The burden of road traffic injuries among patients treated in the largest trauma hospitals in the Republic of Moldova

INTRODUCTION Every year, 1.35 million people die in road accidents, with a high mortality rate among young people aged 15-29 years. The problem of road safety is getting worse every year, causing enormous financial damage to healthcare systems and other forms of human suffering, in special in low-middle income countries. Systems for routinely collecting injury data in the Republic of Moldova are limited. OBJECTIVES This study aimed to identify specific characteristics of road traffic injuries among patients treated in the largest trauma hospitals in the country. METHODS It was tested a pilot iCREATE Injury Registry within 2 Emergency Departments in Chisinau municipality. A total number of 7,946 patients with different types of injuries were collected during one year from the existing patient medical records. RedCap was used to upload the data and analyze it through SPSS. RESULTS There have been identified 2,251 road traffic-related cases (28.3% from total), road traffic-specific questions like helmet and child seat in 391 observations (17.4%). Injury cases prevail among men. The most specific age affected by road injury was 19-39 years; the age group >60 years by falls, the age group 8-18 years by school environment injuries. Most cases happened in urban areas (85%). Road traffic victims used proportionally private/public transport in 49% and ground ambulance in 47%. Most cases happened within the road environment and unintentionally (94%), from them due to falls in 63% and 17% due to road traffic event. Among the main purposes in which the persons were mentioned in one of the risk situations of injury were: travel for certain purposes in certain places of personal interest, vital daily activities, unspecified activities, leisure and play, unpaid work, including domestic activities within the home environment. There have been registered 87% cases having a single distinct injury, 2 distinct injuries in 9%. The main types of injury were fracture, contusion, sprain, and concussion/brain injury. Immediate treatment with follow-up was needed in 60% of the cases, a quarter of the injured persons were treated and admitted to the hospital, 8% were treated and released without follow-up. Referring to the road injury event, the seat belt was used in only 34,5% of cases, child safety restraint in 15,1%, and helmet in 15,4%. CONCLUSION The obtained data underline the importance of an injury register, the need to develop health promotion and health education campaigns among the vulnerable groups, and the involvement of all actors in maintaining road safety

APPLICATION OF IN VITRO AND IN SITU BIOASSAYS FOR EVALUATION OF WATER GENOTOXIC POTENTIAL

Human activity has the great negative impact on water quality. As a consequence, deterioration of freshwater ecosystems has the effect on whole wildlife. Some of the pollutants which are realised into water could interact with DNA molecule and lead to DNA damage. The Velika Morava River is one of the larger tributaries of the Danube River. The major ecological problem of the Velika Morava River basin is discharging of municipal and industrial wastewaters. The aim of our study was the evaluation of genotoxic potential of the Velika Morava River basin. For this purpose, we employed battery of in vitro and in situ bioassays. From 9 selected sites the water samples and blood samples of Alburnus alburnus were collected. Within in vitro approach, the genotoxicity of water samples was tested using the SOS/umuC test on Salmonella thyphimurium TA1535/pSK1002 and alkaline comet assay on the HepG2 cell line. On the other hand, in situ approach included the alkaline and Fpg modified comet assay and the micronucleus test on bleak (A. alburnus) erythrocytes. The obtained results indicated differences of in vitro and in situ tests to evaluate genotoxic potential. The effects of genotoxicity were evident only in tests performed in situ, which is not surprising considering constant exposure of collected organisms to environmental stress. Differential sensitivity was found also within in situ tests where the alkaline comet assay showed the highest potential in distinguishing between sites. So, in accordance with results, we could conclude that application of the battery of in vitro and in situ bioassays is appropriate for assessment of genotoxic potential

Is There a Relationship between Objectively Measured Cognitive Changes in Cancer Patients Undergoing Chemotherapy Treatment and Their Health-related Quality of Life? A Systematic Review

