Browsing by Author "Vukovic, Dejana (14032630200)"

Acute inflammation of the appendix in childhood usually requires an appendectomy. Surgical methods are open appendectomy (OA) and laparoscopic appendectomy (LA). Both have the same goal of removing the appendix. Data collected from the medical records of children who underwent hospitalization and operation for acute appendicitis have been retrospectively analysed and statistically processed. The patients underwent surgery in 2010 at University Children’s Hospital in Belgrade, and the methods that were used were open appendectomy (OA) and laparoscopic appendectomy (LA). The analysed data refer to gender, age, length of hospital stay, surgery duration, use of pain management therapy, and antibiotic therapy, complications during surgery, complications after surgery, re-hospitalizations, and reoperations. A total of 218 children underwent an appendectomy operation, of which 158 (72.5%) underwent OA and 60 (27.5%) underwent LA. the average age of patients who had OA was 11.44 years, and 10.87 years for those who underwent LA. The surgery duration was significantly longer for LA (45.3 vs. 42.1 minutes, p = 0.003). The total number of postoperative complications was lower in LA (1 vs. 12), but there was no statistically significant difference. The number of hospital stay days was significantly lower in LA (3.48 vs. 5.45 days), with a high statistical difference, p = 0.00. The advantages of LA compared with OA are shorter hospital stay, lower total number of intraoperative and postoperative complications, and fewer reoperations. The advantage of OA compared with LA is shorter surgery duration. © 2016, University of Kragujevac, Faculty of Science. All Rights Reserved.

Background: The United Nations Assembly adopted the Sustainable Development Goals to succeed the Millennium Development Goals in September 2015. From a European perspective, the development of health in the countries of North Africa are of special interest as a critical factor of overall social development in Europe’s Mediterranean partners. In this paper, we address the mortality related SDG-3 targets, the likelihood to achieve them until 2030 and analyze how they are defined. Methods: We projected mortality trends from 2000–2015 to 2030, based on mortality estimates by inter-agency groups and the WHO in mother and child health, non-communicable diseases, and road traffic mortality. The gap analysis compares the time remaining until 2030 to the time needed to complete the target assuming a linear trend of the respective indicator. A delay of not more than 3.75 years is considered likely to achieve the target. Results: The SDG-3 targets of a Maternal Mortality Ratio below 70 per 100 000 live births and an U5MR below 25 per 1 000 live births have been achieved by Egypt, Libya, and Tunisia. Libya and Tunisia have also achieved the target for Newborn Mortality with Egypt close to achieving it as well. Algeria and Morocco are generally on track for most of the indicators, including deaths from non-communicable diseases and suicide rates; however, all of the countries are lagging when it comes to deadly Road Traffic Injuries for 2030. Mauritania is the only North African country which is not likely to reach the 2030 targets for any of the mortality indicators. Conclusions: Although mortality statistics may be incomplete there is an impressive gradient from East to West showing Mauritania and deadly road traffic injuries as the most problematic areas. Given the large differences between countries baselines, we consider it preferable to set realistic targets to be achieved until 2030. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Identifying the factors that deter or stimulate the women to participate in screening activities is very important in order to design effective education and motivation strategies, particularly in the countries without an organized system. The study employed a case-control design. The participants were recruited in four primary health care institutions in Belgrade over a month. The study group comprised all women aged 18-70 years, who demonstrated an initiative for a PAP- smear. The controls were women with no Pap smears within the last 4 years, matched by age (±2 years), education and marital status with the study group participants. The study instrument was the 62-item self-administered questionnaire. According to multivariate analysis, adherence to cervical cancer screening practices is significantly related to better financial status [odds ratio (OR) = 10.8, P = 0.001], no gender preference for a gynecologist (OR = 3.1, P = 0.015), consultations with a gynecologist (OR = 4.7, P = 0.029), conversation with the women with cervical cancer about that disease (OR = 2.8, P = 0.029) and higher media exposure to information about cervical cancer prevention (OR = 5.0, P = 0.004). Open communication, social networks and improving social-economic status of women in our society are the most prominent factors, most of which are mainly outside the health services' domain and require multisectoral collaboration to improve women's reproductive health. © The Author 2010.

