Browsing by Author "Jankovic, Janko (15022715100)"

Aim: Waste, including waste from electrical and electronic equipment, has been increasing for many years. This pilot study aims to describe hospital waste management in three European countries (including collection, disposal and recycling). Subject: and methods The survey was carried out in eight hospitals, two in Rome (Italy), three in Dresden (Germany) and three in Belgrade (Serbia). A questionnaire was used to gain more knowledge about hospital waste management, especially regarding electrical and electronic equipment. Results: The survey results show that treatment of electrical and electronic equipment is a difficult and expensive task in all studied hospitals and countries. Only one half of the hospitals have a standardised procedure for waste treatment. While one eighth has a procedure for some equipment, 37.5% do not have one; and whereas one quarter do not have an office of waste management, a waste register is available in 62.5% of the hospitals. Conclusion: Either waste management procedures differ between the eight studied hospitals and countries, or there is no (prescribed) waste management procedure at all. With regard to the two facts, common regulations are necessary to manage waste disposal and treatment in European countries and hospitals. © Springer-Verlag 2011.

Background Roma are Europe’s largest minority population. Serbia and Macedonia have the greatest proportion of Roma outside of the European Union. Our objective was to examine women’s agency and how it related to desired timing of pregnancy among Romani women in Macedonia and Serbia. Methods We surveyed 410 Romani women who had given birth in the last 2 years between November 2012–February 2013 in Serbia and Macedonia using purposeful snowball sampling. Log-Poisson models were used to examine the association between women’s inclusion in healthcare decision- making and desired timing of pregnancy. Results Romani women in Macedonia and Serbia were excluded from the labor market, with over 80% being unemployed, approximately 30% had no schooling, and 17% were not included in healthcare decisions. Romani women who were sole decision-makers in relation to their health were 1.4 times more likely to desire the timing of their most recent pregnancy [RRR = 1.4, CI (1.1, 1.8)]. Conclusions Romani women who have great involvement in their own healthcare decisions were more likely to desire the timing of their current pregnancy. Women’s inclusion in such important decisions is important and empowerment programs that address gender inequity are needed in Romani communities, particularly for control of timing of pregnancy. © 2017, Springer Science+Business Media New York.

Background: Racial discrimination may increase the risk of low birthweight (LBW), but has not been studied among Roma, the largest minority population in Europe. Moreover, few studies test both institutional and interpersonal forms of racial discrimination on health. Our objective was to examine associations between institutional and interpersonal racial discrimination with LBW, and to test potential mediation by smoking during pregnancy. Methods: In 2012-2013, Romani women interviewers surveyed 410 Romani women in Serbia and Macedonia. We measured institutional discrimination (neighborhood segregation, legal status of housing and neighborhood socioeconomic status), interpersonal discrimination [Everyday Discrimination Scale (EDS)], birthweight and smoking by self-report or interviewer report. We estimated relative risks for discrimination on LBW and separately on smoking during pregnancy using log-binomial regression, adjusting for age, parity, years at residence and wealth. Results: The indirect effect of high EDS via smoking on LBW was estimated using inverse odds weighting mediation. Living in a low SES neighborhood showed a 2-fold risk of LBW [adjusted risk ratio (aRR) = 2.4, 95% CI = 1.2, 5.0]; aRRs for segregation and illegal housing were weaker (aRR = 1.8, 95% CI = 0.7, 4.3; aRR = 1.3, 95% CI = 0.6, 2.6, respectively). Institutional measures were not associated with smoking. High EDS was associated with LBW (aRR = 2.4, 95% CI = 1.1, 5.2) and smoking during pregnancy (aRR = 1.4, 95% CI = 1.1, 1.8); the indirect effect of EDS on LBW via smoking was not significant. Conclusion: Interpersonal discrimination and living in a low SES neighborhood were associated with LBW among Roma. Interventions to improve Romani health may benefit from a human rights approach. © 2017 The Author.

