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The generation and disposal of medical waste is an ongoing issue for medical facilities. Medical institutions, including hospitals, clinics, and facilities for patient diagnosis and treatment, produce highly hazardous waste for human. The actual pilot study used the questionnaire, based on the World Health Organization form, translated into Romanian where a number of pertinent questions were chosen. The form has been tested in 21 health facilities at the Republican and municipal levels. Tests were conducted online, the average number of beds in medical institutions being – 142.1±127.3 [M±SD]. The average number of employers in medical facilities was 268±173.9 [M±SD]. Following questionnaire testing and analysis of responses, three questions and 15 response options were excluded, 31 questions were amended or adjusted, and three new questions were added. Following the pilot study, it was noted that most of the questions met the criteria submitted for the form: specificity, clarity, simplicity of wording, veracity and reasoning. Additionally, a number of issues have been identified that require a complex and immediate approach.

Over time, the Republic of Moldova has gone through several stages of development and reform of the Occupational Health and Safety System. This article aimed to assess the complex legal and regulatory framework in the field of occupational health and safety in the Republic of Moldova. Currently, the Republic of Moldova has ratified 43 conventions and 1 protocol, namely - 8 out of 8 fundamental conventions, 4 out of 4 governing conventions (priority) and 31 technical conventions. Over the years, 2 conventions have been denounced. At the beginning of 2021, the Moldavian parliament adopted the International Labour Organization (ILO) Convention No.161 (1985) on occupational health services. The legal and regulatory framework in occupational safety and health is good enough, but major problems are identified in their implementation.

Introduction. Physical activity is the key component of a student's healthy lifestyle, which is a fundamental factor contributing to academic success. The importance of physical activities during the study period is determined particularly by the student's working regime, which is often characterized by a sedentary lifestyle, reduced mobility and constant working position. Material and methods. A cross-sectional epidemiological study (2017-2018) was carried out. The study sample consisted of 783 students, including 430 students from the Republic of Moldova and 353 students from France. The data collection was performed by using a questionnaire that was completed by each study participant online, in electronic form. Results. The mean body mass index (kg/m2) of students from Chisinau was 21.5±0.10 (ranging between 16.16 and 34.72) and of students from Rouen - 22.65±0.22 (15.75-43.76) (p

Currently, the question is no longer if the climate is changing because the magnitude and speed of climate change, but it is a fact confirmed by many teams of specialists. It has become a hotly debated topic for politicians, businessmen, environmentalists, society and media. We designed a pilot study using a questionnaire in order to identify the level of knowledge, skills and practices of family physicians regarding the impact of their work on the environment and climate change. The questionnaire included 42 items regarding socio-demographic data, doctors’ knowledge regarding climate change, global warming, heatwave, thermal stress, the activity performed by doctors during the heat wave and the information received by doctors about heatwave periods. The research results confirm the hypothesis that doctors have some knowledge about the phenomenon of climate change, but there are some gaps and misunderstandings of the cause and effect of the phenomenon, as well as the methods to combat them. There is a need for additional training and guidance of physicians on the relationship between climate change, global warming and population health.

Introduction. Currently, there is a steadily increasing trend in losses due to flooding. Nevertheless, global warming, followed by an inevitable overuse of river valleys might further contribute to an increase in the frequency and destructive power of floods. It is quite important to trace the cause and effect chain of the economic, social and ecological impacts during the flood hazard. Material and methods. A bibliographic research was carried out by using historical and descriptive methods based on the keywords, underlining the medical, social and economic significance of the present issue. Results. There are 57 natural lakes and about 3 400 artificial water reservoirs found on the territory of the Republic of Moldova, including 90 amounting to over 1 million m3 per each. The accumulation basins help in preventing and combating overflows and flooding during spring and summer periods. Most of the dams do not comply with the technical norms, as they do not have channels of respite and drainage, thus, a dam failure on top dike might generate the collapse of the others at the lower watercourse, resulting in disastrous consequences. Therefore, individual health protection measures and appropriate population behavior are vitally important in catastrophic floods. Conclusions. Over the last decades, the floods occurring in the Republic of Moldova have conditioned the need to increase interventions for the prevention and reduction of both economic and human losses both at national and international levels.

