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BACKGROUND We evaluated the prevalence of high blood pressure and the level of awareness, treatment, and control of hypertension in a Serbian population. METHODS A cross-sectional study of an adult population was carried out across Serbia in 2006. The study involved 14 204 adults aged 20 years or older. Interviews and measurements of blood pressure were performed at participants' homes. RESULTS Overall, 47% of the Serbian adult population had hypertension: 25.3% had stage 1 hypertension and 18.1% had stage 2 hypertension. Only 58.0% of the hypertensive population were aware that they had the disease, and 60.4% were receiving medical treatment. Among those receiving medical treatment, only 20.9% had a blood pressure within the normal range. One in 10 participants with hypertension were not treated because, among other reasons, they thought treatment was unnecessary (55.3%) or they lacked money for medication (19.3%). CONCLUSIONS The prevalence of undiagnosed and untreated hypertension is high in the adult population of Serbia. Further action is required to hasten detection and treatment of high blood pressure. Attention should be directed toward educational programs that improve knowledge, attitudes, and awareness of hypertension among adults.

Uvod: U Srbiji nema adekvatne edukacije mladih o reproduktivnom zdravlju, a ono je ugroženo u značajnom stepenu. U Vojvodini je tokom tri cikusa primenjen Vannastavni Program edukacije o reproduktivnom zdravlju. Da bi se intervencija prilagodila uticajima demografskih, socijalnoekonomskih i kontekstualnih faktora koji utiču na ponašanja adolescenata i na efektivnost primenjene intervencije, potrebno je ove faktore identifikovati. Cilj ove disertacije je bio da se evaluira primenjeni vannastavni program zdravstvenog vaspitanja o reproduktivnom zdravlju, u uzrastu 16 godina u AP Vojvodini, kroz ishode (znanje, stavove i ponašanja) i procenom efektivnosti putem evaluacionog SERAT instrumenta (UNESCO), kao i da se utvrdi povezanost demografskih, socijalno-ekonomskih i kontekstualnih faktora sa znanjem, stavovima i ponašanjem u vezi sa seksualnim i reproduktivnim zdravljem.Metode: Sprovedena je analiza efektivnosti navedenog programa na osnovu pre- i post- interventnog anonimnog anketiranja učenika drugih razreda srednjih škola i gimnazija u Vojvodini koji učestvuju u programu tokom 3 ciklusa (2013-2016. godina). U prvom ciklusu istraživanja obuhvaćen je 991 učenik pre i 950 učenika posle edukacije. U drugom ciklusu obuhvaćeno je 4.114 učenika pre i 4.790 učenika nakon edukacije. U trećem ciklusu, obuhvaćeno je 5.026 učenika pre, a nakon edukacije 5.230 učenika. U četvrtoj godini, u delu istraživanja koji se odnosi na evaluaciju ciljeva, principa, sadržaja i implementacije programa primenom SERAT upitnika (2016-2017. godina), uzorak je činilo 57 edukatora, donosilaca odluka i autora programa. Rezultati: Postoji značajna razlika u prosečnom skoru na skali znanja o reproduktivnom zdravlju pre i posle edukativne intervencije, tako da je ono više nakon intervencije: prvi ciklus (t=-22,881; p=0,000); drugi ciklus (t=-41,851; p=0,000); treći ciklus (t=-37,437; p=0,000). Znanje je bilo značajno veće kod učenika: ženskog pola; iz urbanih sredina; sa odličnim ili vrlo dobrim školskim uspehom u odnosu na one sa lošijim uspehom; koji pohađaju gimnaziju u odnosu na učenike iz srednjih stručnih škola; koji imaju oca ili majku sa višim nivoom obrazovanja; koji procenjuju svoje materijalno stanje kao prosečno u odnosu na one koji ga procenjuju kao dobro, osim u 2. ciklusu gde nisu uočene razlike u znanju u odnosu na materijalno stanje. U 2. ciklusu je utvrđena i pozitivna korelacija između višeg znanja i većeg broja časova edukacije. Nakon intervencije, u prvom ciklusu istraživanja značajno veći broj učenika je imao poželjan stav da momak otvoreno kaže devojci da ne želi da ima seksualne odnose ukoliko se tako oseća (χ2=9,487; p=0,002) i tražiti od seksualnog partnera/partnerke da ispita da li ima neku seksualno prenosivu infekciju (χ2=7,054; p=0,008). U drugom ciklusu istraživanja značajno veći broj učenika je imao poželjan stav da se devojka (χ2 =14,343; p=0,000) ili momak (χ2=8,563; p=0,003), otvoreno izjasni da ne želi da ima seksualne odnose ako se tako oseća; tražiti od partnera da ispita da li ima neku seksualno prenosivu infekciju ako sumnja u to (χ2=14,454; p=0,000), da se pri seksualnom odnosu zahteva da partner koristi zaštitu (χ2=27,014; p=0,000) i da se devojka (χ2 =101,132; p=0,000) ili momak (χ2=68,203; p=0,000) otvoreno izjasni da želi da ima seksualni odnos. U trećem ciklusu značajno manje učenika je navelo poželjan stav da devojka otvoreno kaže momku da ne želi da ima seksualni odnos ukoliko se tako oseća (χ2=13,568; p=0,000), značajno više učenika je navelo: da je u redu da momak otvoreno kaže devojci da ne želi da ima seksualni odnos (χ2=35,203; p=0,000), da je u redu da devojka (χ2=71,626; p=0,000) ili momak (χ2=34,323; p=0,000) otvoreno kažu da žele da imaju seksualni odnos. Prediktori poželjnih stavova u multivarijantnom modelu u većini slučajeva bili su: ženski pol, bolji uspeh u školi, pohađanje gimnazije i viši nivo samoprocenjenog socioekonomskog statusa. U drugom ciklusu pohađanje većeg broja radionica bilo je značajno povezano sa prisustvom poželjnih stavova (3 od 6 ispitivanih stavova). U odnosu na rizična ponašanja utvrđeno je da nakon intervencije nije došlo do značajne promene u seksualnim ponašanjima, izuzev u 3. ciklusu kada je značajno manji broj učenika stupio u seksualne odnose sa nepoznatim partnerom ili u vezi kraćoj od tri meseca (χ2=18,913; p=0,000). Prediktori protektivnih ponašanja (kasnije stupanje u seksualne odnose, manji broj seksualnih partnera, duže trajanje veze pre stupanje u seksualne odnose, češće korišćenje kontracepcije, ređe iskustvo prinudnog seksualnog odnosa) u multivarijantnom modelu bili su: ženski pol, poreklo učenika iz urbanih sredina, pohađanje gimnazije i viši nivo samoprocenjenog socioekonomskog statusa. Evaluacijom vannastavnog Programa „Zdravstveno vaspitanje o reproduktivnom zdravlju među srednjoškolcima uzrasta 16 godina u AP Vojvodini“ primenom evaluacionog instrumenta – SERAT, dokazali smo efektivnost programskih ciljeva, sadržaja i implementacije. Zaključak: Istraživanjem su obezbeđeni neophodni podaci i prikazana je odgovarajuća efektivnost programa koji bi se mogao primeniti kao zdravstveno-vaspitni program obrazovanja o seksualnom i reproduktivnom zdravlju, uz uvažavanje minimalnih promena imajući u vidu ove rezultate. Introduction: There is no adequate education of young people in Serbia on reproductive health, and it is significantly endangered. In Vojvodina, the extracurricular Health Education Program about reproductive health was implemented during three cycles. In order to adapt the intervention to the influences of demographic, socio-economic and contextual factors that affect adolescent behavior, it is necessary to identify these factors. The aim of this dissertation was to evaluate extracurricular health education Program: "Health Education on Reproductive Health, at the age of 16 in AP Vojvodina” through outcomes (knowledge, attitudes, and behaviors) and assessment effectiveness through the SERAT instrument (UNESCO), as well as to determine the association of demographic, socio-economic and contextual factors with knowledge, attitudes, and behavior related to sexual and reproductive health. Methods: An analysis of the effectiveness of this program was conducted based on pre- and post-intervention anonymous surveys of students of the high schools in Vojvodina who participated in the program during 3 cycles (2013-2016). The first research cycle included 991 students before and 950 students after education. The second cycle included 4.114 students before and 4.790 students after education. In the third cycle, 5.026 students were included before and 5.230 students after education. In the fourth year, in the part of the research related to the evaluation of goals, principles, content, and implementation of the program using the SERAT questionnaire (2016-2017), the sample consisted of 57 educators, decision-makers, and authors of the program. Results: Results showed that there was a significant difference in the average score on the scale of knowledge before and after the educational intervention, so it was higher after the intervention: first cycle (t=-22.881; p=0.000); second cycle (t=-41.851; p=0.000); third cycle (t=-37.437; p =0.000). Knowledge was significantly higher among students: females; from urban areas; with excellent or very good school performance compared to those with poorer performance; who attend grammar school in relation to students from secondary vocational schools; who have a father or mother with a higher level of education; who assess their material status as average in relation to those who assess it as well, except in the second cycle where differences did not observe in knowledge with regard to material status. In the second cycle, a positive correlation was established between higher knowledge and a larger number of education classes. After the intervention, in the first cycle of research, significantly more students had a desirable attitude - a guy openly tells a girl that he does not want to have sex if he feels that way (χ2=9.487; p=0.002) and asks a partner to examine whether he/she has a sexually transmitted infection (χ2=7.054; p=0.008). In the second cycle of research, a significantly higher number of students had a desirable attitude - a girl (χ2=14.343; p=0.000) or a boy (χ2=8.563; p=0.003) openly declare that he/she does not want to have sex if they feel so; ask their partner to check if he or she has a sexually transmitted infection if he or she suspects it (χ=14.454; p=0.000), ask the partner to use protection during sexual intercourse (χ2 =27.014; p=0.000), and that a girl (χ2=101.132; p=0.000) or a boy (χ2=68.203; p=0.000) openly say that they don’t want to have sex. In the third cycle, significantly fewer students stated a desirable attitude - a girl openly telling a guy that she doesn’t want to have sex if she feels that way (χ2=13.568; p=0.000), significantly more students stated a desirable attitude - a guy openly telling a girl that he does not want to have sex (χ2=35.203; p=0.000), a girl (χ2=71.626; p=0.000) or a guy (χ2=34.323; p=0.000) openly say they want to have sex. Predictors of desirable attitudes in the multivariate model in most case were: female, better school performance, grammar school and a higher level of self-assessed socioeconomic status. In the second cycle, attending a larger number of workshops was significantly associated with the presence of desirable attitudes (3 out of 6 examined attitudes). In relation to risky behaviors, it was determined that there was no significant change in sexual behavior after the intervention, except in the 3rd cycle when a significantly smaller number of students entered into sexual relations with an unknown partner or in a relationship shorter than three months (χ2=18.913; p=0.000). Predictors of protective behaviors (later sexual intercourse, fewer sexual partners, the longer relationship before sexual intercourse, more frequent use of contraception and less frequent experience of unwanted sexual intercourse) in the multivariate model were: female, urban residence, high school attendance and a higher level of self-assessed socioeconomic status. By evaluating the extracurricular program "Health education on reproductive health among high school students aged 16 in AP Vojvodina" using the evaluation instrument - SERAT, the effectiveness of program goals, content, and implementation was determined. Conclusion: The research provided the valuable data and showed the effectiveness of the program that could be applied as a health-educational program on sexual and reproductive health, with respect to minimal changes given these results.

