Parent-teacher interactions, family stress, well-being, and parental depression as contributing factors to parental involvement mechanisms in education of children with autism.

Parental involvement (PI) in education contributes to numerous positive outcomes in children, including educational outcomes and social competence. The goal of the present study was to examine differences in PI mechanisms between parents of children with autism spectrum disorder (ASD) and parents of typically developing (TD) children. An additional goal was to examine factors affecting PI mechanisms in education in parents of children with ASD. The sample for this study consisted of 50 parents of children with ASD and 50 parents of TD children. The results of this study indicate that parents of children with ASD had lower levels of PI mechanisms in education than parents of TD children. The strongest predictors of PI mechanisms in education in parents of children with ASD were subjective well-being and child's emotional reactivity. Implications for future research and practice are discussed.

Engagement of Preschool-Aged Children in Daily Routines.

Child engagement refers to the time spent interacting with physical and social environments according to age, abilities, and a situation. The aim of this study is to assess the functioning of children in early childhood routines using engagement assessment instruments relative to the presence of developmental disabilities, age, gender, and parental characteristics within the contexts of preschool and family routines. The sample comprised 150 children aged 3-5 (AS = 4.02, D = 0.78), including typically developing children (N = 49) and children with developmental disabilities (N = 101). To assess the children's engagement in preschool classrooms, we used the Classroom Measure of Engagement, Independence, and Social Relationships (ClaMEISR), and the Child Engagement in Daily Life Measure was used to assess the children's engagement in family routines. The results obtained indicate a significantly higher rate of engagement in routines and activities among girls and older children. Parental characteristics associated with children's engagement included employment and marital status. Children with developmental disabilities, compared to their typically developing peers, had lower levels of engagement in social relationships and functional independence in daily routines. The results indicate that both instruments have a high internal consistency and are thus suitable for future use in the Republic of Serbia.

Searching for Best Predictors of Paralinguistic Comprehension and Production of Emotions in Communication in Adults With Moderate Intellectual Disability.

Paralinguistic comprehension and production of emotions in communication include the skills of recognizing and interpreting emotional states with the help of facial expressions, prosody and intonation. In the relevant scientific literature, the skills of paralinguistic comprehension and production of emotions in communication are related primarily to receptive language abilities, although some authors found also their correlations with intellectual abilities and acoustic features of the voice. Therefore, the aim of this study was to investigate which of the mentioned variables (receptive language ability, acoustic features of voice, intellectual ability, social-demographic), presents the most relevant predictor of paralinguistic comprehension and paralinguistic production of emotions in communication in adults with moderate intellectual disabilities (MID). The sample included 41 adults with MID, 20-49 years of age (M = 34.34, SD = 7.809), 29 of whom had MID of unknown etiology, while 12 had Down syndrome. All participants are native speakers of Serbian. Two subscales from The Assessment Battery for Communication - Paralinguistic comprehension of emotions in communication and Paralinguistic production of emotions in communication, were used to assess the examinees from the aspect of paralinguistic comprehension and production skills. For the graduation of examinees from the aspect of assumed predictor variables, the following instruments were used: Peabody Picture Vocabulary Test was used to assess receptive language abilities, Computerized Speech Lab ("Kay Elemetrics" Corp., model 4300) was used to assess acoustic features of voice, and Raven's Progressive Matrices were used to assess intellectual ability. Hierarchical regression analysis was applied to investigate to which extent the proposed variables present an actual predictor variables for paralinguistic comprehension and production of emotions in communication as dependent variables. The results of this analysis showed that only receptive language skills had statistically significant predictive value for paralinguistic comprehension of emotions (ß = 0.468, t = 2.236, p < 0.05), while the factor related to voice frequency and interruptions, form the domain of acoustic voice characteristics, displays predictive value for paralinguistic production of emotions (ß = 0.280, t = 2.076, p < 0.05). Consequently, this study, in the adult population with MID, evidenced a greater importance of voice and language in relation to intellectual abilities in understanding and producing emotions.

Social Cognition in Patients With Cerebellar Neurodegenerative Disorders.

