bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in acute coronary syndrome mortality rates between the administrative regions in Serbia, 2006-2022
Authors: Mickovski-Katalina Nataša , Medarević Aleksandar , Miljuš Dragan , Rakočević Ivana , Živković-Perišić Snežana , Plavšić Snežana , Božić Zorica
Published: October 2024

Acute coronary syndrome (ACS) is a common causes of chest pain, emergency admission and sudden cardiac death in developed and developing countries. In the last decade, the Serbian healthcare system has notable improve cardiological health care regarding ACS, including the establishment of additional percutaneous coronary intervention facilities However, a comprehensive and continuous analysis of ACS mortality is often lacking. This study aimed to analyze the trends in ACS mortality in Serbia from 2006 to 2022 by administrative regions. This is a descriptive epidemiological study. Annual ACS mortality data (ICD X revision: I21, I22, I20.0) were used from Serbian acute coronary syndrome Registry, for the period 2006-2022. Age-adjusted mortality rates (AAMR) were calculated for people of 20+ years of age by direct standardization, using the standard European population. Mortality trends were assessed using jointpoint regression analysis by calculating the annual percentage change (APC) across of administrative regions of Serbia: Belgrade, Vojvodina, Southern and Eastern Serbia and Sumadija and Western Serbia Regions. In Belgrade and Southern and Eastern Serbia Regions AAMR have shown stable significant decrease through all observed period, with APC of -5,6 for Belgrade Region, and APC of -5,2 for Southern and Eastern Serbia Region. The Vojvodina Region initially exhibited an increase in the AAMR between 2006 and 2008, with APC=15,4 (p=0,018). After that, the decrease of AAMR was recorded in period 2008-2022, APC=9,9 (p<0,001). The different situation was observed in Sumadija and Western Serbia Region. Initially, the AAMR have shown the decrease, followed by an increase. In period 2006-2016 APC was -5,5 (p< 0,001), and in period 2016-2022 APC was 5,0 (p< 0,001). In Serbia, AAMR generally tend to fall in all, except for the Sumadija and Western Serbia Region. The reasons of AAMR increase are multicausal and depend on numerous factors that need to be explored more deeply.
Impact of the COVID-19 pandemic on the prevention and control of chronic respiratory noncommunicable diseases in the Municipal Institute for Lung diseases and TB Belgrade
Authors: Roksandić-Milenković Marina , Dimić Dejan , Dimić Nemanja
Published: October 2024

Backround: Chronic respiratory noncommunicable diseases (NCDs) are group of chronic diseases of the respiratory tract and other structures of the lung tissue, in the occurrence, origin and course of which factors of the external environment play a significant role. Covid 19 pandemic has caused serious disruptions at the global level in the provision of healthcare services in the field of diagnosis and treatment of these diseases. Objectives and Methods: Aim of this retrospective study was to determine the impact of Covid 19 infection on NCDs and the number of participants of smoking cessation, asthma and COPD schools in Municipal Institute for Lung Diseases and TB in Belgrade when it functioned as Covid triage centre (2020. - 2022.) Results: The average numbers of the first examination under the diagnosis of COPD and asthma before the Covid 19 pandemic (2014. till 2019.) were 10032 and 6696 retrospectively, during the Covid 19 pandemic (2020. - 2022.) 4218, and 3559 retrospectively and after Covid 19 pandemic (2023.) 7389 and 6388 retrospectively. The number of smoking cessation schools held before the Covid 19 pandemic (2014. till 2019.) was 51 with 404 participants (212 participants quit smoking - 52.4%), during Covid 19 pandemic (2020. -2022.) 2 with 80 participants (there is no data of the number who quit smoking) and after the Covid 19 pandemic (2023.) 7 with 79 participants - smoking quit 43 (54.5% ). The number of COPD schools held before the Covid 19 pandemic (2015. till 2019.) was 86 with 670 participants, during the Covid 19 pandemic (2020. - 2022.) 2 with 30 participants, and after the Covid 19 pandemic 13 with 88 participans (2023.) Conclusion: The number of first examinations of NCDs, as well as the number of participants of smoking cessation, asthma and COPD schools in Municipal Institute for Lung Diseases and TB in Belgrade was significantly lower during the Covid 19 pandemic. Neglecting continuous efforts to control and prevent these diseases at any time in the future can be increase the number of people suffering from these diseases with potentially more severe clinical manifestations.
Public health priorities and population health statistics in Angola
Authors: Chitanga Francisca , Candido Teresa , Šantrić-Milićević Milena
Published: October 2024