Background/purpose: Many people living with cancer experience depression. Research suggests that the therapeutic effect of exercise on depression is similar to pharmacotherapy or psychological intervention, yet cancer survivors are under-exercising compared to recommended doses. Self-efficacy may be a factor to explain exercise engagement. This cross-sectional study investigated whether exercise task self-efficacy (ETSE) was associated with exercise engagement, further examining differences between cancer survivors with and without elevated depressive symptoms. \ud \ud Methods: Ninety-seven cancer survivors (60.8 ±9.9 years) were mailed self-report questionnaires on ETSE, exercise engagement, and depressive symptoms. A Hospital Anxiety and Depression Scale D cutoff score (≥8) was used to assign participants to a symptomatic (n = 34) or non-symptomatic group (n = 63). An independent t-test was used to examine differences in ETSE between groups. Correlational analyses were used to examine relationships between exercise task self-efficacy and exercise engagement. \ud \ud Results: There was a significant difference in the degree of exercise task self-efficacy between cancer survivors with (M=35.74, SD= 31.47) and without (M=57.30, SD= 26.71) depressive symptoms, t(95) =_3.56, p<0.01, with a large effect size (d =0.74). A positive association was found between ETSE and exercise engagement, r(95)= 0.49, p<0.01, which was similar for both groups. \ud \ud Conclusions: Exercise task self-efficacy appears to influence exercise engagement independently of mood status, but people with higher levels of depression symptoms tend to have lower self-efficacy. Therefore, future research should examine interventions to enhance exercise task self-efficacy, thereby potentially increasing exercise engagement in cancer survivors. Research Implications: These findings demonstrated that cancer survivors with depressive symptoms have low ETSE and that ETSE can predict exercise engagement. This suggests a role for enhancing ETSE to influence exercise engagement in cancer survivors. Future research could investigate causality between ETSE and exercise engagement and interventions to enhance ETSE. The findings of the present study could assist with more definitive research which could aid clinicians interested in behavioral change with regard to exercise engagement and improvement of depressive symptomatology in cancer survivors. Practice Implications: The findings illustrate that exercise self-efficacy predicts exercise engagement, independently of mood. Therefore, clinicians working with depressed or non-depressed cancer survivors should initially target increasing exercise self-efficacy as opposed to reinforcing the positive health benefits of increased physical activity

Human Traffficking in Romania: An Analysis of Prevention and Outreach Activities

Human trafficking is a growing problem in Romania and around the world. Romania is considered a transit and origin country for human trafficking. Most victims are transported externally to more developed countries, although many victims will stay within Romanian borders. The Romanian government, Non-Governmental Organizations (NGOs), and other stakeholders are making efforts to prevent trafficking. This descriptive study, based on a series of qualitative interviews, examines the actions NGOs, governmental organizations, and church leaders in Cluj County, Romania are taking to prevent trafficking. The strengths and weaknesses of existing programs, as well as recommendations for future action are discussed. A model for prevention, intervention and recovery of victims is also presented

Assessment of health risks of policies

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessmentwith special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals.

Smoking and quitting smoking during pregnancy: A qualitative exploration of the socio-cultural context for the development of a couple-based smoking cessation intervention in Romania

Introduction Smoking during pregnancy has negative effects on the mother and the unborn infant. Barriers to and facilitators of smoking cessation during pregnancy are context-dependent and multifaceted. This qualitative research explored pregnant women’s experiences with smoking and cessation in Romania, and informed the development of a couple-focused smoking cessation intervention. Methods Semi-structured, in-depth interviews were conducted via telephone, with 15 pregnant women who smoked during pregnancy or had quit smoking upon learning about the pregnancy or shortly before. A hybrid inductive-deductive approach to thematic analysis was used, to identify patterns in the data and explore women’s narratives, in relation to smoking and smoking cessation. Results Three main themes emerged from the data, which shaped the socio-cultural adaptation of the intervention to the local context: 1) Access to and mixed messages from the healthcare system that describe an inconsistent discourse from the healthcare system regarding smoking during pregnancy with some physicians not emphasizing the need for cessation, 2) Cessation as individual or team effort with variations in partner dynamics and difficulty in quitting that have important roles in perceptions about team efforts, and 3) Transition to motherhood and motivation to quit for the health of the pregnancy and infant, although in isolated cases women felt less connected with the pregnancy and such motivators. Conclusions Pregnant women in Romania face systemic, interpersonal, and individuallevel barriers that can be responsively integrated in smoking cessation interventions, by culturally adapting them to the local context

Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire

Objective: Empirical data on health literacy (HL) for Romania is almost inexistent. The present study aimed to validate the HLS-EU-Q16 questionnaire for the Romanian population and explore the predictors of HL in the North-West Region of the country. Methods: A non-experimental, cross-sectional study was conducted between March and November 2019 on a representative, stratified random sample of 1,622 participants from the North-Western Region of Romania. Exploratory Factor Analysis (EFA), Principal component analysis (PCA), Pearson correlations, and Chronbach’s Alpha were used to validate the scale. Linear regressions were conducted to assess the determinants of health literacy. Results: Results obtained for the HL scale support its factorial component and reliability, with a Cronbach’s alpha of α = 0.84. Age, gender, education and self-reported health status were identified as determinants of HL. Conclusion: Study findings indicate that the Romanian version of HLS-EU-Q16 is psychometrically sound and comparable to the original version. These results provide the first validated tool to measure HL in Romanian and the first population level data for Romania

Attitudes towards war, killing, and punishment of children among young people in Estonia, Finland, Romania, the Russian Federation, and the USA

OBJECTIVE: To study the cultural differences in moral disengagement, which lends support to attitudes used to justify violence. METHODS: We carried out classroom surveys of a total of 3122 students in the USA (Houston, TX, and Washington, DC) and in four European countries - Estonia (Tartu), Finland (Helsinki), Romania (Satu Mare) and the Russian Federation (St Petersburg). Data were also taken from a random sample telephone survey of 341 young adults (aged 18-35 years) in Texas, USA. Ten distinct groups were studied. Seven questions were common to all the surveys, using identical statements about the participants? agreement with attitudes relating to war, diplomacy, killing, and the punishment of children. FINDINGS: The US students were more likely than those in Europe to agree with the following statements: ??War is necessary?? (20% vs 9%), ??A person has the right to kill to defend property?? (54% vs 17%), and ??Physical punishment is necessary for children?? (27% vs 10%). Justification of war and killing was less common among females than males in all groups; other differences within the US groups and the European groups were smaller than the differences between the US and European groups. CONCLUSION: The results confirm the gap between the US and European groups in moral disengagement attitudes and tendencies that could lead to deadly violence

Educational Interventions to Improve Safety and Health Literacy Among Agricultural Workers: A Systematic Review.

Health and safety education for farmers has the potential to increase the level of health, safety literacy, and thereby improve farmers' health and quality of life. The aim of this paper is to provide a systematic review of the published literature documenting different educational interventions for agricultural workers that have the improvement of health and/or safety literacy as an outcome. A systematic search was conducted in PubMed, Embase, Scopus and PsycINFO databases for articles focusing on educational interventions for farmers' health and safety. From the 3357 initial hits, 36 unduplicated records met the inclusion criteria. The articles included in the review used educational interventions for farmers with the purpose of preventing farm-induced diseases and injuries, increasing the health and well-being of farmers, and promoting good manufacturing practices. The educational approaches considered varied from lectures, videos, newsletters, games, and community fairs, to involving the community in designing the intervention and training farmers to deliver the intervention to the community. Interventions that used evidence-based theories, which took into account cultural aspects and individual factors, used biomarkers as a behavior change measurement, and involved the community in the development of the intervention had the best results in terms of behavior change. The strategies of educational interventions identified in this review that produced good results have the potential to inform future researchers and policy makers in the design and implementation of public health interventions, programs and policies to improve the health of farmers and their families