Uvod: U Srbiji nema adekvatne edukacije mladih o reproduktivnom zdravlju, a ono je ugroženo u značajnom stepenu. U Vojvodini je tokom tri cikusa primenjen Vannastavni Program edukacije o reproduktivnom zdravlju. Da bi se intervencija prilagodila uticajima demografskih, socijalnoekonomskih i kontekstualnih faktora koji utiču na ponašanja adolescenata i na efektivnost primenjene intervencije, potrebno je ove faktore identifikovati. Cilj ove disertacije je bio da se evaluira primenjeni vannastavni program zdravstvenog vaspitanja o reproduktivnom zdravlju, u uzrastu 16 godina u AP Vojvodini, kroz ishode (znanje, stavove i ponašanja) i procenom efektivnosti putem evaluacionog SERAT instrumenta (UNESCO), kao i da se utvrdi povezanost demografskih, socijalno-ekonomskih i kontekstualnih faktora sa znanjem, stavovima i ponašanjem u vezi sa seksualnim i reproduktivnim zdravljem.Metode: Sprovedena je analiza efektivnosti navedenog programa na osnovu pre- i post- interventnog anonimnog anketiranja učenika drugih razreda srednjih škola i gimnazija u Vojvodini koji učestvuju u programu tokom 3 ciklusa (2013-2016. godina). U prvom ciklusu istraživanja obuhvaćen je 991 učenik pre i 950 učenika posle edukacije. U drugom ciklusu obuhvaćeno je 4.114 učenika pre i 4.790 učenika nakon edukacije. U trećem ciklusu, obuhvaćeno je 5.026 učenika pre, a nakon edukacije 5.230 učenika. U četvrtoj godini, u delu istraživanja koji se odnosi na evaluaciju ciljeva, principa, sadržaja i implementacije programa primenom SERAT upitnika (2016-2017. godina), uzorak je činilo 57 edukatora, donosilaca odluka i autora programa. Rezultati: Postoji značajna razlika u prosečnom skoru na skali znanja o reproduktivnom zdravlju pre i posle edukativne intervencije, tako da je ono više nakon intervencije: prvi ciklus (t=-22,881; p=0,000); drugi ciklus (t=-41,851; p=0,000); treći ciklus (t=-37,437; p=0,000). Znanje je bilo značajno veće kod učenika: ženskog pola; iz urbanih sredina; sa odličnim ili vrlo dobrim školskim uspehom u odnosu na one sa lošijim uspehom; koji pohađaju gimnaziju u odnosu na učenike iz srednjih stručnih škola; koji imaju oca ili majku sa višim nivoom obrazovanja; koji procenjuju svoje materijalno stanje kao prosečno u odnosu na one koji ga procenjuju kao dobro, osim u 2. ciklusu gde nisu uočene razlike u znanju u odnosu na materijalno stanje. U 2. ciklusu je utvrđena i pozitivna korelacija između višeg znanja i većeg broja časova edukacije. Nakon intervencije, u prvom ciklusu istraživanja značajno veći broj učenika je imao poželjan stav da momak otvoreno kaže devojci da ne želi da ima seksualne odnose ukoliko se tako oseća (χ2=9,487; p=0,002) i tražiti od seksualnog partnera/partnerke da ispita da li ima neku seksualno prenosivu infekciju (χ2=7,054; p=0,008). U drugom ciklusu istraživanja značajno veći broj učenika je imao poželjan stav da se devojka (χ2 =14,343; p=0,000) ili momak (χ2=8,563; p=0,003), otvoreno izjasni da ne želi da ima seksualne odnose ako se tako oseća; tražiti od partnera da ispita da li ima neku seksualno prenosivu infekciju ako sumnja u to (χ2=14,454; p=0,000), da se pri seksualnom odnosu zahteva da partner koristi zaštitu (χ2=27,014; p=0,000) i da se devojka (χ2 =101,132; p=0,000) ili momak (χ2=68,203; p=0,000) otvoreno izjasni da želi da ima seksualni odnos. U trećem ciklusu značajno manje učenika je navelo poželjan stav da devojka otvoreno kaže momku da ne želi da ima seksualni odnos ukoliko se tako oseća (χ2=13,568; p=0,000), značajno više učenika je navelo: da je u redu da momak otvoreno kaže devojci da ne želi da ima seksualni odnos (χ2=35,203; p=0,000), da je u redu da devojka (χ2=71,626; p=0,000) ili momak (χ2=34,323; p=0,000) otvoreno kažu da žele da imaju seksualni odnos. Prediktori poželjnih stavova u multivarijantnom modelu u većini slučajeva bili su: ženski pol, bolji uspeh u školi, pohađanje gimnazije i viši nivo samoprocenjenog socioekonomskog statusa. U drugom ciklusu pohađanje većeg broja radionica bilo je značajno povezano sa prisustvom poželjnih stavova (3 od 6 ispitivanih stavova). U odnosu na rizična ponašanja utvrđeno je da nakon intervencije nije došlo do značajne promene u seksualnim ponašanjima, izuzev u 3. ciklusu kada je značajno manji broj učenika stupio u seksualne odnose sa nepoznatim partnerom ili u vezi kraćoj od tri meseca (χ2=18,913; p=0,000). Prediktori protektivnih ponašanja (kasnije stupanje u seksualne odnose, manji broj seksualnih partnera, duže trajanje veze pre stupanje u seksualne odnose, češće korišćenje kontracepcije, ređe iskustvo prinudnog seksualnog odnosa) u multivarijantnom modelu bili su: ženski pol, poreklo učenika iz urbanih sredina, pohađanje gimnazije i viši nivo samoprocenjenog socioekonomskog statusa. Evaluacijom vannastavnog Programa „Zdravstveno vaspitanje o reproduktivnom zdravlju među srednjoškolcima uzrasta 16 godina u AP Vojvodini“ primenom evaluacionog instrumenta – SERAT, dokazali smo efektivnost programskih ciljeva, sadržaja i implementacije. Zaključak: Istraživanjem su obezbeđeni neophodni podaci i prikazana je odgovarajuća efektivnost programa koji bi se mogao primeniti kao zdravstveno-vaspitni program obrazovanja o seksualnom i reproduktivnom zdravlju, uz uvažavanje minimalnih promena imajući u vidu ove rezultate., Introduction: There is no adequate education of young people in Serbia on reproductive health, and it is significantly endangered. In Vojvodina, the extracurricular Health Education Program about reproductive health was implemented during three cycles. In order to adapt the intervention to the influences of demographic, socio-economic and contextual factors that affect adolescent behavior, it is necessary to identify these factors. The aim of this dissertation was to evaluate extracurricular health education Program: "Health Education on Reproductive Health, at the age of 16 in AP Vojvodina” through outcomes (knowledge, attitudes, and behaviors) and assessment effectiveness through the SERAT instrument (UNESCO), as well as to determine the association of demographic, socio-economic and contextual factors with knowledge, attitudes, and behavior related to sexual and reproductive health. Methods: An analysis of the effectiveness of this program was conducted based on pre- and post-intervention anonymous surveys of students of the high schools in Vojvodina who participated in the program during 3 cycles (2013-2016). The first research cycle included 991 students before and 950 students after education. The second cycle included 4.114 students before and 4.790 students after education. In the third cycle, 5.026 students were included before and 5.230 students after education. In the fourth year, in the part of the research related to the evaluation of goals, principles, content, and implementation of the program using the SERAT questionnaire (2016-2017), the sample consisted of 57 educators, decision-makers, and authors of the program. Results: Results showed that there was a significant difference in the average score on the scale of knowledge before and after the educational intervention, so it was higher after the intervention: first cycle (t=-22.881; p=0.000); second cycle (t=-41.851; p=0.000); third cycle (t=-37.437; p =0.000). Knowledge was significantly higher among students: females; from urban areas; with excellent or very good school performance compared to those with poorer performance; who attend grammar school in relation to students from secondary vocational schools; who have a father or mother with a higher level of education; who assess their material status as average in relation to those who assess it as well, except in the second cycle where differences did not observe in knowledge with regard to material status. In the second cycle, a positive correlation was established between higher knowledge and a larger number of education classes. After the intervention, in the first cycle of research, significantly more students had a desirable attitude - a guy openly tells a girl that he does not want to have sex if he feels that way (χ2=9.487; p=0.002) and asks a partner to examine whether he/she has a sexually transmitted infection (χ2=7.054; p=0.008). In the second cycle of research, a significantly higher number of students had a desirable attitude - a girl (χ2=14.343; p=0.000) or a boy (χ2=8.563; p=0.003) openly declare that he/she does not want to have sex if they feel so; ask their partner to check if he or she has a sexually transmitted infection if he or she suspects it (χ=14.454; p=0.000), ask the partner to use protection during sexual intercourse (χ2 =27.014; p=0.000), and that a girl (χ2=101.132; p=0.000) or a boy (χ2=68.203; p=0.000) openly say that they don’t want to have sex. In the third cycle, significantly fewer students stated a desirable attitude - a girl openly telling a guy that she doesn’t want to have sex if she feels that way (χ2=13.568; p=0.000), significantly more students stated a desirable attitude - a guy openly telling a girl that he does not want to have sex (χ2=35.203; p=0.000), a girl (χ2=71.626; p=0.000) or a guy (χ2=34.323; p=0.000) openly say they want to have sex. Predictors of desirable attitudes in the multivariate model in most case were: female, better school performance, grammar school and a higher level of self-assessed socioeconomic status. In the second cycle, attending a larger number of workshops was significantly associated with the presence of desirable attitudes (3 out of 6 examined attitudes). In relation to risky behaviors, it was determined that there was no significant change in sexual behavior after the intervention, except in the 3rd cycle when a significantly smaller number of students entered into sexual relations with an unknown partner or in a relationship shorter than three months (χ2=18.913; p=0.000). Predictors of protective behaviors (later sexual intercourse, fewer sexual partners, the longer relationship before sexual intercourse, more frequent use of contraception and less frequent experience of unwanted sexual intercourse) in the multivariate model were: female, urban residence, high school attendance and a higher level of self-assessed socioeconomic status. By evaluating the extracurricular program "Health education on reproductive health among high school students aged 16 in AP Vojvodina" using the evaluation instrument - SERAT, the effectiveness of program goals, content, and implementation was determined. Conclusion: The research provided the valuable data and showed the effectiveness of the program that could be applied as a health-educational program on sexual and reproductive health,with respect to minimal changes given these results.

UVOD: Svetska zdravstvena organizacija definiše farmakovigilancu kao “skup aktivnosti koje se odnose na prikupljanje, otkrivanje, procenu, razumevanje i prevenciju neželjenih reakcija na lek, kao i drugih problema u vezi sa lekom”, a njen krajnji cilj je zaštita javnog zdravlja. Stvaranjem uslova za organizovano i sistematično praćenje potencijalnih neželjenih reakcija, farmakovigilanca predstavlja esencijalnu aktivnost u regulatornom sistemu lekova, omogućavajući ranu detekciju neočekivanih, odloženih i/ili teških neželjenih reakcija na sve preparate i sredstva koja se koriste u preventivnoj i kliničkoj medicini. Osim potpunijeg definisanja bezbednosnog profila leka, jedan od glavnih ciljeva postmarketinškog praćenja i prijavljivanja neželjenih reakcija na lekove (NRL) je i preciznije definisanje odnosa koristi i potencijalnih rizika primene nekog leka u praksi, što u krajnjoj meri uvek vodi ka unapređenju jednog od važnih aspekata javnog zdravlja – bezbednosti pacijenta u procesu lečenja. Edukacija o farmakovigilanci i pridružrnim aktivnostima su važne kompetencije koje studenti zdravstvenih nauka treba da usvoje pre nego što diplomiraju i počnu da se bave kliničkom praksom. Imajući to u vidu, cilj ove studije je bio da se primenom novorazvijenog i validiranog upitnika procene znanja i stavovi o farmakovigilanci u populaciji studenata zdravstvenih nauka u AP Vojvodini, Srbija. METODE: Od februara do jula 2021. godine je sprovedena opservaciona studija preseka među studentima medicine, stomatologije, farmacije i zdravstvene nege na tri fakulteta koji obrazuju buduće zdravstvene radnike u AP Vojvodini. Novorazvijeni trodelni Upitnik za procenu znanja i stavova o farmakovigilanci za studente zdravstvenih nauka, UPZSFV (I - Upitnik o sociodemografskim karakteristikama ispitanika, II - Test znanja o farmakovigilanci za studente zdravstvenih nauka, TZFV i III - Upitnik za procenu stavova studenata zdravstvenih nauka, USFV) je putem Google Forms platforme dobrovoljno i anonimno popunilo ukupno 242 studenata zdravstvenih nauka, od kojih je 211 ispunilo kriterijum za uključivanje u studiju. REZULTATI: Nakon sprovedene ajtem analize, šest pitanja je isključeno iz TZFV-a. Vrednost ordinalne alfe konačne verzije TZFV sa 14 ajtema je bila dobra (αord = 0,83), kao i ostali statistički pokazatelji pouzdanosti. Testiranje pouzdanosti USFV je takođe pokazalo odlične performanse ove sekcije upitnika: αord = 0,91, za obe USFV subskale. Prosečan ostvareni TZFV skor je iznosio M=9,14 (SD=2,65; Me=10), u opsegu 0-14.Testiranjem je utvrđeno da su svi ispitanici statistički značajno znali više od 50% tačnih odgovora u testu, a najviši prosečni ostvareni TZFV skor je registrovan kod studenata integrisanih studija medicine (M=9,96; SD=1,81; Me=10). Kada su u pitanju stavovi ispitanika o farmakovigilanci, prosečni skor dobijen na PSFV subskali koja se odnosi na opšti stav o farmakovigilanci je iznosio M=31,98 (SD=3,68; Me=33), u opsegu 7-35. Prosečan skor na PSNRL subskali koja se odnosi na spremnost ispitanika da učestvuju u aktivnostima farmakovigilance je iznosio M=43,12 (SD=10,63; Me=45), u opsegu 13-65. Najviši PSFV skor su ostvarili studenti osnovnih akademskih studija zdravstvene nege (M=32,84; SD=2,59; Me=34), dok je najviši PSNRL skor registrovan među studentima integrisanih studija medicine (M=46,69; SD=8,03; Me=47,5). ZAKLJUČCI: Razvijen je i iscrpno statistički validiran prvi univerzalan, metodološki korektno i precizno osmišljen i naučno zasnovan upitnik sa dva psihometrijska instrumenta, koji se bez dodatnih prilagođavanja može koristiti za procenu znanja i stavova o farmakovigilanci kod studenata svih studijskih programa iz oblasti zdravstvenih nauka. Ispitanici u posmatranom uzorku su pokazali visok nivo znanja o farmakovigilanci, ostvarivši prosečni skor koji iznosi 65,29% od maksimalnog mogućeg. Istovremeno, istraživanjem je utvrđeno da u ispitivanoj populaciji preovlađuju vrlo pozitivni opšti stavovi prema farmakovigilanci, ali da ispitanici u proseku samo blago naginju pozitivnijim stavovima prema prijavljivanju neželjenih reakcija na lekove u budućoj praksi. INTRODUCTION: Pharmacovigilance is defined by the World Health Organization as "a set of activities related to the collection, detection, assessment, understanding, and prevention of adverse drug reactions and other drug-related problems", with protecting public health as its ultimate goal. By creating conditions for organized and systematic monitoring of potential adverse reactions, pharmacovigilance is an essential activity in the regulatory system of drugs that allows early detection of unexpected, delayed, and/or severe adverse reactions to all preparations and agents used in preventive and clinical medicine. In addition to more fully defining the safety profile of a drug, one of the main goals of post-marketing monitoring and reporting of adverse drug reactions (ADRs) is to more precisely define the benefits and potential risks of a drug in practice, which ultimately leads to the improvement of one of the important aspects of public health - patient safety in the medical treatment process. Pharmacovigilance and related activities education are important competencies that healthcare sciences students should adopt before completing their studies and engaging in clinical practice. Considering this, the aim of this study was to assess pharmacovigilance knowledge and attitudes in a population of health sciences students in AP Vojvodina, Serbia, using a newly developed and validated questionnaire. METHODS: From February to July 2021, an observational cross-sectional study was conducted among students of medicine, dentistry, pharmacy, and nursing science at three faculties that educate future health professionals in Vojvodina. The newly developed three-part Questionnaire for Assessing Knowledge and Attitudes About Pharmacovigilance for Students of Healthcare Sciences, PVKAQ (I Demographic data section, II Pharmacovigilance Knowledge test, PVKT, and III Pharmacovigilance Attitude Questionnaire, PVAQ), was voluntarily and anonymously completed by a total of 242 health sciences students via the Google Forms platform, with 211 meeting the inclusion criteria for the study. RESULTS: After an item analysis, six questions were excluded from the PVKT. The final version of PVKT with 14 items had a good ordinal alpha value (αord = 0.83), as were other statistical indicators of reliability. PVAQ reliability testing also showed excellent performance of this section of the questionnaire: αord = 0.91 for both USFV subscales. The achieved average PVKT score was M = 9.14 (SD = 2.65; Me = 10), in the range of 0-14. Results of statistical testing showed that all respondents knew significantly more than 50% of the correct answers in the test, and the highest average PVKT score was achieved among students of integrated studies of medicine (M = 9.96; SD = 1.81; Me = 10). In contexts of respondents' attitudes toward pharmacovigilance, the average score on the PAPV subscale related to general attitude toward pharmacovigilance was M = 31.98 (SD = 3.68; Me = 33), in the range of 7–35. The average score on the PAADR subscale related to the willingness of the subjects to participate in pharmacovigilance activities was M = 43.12 (SD = 10.63; Me = 45), in the range of 13-65. The highest PAPV score was achieved by students of basic academic studies of nursing science (M = 32.84; SD = 2.59; Me = 34), while the highest PAADR score was registered among students of integrated studies of medicine (M = 46.69; SD = 8.03; Me = 47.5). CONCLUSIONS: The first universal, methodologically correct, precisely designed, and scientifically based questionnaire with two psychometric instruments was developed and thoroughly statistically validated, which can be used to assess knowledge and attitudes about pharmacovigilance among students from all healthcare sciences study programs without any additional adjustments. Respondents in the observed sample demonstrated a high level of pharmacovigilance knowledge, with an average score of 65.29% of the maximum possible. At the same time, the research found that very positive general attitudes towards pharmacovigilance prevailed in the examined population, but that respondents only slightly tended to have more positive attitudes toward reporting adverse drug reactions in future practice.

