Browsing by Author "Bjegović, V. (6602428758)"

Contemporary health-education intervention programs are increasingly used as a tool for improving health of school children [1-4]. Since 1992 a Network of 13 elementary Health Promoting Schools established in Yugoslavia (though not yet admitted to the European Network) has been operational. The Project was approved by the Ministries of Health, Education and Ecology from the very beginning, and financially supported by the Government of Serbia since 1995. The team of up to 40 health professionals, school principals and school project managers worked together for four years to change the working conditions in schools knowledge, attitudes and behaviour of school children and staff in order to improve their health [5]. The goal of this paper is to present results of health education intervention in changing of hygienic conditions in schools, as well as some of the attitudes, behaviour and knowledge of pupils and their parents. METHOD: The study took place before and after the intervention--at two points in time--during 1993 and 1996. The tri-angular approach including (1) pupils, (2) schools (teachers, school environment), and (3) parents, was used. A random pretest and post-test study design with control group (12 experimental and two control schools) has been implemented. The multiphase cluster sample was employed in order to represent all of the country typical regions. Six types of especially designed questionnaires were used to provide comparable variables in the sample of pupils, their parents and teachers. Exception were 1st-graders and 4th-graders for whom information were gathered by means of a "draw-and-write" investigation technique [6]. The response rate was 88.70% before and 98.28% after intervention. Data were analyzed by descriptive and inferential statistics using SPSS/PC software. RESULTS: Schools are somewhat less overcrowded, much cleaner and better maintained after the four-year intervention. Toilets are in a better condition, but there is still much more to be done. The 1st- and 4th-graders, surveyed by the draw-and-write method, mentioned numerous ways of keeping and improving health, which were summarized as fifteen health-improvement measures (Graph 1). The most frequently mentioned measures were nutrition, physical activity, general hygiene, oral and dental hygiene, sleeping and fresh air. Each of these measures was mentioned by over 20% of the surveyed pupils. Eleven of 15 variables showed significant increase in frequencies (at the level of at least p < 0.01) after the intervention. As an indicator of a nutrition behaviour, the regularity of main meals is analyzed (Graph 2). The majority of children eat regularly and the difference before and after intervention is significant only for the school meal (c2 = 30.715, p < 0.001). Although over 70% of children learn that general hygiene is good for health in junior graders, only about little more than 30% of senior graders have a bath or shower every day, while others only once or twice a week. The differences are significant before and after the intervention (c2 = 10.648, p < 0.05) only for everyday practice. More than 90% of senior-grade pupils brush their teeth at least once or several times a day. Over 60% of children in our survey go in for sport, whereas about 20% never do so. It seems that the intervention contributed symbolically to this practice important for health, though before-after difference is significant (c2 = 6.673, p < 0.05). However, in the control group schools children have much less physical activity in 1996, and this difference is significant (c2 = 14.070, p < 0.010). The psycho-emotional status of Yugoslav young people is strongly influenced by the situation in the country the war, the economic disaster and the impact of international sanctions. Consequently, more than one-fourth of the children complained of frequent exhaustion and concentration problems, which their parents also noticed. (ABSTRACT TRUNCATED)

Marketing principles in health care delivery systems, reducing financial funds for health institutions and permanently increasing costs of medical equipment are responsible for the growing influence of management on physician's autonomy and working satisfaction. A questionnaire research was carried out in order to determine the best method of examination of this influence in Belgrade. All tested persons were medical doctors working in a primary health centers for 7 hours per day, who examined about 26 patients every day. More than a half of physician improved their knowledge by reading professional publications 6 hours per week. In spite of the fact that they all worked in the same institution, they expressed different opinions regarding the organisation. In the physicians' opinion clinical freedom and working satisfaction were at the high level, and partly connected with management practice. At the same time they were very unsatisfactory with personal income and budgetary distribution in the institution. It is evident that the method described in this article is useful in the analysis of the present situation related to management and physician's practice in the country.

