bluuebunny/crossref_metadata_2025 huggingface dataset:
Análise da assistência obstétrica prestada a gestantes de alto risco no centro obstétrico de um hospital universitário
Authors: Londero Giulliane Ramos , Tonetto Tamiris Leal , Ferreira Bianca Balbueno , Melchior Amanda Francesquet , Braz Melissa Medeiros , Sehnem Graciela Dutra
Published: October 2024

Objetivo: Caracterizar as intervenções obstétricas que gestantes de alto risco são submetidas no centro obstétrico de um hospital universitário. Métodos: Pesquisa de abordagem quantitativa e caráter transversal, com análise de 420 prontuários de gestantes de alto risco que tiveram seu parto realizado entre janeiro e março de 2020 em um hospital universitário do sul do país. Como instrumento para obtenção da coleta de dados foi utilizado um questionário que abordou: dados da gestante, dados da internação, acompanhamento do trabalho de parto, dados do parto, dados do recém-nascido, dados do pós-parto, eventos sentinelas. Resultados: Em relação ao trabalho de parto, 37,14% sofreram algum tipo de indução. A maioria das mulheres foi submetida a um parto cesáreo (62,14%), sendo 82,32% dessas para cesárea eletiva e em 16,98% das que tiveram partos vaginais (37,86%), foi realizado episiotomia. Considerações finais: Este estudo identificou altos índices de intervenções obstétricas, sendo as mais frequentes a episiotomia e a cesariana. Apesar dos grandes avanços feitos na área da obstetrícia, ainda há aspectos a se melhorar, considerando que as boas práticas não são realizadas de modo homogêneo e são registrados os excessos de intervenções durante a assistência.
Analysis of the evolution of infant mortality rates of children residing in the state of rio grande do sul, brazil
Authors: Melchior Cristiane , Zanini Roselaine Ruviaro , Oliveira Mírian
Published: October 2024

Objective: This study aims to highlight the main characteristics and compare the evolution of infant mortality rates in the state of Rio Grande do Sul (RS) through the ARIMA and ARMA methodologies. Method The monthly infant mortality rates of the period of 2000 to 2017 were obtained from the Unified Health System (SUS) Department of Informatics (DATASUS). A descriptive analysis and time series modelling using the ARIMA and ARMA methodologies were carried out and discussed. Results: Cacique Doble, Alto Alegre, and São Valério do Sul were the cities of residence with the highest infant mortality rates for the state of RS in the period. Based on the residual analysis and the AIC and BIC penalizing criteria, a better quality of fit was observed in the ARMA(4,6) model. Conclusion Although the ARMA model presented better quality of fit, the accuracy measurements were lower in the SARIMA model. The proposed methodologies can guide the planning of preventive and educational policies aimed at the risk of a born alive dying during its first year of life.
Prevalência de fraturas por estresse e fatores associados em corredores de rua amadores
Authors: Hexsel Giovana Castro da Silva , Bim Mateus Augusto , Gonzaga Isadora , Martins Rafael , Carminatti Lorival José , Pelegrini Andreia
Published: October 2024

Apesar da prática de exercícios físicos regulares garantir o ganho de múltiplos benefícios à saúde, a literatura aponta que os praticantes de corrida de rua estão suscetíveis ao desenvolvimento de lesões, dentre essas, as fraturas por estresse. Objetivo: investigar a prevalência e os fatores associados a fraturas por estresse em corredores de rua amadores através de um estudo retrospectivo de delineamento transversal. Método: foram investigados 197 corredores de rua amadores com idade de 19 a 76 anos (média de 38,9 ± 10,0 anos) de ambos os sexos, os quais responderam a um questionário autoaplicado via internet. Foram coletadas informações relativas ao sexo, idade, cor da pele, grau de escolaridade, massa corporal, estatura, prova alvo, tempo de prática de corrida, volume e frequência de treinamento, ocorrência de fratura por estresse, histórico de lesões e, para corredoras do sexo feminino, informações sobre o ciclo menstrual. Resultados: a prevalência de fratura por estresse foi de 12,2%, sem diferença entre os sexos. Foi observada maior prevalência de fratura por estresse naqueles que praticam a modalidade acima de 10 anos, com maior volume mensal e maior frequência semanal de treino, que participaram de sete ou mais competições em 2019, que apresentaram lesão anterior à fratura por estresse e que tiveram mais do que duas lesões anteriores à fratura por estresse. Conclusão: Aproximadamente um em cada oito corredores de rua apresentaram fratura por estresse em decorrência da prática da corrida de rua. Maior tempo de prática, volume de treinamento, frequência de competições e lesões anteriores estiveram associados a fraturas por estresse nos corredores.
Atuação dos profissionais da enfermagem na área forense
Authors: Xavier Rangel Vinícius , Morais Marcos Vinícius Freitas , Andrade Heuler Souza
Published: October 2024