Introduction: Due to historical, economic, and social factors, Angola in Southern Africa faces significant public health challenges. The country's health system was severely affected by civil war, leading to damaged infrastructure and limited human resources. Other challenges include widespread poverty, lack of access to healthcare in rural areas, and high rates of infectious diseases. Method and objective: This study is based on a comprehensive literature review identifying Angola's leading public health priorities. The review process involved a systematic search of reputable databases, including PubMed, Google Scholar, and the World Health Organization's Global Health Observatory, to ensure the inclusion of the most current and relevant research, as well as Health Statistical Yearbooks. Results: The National Health Development Plan 2012-2025 and the National Development Plan 2023-2027 prioritize increasing life expectancy, reducing maternal and child mortality, improving healthcare quality, and expanding the healthcare network while reformulating the financing model and organizing the national health system accordingly. In 2022, life expectancy was 62.5 years (a 20% increase from 2011), maternal mortality was 199 in 2022 per 100,000 live births (17% decrease from 2020), and the under-five mortality rate was 69 deaths per 1,000 live births (65% decrease from 2011). However, mortality rates due to main infectious diseases tend to rise. In 2021, mortality per 100,000 inhabitants due to malaria exceeded 42.44, AIDS: 7.20.and tuberculosis: 4.78 persons. The supply of doctors and nurses per 10,000 inhabitants increased by 348% and 402%, respectively, to 1.8 doctors and 14.1 nurses and midwives. Conclusion: While Angola has significantly improved public health, these achievements are not evenly distributed between urban and rural areas and provinces. The country's multifaceted public health challenges demand an integrated approach combining health interventions with socioeconomic improvements and bolstering educational and preventive programs in disease control and health promotion.
Results of the project "First mammography" in the territory of the autonomous province of Vojvodina from 2019-2023 years
Authors: Milijašević Dragana , Sušnjević Sonja , Mijatović-Jovanović Vesna , Bojanić Snežana
Published: October 2024

Background: Breast cancer is the most common malignant tumor in women around the world and in our country. Regular breast cancer screening can detect small tumor changes and reduce mortality risk. Still, screening mammography assessments are often limited due to a lack of medical providers and distance from medical facilities. Methods and Objectives: The research was conducted as a cross-sectional study from 2019-2023 years as a part of the Project "First Mammography" supported by the Provincial Secretariat for Health. The research instrument was a specially designed questionnaire. Mammographic examinations with a mobile mammogram were carried out simultaneously in two buses in 18 municipalities of the Autonomous Province of Vojvodina, of which 12 municipalities were included in the second cycle of mammography. Results: The analysis included 16,691 women. The average age of the respondents during the observed period ranged from 56.06 to 57.4 years. A total of 19,898 mammograms were performed in two cycles. Every seventh woman (n=2,865, 14.4%) had a positive mammographic finding of BI-RADS 4a, 4b, 4c and 5. A total of 3,289 women (16.5%; of which 103 women did not respond) were invited to additional diagnostic procedures, with the highest number of women referred for US diagnostics (2,821 women, 14.2%), followed by COR biopsy (332 women, 1.7%) and vacuum-assisted biopsy (33 women, 0.2%). The diagnosis of breast cancer was confirmed in 159 women (0.8%). Conclusions: The high screening response of women indicates the problem of availability and utilisation of healthcare services in rural areas, which can serve as a basis for decision-makers to improve and expand infrastructure for screening mammography and further investments and expansion of such programs.
Psychosocial school factors and risk behavior in first-grade secondary school students in Serbia
Authors: Škorić Dragana , Gudelj-Rakić Jelena , Jovanović Verica , Backović Dušan , Soldatović Ivan , Ilić-Živojinović Jelena
Published: October 2024

Background: Adolescent age is a critical period in one's life when different risk behaviors may occur. Among other factors, school environment may be associated with these behaviors. Methods and Objectives: We aimed to examine the association of psychosocial school factors with risk behavior of the first-grade secondary school students in Serbia. We performed a secondary analysis of data from the 2018 Health Behavior in School-aged Children Study conducted in Serbia. A standardized questionnaire was used as a study instrument. We analyzed the following psychosocial school factors: school satisfaction, schoolwork pressure, teacher support, classmate support and being bullied at school. We included the following types of risk behavior in the analysis: smoking, alcohol consumption, risky sexual behavior, and gambling. Univariable and multivariable binary logistic regression was used to assess the independent predictors of each risk behavior among psychosocial school factors. Results: This study included 1605 students (50.3% females), of whom 78.5% attended secondary vocational school and 21.5% grammar school. Students mostly reported low school satisfaction (56.2%), low schoolwork pressure (56.6%), low teacher support (58.5%), high classmate support (67.2%) and not being bullied at school (86.2%). Alcohol consumption was the most prevalent (53.9%) and smoking the least prevalent (20%) risk behavior among students. All tested psychosocial school factors were associated with smoking except for classmate support. Low school satisfaction, low teacher support and being bullied at school independently predicted alcohol consumption. Low school satisfaction and high schoolwork pressure were significantly associated with risky sexual behavior. Low school satisfaction, low teacher support and high classmate support were significantly associated with gambling. Conclusions: Multiple psychosocial school factors were associated with different types of risk behavior in Serbian first-grade secondary school students. This calls for targeted actions aimed at improving psychosocial school environment among the first-grade secondary school students in Serbia.
COVID-19 and lung cancer diagnostic delays in Northern Serbia
Authors: Đekić-Malbaša Jelena , Kovačević Tomi , Bokan Darijo , Zarić Bojan , Stojanović Goran
Published: October 2024

