Gender differences in smoking experience and cessation: do wealth and education matter equally for women and men in Serbia?

BACKGROUND: Although nowadays smoking is less popular, one-third of adults in Serbia still smoke regularly. The aim of this study was to analyze associations of smoking experience and quitting with gender and socio-economic status. METHODS: Cross-sectional, population-based nationally representative household survey (Health Survey, 2006). Age- and multivariate-adjusted logistic regression analyses were used to analyze predictors of smoking experience and cessation. RESULTS: Of 12 365 interviewed, 51.1% used to smoke: current smokers accounted for 36.8% and former smokers for 14.3%. Higher educated women were more prone to smoking [secondary school: odds ratio (OR), 1.75; 95% confidence interval (CI), 1.52-2.01; university degree: OR, 1.53; 95% CI, 1.26-1.86], whereas for men the opposite was observed (university degree: OR, 0.72; 95% CI, 0.60-0.86). Education also was 'pro-quitting' factor (university degree: OR, 1.46; 95% CI, 1.07-1.99 for women; university degree: OR, 1.61; 95% CI, 1.23-1.80 for men). To quit smoking, wealth status was gradually more important for women, while just the richest men were more likely to quit smoking (OR, 1.45; 95% CI, 1.09-1.93). CONCLUSION: The poorest women in Serbia and the least educated men are those least likely to quit smoking, which indicates that ability to quit is predicted by socio-economic status.

Investigation of the 3-D actinic flux field in mountainous terrain.

During three field campaigns spectral actinic flux was measured from 290-500 nm under clear sky conditions in Alpine terrain and the associated O3- and NO2-photolysis frequencies were calculated and the measurement products were then compared with 1-D- and 3-D-model calculations. To do this 3-D-radiative transfer model was adapted for actinic flux calculations in mountainous terrain and the maps of the actinic flux field at the surface, calculated with the 3-D-radiative transfer model, are given. The differences between the 3-D- and 1-D-model results for selected days during the campaigns are shown, together with the ratios of the modeled actinic flux values to the measurements. In many cases the 1-D-model overestimates actinic flux by more than the measurement uncertainty of 10%. The results of using a 3-D-model generally show significantly lower values, and can underestimate the actinic flux by up to 30%. This case study attempts to quantify the impact of snow cover in combination with topography on spectral actinic flux. The impact of snow cover on the actinic flux was ~ 25% in narrow snow covered valleys, but for snow free areas there were no significant changes due snow cover in the surrounding area and it is found that the effect snow-cover at distances over 5 km from the point of interest was below 5%. Overall the 3-D-model can calculate actinic flux to the same accuracy as the 1-D-model for single points, but gives a much more realistic view of the surface actinic flux field in mountains as topography and obstruction of the horizon are taken into account.

The Pannonian plain as a source of Ambrosia pollen in the Balkans.

This study aims to find likely sources of Ambrosia pollen recorded during 2007 at five pollen-monitoring sites in central Europe: Novi Sad, Ruma, Negotin and Nis (Serbia) and Skopje (Macedonia). Ambrosia plants start flowering early in the morning and so Ambrosia pollen grains recorded during the day are likely to be from a local source. Conversely, Ambrosia pollen grains recorded at night or very early in the morning may have arrived via long-range transport. Ambrosia pollen counts were analysed in an attempt to find possible sources of the pollen and to identify Ambrosia pollen episodes suitable for further investigation using back-trajectory analysis. Diurnal variations and the magnitude of Ambrosia pollen counts during the 2007 Ambrosia pollen season showed that Novi Sad and Ruma (Pannonian Plain) and to a lesser degree Negotin (Balkans) were located near to sources of Ambrosia pollen. Mean bi-hourly Ambrosia pollen concentrations peaked during the middle of the day, and concentrations at these sites were notably higher than at Nis and Skopje. Three episodes were selected for further analysis using back-trajectory analysis. Back-trajectories showed that air masses brought Ambrosia pollen from the north to Nis and, on one occasion, to Skopje (Balkans) during the night and early morning after passing to the east of Novi Sad and Ruma during the previous day. The results of this study identified the southern part of the Pannonian Plain around Novi Sad and Ruma as being a potential source region for Ambrosia pollen recorded at Nis and Skopje in the Balkans.

Internal stress and defect-related free volume in submicrocrystalline Ni studied by neutron diffraction and difference dilatometry.

A combined study of neutron diffraction and difference dilatometry on submicrocrystalline Ni prepared by high pressure torsion aims at studying the anisotropic behaviour during dilatometry and its relation to internal stress and structural anisotropy. Macroscopic stresses were undetectable in the dilatometer samples. Along with specific tests such as post cold-rolling, this shows that an observed anisotropic length change upon annealing is not caused by internal stress, but can be explained by the inherent microstructure, i.e. the anisotropic annealing of relaxed vacancies at grain boundaries of shape-anisotropic crystallites.

