bluuebunny/crossref_metadata_2025 huggingface dataset:
LEARNING PATTERNS OF THE CHARACTER EDUCATION IN VIDYA DHARMA BUDDHIST KINDERGARTEN
Authors: Sati Beta Widina , Dewi Sukhitta , Kiryono Kiryono
Published: October 2024

Penelitian ini bertujuan untuk mendeskripsikan peran guru dalam pembelajaran pendidikan karakter dan pola pembelajaran pendidikan karakter di TK Buddhis Vidya Dharma. Penelitian ini menggunakan pendekatan deskriptif kualitatif.  Subjek dalam penelitian ini adalah guru di TK Buddhis Vidya Dharma dan orang tua siswa sebagai data tambahan. Data dikumpulkan melalui metode observasi, wawancara, dan dokumentasi. Data-data hasil penelitian diuji kembali menggunakan keabsahan data dengan menggunakan triangulasi. Hasil penelitian ini menunjukkan Peran guru dalam pembelajaran pendidikan karakter yaitu proses guru dalam mengajar anak agar memiliki karakter yang baik. Guru juga menjelaskan dan memberikan pemahaman kepada anak tentang perilaku baik yang harus dilakukan seperti mengajarkan anak baris-berbaris sebelum masuk kelas, membimbing anak dalam belajar menulis dan mewarnai, melatih anak untuk selalu berdoa sebelum dan sesudah belajar maupun makan, dan mengajarkan anak untuk selalu berbagi kepada anak dan saling tolong menolong. Pola pembelajaran pendidikan karakter di TK Buddhis Vidya Dharma yaitu cara guru mengajar dan merancang pembelajaran. Guru mengajarkan hal-hal baik salah satunya tentang kemandirian dan sopan santun seperti mengajarkan anak berkreativitas dengan membuat kincir angin selain itu guru juga mengajarkan untuk dapat membedakan sebuah gambar. Kegiatan pembelajaran tersebut tetap sesuai dengan tema dan mengacu tujuan pembelajaran.
THE DHAMMAYUTTIKA NIKĀYA (MAHĀYIN GAING) IN MON STATE, MYANMAR
Authors: Obhāsa Ven.
Published: October 2024

This research aims to critically examine the historical background of Dhammayuttika Nikāya in Mon State, Myanmar, and its impact in Buddhism there. The Dhammayuttika Nikāya was founded by King Mongkut of Thailand in the 19th century and expanded under King Chulalongkorn’s reforms, which led to regional resistance in Northern and Northeastern Thailand. The Nikāya also spread to Cambodia and Myanmar. In Myanmar, the Dhammayuttika Nikāya, known locally as the Mahāyin Gaing, was established in 1874 with minimal resistance. This research examines the lineage of the Nikāya's leaders, their ordination practices, and their monastic education. It further explores the social and historical connections between the Dhammayuttika Nikāya and other Nikāyas, and assesses the impact of the Dhammayuttika Nikāya's Buddhist text recitation ceremonies and the Chaungzon monastic examination. Employing a qualitative methodology with a library approach, this study analyzes primary sources such as Buddhist scriptures and secondary sources including scholarly writings, journals and articles, to show the Dhammayuttika Nikāya's contributions for propagation of Buddhism. This research contributes an in-depth understanding on the historical background and impacts of the Dhammayuttika Nikāya or Mahāyin Gaing in Mon State of Myanmar.
Asymptotic behavior of eigenvalues of fourth-order differential operators with spectral parameter in the boundary conditions
Authors: Polyakov Dmitry M.
Published: October 2024

We consider a spectral problem for a fourth-order differential equation with spectral parameter dependent boundary conditions. We determine the high  energy eigenvalue behavior for this operator. Moreover, if the coefficient of  differential equation is sufficiently smooth, we can obtain sharp eigenvalue  asymptotic behavior. This behavior exhibits a non-standard high-frequency  effect generated by the spectral parameter in the boundary conditions. 
For more information see https://ejde.math.txstate.edu/Volumes/2024/62/abstr.html
Educação em saúde para alta nas Unidades de Terapia intensiva Pediátrica e Neonatal
Authors: Ricci Tatiana Souza de Castro Silva , Damaceno Daniela Garcia , Marin Maria José Sanches , Moraes Magali Aparecida Alves de , Rocha Junior Paulo Roberto
Published: October 2024

Com os avanços na Medicina Intensiva houve um aumento na sobrevida das crianças com alguma necessidade especial. Os princípios do Sistema Único de Saúde e as Políticas Nacionais de Humanização propõem estratégias que objetivam a melhora da assistência, como a Educação em Saúde com os pais e familiares. O presente trabalho objetivou analisar as principais estratégias utilizadas no processo de Educação em saúde visando à alta hospitalar nos ambientes da Unidade de Terapia Intensiva Pediátrica (UTIP) e Unidade de Terapia Intensiva Neonatal (UTIN) e suas contribuições. Foi utilizada, para tanto, a Revisão Integrativa da Literatura composta de seis etapas: 1) elaboração da pergunta da pesquisa: Quais as principais estratégias utilizadas no processo de Educação em saúde visando à alta hospitalar nos ambientes da UTIP e UTIN e suas contribuições?; 2) definição das bases de dados: LILACS, MEDLINE, CINAHL, Web of Science, Scopus and SciELO. Vinte e dois artigos compuseram a amostra final, após a aplicação dos critérios de inclusão e exclusão; 3) coletadas as informações para responder ao objetivo; 4) avaliação dos artigos; 5) interpretação dos resultados: prevalência dos estudos realizados nos Estados Unidos; os participantes foram os pais e profissionais de saúde. Houve uma lacuna de 15 anos entre o primeiro e o segundo estudo, o local de maior pesquisa foi a UTIN e a maioria dos estudos pertenceu ao grau de evidência IV e, 6) conclusão: há escassez de estudos de níveis de evidências mais altos na área da saúde; outras categorias da equipe multidisciplinar devem realizar mais pesquisas com esta abordagem e, há necessidade de sensibilizar outros países e as equipes da UTIP a utilizarem esta prática e publicarem seus resultados.
Relação entre a exposição aos agrotóxicos e a insuficiência renal: uma revisão de literatura
Authors: Carvalho Graziela Társis Araujo , Souza Maria Clara Formolo de , Martins Greici Kelli de Medeiros , Cunha Natalia Veronez da , Agostinetto Lenita
Published: October 2024

