Sociodemographic Factors Associated with Breast Cancer Screening among Women in Serbia, National Health Survey.

Background: Approximately 2.3 million female breast cancer cases were identified globally in 2020, resulting in 685,000 fatalities among women. Serbia too experiences a high breast cancer burden. Effective reduction of breast cancer incidence and mortality necessitates strategic measures encompassing the implementation of cost-effective screening technology. However, various impediments to screening implementation persist. We aimed to estimate the impact of socioeconomic factors on breast cancer screening in Serbia. Methods: Data from the 2019 National Health Survey of the population of Serbia was. The research was a descriptive, cross-sectional analytical study by design, on a representative sample of the population of Serbia. Data from women aged 15+ yr were used to examine the demographic and socioeconomic factors associated with breast cancer screening inequalities. Results: In Serbia the age group of women who predominantly participated in organized breast cancer screening (39.5%) were the ones aged 65+ yr. Women with a secondary education were 2.1x more likely to undergo a screening exam voluntarily (57.5%), compared to women with a higher education background (26.6%). When considering marital and financial circumstances, married/unmarried women from an affluent financial category exhibited a notably higher frequency of self-initiating a mammography (73% and 48.5%) in comparison to those financially struggling (27.6%). Conclusion: Strong support is imperative for countries to establish prevention and early detection programs for cancer.

Demographic and Socioeconomic Predictors of Prehypertension and Hypertension in the Adult Population: Serbian National Health Survey.

Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and socioeconomic predictors of prehypertension and hypertension in the adults in Serbia, and to examine the relationship between prehypertension and hypertension and health behavior determinants (smoking, alcohol use, physical activity) and individual aspects of health (a health self-assessment, multimorbidity, BMI, depressive symptoms). Materials and Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 20 and over were used. Results: Women are at a reduced risk for both prehypertension (OR = 0.328) and hypertension (OR = 0.349) by nearly 70%. Similarly, those aged below 60 years have a lower risk for prehypertension and those younger than 40 years have a lower risk for hypertension (OR = 0.995), whereas people with a lower education have a 4.3 times higher risk of prehypertension (OR = 4.323) and a 1.6 times higher risk of hypertension (OR = 1.614). The poor have a 1.4 times higher risk of prehypertension (OR = 1.413) and a 1 times higher risk of hypertension (OR = 1.035). People with multimorbidity have a 1.2 times higher risk of both prehypertension (OR = 1.218) and a 4.8 times higher risk of hypertension (OR = 4.867). Conclusions: Male gender, lower education, poverty, age and the presence of multimorbidity are significant predictors of prehypertension and hypertension in the Serbian adult population, so preventive strategies should be aimed at these sensitive population groups.

Burnout syndrome among medical nurse-technicians in intensive care units in cardiovascular surgery.

Background: Healthcare workers in intensive care units work under specifically hard conditions compared to healthcare workers who work under regular clinical conditions. In this sense, the research aims at assessing the level of burnout symptomatology among nurse technicians working in intensive care units for cardiovascular surgery and to compare those burnout levels with those recorded for medical technicians working under regular clinical conditions. Method: The research was designed as a cross-sectional study. The sample consisted of nurse technicians working in intensive care units specializing in cardiovascular surgery (70 participants) and nurse technicians working under regular clinical conditions (70 participants) at the Institute for Cardiovascular Diseases "Dedinje," Belgrade, Serbia. To evaluate the manifestation of burnout syndrome at work, the analysis uses the Serbian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results: To examine the variances in the average sub-scores for burnout within two groups of medical technicians, the study used Two Independent Samples T-test. The statistically noteworthy differentiation was ascertained for emotional exhaustion and personal accomplishment, but this does not hold true for depersonalization. However, the mean score values across the different burnout levels (low, moderate, high) are similar in two cohorts of respondents (p > 0.05). Conclusion: This study will serve as an impetus for a policy reform focused on ameliorating working conditions and improving healthcare workers' satisfaction and overall healthcare quality.

Social support score in patients with malignant diseases-with sociodemographic and medical characteristics.