Comparative survival analysis of urea kinetic based indices.

BACKGROUND: Although urea kinetic modeling indices for measuring dialysis dose are recommended by world expert groups, it is not quite clear whether some of these are superior in predicting the outcome over others. This prospective, single-center study was carried out with the aim to compare predictive value of different indices and methods of measuring dialysis dose. METHODS: The analysis included 93 anuric patients having been on hemodialysis for at least 2 years who were followed-up for 75-months. The dialysis dose was measured by Kt/V (formal UKM, 3 and 2 urea samples), Kt/V (Daugirdas), Kt/V (Lowrie), eKt/V (Daugirdas), URR and TAC urea. RESULTS: Correlations between dialysis indices and survival time were significant for all indices (p<0.01) except for TAC. All indices, except for TAC urea, were significant predictors of mortality (multivariate Cox regression analysis; p<0.01) and differences of significant levels among these colinear parameters were small. CONCLUSION: All examined indices except for TAC urea were highly predictive of patient mortality. Daugirdas and Lowrie simplified Kt/V indices are as predictive of all-cause mortality as more complex formal UKM methods in long-term patients on a 3x4h/week schedule.

Evaluation of the epidemiology of hepatitis B virus cross-infection in a maternity hospital.

OBJECTIVE: To determine the hepatitis B infection risk in a university hospital of obstetrics and gynecology. SETTING: The University Hospital of Obstetrics and Gynecology, The University of Sarajevo, Yugoslavia. DESIGN: Staff members were divided into three groups: 73 doctors, 184 medical technicians working in delivery rooms, and 55 medical technicians working with postnatal care. The patients were 63 women, aged 17 to 39 years (mean = 26.11 years), pregnant for the first time and in the first stage of labor. Participants all had a negative history of hepatitis B and no known contact with the hepatitis B virus. RESULTS: The incidence of hepatitis B infections among physicians, technicians, and postnatal care technicians was 1.36%, 3.8%, and 3.6%, respectively. The incidence among patients was 4.76%. The daily infection risk varied between 1% and 17% of all deliveries. CONCLUSIONS: The risks of transmission of the hepatitis B virus to hospital workers in this setting is indeed high enough to make a case for hepatitis B vaccination in susceptible staff members. Even if vaccination of staff members is carried out, hygienic measures to prevent the transmission of bloodborne infection between patients and from patients to staff are of the utmost importance.

Infant mortality and economic instability in Yugoslavia.

Efforts to manage Yugoslavia's debt crisis beginning in 1979 led to economic policies which resulted in declining real income in subsequent years. This has been associated with a slowing of the rate at which infant mortality has declined. There is no evidence, however, that populations in poor parts of the country experienced a more dramatic impact on infant mortality than did populations in more favored regions. The lack of difference is attributed to redistributive social policies among and within republics.

Nutritional effects of the siege on new-born babies in Sarajevo.

OBJECTIVE: To investigate the influence of maternal nutrition on perinatal mortality, morbidity, malformations and low birth weight (< 2500 grams). DESIGN: All mothers and their babies born in Kosevo Hospital during three different time periods were sampled: September 1992 to February 1993 (pilot study), May 1993 to February 1994 (main study) and statistics compiled in 1991 (pre-war). SETTING: Data were collected at the gynaecology and obstetric clinic, Kosevo hospital, city of Sarajevo. SUBJECTS: A total of 920 babies were included in the pilot study, 1225 mothers of 1237 babies participated in the main study and birth data from 8676 babies born in 1991 were used as baseline data. INTERVENTIONS: Birth outcome data were compiled for all three time periods. In the main study, a questionnaire was administered on arrival at the clinic in which mothers were asked to estimate their weight prior to pregnancy. Information on energy and protein intake was collected for all women by estimating weekly food intake during pregnancy. Mothers were weighed and had their heights measured within 12 hours of delivery. Women were divided into three groups based on their body mass index (BMI) using self-reported prepregnancy weight (underweight BMI < 21.5; normal weight BMI 21.5-25.6; overweight BMI > 25.6). Four groups were defined according to dietary intake during pregnancy (daily energy intake < 2755 kcal and 2755 + kcal; protein intake < 80 and 80 + grams). RESULTS: Weight gain during pregnancy was low in overweight women (3.2 kg) compared with normal weight (10.4 kg) and underweight (11.7 kg) women. Underweight women had babies with the lowest mean birthweight (3072 grams) and the highest percentage of low birth weight babies (13.0%). Perinatal mortality increased from 15.8/1000 live births in 1991 (pre-war) to 36/1000 in May 1993-February 1994. Morbidity among babies increased from 3.4% to 8.2% in the same time period. There was a significant increase in babies born with malformations from 0.4% in the pre-war period to 3.0% in May 1993 to February 1994. CONCLUSIONS: It is concluded that the war has had a deleterious effect on birth outcomes in Sarajevo.

