Health Systems in Eastern Europe—The Impact of Reform

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

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Republic of Moldova in the Context of Regional Security Challenges in Eastern Europe

Історико-політичні проблеми сучасного світу ◽

10.31861/mhpi2018.37-38.281-286 ◽

2018 ◽

pp. 299-304

Author(s):

Stefan Tibuleac

Keyword(s):

Eastern Europe ◽

Security Policy ◽

Security System ◽

Regional Security ◽

Strategic Uncertainty ◽

European Security ◽

Republic Of Moldova ◽

The Republic ◽

The Impact

This article analyzes the most current security issues for the Republic of Moldova that are part of the regional security context of Eastern Europe –the region that can be considered the epicenter of international tensions through which the„geopolitical line of fracture”passes. The geographical position of the Republic of Moldova makes this state particularly sensitive to any negative trends in theregion. Growing of international tensions creates security threats and complicates economic development. From a historical point of view, Moldova has repeatedly fallen victim by the confrontation of the great powers. Therefore, the Republic of Moldova has a vital interest in preventing a new conflict in Eastern Europe. This article is based on a number of assumptions made by changes in the European security environment, such as the „shift of weight” to the East, strategic uncertainty, increasing the role of non-state actors, the situation in eastern Ukraine, etc. Based on these assumptions, this article makes an attempt to outline the potential role of the Republic of Moldova in the Eastern European security system, taking into account the desideratum for integration of the republic into the European Union. Other relevant factors will be taken into account for shaping the role of the Republic of Moldova in the European security system, namely: the security deficit; the impact of NATO and EU security policy; the rebirth of the project to create a regional defense alliance, etc. This article will largely take into account the military aspects of security. Keywords: Republic of Moldova, national security, Eastern Europe, NATO, Intermarium, defence, threats, risks, challenges

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Here there Be Tygers: Profit, Non-profit, and Loss in the Age of Disintermediation

Canadian Journal of Communication ◽

10.22230/cjc.1997v22n3a1008 ◽

1997 ◽

Vol 22 (3) ◽

Cited By ~ 2

Author(s):

Michael Jensen

Keyword(s):

Eastern Europe ◽

Social Institutions ◽

Scholarly Publishing ◽

The Political ◽

Quality Information ◽

High Quality ◽

Non Profit ◽

High Quality Information ◽

Europe De L’Est ◽

The Impact

Abstract: Scholarly publishing and access to high-quality information may in fact be threatened, rather than improved, by the revolution in communications, particularly in a fully commercial Internet. The effects of the political revolution in Eastern Europe on scholarship and quality publishing are used as a touchstone of the dangers that occur when naïve revolutionaries make swift changes without fully recognizing the impact upon delicately balanced social institutions such as non-profit organizations. Résumé: La révolution en communications, particulièrement en ce qui regarde un Internet commercialisé, plutôt que d'améliorer l'édition savante et l'accès à de l'information de haute qualité, pourrait en fait poser une menace pour ceux-ci. Cet article examine comment la révolution politique en Europe de l'Est a influé sur la recherche et l'édition de qualité. Il utilise cet exemple pour examiner les dangers que peuvent courir certains révolutionnaires naïfs quand ils instaurent des changements rapides san songer à leur impact sur des institutions sociales à équilibre délicat comme les organisations à but non lucratif.

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The impact of economic sanctions on health and health systems in low- and middle-income countries

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.912 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Suhrcke ◽

M Pinna Pintor ◽

C Hamelmann

Keyword(s):

