Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over ...traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics.
This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013-14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course.
Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001).
This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient alternative to traditional classroom training in medical statistics.
Problem-based learning (PBL) allows students to learn medical statistics through problem solving experience. The aim of this study was to assess the efficiency of PBL modules implemented in the ...blended learning courses in medical statistics through knowledge outcomes and student satisfaction. The pilot study was designed as a randomized controlled trial that included 53 medical students who had completed all course activities. The students were randomized in two groups: the group with access to PBL modules within the blended learning course (hPBL group) and the group without access to PBL modules-only blended learning course (BL group). There were no significant differences between the groups concerning socio-demographic characteristics, previous academic success and modality of access to course materials. Students from hPBL group had a significantly higher problem solving score (p = 0.012; effect size 0.69) and the total medical statistics score (p = 0,046; effect size 0.57). Multivariate regression analysis with problem solving as an outcome variable showed that problem solving was associated with being in hPBL group (p = 0.010) and having higher grade point average (p = 0.037). Multivariate regression analysis with the medical statistics score as an outcome variable showed the association between a higher score on medical statistics with access to PBL modules (p = 0.045) and a higher grade point average (p = 0.021). All students in hPBL group (100.0%) considered PBL modules useful for learning medical statistics. PBL modules can be easily implemented in the existing courses within medical statistics using the Moodle platform, they have high applicability and can complement, but not replace other forms of teaching. These modules were shown to be efficient in learning, to be well accepted among students and to be a potential missing link between teaching and learning medical statistics. The authors of this study are planning to create PBL modules for advanced courses in medical statistics and to conduct this study on other universities with a more representative study sample, with the aim to overcome the limitations of the existing study and confirm its results.
This research focusses on the potential application of artificial intelligence (AI) techniques in the analysis of behavioural addictions, specifically addressing problematic Internet use among ...adolescents. Using tabular data from a representative sample from Serbian high schools, the authors investigated the feasibility of employing eXplainable AI (XAI) techniques, placing special emphasis on feature selection and feature importance methods. The results indicate a successful application to tabular data, with global interpretations that effectively describe predictive models. These findings align with previous research, which confirms both relevance and accuracy. Interpretations of individual predictions reveal the impact of features, especially in cases of misclassified instances, underscoring the significance of XAI techniques in error analysis and resolution. Although AI’s influence on the medical domain is substantial, the current state of XAI techniques, although useful, is not yet advanced enough for the reliable interpretation of predictions. Nevertheless, XAI techniques play a crucial role in problem identification and the validation of AI models.
Given the widespread use of dietary supplements (DS) and herbal products (HP), healthcare professionals (HCPs) will increasingly encounter patients who use these preparations with conventional drugs ...and who need their services to reduce the consequences of adverse therapeutic outcomes. The aim of our survey was to assess the knowledge and behaviors of HCPs regarding the risk of potential drug−dietary supplement (DDSIs) and drug−herbal product (DHPIs) interactions. This cross-sectional survey collected data via on paper-based questionnaire among general practitioners (GPs) (n = 105), specialty doctors (n = 87) and nurses (n = 154). The HCPs were mostly familiar with the interaction of doxycycline with magnesium (83%) and were least familiar with interaction of warfarin with glucosamine (14%). The results on DDSIs and DHPIs knowledge showed that GPs scored significantly higher than nurses (p < 0.001 and p = 0.003, respectively), while specialty doctors scored significantly higher than nurses only on DDSIs knowledge (p < 0.001). Only 28% of respondents reported that they often or always ask patients on drug therapy about the use of DS or HP, and 25% of respondents record such data in the medical documentation of patients. Our results showed that HCPs have sufficient knowledge about most major DDSIs and DHPIs, but insufficient knowledge about most moderate interactions. However, their overall knowledge and behavior regarding the risk of these interactions indicate the need for further continuing education and training.
Improved understanding of the relationships between heavy metals fractionation in agricultural soils and biological uptake could be obtained by analysing samples of biota in parallel with sequential ...extraction of their grown media. The overall goals of this study were to identify the characteristics of metal fractions and their bioavailability to maize and potato plants in the agricultural land of the Ibar River in southern Serbia and northern Kosovo. The concentrations of Pb, Zn, Cd, Ni, Cr and Cu in soil and vegetable samples were determined by the ICP-OES method. Pb/Zn production and industrial waste disposal significantly increased the pseudo-total concentrations of heavy metals in the soil together with their mobile and potentially bioavailable amounts. The Pb concentrations in the vegetable samples were generally above the EU maximum permitted concentrations in foodstuffs. However, the concentrations of Zn, Ni, Cr and Cu in the vegetables were below the critical levels. The results of the present study indicated that the intensive industrial production of Pb/Zn over the years and permanent pollution were responsible for the environmental contamination by heavy metals in the study area, particularly by Pb and Zn. The quantity of the mobile and potentially bioavailable heavy metals in the studied soils threatens the quality of
Zea mays
L. and
Solanum tuberosum
L. crops, with a real risk that these elements could enter the food chain.
This work investigates the influence of a high-magnitude flood event on heavy elements (HEs) pollution and mobility in the agricultural soils along Ibar River in Southern Serbia and Northern Kosovo. ...The study area was one of the most important Pb/Zn industrial regions in Europe. Soil samples (
n
= 50) collected before and after the floods in May 2014 were subjected to the sequential extraction procedure proposed by the Community Bureau of Reference (BCR). The results indicated that the floods significantly increased not only the pseudo total concentrations of HEs in the soil but also their mobile and potentially bioavailable amounts. Moreover, higher concentrations (both pseudo total and potentially bioavailable) were found in the agricultural soils closer to the industrial hotspots. Principal component analysis and hierarchical cluster analysis successfully grouped the analyzed elements according to their anthropogenic or natural origin. The floods significantly increased the potential ecological risk of HEs associated with Pb/Zn industrial activities in the study area. The potential ecological risk of Cd after the floods was highest and should be of special concern.