Background: Introduction of vaccines against COVID-19 has not encountered expected acceptance. The uptake of COVID-19 vaccines in Western Balkans countries is lagging behind the European Union average. The aim of our study was to assess the intention to get vaccinated against COVID-19 in the population of unvaccinated adult citizens of five Western Balkans countries, and to explore factors that influence the vaccination intention. Methods: Cross-sectional study was conducted in the period from July to October 2021. The questionnaire was shared through online social media. Intention to get vaccinated against COVID-19 was measured by a single item assessing the likelihood of getting vaccinated on a 5-points Likert scale. Linear regressions were conducted with socio-demographic characteristics, presence of chronic diseases and attitudes towards COVID-19 vaccination as independent factors. Results: The largest proportion of unvaccinated respondents willing to get vaccinated in the future was observed in Montenegro and Albania (40.4% in each country), while in the Serbian sample, the willingness to get vaccinated was the lowest (22.6%). Socio-demographic characteristics were not significantly associated with the intention to get vaccinated against COVID-19 in most of the countries. In Albania, Bosnia and Herzegovina, North Macedonia and Serbia the strongest determinant of COVID-19 vaccination intention was the higher sense of social responsibility. Conclusions: Vaccination interventions and campaigns aiming to improve the COVID-19 vaccine uptake should be focussed on specific set of factors in each country, appealing to social responsibility as most prevalent determinant of vaccination intention in Western Balkans. © 2023 The Author(s). Published by Oxford University Press on behalf of the European Public Health Association.

Introduction: Palmoplantar psoriasis (PPP) is a variant of psoriasis that affects the palms and/or soles. Although PPP is a disabling and therapeutically challenging condition, its epidemiology is poorly defined. Aim: To assess the prevalence of PPP locations (palms, soles or both), and to analyse epidemiological and clinical characteristics of the disease. Material and methods: Two bibliographic databases (MEDLINE and SCOPUS) were used as data sources searched from inception to October 2017. The selection of articles was limited to human subjects and English or French languages. Results: A search resulted in a total of 293 articles, out of which 24 were utilized for the current systematic review and 21 for meta-analysis. All listed studies comprised a total of 2083 patients with PPP, with more males than females. According to the results of meta-analysis, majority of patients had the highest prevalence of both palms and soles involvement (95% CI: 47–67), with an almost equal prevalence showing palmar (21%; 95% CI: 13–30) or plantar (20%; 95% CI: 12–29) involvement. The most prevalent type of PPP was plaque/hyperkeratotic, followed by the pustular type. Conclusions: Almost three-fifths (59%) of all PPP patients had involvement of both palms and soles, while exclusive palmar or plantar involvement was seen in 21% and 20% of patients, respectively. Future research should be performed to elucidate basic epidemiological and clinical characteristics of PPP, which would be helpful for proper consideration of this condition. © 2019 Termedia Publishing House Ltd.. All rights reserved.

Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality worldwide, hence significant efforts have been made to establish behavior and risk factors associated with CVD. The American Heart Association proposed a 7-metric tool to promote ideal cardiovascular health (CVH). Recent data demonstrated that a higher number of ideal CVH metrics was associated with a lower risk of CVD, stroke, and mortality. Our study aimed to perform a systematic review and meta-analysis of prospective studies investigating the association of ideal CVH metrics and CVD, stroke, and cardiovascular mortality (CVM) in the general population. Medline and Scopus databases were searched from January 2010 to June 2022 for prospective studies reporting CVH metrics and outcomes on composite-CVD, coronary heart disease, myocardial infarction, stroke, and CVM. Each CVH metrics group was compared to another. Twenty-two studies totaling 3,240,660 adults (57.8% men) were analyzed. The follow-up duration was 12.0 ± 7.2 years. Our analysis confirmed that a higher number of ideal CVH metrics led to lower risk for CVD and CVM (statistically significant for composite-CVD, stroke, and CVM; p < 0.05). Conclusion: Even modest improvements in CVH are associated with CV-morbidity and mortality benefits, providing a strong public health message about the importance of a healthier lifestyle. © 2023 by the authors.

BACKGROUND: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, with a significant effect on the quality of life (QoL). This study aims to evaluate the impact of AD on the QoL of children and their parents and to identify predictors affecting their QoL. METHODS: The cross-sectional study was conducted in Montenegro. It included 200 children with AD aged 5-16 years and their parents. The severity of disease was measured by the Three Item Severity (TIS) score, while QoL was assessed with the Children's Dermatology Life Quality Index (CDLQI) and the Dermatitis Family Impact (DFI) questionnaire. RESULTS: The mean CDLQI score of the children affected by AD was 17.11 and the mean DFI score of their parents 19.86. There was a significant correlation between AD severity score assessed by a doctor (TIS) and both CDLQI and DFI scores (r=0.53 and r=0.27, respectively). A moderate positive correlation was observed between the QoL of children with AD and QoL of their parents (r=0.53). According to multiple linear regression, more impaired QoL of affected children was associated with more severe AD, younger parent's age and their lower educational level. Poorer QoL of parents was associated with female sex, younger age of children, more severe AD, lower educational level of parents and absence of a family history of atopic disease. CONCLUSIONS: The present study confirmed that AD has a large negative impact on QoL of both patients with AD and their families. More impaired QoL was associated with more severe AD. © 2021 Edizioni Minerva Medica. All rights reserved.