OBJECTIVE: Cerebellar neurodegenerative disorders (CDs) are a heterogeneous group of disorders. It is known that the cerebellum plays a role not only in motor, but also in cognitive and social cognitive functions. The aim of this study was to investigate social cognition in patients with different CDs. MATERIALS AND METHODS: Social cognition was examined in 34 patients, 12 with spinocerebellar ataxia type 1 (SCA1), 6 with spinocerebellar ataxia type 2 (SCA2), and 16 with idiopathic late onset cerebellar ataxia (ILOCA). All patients were clinically evaluated using the Scale for the Rating and Assessment of Ataxia. In addition, 34 age, sex, and education-matched healthy control (HC) subjects were similarly analyzed. Social cognition was studied using two tests: the Faux Pas Recognition Test and the Reading the Mind in the Eyes Test (RMET). An appropriate array of neuropsychological tests was used to assess the global cognitive status as well as the frontal functions and mood. RESULTS: CD patients achieved significantly worse results on both tests of social cognition compared to the HCs. The SCA1 + 2 group achieved the poorest results on the Faux Pas Recognition Test and exhibited poor performance on all cognitive tests, but was only significantly worse compared to the ILOCA group on the Free and Cued Selective Reminding Test (FCSRT) - recognition. The patients in the SCA1 + 2 and ILOCA groups obtained similar scores on RMET. In the SCA1 + 2 group the findings significantly correlated with clinical parameters of disease severity and duration and executive functions (EFs), and with mood and executive functions in the ILOCA group. In the SCA group EFs appeared as the only significant predictor of RMET achievement. The Boston Naming Test (BTN) was a significant predictor of the CD patients' achievement on RMET, while the BTN, the Trail Making Test Part A and FCSRT - Delayed free recall predicted their performance on the Faux Pas Recognition Test. CONCLUSION: Patients with CD have social cognitive impairments as demonstrated by the Faux Pas Test and the RMET test results. The SCA1 and 2 patients exhibited a more pronounced impairment compared with the ILOCA patients. The independent cognitive predictors of social cognition impairment were EFs and language.

Empowerment Practice in Families Whose Child Has a Developmental Disability in the Serbian Context.

PURPOSE: To evaluate the extent to which families of children with developmental disabilities, in relation to parents of typically developing children, feel empowered and the way that their empowerment manifests itself. DESIGN AND METHODS: The comparative research design was used in a quantitative, descriptive analysis of 99 families (57.6% were parents of children with developmental disabilities and 42.4% were parents of typically developing children). With regard to the research instrument, the Family Empowerment Scale was used based on a conceptual framework consisting of two dimensions: the level of empowerment and the way it is expressed. RESULTS: The highest levels of parental empowerment were observed in the Family domain (M = 3.9; SD = 0.6), while the lowest were in the Community domain (M = 2.9, SD = 0.9). The statistical differences between the comparing groups of parents were most pronounced in the Family domain (Mann-Whitney U = 693.00, p = 0.00). Parents of children with developmental disabilities have demonstrated a lower level of family empowerment associated with attitudes, as well as behaviours and knowledge about specific ways in which they can help their child. CONCLUSION: Based on data obtained from this study, it can be concluded that parents of children with developmental disabilities require extra support and empowerment in order to take a more active part in working with their child and making decisions relevant to his/her development in order to utilize all community - based resources available.

A Demonstration Project for the Utility of Kinect-Based Educational Games to Benefit Motor Skills of Children with ASD.