UVOD: Svetska zdravstvena organizacija definiše farmakovigilancu kao “skup aktivnosti koje se odnose na prikupljanje, otkrivanje, procenu, razumevanje i prevenciju neželjenih reakcija na lek, kao i drugih problema u vezi sa lekom”, a njen krajnji cilj je zaštita javnog zdravlja. Stvaranjem uslova za organizovano i sistematično praćenje potencijalnih neželjenih reakcija, farmakovigilanca predstavlja esencijalnu aktivnost u regulatornom sistemu lekova, omogućavajući ranu detekciju neočekivanih, odloženih i/ili teških neželjenih reakcija na sve preparate i sredstva koja se koriste u preventivnoj i kliničkoj medicini. Osim potpunijeg definisanja bezbednosnog profila leka, jedan od glavnih ciljeva postmarketinškog praćenja i prijavljivanja neželjenih reakcija na lekove (NRL) je i preciznije definisanje odnosa koristi i potencijalnih rizika primene nekog leka u praksi, što u krajnjoj meri uvek vodi ka unapređenju jednog od važnih aspekata javnog zdravlja – bezbednosti pacijenta u procesu lečenja. Edukacija o farmakovigilanci i pridružrnim aktivnostima su važne kompetencije koje studenti zdravstvenihnauka treba da usvoje pre nego što diplomiraju i počnu da se bave kliničkom praksom. Imajući to u vidu, cilj ove studije je bio da se primenom novorazvijenog i validiranog upitnika procene znanja i stavovi o farmakovigilanci u populaciji studenata zdravstvenih nauka u AP Vojvodini, Srbija. METODE: Od februara do jula 2021. godine je sprovedena opservaciona studija preseka među studentima medicine, stomatologije, farmacije i zdravstvene nege na tri fakulteta koji obrazuju buduće zdravstvene radnike u AP Vojvodini. Novorazvijeni trodelni Upitnik za procenu znanja i stavova o farmakovigilanci za studente zdravstvenih nauka, UPZSFV (I - Upitnik o sociodemografskim karakteristikama ispitanika, II - Test znanja o farmakovigilanci za studente zdravstvenih nauka, TZFV i III - Upitnik za procenu stavova studenata zdravstvenih nauka, USFV) je putem Google Forms platforme dobrovoljno i anonimno popunilo ukupno 242 studenata zdravstvenih nauka, od kojih je 211 ispunilo kriterijum za uključivanje u studiju. REZULTATI: Nakon sprovedene ajtem analize, šest pitanja je isključeno iz TZFV-a. Vrednost ordinalne alfe konačne verzije TZFV sa 14 ajtema je bila dobra (αord = 0,83), kao i ostali statistički pokazatelji pouzdanosti. Testiranje pouzdanosti USFV je takođe pokazalo odlične performanse ove sekcije upitnika: αord = 0,91, za obe USFV subskale. Prosečan ostvareni TZFV skor je iznosio M=9,14 (SD=2,65; Me=10), u opsegu 0-14.Testiranjem je utvrđeno da su svi ispitanici statistički značajno znali više od 50% tačnih odgovora u testu, a najviši prosečni ostvareni TZFV skor je registrovan kod studenata integrisanih studija medicine (M=9,96; SD=1,81; Me=10). Kada su u pitanju stavovi ispitanika o farmakovigilanci, prosečni skor dobijen na PSFV subskali koja se odnosi na opšti stav o farmakovigilanci je iznosio M=31,98 (SD=3,68; Me=33), u opsegu 7-35. Prosečan skor na PSNRL subskali koja se odnosi na spremnost ispitanika da učestvuju u aktivnostima farmakovigilance je iznosio M=43,12 (SD=10,63; Me=45), u opsegu 13-65. Najviši PSFV skor su ostvarili studenti osnovnih akademskih studija zdravstvene nege (M=32,84; SD=2,59; Me=34), dok je najviši PSNRL skor registrovan među studentima integrisanih studija medicine (M=46,69; SD=8,03; Me=47,5). ZAKLJUČCI: Razvijen je i iscrpno statistički validiran prvi univerzalan, metodološki korektno i precizno osmišljen i naučno zasnovan upitnik sa dva psihometrijska instrumenta, koji se bez dodatnih prilagođavanja može koristiti za procenu znanja i stavova o farmakovigilanci kod studenata svih studijskih programa iz oblasti zdravstvenih nauka. Ispitanici u posmatranom uzorku su pokazali visok nivo znanja o farmakovigilanci, ostvarivši prosečni skor koji iznosi 65,29% od maksimalnog mogućeg. Istovremeno, istraživanjem je utvrđeno da u ispitivanoj populaciji preovlađuju vrlo pozitivni opšti stavovi prema farmakovigilanci, ali da ispitanici u proseku samo blago naginju pozitivnijim stavovima prema prijavljivanju neželjenih reakcija na lekove u budućoj praksi., INTRODUCTION: Pharmacovigilance is defined by the World Health Organization as "a set of activities related to the collection, detection, assessment, understanding, and prevention of adverse drug reactions and other drug-related problems", with protecting public health as its ultimate goal. By creating conditions for organized and systematic monitoring of potential adverse reactions, pharmacovigilance is an essential activity in the regulatory system of drugs that allows early detection of unexpected, delayed, and/or severe adverse reactions to all preparations and agents used in preventive and clinical medicine. In addition to more fully defining the safety profile of a drug, one of the main goals of post-marketing monitoring and reporting of adverse drug reactions (ADRs) is to more precisely define the benefits and potential risks of a drug in practice, which ultimately leads to the improvement of one of the important aspects of public health - patient safety in the medical treatment process. Pharmacovigilance and related activities education are important competencies that healthcare sciences students should adopt before completing their studies and engaging in clinical practice. Considering this, the aim of this study was toassess pharmacovigilance knowledge and attitudes in a population of health sciences students in AP Vojvodina, Serbia, using a newly developed and validated questionnaire. METHODS: From February to July 2021, an observational cross-sectional study was conducted among students of medicine, dentistry, pharmacy, and nursing science at three faculties that educate future health professionals in Vojvodina. The newly developed three-part Questionnaire for Assessing Knowledge and Attitudes About Pharmacovigilance for Students of Healthcare Sciences, PVKAQ (I Demographic data section, II Pharmacovigilance Knowledge test, PVKT, and III Pharmacovigilance Attitude Questionnaire, PVAQ), was voluntarily and anonymously completed by a total of 242 health sciences students via the Google Forms platform, with 211 meeting the inclusion criteria for the study. RESULTS: After an item analysis, six questions were excluded from the PVKT. The final version of PVKT with 14 items had a good ordinal alpha value (αord = 0.83), as were other statistical indicators of reliability. PVAQ reliability testing also showed excellent performance of this section of the questionnaire: αord = 0.91 for both USFV subscales. The achieved average PVKT score was M = 9.14 (SD = 2.65; Me = 10), in the range of 0-14. Results of statistical testing showed that all respondents knew significantly more than 50% of the correct answers in the test, and the highest average PVKT score was achieved among students of integrated studies of medicine (M = 9.96; SD = 1.81; Me = 10). In contexts of respondents' attitudes toward pharmacovigilance, the average score on the PAPV subscale related to general attitude toward pharmacovigilance was M = 31.98 (SD = 3.68; Me = 33), in the range of 7–35. The average score on the PAADR subscale related to the willingness of the subjects to participate in pharmacovigilance activities was M = 43.12 (SD = 10.63; Me = 45), in the range of 13-65. The highest PAPV score was achieved by students of basic academic studies of nursing science (M = 32.84; SD = 2.59; Me = 34), while the highest PAADR score was registered among students of integrated studies of medicine (M = 46.69; SD = 8.03; Me = 47.5). CONCLUSIONS: The first universal, methodologically correct, precisely designed, and scientifically based questionnaire with two psychometric instruments was developed and thoroughly statistically validated, which can be used to assess knowledge and attitudes about pharmacovigilance among students from all healthcare sciences study programs without any additional adjustments. Respondents in the observed sample demonstrated a high level of pharmacovigilance knowledge, with an average score of 65.29% of the maximum possible. At the same time, the research found that very positive general attitudes towards pharmacovigilance prevailed in the examined population, but that respondents only slightly tended to have more positive attitudes toward reporting adverse drug reactions in future practice.

случајева годишње. Упркос смањењу учесталости пушења у многим земљама у претходним деценијама, појава нових производа као што су електронске цигарете и пораст популарности наргила учинили су контролу дувана још комплекснијом. Процене учесталости коришћења појединачних производа могу маскирати комплексне обрасце употреба дувана и електронских цигарета као што је истовремена употреба два или више производа која у неким државама представља доминантан вид коришћења ових производа међу децом средњих и виших школа. Поред процене образаца употребе дуванских и никотинских производа, потребно је утврдити и факторе ризика за различите групе корисника никотинских и дуванских производа. Метод: У овој студији коришћени су подаци из три национална истраживања спроведена 2017. и 2018. године по типу студија пресека на репрезентативном узорку и то: Истраживања здравственог понашања деце школског узраста и то Пилот истраживање из 2017. године и Истраживање спроведено 2018. године као и Истраживањем о употреби дувана које се спроведено у Србији 2017. године. Као инструмент испитивања коришћени су упитници. Циљна група истраживања су ученици старости 11,13 и 15 година. Резултати: У Србији цигарете пуши 11% ученика старости 13-15 година, наргиле пуши 9,0% ученика, а електронске цигарете 6,2%. Најучесталији образац коришћења у односу на број и врсту производа је употреба наргила и/или електронских цигарета без коришћења цигарета (7.5%), а након тога искључиво коришћење цигарета (5.8%). Међу пушачима цигарета нешто више од половине користи само цигарете (52,8). Ученици који су изложени промоцијама и рекламама дуванске индустрије статистички чешће пуше од оних који нису изложени овом виду маркетинга дуванских производа. Међу пушачима, више од половине (50,9%) наводи да пуши више у циљу контроле телесне тежине, а 24.3% није задовољна сопственим изгледом. Депресија је значајан предиктор пушења. Ученици који упражњавају друга ризична понашања имају статистички значајно веће шансе до буду и пушачи... Smoking cause at annual level 7-10 premature deaths. Despite decline in smoking prevalence in many countries, emerging tobacco products such as e-cigarettes and waterpipes makes tobacco control even more challenging. Focusing only at prevalence and patterns of use of one product can mask complex patters such as dual and poly tobacco/nicotine products use. Of importance is to explore and determine risk factors associated with different groups of users of cigarette, e-cigarette and waterpipe. Method: in this thesis data from three cross sectional studies were used: Global Youth Tobacco Survey 2017, Pilot Health behavior in School -aged Children Survey 2017 and Health Behavior in School -aged Children Survey 2018 surveys conducted in Serbia. Data were collected through standardized questionnaires. Target groups are students aged 11,13, and 15 years old. Results: in Serbia, 115 of students smoke cigarettes, 9% smoke waterpipe and 6,2% smoke ecigarettes. The most prevalent pattern of use is waterpipe and/or e-cigarette use without cigarette smoking (7,5%), followed by exclusive cigarette smoking. Among smokers, only 52,8% use only this tobacco product. Students exposed to tobacco product marketing statistically significantly more smoke than those who are not exposed. Among smokers, more than half (50,9) smoke more for weight control and 24,3% are not satisfied with their physical appearance. Depression is significant predictor of smoking in both sex. Students who practice other risk behaviors statistically significantly more smoke...

