Hospital admission tendencies caused by day-to-day temperature changes during summer: a case study for the city of Novi Sad (Serbia).

Increased temperature risk in cities threatens the health and well-being of urban population and is fueled by climate change and intensive urbanization. Consequently, further steps must be taken for assessing temperature conditions in cities and their association with public health, in order to improve public health prevention at local or regional level. This study contributes to solving the problems by analyzing the connection between extreme temperatures and the tendencies of all-cause hospital admissions. The analyses used (a) 1-h air temperature data, and (b) daily data of all-cause hospital admissions. The datasets include the summer period (June, July, August) for the years 2016 and 2017. We tested the effects of two temperature indices, day-to-day change in maximum temperature - Tmax,c and daily temperature range - Tr, with all-cause hospital admission subgroups, such as all-cause cases - Ha, hospital admissions in the population below 65 - Ha<65, and hospital admissions in the population aged 65 and over - Ha≥65. The results show the highest values of Ha when Tmax,c is between 6 and 10 °C. Therefore, more intensive hospital admissions can be expected when Tmax increases from day-to-day (positive values of Tmax,c), and it is more visible for Ha and Ha<65 (1 °C = 1% increase in hospital admissions). Also, Tr values between 10 °C and 14 °C cause an increase in the number of hospital admissions, and it is more noticeable for Ha≥65.

Circular bioeconomy for olive oil waste and by-product valorisation: Actors' strategies and conditions in the Mediterranean area.

The circular economy and bioeconomy can contribute to transitioning towards more sustainable production and consumption in the olive oil sector. This article is the first to analyse multi-actor strategies and multi-level socio-economic conditions for olive oil waste and by-product valorisation in the Mediterranean area using circular bioeconomy principles. Government policies, the strategies of corporations and farmers and consumers' perceptions are discussed, and various methods are applied, such as desk reviews, case studies and quantitative and qualitative surveys. The findings show strong aspirations for improved sustainability in the olive industry. Furthermore, waste and by-product valorisation strategies foster the creation of innovative practices. However, a common regulatory framework, public financial measures, new circular business models using innovative technologies, multi-actor collaboration and increased consumer awareness of the circular economy and new olive oil waste-based products are necessary for more efficient and sustainable use of olive resources. The policy and management recommendations presented in this study may aid in improving and innovating frameworks and practices for better sustainable management of valuable olive resources.

Stigmatising Attitudes Towards Mental Health Conditions Among Medical Students In Five South-Eastern European Countries.

Introduction: Stigmatising attitudes towards mentally ill people are present among healthcare professionals. The aim of the study was to evaluate medical students' attitudes in five medical schools from Albania, Bulgaria, Moldova, Romania and Serbia and to determine if psychiatry clerkship improves these attitudes. Methods: In the first stage, the study included students from the first and final years of medical school; in the second stage, only final-year students were included; The Mental Illness Clinicians' Attitude Scale (MICA-2) and the Attribution Questionnaire (AQ-9) were used in this study. The total sample comprised 1,526 medical students in the first stage and 614 in the second stage. Results: The analysis of the average AQ-9 and MICA-2 scores between countries revealed significant differences (p<0.05). Multivariable analysis showed that female students were 30% more likely to have elevated AQ-9 scores than male students (p=0.029). Final-year students had a significantly lower chance of having a higher MICA-2 score compared to first-year students (OR=0.7; p<0.05). Conclusions: Psychiatry clerkship contributes to a decrease in the level of stigmatising attitudes among medical students. Further research is required to assess the curricula to achieve better results in reducing stigma among future doctors.

Knowledge of Healthcare Workers Regarding Road Traffic Child Safety in South Backa District, Serbia.

