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Cancers

More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 ... more More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic researc...

Introduction: This paper examines the factors and approaches the question of patients’ satisfacti... more Introduction: This paper examines the factors and approaches the question of patients’ satisfaction in the health care delivery system in North Macedonia. Aim: The study aims to assess how key service quality dimensions relate to an important measure of performance patient satisfaction and to find the elements that are valued by patients and the reasons behind patient satisfaction or dissatisfaction. Materials and method: In this research study, the factor analysis was used to group 12 questions measuring patient satisfaction under certain extent with Promax oblique rotation using the satisfaction responses gauged by importance. We have performed a structural equation model (SEM) to determine the relationships between one or more independent variables (IVs). Results: All component measures were greater than .702 which shows strong internal reliability among components. The reliability levels for the three components were .842 for the hospital environment, .835 for admin and .702 for...

Introduction: Acne vulgaris is a disorder of the pilosebaceous units. It is a chronic inflammator... more Introduction: Acne vulgaris is a disorder of the pilosebaceous units. It is a chronic inflammatory dermatosis notable for open/closed comedones, papules, pustules, nodules. It is characterized by open comedones, closed comedones and pustular nodules. Aim of study: To examine factors underlying the quality of life of people with acne. Materials and method: A total of 576 respondents were included in the study. Acne specific Quality of Life questionnaire was used for this purpose. A prospective cross-sectional study was conducted, performed in private dermatological clinic as well as on-line. All analyses were conducted by using the SPSS.26 for Windows. Results and Discussion: 5.7 % were males and 94.3 percent were females. About 69.4% were aged between 15-25; 16.7 % between 26 to 30; 8.8% between 31 to 35 years old. Quality of life and emotional perception towards the social environment is demonstrated by the three components (self-perception of discomfort, functionality, and social ...

Within the last 10 years and in comparison to European countries, Macedonia has one of the lowest... more Within the last 10 years and in comparison to European countries, Macedonia has one of the lowest contraceptive use rates and one of the highest abortion rates. While studies have been conducted on the determinants of abortion and contraceptive use, there is a lack of knowledge about the perceptions and every day experiences of health care practitioners’ practices dealing with abortion and contraceptive services. The main goal of the study is to explore experiences and motives of health care professionals in their everyday work with clients who are seeking contraceptive and abortion services. We used a qualitative approach with in-depth interviews and focus group discussions with women who use health services during their reproductive period (from ages 12-49). We analyzed the data according to domains into which themes were classified: Perception and interaction with clients, good professionals, social settings, education, financial issues, and health care system services. The exper...

The study assesses the level of integration of public health measures into national climate chang... more The study assesses the level of integration of public health measures into national climate change adaptation strategies or action plans in the EU 28 countries in 2017-8, as part of the Pagoda WHO project. Areas covered in the analysis are: governance and policies on climate change and health impact, vulnerability assessment of climate change, integrated climate information into infectious disease surveillance, early warning systems for extreme weather, recent projects on climate change and human health, health effects of climate change, best practices, main risks and priorities protecting from climate change. A qualitative approach was applied in this research study based on responses of 20 questionnaires of WHO European Member States. 15 of the responding countries had developed a climate change health adaptation strategy and an associated implementation plan (75%), and these were approved by the government in 13 countries (65%). The results revealed certain specific areas for tec...

International Journal for Equity in Health

Introduction: Roma, the largest minority group in Europe, face widespread racism and health disad... more Introduction: Roma, the largest minority group in Europe, face widespread racism and health disadvantage. Using qualitative data from Serbia and Macedonia, our objective was to develop a conceptual framework showing how three levels of racism-personal, internalized, and institutional-affect access to maternal health care among Romani women. Methods: Eight focus groups of Romani women aged 14-44 (n = 71), as well as in-depth semi-structured interviews with gynecologists (n = 8) and key informants from NGOs and state institutions (n = 11) were conducted on maternal health care seeking, experiences during care, and perceived health care discrimination. Transcripts were coded, and analyzed using a grounded theory approach. Themes were categorized into domains. Results: Twenty-two emergent themes identified barriers that reflected how racism affects access to maternal health care. The domains into which the themes were classified were perceptions and interactions with health system, psychological factors, social environment and resources, lack of health system accountability, financial needs, and exclusion from education. Conclusions: The experiences of Romani women demonstrate psychosocial and structural pathways by which racism and discrimination affect access to prenatal and maternity care. Interventions to address maternal health inequalities should target barriers within all three levels of racism.

This paper examines the factors and approaches in patients’ satisfaction in the health care deliv... more This paper examines the factors and approaches in patients’ satisfaction in the health care delivery system in N. Macedonia. The study aims to assess how key service quality dimensions relate to an important measure of performance in patient satisfaction and to find the elements that are valued by patients and the reasons behind patient satisfaction or dissatisfaction. The main tool used in this study was the instrument developed for measuring service quality named as SERVQUAL. The overall patient-satisfaction item was skewed towards low patient satisfaction in the health care system: 2.43 on a scale of 1-3. The strongest predictors were experienced healthcare professionals (β = -0.32), expected diagnosis (β =0.14) and modern equipment (β =-0.130). The regression model explained 62% of the variance in overall patient satisfaction. The findings of the study are of great importance for public hospital administrators in N. Macedonia with respect to the outpatient aspects of service qua...