Background: The influence of COVID-19 on lung cancer (LC) diagnostic delays has been reported worldwide, but our country has limited data. The Institute for Pulmonary Diseases of Vojvodina (IPBV) is the tertiary healthcare institution specializing in diagnosing and treatment of pulmonary diseases in Vojvodina Province. Since 2009 data from all diagnosed LC patients have been entered into the IPBVs LC registry (LCR). Methods and Objectives: To determine the COVID-19 impact we retrospectively analyzed five years period (2018-2022) using the hospital LCR data (age, gender, LC type, stage of the disease, ECOG PS and smoking habits). Results: During the observed period a total of 6,083 LCs were diagnosed. The number of LC patients in 2020 (1057) was significantly lower compared to the previous ten-year average (2010-2019) (1211), and the 2018-2019 average (1303). Male to female ratio (64.4% vs. 35.6%, p=0.243), smoking status (61.8% of active smokers, 27.9% of ex-smokers and 10.3% of non-smokers, p=0.086), and ECOF PS (p=0.069) showed no significant changes during five years. A significant increase in the average pack-years (36.77±13.359, p=0.04) and in the average age of LC patients (65.61±8.25, p<0.001) in 2022 compared to previous years was observed. In the five years distribution of LC by I, II, IIa, IIIb, and IV stages were 7.8%, 7.9%, 15.6%, 22.3%, and 44.6%, respectively. Stage IV was more often registered in 2021 than in all other years (48.6% vs. 44.6%, p=0.012). Conclusion: The year of the beginning of COVID-19 was followed by a decrease in the number of LC cases in 2020. A delay in LC detection in 2020 could influence of higher percentage of stage IV LC in 2021. An increase in LC detection in stage IV, and in pack-years are alarms for further comprehensive preventive activity for early LC detection and decreasing smoking prevalence.
Patients with oral cancer in the healthcare system of Serbia
Authors: Milošević-Marković Maja , Petrović Milan , Jelovac Drago , Đorđević Igor , Jovanović Svetlana
Published: October 2024

Background: Patients with oral cancer have a significantly impaired quality of life and in Serbia they are among the ten most common tumours in male population. Methods and Objectives: The aim of this study was to determine the recognition of this population group in the health care system in Serbia. During the June 2024 a review and analysis of relevant health policies, strategies, programs and other documents related to health in the Republic of Serbia, was undertaken. Results: According to the Law on Health Insurance, these patients have the right to full coverage of costs for examinations and treatment of teeth and mouth diseases as part of the preoperative and postoperative treatment, as well as rehabilitation with post-resection prostheses. The measures and activities of currently active programs for prevention and early detection of certain types of tumours and the National Program of Preventive Dental Health Care (2009) do not recognize this population group as a priority. Given that a third of these tumours are caused by Human Papillomavirus (HPV) infection, the availability of this vaccine in our country is significant. Since 2006 the HPV vaccine has been available in Serbia, since 2019 it is on the list of recommended vaccines by the National Immunization Program, and since 2022 it is available through health insurance fund. Policies and strategies that target commercial determinants, such as alcohol and tobacco, are receiving increasing attention at the national level, in recent years. Conclusions: In the observed Serbian population, despite a good dental health care coverage there are plenty of space to improve actions and measures to prevent oral cancer.
Lessons from a cross-sectional study on antibiotic use in the population of the Republic of Serbia during COVID-19
Authors: Belamarić Gordana , Bukumirić Zoran , Marković Gordana , Vuković Dejana
Published: October 2024

