The burden of breast, cervical, and colon and rectum cancer in the Balkan countries, 1990–2019 and forecast to 2030.

Background Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019, including a forecast to 2030. Methods We described the 2019 Global Burden of Disease (GBD) estimates for breast, cervical, and colon and rectum cancers in eleven Balkan countries over the period 1990–2019, including incidence, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs) rates per 100,000 population and accompanied 95% uncertainty interval. With the Autoregressive Integrated Moving Average, we forecasted these rates per country up to 2030. Results In the Balkan region, the highest incidence and DALYs rates in the study period were for colon and rectum, and breast cancers. Over the study period, the DALYs rates for breast cancer per 100,000 population were the highest in Serbia (reaching 670.84 in 2019) but the lowest in Albania (reaching 271.24 in 2019). In 2019, the highest incidence of breast cancer (85 /100,000) and highest YLD rate (64 /100,000) were observed in Greece. Romania had the highest incidence rates, YLD rates, DALY rates, and YLL rates of cervical cancer, with respective 20.59%, 23.39% 4.00%, and 3.47% increases for the 1990/2019 period, and the highest forecasted burden for cervical cancer in 2030. The highest incidence rates, YLD rates and DALY rates of colon and rectum cancers were continuously recorded in Croatia (an increase of 130.75%, 48.23%, and 63.28%, respectively), while the highest YLL rates were in Bulgaria (an increase of 63.85%). The YLL rates due to colon and rectum cancers are forecasted to progress by 2030 in all Balkan countries. Conclusion As most of the DALYs burden for breast, cervical, and colon and rectum cancer is due to premature mortality, the numerous country-specific barriers to cancer early detection and quality and care continuum should be a public priority of multi-stakeholder collaboration in the Balkan region

Cross-cultural validation and psychometric testing of the counseling center assessment of psychological symptoms: Experience of Serbia

Psychological distress in university students represents a rising public health concern. The complexity of this phenomenon calls for a more in-depth scrutiny, in order to address the wide diversity of mental health issues that may arise in this population. The instrument designed for the purpose of measuring the student-specific distress is needed. An appropriate tool is the Counseling Center Assessment of Psychological Symptoms 62 (CCAPS-62), multidimensional scale widely used at many universities. The objective of the present study was to translate, culturally adapt and psychometrically validate CCAPS-62 in Serbian student population. A total of 1326 Belgrade University students were recruited from twelve different faculties. Considering the possible culturally conditioned differences in the quality of distress both exploratory and confirmatory factor analyses were performed. The results of the exploratory factor analysis supported the eight-factor model with the item composition of the factors different to a certain extent from the original version. This measurement model was verified by confirmatory factor analysis. Findings demonstrated good internal consistency for the total scale as well as for the eight subscales applied among Serbian students. Implications are discussed with respect to the cultural context of mental health concerns in student population

Education for public health in Europe and its global outreach

Introduction: At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review: Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions: As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice

Schools of public health in Europe: Common mission-different progress

Background: European Essential Public Health Operations (EPHOs) supposedly drive improvements in public health outcomes, including Schools and Departments of Public Health (SPHs). Overall, SPHs did not progress significantly in delivering outcomes related to the EPHOs between 2011 (Survey I) and 2015/16 (Survey II). This analysis attempts to identify the positive or negative development of individual SPHs. Methods: The analysis has utilized data obtained from SPHs through questionnaire-based surveys, which contained information about learning outcomes of Master of Public Health (MPH) programs necessary for the implementation of EPHOs. To differentiate the progress of SPHs, we applied cluster analyses for a group of 36 SPHs with complete data sets for both surveys. Results: The statistical analysis identified three clusters for Survey I and Survey II, defined by their medians and position vectors. A comparison shows that between the two surveys, all clusters overlap and thus are not significantly different. Of the individual SPHs, 16 of 36 (44.4%) improved between 2011 and 2015/16 according to the increased magnitude of their position vector, whereas 9 SPHs (25.0%) show significant progress at P<0.05. From the 20 SPHs (55.6%) that decreased their performance, 11 (30.6%) showed a significant reduction in the outcome of Master of Public Health programs at P<0.05. This outcome implies that N=20 or 55.6% of the participating SPHs evidenced substantial changes. Analysis of 11 available nominal variables did not significantly explain the cluster positions in Survey I and II. Conclusions: Overall, there is no significant progress in the performance of SPHs between 2011 and 2015/16. However, detailed cluster analysis can demonstrate considerable progress for one-fifth of participating SPHs, whereas more than half lag