Injúria renal aguda (IRA) e doença renal crônica (DRC) são duas entidades associadas a dano estrutural e funcional do rim cuja incidência tem aumentado nos últimos anos, o que tem despertado atenção para possíveis novos fatores de risco e etiologias. Diante da crescente utilização de agrotóxicos no Brasil, uma das hipóteses estudadas é a de que a exposição a estes químicos esteja relacionada ao desenvolvimento de doenças renais. Este estudo objetivou identificar na literatura como é a relação entre a exposição aos agrotóxicos e o desenvolvimento de insuficiência renal. Consiste numa revisão integrativa de artigos científicos publicados no PubMed entre os anos de 2010 e 2020 através dos descritores “insuficiência renal” e “agroquímicos”, de livre acesso na forma completa e pesquisas realizadas em humanos. A partir destes critérios de seleção, foram selecionados 20 artigos científicos, que foram organizados em um quadro de revisão. A análise dos artigos gerou a elaboração de três categorias de discussão: terminologias utilizadas para denominar a doença renal associada a agrotóxicos, dados epidemiológicos relativos à exposição a agrotóxicos como fator de risco para DRC e fisiopatologia do dano renal causado por agrotóxicos. Concluiu-se que os dados são insuficientes para afirmar a associação causal direta entre a exposição aos agrotóxicos e a insuficiência renal, porém, constatou-se que a exposição aos agrotóxicos é um fator desencadeante da doença renal crônica.
Comparação do perfil citopatológico de exames ginecológicos em diferentes planos de saúde
Authors: Carazzo Isadora , Carvalho Fernanda Peruzzolo , Silveira Daniela Augustin , Siqueira Luciano de Oliveira
Published: October 2024

Introdução: o objetivo do presente estudo foi comparar o exame citológico preventivo do colo do útero realizado no Sistema Único de Saúde (SUS) e de pacientes atendidos por diferentes planos de saúde e privados na cidade de Passo Fundo. Métodos: Trata-se de um estudo quantitativo descritivo de corte transversal, em 4.523 laudos de Exames Ginecológicos realizados pelo SUS, pelos planos de saúde e pela rede privada, no ano de 2019, no setor de patologia do Hospital São Vicente de Paulo, da cidade de Passo Fundo – RS. Resultados: Foram analisados 896 coletados pelo SUS, 3.182 por diversos convênios e 445 de forma particular. A inflamação cervicovaginal mais prevalente no SUS foi a Gardnerella mobiluncus, em outros convênios Gardnerella vaginalis assim como no particular. Observando as três diferentes redes de saúde a faixa etária mais atingida pela G. mobiluncus foi de 40 a 49 anos e pela G. vaginalis de 20 a 29 anos assim como na Candida sp. Conclusões: Foi observado que o SUS possui menor escolaridade, esse pode ser o motivo de apresentarem maiores alterações celulares escamosas relatadas pelo exame citológico preventivo, já que pela falta de informação estas procuram realizar o exame somente quando apresentam alguma sintomatologia.
Prevalência de aleitamento materno de crianças atendidas em uma unidade básica de saúde da periferia de uma capital do sul do Brasil
Authors: Cunha Andréia Ferlini da , Bennedetti Luiza Vigne , Zanella Priscila Berti , Santos Bruna Lisboa Mendes dos
Published: October 2024

Objetivos: analisar a taxa de prevalência de aleitamento materno exclusivo (AME) até o sexto mês de idade e o que foi introduzido precocemente na alimentação de crianças. Métodos: Estudo transversal realizado com 30 mães de crianças. Foi realizada coleta dos dados sociodemográficos, sobre o pré-natal e sobre a amamentação e a introdução alimentar durante uma visita domiciliar. Resultados: Das crianças das mães incluídas 17 eram do sexo masculino (56,7%) e a idade das mães apresentou média de 25,5±5,8 anos. Em relação aos dados relacionados ao nascimento das crianças,83,3% fizeram seis ou mais consultas de pré-natal. Quase dois terços das crianças mamaram na primeira hora de vida. A introdução precoce de líquidos antes dos seis meses foi consideravelmente maior do que a introdução precoce de alimentos sólidos (p<0,05), sendo os principais água e outros leites. Em relação ao AME, tanto aos quatro meses de vida quanto aos seis meses, foi encontrada associação significativa positiva com o fato de a criança ter mamado na sua primeira hora de vida (p<0,05). Conclusões: A prevalência de AME até os seis meses de vida da criança foi de apenas 24% uma vez que se teve introdução precoce principalmente de líquidos. A criança ter mamado na primeira hora de vida foi positivo para a manutenção do AME.
Estado nutricional e risco de disfagia em idosos institucionalizados
Authors: Genehr Simone de Souza , Silva Gabriele Dos Anjos Palagi da , Pichini Fernanda dos Santos , Busanello-Stella Angela Ruviaro , Pasqualoto Adriane Schmidt
Published: October 2024