Introduction: Healthcare workers (HCW) can have an important role in educating parents about child road safety, but research on the topic shows that they usually do not have adequate knowledge. Thus, the aim of our study was to analyze their knowledge in the field of child road safety. Methods: The cross-sectional study was conducted among HCW from South Backa district, Serbia, using a specially created questionnaire for assessing knowledge on road traffic injuries in children. Results: The research involved the participation of 317 healthcare workers (86 physicians and 231 nurses). Healthcare workers from primary healthcare made up almost 70% of all respondents, followed by those from tertiary (21.8%) and secondary (11.3%) level institutions. The average percentage of correct answers on the knowledge test was 74.3% (mean=22.3, SD=4.0). Out of all respondents, HCWs employed in the paediatrics department had a significantly higher percentage of correct answers at 77.7% (mean=23.3, SD=3.4) compared to other health workers at 73% (mean=21.9, SD=4.1) (p=0.002). Association analysis demonstrated that HCW employed at paediatric departments on average scored 1.37 (95% CI: 0.40-2.33, p=0.006) points higher in comparison with other HCW. Conclusion: This research demonstrated an unsatisfactory level of knowledge on child road safety by HCW, and the variability across different question domains, which underlines the need for continuous educations in order to improve their knowledge. Our results may serve in planning additional public health measures and can provide a reference for future studies.

Assessment of thoracic disc degeneration using dual-energy CT-based collagen maps.

BACKGROUND: We evaluated the role of dual-energy computed tomography (DECT)-based collagen maps in assessing thoracic disc degeneration. METHODS: We performed a retrospective analysis of patients who underwent DECT and magnetic resonance imaging (MRI) of the thoracic spine within a 2-week period from July 2019 to October 2022. Thoracic disc degeneration was classified by three blinded radiologists into three Pfirrmann categories: no/mild (grade 1-2), moderate (grade 3-4), and severe (grade 5). The DECT performance was determined using MRI as a reference standard. Interreader reliability was assessed using intraclass correlation coefficient (ICC). Five-point Likert scales were used to assess diagnostic confidence and image quality. RESULTS: In total, 612 intervertebral discs across 51 patients aged 68 ± 16 years (mean ± standard deviation), 28 males and 23 females, were assessed. MRI revealed 135 no/mildly degenerated discs (22.1%), 470 moderately degenerated discs (76.8%), and 7 severely degenerated discs (1.1%). DECT collagen maps achieved an overall accuracy of 1,483/1,838 (80.8%) for thoracic disc degeneration. Overall recall (sensitivity) was 331/405 (81.7%) for detecting no/mild degeneration, 1,134/1,410 (80.4%) for moderate degeneration, and 18/21 (85.7%) for severe degeneration. Interrater agreement was good (ICC = 0.89). Assessment of DECT-based collagen maps demonstrated high diagnostic confidence (median 4; interquartile range 3-4) and good image quality (median 4; interquartile range 4-4). CONCLUSION: DECT showed an overall 81% accuracy for disc degeneration by visualizing differences in the collagen content of thoracic discs. RELEVANCE STATEMENT: Utilizing DECT-based collagen maps to distinguish various stages of thoracic disc degeneration could be clinically relevant for early detection of disc-related conditions. This approach may be particularly beneficial when MRI is contraindicated. KEY POINTS: A total of 612 intervertebral discs across 51 patients were retrospectively assessed with DECT, using MRI as a reference standard. DECT-based collagen maps allowed thoracic disc degeneration assessment achieving an overall 81% accuracy with good interrater agreement (ICC = 0.89). DECT-based collagen maps could be a good alternative in the case of contraindications to MRI.

Potential of Dual-Energy CT-Based Collagen Maps for the Assessment of Disk Degeneration in the Lumbar Spine.