Background: Antimicrobial resistance is one of the major global public health concerns. Recent studies highlighted the threats of inappropriate use of antibiotics, especially during the health crises such as COVID-19 pandemic. Methods and Objectives: A cross-sectional study was conducted in December 2022, with a total of 1014 respondents. The sample of the general population of the Republic of Serbia was obtained through stratification and three-stage sampling. The data were processed using descriptive and inferential statistics. Pearson's chi-square test was employed to assess the significance of differences. Logistic regression models were utilized to analyze the use of antibiotics and the impact of knowledge as potential predictor of antibiotic use. Data analysis was performed using SPSS 20.0. Results : The majority of respondents took antibiotics (76.8%) during 2022, most of them by a doctor's prescription (78.4%), with the following most common reasons: sore throat, cold, fever and cough. More than two-thirds of the respondents which were infected with the SARS-CoV-2 virus, took antibiotics, while 64.8% of them had a prescription. Less than a third of all respondents (31.3%) received some advice about the rational use of antibiotics, and half of them changed their opinion about the use of antibiotics after receiving this information. Multivariate ordinal logistic regression analysis showed that female gender (OR=0.55; p<0.001), a higher level of education (OR=1.44; p=0.001), and the willingness to change opinions regarding the usage of antibiotics after receiving information about the rational use of antibiotics (OR=1.28; p=0.046), were significant predictors of better knowledge about antibiotics. Employed (B=-0.900; p=0.038) and unemployed persons (B=-0.951; p=0.047) have a 60% lower chance of desirable behavior regarding antibiotics use compared to retired persons, while students (B=-1.613; p=0.016) have an 80% lower chance of desirable behavior compared to retired respondents. Conclusions: Effective communication and education about the appropriate use of antibiotic for specific population groups could mitigate the risk of antimicrobial resistance, ensuring better preparedness for future public health crises.
Do we need new staffing norms at high-volume clinical-biochemical laboratories in Serbia?
Authors: Stanković Sanja , Šantrić-Milićević Milena
Published: October 2024

Background: Laboratory management has long struggled with staffing challenges, and a uniform staffing formula for medical laboratories remains elusive because of the varied and complex nature of the tasks that laboratory professionals perform, laboratory staff qualifications, skills, competencies, and additional activities. In Serbia, the laboratory staffing norm is based on the scope of work of 120,000 tests per year. Methods and Objectives: This study aimed to determine optimal staff requirements and staffing norms for two priority laboratory workers (medical biochemists and medical laboratory technicians) in 13 laboratories of the Center for Medical Biochemistry of the University Clinical Centre of Serbia (CMB/UCCS), the leading reference institution in Serbia in the field of laboratory diagnostics in 2018/19. In a cross-sectional study design, we applied the Workload Indicators of Staffing Needs (WISN) mixed-method approach, which included a qualitative review of regulations, quantitative analysis of annual routinely collected staffing and performance statistics, narrative reports of the observed laboratory processes, and structured interviews with lab staff. The WISN indicators for their core health care services and additional activities were identified, and staffing requirements and norms were evaluated. Results: The WISN method revealed laboratory workforce shortages in the CMB UCCS. Workforce maldistribution regarding the laboratory workload contributes to a moderate-high workload pressure of medical biochemists in five and medical laboratory technicians in nine organizational units. A modern, well-equipped, and accredited referent medical biochemical laboratory requires 1 medical biochemist and 4 medical laboratory technicians on the scope of 240,000 tests per year for each, that is, 6 medical biochemists and 23 medical laboratory technicians per 100,000 patient population. Conclusions: This study provides evidence to prompt a revisit of the staffing policies and the adoption of better workload-based norms for more efficient utilization of the existing workforce, which will provide quality laboratory services for all.
The turnover intention among public health professionals
Authors: Tripković Katica , Šantrić-Milićević Milena
Published: October 2024

Background: The turnover intention (TI) among public health professionals (PHPs) may lead to substantial workforce losses and negatively affect the public health system's performance. The rate of TI varies among different countries and types of public health workers. Most research has consistently confirmed that job satisfaction significantly influences PHPs' decisions to leave their jobs. Methods and Objectives: This study identifies PHPs' intention to leave the job and associated factors using cross-sectional national surveys on employee satisfaction from 2015 to 2020 and provides short-term historical forecasts of TI in public health institutes. Results: TI tendencies are increasingly common among public health professionals (PHPs) in public health institutes in Serbia, where the prevalence of TI increased from 18.5% in 2015 to 27.1% in 2019 before returning to 18.6% in 2020. However, the growing trend is projected to continue. Results also demonstrate a consistent association between organizational factors and PHPs' TI, including job-related stress, interpersonal relationships with colleagues and supervisors, salary, opportunities for professional development, recognition and valuing of work, and organizational culture. While individual factors such as gender, age, marital status, and external factors like employment opportunities, household income level, family size, and family responsibilities may also underlie the TI, their significance is less clear and varies across different studies. Conclusions: TI tendencies are increasingly common among public health practitioners in Serbia, indicating that a holistic approach is effective in developing retention strategies. In addition to prioritizing the health and safety of PHPs, these strategies should focus on enhancing job satisfaction, acknowledging employees' values and accomplishments, and establishing supportive and efficient work environments. To attract and retain the new generation of PHPs, management interventions in public health organizations should be geared towards fostering innovation and creativity in the workplace.
With nutrition counselling again
Authors: Jović Dragana , Kašanin Jelena , Knežević Sunčica , Stanojević Nemanja
Published: October 2024

