Search

There are limited data regarding the significance of multifocality in testicular cancer patients. This study evaluated the relationship between multifocality and clinicopathological features determined at the time of radical orchiectomy. The study involved 280 consecutive patients who underwent radical orchiectomy between 2018 and 2023. Multifocality was defined as a distinct tumor focus characterized by a group of malignant cells > 1 mm, clearly differentiated from the primary tumor mass. Uni- and multivariate logistic regression analyses were employed to investigate the association between multifocality and histopathological parameters along with potential risk factors for clinical stages II + III. Multifocality was identified in 44 (15.7%) patients. Significantly smaller primary tumors were observed in subjects with multifocality (20.0 mm vs. 30.0 mm, p = 0.0001), while those exhibiting monofocality presented a markedly elevated rate of tumors exceeding 4 cm (40.3% vs. 18.2%, p = 0.005). Furthermore, multifocality was associated with a significantly higher rate of primary tumors < 2 cm (52.3% vs. 29.2%, p = 0.003). Univariate logistic regression analysis revealed a substantial decrease in the likelihood of multifocality occurrence in seminoma patients with tumors > 4 cm (OR = 0.38, p = 0.017). Meanwhile, in multivariate logistic regression, multifocality did not emerge as a significant risk factor for clinical stages II + III in either seminoma (p = 0.381) or non-seminoma (p = 0.672) cases. Our study suggests that multifocality holds no substantial prognostic relevance for clinically advanced disease in testicular cancer patients. The findings indicate that multifocality is associated with smaller primary tumors, particularly those measuring less than 2 cm.

Recent data indicate that lead (Pb) can induce adverse effects even at low exposure levels. Moreover, the corresponding mechanisms of low Pb toxicity have not been well identified. In the liver and the kidneys, Pb was found to induce various toxic mechanisms leading to organ physiological disruption. Therefore, the purpose of the study was to simulate low-dose Pb exposure in an animal model with the aim of assessing oxidative status and essential element levels as the main mechanism of Pb toxicity in the liver and kidneys. Furthermore, dose–response modelling was performed in order to determine the benchmark dose (BMD). Forty-two male Wistar rats were divided into seven groups: one control group, and six groups treated for 28 days with 0.1, 0.5, 1, 3, 7, and 15 mg Pb/kg b.w./day, respectively. Oxidative status parameters (superoxide dismutase activity (SOD), superoxide anion radical (O2−), malondialdehyde (MDA), total sulfhydryl groups (SHG), and advanced oxidation protein products (AOPP)) and Pb, copper (Cu), zinc (Zn), manganese (Mn), and iron (Fe) levels were measured. Lowering Cu levels (BMD: 2.7 ng/kg b.w./day), raising AOPP levels (BMD: 0.25 µg/kg b.w./day) in the liver, and inhibiting SOD (BMD: 1.3 ng/kg b.w./day) in the kidneys appear to be the main mechanisms of Pb toxicity. The lowest BMD was derived for a decrease in Cu levels in liver, indicating that this effect is the most sensitive.