Socijalno-ekonomske nejednakosti u zdravlju jesu važan i stalan javnozdravstveni problem u svim evropskim zemljama. Nejednakost u zdravlju u većini društava podrazumeva da žene imaju manji pristup i kontrolu nad resursima za zaštitu svog zdravlja, kao i manje mogućnosti da budu uključene u odlučivanje o sopstvenom zdravlju. Svi navedeni aspekti u značajnoj meri utiču na zdravlje žena. Cilj ovog rada bio je da se proceni vulnerabilnost u zdravlju žena, korišćenje i razlike u korišćenju zdravstvene zaštite žena, kao i da se identifikuju najznačajnije determinante povezane sa nejednakostima u zdravlju žena. Doktorska disertacija predstavlja deo Istraživanja zdravlja stanovništva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije. Istraživanjem je obuhvaćeno 1.840 žena uzrasta 20 i više godina sa područja Vojvodine. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja, a podaci o telesnoj masi, telesnoj visini i krvnom pritisku su dobijeni merenjem. Rezultati istraživanja su pokazali da je su najstarije žene u strukturi uzorka, (OR=9,64; 95%CI = [5,79-16,04]; p, Socio-economic inequalities in health are an important and constant public health problem in all European countries. Inequality in health in most societies means that women have less access to and control over resources to protect their health, as well as fewer opportunities to be involved in deciding on their health. All of these aspects significantly affect women's health. This study aimed to assess the vulnerability in women's health, the use and differences in the use of women's health care, as well as to identify the most important determinants associated with inequalities in women's health. The doctoral dissertation is a part of the Health Survey of the Population of Serbia from 2013, which was conducted by the Ministry of Health of the Republic of Serbia. The research included 1,840 women aged 20 and over from the area of Vojvodina. The research instrument was questionnaires constructed following the European Health Research Questionnaire, and data on body weight, body height and blood pressure were obtained by measurement. The results of the research showed that the oldest women in the sample structure, (OR = 9.64; 95% CI = [5.79-16.04]; p

Ispitivanu grupu činilo je 1247 ispitanika sa povredama prednje ukrštene veze kolena koji su operativno lečeni u periodu 2012.-2017. godina na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Ciljevi istraživanja bili su utvrđivanje uticaja nivoa sportske aktivnosti i mehanizama povređivanja na nastanak povreda prednje ukrštene veze kolena, zatim uticaj spoljašnjih faktora rizika (vrsta sporta, rang takmičenja, vrsta podloge, trening ili utakmica, period treninga) na nastanak povreda prednje ukrštene veze kolena, odnosno uticaj unutrašnjih faktora rizika (pol, starost, BMI) na nastanak povreda ove strukture kolena. Od ukupnog broja ispitanika njih 517 (41,5%) su činili aktivni sportisti, a 730 (58,5%) rekreativci. Značajnu većinu u posmatranom uzorku su činili muškarci (82,6%), osobe starosti od 16 do 25 godina (62,6%) i normalno uhranjenje osobe (62%). Do povrede prednje ukrštene veze došlo je kod njih 504 (40,5%) prilikom aktivnog bavljenja sportom, dok su se povrede prilikom rekreativnog bavljenja sportom dogodile kod 741 ispitanika (59,5%). Među aktivnim sportistima, više od dve trećine se takmičilo na internacionalnom ili republičkom nivou, odnosno u najvišim rangovima takmičenja. Kontaktnim kolektivnim sportovima (fudbal, košarka i rukomet) bavilo se 77,9% ispitanika. Nekontaktnim sportovima kao što su odbojka, borilački sportovi i skijanje bavilo se 22,1% ispitanika, pri čemu je najveći broj povreda nastao prilikom igranja fudbala (51,3%). Statistički značajno više povreda (i prilikom aktivnog i prilikom rekreativnog bavljenja sportom) je nastalo bez direktnog kontakta (nekontaktne povrede koje su činile 78,7% povreda), pri čemu je najveći broj povreda nastao usled promene pravca i ritma kretanja. Kod aktivnih sportista najviše povreda dogodilo se na utakmicama (73,8%), slede povrede na treningu (24,1%), dok se na rekreaciji povredilo svega 2,1% ispitanika. Značajno više povreda dogodilo se na sredini bavljenja sportskom aktivnošću (47,4%) u odnosu na povrede na zagrevanju, početku, odnosno kraju sportske aktivnosti. Povrede su značajno češće nastajale na travi (42%) i parketu (28%), nego na drugim vrstama podloge. Najveći broj ispitanika povredio se noseći patike prilikom bavljenja sportskom aktivnošću. Postoje značajne razlike u kontekstu povređivanja u zavisnosti od pola ispitanika. Žene su u značajno većem procentu povređivane prikom aktivnog bavljenja sportom, dok su se muškarci češće povređivali na rekreaciji. Žene su se najčešće povređivale na rukometu, muškarci na fudbalu. U odnosu na muškarce, kod žena su povrede znatno ređe nastajale prilikom direktnog kontakta, a kad je u pitanju mesto povređivanja, žene su se češće nego muškarci povređivale na treningu. Preko 50% žena je povređeno na parketu, dok se najveći broj muškaraca povredio na travi. Ispitanici sa prekomernom telesnom masom značajno češće su se povređivali prilikom rekreacije, dok su se normalno uhranjeni češće povređivali prilikom aktivnog bavljenja sportom. Faktori rizika za nastanak povreda prednje ukrštene veze su brojni i specifični, odnosno da za svaku populacionu kategoriju postoje rizici, ali se uočava da su u svim sportovima, na svim podlogama i kod svih ispitanika povrede najčešće nastajale nekontaknim mehanizmom povređivanja. Formiranjem registra povređenih omogućilo bi se bolje razumevanje faktora rizika i njihovog međusobnog uticaja, kao i definisanje profila osoba pod najvećim rizikom za nastanak povrede prednje ukršene veze kolena. Na taj način obezbedile bi se potrebne informacije za planiranje preventivnih programa usmerenih na smanjenje rizika od povređivanja i omogućilo bi se sprovođenje odgovarajućih mera selektivne prevencije., The study group consisted of 1247 respondents with anterior cruciate ligament injuries who were surgically treated in the period 2012-2017. at the Clinic for Orthopedic Surgery and Traumatology of the Clinical Center of Vojvodina. The objectives of the study were to determine the impact of sports activity levels and injury mechanisms on the occurrence of anterior cruciate ligament injuries, then the impact of external risk factors (type of sport, competition rank, type of surface, training or match, training period) on the occurrence of anterior cruciate ligament injuries and the influence of internal risk factors (gender, age, BMI) on the occurrence of injuries of this knee structure. Out of the total number of respondents 517 (41.5%) were active athletes, and 730 (58.5%) were recreational athletes. A significant majority in the observed group were men (82.6%), persons aged 16 to 25 years (62.6%) and normal BMI respondents (62%). Anterior cruciate ligament injury occurred in 504 of them (40.5%) during active sports, while injuries during recreational sports occurred in 741 respondents (59.5%). Among active athletes, more than two thirds competed at the international or national level- in the highest ranks of the competition. Contact collective sports (football, basketball and handball) were practiced by 77.9% of respondents. 22.1% of respondents practiced non-contact sports such as volleyball, martial arts sports and skiing. The largest number of injuries occurring while playing football (51.3%). Statistically significantly more injuries (both during active and recreational sports) occurred without direct contact (noncontact injuries-78,7% of total injuries number), with the largest number of injuries caused by changes in the direction and rhythm of movement. Among active athletes, most injuries occurred in matches (73.8%), followed by injuries in training (24.1%), while only 2.1% of respondents were injured in recreation. Significantly more injuries occurred in the middle of engaging in sports activity (47.4%) compared to injuries during the warm-up, beginning and end of sports activity. Injuries occurred significantly more often on grass (42%) and floor (28%) than on other types of surfaces. Most of the respondents were injured wearing sneakers while doing sports. There are significant differences in the context of injury depending on the gender of the respondents. A significantly higher percentage of women were injured during active sports, while men were more often injured during recreational sport activities. Women were most often injured in handball, men in football. Compared to men, injuries were much less common in women during direct contact, and when it comes to the place of injury, women were injured more often than men during training acitivities. Over 50% of women were injured on the floor, while the largest number of men were injured on the grass. Subjects with overweight were significantly more likely to be injured during recreational sport acitivites, while those with normal BMI were more likely to be injured during active sports. Risk factors for anterior cruciate ligament injuries are numerous and specific and there are risks for each population category, but it is noticed that in all sports, on all surfaces and in all subjects, injuries were most often caused by a noncontact injury mechanism. The formation of a Register of injuries would enable a better understanding of risk factors and their mutual influence, as well as the definition of the profile of persons at greatest risk for the occurrence of an anterior cruciate ligament injury. This would provide the necessary information for planning prevention programs aimed at reducing the risk of injury and would enable the implementation of appropriate selective prevention measures.

Kvalitet vazduha u urbanim sredinama predstavlja jedan od glavnih uzroka zdravstvenih problema. Prema podacima SZO u svetu se godišnje usled zagađenja vazduha u urbanim sredinama dogodi preko 2,7 miliona smrtnih slučajeva. Procenjuje se da najbolji indikator za procenu veličine zdravstvenog rizika od zagađenja vazduha jeste koncentracija suspendovanih čestica PM2,5 u vazduhu životne sredine. Cilj: Proceniti uticaj suspendovanih čestica PM2,5 iz vazduha životne sredine na ukupan mortalitet, kardiovaskularni i respiratorni bolnički morbiditet odraslog stanovništva Grada Novog Sada. Takođe, cilj istraživanja je bio da se i utvrdi koncentracija i hemijski sastav suspendovanih čestica PM2,5 u vazduhu životne sredine na teritoriji Grada Novog Sada, na dnevnom i godišnjem nivou, uzimajući u obzir i uticaj meteoroloških parametara. Metod: Istraživanje je sprovedeno kao prospektivna studija vremenske serije podataka o kvalitetu vazduha, meteorološkim parametrima i zdravstvenim ishodima, u intervalima od najmanje 30 dana tokom sva četiri godišnja doba 2017. godine. Uzorkovanje i određivanje koncentracije i hemijskog sastava čestica PM2,5 u skladu sa propisanim standardnim metodama, je obavljeno na mernim mestima u životnoj sredini Grada Novog Sada, koja reprezentuju uticaj saobraćaja i urbanog pozadinskog područja na zagađenje vazduha životne sredine. Primenjen je Lenschow pristup za kvantifikaciju veličine doprinosa saobraćaja porastu koncentracije suspendovanih čestica PM2,5 u vazduhu životne sredine. Podaci o meteorološkim parametrima (temperatura vazduha, relativna vlažnost vazduha i brzina vetra), su preuzeti od Republičkog hidrometeorološkog zavoda Srbije. Podaci o zdravstvenim ishodima (dnevni broj umrlih i hospitalizovanih zbog kardiovaskularnih i respiratornih bolesti), za stanovništvo starije od 18 godina, čije mesto stanovanja pripada teritoriji Grada Novog Sada, obezbeđeni su od strane Centra za informatiku i biostatistiku u zdravstvu Instituta za javno zdravlje Vojvodine. Za procenu uticaja nezavisnih promenljivih na zavisne (ukupan mortalitet / bolnički morbiditet) primenjen je generalizovani linearni model regresione analize za vremenske serije podataka (Poason). Rezultati: Prosečna godišnja koncentracija suspendovanih čestica PM2,5 iz vazduha životne sredine na teritoriji Grada Novog Sada je iznosila 30,27 μg/m3, a srednje dnevne koncentracije 8-79 g/m3. Približno 30% varijabilnosti srednjih dnevnih koncentracije suspendovanih čestica PM2,5 se može objasniti lokalnim meteorološkim uslovima. Hemijski sastav čestica na području Grada Novog Sada u najvećem procentu čini ekvivalent karbonatne frakcije čestica, zatim sekundarni neorganski aerosol i rastvorljiva organska frakcija, dok su joni rastvorljivi u vodi (kalcijum, hloridi, natrijum, kalijum i magnezijum) zastupljeni u najmanjem procentu. Prisutni izvori zagađenja vazduha životne sredine na području Grada Novog Sada su procesi sagorevanja fosilnih goriva i biomase, saobraćaj, mineralna (zemljišna) prašina i sekundarno zagađenje regionalnog porekla. Doprinos saobraćaja porastu prosečne godišnje koncentracije suspendovanih čestica PM2,5 je iznosio 40%. Masena koncentracija čestica PM2,5, kao i hemijski sastav čestica (ekvivalent karbonatne frakcije, rastvorljiva organska frakcija, joni kalijuma i kalcijuma) doprinose umiranju i oboljevanju odraslog stanovništva Grada Novog Sada. Na uticaj masene koncentracije i hemijskog sastava čestica PM2,5 najosetljivije su žene i stanovništvo starosti ≥ 65 godina, kao i muškarci u pogledu uticaja ekvivalenta karbonatne frakcije čestica PM2,5. Zaključak: Dobijeni rezultati po prvi put opisuju zdravstveni uticaj masene koncentracije i hemijskog sastava čestica PM2,5 na području Grada Novog Sada, odnosno kvantifikuju rizik za ukupan mortalilteta i kardiovaskualrni i respiratorni morbiditet. Razumevanje uticaja suspendovanih čestica PM2,5 na oboljevanje i umiranje stanovništva, stratifikovanih prema starosnoj i polnoj strukturi, uz identifikaciju mogućih izvora zađenja vazduha na području Grada Novog Sada, predstavlja osnovu za razvoj javnozdravstvene politike u cilju unapređenja zdravlja stanovništva Grada Novog Sada. Urban ambient air pollution is one of the leading causes of health problems. According to WHO data, over 2.7 million deaths occur in urban areas annually due to urban air pollution. Particulate matter PM2.5 is estimated to be the best indicator for assessing the magnitude of the health risk induces by ambient air pollution. Aim: To assess the impact of PM2.5 on total mortality, cardiovascular and respiratory hospital morbidity of the adult population of the City of Novi Sad. Also, the aim of the study was to determine the concentration and chemical composition of ambient PM 2.5 particles in the territory of the City of Novi Sad, on daily and annual bases, taking into account the impact of meteorological parameters. Method: The study was conducted as a prospective, a time series study of of data on air quality, meteorological parameters and health outcomes, at intervals of at least 30 days during all four seasons of 2017. Sampling and determination of the mass concentration and chemical composition of PM2.5 particles in accordance with the prescribed standard methods, it was performed at sampling stations in the City of Novi Sad, representing the impact of traffic and urban background impact on environmental air pollution. A Lenschow approach was used to quantify the magnitude of traffic contribution to the increase of ambient PM2.5 mass concentration. Meteorological data (air temperature, relative humidity and wind velocity) were taken from the Republic Hydrometeorological Institute of Serbia. Data on health outcomes (daily number of deaths and hospitalizations due to cardiovascular and respiratory diseases) for the population older than 18, residing within the territory of the City of Novi Sad, have been provided by the Centre for Informatics and Biostatistics, Institute of Public Health of Vojvodina. To evaluate the impact of independent variables on dependent (total mortality/hospital morbidity), a generalized linear regression model for time series data (Poisson) was applied. Results: The average annual mass concentration of PM2.5 in the territory of the City of Novi Sad was 30.27μg/m3, while mean daily concentrations were 8- 79μg/m3. Approximately 30% of the variability in mean daily concentrations of PM2.5 particles can be explained with local meteorological conditions. The chemical composition of PM2.5 in the area of Novi Sad is to the a great extent the equivalent of the carbonate fraction of the particles, then the secondary inorganic aerosol and the soluble organic fraction, while the water-soluble ions (calcium, chlorides, sodium, potassium and magnesium) are present in the lowest percentage. The sources of ambient air pollution in the area of the City of Novi Sad were the combustion of fossil fuels and biomass, traffic, mineral (soil dust) and secondary pollution of regional origin. Contribution of traffic to the increase of the average annual mass concentrations of PM2.5 particles was 40%. PM2.5 particle mass concentration, as well as the chemical composition of the particles (carbonate fraction equivalent, soluble organic fraction, potassium and calcium ions) contribute to the deaths and diseases of the adult population of the City of Novi Sad. Women and the population aged ≥65, were more susceptible to mass concentration and chemical composition of PM2.5 related deaths and diseases, as well as men according to the impact of the equivalents of carbonate fractions of PM2.5. Conclusion: The results obtained show for the first time the health effects of mass concentration and chemical composition of PM2.5 particles in the City of Novi Sad, i.e. they quantify the risk for total mortality and cardiovascular and respiratory morbidity. Understanding the impact of suspended particles PM2.5 on population mortality and morbidity, stratified by age and sex structure, along with identifying of possible air pollution sources is the basis for the development of public health policies aimed at improving the population health in the City of Novi Sad.