Introdução: A Enfermagem Forense é uma área em ascensão na atualidade, porém pouco conhecida e estruturada em alguns países. Demonstra sua importância ao assistir não somente a vítima, mas também ao perpetrador, familiares dos envolvidos e a entidades judiciais. Objetivo: Identificar a atuação dos profissionais de enfermagem na área forense. Método: Trata-se de uma revisão integrativa de literatura, realizada no ano de 2021, que visa analisar dados de produções científicas publicadas anteriormente, interpretá-los e sintetizar conteúdos, englobando as situações encontradas. Como delineamento, usou-se a metodologia CheckList Preferred Reporting Itens for Systematic Review Sand Meta-Analyses.Resultados: Foram selecionados 13 artigos e, a partir da análise destes, elucidou-se cinco categorias de atuação da Enfermagem na área forense: 1) assistência à vítima, 2) assistência ao perpetrador, 3) educação e prevenção, 4) apoio judicial e 5) outras atividades gerais.Considerações Finais: O estudo realizado permitiu uma melhor visão da atuação da Enfermagem na área forense, o que contribui para a conscientização dos profissionais sobre essa dimensão do cuidado.
Análise microbiológica de superfícies inanimadas de Unidades de terapia intensiva em hospital privado e público
Authors: Paula Cristiane Coimbra de , Passos João Pedro Castoldo , Paula Caroline Aquino Vieira de Lamare , Shimoya-Bittencourt Walkiria
Published: October 2024

Objetivo: Analisar microbiologicamente superfícies inanimadas de um hospital público e um privado no município de Cuiabá-MT, e comparar os microrganismos mais encontrados e os respectivos mecanismos de resistência. Método: Estudo observacional do tipo transversal realizado nas Unidades de Terapia Intensiva (UTI). Foram coletadas 24 amostras de cada hospital usando swab stuart, as quais foram semeadas nos meios de cultura ágar chocolate, sangue e o MacConkey e incubadas. Posteriormente depois foi realizado a identificação dos microrganismos e a realização do antibiograma em ágar Mueller hinton. Resultado: No Hospital público foram isolados 21 microrganismos: Pseudomonas aeruginosa (19,1%), Acinetobacter baumannii e Staphylococcus sp coagulase neg. (14,3%), Burkholderia cepacia, Serratia marcescens e a Klebsiella pneumoniae (9,5%), Citrobacter freundii, Escherichia coli, Serratia liquefaciens, Enterobacter aerogenes e a Candida correspondem (4,8%). No Hospital privado foram isolados 30 microrganismos: Pseudomonas aeruginosa (33,3%), Acinetobacter sp. (16,7%), Klebsiella sp. (13,3%), Stenotrhophomonas maltophilia (10%); Serratia marcescens (6,7%), Achomobacter, Citrobacter, Flavobacterium e a Candida sp. (3,3%). Considerações finais: Estas descobertas enfatizam a capacidade das bactérias sobreviverem em superfícies inanimadas hospitalares, representando um risco para os pacientes adquirirem uma infecção hospitalar.
Efeito do cortisol e atividade física na qualidade do sono: uma revisão integrativa
Authors: Silva Leonardo Pereira da , Lima Gustavo de Sá Oliveira , Cunha Tatiana Sousa , Casalli Karina Rabelo , Nascimento Marcos Antonio do
Published: October 2024

Durante o sono, inúmeras respostas fisiológicas são desencadeadas para restabelecimento de componentes corporais vitais à memória. Têm se observado com frequência o aumento exponencial de distúrbios de sono entre os indivíduos em todo o planeta, como consequência disso temos o aumento de comorbidades como obesidade, hipertensão, diabete. Ademais, estudos demonstram que a atividade física regular e a produção de cortisol no corpo humano podem influenciar na qualidade do sono. Com isso, o objetivo desta pesquisa foi analisar as pesquisas científicas atualmente disponíveis sobre o impacto do cortisol e da atividade física na qualidade do sono. Trata-se de uma pesquisa qualitativa, descritiva, desenvolvida a partir de uma revisão integrativa de literatura, realizada em outubro de 2023, por meio de levantamento bibliográfico, utilizando a base PubMed, por meio dos descritores “cortisol”, “sleep” e “physical activity”, combinando-os com o operador booleano “AND”, conforme as diretrizes preconizadas do PRISMA. Ao todo, 21 estudos foram encontrados. Adotaram-se como critérios de inclusão: artigos disponíveis gratuitamente, em texto completo, ensaios clínicos, em inglês, publicados nos últimos 10 anos e que abordassem a temática. Após extensivas análises, apenas 05 trabalhos preencheram todos os critérios de seleção e foram incluídos neste estudo. Os resultados apontam que há relação entre a qualidade do sono, atividade física e efeito do cortisol. Estudos encontrados na literatura refletem sobre a melhora da qualidade do sono com a prática de atividade física, além da redução dos níveis plasmáticos de cortisol. Além disso, observou-se nos estudos outras técnicas (enfermagem) e ferramentas (alimentação) que podem influenciar na qualidade do sono. Dessa forma, os estudos destacam a importância do sono e da atividade física como componentes essenciais da saúde e do bem-estar, com implicações significativas em diferentes populações e condições de saúde, sobretudo hormonal.
Ekonomiczne determinanty popytu na ubezpieczenia na życie – ujęcie regionalne
Authors: Laskowska Iwona
Published: October 2024

