Nela Djonovic, Ivana Simic Vukomanovic and Dalibor Stajic
The new Law on Public Health was published in the Official Gazette of the Republic of Serbia No. 15 dated 25 February 2016. Comparing to the previous Law, the biggest changes have been made in the domain of monitoring the indicators of the environment and population health. The responsibility of controlling the quality and safety of food was given back to the Ministry of Health. This paper presents the principal regulations regarding the main functions, principals and organizational features of the public health system in Serbia.
Svetlana Radevic, Nela Djonovic, Natasa Mihailovic, Ivana Simic Vukomanovic, Katarina Janicijevic, Marija Sekulic and Sanja Kocic
Depression is the most frequent mental health problem in older age with serious consequences on personal, interpersonal and social level. Th e aim of this study was to determine the association of demographic factors, socio-economic factors and health status characteristics, with the presence of depressive symptoms in the elderly persons. Th e survey was conducted as a part of the national study “Health Survey of the Serbian population” in 2013. Data on the population aged 65 years and over were used for the purposes of this study (3540 respondents). PHQ-8 questionnaire was used to assess the presence of symptoms of depression. Th e relations between the presence of depressive symptoms, as a dependent variable, and a set of independent variables was examined by univariate and multivariate logistic regressions. Depression (PHQ-8 score≥10) was registered in 10% of the population aged 65 and above, wherein it was statistically signifi cantly higher in women (12.7%) than in men (6.5%). Limitations in performing of daily activities showed to be the strongest predictor of depression in the elderly, while respondents who have had serious limitations had even six times more chanse to develop depression (OR=6.84). Respondents who rated their health as “bad or very bad” for 49.5% more frequently manifested depressive symptoms compared to those who evaluated their health as “very good or good” (OR=3.49). Respondents who have had two or more chronic diseases were three times more likely to have depression (OR=3.1) compared to people without chronic disease.
Dalibor Stajic, Sandra Zivanovic, Ana Miric, Marija Sekulic and Nela Djonovic
Osteoporosis is a progressive bone disorder that can be influenced by many different factors. A cross-sectional study has been conducted with the aim to assess the prevalence of risk factors as well as to identify the possible causes of improvement of the disease. Th e study population consisted of 97 women older than 35 who had previously been diagnosed with osteoporosis. Dualenergy X-ray Absorptiometry (DXA) scan was used to determine bone mineral density (BMD) in order to assess the current state of the disease. Th e participants were asked to complete a standardized IOF (International Osteoporosis Foundation) questionnaire. According to BMD measurements, 24.7% of women had normal bone density while 18.6% had T-score lower than -2.5. Th ere was a statistically significant correlation between T-score and the history of previous bone fractures. Besides, a relatively high prevalence of certain risk factors (such as underweight, early menopause, oophorectomy, thyroid and parathyroid disorders etc.) was observed in woman with osteoporosis
Indoor air quality (IAQ) is rated as a serious public health issue. Knowing children are accounted as more vulnerable to environmental health hazards, data are needed on air quality in schools.
A project was conducted from 2007 until 2009 (SEARCH, School Environment and Respiratory Health of Children), aiming to verify links between IAQ and children’s respiratory health. Study was conducted in ten primary schools on 735 children, in 44 classrooms. Children were randomly selected. Research tools and indicators used for children’s exposure to school environment were indoor and outdoor pollutants, two standardized questionnaires for school and classroom characteristics. In both classroom air and ambient air in front of them we measured, during a 5-day exposure period for continuous 24h measuring: carbon monoxide, carbon dioxide, indoor air temperature, relative humidity, and PM10 during classes.
PM10 concentrations were significantly most frequent in an interval of ≥80.1μg/m3, that is, in the interval above 50μg/m3. Mean PM10 value was 82.24±42.43 μg/m3, ranging from 32.00μg/m3 to of 197.00μg/m3.
