Violence against medical residents from Cluj-Napoca hospitals: rationale and methodology

Introduction. Even though workplace violence is frequent in healthcare, such events were exacerbated by the COVID-19 pandemic. During this period, new challenges arose for medical residents (change of specialty, increased workload, different schedules, extended exposure and contact with patients), and yet little is known about how the pandemic impacted their experience with workplace violence. Aim. The first objective of this study was to document the prevalence and preventive measures regarding workplace violence, as experienced by medical residents, before and during the COVID-19 pandemic in Cluj-Napoca's public hospitals. Building on the outcomes of the first objective, a second objective is to provide insights into medical residents' perceptions of violent events and their views on prospective prevention measures. Material and methods. A mixed-methods design was used, combining secondary data analysis from a larger study and primary data collection, using interviews with resident doctors. This study is a part of a larger research project that had the main goal to measure violence against healthcare workers during the COVID pandemic, not only in Romania, but also in partner countries – Armenia, Georgia and Moldova, supported by ICREATE: Increasing Injury Capacity in Research in Eastern Europe. For this research, a sub-sample of the total population from Romania (N=199), out of which 100 resident doctors were used, who worked in 8 different hospitals in Cluj-Napoca, between April and November 2022. The disseminated questionnaire contained multiple domains: socio-demographic information, workplace violence measures set in place in public hospitals of Cluj-Napoca and healthcare professionals' experience before and during COVID-19. Having the questionnaire as a baseline, a secondary data analysis was conducted, acting as preliminary results to be used for in-depth interviews. Guided by this secondary data analysis, it was observed that the term workplace violence is understood differently across groups. Also, there were differences between proposed prevention strategies in the hospitals and how workplace violence was perceived, leading to a necessity to develop an interview guide to explore the meaning of violence in their respective hospitals. Thus, the interviews are pending and will be held with medical residents, to grasp concepts and perceptions about workplace safety among them. Results. Secondary-data analysis showed that the most predominant forms of workplace violence before and during the pandemic are verbal threats (59.6% before and 54.2% during), followed by theft (26.8% and 19.1%) and physical violence (12.2% and 14.6%). The qualitative part is in progress and will complement the first set of data, by offering more in-depth information about the experiences and causes of violence, event follow-up, needs and future expectations. Conclusions. This study adds value to the existing literature and practices, by putting a spotlight on the prevalence of different types of violence against medical residents in hospitals of Cluj-Napoca, before and during the COVID-19 pandemic; as well as preventive and management measures

Capacity building for injury prevention and control: achievements and future directions

Introduction. The global injury burden is disproportionately concentrated in low- and middle-income countries. The ICREATE: Increasing Injury Capacity for Research in EAsTern Europe project, expands on five successful years of building injury research and education capacity in the countries of Armenia, Georgia, and Moldova. iCREATE focuses on building capacity for research, aiming to train a critical mass of researchers from Armenia, Georgia, and Moldova Material and methods. iCREATE trainees conduct innovative research and develop evidence-based and best-practice guidelines for the prevention and treatment of injuries. The first funding cycle of the project was from 2016 to 2021 (iCREATE1) and was funded by the United States National Institutes of Health, and coordinated by the University of Iowa, USA, and Babes-Bolyai University, Romania (NIH/2D43TW007261). The second funding cycle of the project (iCREATE2) has been secured until 2026. Results. The promotion of research capacity in injury prevention and control has been accomplished through the establishment of new curriculum across three partner institutions, conducting collaborative projects across multiple countries, and providing advanced MPH and PhD students and young professionals with opportunities for mentored experiential learning projects. During the initial funding cycle (iCREATE1), the project focused on acute care, road traffic safety, and violence against women and children, while in the second cycle of funding the grant expanded to include alcohol use and integrated a focus on implementation science. An 8-hospital emergency department trauma registry has been established, collecting 13,082 patient records, out of which 12,992 are included in a final database, thus expanding the data capacity of all partners. These registries have been utilized for student projects and trainee publications and presentations. In total, 40 MPH students and 9 PhD students received training, 43 experiential learning projects were mentored, and 13 peer-reviewed papers were published between 2016 and 2021, as a result of the aforementioned activities. Each consortium partner has hosted capacity-building activities such as injury prevention summer schools (n=3), annual injury-focused symposia (n=5), and skillbuilding workshops with over 600 participants attending. The work continued during the no-cost extension phase in 2022 as well, showing partner's continued engagement and dedication. Conclusions. iCREATE is a successful program in building capacity and promoting injury prevention and control. The activities have led to the creation of a critical mass of injury researchers, the advancement of professional careers and leadership roles for partners, and the establishment of a long-term regional network for collaborative injury and violence prevention activities. The achievements indicate a promising future for injury research and prevention, with the potential for sustained progress and impact in the field

