Elisaveta Stikova

Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupati...

Key issues: The notion of Public-Private Partnerships (PPPs) is not a new one, but it certainly is underused tool and even less investigated field of cooperation in the improvement of the global access to health. The three rather distinguished sectors (public, private and civil society), even though sometimes having similar or even same stakes, and maybe playing in the same game, are rarely part of the same team. Their relationships are more often than not, relentlessly bound to unilateral interests - communication and interest exist in both directions, but the efforts are usually done only in one way at a time. Objectives / Projects: This paper will explore the motivation (rationale) behind the notion of the PPP, optimally described as ‘a cooperative venture between the public and private sectors, built on the expertise of each partner, that best meets clearly defined public needs through the appropriate allocation of resources, risks and rewards’ (CCPPP). Also, the paper intends t...

Background: After the breakup of Yugoslavia in 1990, Macedonia started to build its own health care system based on the universal principles of equity, solidarity and accessibility. Throughout its independence, the country is faced with high unemployment (32,2% in 2009) and poverty (30,9% poor people). The aim of this paper is to present the state of infant and perinatal mortality in Macedonia in the period 1991-2009 during the period of economic transition and to assess the opportunity to prevent perinatal conditions that contribute to the global burden of diseases in the country. Methods: A descriptive statistical method was applied with retrospective analysis of data for the period 1991-2009. Data from standardized statistical reports (WHO-HFA, Health Maps and Statistical Yearbooks) were used. Results: The infant mortality rate in Macedonia in1991 was 28.2 per 1000 live births. Over the past 20 years it has decreased by 60% to 11.4/1000. Despite this remarkable progress, the rate...

Globalization, migration of the population, climate change, and war and other conflicts throughout the world have created an increasingly complex environment for humanitarian aid and international response and relations. In the past two decades, wars and other conflicts have increasingly become an internal problem for fragile nation-states, and these disrupted states often suffer from inequalities in social, economic, and political development, exacerbated by long-term ethnic, religious, and minority conflicts and by the fierce competition for existing resources. In the meantime, these animosities become an international problem to solve. The humanitarian response to war-related crises and disasters has gradually evolved from charitable but uncoordinated efforts into more systematized interventions. Large, multinational organizations have developed significant technical and logistical capacity in responding to the public health needs of large vulnerable populations. The authors anal...

WRA is a new approach in the traditionally oriented occupational health. Current techniques for recognising and managing occupational safety and health risks were mainly oriented and defined as ―workplace analysis‖ and they lack a risk management and risk quantification component. This module introduces a modern approach to risk quantification that incorporates recent scientific and legal advances in occupational safety and health, consistent with international regulations.

Key issues: Across the EU, the fundamental principles of harmonization and free movement of labor and capital have led to a common basis for health and safety legislation and also training and mutual recognition of medical specialists and other experts in this field. However, responsible bodies, while using the word competent, have not defined what is meant by it when referring to trained occupational physicians and other occupational safety experts. The curricula of specialist training within EU is underpinned by general principles, ILO and WHO agreements, and recently, the EASOM recommendations. However, within Europe it is clear that the emphasis of training, and the roles of OSH experts and physicians, have varied considerably depending on historical practice and local legislation. In the process of preparation for EU accession, the countries have to revise their OSH policy, to adopt more modern approach and to build their capacities in this field. Three countries selected to pa...