Objetivo: Avaliar e relacionar o estado nutricional e a deglutição, por escores de estimativa de vida em idosos institucionalizados. Métodos: Participaram do estudo 13 idosos do sexo masculino, residentes de uma Instituição de longa permanência.  A amostra foi estratificada em dois grupos de acordo com Índice de Charlson corrigido para idade: alto risco de mortalidade (n=8) e baixo risco de mortalidade (n=5). A média de idade foi de 81,31±7,1 anos. Realizadas avaliações nutricionais (cálculo do Índice de Massa Corporal, mensuração de circunferências abdominal, braço e panturrillha; bioimpedância, miniavaliação alimentar-, força de preensão palmar); avaliação clínica da deglutição e do risco para disfagia. Resultados: O grupo com alto risco de mortalidade apresentou sobrepeso (62,5%), risco para doença cardiovascular pela circunferência abdominal (50%), risco para desnutrição pela miniavaliação alimentar (50%), dinapenia (50%) e risco para disfagia (62,5%). O grupo com baixo risco de mortalidade apresentou sobrepeso (80%), risco para doença cardiovascular (80%); risco para desnutrição (20%) e risco para disfagia (80%). Foi encontrada relação positiva e moderada entre Índice de Charlson e miniavaliação alimentar (r=0,62); negativa e moderada entre miniavaliação alimentar e o risco de disfagia (rho=-0,59) e positiva e moderada entre o risco para disfagia e a força de preensão palmar (rho=0,67). Conclusão: Idosos, independente da estimativa de vida, apresentaram alteração nutricional e risco para disfagia. No entanto, a dinapenia foi prevalente no grupo com alto risco de mortalidade.
Desenvolvimento e avaliação de material educativo sobre abordagens de alimentação complementar
Authors: Pereira Fernanda Marassi Jorge , Gomes Ana Paula Fernandes
Published: October 2024

Objetivo: Desenvolver e avaliar um material educativo sobre abordagens de alimentação complementar. Métodos: Estudo propositivo de delineamento quanti-qualitativo, realizado no período de novembro de 2021 a julho de 2022, em três etapas: 1 - revisão da literatura científica; 2 - elaboração do material; 3 - desenvolvimento do material a partir do grau de concordância de pareceristas e público com uma escala de Likert, analisada com o Índice de Validade de Conteúdo. Resultados: Com base na avaliação dos pareceristas aprimorou-se o material educativo e realizou-se o encaminhamento para avaliação do público. O material educativo foi avaliado com Índice de Validade de Conteúdo Global 0,88 (±0,19) pelos pareceristas, 0,96 (±0,03) pelo público, e 0,94 (±0,04) pela amostra integral. Considerações Finais: O material educativo alcançou Índice de Validade de Conteúdo acima dos parâmetros aceitáveis recomendados, em todos os grupos avaliadores, especialmente no que tange a pertinência e organização das informações.
“He would do nothing in the office”: Work and alienation in cinematic adaptations of Herman Melville’s Bartleby.
Authors: Müeller Alexandra
Published: October 2024

This paper analyzes the representation of the office workplace in filmic adaptations of Melville’s short story “Bartleby, the Scrivener”. Following a brief overview of film adaptations of Melville’s short story, this article will discuss Miro Bilbrough’s (2001) and Gerard Amsellem’s (2013) short films, Andreas Honneths (2010) experimental interpretation as well as Laura Naylor and Kristen Kee’s (2017) stop-motion movie. By, for instance, analyzing how the movies try to replicate the first-person narration, find visual images for Melville’s uncinematic descriptive prose, or underline the thematic importance of writing by incorporating different forms of written text, I will firstly examine techniques of intermedial transposition. Since the filmmakers deploy the setting to reimagine or modernize the story, the set design is to be regarded as an essential part of the adaptation process. Paying particular attention to the usage of space, the visual presentation of physical and metaphorical walls, as well as the utilization of non-human entities as ‘actors,’ I will seek to demonstrate how the movies under study reflect contemporary office environments and dynamics of work culture. Updating the nineteenth-century quills and inkpots to modern office technology, for example, allows the directors to reflect upon how electronic communication can cause or reinforce isolation. Different concepts of alienation serve as an essential theoretical framework for the movies. The adaptations concern themselves with social disconnect, engage in questions of ecological alienation, or focus on a political and socioeconomic interpretation of Bartleby’s passive resistance to productivity and consumption.
The Geopolitical Imaginaries in Moby-Dick; or, The Whale and Hakugei: Legend of the Moby Dick
Authors: Sakuma Mikayo
Published: October 2024

