Psychometric Properties of the World Health Organization's Quality of Life (WHOQOL-BREF) Questionnaire in Medical Students.

Background and Objectives: Studies on the effects of studying on a medical student's quality of life are sparse. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used scale that enables the assessment and international comparisons of the quality of life. The aim of this study was to evaluate psychometric properties of the WHOQOL-BREF questionnaire among Serbian medical students. Material and Methods: We conducted a cross-sectional study that involved 760 medical students at a state medical faculty at the University of Kragujevac, Serbia. The reliability of the WHOQOL-BREF was evaluated using Cronbach's alpha coefficient and test-retest analysis, and the validity was examined using principal component analysis, with Promax rotation method. Results: Cronbach's alpha coefficient for the whole WHOQOL-BREF scale was 0.896. Internal reliability for all domains was above 0.70, except for the domain "Social Relationships" (0.533). The test-retest reliability for all domains was significant at p 0.01 level, showing good stability of the scale. Principal component analysis with Promax rotation method indicated four main components that explained 49.5% of variance. Conclusion: The Serbian version of the WHOQOL-BREF scale showed satisfactory psychometric properties that facilitate estimation of the quality of life of medical students.

Relationship Between Socio-Demographic Characteristics, Reproductive Health Behaviors, and Health Literacy of Women in Serbia.

Introduction: Health literacy of women can significantly affect different aspects of reproductive health. The aim of this study was the assessment of relationship of health literacy, socio-demographic characteristics and reproductive health behaviors of women in Serbia. Methodology: This was a cross-sectional study on a random sample of women aged 18 and over from the territories of three Serbian regions, stratified according to age groups, region and type of settlement. A standardized version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used in assessing health literacy of women. Results: Based on the calculated index of health literacy, 9.6% of respondents had inadequate health literacy. Inadequate levels of health literacy were more common in women living in rural areas (OR = 1.111) and the poorer classes (OR = 5.122). Employed women (OP = 1.249), with good health (OR = 1.512) with a degree (OR = 1.535) had bigger odds to have adequate health literacy. Multivariate regression analysis showed the following significant predictors: commitment to the chosen gynecologist (OR = 1.530), contraceptive use (OR = 1.020), knowledge of the damages that could be caused by the human papillomavirus (HPV) (OR = 1.578), awareness of vaccine availability against HPV infection (OR = 1.217) and following the health-related topics (OR = 2.350). Conclusion: Limited levels of health literacy were significantly higher among middle-aged women, among those living in rural areas, among women who rated their health as poor or very poor, and who exhibited more negative patterns of reproductive health behavior, indicating the need for implementation of prevention programs and strategies with the aim of increasing the level of health literacy.

Mental Health Assessment of Cancer Patients: Prevalence and Predictive Factors of Depression and Anxiety.

BACKGROUND: Patients with oncological diseases often have mental disorders in the form of comorbidity. The aim of this study was to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients. METHODS: This prospective observational study done in 2020 included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD- and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms. RESULTS: The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression. The level of depression was higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. All subjects were characterized as persons with severe anxiety (score 26-63). The level of anxiety was higher in older respondents, in the presence of long-term illness, with greater limitations of activities and difficulties in performing daily activities, with a more pronounced influence of pain on performing activities and the influence of the media. CONCLUSION: Caring for the mental health of cancer patients must occupy a significant part of each country's national health policy.

The Unmet Healthcare Needs: Evidence from Serbia.

BACKGROUND: We aimed to determine the socio-economic factors associated with unmet healthcare needs of the population aged 20 and over in Serbia. METHODS: We used data from the 2013 National Health Survey (NHS) of the population of Serbia. We focused only on the data concerning the population aged 20 and over. The final sample thus included 13,765 participants. The logistic regression was used to examine the socio-economic factors associated with unmet health care needs. RESULTS: According to the data obtained in this study, 26.2% of the population aged 20 and over reported unmet health care needs during the previous 12 months. The multivariate analysis shows that significant indicators of unmet healthcare needs include: gender, age, marital status, level of education, financial and employment status. CONCLUSION: Females, the elderly and those with the lowest levels of education and household income, as well as those who are divorced and unemployed are at highest risk of unmet healthcare needs. Different policies and approaches should be taken into consideration when it comes to vulnerable population groups in order to reduce the currently existing gaps to a minimum and provide more equal opportunities for health care to all citizens.