Background: In the year of its 100th anniversary celebration, the Institute of Public Health of Serbia enters with a new Nutrition Counseling Unit (NCU) at the Center for Hygiene and Human Ecology, providing nutrition health services again through referral of a chosen doctor. Services provided on this occasion include anthropometric measurements during the examination of the individual's nutrition, determination of anthropometric indices, evaluation of the results of biochemical indicators of blood and urine, nutrition anamnesis, preparation of diet therapy for the individual at the first visit and control examination and for different pathological conditions. It is also ensured that Primary Health Centers (PHC) may refer their patients through the National System for Electronic Health Records "My Doctor". Methods and Objectives: This retrospective study, was aimed to bring overview of health status of the NCU patients, using referral and final diagnoses from patient's protocol for the period July 2023 - July 2024. Results: The records of the referral and final diagnoses showed that there were significantly more women than men who turned to the NCU (81.9% vs. 18.1%, respectively). Patients most often sought nutrition advice due to obesity (50% of men; 57.9% of women), dyslipidemia (7.9% of men; 7% of women) and hypertension (8% of men; 5.5% of women), less often due to nutritional risk factors prevention. In patients with obesity, among the comorbidities, there were mostly diagnoses from the International Classification of Diseases group IV (Diseases of glands with internal secretion, nutrition and metabolism), IX (Diseases of the circulatory system) and XI (Diseases of the digestive system). Conclusions: Work in the NCU, as prevention of nutritional risk factors and medical nutrition therapy, are based on an individual dietary approach. Our experiences indicate that significance of medical nutrition therapy and medical nutritional prevention were important determinants for both medical doctors in PHC and patients as well.
The effect of physical exercise on the body water levels and muscle mass in subjects engaged in recreative physical activity
Authors: Hodžić Damir , Purković Miloš , Maksimović Katarina , Soldatović Ivan , Ilić-Živojinović Jelena , Gudelj-Rakić Jelena , Maksimović Miloš
Published: October 2024

Background: Different research studies show that people who exercise regularly have higher levels of body water due to predominance of lean muscle tissue instead of adipose tissue. Sedentary lifestyle leads to increase in the body fat mass and decrease in the percentage of body water. The aim of the study was to explore the effects of regular recreative physical exercise on the body water levels and muscle. Methods and Objectives: Study included 50 subjects of both genders aged 18 to 55 years, who engaged in recreational physical exercise. All subjects were measured at baseline, before they started to exercise and after period of three months. Body composition was analyzed by Bioelectrical impedance. All subjects exercised three times a week for 75 minutes. Exercise plan consisted of combined anaerobic training for 45 minutes and aerobic training for 30 minutes. Dietary advice was not provided for participants. Descriptive and analytical statistics methods were used in statistical data processing. Statistical data processing was done in the SPSS Windows version 25 software package. Results: After three months, the percentage of body water was increased by 1.95% (p<0.001) and it was statistically significant in both sexes (p<0.001). At the end of the study, muscle mass values were higher by 0.62 kg (p=0.034). In relation to gender, a statistically significant difference was found between two measurements in women (p=0.025), while in men this difference was not significant (p=0.194). Conclusions: Results show that regular physical activity has a favorable effect on the level of body water and muscle mass, that leads to better cardiovascular outcomes.
Measurement of K-40 and Cs-137 activity concentrations in food packaging and health risk assessment
Authors: Kuzmanović Predrag , Srećković Marijana , Vujković Branko , Dragičević Igor
Published: October 2024

Background: Potassium-40 (K-40) is a naturally occurring radionuclide that can be found in the environment in varying concentrations, unlike cesium-137 (Cs-137), which is an artificial radionuclide resulting from the operation of nuclear power plants and nuclear tests. If these two radionuclides are found in significant concentrations in packaging materials used for food, they can contribute to an increase in the annual gamma radiation dose received by humans above the recommended levels. Methods and Objectives: Using gamma spectrometry, the activity concentrations of K-40 and Cs-137 were determined in samples of three-layer and five-layer cardboard, five granules used to make food packaging, various types of paper, packaging boxes, and LDPE bags (low-density polyethylene bags). The samples were collected between 2010 and 2023 from packaging product manufacturers and during imports into the Republic of Serbia. Health risk was assessed after measuring the activity concentrations of these two radionuclides in terms of annual effective dose values in accordance with the law regulating this area, which considers food packaging materials as items of general use. The radionuclide content in items of general use must not exceed levels that could contribute to an increase in dose for the population above 1 mSv/year. The aim of this study is to assess the health risk from the use of cardboard and plastic food packaging. Results: The measured activity concentration values of K-40 for most analyzed samples are below the minimum detectable activity. The maximum measured value for K-40 is 1380±31 Bq/kg in three-layer cardboard. Similarly, for most samples, the measured values of Cs-137 are below the minimum detectable activity, with a maximum value of 8.1±1.7 Bq/kg in three-layer cardboard. The estimated annual effective dose values for all analyzed samples are below 1 mSv/year. Conclusions: Based on the measured values of K-40 and Cs-137, as well as the estimated values of annual effective doses, it can be concluded that there is no health risk from the use of the tested food packaging materials, considering that all annual values were below the recommended value of 1 mSv/year.
Review of the experience and results of editing a research topic in the Journal Frontiers in Public Health
Authors: Višnjić Aleksandar , Terzić-Šupić Zorica , Stanković Miodrag
Published: October 2024

