bluuebunny/crossref_metadata_2025 huggingface dataset:
Decoding patient choices: Findings from the REASON4HEALTH project
Authors: Zupan Zorana , Stanković Sanda , Purić Danka , Lazarević Ljiljana , Knežević Goran , Žeželj Iris
Published: October 2024

Background: In the REASON4HEALTH project, we explored the structure, prevalence, and psychological factors predicting intentional non-adherence to official medical recommendations (iNAR) and the use of traditional, complementary, and alternative medicine (TCAM) in Serbia. Methods: Focus groups with clinicians and TCAM practitioners and a literature review informed the development of instruments assessing iNAR and TCAM use. We tested these instruments in an online sample of 583 adult Serbian citizens (M_age = 39.01, SD_age = 12.10) and collected data on iNAR, TCAM, and relevant psychological factors in a nationally representative sample (N = 1003, M_age = 39.01, SD_age = 16.67). Results: Intentional non-adherence behaviors (avoiding medical check-ups, self-medication, and self-initiated changes in therapy) formed a single factor. TCAM use formed an overarching factor with four domains: natural product-based practices, alternative medical systems, "new age" practices, and customs/rituals. The nationally representative sample revealed a lifetime prevalence of iNAR at 91.3%. Notably, 47% had taken antibiotics without a prescription, and 29% changed therapy without consulting a doctor; 97% used natural-product based practices, 75% engaged in customs/ rituals, 49% used alternative medical systems, and 35% participated in "new age" practices. Physicians highlighted a lack of health education, insufficient time with patients, and simplicity of TCAM as factors influencing these behaviors, while TCAM practitioners cited a holistic approach and a dedicated relationship with patients. Negative experiences with the health system predicted iNAR (b = .19 to .25, p < .001). Irrational beliefs, such as magical beliefs about health (b = .13 to .25, p < .05), superstitions (b = .19, p < .01), and beliefs in extrasensory perception (b = .11, p < .01) predicted TCAM use. Conclusion: Our studies highlight the widespread prevalence of iNAR and TCAM and underscore the need for interventions targeting unfounded beliefs and improving patients' experiences with the health system.
Programs for rare diseases in Serbia and Europe
Authors: Plavšić Snežana , Miljuš Dragan , Rakočević Ivana , Živković-Perišić Snežana , Mickovski-Katalina Nataša , Božić Zorica
Published: October 2024

Background: At the end of the 20th century, in the countries of the European Union (EU), the need to define a European policy in the field of rare diseases (RD) was recognized, which resulted in the adoption of a series of strategic documents, the opening of the first expert centers and registries for RD. Methods and Objectives: In order to assess the health care of patients with RD, a situational analysis of the available strategic/program documents in the field of RD in our country and in Europe was done. Results: Regulation on orphan drugs no. 141/2000 of the European Parliament and the Council on orphan drugs from 1999, the European definition of RD was adopted and the criteria for the designation of orphan drugs in the EU were established. The regulation provided basic guidelines for the development of strategies for RD in EU countries with the aim of encouraging research, diagnosis, treatment and care of people with RD. In 2008, the European Commission published a report on RD, on the basis of which the European Council of Ministers of Health adopted Recommendations in the field of RD in 2009. The recommendations emphasized the importance of: developing and adopting national plans/strategies for RD, encouraging research, strengthening patient organizations and sustainability information, research and health infrastructures. By the end of 2014, 20 national plans/strategies for rare diseases were adopted in the EU. In 2019, the government of our country adopted the first National Development Program for RD for the period 2020-2022, with the main goal of improving the health care of patients with RD. Conclusions: The recommendation of the two-year study "Rare 2030" initiated by the European Parliament is the development of a broader strategy on RD, and this initiative is supported by 21 EU member states. In Serbia, the development of a new National Program for RD is underway.
Staphylococcus aureus, the most prevalent isolate among surgically treated patients
Authors: Habibović Selma , Jovanović Aleksandra , Ribis Snežana
Published: October 2024

Background and Objective: According to available research data, one of the greatest treats for surgical departments is presence of chronical staphylococcal infections in patients admitted for hospital treatment. These infections can be caused by wild-type strains, but also resistant strains of this bacteria gained after frequent hospital treatments. Any of these strains in hospital environment has a plenty possibility for further evolution, which mainly can be modified by proper or inappropriate usage of antibiotics. The goal of our research was to explore the variety of microbes present in wounds after surgical treatment and their susceptibility to antibiotics. Methods: Our investigation was conducted as a retrospective study in Public Health Institute Novi Pazar from July 2021 to January 2022. The study outlined 183 bacterial isolates from surgical wounds of 94 inpatients and 89 outpatients. Identification of isolated bacteria has been performed using conventional microbiological techniques and susceptibility testing was done according to the EUCAST standards. Results: The most prevalent isolate was Staphylococcus aureus (35%), present in 13.7% of inpatients wounds and 21.3% of outpatients' wounds. It was followed by Klebsiella spp. (22.4%), Escherichia coli (15.8%) and Pseudomonas aeruginosa (8.2%). Among inpatients, Staphylococcus aureus dominated infections of wounds after Cesarean section (29.7% of all its isolates). Compared to the outpatients, Staphylococcus aureus was predominantly found in wounds of inpatients after genitourinary surgery, including Cesarean section. However, all together, the most frequently it was present in wounds of outpatients after surgical interventions (orthopedic, vascular, general, abdominal, chest and plastic surgery). Meticillin-resistant strains of Staphylococcus aureus were generally detected in wounds of inpatients, except orthopedic outpatients, where the wounds have been mostly affected by trauma or chronical infection presence. Conclusion: Hospital-acquired infections are of great importance, particularly in light of the rapid increase in bacterial resistance. In this regard, it is essential to study roots of their spreading as well as to detect weak points of established antimicrobial therapy protocols in tertiary health care units.
The importance of molecular diagnostics in the fight against infectious diseases
Authors: Malbaški Marina , Vujković Branko
Published: October 2024

