Search Results (81)

The Roma population is one of Europe’s largest ethnic minorities, often living in inadequate living conditions, worse than those of the majority population. They frequently lack access to essential services, even in high-income countries. This lack of basic services—particularly in combination with proximity to (stray) animals and human and solid waste—significantly increases environmental health risks, and leads to a higher rate of endoparasitic infections. Our study sheds light on the living conditions and health situation in Roma communities in Slovakia, focusing on the prevalence of intestinal endoparasitic infections across various settlement localisations. It highlights disparities and challenges in access to safe drinking water, sanitation, and hygiene (WASH) and other potentially disease-exposing factors among these marginalised populations. This study combines a comprehensive review of living conditions as per national data provided through the Atlas of Roma communities with an analysis of empirical data on parasitological infection rates in humans, animals, and the environment in settlements, applying descriptive statistical methods. It is the first study in Europe to provide detailed insights into how living conditions vary and cause health risks across Roma settlements, ranging from those integrated within villages (inside, urban), to those isolated on the outskirts (edge, sub-urban) or outside villages (natural/rural). Our study shows clear disparities in access to services, and in health outcomes, based on where people live. Our findings underscore the fact that (i) place—geographical centrality in particular—in an already challenged population group plays a major role in health inequalities and disease exposure, as well as (ii) the urgent need for more current and comprehensive data. Our study highlights persistent disparities in living conditions within high-income countries and stresses the need for greater attention and more sensitive targeted health-promoting approaches with marginalised communities in Europe that take into consideration any and all of the humans, ecology, and animals affected (=One Health). Full article

Background/Objective: The priority task of each country is to ensure the protection of and improvement in its people’s health. One of the key aspects of health is related to food culture, consuming foods that ensure growth and normal development in a person and also prevent diseases. The consumption of foods that contain essential nutrients and functional foods, which include those containing probiotics, is the basis of a healthy diet. Methods: A structured anonymous interview was conducted with 90 parents from the Roma minority group to assess the nutritional culture of children from these families. The knowledge of Roma parents about probiotics, as well as their attitudes to apply them to their children, was examined. The survey was based on a questionnaire that was distributed among the respondents, Roma students, under the guidance of a mentor. Roma students study health specialties and are also participants in a Scholarship Programme. Results: We have established that the daily diet of children from this minority group consists of foods containing hydrogenated fats and sugar, which was indicated by 53.3% of respondents, and only 28.9% of respondents noted that their children consume fresh fruit every day. We have established that less than half of the children (35.6%) consume yoghurt daily as a source of valuable probiotics. We applied a nonparametric Kruskal–Wallis test and found statistically significant differences in the respondents’ knowledge of probiotics (χ² = 16.186, p = 0.001): those receiving secondary specialized education were better informed, but education has not affected their knowledge of the health benefits of probiotics (χ² = 5.462, p = 0.141). Children from minority groups tend to eat unhealthy foods. Conclusions: The role of Roma students studying health specialties as participants in the Scholarship Programme is to assist parents in forming a nutritional culture in their children. Roma students, due to their ethnic and cultural proximity and potential to be health professionals, contribute to sustainable health improvements among the Roma community as a whole. Full article

Background: Joubert syndrome (JS) is a multi-systemic ciliopathy, characterized by intellectual disability and congenital anomalies involving the brain, kidney, heart, and eye. Even if clinical presentation is variable, most authors consider a brain abnormality known as the molar tooth sign (MTS) as mandatory for diagnosis. About 40 genes were identified to be associated with JS, usually with an autosomal recessive pattern. KATNIP variants represent a rare cause of JS; only six families were previously reported. Methods: We performed exome sequencing in a child with a syndromic phenotype, described the clinical features and molecular findings, and performed a review of the literature to identify known individuals with pathogenic variants in KATNIP, highlighting clinical characteristics and gene-phenotype correlations. Results: Using exome sequencing, we identified a homozygous novel frameshift variant c.808del, p.Ser270ValfsTer28 in KATNIP in a 5-year-old male from a consanguineous family of Roma ethnic background. Notable clinical features of the proband include severe developmental delay, hypotonia, and post-axial polydactyly. He did not have MTS, but showed severe anemia and esophageal atresia, which was already reported in association with a KATNIP variant. We collected the phenotypes of all reported patients and discussed common and distinct features with respect to typical JS. Affected individuals shared JS clinical features, although the typical MTS was not always present, polydactyly and renal abnormalities were absent, while pituitary abnormalities were common. Conclusions: Our report provides new data for KATNIP-related JS, expanding the clinical phenotypic spectrum and suggesting a possible role of KATNIP defects in the development of esophageal atresia. Full article