This paper explores the geopolitical imaginaries in Herman Melville’s Moby-Dick; or, The Whale (1851) and in the Japanese science fiction animation titled Hakugei: Legend of the Moby Dick (1997-1999) by the Japanese animation artist Osamu Dezaki. Although it is an adaptation of Moby-Dick, the setting of Hakugei has been creatively changed from the sea to space. In the mid-nineteenth century, when Melville chose the sea as the setting of his quest novel, the sea was inextricably intertwined with the nineteenth-century myth of U.S. expansionism. Melville presents a double vision of imaginary islands in the South Sea and the actual geopolitical relationships between existing transatlantic countries. Yet in the second half of the twentieth century, especially in the wake of Transpacific tensions, the sea as a place of quest among Japanese writers could not be delineated in the same kind of prefigurative language used by Melville, such as by drawing on symbolism. Instead, the animation reflects a Cold War psychology that was prevalent among Japanese after the defeat of World War II. As this paper suggests, Hakugei displays both fear and hope for the geopolitical transformation of the Pacific Rim countries and their future safety by choosing outer space as a site for the fable. It is in this way that the Japanese animator Dezaki draws on Melville’s Moby-Dick as a source text by engaging geopolitics, anti-war psychology, and uneasiness toward expansionism. Melville’s pacifism can be argued for as major transcultural influence, at the very least, driving Hakugei’s anime characterization. In fact, going beyond drawing on certain characters, including Ahab, Dezaki retains Melville’s anxiety over the proximity of creation and destruction in yet another era of increasing concern for world peace.
Pengaruh Corporate Governance terhadap Kinerja Perusahaan dalam Masa Pandemi Covid 19
Authors: Idrus Olivia , Irma Irma , Thohir Wijaya Raden Abdurrohman , Hadiwidjaja Rini Dwiyani , Trisnowati Yanuar
Published: October 2024

Pandemi Covid-19 yang melanda sejak awal tahun 2020 membawa dampak signifikan terhadap berbagai sektor ekonomi, termasuk sektor industri di Indonesia. Pembatasan mobilitas dan kegiatan masyarakat menyebabkan penurunan permintaan serta gangguan dalam rantai pasokan, yang pada akhirnya mempengaruhi kinerja perusahaan. Dalam kondisi yang penuh tantangan ini, tata kelola perusahaan (corporate governance) menjadi faktor krusial dalam menjaga stabilitas dan kinerja perusahaan. Penelitian ini bertujuan untuk menganalisis pengaruh variabel corporate governance yang diukur dengan dewan komisaris, komite audit, dan kualitas audit terhadap kinerja Perusahaan yang diukur dengan TobinsQ dan Altman Z score. Populasi dalam penelitian ini ada perusahaan yang terdaftar di Bursa Efek Indonesia sektor perindustrian dengan total sebanyak 63 perusahaan. Teknik pengambilan sampel dilakukan menggunakan teknik purposive sampling dengan kriteria perusahaan yang terdaftar secara berturut-turut selama tahun 2021 dan 2022 dan menerbitkan laporan keuangan dan laporan tahunan pada periode tahun 2021 dan 2022. Jumlah sampel yang digunakan dalam penelitian adalah 41 perusahaan. Data yang digunakan dalam penelitian ini merupakan data sekunder berupa laporan keuangan dan laporan tahunan yang bersumber pada Bursa Efek Indonesia. Hasil penelitian ini menunjukkan bahwa variabel dewan komisaris yang diukur dengan dimensi jumlah dewan komisaris dan jumlah dewan komisaris independent secara signifikan berpengaruh terhadap kinerja perusahaan, variabel komite audit yang diukur dengan dimensi jumlah komite dan pengalaman komite audit tidak berpengaruh terhadap kinerja perusahaan dan variabel kualitas audit yang diukur dengan big four auditor dan opini audit secara signifikan berpengaruh terhadap kinerja perusahaan.
Transforming health systems: Challenges in times of change
Authors: Bjegović-Mikanović Vesna
Published: October 2024

Background: Health system transformation refers to comprehensive changes aimed at improving the efficiency, quality, equity, and sustainability of healthcare delivery. This transformation can be driven by various factors and often encompasses technological advancements, policy and regulatory changes, economic aspects, innovation in service delivery, and global health challenges. Objectives and Methods: This narrative review aims to comprehend different health system transformation models, drivers of change, and associated outcomes. Its scope focuses on European countries and their diverse population profiles, health status, and environmental, economic, and political contexts. The review covers the building blocks of health systems (governance, service delivery, workforce, information systems, medical products, vaccines, technologies, and financing). It particularly looks at initiatives integrating bottom-up and top-down approaches to system changes. Results: Inspired by the recent policy brief of the European Observatory on Health Systems and Policies titled "Transforming Health Service Delivery: What Can Policy-Makers Do to Drive Change?", this review provides a summary of the evidence, identifying common themes, trends, gaps, and divergences in the literature. The intended changes in the health system models of various European countries often aim to address current challenges, improve efficiency, enhance patient outcomes, and ensure sustainability. The theoretical and practical approaches to health system transformations often fail to emphasize practical steps for achieving higher quality and efficiency of health service delivery, which would be more responsive to demands. Nevertheless, the main themes in the transformation of health systems underline the consumer-centric approach with acknowledgement of human rights and vulnerable groups, universal health coverage, and application of innovative and affordable technologies with "more resources in the right places". Actual literature underlines coordination across primary, secondary, and tertiary care to provide comprehensive services that address the full spectrum of patient needs while also respecting a community-based approach by leveraging health workers and local resources to deliver care, particularly in underserved areas. Conclusions: In an era of rapid technological advancements and shifting demographics, transforming health systems has become critical. Integrating digital health solutions, promoting preventive care, and addressing social determinants of health are essential for long-term success in times of change.
Building integrated epidemiology and National Microbiology Reference Laboratory (NRL) system for infectious disease control in Finland over 40 years
Authors: Ruutu Petri
Published: October 2024