Background: The various forms of Internet use, including social networking, online shopping, gambling, and gaming are products of the time in which we live and represent an integral part of how we conduct and engage in social interaction. However, excessive use of Internet-related content has increasingly been linked with mental health issues and aspects, such as addictive behavior, which was a central theme of this Research Topic. Methods and Objectives: Within this thematic unit, 51 papers were received, of which 20 were accepted for publication. It should be emphasized that distribution of the published articles by type was as following: 17 Original research, 2 Brief Research Report and 1 Hypothesis and Theory. Results: The novel approaches, rigorous research methodologies and statistically significant findings, which are presented under this Research Topic, altogether speak in favor of the fact that Excessive Internet Use is quite problematic nowadays and that more care should be taken in how to deal with it. Although any Internet-related addiction is not specifically identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or International Classification of Diseases (ICD-11), the growing body of literature suggest it shares a common underlying etiological framework with other (substance or behavioral) addictions. In this regard, the connections between the excessive use of the Internet (especially social networks) with pronounced occurrences of various symptoms of mental health, as well as health in general, were unequivocally established. Conclusions: Overall, it is of great importance that the research on the impact of Internet usage on mental health continues and gains momentum. Comprehensive and interdisciplinary efforts toward clarification of the hidden patterns and elusive aspects on the population level as well as on the individual level are largely needed.
Associations of sociodemographic characteristics and cigarette smoking with binge drinking in adult population in AP Vojvodina, Serbia
Authors: Tomašević Tanja , Mijatović-Jovanović Vesna , Radić Ivana , Ukropina Snežana , Milijašević Dragana , Čanković Sonja , Pustahija Tatjana , Petrović Vladimir
Published: October 2024

Background: This study aims to determine the association of sociodemographic characteristics and cigarette smoking with binge drinking in the past month, in adult population in AP Vojvodina. Methods and Objectives: Data were derived from a cross-sectional study. The research instrument was a specially designed questionnaire based on a questionnaire from the Behavioral Risk Factor Surveillance System in the sample of 3910 respondents aged 18 and older. The respondents who drank were divided into non-binge drinkers and binge drinkers. Binge drinkers were considered females who drank 4 and more drinks and males who drank 5 and more drinks in one occasion in the past month. Pearson chi-square test was used to compare differences between groups. Multivariate logistic regression was implemented to determine the association between binge drinking as a dependent variable and smoking and sociodemographic characteristics as independent variables (gender, age, type of settlement, marital status, and level of education). Results: Out of a total, 49.4% of adults were drinking alkohol in the past 30 days. Among them, 49.5% reported binge drinking in past month (59,1% of males and 32,5% of females). Multivariate logistic regression showed that among persons who drink, binge drinkers were more likely to be male (OR 3.53; 95% CI 2.74-4.53), from rural settlements (OR 1.87; 95% CI 1.47-2.38) and smokers (OR 2.79; 95% CI 2.18-3.55). Younger adults had higher odds of binge drinking compared to adults 65 and over. Conclusions: The research shows that there is a strong association between social determinants and binge drinking, which could help policymakers to create public health interventions across multiple levels to reduce alcohol consumption. These interventions should be specially directed to males, the younger population, smokers, and those who live in rural settlement.
Main findings of the Water, Sanitation and Hygiene (WASH) survey in primary schools in the Republic of Srpska, Bosnia and Herzegovina
Authors: Kotur Borka , Rudić-Grujić Vesna , Grabež Milkica , Petković Vesna
Published: October 2024

Background: Within the goals of the Protocol on Water and Health, Bosnia and Herzegovina has set the objective of improving Water, Sanitation, and Hygiene (WASH) in primary schools. The baseline WASH survey in primary schools is planned as the first activity in its achievement. The aim of the research is to examine the state of WASH in primary schools in the Republic of Srpska. Methods and Objectives: This survey was conducted from September 2019 to March 2020 in the Republic of Srpska. We evaluated the condition of WASH in 66 primary schools. Two primary instruments were employed for data collection: a survey questionnaire administered to school administrative staff and a checklist focusing on the hygienic and sanitary attributes of individual toilets and handwashing facilities, based on WHO and UNICEF guidelines (2019). Results: The survey results indicated that all investigated schools provided basic water services. Additionally, 75.7% of toilets and 61.2% of handwashing facilities met basic sanitary and hygiene standards. However, critical infrastructure gaps were identified, including the absence of gender-segregated toilets, insufficient toilet paper, lack of trash bins in stalls, and inadequate accessibility for the pupils with disabilities. Only 25 toilets (7.7%) were adapted for disabled pupils. Moreover, while menstrual hygiene education is essential, only 41 schools (62.1%) provided it. Conclusions: Our survey underscores that children with disabilities face significant barriers to accessing appropriate toilet facilities, and girls encounter inadequate menstrual hygiene management. Addressing these deficiencies is crucial for advancing Sustainable Development Goals, particularly Goal 10 (reducing inequality) ang Goal 4 (achieving gender equality). Effective solutions require collaboration between public health initiatives and local communities to foster a supportive and inclusive school environment that meets the diverse needs of all students.
Building resilience in health security: Academic insights on infodemic management
Authors: Mandić-Rajčević Stefan , Stevanović Aleksandar , Rowland Amy , Sotirović Ivana , Vidojević Jovana , Zdujić Marija , Martin Rebecca
Published: October 2024