ABSTRACT PURPOSE: Medical X-ray exposures have been the largest man-made source of population exposure to ionizing radiation in developed countries for many years. It is therefore important for radiation protection and healthcare authorities in each country to regularly assess the magnitude and the distribution of this large and increasing source of population exposure. The purpose of this paper is to present results from the survey on the number of typical X-ray examination procedures in the Republic of Macedonia for 2010, the distribution of examination procedures by type per modality for adults and pediatric patients, the annual frequency per 1000 population and the collective effective dose per 1000 population from the X-ray examination procedures performed in the Republic of Macedonia in 2010. MATERIALS AND METHODS: In the beginning of 2011, a survey was initiated in the Republic of Macedonia for collecting data on the number of typical X-ray examination procedures conducted in 2010 as a basis for estimating frequency of these procedures and associated population doses. The survey was initiated within a Dose Data Med project launched by the European Commission to study population doses from medical exposures within the Union. The Republic of Macedonia was invited to participate in this projectas a test country . Typical X-ray examination procedures encompass those that are recognized to be the most important for the total population dose, referred to as TOP20 X-ray procedures. The survey was based on a specific questionnaire being prepared and distributed to the 87 X-ray departments in the Republic of Macedonia intended to cover the data for the year of 2010. The data was collected and summarized. Based on data gathered, the total number of examination procedures, annual frequency and their distribution by modality were calculated. Thereafter, the annual collective effective dose per 1000 population for each examination procedure in the TOP20 group and collective effective doses were estimated using literature data for values of the mean effective dose per typical examination procedure. Finally, normalization of the total collective effective dose from all TOP 20 X-ray procedures for the whole population in the Republic of Macedonia was performed. RESULTS: 67% of X-ray departments present in the Republic of Macedonia at the time the survey was initiated provided data on the number of TOP20 X-ray examination procedures performed in 2010. On the basis of the data gathered, a total of 322039 TOP20 X-ray examination procedures were performed in 2010 for both adult and pediatric patients. Plain radiography examination procedures (dental excluded) were the most commonly performed procedures in the Republic of Macedonia that year and the plain radiography of chest/thorax had the highest frequency of examinations (64 examinations) per 1000 population. The Ba meal examination procedure with an annual frequency of 2.93 per 1000 population has the highest contribution to the annual collective effective dose of all other procedures. Still, in total, the contribution of X-ray examinations in the plain radiography modality to the collective effective dose is the highest. The total collective dose from TOP 20 X-ray examination procedures in 2010 is 507 man Sv, while the normalized collective dose to the population is 249.7 mSv/1000 population. CONCLUSIONS: The most common type of examination in the Republic of Macedonia for 2010 is X-ray projection of lungs. The contribution to the collective effective dose from X-ray examinations in the plain radiography modality is the highest, followed by contributions from fluoroscopy procedures, computer tomography and interventional radiology procedures. Comparision of the estimated collective dose from TOP20 X-ray examination procedures in other countries suggests possible underestimation in the estimated doses comparing to actual doses. A more comprehensive survey and analysis are needed to be carried out in future in order to obtain more precise estimates of the frequency of X-ray examinations and associated population doses in the Republic of Macedonia. Ideally, this need to be done on a regular basis with a commitment by relevant institutions. Keywords – frequency of X-ray examination, population dose

... Room 312, Pittsburgh, PA, USA Michalski, Aleksander Military Institute of Hygiene & Epidemiology UI Lubelska 2, 24-100 Pulawy, Poland Mijakoski, Dragan Institute of Occupational Health, II Makedonska Brigada 43, Skopje, Macedonia 1000 Milevska-Kostova, Neda Center for ...

ABSTRACT Within this study a qualitative review has been conducted leading to a clarifying finding of Cooperation and Information Interaction in the field of counteracting biological threats. Three cornerstone incentives of Information Sharing have been highlighted: Psychological, Technological and Economical. The proposals to use the architecture experience of CERN; strategy of ISE, USA; standards, rules and formats of NIEM, USA; practice of EMERCOM, RF for building a Global Anti-Terrorism Information Sharing Infrastructure are presented.

EXECUTIVE SUMMARY Introduction 1. The Republic of Macedonia is in a period of transition in moving towards a market based economy. During this period, it is crucial to consider environmental concerns to integrate policies of protecting human health and the environment with the development initiatives in the country. Thus, this National Environmental Action Plan (NEAP) has been developed with a goal of integrating environmental issues with the economic and social development programs of the country. The NEAP highlights the environmental problems and recommends actions related to policy, institutions, and priority investments. In preparing the action plan the following three criteria were considered: - protecting human health; - improving the environment to enhance quality of life; and - conserving natural resources for sustainable development 2. One key priority action is developing an environmental management system with adequate institutional capacity and an appropriate regulatory ...