Introduction: According to scientific literature, infectious disease (ID) surveillance by passive, physician notification-based surveillance has low sensitivity. Direct data inputs are required from clinical and reference microbiology to meet the needs of ID public health control programs. Description of developments: The National Public Health Institute (acronym KTL/THL) provided until the 1980s a wide range of clinical microbiology diagnostic services in its regional branches and the central institute. Competition with developing publicly funded hospital clinical microbiology laboratories, together with a strategic decision to change the national institute into a scientific and expert institution led to stopping the clinical microbiology services at KTL/THL. In the early 1990s KTL/THL established infectious disease epidemiology, previously non-existent in the institute, and introduced a digital national surveillance system, based primarily on notifications from clinical microbiology laboratories. Initially vaccination program oriented, the epidemiology service was expanded by early 2000s to cover all ID control programs. By early 2000s, it was obvious that the KTL/THL laboratory units were not coordinated for effective NRL support of ID control programs. The institute's epidemiologists and NRL microbiologists intensified their collaboration to focus on optimizing the key NRL objectives, technical processes, resources and their priorities. At the same time the fragmented laboratory organization of KTL/ THL was simplified through mergers, ending up in 2010s as only one NRL unit (Expert NRL Microbiology) in the same department with the ID epidemiology functions, moving at the same time a number of microbiology and immunology research functions to the universities. This has led to more effective and ID control program-oriented use of technical capacities and human resources across different areas of NRL microbiology in the institute. The latest organizational changes (in 2024) seek further technical and resource synergy for both ID and non-ID epidemiology. Conclusions: Over 40 years KTL/THL strategically developed, through organizational changes, training and recruitment, the NRL microbiology and ID epidemiology functions in an integrated manner to focus on producing data for surveillance, outbreak control and other key ID public health areas. This could serve as a model for developing these functions in Serbia for effective ID public health.
Understanding COVID-19 vaccine effectiveness in preventing severe disease
Authors: Katz Mark
Published: October 2024

Understanding COVID-19 vaccine effectiveness (VE) in preventing severe disease is critical to inform vaccine policy. In this talk I will describe the results of a study that used the test-negative design to estimate VE against SARS-CoV-2-confirmed hospitalisation in adults ≥ 18 years in the Eastern part of the WHO European region. We included patients hospitalised for severe acute respiratory infection (SARI) at sentinel surveillance sites in six countries and areas, including in Serbia. We collected demographic information, COVID-19 vaccination history, and tested respiratory samples for SARS-CoV-2 by RT-PCR. We calculated VE of any vaccine dose received within 12 months (Annual VE) as [(1 - adjusted Odds Ratio) x 100%] using a one-stage pooled analysis. The reference group included unvaccinated individuals and those who received their last vaccine > 12 months before symptom onset. Results of this study will be presented in the context of vaccine effectiveness estimates in other countries in other regions of the world, and in the context of current recommendations for COVID-19 vaccination.
Laboratory support of vaccine-preventable infections: Unsolved and/or unsolvable problems of vaccinology
Authors: Agletdinov Eduard , Kandrushina Marina , Kuvshinova Irina , Nekrasov Boris , Samsonov Sergey
Published: October 2024

Background: The COVID-19 pandemic has forced humanity to rethink global threats to biological safety and develop effective anti-epidemic measures. The medical community is once again turning its attention to methods of specific immunological prevention of infectious diseases as accessible and effective measures to prevent infection and/or the development of severe forms of the disease. Methods and Objectives: To assess humoral immunity to some vaccine-preventable infections the content of antibodies in the blood serum to pathogens of infectious diseases (measles, rubella, tick-borne encephalitis, parotitis, VZV, hepatitis A, hepatitis B) was determined by the enzyme immu-noassay method using reagent kits manufactured by Vector-Best in accordance with the instructions for use. Objective of the study: donors (n=521), Vector-Best employees (n=710), and healthcare workers (n=1875). Results: The results of the assessment of population immunity to pathogens of some vaccine-preventable infections indicate different levels of seroprevalence to various pathogens, as well as depending on professional affiliation and place of work. For example, antibodies to the measles virus were not detected in 46% of donors, 24% of employees of a non-medical organization, and only in 5% of healthcare workers of an infection hospital. The proportion of people not protected from the rubella pathogen ranges from 2 to 15.5%. A low level of tick-borne encephalitis virus seroprevalence was revealed in the endemic region (58.4%). Significant individual differences in the duration of circulation of antibodies to tick-borne encephalitis virus after vaccination have been demonstrated. In 7 people, the phenomenon of immune amnesia was discovered in relation to the pathogens of rubella, mumps and tick-borne encephalitis after suffering from measles. Conclusions: The obtained results must be considered when organizing preventive vaccination measures to predict and prevent infectious diseases, vaccine and immune certification of the population.
Routine serological testing for determination of EBV infection
Authors: Minić-Vasić Jelena , Dimitrijević Mirjana , Gluvakov Jelena , Trajković Suzana , Stanišić Olivera , Perović Aleksandra , Stajić Tamara , Nikolovski Dubravka
Published: October 2024