Introduction: The outbreak of the disease caused by the novel coronavirus, SARS-CoV-2 named COVID-19 has spread throughout the world. The number of registered cases is increasing and almost no country or territory worldwide has been without any COVID-19 patient. The aim of this study was to examine the level of knowledge on the SARS-COv-2 and COVID-19 among medical students and to explore the differences in attitudes, practices and fear of COVID-19 among students with sufficient and students with insufficient knowledge. Methodology: The cross-sectional study among the 1,722 medical students was conducted through an online platform of the Faculty of Medicine, University of Belgrade. The instrument used was a questionnaire with sections on socio-demographic characteristics, knowledge, attitudes and practices towards COVID-19 and the Fear of COVID-19 scale. Results: Total of 1576 (91.50%) students were in the sufficient knowledge group. The multivariate logistic regression analysis showed that there was a significant association between the sufficient knowledge on COVID-19 and female sex (OR = 1.70, 95% CI = 1.18-2.45), age (OR = 1.10, 95% CI = 1.02-1.18), considering the preventive measures enforced in Serbia as good (OR = 2.57, 95% CI = 1.18-5.56), wearing the surgical mask outside of the household in the past 14 days (OR = 1.87, 95% CI = 1.22-2.87) and score on Fear of COVID-19 scale (OR = 0.94, 95% CI = 0.91-0.98). Conclusions: Medical students showed good knowledge of COVID-19 and could be a part of the promotion of health education messages as a part of preventive measures. Copyright © 2021 Terzic-Supic et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction: The outbreak of the disease caused by the novel coronavirus, SARS-CoV-2 named COVID-19 has spread throughout the world. The number of registered cases is increasing and almost no country or territory worldwide has been without any COVID-19 patient. The aim of this study was to examine the level of knowledge on the SARS-COv-2 and COVID-19 among medical students and to explore the differences in attitudes, practices and fear of COVID-19 among students with sufficient and students with insufficient knowledge. Methodology: The cross-sectional study among the 1,722 medical students was conducted through an online platform of the Faculty of Medicine, University of Belgrade. The instrument used was a questionnaire with sections on socio-demographic characteristics, knowledge, attitudes and practices towards COVID-19 and the Fear of COVID-19 scale. Results: Total of 1576 (91.50%) students were in the sufficient knowledge group. The multivariate logistic regression analysis showed that there was a significant association between the sufficient knowledge on COVID-19 and female sex (OR = 1.70, 95% CI = 1.18-2.45), age (OR = 1.10, 95% CI = 1.02-1.18), considering the preventive measures enforced in Serbia as good (OR = 2.57, 95% CI = 1.18-5.56), wearing the surgical mask outside of the household in the past 14 days (OR = 1.87, 95% CI = 1.22-2.87) and score on Fear of COVID-19 scale (OR = 0.94, 95% CI = 0.91-0.98). Conclusions: Medical students showed good knowledge of COVID-19 and could be a part of the promotion of health education messages as a part of preventive measures. Copyright © 2021 Terzic-Supic et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Exposure to blood borne pathogens poses a serious risk to healthcare workers (HCWs). This study was undertaken to investigate knowledge, attitudes and practices among HCWs towards blood borne pathogens. We carried out a cross sectional KAP (Knowledge, Attitudes and Practice) study, using self-administered questionnaire. The study population consisted of 127(23.6%) physicians, and 410 (76.4%) nurses and laboratory technicians. Factor analysis and conditional multiple logistic regression were used in statistical analysis. We found that the knowledge of the epidemiological characteristics of blood-borne infection, the risk of acquisition and available preventative measures among HCWs is insufficient. Doctors were more knowledgeable about the transmissibility of blood borne pathogens regarding sexual transmission after percutaneous exposure (odds ratio) OR=2.71; 95% (confidence interval) CI=1.51-4.84, OR=2.45; 95% CI=1.21-4.96), respectively. Nurses reported professional exposure to patient's blood more often than doctors (OR=0.90; 95% CI=0.84-0.96). Negative attitudes towards HIV positive patients were also noted. Less than half of HCWs used appropriate barriers (gloves, mask, and glasses) to protect them regularly. The compulsory preventive measures implied by the results of this study are continuous education, immunization against Hepatitis B, implementing Standard Precautions, as well as the development of written guidelines on the prevention of blood-borne infections. © 2009 Versita Warsaw and Springer-Verlag Berlin Heidelberg.