Insurance has various functions in the economic and social spheres. Life insurance is a specific type of insurance, offered in the form of individual or group insurance. Research on insurance market at regional level is undertaken relatively rarely. The aim of the study presented in this paper is to identify economic factors determining the level of demand for individual and group life insurance on regional insurance markets. Dynamic econometric models for panel data (GMM estimator) with demand expressed in gross written premium per capita (life insurance density) have been used in the analysis. The research was carried out on the basis of data at voivodship level for the period of 2017–2021 from Statistics Poland and the Polish Financial Supervision Authority. The regression analysis demonstrated that an improving economic situation of the region and households’ growing disposable income positively affected demand for life insurance, while a poor situation on the labor market (indicated by the unemployment rate) had a reverse effect. Individual insurance demand responded stronger to changes in disposable income and the unemployment rate, whereas group insurance demand was more sensitive to changes in the region's economic situation. The level of insurance consumption observed in a given period is determined by that observed in the previous period, which indicates the phenomena occurring on this market are of a relatively stable character.
The Effect of Competence of Conservative Dentist Specialists on Patient Satisfaction with Dental Health Services and Its Relationship to BPJS Patient Loyalty at the Hospital
Authors: Hartini Jeanny Kathleen , Kosasih Kosasih
Published: October 2024

This study examines the influence of the competence of dental conservation specialists on patient satisfaction and its relationship to BPJS patient loyalty in hospitals. The competencies of dental specialists, including technical expertise, deep knowledge, and communication skills, are crucial in delivering high-quality and satisfying dental health services. Patient satisfaction is a key indicator of healthcare success, especially in dental services, where procedures such as root canal therapy and dental restoration require a high level of expertise. This research aims to analyze how the competence of dental conservation specialists impacts patient satisfaction and how this satisfaction influences BPJS patient loyalty.
The research utilizes a qualitative approach with a case study method involving BPJS patients who received dental conservation services in hospitals. Data were collected through semi-structured interviews and questionnaires, focusing on patients' experiences with dental services. The data were analyzed using thematic analysis, identifying key themes related to dentist competence, patient satisfaction, and loyalty. The findings highlight the importance of continuous training for dental conservation specialists in improving patient satisfaction and fostering loyalty to the hospital's services. These efforts will not only enhance the quality of dental care but also support the sustainability of the BPJS program in providing accessible and affordable healthcare.
The Influence Of Compensation, Physical Work Environment, Organizational Climate On Performance With Work Motivation As An Intervening Variable On Workers In DKI Jakarta
Authors: Susanto Mitha , Erdiansyah Rezi
Published: October 2024

This research investigates the relationship between compensation, physical work environment, and organizational climate with the work motivation and performance of labor employees in DKI Jakarta. Using quantitative methods and a cross-sectional descriptive approach, data was collected from 340 respondents via an online questionnaire. The results of analysis using Structural Equation Modeling (SEM) show that the physical work environment and organizational climate have a significant positive influence on employee performance, while compensation does not have a significant influence. However, work motivation is proven to have a significant positive influence on employee performance. These results imply that it is important for companies to pay attention to the physical work environment, organizational climate, and work motivation to improve employee performance. Suggestions for further research include increasing exploration and adding mediating variables.
The Impact of Public Health on Health Education
Authors:   School of Natural and Applied Sciences Kampala International University Uganda, Mugo Moses H.
Published: October 2024

Public health and health education are interconnected professions, with public health providing the framework for effective health education. This study examines the historical history of public health, important principles that characterize the relationship between public health and health education, and the role public health plays in developing educational programs. By evaluating previous and present public health initiatives, the report emphasizes the importance of health education in improving community well-being. Furthermore, this analysis uses case studies to highlight how public health policies can influence and improve the effectiveness of health education methods. Finally, this study emphasizes that the effectiveness of health education initiatives is dependant on their alignment with public health principles, which allows for the development of evidence-based programs that target specific community needs. Keywords: Public health, health education, community well-being, health promotion, disease prevention
The Impact of Public Health on Health Monitoring
Authors:   School of Natural and Applied Sciences Kampala International University Uganda, Wambui Kibibi J.
Published: October 2024

The relationship between public health and health monitoring has evolved significantly, shaped by historical developments, technological advancements, and changing societal needs. This paper examines the mutual influence of public health initiatives and health-monitoring systems, particularly in the context of late 20th-century England. The historical perspective highlights the role of public health efforts in establishing systematic health monitoring, which was critical for addressing widespread health issues. Key public health concepts and their implications for health monitoring are discussed, followed by an exploration of modern technological advancements, such as mobile health applications and wearable devices, which have transformed personal and population health management. Finally, the paper considers challenges and future directions, focusing on ethical concerns, the role of big data, and the need for integrated global health strategies. The paper argues that public health and health monitoring are increasingly interdependent, with advancements in health monitoring playing a vital role in shaping the future of public health. Keywords: Public health, Health monitoring, Technological advancements, Health surveillance, Wearable devices.
The matrix of burden of disease metrics for health promotion
Authors: Šantrić-Milićević Milena
Published: October 2024

