South Eastern European Journal of Public Health

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Authors: Genc Burazeri, Slavenka Jankovic, Ulrich Laaser, Jose M. Martin-Moreno

The South Eastern European Journal of Public Health (SEEJPH) is an online, open-access, international, peer-reviewed journal, published by Jacobs Company in Germany. Starting from 2014, the journal will initially release two issues per year, at the end of June and the end of December, although articles will be immediately published online following acceptance – a unique advantage of open-access journals, whose relevance within the corpus of scientific literature has been growing in recent years.

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Authors: Mariana Dyakova, Christian Drew, Nicola Wright, Aileen Clarke, Karen Rees

A large number of people, considered at increased risk of vascular disease, remain unidentified, untreated and not reached by lifestyle advice or intervention, despite public health and clinical efforts. This has prompted the initiation of national screening/systematic risk assessment programmes for vascular disease in healthy populations. These exist in addition to the more ad hoc opportunistic risk assessment initiatives undertaken worldwide. There is currently not enough indisputable evidence either showing clear clinical or economic benefits of systematic screening-like programmes over opportunistic risk assessment of cardiovascular disease (CVD) in primary care. We present the rationale and methodology of a Cochrane systematic review, assessing the effectiveness, costs and adverse effects of systematic risk assessment compared to opportunistic risk assessment for the primary prevention of CVD. Keywords: cardiovascular disease, Cochrane systematic review protocol, risk assessment.

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Authors: Jolanda Hyska, Ehadu Mersini, Iris Mone, Entela Bushi, Edite Sadiku, Kliti Hoti, Arjan Bregu

Aim: the aim of this survey was twofold: (i): to assess medical students’ knowledge, attitudes and practices regarding nutrition in general, in order to identify their level of competences in the field of nutrition which will be useful in their future role of providers/health care professionals, and; (ii) to assess the knowledge, attitudes and practices regarding the discipline of public health nutrition in order to identify the needs for improving the curriculum of this subject in all the branches of the University of Medicine in Tirana. Methods: A cross-sectional study was conducted in June-July 2013 including a representative sample of 347 students at the University of Medicine in Tirana, Albania (61% females and 39% males; overall mean age: 23±2 years; response rate: 87%). A nutritional questionnaire, adopted according to the models used in previous international studies, was used to assess the level of knowledge, attitudes and practices among the university students. Results: Overall, about one third of the students was not satisfied with the quality and quantity of nutritional education and demanded a more scientifically rigorous curriculum. In general, students’ knowledge about infant feeding practices was adequate. However, there were gaps in the students’ knowledge regarding the commencement of breastfeeding, or the duration of exclusive breast-feeding. Furthermore, there was evidence of an insufficient level of knowledge among students regarding diet and nutrition in general and their health impact, especially on development and prevention of chronic diseases. Conclusion: This survey identified significant gaps in the current curriculum of public health nutrition at the University of Medicine in Tirana. Our findings suggest the need for intervention programs to improve both the quantitative and the qualitative aspects of nutrition curricula in all the branches of the University of Medicine Tirana, in accordance with the professional expectations of this teaching institution, as well as the urge for a movement towards a more integrated curriculum and problem-based learning approach.

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Authors: Gazmend Bojaj, Katarzyna Czabanowska, Fitim Skeraj, Genc Burazeri

Aim: Besides the health professionals’ perspective, it is equally important to assess the perceptions of the users of health care services with regard to abilities, skills and competencies of their family physicians. Our aim was to assess the level of competencies of family physicians from patients’ viewpoint in transitional Kosovo. Methods: A nationwide survey was conducted in Kosovo in 2013, including a representative sample of 1340 primary health care users aged ≥18 years (49% males aged 50.7±18.4 years and 51% females aged 50.4±17.4 years; response rate: 89%). Participants were asked to assess the level of competencies of their respective family physicians regarding different domains of the medical encounter. The self-administered questionnaire included 37 items structured into six domains. Answers for each item of the instrument ranged from one (“novice” physicians) to five (“expert” physicians). An overall summary score related to family physicians’ competencies was calculated for each participant [range: from 37 (minimal competencies) to 185 (maximal competencies)]. Furthermore, demographic and socioeconomic data were collected. General Linear Model was used to assess the demographic and socioeconomic correlates of the overall level of family physicians’ competences according to patients’ perspective. Results: Mean value of the overall summary score for the 37-item instrument was 118.0±19.7. It was higher among the younger and the low-income participants, and in patients who reported frequent health visits and those not satisfied with the quality of the medical encounter. Conversely, no sex, or educational differences were noted. Conclusions: Our findings indicate a relatively high level of competencies of family physicians from patients’ perspective in post-war Kosovo. Future studies should comprehensively assess the main determinants of self-perceived competencies of family physicians among primary health care users in Kosovo.

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Authors: Ermira Kola, Ermela Çelaj, Iliriana Bakalli, Robert Lluka, Gjeorgjina Kuli-Lito, Sashenka Sallabanda

Aim: Additional treatments for sepsis to be administered alongside the standard therapy recommended by the Surviving Sepsis Campaign have recently undergone evaluation. Due to its anti-bacterial, anti-inflammatory and immunomodulatory properties, intravenous polyvalent immunoglobulin M (IgM)–enriched immunoglobulins (IgM preparation) has been investigated as one of these potentially valid adjunctive therapies. The aim of this trial was to assess the efficacy of an IgM preparation as adjuvant therapy in the treatment of pediatric patients with sepsis. Methods: In our study, 78 septic patients admitted to a pediatric intensive care unit (PICU) at the University Hospital Center “Mother Teresa” in Tirana, Albania, were randomized into two groups (intervention and control). All patients were treated according to standard PICU sepsis guidelines. Additionally, patients in the intervention group received the IgM preparation Pentaglobin® while patients in the control group received standard sepsis therapy, but no immunoglobulin administration. Results: The survival rate was higher in the intervention group (87%, N=34) than in the control group (64%, N=25), and this difference was statistically significant (P=0.03). Length of stay (LOS) was also significantly shorter in the intervention group. Conclusion: In this study conducted in Albania, use of an IgM preparation, in addition to standard sepsis therapy, led to a significant increase in the survival rate as well as a significant reduction in LOS compared with placebo, when administered in PICU patients with sepsis.