Using machine learning algorithms and techniques for defining the impact of affective temperament types, content search and activities on the internet on the development of problematic internet use in adolescents' population.

Background: By using algorithms and Machine Learning - ML techniques, the aim of this research was to determine the impact of the following factors on the development of Problematic Internet Use (PIU): sociodemographic factors, the intensity of using the Internet, different contents accessed on the Internet by adolescents, adolescents' online activities, life habits and different affective temperament types. Methods: Sample included 2,113 adolescents. The following instruments were used: questionnaire about: socio-demographic characteristics, intensity of the Internet use, content categories and online activities on the Internet; Facebook (FB) usage and life habits; The Internet Use Disorder Scale (IUDS). Based on their scores on the scale, subjects were divided into two groups - with or without PIU; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego scale for adolescents (A-TEMPS-A). Results: Various ML classification models on our data set were trained. Binary classification models were created (class-label attribute was PIU value). Models hyperparameters were optimized using grid search method and models were validated using k-fold cross-validation technique. Random forest was the model with the best overall results and the time spent on FB and the cyclothymic temperament were variables of highest importance for these model. We also applied the ML techniques Lasso and ElasticNet. The three most important variables for the development of PIU with both techniques were: cyclothymic temperament, the longer use of the Internet and the desire to use the Internet more than at present time. Group of variables having a protective effect (regarding the prevention of the development of PIU) was found with both techniques. The three most important were: achievement, search for contents related to art and culture and hyperthymic temperament. Next, 34 important variables that explain 0.76% of variance were detected using the genetic algorithms. Finally, the binary classification model (with or without PIU) with the best characteristics was trained using artificial neural network. Conclusion: Variables related to the temporal determinants of Internet usage, cyclothymic temperament, the desire for increased Internet usage, anxious and irritable temperament, on line gaming, pornography, and some variables related to FB usage consistently appear as important variables for the development of PIU.

Personality traits and attitude towards euthanasia among medical students in Serbia.

OBJECTIVE: Various factors may influence the attitudes of medical students towards euthanasia, including personal values, beliefs, and personality traits. The objective of this study was to examine the attitudes of 2nd and 5th year medical students about euthanasia and the relationship between these attitudes and students' personality traits. METHODS: Medical students from the Universities of Kragujevac and Belgrade, Serbia, participated in this study. A questionnaire was administered assessing attitudes toward euthanasia and student personality traits (honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, and openness using the HEXACO-60). RESULTS: More than 50% of students in the second year and 60% of students in the fifth year were supportive of euthanasia. Students in the 5th year were 2.5 times more likely to express a concern that euthanasia needs to be clearly regulated by law compared to students in the second year. Adjusted analyses indicated that lower levels of honesty-humility and emotionality were positively correlated with students' belief that euthanasia should be legalized. CONCLUSION: Many medical students in Serbia have a positive attitude towards euthanasia. It is important to consider the possible influences of culture, religion, and the law on attitudes towards euthanasia. Undergraduate medical training should include more hours dedicated to palliative care and end-of-life topics to raise awareness of patients' preferences in this regard.

Association between affective temperaments and psychosomatic symptoms in women with Hashimoto's thyroiditis.

BACKGROUND: Hashimoto's thyroiditis (HT) is a prevalent autoimmune disease of thyroid gland with a shared immunological mechanism with mood disorders. Affective temperament (AT) is a biologically determined personality trait that has been linked to mood disorders. The aim of this study was to examine the association between dominant AT and levels of psychosomatic symptoms in women newly diagnosed with HT in comparison to clinically healthy subjects. METHODS: The observational cross-sectional study with nested case control study was involving 146 consecutive participants, who were divided into three groups. The two study groups consisted of women with HT (73), including 49 with hypothyroid HT and 24 with euthyroid HT, and the third group was a control group of healthy participants (73). The Serbian version of the TEMPS-A was utilized to assess AT, while the 4DSQ was used to measure psychosomatic symptoms. RESULTS: The results showed that hyperthymic AT was dominant in all examined groups. The groups with HT differed from the control group in terms of depressive and cyclothymic AT. Furthermore, the study found higher levels of psychosomatic symptoms in the group with HT compared to the control group, with significant differences in distress (p = 0.005) and somatization (p = 0.023) levels. All AT was associated with levels of psychosomatic symptoms in subjects with hypothyroid HT. In contrast, in subjects with euthyroid HT, the association was only found between depressive and cyclothymic AT with distress and depression levels, as well as between somatization and cyclothymic AT. No association was found between AT and anxiety levels in subjects with euthyroid HT. CONCLUSION: The research found differences between study groups in the association between AT and levels of psychosomatic symptoms. Further research with a larger sample size is necessary to more clearly define the associations between affective temperaments and psychosomatic symptoms in women with euthyroid and hypothyroid HT.

