This cross-sectional study aimed to investigate the association between psychosocial school factors and life satisfaction, symptoms of depression and psychosomatic health complaints among first grade ...secondary school students in Serbia. We analysed data from the 2018 Health Behaviour in School-aged Children (HBSC) study in the Republic of Serbia. Analyzed psychosocial school factors included satisfaction with school, schoolwork pressure, teacher support, classmate support and being bullied at school. Life satisfaction was assessed by the 11-step Cantril's ladder (cutoff >5). Symptoms of depression were measured by the Center for Epidemiologic Studies Depression Scale (CESD-10) and psychosomatic health complaints by using the HBSC symptom checklist. Univariable and multivariable binary logistic regression was used to determine independent predictors of students' life satisfaction, symptoms of depression and psychosomatic health complaints in the school environment, while also considering their socio-demographic characteristics and perceived family and friend support. The study included 1605 students (average age 15.26 ±0.44 years), of whom 50.3% were females. Results from the binary logistic regression analyses showed that life satisfaction was positively related to school satisfaction and classmate support, and negatively to being bullied at school. Symptoms of depression were positively associated with schoolwork pressure and being bullied at school, and negatively with teacher and classmate support. All analyzed factors of the school environment were significantly related to psychosomatic health complaints, whereby schoolwork pressure and being bullied at school were positively associated, while teacher and classmate support and satisfaction with school were negatively associated. Given the established association of psychosocial school factors with mental health, there is a need for targeted measures both at school and community level with the aim of improving social support in the school environment, reducing schoolwork burden and preventing bullying at school, potentially resulting in the overall improvement of mental health of the first grade secondary school students.
Severe acute respiratory infections (SARI) are estimated to be the cause of death in about 19% of all children younger than 5 years globally. The outbreak of coronaviral disease (COVID-19) caused by ...SARS-CoV-2, increased considerably the burden of SARI worldwide. We used data from a vaccine effectiveness study to identify the factors associated with SARS CoV-2 infection among hospitalized SARI patients. We recruited SARI patients at 3 hospitals in Serbia from 7 April 2022-1 May 2023. We collected demographic and clinical data from patients using a structured questionnaire, and all SARI patients were tested for SARS-CoV-2 by RT-PCR. We conducted an unmatched test negative case-control study. SARS-CoV-2 infected SARI patients were considered cases, while SARS CoV-2 negative SARI patients were controls. We conducted bivariate and multivariable logistic regression analysis in order to identify variables associated with SARS-CoV-2 infection. We included 110 SARI patients: 74 were cases and 36 controls. We identified 5 factors associated with SARS-CoV-2 positivity, age (OR = 1.04; 95% CI = 1.01-1.07), having received primary COVID-19 vaccine series (OR = 0.28; 95% CI = 0.09-0.88), current smoking (OR = 8.64; 95% CI = 2.43-30.72), previous SARS CoV-2 infection (OR = 3.48; 95% CI = 1.50-8.11) and number of days before seeking medical help (OR = 0.81; 95% CI = 0.64-1.02). In Serbia during a period of Omicron circulation, we found that older age, unvaccinated, hospitalized SARI patients, previously infected with SARS CoV-2 virus and those who smoked, were more likely to be SARS-CoV-2-positive; these patient populations should be prioritized for COVID vaccination.
The presented study tracks the increase or decrease in the prevalence of seventeen different chronic non-communicable diseases in Serbia. This analysis considers factors such as region, age, and ...gender and is based on data from two national cross-sectional studies conducted in 2013 and 2019. The research aims to accurately identify the regions with the highest percentage of affected individuals, as well as their respective age and gender groups. The ultimate goal is to facilitate organized, free preventive screenings for these population categories within a very short time-frame in the future.
The study analyzed two cross-sectional studies conducted between 2013 and 2019, using data obtained from the Institute of Public Health of Serbia. Both studies involved a total of 27801 participants. The study compared the performance of Decision Tree and Support Vector Regressor models with artificial neural network (ANN) models that employed two encoding functions. The new methodology for the ANN-L36 model was based on artificial neural networks constructed using a Latin square (L36) design, incorporating Taguchi's robust design optimization.
The results of the analysis from three different models have shown that cardiovascular diseases are the most prevalent illnesses among the population in Serbia, with hypertension as the leading condition in all regions, particularly among individuals aged 64 to 75 years, and more prevalent among females. In 2019, there was a decrease in the percentage of the leading disease, hypertension, compared to 2013, with a decrease from 34.0% to 32.2%. The ANN-L36 model with Fuzzy encoding function demonstrated the highest precision, achieving the smallest relative error of 0.1%.