The aim of this cross-sectional study was to compare occupational burnout in two groups of teachers from the district of Bijeljina (Bosnia and Herzegovina) measured with the Serbian version of the Maslach Burnout Inventory survey for workers in human services (MBI-HSS) at the beginning (group 1) and the end of the school year 2018/2019 (group 2) to see if there are seasonal differences. The questionnaire also included standard sociodemographic data and job description (primary and/or secondary school position, length of service, and overtime work). The prevalence of emotional exhaustion and depersonalisation was low in both groups. However, emotional exhaustion and depersonalisation scores significantly shifted to higher values between the beginning and the end of the school year. We also found a statistically significant association between emotional exhaustion and overtime and between depersonalisation and work in a secondary school (p<0.05). These findings invite further research of occupational burnout seasonality in schoolteachers, preferably by following up cohorts which would be controlled for sociodemographic and work-related variables., U ovom je presječnom istraživanju uspoređena prevalencija sindroma izgaranja na poslu u dvjema skupinama nastavnika na području Bijeljine u Bosni i Hercegovini te je procijenjen njegov sezonski karakter. Sindrom izgaranja na poslu mjeren je na početku (skupina I.) i na kraju školske 2018./2019. godine (skupina II.). Za potrebe ovoga istraživanje korištena je srpska inačica Maslachina upitnika izgaranja na poslu za stručnjake pomagačkih zanimanja (izv. Maslach Burnout Inventory Survey for Workers in Human Services, krat. MBI-HSS). Upitnik je uključivao i standardne sociodemografske podatke, kao i podatke o radnomu mjestu (rad u osnovnoj i/ili srednjoj školi, dužina radnog staža i prekovremeni rad). Prevalencija emocionalne iscrpljenosti i depersonalizacije bila je niska u objema skupinama ispitanika na početku mjerenja, ali se na kraju školske godine povećala. Utvrđena je statistički značajna razlika između emocionalne iscrpljenosti i prekovremenoga rada, kao i između depersonalizacije i rada u srednjim školama (p<0,05). Rezultati istraživanja upućuju na potrebu daljnjeg ispitivanja sezonskoga karaktera sindroma izgaranja na nastavničkom poslu, po mogućnosti kohortnim istraživanjem kojim bi se pratile sociodemografske i radne varijable ispitanika.

Primarni cilj istraživanja bio je utvrđivanje intenziteta i kvaliteta psihološkog distresa u populaciji studenata, kao i njegove povezanosti sa različitim faktorima uključujući socio-demografske osobine, radno angažovanje ispitanika, dimenzije profesionalne adaptibilnosti, i afektivne i fizičke karakteristike radnog konteksta. Sekundarni ciljevi odnosili su se na prevod, lingvističku i kulturnu adaptaciju i psihometrijsku validaciju instrumenata i utvrđivanje prediktora spremnosti za traženje profesionalne psihološke pomoći. Istraživanje je izvedeno po principu deskriptivne eksplorativne studije preseka, a diseminacija upitnika odvijala se u periodu mart-jun 2018. godine. Formirana su četiri različita uzorka od ukupno 3310 ispitanika; po jedan u svrhu validacije svakog od instrumenata i jedan u svrhu utvrđivanja prediktora psihološkog distresa i spremnosti na traženje profesionalne psihološke pomoći. Ispitanici su u sva četiri slučaja selektovani prema principu višefaznog proporcionalnog stratifikovanog uzorka. U statističkoj obradi podataka korišćene su deskriptivne statističke mere, Pirsonov i Spirmanov koeficijent korelacije, multipla linearna regresiona analiza i univarijatna i multipla ordinalna i Firtova logistička regresiona analiza. Psihomerijske karakteristike instrumenata u procesu validacije utvrđivane su uz pomoć eksploratorne i konfirmatorne faktorske analize i analizom pouzdanosti. Rezultati psihometrijske validacije Instrumenta za procenu psiholoških simptoma u savetovalištu, Dinamske skale za procenu u domenu profesije i Skale za procenu simboličke radne motivacije potvrdili su postojanje originalnih faktorskih struktura i visoku pouzdanost skala i subskala. Analiza intenziteta i kvaliteta psihološkog distresa ukazala je da najizraženiju dimenziju predstavlja samopoštovanje (AS=2.74, SD=0.80). Kao najizraženiji simptomi javljaju se simptomi akademskog distresa (AS=1.82, SD=1.07) i socijalne anksioznosti (AS=1.35, SD=1.04). Najslabije su bili izraženi, The primary aim of this research was to determine the intensity and quality of the psychological