Introduction: Social support as a complex construct has a positive influence not only on a patient's condition but also on the process of the patient's emotional adjustment to cancer. The goal of this study is to investigate aspects of the level of social support in oncology patients and its interconnection with sociodemographic and medical variables. Method: The study was conducted as a prospective observational study in 2020, including 250 patients aged 19 and over, both sexes, with a diagnosis of oncological disease. The research was conducted in the Department of General Medicine of the Health Center Trstenik, Central Serbia, after approval by the Ethics Committee of the Health Center Trstenik, Central Serbia. A social support assessment questionnaire (Oslo-3 Social Support Scale) was used as a research instrument. Results: Data collected from the entire study population showed that bad social support was present in almost 90% of cases. Univariate and multivariate regression analysis showed a statistically significant influence of the following variables on the bad social support: education level, activity limitation, difficulties in performing daily activities, the impact of pain on the performance of activities, the need for additional help with activity, the need for help at home, unfulfilled needs for health care, means of information, anxiety score and depression score. Conclusion: Interventions to increase social support may be important for enhancing mental health and quality of life in cancer patients.

Mortality of Malignant Melanoma in Central Serbia, in the Period 1999-2015.

INTRODUCTION: Malignant melanoma is one of the rarest forms of skin cancer but it is the most deadly. OBJECTIVE: The objective of this paper was to analyze the epidemiological characteristics and trends of mortality from malignant melanoma in the population of Central Serbia in the period 1999-2015. METHODS: The study was designed as a retrospective descriptive epidemiological study. Standardized mortality rates were used in statistical data processing. A linear trend model and regression analysis were used to examine trends in malignant melanoma mortality. RESULTS: In Serbia, malignant melanoma mortality shows an increasing trend. The overall age-adjusted melanoma death rate was 2.6 per 100,000 with a higher death rate among men (3.03 per 100,000) than among women (2.1 per 100,000). Malignant melanoma mortality rates increase with age in both sexes and are highest in the age group of 75 and older. The highest increase in mortality in men is recorded in the 65-69 age group, with an average percentage increase of 21.33 (95% CI, 8.40 - 51.05), while in women the largest increase in mortality was recorded in the 35-39 age group, with an average percentage increase of 31.4 and in the 70-74 age group, 12.9. CONCLUSIONS: The trend of increasing mortality from malignant melanoma in Serbia is similar to those in most developed countries. Education and improvement of awareness in the general population and among health professionals are vital to reducing melanoma mortality in the future.

Demographic and socioeconomic factors associated with cervical cancer screening among women in Serbia.

Objectives: Effective reduction of cervical cancer incidence and mortality requires strategic measures encompassing the implementation of a cost-effective screening technology. Serbia has made significant strides, introducing organized cervical cancer screening in 2012. However, various impediments to screening implementation persist. The aim of the study was to estimate the socioeconomic factors associated with cervical cancer screening among women in Serbia. Methods: Data from 2019 National Health Survey of the population of Serbia were used in this study. The study is cross sectional survey on a representative sample of the population of Serbia. Present total number of participants analyzed in survey 6,747. Results: In Serbia, 67.2% of women have done a Pap test at any time during their lives, of which 46.1% of women have undergone cervical cancer screening in the past 3 years. About a quarter of women have never undergone a Pap test in their life (24.3%). The probability of never having a Pap test have: the youngest age group (15-24 years) is 1.3 times more likely than the oldest age group (OR = 1.31), unmarried women 0.3 times more often than married women (OR = 0.37), respondents with basic education 0.9 times more often than married women (OR = 0.98), the women of lower socioeconomic status 0.5 times more often than respondents of high socioeconomic status (OR = 0.56). Conclusion: Enhancement of the existing CCS would be the appropriate public health approach to decrease the incidence and mortality of cervical cancer in the Republic of Serbia.

Dyspepsia in Montenegrin chronic kidney disease patients undergoing hemodialysis: endoscopic and histopathological features.