Ace/actn3 genetic polymorphisms and athletic performance of female soccer players` / Polimorfismos genéticos em ace/actn3 e desempenho atlético de atletas de futebol feminino / Polimorfismos genéticos en ace/actn3 y desempeño atlético de atletas de fútbol femenino

ABSTRACT Objective: Previous studies have shown controversial relationships between ACE and ACTN3 gene polymorphisms and sports performance. Thus, the aim of our study was to assess anaerobic and aerobic performance indicators of young female soccer players with different ACE/ACTN3 gene profiles. Methods: Twenty-seven female soccer players aged 16-18 underwent acceleration, speed, strength, anaerobic power and aerobic endurance tests and had their ACE and ACTN3 polymorphisms determined. Results: Based on genetic analysis, they were divided into the following groups: ACE II (n=2), ACE ID (n=11), ACE DD (n=14), ACTN3 XX (n=5), ACTN3 RR (n=7) and ACTN3 RX (n=15). ACE DD and ACE ID groups differed significantly in terms of results achieved on the 5 m sprint test (1.15±0.05 s vs 1.10±0.05 s, P=0.42). ACTN3 RR and RX achieved better results than the ACTN3 XX group in seven continuous vertical jumps (26.57±1.59 cm vs 25.77±2.51 cm vs 22.86±1.16 cm, respectively; P=0.007 for RR vs XX and P=0.021 for RX vs XX). Conclusion: High prevalence of ACE DD and ACTN3 RX genotypes in our subjects may suggest that faster and more powerful young females tend to perform better in soccer. Nevertheless, the absence of differences in most of the physical test results indicates that different genotypes are compatible with high-level soccer performance, meaning that it is the phenotype-genotype interaction that makes a successful female soccer player. Level of Evidence I, Prognostic studies — Investigating the effect of a patient characteristic on disease outcome.

RESUMO Objetivo: Estudos anteriores mostraram relações controvertidas entre os polimorfismos dos genes ACE e ACTN3 e desempenho esportivo. Assim sendo, o objetivo deste estudo foi avaliar os indicadores de desempenho anaeróbico e aeróbico de jovens futebolistas do sexo feminino com diferentes perfis dos genes ACE/ACTN3. Métodos: Vinte e sete jogadoras com idade entre 16 e 18 anos realizaram testes de aceleração, velocidade, força, potência anaeróbica e resistência aeróbica e os polimorfismos de seus genes ACE e ACTN3 foram determinados. Resultados: Com base na análise genética, elas foram divididas nos seguintes grupos: ACE II (n = 2), ACE ID (n = 11), ACE DD (n = 14), ACTN3 XX (n = 5), ACTN3 RR (n = 7) e ACTN3 RX (n = 15). Os grupos ACE DD e ACE ID diferiram significativamente quanto aos resultados obtidos no sprint test de 5 metros (1,15 ± 0,05 s vs. 1,10 ± 0,05 s, P = 0,42). Os grupos ACTN3 RR e RX atingiram resultados melhores do que o grupo ACTN3 XX em sete saltos verticais contínuos (26,57 ± 1,59 cm vs. 25,77 ± 2,51 cm vs. 22,86 ± 1,16 cm, respectivamente; P = 0,007 para RR vs. XX e P = 0,021 para RX vs. XX). Conclusão: A alta prevalência de genótipos RX em ACE DD e ACTN3 em nossa amostra pode sugerir que as jovens atletas mais rápidas e com maior potência tendem a ter melhor desempenho no futebol. No entanto, a ausência de diferença na maioria dos resultados dos testes físicos indica que genótipos distintos são compatíveis com o desempenho futebolístico de alto nível, o que significa que é a interação fenótipo-genótipo que faz uma jogadora de futebol ser bem-sucedida. Nível de Evidência I, Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