New strategies for polymer development in pharmaceutical science--a short review.

We are developing synthetic polymers for pharmaceutical and medical applications. These applications can be broadly grouped on how the polymer will be utilized e.g. material, excipient or molecule. Our focus is to develop polymers with more defined structures that are based on biological, physicochemical and/or materials criteria. Strategies are being developed to more efficiently optimize structure-property correlations during preclinical development. We describe two examples of our research on pharmaceutical polymer development: narrow molecular weight distribution (MWD) homopolymeric precursors which can be functionalized to give families of narrow MWD homo- and co-polymers, and hydrolytically degradable polymers.

Survey of natural and anthropogenic radioactivity in environmental samples from Yugoslavia.

The radioactivity of 238U, 226Ra, 232Th, 40K and 137Cs in sediments, soil, turf and honey from Serbia and Kosovo (Yugoslavia) was measured using gamma and alpha spectrometry in order to estimate the radiation hazard from natural and man-made sources, as well as to compile a database for radioactivity levels in those regions. One sample, collected in the vicinity of a "depleted uranium" (DU) shell of the recent Balkan war, revealed a high 238U activity and a non-natural 235U/238U activity ratio, confirming therefore its anthropogenic origin. However, some other soil samples coming from characteristic DU craters did not show any characteristic level of radioactivity. The other sediment and turf samples taken all around the country show low radioactivity levels for all the isotopes here considered. With the aim of obtaining some indication about radioactivity migration in the food chain, several honey samples have been examined too. All samples show very low radioactivity content, often indistinguishable from natural background.

Management of hospital discharge data in Belgrade.

The paper presents a database on clinically treated patients in Belgrade, a computerized health-statistics information sub-system. It also analyses the organisation of report processing related to hospitalisation, types of indicators on hospital treatment (which are the result of such a processing) as well as their further utilisation on different levels of management within the system of health care in Belgrade.

The survey of healthcare software in Yugoslavia.

The aim of this study is to identify vendors of software packages applicable to health care system as well as to evaluate software packages offered to the health sector by a variety of sources, namely state owned software development companies, privately operated software development companies as well as sole traders. The approach undertaken was to preselect the potential suppliers via an initial targeted interview. Subsequently a questionnaire, consisting of 23 questions, was addressed to the selected vendors and suppliers. The response rate to the questionnaire was 58%. Investigation of 113 has revealed the non government software suppliers clearly lead in copyright ownership, IBM compatible personal computers were the platform of choice whereas majority of code was written utilising languages capable of supporting relational data base queries. The final outcome of the above study is a database of software packages and applications available to the health sector offering the health professionals and institutions guide lines and support in developing information systems, relevant subsystems and modules.

Personal identifying number as a unique patient identifier in database on clinically treated patients in Belgrade: its use, advantages and drawbacks.

Database on clinically treated patients in Belgrade served as an example for analysis of possibilities for the use of Personal Identifying Number (PIN) as an Unique Patient Identifier. In the first part of the paper we analyzed filling up of the fields which contained data on PIN within complete databases in 1981, 1991 and 1996. Filling up of PIN was significantly changed in the three observed years: it was 18% in 1981; 68% in 1991, and 56% in 1996 respectively. Analysis of interactions among the chosen factors (type of hospital, demographic and social characteristics of patients, length of stay in hospital, manner of treatment, main diagnosis, treatment outcome) and measuring time, showed a different degree of statistical significance. In the second part of our paper we analyzed the unexpected decrease in filling up of PIN in 1996 (as compared to 1991) ussing the method of logistic regression, on 1% samples from the databases for the two respective years. On the basis of obtained models of filling up of UPI data, taken as dependent variable and the above factors (predictors) we analyzed the advantages and drawbacks of UPI application as an unique patient identifier.

Developing mortality patterns: robust modified generalized likelihood ratio algorithm for infant mortality rate change detection.

A new robust modified generalized likelihood ratio algorithm, which enables the changes of mortality rates to be detected automatically, is applied. The procedure is based on the calculation of discrimination function using robust least squares estimates of AR mortality rates residuals. The feasibility of the approach is demonstrated with experimental data concerning infant mortality rate in Serbia.