To date, no studies have been conducted at the national level in Serbia to comprehensively track and identify chronic diseases in the manner proposed by this study. The model presented in this research will be implemented in practice and is set to significantly contribute to the future healthcare framework in Serbia, shaping and advancing the approach towards addressing these conditions. Furthermore, experimental evidence has shown that Taguchi's optimization approach yields the best results for identifying various chronic non-communicable diseases.
In previous years, significant attempts have been made to enhance computer-aided diagnosis and prediction applications. This paper presents the results obtained using different machine learning (ML) ...algorithms and a special type of a neural network map to uncover previously unknown comorbidities associated with chronic diseases, allowing for fast, accurate, and precise predictions. Furthermore, we are presenting a comparative study on different artificial intelligence (AI) tools like the Kohonen self-organizing map (SOM) neural network, random forest, and decision tree for predicting 17 different chronic non-communicable diseases such as asthma, chronic lung diseases, myocardial infarction, coronary heart disease, hypertension, stroke, arthrosis, lower back diseases, cervical spine diseases, diabetes mellitus, allergies, liver cirrhosis, urinary tract diseases, kidney diseases, depression, high cholesterol, and cancer. The research was developed as an observational cross-sectional study through the support of the European Union project, with the data collected from the largest Institute of Public Health "Dr. Milan Jovanovic Batut" in Serbia. The study found that hypertension is the most prevalent disease in Sumadija and western Serbia region, affecting 9.8% of the population, and it is particularly prominent in the age group of 65 to 74 years, with a prevalence rate of 33.2%. The use of Random Forest algorithms can also aid in identifying comorbidities associated with hypertension, with the highest number of comorbidities established as 11. These findings highlight the potential for ML algorithms to provide accurate and personalized diagnoses, identify risk factors and interventions, and ultimately improve patient outcomes while reducing healthcare costs. Moreover, they will be utilized to develop targeted public health interventions and policies for future healthcare frameworks to reduce the burden of chronic diseases in Serbia.
Background West Nile virus (WNV) is an emerging mosquito-borne pathogen in Serbia, where it has been detected as a cause of infection in humans since 2012. We analyzed and modelled WNV transmission ...patterns in the country between 2012 and 2023. Methods We applied a previously developed modelling approach to quantify epidemiological parameters of interest and to identify the most important environmental drivers of the force of infection (FOI) by means of statistical analysis in the human population in the country. Results During the study period, 1,387 human cases were recorded, with substantial heterogeneity across years. We found that spring temperature is of paramount importance for WNV transmission, as FOI magnitude and peak timing are positively associated with it. Furthermore, FOI is also estimated to be greater in regions with a larger fraction of older adult people, who are at higher risk to develop severe infections. Conclusion Our results highlight that temperature plays a key role in shaping WNV outbreak magnitude in Serbia, confirming the association between spring climatic conditions and WNV human transmission risk and thus pointing out the importance of this factor as a potential early warning predictor for timely application of preventive and control measures.
Herein we provide an assessment of cyanobacterial diversity and habitat preferences of potentially toxic and alien taxa, which could be an important tool for human health risk assessment regarding ...recreational and water-supply waterbodies. The diversity changes of cyanobacteria in waters intended for human consumption in Serbia were analyzed two decades after the first floristic study was published. The examination included phytoplankton and phytobenthic sample analysis from 35 localities in the period between 2012 and 2017, together with published literature records. The results indicate that the number of identified taxa doubled since the first Serbian Flora of Cyanobacteria was released two decades ago. The changes most likely occurred due to environmental factors, including hydrological transformations of habitats, cultural eutrophication and global warming. Many frequently recorded taxa are potentially toxic and bloom-forming. The spread of alien species with potentially invasive characteristics has also been noted. Canonical correspondence analysis (CCA) indicates that shallow waterbodies are the most vulnerable regarding the occurrence and expansion of bloom-forming, potentially toxic and invasive taxa. This shows the urgent need for a more detailed investigation. Additionally, although most of the research was focused on planktonic forms, benthic cyanobacteria represent an important component for public health risk assessment and therefore should be more frequently investigated.
The Republic of Serbia applied the booster dose of the following COVID-19 vaccines: BNT162b2 mRNA (Pfizer-BioNTech), Sinopharm BBIBP-CorV (Vero Cell®), Gam-COVID-Vac (Sputnik V) and ChAdOk1 nCoV-19 ...(AstraZeneca). We aimed to examine the immunogenicity and reactogenicity of the booster dose and identify factors related to immune response and adverse events. Panel study, conducted during August and September 2021, included 300 persons receiving the booster dose at the Institute of Public Health of Serbia. Blood samples were taken on the day of receiving the booster dose, and after 7 and 28 days. When applying homologous regimen, the average increase in anti-spike immunoglobulin G was 8782.2 (after 7 days), 1213.9 after 28 days, while 9179.5 (after 7 days) and 16,728.1 after 28 days of heterologous regimen. Sinopharm BBIBP-CorV (p < 0.001) and Sputnik V (p < 0.001), age 65 and over (p = 0.001) and currently smoking (p < 0.001) were independently associated with lower levels of anti-spike immunoglobulin G. Female sex (OR = 1.77; 95%CI = 1.01−3.12), previous COVID-19 infection (OR = 3.62; 95%CI = 1.13−11.63) and adverse events after the second dose (OR = 2.66; 95%CI = 1.33−5.32) were independently associated with intense systemic adverse events 7 days after. Booster dose significantly increased antibodies titers, especially 28 days after heterologous regimen, without a significant increase in reactogenicity.
