Slovenian Journal of Public Health Feed

Forms of Violent Behavior in Patients with Mental Disorders at the University Psychiatric Clinic Ljubljana from 2018 to 2021 Using the OAS/BVC Scale Assessment—A Descriptive Study

Tue, 01 Sep 2026 00:00:00 GMT

IntroductionThe high incidence of violence directed at healthcare workers is a major public health concern. The purpose of the study was to investigate the incidence of various forms of aggression at the University Psychiatric Clinic Ljubljana from 2018 to 2021, stratified by perpetrator gender, time of occurrence, and ward type.MethodsData were collected using completed standardised forms (the OAS and BVC scales) during 2018–2021. A total of 4,392 episodes of various forms of violent behaviour were detected. Descriptive and bivariate statistics were performed using IBM SPSS. The level of statistical significance was set at p < 0.05.ResultsThe total aggression score was significantly higher in men (t = 8.471, p < 0.001). Wards differed in the forms of aggressive behaviour (p < 0.05). The total aggression score (AS score) was significantly higher during the evening shift than during the morning shift (p < 0.001) or the night shift (p = 0.037). A positive correlation was found between OAS and BVC scores (r = 0.672, p < 0.001).ConclusionsOur findings are consistent with previous international research, confirming that violence remains a common challenge in psychiatric inpatient settings. The positive association between BVC and OAS scores supports the complementary use of both instruments for violence risk assessment and incident evaluation. In line with previous research, the results support recommendations that violence prevention should extend beyond assessment tools and staff training to include a culture of safety and organisational commitment to preventing and managing aggression.

A Comparative Analysis of the Economic Burden of Breast, Colorectal and Lung Cancer-Related Premature Mortality in Slovenia: Value-Added Decomposition by Occupation-Gender Groups

Tue, 01 Sep 2026 00:00:00 GMT

IntroductionThis paper aims to estimate the value-added loss attributable to premature deaths from breast, colorectal and lung cancer in Slovenia using a novel methodology using linked employer-employee data, enabling value-added decomposition by occupation-gender groups.MethodsThe analysis is based on population-level microdata for the 2016–2022 period matched from several sources. Premature mortality costs are estimated using occupation- and gender-specific output losses rather than assuming uniform productivity across working-age individuals. We approximate intangible capital using each firm's occupational and gender structure and estimate productivity losses due to premature mortality by specific occupation, revealing differences in the economic footprint of different cancer types.ResultsOn average, the loss of value added from a premature death due to colorectal cancer is between €352,000 and €392,000, from lung cancer, on average, between €150,000 and €178,000 and from breast cancer, around €436,000. In total, given that Slovenia's GDP in 2024 was around €66 billion (€52 billion at constant 2015 prices), the total value-added loss associated with these three cancer types amounted to about 0.5% of Slovenia's 2024 GDP. Over the study period, premature mortality attributable to these cancers translated into an estimated cumulative (current and future) GDP loss of roughly €371 million.ConclusionsResults indicate that notable reductions in indirect costs could be achieved in Slovenia through efficient and effective measures to manage the burden of cancer, including cancer screening programmes, other primary prevention approaches, timely access to diagnostics and treatment, and return-to-work policies.

Inpatient Burden, Costs, and Characteristics of Peripheral Artery Disease in Slovenia

Tue, 01 Sep 2026 00:00:00 GMT

IntroductionWe assessed inpatient burden, costs, demographics, comorbidity patterns, and outcomes of peripheral artery disease (PAD) in Slovenia.MethodsWe included patients hospitalised for PAD (primary diagnosis, International Classification of Diseases, 10th revision, code I70.2–I70.9) in Slovenia between January 1st, 2015, and December 31st, 2022. We estimated crude and age-standardised hospitalisation rates, hospitalisation reimbursement costs, patient characteristics (age and sex distribution, disease severity and prevalence of comorbidities), uptake of revascularisation, major amputations and in-hospital mortality.ResultsWe included 15,978 patients (60% men, median age 72 years, 32% chronic limb-threatening ischaemia) with 27,139 hospital episodes, yielding a mean of ~3,400 hospitalisations per year (hospitalisation rate 161 per 100,000/year). Median direct cost (inflation-adjusted to 2025) per hospital episode was €3,177, yielding total costs of €10.8 million/year. The most common comorbidities were arterial hypertension (35%), dyslipidemia (21%) and diabetes mellitus (19%), with a significantly higher prevalence in patients with chronic limb-threatening ischaemia. During the observation period, revascularisation procedures increased from 77.5% to 80.2%, while major amputations decreased from 13.2% to 7.9%, and mortality decreased from 5.0% to 3.3%.ConclusionsThe inpatient burden of PAD is considerable in Slovenia. Patients hospitalised for PAD have a high burden of comorbidities, especially when presenting with chronic limb-threatening ischaemia; nonetheless, in-hospital major amputations and mortality decreased substantially over the last decade.