Background The objective of this study was to examine predictors of prenatal smoking, and attempted smoking cessation during pregnancy among Romani women. Methods A community-based, cross-sectional study (November 2012 to February 2013) of 410 Romani women in Roma settlements in Serbia and Macedonia was conducted. Logistic regression was used to identify predictors of prenatal smoking and attempted smoking cessation during pregnancy. Results Romani women older than 30 years and those who were living with a man were over twice as likely (adjusted odds ratio (aOR) 2.48, 95% confidence interval (CI) 1.12–5.46; aOR 2.09, 95% CI 1.27–3.43) to smoke during pregnancy, compared to women <20 and married women, respectively. An inverse relationship between education and prenatal smoking was observed (for primary education versus no education, aOR 0.56, 95% CI 0.32–0.98; for secondary or higher education versus no education, aOR 0.38, 95% CI 0.16–0.90). Having a husband/partner who smokes was associated with significantly increased likelihood of prenatal smoking (aOR 3.71, 95% CI 2.20–6.25) and decreased likelihood of attempting to quit (aOR 0.51, 95% CI 0.24–1.06). Conclusions Culturally sensitive and comprehensive prevention strategies and intervention programs are needed to reduce smoking during pregnancy among Romani women, including interventions targeting male partners. © The Author 2016.

A case-control study of 110 consecutive psoriatic outpatients and 200 unmatched controls was carried out in order to analyze the association of psoriasis with smoking habits, alcohol consumption, family history of psoriasis and stressful life events. Stressful life events were assessed with Paykel's Interview for Recent Life Events, a semi-structured interview covering 63 life events. According to our results, the risk of psoriasis is higher in urban dwellers (odds ratio [OR] = 3.61; 95% confidence interval [CI] = 0.99-13.18), patients who were divorced (OR = 5.69; 95% CI = 2.26-14.34) and those exposed to environmental tobacco smoke at home (OR = 2.29; 95% CI = 1.12-4.67). Alcohol consumption (OR = 2.55; 95% CI = 1.26-5.17), family history of psoriasis (OR = 33.96; 95% CI = 14.14-81.57) and change in work conditions (OR = 8.34; 95% CI = 1.86-37.43) are also risk factors for psoriasis. Separate analyses for men and women showed that the risk of developing psoriasis was stronger in men with a family history of psoriasis (OR = 30.39; 95% CI = 6.72-137.42) than in women (OR = 16.99; 95% CI = 7.21-40.07). The effect of environmental tobacco smoke at home was found only in women (OR = 2.44; 95% CI = 1.26-4.73). Future well-designed epidemiological studies need to be performed in order to determine whether lifestyle factors and stress could be risk factors triggering or aggravating psoriasis. © 2009 Japanese Dermatological Association.

Objective: Allergic rhinitis is a major respiratory disorder and represents a global health concern. Its prevalence is increasing over the last decades and the reasons for this increase are not completely clear. The aim of this study was to investigate the factors associated with allergic rhinitis in the adult Serbian population. Method: A case-control study of 100 outpatients with allergic rhinitis and 100 control subjects was conducted in Belgrade, Serbia in 2006. Cases and controls were matched by sex and age (± 5 years). A detailed questionnaire based on the latest research results in this field was used to obtain information about known risk factors. Univariate and multivariate logistic regression analyses were used for statistical analysis. Results: The following factors were dependently associated with occurrence of allergic rhinitis: allergic asthma (Odds Ratio [OR], 3.00; 95% confidence interval [CI], 1.36-6.64) and atopic dermatitis (OR, 4.24; 95%CI, 1.35-13.31) among family members, allergic rhinitis (OR, 24.07; 95%CI, 3.15-183.89), allergic asthma (OR, 6.22; 95%CI, 1.34-28.87), infections of the airways (OR, 3.49; 95%CI, 1.82-6.72) and drug allergy (OR, 2.95; 95%CI, 1.01-8.61) in childhood, atopic dermatitis (OR, 3.02; 95%CI, 1.03-8.83), sinusitis (OR = 3.34; 95%CI, 1.52-7.35), and breastfeeding in the first months (OR, 2.86; 95%CI, 1.17-6.96). Asthma among family members was the only independent risk factor for allergic rhinitis (OR, Conclusion: Our study indicates potentially important role of both genetic and environmental factors in the etiology of allergic rhinitis.

