Poverty and other correlates of obesity and underweight among 7-year-olds from Croatia and Montenegro.

OBJECTIVES: This study aimed at investigating poverty and other correlates of childhood underweight and obesity in two urban regions with lower (Podgorica, Montenegro) and higher economic development (Osijek, Croatia). STUDY DESIGN: Comparative study. METHODS: A comparative study was conducted on 693 children (52% boys), aged 7 years old (224 from Podgorica and 469 from Osijek). Parents completed the study-specific questionnaire on relevant factors for children's nutritional status. We measured children's height and weight and calculated their body mass index (BMI). International Obesity Task Force cut-off values of BMI were used to assess children's nutritional status. Subjective social position was assessed by the Mac Arthur scale. RESULTS: There were more underweight children in Osijek compared with Podgorica, both among boys (5.5% vs. 1.6%) and girls (6.9% vs. 1.0%). Obesity was more frequent in Podgorica than Osijek, both among boys (11.3% vs. 5.9%) and girls (10.0% vs. 4.3%). However, poverty in two cities diminished observed differences in children's nutritional status. The odds for child underweight decreased by 12.2%, while the odds for obesity increased by 3.6% per each paternal BMI unit. The frequency of child obesity was lowered per each step higher on the Mac Arthur scale and with breastfeeding by 23.2% and 68.0%, respectively. CONCLUSIONS: We show that a higher economic development is related to less obese children but more underweight children. However, poverty seems to impact nutritionally all children equally, regardless of the regional economic development. Paternal and not maternal BMI is relevant for both extremes in children's nutritional status. Breastfeeding and higher social position independently protect from child obesity.

Tool for decision-making regarding general evacuation during a rapid river flood.

OBJECTIVES: To propose a simple and effective tool for decision-making regarding general evacuation during a rapid river flood. STUDY DESIGN: Virtual testing of a tool in a real event. METHOD: A four-component tool was applied to build an alternative scenario of the catastrophic river flood in Obrenovac, Serbia, on May 2014. The components of this tool are: (1) the amount of precipitation above the 95th percentile of all previous measurements; (2) upstream river discharge above the 95th percentile of all previous measurements; (3) upstream river level above the 95th percentile of all previous measurements; and (4) worsening of the hydrometeorological situation in the following 48 h. RESULTS: In the early morning of 16 May 2014, a rapid river wave flooded 80% of the Obrenovac territory. There were 13 deaths due to drowning. Application of the study tool shows that these lives could have been saved, as the score to recommend general evacuation was reached 1 day before the flooding. The application of this tool to two previous great floods in Serbia shows that the score to recommend general evacuation was reached either 1 day before or on the onset of flash flooding. CONCLUSIONS: Due to its simplicity, this tool is universally applicable to facilitate decision-making regarding general evacuation during a rapid river flood, and it should be further tested in future similar catastrophes.

Hypertension and correlates among Montenegrin schoolchildren-a cross-sectional study.

OBJECTIVES: In one of the few national studies of children in a former Eastern bloc country emerging as a Western democracy and the first such study ever in Montenegro, this study establishes the prevalence and correlates of childhood hypertension (CH). STUDY DESIGN: A cross-sectional national study. METHODS: The study was conducted with 3254 children aged 7-13 years (50.3% male) from 39 elementary schools. We used a structured questionnaire to gather sociodemographic information as well as data on factors potentially related to CH. Children's nutritional status was assessed using the criteria of the International Obesity Task Force. Waist circumference was also measured. Blood pressure was measured in schools using an oscillometric monitor. CH was defined as an average systolic blood pressure and/or diastolic blood pressure greater than or equal to the 95th percentile for sex, age, and height. RESULTS: The prevalence of CH was 10.4% with no differences between boys and girls. Multiple regression revealed that the odds for child hypertension were lowered by 10% for each year of age. On the other hand, rural environment and child obesity raised the odds of hypertension by 38% and 68%, respectively. CONCLUSIONS: We found hypertension in one out of ten Montenegrin schoolchildren, with no gender differences. Obesity and rural areas may be unfriendly to children's blood pressure.