Burnout syndrome develops as a consequence of chronic stress among employees. The study objective was to examine what socio-descriptive characteristics of employees might be associated with the ...appearance of the occupational burnout and to evaluate the relationship between job burnout and the quality of life among security employees of the professional private security sector in Central Serbia.
A multicenter cross-sectional questionnaire-based study was performed. A multivariate logistic regression analysis and ANOVA post choc test was applied.
A total of 353 respondents (330 male and 23 female) participated in the study. Female sex and older age were associated with a higher risk of total burnout and the development of emotional exhaustion while male sex, higher education, and managerial position were associated with higher personal achievement and lower risk of total burnout. Male sex, marital union, two or more children, and direct contact with clients were significantly associated with a lower quality of life of employees. A significant negative correlation was found between total burnout and the Physical Health Composite Score (PHC) score with a correlation coefficient (
) of -0.265 (95%CI from -0.361 to -0.163); between total burnout and the and Mental Health Composite Score (MHC) score with a
of -0.391 (95%CI from -0.480 to -0.301); and between total burnout and TQL score with a
of -0.351 (95%CI from -0.445 to -0.258).
Female sex and older age were associated with a higher risk of total burnout and the development of EE while a managerial position and higher education were protective factors in relation to the development of burnout. Male sex, marital union, two or more children, and direct contact with clients were significantly associated with a lower quality of life of the employees. Shift work significantly reduced the total quality of life, while managerial positions increased the quality of life.
Objectives:
Adults aged 65 years and older comprise one fifth of the Serbian population. Many of them have multiple, often diet-related comorbidities. We aimed to investigate their dietary habits by ...comparing them with younger adults' and to determine the relation of the differing ones to demographic, socioeconomic and health factors.
Methods:
We performed a secondary analysis of 2013 Serbian National Health Survey data on 14,082 adults. Binary logistic regression was used to determine dietary habits associated with older age (≥65 years) compared to younger age (18–64 years) and to assess their independent predictors in older adults.
Results:
Older adults more often reported everyday breakfast (OR = 2.085, 95%CI = 1.622–2.680) and brown/wholegrain bread consumption (OR = 1.681, 95% CI = 1.537–1.839), while using margarine (OR = 0.578, 95%CI = 0.397–0.839), discretionary salt (sometimes: OR = 0.648, 95%CI = 0.596–0.705, almost always: OR = 0.522, 95%CI = 0.445–0.614) and consuming fish (two or more times a week: OR = 0.465, 95%CI = 0.383–0.566) less frequently than younger adults. This was mainly positively related to urban environment, affluence, higher education and poor health.
Conclusion:
Using nationally representative data, we found that older adults reported healthier dietary habits compared to younger adults, which requires timely public health action.
After Action Reviews (AAR) with a One Health perspective were performed in Slovenia, Italy, Serbia and Greece following a severe West Nile virus (WNV) transmission season in 2018. A protocol ...combining traditional techniques and organizational process analysis was developed and then implemented in each country.
In 2018, response to the unusually intense transmission season of WNV in Slovenia, Italy, Serbia and Greece took place through routine response mechanisms. None of the four countries declared a national or subnational emergency. We found a very strong consensus on the strengths identified in responding to this event. All countries indicated the availability of One Health Plans for surveillance and response; very high laboratory diagnostic capacity in the human, veterinary and entomology sectors and strong inter-sectoral collaboration with strong commitment of engaged institutions as critical in the management of the event. Finally, countries implementing One Health surveillance for WNV (in terms of early warning and early activation of prevention measures) consistently reported a positive impact on their activities, in particular when combining mosquito and bird surveillance with surveillance of cases in humans and equids. Recurring priority areas for improvement included: increasing knowledge on vector-control measures, ensuring the sustainability of vector monitoring and surveillance, and improving capacity to manage media pressure.
The AARs presented here demonstrate the benefit of cross-sectoral and cross-disciplinary approaches to preparedness for West Nile virus outbreaks in Europe. In the coming years, priorities include fostering and strengthening arrangements that: enable coordinated One Health surveillance and response during WNV transmission seasons; ensure adequate laboratory capacities; strengthen risk communication; and fund longer-term research to address the knowledge gaps identified in this study.
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