This study examines the integration of disadvantaged Roma ethnic minority students in Hungarian-language vocational schools in Central European countries with highly segregated education systems. It focuses on Romania, Slovakia, and Hungary, where Roma students face significant segregation. This research investigates two Romanian, two Slovak, and four Hungarian vocational schools, selected based on their proportion of Roma students aligning with national averages. Surveys and interviews were conducted with teachers to assess their attitudes, commitment, and preparedness in educating Roma students. The main findings of this research are that schools with Roma student proportions matching national averages do not face significant challenges in co-education, teachers generally believe Roma students should complete lower secondary education, and teachers are committed to supporting Roma students but often feel unprepared to teach them. This study’s results suggest that governments should implement policies to eliminate educational segregation in vocational schools and promote inclusive education. Teacher training programs should focus on equipping educators with better tools to support Roma students. Possible directions for further research include a comparative analysis of vocational and grammar secondary schools in the integration of Roma students, longitudinal studies on the long-term educational and career outcomes of Roma students in vocational schools, and an examination of best practices in inclusive vocational education across different European countries. Full article

MyD88 deficiency is a rare inborn error of immunity (IEI) characterized by susceptibility to pyogenic infections without overt signs of inflammation. Half of the reported patients belong to Roma descent, an itinerant ethnic group living mostly in Europe, with an increased risk of childhood mortality due to limited access to healthcare services. We describe three unrelated patients from the Campania region in Italy with MyD88 deficiency, all belonging to Roma descent and displaying severe or recurrent infections in early infancy. They underwent a comprehensive immunological work-up including targeted next-generation sequencing for IEIs that identified a homozygous pathogenic in-frame deletion c.157_159del p.(Glu53del) in MYD88 gene, already described in this ethnic group, suggesting a founder effect. A high level of alert should be kept in patients of Roma ethnicity with early onset severe infections. Moreover, being associated with increased Immunoglobulin E (IgE) levels, this condition should be included in the differential diagnosis of Hyper-IgE syndromes. Full article

The Roma population is one of the most discriminated social groups. Ignorance of their culture, traditions, etc. generates prejudices and stereotypes that hinder the processes of intercultural coexistence. The aim is to make the Roma people visible and to intervene in the university population, promoting intercultural and inclusive learning spaces to reduce behaviors that generate inequalities. Students from the University of Valladolid were involved, 1255 students in particular, distributed in control and experimental groups. The instrument consists of 40 closed questions and one open-ended. A quantitative analysis was carried out in the anti-Gypsy attitudes categories with t-tests. Item to item differences were not significant in categories A, B and C, but there were differences in D between the experimental and the control groups, which confirms important trends in the target population. Prejudices towards the Roma population continue to exist. University students who receive training have fewer prejudices than students who do not, although other variables can influence the process. Of the students, 72.2% are disturbed by the same negative behaviors, regardless of the ethnic group, and half of them are disturbed by behaviors based on prejudices. It is confirmed the need for preventive interventions to avoid the establishment of erroneous beliefs about the Roma community. Full article

The Roma population—with a unique history marked by migration, settlement issues, and ongoing resilience—has always faced significant social marginalization and has often been subjected to forced migration. Despite being one of the largest and most diverse ethnic groups in Europe, Roma continue to face systemic discrimination and social exclusion, leading to poor outcomes in education, employment, health, and housing. This article analyses the migration pathways, settlement experiences, and persistent obstacles faced by Roma. We argue that removing historical and systemic barriers to create a more equitable and welcoming environment for the Roma community is their right. The resilience of the Roma community in the face of adversity is a testament to their cultural strength and adaptability. This research aims to document these aspects and thus provide a basis for policies that promote social inclusion, equality, and respect for cultural diversity. Full article