The purpose was to determinate possible factors associated with psychosocial health through self-perceived health and psychological well-being among Serbian schoolchildren and adolescents. A cross-sectional study. The study is based on the 2006 National Health Survey of the population of Serbia. A total of 2,721 schoolchildren and adolescents were included. Face-to-face questionnaire and self-administered questionnaire were used for collection of data. For the assessment of psychosocial health we created two indicators (varibles): Self perceived health (using the categorical principal components), and Psychological well-being (using reliability analisys). Data were analyzed using descriptive statistics, Pearson's correlation coeficient and categorical regression. Self-perceived health was found to have a positive association with gender, age, objective and subjective socioeconomic status. Psychological well-being was associated with gender, age, social support, objective and subjective socioeconomic status. Age group was strongly associated with self-perceived health and psychological well-being. Older respondents and female perceived their health to be better than others. Male and respondents in age group 7-11 had higher levels of psychological well-being. Results show that both demographic and socioeconomic variables have an important influence on schoolchildren and adolescent self-perceived health and psychological well-being. © Versita Sp. z o.o.

Introduction: Many time-series studies have shown a positive association between air pollution and asthma exacerbation. However, till now only one study in Serbia has examined this relationship. Aim: To examine the associations between air pollution and asthma emergency department (ED) visits in the Uzice region, Serbia. Material and methods: A time-stratified case-crossover design was applied to 424 ED visits for asthma exacerbation that occurred in the Uzice region, Serbia, in 2012 2014. Data about ED visits were routinely collected in the Uzice Health Centre. The daily average concentrations of particulate matter (PM2.5 and PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), and black carbon (BC) were measured by automatic ambient air quality monitoring stations. Odds ratios and their corresponding 95% confidence intervals were estimated using conditional logistic regression adjusted for the potential confounding influence of weather variables (temperature, humidity and air pressure). Results: Statistically significant associations were observed between ED visits for asthma and 3-day lagged exposure to BC (OR = 3.23; 95% CI: 1.05 9.95), and between ED visits for asthma with coexisting allergic rhinitis and 0-day lag exposure to NO2 (OR = 1.57; 95% CI: 0.94 2.65), 2-day lag exposure to SO2 (OR = 1.97; 95% CI: 1.02 3.80), and 3-day lag exposure to PM10 (OR = 2.38; 95% CI: 1.17 4.84). Conclusions: Exposure to ambient air pollution in the Uzice region increases the risk of ED visits for asthma, particularly during the heating season. © 2020 Termedia Publishing House Ltd.. All rights reserved.

Aim: The aim of the study was to examine socio-demographic inequalities in user satisfaction with PHC and utilization of chosen doctors’ services. Methods: This cross-sectional study was conducted in 2016 among 232 respondents who participated in PHC user satisfaction survey in PHC center Valjevo, Serbia. Inclusion criteria were an age of at least 20 years, sufficient skills of Serbian language to fill in questionnaires and consent to participation. Two hundreds and six patients completed an anonymous questionnaire about the user satisfaction with PHC. Results: The chosen doctor was seven times more often visited by the elderly (OR=7.03) and almost three times more often by the middle-aged (OR=2.66) compared to the youngest category of respondents. Those with low education and poor financial status of the household visited a doctor four (OR=4.14) and almost nine times (OR=8.66) more often, respectively, compared to those with high education and good socioeconomic status. A statistically significant higher level of PHC satisfaction was recorded in the rural population (p<0.001) and among respondents with poor socioeconomic status of the household (p=0.014). Conclusion: The chosen doctor was more frequently visited by respondents with low education and those with poor socioeconomic status of the household, while a higher degree of satisfaction with PHC was recorded in the rural population as well as in those with poor socioeconomic status of the household. © 2020 Jovanovic et al.

