcare, and support services creating an increased demand for opioid substitution therapy and other medication. Thus, comprehensive, and sustainable policies are needed to combat the public health threats associated with these challenges and to ensure the continuity of care.
Policy Options: The challenging circumstances brought by the COVID-19 pandemic require policymakers need to take action to build capacity and resiliency for those facing drug-related health and social problems. These should include the adoption of integrated strategies that combine drug consumption rooms, substance-specific therapies, provision of free needles and naloxone, primary healthcare, and social support.
Recommendations: The creation of an integrated drug policy framework addressed to European Union member states is necessary to create robust drug services capable of surviving a crisis. This is guided by a relevant policy design and implementation framework, alongside tangible action principles in line with low-threshold service provision.
IMPACT: Ideal Measures for Participation and Awareness of Climate Change: Stronger Together Citizen participation in achieving the European Green Deal in the Meuse-Rhine Euroregion
Authors: Alsamara Issam Moussa , Beinert Stefanie Felicitas , Jong Jeanne Catelijne de , Klapp Maaike Jeannette Barbara , Marewsk Viktoria Sirkku , Orhan Rana
Published: May 2023

Context: The European Green Deal is a tool to make Europe the first climate-neutral continent by 2050. To reach this goal, action is needed on all organizational levels. At the same time, temperatures keep rising, and the Meuse-Rhine Euroregion (EMR) suffered from heavy floods in the summer of 2021and extreme weather events are expected to increase. This is an example of a cross-border issue and therefore shows the need for cross-border climate action. The EMR could be a showcase for climate action and collaboration for other border regions across Europe and worldwide.
Policy Options: Citizens often do not feel responsible for taking climate action; however, everyone should contribute to achieving the biggest results in tackling climate change. Therefore, three policy options are presented to increase citizen participation in climate action: local climate measurements, sustainable food consumption, less food waste, and sustainable cities through urban gardening. These policy areas deserve more attention and have room for improvement.
Recommendations:

Encourage the implementation of citizen science projects in the EMR.
Gather insights on the region's greenhouse gas emissions.
Provide more sustainable food in institutional canteens and reduce food waste.
Use social media as a tool to provide information about sustainable food.
Use urban areas for urban gardening projects.
Create community sustainability challenges.
Proposing a Code of Ethics for Public Health Professionals in Europe
Authors: Agarici Sylvia , Elabbasy Darin , Hirche Anja , Saha Royina , Witte Jente , Thomas James C.
Published: May 2023

Context: Public health practitioners are involved in a wide array of contexts. Local and national government public health agencies; domestic and international nongovernmental organizations (NGOs); and academic institutions are just a few examples of the settings where public health practitioners work. Acting ethically and meeting ethical commitments in a practical and transdisciplinary endeavor as complicated as public health necessitates careful consideration. Ethical practice ensures that public health institutions work properly and that individual public health practitioners maintain their integrity. There is little debate about the importance of ethics in public health professional practice and, as a result, the necessity for a corresponding professional code of ethics.  
Policy Options: Only an US-American code of public health ethics has been created so far. Since ethical considerations in public health are heavily dependent in contexts, the aim of this document is to initiate a discussion surrounding the establishment of a Code of Ethics for Public Health Professionals in Europe.
Recommendations:

Stimulate the discussion on a European code of public health ethics.
Make a clear distinction between public health ethics and medical ethics.
Recognize public health as a profession and not just a medical specialty.
Recognize the need for a common code of ethics among public health professionals in Europe.
Use Kotter's Model based on the Theory of Change as a roadmap when creating the European public health code of ethics.
Treat the European code of ethics as a "living document".
Encourage further research on a European code of ethics.
Centralized vaccine procurement in the post-COVID-19 European Union
Authors: Jagusiewicz Agata , Uteh Cyril Onwuelazu , Götz Jan-Philipp
Published: May 2023

The COVID-19 pandemic has confronted healthcare systems worldwide with societal, psychological, and economic burdens. The widespread use of the developed COVID-19 vaccines has been generally pursued to stop the spread, decrease mortality rates, and lift the economic burden of healthcare systems. However, it became apparent that the demand for vaccines outnumbers the supply provided by pharmaceutical manufacturers. This policy brief explores the use of centralized procurement globally to formulate recommendations on how the European Union (EU) and its member states can benefit from such an approach.
Health status of the populations and health sector reforms in Albania and Kosovo
Authors: Jerliu Naim
Published: May 2023

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Level of satisfaction and socio-demographic correlates among users of primary health care services in Kosovo
Authors: Kamberi Haxhi , Tanushi Vanesa , Kadrija Muhamet , Kamberi Safete , Jerliu Naim
Published: May 2023

Aim: The aim of this study was to assess the level and socio-demographic correlates of satisfaction with services among adult primary health care users in Kosovo.
Methods: A cross-sectional study was conducted in Kosovo during the period May-June 2022 including a representative sample of 510 adult users (238 men and 272 women) of primary health care services in Kosovo (mean age: 44.6±19.2 years). In addition to socio-demographic data, a structured 23-item questionnaire aiming at assessing the level of satisfaction with primary health care services was administered to all participants (each item ranging from 1 [high] to 5 [low]). A summary score was calculated for all 23 items related to satisfaction level ranging from 23 (the highest satisfaction level) to 115 (the lowest satisfaction level). General linear model was used to assess the association between the summary score of satisfaction level with primary health care services and socio-demographic factors of study participants.  
Results: Mean summary score of the 23 items related to the satisfaction level with primary health care services was 49.8±13.0; median score was 49 (interquartile range: 41-57). In multivariable-adjusted models, the level of satisfaction with primary health care services was significantly higher among participants with a lower educational attainment, individuals with e lower income level, and ethnic Albanian participants.
Conclusion: This study identified important socio-demographic correlates of the level of satisfaction with primary health care services in the adult population of Kosovo. Findings from this study should raise the awareness of policymakers and decision-makers in Kosovo and elsewhere in order to improve the quality of primary health care services.