Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare.

No abstract

Fertile soils in the River Neretva estuary were developed by fluvial sedimentation and deposition of the eroded soil material from the karst hills within the catchment. After extensive reclamation, two reclaimed land zones (fluvial terraces and lower-laying terraces) have been delineated, both used for agriculture. The main objectives of this study were to evaluate soil chemical and geochemical properties in reclaimed zones that differ mainly in topography, soil types and agricultural land use. The origin of the trace metals in the arable soils was studied using multivariate statistics, and interpolation maps of trace metals were produced using GIS and geostatistics. Soil trace metal concentrations do not exceed a threshold value established by the Croatian Government regulation, with exception of copper. Comparative analysis of the main soil properties and trace metal concentrations in the study area showed a pronounced spatial variation and differences between two reclaimed zones in soil organic matter content, bioavailable P and total concentrations of Cd and Cu. Factor analysis in the area of the lower-laying terraces showed grouping of bioavailable P and K, organic matter content and pH (negative loading) in the component associated mostly with the land use. In the area of the fluvial terraces, bioavailable P and total Cd were grouped in the same component that may be explained by the traditional small farm agriculture and overuse of mineral fertilizers. In the whole study area, processes of secondary salinization were determined, accompanied by the raised chloride and sodium concentration measured in the saturation soil extract.

Background : The Covid-19 pandemic is associated with adverse mental health outcomes for people worldwide. Objective : The study aimed to assess mental health during the Covid-19 pandemic and the key risk factors from the human ecology perspective in Croatia’s adult population. Method : An online panel survey with 1,201 adult participants (50.1% women) was done with a nationally representative sample in terms of gender, age, and country region four months after the nation lockdown began and two months after most of the restrictions were lifted. Indicators of mental health included symptoms of adjustment disorder (ADNM-8); depression, anxiety, and stress (DASS-21); symptoms of post-traumatic stress disorder (PC-PTSD-5); and well-being (WHO-5). Results : In the entire sample, 9.8% (95% confidence interval [CI]: 7.9%, 14.0%) of the participants were at risk of adjustment disorder, 7.7% (95% CI: 6.7%, 11.9%) were at risk of depression disorder, and 7.8% (95% CI: 5.3%, 10.3%) were at risk of anxiety disorder. In addition, 7.2% (95% CI: 5.3%, 10.2%) were experiencing high levels of stress. The average well-being score was 56.5 ( SD = 21.91) on a scale from 0 to 100. Among the participants who have lifetime traumatic experience ( n = 429), 14% (95% CI: 10.6%, 17.2%) were at risk for PTSD. Key risk factors for specific mental health outcomes differed, but the common ones included: current health status, previous mental health diagnosis, and psychological resilience. Being younger, having a below-average income, and excessively following news about Covid-19 were predictive for some of the mental health problems. Conclusions : Together, the key risk factors identified in this study indicate the need for public health interventions addressing the general population’s mental health, but also for specific risk groups. Lower rates of mental health symptoms assessed soon after lifting quarantine measures that have been found in other studies may indicate human resilience capacity.

The current political crisis, conflicts and riots in many Middle Eastern and African countries have led to massive migration waves towards Europe. European countries, receiving these migratory waves as first port of entry (POE) over the past few years, were confronted with several challenges as a result of the sheer volume of newly arriving refugees. This humanitarian refugee crisis represents the biggest displacement crisis of a generation. Although the refugee crisis created significant challenges for all national healthcare systems across Europe, limited attention has been given to the role of primary health care (PHC) to facilitate an integrated delivery of care by enhancing care provision to refugees upon arrival, on transit or even for longer periods. Evidence-based interventions, encompassing elements of patient-centredness, shared decision-making and compassionate care, could contribute to the assessment of refugee healthcare needs and to the development and the implementation of training programmes for rapid capacity-building for the needs of these vulnerable groups and in the context of integrated PHC care. This article reports on methods used for enhancing PHC for refugees through rapid capacity-building actions in the context of a structured European project under the auspices of the European Commission and funded under the 3rd Health Programme by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). The methods include the assessment of the health needs of all the people reaching Europe during the study period, and the identification, development, and testing of educational tools. The developed tools were evaluated following implementation in selected European primary care settings.