Uvod: Kardiovaskularne bolesti predstavljaju vodeći uzrok obolevanja i umiranja savremenog čoveka i vodeći su javno-zdravstveni problem u svetu i kod nas. Brojna istraživanja sugerišu da se mediteranski način ishrane povezuje sa smanjenjem rizika za nastanak i razvoj kardiovaskularnih bolesti i drugih masovnih nezaraznih bolesti kao i smanjenjem stope ukupnog mortaliteta. Cilj istraživanja: Utvrditi stepen pridržavanja mediteranskom načinu ishrane kod obolelih od akutnog koronarnog sindroma i kod osoba sa utvrđenim rizikom za nastanak kardiovaskularnih bolesti, upotrebom validovanog skora mediteranske ishrane – MedDiet skora. Takođe, cilj istraživanja je bio da se utvrdi da li postoji značajna razlika u vrednostima biohemijskih i kliničkih faktora rizika za razvoj kardiovaskularnih bolesti između dve posmatrane grupe ispitanika, kao i da se odredi granična vrednost MedDiet skora između poželjnog i rizičnog načina ishrane za nastanak akutnog koronarnog sindroma. Metod: Istraživanje je sprovedeno kao analitička studija preseka na uzorku od 294 ispitanika (146 žena i 148 muškaraca), starosti od 30 do 82 godine. Istraživanje je sprovedeno u vremenskom periodu od 07.02.2016. godine do 16.03.2017. godine. Prvu grupu činili su ispitanici kod kojih je dijagnostikovan akutni koronarni sindrom, koji su hospitalizovani u Institutu za kardiovaskularne bolesti Vojvodine u Sremskoj Kamenici, dok su drugu grupu činili ispitanici kod kojih je utvrđeno prisustvo najmanje jednog faktora rizika za nastanak kardiovaskularnih bolesti, bez klinički manifestne koronarne bolesti, koji su se javili na pregled u Savetovalište za pravilnu ishranu, Instituta za javno zdravlje Vojvodine u Novom Sadu. Kod svih učesnika u studiji izvršena su: antropometrijska merenja, merenje arterijskog krvnog pritiska, odgovarajuće biohemijske analize, EKG i anketiranje upotrebom posebno pripremljenog upitnika, u čijem sastavu se nalazio i MedDiet skor – validovan skor system za procenu stepena zastupljenosti mediteranskog načina ishrane kod pojedinca. Rezultati istraživanja: Srednja vrednost MedDiet skora ispitanika bez akutnog koronarnog sindroma bila je 27,48±6,59, dok je srednja vrednost MedDiet skora ispitanika sa akutnim koronarnim sindromom bila 20,53±4,01. Razlika srednjih vrednosti MedDiet skora između dve grupe ispitanika bila je statistički značajna (p=0,029). Ispitivanjem prediktivnih vrednosti pojedinih varijabli utvrđeno je da su MedDiet skor i glikemija našte odlični markeri za akutni koronarni sindrom (AUROC=0,815, p22,5 ukazuju na smanjen rizik za nastanak akutnog koronarnog sindroma. Multivarijantnom regresionom analizom pokazano je da na pojavu akutnog koronarnog sindroma utiču sledeći faktori rizika: godine starosti 1,063 (1,270-1,819), muški pol 4,071 (1,901-8,719), pušenje 3,067 (1,322-7,114), indeks telesne mase 0,902 (0,839-0,970), sistolni pritisak 1,020 (1,003-1,037), glikemija našte 1,520 (1,025-1,101) i MedDiet skor 0,783 (0,722-0,849). Zaključak: Akutni koronarni sindrom predstavlja značajan javno-zdravstveni problem odraslog stanovništva u Republici Srbiji na šta ukazuju visoke prevalencije u populaciji. Rezultati sprovedenog istraživanja pokazuju da je i diskretnim povećanjem unosa namirnica koje predstavljaju osnovu mediteranskog načina ishrane moguće postići značajne zdravstvene koristi. Ovi rezultati mogu predstavljati okvir za razvoj lokalnog skoring sistema ishrane prikladnog za nemediteransko područje, kao i modela za procenu rizika za nastanak akutnog koronarnog sindroma u našoj populaciji., Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality of a modern society and are major public health problem in our country and also worldwide. Numerous studies suggest that the Mediterranean diet is associated with a reduction in the risk of developing cardiovascular diseases and other non-communicable diseases, as well as reduction in the overall mortality rate. Aim: To determine the degree of Mediterranean diet complience in subjects with acute coronary syndrome and subjects with an established risk for developing cardiovascular diseases, using validated Mediterranean diet score - MedDiet. Also, the aim of the study was to determine whether there is a significant difference in the values of the biochemical and clinical risk factors for the development of cardiovascular diseases between the two observed groups of subjects, and to determine the cut-off value of the MedDiet score between the favorable and unfavorable dietaty pattern for the development of acute coronary syndrome. Method: The study was conducted as an analytical cross-sectional study with enrollment of 294 subjects (146 women and 148 men), 30 to 82 years of age. The research was conducted during the period from 02/07/2016 until 03/16/2017. The first group of subjects consisted of patients diagnosed with acute coronary syndrome who were hospitalized at the Institute for Cardiovascular Diseases Vojvodina in Sremska Kamenica. The second group was comprised of subjects with established at least one major risk factor for the development of cardiovascular diseases but without clinically manifest coronary artery disease, who came to the medical examination of the Counseling Center for Proper Nutrition, Institute of Public Health of Vojvodina in Novi Sad. Among all participants in the study the following examinations were conducted: anthropometric measurements, arterial blood pressure measurements, appropriate biochemical analysis, ECG and surveys using a specially prepared questionnaire, which included MedDiet score - validated score system for assessing the degree of compliance with Mediterranean dietary pattern among subjects. Results of the study: The average value of the MedDiet score among subjects without acute coronary syndrome was 27.48 ± 6.59, while the average value of MedDiet score among subjects with acute coronary syndrome was 20.53 ± 4.01. The difference in MedDiet average values between the two groups of subjects was statistically significant (p = 0.029). By examining the predictive values of individual variables, it was shown that MedDiet score and fasting blood sugar were excellent markers for acute coronary syndrome (AUROC = 0.815, p 22.5 indicated reduced risk for the development of acute coronary syndrome. Multivariate regression analysis showed that acute coronary syndrome is affected by the following risk factors: age 1,063 (1,270-1,819), male gender 4,071 (1,901-8,719), smoking 3,067 (1,322-7,114), body mass index 0,902 (0.839-0.970 ), systolic blood pressure 1.020 (1.003-1.037), fasting blood sugar 1.520 (1.025-1.101) and MedDiet score 0.783 (0.722- 0.849). Conclusion: Acute coronary syndrome is a major public health problem in the adult population of the Republic of Serbia, as indicated by its high prevalence. The results of the conducted research show that discrete increase in food intakes of foods which represent the basis of the Mediterranean diet, can lead to significant health benefits. These results can represent a framework for the development of a local scoring system for a non-mediterranean area, and also for creation of risk assessment model for acute coronary syndrome in our population.

Старење становништва је велики изазов са којим се суочава светска популација у XXI веку. Становништво Војводине спада у веома старо становништво, а процењује се да ће до средине овог века чак свака трећа особа бити старија од 60 година. Циљ овог рада је био да се процени здравље, разлике у здрављу и коришћење здравствене заштите, као и да се идентификују предиктори здравља и коришћења здравствене заштите код особа старости 65 и више година на територији Војводине. Истраживање представља део Истраживања здравља становништва Србије из 2013. године које је спровело Министарство здравља Републике Србије. Истраживањем је обухваћено 886 испитаника старости 65 и више година са територије Војводине. Инструмент истраживања су били упитници конструисани у складу са упитником Европског истраживања здравља, а подаци о телесној маси, телесној висини и крвном притиску су добијени мерењем. Резултати су показали да су имали већу шансу да процене своје здравље као лошије жене (OR=2,14; 95%CI=[1,42-3,23]; p

Старење становништва је велики изазов са којим се суочава светска популација у XXI веку. Становништво Војводине спада у веома старо становништво, а процењује се да ће до средине овог века чак свака трећа особа бити старија од 60 година. Циљ овог рада је био да се процени здравље, разлике у здрављу и коришћење здравствене заштите, као и да се идентификују предиктори здравља и коришћења здравствене заштите код особа старости 65 и више година на територији Војводине. Истраживање представља део Истраживања здравља становништва Србије из 2013. године које је спровело Министарство здравља Републике Србије. Истраживањем је обухваћено 886 испитаника старости 65 и више година са територије Војводине. Инструмент истраживања су били упитници конструисани у складу са упитником Европског истраживања здравља, а подаци о телесној маси, телесној висини и крвном притиску су добијени мерењем. Резултати су показали да су имали већу шансу да процене своје здравље као лошије жене (OR=2,14; 95%CI=[1,42-3,23]; p, Starenje stanovništva je veliki izazov sa kojim se suočava svetska populacija u XXI veku. Stanovništvo Vojvodine spada u veoma staro stanovništvo, a procenjuje se da će do sredine ovog veka čak svaka treća osoba biti starija od 60 godina. Cilj ovog rada je bio da se proceni zdravlje, razlike u zdravlju i korišćenje zdravstvene zaštite, kao i da se identifikuju prediktori zdravlja i korišćenja zdravstvene zaštite kod osoba starosti 65 i više godina na teritoriji Vojvodine. Istraživanje predstavlja deo Istraživanja zdravlja stanovništva Srbije iz 2013. godine koje je sprovelo Ministarstvo zdravlja Republike Srbije. Istraživanjem je obuhvaćeno 886 ispitanika starosti 65 i više godina sa teritorije Vojvodine. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja, a podaci o telesnoj masi, telesnoj visini i krvnom pritisku su dobijeni merenjem. Rezultati su pokazali da su imali veću šansu da procene svoje zdravlje kao lošije žene (OR=2,14; 95%CI=[1,42-3,23]; p, Aging is the great challenge of the XXI century. Population of Vojvodina is very old, and projections indicate that by 2050 one in three persons will be older than 60 years. The aim of this study was to evaluate health, health differences and health care utilization, as well as to indentify predictors of health and health care utilization in people aged 65 and over in Vojvodina. The study represents part of the National health survey Serbia conducted in 2013 by the Ministry of Health of Republic of Serbia. Study included 886 examinees aged 65 and over who were interviewed on the territory of Vojvodina. The instruments were questionnaires designed according to the European Health Interview Survey questionnaire, and data on body mass, body height and blood pressure were measured. Results showed that the highest odds of assessing their health as poor had women (OR=2.14; 95%CI=[1.42-3.23]; p