Charcot–Marie–Tooth neuropathy type 4D (CMT4D) is a rare genetic disorder of the peripheral nervous system caused by biallelic mutations in the N-Myc Downstream Regulated 1 gene (NDRG1). Patients present with an early onset demyelinating peripheral neuropathy causing severe distal muscle weakness and sensory loss, leading to loss of ambulation and progressive sensorineural hearing loss. The disorder was initially described in the Roma community due to a common founder mutation, and only a handful of disease-causing variants have been described in this gene so far. Here, we present genetic and clinical findings from a large Bulgarian cohort of demyelinating CMT patients harboring recurrent and novel variants in the NDRG1 gene. Notably, two splice-site variants are exclusive to Bulgarian Muslims and reside in ancestral haplotypes, suggesting a founder effect. Functional characterization of these novel variants implicates a loss-of-function mechanism due to shorter gene products. Our findings contribute to a deeper understanding of the genetic and clinical heterogeneity of CMT4D and highlight novel founder mutations in the ethnic minority of Bulgarian Muslims. Full article

The Roma population is Europe’s largest ethnic minority, yet data on the prevalence of non-communicable diseases remain scarce in medical literature. This study aimed to compare the clinical and metabolic particularities of a Roma population with diabetes with a group of non-Roma. We conducted an observational, transversal study and evaluated 808 adult patients with diabetes mellitus, from a tertiary diabetes care hospital. The prevalence of metabolic syndrome was high among both groups, 94.3% in the Roma patients and 89.1% in the non-Roma. A slightly higher mean value of the triglyceride–glucose (TyG) index was observed among the Roma group (10.07 ± 0.71 versus 9.71 ± 0.82). Among the non-Roma, variables that were significantly associated with the TyG index were glycated hemoglobin (HbA1c), total cholesterol (TC), high density lipoprotein–cholesterol (HDL-c), and low-density lipoprotein-cholesterol (LDL-c), while among the Roma, HbA1c and HDL-c were correlated with this index. There were no differences concerning myocardial infarction; however, the number of patients with a history of stroke was 2.1 times higher in the Roma group compared to the non-Roma group. The prevalence of cardiovascular risk factors, cardiovascular disease, and microvascular complications among the study’s Roma population are quite significant, underscoring the importance of ethnic disparities in approaching healthcare management strategies. Full article

Background: Europe’s largest ethnic minority, the Roma, are often confronted with substantial obstacles that result in health disparities. Research indicates that there are elevated rates of both communicable and non-communicable diseases, such as metabolic syndrome (MetS), among Roma communities, often linked to living conditions, limited education, or poverty. This study centers on remote rural Roma settlements in Romania, evaluating the prevalence of metabolic dysfunction, obesity, and liver steatosis while considering socio-economic and lifestyle factors. Methods: Over a period of 36 months, local visits to a total of 25 rural Roma communities were conducted, where a medical team gathered information through a standardized questionnaire and conducted a physical exam on every participant. Liver steatosis was also recorded with the help of a portable wireless ultrasound device. Results: Our study included 343 participants, with a predominance of female subjects, representing 72.5% (n = 249) of the patients. The prevalence of obesity, defined by a body mass index (BMI) above 30 kg/m², was 32.2% (n = 111). Arterial hypertension was found to have a prevalence of 54.1% (n = 185), with de novo hypertension being observed in 19.2% patients (n = 66). Type 2 diabetes mellitus was found in 28.9% patients (n = 99), with 19.5% being de novo cases. The prevalence of hepatic steatosis was 57.2% (n = 111/194). A positive association between metabolic features and at-risk behaviors was found. Conclusions: This study underscores the transition from infectious to metabolic diseases in vulnerable communities and highlights the urgency of targeted public health strategies tailored to the unique needs of rural Roma populations, aiming to mitigate health disparities and promote equitable healthcare access. Full article