Why Organised Cancer Screening Works: Lessons from Slovenia and the Next Phase of Evidence-Based Implementation

Tue, 01 Sep 2026 00:00:00 GMT

Slovenia's experience shows that cancer screening becomes effective only when a test is embedded in an organised, population-based programme that reaches the target population equitably, assures quality across the whole pathway and uses individual- and programme-level data for improvement. Since the national roll-out of Programme ZORA for cervical cancer screening in 2003, followed by DORA for breast cancer screening in 2008 and Programme Svit for colorectal cancer screening in 2009, Slovenia has built a coherent screening infrastructure with visible population effects. Cervical and colorectal cancer incidence and mortality are decreasing, breast cancers detected through DORA are increasingly diagnosed at a localised stage, and Slovenia ranks among the strongest European performers in screening coverage and policy. This editorial argues that these achievements should be understood not as three isolated programme successes, but as the result of governance, registries, quality assurance, legal foundations, public trust and international alignment. The same principles must now guide the modernisation of existing programmes and the cautious, evidence-based introduction of lung, prostate and gastric cancer screening.

Osteoporosis Treatment Gap — A Systematic Literature Review

Tue, 01 Sep 2026 00:00:00 GMT

IntroductionOsteoporosis is a common metabolic bone disease that increases fracture risk, particularly among older adults, and imposes a substantial global burden. Despite advances in risk assessment and treatment, a large treatment gap remains, with many high-risk individuals not receiving care.MethodsWe conducted a systematic review of English-language studies published up to April 2025, identified through searches in multiple databases (PubMed, Scopus, Web of Science, ScienceDirect, Europe PMC). 43 studies were included. Due to the heterogeneity of study designs and treatment gap definitions, a narrative thematic synthesis was performed.ResultsReported treatment gap estimates varied widely (38.8–94.6%) across countries and study populations. Lower treatment rates were associated with patient factors (male sex, lower socio-economic status, comorbidities) and healthcare system factors (limited physician awareness, institutional barriers, poor interprofessional communication). Higher treatment rates were associated with older age, family history of osteoporosis, prior diagnosis or bone mineral density testing, and participation in structured care programmes.ConclusionsSubstantial global treatment gaps in osteoporosis care persist, particularly following fragility fractures. These gaps arise from multiple patient, physician, and system-level factors, with persistent disparities by sex, ethnicity, comorbidities, and socio-economic status. Findings highlight the need for standardised definitions of the treatment gap and suggest areas for future research and intervention development.

Ill-Defined Deaths in Slovenia: Implications for Mortality Data Quality and Burden of Disease Studies

Tue, 01 Sep 2026 00:00:00 GMT

IntroductionIll-defined deaths (IDDs) are deaths assigned non-specific or insufficiently informative causes that do not identify a distinct underlying disease or injury. They reduce the accuracy of mortality statistics. In Slovenia, the overall proportion, structure and distribution of IDDs have not yet been comprehensively evaluated. This study examined the most frequent IDDs and their demographic and regional patterns in Slovenia from 2010 to 2021.MethodsIndividual-level mortality data from 2010 to 2021 were analysed. Deaths assigned ICD-10 codes denoting vague/non-specific conditions were classified as IDDs using the GBD 2019 cause list. Frequencies and distributions were examined overall and by sex, age group, and regions.ResultsOf 243,166 deaths, 53,020 (21.8%) were IDDs. The proportion was higher in females and increased with age. Heart failure was the most frequent IDD and showed a distinctly higher share among females. Other common IDDs included unspecified stroke, unspecified lower respiratory infections, unspecified cancers, and R99-coded (Ill-defined and unknown cause of mortality) deaths. Clear variation in age groups was observed: poisoning-related IDDs were concentrated in young adults, R99 predominated in working age groups, and cardiovascular-related IDDs dominated in older adults. Regional distributions of the top categories of IDDs resembled the national one, except for unspecified cardiomyopathy, which appeared prominently in two north-eastern regions.ConclusionsHeart failure is the major contributor to IDDs in Slovenia, with demographic and regional variation. The findings highlight the need to strengthen death certification and improve the quality of mortality data to support burden-of-disease analyses.