distress in student population, as well as its relationship to the various factors including socio-demographic variables, work engagement, career adaptability, and affective and physical characteristics of the work context. The secondary goals were translation, linguistic and cultural adaptation, and psychometric validation of the instruments, and the examination of the predictors of willingness for seeking professional psychological help. The research was organized as a cross-sectional study and the questionnaire dissemination took place in the period from March to June, 2018. Four different samples comprising of 3310 respondents in total were formed; one for the purpose of validation of each of the instruments and one for the purpose of determination of the predictors of psychological distress and willingness to seek professional psychological help.In all four cases, the subjects were selected according to the principle of multistage proportional stratified sampling. The statistical analysis comprised descriptive statics, Pearson’s and Spearman’s correlation coefficients, multiple linear regression analysis, univariate and multiple ordinal regression analysis and Firth’s logistic regression analysis. Psychometric characteristics of the instruments were assessed using exploratory and confirmatory factor analysis and analysis of reliability. The results of psychometric validation of the Counseling Center Assessment of Psychological Symptoms scale, the Dynamic Career Scale, and the Work Symbolic Motivation Scale confirmed the original factor structures and high reliability of the scales and subscales. The analysis of the intensity and quality of the psychological distress showed that the highest scores were obtained at Self-esteem (AS=2.74, SD=0.80). Symptoms of Academic distress (AS = 1.82, SD = 1.07) and Social anxiety (AS = 1.35, SD = 1.04) appear as the most pronounce

Sindrom sagorevanja na poslu je u fokusu istraživanja od 1970-te godine. Definiše se kao interpersonalna stresogena reakcija na radnom mestu koju karakterišu tri dimenzije: emocionalna iscrpljenost, cinizam ili depersonalizacija i osećaj male lične ostvarenosti. Istraživanje ovog sindroma je u centru pažnje pre svega zbog posledica koje ostavlja na zdravlje zaposlenih i njihove radne performanse što neminovno vodi do ekonomskih opterećenja za poslodavce i samu državu. U Norveškoj je procenjeno da godišnji troškovi povezani sa ovim fenomenom dosežu i do 1,7 milijardi evra. U Nemačkoj se smatra da poremećaji prouzrokovani stresom predstavljaju vodeće uzroke prevremenog penzionisanja. Sindromom sagorevanja na poslu pogođen je širok spektar zanimanja (zdravstveni radnici, psiholozi, socijalni radnici, nastavno osoblje, menadžeri), međutim, nastavničko zanimanje se ističe kao jedno od zanimanja sa velikim socioekonomskim značajem. Istraživanje sindroma sagorevanja na poslu u ovoj populaciji zahteva dodatnu pažnju pre svega zbog posledica koje ostavlja na mentalni i emotivni razvoj dece, njihova akademska postignuća, te samim tim i na celokupan obrazovni sistem. U nastanku ovoga sindroma karakteristike radne sredine su značajni prediktori, zbog čega je i prepoznat kao profesionalno oboljenje u nekoliko zemalja Evrope. Ipak, iako svi zaposleni dele istu radnu sredinu ne razvijaju svi sindrom sagorevanja na poslu, što ukazuje i na značaj ličnih karakteristika (tip ličnosti, temperament, afekat, samopoštovanje i druge) u razvoju ovoga sindroma. U literaturi se nalaze različiti kontradiktorni podaci o uticaju sociodemografskih karakteristika, kao što su pol, polna jednakost, bračni status, nivo obrazovanja i radni staž na sindrom sagorevanja na poslu. Pored njih, istraživani su još sukob poslovnih i porodičnih uloga i socijalna podrška. Neminovno je da podaci o etiološkim faktorima ovoga fenomena i dalje nedostaju, što ukazuje na potrebu za istraživanjima. Ciljevi Cilj ovog i, interpersonal stressful reaction at workplace, characterized through three dimensions: emotional exhaustion, cynicism or depersonalization and the feeling of reduced personal accomplishment. Examining this syndrome is in the center of attention primarily due to the consequences it has on employees’ health and their work performance, which undoubtedly creates the economic burden for both the employer and the country. It is estimated that annual costs of burnout-related phenomenon reach up to 1.7 billion euro in Norway. In Germany, it is believed that stress-related disorders make the leading causes of