Browsing by Author "Stamenkovic, Zeljka (57188960067)"

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: 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.

There is an error in the Acknowledgment statement. The correct number for project number is 175042. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated. © 2021 Stamenkovic,Matejic, Djikanovic and Bjegovic-Mikanovic.

Objectives The aims of this study were to estimate the level of knowledge, attitudes, and intentions about human papillomavirus (HPV) infection and HPV vaccine among gynecologists and to explore predictors of gynecologists' intention to recommend the HPV vaccine. Method This research was conducted between April and June 2014 among all gynecologists working at women's health departments in all primary health centers in Belgrade, the capital of Serbia, using a specially designed questionnaire. Results The response rate was 88.2%. The knowledge of gynecologists was estimated as average. The most frequently reported obstacles to HPV vaccination was the financial concern (59.8%). More than two thirds of the gynecologists were willing to recommend the vaccine (68.4%). The factors associated with the gynecologists' intention to recommend the vaccine included their positive attitudes toward boys' vaccination (odds ratio [OR], 8.96; 95% confidence interval [CI], 2.85-28.16), negative attitudes toward frequent changes the recommendations (OR, 0.31; 95% CI, 0.10-0.93), and beliefs that the vaccine application would decrease condom usage (OR, 0.31; 95% CI, 0.06-0.68). Conclusions The findings provide an important insight into the current point of view of the gynecologists, which confirms that the better the knowledge of HPV and vaccine, the higher the likelihood of recommending it. © Lippincott Williams & Wilkins.

Background: Certain lifestyle characteristics, such as dietary patterns, physical activity, and maintenance of recommended body weight, low-risk alcohol consumption and non-smoking are associated with the lower likelihood for the development of chronic-non communicable disease in the general population. These lifestyles are called health promoting behaviors (HPBs). We aimed to examine the prevalence of the HPBs among the women of reproductive age in Serbia and the factors associated with the compliance with four or more of these behaviors. Methods: The study was the secondary analysis of the data from the National Health survey in Serbia from 2019 that examined social, health status, mental health (using PHQ-8) and lifestyle characteristics of the general population in Serbia. Results: The prevalence of compliance with four or more HPBs was 22%. Among the HPBs the most frequent was a non-risky alcohol consumption reported by 2585 participants (99.2%), followed by normal weight (201869.2%) and non-smoking (1469-69%), daily fruit and vegetables intake (969-33.2%) and sufficient aerobic PA (216-7.9%). Multivariate logistic regression analysis with four or more HPBs as an outcome variable showed that the association of compliance with four or more HPBs with tertiary education (OR 1.91, 95% CI: 1.32-2.76) use of prescription medications (OR: 0.62, 95% CI: 0.44-0.87) and score on PHQ-8 (OR: 0.88, 95% CI: 0.79-0.98). Conclusion: There is a need for deeper promotion of health-related behaviors among all educational and vocational groups, including health promotion activities at the primary health care level, which is available to the entire population. © 2024 Todorovic et al.

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.

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.

Background: Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Materials and Methods: This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. Results: The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, p = 0.910). Exclusive breastfeeding was significantly more often (p < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03–0.92; eastern Serbia: OR 0.02, CI 95% 0.01–0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94–55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80–28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09–20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14–1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34–53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusion: The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards. © Copyright © 2020 Stamenkovic, Matejic, Djikanovic and Bjegovic-Mikanovic.

Background: Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective: To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019, including a forecast to 2030. Methods: We described the 2019 Global Burden of Disease (GBD) estimates for breast, cervical, and colon and rectum cancers in eleven Balkan countries over the period 1990–2019, including incidence, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALYs) rates per 100,000 population and accompanied 95% uncertainty interval. With the Autoregressive Integrated Moving Average, we forecasted these rates per country up to 2030. Results: In the Balkan region, the highest incidence and DALYs rates in the study period were for colon and rectum, and breast cancers. Over the study period, the DALYs rates for breast cancer per 100,000 population were the highest in Serbia (reaching 670.84 in 2019) but the lowest in Albania (reaching 271.24 in 2019). In 2019, the highest incidence of breast cancer (85 /100,000) and highest YLD rate (64 /100,000) were observed in Greece. Romania had the highest incidence rates, YLD rates, DALY rates, and YLL rates of cervical cancer, with respective 20.59%, 23.39% 4.00%, and 3.47% increases for the 1990/2019 period, and the highest forecasted burden for cervical cancer in 2030. The highest incidence rates, YLD rates and DALY rates of colon and rectum cancers were continuously recorded in Croatia (an increase of 130.75%, 48.23%, and 63.28%, respectively), while the highest YLL rates were in Bulgaria (an increase of 63.85%). The YLL rates due to colon and rectum cancers are forecasted to progress by 2030 in all Balkan countries. Conclusion: As most of the DALYs burden for breast, cervical, and colon and rectum cancer is due to premature mortality, the numerous country-specific barriers to cancer early detection and quality and care continuum should be a public priority of multi-stakeholder collaboration in the Balkan region. © 2023, BioMed Central Ltd., part of Springer Nature.