Trends in Unintentional Injury Mortality Among Children and Adolescents in Poland, 2010–2024: An Unfinished Lesson for Public Health in Changing Social Realities

Tue, 01 Sep 2026 00:00:00 GMT

IntroductionUnintentional injuries are a major cause of death among children and adolescents in Europe. Poland has historically reported elevated mortality levels. This study assesses national trends in injury mortality among individuals aged 1–19 years from 2010 to 2024.MethodsA national time-trend analysis was conducted using Statistics Poland death registry data. Mortality rates were calculated by age group, sex, residence, and cause of death. Trends were modelled using log-linear Poisson regression to estimate annual percent change (APC). Global Burden of Disease estimates provided international context.ResultsA total of 6,812 deaths from unintentional injuries occurred during 2010–2024. Overall mortality decreased from 8.5 to 4.9 per 100,000 (APC −4.8%; 95% CI −5.3 to −4.3). The highest average mortality rate during 2010–2024 was observed in the 15–19 age group (15.4; 95% CI 14.9–15.8). Rural areas showed the steepest improvement (APC −6.7%), with rates declining from 11.7 in 2010 to 4.7 in 2024. The fastest age-specific decline occurred among children aged 5–9 years (APC −6.7%). Transport-related injuries contributed approximately 71% of the total decline. Drowning mortality showed the most pronounced relative decrease (APC −10.0%), while poisoning mortality increased significantly (APC +6.3%).ConclusionsMortality from unintentional injuries among children and adolescents in Poland has declined to levels comparable with the European Union; however, these improvements have been uneven across population groups. Further progress will require adapting prevention strategies to increasingly complex and evolving risk factors shaped by changing societal conditions.

Mental Health Service Preparedness during a Pandemic: A Delphi Study in Slovenia

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionThe COVID-19 pandemic posed significant challenges for mental health, requiring many mental health services to reorganise. The aim of this study was to develop a set of consensus-based recommendations outlining measures and activities for the operation of mental health services during a potential pandemic in Slovenia.MethodsTo develop a preliminary list of measures, relevant literature, existing guidelines, and COVID-19 response practices were reviewed. These measures were then evaluated using a modified Delphi method. Eleven Slovenian mental health experts participated in 4 Delphi rounds to determine which measures should be implemented and at which stage of a potential future pandemic.ResultsConsensus was reached on 47 measures and activities. The majority were classified for implementation before or at the onset of a potential pandemic, with only a small number designated for implementation during the pandemic.ConclusionsThe identified measures and activities are discussed in relation to existing research and international frameworks. They represent consensus-based preparedness guidance for the organisation of mental health services during a pandemic or similar public health emergency and may inform the future development of national guidelines and strategic frameworks.

Health Literacy is a Rising Star in Policy and Research, also in Slovenia

Mon, 01 Jun 2026 00:00:00 GMT

The World Health Organization has identified health literacy as a key pillar for resilient health systems in its current global strategy for 2025–2028. In this editorial, we argue that effectively addressing health literacy requires its integration into key strategic frameworks at both the global and national levels, as this represents a fundamental precondition for a more coordinated and systematic approach to the issue. Slovenia has followed these global directions by adopting the National Health Literacy Strategy 2025–2035 in 2025, establishing a ten-year strategic framework to strengthen health literacy. The country is also adhering to recommendations for ongoing research in this field; in 2026, the second national health literacy survey will be conducted. Looking ahead, the focus should be on developing and implementing practical public health interventions, and on strengthening coordination with existing health promotion and prevention programmes in Slovenia that are already delivering measurable impact. A key challenge will be to strengthen collaboration between researchers, policy-makers, and practitioners to help create a supportive, health-literate environment in Slovenia.