Aim: The aim of the study was to examine socio-demographic inequalities in user satisfaction with PHC and utilization of chosen doctors’ services. Methods: This cross-sectional study was conducted in 2016 among 232 respondents who participated in PHC user satisfaction survey in PHC center Valjevo, Serbia. Inclusion criteria were an age of at least 20 years, sufficient skills of Serbian language to fill in questionnaires and consent to participation. Two hundreds and six patients completed an anonymous questionnaire about the user satisfaction with PHC. Results: The chosen doctor was seven times more often visited by the elderly (OR=7.03) and almost three times more often by the middle-aged (OR=2.66) compared to the youngest category of respondents. Those with low education and poor financial status of the household visited a doctor four (OR=4.14) and almost nine times (OR=8.66) more often, respectively, compared to those with high education and good socioeconomic status. A statistically significant higher level of PHC satisfaction was recorded in the rural population (p<0.001) and among respondents with poor socioeconomic status of the household (p=0.014). Conclusion: The chosen doctor was more frequently visited by respondents with low education and those with poor socioeconomic status of the household, while a higher degree of satisfaction with PHC was recorded in the rural population as well as in those with poor socioeconomic status of the household. © 2020 Jovanovic et al.

Objective: Roma experience high levels of discrimination and social exclusion. Our objective was to examine differences in self-rated health (SRH) between Roma and non-Roma in Serbia. Methods: Using data from the 2007 Living Standards Measurement Survey in Serbia (n = 14,313), we used binomial regression to estimate the relative risk (RR) of poor (SRH) among Roma (n = 267) relative to non-Roma. We additionally conducted group comparisons of combinations of Romani ethnicity, poverty, and gender, relative to the baseline group of non-Roma males not in poverty. Results: Adjusting for age, Roma were more than twice as likely as non-Roma to report poor SRH (RR = 2.3, 95% Confidence Interval (CI) = 1.8, 2.8). After adjustment for household consumption, employment, and education, the RR was reduced to 1.6 (95% CI = 1.3, 2.0). Romani women, regardless of whether they were living in poverty or not, experienced the greatest risk of poor SRH, with risks relative to non-Roma males not in poverty of 3.2 (95% CI = 2.3, 4.2) and 3.1 (95% CI = 2.4, 4.0), respectively. Conclusion: Roma in Serbia are at increased risk of poor SRH; Romani women experience the greatest burden of poor SRH. © 2011 Swiss School of Public Health.

Introduction: The aim of this paper is to present an experience from the School of Medicine (University of Belgrade, Serbia) in restructuring of study programs to be compliant with Bologna standards and European best practices in public and community health. We devised the new module with the idea to implement both the concept of patient-centered medicine and community-based learning activity, in the pre-clinical phase of medical education. It emphasis importance of social determinants of health, community activities on health promotion, early contacts with patients, developing communication skills and introduction of primary health care settings Method: All participants of overall four generations of this curriculum (students, patients and physicians) were asked to evaluate their participation in the module, using three types of self-administered questionnaires. Results: Overall 1529 students (response rate 74.1%), 1011 patients (response rate 57.2%) and 118 physicians (response rate 69.5%) had participated in this evaluation. One-way analysis of variance (ANOVA) demonstrated significantly higher satisfaction of patient with the participation in the new module (4.48), than the students (3.90) and physicians (4.08) (F=69.882, p = 0.000). Conclusion: The satisfaction of patients enrolled in this module encourages us to continue. Broadening of medical training to primary health care and other "non-medical" community settings enabled students to get insight into the different social determinants of health. However, the instructors need to improve the student's understanding and devotion for this conception.

Purpose: The aims of this study were to translate the Cardiff Acne Disability Index (CADI) into Serbian and to assess its validity and reliability in Serbian acne patients. Methods: The CADI was translated and linguistically validated into Serbian according to published guidelines. This version of CADI, along with the Serbian version of Children's Dermatology Life Quality Index (CDLQI) and a short demographic questionnaire, was administrated to a cohort of secondary school pupils. The Global Acne Grading Score was used to measure the clinical severity of acne. The internal consistency reliability of the Serbian version of CADI was assessed by Cronbach's alpha coefficient while its concurrent validity was assessed by Spearman's correlation coefficient. Construct validity was examined by factor analysis. Results: A total of 465 pupils completed questionnaires. Self-reported acne was present in 76% of pupils (353/465). The Serbian version of CADI showed high internal consistency reliability (Cronbach's alpha coefficient = 0.79). The mean item-total correlation coefficient was 0.74 with a range of 0.53-0.81. The concurrent validity of the scale was supported by a moderate but highly significant correlation with the CDLQI (Spearman's rho = 0.66; P < 0.001). Factor analysis revealed the presence of two dimensions underlying the factor structure of the scale. Conclusions: The Serbian version of the CADI is a reliable, valid, and valuable tool for assessing the impact of acne on the quality of life of Serbian-speaking patients. © 2012 Springer Science+Business Media B.V.