Objectives: To assess the exit competences of public health graduates across a diverse European landscape. Methods: The target population comprised 80 full institutional members of the Association of Schools of Public Health in the European Region with a participation rate 82.5 %. The web-based questionnaire covered institutional profiles and the ranking of exit competences for master of public health programmes, grouped according to WHO Essential Public Health Operations. Results: European schools and departments usually are small units, funded from tax money. A total of 130 programmes have been indicated, together releasing 3,035 graduates in the last year before the survey. All competence groups showed high reliability and high internal consistency (α > 0.75, p < 0.01). The best teaching output has been assessed for health promotion, followed by disease prevention and identification of health hazards in the community, the least in emergency preparedness. Conclusions: Given the fragmentation of the institutional infrastructure, the harmonisation of programme content and thinking is impressive. However, the educational capacity in the European Region is far from being sufficient if compared to aspired US levels. © 2012 Swiss School of Public Health.

Objectives: The prevalence of smoking is very high in Serbia. A wide range of tobacco control measures and activities have been undertaken to encourage smoking cessation, but it is not known whether smokers in Serbia are willing to quit, and if inequalities exist between them. This study analysed intentions to quit smoking, using the Stages of Change Model, among a population of current and/or former adult smokers in Serbia, and compared socio-economic and demographic characteristics. Study design: Cross-sectional study on a nationally representative population sample, using data from the 2006 National Health Survey. The sample consisted of 5905 current or former daily smokers. Methods: Logistical regression analysis was used to identify associations between socio-economic and demographic characteristics of former/current smokers, and their stage of change in terms of smoking (precontemplation, contemplation, preparation, action, maintenance and termination). Results: More than one-fifth (22%) of current smokers did not intend to quit smoking (precontemplation stage). Women were twice as likely to contemplate quitting compared with men [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.68-2.58]. However, women were less successful in quitting smoking (termination stage) than men (OR 0.64, 95% CI 0.52-0.79). In addition to gender, educational inequalities in intentions to quit smoking were identified; less-educated individuals were less willing to quit smoking (preparation and action stages) regardless of their socio-economic status or chronic disease status. Conclusion: Tobacco control interventions should be sensitive to gender and educational inequalities in quitting smoking. © 2012 The Royal Society for Public Health.

Aim: Tuberculosis (TB) continues to be an important health problem in Serbia, as a country with numerous socioeconomic problems. Health care workers, especially medical and dental students could be key persons to engage in prevention of TB. The aim of our study was to compare the knowledge level and awareness of TB among medical and dental students. Methods: Cross-sectional study was conducted at the School of Medicine and the School of Dentistry, University of Belgrade, Serbia. A sample of 350 students was selected by stratified sampling.Data about knowledge and awareness of TB was collected through the anonymous (self-administered) questionnaire. Results: 300 questionnaires were returned; response rate was 85.7%. Medical students gave significantlyhigher correct responses about modes of transmission of TB (p<0.001). Significantly higher proportion of medical students (p=0.003) knew that age above 65 years is risk period of life for getting TB, but only 6.5% of them noted that the age of puberty is the risk period too. High proportion of both groups agreed that alcoholism and AIDS are the conditions, which can increase risk for getting TB. Medical students have better knowledge about therapy of TB, but there were no differences concerning questions about diagnosis. Conclusion: In spite of valid basic awareness of TB, there were some gaps in the knowledge, more frequently among dental then medical students. This study suggests that students need more training and more practice.

