Pharmacovigilance as a science and group of activities related to detection, collection, analysis, understanding and prevention of adverse drug reactions (ADRs) is an essential activity in the ...regulatory system of drugs of any country. Defining increased patient safety as the main purpose of ADR reporting, a well-designed national pharmacovigilance system achieves its ultimate goal, i.e., protection of public health. In organizational and technical terms, the Republic of Serbia has a well-developed system of pharmacovigilance, created on the basis of a proven reliable system of the former SFR Yugoslavia, and carried out by the National Agency for Medicines and Medical Devices of Serbia (ALIMS), which conducts all organized activities aimed at strengthening the national system of ADR monitoring and reporting. Unlike the neighboring Croatia and Montenegro with similar pharmacovigilance systems, Serbia has only recently approached the WHO standard of 200 reports per million inhabitants despite a significant increase of 180 ADR reports per million inhabitants in 2019 (1251 in total). Considering this, our study aimed to provide a critical insight into the practice of pharmacovigilance in Serbia by pharmacoepidemiologic analysis of a ten-year period of ADR monitoring and reporting activities.
The World Health Organization (WHO) identified four broad domains as being universally relevant to the quality of life, namely physical, and psychological health, social relationships, and ...environment. The aim of this study was to assess the relationship between sociodemographic characteristics and quality of life of old people.
The World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was used to assess quality of life on a random sample of 200 people aged 60 years and over who lived in the Retirement Home in Novi Sad. Items within the questionnaire were organized into four domains: physical, psychological, social relationships and environment.
The majority of the participants were women (69.8%). The mean age was 79.2 years (SD = 6.6 years). Most of them were widowed (73.4%). More than two thirds of participants (68.8%) reported that they were ill at that moment and almost half of them (48.8%) had cardiovascular, 18.5% musculoskeletal, 9.6% endocrine and 5.9% neurological disease. In the social relations domain scores were lower in males (t = 2.4; p = 0.017). Scores of other domains did not differ significantly with regard to the age, educational level and the marital status of the participants. Participants who reported the presence of a disease had significantly lower mean scores of physical, psychological and environment domain.
The presence of disease is a relevant factor for quality of life, whereas age, education and marital status do not reflect on physical health, psychological and environmental domain of quality of life.
Background/Aim. The mental health of medical students worsens during their studies, and research shows that medical students are at high risk of depression. The aim of this study was to evaluate the ...prevalence of depressive symptoms and to examine the association between various risk factors and depressive symptoms in a sample of first- and sixth-year medical students at the University of Novi Sad. Methods. A cross-sectional study was conducted at the Faculty of Medicine of the University of Novi Sad. The sample consisted of 308 students divided into two groups ? 213 students in the first year and 9 5 students in the final (sixth) year of medical studies. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Within this instrument, item 9 was used to identify suicidal ideation. Self-esteem was evaluated with the Rosenberg Self-Esteem Scale (RSES). Additional questions were focused on self-assessed material status, lifestyle factors, and mental healthcare-seeking. Univariate and multivariate logistic regression analyses were applied. Results. The prevalence of depressive episodes among medical students was 16.6%. Almost 9% had thoughts of committing suicide. First-year students with low self-esteem were almost seven times more likely to suffer from moderate to severe depressive symptoms than those with high self-esteem. Students who had used sleeping pills or sedatives without a prescription were nearly five times more likely to have a PHQ-9 score ? 10 than those who had not odds ratio (OR) = 4.97, 95% confidence interval (CI): 1.83?13.52). Sixth-year students with poor or average self-assessed social relation-ships and low self-esteem had a stronger association with a PHQ-9 score ? 1 0. Conclusion. There is a high prevalence of depressive episodes among first and sixth-year medical students, and it is associated with low self-esteem in both groups, use of sleeping or sedative pills without a prescription among first-year students, and poor social health in sixth-year students. We recommend routine screening for depression in medical students and establishing prevention and intervention programs.
Background/Aim. Radial artery perforator flap (RAPF) is a type of fasciocutaneous or adipofascial reverse pedicle flap, which proved to be a versatile flap for the reconstruction of small and ...moderate size soft tissue defects of the forearm, wrist, and hand. RAPF provides suitable skin coverage with elastic subcutaneous tissue thus enabling the protection of exposed or damaged functional structures and their simultaneous repair. The aim of this study was to summarize and analyze the results of the treatment of patients with upper extremity soft tissue defects caused by trauma, infection, burn, or tumor removal, which were re-constructed with RAPF. Methods. This retrospective study included 20 consecutive patients with skin and soft tissue defects of the hand and wrist, treated at the University Clinical Center of Vojvodina from 2012 to 2022. The design of the flaps and length of the pedicles were determined by the recipient site. Tourniquet-induced exsanguination was used during surgery for better visualization. The flaps were elevated and placed at the site of the defect. Data on patients and flaps were summarized upon their collection. Results. Distally based fasciocutaneous RAPF was used in all cases. The average age of the patients was 48 years, predominantly (64%) males. Defects were most often localized on the dorsal part of the hand (60%) and wrist (20%). The most common indications for surgery were trauma (45%) and tumor resection (25%). A satisfactory coverage of the defect was achieved in all 20 patients with no flap loss. Venous congestion was noted in 4 (20%) patients, which resulted in partial necrosis of the flap in 3 (15%) patients. Wound healing was achieved upon conservative treatment by secondary intention in two patients and with a secondary suture in the last one. A surgical site infection occurred in 2 (10%) patients who withdrew after proper local and systemic therapy. Conclusion. RAPF proved to be a workhorse flap for soft tissue reconstruction of the upper limb. This surgical solution led to an excellent functional and aesthetic outcome in the majority of patients. Complex surgical procedures could be done simultaneously, together with the reconstruction of tendons, joints, or fracture stabilization. The reliability and safety of these flaps are confirmed through our clinical data.