Background: Infectious diseases are caused by pathogenic microorganisms that spread directly or indirectly from one person to another. They are the main global cause of morbidity and mortality, seriously affecting public health and socioeconomic stability.They can be caused by a wide range of pathogens with similar clinical manifestations. Selection of appropriate techniques for rapid pathogen identification is critical for disease diagnosis and public health management. Real Time-PCR is a molecular method of proving nucleic acid directly in the patient's material, in which multiplication and quantification of pathogen DNA takes place simultaneously. It has high sensitivity, specificity, and an important role in the early and rapid detection of pathogens. Methods and Objectives: In the detection of pathogens of infectious diseases, a molecular method, Real Time PCR, was used. The aim of the work is to show the advantages of using molecular diagnostics in the fight against infectious diseases, to consider its applicability in controlling infectious diseases, reducing their spread and rapid public health response to serious public health events. Results: In the period from June 2022 until June 2024, a team of two two laboratory technicians, one medical microbiology specialist and one biologist are employed at the Department for Molecular Diagnostics at Institute of Public Health of Šabac, processed and tested 40,595 samples for the needs of patients in the Mačva and Kolubara districts. The tested samples painted an epidemiological picture of the district. Conclusion: The unexpected emergence of infectious diseases in the last decade has been rapidly detected using molecular methods. Information obtained from RT-PCR testing provided early insights that guided the public health response. In an environment with limited resources and a wide range of possible etiologies, molecular technologies offer an efficient solution for the diagnosis of infectious diseases, because they are fast, flexible and agile. It makes it possible to cover a large territory with few resources. Health systems that routinely use molecular diagnostics will achieve economies of scale, maximize limited expertise, and respond rapidly to emerging threats.
Comparison of three commercial tests for the SARS-CoV2 detection in the samples during 2022
Authors: Ivanović Jovana , Simić Nataša , Čabrilo Maja , Ivanović Milica , Gospodinović Hristina , Grego Edita
Published: October 2024

Background: Comparison of the sensitivity of three different RT-PCR tests in the analysis of samples for SARS-CoV-2 detection. Methods and Objectives: In the laboratory of the Department for Molecular Microbiology, Institute of Public Health of Serbia Dr Milan Jovanovic Batut in 2022, a total of 125.116 samples were received for detection of the SARS-CoV-2 using the RT-PCR method. This study presents the results obtained by retesting 200 borderline positive nasopharyngeal swabs. Three different tests were used to detect and confirm SARS-CoV-2 positive samples: 2019-nCoV (Sansure Biotech Inc., China), Xpert Xpress SARS-CoV-2 test (Cepheid, GeneXpert) and Bio-Speedy (Bioeksen). Results: Using the 2019-nCoV test the borderline positive samples with high Ct values (38 ≤ Ct ≤ 41) were retested in order to confirm results obtained. 100 borderline positive samples were retested using Xpert Xpress test, and 73 (73%) of them were confirmed positive. The rest of 100 borderline positive samples were retested using Bio Speedy test, and 30 (30%) of them were confirmed positive. Conclusions: Based on the results presented in this study it can be concluded that retesting of borderline positive samples using two different methods is necessary step in order to obtain more reliable results.
Decade of progress: Declining trichinellosis rates in Serbia and the role of the National Reference Laboratory in control and research
Authors: Mitić Ivana , Vasilev Saša , Glamoclija Sofija , Sabljić Ljiljana , Plavša Dragana , Sofronić-Milosavljević Ljiljana , Gruden-Movsesijan Alisa
Published: October 2024

