Higher education training in social work in Albania: insights from the experiences of the T@sk project

In March 2020, the European Union decided to open accession negotiations with Albania, candidate country since 2014. In order to achieve this important goal in the long path of European integration, Albania had to pursue a set of requirements. Among them, the centrality of human rights affects the implementation of policies aiming at integrating minorities, as well as at granting social rights to unprivileged citizens (La Cava Nanetti 2000, Solidar 2016). In this scenario, the evolution of the professional expertise of Albanian social workers plays a relevant role. In academic and professional terms, social work has a poor tradition in Albania, as in most of post-communist countries (Hoti 2015). In order to face the difficulties of the professional and academic evolution of social work and to facilitate a process of Europeanisation of the Social Services delivery in Albania, the European Commission has funded the project T@sk Towards Increased Awareness, Responsibility and Shared Quality in Social work (2017-2020). The main aim of the project consists in strengthening the delivery of Social Services in Albania through the empowerment of the Higher Education system in social work. The consortium includes all public universities offering BA and MA courses in social work in Albania – University of Tirana, University of Shkoder and University of Elbasan –, and the University of Florence, the UCM of Madrid, the ISCTE of Lisbon and the Professional Order of Social workers of the Tuscany Region as Higher Education institutions of the program countries. The project operates at three levels: peer-to peer theoretical and empirical update amongst the project partners; triangulation of knowledge, transdisciplinary cooperation with the societal stakeholders and digital innovation; selection and dissemination of best practices. The project was concluded in December 2020 and it is possible to elaborate on the main theoretical and empirical framework adopted, on the results achieved, and on the challenges to create a favorable environment for the development of social work profession in Albania. The article sheds light in the pattern of evolution of social work practices in Albania, focusing on the social and cultural background of the country, and describing the main achievements of the T@sk project

Course and Lethality of SARS-CoV2 Epidemic in Nursing Homes after Vaccination in Florence, Italy

Evidence on the effectiveness of SARS-CoV-2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV-2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV-2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October–26 December 2020) and post-vaccination period (27 December 2020–31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%–6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV-2+ during the post-vaccination period. FV showed significantly lower hospitalization and mortality rates than PV and UV (hospitalization: FV 3%, PV 14%, UV 33%; mortality: FV 6%, PV 18%, UV 56%). The death risk was 84% and 96% lower in PV (HR 0.157, 95%CI 0.049–0.491) and FV (HR 0.037, 95%CI 0.006–0.223) versus UV. SARS-CoV-2 vaccination was followed by a marked decline in infection rates and was associated with lower morbidity and mortality among infected NH residents

Missing not at random in end of life care studies: multiple imputation and sensitivity analysis on data from the ACTION study

Background: Missing data are common in end-of-life care studies, but there is still relatively little exploration of which is the best method to deal with them, and, in particular, if the missing at random (MAR) assumption is valid or missing not at random (MNAR) mechanisms should be assumed. In this paper we investigated this issue through a sensitivity analysis within the ACTION study, a multicenter cluster randomized controlled trial testing advance care planning in patients with advanced lung or colorectal cancer. Methods: Multiple imputation procedures under MAR and MNAR assumptions were implemented. Possible violation of the MAR assumption was addressed with reference to variables measuring quality of life and symptoms. The MNAR model assumed that patients with worse health were more likely to have missing questionnaires, making a distinction between single missing items, which were assumed to satisfy the MAR assumption, and missing values due to completely missing questionnaire for which a MNAR mechanism was hypothesized. We explored the sensitivity to possible departures from MAR on gender differences between

T@Sk Project: building bridges between University and society through social work

