Southeastern European Countries Research Articles

Stigmatising Attitudes Towards Mental Health Conditions Among Medical Students In Five South-Eastern European Countries.

Stigmatising attitudes towards mentally ill people are present among healthcare professionals. The aim of the study was to evaluate medical students' attitudes in five medical schools from Albania, Bulgaria, Moldova, Romania and Serbia and to determine if psychiatry clerkship improves these attitudes. In the first stage, the study included students from the first and final years of medical school; in the second stage, only final-year students were included; The Mental Illness Clinicians' Attitude Scale (MICA-2) and the Attribution Questionnaire (AQ-9) were used in this study. The total sample comprised 1,526 medical students in the first stage and 614 in the second stage. The analysis of the average AQ-9 and MICA-2 scores between countries revealed significant differences (p<0.05). Multivariable analysis showed that female students were 30% more likely to have elevated AQ-9 scores than male students (p=0.029). Final-year students had a significantly lower chance of having a higher MICA-2 score compared to first-year students (OR=0.7; p<0.05). Psychiatry clerkship contributes to a decrease in the level of stigmatising attitudes among medical students. Further research is required to assess the curricula to achieve better results in reducing stigma among future doctors.

Genomic diversity and population structure of Carniolan honey bee in its native habitat

BackgroundResearch into the genetic diversity of honey bee (Apis melliferaL.) populations has become increasingly significant in recent decades, primarily due to population declines attributed to human activities and climate change. As a species of great importance, breeding programs that leverage understanding of genomic diversity could offer solutions to mitigate these challenges. The objective of this study was to examine the genomic diversity and population structure of Carniolan honey bees (Apis mellifera carnica) using the Illumina SNP chip on a large honey bee sample collected from Central and South-Eastern European countries. The study also aims to offer recommendations for future breeding programs.ResultsOur analysis involved Discriminant Analysis of Principal Components (DAPC), heterozygosity, admixture analysis, fixation indices (FST), Neighbour-Joining tree, gene flow and Isolation-by-distance analysis. DAPC indicated distinct separation between the Carniolan and Italian honey bee (Apis mellifera ligustica) populations, whereas the admixture analysis revealed varying levels of gene flow and genetic admixture within the Carniolan honey bee populations, demonstrating closer relationships between specific geographic regions (confirmed by Isolation-by-distance analysis). Furthermore, the research of heterozygosity, genomic inbreeding, pairwise FST values, and Neighbour-Joining tree provided insights into the patterns of genetic differentiation and similarity among the populations of Carniolan honey bee within its natural habitat. We have observed genetic homogeneity of the Carniolan honey bee population when considered in a broader genetic/geographical context. However, the Carniolan honey bee has sufficient genetic diversity in its geographical home range that needs to be carefully monitored and maintained.ConclusionsThis study provides important insights into the genetic composition, differentiation, and relationships among Carniolan honey bee populations in Central and South-Eastern European countries. The findings are crucial for conservation efforts, breeding programs, and sustainable beekeeping practices. They emphasise the importance of considering genetic factors and population structure in the breeding and management of honey bees. By understanding these genetic relationships, we can develop strategies to preserve genetic diversity, improve breeding outcomes, and ensure the resilience of honey bee populations in the face of environmental changes and challenges. This knowledge can also inform policy makers and stakeholders on best practices to maintain healthy bee populations, which are vital for ecosystem services and agricultural productivity.

Systematic Investigation of the Influence of Religion on Business Management: A Bibliometric Approach

Abstract In the dynamic context of modern business, the role of religion in business management is increasingly attracting the attention of researchers and practitioners. Religion, seen as a set of spiritual beliefs and practices, deeply shapes people’s values, behaviors, and decisions, thus impacting the way organizations are managed. Using bibliometric analysis allowed us to identify research trends, the links between the keywords underlying the selected studies, and the impact of the publications on the business environment. The study revealed that religious values can shape ethical behavior, leadership styles, and corporate social responsibility in business. Most studies focus on the influences of Islamic, Catholic, and Protestant religions, leaving a significant gap in understanding how orthodox values and practices influence organizational behavior and business ethics, even though this is the dominant religion in many Eastern and South-Eastern European countries. For a more comprehensive perspective, future research should include case studies and surveys in these geographical and cultural regions, combining qualitative and quantitative methods of data analysis. This study provides a robust basis for future research, stimulating reflection on how religious values can shape the business landscape in the 21st century.