Clozapine prescription rates in Southeast Europe: A cross-sectional study.

Introduction: International reports indicate that clozapine is under prescribed. Yet, this has not been explored in Southeast European (SEE) countries. This cross-sectional study investigates clozapine prescription rates in a sample of 401 outpatients with psychosis from Bosnia and Herzegovina, Kosovo by United Nations resolution, North Macedonia, Montenegro and Serbia. Methods: Descriptive analysis was used to explore clozapine prescription rates; daily antipsychotic dosage was calculated and converted into olanzapine equivalents. Patients receiving clozapine were compared to those not receiving clozapine; next those that were on clozapine monotherapy were compared to those who were on clozapine polytherapy regime. Results: It was showed that clozapine was prescribed to 37.7% of patients (with cross-country variation: from 25% in North Macedonia to 43.8% in Montenegro), with average dose of 130.7 mg/daily. The majority of patients on clozapine (70.5%) were prescribed at least one more antipsychotic (the most frequent combination was with haloperidol). Discussion: Our findings suggested that clozapine prescription rate in SEE outpatients is higher than in Western Europe. The average dose is significantly below the optimal therapeutic dosage recommended by clinical guidelines, and clozapine polytherapy is common. This might indicate that clozapine is prescribed mainly for its sedative effect rather than antipsychotic. We hope that this finding will be taken up by relevant stakeholders to address this non-evidence-based practice.

Total costs of inpatient treatment for COVID-19 in a tertiary hospital in Serbia.

BACKGROUND: Our study aimed to identify the total costs of inpatient treatment for coronavirus disease 2019 (COVID-19) in a tertiary institution in Serbia, an upper-middle-income country in Southeast Europe. METHODS: An observational, retrospective, cost-of-illness study was performed from the perspective of the National Health Insurance Fund and included a cohort of 78 females and 118 males admitted to the COVID-19 ward units of a tertiary center during the first wave of the pandemic. RESULTS: The median of the total costs in the non-survivors subgroup (n =43) was 3,279.16 Euros [interquartile range (IQR): 4,023.34; range: 355.20-9,909.61) which is higher than in the survivors (n =153) subgroup 747.10 Euros (IQR: 1,088.21; 46.71-3,265.91). The cut-off value of 156.46 Euros regarding the total costs per day was estimated to have 95.3 % sensitivity and 91.5 % specificity for predicting patients' dismal prognosis, with the area under the curve (AUC) of 0.968 (95 % confidence interval: 0.940-0.996, p <0.001). CONCLUSIONS: Direct medical inpatient treatment costs for COVID-19 represent a significant economic burden. The link between increased costs and an ultimate unfavorable outcome should be further explored.HIPPOKRATIA 2022, 26 (2):62-69.