Introduction: Conflicts, social unrest, and disasters can significantly affect the ability of a healthcare system to provide for the needs of its citizens. The collapse of the primary healthcare system in Serbia is a model of the effects that civil unrest can have on the health of a population. However, with improving social and political conditions, focus now can be turned towards the greatly needed development and reorganization of the primary healthcare system in Serbia. Due to the complexity of health-system reform in the post-conflict/post-disaster setting, attempts to restructure health services are fraught with pitfalls that often are unanticipated because of inadequate preliminary assessments. A multimodal assessment involving quantitative and qualitative methodologies may provide a more robust mechanism to identify key programmatic priorities and critical barriers for appropriate and sustainable health-system interventions. The purpose of this study is to describe a multimodal assessment using primary healthcare in post-conflict Serbia as a model.Methods: Integrated quantitative and qualitative methodologies - system characterization and observation, focus group discussions, free-response questionnaires, and Q-methodology - were used to identify needs, problems, and potential barriers to primary healthcare development in Serbia. Participants included primary healthcare providers and administrators from 13 institutions throughout Belgrade.Results: Demographic data indicate a well-established infrastructure of primary health centers and stations. However, focus group discussions and free-response questionnaires reveal significant impediments to delivery of care: (1) Inadequate equipment, supplies, and medications; (2) Poor financial investment; (3) Discouraging worker salaries; (4) Few opportunities for professional development; and (5) Little emphasis on or respect for primary healthcare. Q-methodology of provider perceptions and opinions supports these concerns, shows remarkable consensus among participants, and provides further insights toward system development by grouping respondents into distinctive types.Conclusions: This study identified the critical needs and barriers to development of primary healthcare in Serbia. This combined methodology may serve as a model for future health system assessments in the post-conflict and post-disaster settings. © World Association for Disaster and Emergency Medicine 2003.

Introduction: Conflicts, social unrest, and disasters can significantly affect the ability of a healthcare system to provide for the needs of its citizens. The collapse of the primary healthcare system in Serbia is a model of the effects that civil unrest can have on the health of a population. However, with improving social and political conditions, focus now can be turned towards the greatly needed development and reorganization of the primary healthcare system in Serbia. Due to the complexity of health-system reform in the post-conflict/post-disaster setting, attempts to restructure health services are fraught with pitfalls that often are unanticipated because of inadequate preliminary assessments. A multimodal assessment involving quantitative and qualitative methodologies may provide a more robust mechanism to identify key programmatic priorities and critical barriers for appropriate and sustainable health-system interventions. The purpose of this study is to describe a multimodal assessment using primary healthcare in post-conflict Serbia as a model.Methods: Integrated quantitative and qualitative methodologies - system characterization and observation, focus group discussions, free-response questionnaires, and Q-methodology - were used to identify needs, problems, and potential barriers to primary healthcare development in Serbia. Participants included primary healthcare providers and administrators from 13 institutions throughout Belgrade.Results: Demographic data indicate a well-established infrastructure of primary health centers and stations. However, focus group discussions and free-response questionnaires reveal significant impediments to delivery of care: (1) Inadequate equipment, supplies, and medications; (2) Poor financial investment; (3) Discouraging worker salaries; (4) Few opportunities for professional development; and (5) Little emphasis on or respect for primary healthcare. Q-methodology of provider perceptions and opinions supports these concerns, shows remarkable consensus among participants, and provides further insights toward system development by grouping respondents into distinctive types.Conclusions: This study identified the critical needs and barriers to development of primary healthcare in Serbia. This combined methodology may serve as a model for future health system assessments in the post-conflict and post-disaster settings. © World Association for Disaster and Emergency Medicine 2003.

Objectives: This study aimed to identify to what extent negative attitudes towards intimate partner violence against women are present among young women and men living in Serbia, in Roma and non-Roma settlements. Methods: We used the data from the 2010 Multiple Indicator Cluster Survey conducted in Serbia, for the respondents who were 15–24 years old. Regression analyses were used to examine the association between judgmental attitudes, socio-demographic factors and life satisfaction. Results: In Roma settlements, 34.8% of men and 23.6% of women believed that under certain circumstances men are justified to be violent towards wives, while among non-Roma it was 5.6 and 4.0%, respectively. These negative attitudes were significantly associated with lower educational level, lower socio-economic status and being married. In multivariate model, in both Roma and non-Roma population women who were not married were less judgmental, while the richest Roma men were least judgmental (OR 0.40, 95% CI 0.18–0.87). Conclusions: Violence prevention activities have to be focused on promoting gender equality among youth in vulnerable population groups such as Roma, especially through social support, strengthening their education and employment. © 2017, Swiss School of Public Health (SSPH+).