Managing challenging behaviours is crucially important in order for a child to start learning, and this chapter provides teachers with certain tips and recommendations that are meant to improve the quality of life of autistic children, which implies, in particular, increasing their level of independence, the ability to establish social relationships, the opportunity to study and work, access to outdoor and leisure activities. The main aims of this chapter would be addressing the development of new positive behaviour skills which will facilitate social interaction, communication, and learning readiness and the reduction of undesirable forms of behaviour (aggression, self-aggression, hysterics, fears, unusual interests, stereotype behaviours), which are the main factors that hinder socialization and learning. This chapter will present some instruments to collect data about managing behaviours, interpret the data, and address the challenging behaviour in an appropriate manner.

Open-Source MANO (OSM) is an ETSI-hosted project supporting the development of Open-Source Network Function Virtualization (NFV) Management and Orchestration (MANO) software stack aligned with ETSI NFV. Control System Hub (CSH) is an own Software as a Service (SaaS) platform service assurance and analytics for Quality of Service (QoS) or other parameters solution. To outcome the grow demand on IT applications, the enterprises and service providers must build and expand the use of edge and multi-access edge (MEC) compute. This can lead to possible difficulties concerning how to optimum place workloads of network services automation and evaluate the costs. This paper’s intention is to overcome these difficulties and present a deployment and monitor of edge services in three different use-cases which can have the same hardware trail and logical topology.

Network function virtualization (NFV) and network slicing are two promising enabling technologies for 5G networks. Considering the volume of data traffic generated by Internet of things (IoT) applications and their service requirement diversity as well as that network resources are spread across different locations, it is imperative to find solutions for optimal service placement and resource allocation for quality of service (QoS) provisioning. In this paper, we address the challenges of optimal network service placement with active QoS monitoring in NFV and network slicing enabled 5G IoT networks and propose a network architecture with optimal computation and resource placement over core, local, and edge data centers. The solution is implemented through virtualized infrastructure managers where operation costs and QoS requirements are considered for service placement. Optimal algorithms are developed based on a control system hub platform with an open source management and orchestration framework. To monitor the performance during traffic runtime, virtual charmed factors are adopted for control and QoS measurement.

Background In Europe, alcohol consumption (AC), especially binge drinking (BD) and behavioural risk factors among students in higher education remain to be investigated. The aim of the study was to assess the evolution of AC, and BD and the behavioural factors associated in university students in four European universities: Chisinau (Ch) in Republic of Moldova, Cluj-Napoca (Cl) in Romania, Miskolc (Ms) in Hungary and Rouen (Ro) in France. Methods In the four countries in 2018, students in higher education completed an anonymous standardized self-questionnaire. The questionnaire collected age, gender (M, W), housing, curricula, smoking, cannabis consumption. Alcohol abuse problems were assessed by ADOSPA test and by AUDIT test.. Frequent BD was determined as a consumption of five or most alcoholic drinks on one occasion at least twice a month. A risk profile of consumers was conducted according to the consumption of alcohol and frequency of BD. Results A total of 3076 students were included, 705 in Ch, 582 in Cl, 534 in Ms and 1255 in Ro. Globally, the sex-ratio was quite similar (M:F=0.45), the mean age was 21.2 (SD = 4.1). In Ro, 83.6% of students consumed alcohol at least 1 per week, 86.4% in Ch, 27.6% in Cl, 43.6% in Ms. The prevalence of frequent BD was 15.9% in Ms and 13.8% in Ro, 11.5% in Ch and 12.6% in Cl. Alcohol hazardous drinking and risk of addiction levels were found in 19.3% of students in Ro, 27.6%, in Ms, 7.4% in Cl and 13,6% in Ch. Regarding patterns of consumption significant difference by gender were found. After multivariate analysis, different risk behaviours were found. Conclusions BD patterns in students were quite similar in the four countries, especially in male students. BD appears as a frequent, whose consequences remain to be investigated. It might be necessary in the future to screen students for potential ED upon entry to the university and also to inform student about the risk of ED and advise them to consult a healthcare professional. Key messages The study showed that alcohol is a central part of students’ lives in France, Hungary, Republic of Moldova and Romania. Specific target populations for public health interventions were identified.