Background: The field of health promotion aspires to move beyond the conventional biomedical approach and consider a broader range of social and environmental interventions. This shift acknowledges the crucial influence of social and economic determinants on health and emphasizes the interconnectedness of the health of individuals, animals, and ecosystems. Methods and Objectives: This review provides a cross-conceptual analysis of health promotion and the burden of diseases by aligning the scope with relevant indicators. It underscores the importance of considering intersectoral enablers to effectively identify, measure, assess, prioritize, and financially support appropriate health promotion actions in countries. Results: Matrices of various indicators are used to strengthen health promotion interventions targeting various risk factors, disease prevention and adverse health events. For instance, a significant focus on disease prevention within the realm of health promotion is evident in initiatives such as the European Commission's launch of Healthier Together and the implementation of the EU4Health Programme. Over the past two decades, many actors have created multiple sets of indicators to assess the health conditions of various populations. Some of these actors include UNICEF, which supports multi-indicator cluster surveys; the World Health Organization, which produces world health statistics reports; the United States Agency for International Development, which conducts demographic and health surveys; and the IHME-led Global Burden of Disease studies. The burden of disease matrix of metrics is used to cover trends and drivers of 359 diseases and injuries worldwide. Having matrices of indicators helps hold policymakers and their organizations accountable for health promotion as well. Conclusions: Health metrics play a pivotal role in shedding light on health challenges and contributing to fostering a more objective and accountable approach to policy-making in health promotion. The burden of disease metrics matrix can be used to facilitate the development of a credible national health information system for health promotion goals and targets.
The return of whooping cough: The experience of the Center for Microbiology of the Institute of Public Health of Serbia
Authors: Pavlović Ljiljana , Grego Edita , Pavlović Jovan , Dacić Slavica , Mitrović Tamara , Gospodinović Hristina , Ljubičić Miljan
Published: October 2024

Background: The development of a highly effective whooping cough vaccine in the 1940s led to a decline in the number of cases. In the 1980s, researchers in Japan discovered an acellular vaccine. Nowdays, the number of cases of whooping cough in the world is increasing again. During 2023 and the first half of 2024, an increase in the number of whooping cough lab cases was registered in the Center for Microbiology at the Institute of Public Health of Serbia. Methods and Objectives: Serum or nasopharyngeal swabs of the patients were sampled either at the Batut Institute, or they were sampled at other health institutions from Belgrade and Serbia, with the exception of Vojvodina, and delivered in a transport container to the Batut Institute. DNA was extracted from each sample using the MagMAX Viral/Pathogen kit. The presence of B. pertussis was determined using two PCR assays, VIASURE Bordetella Real Time PCR Detection Kit and Bosphore B. pertussis/parapertussis Genotyping Kit, Anatolia Geneworks. Detection of IgG antibodies to Bordetella pertussis toxin was performed by ELISA method using tests manufactured by Euroimmun, PerkinElmer Germany Diagnostics GmbH. Results: Of the 1163 laboratory-detected positive results, 594 (51.1%) were detected serologically, while 569 (48.9%) were detected using the RT-PCR method. The largest number of samples was from the Belgrade region (928), followed by the South and Eastern Serbia regions (135) and the Sumadija and Western Serbia regions (77). The largest number of lab cases was in the age groups of 10-14 years (454), 15-19 years (224), over 20 years (217) and in children under one year of age (158). Conclusions: The reasons for the re-emergence may be: less effective long-term protection declining immunization coverage, asymptomatic transmission in adolescents and adults, genetic modifications of B. pertussis, increased awareness of the disease, and more readily available laboratory diagnostics.
The 2020 estimates of men having sex with men prevalence in Belgrade, Novi Sad, Kragujevac and Niš, Serbia
Authors: Simić Danijela , Baroš Slađana , Milosavljević Zoran
Published: October 2024

Background: Epidemic potential is influenced by a combination of the HIV prevalence, the size of the population at risk, and quantified risk. In Serbia HIV epidemic is concentrated among men who have sex with men (MSM). While Serbia has existing data on HIV prevalence, new estimates for the size of the MSM population were needed, using the same methodology as previous studies for comparison. Methods and Objectives: To estimate the MSM population size in Belgrade, Novi Sad, Kragujevac, and Niš in 2020, we used the classic multiplier method, an indirect estimation technique. This method involves combining data from two independent sources that overlap in the known way: survey data (proportion of respondents aged 18-49 who used specific services in a certain time and location) and benchmark data (number of MSM aged 18-49 receiving: a) prevention services in community, obtained from the national HIV database, and b) voluntary counselling and testing (VCT) services in Belgrade and Novi Sad obtained from national VCT database). Results: In Belgrade, the 2020 MSM prevalence estimate was approximately 17,000, double the estimates from 2012, 2011, and 2009/2010 (7,000 to 9,000) when applying prevention services in community as benchmark. Estimates for community-based HIV testing in Belgrade were higher for 2020, as well as for the previous years applying HIV testing in Institute for Students Health Care in Belgrade as benchmark (17,000 vs. around 3,000). In Novi Sad, the 2020 estimate applying prevention services in community was 5,442, higher than in 2012 (3,863) but lower than in 2011 and 2009 (8,721 and 8,335). In Kragujevac, the 2020 estimate applying prevention services in community was 3,632, lower than in 2012 (4,483). In Niš, the 2020 estimate applying prevention services in community was higher than the community-based HIV testing estimate (3,556 vs. 2,052). The most reliable 2020 estimates using the multiplier method were: for Belgrade -17,000 MSM aged 18-49 (4.7% of the total male population aged 18-49); for Novi Sad: 5,442 MSM aged 18-49 (6.8%); for Kragujevac: 3,632 MSM aged 18-49 (10%); for Niš: 3,556 MSM aged 18-49 (6.6%). Conclusions: Multiple estimation methods and repeated measurements using the same methodology are necessary for verification and validation of results. A consensus among relevant actors is required to determine the best estimate of the MSM population size in Serbia.
Stages and types of lung cancers in the pilot lung cancer screening program in Vojodina, Serbia
Authors: Đekić-Malbaša Jelena , Kovačević Tomi , Zarić Bojan , Stojanović Goran , Stojšić Vladimir , Simurdić Petar
Published: October 2024