Numerous recent studies point out a relationship between bronchial reactivity and the inflammation of the airways. The paper deals with the most frequent mechanisms of bronchoconstriction in occupational asthma combined with inflammatory process. The importance of inflammation in the Moira Chan-Yeung classification of occupational asthma is emphasized. According to this classification several types of occupational asthma are associated with the working environment. It is stressed that continuing prophylaxis of inflammation should protect the worker from irreversible airflow obstruction. This is of special interest to the population suffering from occupational asthma.

Albania today is still a low HIV prevalence country, but major concerns exist that since the 1990s there has been an uncontrollable increase in the risk-behaviours coupled with spontaneous massive internal and external migration, and a lack of information about the causes and prevention of HIV/AIDS. By the end of 2004, there were 149 HIV cases in Albania, of which 48 cases of AIDS (with 25 deaths). Sexual transmission, both homosexual and heterosexual, accounts for over 90% of HIV cases in Albania and the age-group most affected is 30-40 years old. The majority of reported HIV cases were acquired outside Albania. According to projections of the National HIV/AIDS Program, in 2010, the number of HIV cases might reach 10,000-15,000 if the necessary prevention measures would not be taken. Thus, after 2000, there was an emerging need for a national strategy of control and prevention of HIV/AIDS in Albania. This was due to the increasing number of new cases every year as a consequence of ...

Major emergencies, disasters and other crises do not respect national borders and never occur at convenient times. The magnitude of human suffering caused by these events is huge, and many aspects of people's lives are affected – health, security, housing, access to food, water and other life commodities, to name just a few. That is why it is vital to strengthen public health preparedness and response to different natural and man-made disasters. Disaster management has a crucial role in mitigation of disaster consequences. The aim of disaster management is to support countries in building their emergency response capacities, stressing a multisectoral and comprehensive approach in terms of risk reduction. Since the risk is a function of the hazards to which a community is exposed and the vulnerabilities of that community, the risk can be modified by the level of the emergency preparedness of the community at risk. The challenge is to put in place systematic capacities such as: le...

This module examines the health policy development and in particular the functions of health policy analysis in the policy-making process. The module starts with a short overview of the historical background of policy analysis, which shows that the aim of policy analysis, today as in the past, has been to provide policymakers with information that can be used to solve practical problems. The module continues with a description of the policy development in the health sector. Although policy analysis is an intellectual activity, it is also embedded in a social and political process known as policymaking. Health policies are important because it is what gives content to the practices of the health sector. Policies are expressed in a whole series of practices, statements, regulations and even laws which are the result of decisions about how we will do things.

Albania today is still a low HIV prevalence country, but major concerns exist that since the 1990s there has been an uncontrollable increase in the risk-behaviours coupled with spontaneous massive internal and external migration, and a lack of information about the causes and prevention of HIV/AIDS. By the end of 2004, there were 149 HIV cases in Albania, of which 48 cases of AIDS (with 25 deaths). Sexual transmission, both homosexual and heterosexual, accounts for over 90% of HIV cases in Albania and the age-group most affected is 30-40 years old. The majority of reported HIV cases were acquired outside Albania. According to projections of the National HIV/AIDS Program, in 2010, the number of HIV cases might reach 10,000-15,000 if the necessary prevention measures would not be taken. Thus, after 2000, there was an emerging need for a national strategy of control and prevention of HIV/AIDS in Albania. This was due to the increasing number of new cases every year as a consequence of ...