INTRODUCTION Concurrent use of tobacco products is associated with an increased risk of nicotine dependence and smoking-related health complications. Growing popularity of concurrent use of cigarettes and electronic cigarettes and/or waterpipe tobacco is of concern, especially due to the adolescents' exposure to nicotine and call for the better understanding of patterns and predictors of multiple product use. METHODS This is a secondary analysis of cross-sectional data obtained through the 2017 Global Youth Tobacco Survey conducted in Serbia on a nationally representative sample of 3362 students aged 13-15 years. Students were categorized into eight groups based on their experience with cigarette, e-cigarette and waterpipe use. To explore differences in sociodemographic and psychosocial characteristics, students were further placed in four groups: non-users; exclusive cigarette users; users of e-cigarette and/or waterpipe who do not smoke cigarettes; cigarette and other product users. RESULTS We show that among the 13-15 years old students, the most common pattern of tobacco/nicotine use is waterpipe and/or e-cigarette use with no cigarette smoking (7.5%, 95% CI: 6.6-8.4) followed by exclusive cigarette use (5.8 %, 95% CI: 5.0-6.6). Among cigarette smokers, 52.8% were exclusive cigarette smokers. Having the majority of their friends smoking is a mutual predictor for exclusive cigarette (AOR=33.2, 95% CI: 14.52-75.90) waterpipe and/or e-cigarette (AOR=2.57, 95% CI: 1.56-4.25) and cigarette and other products use (AOR=52.3, 95% CI:12.28-223.22) compared to no use of any product, and the same in the case of exposure at the point-of-sale marketing: exclusive cigarette vs not any product users (AOR=1.82, 95% CI: 1.22-2.73); waterpipe and or/ecigarette vs not any product users (AOR=1.64, 95% CI:1.18-2.28); and cigarette and other products vs not any product users (AOR=3.40, 95% CI: 1.99-5.80). CONCLUSIONS Tobacco control interventions should address dual- and poly-tobacco use with special focus on inter-personal factors and protection from exposure to advertising of e-cigarettes and waterpipes. © 2019 Kilibarda B.

INTRODUCTION Concurrent use of tobacco products is associated with an increased risk of nicotine dependence and smoking-related health complications. Growing popularity of concurrent use of cigarettes and electronic cigarettes and/or waterpipe tobacco is of concern, especially due to the adolescents' exposure to nicotine and call for the better understanding of patterns and predictors of multiple product use. METHODS This is a secondary analysis of cross-sectional data obtained through the 2017 Global Youth Tobacco Survey conducted in Serbia on a nationally representative sample of 3362 students aged 13-15 years. Students were categorized into eight groups based on their experience with cigarette, e-cigarette and waterpipe use. To explore differences in sociodemographic and psychosocial characteristics, students were further placed in four groups: non-users; exclusive cigarette users; users of e-cigarette and/or waterpipe who do not smoke cigarettes; cigarette and other product users. RESULTS We show that among the 13-15 years old students, the most common pattern of tobacco/nicotine use is waterpipe and/or e-cigarette use with no cigarette smoking (7.5%, 95% CI: 6.6-8.4) followed by exclusive cigarette use (5.8 %, 95% CI: 5.0-6.6). Among cigarette smokers, 52.8% were exclusive cigarette smokers. Having the majority of their friends smoking is a mutual predictor for exclusive cigarette (AOR=33.2, 95% CI: 14.52-75.90) waterpipe and/or e-cigarette (AOR=2.57, 95% CI: 1.56-4.25) and cigarette and other products use (AOR=52.3, 95% CI:12.28-223.22) compared to no use of any product, and the same in the case of exposure at the point-of-sale marketing: exclusive cigarette vs not any product users (AOR=1.82, 95% CI: 1.22-2.73); waterpipe and or/ecigarette vs not any product users (AOR=1.64, 95% CI:1.18-2.28); and cigarette and other products vs not any product users (AOR=3.40, 95% CI: 1.99-5.80). CONCLUSIONS Tobacco control interventions should address dual- and poly-tobacco use with special focus on inter-personal factors and protection from exposure to advertising of e-cigarettes and waterpipes. © 2019 Kilibarda B.