The Societal and Patient-Level Burden of Sickness Absenteeism in Patients with Rheumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis Across Two Decades in Slovenia

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionTo analyse the long-term dynamics of the burden of sickness absenteeism (SA) at the societal and patient levels in employed patients with selected inflammatory rheumatic diseases (IRDs).MethodsThe burden of SA was analysed over 2 decades prior to the COVID-19 pandemic, with a focus on the subperiod following the introduction of the rheumatology clinical registry biorx.si. Population data for full-time employees on sick leave due to rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) were obtained from the national administrative database. The societal burden of SA was defined as the total annual number of calendar days on sick leave. The patient-level burden of SA was defined as the average annual number of days on sick leave per patient which was further disaggregated into the average annual number of sick leave episodes per patient and the average annual number of days per sick leave episode. The costs of SA were estimated using the human capital approach. An exponential trend method was used for analysis, and time series were tested for structural breaks.ResultsThe societal burden of SA during the subperiod following the registry introduction decreased, on average, by 3.3% annually among RA patients. The average annual increase in the societal burden of SA was marginal for PsA patients (0.4%) and substantial for AS patients (8.7%). The societal and patient-level burdens of SA varied by sex and job sector. The patient-level burden of SA, however, decreased on average by 2.5% annually for RA patients and increased marginally for both PsA and AS patients. The key pattern suggesting potential improvements in the patient-level burden of SA for the analysed IRDs was an increase in the number of sick leave episodes per patient, offset by shorter episode duration.ConclusionsA study of the societal burden of SA, including its components, and the patient-level burden of SA can support the development of more effective strategies for managing SA and facilitating a faster return to work.

Patient Safety in Family Medicine through the Eyes of People with Chronic Conditions in Slovenia

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionPatient safety is a key dimension of healthcare quality, although most research has focused on hospital settings. This study analysed patient-reported experiences related to safety in Slovenian family medicine using data from the OECD PaRIS survey.MethodsA cross-sectional study was conducted in 2023 among 70 family medicine practices in Slovenia. Data were collected using two validated questionnaires: the PaRIS Primary Care Patient Questionnaire (PaRIS-PQ) and the Primary Care Practice Questionnaire (PaRIS-PCPQ). Items Q69–Q75 of the PaRIS-PQ were analysed to assess experiences related to the use of medicines, medication review, repetition of information, adverse events, encouragement to express concerns, and barriers to care. Descriptive statistics, chi-square tests, correlation analysis, and binary logistic regression were used in data analysis.ResultsRespondents with chronic conditions totalled 2,133 (mean age 63.1 ± 10.9 years; 62.7% female). Polypharmacy (≥ 3 medications) occurred in 27% of respondents; only 19.7% had received a medication review in the previous 12 months. Seventeen percent reported experiencing at least one adverse event. Significant predictors of reported adverse events included repeated requests for personal medical information (p < 0.001), lack of encouragement to express concerns (p = 0.008), and transport barriers to accessing care (p = 0.024). The regression model explained a small proportion of the variance (Nagelkerke R2 = 0.02).ConclusionsPatient safety in Slovenian family medicine shows both strengths and areas requiring improvement. Communication processes, access barriers, and coordination of information appear to play an important role in perceived safety. Strengthening medication review practices and improving digital interoperability across healthcare settings may contribute to safer care in family medicine. Patient-reported measures such as PaRIS provide valuable insights for monitoring and improving patient safety in family medicine.

National Cancer Control Programmes in Europe in 2024: State of Play and Alignment with the European Guide for Quality NCCPs

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionNational Cancer Control Programmes (NCCPs) are essential policy documents guiding national cancer control planning. Their existence and quality are crucial for reducing cancer incidence, morbidity, and mortality, and for improving the quality of life of people with cancer and the population. The main aim of the present research, conducted within OriON Joint Action (2024–2025), was to explore and analyse the state of play, type, duration, evaluation, and quality of NCCPs across the European Union (EU) and selected countries, with a focus on the inclusion of key elements outlined in the European Guide for Quality NCCPs (Guide).MethodsA structured survey was prepared, validated, and carried out in 2024 across 34 countries, including EU Member States, Iceland, Montenegro, Norway, Turkey, and Ukraine. The results were analysed and presented in tables and figures. Descriptive analysis using frequencies and percentages was conducted.ResultsThe response rate was 100%. Of the 34 participating countries, 31 reported having an NCCP or equivalent cancer control document in 2024. Most countries had 1 comprehensive document, while 9 prepared multiple documents. The majority were defined as programmes and/or strategies, followed by plans and policies. In terms of quality, as recommended by the Guide, only 6 countries fully incorporated all suggested elements into their NCCPs.ConclusionsOur findings indicate that most European countries recognise the significant challenge posed by cancer as a major public health problem and have developed NCCPs or equivalent cancer control documents. However, in terms of quality, there remains considerable room for improvement.