Background/Aim. Domestic violence against women is a significant public health problem resulting in serious health and social consequences, for women and their families. The aim of this study was to ...analyze the sociodemographic characteristic of women who were exposed to domestic violence, as well as the impact of violence on women's health. Methods. Data from cross-sectional study from the 2013 National Health Survey in Serbia were used analyzing 6,320 women aged 20?75 years. Univariate and multivariate logistic regression analyses were implemented to assess the association of exposure to domestic violence against women with sociodemographic characteristics, as well as with selected health indicators and health risk behaviors. Results. Out of total number of examined women, 307 (4.9%) reported that they experienced physical and/or psychological violence in the last 12 months. Divorced or separated women, poor women and women with poor social support had greater odds for exposure to domestic violence. Women who had experienced domestic violence were less likely to perceived their health as good than women who had not experienced domestic violence adjusted odds ratio (AOR) = 0.47; 95% confidence interval (CI) = 0.32?0.71, and more likely to report severe or very severe pain (AOR = 2.41; 95% CI = 1.74?3.33), stress and pressure exposure (AOR = 2.62; 95% CI = 1.89?3.64) and depression (AOR = 3.24; 95% CI = 2.08?5.03). Exposure to violence was also associated with the use of sleeping pills or sedative (AOR = 2.21; 95% CI = 1.67?2.93), with frequent use of alcohol (AOR = 1.42; 95% CI = 1.08?1.86) and abortion (AOR = 3.11; 95% CI = 1.48?6.54). Conclusion. Women, victims of domestic violence are more likely to have physical and mental disorders compared to women who are not victims of domestic violence. Violence prevention demands a multisectoral approach, in which the health sector has a central role that includes early identification and recognition of abuse, appropriate care as well as documenting and reporting violence.
nema
Studies have shown the importance of self-efficacy in the domain of risky sexual behaviour. The aim of this study was to examine the association of unwanted sexual intercourse among secondary-school ...students with socio-demographic factors and perceived self-efficacy, and to assess the effectiveness of the programme on reproductive health.
The study involved 5,026 second-grade students in 72 high schools in the Province of Vojvodina, Serbia (APV). They were surveyed before and after the implementation of the extracurricular 'Reproductive health education programme for secondary-school students in APV'. A questionnaire consisting of 57 questions (socio-demographic characteristics, knowledge, attitudes, and behaviour of students regarding reproductive health, and a general self-efficacy scale) was used as the research instrument.
One quarter of students had engaged in unwanted sexual intercourse on one or more occasions. Students with poor material status were twice as likely to engage in unwanted sexual intercourse (ОR=2.01; 95%CI=1.07-3.75) as students with average or good material status. Students who did not engage in unwanted sexual intercourse had a higher self-efficacy score than students who who did (t=2.903; p<0.01). After the programme was completed, there was an increase in general self-efficacy.
Poor material status is a predictor of unwanted sexual intercourse. Students who have a higher level of self-efficacy engaged to a lesser degree in unwanted sexual intercourse. The programme is effective in terms of increasing general self-efficacy, and can be applied to encourage responsible sexual behaviour.
Background/Aim. Depression is a growing public health concern associated with disability, decreased quality of life, increased multimorbidity, and premature mortality. The aim of this study was to ...estimate the prevalence of depressive symptoms (DS) in the general population of Serbia and to analyze its association with sociodemographic factors. Methods. Data from the 2019 Serbian National Health Survey was analyzed (a sample of 12,406 respondents). The questionnaires used in this study were in accordance with the methodology of the European Health Interview Survey (EHIS) Wave 3. Patient Health Questionnaire eight-item depression (PHQ-8) scale was used to determine the prevalence of DS among the population aged ? 15 years. Multi-variate logistic regression analyses (MLRA) were implemented to assess the association of the prevalence of DS with the sociodemographic characteristics of the population. Results. The prevalence of both mild (7.5% vs. 4.4%) and moderate/severe DS (2.6% vs. 1.5%) was higher among women than men and increased continuously with age (13.6% of adults aged ? 65 years had mild and 5.0% moderate/severe symptoms). The highest rates of moderate/severe DS were present in respondents from Vojvodina (2.7%), among those who lived without a partner (2.7%), the lower educated (4.4%), the poor (3.4%), those with inactive employment status (3.7%), and those with poor social support (6.6%). MLRA showed that the highest odds of DS were present among the respondents aged ? 65 years odds ratio (OR) = 6.53; 95% confidence interval (CI): 6.37?6.69 in the Vojvodina region, particularly males (OR = 1.96; 95% CI: 1.89?2.04), respondents who lived without a partner (OR = 1.49; 95% CI: 1.47?1.51), the lower educated (OR = 2.27; 95% CI: 2.22?2.33), the poor (OR = 2.54; 95% CI: 2.49?2.58), as well as those with poor social support (OR = 3.71; 95% CI: 3.64?3.77). Conclusion. The prevalence of DS in the general population of Serbia was relatively low and requires further monitoring. Female gender, older age, living in the region of Vojvodina, life without a partner, socioeconomic disadvantages, as well as the lack of social support were identified as the main factors associated with the occurrence of DS.