Background: The COVID-19 pandemic disproportionately affected vulnerable populations like Roma patients in Western Romania due to marginalization and limited healthcare access. Methods: A retrospective study analyzed COVID-19 cases between March 2020 and August 2022 using data from the Directorate of Public Health in Timis county. Demographic, epidemiological, clinical, and laboratory data were assessed, along with risk factors and biomarkers for ICU admission and mortality prediction. The following biomarkers were assessed: C-reactive protein (CRP), ferritin (FER), IL-6, D-dimers, lactate dehydrogenase (LDH), high density lipoprotein cholesterol (HDL), and 25-OH vitamin D (25-OHD). Results: In comparison with the general population (GP), Roma patients were more overweight (p = 0.0292), came from rural areas (p = 0.0001), could not recall transmission source (p = 0.0215), were admitted to the intensive care unit (ICU, p = 0.0399) more frequently, had worse symptomatology (p = 0.0490), showed more elevated levels of CRP (p = 0.0245) and IL-6 (p < 0.0001) and lower levels of HDL (p = 0.0008) and 25-OHD (p = 0.0299). A stronger, significant correlation was observed between CRP and severity (rho = 0.791 vs. 0.433 in GP), and an inverse stronger significant one was observed between HDL and severity (rho = −0.850 vs. −0.734 in GP) in the Roma patients. The male sex continues to be an important risk factor for ICU admission (OR = 2.379) and death (OR = 1.975), while heavy smoking was more important in relation to ICU admission (OR = 1.768). Although the Roma ethnicity was 1.454 times more at risk of ICU admission than the GP, this did not prove statistically significant (p = 0.0751). CRP was the most important predictive factor in regards to admission to the ICU for both Roma (OR = 1.381) and the GP (OR = 1.110) and in regards to death (OR = 1.154 for Roma, OR = 1.104 for GP). A protective effect of normal values of HDL and 25-OHD was observed in the GP for both ICU admission (OR = 0.947, 0.853, respectively) and death (OR = 0.920, 0.921, respectively), while for the Roma group, normal 25-OHD values were only considered protective in regards to death (OR = 0.703). Cutoff values for ICU admission were 28.98 mg/L for Roma and 29.03 mg/L for GP patients, with high specificity for both groups (over 95). Conclusions: Higher rates of ICU admissions, severe symptomatology, and distinct laboratory biomarker profiles among Roma patients emphasize the critical importance of personalized care strategies and targeted interventions to mitigate the disproportionate burden of COVID-19 on vulnerable communities. CRP values at admission have had a clear impact as a risk assessment biomarker for Roma patients, while the significance of IL-6, HDL, and 25-OHD should also not be overlooked in these patients. Full article

Scientific literature has evidenced that some social work practices and research tend to foster assimilation and silence ethnic minorities. In the case of Roma, previous research has shown that many social welfare practices do not consider their voices and end up in actions for surveillance and control over social transformation. However, the successful practices in social work with the Roma population that overcome these limitations remain underexplored. This work contributes to this gap in the scientific literature by uncovering one key criterion of some successful actions in this regard. Through the communicative methodology, six women’s focus groups and 30 life stories were conducted. In total, this included 47 Roma women and 33 Roma men from three different Spanish regions, as well as interviews with 30 professionals from education, social services, and civic organizations. The results from the studied context present evidence of a main successful criterion in some social work practices: the inclusion of scientific evidence in the intervention with co-creation with the end-users through egalitarian dialogue. That is, in this context, through the use of scientific evidence together with the co-creation process, the results were very positive. Full article