Child safety restraint patterns in Moldova

ABSTRACT Objective: The Republic of Moldova has one of the European region’s highest road traffic injury rates and also has an increase in motorization and exposure of children as vehicle passengers. This study describes child restraint use, and parents’ knowledge and attitudes toward child restraint based on observations in Chisinau, the country’s capital and largest city. The study aims to describe the use of child restraints and to compare data with existing standards of good practice. Methods: An observational study on child safety restraint use was conducted in 2018. Observational sites included 22 early education institutions, where drivers (n¼611) and child passengers (n¼710) were observed. Observations were conducted as motor vehicles parked or pulled to a stop near the early education institutions and included a driver survey on knowledge and attitudes toward restraint legislation and child safety behavior. Results: Of the 710 child passengers observed, 462 (65.1%) were appropriately restrained, 145 (20.4%) were seated in restraints inappropriate for the child and 103 (14.5%) of children were unrestrained. Younger children (0-3 year-old) were 7 times more likely to be properly restrained compared with children with ages between 4 and 6 (OR 1.92, 95% CI 1.15 to 3.22). Two-thirds out of 609 observed drivers with full study data, N¼431 (70,8%), knew about the mandatory legislation on using child safety restraints in the Republic of Moldova. The drivers using child safety restraints responded that they used them because of their safety features, and the major reason for nonuse was high price/affordability. Conclusion: This study, the first to document child safety restraint use among children, indicates that much progress has been made, in that the majority of children are restrained and most drivers of children are aware of safety policies. However, progress can be made to increase knowledge and motivation to safely transport children, and to ensure safety seats are affordable and available. These data will be an important foundation on which to advocate for increased safety activities, child restraint policies, educational approaches in Moldova and to monitor progress over time

Unravelling networks in local public health policymaking in three European countries:a systems analysis

Background: Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases.Methods: A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed.Results: The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange.Conclusions: A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and their mutual relations. This information can be an important starting point to enhance the uptake of evidence and build more effective public health policies

Plant-Based Dairy Alternatives—A Future Direction to the Milky Way

One significant food group that is part of our daily diet is the dairy group, and both research and industry are actively involved to meet the increasing requirement for plant-based dairy alternatives (PBDAs). The production tendency of PBDAs is growing with a predictable rate of over 18.5% in 2023 from 7.4% at the moment. A multitude of sources can be used for development such as cereals, pseudocereals, legumes, nuts, and seeds to obtain food products such as vegetal milk, cheese, cream, yogurt, butter, and different sweets, such as ice cream, which have nearly similar nutritional profiles to those of animal-origin products. Increased interest in PBDAs is manifested in groups with special dietary needs (e.g., lactose intolerant individuals, pregnant women, newborns, and the elderly) or with pathologies such as metabolic syndromes, dermatological diseases, and arthritis. In spite of the vast range of production perspectives, certain industrial challenges arise during development, such as processing and preservation technologies. This paper aims at providing an overview of the currently available PBDAs based on recent studies selected from the electronic databases PubMed, Web of Science Core Collection, and Scopus. We found 148 publications regarding PBDAs in correlation with their nutritional and technological aspects, together with the implications in terms of health. Therefore, this review focuses on the relationship between plant-based alternatives for dairy products and the human diet, from the raw material to the final products, including the industrial processes and health-related concerns

Under-reporting bicycle accidents to police in the COST TU1101 international survey: Cross-country comparisons and associated factors

Police crash reports are often the main source for official data in many countries. However, with the exception of fatal crashes, crashes are often underreported in a biased manner. Consequently, the countermeasures adopted according to them may be inefficient. In the case of bicycle crashes, this bias is most acute and it probably varies across countries, with some of them being more prone to reporting accidents to police than others. Assessing if this bias occurs and the size of it can be of great importance for evaluating the risks associated with bicycling. This study utilized data collected in the COST TU1101 action “Towards safer bicycling through optimization of bicycle helmets and usage”. The data came from an online survey that included questions related to bicyclists' attitudes, behaviour, cycling habits, accidents, and patterns of use of helmets. The survey was filled by 8655 bicyclists from 30 different countries. After applying various exclusion factors, 7015 questionnaires filled by adult cyclists from 17 countries, each with at least 100 valid responses, remained in our sample. The results showed that across all countries, an average of only 10% of all crashes were reported to the police, with a wide range among countries: from a minimum of 0.0% (Israel) and 2.6% (Croatia) to a maximum of a 35.0% (Germany). Some factors associated with the reporting levels were type of crash, type of vehicle involved, and injury severity. No relation was found between the likelihood of reporting and the cyclist's gender, age, educational level, marital status, being a parent, use of helmet, and type of bicycle

Additional file 5: of Development of measurable indicators to enhance public health evidence-informed policy-making

Overview of the results of the two internet-based Delphi rounds in terms of medians and first quartiles of relevance and feasibility ratings for the indicators for EIPM developed in this study. (DOCX 21 kb