Trichinellosis, a mandatory reportable disease, remains a persistent zoonosis in Serbia due to regulatory violations, inadequate pork inspection, and insufficient awareness of health risks. Nonetheless, epidemiological data from the past decade (2014-2023) show a significant downward trend in Trichinella infection among the population, with the number of cases in the last five years being three times lower than in the previous five years. Over this ten-year period (except 2021) there have been 489 trichinellosis cases. Among these, 26% of serum samples were analyzed by the NRLT-INEP, with 113 (90%) confirmed positive for anti-Trichinella antibodies. Serum samples were also sent to NRLT-INEP for confirmatory testing using Western blot (Wb) when routine enzyme-linked immunosorbent assay (ELISA) or indirect immunofluorescence assay (IFA) tests failed to provide an unequivocal result. During this period, Wb was performed in 14 cases (11%) due to discrepancies between IFA and ELISA results. In addition to its role in definitive serodiagnosis of Trichinella infection for patients, the NRLT has made several national contributions by evaluating the immune response in the first recognized trichinellosis outbreak in Serbia caused by Trichinella britovi; showing that specific anti-Trichinella spiralis antibodies can persist in individuals for 13 and 18 years after infection; monitoring humoral and cellular immune responses to both the SARS-CoV-2 virus and Trichinella spiralis in patients with trichinellosis during the COVID-19 pandemic; demonstrating that applying the One Health concept in Serbia has improved infection control and reduced disease incidence in humans. Internationally, the NRLT collaborates with EU reference laboratories, participating in follow-up investigations of trichinellosis cases and in workshops and PT schemes organized by EURLP, ISS in Rome, Italy.
COVID-19 vaccination among tuberculosis patients in Serbia, 2022
Authors: Stošić Maja , Veljković Marko
Published: October 2024

Background: Since the beginning of the pandemic, COVID-19 affected lot of tuberculosis (TB) cases globally. Co-infection can lead to severe acute illness with possibilities of amplification of mortality and chronic lung sequelae. There is lack of data on COVID-19 vaccination coverage among TB cases globally. Methods and Objectives: A retrospective analysis of COVID-19 vaccination status among TB cases notified in 2022 in Serbia was performed with the aim to compare vaccination coverage with general population in Serbia and to identify factors associated with COVID vaccination among TB patients. We conducted bivariate and multivariable logistic regression statistical analysis. Results: Out of 468 TB patients notified in 2022, data on COVID-19 vaccination status were available for 399. There was no statistically significant difference between the coverage of at least one dose of COVID-19 vaccine among all TB patients, and patients aged 18+ compared to general population in Serbia (p value >0.05). At least one dose of COVID-19 vaccine was received by 51.6% of all TB patients, while by 55.4% TB patients aged 18+ respectively (compared to 52.1% coverage of all Serbian citizens and 55.6% of Serbian citizens aged 18+). The coverage by primary COVID-19 vaccine series is lower among TB patients aged 12-17 and 18-24 compared to the respective ages of the general population (p values <0.001), and likewise in age groups 60-69 and 70-79, compared to general population (p values <0.05), while similar coverage in age groups 25-49 and 50-59 (p values >0.05). However, it was higher among TB patients aged 80+ compared to general population (p value <0.05). We identified two statistically significant predictors of COVID-19 vaccination among TB patients: at least one comorbidity (OR = 2.41; 95% CI = 1.60-3.60) and age 50+ (OR = 3.33; 95% CI = 2.20-5.04). Conclusions: We found lower coverage of primary COVID-19 vaccination series among TB patients compared to general population in Serbia. Efforts should be made to increase COVID-19 vaccination coverage among TB patients since COVID-19 and TB co-infection can lead to poorer TB treatment outcomes.
Vaccination against influenza virus: Immunization as the basic of public health
Authors: Pocevski Božidar , Pocevski Predrag , Pocevski Marija
Published: October 2024

The basics of public health and health education are learned, if not from an early age in the family and preschool institutions, then certainly in the first grades of primary education. Vaccination prophylaxis is the introduction of live, weakened or dead causative agents of infectious diseases or their products into the body of a person or animal, with the aim of creating specific active immunity. Vaccination results are largely influenced by the attitude of the population towards its importance. We are of the opinion that half a century ago, the doctor's word was more respected, and people saw that collective immunization was necessary in order to save many lives. Immunization against seasonal flu - Influenza virus (quadrivalent vaccine with strains H1N1, H3N2, B/Washington/02/2019-like strain, B/Phuket/3073/2013-like strain), is from October 2 to November 2, 2022. conducted on 23 people, 17 men (range 32 - 80, mean 49.7) and 6 women (range 30 - 70, mean 48.6). Comorbidities among male patients are hypertension (HTA) - 4, DM - 1, Ca prostate - 1, arrhythmias - 1, anxiety-depressive disorder - 1. Comorbidities among female patients are HTA - 1, ulcerative colitis - 1, while one patient was pregnant. The immediate post-vaccination evaluation went well. The three-day follow-up was also without adverse effects. The solution to more serious clinical symptoms after infection, primarily in people with comorbidities, is certainly prescribed immunization by vaccination. Discipline and health hygiene culture are of crucial importance. It is up to health workers, professors, doctors, pharmacists and medical assistants to raise awareness among the people and educate the people about health. It is also regulated by adequate legal regulations. The fact that vaccines have successfully protected our population, now for 225 years, tells us that vaccines are not a problem - but a reality and a necessity.
Trends in lung cancer incidence and mortality, and gender disparities in Central Serbia from 2000 to 2019
Authors: Srećković Marijana , Dugandžija Tihomir , Kuzmanović Predrag , Čapo Nataša , Jovanović Zoran , Đekić-Malbaša Jelena
Published: October 2024