Unusual epidemic events: a new method of early orientation and differentiation between natural and deliberate epidemics.

OBJECTIVE: To develop a model for quick and accurate evaluation of unusual epidemic events (UEE), based on the original model of bioterrorism risk assessment. METHODS: A new scoring system was developed for quick differentiation between a biological attack and other epidemics, using eight qualitative and six quantitative indicators. RESULTS: A new scoring system was applied to three UEEs: (1) a spontaneous outbreak of a new or re-emerging disease ('swine flu'); (2) a spontaneous outbreak following accidental release of a pathogen (Sverdlovsk anthrax); and (3) a spontaneous natural outbreak of a known endemic disease that may mimic bioterrorism or biowarfare (Kosovo tularaemia). The disease agent was found to be the most important and the most informative UEE component of the scoring system. CONCLUSIONS: This new scoring system may be useful for public health institutions and federal civil and military officials responsible for bio-attack investigations.

Prevalence of obesity among children aged 6-7 years in South-East Serbia.

A cross-sectional study of the prevalence of obesity in urban and rural areas of South-East Serbia was performed on 541 children (273 boys and 268 girls), aged 6-7 years. Prevalence of obesity in urban boys and girls was 6.3% and 3.8% respectively (P > 0.05). Prevalence of obesity in rural boys and girls was 1.1% and 3.3% respectively (P > 0.05). The difference in the prevalence of obesity between urban boys and rural boys was statistically significant (P < 0.05), while the difference between urban and rural girls was insignificant (P > 0.05). Urban boys consumed more sweets and fast food compared with rural boys (P < 0.05). Urban children spent more time in watching TV compared with rural children (P < 0.05).

Noise and mental performance: personality attributes and noise sensitivity.

The contradictory and confusing results in noise research on humans may partly be due to individual differences between the subjects participating in different studies. This review is based on a twelve year research on the role of neuroticism, extroversion and subjective noise sensitivity during mental work in noisy environment. Neurotic persons might show enhanced "arousability" i.e. their arousal level increases more in stress. Additional unfavorable factors for neurotics are worrying and anxiety, which might prevent them coping successfully with noise, or some other stressors during mental performance. In numerous experiments introverts have showed higher sensitivity to noise during mental performance compared to extroverts, while extroverts often cope with a boring task even by requesting short periods of noise during performance. Correlation analyses have regularly revealed a highly significant negative relation between extroversion and noise annoyance during mental processing. Numerous studies have shown that people with high noise sensitivity may be prevented from achieving the same work results as other people in noisy environment, thus leading to psychosomatic, neurotic or other difficulties. Positive relation between noise annoyance and subjective noise sensitivity might be very strong. Our results have shown, after matching with the results of other relevant studies, that more stable personality, with extroversive tendencies and with a relatively lower subjective noise sensitivity measured with standard questionnaires, may be expected to better adapt to noise during mental performance, compared to people with opposite personality traits.

[Aluminum and Alzheimer's disease]. / Aluminijum i Alchajmerova bolest.

Neuro-toxic effects of aluminium, with disorders mainly in motor coordination, have been proved in epidemiological studies of subjects professionally exposed to aluminium. However, there is, as yet, no adequate evidence that neurotoxicity of aluminium leads to progressive dementia and Alzheimer's disease. It is likely that long-term use of drinking water with a high aluminium concentration, with pH about or less than 7.0, and with low fluoride concentration, is associated with the increased relative risk of Alzheimer's disease. The use of aluminium-containing antiacids, antiperspirants and beverages from aluminium cans, are probably of small importance concerning Alzheimer's disease. The relation of aluminium cumulated in the brain to onset of Alzheimer's disease is still unclear, as neuro-pathological lesions, which can be noticed in acute dementia caused with aluminium, significantly differ from those in Alzheimer's disease. Furthermore, morphological and biochemical characteristics of neurofibrillary tangles which occur in the brain after experimental injection of aluminium are different from the tangles in Alzheimer's disease. Results of the studies concerning aluminium concentrations in the brain of patients with Alzheimer's disease are incoherent. To resolve this scientific problem it is necessary to follow-up the prognosis of neurotoxic disorders caused by aluminium. It should be clarified as well whether aluminium in neuro-pathological findings of Alzheimer's disease is an artefact caused by alumino-silicates present in most reagents for tissue-staining.