May Measurement Month 2021: an analysis of blood pressure screening results from Albania.

This article describes the May Measurement Month (MMM) 2021 campaign, which was the fourth time this annual hypertension screening campaign was conducted in Albania, a Mediterranean country in southeastern Europe. The MMM21 was conducted during the period of 28 September-30 November 2021, in 32 sites across several districts of Albania. Overall, 11 788 participants aged ≥18 years were included (63% women), with a mean age of 49.7 ± 14.9 years. Blood pressure (BP) was measured three times with Omron sphygmomanometers (model M3, Omron Healthcare, Kyoto, Japan), which are automatic upper arm BP monitors. Hypertension was defined as SBP ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg (based on the mean of the second and third recordings for SBP and DBP, respectively) or on antihypertensive medication. Self-reported data included pre-existing conditions, physical activity, smoking, alcohol consumption, COVID-19 testing, and use of contraception in women. Overall, 47.3% of screened participants had hypertension. Of those with hypertension, 70.1% were aware of their condition and 67.0% were on antihypertensive medication. About half (49.3%) of participants on antihypertensive medication had controlled BP (<140/90 mmHg). On average, BP was higher in those on antihypertensive medication and with increasing alcohol intake but lower in those with a history of stroke and those with higher levels of physical activity, previous positive COVID-19 test, and contraception use in women. In Albania, the MMM campaign continues to contribute to the early detection of hypertension among adults. Hence, it constitutes a valuable opportunistic screening instrument among other routine tools applied in the general Albanian population.

Is There an Asymmetric Effect Due to Foreign Direct Investment on the Exports of the Manufacturing and Service Sectors of Central, Eastern, and South-Eastern European Countries?

ABSTRACT This study estimates the asymmetric effect of foreign direct investment on the exports of the manufacturing and service sectors of 11 Central, Eastern, and South-Eastern (CESEE) countries, using the nonlinear ARDL model, over the period of 1996–2022. The results show an asymmetric effect due to mergers & acquisitions (M&A) on the exports of 3 countries, while greenfield foreign direct investment (GFDI) has an impact on the exports of 4 of the 17 manufacturing sectors. There is also an asymmetric effect due to M&A on the exports of 5 out of the 6 service sectors.

Why do information technology companies in Kosovo fail? An analysis of factors

ABSTRACT This research enhances our understanding of regional entrepreneurship challenges, informs policymakers, and guides aspiring entrepreneurs. It has practical implications for policy development, entrepreneurial education, and future research. Kosovo, a developing country in South-Eastern Europe, faces economic challenges despite recent growth. Its technology sector, crucial for a knowledge economy, struggles with IT company failures. This study uses a qualitative cross-case analysis to compare 15 failed IT companies with 5 successful ones, identifying specific attributes and factors associated with their outcomes. The findings reveal that managerial experience, strategic planning, marketing, networking, dedication, and commitment differentiate successful IT companies from those that fail. Additionally, the research highlights the importance of international markets, favorable financial conditions, government support, competitive strategies, and workforce skills in business success. This research provides valuable insights into business dynamics in a developing economy and informs policymakers in crafting targeted support.

Perspectives on vulnerability from the narratives of older migrants.

Older migrants are considered avulnerable population group in many ways. Marginalization and social exclusion lead to unequal opportunities for social participation. In order to break down barriers for older migrants, the perspectives of people with migration biographies should be given greater consideration. To this end, the results of an explorative intersectional ethical analysis of care narratives of older migrants are discussed in the light of aging studies research. The focus is on the ethical analysis of five guided interviews with older migrants between 65 and 80years old, who have migrated from different countries in southeastern Europe. In contrast to the prevalent expert perspective, the narratives of the older migrants interviewed revealed not only resistance to vulnerabilization but also multiple negotiations of autonomy and dependency. By making ambivalent narrative and action strategies visible and linking them to narratives of intergenerational care relationships, the significance of care-ethical interpretations of vulnerability and characterization of vulnerability as "auniversal, inevitable, and anthropological feature of humanity resulting from the embodied, finite, and socially contingent structure of human existence" [4] can be demonstrated.