TREATMENT COSTS FOR COVID-19 PATIENTS IN A TERTIARY HOSPITAL FROM SERBIA

IntroductionAim of our study was to identify total costs of COVID-19 inpatients treatment in an upper-middle income country from Southeast Europe. MethodsThis retrospective, observational cost of illness study was performed from National Health Insurance Fund perspective and included a cohort of 118 males and 78 females admitted to COVID-19 ward units of a tertiary center, during the first wave of epidemics. ResultsThe median of total costs in the non-survivors subgroup (n=43) was 3279.16 Euro (4023.34, 355.20, 9909.61) which is higher than in the survivors (n=153) subgroup 747.10 Euro (1088.21, 46.71, 3265.91). The odds ratio of Charlson Comorbidity Index total score and every 100-Euros increase of patients total hospital treatment costs for fatal outcome were 1.804 (95% confidence interval 1.408-2.311, p<0.001) and 1.050 (1.029-1.072, p<0.001), respectively. ConclusionsDirect medical treatment costs for COVID-19 inpatients represent significant economic burden. The link between increased costs and unfavorable final outcome should be further explored.

HEXACO-60 Personality Trait Inventory: Psychometric characteristics in a sample of medical students from Serbia.

The 60-item HEXACO (HEXACO-60) Personality Trait Inventory may be strategically more important for researchers compared to the 100-item HEXACO. The aim of this study was to assess the psychometric properties of the 60-item HEXACO questionnaire in the Serbian language. This cross-sectional study, conducted at three of five Faculties of Medicine during the summer semester of the 2016/2017 academic year, included 617 students. Relevant data were collected by an anonymous questionnaire. Cronbach's α and McDonald's ω coefficients for the total scale were .71 and .72, respectively. Apart from Agreeableness, all other domains showed an adequate level of internal consistency (both Cronbach's α and McDonald's ω coefficients were >.70). Random data eigenvalues obtained on the parallel analysis had higher values than initial exploratory factor analysis eigenvalues up to the sixth factor. Accordingly, it was concluded that six factors should be extracted from the Serbian HEXACO-60. These factors corresponded in item distribution with the original ones. Based on the confirmatory factor analysis, using both 60 items and 24 facets, overall goodness of fit of the Serbian HEXACO-60 was acceptable. Moreover, there were no domains with completely invalid indices, as there were at least two indices that were acceptable for each domain. The Serbian version of the HEXACO-60 has acceptable psychometric properties. This shorter version with 60 items may be more suitable for brief surveys or when the time allocated to fill in a questionnaire is limited.

Prescription attitudes and practices regarding clozapine among Serbian psychiatrists: results of a nationwide survey.

OBJECTIVE: Despite clozapine being the most effective treatment for treatment-resistant schizophrenia (TRS), a clear explanation as to why it is underutilized and why its initiation is delayed remains unclear. The first aim of the study was to conduct a nation-wide assessment of both the psychiatrists' attitudes of the obstacles for prescribing clozapine as well as their prescription practices. The second aim was to make recommendations, based on the results obtained, for improving the Serbian clozapine guidelines. METHODS: A questionnaire was conducted consisting of two parts. One regarded the clinical characteristics of the psychiatrists, while the second contained questions about indications for clozapine initiation, clozapine prescribing tendencies, and barriers to clozapine use. The questionnaire was sent to 302 Serbian psychiatrists. RESULTS: With 161 out of the 302 psychiatrists returning the questionnaires, the response rate was 53.3%. Nearly 60% of the psychiatrists treated 10 or more patients with clozapine, with TRS being the most common indication. Only four psychiatrists (2.5%) had no patients currently on clozapine. Psychiatrists indicated that their fear of agranulocytosis (68%) constituted the greatest obstacle for clozapine prescription, followed closely by weight gain (56%), and sedation (39%). Despite their fear of agranulocytosis, only 83.9% of the psychiatrists monitored leukocytes regularly. CONCLUSION: In general, psychiatrists in Serbia seem to be confident in prescribing clozapine, even in the absence of clear monitoring guidelines and the possibility of therapeutic drug monitoring. In order to reduce obstacles for clozapine prescription, monitoring laxity, and an overreliance on personal experience, we recommend three modifications of the existing clozapine guideline.

Which affective temperaments are most expressed in patients with chronic sub-jective tinnitus?