Background: Lung cancer (LC) is the second most diagnosed cancer globally with 2.2 million cases (11.4% of all diagnoses) and the leading cause of cancer-related deaths, accounting for 18.7% (1.8 million fatalities). Methods and Objectives: The primary aim of our study was to analyse LC rates in Central Serbia (CS) over a twenty-year period, recognizing its status as the most commonly diagnosed cancer among males and the leading cause of cancer mortality in both sexes, both in Serbia and globally. This retrospective study utilized data from the Serbian cancer registry spanning 2000 to 2019 to analyze LC incidence and mortality trends in CS. A descriptive statistical analysis was performed, and the linear trend was calculated using Excel. Results: In CS, from 2000 to 2019, the average incidence and mortality rates among males were 63.1±5.1 and 50.7±2.5, respectively, while among females they were 19.4±3.7 and 15.3±2.6, respectively. There was a significant increase of 2.8%, both for incidence and for mortality LC rates for females (R²=0.72 and R²=0.93, respectively) in CS. Among males, however, the incidence and mortality rates showed slight increases of 0.2% (R²=0.02) and 0.4% (R²=0.20), respectively. During the observed period, the male-to-female incidence ratio decreased from 3.9 in 2000 to 2.6 in 2019 (with the average incidence rate in males being 3.3 times higher than in females), while the male-to-female mortality ratio declined from 4.2 in 2000 to 2.6 in 2019 (with an average ratio of 3.4). Conclusions: The findings highlight the need for enhanced smoking prevention efforts and the introduction of screening programs for high-risk populations to address the increasing lung cancer rates, particularly among women, in Central Serbia. Further measurements and monitoring of radon concentration in closed spaces in Serbia are needed in order to indicate the seriousness and remediation of radon-endangered houses. This is important for identifying micro-areas with radon concentrations above 300 Bq/m3 .
The burden of cancer in the population of Serbia
Authors: Miljuš Dragan , Živković-Perišić Snežana , Mickovski-Katalina Nataša , Rakočević Ivana , Plavšić Snežana , Božić Zorica
Published: October 2024

Background: Malignant tumors have dominated in our national pathology for decades. They are the leading cause of illness, absenteeism, disability and premature death. Approximately every fifth resident of Serbia dies from malignant tumors. Methods and Objectives: Data from the Cancer Registry in Serbia on incidence and mortality from malignant tumors for the year 2022 were analyzed with the aim of assessing the cancer burden of the population of Serbia. Absolute distributions, crude and standardized rates of cancer incidence and death per 100,000 population in Serbia were used. The rates were standardized using the direct standardization method, and the population of the world was used as the standard population (ASR). Results: Based on the data from the Serbian Cancer Registry, in 2022, 41,578 new cancer patients were registred, while 19,350 people died from malignant tumors. Crude incidence rates were higher in men (682.4) than in women (571.7). The highest incidence of ASR in men was registered in Belgrade (469.1), and in women in the North Banat area (437.7). In the same year, the lowest ASR cancer incidence rates were observed in men in Raska (280.3), and in women in the Morava area (231.6). Crude mortality rates from cancer were 328.5 in men and 255.8 in women. The highest ASR mortality from cancer were observed in men in the North Banat area (178.3), and in women in the Middle Banat area (125.4). The lowest values of standardized mortality rates from malignant tumors were recorded in men in the Pcinja area (108.8) and in women in Morava area (73.3). Conclusions: Although a decrease in the mortality rate from all malignant tumors has been registered, there is still an increase in the incidence rate from malignant diseases, which significantly burden the population of our country.
Utilization of laboratory capacities in Serbian health institutions and public health institutes during the COVID-19 pandemic, 2020-2022
Authors: Vukša Ana , Đurić Petar , Ninković Olivera
Published: October 2024

Background: In 2020, the COVID-19 pandemic emerged as a public health emergency of international concern. Health system preparedness and response capacities have been diverted for surveillance and epidemic suppression in Serbia. This study evaluates the public health institutes (PHIs) network's contribution to performing SARS-CoV-2-related laboratory services (LSs). Methods: We collected and analyzed nationwide data on SARS-CoV-2-related LSs performed in all health care (HC) levels and PHIs in Serbia for the 2020-2022 period. The PHI-LSs contribution was calculated as a proportion of the total number of LSs performed in all HC facilities and PHIs and the ratio between PHIs and primary HC facilities LSs (Rls). Results: The highest contribution and Rls in SARS-CoV-2-related LSs were during 2020 (12.3%; 0.2) and the lowest in 2022 (2.2%; 0.03), with decreasing trend on the annual level. The highest district-level PHI's contribution in SARS-CoV-2-related LSs in the 2020-2022 period was as follows: 2020: Nišava district (39.5%), 2021: West Bačka district (27.5%) and 2022: Pčinja district (11.3%). On the other hand, the primary HC facilities enlarged their contribution over time (2020, 2021, 2022: 62.5%, 76.3%, 75.0%). During the observed period, secondary and tertiary HC facilities had the following annual SARS-CoV-2-related LSs contributions: 2020, 2021, 2022: 25.1%, 17.4%, 22.7%. Conclusions: At the beginning of the pandemic, PHIs had a greater LSs contribution, after which the focus of SARS-CoV-2-related LSs provision shifted toward the primary HC level. LSs in hospitals were performed based on relevant clinical guidelines and indications.
An overview of the activities on palliative care improvement in Belgrade during the last ten years
Authors: Vojvodić Katarina , Nešković Anđelija
Published: October 2024