Long COVID and Its Impact on Daily Functioning: Findings from the Si-Panda Behavioural Insights Survey in Slovenia

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionResearch on the long-term consequences of COVID-19 has initially focused on the symptoms and prevalence of long COVID. However, few studies have fully incorporated the World Health Organization definition or explored its diverse predictors, including mental health factors. This study aims to deepen the understanding of long-term outcomes of COVID-19 and their associated factors.MethodsData were drawn from the SI-PANDA Behavioural Insights survey on COVID-19, an online questionnaire administered to a selected sample of participants from an online access panel in Slovenia. The study included 5,961 participants aged 18 to 74. A multivariate logistic regression model was used to identify factors associated with reporting long COVID.ResultsAmong the 5,961 respondents, 3,234 reported having been infected with SARS-CoV-2 at least once. Of those, 38% reported persistent fatigue and lack of energy. Long COVID developed in 16.1% (n = 520) of respondents who had been infected. The factor most strongly associated with long COVID was experiencing at least one severe episode of COVID-19, which was associated with a fourfold increase in the odds (OR = 3.99; 95% CI: 3.25–4.91). Other significant associations were observed for risk of a depressive disorder (OR = 2.50; 95% CI: 1.79–3.44), three or more SARS-CoV-2 infections (OR = 2.30; 95% CI: 1.45–3.64), risky stress behaviour (OR = 2.10; 95% CI: 1.38–3.30), and the presence of at least one chronic disease (OR = 1.50; 95% CI: 1.24–1.91).ConclusionsUnderstanding and effectively addressing infectious diseases like COVID-19 requires not only insight into the virus’s biology and evolution but also recognition of the important role of mental health and psychological factors.

Validation and Reliability of the Slovenian Translation of the Adherence to Exercise for Musculoskeletal Pain Tool (ATEMPT)

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionSubjective measures for assessing exercise adherence in patients with non-cancer widespread chronic muscle pain (CMP) are limited. Following the recent development of the valid and reliable Adherence To Exercise for Musculoskeletal Pain Tool (ATEMPT), this study aimed to assess the reliability of the Slovenian translation of the questionnaire for measuring exercise adherence in Slovenian patients with CMP.MethodsThis cross-sectional study included 107 patients with CMP (95% female), with a mean (SD) age of 56 (8) years, to assess the reliability and construct validity of the Slovenian version of ATEMPT. Following initial translation into Slovenian by 2 experienced translators and minor adaptation of terminology after discussing with people and an exercise specialist, the questionnaire was administered on 2 occasions, with a median (IQR) of 8 (0) days between assessments.ResultsOverall, test-retest comparisons showed similar scores for each item and for the score. Correlations between test and retest scores for each item and the total score were positive and moderate to high (all 0.533 < r < 0.733, all p < 0.001). Reliability of each item and the total score was significant and ranged from moderate (first, third and fourth items; intraclass correlation coefficients [ICCs] = 0.688–0.700) to good (second and sixth items and overall score; ICC = 0.824–0.852). Construct validity was strong, with all items loading onto a single underlying factor that explained 57% of the variance in ATEMPT scores.ConclusionsThe Slovenian translation of ATEMPT demonstrated moderate to excellent measurement properties and can therefore be used to assess exercise adherence in people with CMP.

Quality Indicators for the Care of People with Intellectual Disability in Family Medicine in Slovenia: A Modified Delphi Study