Background: The information environment significantly impacts public health decisions, behaviors, and health security. The spread of misinformation and disinformation, known as the infodemic, undermines health interventions and public trust. Addressing this challenge requires innovative transformations in public health education to create a competent workforce. This study aimed to assess the scope and relevance of infodemic management (IM) across different academic fields and identify the training needs to enhance the current educational frameworks. Methods and Objectives: As part of the US Federal Assistance Award within the University Partnership Program between Emory University and the University of Belgrade, a mixed-methods study was conducted. The curricula of all 31 faculties at the University of Belgrade were evaluated, and an online survey was distributed to deans and selected teaching personnel. This approach provided a comprehensive view of the current educational framework and opinions on IM in various academic fields. Results: The survey received 33 responses from different departments at the University of Belgrade. Over 75% of participants identified misinformation as prevalent in their respective fields. More than half of the respondents believe that students are not sufficiently familiar with the concept of the infodemic and its potential consequences. Only 9% believe these topics are well covered in the current curriculum, and over 90% agree that additional content on IM is required to update study programs, indicating a significant gap in the current educational approach. Conclusions: The academic community widely acknowledges the issue of misinformation and its negative impact on public health. Current gaps in academic curricula highlight the critical necessity of integrating IM into educational programs. This innovative approach will equip future specialists with the necessary skills to navigate the complexities of the modern information ecosystem.
Who are and who should be educators of the health education in schools?
Authors: Marković Roberta , Višnjić Aleksandar , Jovanović Tamara , Ignjatović Aleksandra , Todorović Kosta , Stojanović Miodrag
Published: October 2024

Background: Health education has a long tradition in schools in Nišava district/the Republic of Serbia, and it is implemented through two similar programs: Program for improving the health of children in primary schools and Program for improving the health of children in secondary schools. The results of the International Health Behaviour in School-aged Children Survey from 2017/2018, which recognized many risks and challenges that school children are exposed to, open the question of whether and to what extent the existing programs and the way of implementation are in accordance with modern Health education trends. Methods and Objectives: In order to understand the problem, an analysis of Health-educational programs, intended for children of primary and secondary schools in the Nišava administrative district, was carried out. The analysis was carried out through: analysis of reports on Health educational programs performed in primary and secondary schools in the period 2010-2020 year, which the public health centres of the Nišava district deliver to the Centre for Health Promotion of the Institute for Public Health Niš, as well literary review of papers and available, related documents. Results: In primary and secondary schools of the Republic of Serbia and the Nišava District, health education is carried out by health professionals, health assistants and educators. Through all the analyzed years in the period 2010-2020, health educators in primary and secondary schools were predominantly health professionals: in 2010, in primary schools, health professionals participated in health education with 63.4%, in 2013 with 59.3%, so that in 2020 they participated with 74.5%. Throughout all the years, associates and teachers are far less present as educators of the Health education. In secondary schools, this difference is even more obvious. Conclusions: Dominantly, Health professionals are health education educators, in difference to the recommendations and experience in countries participating the Health Promoting Schools program.
Public health interventions to increase HPV vaccination coverage In Krapina Zagorje County, Croatia
Authors: Mahmutović Bojana , Ramadani Husen , Gredičak Marica , Krajačić-Jagarčec Gabrijela , Lipovac Ivan , Popijač-Cesar Gordana , Stanković-Gjuretek Marina , Zadravec Marijana , Horvat Vlatka , Emanović-Brkić Marinela , Paradi Leona
Published: October 2024