Background: The provision of palliative care (PC) is multidisciplinary and in addition to the health system and health workers, patients' family members also participate in it. The need for this type of health care in Belgrade is increasing due to the aging population, the increase in malignant diseases' morbidity, diabetes, chronic obstructive pulmonary disease or trauma. Recognizing this problem, the Institute of Public Health of Belgrade, supported by the Secretariat of Health of the City of Belgrade implemented a series of activities on PC improvement in Belgrade. Methods and Objectives: The objectives of this study were to examine the capacities and workflow of and needs for PC services in Belgrade and to define the measures for improvement. This study represents the mixed method of retrospective analysis and focus groups. First, the retrospective analysis was done using the available data on capacities, provision and utilisation of PC at all levels of healthcare in Belgrade. Then, a series of focus groups with PC professionals were organized to collect additional data in line with the objectives. Results: The data from 18 primary health care centres and 4 clinical centres were analysed showing that 6,000 patients annually received PC (83.3% on primary level). Based on the results of the analysis, proposals for improvement of PC organization were prepared including needs for definition of criteria for admission to PC services, health workforce standards, reporting on provided services. In the next phase, activities were carried out to create a manual to help family caregivers in caring for family members in need of a PC. The manual contained answers to the most common questions that family caregivers ask health professionals during home visits. In the last phase, a series of accredited continuing medical educations for health workers and associates providing PC services were held. Conclusions: Our results show that there is a lot of space for further improvement of PC organization, services provision and reporting, quality of PC, needed resources and education of PC workers so as family caregivers.
The relationship between job demands and burnout among healthcare workers in diverse healthcare settings
Authors: Bachanovikj Marina , Kjosevska Elena , Karadzinska-Bislimovska Jovanka , Petrovski Martin , Prosheva Sanja , Totikj Nadica
Published: October 2024

Introduction: Healthcare workers (HWs) are exposed to high job demands that require cosiderable effort, often leading to overburdening, which can result in burnout syndrome and various health problems. Aim: To determine the association between job demands among HWs in diverse healthcare settings in the Republic of North Macedonia. Materials and Methods: This descriptive-analytical cross-sectional study included 415 employees in healthcare institutions: HWs in hospital activity, HWs in outpatient activity, and employees who are not HWs (technical support and administrative staff). Data were collected using: Demographic and Job Characteristics Questionnaire, Job Demands Questionnaire, and Maslach Burnout Inventory. For data analysis, both bivariate and multiple regression methods were used. Results and discussion: The average value of physical job demands in the total sample was significantly higher than the average values of other job demands (organizational, emotional, and cognitive). HWs in hospital activity were more exposed to physical and organizational job demands compared to those in outpatient activity. Average scores of emotional exhaustion and depersonalization were 27.5±15.19 and 12.3±6.99, respectively. The highest levels of emotional exhaustion and depersonalisation were identified among HWs in hospital activity (29.2 and 13.1, respectively). Working in the hospital activity compared to the outpatient activity predicted significantly higher emotional exhaustion and depersonalisation. A significant positive moderate correlation was found between the dimensions of burnout syndrome and job demands. Burnout syndrome was detected in 51.6% of HWs in hospital activity, a significantly higher percentage compared to the other groups. Significantly higher values of physical, organizational, emotional, and cognitive job demands were observed among respondents with confirmed burnout syndrome. Physical and emotional job demands were significant positive predictors for emotional exhaustion and depersonalisation, increasing the chances of developing burnout syndrome by 1.7 and 3 times, respectively. Conclusion: Urgent interventions to reduce job demands and mitigate burnout syndrome among HWs in hospital activity, as well as to prevent further development of burnout syndrome among HWs in outpatient activity, are crucial for improving HWs' well-being and the quality of patient care services.
Improvements in primary school sanitation and hygiene: A decade of progress in the Mačva District, Serbia (2014-2023)
Authors: Srećković Marijana , Vujković Branko , Dragičević Igor , Panić Snežana , Damnjanović Bojan , Đekić-Malbaša Jelena
Published: October 2024