Background: Lung cancer (LC) screening with LDCT reduces LC mortality by 20% due to detection in the early stage of the disease. The aim was to analyze LC stages, histological types, and demographic characteristics of LC patients in the pilot LC screening program in Vojvodina from October 2020 to July 2024. Objectives and Methods: Persons aged 50-74 years, with a smoking history of 30 pack-years or more or 20 pack-years with additional risks (COPD, prior pneumonia, other malignancy, LC hereditary history) underwent LDCT evaluation. Radiological assessment and further evaluation were done per Lung RADS score. Results: During the observed period, a total of 9,006 LDCT scans were performed on 5,483 screen participants. The majority were females (58.2%). Prevalence of Lung RADS scores 0, 1, 2, 3, 4A, 4B and 4X were respectively 1.0%, 41.0%, 40.5%, 7.8%, 6.5%, 1.1% and 2.0%. The total number of patients with malignancy was 108, and the LC detection rate was 1.8%. From a total number of LC, 54.4% were detected among males. The average age of LC patients was 66 years (65.79±8.97), with no observed differences by gender (p=0.218). Percentage of LC by stage I, II, IIIA, IIIB and IV were respectively 48.5%, 12.6%, 8.7%, 10.7%, and 19.4%. From 2021 to 2024 percentage of LC stage I by years was 31.8%, 48.0%, 54.5% and 58.3%, respectively. Among LC types, 86.3% were NSCLC (adenocarcinoma 52.4%, squamous cell carcinoma 25.2%, NOS 8.7%), 9.7% were SCLC, and 3.9% other types. Conclusion: Lung RADS score positive results were found in 9.6% of screening participants. 61.7% of LCs detected in screening were in the I and II stages.
Interactive visualization of national health statistics: Development of an interactive dashboard
Authors: Medarević Aleksandar , Grujić Danijela , Tomašević Slobodanka , Ilić Nikola
Published: October 2024

Visual analytics is a multidisciplinary field that involves using visual interfaces to facilitate analytical reasoning. Interactive visualization, a specific approach within visual analytics, refers to computational tools that store, process, and visually represent data, enabling users to explore the data interactively. This interactive nature of visualization enhances the potential for utilizing collected healthcare data and involves users in activities such as sense-making, knowledge discovery, and hypothesis generation, making them an active part of the process. Since 2020, interactive visualization has become the standard for producers of health statistics, ensuring that the audience feels engaged and involved through numerous dashboards and interactive tools. The Institute for Public Health of Serbia has created an interactive dashboard using the user-friendly Microsoft Power BI cloud-based tool. The dashboard aims to offer comprehensive and readily accessible information to both professionals and the general public, ensuring a comfortable and easy user experience. As part of the Microsoft Office suite, Power BI follows principles similar to those of other programs in the package. It requires minimal DAX language coding in application development, making it particularly accessible and easy for public health workers. The Health for All family of databases, created by the World Health Organization, has been used since 2000 and includes the following indicator groups: demography and other socio-economic indicators, mortality, morbidity, lifestyles, environment, health resources, use of health services, and maternal and child health. The data is available for regional, national, and European Union levels as a reference. The information is presented through summary tables, time trends, maps, and a data dictionary. The application is bilingual in Serbian and English, making it accessible to a broad audience. The cloud-based tool allows access from computers, laptops, and smartphones. It provides interactive presentations and report creation through a Web browser without installing additional software.
Willingness of medical students to be subjects in vaccine trials
Authors: Sič Aleksandar , Gazibara Tatjana
Published: October 2024

Background: Field trials of new vaccines are essential to enhance generalizable knowledge and offer potential novel solutions for the prevention and control of communicable diseases. Thus far, evidence regarding medical students' attitudes as participants in vaccine trials is scarce. The purpose of this study was to evaluate the interest of medical students towards participation as volunteer subjects in vaccine trials. Methods: Medical students in years 4, 5 and 6 (clinical training) at the University of Belgrade participated in a cross-sectional study. Data collection using a PEN-and-paper questionnaire was carried out from October to December 2023. Students were asked about demographic characteristics, health status, previous volunteering experience and blood donation and willingness to participate in vaccine trials graded on a Likert-type scale: 1-never, 2-probably not (negative responses), 3-unsure/ undecided, 4-probably yes and 5-surely yes (positive responses). Adjusted linear regression and logistic regression were used to analyze data. Results: Out of 297 participants (females 66.7%; average age 24.1±1.7), 21 students (7.1%) responded positively. Most students had negative opinion about participation (166, 56.1%), while others were undecided. The adjusted regression models showed that being younger (B=-0.07, 95% confidence interval [CI] -0.13, -0.01; p=0.019), having chronic illnesses (odds ratio [OR]=4.86, 95CI 1.69-13.96; p=0.003) and having been blood donor before (B=0.25, 95%CI 0.04, 0.046; p=0.020) were independently associated with being willing to participate in vaccine trials as research subjects. Conclusion: Few students were willing to be volunteer subjects in vaccine trials. Our findings suggest that students who are blood donors and who have chronic illnesses were more willing to participate in vaccine trials as subjects. The promotion of blood donation could help enhance the response of medical students to participate in vaccine trials.
Examining the relationship between cigarette smoking habit and psychosocial factors of students
Authors: Mačkaški Aleksandra , Višnjić Aleksandar , Vojinov Nikola , Ristić Saša
Published: October 2024