Mon, 01 Jun 2026 00:00:00 GMT

IntroductionPeople with intellectual disability (ID) experience poorer health outcomes and shorter life expectancy than the general population—gaps that could be mitigated by high-quality healthcare. In Slovenia, there are no specific recommendations for this population. The aim of this study was to identify and validate quality indicators (QIs) for the care of people with ID in family medicine, to serve as recommendations for this population in Slovenia.MethodsA three-round Delphi study was conducted with 15 national experts. An initial set of 44 indicators, derived from the literature, was presented, and panel members proposed eight additional indicators. In the first round, panel members rated the importance of each indicator. Based on feedback, the indicators were revised to separate importance from the implementation interval. In the second and third rounds, panel members rated importance and feasibility and selected the most appropriate time interval.ResultsA total of 33 indicators were validated. These indicators cover multiple aspects of healthcare, including lifestyle factors, lifestyle advice, clinical outcomes, ongoing care, preventive medicine, and administration. Of the original 44 indicators, 28 were confirmed (64%). Of the 8 indicators proposed by panel members, 5 were validated (62.5%). A total of 9 of the original indicators (20%) and 3 of the panel-proposed indicators (37.5%) were considered important but not feasible.ConclusionsThis three-round Delphi study successfully developed QIs for the care of people with ID in Slovenia. These QIs can be integrated directly into existing system structures. The study provides a set of indicators that can inform the development of a clinical checklist and serve as a practical tool for evaluating both organisational and clinical aspects of quality of care.

Secular Trends in Height, Body Mass, and BMI among Girls in the Eastern Poland Region (1986–2021): Public Health Perspectives

Sun, 01 Mar 2026 00:00:00 GMT

IntroductionTo assess long-term changes in body mass index (BMI) and weight status among girls from Eastern Poland between 1986 and 2021.MethodsData were obtained from repeated cross-sectional, population-based surveys conducted in Eastern Poland in 1986, 1996, 2006, 2016, and 2021. The study included 14,825 girls aged 8, 13, and 17 years, recruited from the same schools across survey waves. Body height and body mass were measured by trained personnel using standardised procedures, and BMI was calculated. Weight status categories (underweight, normal weight, overweight and obesity) were defined using international BMI cut-off points. Statistical analyses included analysis of variance and post hoc comparisons.ResultsBetween 1986 and 2021, the largest increase in BMI was observed among 13-year-old girls (+1.66 kg/m2), followed by 8-year-olds (+1.14 kg/m2), while a decrease occurred among 17-year-olds (−1.13 kg/m2). The prevalence of underweight declined among 8- and 13-year-olds by 2.70 and 3.15 percentage points, respectively, but increased among 17-year-olds by 1.85 percentage points. In parallel, the combined prevalence of overweight and obesity increased across all age groups: 19.89 percentage points among 8-year-olds, 10.66 among 13-year-olds, and 3.87 among 17-year-olds, with the greatest increases occurring in recent survey periods.ConclusionsOver the past 35 years, BMI distribution among girls in Eastern Poland has shifted towards higher values, accompanied by a rise in overweight and obesity. The increase in underweight among older adolescents may reflect psychosocial pressures. These findings highlight the need for age-specific public health strategies addressing both excessive and insufficient body mass.

Comparison of the Number and Reasons for Self-Perceived Barriers to Accessing Primary Health Care Services Between Roma and Ethnic Albanians

Sun, 01 Mar 2026 00:00:00 GMT

IntroductionTo compare the number and reasons for self-perceived barriers to accessing primary health care (PHC) services between Roma/Egyptian and ethnic Albanians.Methods533 adults (mean age: 45±18 years; ≈60% women) reporting barriers to accessing PHC services were recruited consecutively during a nationwide survey in October 2024 across all four regions of Albania, using probability-proportional-to-size sampling. A semi-structured questionnaire was administered by trained interviewers inquiring about the number and reasons for self-perceived barriers to accessing PHC services, health characteristics, and sociodemographic factors. General linear models and binary logistic regression were employed to assess the association between perceived barriers and ethnic groups.Results444 (≈83%) participants were ethnic Albanians, whereas the remaining 89 (≈17%) individuals belonged to other ethnic groups, including Roma (n = 57), Egyptians (n = 30), and Gorani or Macedonians (n = 2). Overall, cost and waiting time were the most common barriers. Roma/Egyptian minorities faced more cultural and language issues, whereas Albanians reported higher distrust and service-related expectations. The crude mean number of barriers to accessing PHC services was higher among Roma/Egyptian minorities than among Albanians (1.8 vs. 1.6, respectively; P = 0.04). The multivariable-adjusted odds of reporting ≥ 2 barriers to accessing PHC services were 93% higher among Roma/Egyptian minorities than in Albanians (P = 0.03).ConclusionsRoma/Egyptian minorities experience more barriers in accessing PHC services than ethnic Albanians. However, the cost of services constitutes the main barrier across both groups. Conversely, communication-related barriers affect mainly Roma/Egyptian minorities, whereas Albanians perceive more systemic barriers. In Albania, there is a need for targeted, equity-focused interventions.