Introduction/Objective. The aim of this study was to examine the association between flat feet and socio-demographic factors and nutritional status in children aged 7?14 years of the Province of ...Vojvodina, Serbia. Methods. The research was conducted as a cross-sectional study. The survey instrument was a questionnaire, and anthropometric measurements were done using standardized procedures. To determine the impact of socio-demographic factors and nutritional status as independent variables on the flat feet in schoolchildren as a dependent variable, a multivariate logistic regression model was implemented. A multivariate model was adjusted for age, sex, type of settlement, and material status. Results. This study included 1376 children (685 boys and 691 girls). Significant differences were observed in the frequency of flat feet between normal weight, overweight, and obesity (p = 0.006), where obese children were rated highest in the flat foot category. Overweight children had a 1.76 times higher chance to have flat feet than those with normal weight (OR = 1.76; 95% CI 1.08?2.88), while obese children were 1.88 times more likely to have flat feet than those with normal weight (OR = 1.88; 95% CI 1.14?3.11). Conclusion. The research showed that nutritional status was significantly associated with the presence of flat feet in schoolchildren. The high prevalence of flat feet and obesity in schoolchildren should be accepted as a warning sign, and many public health policies should be undertaken to solve these issues.
Background/Aim. Oral diseases appear to be the major risk factors for tooth loss, but social factors and other determinants could play an important role as well. The aim of this study was to ...determine whether the possible independent sociodemographic risk factors and depressive disorders could contribute to the tooth loss in the adult population of Serbia. Methods. This cross-sectional study analysed the 2013 National Health Survey results for the population of Serbia (without the data for Kosovo and Metohia population). The sample was selected to provide the statistically reliable estimates at the national level. Study included 13,519 adults of 20 years of age, or above. The mean age of participants was 49.9 years including 6,998 (51.8%) females and 6,518 (48.2%) males. The number of missing teeth was dependent variable while the independent variables were: gender, age, marital status, education, employment status, Wealth Index, smoking status, body mass index (BMI), milk and milk products intake, fruit intake excluding juices, vegetable and salad intake (excluding potato), and depression. To measure the current depression, the standardized and validated the Patient Health Questionnaire (PHQ)-8 score was used. Edentulism (complete or partial) was defined as a loss of natural teeth. In order to determine the predictors of tooth loss, the bivariate and multivariate logistic regression models were implemented for all types of tooth loss. Results. The significant differences were observed among the categories of edentulism in relation to independent variables except vegetable and salad intake. The prevalence of all missing teeth was highest in the females, the respondents with a low level of education, inactive, underweight (BMI < 18.5) and respondents with moderately severe depressive episodes (PHQ-8 score 15 to 19). In the multivariate model, we found that the demographic factors (age, living with a partner), socioeconomic factors (primary and secondary education, Wealth Index), smoking, BMI, the PHQ-8 score and the depressive symptoms were significantly associated with partial tooth loss. Conclusion. Study demonstrated that sociodemographic and lifestyle factors as well as the symptoms of depresssion are also important factors related to the tooth loss. This study can help to advance the need for health programs focusing on education, smoking cessation, dietary habits as well as regular visits to the dentist.
nema
Obesity is a complex and multifactorial condition related to morbidity, mortality, poor quality of life and many other problems. The aim of the study was to determine the prevalence of overweight and ...obesity and factors associated with them (demographic, socioeconomic factors and lifestyle) in adults aged 50 years and above in Serbia.
This cross-sectional study, representative for the population in Serbia, was carried out in one-year period, including 6,932 people aged 50 and over. Individuals were interviewed and anthropometrically examined. The association between overweight and obesity with demographic, socioeconomic and behavioral factors was analyzed using multivariate logistic regression.
Age, level of education and smoking were significantly associated with overweight and obesity, regardless of gender. Marital status was significantly associated with obesity, regardless of gender and with overweight only in women. Breakfast consumption habit was significantly associated with obesity only in men. There was no significant association of overweight and obesity with the type of settlement, alcohol consumption and physical activity, regardless of gender.
The results of our study indicate the need for more intensive implementation of measures affecting the factors which contribute to overweight and obesity. Emphasis should be put on the population-based policies and programs that support environmental changes.
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