premature retirement. The burnout syndrome affects a large number of professions (health workers, psychologists, social workers, teachers, managers), but it is the teaching profession that is emphasized as one of the professions with a great socio-economic importance. Conducting research in the field of burnout syndrome among this population requires additional attention mostly due to consequences it has on mental and emotional development of children, their academic achievement and therefore, educational system, as well. Working environment plays an important part in developing this syndrome, which is why the syndrome has been recognized as a occupational disease in several European countries. However, although every employee shares the same working environment, not all of them develop burnout syndrome. This shows how important personal characteristics are (personality type, temper, affect, self-esteem, and some others) in developing this syndrome. There is various contradictory data in literature regarding the influence of socio-demographic characteristics such as gender, gender equality, marital status, education level and length of service onburnout syndrome. Apart from these properties, the conflict of professional and family roles has also been examined, as well as social support. It is clear that the data on etiological factors of this phenomenon still lacks, whi

uključeni u zdravstvenu zaštitu adolescenata u vezi sa poštovanjem prava na poverljivost u oblasti reproduktivnog zdravlja i svojom ulogom u obezbeđivanju poverljivosti. Pored toga, ispitivani su faktori koji su u vezi sa odlukom lekara da obezbede pravo na poverljivost u zaštiti reproduktivnog zdravlja adolescenata. U svrhu ispitivanja znanja, stavova i ponašanja lekara konstruisan je i validiran novi instrument istraživanja – upitnik za anketiranje lekara o poštovanju prava na poverljivost u zaštiti reproduktivnog zdravlja adolescenata. Istraživanje je sprovedeno kao studija preseka. U istraživanju je korišćen kombinovani, kvalitativno-kvantitativni eksploratorni dizajnkoji sjedinjuje kvalitativnu i kvantitativnu metodologiju prikupljanja podataka. Prva faza je bila preliminarno kvalitativno istraživanje, kojim su se kroz intervjue sa manjim brojem ispitanika identifikovale ključne teme. Na osnovu rezultata kvalitativnog istraživanja, tj. identifikovanih tema razvijen je instrument za drugu fazu - kvantitativno istraživanje znanja, stavova i ponašanja na većem uzorku lekara. Kvalitativna studija je sprovedena u sedam domova zdravlja na teritoriji Beograda i Republičkom centru za planiranje porodice u okviru Instituta za zdravstvenu zaštitu majke i deteta Srbije “Dr Vukan Čupić”, u periodu od marta do maja 2016. godine. Kriterijum za uključivanje u kvalitativnu studiju je bio da su ispitanici lekari uključeni u primarnu zdravstvenu zaštitu adolescenata u oblasti reproduktivnog zdravlja, dakle lekari zaposleni u u službi za zdravstvenu zaštitu školske dece i službi za zdravstvenu zaštitu žena. Uzorkovanje ispitanika je bilo svrsishodno, kako bi se obuhvatila što različitija, bogatija i kompleksnija viđenja i shvatanja ispitanika. Podaci u kvalitativnom istraživanju su prikupljani putem polustrukturisanih intervjua, tokom kojih je korišćen namenski osmišljen tematski vodič za intervjuisanje. Intervjui su trajali aproksimativno 60 minuta, i snimani su diktafonom uz do, The aim of this study was to assess knowledge, attitudes and practice regarding primary care physicians’ confidentiality respect in adolescent reproductive health care, and their role in providing confidentiality. In addition, factors that affect physicians’ decision to provide confidential health care to adolescents were explored. With the aim to assess knowledge, attitudes and practice of physicians the new instrument was constructed and validated – the questionnaire for surveying phyisicans regarding respect of confidentiality in adolescent reproductive health care. The study was organized as a cross-sectional study. A qualitative-quantitative mixed method was employed. Mixed methods combines qualitative and quantitative methodology of data collecting. The first phase was exploratory qualitative study, that identified the key topics through interviewing a small number of participants. Based on qualitative study results, an instrument for the second, quantitative phase was developed, that was applied on a larger sample of participants. Qualitative study was conducted at the seven primary care institutions at the