Background: Schools should ensure a healthy learning environment by providing safe water, adequate toilet and hand-washing facilities, and waste disposal systems while promoting hygiene practices. Without these, illnesses like diarrhea and helminth infections increase, impacting attendance and academic performance. Methods and Objectives: Based on the report from the Center for Hygiene and Medical Ecology of the Institute of Public Health of Sabac, we analyzed Primary School WASH facilities in the Mačva District from 2014 to 2023. The study aims to assess the condition and quality of sanitary and hygiene facilities in schools, identify key problems, and propose measures to improve these conditions to enhance student health and well-being. Results: Our analysis reveals several key trends and significant improvements in Primary School WASH facilities in the Mačva District from 2014 to 2023. Reliance on local water supply and private wells consistently decreased, with notable annual decreases in 2018 (-4.98%) and 2019 (-4.90%) (R²=0.9052). Conversely, central water supply steadily increased, particularly in 2018 (+8.22%) and 2019 (+7.11%) (R²=0.9052). The installation of central sewage systems slightly increased, with the highest growth in 2016 (+3.79%) and 2019 (+2.17%) (R²=0.873). The presence of septic tanks consistently increased, especially in 2017 (+5.68%) and 2020 (+7.86%) (R²=0.9134). Primary schools without septic tanks significantly decreased, with notable declines in 2016 (-33.33%) and 2020 (-75.90%) (R²=0.9124). The availability of sanitary facilities consistently improved, with significant increases in 2020 (+8.19%) and 2021 (+1.04%) (R²=0.9558). Conversely, schools lacking sanitary facilities dramatically decreased, especially in 2020 (-66.97%) and 2021 (-27.78%) (R²=0.9558). Conclusions: These findings indicate substantial progress in improving WASH facilities in primary schools within the Mačva District from 2014 to 2023. Improvements in central water supply and sanitary facilities reflect successful interventions enhancing student health and well-being. The reduction in schools without adequate sanitation underscores the effectiveness of efforts to provide a healthier learning environment.
Determination of antimony in natural mineral bottled water
Authors: Jovanović Katarina , Milenković Milica , Dodevska Margarita , Blagojević Zorica , Ignjatović Marija , Mandić Olgica
Published: October 2024

Objectives: Antimony (Sb) is semimetallic chemical element which occurs naturally as sulphide ore, stibnite and valentinite. Human can be exposed to antimony by drinking water, food and soil contact. Polyethylene terephthalate (PET) is a thermoplastic polymer widely used in synthetic fibre, films and bottles. PET is the most popular material for food and beverage packaging. Antimony trioxide (Sb2 O3 ), together with antimony acetate and antimony glycolate, is the most frequently used catalyst in the production of PET resin and antimony remains in the produced objects. Drinking water that contains high levels of antimony may affect the liver and gastrointestinal system. Other health effects that have been reported include kidney, cardiovascular, metabolic, and developmental effects. Methods: Thirty-two samples of bottled water from the market of Republic of Serbia were collected and analysed. Determination of antimony in bottled water samples is done using US EPA method 200.8: "Determination of Trace Elements in Waters and Wastes by Inductively Coupled Plasma - Mass Spectrometry (ICP-MS)." Validation parameters: limit of quantification (LOQ): 0.0004 mg/L, scope of the method: 0.0004 - 0.05 mg/L and measurement uncertainty: 10% Results: Thirty-two samples of bottled water were collected and analysed. The results ranged from LOQ to 0.004 mg/L. The results of 6 (18.75%) samples were higher than LOQ but below maximum acceptable concentration (MAC). The water quality control is performed according to the valid book of rules on hygienic accuracy of drinking water. MAC for antimony in natural mineral bottled water is 0.005 mg/L. Conclusion: From the obtained results, it can be seen that all results are below maximum acceptable concentration which indicates that water is healthy and meets the current legal regulations" .
Determination of trihalomethane content in drinking water
Authors: Dodevska Margarita , Ignjatović Marija , Jovanović Katarina , Blagojević Zorica , Labus-Blagojević Svetlana
Published: October 2024

Background: Disinfection is the most important stage in preparation of drinking water, and the most commonly used disinfectant is chlorine. However, despite chlorine's effectiveness as a disinfectant, its oxidizing power can form disinfection byproducts, derived from oxidation reactions involving natural or artificial compounds present in water. The most common disinfection by-products are trihalomethanes (THMs), of which there are four main ones: chloroform, bromodichloromethane, dibromochloromethane and bromoform. Exposure to THMs occurs via oral, dermal and inhalation routes of exposure. After absorption, these elements tend to bioaccumulate in adipose tissue, liver, kidneys and lungs according to their concentration and mode of exposure and can cause both short-term and long-term health effects, which can lead to cancer risks and adverse reproductive outcomes. Methods and Objectives: The aim of this work was to determine the content of THMs in drinking water and to determine whether the obtained values are in accordance with the legal regulations. Drinking water was sampled at 18 different locations in the city of Belgrade THMs were determined by GC-MS (THERMO Scientific ISQ Series single quadrupole GC-MS). A Thermo HP-MS chromatographic column 30m x 0.25mm x 0.25µm was used, and calibration was carried out using a certified reference material, AccuStandard Inc, Trihalomethanes Mix, lot 214111083. Results: Limit of quantification (LOQ) value for each individual THM was 1 µg/L. In the examined samples, the obtained values for THMs did not exceed the maximum permissible value (100 µg/L). Chloroform content was in the range of 5-20 µg/L; dichlorobromomethane from 1-10 µg/L, dibromochloromethane from 1-5 µg/L, while bromoform was less than the LOQ. Conclusion: From the obtained results, it is evident that chloroform (max 20 µg/L) predominates among trihalomethanes, while the content of bromoform is below LOQ. The results of testing trihalomethanes in drinking water samples sampled in the territory of the city of Belgrade are not above the maximum acceptable concentration of 100 µg/L, which indicates that the water is healthy and meets the current legal regulations.
Ode to youth
Authors: Tešmanović Darko
Published: October 2024

