South Eastern European Journal of Public Health (SEEJPH) <p>The South Eastern European Journal of Public Health (SEEJPH) is an open-access international peer-reviewed journal involving all areas of health sciences and public health. Devoted to the global health SEEJPH welcomes submissions of scientists, researchers, and practitioners from all over the world, but particularly pertinent to southern and eastern countries in transition.</p> Jacobs Verlag en-US South Eastern European Journal of Public Health (SEEJPH) 2197-5248 <p class="hide_copyright_frontend">Authors retain copyright and grant the journal right of first publication in print and online. The work is distributed under the terms of the Creative Commons Attribution License CC-BY (<a class="moz-txt-link-freetext" href=""></a>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> Facing the COVID-19 challenge: When the world depends on effective public health interventions Jose M. Martin-Moreno Copyright (c) 2020 Jose M. Martin-Moreno 2020-05-04 2020-05-04 10.4119/seejph-3442 When the world depends on effective public health intervention – and public health does not deliver <p>The COVID-19 crisis offers both special opportunities and challenges for Public Health. The initial management of the pandemic was dominated by virologists, supported by epidemiologists who did not always meet indispensable scientific requirements. Interdisciplinary and complex Public Health concerns and expertise, however, did not have tangible impact in the COVID-19 debate. Public Health is universal and goes beyond health security as social and other upstream determinants of health play a central role. As an explicitly political concept Public Health must safeguard its broad socio-political approach and obviate all tendency towards biomedical reductionism.</p> <p>&nbsp;</p> <p><strong>Conflicts of interest: </strong>None declared.</p> Jens Holst Copyright (c) 2020 Jens Holst 2020-05-23 2020-05-23 10.4119/seejph-3469 School-based intervention to promote healthy nutrition and physical activity in Palestinian girls - Process evaluation <p><strong>Aim: </strong>School-based interventions have the potential to intervene with the students and teachers, and to reach their families. A controlled program trial was designed to promote healthy eating and physical activity among Palestinian females, while the process evaluation aimed to monitor the program’s implementation and identify factors that led to its success.</p> <p><strong>Methods: </strong>A randomized controlled program trial was conducted in 14-Palestinian schools under 4-different jurisdictions, divided into 7-control and 7-intervention schools chosen randomly after applying a sample size calculation. A monitoring system, elucidated factors which contributed to improved outcomes, was applied in the intervention schools only, while the control schools continued with their regular curriculum. The process evaluation tracked the timing and implementation of interventions including changes in the school strategy, policy and structure, teachers’ capacity building, mothers’ education and involvement, the school’s supportive&nbsp;health environment, and integration food consumption records and physical activity into the daily class routine.</p> <p><strong>Results: </strong>The intervention included 3,805 schoolchildren and their mothers’ as-well-as 147 teachers. At the completion of the 18-month intervention the schools had successfully participated in the various intervention activities. Only the private school did not sustain some of the interventions, which put it at 55% completion of the school supportive environment activities compared to the other schools which all reached the 100% completion of planned activities.</p> <p><strong>Conclusion: </strong>This process evaluation approach enabled a more comprehensive understanding of the intervention implementation and outcomes and identified factors that contribute to the sustainability of the intervention. Each school required a different amount of time for understanding, applying and implementing the program depending on its needs.</p> <p><strong>&nbsp;</strong></p> <p><strong>Acknowledgments: </strong>The authors thank the participating schools, the Palestinian Ministry of Education, the UNRWA Office of Education and Jerusalem Municipality for facilitating fieldwork. I would like to acknowledge my gratitude to my doctoral thesis supervisors, Prof. Elliot Berry and Prof. Ziad Abdeen.</p> <p><strong>&nbsp;</strong></p> <p><strong>Source of funding</strong>: This study is a part of Ph.D. degree. The researcher received scholarship from Joint Distribution Committee (JDC). The author thanks Nutrition and Health Research Institute Al-Quds University for funding part of the research. The Linda Joy Pollin Cardiovascular Wellness Center for Women at the Division of Cardiology of Hadassah University Medical Center, directed by Dr. Donna Zfat funded the mothers’ activities and lectures towards the end of the intervention, as well as the implementation of the program at the control schools one year after the study ended, as they were promised when they got selected.