Health Outcomes ◽

Health System ◽

Health Systems ◽

Grey Literature ◽

Economic Sanctions ◽

Political Crisis ◽

Middle Income ◽

Financial Flows ◽

Adverse Health ◽

The Impact

Abstract Background Economic sanctions, understood as measures taken by one state or a group of states to coerce another into a desired conduct (eg by restricting trade and financial flows) do not primarily seek to adversely affect the health or health system of the target country's population. Yet, there may be indirect or unintended health and health system consequences that ought to be borne in mind when assessing the full set of effects of sanctions. We take stock of the evidence to date in terms of whether - and if so, how - economic sanctions impact health and health systems in LMICs. Methods We undertook a structured literature review (using MEDLINE and Google Scholar), covering the peer-reviewed and grey literature published from 1970-2019, with a specific focus on quantitative assessments. Results Most studies (23/27) that met our inclusion criteria focus on the relationship between sanctions and health outcomes, ranging from infant or child mortality as the most frequent case over viral hepatitis to diabetes and HIV, among others. Fewer studies (9/27) examined health system related indicators, either as a sole focus or jointly with health outcomes. A minority of studies explicitly addressed some of the methodological challenges, incl. control for relevant confounders and the endogeneity of sanctions. Taking the results at face value, the evidence is almost unanimous in highlighting the adverse health and health system effects of economic sanctions. Conclusions Quantitatively assessing the impact of economic sanctions on health or health systems is a challenging task, not least as it is persistently difficult to disentangle the effect of sanctions from many other, potentially major factors at work that matter for health (as, for instance, war). In addition, in times of severe economic and political crisis (which often coincide with sanctions), the collection of accurate and comprehensive data that could allow appropriate measurement is typically not a priority. Key messages The existing evidence is almost unanimous in highlighting the adverse health and health system effects of economic sanctions. There is preciously little good quality evidence on the health (system) impact of economic sanctions.

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The COVID-19 Pandemic and nursing challenges: A review of the early literature

Work ◽

10.3233/wor-213458 ◽

2021 ◽

pp. 1-14

Author(s):

Mojtaba K. Danesh ◽

Ehsan Garosi ◽

Hamedeh Golmohamadpour

Keyword(s):

Health Systems ◽

Personal Protective Equipment ◽

Qualitative Studies ◽

Systematic Search ◽

Current Paper ◽

Protective Equipment ◽

Early Literature ◽

The Face ◽

Physical Distress ◽

The Impact

BACKGROUND: The COVID-19 pandemic has put health systems under unprecedented pressure, challenging their workforce, especially nurses. OBJECTIVE: The current paper presented a review of the early literature concerning emerging nursing challenges during the early stages of the COVID-19 pandemic. METHODS: A systematic search of the published literature between January and May 2020 was carried out in Medline, Science Direct, and Google Scholar to identify relevant quantitative and qualitative studies. RESULTS: Twenty-two original articles were retrieved, the majority of which were survey studies from China. Synthesis of the evidence resulted in four overarching themes including “being physically and mentally drained in the face of fear and uncertainty,” “shortage of personal protective equipment and usability issues,” “psychosomatic disturbances among nurses,” and “moderators to mitigate nurses’ challenges.” CONCLUSIONS: Providing care for demanding COVID-19 patients, nurses experienced a gruelling situation, during which a significant amount of psychological and physical distress was inflicted to them. However, receiving proper support from their organization and society could improve the condition substantially. Further research is required to explore the impact of the COVID-19 pandemic on nurses, especially from Western countries.

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‘Protecting Life in Global Health Assistance’? Towards a framework for assessing the health systems impact of the expanded Global Gag Rule

BMJ Global Health ◽

10.1136/bmjgh-2019-001786 ◽

2019 ◽

Vol 4 (5) ◽

pp. e001786 ◽

Cited By ~ 4

Author(s):

Marta Schaaf ◽

Emily Maistrellis ◽

Hana Thomas ◽

Bergen Cooper

Keyword(s):

Global Health ◽

Mexico City ◽

Health Systems ◽

Grey Literature ◽

Policy Changes ◽

Us Government ◽

Potential Impact ◽

City Policy ◽

The Impact ◽

Initial Research

During his first week in office, US President Donald J Trump issued a presidential memorandum to reinstate and broaden the reach of the Mexico City policy. The Mexico City policy (which was in place from 1985–1993, 1999–2000 and 2001–2009) barred foreign non-governmental organisations (NGOs) that received US government family planning (FP) assistance from using US funds or their own funds for performing, providing counselling, referring or advocating for safe abortions as a method of FP. The renamed policy, Protecting Life in Global Health Assistance (PLGHA), expands the Mexico City policy by applying it to most US global health assistance. Thus, foreign NGOs receiving US global health assistance of nearly any type must agree to the policy, regardless of whether they work in reproductive health. This article summarises academic and grey literature on the impact of previous iterations of the Mexico City policy, and initial research on impacts of the expanded policy. It builds on this analysis to propose a hypothesis regarding the potential impact of PLGHA on health systems. Because PLGHA applies to much more funding than it did in its previous iterations, and because health services have generally become more integrated in the past decade, we hypothesise that the health systems impacts of PLGHA could be significant. We present this hypothesis as a tool that may be useful to others’ and to our own research on the impact of PLGHA and similar exogenous overseas development assistance policy changes.