Backround: Smoking cigarettes is still a risk factor and a preventable cause of morbidity and mortality worldwide. Previous research revealed that family and peer relationships amongst other psychosocial risk factors, play a vital role in the initiation and level of tobacco use. Objectives and Methods: This study aimed to examine the relationship between smoking and psychosocial factors within the Serbian group and the English group of medical students, and the influence of peer and family members' smoking habits, individual beliefs and attitudes, as factors explaining the similarities and differences of smoking behaviour among those study groups. This study was conducted among 103 medical students at the University of Niš (Serbia). The data was collected through an online Google form survey. Survey responses were used to determine social and personal traits of the individual including Smoking Habits and status, and reasons for smoking or not smoking. Statistical analysis was performed using IBM SPSS Statistics (version 18.0). Results: There were significantly more smokers among the Serbian medical students compared to English students (ch2=5.720; p<0.001). A higher number of Serbian students use smoking as a defence mechanism against stress and anxiety (ch2=8.189; p=0.004). Additionally, the presence of peer and parental smoking was strongly associated with smoking susceptibility among Serbian students. English students are less likely to smoke under societal influence compared to Serbian students (ch2=13.004; p=0.011). Conclusion: The findings illustrate that there were significant differences in smoking behaviours and psychosocial influences between Serbian and English students thus health education, programs and policies associated with cigarette smoking need to be culturally sensitive and tailored based on these psychosocial factors.
Challenges in rare diseases: The example of mitochondrial diseases
Authors: Novaković Ivana , Janković Milena , Marjanović Ana , Branković Marija , Svetel Marina , Jančić Jasna
Published: October 2024

Background: Mitochondrial diseases are a group of disorders caused by dysfunction of mitochondria - the organelles that generate energy for the cell by converting the energy of food molecules into the ATP that powers most cell functions. Mitochondrial diseases are one of the most common groups of rare diseases with a minimum prevalence of greater than 1 in 5000 in adults. Clinical manifestations of mitochondrial diseases are heterogonous, mostly affecting nervous and muscle systems and sensory organs; symptoms can appear at birth or they may not appear until adulthood These diseases have genetic basis, and could be caused by mutations in nuclear genes, as well as by mutations in mitochondrial DNA (mtDNA) - small, maternally inherited, DNA molecule. An additional aspect of their genetic complexity is given by phenomenon of mtDNA heteroplasmy. Having all this in mind, the detection of the causative gene mutation is of crucial importance for diagnostics and further management of mitochondrial diseases. In addition, development of new therapeutic strategies is based on best knowledge ate genomic level. Methods and objectives: Genetic analyses were performed at patients suspect with mitochondrial diseases in order to detect causative gene mutations. Applied methods were targeted sequencing of mtDNA and clinical exome analysis by next generation sequencing. Results: In this report we will present our experience with genetic testing of mitochondrial diseases, challenges in genetic counselling, and possible new therapeutic options in mitochondrial diseases. Conclusion: Modern management of mitochondrial diseases is based on their genetic diagnostics. Contemporary algorithms and guidelines should be applied in this field of rare diseases.
Molecular detection of Bordatella pertussis during the June 2023 to June 2024 epidemic
Authors: Simić Nataša , Ivanović Milica , Ivanović Jovana , Čabrilo Maja , Gospodinović Hristina , Grego Edita
Published: October 2024

Background: Whooping cough is an acute infectious disease caused by the Bordetella pertussis bacteria. Increase in the number of infections caused by this bacterium has been noticed in many countries, even in those with high vaccination rates. Proper diagnostics are crucial for adequate treatment and prevention of further spreading of infection. Methods andObjectives: 2285 nasopharyngeal swabs have been analyzed. All samples were collected in COPAN eSwab media. Sampling was carried out at the Institute of Public Health of Serbia "Dr Milan Jovanović Batut, health centers and hospitals. VIASURE Bordetella Real Time PCR Detection Kit (CerTest Biotec), B.pertussis/parapertussis Genotyping Kit (Anatolia geneworks) (detecting the IS481 insertion sequence region), as well as RealBest DNA Bordetella species/Bordetella pertussis/ Bordetella bronchiseptica Kit (Vector Best) (detecting 16S rRNA and FIM3 genes) have been used. The aim of this study is an overview of the results obtained using molecular tests of three different manufacturers during the epidemic in the period June 2023-June 2024. Results: By analyzing 2285 samples, using the mentioned tests, it was observed that 25.4% of the samples were positive. The largest number of patients was tested in December 2023, with 29% of positive cases detected. Conclusions: Real time PCR tests for Bordetella pertussis enable time-efficient and reliable diagnosis, which is of great importance in conditions of increased number of samples. Increased sensitivity and speed of analysis are crucial for patients with borderline positive values, but also for unvaccinated and newborns, for whom infection can have a lethal effect.
Detection of high-risk HPV genotypes by the RT-PCR method on the territory of Belgrade (Cctober 2022-October 2023)
Authors: Ivanović Milica , Simić Nataša , Ivanović Jovana , Čabrilo Maja , Gospodinović Hristina , Grego Edita
Published: October 2024