Cancers

More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 ... more More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic researc...

Introduction: This paper examines the factors and approaches the question of patients’ satisfacti... more Introduction: This paper examines the factors and approaches the question of patients’ satisfaction in the health care delivery system in North Macedonia. Aim: The study aims to assess how key service quality dimensions relate to an important measure of performance patient satisfaction and to find the elements that are valued by patients and the reasons behind patient satisfaction or dissatisfaction. Materials and method: In this research study, the factor analysis was used to group 12 questions measuring patient satisfaction under certain extent with Promax oblique rotation using the satisfaction responses gauged by importance. We have performed a structural equation model (SEM) to determine the relationships between one or more independent variables (IVs). Results: All component measures were greater than .702 which shows strong internal reliability among components. The reliability levels for the three components were .842 for the hospital environment, .835 for admin and .702 for...

Introduction: Acne vulgaris is a disorder of the pilosebaceous units. It is a chronic inflammator... more Introduction: Acne vulgaris is a disorder of the pilosebaceous units. It is a chronic inflammatory dermatosis notable for open/closed comedones, papules, pustules, nodules. It is characterized by open comedones, closed comedones and pustular nodules. Aim of study: To examine factors underlying the quality of life of people with acne. Materials and method: A total of 576 respondents were included in the study. Acne specific Quality of Life questionnaire was used for this purpose. A prospective cross-sectional study was conducted, performed in private dermatological clinic as well as on-line. All analyses were conducted by using the SPSS.26 for Windows. Results and Discussion: 5.7 % were males and 94.3 percent were females. About 69.4% were aged between 15-25; 16.7 % between 26 to 30; 8.8% between 31 to 35 years old. Quality of life and emotional perception towards the social environment is demonstrated by the three components (self-perception of discomfort, functionality, and social ...

Within the last 10 years and in comparison to European countries, Macedonia has one of the lowest... more Within the last 10 years and in comparison to European countries, Macedonia has one of the lowest contraceptive use rates and one of the highest abortion rates. While studies have been conducted on the determinants of abortion and contraceptive use, there is a lack of knowledge about the perceptions and every day experiences of health care practitioners’ practices dealing with abortion and contraceptive services. The main goal of the study is to explore experiences and motives of health care professionals in their everyday work with clients who are seeking contraceptive and abortion services. We used a qualitative approach with in-depth interviews and focus group discussions with women who use health services during their reproductive period (from ages 12-49). We analyzed the data according to domains into which themes were classified: Perception and interaction with clients, good professionals, social settings, education, financial issues, and health care system services. The exper...

The study assesses the level of integration of public health measures into national climate chang... more The study assesses the level of integration of public health measures into national climate change adaptation strategies or action plans in the EU 28 countries in 2017-8, as part of the Pagoda WHO project. Areas covered in the analysis are: governance and policies on climate change and health impact, vulnerability assessment of climate change, integrated climate information into infectious disease surveillance, early warning systems for extreme weather, recent projects on climate change and human health, health effects of climate change, best practices, main risks and priorities protecting from climate change. A qualitative approach was applied in this research study based on responses of 20 questionnaires of WHO European Member States. 15 of the responding countries had developed a climate change health adaptation strategy and an associated implementation plan (75%), and these were approved by the government in 13 countries (65%). The results revealed certain specific areas for tec...

International Journal for Equity in Health

Introduction: Roma, the largest minority group in Europe, face widespread racism and health disad... more Introduction: Roma, the largest minority group in Europe, face widespread racism and health disadvantage. Using qualitative data from Serbia and Macedonia, our objective was to develop a conceptual framework showing how three levels of racism-personal, internalized, and institutional-affect access to maternal health care among Romani women. Methods: Eight focus groups of Romani women aged 14-44 (n = 71), as well as in-depth semi-structured interviews with gynecologists (n = 8) and key informants from NGOs and state institutions (n = 11) were conducted on maternal health care seeking, experiences during care, and perceived health care discrimination. Transcripts were coded, and analyzed using a grounded theory approach. Themes were categorized into domains. Results: Twenty-two emergent themes identified barriers that reflected how racism affects access to maternal health care. The domains into which the themes were classified were perceptions and interactions with health system, psychological factors, social environment and resources, lack of health system accountability, financial needs, and exclusion from education. Conclusions: The experiences of Romani women demonstrate psychosocial and structural pathways by which racism and discrimination affect access to prenatal and maternity care. Interventions to address maternal health inequalities should target barriers within all three levels of racism.

This paper examines the factors and approaches in patients’ satisfaction in the health care deliv... more This paper examines the factors and approaches in patients’ satisfaction in the health care delivery system in N. Macedonia. The study aims to assess how key service quality dimensions relate to an important measure of performance in patient satisfaction and to find the elements that are valued by patients and the reasons behind patient satisfaction or dissatisfaction. The main tool used in this study was the instrument developed for measuring service quality named as SERVQUAL. The overall patient-satisfaction item was skewed towards low patient satisfaction in the health care system: 2.43 on a scale of 1-3. The strongest predictors were experienced healthcare professionals (β = -0.32), expected diagnosis (β =0.14) and modern equipment (β =-0.130). The regression model explained 62% of the variance in overall patient satisfaction. The findings of the study are of great importance for public hospital administrators in N. Macedonia with respect to the outpatient aspects of service qua...