BACKGROUND: Although chronic subjective tinnitus is one of the most common symptoms, the background of its pathophysiological mechanism and etiology is not fully understood. No studies are exploring various affective temperaments in persons with chronic tinnitus. METHODS: We included in this study 57 patients with tinnitus who filled out the Serbian 41-item version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto questionnaire (TEMPS-A) and a short sociodemographic questionnaire. Patients were assessed using audiometry (measuring the hearing threshold for frequencies of 250, 500, 1,000, 2,000, 4,000, and 8,000 Hz) and tympanometry. RESULTS: Our research showed that patients with chronic tinnitus predominantly had anxious affective temperament [anxious-cognitive (AnxC): 26.23 %, anxious-somatic (AnxS): 25.6 %). AnxS was dominant in people without hearing loss (46 %) and males (37.39 %). AnxC was dominant in people with a significant hearing loss and females (30.3 %). Both AnxS and AnxC temperaments correlated with hearing loss in the right ear more than in the left one. CONCLUSION: Our study revealed that anxious temperaments (AnxC and AnxS) were predominant in patients with chronic subjective tinnitus. Affective temperaments could play a significant role in explaining this disorder's currently unclear pathophysiology of, but further research is needed. HIPPOKRATIA 2020, 24(2): 77-83.

The Glasgow antipsychotic side-effects scale for clozapine in inpatients and outpatients with schizophrenia or schizoaffective disorder.

BACKGROUND: The inconsistency in clinician and patient ratings of clozapine-induced side effects underscore the need to supplement clinician-based estimates of side effects with patient-reported ones. AIMS: The main aims of the study are validation of the Glasgow antipsychotic side-effects scale for clozapine (GASS-C) in Serbian inpatients/outpatients with schizophrenia or schizo-affective disorder and recommendations for its future use, based on common and rare clozapine-associated side-effects. METHODS: The GASS-C was administered to 95 outpatients/inpatients diagnosed with schizophrenia, schizoaffective, or chronic psychotic disorder. RESULTS: The scale showed good overall reliability, with an internal consistency coefficient of α = 0.84, an average retest coefficient of rho = 0.76, and a Spearman-Brown coefficient of validity of 0.81. Side effects were absent or mild in 64.2% of the patients, moderate in 31.6%, severe in 4.2%; 14% of the subjects considered their symptoms distressing. The most commonly reported side-effects were drowsiness, thirst, frequent urination, and dry mouth. Women reported more side effects than men, and patients not in a relationship reported significantly fewer side effects than patients in a relationship. Results indicate a weak positive correlation (rho = 0.231; p = .025) between severity of side effects and clozapine dose. CONCLUSIONS: The GASS-C showed good psychometric characteristics in clinical population of patients on clozapine. In future studies, clozapine serum concentrations should be measured when using the GASS-C to monitor side effects.

Factors Influencing The Six-Month Mortality Rate In Patients With A Hip Fracture: DEJAVNIKI, KI VPLIVAJO NA SESTMESECNO STOPNJO UMRLJIVOSTI PRI BOLNIKIH Z ZLOMOM KOLKA.

BACKGROUND: There are several potential risk factors in patients with a hip fracture for a higher rate of mortality that include: comorbid disorders, poor general health, age, male gender, poor mobility prior to injury, type of fracture, poor cognitive status, place of residence. The aim of this study was to assess the influence of potential risk factors for six-month mortality in hip fracture patients. METHODS: The study included all patients with a hip fracture older than 65 who had been admitted to the Clinic for orthopaedic surgery during one year. One hundred and ninety-two patients were included in the study. RESULTS: Six months after admission due to a hip fracture, 48 patients had died (6-month mortality rate was 25%). The deceased were statistically older than the patients who had survived. Univariate regression analysis indicated that six variables had a significant effect on hip fracture patients' survival: age, mobility prior to the fracture, poor cognitive status, activity of daily living, comorbidities and the place where they had fallen. Multivariate regression modelling showed that the following factors were independently associated with mortality at 6 months post fracture: poor cognitive status, poor mobility prior to the fracture, comorbid disease. CONCLUSION: Poor cognitive status appeared to be the strongest mortality predictor. The employment of brief tests for cognitive status evaluation would enable orthopaedists to have good criteria for the choice of treatment for each patient screened.