Background: Cervical cancer is an important health issue in Croatia, with around 320 cases and 120 deaths annually over the past decade. In 2022, Krapina Zagorje County recorded 40 new cases and 3 deaths. Human papilloma virus (HPV) causes nearly 99% of these cancers. It also causes cancers of the anus, vulva, vagina, penis, and oropharynx, and genital warts in both sexes. HPV vaccination and early detection through Pap smears are two essential tools in the fight against cervical cancer. HPV vaccination was introduced in 2015 in Croatia and is free and voluntary for everyone until 25 years old. Methods and Objectives: Since school year 2015/2016 HPV vaccination provided in schools is available to all eighth-grade students, and since 2023/2024 to students from fifth to eighth grade. School medicine doctors vaccinate students, while others can receive the vaccine at public health epidemiological clinics, which are also included in vaccination promotion and provide information about vaccines. In Krapina Zagorje County, public health interventions aimed at increasing vaccination coverage were implemented since 2015 and included: students' education in person, parents' education in person, and vaccination in schools. In 2019 we introduced parents' reminder system, and switched to parents' education through informative consent leaflet. In 2024, a comprehensive campaign was implemented and included multi-sector and multilevel cooperation within the Institute's departments, Non-governmental organizations, the General Hospital, the Medical Faculty, media and Local authorities. Results: From 2015 until 2018 Krapina Zagorje County had under 50% of vaccinated students each year. Since 2019, we continuously reached vaccination coverage over 70%, which makes us the County with the best vaccination coverage in Croatia, aiming to 90%. Conclusions: In order to achieve the desired vaccination coverage, it is necessary to clearly define the strategy of HPV vaccination promotion, create an implementation project plan, and expand the collaboration at multiple levels vertically and horizontally.
Role of communication skills of health professionals in promotion of HPV vaccination in the Federation of Bosna and Herzegovina
Authors: Ramić-Catak Aida , Skočibušić Siniša , Musa Sanjin , Cilović-Lagarija Šeila
Published: October 2024

Background: In aim to promote HPV vaccination among children and youth, the Institute for Public Health of the Federation of BiH in 2023 developed an HPV immunization program, furtherly accepted by the Federal Ministry of Health. In collaboration with WHO and UNFPA country offices, the Institute for Public Health of the Federation of BiH initiated education to emphasize the importance of improving the knowledge and skills for over 280 health professionals in effective communication with parents in the promotion of HPV vaccination. Methods and materials: Paper presents an analysis of results of the pre and post testing of the health professionals directly involved in the HPV vaccination process in the Federation of BiH, regarding their self-confidence in communication with parents about HPV vaccination. For data collection was used the questionnaire as a part of the WHO document "Communicating with caregivers about HPV vaccination: facilitator's guide" published in 2023. The questionnaire was created in Google Forms for health professionals who participated on training. For descriptive and inferential statistics of collected data used IBM SPSS20 package. Results: The data showed an increase in self-confidence of health professionals in communication with parents after completed training. Before training 32.5% of health professionals confirmed self-confidence in talking to parents about HPV vaccination while 68.0% of them after training. Self-confidence about adverse reactions after HPV vaccination is confirmed by 27.4% health professionals before training and by 64.4% of them after training. Conclusions: A systematic approach in improving the communication knowledge and skills of health professionals is significant support for increasement of the coverage and promotion of HPV vaccination.
Sociodemographic characteristics of the adult population who drive a motor vehicle under the influence of alcohol in Autonomous Province of Vojvodina (APV), Serbia
Authors: Mijatović-Jovanović Vesna , Tomašević Tanja , Radić Ivana , Čanković Sonja , Ukropina Snežana , Milijašević Dragana , Dragnić Nataša
Published: October 2024

Background: Driving under the influence of alcohol (DUIA) increases the risk of road traffic crashes that result in serious injuries or death. This work aimed to examine the prevalence of DUIA and the differences in relation to the sociodemographic characteristics of the respondents. Methods and Objectives: This research is part of the Special Public Health Program planned by the Provincial Secretariat for Health Care APV in 2023: Surveillance of behavioral risk factors for noncommunicable diseases in the adult population in APV. The research was performed as a cross-sectional study on a sample of 3,910 respondents aged 18 and older. A personal interview was conducted. The research instrument was a specially designed questionnaire based on a questionnaire from the BRFSS (Behavioral Risk Factor Surveillance System, CDC). Pearson chi-square test and Confidence Interval (95%CI) was used to compare differences between sociodemographic categories of respondents who drive under the influence of alcohol. Results: Out of a total of 1,488 respondents who consumed alcohol in the last 30 days, 225 (15.1%) reported to have been driving a car or other motor vehicle under the influence of alcohol, significantly more often males (19.9%; 95%CI 17.4-22.6 vs. 6.4% females; 95%CI 4.5-8.9), divorced persons (24.1%; 95%CI 16.4-33.6) and employed respondents (17.4%; 95%CI 15.2-19.8). The highest percentage of drink-drivers was in the Northbacka district (22.6%; 95%CI 15.3-31.3). There were no significant differences in DUIA regarding other sociodemographic characteristics. On average, the respondents drove under the influence of alcohol 3.3 times in the last months, with no significant differences in the observed characteristics. Conclusions: The number of drivers under the influence of alcohol is significant in Vojvodina. The results indicate the necessity of holistic public health action aimed at road safety. This requires involvement from multiple sectors, such as traffic law enforcement, transport, police, health, and education.