Legal environment as a factor in the inflow of Foreign Direct Investment: Case of Serbia

The economic growth and development of a country depend on the inflow of foreign direct investment, and the legal environment factors play an important role in securing it. Compared to other countries in South-Eastern Europe, Serbia has achieved remarkable results in terms of FDI inflows over the last ten years. The research examines the impact of the legal environment on FDI inflows in Serbia. The study was conducted using a quantitative approach and a survey technique based on a structured questionnaire. The basic set of the research consists of the 300 most prominent foreign investors (response rate of 28%) who invested capital in Serbia in the period 2011-2019. The results of the conducted research show that ownership in Serbian companies is the most important factor in the legal environment that influences a foreign investor's decision to invest capital in these companies. The results show that labor legislation, law enforcement, and confidence in the legal system can significantly contribute to a foreign investor's decision to invest capital in Serbia. The legal environment's implications influence investor decisions and shape the overall investment climate of a country. A well-structured and investor-friendly legal framework will increase Serbia's competitiveness and attractiveness for foreign investments.

Affordability of cigarettes in ten Southeastern European countries between 2008 and 2019

BackgroundThe empirical evidence shows that tobacco consumption is strongly associated with its affordability. The nominal growth in tobacco prices imposed by taxation should exceed or at least keep pace with...

The influence of Turkish cuisine in Romania

Romania is a major country in south-eastern Europe, located in the northern region of the Balkans. Due to Romania's proximity to Western European countries and the transit routes that reach these countries, various peoples have settled in Romanian lands since ancient times. Between 1400 and 1878, the Ottoman Empire ruled Romania. The Turks brought their unique cuisine along with the other customs and traditions to the places they conquered. In Romania, and particularly in the Dobruja region, we see the interplay of Turkish names in kitchenware and food and drink.

Femicide and COVID-19 Pandemic: Examining the Situation in Croatia, Hungary, Montenegro, North Macedonia, and Slovenia

Government measures to limit the spread of COVID-19 affected crime opportunities and criminal justice systems, resulting in changes in crime trends. This article explores the effects of restrictions (lockdowns) on the number of femicides. The monthly data on femicides from 2017 to 2021 were collected in five Central and South-eastern European countries: Croatia, Hungary, Montenegro, North Macedonia, and Slovenia. The total number of femicides from 2017 to 2021 decreased in all observed countries. Increases were detected in Croatia and Slovenia in 2020. However, they presented an exception to the general trend. The monthly distribution of femicides showed that there was no common point peak month(s) among observed countries. Analyzing the effects of the level of restrictions using the Stringency Index on the number of femicides confirmed the initial observation that the number of femicides was not dependent on lockdown measures. In general, the findings show that restriction measures had no effect on the number of femicides in the studied countries.

Pothiti Hantzaroula, Child Survivors of the Holocaust in Greece: Memory, Testimony and Subjectivity

This article reviews Pothiti Hantzaroula's Child Survivors of the Holocaust in Greece: Memory, Testimony and Subjectivity (Routledge, 2020). It highlights how Hantzaroula’s book represents a needed and much welcome addition to the study of child survivors of World War II by offering students and scholars of the Holocaust a comprehensive insight into the specifics of Greece, which can serve as a basis for subsequent comparative or kindred assessments in the case of other Southeastern European countries.

Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures.

Rare cancers are defined by an annual incidence of fewer than 6 per 100,000. Bearing similarities to rare diseases, they are associated with substantial health inequalities due to diagnostic complexity and delayed access to innovative therapies. This situation is further aggravated in Southeastern European countries like Bulgaria, where limited public resources and expertise underscore the need for additional policy and translational research on rare cancers. This study aimed to explore the availability and access to orphan drugs for rare cancers in Bulgaria for the period of 2020-2023. We cross-compared data from both the European Union and national public sources to evaluate the number of available and accessible orphan drugs for rare cancers, the delay from market authorization to reimbursement, the dynamics of public expenditures, and regional disparities in access across the country. We juxtaposed the main characteristics of oncological and non-oncological orphan drugs as well. Only 15 out of 50 oncological orphan drugs that were authorized by the European Medicine Agency were accessible for rare cancer patients in Bulgaria. The median delay between market authorization and inclusion in the Bulgarian Positive Drug List was 760 days. The total expenditures for all orphan drugs for rare cancers amounted to EUR 74,353,493 from 2020 to 2023. The budgetary impact of this group rose from 0.24% to 3.77% of total public medicinal product expenditures for the study period. Rare cancer patients represent a vulnerable population that often faces limited to no access to treatment. We call for targeted European and national policies to address this major inequality.