RATIONALE AND OBJECTIVES: Lumbar disk degeneration is a common condition contributing significantly to back pain. The objective of the study was to evaluate the potential of dual-energy CT (DECT)-derived collagen maps for the assessment of lumbar disk degeneration. PATIENTS AND METHODS: We conducted a retrospective analysis of 127 patients who underwent dual-source DECT and MRI of the lumbar spine between 07/2019 and 10/2022. The level of lumbar disk degeneration was categorized by three radiologists as follows: no/mild (Pfirrmann 1&2), moderate (Pfirrmann 3&4), and severe (Pfirrmann 5). Recall (sensitivity) and accuracy of DECT collagen maps were calculated. Intraclass correlation coefficient (ICC) was used to evaluate inter-reader reliability. Subjective evaluations were performed using 5-point Likert scales for diagnostic confidence and image quality. RESULTS: We evaluated a total of 762 intervertebral disks from 127 patients (median age, 69.7 (range, 23.0-93.7), female, 56). MRI identified 230 non/mildly degenerated disks (30.2%), 484 moderately degenerated disks (63.5%), and 48 severely degenerated disks (6.3%). DECT collagen maps yielded an overall accuracy of 85.5% (1955/2286). Recall (sensitivity) was 79.3% (547/690) for the detection of no/mild lumbar disk degeneration, 88.7% (1288/1452) for the detection of moderate disk degeneration, and 83.3% (120/144) for the detection of severe disk degeneration (ICC=0.9). Subjective evaluations of DECT collagen maps showed high diagnostic confidence (median 4) and good image quality (median 4). CONCLUSION: The use of DECT collagen maps to distinguish different stages of lumbar disk degeneration may have clinical significance in the early diagnosis of disk-related pathologies in patients with contraindications for MRI or in cases of unavailability of MRI.

Short-term health effects of air quality changes during the COVID­19 pandemic in the City of Novi Sad, the Republic of Serbia.

OBJECTIVES: The objective of this research is to determine the change in outdoor air quality during the COVID­19 related state of emergency resulting in a lockdown and the potential health benefits for the urban population. MATERIAL AND METHODS: During 53 days of the COVID­19 related state of emergency with a lockdown (March 15-May 6, 2020) in the Republic of Serbia, as well as in the corresponding periods of 2018 and 2019, data on the daily sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3) and particulate matter (PM10 and PM2.5) concentrations were analyzed. The total mortality data were analyzed to estimate the impact of the COVID­19 related lockdown measures on the burden of health in a given population, attributed to the outdoor air quality in the City of Novi Sad, using AirQ+ software. RESULTS: The average daily concentrations of PM2.5, NO2, PM10 and SO2 were reduced by 35%, 34%, 23% and 18%, respectively. In contrast, the average daily concentration of O3 increased by 8%, even if the primary precursors were reducing, thus representing a challenge for air quality management. In the City of Novi Sad, a reduction in the average daily PM2.5 concentration of 11.23 µg/m³ was significant, which resulted in a quantified number of avoided deaths. CONCLUSIONS: Air pollution in the City of Novi Sad had a chance to be improved due to some preventive measures related to the infectious disease (the COVID­19 related lockdown), which in turn was the mitigation measure to air pollution with positive public health effects. The confirmed positive effects of the improved air quality on public health could also include raising collective resistance to mass non-communicable and infectious diseases such as COVID­19 and reducing economic costs. Int J Occup Med Environ Health. 2021;34(2):223-37.

Predictors of overweight and obesity among adults aged 50 years and above: Serbian national health survey.

Background/Aim: 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. Methods: 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. Results: 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. Conclusion: 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.

Quality of life of elderly people living in a retirement home.

BACKGROUND/AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Loaches in a long term study of the Drava River in Croatia.

The diversity, species composition and structure of the fish community were studied in the vicinity of three power plant reservoirs in the middle part of the Drava River in Croatia. Over a period of twenty years in a collection of 25,913 fishes, 56 different fish species belonging to 16 families were recorded. The family Cobitidae is represented by two species: Cobitis elongatoides and Misgurnus fossilis, while the family Balitoridae is represented by only one species, Barbatula barbatula. The presence of the Cobitidae family was recorded in eleven of seventeen investigated localities, while Balitoridae was found in six localities. In the studied fish community, the percentage of C. elongatoides is 1.41% of the total number of individuals, and B. harbatula is 1.02%. M. fossilis is a rare species (0.03 %). Both C. elongatoides and B. barbatula were not caught at the beginning of investigation. C. elongatoides and B. harhatula were first caught in 1985, while M. fossilis was first caught in 1996. The proportion of C. elongatoides in the entire community increased, while the proportion of B. barhatula decreased in later years.