This project is an observational, descriptive study evaluating frequencies of rotavirus disease in hospitalized children aged less than 5 years old between 2015 and 2021 in the Pediatric Hospital of Brasov, Central Romania. The study compares socio-demographic (age, sex, place of living and ethnicity), clinical, and treatment aspects between community-acquired rotavirus gastroenteritis (CARG) and hospital-acquired rotavirus gastroenteritis (HARG). During that period, 1913 hospitalized children had a rapid positive immunichromatographic rotavirus test from stool specimens. Among them, 1620 (84.6%) were CARG and 293 (15.4%) were HARG. CARG conditions represented 28.5% of all acute hospitalized gastroenteritis (n = 5673) whereas HARG represented 5.2%. Around the same percentage of urban children were seen in CARG as in HARG (58.5% (n = 948) for CARG and 56.3% (n = 164) for HARG). About 64.9% (n = 1052) of CARG cases were from Roma population, and 66.5% (n = 195) in HARG. The age group with the highest frequency of the disease was 12 to 24 months old for both CARG and HARG. The average hospital duration was 5.09 days for CARG and 7.62 days for HARG. Diarrhea was the principal symptom in both CARG and HARG (92.6% (n = 1500) for CARG and 93.9% (n = 275) for HARG). Most CARG patients (61% (n = 989)) were treated for symptomatic management with iv fluids. Most HARG (60.4% (n = 177)) were treated for symptomatic management with iv fluids and antibiotics. A significant seasonal shift to a later period in the year was observed during the last registration year of 2021, possibly due to the COVID-19 epidemic. The seasonal disease burden of rotavirus infection in children remains high in hospital care in Romania, which may justify the systematic introduction of rotavirus vaccination across the whole country. Full article

Screening for visual acuity loss (VAL) is not applied systematically because of uncertain recommendations based on observations from affordable countries. Our study aimed to evaluate the effectiveness of primary health care-based screening. A cross-sectional investigation was carried out among adults who did not wear glasses and did not visit an ophthalmologist in a year (N = 2070). The risk factor role of sociodemographic factors and the cardiometabolic status for hidden VAL was determined by multivariable linear regression models. The prevalence of unknown VAL of at least 0.5 was 3.7% and 9.1% in adults and in the above-65 population. Female sex (b = 1.27, 95% CI: 0.35; 2.18), age (b = 0.15, 0.12; 0.19), and Roma ethnicity (b = 2.60, 95% CI: 1.22; 3.97) were significant risk factors. Higher than primary school (b_{secondaryschoolwithoutgraduation} = −2.06, 95% CI: −3.64; −0.47; and b_{secondaryschoolwithgraduation} = −2.08, 95% CI: −3.65; −0.51), employment (b = −1.33, 95% CI: −2.25; 0.40), and properly treated diabetes mellitus (b = −2.84, 95% CI: −5.08; −0.60) were protective factors. Above 65 years, female sex (b = 3.85, 95% CI: 0.50; 7.20), age (b = 0.39, 95% CI: 0.10; 0.67), Roma ethnicity (b = 24.79, 95% CI: 13.83; 35.76), and untreated diabetes (b = 7.30, 95% CI: 1.29; 13.31) were associated with VAL. Considering the huge differences between the health care and the population’s social status of the recommendation-establishing countries and Hungary which represent non-high-income countries, the uncertain recommendation of VAL screening should not discourage general practitioners from organizing population-based screening for VAL in non-affordable populations. Full article

This article aims to present the specifics and characteristics of personality development during adolescence in light of the family’s influence on the adolescent’s self-esteem, self-perception, and behavior. Self-concept holds a particular importance in an individual’s psychological and social development and expression. Self-concept contributes to an individual’s communication, personal confidence, and independence. The objectives of the article are as follows: to trace some basic aspects of the influence of family on personality and its formation; to present concrete empirical dimensions of the Self-concept of students in a Bulgarian environment as well as their relationships with their parents; to show whether there are differences among the main ethnic groups in terms of their Self-concept and parental influence. The empirical analysis of the article is based on research conducted with secondary school students in 2018 within the framework of the “Modern Bulgarian Education: Status and Deficits” project, of which there were 130 Bulgarian, 70 Turk, and 70 Roma students aged 14–16 and of both sexes. The students were randomly selected from several Bulgarian secondary schools. To establish Self-images and the formation of various qualities, we used a method highlighting the types of personality tests used to register Self-concept profiles, including various personal qualities in different areas of personality expression. Students rate the qualities as real and as their desire to possess them on a five-degree scale from “1”—I do not possess at all to “5”—I completely possess the corresponding quality. The survey results showed that young people to a large extent tend to strive for the construction of their Self-image as open to sociability, contacts, and communication to attain affirmation among peers and autonomy. The article also analyzes assessments of parents’ involvement in children’s lives as well as the importance of family as a value. The main conclusion of the article is that upbringing in the family is key to the development of a child’s Self-concept and success, the value structure and emotional state, as well as overall personal activity. Full article