Background: Epstein-Barr virus (EBV) or human herpesvirus 4 is one of the most common human widespread viruses, infecting more than 90% of the world's population. After primary infection, which is often unrecognized or asymptomatic, the virus persists for life in infected host cells. In children and young people, the primary infection can manifest itself in the form of a clinical syndrome of infectious mononucleosis (IM). Early, accurate and complete results of laboratory tests are vital for timely diagnosis, appropriate treatment and cure. A key challenge for the physician, in cases where the disease may present atypically, is to distinguish bacterial infections from early acute IM. Methods and Objectives: The aim of our analysis was to reveal the frequency of seropositive patients with suspected EBV infection, to determine the serological profile of persons with active primary infection and persons with persistent infection and the percentage of incomplete requests where the clinician requested only IgM or IgG antibodies to EBV, in the period of the first six months of 2024, in 175 outpatients who were referred to the Center of Microbiology, ZZJZ Pančevo, due to suspicion of IM. According to the instructions of prescribing physicians, we performed serum analysis for the presence of IgM VCA, IgG VCA and IgG EBNA antibodies on EBV, using an enzyme-linked immunosorbent assay (ELISA) manufactured by TestLine Clinical Diagnostics s.r.o. The obtained data were analyzed and statistically processed. Results: Out of all the tested patients, 48 of them were referred for analysis of the detection of IgM antibodies to EBV, among which the presence was proven in 39.5%. In 10 patients, only IgG antibodies were sought. Among other patients, acute EBV infection was proven in 19.65%, old persistent infection in 65.8% and absence of immunity in 15 patients (12.8%). We detected an atypical serological profile in 7 patients. The distribution according to age and gender does not deviate from the results found in the literature. Conclusions: A typical serological profile was detected in the largest number of those we tested, but this study points out that clinical diagnosis as well as additional tests in the confirmation of IM are important for the interpretation of the obtained serological results.
Overview of pertussis epidemiology in Bitola, North Macedonia
Authors: Popovska Kljuseva , Nikolovska Jasmina
Published: October 2024

Background: Pertussis is an endemic disease in the Europe and worldwide. Every three to five years, larger epidemics are expected even with high vaccination coverge. In the first 6 mounts of 2024, a total of 857 cases of pertussis have been registered in Republic of North Macedonia, with an incidence of 46.7/100,000 inhabitants. That represents a several-fold increase the number of patients in relation to the past five-year period (2019-2023), when a total of 10 cases were registered. Methods and Objectives: The aim of this study was to present the epidemiological characteristics of patients with pertussis in the period January-June 2024 in Bitola, a second largest town in North Macedonia. This is a descriptive study presenting epidemiological characteristic of patients with pertussis in Bitola, in the period January-June 2024. The data were obtained from the records at the Center for Public Health-Bitola, Department of Epidemiology. Results: About 38 cases of pertussis were registered, with an incidence of 40.8/100,000 inhabitants, 44.7% males and 55.3% females. Median age of the patients was 11.5 years (minimum age 10 days, maximum 78 years). Most affected age groups were 5-9 years (21.1%) and 10-14 years (18.4%). According to vaccination status of the patients, 44.7% were completely vaccinated, 15.8% were incompletely vaccinated according to age, 21.1% were completely vaccinated according to age and 18.4% were unvaccinated. About 15.8% of the cases were hospitalized, and 10.5% of cases had contact with a confirmed case. Conclusions: This study showed that pertussis continues to circulate in Bitola, in all age groups. It is important for continuous surveillance of pertussis, including appropriate contact tracing around the cases to protect close contacts at risk of severe disease.
Gender-specific mortality predictors in patients with severe COVID-19: A critical care perspective
Authors: Beronja Branko , Stevanović Olja , Nikolić Nataša , Todorović Nevena , Filipović Ana , Simić Jelena , Gazibara Tatjana , Dotlić Jelena , Milošević Ivana
Published: October 2024

Objective: The aim of this study was to assess factors associated with the risk of death in men and women individually and shed light on new aspects. Patients and methods: This retrospective cohort study was carried out at two healthcare institutions in Serbia, involving 457 patients. Patients were categorized based on their gender. The primary study endpoint was survival, specifically patient mortality. Demographic and clinical information were retrieved from electronic health records. Results: Among men, 11.4% required treatment in the intensive care unit (ICU), with a 5.7% mortality rate. Multivariate analysis confirmed associations with ICU mortality, including longer hospitalization (p=0.010), non-vaccination (p=0.024), obesity (p=0.013), elevated levels of lactate dehydrogenase (p=0.048), C-reactive protein (p=0.041), aspartate aminotransferase (p=0.008), interleukin-6 (p=0.019), and lower lymphocyte counts (p=0.043). For women, 16% required ICU treatment, with an 8.6% mortality rate. Multivariate analysis confirmed associations with ICU mortality, including longer hospitalization (p=0.014), non-vaccination (p=0.019), chronic kidney disease, elevated levels of lactate dehydrogenase (p=0.012), creatinine (p=0.015), C-reactive protein (p=0.015), interleukin-6 (p=0.019), lower lymphocyte counts (p=0.077), and erythrocyte counts (p=0.033). Conclusion: Survival in severe COVID-19 is similar between genders, but specific risk factors vary. Prolonged hospitalization, low lymphocyte count, high biomarker levels, and vaccine avoidance contribute to mortality in both genders. Men face risks from obesity and elevated AST levels, while women face risks from lower erythrocyte counts and CKD. This highlights the need for a gender-specific approach in managing fatal COVID-19.
Malignant diseases in the Jablanica District from 1999 to 2021
Authors: Ilić Vanja
Published: October 2024