Motor disorders often accompany autism spectrum disorder (ASD), although they are not included in its diagnostic criteria. Slower motor development is evident in early childhood in this population, making early motor skills intervention advisable. As educational games and modern technology can represent new forms of treatment, this study evaluated four Kinect-based visuo-motor games called Fruits that were specially designed for this research. We sought to test whether children with ASD would show behavior changes during their game play and whether any effects would generalize to another game called Rackets. The study included 10 elementary school children with ASD, aged 9-13 years, who were divided into (a) an experimental group (n = 5) who, in addition to standard treatment, played Fruits once a week for a 5-week period and Rackets both before and after the 5-week period and (b) a control group (n = 5) who received only standard treatment during this period and also played Rackets before and after it. We found significant improvements in gross motor skills and successful generalization of acquired skills among children in the experimental group relative to the control group. The experimental group also showed an increase in positive emotions and a decrease in loss of attention while playing the games. These preliminary findings indicate a motor skill benefit for children with ASD who play Kinect-based educational games, but further research is needed to replicate and expand these findings with larger participant samples.

Paralinguistic abilities of adults with intellectual disability.

The aim of this research was to determine the ability level of paralinguistic production and comprehension in adults with intellectual disability (ID) with regard to the level of their intellectual functioning and presence of co-morbid psychiatric conditions or dual diagnosis (DD). The sample consisted of 120 participants of both genders, ranging in age between 20 and 56 years (M=31.82, SD=8.702). Approximately 50% of the sample comprised participants with a co-existing psychiatric condition. Each of these two sub-samples (those with ID only and those with DD) consisted of 25 participants with mild ID and 35 participants with moderate ID. The paralinguistic scale from The Assessment Battery for Communication (ABaCo; Sacco et al., 2008) was used to assess the abilities of comprehension and production of paralinguistic elements. The results showed that the participants with mild ID are more successful than the participants with moderate ID both in paralinguistic comprehension tasks (p=.000) and in paralinguistic production tasks (p=.001). Additionally, the results indicated the presence of separate influences of both ID levels on all of the paralinguistic abilities (F [116]=42.549, p=.000) and the existence of DD (F [116]=18.215, p=.000).

[The choice of antimicrobial therapy by application of pharmacoeconomic principles in view of the most frequently isolated pathogens at the Clinic for Infectious Diseases of the Clinical Center of Vojvodina].

The research on the use of pharmaco-therapeutic/pharmacoeconomic guidelines in therapy of bacterial infections was carried out in all patients hospitalized at the Clinic for Infectious Diseases of the Clinical Center of Vojvodina in a three-month period. The overall antibiotic utilization in therapy of bacterial infections was determined. The total cost of all administered antibiotics was calculated as well as the defined daily dose/100 patient-days. The structure of bacterial causes and their resistance to standard antimicrobial therapy was established for all isolated strains. The results of bacterial resistance surveillance were the basis to lay down the guidelines for initial adequate antimicrobial therapy (according to the site of infection and pathogen), in view of resistance maps for bacterial strains isolated from the tested materials. The guidelines for choosing appropriate antibiotic therapy were based on pharmaco-therapeutic/pharmacoeconomic principles, taking into account the state of bacterial resistance, drug administration schedule, and lowest therapy cost. During the implementation of guidelines for appropriate initial antimicrobial therapy, large therapy cost savings of 1.275.576.9 dinars (33.9%.) were recorded, compared to the period before the implementation of the guidelines.

[Enterococcal endocarditis--a case report].

INTRODUCTION: Bacteria from genus Enterococcus may cause infections mostly in those who are immunocompromised and those who underwent endoscopic or surgical procedures. Endocarditis is caused by enterococci in 5-10% of cases. Its clinical presentation does not differ from endocarditis of other bacterial origin. Previous susceptibility testing is needed for appropriate choice of antibiotics against enterococci. The treatment recommendations for enterococcal endocarditis were given by American Heart Association recently. CASE REPORT: A case ofenterococcal endocarditis in a young female person hospitalised at Clinic for infectious diseases was reviewed. The disease was diagnosed during an extensive diagnostic procedure. Multiply repeated echocardiographic examination helped to find out bacterial vegetations on the mitral valve. Enterococcus species was isolated from several blood cultures. Despite powerful antibiotic treatment, the additional valvular replacement had to be done. DISCUSSION: A case of enerococcal endocarditis in a young female person was reviewed. The right diagnosis was based on a thorough clinical examination in cooperation with cardiologists using repeated transthoracic and transesophageal echocardiography. Echocardiography, even if it is transesophageal, has limited sensitivity and specificity, so it is sometimes necessary to be repeated for several times in diagnosing endocarditis. The source of endocarditis was not identified. The combined antimicrobial and surgical treatment led to the complete recovery of patient. CONCLUSION: Enterococcal endocarditis rarely occurrs in young females. Infective disease specialists sometimes face enterococcal endocarditis in their practice, mostly when they have to cope with fever of unknown origin. An appropriate approach to such conditions includes careful search for heart valve changes by repeated echocardiographic finding, if necessary.