Effect of Biological Therapy on Symptom Burden and Functional Disability in Patients with Migraine: A Before-and-After Analysis

Sun, 01 Mar 2026 00:00:00 GMT

IntroductionThis study aims to assess the effectiveness of biological therapies in reducing migraine-related symptom burden and functional disability, including reductions in monthly migraine days, pain intensity, and analgesic consumption, among patients with migraine in Slovenia.MethodsThis retrospective study analysed 92 adult patients with migraine receiving prophylactic biological treatment at the University Medical Centre Ljubljana. Average number of monthly migraine days (MMD), average analgesic consumption, pain intensity (VAS), and functional disability score (MIDAS) were collected before treatment and after 3 and 12 months. Statistical analysis involved the Friedman test to assess changes over time, followed by Wilcoxon tests with Bonferroni correction for post hoc comparisons.Results83 patients completed 12 months of treatment. Significant reductions (p < 0.001) were observed in MMD (median 10 vs. 2 days), analgesic consumption, VAS scores (median 8 vs. 4), and MIDAS scores after 3 months (median 19 vs. 2), sustained at 12 months. Treatment discontinuation occurred in 9 patients due to inefficacy or side effects. Most patients tolerated biologics well, with mild adverse effects reported.ConclusionsBiological therapies significantly reduced migraine-related symptom burden and functional disability, including decreases in migraine frequency, pain intensity, and analgesic use, in a Slovenian migraine cohort. These findings support the use of biologics as effective and safe options for migraine prevention in real-world clinical practice.

Evaluating the Psychometric Properties of the 7C Vaccination Readiness Scale: Evidence from Slovenia

Sun, 01 Mar 2026 00:00:00 GMT

IntroductionVaccine hesitancy remains a major global public health challenge. Psychological models, such as the 7C vaccination readiness scale, aim to identify key psychological determinants of vaccine uptake. While the scale has shown validity in various cultural contexts, its psychometric properties have not yet been evaluated in Slovenia.MethodsThis study assessed the psychometric properties, convergent validity, and criterion validity of the Slovenian version of the 7C scale using a representative sample of 1,350 adults via confirmatory factor analysis (CFA), correlation coefficients, and regression analyses.ResultsThe bifactor model showed mixed psychometric properties. CFA revealed a weak model fit, with two items showing inadmissible estimates; these were removed. The revised model showed improved estimation and acceptable, though still suboptimal, fit indices. Convergent validity was supported by significant correlations between the general vaccination readiness factor and conspiracy beliefs, while individual components showed weaker associations. Criterion validity analyses showed that the general factor was the strongest predictor of vaccination intention, with calculation and compliance also contributing. The 7C model explained more variance in vaccination intention than the 5C model, suggesting greater utility. Despite structural limitations, the scale demonstrates practical value and offers recommendations for refinement.ConclusionsThe Slovenian version of the 7C scale proved to be a valuable tool for predicting vaccination intention. The general factor was a robust predictor, and calculation and compliance showed additional validity. However, components like complacency and constraints need revision to improve model fit. With refinement, the 7C scale holds promise for research and public health applications across contexts.

Fifteen Years of Health-and-Environment Research in Slovenia

Sun, 01 Mar 2026 00:00:00 GMT

The environment in which we are born, live, work, and age is an important determinant of human health. This review summarises key epidemiological studies conducted over the past 15 years at the Department of Public Health, Faculty of Medicine, University of Ljubljana, in collaboration with experts in public health, clinical medicine, and other health and environmental disciplines. Methodological approaches for linking health and environmental data, including advanced spatial epidemiological methods to assess the impact of ambient air pollutants on respiratory diseases and diabetes, were highlighted. Considering the observed health outcomes among children and adolescents, new tools were developed and validated to estimate the prevalence of asthma and sleep-related problems among youths. In adults, the review examines the lifetime prevalence of first and recurrent systemic allergic reactions to bee venom among beekeepers, emphasising the need for effective risk-management strategies. Overall, the studies demonstrated the value of integrating health and environmental data to better understand and address public health challenges in Slovenia. The findings underscore the importance of interdisciplinary collaboration in developing evidence-based public health policies to mitigate environmental health risks and promote a high quality of life for present and future generations.