</p> <p>&nbsp;</p> <p><strong>Conflicts of interest: </strong>None declared.</p> Maha Nubani Husseini Milka Donchin Copyright (c) 2020 Maha Nubani Husseini, Milka Donchin 2020-04-15 2020-04-15 10.4119/seejph-3407 Aflatoxin B1 as an endocrine disruptor among miller flour workers <p><strong>Aim</strong>: Aflatoxin В1 has been stated to inhibit the function of different endocrine glands. This study was proposed to clarify the possible effects of aflatoxin B1 as an endocrine disruptor on pituitary gland, thyroid gland and gonads among miller flour workers, and to evaluate its effects on human male sexual function.</p> <p><strong>Methods: </strong>A case-control study was conducted in a flour mill in Helwan District Cairo, Egypt in 2019. The study included 42 exposed flour milling male workers from the grinding department which showed the highest level of aspergillus flavus in the air sampling of airborne fungi and 40 non-exposed males. Serumaflatoxin В1/albumin, luteinizing hormone, follicle stimulating hormone, testosterone, 17-beta-estradiol, free triiodothyronine, free thyroxin and thyroid stimulating hormone were measured for the studied groups.</p> <p><strong>Results</strong>: Sampling of airborne fungi revealed that aspergillus flavus and penicillum were the predominant fungal types in the flour mill. Indoor/Outdoor ratios for aspergillus flavus were ≥ 1 in all the locations indicating presence of indoor sources. Serum Aflatoxin В1/albumin, luteinizing hormone and follicle stimulating, the existence of various types of sexual disorders (decreased libido, impotence and premature ejaculation) were higher while testosterone was lower in the miller flour workers compared to non-exposed. However, there was no significant difference regarding 17-beta-estradioland thyroid hormone levels between both studied groups.</p> <p><strong>Conclusion: </strong>Aflatoxin B1creates possible human male reproductive health distresses in miller flour workers.</p> <p>&nbsp;</p> <p><strong>Acknowledgement: </strong>The authors are grateful to the National Research Centre for funding this research.</p> <p>&nbsp;</p> <p><strong>Funding: </strong>This study was funded by the National Research Centre, Egypt.</p> <p>&nbsp;</p> <p><strong>Conflicts of interest: </strong>None declared.&nbsp;&nbsp;&nbsp;&nbsp;</p> Safia Beshir Weam Shaheen Amal Saad-Hussein Yuosra Saeed Copyright (c) 2020 Safia Beshir, Weam Shaheen, Amal Saad-Hussein, Yuosra Saeed 2020-05-04 2020-05-04 10.4119/seejph-3441 Serbian Citizens’ Opinion on the COVID-19 Epidemic <p><strong>Aim: </strong>The Centre for International Public Policy has undertaken a public opinion research in which we tested the opinions of the citizens of Serbia on the coronavirus epidemic. The respondents had the opportunity to express their opinion on measures undertaken by the Serbian Government to combat the virus, to state their trust in the media, as well as the health system in general. In addition, we tested the prevalence of different conspiracy theories among citizens, whether the pandemic gave China a new image in the minds of the people and, most importantly, the level of solidarity among Serbian citizens as well as within the European / international community as a whole.</p> <p><strong>Methods: </strong>In seven days, from 8-15<sup>th</sup> April 2020, we gathered a convenient sample of N=5989 respondents, which makes this the largest public opinion research project in Serbia on the topic of COVID-19 since the start of the epidemic. The electronic questionnaire consisted of 24 questions of mixed and closed type.</p> <p><strong>Results: </strong>The findings of this research suggest that citizens of Serbia are not afraid of COVID-19, but are nevertheless cautious (86%). The percentage of those willing to consult a doctor when they notice any symptoms lies at 70%. Half of the respondents do not believe in alternative theories regarding the origin of the COVID-19 virus. The majority of the respondents (55%) hold government officials accountable for spreading panic through public speeches and daily public addresses. Moreover, 60% of the respondents do not trust the Serbian media outlets that are currently reporting on the COVID-19 pandemic. Furthermore, over half of the respondents are prepared to report their neighbour when he or she is coming from abroad and violates the obligation to self-isolate. However, mostly due to the significant fines, 65% of the respondents would not report the elderly when they are breaking the limited-movement restriction measures.</p> <p><strong>Conclusion:</strong> As before the epidemic, opinions of the Serbian population on current topics are somewhat polarized. Although the majority of the respondents are cautious, a significant number also believes in conspiracy theories and does not fully trust the information provided by the media or the government.