Introduction. Antimicrobial resistance is a widespread and tough challenge, if not impossible, to limit by biological, physical or geographical barriers. This is the reason behind the "One Health" approach, which guides all rules and research plans on antimicrobial resistance worldwide. The abusive and excessive use of antimicrobials in human medicine, veterinary practices, agriculture and aquaculture has traditionally been considered the main reason for the global spread of antimicrobial resistance. The purpose was to assess the epidemiological risk of wastewater as a source of antimicrobial-resistant bacteria concerning public health, focusing on low- and middle-income Eastern European countries. Material and methods. To achieve this goal, the development of a secure, cost-effective and sustainable technology has been planned, which could easily be introduced in low- and middle-income countries. There have been outlined the following steps: mapping the consumption of antimicrobial emulsions at the national level (primary, cross-sectional study, complete sampling, based on imported data and centralized public acquirement of medicines); research regarding the knowledge, attitudes and practices of the population on antimicrobial resistance (primary, cross-sectional, descriptive study); qualitative and descriptive evaluation of barriers to reduce the phenomenon of antimicrobial resistance by the healthcare services; research regarding the knowledge, attitudes and practices in human and veterinary healthcare on antimicrobial resistance (primary, cross-sectional, descriptive study); screening and investigation of the microbial resistance mechanisms to the strains isolated from patients with infectious pathological processes (preclinical study); analysis of the specific features and sampling of the Constructed Wetlands in Orhei (preclinical study). The Ethics Committee of the Ministry of Health of RM positively approved the Research PhageLand. Results. The obtained results of this research will contribute to a better understanding of the involved factors that are generating the broadening of antimicrobial resistance and how they influence the transmission among different hosts (bacteria, animals and humans). Moreover, it can also have a major impact to the engineering field and wastewater management companies by expanding the range of tools with sophisticated technologies, designed to reduce the risk of transmitting antimicrobial resistance in wastewater and improve sewerage practices. Conclusions. The effective use of knowledge and practices in the worldwide fight against antimicrobial resistance, providing useful data, applicable knowledge, efficient, environmentally friendly and cost-effective protocols and technologies, which can be scaled, implemented and used at the European and international levels with no economic or geographical obstacles. Acknowledgment. The research was conducted in the Republic of Moldova within the JPIAMR projects (PhageLand), project number - 22.80013.8007.1.

Objectives. The estimation of correlative connections between the harmful factors present on the premises, where meals are cooked and certain diseases of the respiratory system are conditioned by indoor air quality. Material and methods. Three areas of the Republic of Moldova have been selected for research (North, Center, and South). 150 resident persons from the selected areas participated in the study, and they were invited to answer a series of questions. The air temperature, relative air humidity, and carbon dioxide were measured on the premises in which meals were cooked. Results. The air pollution in kitchens correlates more essentially when using the bottled gas as fuel (0.18 ≤ r ≤ 0.44, p < 0.001) and has an influence of 37.5 - 41.5% as compared to natural gas. In case of cooking meals in the dwelling room using bottled gas, an average correlation was established with bronchitis (r = 0.48, p < 0.01), pneumonia (r = 0.56, p < 0.001), obstructive bronchitis (r = 0.54, p < 0.01) and very strongly with bronchial asthma (r = 0.84, p < 0.01). In case of cooking meals in summer kitchens, the average correlation was recorded between the use of peasant stoves and the installation of bronchitis, pneumonia, obstructive bronchitis and a especially bronchial asthma. Conclusion. The need is imposed to develop certain mechanisms of supervision of the indoor air quality. People responsible for the construction, furnishing and equipping the kitchens should fulfill certain rules that would not only relate to the architectural aesthetics, comfort or benefits implied, but also to the health of the people who will work on such premises with special destination.