Background: Malignant tumors are a significant public health issue worldwide, including in Serbia and the Jablanica District. Understanding trends in incidence and mortality is essential for effective prevention and treatment planning. Data from cancer registries provide insights into the number of cases and help monitor the health of the population, including incidence, prevalence, and mortality rates. Methods and Objectives: This study aims to analyze the incidence and mortality of malignant tumors in the Jablanica District from 1999 to 2021 using a descriptive epidemiological method. Data sources include the Central Serbia Cancer Registry (1999-2015), the Republic of Serbia Cancer Registry (2016-2021), and the Jablanica District cancer registry. The study reveals an increasing trend in both incidence and prevalence of malignant diseases over the period. Results: Results show that, on average, 930 people per year were diagnosed with malignant diseases in the Jablanica District, with 540 annual deaths. From 1999 to 2021, there were 21,421 new cases and 12,461 deaths from all malignant tumors (C00-C97). Men accounted for 54.8% of new cases (11,745), while women accounted for 45.17% (9,676). The average standardized incidence rate was 254.51 per 100,000 men and 205.23 per 100,000 women, with increasing trends observed (i=6.437x+177.3 for men and i=4.864x+146.8 for women). The average standardized mortality rate was 152.38 per 100,000 men and 92.08 per 100,000 women, also showing increasing trends (i=0.973x+140.6 for men and i=1.545x+68.92 for women). The most common cancers were lung and bronchial cancer in men (20.22%) and breast cancer in women (25.5%). Men frequently died from lung cancer (30.8%) and women from breast cancer (19.5%). Conclusions: Effective cancer prevention has substantial public health potential and should be prioritized. Targeted interventions, including early detection and primary prevention, are essential for reducing cancer incidence and mortality.
Accessibility of health care among patients with non-communicable diseases in urban and rural areas in the Pelagonia region, North Macedonia
Authors: Popovska-Kljuseva Svetlana , Velikj-Stefanovska Vesna , Kochinski Dragan
Published: October 2024

Background: Public health issue at global level is to improve access to health care with intention of achieving equality and equity. Patients with non-communicable diseases face multiple barriers in health care including barriers in accessibility of health care (distance to health facilities, waiting lists, etc.). Aim: The aim was to perceive the accessibility of health care in terms of geographical distance from home, among patients with non-communicable diseases in urban and rural areas in the Pelagonia region, North Macedonia. Material and methods This was a cross-sectional study conducted in the period June-September 2023. A questionnaire derived from existing literature was used for completing the purposes of the study. Patients with heart attack, strocke, cancer, chronic obstructive pulmonary disease, asthma and/or diabetes mellitus were included. Results: About 118 patients were included in the study, 57.63% from rural and 42.37% from urban areas. Patients living in rural areas face insufficient access to various health services more common compared to those from urban areas: pharmacies - 4.39 times OR=4,39 [95% CI (1,71-11,29)]; general practitioners - 3.08 times OR=3,08 [95% CI (1,28-7,43)]; public hospital health services - 24 times OR=24.0 [95% CI (8.64-66.68)], public health services of specialist doctors - 34.2 times OR=34.20 [95% CI (11.44-102,21)]. Distance as a problem for an examination by a specialist doctor was 5.76 times more common in rural areas OR=5,76 [95% CI (2,39-13,89)]. Conclusion: It is essential to conduct a national study that would determine the differences by region and place of residence (rural/ urban) in terms of accessibility to health care. The results would contribute in creation health policies in order to achieve equity in health care.
Factors influencing recurrent induced pregnancy abortions
Authors: Gazibara Tatjana , Dotlić Jelena , Maksimović Nataša , Maksimović Jadranka , Tulić Lidija , Bila Jovan , Stojnić Jelena , Miloradović Maja , Plavša Dragana
Published: October 2024

Background: Some women undergo recurrent or repeated induced abortion i.e. two or more abortions in their lifetime. Methods and objectives: The study aimed to investigate the frequency and factors that influence the decision to have recurrent induced abortion among women from Belgrade, Serbia. Women undergoing induced abortions at the Clinic for Ob/Gyn, University Clinical Center of Serbia from 2022 to 2024 were recruited for the study. Data were collected by an anonymous questionnaire examining socio-demographic data and gynecological history of women. Results: The study included 433 women aged 16 to 49 years. The investigated women had up to 5 births (in average 1.5 +/-1.1), and 14.1% were never previously pregnant. In our sample, 55.7% of women had recurrent induced abortions. Before this abortion, they mostly had just one (32.1%), although there were two women who had 6 and 9 previous abortions. Having recurrent induced abortions was associated with being in a steady relationship or marriage, having more children, having gynecological illnesses and having a physically vigorous professional activity. Furthermore, older age, having more children and having a physically vigorous professional activity were found to be predictors of a higher number of recurrent abortions. Conclusion: One-half of women in this sample underwent multiple abortions. The study findings highlight the problem of recurrent abortions and the need for better access to reproductive health and contraception knowledge to women especially those who are physical workers, in steady relationships or marriage and who already have children.
Habits and behavioral patterns of students in relation to the six components of social network sites addiction
Authors: Jovanović Tamara , Višnjić Aleksandar , Marković Roberta , Nikolić Dragan
Published: October 2024