Parameters of Calcium Metabolism Fluctuated during Initiation or Changing of Antipsychotic Drugs.

OBJECTIVE: Serum parameters of calcium homeostasis were measured based on previously published evidence linking osteoporotic fractures and/or bone/mineral loss with antipsychotics. METHODS: Prospective, four-week, time-series trial was conducted and study population consisted of patients of both genders, aged 35-85 years, admitted within the routine practice, with acute psychotic symptoms, to whom an antipsychotic drug was either introduced or substituted. Serial measurements of serum calcium, phosphorous, magnesium, 25(OH)D, parathyroid hormone, calcitonin, osteocalcin and C-telopeptide were made from patient venous blood samples. RESULTS: Calcium serum concentrations significantly decreased from baseline to the fourth week (2.42±0.12 vs. 2.33±0.16 mmol/L, p=0.022, n=25). The mean of all calcemia changes from the baseline was -2.6±5.7% (-24.1 to 7.7) with more decreases than increases (78 vs. 49, p=0.010) and more patents having negative sum of calcemia changes from baseline (n=28) than positive ones (n=10) (p=0.004). There were simultaneous falls of calcium and magnesium from baseline (63/15 vs. 23/26, p<0.001; OR=4.75, 95% CI 2.14-10.51), phosphorous (45/33 vs. 9/40, p<0.001; 6.06, 2.59-14.20) and 25(OH)D concentrations (57/21 vs. 13/35, p<0.001; 7.31, 3.25-16.42), respectively. Calcemia positively correlated with magnesemia, phosphatemia and 25(OH)D values. Parathyroid hormone and C-telopeptide showed only subtle oscillations of their absolute concentrations or changes from baseline; calcitonin and osteocalcin did not change. Adjustment of final calcemia trend (depletion/accumulation) for relevant risk factors, generally, did not change the results. CONCLUSION: In patients with psychotic disorders and several risks for bone metabolism disturbances antipsychotic treatment was associated with the decrease of calcemia and changes in levels of the associated ions.

Parameters of Calcium Metabolism Fluctuated during Initiation or Changing of Antipsychotic Drugs

OBJECTIVE: Serum parameters of calcium homeostasis were measured based on previously published evidence linking osteoporotic fractures and/or bone/mineral loss with antipsychotics. METHODS: Prospective, four-week, time-series trial was conducted and study population consisted of patients of both genders, aged 35-85 years, admitted within the routine practice, with acute psychotic symptoms, to whom an antipsychotic drug was either introduced or substituted. Serial measurements of serum calcium, phosphorous, magnesium, 25(OH)D, parathyroid hormone, calcitonin, osteocalcin and C-telopeptide were made from patient venous blood samples. RESULTS: Calcium serum concentrations significantly decreased from baseline to the fourth week (2.42+/-0.12 vs. 2.33+/-0.16 mmol/L, p=0.022, n=25). The mean of all calcemia changes from the baseline was -2.6+/-5.7% (-24.1 to 7.7) with more decreases than increases (78 vs. 49, p=0.010) and more patents having negative sum of calcemia changes from baseline (n=28) than positive ones (n=10) (p=0.004). There were simultaneous falls of calcium and magnesium from baseline (63/15 vs. 23/26, p<0.001; OR=4.75, 95% CI 2.14-10.51), phosphorous (45/33 vs. 9/40, p<0.001; 6.06, 2.59-14.20) and 25(OH)D concentrations (57/21 vs. 13/35, p<0.001; 7.31, 3.25-16.42), respectively. Calcemia positively correlated with magnesemia, phosphatemia and 25(OH)D values. Parathyroid hormone and C-telopeptide showed only subtle oscillations of their absolute concentrations or changes from baseline; calcitonin and osteocalcin did not change. Adjustment of final calcemia trend (depletion/accumulation) for relevant risk factors, generally, did not change the results. CONCLUSION: In patients with psychotic disorders and several risks for bone metabolism disturbances antipsychotic treatment was associated with the decrease of calcemia and changes in levels of the associated ions.

Is bioavailability altered in generic versus brand anticonvulsants?