Sustainable Earthquake Preparedness: A Cross-Cultural Comparative Analysis in Montenegro, North Macedonia, and Serbia

Authorities and governmental bodies strongly emphasize the importance of residents preparing for natural disasters, particularly underscoring the significance of readiness for geophysical hazards like earthquakes. In this study, which represents comparative quantitative research, the levels and predictors of the impact on preparedness for earthquake-induced disasters in South-Eastern European countries such as Montenegro, North Macedonia, and Serbia are examined. Using the snowball sampling technique (online questionnaire), a survey of 1245 respondents (Montenegro (n = 400), North Macedonia (n = 345), and Serbia (n = 500) was conducted from February 2023 to February 2024. The paper is based on the central hypothesis that the most significant predictor of earthquake preparedness in Montenegro, North Macedonia, and Serbia is age, followed by education and gender. Multivariate regression analysis was used to determine the extent to which five scores of the subscales (household preparedness, community preparedness, disaster preparation, earthquake risk awareness, and reinforced house) were associated with seventh demographic and socio-economic variables. In addition to the mentioned analysis, other statistical analyses such as t-test, one-way ANOVA analysis, and Pearson correlation were also utilized. The results indicate that age emerges as a predictor in various aspects of earthquake-induced disaster preparedness and awareness in most models, followed by education and gender. These findings confirm the significance of respondents’ age in determining levels of preparedness and earthquake awareness. Overall, in North Macedonia, respondents recorded the highest ratings (M = 3.52) for household preparedness for earthquakes, compared to Serbia (M = 3.26) and Montenegro (M = 2.98), where the lower ratings were recorded. Research findings, taking into account cultural characteristics, can serve as a basis for the development of targeted interventions, strategies, policies, and programs aimed at improving the level of societal preparedness for earthquake-induced disasters.

Unravelling open innovation determinants and firm performance relationships in CEE and SEE countries

Purpose Open innovation (OI), by now one of the major concepts for the analysis of innovation, is seen as a methodology for collaboratively designing and implementing solutions by engaging stakeholders in an iterative and inclusive service design process. This paper aims to empirically investigate OI capacities, defined as a cooperative, knowledge-sharing innovation ecosystem, and to explore how it can lead to improved performance of firms in Central and Eastern European (CEE) and Southeastern European (SEE) countries.Design/methodology/approach The study builds on the World Bank/European Bank for Reconstruction and Development (EBRD’s) Business Environment Enterprise Performance Survey (BEEPS) dataset for 2009, 2013 and 2019. Primarily, the research model was estimated using log-transformed ordinary least squares (OLS). Taking into consideration that this method might produce substantial bias, yielding misleading inferences, this study is fitting Poisson pseudo maximum likelihood estimators with robust standard errors and instrumental variable/generalized method of moments estimation (IV/GMM) approach for comparative results. Secondarily, the research model was tested using structural equation modelling (SEM) to investigate the relationship between five OI capacities and firm performance.Findings The findings indicate that there is a significant positive relationship between most OI capacities and firm performance, except for innovation, which did not show a statistically significant relationship with firm performance. Specifically, research and development (R&D), knowledge and coopetition are statistically significant and positively associated with firm performance, whereas transformation is statistically significant but negatively associated with firm performance. The IV/GMM estimations’ findings support the view that the firm performance is significantly affected by OI capacities, together with some control variables such as size, age, foreign ownership and year dummy to have a significant impact on firm performance.Originality/value This paper fills an identified gap in the literature by investigating the impact of OI on firm performance executed in the specific CEE and SEE country context.

The economic burden of obesity in 4 south-eastern European countries associated with obesity-related co-morbidities

ObjectiveTo provide an assessment of the cost burden of obesity across a spectrum of obesity-related comorbidities (ORCs) for four countries in South-Eastern Europe (SEE).MethodsA micro-costing analysis from the public payer perspective was conducted to estimate direct healthcare costs associated with ten obesity-related comorbidities (ORCs) in Czech Republic, Greece, Hungary, and Romania. A survey was administered to obtain healthcare resource use and unit cost data. Cost estimates were validated by local steering committees which comprised at least one public sector clinician and a panel of independent industry experts.ResultsChronic kidney disease and cardiovascular diseases were the costliest ORCs across all 4 countries, where annual cost burden per ORC exceeded 1,500 USD per patient per year. In general, costs were driven by the tertiary care resources allocated to address treatment-related adverse events, disease complications, and associated inpatient procedures.ConclusionsOur findings confirm that the high prevalence of obesity and its comorbidities result in substantial financial burden to all 4 SEE public payers. By quantifying the burden of obesity from a public healthcare perspective, our study aims to support policy efforts that promote health education and promotion in combating obesity in the region.