Growth of Cobitis narentana Karaman, 1928 in the Neretva River, Croatia.

Age and growth of Cobitis narentana were examined in the delta of Neretva River in Croatia. Maximum observed length was 100.4 mm for females and 63.5 for males. Five age classes were determined, from 0+ to 4+. For both females (61.0%) and males (53.8%), the greatest proportion of specimens were in the 1+ age category. Growth was faster in males in the first year of life, while females grew at a faster rate than males after the first year. The Fulton condition factor was determined (CF=0.588 for males and CF=0.618 for females). The length-weight relationship was determined for females (W=8xl0(-5)L2.9325) and males (W=2x l0(-5)L2.6431). The parameter b was calculated as less than b=3.0, thus establishing that growth in both males and females was allometric. Growth rate was determined using the von Bertalanffy growth rate curves for females (Lt=101.1[ 1-e(-0.5(t-0.94)]; r2=0.99) and for males (Lt=65.3[1-e(-0.54(t-2.27)]; r2=0.97). The resulting growth rate coefficient (K) was found to be slightly higher in males (0.54) than in females (0.5).

[Attitudes towards suicide among adolescents].

INTRODUCTION: Having a relatively high suicide rate of 19.5 per 100.000 inhabitants, the Republic of Serbia is in the first half on the list of the European countries concerning the number of suicides. However, the situation is particularly alarming in Vojvodina, which has been one of the areas with a very high population mortality rate caused by suicide for a long period of time not only in Serbia of nowadays, but also in former Yugoslavia. The number of suicides has increased by almost 50% over the last five and a half decades, and every eighth suicide was committed by a young person. The aim of this paper was to explore adolescents' attitudes towards suicide and to find out whether the difference in age affects changes in attitudes regarding suicide. MATERIAL AND METHODS: The George Domino's Suicide Opinion Questionnaire was completed by 254 adolescents divided into two age groups--124 respondents were in the age group 13 to 15 and 130 of them in the age group 18 to 19. RESULTS: The results of this study suggest that the attitudes of younger and older group of adolescents towards suicide mostly coincide and there is no statistically significant difference in the answers according to the analyzed clusters. CONCLUSION: This research shows that the attitudes of respondents of both age groups indicate a lack of awareness about suicide, its causes and dynamics of development of this public health problem. This leaves space for more intensive educational work in the mental health of the population, especially young people and for further research of the suicide problem as a basis for developing strategies.

Gender Differences in Mental Health among Adult Population in Vojvodina, Serbia.

BACKGROUND: Mental health and mental disorders are determined by multiple and interacting social, psychological and biological factors which determine the prevalence, onset and course of mental and behavioral disorders. The aim of the study was to evaluate differences in mental health status regarding gender of the adult population in the Province of Vojvodina. METHODS: Research was carried out as a retrospective cross-sectional study. Data was obtained from the "National Health Survey in Serbia, 2006" database that refers to the representative adult population of Vojvodina, aged 20 and over. A specially designed questionnaire was applied as a research instrument. RESULTS: This study included 3627 examinees, average age 49.9 years. In the month prior to the study, a half of the adult population in Vojvodina (48.4%) was exposed to stress and one third had emotional problems (32.9%), while both stress and emotional problems were more prevalent in females. The average score value on the psychological distress scale (presence of negative conditions and feelings) of all examinees was 64.1 (from 0 to 100) and it was statistically significantly lower in women (62.0), compared to men (66.6) (P<0.001). Statisticaly significant differences were also observed between average score values on the role-emotional and vitality scales (P<0.001). CONCLUSION: When mental health is considered, this research showed that female population is more vulnerable compared to males. Women are more often exposed to stressful situations and emotional problems and more often faced with negative conditions and feelings.