The study identifies the prevalence of violence victimization and the perpetration among youths, and explores the determinants and predictors using a socio-ecological model. The data of 36 variables from a representative sample of 1722 persons, ages 15–24 years, from the National Health Survey of Serbia in 2013, were analyzed by a multivariate logistic regression modeling. The study shows that 13.4% of youths experienced multi-victimization, while 10.4% were perpetrators of violence. Up to one-third of the victims were violence perpetrators. A small percentage of victims seek family and community support. Predictors of violence among youths were: male sex, households with fewer members, urban settlements, violence perpetration, self-assessed health as poor, lack of close friends and perception that it was difficult to obtain the assistance needed. Predictors of youth violence highlighted the need to improve health education, social support and community regulations, as well as strengthen the promotion of gender equality and a healthy environment. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

The study identifies the prevalence of violence victimization and the perpetration among youths, and explores the determinants and predictors using a socio-ecological model. The data of 36 variables from a representative sample of 1722 persons, ages 15–24 years, from the National Health Survey of Serbia in 2013, were analyzed by a multivariate logistic regression modeling. The study shows that 13.4% of youths experienced multi-victimization, while 10.4% were perpetrators of violence. Up to one-third of the victims were violence perpetrators. A small percentage of victims seek family and community support. Predictors of violence among youths were: male sex, households with fewer members, urban settlements, violence perpetration, self-assessed health as poor, lack of close friends and perception that it was difficult to obtain the assistance needed. Predictors of youth violence highlighted the need to improve health education, social support and community regulations, as well as strengthen the promotion of gender equality and a healthy environment. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Background: Multidrug resistant (MDR) tuberculosis (TB) represents TB which is simultaneous resistant to at least rifampicin (R) and isoniazid (H). Identifying inadequate therapy as the main cause of this form of the disease and explaining the factors leading to its occurrence, numerous social determinants that affect the risk of developing resistance are highlighted. The objectives of the study was to identify independent factors of MDR-TB among tuberculosis patients. Methods: Case-control study was conducted from 1st September 2009 to 1st June 2014 in 31 healthcare institutions in Serbia where MDR-TB and TB patients were treated. TB patients infected with MDR- M. tuberculosis and non MDR- M. tuberculosis strain were considered as cases and controls, respectively. Cases and controls were matched by the date of hospitalization. The data was collected using structured questionnaire with face to face interview. Bivariate and multivariable logistic regression analysis (MLRA) were used to identify determinants associated with MDR-TB. Results: A total of 124 respondents, 31 cases and 93 controls were participated in the study. MLRA identified six significant independent risk factors for the occurrence of MDR-TB as follows: monthly income of the family (Odds ratio (OR) = 3.71; 95% Confidence Interval (CI) = 1.22-11.28), defaulting from treatment (OR = 3.33; 95% CI = 1.14-9.09), stigma associated with TB (OR = 2.97; 95% CI = 1.18-7.45), subjective feeling of sadness (OR = 4.05; 95% CI = 1.69-9.70), use of sedatives (OR = 2.79; 95% CI = 1.02-7.65) and chronic obstructive pulmonary disease (OR = 4.51; 95% CI = 1.07-18.96). Conclusion: In order to reduce burden of drug resistance, strategies of controlling MDR-TB in Serbia should emphasize multi-sectorial actions, addressing health care and social needs of TB patients. © 2018 The Author(s).

Background: Health care workers (HCWs) are at risk of occupational exposure to human immunodeficiency virus (HIV). Aim: To investigate the perception of professional risk from, and the knowledge, attitudes and practice of HCWs to HIV and AIDS in Serbia. Methods: Cross-sectional study of 1559 Serbian HCWs using self-administered anonymous questionnaires. Chi-square testing and multiple logistic regression analysis were applied. Results: Eighty-nine per cent of HCWs believed that they were at risk of acquiring HIV through occupational exposure. The perception of professional risk was higher among HCWs frequently exposed to patients' blood and body fluids (OR 7.9, 95% CI 4.4-14.5), who used additional personal protection if the HIV status of patient was known (OR 2.6, 95% CI 1.5-4.6), who had experienced sharp injuries within the last year (OR 1.9, 95% CI 1.0-3.8) or who had been tested for HIV (OR 2.1, 95% CI 1.2-3.5), and among HCWs who had treated HIV-positive patients (OR 1.7, 95% CI 1.1-2.8). The majority of respondents had deficient knowledge about modes of HIV transmission. Attitudes towards HIV-positive patients were significantly different by occupation. Seventy per cent of HCWs used appropriate protection during their daily work with patients. Conclusions: HCWs require specific educational programmes and training protocols to ensure that they are adequately protected when carrying out high quality care. © 2006 Oxford University Press.