82 patients, who had been diagnosed with colo-rectal adenocarcinoma in our department between 2007 and 2014, were included in our study. Additionally, 31 patients with colo-rectal polyps (20 conventional adenomatous polyps and 11 malignant colo-rectal polyps) were also included in this study. The patients with colo-rectal adenocarcinoma were reevaluated in terms of gender, age, topography of recto-colic tumor, TNM stadialization, vasculo-lymphatic invasion, lymph nodes metastases and distant metastases. The study of CD8, Ki67, p53, CDX2 and D2-40 immunoexpression in colo-rectal cancer patients revealed: an elevated positivity index in patients with pT2 and pT3 stages and in patients with lymph node metastases in case of the CD8; an elevated positivity index in patients with pT2, pT3 and pT4 stage in case of Ki67; an elevated positivity index in patients with pT4 stage in in case of the p53; an increased positivity index in the pT2, pT3 stage, the absence of vasculo-lymphatic invasion, the absence of lymph node and distant metastases in case of the CDX2 and an increased positivity index in patients with the pT2, pT3 stage, the abscence of lymph node and distant metastases in case of the D2-40 Tumoral staging (pT2, pT3 and pT4) has been shown to be correlated with immunoexpression of the following markers: CD8, CDX2 and p53.

Biomarkers are important diagnostic and prognostic tools as they provide results in a short time while still being an inexpensive, reproducible and accessible method. Their well-known benefits have placed them at the forefront of research in recent years, with new and innovative discoveries being implemented. Cardiovascular and neurological diseases often share common risk factors and pathological pathways which may play an important role in the use and interpretation of biomarkers’ values. Among the biomarkers used extensively in clinical practice in cardiology, hs-TroponinT, CK-MB and NTproBNP have been shown to be strongly influenced by multiple neurological conditions. Newer ones such as galectin-3, lysophosphatidylcholine, copeptin, sST2, S100B, myeloperoxidase and GDF-15 have been extensively studied in recent years as alternatives with an increased sensitivity for cardiovascular diseases, but also with significant results in the field of neurology. Thus, given their low specificity, the values interpretation must be correlated with the clinical judgment and other available investigations.

Media has a colossal power; currently, it forms public opinion and engages in decision-making. This chapter aimed to analyze how “nutrition” and “food” were reflected in the online media from the Republic of Moldova. As a source for data collection, the search browser www.google.com was used. The analysis was carried out using a grid analysis of forty-five items. The topics of nutrition and food were analyzed in news and media websites, TV station/websites, newspapers, aggregate online sites, and news agencies. As a result, recommendations on healthy food and nutrition, health in general, diets, and diseases are made in most articles. The information about nutrition and food information varied and was of medium quality.

Food, along with breathing, hydration and movement, is a conditional factor of human life. This chapter aims to analyze the media coverage of scientific studies in the Republic of Moldova. The research data includes national scientific articles, selected according to a conventional algorithm used for all the countries included in the study. The working tool is the content analysis grid for scientific articles. The keywords used “Nutrition” and “Food” were searched during the reference time interval between 1 January 2014 and 1 January 2017. There are articles in the field of nutrition in the Republic of Moldova, but they are published in national media which are not promoted on scientific networks and websites.