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> Ivanović Marta Đorđević Mirjana Klarić Aleksandar MA Mikanović Filip Nikolić Kristina Perić Tamara Savić Tamara Steljić Katarina Subotić Lazar Todorović Marko Todorovski Irena Totić Bojan Copyright (c) 2020 Ivanović Marta, Đorđević Mirjana, Klarić Aleksandar MA, Mikanović Filip, Nikolić Kristina, Perić Tamara, Savić Tamara, Steljić Katarina, Subotić Lazar, Todorović Marko, Todorovski Irena, Totić Bojan 2020-05-16 2020-05-16 10.4119/seejph-3459 COVID-19 in the Gaza Strip and the West Bank under the political conflict in Palestine <p>COVID-19 is a serious pandemic with variation of spread, morbidity, and fatalities between countries. Palestinians are facing the epidemic, with around 2 million inhabitants under siege in the highly populated Gaza Strip for the last 14 years. The siege may be the main threat for the spread of disease among the Palestinian population. The Palestinians faced the Corona epidemic with limited facilities in their hand. However, the risk factors remain multiple, the most important are overcrowding in the Gaza Strip, poor health care facilities, and the risk of workers moving between the West Bank and Israel. Palestinian Health authorities responded directly to the pandemic and took strict closure measures to prevent rapid spread. The Palestinian strategy has focused on social spacing, personal hygiene, control of border crossings and health preparedness to deal with medical cases while continuing to provide health services to the population. The difficult economic situation is the major obstacle facing Palestinians to overcome the disease spread where workers continue their jobs inside Israel and Gaza cannot enforce low-income workers to stay at home. More is needed to ensure community engagement, support coordination among all health care providers in Palestine, and take effective steps to promote social spacing. Friendly countries and international organizations can assist and support the Palestinian population in providing laboratory diagnostic materials, providing personal protective devices, strengthening intensive care units, and supporting outreach activities and training programmes.</p> <p><em>&nbsp;</em></p> <p><strong>Conflicts of interest</strong>: None declared.</p> Yehia Abed Copyright (c) 2020 Yehia Abed 2020-06-27 2020-06-27 10.4119/seejph-3543 Navigating barriers to gender equality in the European Union context: The case of healthcare sector <p><span style="font-size: medium;"><strong>Context: </strong></span><span style="font-family: Times New Roman,Times New Roman PSMT; font-size: medium;">Progress towards achieving gender equality in the European Union context is reported slow and fragmented, although some achievements have been made. Scholarship has been discuss-ing extensively the gendered barriers, yet their manifestation on a comprehensive and prevalence basis has received scant attention so far. Highlighting the big picture of all (in)visible gendered barriers and their manifestation in relation to countries’ specificity may contribute in understand-ing better the missing link between policy and practice. This study aims firstly, to identify com-prehensively the gendered barriers and their prevalence, and secondly, to gain deeper insights on how a persisting policy problem at the EU and Member States level remained poorly addressed for over two decades. </span></p> <p><span style="font-size: medium;"><strong>Methods: </strong></span><span style="font-family: Times New Roman,Times New Roman PSMT; font-size: medium;">A mixed methods approach was adopted to ensure the qualitative research quality cri-teria. The systematic literature review, questionnaire and semi-structured interviews methods to obtain and analyze data were included. Qualitative analysis was supplemented by the fundamental tenet of feminist research on the centrality of women. </span></p> <p><span style="font-size: medium;"><strong>Results: </strong></span><span style="font-family: Times New Roman,Times New Roman PSMT; font-size: medium;">Twenty-six gendered barriers with quantitative logic and varying degree of prevalence were identified and depicted in the Barriers Thematic Map (BTM) across healthcare, academia and business sectors. Twenty and twenty-one gendered barriers in Greek and Maltese healthcare set-tings were found respectively unveiling the country’s specificity in barriers’ manifestation. The sustainable development thinking in gender equality objectives in EU and MS was found suffering from inconsistencies and misplaced priorities. </span></p> <p><span style="font-size: medium;"><strong>Conclusion</strong></span><span style="font-family: Times New Roman,Times New Roman PSMT; font-size: medium;">: The gendered barriers are multiple, manifest themselves in chorus and with a varying degree of prevalence across sectors and are greatly influenced by country’s specificity. Evidence informed gendered policies respecting national priorities may need to be revisited by policy actors to deliver the promised egalitarian social orderand sustainable future for the EU citizens. </span></p> Stavroula Kalaitzi Copyright (c) 2020 Stavroula Kalaitzi 2020-06-01 2020-06-01 10.4119/seejph-3492