Therapeutic window of anticonvulsants is not a wide one, with phenytoin being one extreme, which can be classified as a narrow therapeutic index drug, since its ratio between the least toxic and the least effective concentration is less than twofold. In order to obtain marketing authorization, a generic anticonvulsant should demonstrate relative bioequivalence with its brand-name counterpart. However, although bioequivalent, generic anticonvulsants still do not have the same bioavailability as brand-name drugs, which may lead to larger fluctuations of steady-state plasma concentrations, and sometimes to loss of seizure control if a patient is switched from brand-name to generic or from generic to generic anticonvulsant. Generic anticonvulsants are effective, safe and affordable drugs for treatment of epilepsy, and patients could be successfully treated with them from the very beginning. It is switching from brand-name to generic anticonvulsant or from one generic anticonvulsant to another that should be avoided in clinical practice, since subtle differences in bioavailability may disturb optimal degree of seizure control to which the patient was previously successfully titrated.

Factors associated with severe postoperative pain in patients with total hip arthroplasty.

OBJECTIVE: The aim of this study was to determine the risk factors for the development of postoperative pain following total hip arthroplasty, particularly those connected with psychological distress and personality traits. METHODS: The study included 90 patients with complaints of postoperative pain following cemented total hip replacement divided into two groups based on the intensity of postoperative pain as measured using the numerical rating scale (NRS). Patients with NRS scores of 5 or higher were included in the study group and those with NRS of less than 5 were included in the control group. The Hamilton scales for anxiety and depression and the DS14 test for the identification of Type D personality were used for psychological evaluation. RESULTS: In the study group, more patients were female (29 vs. 13) and had more anxiety (13 vs. 3), depression symptoms (11 vs. 2), and Type D personality (18 vs. 9) than the control group. Mean preoperative NRS was 7.2 ± 1.7 in the study and 6.0 ± 1.2 in the control group (p<0.001). Factors associated with development of strong postoperative pain was female gender (OR=4.91, 95% CI=2.01 to 12.01, p<0.001), Type D personality (OR=2.81, CI=1.17 to 7.32, p=0.030), severe anxiety (OR=6.01, CI=1.58 to 22.90, p=0.009), depressive symptoms (OR=7.33, CI=1.52 to 35.34, p=0.013) and subjects with marked preoperative painful condition (OR=2.64, CI=1.17 to 5.44, p<0.001). CONCLUSION: Patients with severe anxiety, depression and Type D personality appear to be at risk of developing severe postoperative pain. In addition, female gender and the intensity of pain immediately after procedure were found to be important risk factors.

Risk factors for lethal outcome in patients with delirium tremens - psychiatrist's perspective: a nested case-control study.

BACKGROUND: The aim was to identify potential risk factors for lethal outcome in patients with delirium tremens (DT) treated in the psychiatric setting. METHODS: In a nested case-control study, a total of 190 medical records of patients with DT hospitalized at the Psychiatric Clinic in Serbia between 2002 and 2011 were reviewed and analyzed. The characteristics of patients who died (cases) were compared with those who survived (controls). For each case, two controls (matched for age, gender, and year of hospitalization) were randomly chosen. RESULTS: Significant differences between cases and controls were found for serum potassium levels (p < 0.001), the number of hospitalizations (p < 0.001), and duration of hospitalization (p < 0.001). A significant association with lethal outcome was found for serum potassium levels even in the normal range (adjusted odds ratio 40.52; 95% CI 1.20, >1,000.00; p = 0.004). CONCLUSIONS: Even though the number and duration of psychiatric hospitalizations were identified as factors determining survival after admission for DT, only serum potassium levels were found to be significant. Patients with an increase in potassium (or absence of hypokalemia) may require more intensive treatment. Monitoring of serum levels of potassium is important not only as an indicator for replacement but also as an indicator of maladaptation.

The frequency of dyscalculia among primary school children.