Background Eating disorders (ED) and behavioural risk factors among students in higher education remain to be investigated. The aim of the study was to identify the prevalence of ED and the behavioural factors associated with ED in university students in four European universities: Chisinau (Ch) in Republic of Moldava, Cluj-Napoca (CN) in Romania, Miskolc (Ms) in Hungary and Rouen (R) in France. Methods In the four countries, students in higher education completed an anonymous standardized self-questionnaire, from 2016 to 2018. The questionnaire collected age, gender (M, W), housing, curricula, smoking, cannabis consumption, alcohol abuse problems (ADOSPA test), and perceived stress (Cohen score). The Sick, Control, One stone, Fat, Food (SCOFF scale) screening test was used to identify student with ED. Results A total of 3076 students were included, 705 in Ch, 582 in CL, 534 in Ms and 1255 in R. The sex-ratio was M:F=0.31 Ch, 0.30 in CN, 0.44 in Ms and 0.66 in R. The mean age was 21.2 (SD = 3.98) in Ch, 21.2 (SD = 3.2) in CL, 23.8 (SD = 5.1) in Ms and 20.0 (SD = 3.4) in R. The global prevalence of ED was 23.8%. According to the gender, the prevalence of ED in the four universities was 14.7% in M and 38.3% in W in Ch, 21.8% in M and 24.7% in W in CN, 19.7% in M and 21.4% in W in Ms and 16.1% in M and 34.0% in W in R (p < 10-4). After logistic regression, significant positive relation between the positive SCOFF was observed with female gender, alcohol abuse problems and stress level. Conclusions ED prevalence patterns were quite similar in the four countries, with high prevalence of ED, even in men. Associated behavioural risk-factors were quite similar. It might be necessary in the future to screen students for potential ED upon entry to the university and also to inform student about the risk of ED and advise them to consult a healthcare professional. Key messages Our study highlights the high prevalence of eating disorders, with similar behaviours in university students in four countries. Because of the detrimental effects of ED on physical and emotional health, it seems mandatory to set up public health programs (health promotion, prevention).

Objectives. The aim of the study was the evaluation of the air quality in the process of food preparation in rural households of the Republic of Moldova. Material and methods. The study was conducted in three areas of the Republic of Moldova (northern, central and southern areas). We evaluated the temperature, the relative humidity of the air, as well as the carbon dioxide and the carbon monoxide in the air. The measurements were carried out during summertime, with Air Quality Monitor 500 in 4 stages: before the cooking process, one hour after the beginning of the cooking process, at the end of the cooking process and one hour after the end of the cooking process. Results. The air temperature and the relative humidity rose the most in the process of food preparation in the room designed for living. In ¾ of the households, the concentration of the carbon dioxide in the room designed for living surpassed the limit of the norms maximum to 0.3 mg/l. The concentration of carbon monoxide was detected in few cases, especially during food preparation in rooms designed for living and summer kitchens when the fuel sources were biomass and cereal crops residues. Conclusions. Air quality worsens towards the end of the cooking process and in most cases it is maintained over an hour after the end of the preparation process, representing a source of indoor pollution to the whole family.

International audience

International audience; BackgroundEating disorders are particularly frequent in young adults, college students included. However eating disorders among European healthcare students are not well known. The objectives were to identify the prevalence of eating disorder (ED) among healthcare students and the associated factors.MethodsA cross-sectional study was conducted in France (Rouen, West opal coast and Lille), in Romania (Cluj-Napoca), and in Moldavia (Chisinau). An anonymous self-questionnaire collected age, gender, year of study, depression, anxiety and stress (DASS 21), estimated academic level, smoking and eating disorder (SCOFF test). A clinical algorithm (Expali™) identified the four Broad Categories of ED (hyperphagic, bulimic, anorexic and other ED) derived from DSM-5 with the combine of answers to SCOFF test and body mass index.ResultsIn total, 1273 healthcare students were included (434 in France, 270 in Moldavia and 569 in Romania). Sex ratio (M:F) was 0.30 and the mean of age 20.2 [standard deviation (SD) = 1.32]. The body mass index were 13.1% of underweight and 14.4% of overweight/obese without difference between the countries (P = 0.34). The prevalence of ED was 19.6% in France, 35.6% in Moldavia and 24.2% in Romania (P < 0.0001). Bulimic disorder was the main ED (42.2%) following by hyperphagic disorders (32.6%), anorexic disorders (10.9%) and other ED (14.3%) with difference between the 3 countries (P = 0.004). After logistic regression, the associated factors with ED were: gender [female AOR = 2.0; 95% CI (1.3–3.1)], year of study [first year AOR = 2.0; 95% CI (1.3–2.9)], depression [AOR = 1.8; 95% CI (1.3–2.5)], anxiety [AOR = 1.6; 95% CI (1.1–2.2)] and country [Moldavia AOR = 2.1; 95% CI (1.4–3.0)].ConclusionOur study provides different prevalence of ED among healthcare students in three European countries. The categories of ED were also different according the country. Individual as well as institutional interventions should be targeted university students with the help an easy and quick screening test such as the SCOFF questionnaire, especially in the first year of study.