An ongoing issue of expired medications accumulating in some households is a universal problem around the world. The aim of the study was to investigate the extent and structure of expired ...medications in Serbian households, and to determine which therapeutic groups generated the most waste.
This was an observational, cross-sectional study conducted in households in the city of Novi Sad, Serbia. The study had been performed over 8 month period (December 2011 - July 2012) and it consisted of personal insights into the medication inventory in households.
Of 1008 families, 383 agreed to participate and complete the questionnaire (38.3% response rate). In almost a half of households (44.4%), expired medications were maintained. The amount of expired medications was 402 items, corresponding to 9.2% of total medications presented in surveyed households. The majority of expired medications (64.7%) was in solid dosage (tablets, capsules, granules, lozenges), following semisolid (ointments, creams, gel, suppositories) and liquid dosage forms (drops, syrups). Expired medications in the households belonged mostly to 3 categories: antimicrobials for systemic use (16.7%), dermatological preparation (15.9%) and medications for alimentary tract and metabolism (14.2%).
This study revealed that there were relatively large quantities of expired medications in Serbian households, with a high prevalence of antibiotics for systemic use, anti-inflammatory and antirheumatic products, and medications for alimentary tract and metabolism.
BACKGROUNDPrevious studies suggest that temperament features of adolescents may be good predictors of the development of future psychopathology in this population. The aim of the study was to adapt ...the content and validate the psychometric properties of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Auto-questionnaire in a sample of Serbian adolescents. SUBJECTS AND METHODSThe sample included 2113 adolescents, 56% girls and 44% boys, average age 16.73±0.47, attending 48 Serbian secondary schools. The base for the development of this scale included Serbian standardised versions as well as the TEMPS-I, Interview version. RESULTSThe final scale is comprised of 36 items, with six factors (depressive, cyclothymic, hyperthymic, irritable, and anxious-cognitive/somatic) explaining 39.9% of the total variance, the internal consistency coefficient α=0.77, and the average test-retest coefficient (rho=0.84). The correlations among the temperaments ranged from weak to moderate, with the highest positive correlations between the depressive, cyclothymic and anxious scales. The highest values were detected on hyperthymic and the lowest on depressive temperament. Significantly higher scores of depressive, cyclothymic and anxious temperaments were detected in girls, whereas boys had higher scores on the hyperthymic scale. CONCLUSIONSThe scale has shown good psychometric properties, which encourages its further use in adolescent population. The results show certain specific features of this population, such as higher scores on all temperament types than the ones in student and adult population and a tendency of socially desirable answers.
This article reports the results of a study focused on the presence and bioavailability of arsenic in agricultural soil in the mining and industrial regions of northern Kosovo and southern Serbia, as ...well as uptake and bioaccumulation of arsenic in two commonly cultivated plant species (Zea mays L. and Solanum tuberosum L.). This area was one of the most important mining districts in Europe. The collected soil samples were subjected to a modified BCR three-step sequential extraction procedure in order to investigate the chemical partitioning of arsenic in the soils. The general distribution of arsenic in various fractions was: exchangeable < reducible < oxidizable fractions. Highest concentrations of total arsenic in soil were found close to industrial facilities and tailing ponds. In addition, fluvisols were significantly more enriched with arsenic than soils at a distance from the river flows. The edible parts of the plant specimen showed different As contents, suggesting that these plant species have different propensities for the uptake and bioaccumulation of arsenic from soil.
Purpose The extent of functional independence ultimately achieved by an individual patient will be influenced by a variety of medical and non-medical factors. Subjects and Methods this study included ...419 patients with spinal cord lesions treated in the Clinic for Rehabilitation “Dr M. Zotovic”, Belgrade, Serbia, from January 2000 to December 2009. The patients were divided in two groups according to achievement of increase in Functional Independence Measure (FIM) score of more than 13 at discharge compared to admission. A variety of clinical variables were followed in both groups. Results one hundred twenty-one patients (28.9%) showed improvements in FIM score of ≤13, while 298 (71.1%) patients showed an increases in FIM score of >13 at discharge compared to admission. Better functional recovery was observed in patients with non-traumatic spinal cord lesions, lower neurological levels of the lesion (OR = 6.07), and in patients treated surgically, but the level of the spinal cord lesion was the most influential factor affecting outcome. Conclusion the patients with spinal cord lesions should not only be grouped by traumatic and non-traumatic lesions only, but also sub-categorized, according to the etiology, level of injury and treatment method.
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