Background: In 8000 BC, at the time when agriculture was discovered, the world's population was around 10 million. Over a long period, the population increased slowly. It took all of human history, until around 1800, for the world's population to reach one billion. Then the industrial revolution happened. People no longer died young. The increase in the number of inhabitants accelerated. Today, 8 billion people live on Earth. Methods and Objectives: Background and data were obtained by looking at the work of Hans Rosling and Stephen Shaw's documentary "Birthgap-Childless World"; as well as the internet portals Small Circles Forward and Gravitas Plus: "World is One News". Are we living in the most populous time on the planet? What caused the huge increase in people who suffer from "unplanned childlessness"? Results: Throughout history, there was an average of about six babies born per woman. It is specific to humans as a species. In 1965, the number of children born per woman dropped to five. Now it's about 2.5 and still going down. An educated woman chooses to have significantly fewer children. Her time is worth money, and having children could negatively affect her career and income. Women are now waiting longer to get married and have their first child, and they are spacing pregnancies more apart. Access to legal and safe abortions contributes to further declines in the birth rate. The world welcomes people who delay parenthood. This becomes a cultural phenomenon and spreads. Mass aging of society is inevitable. All the places in the world that, decade after decade, have been well below the required birth rate are on the way to population decline. Conclusions : It is necessary to point out to young people the short duration of the "age of fertility"! The period of life spent in education and commitment to a career must be coordinated with the period of family and offspring formation. Society needs to make parenting worthwhile again.
The importance of digital literacy in disease prevention and improving the quality of life
Authors: Pajičić Ana , Radojičić Dragana , Vujković Branko
Published: October 2024

Background: The World Health Organization defines health literacy as cognitive and social skills and the ability to access, understand and use information in a way that promotes and protects people's health. Digital health literacy is an individual's ability to search for health information in order to achieve an optimal level of health and good general condition, as well as to solve certain health-related challenges. Today, the Internet has become a synonym for a source of health information. People who have a higher level of digital health literacy are more responsible for their health, as well as for the health of their community. Methods and objectives: A descriptive method was used to determine the characteristics of the respondents. The aim of this study was to assess the level of health and digital literacy in the territory of the Mačva district, and the impact it has on the behavior of patients. Results: On a sample of 475 respondents, aged 19-94, the results showed that the levels of digital health literacy decrease with the age of the population. Conclusion: Health and digital literacy represent a major challenge for public health. Improving health and digital literacy will enable greater independence and personal empowerment of the individual in the processes of improving the quality of life. This will be a unique tool for improving people's empowerment in the domains of health care, disease prevention and health promotion. Health and digital literacy should be understood as a necessary factor in health when formulating strategies and actions for its improvement.
Program of organized breast cancer screening in the period from 2013 to 2024
Authors: Radosavljević Radoljupka , Jovanović Verica , Naumović Tamara , Kravić Klaudia
Published: October 2024

Background: Breast cancer is the leading cause of morbidity and mortality from malignant diseases in the female population worldwide, as well as in Serbia, and represents one of the most significant public health problems. Since 2013, when organized breast cancer screening in the Republic of Serbia started, the number of women suffering from breast cancer in Serbia has increased by 38.3%. In the period 2013-2022, the number of women who died from this disease decreased by 16.9%. The Institute of Public Health of Serbia assumed control of the organization of the mobile mammography service in 2018 and thus significantly contributed to the organized screening program. Methods and Objectives: The aim of this study is to present the results from 6 cycles of organized breast cancer screening program (2013-2024) and mobile mammography service in 2018-2024. The sources of the data were reports from primary health care centers and databases from mobile mammography unite. The Clinical Path form was used to collect data from the participants in the screening in the mobile mammography unite. Results: In the period from 2013 to June 2024, in the organized screening program a total of 333.505 women were examined and histopathologically confirmed 1149 cancers. In the period from 2018 to August 2024 in the mobile mammography unit 55.246 women were examined, 2826 women had a positive result (according to BIRADS classification) and were referred for additional diagnostic procedures. A total of 109 cancers were histopathologically confirmed. Conclusions: Activities from organized screening and mobile mammography unit enable early detection and treatment of breast cancer in women who have no symptoms. By treating breast cancer costs are reduced, the prognosis of the outcome of this disease is better, and the quality of life of affected women is preserved.
Urine culture results correlated with urine sediment tests
Authors: Stanković-Nedeljković Nataša , Branković Srbobran , Turk Ana
Published: October 2024