PURPOSE: The main purpose of this study was to analyze the characteristics of dyspepsia and contributing factors in Montenegrin maintenance hemodialysis patients. METHODS: The study included 43 patients undergoing hemodialysis with symptoms of dyspepsia and 40 control dyspeptic subjects with preserved kidney function. All subjects underwent an interview about dyspeptic symptoms, physical and biochemical examination, and upper gastrointestinal endoscopy with pathohistological analysis of biopsy specimens. RESULTS: Early satiety, bloating and heartburn were the most common symptoms in hemodialysis patients but without significant difference in frequency in relation to controls. Chronic kidney disease patients had statistically lower concentration of total proteins and albumin (p < 0.001), as well lower BMI values (p = 0.002). Despite this, no significant correlation of laboratory parameters with dyspeptic symptoms was found. Pathohistological examination indicated that the most common finding in hemodialysis patients was chronic active gastritis (58%), while chronic atrophic gastritis was significantly more common in dialytic patients (p = 0.032). Patients on hemodialysis had more frequently atrophy of corpus mucosa, which was positively related to dialysis duration (p = 0.001) and negatively related to pH values (p = 0.004) and bicarbonate concentration (p = 0.049). Helicobacter pylori was considerably more common in patients who underwent shorter time on hemodialysis (p < 0.001) and had higher values of bicarbonate (p = 0.037). CONCLUSION: Maintenance hemodialysis patients are at risk for chronic gastric diseases that correlated with both dialysis vintage and duration.

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.

Differences Regarding Knowledge of Sexually Transmitted Infections, Sexual Habits, and Behavior Between University Students of Medical and Nonmedical Professions in Serbia.

Aim: The aim of this study is to assess the knowledge of sexually transmitted infections (STIs), sexual habits, and behavior among students of medical and nonmedical students in Serbia. Methodology: The cross-sectional study of 1,273 university students of four undergraduate institutions in Serbia, two of medical and two of nonmedical orientation. A standardized questionnaire, prepared in line with the questionnaire of the European health research-the second wave (European Health Interview Survey-EHIS wave 2), according to defined internationally accepted indicators, was used as a survey instrument. Results: Statistically significant difference (p < 0.001) between medical and nonmedical student groups was determined for the following parameters: naming four of five STIs (29.1 vs. 13.4%), knowledge about vaccines against some STIs (26.0 vs. 17.0%), relationship between HPV infection and cervical malignancy (48.2 vs. 16.7%) engaged in the sexual relations (87.9 vs. 76.4%), never used a condom (15.2 vs. 10.4%), underwent gynecological or urological examination (66.7 vs. 44.1%), and tested to one of STIs (10.5 vs. 4.9%). Conclusion: Both student groups have limited knowledge on possible consequences that risky sexual behavior has for reproductive health. Promotion of knowledge about STIs, awareness of all complications, and consequences of these infections certainly affect the reduction of risky behavior.

[General characteristics of psychoactive substances consumption and abuse among high school population].

INTRODUCTION: Consumption of psychoactive substances among the youth is suggestive of a trend indicating an accelerated and continual growth of the tendency in question. This research was aimed at investigating the frequency of psychoactive substance consumption among high school students on the territory of the town of Kragujevac so that the adequate measures on prevention could be taken. MATERIAL AND METHODS: Data from the questionnaire answered by high school student attending the 1st and 4th grade of the medical, technical and economic high schools in Kragujevac were thereby used. The survey included the overall number of 1280 students: there were 793 (62%) male participants and 487 (38%) female. The research was conducted from October 2007 until January 2008. The questionnaire from the project "Health Status, Health Needs and Utilization of Health Care of the Population of Serbia" conducted by the Institute of Public Health of Serbia "Dr Milan Jovanovic Batut" in 2000 was used in the survey. RESULTS AND DISCUSSION: According to the answers, alcohol was used by 45.5%, cigarettes by 20% and drugs by 3.1% of the examined subjects. Following the use of alcohol and cigarettes, the most often used psychoactive substance was cannabis, which was consumed by 7.8% of the examined subjects out of who 9.8% were boys and 4.8% were girls. Since the risky behaviour seems not to be isolated and individual but rather as a combination of several forms of it, school programmes should treat young people before certain forms of behaviour are established. Family, school, health service and society should work on an organized basis as well as methodically on prevention and on fighting against these inadequate habits.