Two recent developments have redirected the course of Public Health in Europe - the Public Health Mandate of the European Commission and the conceptualization of a New Public Health. For the transition, countries in South Eastern Europe, particularly Serbia, provide support to essential public health reforms in four areas: strategic management, public health information, public health legislation, and public health training and research. The roles of the Dubrovnik Pledge (2001) and the Stability Pact, which has international support, have been central. © 2007 Palgrave Macmillan Ltd.

Strategic Management, Public Health Information, Public Health Legislation, as well as Public Health Training and Research are considered essential elements of a coherent public health strategy for Serbia, a republic of the former Yugoslavia. Whereas the strategic framework in Serbia is outlined in detail, which includes an action plan that is linked with local pilot initiatives, the information base is well developed but not yet sufficiently related to the strategic objectives. The transformation of strategic considerations and information into meaningful legislative acts stands at halfway and has to cope with a heritage of unrelated and dysfunctional laws. A big step forward was made with the establishment of a modern School of Public Health in Belgrade in 2004, which acts as a brain-trust for the New Public Health in Serbia. The multi-professionalism at the Institutes of Public Health and the corresponding inter-disciplinarity at the academic Schools of Public Health provide an adequate institutional environment if the resources of skills, knowledge and experience are adequately managed - in a participatory and supportive system representing a flat hierarchy.

Strategic Management, Public Health Information, Public Health Legislation, as well as Public Health Training and Research are considered essential elements of a coherent public health strategy for Serbia, a republic of the former Yugoslavia. Whereas the strategic framework in Serbia is outlined in detail, which includes an action plan that is linked with local pilot initiatives, the information base is well developed but not yet sufficiently related to the strategic objectives. The transformation of strategic considerations and information into meaningful legislative acts stands at halfway and has to cope with a heritage of unrelated and dysfunctional laws. A big step forward was made with the establishment of a modern School of Public Health in Belgrade in 2004, which acts as a brain-trust for the New Public Health in Serbia. The multi-professionalism at the Institutes of Public Health and the corresponding inter-disciplinarity at the academic Schools of Public Health provide an adequate institutional environment if the resources of skills, knowledge and experience are adequately managed - in a participatory and supportive system representing a flat hierarchy.

Introduction: The aim of this paper is to present an experience from the School of Medicine (University of Belgrade, Serbia) in restructuring of study programs to be compliant with Bologna standards and European best practices in public and community health. We devised the new module with the idea to implement both the concept of patient-centered medicine and community-based learning activity, in the pre-clinical phase of medical education. It emphasis importance of social determinants of health, community activities on health promotion, early contacts with patients, developing communication skills and introduction of primary health care settings Method: All participants of overall four generations of this curriculum (students, patients and physicians) were asked to evaluate their participation in the module, using three types of self-administered questionnaires. Results: Overall 1529 students (response rate 74.1%), 1011 patients (response rate 57.2%) and 118 physicians (response rate 69.5%) had participated in this evaluation. One-way analysis of variance (ANOVA) demonstrated significantly higher satisfaction of patient with the participation in the new module (4.48), than the students (3.90) and physicians (4.08) (F=69.882, p = 0.000). Conclusion: The satisfaction of patients enrolled in this module encourages us to continue. Broadening of medical training to primary health care and other "non-medical" community settings enabled students to get insight into the different social determinants of health. However, the instructors need to improve the student's understanding and devotion for this conception.

Objectives: To explore largely unknown experience and expectations of European employers of public health professionals with regard to competences required to perform in the best way for the public health. Methods: A survey targeting employers in Europe was carried out September 2011-October 2012. The web-based questionnaire on public health competences and expected performance levels was returned by 63 organisations out of 109 contacted (57.8 %) as provided by Schools and Departments of Public Health (SDPH) in 30 European countries. Results: The assessment of the current and desired levels of performance did not show significant differences between employer categories. However, current and desired levels across all employers differ significantly (p < 0.001), varying around a difference of one rank of a five-point scale. On the other hand, SDPH rank the exit qualifications of their graduates with one exception (presumed competences in preparedness for public health emergencies) higher than the current performance level as determined by employers, i.e. closer to their expectations. Conclusions: SDPH should reconsider priorities and question their estimate of exit qualifications in close contact with potential employers of their graduates. © 2013 Swiss School of Public Health.