[Effects of urban noise on mental health]. / Dejstvo gradske buke na mentalno zdravlje.

The results of the latest studies on the effects of urban noise on mental health are presented in this paper. Numerous psychiatric symptoms have been frequently noticed in the population of the settlements with a high level of urban noise: fatigue, headaches, tension, anxiety, irritability, bad concentration, insomnia, whith a consequently high consumption of psychotropic medicines. Higher admission rates in psychiatric hospitals have been noticed from noisy areas in comparison with low noise regions. By use of diagnostic psychiatric interviews it has been shown as well, that in sensitive categories of population positive correlation can be expected between the number of persons with mental disorder and the level of environmental noise. Noise annoyance and sleep disturbance, namely shortening or absence of the sleep phase 4 and REM, are the basic negative psychological effects of noise, with an adverse effect on mental health in general.

[Effect of a reducing diet and physical activity in obese individuals with arterial hypertension]. / Efekti redukcione dijete i fizicke aktivnosti kod gojaznih osoba sa arterijskom hipertenzijom.

The effects of reducing diet of 4.4 MJ with reduced daily sodium chloride intake and physical activity (walking and floor exercise) in 90 patients of the Counseling office for Dietetics (23 males and 67 females) with excessive obesity and arterial hypertension (AH) were examined. Although both groups of patients were of the similar nutritional status, rate of the body mass loss during the diet was significantly higher in males (p < 0.05). At the end of the diet therapy, beside reduced body mass, significantly lower average systolic and diastolic pressure (p < 0.01) was observed in both sexes. Correlation analysis showed significant positive correlation between the weight loss rate and reduced diastolic pressure (p < 0.05) only in females.

[The hardness of drinking water and cardiovascular diseases]. / Tvrdoca voda za pice i kardiovaskularna oboljenja.

The paper deals with the results of the investigations so far, which have pointed out an inverse correlation between drinking-water hardness and morbidity and mortality rates of cardiovascular diseases. Among the water hardness elements special attention has been given to magnesium, as its deficiency in organism is likely to present an important risk factor for cardiovascular disorders. The options of preventive measures in this field are discussed-adding of magnesium to soft drinking-waters, salt enriched with magnesium, consumption of natural mineral waters, or Mg supplements.

Effects of noise on mental performance with regard to subjective noise sensitivity.

Objective and subjective effects of moderate levels of recorded traffic noise [Leq = 55 dB(A) and 75 dB(A)] on mental performance were studied in a laboratory setting. A total of 45 subjects (23 males and 22 females) were investigated with respect to subjective noise sensitivity (SNS). Four cognitive tasks were applied involving different psychological functions: Short-Term Memory (STM), Search and Memory 5 (SAM 5) (vigilance), Hidden Figures (HF) (spatial reasoning) and Mental Arithmetic (MA) (parallel processing). Three groups of 15 subjects were defined according to their scores on Weinstein's Noise Sensitivity Scale as tolerant, moderately sensitive or highly sensitive to noise. A similar level of performance was observed in the three groups under quiet conditions [30 dB(A) Leq], but under noisy conditions significant differences (P < 0.05) were seen between them on the STM (words) and MA (total results) tasks, and the lowest performance accuracy was demonstrated by the noise-sensitive subjects. SNS was the primary factor responsible for these differences. There were no significant differences between the groups in respect of the SAM 5 and HF tasks, under either quiet or noisy conditions. Annoyance while performing tasks under noisy conditions was regularly and significantly higher among subjects judged to be noise sensitive on Weinstein's scale, as compared with those judged to have low or moderate SNS.