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Evolution of top management’s understanding of product quality in Eastern Europe since the end of communism

The TQM Journal ◽

10.1108/tqm-09-2015-0115 ◽

2017 ◽

Vol 29 (1) ◽

pp. 82-100

Author(s):

Svetoslav Georgiev ◽

Emil Georgiev

Keyword(s):

Eastern Europe ◽

Product Quality ◽

Quantitative Research ◽

Business Performance ◽

Research Approach ◽

Senior Managers ◽

Content Type ◽

Doing Business ◽

Using Data ◽

The Impact

Purpose The purpose of this paper is to analyse the evolution of top management’s understanding of product quality in Bulgaria since the end of communism. The study examines three specific areas: top management’s understanding of the term “quality”; top management’s understanding of the relationship between quality and business performance; and top management’s understanding of the impact of job position on quality. Design/methodology/approach The paper relies on a quantitative research approach by using data from a survey of 186 companies in Bulgaria. Findings The paper suggests that senior managers in Bulgaria continue to base their understanding of “quality” on a single approach (*a characteristic of the communist era), with the product-based and the user-based approaches currently being the two most common ones. At the same time, surprisingly enough, this study claims that senior management in Bulgaria is currently well aware of the importance of quality as a dimension of firm’s competitiveness, and is also highly conscious of its roles’ impact on product quality. Research limitations/implications The results of this study are exclusively based on the case of Bulgaria and must be treated with caution in the case of other former communist states from the Central and Eastern Europe (CEE) region. Practical implications This paper has relevance for both managers and companies doing business in Eastern Europe. Originality/value This is the first paper to provide detailed analysis of the evolution of the understanding of “product quality” in CEE since the end of communism. Moreover, this paper applies, for the first time, Garvin’s five approaches to defining quality within a practical context.

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The impact of residential combustion emissions on atmospheric aerosol, human health, and climate

Atmospheric Chemistry and Physics ◽

10.5194/acp-16-873-2016 ◽

2016 ◽

Vol 16 (2) ◽

pp. 873-905 ◽

Cited By ~ 68

Author(s):

E. W. Butt ◽

A. Rap ◽

A. Schmidt ◽

C. E. Scott ◽

K. J. Pringle ◽

...

Keyword(s):

Eastern Europe ◽

Human Health ◽

Atmospheric Aerosol ◽

Radiative Transfer Model ◽

Transfer Model ◽

So2 Emissions ◽

Residential Sector ◽

Residential Combustion ◽

Combustion Emissions ◽

The Impact

Abstract. Combustion of fuels in the residential sector for cooking and heating results in the emission of aerosol and aerosol precursors impacting air quality, human health, and climate. Residential emissions are dominated by the combustion of solid fuels. We use a global aerosol microphysics model to simulate the impact of residential fuel combustion on atmospheric aerosol for the year 2000. The model underestimates black carbon (BC) and organic carbon (OC) mass concentrations observed over Asia, Eastern Europe, and Africa, with better prediction when carbonaceous emissions from the residential sector are doubled. Observed seasonal variability of BC and OC concentrations are better simulated when residential emissions include a seasonal cycle. The largest contributions of residential emissions to annual surface mean particulate matter (PM2.5) concentrations are simulated for East Asia, South Asia, and Eastern Europe. We use a concentration response function to estimate the human health impact due to long-term exposure to ambient PM2.5 from residential emissions. We estimate global annual excess adult (>  30 years of age) premature mortality (due to both cardiopulmonary disease and lung cancer) to be 308 000 (113 300–497 000, 5th to 95th percentile uncertainty range) for monthly varying residential emissions and 517 000 (192 000–827 000) when residential carbonaceous emissions are doubled. Mortality due to residential emissions is greatest in Asia, with China and India accounting for 50 % of simulated global excess mortality. Using an offline radiative transfer model we estimate that residential emissions exert a global annual mean direct radiative effect between −66 and +21 mW m−2, with sensitivity to the residential emission flux and the assumed ratio of BC, OC, and SO2 emissions. Residential emissions exert a global annual mean first aerosol indirect effect of between −52 and −16 mW m−2, which is sensitive to the assumed size distribution of carbonaceous emissions. Overall, our results demonstrate that reducing residential combustion emissions would have substantial benefits for human health through reductions in ambient PM2.5 concentrations.

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