Professionalization, modernization and Europeanization of Social Services in Albania have been the main goals of the Erasmus+ Capacity Building T@sk Project “Towards Increased Awareness, Responsibility and Shared Quality in Social Work” (2017-2020). T@sk Project pursued these aims through three main actions: 1) Internationalisation and 'Europeanisation' of Albanian Higher Education Institutions; 2) Knowledge triangulation between university lecturers, students, and social stakeholders; 3) Networking of social and political stakeholders. T@sk methodology was based on a subsidiary and multilevel approach agreed amongst the project consortium composed of the University of Florence, the Complutense University of Madrid, the ISCTE of Lisbon, the Professional Order of Social Workers of Tuscany and the three Albanian public universities that offer Bachelor and Master courses in Social Work: University of Tirana, University of Elbasan, University of Shkodra. T@sk project achieved its objectives thanks to the engagement of Higher Education staff with the changing social work environment in Albania and in the participating countries (Italy, Spain, Portugal). The promotion of a constant dialogue with social services on the ground in the four countries, the identification of the respective social needs and the reflection on theoretical and empirical research were the key actions of the project. A dense network of associated partners (social workers operating in the public and in the private sectors, NGOS, institutional stakeholders) complemented the peer-to-peer training programme for teachers, students and trainers. During the three years of the project, participants were confronted with problems related to the regulation of the social work profession in their own country. Those experiences have supported the production of 3 volumes dedicated to the Albanian Social Services, standardized guidelines for social workers, and a code of ethics (all publications and training materials are available and downloadable from the project website: https://www.taskproject.eu). The project followed the creation of the professional Order of Social Workers in Albania, finally accomplished in 2022. By the end of the project 50 university teachers, 140 social workers and 500 students had been trained. A total of 21 memoranda of understanding were signed by local and central policy makers, new agreements implemented, and 2 ICT laboratories created. The investment of T@sk in the digitalisation of teaching and learning activities in Albania proved to be strategic at a time when the Covid-19 pandemic made the use of online learning management systems indispensable. Despite the fact that Albania was the beneficiary partner, the co-design of training activities allowed a cross-reflection on the welfare models adopted by the participating countries. The translation of universal social rights into tailored interventions rests upon institutional, economic and cultural variables, all taken into account through the comparative approach of the project. Currently, project members are continuing to collaborate on specific research project focusing on the resiliency of Social Services in the face of new challenges (digitalization; new forms of poverty, epidemiological, social and economic effects of COIVD-19) that strongly question the capacity of any Welfare system

The impact of ACP on patient's relationships

Background: In the period 2013-2018 an important European study (ACTION) involving six countries, financed according to the 7\ub0 European framework, has been performed. The ACTION study dealt with the issue of advance care planning (ACP) in oncology and searched for evidence of its impact on patient and family

Sarcopenia: assessment of disease burden and strategies to improve outcomes

Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength - a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors - in particular, nutritional status and degree of physical activity. According to the operational definition by the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function, which can be defined by low muscle strength or low physical performance. Moreover, biomarkers of sarcopenia have been identified for its early detection and for a detailed identification of the main pathophysiological mechanisms involved in its development. Because sarcopenia is associated with important adverse health outcomes, such as frailty, hospitalization, and mortality, several therapeutic strategies have been identified that involve exercise training, nutritional supplementation, hormonal therapies, and novel strategies and are still under investigation. At the present time, only physical exercise has showed a positive effect in managing and preventing sarcopenia and its adverse health outcomes. Thus, further well-designed and well-conducted studies on sarcopenia are needed

Acute care hospital at different levels of intensity: the role of Geriatrician

The traditional model of care is based on "disease-centered" management that requires the organization of the hospital in specialized wards, to which the patient is assigned for the main disease. The growing need to optimize economical and human resources and to promote a global approach to the patient has led to the setting up of the intensity of care model. It is a health system based on a "patient-centered" approach, where the hospital is organized in departments dedicated to patients with homogenous needs of care. In Italy, intensity of care model is currently being tested in the hospital organization, where three levels of intensity are proposed: low, medium and high. The purpose of the following review is to describe the role and importance of the Geriatrician in each of these care settings and to highlight the contradiction of a National Health System which promotes the geriatric approach to all types of patients, but does not invest in the formation and integration of the figure of the Geriatrician in clinical practice, condemning it to marginalization or even extinction