Socijalno-ekonomske nejednakosti u zdravlju su nepravedne i rezultiraju iz nejednake distribucije socijalnih determinanti koje utiču na mogućnost jedne individue da bude zdrava, njen rizik od bolesti kao i korišćenje usluga zdravstvene zaštite. Cilj ove disertacije bio je da se ispita povezanost demografskih i socijalno-ekonomskih determinanti sa korišćenjem usluga zdravstvene zaštite žena i dece tokom prenatalnog, antenatalnog i postnatalnog perioda, zatim uz pomoć koncentracionih indeksa proveriti da li nejednakosti u korišćenju usluga postoje, kao poređenje ovih nejednakosti tokom 2005., 2010. i 2014. godine u Srbiji među opštom populacijom žena i među ženama iz romskih naselja. Metod: U istraživanju su korišćeni podaci iz tri istraživanja istraživanja višestrukih pokazatelja (Multiple Indicators Cluster Survey - MICS): MICS3 iz 2005., MICS4 iz 2010. i MICS5 iz 2014. Godine sprovedenih u Srbiji na reprezentativnom uzorku opšte populacije žena i žena koje žive u romskim naseljima starosti od 15-49 godina. Kao instrumenti istraživanja korišćeni su upitnici. Rezultati: Među populacijom žena u Srbiji uočava se pad nezadovoljene potrebe za kontracepcijom u poslednjih 10 godina. U odnosu na Beograd kao referentnu kategoriju, sve žene koje žive na teritoriji Vojvodine tokom proteklih 10 godina imale su značajno manje šanse za postojanje nezadovoljenih potreba za kontracepcijom. U odnosu na 2005. godinu, upotreba kontracepcije je višestruko porasla u obe populacije tokom 2010. i 2014. godine i bila je veća među ženama koje su živele u romskim naseljima u odnosu na opštu populaciju žena... Social and economic inequalities in health are unfair and occur as a result of unequal distribution of social determinants that affect the ability of an individual to be healthy, its risk of disease and also the utilisation of health care services. The aim of this thesis was to examine the association between the demographic and socio-economic determinants and the utilization of health services in women and children during the prenatal, antenatal and postnatal periods, to explore whether health inequalities in the utilization of health service exists by using concentration index and compare them over 2005, 2010 and 2014 in Serbia among the general population of women and among women from Roma settlements. Method: The study used data from three Multiple Indicator Cluster Survey (MICS): MICS3 from 2005, MICS4 from 2010 and MICS5 from 2014. All studies were conducted in Serbia on a representative sample of the general population of women and also on women living in Roma settlements aged 15-49 years. The survey instruments were questionnaires. Results: Among all women it was identified the decrease in unmet need for contraception in the last 10 years. Compared to Belgrade, as the reference category, all women living in Vojvodina had significantly less chance for the existence of unmet need for contraception over the past 10 years. Compared to 2005, the use of contraception has grown significantly in both populations in 2010 and 2014. The rise was higher among women who live in Roma settlements compared to the general population of women. Withdrawn was reported as the most frequent method of contraception among all women during the three years of the study (significantly more frequent among the population in Roma settlements)...

Depresija je jedan od najčešćih mentalnih poremećaja u opštoj populaciji širom sveta i prema podacima Svetske zdravstvene organizacije se nalazi na trećem mestu globalnog opterećenja bolestima. Cilj ovog istraživanja je bio da se utvrdi prevalencija depresije u populaciji odraslog stanovništva Vojvodine, da se identifikuju kategorije stanovništva pod najvećim rizikom i da se utvrdi povezanost depresije sa determinantama zdravlja, zdravstvenim stanjem i korišćenjem zdravstvene zaštite. Istraživanje je sprovedeno kao studija preseka na reprezentativnom uzorku stanovništva Vojvodine starosti 15 i više godina, kao deo nacionalne studije „Istraživanje zdravlja stanovništva Srbije“ koju je sprovelo Ministarstvo zdravlja Republike Srbije 2013. godine. Kao instrument istraživanja su korišćeni upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja. Prisustvo depresivnih simptoma je analizirano primenom PHQ-8 upitnika (Patient Health Questionnaire-8) a vrednost PHQ-8 skora 10 i više je ukazivala na prisustvo depresivne epizode (depresije). Istraživanjem je obuhvaćeno 3550 ispitanika prosečne starosti 50,2 godine. Prevalencija depresije je iznosila 4,8%. Primenom multivarijantne regresije je utvrđeno da žene imaju za 40% veću šansu za depresiju u odnosu na muškarce (OR=1,4), a kao prediktori depresije su se pokazali i starija životna dob, razvod/razlaz ili udovstvo, niži nivo obrazovanja, nezaposlenost, ekonomska neaktivnost i niži materijalni status. Osobe koje su u mesecu koji je prethodio istraživanju bile izložene stresu su imale oko sedam puta veću šansu za depresiju (OR=6,8), a kod ispitanika sa lošom socijalnom podrškom šansa za depresiju je bila oko četiri puta veća nego kod ispitanika sa jakom socijalnom podrškom (OR=3,7). Multimorbiditet je bio značajno prisutniji među ispitanicima sa depresijom, a šansa za prisustvo dve ili više hroničnih bolesti je kod njih bila skoro pet puta veća (OR=4,6) u odnosu na ispitanike koji nisu imali depresivne simptome. Depresija se pokazala i kao značajan prediktor češćeg korišćenja usluga zdravstvene zaštite. Dobijeni rezultati su potvrdili javnozdravstveni značaj depresije i istovremeno obezbedili podatke koji se mogu koristiti kao osnova za buduća prospektivna istraživanja, kao i za kreiranje programa za prevenciju i kontrolu depresivnih poremećaja i unapređenje mentalnog zdravlja., Depression is one of the most common mental disorders in the general population worldwide and according to the World Health Organization it is the third leading cause of the global burden of disease. The aim of this study was to determine the prevalence of depression in the adult population of Vojvodina, to identify groups at the greatest risk of depression and to determine the relationship of depression with health determinants, health status and use of health care services. The research was carried out as a cross-sectional study on a representative sample of the population of Vojvodina, aged 15 and over as part of the National Health Survey of Serbia which was conducted by the Ministry of Health of the Republic of Serbia in 2013. Data was gathered by using questionnaires designed in accordance to the European Health Interview Survey. The presence of depressive symptoms was analyzed using the PHQ-8 questionnaire (Patient Health Questionnaire-8) and the score of 10 or above indicated a presence of a depressive episode (depression). The study included 3550 examinees with an average age of 50.2 years. The prevalence of depression was 4.8%. Multivariate regression showed that women had a 40% greater chance to suffer from depression as compared to men (OR=1.4). Also, factors such as older age, divorce/separation or widowhood, lower level of education, economic inactivity and poor financial situation were predictors of depression. People who were exposed to stress in the month prior to the survey had about seven times greater odds of depression (OR=6.8), and in patients with poor social support the chance of depression was about four times higher than among those with a strong social support (OR=3.7). Multimorbidity was significantly more prevalent among respondents with depression and they had five times higher odds of the presence of two or more chronic diseases (OR=4.6) in comparison with those who did not show depressive symptoms. Depression has been revealed as a significant predictor of more frequent use of health care services. The results confirmed the importance of depression to public health and also provided the data that can be used as a basis for future prospective studies, as well as for the development of the programs for the prevention and control of depressive disorders and mental health improvement.

Gojaznost i fizička neaktivnost su među najznačajnijim faktorima rizika za hronične nezarazne bolesti, koje su vodeći javnozdravstveni problemi u svetu i kod nas. Cilj istraživanja je procena prevalencija gojaznosti, predgojaznosti i fizičke neaktivnosti u slobodno vreme kod odraslog stanovništva Vojvodine, kao i procena povezanosti demografskih, socio-ekonomskih i bihevioralnih faktora sa gojaznošću i fizičkom neaktivnošću u slobodno vreme. Istraživanje predstavlja deo Istraživanja zdravlja stanovništva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije, kao studija preseka na reprezentativnom stratifikovanom dvoetapnom uzorku. Istraživanjem je obuhvaćeno 3337 osoba uzrasta 20 i više godina sa prebivalištem u Vojvodini. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja, a podaci o telesnoj masi i telesnoj visini su dobijeni merenjem. Rezultati istraživanja su pokazali da je u 2013. godini svaka četvrta odrasla osoba u Vojvodini bila gojazna, a svaka treća osoba predgojazna. U odnosu na 2000. godinu nije došlo do značajnog povećanja prevalencija gojaznosti i predgojaznosti, mada su se prevalencije održale na visokom nivou. Šanse za gojaznost su rasle do 75-te godine života, a nakon toga opadaju. Najveću šansu za gojaznost su imale osobe u braku ili vanbračnoj zajednici. Gojaznost je povezana sa socio-ekonomskim karakteristikama samo kod žena. Značajni prediktori gojaznosti kod žena su bili najniži nivo obrazovanja, loš materijalni status i nezaposlenost/ekonomska neaktivnost. Bivši pušači su imali oko dva puta veću šansu za gojaznost u odnosu na pušače, dok je šansa za gojaznost bila manja kod osoba koje su u poslednjih 12 meseci konzumirale alkohol. Fizička neaktivnost u slobodno vreme, kao i fizička neaktivnost u domenu transporta povećavaju verovatnoću za pojavu gojaznosti. Prevalencija fizičke neaktivnosti u slobodno vreme je bila veoma visoka (89%). Šanse za fizičku neaktivnost u slobodno vreme su se značajno povećavale sa starošću. Prediktori fizičke neaktivnosti su bili ženski pol, život u braku/vanbračnoj zajednici, nizak nivo obrazovanja i loš materijalni status. Pušači su imali oko dva puta veću šansu da budu fizički neaktivni u odnosu na nepušače, dok je stanovništvo koje je konzumiralo alkohol imalo manju šansu da bude fizički neaktivno u slobodno vreme. Gojazne osobe, kao i fizički neaktivne osobe su lošije ocenjivale svoje zdravlje. Gojazne osobe (bez obzira na nivo fizičke aktivnosti) su imale oko 3,5 puta veću šansu za pojavu multimorbiditeta u odnosu na osobe sa optimalnom telesnom masom koje su fizički aktivne u slobodno vreme. Gojazne osobe su imale četiri puta veću šansu za arterijsku hipertenziju i skoro četiri puta veću šansu za dijabetes u odnosu na normalno uhranjene osobe. Gojaznost i fizička neaktivnost u slobodno vreme su značajni javnozdravstveni problemi kod odraslog stanovništva u Vojvodini na šta ukazuju visoke prevalencije, velika zastupljenost među vulnerabilnim kategorijama stanovništva, nejednakost u frekvenciji između različitih socio-ekonomskih kategorija stanovništva, preventabilnost, povezanost sa lošijom samoprocenom zdravlja i hroničnim bolestima., Obesity and physical inactivity are one of the most significant risk factors for chronic noncommunicable diseases, which are one of the most important public health problems in the world and also in our country. The aim of the study was to evaluate the prevalence of obesity and leisure time physical inactivity among the adult population of Vojvodina, and also to evaluate the association of demographic, socio-economic and behavioral factors with obesity and leisure time physical inactivity. The study is part of the National Health Survey of Serbia, a cross-sectional study conducted in year 2013 by the Ministry of Health of Republic of Serbia on a representative stratified two-stage sample. The study included 3337 participants aged 20 and over who resided in Vojvodina. The instruments were questionnaires designed in line with the European Health Interview Survey questionnaire, and data on body mass and body height were measured. Results showed that in year 2013 every fourth adult person in Vojvodina was obese, and every third overweight. There was no increase in prevalences compared to year 2000, although they remained high. Odds of obesity increased until age 75, and afterwards decreased. The highest odds of obesity were among persons who were married or living with a partner. Obesity was associated with socio-economic factors only among women. The predictors of obesity among women were: low level of education, low wealth index and unemployment/economical inactivity. Former smokers had two times higher odds of obesity, compared to smokers, while persons who consumed alcohol in the last 12 months had lower odds to be obese. Leisure time physical inactivity, as well as transport related physical inactivity were important predictors of obesity. Prevalence of leisure time physical inactivity was very high (89%). With increasing age, odds of physical inactivity increased. Predictors of physical inactivity were female gender, being married or living with a partner, low level of education and low wealth index. Smokers had two times higher odds of physical inactivity in comparison to nonsmokers, while persons who consumed alcohol in the last 12 months had lower odds of physical inactivity. Obese and physically inactive persons were more likely to assess their health as average, poor or very poor. Obese persons (regardless of the level of physical activity) had three and a half times higher odds of multimorbidity compared to persons with healthy weight who were physically active. Obese persons had four times higher odds of arterial hypertension and almost four times higher odds of diabetes. Obesity and physical inactivity are important public health problems among the adult population in Vojvodina due to high prevalences in population, especially among vulnerable groups, inequality in frequency among different socio-economic groups, preventability and association with poor health perception and chronic diseases.