Background: To reduce behavioral risk factors is a priority of health policies in the Republic of Moldova. However, the promotion of health is a prerogative of the health system and less in educational activities in schools or universities. The aim: to identify medical students’ behavioral risks and their perception in health promotion. Materials and methods: A cross-sectional study was performed using the CORT questionnaire (elaborated and validated at UMF "V. Babes", Timisoara, Romania). Data on demographic and socio-economic characteristics and student’s behaviors were collected: dietary habits, drugs, smoking, family and school environment etc. A structured interview with 473 students was performed. This study was conducted according to the principles of the Helsinki Declaration (1996) and approval of the Nicolae Testemitanu SUMPh ethics committee no.16 from 14.11.2016. Results: There were 473 students integrated into the study, including 359 (75.9%) females and 114 (24.1%) males, mean age 20.42±1.57 years old. The anthropometric indices showed that the average height was 1.69±0.09m and the body mass was 61.31±0.53kg (σ=0.089). The nutritional status with a deficit is 16.1%, the surplus status is 25.2%. Non-smokers - 59.1%, who do not consume alcohol - 28.8%, who do not consume drugs - 95.1%. Conclusion: Our results require us to develop measures to reduce and, in some cases, eliminate health problems, students' negative behavioral attitudes and risk factors responsible for the health condition, mental health and health culture.

The chapter focuses on migration as a problem that carries complex consequences for society. Content analysis was applied on a sample of articles published on three websites of online media in Moldova. The results of the analysis indicate that the articles are of interest to readers, but few of the viewers submit comments. The articles depicted emigrants’ violence, especially theft and murder. In the case of theft, the emigrant, in most cases is the aggressor and, on the contrary, when the description of the murder is showed, in most cases, the emigrant is a victim. Also, the analysis shows that journalists try to capture their readers’ attention by placing the main idea directly in the titles of their articles.

The current crisis has revealed the existence of certain fundamental weaknesses in the functioning of financial markets and weaknesses in risk management, which require a deep reform of the financial regulatory and supervisory framework. The magnitude of the current crisis has brought new attention to issues of transparency and liquidity of financial systems. The current crisis is further proof that free markets are not up to the deregulated markets and that excessive confidence in the self-healing powers / regulation of markets is very dangerous. We must keep in mind that financial innovation benefits when supporting dynamism and growth, but at the same time can lead to additional risks. In the context of maintaining international financial crisis and the consequences of measures taken to counteract its effects, the reconfiguration problem of the supervisory architecture and how it should ensure the smooth functioning of global and regional financial markets came to the attention of public authorities responsible to issue regulations, best practices and rules in areas which exert a significant influence in achieving this objective. This paper focuses on the structural causes of the current global crisis expressed by several authors and their views on the need to implement new supervisory architecture internationally and regionally, to ensure global financial stability.

PLOS ONE 17(1), e0262110 (2022). doi:10.1371/journal.pone.0262110, Published by PLOS, San Francisco, California, US