[Mechanisms of bacterial resistance to antibiotics].

Development of bacterial resistance to antibiotics brought many problems among which the most important are infections caused by multiple resistant bacterial strains. Bacteria have amazing 'equipment' of biochemical and genetic mechanisms to ensure evolution and spread of antibacterial resistance genes. The results obtained from very important projects all around the world and in our country show that bacterial resistance to certain groups of antibiotics is very high (up to 100%), because of uncritical use of antibiotics out of these groups. Due to the development of resistant bacterial strains, we may soon run out of efficient antibiotics for some patients. Outcome of the race between science and pharmaceutical industry on one side, and bacterial adaptation trough acquisition of resistant genes on the other side, is very uncertain. Actions must be taken to slow down the evolution and spread of antibiotic resistance genes in which the major single factor is the proper use of antibiotics in human medicine, veterinary medicine and agriculture, respectively.

[Phamacoeconomic analysis of antibiotics use in the Clinical Center of Vojvodina].

INTRODUCTION: The investigation was performed in three phases and included all patients hospitalized at eight selected clinics known to be the biggest antibiotic spenders in the Clinical center of Vojvodina. MATERIAL AND METHODS: The first phase comprised retrospective evaluation of the total antibiotic use in therapy of all bacterial infections during a three-month period in 2006/2007. A total cost of all spent antibiotics was calculated, and a daily dose per 100 clinical day care was defined for each of investigated clinics. In the second phase, the structure of bacterial causes and their resistance to standard antimicrobial therapy was established for all isolated strains from each clinic. According to the the results of bacterial resistance surveilance, guidelines for initial adequate antimicrobial therapy were made (regarding localization and type of bacteria) considering resistance maps for isolated bacterial strains. The guidelines took into consideration all essential ellements: pharamcotherapeutic/pharmacoeconomic principles, bacterial resistance, patterns of antimicrobial prescriptions and lowest therapy costs. RESULTS AND CONCLUSION: In the third phase, (three-month period in 2007/2008), the guidelines were implemented in therapy of bacterial infections. In this period, only by implementing the guidelines for initial adequate antimicrobial therapy, the therapy costs savings were 2027018.52 dinars (12.8%) at four of eight investigated clinics, compared to the period before implementation of the guidelines. This was the first pharmacoeconomic study in Vojvodina.

[Significance of group A streptococcal infections in human pathology].

INTRODUCTION: Group A streptococci is the causative agent in 80 percents of human streptococcal infections. The only member of this group is Streptococcus pyogenes. CLINICALFEATURES OF GAS INFECTIONS: The various clinical entities and related complications caused by pyogenic streptococci are reviewed in the article. Pharyngitis, scarlet fever, skin and soft tissue infections (pyoderma, cellulitis, perianal dermatitis, necrotising fasciitis) and streptococcal toxic shock syndrome are described. DIAGNOSIS OF GAS INFECTIONS: The way of setting the diagnosis including epidemiological data, clinical features and the course of illness, laboratory findings and supportive diagnostic methods are represented in the article. DIFFERENTIAL DIAGNOSIS: The most important clinical entities which should be discussed in differential diagnosis of diseases caused by pyogenic streptococci are listed. TREATMENT OF GAS INFECTIONS: The major principles of etiologic treatment through widely accepted strategies related to first choice antibiotics and alternatives are reviewed.

[On the development of the infectology service in Novi Sad].