RESUMEN Objetivo: Estudios anteriores mostraron relaciones controvertidas entre los polimorfismos de los genes ACE y ACTN3 y desempeño deportivo. Siendo así, el objetivo de este estudio fue evaluar los indicadores de desempeño anaeróbico y aeróbico de jóvenes futbolistas del sexo femenino con diferentes perfiles de los genes ACE/ACTN3. Métodos: Veintisiete jugadoras con edad entre 16 y 18 años realizaron tests de aceleración, velocidad, fuerza, potencia anaeróbica y resistencia aeróbica y fueron determinados los polimorfismos de sus genes ACE e ACTN3. Resultados: Con base en el análisis genético, ellas fueron divididas en los siguientes grupos: ACE II (n = 2), ACE ID (n = 11), ACE DD (n = 14), ACTN3 XX (n = 5), ACTN3 RR (n = 7) y ACTN3 RX (n = 15). Los grupos ACE DD y ACE ID difirieron significativamente cuanto a los resultados obtenidos en el sprint test de 5 metros (1,15 ± 0,05 s vs. 1,10 ± 0,05 s, P = 0,42). Los grupos ACTN3 RR y RX alcanzaron resultados mejores que el grupo ACTN3 XX en siete saltos verticales continuos (26,57 ± 1,59 cm vs. 25,77 ± 2,51 cm vs. 22,86 ± 1,16 cm, respectivamente; P = 0,007 para RR vs. XX y P = 0,021 para RX vs. XX). Conclusión: La alta prevalencia de genotipos RX en ACE DD y ACTN3 en nuestra muestra puede sugerir que las jóvenes atletas más rápidas y con mayor potencia tienden a tener mejor desempeño en el fútbol. Sin embargo, la ausencia de diferencia en la mayoría de los resultados de los tests físicos indica que genotipos distintos son compatibles con el desempeño futbolístico de alto nivel, lo que significa que es la interacción fenotipo-genotipo que hace que una jugadora de fútbol sea exitosa. Nivel de Evidencia I, Estudios pronósticos - Investigación del efecto de característica de un paciente sobre el desenlace de la enfermedad.

Sex differences in anatomical parameters of acetabulum among asymptomatic Serbian population.

BACKGROUND/AIM: Anatomical parameters of the bony components of the hip joint are essential for better understanding of etiopathogenesis of diseases like primary osteoarthrosis of the hip joint. The aim of this reserch was to examine the normal acetabular morphometry in Serbian population and to determine whether there are sex differences in anatomical parameters of the acetabulum among asymptomatic subjects. METHODS: Pelvic radiographics of 320 adult asymptomatic patients (640 hips) were analyzed in 170 men and 150 women to determine the morphology of the acetabulum in Serbian population. For each hip the center edge angle of Wiberg (CEA), the acetabular angle of Sharp (AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle (RA) were measured. RESULTS: The following average measurements for acetabulum geometry were obtained (x +/- SD): CEA - 33.5 +/- 6.5 degrees (33.6 +/- 5.8 degrees in male, 33.3 +/- 6.9 degrees in female), AA - 38.0 +/- 3.8 degrees (37.5 +/- 3.6 degrees in male, 38.5 +/- 3.9 degrees in female), AD - 11.9 +/- 2.8 mm (12.5 +/- 2.7 mm in male, 11.2 +/- 2.7 mm in female), ARO - 7.6 +/- 5.7 degrees (6.2 +/- 4.9 degrees in male, 9.0 +/- 6.0 degrees in female) and RA - 18.4 +/- 10.0 degrees (19.6 +/- 8.5 degrees in male, 17.1 +/- 9.5 degrees in female). There were significant differences in the CEA, AA, AD, ARO and RA related to gender (p < 0.01, t-test). CONCLUSION: There are significant gender differences in Serbian population for all the examined anatomical parameters of acetabulum. We found sex-related differences in acetabular morphology, female acetabulum being marginally more dysplastic than male acetabulum. There is also a clear tendency of female hips to be more dysplastic than male ones.