territory of Belgrade (Dom zdravlja Novi Beograd, Dom zdravlja Palilula, Dom zdravlja Stari grad, Dom zdravlja Savski venac, Dom zdravlja Lazarevac, Dom zdravlja Barajevo, Dom zdravlja Rakovica) and at the Republic center for Family Planning within the Institute of mother and child health care “Dr Vukan Čupić”, in the period March-May 2016. The inclusion criteria for the qualitative study was that participants were included in the adolescent reproductive health care at the primary care level (physicians employed at the school children health department and women health department). The purposive sampling was applied, with the aim to include diverse, rich and complex perspectives and understandings of participants. Data in the qualitative study were gained through semi-structured interviews, with the use of purposefully designed interview guide. Interviews

Хипертензија je важaн јавноздравствени проблем широм света. Иако се на њу може утицати, она је чест фактор ризика за кардиоваскуларне болести. Циљ истраживања је био да утврди преваленцију хипертензије и потенцијалних фактора ризика за настанак артеријске хипертензије код одраслих становника Републике Србије. Методе: Студија пресека је обухватила 14.623 одраслих испитаника, од којих је 14.422 пристало да им се измери крвни притисак. Коришћен је стратификовани двоетапни репрезентативни случајни узорак становништва Србије. У статистичкој анализи података коришћени су χ2 квадрат тест, t-тест, униваријантна (УЛРА) и мултиваријантна (МЛРА) логистичка регресиона анализа. Резултати: У 2013. години 17,7% одраслих, узраста 15 и више година, било је нормотензивно, свака трећа особа је имала прехипертензију (33,1%), а свака друга хипертензију (49,3%). Стандардизована преваленција прехипертензије је била 40,6%, а хипертензије 34,5%. Према резултатима МЛРА, значајни независни фактори ризика за хипертензију, у односу на особе са нормотензијом, били су узраст (50 и више година), прекомерна тежина и гојазност, умерено велики и велики обим струка код оба пола, и место боравка ван градова само код жена. Код жена, значајни независни фактори ризика за прехипертензију, у поређењу са особама са нормотензијом, били су узраст (50 и више година), прекомерна тежина и гојазност, умерено велики и велики обим струка, док је висок степен физичке активности био значајан протективан фактор. Код мушкараца, прекомерна тежина и гојазност су били значајни независни фактори ризика за прехипертензију. Закључак: Република Србија припада земљама са високом преваленцијом прехипертензије и хипертензије. Наши резултати истичу потребу за новом јавном здравственом стратегијом за превенцију, откривање и лечење прехипертензије и хипертензије., Hypertension are an important public health problem worldwide and although they can be modified, it is often a risk for cardiovascular disease. Aim of this study was to determine the prevalence of hypertension and associated risk factors in the adult population of Serbia. Methods: The cross-sectional study covered 14,623 adult respondents, but 14,422 volunteered to measure their blood pressure. A stratified two-stage national representative random sampling approach was used for the selection of the survey sample. In statistical analysis of data chi square test, t-test, univariate logistic regression analysis and multivariate logistic regression analysis (MLRA) were used. Results: In 2013, 17.7% of Serbian population, aged 15 and over, was normotensive, every third person had prehypertension (33.1%), and every second had hypertension (49.3%). The standardized prevalence of prehypertension was 40.6% and 34.5% for hypertension. According to the results of MLRA, independently significant risk factors for hypertension compared to persons with normotension were older age (50 and more), overweight and obesity, moderate and large waist circumference in both sexes, and nonurban place of residence in females. In females, independently significant risk factors for prehypertension compared to persons with normotension were older age (50 and more), overweight and obesity, moderate and large waist circumference, but high level of physical activity was significantly protective. In males, overweight and obesity were independently significant risk factors for prehypertension. Conclusions: Serbia belongs to countries with a high prevalence of prehypertension and hypertension. Our results emphasize the need for a new public health strategy for the prevention, detection and treatment of prehypertension and hypertension.