Aim: Urinary tract infections are one of the most common reasons for visiting a doctor, but also one of the most common reasons for the use of antibiotics. Methods: Our investigation was conducted in the Department of Microbiological Diagnostics of the Health Center ‚‚Aleksinac‚ in Aleksinac, during 2024. It included urine samples of outpatient and hospital origin. Causes were inoculated on blood agar plates and UTI agar (‚‚HiMedia‚‚) and the sediment of each urine was examined. Bacteria were identified based on cultural and biochemical characteristics, and resistance was determined according to EUCAST standards. Results: During the work, 364 urine samples were examined, 270 samples of women and 74 of men. However, in 26.29% of women, pathogenic bacteria were cultured in a number that is considered relevant, and in 35.1% of men. The largest number of respondents were aged 70 to 79 (25.82%). 42.3% of the samples were sterile, and in 23.9% of the samples more than 2 bacteria were cultured, and those samples were declared inadequate. Cultivation results were correlated with sediment test results in 87.45% of urine. The most commonly cultivated bacteria was E.coli (57%), followed by Enterobacter spp, Enterococuus faecalis, Proteus mirabilis, Klepsiellla spp and others. Our samples were most sensitive to meropenem (97.7%), imipenem (96.1%), piperacillin-tazobactam (96.1%), cefixime (91.17%), amikacin (71.42%) and ceftriaxone ( 71.13%). The sensitivity of E.coli isolates to nitroxoline and fosfomycin was high (98% and 97.8). Discussion: Our results are similar to those of similar studies. Conclusion: Cultivation results are correlated with urine sediment test results in the largest number of subjects. Since the resistance of E. coli to trimethoprim-sulfomethoxazole is 53.3%, trimethoprim-sulfomethoxazole cannot be used routinely in the treatment of infections caused by this bacterium, and checking the sensitivity of E. coli to trimethoprim in a certain area is a recommendation of the Good Practice Guide.
En la cuerda floja
Authors: Guevara Aristizábal Juan Felipe
Published: October 2024

La segunda mitad del siglo xix en Alemania fue testigo de una controversia que dividió el campo de las ciencias. Por un lado, las ciencias de la naturaleza pretendían cercar el dominio de lo empírico a todo aquello que permitiera inferir leyes universales para explicar la realidad. Por otro, las ciencias del espíritu formulaban distintas posturas entre las que se encontraban adaptarse al modelo de las ciencias de la naturaleza o reivindicar un modelo propio y autónomo en el que la experiencia empírica no se agotaba con la metodología de las ciencias de la naturaleza. Un panorama más amplio de esta controversia revela otro tipo de aspectos en la discusión, como son el problema de la unidad de la ciencia y la unidad nacional, el liberalismo como programa político progresista y las alianzas con el capitalismo industrial y la burguesía. Recuperar este entramado denso pone en cuestión el lugar de la experiencia y anima una exploración de uno de los episodios filosóficos en los que la experiencia quedó repartida: la filosofía crítica kantiana. Regresar a las preguntas de Kant antes de separar los dos dominios de la filosofía, el teórico y el práctico, posibilita una reconsideración del carácter limítrofe de la experiencia.
Consequences of increasing greenhouse gas emissions: case study on the impact of the food industry
Authors:   Transilvania University of Brasov, Faculty of Food and Tourism, Street Castelului, no.148, Brasov, Romania, Moja Adelina Ioana , Pădureanu Vasile ,   Transilvania University of Brasov, Faculty of Food and Tourism, Street Castelului, no.148, Brasov, Romania, Canja Cristina ,   Transilvania University of Brasov, Faculty of Food and Tourism, Street Castelului, no.148, Brasov, Romania, Brănescu Geronimo Răducu ,   Transilvania University of Brasov, Faculty of Food and Tourism, Street Castelului, no.148, Brasov, Romania, Calefariu Gavrilă ,   2Transilvania University of Brasov, Faculty of Industrial Engineering and Management, Street Univesitatii, no. 1, Brasov, Romania
Published: October 2024

The global carbon footprint has increased to frightening heights due to rising greenhouse gas emissions, mainly from the energy and industrial sectors, which include the food industry. This case study examines how the industry's carbon emissions have changed over time, highlighting the sector's major environmental impact and the pressing need to implement decarbonization plans. The particularity of the study lies in the analysis of the crucial role that emissions from the food industry play in global emissions. An overview of the global industrial carbon footprint was created through an analysis of carbon emissions data from multiple sources, with a particular focus on the food industry. Since the Industrial Revolution, carbon dioxide emissions have increased dramatically worldwide, reaching a record high of 36.3 billion tons in 2019. With around 23% of global emissions coming from industry, the energy sector is the largest emitter. The main cause of emissions is the use of fossil fuels in heavy industries such as steelmaking, cement, and chemicals; the two largest emitters are China and the United States. Achieving the goals outlined in the Paris Agreement and halting climate change requires reducing carbon emissions from the food industry. The adoption of low-carbon technologies, increased energy efficiency and a shift to cleaner energy sources are essential remedies. The industrial sector needs to decarbonize faster, and this can only be achieved through international cooperation and strong government regulations.
Experiencias en tránsito · Entre el sentir-se y el ser migrante
Authors: Piedrahita Alejandra , Didonet Candice
Published: October 2024

Este relato experiencial nace en el tránsito entre ser participantes y observadoras/participantes en el proyecto TransMigrARTS. Nuestras palabras caminan con experiencias que han sido realizadas desde los talleres “Prácticas del Transitar” en Bogotá en el año de 2022 y “Teatro de Creación aplicada como herramienta para el trabajo social y el entendimiento” en Madrid en el año de 2023.