Mycotoxins are toxic substances produced mostly as secondary metabolites by filamentous fungi that grown on seeds, grains, feed and contaminate them during storage and pose the most serious threads to human and animals health while consumption. The most alternative aspects derived from previous studies suggested that herbal compounds and plants extracts could act as antifungal and antimycotoxigenic agents without side effects. In the present study the antifungal activity of some herbal compounds and plants extracts from sixteen medicinal plants at different concentration were tested against three important mycotoxin producing fungal species, Aspergillus parasiticus, Penicillium verucossum, Fusarium monilliforme. Among the herbal compounds and plant extracts were screened, clove oil at 0.5% concentration was showed (100%) complete inhibition against A.parasiticus, P. verrucossum, F.monilliforme. In addition, pepper (0.5%), turmeric (0.5%), eucalyptus oil (2%) was showed (100%) comple...

Aim: Healthcare authorities constantly search for new approaches of assessing the performance of the health sector. Comparative studies help for improvements in healthcare by learning from each-other. Our aim was to assess the performance of the public healthcare system in the Republic of Macedonia, through the analysis of preparedness of institutions to fulfill the population’s healthcare needs and expectations. Methods: This study had a regional character. The national research team interviewed 175 randomly selected participants from Macedonia. The research was performed in the period March 2012 – March 2013. For the research purposes there were used especially designed questionnaires for cancer, stroke, myocardial infarction, diabetes mellitus and injuries. For assessment of the performances, the appropriate techniques were developed. Results: Macedonians consider public healthcare system as being medium-good in all aspects: accessibility, availability, quality of health care ser...

Безбедноста на житата и житните производи е од големо нутритивно и токсиколошко значење, бидејќи житната индустрија и нејзините производи имаат голема економска и социјална важност на светско ниво. Во ова пилот истражување е испитана концентрацијата на токсичните елементи во траги арсен, кадмиум и олово, во три мостри од различни производители на ориз: 11,67+5,69mg/kg, 25,67+6,43mg/kg, 47,67+18,01mg/kg, пченично брашно: 7+5mg/kg, 9+1,73mg/kg, 69,92+16,92mg/kg за As, Cd и Pb, соодветно, и производи од брашно (леб: 9,33+2,08mg/kg, 6,67+0,58mg/kg, 36+3,6mg/kg, тестенини: 1,61+1,15mg/kg, 2,67+2,08mg/kg, 30+7mg/kg и чајни колачи: 4,67+4,04mg/kg, 1,33+0,58mg/kg, 53+9,64mg/kg за As, Cd и Pb, соодветно) од македонскиот пазар, со употреба на хидридно генерирачка и електротермичка атомска апсорпциона спектрометрија со мокра дигестија. Извршена е пресметка на учеството во просечниот дневен внес за токсични елементи внесени преку дневна консумација на жито и производи од жито (20% од целодневни...

Безбедноста на житата и житните производи е од големо нутритивно и токсиколошко значење, бидејќи житната индустрија и нејзините производи имаат голема економска и социјална важност на светско ниво. Во ова пилот истражување е испитана концентрацијата на токсичните елементи во траги арсен, кадмиум и олово, во три мостри од различни производители на ориз: 11,67+5,69mg/kg, 25,67+6,43mg/kg, 47,67+18,01mg/kg, пченично брашно: 7+5mg/kg, 9+1,73mg/kg, 69,92+16,92mg/kg за As, Cd и Pb, соодветно, и производи од брашно (леб: 9,33+2,08mg/kg, 6,67+0,58mg/kg, 36+3,6mg/kg, тестенини: 1,61+1,15mg/kg, 2,67+2,08mg/kg, 30+7mg/kg и чајни колачи: 4,67+4,04mg/kg, 1,33+0,58mg/kg, 53+9,64mg/kg за As, Cd и Pb, соодветно) од македонскиот пазар, со употреба на хидридно генерирачка и електротермичка атомска апсорпциона спектрометрија со мокра дигестија. Извршена е пресметка на учеството во просечниот дневен внес за токсични елементи внесени преку дневна консумација на жито и производи од жито (20% од целодневни...