Trust in the central bank, financial literacy, and personal beliefs

This paper examines trust in the central bank across ten Central, Eastern and Southeastern European countries, using survey data collected from 61,398 individuals. Our results show that financially literate individuals are more likely to trust central banks. The association is stronger in countries with inflation targeting and flexible exchange rates regimes. Distrust in the central bank is associated with higher inflation expectations, savings in foreign currency or a preference for cash. Even when the sample is restricted to individuals with high inflation expectations, financial literacy remains associated with greater trust in the central bank. We find that trust in the central bank correlates negatively with financial inclusion but positively with wealth. Financially literate citizens express less trust in the government, which highlights that trust in the central bank is not entirely indicative of trust in the government. However, individuals who think that prices will rise and the local currency will depreciate distrust both the central bank and the government.

Imported viremic dengue case in a southeastern European country: Established Aedes mosquitoes warrant urgent surveillance.

Imported viremic dengue case in a southeastern European country: Established Aedes mosquitoes warrant urgent surveillance.

The utilization of psychopharmacological treatments for individuals with autism spectrum disorder (ASD) in a middle-income European country

BackgroundStudies examining the utilization of psychopharmacological treatments (psychotropic medications) for autism spectrum disorder (ASD) have primarily been carried out in affluent nations. Nonetheless, there is an evident dearth of data originating from low- and middle-income countries. Our study sought to comprehensively evaluate the usage of psychopharmacological treatments and the effectiveness of those treatments as perceived by the parents of individuals with autism spectrum disorder (ASD) in Macedonia, a middle-income country in South-Eastern Europe. MethodsWe conducted a survey involving 103 parents of individuals with ASD and analyzed the questionnaire responses using descriptive statistics and non-parametric tests. ResultsOur research uncovered that 62% of individuals diagnosed with ASD were prescribed psychopharmacological treatments, yet only 48% actually utilized them. Among the medications prescribed, antipsychotics (55%) and antiepileptics (44%) were the most common, with risperidone and valproate being the preferred options. Psychopharmacological treatments were found to be more commonly used among individuals aged 15 years and above, with children under 8 years closely following suit at a rate of 56%. Furthermore, we discovered a noteworthy association between the severity of ASD symptoms and the utilization of these interventions. Intriguingly, the majority of parents (73%) regarded the effectiveness of psychopharmacological treatments as only partially effective. ConclusionOur study emphasizes the prevalent utilization of psychotropic medication, especially among young individuals, and underscores the necessity for enhanced dissemination of information to parents regarding prescribed medications. By integrating our research findings, medical professionals and policymakers can enhance the strategies and initiatives used to improve the quality of care and support for individuals on the autism spectrum.

Monitoring of species’ genetic diversity in Europe varies greatly and overlooks potential climate change impacts

Genetic monitoring of populations currently attracts interest in the context of the Convention on Biological Diversity but needs long-term planning and investments. However, genetic diversity has been largely neglected in biodiversity monitoring, and when addressed, it is treated separately, detached from other conservation issues, such as habitat alteration due to climate change. We report an accounting of efforts to monitor population genetic diversity in Europe (genetic monitoring effort, GME), the evaluation of which can help guide future capacity building and collaboration towards areas most in need of expanded monitoring. Overlaying GME with areas where the ranges of selected species of conservation interest approach current and future climate niche limits helps identify whether GME coincides with anticipated climate change effects on biodiversity. Our analysis suggests that country area, financial resources and conservation policy influence GME, high values of which only partially match species’ joint patterns of limits to suitable climatic conditions. Populations at trailing climatic niche margins probably hold genetic diversity that is important for adaptation to changing climate. Our results illuminate the need in Europe for expanded investment in genetic monitoring across climate gradients occupied by focal species, a need arguably greatest in southeastern European countries. This need could be met in part by expanding the European Union’s Birds and Habitats Directives to fully address the conservation and monitoring of genetic diversity.