Backround: Young adults are especialy drawn to social media because at this age of life, when social needs are at their peak, it allows them to connect with others and express themselves in ways that weren't possible before. During the COVID-19 pandemic, this need was even more pronounced. We describe the use of social networks as excessive when there is immoderate, obsessive use, followed by preoccupation and a sense of loss of control, which leads to various negative consequences. Addiction to social networks is an extreme form of its excessive use. Objectives and Methods: The goal of our research was to determine which habits and patterns of behavior, before and during COVID-19, represent risk factors for excessive use of social networks among students of the Faculty of Medicine in Niš. The study included 357 randomly selected students. It was conducted through a Google forms electronic questionnaire. Symptoms of excessive use of social networks were measured with the Bergen Social Media Addiction Scale - BSMAS. The socioeconomic characteristics and patterns of behavior were also assessed as a part of the survey. Results: All 6 specific components of addiction were positively and most strongly associated with time spent on social networks. Slightly weaker correlations were found for the components Tolerance, Mood Change and Withdrawal Symptoms in favor of male students. The number of active accounts showed a significant association with the Tolerance component, as well as with Withdrawal Symptoms and Conflict, while the number of active devices was only associated with Relapse and Tolerance. It was found that the Tolerance component is positively correlated with the length of night's sleep. Except for Relapse, "Adequately provided compensation for content denied to students during the pandemic" correlated positively with all other five addiction components. "Home isolation" for the duration of the pandemic, however, negatively correlated with all examined addiction components, except for Prominence and Tolerance Conclusion: The higher prevalence of social media addiction among younger age groups can be attributed to their higher level of digital literacy and competence. A statistically significant increase in the number of active accounts, time spent on social networks, but also a decrease in the number of active devices during the COVID-19 pandemic was determined.
Determination of cyanotoxins present in water accumulations on territory of the Republic of Serbia
Authors: Milenković Milan , Ugrenović Željka , Jovanović Jelena , Karadžić Vesna , Jovanović Katarina , Blagojević Zorica
Published: October 2024

Background: A worldwide problem with numerous adverse effects on aquatic ecosystems and drinking water resources is caused by algal bloom. Reduce in the quality of freshwater bodies, such as lowered dissolved oxygen and changes in color, odor, and taste of water, could be caused by cyanobacterial bloom. Cyanobacterial produce toxins that are the main concern. Toxic compounds identified on the territory of the Republic of Serbia were: microcystines (MC RR, MC DMRR, MC LR, MC DMLR, MC YR), cilindrospermopsin (CYN) and anatoxin (ATX). The presence of identified toxins requires their concentration monitoring. Methods and Objectives: Method for the determination of cyanotoxins was developed using liquid chromatography with mass spectrometry (LC-MS). Gradient method elution was employed using A: 0.1% formic acid in water and B: 0.1% formic acid in acetonitrile: 0 min 21% B, 18 min 72% B, 20 min 72%, 20.1 min 21%, 25 min 21% end. Flow rate was 0.350 ml/min, on Acclaim Polar Advantage II (Thermo Scientific) column. Samples were prepared by filtration and solid phase extraction, using hydrophylic-lipophylic (HLB) and porous graphite carbon (PGC) cartridges. Single ion monitoring (SIM) method was engaged for detection and quantitation using mass-to-charge ratio (m/z): MC RR-520, MC DMRR-512, MC LR-996, MC DMLR-982, MC YR-1046, CYN-416, and ATX-166. Results: Microcystin's, cilindrospermopsin and anatoxin were detected during the past 5 years. Concentration ranges found, in µg/L, were: MC RR (0.005-0.830), MC LR (0.012-1.454), MC DMRR (0.005-0.530), MC DMLR (0.003-0.896), MC YR (0.007-0.998), CYN (0.009-0.686) and ATX (0.004-0.491). Concentrations found in some samples were above the recommendations of 1 µg/L (WHO guideline 2021). Fortunately, those samples were from water accumulations that were not used for purposes of drinking water production. Conclusions: Monitoring the presence and the amount of cyanobacterial toxic compounds in water accumulations, especially used in the water production process, is crucial for the public health of one country.
Health outcomes of the depression screening program conducted in the Republic of Srpska
Authors: Štrkić Dijana , Niškanović Jelena
Published: October 2024

Background: Public Health Institute designed methodological guidelines for the depression screening program, implemented in 2021/2022, in ten primary health care centers, through collaboration of mental health centers (MHC) and family medicine teams (FMT). Main objective of the program was to improve mental health and quality of life of the adult population at increased risk of depression. Methods and Objectives: Opportunistic screening of the patients was conducted in FMT and patients with increased risk for depression, according to Patient Health Questionnaire 9 (PHQ 9), were referred to MHC, for additional support and treatment. In MHC the Hamilton Depression Rating Scale (HAM-D) scale was used for confirmation of depression and control measurement of patients after three months of treatment, along with Quality-of-Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). Results: Screening of 1678 patients resulted with 747 patients referred to MHC. Among referred patients, 57.8% (n=432) sought professional support at MHC, where depression was confirmed among 418 patients. Most of them, according to the HAM-D scale, had severe depression (31.5%), while 27.2% of the patients had mild depression. After three months of the treatment, 41.6% patients had no depression, while 38.8% patients had mild depression. Overall, percentage of the patients with no signs of depression increased after three months of treatment from 1.5% to 41.6%, while percentages of patients with severe depression decreased from 31.5% to 4%. There was a significant improvement in satisfaction with quality of life (Q-LES-Q-SF) among patients at the end of the treatment (AS= 57.4) in comparison with the beginning of the treatment (AS=40.3) (t= 19.85, p<0.001). Conclusions: Results showed that the program's objective was accomplished, mental health and quality of life of patients were improved. Collaboration between FMT and MHC in the primary health care centers is crucial for a successful implementation.