Oralno zdravlje predstavlja stanje zdravlja svih anatomskih i funkcionalnih delova usne duplje, jedan je od osnovnih elemenata blagostanja i važan pokazatelj kvaliteta života stanovništva. Podaci Svetske zdravstvene organizacije (SZO) ukazuju da je 15-20% svetskog stanovništva srednje životne dobi (starosti od 35 do 44 godine) pod rizikom od gubitka zuba, a oko 30% stanovništva starosti od 65 do 74 godine nema svoje zube. Oboljenja usta i zuba su jedan od vodećih javno zdravstvenih problema 21. veka u svetu i nalaze se na 4. mestu po visini troškova. Osnovni cilj ovog istraživanja je bio da se utvrdi stanje oralnog zdravlja odraslog stanovništva Srbije starosne dobi 20 i više godina i evaluiraju činioci koji na njega utiču. Istraživanje predstavlja deo nacionalne studije “Istraživanje zdravlja stanovnika Srbije” za 2013. godinu Ministarstva zdravlja Republike Srbije, koja je sprovedena u vidu studije preseka na reprezentativnom uzorku od 13690 ispitanika (53,8% žene i 46,2% muškarci). U istraživanju su korišćene tri vrste upitnika koji su dizajnirani u skladu sa upitnikom Evropskog istraživanja zdravlja. Svaki ispitanik stariji za jednu godinu ima 8% veću šansu da svoje oralno zdravlje oceni kao loše (OR=1.08; 95% IP=(1.07-1.09); p=0,000). Ispitanici sa blagim depresivnim simptomima i depresivnim poremećajima imaju 2,04 odnosno 3,48 puta veću šansu da svoje oralno zdravlje ocene kao loše u odnosu na ispitanike koji nisu depresivni (OR=2.04; 95% IP=(1.28-3.26); p=0,003) (OR=3.48; 95% IP=(1.14-10.59); p=0,028). Žene imaju 30% veću šansu da pripadnu povoljnoj kategoriji poseta stomatologu u odnosu na muškarce (OR=0.70; 95% IP=(0.63-0.78); p=0,000). Ispitanici sa nižim i srednjim obrazovanjem imaju 5,70 odnosno 2,45 puta veću šansu da svoje zube operu povremeno u odnosu na visoko obrazovane (OR=5.70; 95% IP=(4.35-7.48); p=0,000) (OR=2.45; 95% IP=(1.91-3.13); p=0,000). Ispitanici najsiromašnijeg sloja imaju 4,88, siromašnog sloja 3,73, srednjeg sloja 2,52 i bogatog sloja 2,01 put veću šansu da izgube 10 i više zuba u odnosu na najbogatiji sloj (OR=4.88; 95% IP=(2.95-8.08); p=0,000) (OR=3.73; 95% IP=(2.42-5.75); p=0,000) (OR=2.52; 95% IP=(1.69-3.76); p=0.000) (OR=2.01; 95% IP=(1.38-2.91); p=0,000). Bivši pušači i pušači imaju 1,43 odnosno 2,80 puta veću šansu da izgube 10 i više zuba u odnosu na nepušače (OR=1.43; 95% IP=(1.00-2.03); p=0,046) (OR=2.80; 95% IP=(2.08-3.76); p=0,000). Najučestaliji prediktori oralnog zdravlja su žene, starije stanovništvo, niže obrazovanje, nezaposleno i neaktivno stanovništvo, najsiromašniji i pušači., Oral health represents health status of all anatomic and functional parts of oral cavity, it is one of the basic elements of well-being and important quality of life indicator. According to the World Health Organization (WHO) 15-20% of world population aged 35-44 have risk of tooth loss, and about 30% population aged 65-74 does not have own teeth. Oral and dental diseases are one of the leading public health problems in 21st century and on the 4th place of the health care expenditure. The main aim of this research was to assess oral health of adult population in Serbia aged 20 years and older and to evaluate related factors. The research represents a part of “National Health Survey in Serbia 2013” implemented by The Ministry of Health of the Republic of Serbia, which was conducted as a cross-sectional study on the representative sample of adult population in Serbia. The study included 13690 examinees (53.8% females and 46.2% males). Three types of questionnaires which were designed according to the European Health Interview Survey were used. Every examinee older for one year had 8% greater odds to assess their oral health as bed (OR=1.08; 95% CI=(1.07-1.09); p=0.000). Respondents with mild depressive symptoms and depressive disorders had 2.04 and 3.48 times greater odds to assess their oral health as bed compared to one who were not depressed (OR=2.04; 95% CI=(1.28-3.26); p=0.003) (OR=3.48; 95% CI=(1.14-10.59); p=0.028). Females had 30% more odds to be in the category of affordable dental visit compared to men (OR=0.70; 95% CI=(0.63-0.78); p=0.000). Respondents with lower and middle level of education had 5.70 and 2.45 greater odds to brush their teeth occasionally compared to higher educated (OR=5.70; 95% CI=(4.35-7.48); p=0.000) (OR=2.45; 95% CI=(1.91-3.13); p=0.000). Respondents who belonged to the poorest class had 4.88, poorer 3.73, middle 2.52 and richer class 2.01 greater odds to lose 10 and more teeth compared to the richest (OR=4.88; 95% CI=(2.95-8.08); p=0.000) (OR=3.73; 95% CI=(2.42-5.75); p=0.000) (OR=2.52; 95% CI=(1.69-3.76); p=0.000) (OR=2.01; 95% CI=(1.38-2.91); p=0.000). Former smokers and smokers had 1.43 and 2.80 times greater odds to lose 10 and more teeth compared with non smokers (OR=1.43; 95% CI=(1.00-2.03); p=0.046) (OR=2.80; 95% CI=(2.08-3.76); p=0.000). The most frequent predictors of oral health are: women, elderly people, those with low educational attainment, unemployed, inactive and respondents who assessed their financial situation as poor and smokers.

Uvod: Iako analize geografskih varijacija, učestalosti obolevanja i faktora čije je prisustvo povezano sa pojavom hroničnih nezaraznih bolesti imaju dugu tradiciju, tek nedavno su se naučna istraživanja fokusirala i na proučavanje prostornog konteksta, odnosno na to kako su karakteristike susedstva (engl. neighbourhood environment) povezane sa obolevanjem od hroničnih nezaraznih bolesti. Smatra se da karakteristike susedstva, naročito socijalno-ekonomske, mogu da oblikuju zdravstvene ishode nezavisno od individualnih karakteristika odnosno da formiraju kontekst koji daje povod za prisustvo faktora rizika po zdravlje. Cilj ove disertacije bio je da se ispita povezanost individualnih karakteristika, karakteristika domaćinstava i karakteristika opština sa prisustvom bilo koje hronične bolesti, prisustvom kardiovaskularnih bolesti i prisustvom dve ili više hroničnih bolesti (multimorbiditetom) kod odraslih stanovnika Srbije, primenom univarijantne i multivarijantne dvostepene logističke regresije. Metod: U ovoj studiji korišćeni su podaci iz istraživanja zdravlja stanovnika Srbije, sprovedenog 2013. godine po tipu studije preseka, na reprezentativnom uzorku odraslih osoba uzrasta 20 i više godina; rezultati Popisa stanovništva, domaćinstava i stanova u Republici Srbiji, sprovedenog 2011. godine, za nivo opština i podaci iz DevInfo opštinskih profila za 2013. godinu. Kao instrumenti prikupljanja podataka u navedenim istraživanjima korišćeni su upitnici. Rezultati: Kardiovaskularne bolesti predstavljaju najzastupljeniju grupu hroničnih nezaraznih bolesti kod odraslih osoba u Srbiji (40,4%). Bilo koju od 12 posmatranih hroničnih bolesti ima polovina (48,0%), a dve ili više hroničnih bolesti trećina odraslog stanovništva (30,1%). Postoje značajne razlike u prisustvu bilo koje hronične bolesti, prisustvu dve ili više hroničnih bolesti i prisustvu kardiovaskularnih bolesti u odnosu na većinu posmatranih individualnih karakteristika ispitanika, kao i karakteristika domaćinstva i karakteristika opština u kojima ispitanici žive. Prema modelima multivarijantne dvostepene logističke regresije, 8% varijacija u prisustvu bilo koje hronične bolesti, 3,2% varijacija u prisustvu kardiovaskularnih bolesti, 10% varijacija u prisustvu dve ili više bolesti kod odraslih između opština, 4,4% varijacija u prisustvu kardiovaskularnih bolesti kod žena između opština, može se objasniti karakteristikama opština... Introduction: Despite the long analysis tradition relating to the geographic variations, the prevalence of diseases and the factors whose presence is associated with the occurrence of noncommunicable diseases, it was only recently that the scientific research shifted its focus on the study of the spatial context, i.e. how the facts about the neighborhood environment are associated with noncommunicable diseases morbidity. It is suggested that the neighborhood environment, especially the socio-economic, can shape the health outcomes independently of individual characteristics, thus creating a context that gives rise to the subsistence of health risk factors. The aim of this thesis was to explore the association between the individual, household and municipal characteristics and presence of any chronic disease, presence of cardiovascular diseases and presence two or more chronic diseases (multimorbidity) in the adult population of Serbia, whereby using a univariate and multivariate two-level logistic regression. Method: This study utilized data from the following datasets: the Serbian Population Health Survey, conducted in 2013 (as a cross sectional study, on a representative sample of adults aged 20 and older); results of the Census of Population conducted in 2011 (for the level of municipalities); and the data from DevInfo municipal profiles for 2013. Above surveys involved questionnaires, as instruments for the data collection. Results: Cardiovascular diseases are the most prevalent group of noncommunicable diseases among adults in Serbia (40.4%). Half of the adult population (48.0%) have any of the 12 observed chronic diseases, and a third (30.1%) have two or more chronic diseases. There are significant differences regarding the presence of any chronic disease, two or more chronic diseases, and cardiovascular diseases as compared to the most monitored individual characteristics of respondents, their households and their municipalities. By municipal characteristics, the multivariate two-level logistic regression models can clarify 8% of variations concerning any chronic disease, 3,2% of variations concerning cardiovascular diseases, 10% of variations concerning adults with two or more diseases, and 4,4% of variations concerning cardiovascular diseasese in women...

Klaster analiza ima dugu istoriju i mada seprimenjuje u mnogim oblastima i dalje ostajuznačajni izazovi. U disertaciji je prikazan uvodu neglatki optimizacioni pristup uklasterovanju, sa osvrtom na problemklasterovanja velikih skupova podataka.Međutim, ovi optimizacioni algoritmi boljefunkcionišu u radu sa neprekidnim podacima.Jedan od glavnih izazova u klaster analizi jerad sa velikim skupovima podataka sakategorijalnim i kombinovanim (numerički ikategorijalni) tipovima promenljivih. Rad savelikim brojem instanci (objekata) i velikimbrojem dimenzija (promenljivih), možepredstavljati problem u klaster analizi, zbogvremenske složenosti. Jedan od načinarešavanja ovog problema je redukovanje brojainstanci, bez gubitka informacija.Prvi cilj disertacije je bio upoređivanjerezultata klasterovanja na celom skupu iprostim slučajnim uzorcima sa kategorijalnim ikombinovanim podacima, za različite veličineuzorka i različit broj klastera. Nije utvrđenaznačajna razlika (p>0.05) u rezultatimaklasterovanja na uzorcima obima0.03m,0.05m,0.1m,0.3m (gde je m obimposmatranog skupa) i celom skupu.Drugi cilj disertacije je bio konstrukcijaefikasnog postupka klasterovanja velikihskupova podataka sa kategorijalnim ikombinovanim tipovima promenljivih.Predloženi postupak se sastoji iz sledećihkoraka: 1. klasterovanje na prostim slučajnimuzorcima određene kardinalnosti; 2.određivanje najboljeg klasterskog rešenja nauzorku, primenom odgovarajućeg kriterijumavalidnosti; 3. dobijeni centri klastera iz ovoguzorka služe za klasterovanje ostatka skupa.Treći cilj disertacije predstavlja primenuklaster analize u definisanju klasterabihejvioralnih faktora rizika u populacijiodraslog stanovništva Srbije, kao i analizusociodemografskih karakteristika dobijenihklastera. Klaster analiza je primenjena navelikom reprezentativnom uzorku odraslogstanovništva Srbije, starosti 20 i više godina.Izdvojeno je pet jasno odvojenih klastera sakarakterističnim kombinacijama bihejvioralnihfaktora rizika: Bez rizičnih faktora, Štetnaupotreba alkohola i druge rizične navike,Nepravilna ishrana i druge rizične navike,Nedovoljna fizička aktivnost, Pušenje. Rezultatimultinomnog logističkog regresionog modelaukazuju da ispitanici koji nisu u braku, lošijegsu materijalnog stanja, nižeg obrazovanja i živeu Vojvodini imaju veću šansu za prisustvovišestrukih bihejvioralnih faktora rizika., The cluster analysis has a long history and alarge number of clustering techniques havebeen developed in many areas, however,significant challenges still remain. In thisthesis we have provided a introduction tononsmooth optimization approach to clusteringwith reference to clustering large datasets.Nevertheless, these optimization clusteringalgorithms work much better when a datasetcontains only vectors with continuous features.One of the main challenges is clustering of largedatasets with categorical and mixed (numericaland categorical) data. Clustering deals with alarge number of instances (objects) and a largenumber of dimensions (variables) can beproblematic because of time complexity. One ofthe ways to solve this problem is by reducingthe number of instances, without the loss ofinformation.The first aim of this thesis was to comparethe results of cluster algorithms on the wholedataset and on simple random samples withcategorical and mixed data, in terms of validity,for different number of clusters and fordifferent sample sizes. There were nosignificant differences (p>0.05) between theobtained results on the samples of the size of0.03m,0.05m,0.1m,0.3m (where m is the size ofthe dataset) and the whole dataset.The second aim of this thesis was todevelop an efficient clustering procedure forlarge datasets with categorical and mixed(numeric and categorical) values. The proposedprocedure consists of the following steps: 1.clustering on simple random samples of a givencardinality; 2. finding the best cluster solutionon a sample (by appropriate validity measure);3. using cluster centers from this sample forclustering of the remaining data.The third aim of this thesis was toexamine clustering of four lifestyle risk factorsand to examine the variation across differentsocio-demographic groups in a Serbian adultpopulation. Cluster analysis was carried out ona large representative sample of Serbian adultsaged 20 and over. We identified fivehomogenous health behaviour clusters withspecific combination of risk factors: 'No RiskBehaviours', 'Drinkers with Risk Behaviours','Unhealthy diet with Risk Behaviours','Smoking'. Results of multinomial logisticregression indicated that single adults, lesseducated, with low socio-economic status andliving in the region of Vojvodina are most likelyto be a part of the clusters with a high-riskprofile.