[Subjective sensitivity to noise]. / Subjektivna osetljivost na buku.

It is likely that individual variations in subjectively estimated noise sensitivity influence different social and psychophysiological reactions of people exposed to noise. Subjective noise sensitivity might be a relatively stable personal characteristic. A correlation have been found between high sensitiveness to noise and some medical symptoms (sleep disturbance, nervousness, depression), and worse work performance in noisy environments. An introvert person with neurotic symptoms is more frequently found in people highly sensitive to noise. Testing for subjective sensitivity to noise might be helpful in professional selection and orientation for noisy work-places as well as in housing advising.

[The effect of a preventive health care program in a textile plant]. / Efekti programa preventivnih zdravstvenih mera u fabrici tekstila.

A two-month field experiment was carried out on a sample of 95 women spinners and weavers in a textile plant. In the experimental group, which consisted of 54 workers, a programme of four preventive health measures was applied. The workers were asked to wear a combination of ear-muffs and cotton-wool offering optimal hearing protection and to take up individual mini programmes of physical exercise at work; they were offered a meal of the Pliva dietetic preparation Vitamalt before work and Donat-Mg natural mineral water from Zdravilisce Rogaska Slatina as a magnesium supplement. The measures from the programme were accepted and respected by 85-94% of the workers. As a result, fatigue at work was significantly reduced, and the subjectively estimated work satisfaction was markedly improved. A statistically insignificant trend towards the rise of productivity was also noticed during the period of programme application.

[Specific hormone reactions to aircraft noise in pregnant women]. / Specificnosti hormonskog reagovanja trudnica na dejstvo avionske buke.

In order to find out if there is some specific hormonal reaction to JET aircraft noise, a group of eight pregnant women, living in a small suburban community near the airport "Beograd", were investigated. Pregnant women in the first three-months of pregnancy were exposed to the aircraft noise of 75-85 dB/A during 60 minutes, before and after that blood and urine samplers were taken for analyses. Those preliminary result of the level of cortisone, cortisol, testosterone and prolactin suggested that aircraft noise modified the hormonal reaction. Further investigation is needed in order to point out some other possibilities.

[The importance of work conditions in the textile industry to worker absenteeism]. / Znacaj uslova rada u tekstilnoj industriji za apsentizam radnica.

A study was performed in the "Belgrade Wool Co." as a retrospective epidemiological investigation, for a three-year period (1985-1987), on a sample of 134 blue-collar female workers. The following statistically significant facts were established: in favourable working conditions (sewing department) the older workers (above the age of 35 years) were absent from work because of illness longer than the younger workers; the number of the younger workers (age 35 years or under) with sick absences increased as working conditions worsened (wool-mills compared to sewing departments). Respiratory diseases made the most frequent cause of absence from work. Harder working conditions influenced the morbidity structure as cause of absenteeism resulting in the rise of prevalence of mental disorders among the younger workers, and of locomotor and circulatory diseases among the older ones. The younger workers showed a rising trend in the severity and frequency of injuries as causes of absence from work, which correlated with the degree of deterioration of working conditions. Finally, under extremely hard working conditions (wool-mills) the rate of occupationally induced injuries among the younger workers was as much as three times higher than among the older ones, and the duration of sick absences was longer.

Failure of industrial noise to change the patterns of vanilmandelic acid and 17-hydroxycorticosteroids in the urine of the female weavers with hearing loss.

The field experiments were undertaken on two consecutive working days on seven female weavers with noise-induced hearing loss (NIHL), and a control group of seven sewers with normal hearing. The first day, urine was collected during the shift (06:00-14:00 h) and at home (17:00-05:00 h) for measurements of 17-hydroxycorticosteroids (17-OH) levels. The following day, the procedure was repeated, but for vanilmandelic acid (VMA) analysis. No significant changes in the hormone levels were found, both concerning the different occupational noise exposure and the periods of a working day.