The increase of outdoor PM10 concentration significantly affects the increase of indoor PM10. A statistically significant difference exists for average IAQ PM10 concentrations vs. indicators of indoor thermal comfort zone (p<0.0001); they are lower in the classrooms with indicators within the comfort zone. Moreover, dominant factors for the increase of PM10 are: high occupancy rate in the classroom (<2m2 of space per child), high relative humidity (>75%), and indoor temperature beyond 23°C, as well as bad ventilation habits (keeping windows shut most of the time).
Olivera Djurovic, Snezana Radovanovic, Nela Djonovic, Ivana Simic Vukomanovic, Gordana Gajovic and Svetlana Radevic
Falls and fall-related injuries during hospitalization may cause serious problems and consequences for patients, their quality of life as well as increased healthcare expenses. The aim of the paper were to assess fall risks and identify risk factors, related to falls among stroke patients. This was a retrospective cohort study that included 217 neurological patients with acute stroke who have experienced fall during hospitalization. Morse Fall Scale was used to estimate a likelihood of falling for hospitalized patients. In total, 1.4% patients with acute stroke experienced a fall during hospitalization. According to the fall risk assessment, 77% of the patients presented a high risk for falls. Women, older respondents and those who were hospitalized for period longer than 22 days and who had higher levels of care, had higher values of Morse score. The most common risk factors for falls are: the presence of other medical diagnosis, the use of disability aids while walking, the use of intravenous therapy, disorientation in time and space, and the largest contribution to Morse score comes from using disability aids while walking and transferring patients. Greater risk of falling was observed in older neurological patients with ischemic type of stroke and weakness on the left side of the body, patients with longer hospitalization period and those with higher level of care.
Marija R. Sekulic, Dalibor Stajic and Nela Djonovic
The consumption and amounts of a variety of food products used in a diet affect the incidence of anemia and different levels of nutritional status among school-age children. The prevalence of food intake comprised of fats, carbohydrates and sodium (salt) is a significant contributing factor to the incidence of excessive weight. Apart from nutrition, a leisure-time physical activity and the time spent in front of the TV or computer may contribute to an increase in anemia and obesity rates. The objective of this paper was to examine nutritional status, dietary habits and anemia among school-age children in the central Serbia region (the city of Kragujevac). It was established that 47.3% of the surveyed children fell into the normal weight group, 24.5% of the children are considered to be at risk of being overweight, 21.4 % of the children are considered as obese, whereas 6.8% of the children fell into the under-weight group. The incidence of anemia was noted in 10.8% of the cases, whereas anemia in obese children was observed in 21.6% of the cases (n=114; during the school year of 2014-2015). The obtained results show a statistically significant correlation between an increase in the consumption of fast food and anemia in children, whereas the amount of time children spend in front of the TV is also associated with the higher percentage of anemia and obesity.
The aim of the work is to assess vulnerability degree of reproductive health in adolescent population in Serbia by analyzing their sexual behavior. The paper is based on data from a National health survey of the population in Serbia in 2013 (without Kosovo and Metohija region), conducted by the Ministry of Health of the Republic of Serbia. For the purposes of this study, the data used are referred to households and population of age 15 and over, so that the final number for analysis is a sample of 1722 respondents aged 15-24. The study included demographic characteristics of respondents (age, gender, settlement type, region) and the characteristics of reproductive health: sexual behavior, use of contraceptive protection, knowledge and attitudes towards HIV, protection of reproductive health. χ2 test was applied for testing differences in frequency of categorical variables. All results with a probability that equals to or is less than 5% (p≤0.05) are considered statistically significant. Among the respondents, there were more than half (53.5%) of sexually active adolescents. The highest percentage of them- 16.6% responded that they had first sexual intercourse at the age of 17. 53.4% of adolescents had sexual intercourse with one partner, 26.4% of respondents had sexual intercourse with two or more partners. The most commonly used contraceptive method was interrupted intercourse (coitus interruptus) with 34.7% of respondents.