The aim of the research was to investigate the average salt intake in a sample of adult population of the city of Novi Sad, by using the internationally recognized 24hour urinary sodium excretion method. The prevalence of excessive salt intake, one of the major risk factors for development of cardiovascular disease, hypertension, stroke, fluid retention and edema, osteoporosis, chronic kidney disease, stomach cancer and other diseases associated with excessive salt intake, was determined for the first time in the country. The correlation of salt intake and body mass index and blood pressure was assessed, as well as knowledge, attitude and practice of respondents regarding harmful effects of excessive salt intake. The investigation was conducted as an observational analytical cross-sectional study among 150 eligible adult residents of the city of Novi Sad (75 women and 75 men), aged 18-65, referred for a preventive health check-up in the Institute of Public Health of Vojvodina and Institute of Occupational Health Novi Sad, in the period February 18th - April 29th 2011, and January 09th and April 30th 2012. The initial sample of 296 respondents met the inclusion criteria, of which 146 examinees were excluded by exclusion criteria. The estimated average salt intake in the sample was 12.12 ± 4.79 g; 14.22 ± 4.98 g in men, significantly higher than the average of 10.02 ± 3.54 g in women. Nearly all of the subjects exceeded the World Health Organization population salt intake goal of 5 g a day, and none of them consumed the amount of salt recommended in non-pharmacological treatment of hypertension. Daily salt intake was significantly higher in obese and subjects with central body fat distribution compared to non-obese subjects. There was a positive correlation between body mass index and daily salt intake (28 percents of the variability of BMI may be attributed to the amount of daily salt intake). There was a positive correlation between salt intake and systolic and diastolic blood pressure, while 7 percents and 8 percents of variability of systolic and diastolic blood pressure, respectively, can be explained by the amount of daily salt intake. Almost all subjects were aware that excessive salt intake may damage their health and lead to hypertension, stroke and chronic kidney disease. A high percentage of subjects had high level of knowledge regarding salt content in most foods. More than half of the respondents knew the amount of the recommended daily salt intake. Only 28 percents of subjects knew that processed food is the main dietary source of salt, and 77 percents of them did not recognize bread and rolls as food with high salt content. A low level of knowledge was established regarding the association between excessive salt intake and gastric cancer, osteoporosis and dementia. Older more likely than younger respondents, knew that too much salt is associated with hypertension and stroke and knew the amount of salt in certain types of food. Frequent use of salt during cooking and at the table was reported by 2/3, and 20 percents of subjects, respectively. Most of the members of population in question had an appropriate attitude towards the need of labeling the salt content and reducing salt intake. A statistically high salt intake was recorded in all examinees regardless of their knowledge, attitude and practice regarding salt usage. The established average salt intake of 12.12±4.79g in the examined sample is substantially higher than recommended by World Health Organization. Thus, labelling, reformulation of processed food by reducing salt content, as well as raising population awareness in regard to main dietary sources of salt, are cornerstones of the salt reduction strategy in given population.

Istraživanje predstavlja studiju preseka na reprezentativnom uzorku od 672 deteta starosti od 7 do 19 godina u Vojvodini. Kao instrument istraživanja korišćeni su upitnici kojima su dobijeni podaci o demografskim i socijalno-ekonomskim karakteristikama, samoproceni zdravlja, zadovoljstvu životom, higijenskim navikama, navikama o ishrani, fizičkoj aktivnosti i slobodnom vremenu, mentalnom zdravlju, zastupljenosti rizika po zdravlje i korišćenju zdravstvene službe. Objektivni nalaz dobijen je merenjem telesne mase i visine, određivanjem indeksa telesne mase i merenjem krvnog pritiska. Osnovni ciljevi ovog rada bili su da se dobije ocena zdravstvenog stanja i utvrde vodeći zdravstveni rizici kao i razlike u odnosu na demografske i socijalne karakteristike, da se utvrde promene u zdravstvenom stanju školske dece i omladine u odnosu na retrospektivni deo istraživanja i da se testira validnost instrumenta. Rezultati su pokazali da 40,2% dece živi u domaćinstvima koja pripadaju grupi siromašnih, imaju jednog brata/sestru, 88% živi sa oba roditelja, a dve trećine ima svoju sobu. Redovne higijenske navike češće imaju devojčice, stariji uzast i deca iz bogatijih domaćinstava. Ishrana je neadekvatna kako sa aspekta redovnosti, tako i unosa pojedinih namirnica, nedovoljan je unos mleka i mlečnih proizvoda, voća i povrća i ribe, a prekomeran unos namirnica koje su izvor tzv. „praznih kalorija“, dok je 17% dece sa prekomernom telesnom masom i gojazno. Slobodno vreme karakterišu sedenterne aktivnosti i nedovoljna fizička aktivnost. Ponašanje u saobraćaju je rizično, većina ne koristi zaštitne mere. Povredu je imalo oko 15% dece, petina je bila izložena nekom obliku fizičkog ili psihičkog nasilja. Većina ocenjuje svoje zdravlje kao dobro, dve trećine svoju telesnu masu kao normalnu a tri četvrtine svoju fizičku aktivnost kao dobru. Higijenu i mogućnost rekreacije u školi petina ocenjuje kao lošu a svako deseto dete bezbesnost u školi kao lošu. Informacije o zdravlju najčešće dobijaju od roditelja. Zdravlje stavljaju na prvo mesto na lestvici životnih vrednosti i imaju visok nivo zadovoljstva životom. Većina ima dobru komunikaciju sa majkom a tri četvrtine sa ocem. Petina oseća napetost, stres i ima emocionalne probleme, lošije vrednosti na skali psihološkog distresa ima svaka šesta a na skali vitalnosti skoro svaka druga mlada osoba. Pušenje i konzumacija alkohola su visoko zastupljeni, a svaka deseta mlada osoba probala je neku od psihoaktivnih supstanci. Korišćenje zdravstvene zaštite je zadovoljavajuće osim u sferi reproduktivnog zdravlja adolescentinja, seksualno ponašanje karakteriše rano stupanje u seksualni odnos i nedovoljna zaštita. U odnosu na retrospektivni deo istraživanja značajne razlike dobijene su u higijenskim navikama, ishrani, fizičkoj aktivnosti i sedenternim aktivnostima, procentu gojaznih, oceni svog zdravlja, zadovoljstvu životom, mentalnom zdravlju, izloženosti duvanskom dimu, konzumaciji alkohola, poznavanju psihoaktivnih supstanci, seksualnom ponašanju, reproduktivnom zdravlju i korišćenju zdravstvene službe., The research represents a cross-sectional study of the representative sample of 672 schoolchildren 7-19 of age in Vojvodina. Instrument was specially constructed questionnaire providing data about demographic and socio-economic characteristics, self assessment of the health, life satisfaction, hygiene, nutrition, physical activity, leisure time, mental health, social support, presence of risk factors, and use of health care. Anthropometric measures included body mass, height, blood pressure measurement and calculating body mass index. The aim of the study was to assess health status of the children, identify health risks and determine demographic and socio-economic differences, as well as to determine differences in relation to the retrospective part of the study, and to determine validity of the instrument. Results showed that 40 percents of children live in households with low level of socio-economic status (SES), 88 percents live with both parents, have 1 sibling, and two thirds have their own room. Good hygiene practice is more likely present in girls, older age and children with better SES. Nutrition habits are inadequate regarding regularity and different food intake, there is low consumption of milk and dairy products, fruits, vegetables and fish, high intake of sweets, snacks and sweet beverages, and there is 17 percents of overweight and obese children. Leisure time is characterized with sedentary activities and lack of physical activity. Road traffic behavior is risky with inadequate safety measures. Injury had 15 percents of children, and the fifth was object of physical and psychological violence. Most of the children assessed their health as good and very good, two thirds their body mass as normal and three quarters their physical activity as good. School hygiene and recreational conditions were poorly rated by fifth of the children, and one in ten assessed school safety as bed. Health information are mostly provided by parents. Health is highly rated among life values and life satisfaction is high. Most of them easy communicate with their mothers and three quoters with their fathers. Every fifth child is having emotional problems, anxiety and stress, lower values on Psychological Distress Scale has every sixth child and on Vitality Scale every second child. Prevalence of smoking and alcohol consumption is high, one in ten adolescents experimented or consumed drugs. Health care use is satisfying except in the sphere of reproductive health of female adolescents. Sexual behavior is characterized with early onset of sexual intercourse and inadequate protection against pregnancy and STD. Differences regarding retrospective part of the study exist in hygiene practice, nutrition, physical activity, sedentary activities, prevalence of overweight and obesity, self assessment of health, life satisfaction, mental health, exposure to tobacco, alcohol consumption, knowledge about drugs, sexual behavior and health care use.

Determination of smoking prevalence within the representative sample of pregnant women in Vojvodina is facilitating insight into dispersion of the most frequent behavioral risk factor in one of the most vulnerable population categories, as well as consideration of influence of smoking to pregnancy outcome. The survey was performed on representative sample of three months cohort, 726 pregnant women in Vojvodina, by stratified two-stage random cluster sampling with an aim to assess: prevalence and intensity of smoking immediately before cognition of pregnancy, at each trimester during the pregnancy and at 3 and 6 months after delivery, exposure to environmental smoke at home, rate and reasons for smoking cessation up to 6 months after delivery and pregnancy outcome by infants` birth weight, body height and circumference of the head analysis. Three questionairres were used as survey instruments, composed with consideration of survey protocols used for attainment of smoking prevalence with pregnant women in earlier studies, pilot-study results and form for transcript of variables from the Newborn Infant Record. It is determined that smoking prevalence during pregnancy is high (40.9 percents smoked at some point during the pregnancy), as well as exposure to tobacco smoke at home (56.2 percents lives in a home with at least one smoker whilst 83.5 percents allowes smoking at home). More than one third of pregnant women (39.2 percents) attemped to quit smoking after the delivery, majority immediately after the birth (85.3 percents), but over 55 percents continued to smoke afer only one week. Almost one quarter of pregnant women (24.4 percents) that quit smoking during the pregnancy is still abstaining three months after the birth, and nearly one fifth of examinees (19.3 percents) is successful even six months after giving birth which could be considered as definite efficacy of cessation. Smoking in pregnancy was significantly influential to infants` birth weight, body height and circumference of the head. Infants whose mothers smoked immediately before the pregnancy, and during the course of pregnancy, had lower birth weight compared to infants of nonsmoking mothers (for 95.3 g i.e. 86.3 g), while body height was smaller for 0.59 cm, i.e. 0.54 cm. Arrear in birth weight and birth height was more expressed in infants whose mothers smoked constantly during the course of pregnancy and more than 20 cigarettes per day in average than in mothers smoking less frequently and less intensively. Circumference of the newborns` head was affected by frequency and quantity of consumed cigarettes. Infants whose mothers smoked constantly during the pregnancy and more than 20 cigarettes per day in average had smaller circumference of the head for approximately 1 cm compared to infants delivered by mothers who smoked occasionally and less cigarettes. The results impose an obligation for establishing population-specific aims for decrement of smoking prevalence among pregnant and post-partum women. Vulnerability of this population group draws attention to urgency of action(s).

Determination of smoking prevalence within the representative sample of pregnant women in Vojvodina is facilitating insight into dispersion of the most frequent behavioral risk factor in one of the most vulnerable population categories, as well as consideration of influence of smoking to pregnancy outcome. The survey was performed on representative sample of three months cohort, 726 pregnant women in Vojvodina, by stratified two-stage random cluster sampling with an aim to assess: prevalence and intensity of smoking immediately before cognition of pregnancy, at each trimester during the pregnancy and at 3 and 6 months after delivery, exposure to environmental smoke at home, rate and reasons for smoking cessation up to 6 months after delivery and pregnancy outcome by infants` birth weight, body height and circumference of the head analysis. Three questionairres were used as survey instruments, composed with consideration of survey protocols used for attainment of smoking prevalence with pregnant women in earlier studies, pilot-study results and form for transcript of variables from the Newborn Infant Record. It is determined that smoking prevalence during pregnancy is high (40.9 percents smoked at some point during the pregnancy), as well as exposure to tobacco smoke at home (56.2 percents lives in a home with at least one smoker whilst 83.5 percents allowes smoking at home). More than one third of pregnant women (39.2 percents) attemped to quit smoking after the delivery, majority immediately after the birth (85.3 percents), but over 55 percents continued to smoke afer only one week. Almost one quarter of pregnant women (24.4 percents) that quit smoking during the pregnancy is still abstaining three months after the birth, and nearly one fifth of examinees (19.3 percents) is successful even six months after giving birth which could be considered as definite efficacy of cessation. Smoking in pregnancy was significantly influential to infants` birth weight, body height and circumference of the head. Infants whose mothers smoked immediately before the pregnancy, and during the course of pregnancy, had lower birth weight compared to infants of nonsmoking mothers (for 95.3 g i.e. 86.3 g), while body height was smaller for 0.59 cm, i.e. 0.54 cm. Arrear in birth weight and birth height was more expressed in infants whose mothers smoked constantly during the course of pregnancy and more than 20 cigarettes per day in average than in mothers smoking less frequently and less intensively. Circumference of the newborns` head was affected by frequency and quantity of consumed cigarettes. Infants whose mothers smoked constantly during the pregnancy and more than 20 cigarettes per day in average had smaller circumference of the head for approximately 1 cm compared to infants delivered by mothers who smoked occasionally and less cigarettes. The results impose an obligation for establishing population-specific aims for decrement of smoking prevalence among pregnant and post-partum women. Vulnerability of this population group draws attention to urgency of action(s).