INTRODUCTION: Infectious diseases are a part of the history of this region. Devastating epidemics of plague, smallpox, and cholera were frequent during the 18th and the 19th centuries. Other infectious diseases were a serious problem as well: alimentary tract infections, scarlet fever, diphtheria, whooping cough. Geographic position, climate, migrations, as well as the tradition and lack of medical staff and medications, affected the frequency and outcome of infections. THE HISTORY OF THE TREATMENT OF INFECTIOUS DISEASES: Patients with infectious diseases were first treated at home. Later, a hospital in Visarion street was opened as an isolation facility and a hospital for homeless patients. The development of science and the education of medical personnel exerted the greatest influence on the control and later treatment of infectious diseases. These measures resulted in the establishment of the first specialized medical institutions in Novi Sad during the cholera outbreak in 1884. After that, temporary pediatric units were organized for the treatment of scarlet fever, diphtheria and smallpox. A ward for infectious diseases was founded in the The Great City Hospital in the second half of the 19th century (1892). The 20th century was a period of control and eradication of infectious diseases in Vojvodina (smallpox, malaria, diphtheria, polio). MODERN INFECTIOUS DISEASES: Nowdays, major infectious deseases include respiratory, alimentary and parasitic infections. However, new diseases are being registered as well - hemorrhagic fevers, Lyme disease, HIV infection. The Infectologic Service in Novi Sad was developed from an Infectology Departement as part of the Departement of Internal Diseases in the new Provincial Hospital (1909) to the independent Departement for Infectious Diseases (1945). Today, Clinic of lnfectious Diseases is an integral part of the Clinical Center of Vojvodina. DEPARTMENT OF INFECTIOUS DISEASES: The Department of Infectious Diseases of the Faculty of Medicine in Novi Sad was founded in 1960. Undergraduate studies started in 1963/64 for students of medicine and in 1978/79 jor dentistry students. Today. the faculty of the Department takes part in undergraduate studies of medicine, dentistry, health care, as well as in graduate programs. The faculty members are also taking part in specialization programs at the Faculty of Medicine. Infectious disease physicians are involved in the activities of the Infectology Section (founded in 1979) of the Society of Physicians of Vojvodine of the Medical Society of Serbia. The first president of the Infectology Section was Dr. Vera Mudric, professor, infectologists, whereas Dr. Grozdana Canak, professor, was the vice-president from 2000-2004. The Infectology Section collaborates with various national and international societies for infectious diseases.

[Clinical characteristics and prognostic significance of preherpetic neuralgia]. / Klinicke karakteristike i prognosticki znacaj preherpeticne neuralgije.

INTRODUCTION: Herpes zoster is a world-wide disease of older age commonly presenting with preherpetic pain. The aim of the study was to determine clinical characteristics of preherpetic neuralgia and its influence on occurrence of postherpetic neuralgia. MATERIAL AND METHODS: A prospective, controlled trial included 88 patients with preherpetic neuralgia. 44 herpes zoster patients without preherpetic neuralgia were included in the control group. All of them were clinically followed-up for three months after complete healing of skin lesions. RESULTS: Older age (> 60 years) was significantly predominant (59.1%) compared with other age groups (p < 0.01) as well as female sex (59.9%) compared with the male sex (p < 0.01). There was no significant predominance of any type of preherpetic neuralgia (stabbing, burning, itching, dull pain). More intense preherpetic pain (reported as "severe" and "moderate") was established more often than mild pain. The mean duration of preherpetic pain was 4.4 days (ranged between 1-20 days). Postherpetic neuralgia developed in 36/88 patients with preherpetic neuralgia (affecting predominantly older than 50 years of age--31/36), but there was no significant difference in proportion of postherpetic neuralgia (PHN) according to those without preherpetic neuralgia. DISCUSSION AND CONCLUSION: People older than 60 years are the most common age group among herpes zoster patients suffering from preherpetic neuralgia. Sex distribution of patients with preherpetic pain reveals highly significant predominance of female sex. Opposite to some other authors' reports, preherpetic neuralgia and its severity have not been proven as risk factors for postherpetic neuralgia in patients involved in our trial.