BACKGROUND: Formal education, daily living activities and jobs require knowledge and application skills of counting and simple mathematical operations. Problems with mathematics start in primary school and persist till adulthood. This is known as dyscalculia and its prevalence in the school population ranges from 3 to 6.5%. SUBJECTS AND METHODS: The study included 1424 third-grade students (aged 9-10) of all primary schools in the City of Kragujevac, Serbia. Tests in mathematics were given in order to determine their mathematical achievement. 1078 students (538 boys and 540 girls) completed all five tests. RESULTS: The frequency of dyscalculia in the sample was 9.9%. The difference between boys and girls according to the total score on the test was statistically significant (p<0.005). The difference between students according to their school achievement (excellent, very good, good, sufficient and insufficient) was statistically significant for all tests (p<0.0005). The influence of place of residence/school was significant for all tests (p<0.0005). Independent prognostic variables associated with dyscalculia are marks in mathematics and Serbian language. CONCLUSION: Frequency of dyscalculia of 9.9% in the sample is higher than in the other similar studies. Further research should identify possible causes of such frequency of dyscalculia in order to improve students` mathematical abilities.

Validation of the Temps-A in university student population in Serbia.

BACKGROUND AND AIMS: The TEMPS-A scale is a self-evaluation measure which assesses five affective temperaments. This study is a comparative analysis of affective temperament types in different educational fields, and the first validation of the Serbian version of the TEMPS-A. METHODS: The TEMPS-A questionnaire has been adapted following the translation-back translation methodology from English to Serbian. It was then administered to 770 undergraduate students from eight different faculties. RESULTS: Five factors were extracted through Principal Component Analysis (Varimax rotation), each including ten items with loadings above 0.40. The internal consistency of this abbreviated 50-item scale was α=0.77 and the average test-retest coefficient (rho=0.82) indicates a stable reliability. The correlations among the temperaments ranged from weak to moderate, with the highest positive correlations obtained between the depressive and cyclothymic, and, depressive and anxious scales. The highest score was detected among the hyperthymic (0.64) and lowest among the depressive temperament (0.15). The male participants attained significantly higher scores for the hyperthymic temperament, while female scored significantly higher on the depressive and anxious temperaments. The students of physical education showed significantly lower results on the depressive and anxious subscales and higher on the hyperthymic, in comparison to other educational fields. LIMITATIONS: The student sample is not representative of the general population, therefore further investigation in older population would be necessary for the evaluation of norms in additional age categories. The external validation with other personality scales has not been the subject of this research, but will be a part of some future studies. CONCLUSIONS: The Serbian 50-item version of the TEMPS-A showed good overall internal consistency and reliability, and the results generally cohere with those from previously validated versions in other languages.

The influence of alcohol intoxication on the severity of injuries suffered by drivers in road traffic accidents.

PURPOSE: To determine the severity of injuries in drunk and sober drivers in traffic accidents, by using the Injury Severity Score (ISS), as well as the most vulnerable body region of those involved. METHODS: This was an observational case-control study covering a 1-year period of patients treated in the emergency department of the Health Center in Kraljevo, Serbia. Seventy-five patients were identified as drunken drivers [blood alcohol concentration (BAC) >0.03 %] (group of cases), while 70 patients were found to be sober drivers (group of controls). Injuries were categorized by body region according to the ISS. RESULTS: Half of all drivers (51.7 %) injured in traffic accidents were under the influence of alcohol. Males represented a substantial majority of both groups. In both categories of drivers, the greatest incidence of traffic accidents was in the age group 19-35 years. Injuries of drunken drivers were more frequently present in all body regions except in the areas of limbs with shoulder and pelvic bones. Drivers under the influence of alcohol have a 3.80 times greater risk of suffering deadly injuries in traffic accidents. The average ISS in drunken drivers was higher in comparison to sober drivers (p < 0.05). The greatest ISS was in the drunk group with BAC level over 0.051 % (the ISS range was 15-20). A strong correlation was found between the BAC level and the degree of injury (r = 0.63). CONCLUSION: The severity of injuries and, especially, the 3.80 times greater risk of suffering deadly injuries in traffic accidents for drunken drivers obliges us to pay attention to prevention strategies.