Prevention of AIDS is very complex and requires, apart from basic knowledge about modes of transmission and protection, individual awareness of personal risk of infection and modification of one's risky behavior. Perception of risk has been suggested as an important element of sexual behavior change among people who engage in behaviors that place them at risk of HIV infection. This study investigates perceived risk of an HIV infection among inhabitants of municipality of Palilula. The purpose of this study was to determine the relative accuracy of risk assessment, especially for those with high-risk sexual behavior and to assess the factors related to self perception of developing AIDS. The survey was conducted as a household survey in Belgrade municipality "Palilula". The design of the survey was based on a two-stage stratified random sample. The population of Palilula municipality was divided in two stratums and 840 households were selected from each stratum. All members of selected households aged 15-49 years were interviewed. Total of 2659 persons was interviewed. Self administered questionnaire, developed by WHO and described in the Evaluation of National AIDS Programme: A Methods Package 1. Prevention of HIV infection, Geneva, 1994, was translated and adapted for local application. For analysis of findings methods of descriptive statistics, chi square test and logistic regression were used. Statistical analysis was performed using SPSS/PC. The results showed that most of the respondents (1662, 62.5%) do not perceive themselves to be at risk of HIV infection. Interestingly, almost one quarter of the sample couldn't estimate personal chances of being HIV infected. Significantly larger proportion of respondents living in urban area than those living in rural area perceived themselves at risk (17.1% of urban vs. 7.7% from rural area, chi square = 54.06, Ir0.00). Significant differences between age groups were found for perception of personal risk. Respondents up to 19 and those older than 25 in more than 60 percent and only a half of those between 20 and 24 believed that there was no chance they could become HIV infected. Almost 16% of respondents between 20 and 24 believed that they had some chances of contracting HIV, also approximately one third of them couldn't estimate personal risk of contracting HIV infection (chi square = 2.10, p = 0.00)(Graphe 1). Those who engaged in sex with irregular partners were found to perceive themselves in higher risk then those who were engaged in sex only with regular partners in previous 12 months. One fifth of those with irregular partners estimated their chances as good versus only 10% of those with only regular partners. A logistic regression analysis found that those who believed they were personally at risk knew someone with HIV, had more irregular sexual partners in last 12 months, were younger, and lived in urban area (Table 1). People correctly perceived the risk of HIV infection as being minimal as most of them didn't engage in risk behavior. Risk perception was higher among those who had more irregular partners, younger and those from urban area. Most important predictor of risk perception was knowledge of HIV positive individual.

The aim of this paper was to assess pupil's habits concerning physical activity and to identify factors related to these habits. METHOD: The data in this analysis were taken from the baseline survey of "Healthy School Project". A total of 215 pupils from four schools completed self administered questionnaires (response rate 91.49%). The children obtained questionnaires for their parents and returned them completed the next day. A total of 201 parents completed the questionnaire (response rate 85.53%). The questionnaire covered different health related topics including physical activity. In this study we analyzed questions concerning the frequency of out school physical activity, attendance in physical education classes and attitudes towards physical activity. Data were analyzed using SPSS/PC. Gender differences and grade differences were assessed with chi square calculations. To assess the contribution of predictor variables, stepwise multiple regression analyses were computed, for the total sample and for the fifth and the eighth grades separately. RESULTS: The majority of pupils, more than 60 percent, reported involving in leisure time physical activity a few times a week or even every day. Chi-square showed no statistical gender difference in the fifth grade in reports on leisure time physical activity, but in the eighth grade boys reported significantly more regular physical exercise. Pupils reported a high attendance in physical education classes (99.1% in the fifth and 82.4% in the eighth grades). A large majority of pupils thought that they would be involved in physical activity in the future (84.2% in the fifth and 77.4% in the eighth grades). Multiple regression analyses showed that for the present physical activity of pupils the regular parent's physical activity was the strongest predictor. When done separately for the fifth and the eighth grades multiple regressions analyses showed that only for younger children the parents' physical activity was also the predictor of theirs. Multiple regressions analyses showed that for the attitude towards future physical activity the strongest predictor was the frequency of the present physical exercise, and it was so far both the fifth and the eighth grades. For pupils in the fifth grade parents' physical activity was also the predictor but it was not for the pupils in the eighth grade. DISCUSSION: A positive finding was that the majority of pupils reported regular physical exercise and intention to continue with physical activity in the future. In the fifth grade there was no significant difference in leisure time physical activity but in the eighth grade girls reported less leisure time physical activity, and this might be the result of traditional opinion that physical activity and physical fitness are very important for boys but not for girls [15, 16]. Multiple regression analyses also showed that physical activity was related to regular parent's physical activity for younger children, and also the parents' physical activity was the predictor of intention for involving in physical activity in the future; this means that parents' behaviour is the model for their children.