Background: Human papillomavirus (HPV) is a small DNA virus, from the family Papillomaviridae and genus Papillomavirus. The genome is a circular, double-stranded DNA. Over 200 HPV genotypes, that can infect humans, have been identified so far. They are usually transmitted through sexual contact. Based on the consequences they can have on humans, we can classify them into low-risk and high-risk genotypes. High-risk HPV genotypes are also classified as carcinogens, because they cause cancers of the cervix, penis, anus, vagina and oropharynx. Methods and Objectives: 2154 cervical and urethral swabs have been analyzed. Sampling was carried out at the Institute for Student Health Care and at the Institute of Public Health of Serbia "Dr Milan Jovanović Batut". Samples were collected in Amies (COPAN Diagnostics, Inc.) medium. The molecular method used for detection has been Real Time PCR, and the diagnostic test Viasure High-Risk Human Papillomavirus (CerTest Biotec, S.L.). The aim of the paper is to highlight the role and importance of the RT-PCR method in the diagnostics of high-risk HPV genotypes, as well as the consequences of infection with this virus. Results: Of the 2154 samples tested, 715 (33%) gave a positive result. Of the 715 positives, 384 were samples from the Institute for Student Health Care. Most frequently detected were HPV genotype 16 (21%) and HPV genotypes from a group (31, 39, 56) (32%). Conclusions: HPV represents one of the most significant and complex targets in molecular diagnostics. The importance of diagnostics stems from its direct connection with the development of cancer. The RT-PCR method is extremely effective in the diagnostics of HPV due to the speed of analysis and the sensitivity of the tests.
Patronage services in primary health care centers and coverage of different population groups in Serbia during period of five years (2018 to 2022)
Authors: Dukić Danijela , Damjanović Ana , Đurić Petar , Bukumirić Dragica
Published: October 2024

Background: In everyday life, it is considered that patronage services are delivered only to newborns and women who had given birth. Ministry of Health and Health Insurance Fund (HIF) regulated, that patronage should deliver services at least once a year, to small children at second and fourth year of life, pregnant women, women with high risk pregnancy if it is indicated by their gynecologist, as well as to adult population (19+) if it is indicated by their general practitioner including elderly people (65+) and persons with invalidity. This study aimed to analyze coverage of different age population groups in Serbia, with patronage preventive services in the Primary health care centers (PHCC) from 2018 to 2022. Methods: We used data obtained from HIF, as reports of patronage services from 2018 to 2022, through invoiced realization of health services of all primary health care centers in Serbia. Results: Data from five years (2018-2022) shows that newborns (including their mothers) as well as women with high risk pregnancy had the highest coverage by patronage services. For newborns those data ranged from 86% in 2018 to 97% in 2022, and for women with high risk pregnancy those data ranged from 92% in 2018 to 72% in 2022. Among other population groups, it is noticeable that adults (19+) and elderly people (65+) are less covered by patronage services. Those data showed that for elderly people (65+) coverage was less than 20%, while for adults (19+) was less than 10% in observed five years period. As we don't know the number of persons with invalidity, we couldn't analyze coverage of that group by patronage services. Conclusions: If we exclude newborns and women who had given birth as well as women with high risk pregnancy, other population groups are not sufficiently covered by patronage services.
Evaluation of burden on the capacity of the mental health care system in Serbia due to the leading causes of hospitalization, 2021-2023
Authors: Đuric Petar , Atanasijević Dragana
Published: October 2024

Background: Many mental disorders require hospital care (HC) and long-term care (LTC), while in their stable presentation, they can be treated in outpatient care (OC) settings. In light of the Serbian system's transition towards community-based mental health care, this study aimed to determine the extent of the system's burden by schizophrenia, depression and psychoses, which require hospitalization and how LTC and to what extent OC services relieve them. Methods and Objectives: We used data on the number of patients, hospital days (HD) and the episodes of hospital treatment, aggregated based on the diagnostic groups (DGs): F23-29: Psychoses, F20-21: Schizophrenia and F32-33: Depression, according to the International Classification of Diseases, Tenth Revision, for 2021-2023 in Serbian hospitals. Results: In the 2021-2023 period, among patients with psychoses, an increasing number of LTC days spent and its share in the total HD for the specified DG [(2021, 2022, 2023: 21.1; 22.0; 23.2), %] was observed. Patients with schizophrenia spent the highest number of HDs in the LTC setting, with a growing share of the total time spent in LTC [(2021, 2022, 2023: 17.3; 18.7; 18,5), %]. Compared to psychoses and schizophrenia, patients with depression spent a higher proportion of days in OC settings, with an increase in the observed period [(2021, 2022, 2023: 16.1; 18.3; 18.6), %]. At the same time, patients with depression had a higher number of treatment episodes in the OC per person than other DGs, with an annual increase (p<0.05). Conclusions: To be able to more efficiently monitor and more clearly interpret the performance of the mental health care system in Serbia, more detailed analyses of individual data are necessary, as well as the implementation of new indicators that would monitor the relationship between interventions and health outcomes at the individual and population level.
Factors related to unmet dental health care needs in the Republic of Serbia in 2019: A cross-sectional analysis
Authors: Jakovljević Milena , Matejić Bojana , Ćirković Anđa
Published: October 2024

Background: Ensuring timely and equal access to quality dental health care is an important public health issue. This study provides insight into significant individual factors associated with unmet dental health needs in Serbia in 2019. Method: The study is a secondary analysis of data from Survey of income and living conditions 2019, conducted as a cross-sectional study on a sample of 13,733 respondents aged 16+ (source: Statistical Office of the Republic of Serbia). The outcome variable is self-reported unmet need for dentist's service during last 12 months. Multivariate logistic regression is used to identify factors significantly related to unmet needs. Demographic, socioeconomic factors and health status, which have been found to be significant for outcome in univariate logistic regression, have been entered in final analysis. Results: Sex, age, educational level, marital, employment status, income and health status were shown to be significant factors for unmet needs. Compared to men, women were less likely to report unmet need, OR=0.7(CI=0.7-0.8). Compared to 16-24 age group, aged 45-64 had higher odds for unmet need, OR=1.7(CI=1.3-2.4), as well as 65+ age group, OR=1.5(CI=1.0-2.2). Those with master's/ PhD degrees, OR=0.2(CI=0.1-0.5), postsecondary, OR=0.4(CI=0.3-0.5), and secondary educational level, OR=0.6(CI=0.5-0.7), were less likely to report unmet need than the least educated group. Separated/divorced had higher odds for unmet needs than married ones, OR=1.4(CI=1.1-1.7); as well as unemployed than employed, OR=1.2(CI=1.0-1.4). Fewer odds were proven for pupils/ students, OR=0.2(CI=0.1-0.4), and retirees, OR=0.6(CI=0.5-0.8). Those from 5th quintile, based on equalized disposable household income, were less likely to report unmet need compared to the 1st quintile, OR=0.4(CI=0.3-0.5). A gradient across all quintiles was proven (for 4th quintile OR=0.5(CI=0.4-0.6), for 3rd OR=0.6(CI=0.5-0.7), for 2nd OR=0.7(CI=0.6-0.9)). Compared to participants with very good/good health, those who perceive own health as very poor/poor had 2.2 times higher odds (CI=1.8-2.6) to report unmet need; for those with average health OR was 1.9 (CI=1.6-2.2). Suffering from chronic illness increases odds 1.5 times (CI=1.3-1.7). Conclusion: The highest probability for unmet dental needs was established across most vulnerable groups. It is necessary to address these inequalities in future strategic and operational documents focused on oral health of population.
The importance of a multidisciplinary approach in the fight against MDRO
Authors: Mioljević Vesna , Stevanović Goran , Damnjanović Biljana , Barać Aleksandra , Jovanović Snežana , Glidžić-Pakenham Martina , Rajinac Dragana , Vrućinić-Kozić Jelena
Published: October 2024

Introduction: The emergence of organisms resistant to multiple antibiotics (MDRO) is a major public health problem in the twenty-first century in all countries of the world. The emergence of MDRO limits the possibilities of adequate antimicrobial treatment of infections and increases morbidity, mortality and healthcare costs in healthcare institutions worldwide. Numerous studies indicate a significant association between the level of antibiotic consumption and the frequency of antibiotic resistance. According to data from the Center for Disease Control and Prevention (SDS) from 2019, 2.8 million infections and 32,000 deaths caused by pathogens resistant to antimicrobial drugs are registered every year. In addition, the World Health Organization (WHO) has approved guidelines for the monitoring and assessment of emerging antimicrobial resistance. The European Center for Disease Prevention and Control (ECDC) estimates that nearly 9 million nosocomial infections (or healthcare-associated infections) occur each year in European hospitals alone, with 1/3 of these infections caused by antimicrobial-resistant pathogens. Objective: The objective of the paper is to point out the importance of a multidisciplinary approach in the fight against antimicrobial resistance. Methodology: WHO Organization Antimicrobial Resistance Division https://www.who.int/ antimicrobial-resistance/en/; CDC Training on Antibiotic Stewardship; Antimicrobial stewardship interventions: a practical guide (WHO Regional Office for Europe, 2021). We searched PubMed to identify eligible systematic reviews from 2015 to May 2023. Results: Antimicrobial stewardship programs (ASP) are instrumental and crucial in the fight against antimicrobial resistance. ASP is effective in the fight against the growing resistance of pathogens to antimicrobial drugs. Due to the importance of the problem of resistance of pathogens to antimicrobial drugs, a multidisciplinary approach to solving the problem of AMR is necessary, in which doctors of various specialties participate (infectologist, anesthesiologist, surgeon, microbiologist, epidemiologist, clinical pharmacologist... ). These activities are necessary for the purpose of reducing antimicrobial resistance, reducing healthcare-related infections and reducing treatment costs, with an emphasis on a multidisciplinary approach in solving this major global public health problem. Conclusion: Approaches to the prevention and control of MDRO need to be adapted to the specific needs of each population and individual institution. Prevention and control of MDRO is a national priority - a priority that requires all health institutions and agencies to undertake appropriate activities. A multidisciplinary approach to solving the growing resistance to antimicrobial drugs is of great importance in solving this major global public health problem.