Objective The present study aimed to identify the role of mother's education in the nutritional status of children aged 2-5 years in Serbia. Design Nationally representative population-based study. Age- and gender-specific BMI percentiles of children were analysed. In accordance with the WHO growth reference, children with BMI less than the 5th percentile were considered undernourished. Logistic regression was used to calculate the association between mother's education and other socio-economic determinants as possible confounders. Setting UNICEF's fourth Multiple Indicator Cluster Survey, conducted in both Roma and non-Roma settlements in Serbia. Subjects Children (n 2603) aged 2-5 years (mean age 3·05 years). Results Less than 5 % of children aged 2-5 years were undernourished. There were significantly more undernourished children among the Roma population, in the capital of Serbia and among those whose mothers were less educated. There were statistically significant differences according to mother's education in all socio-economic characteristics (ethnicity, area, region of living and wealth index). Mother's level of education proved to be the most important factor for child's nutritional status; place of living (region) was also associated. Conclusions Mother's education is the most significant predictor of children's undernutrition. It confirms that investment in females' education will bring benefits and progress not only for women and their children, but also for society as a whole. © The Authors 2016.

Objective The present study aimed to identify the role of mother's education in the nutritional status of children aged 2-5 years in Serbia. Design Nationally representative population-based study. Age- and gender-specific BMI percentiles of children were analysed. In accordance with the WHO growth reference, children with BMI less than the 5th percentile were considered undernourished. Logistic regression was used to calculate the association between mother's education and other socio-economic determinants as possible confounders. Setting UNICEF's fourth Multiple Indicator Cluster Survey, conducted in both Roma and non-Roma settlements in Serbia. Subjects Children (n 2603) aged 2-5 years (mean age 3·05 years). Results Less than 5 % of children aged 2-5 years were undernourished. There were significantly more undernourished children among the Roma population, in the capital of Serbia and among those whose mothers were less educated. There were statistically significant differences according to mother's education in all socio-economic characteristics (ethnicity, area, region of living and wealth index). Mother's level of education proved to be the most important factor for child's nutritional status; place of living (region) was also associated. Conclusions Mother's education is the most significant predictor of children's undernutrition. It confirms that investment in females' education will bring benefits and progress not only for women and their children, but also for society as a whole. © The Authors 2016.

Aim: Disease prevention and health promotion are closely related through the lifestyle concept and teaching modules on them should be a part of the postgraduate curriculum of every School of Public Health (SPH) in the European Region and beyond. We aimed to determine to which degree the European SPH offer modules on Disease Prevention and Health Promotion in their postgraduate programs, but also the delay in full implementation for the target year 2030 that has been set at 100% for all SPHs. Methods: The Association of Schools of Public Health in the European Region (ASPHER) con-ducted two surveys on the activities of its members in 2011 and 2015/16. A group of 48 SPH responded in both surveys. Questions were related to the content offered by SPHs, the types of teaching methods that are in use and presentations of the modules at social networks. Results: For both modules, the 2nd survey in 2015/16 shows slightly less positive results as compared to the 1st Survey in 2011 (72.9% vs. 77.1% and 81.3% v. 87.5%). The only exception is the use of social media which increased for disease prevention from 20.8% to 37.5% of all SPH and for health promotion from 22.9% to 39.6%. Referring to the set target of 100%, delays between 4 and 13.5 years accumulate for the target year 2030. Conclusion: With the exception of the use of social media, progress towards 2030 is slow or even negative. Serious efforts have to be made by ASPHER to revert this process. © 2021 Stamenkovic;.

Aim: Disease prevention and health promotion are closely related through the lifestyle concept and teaching modules on them should be a part of the postgraduate curriculum of every School of Public Health (SPH) in the European Region and beyond. We aimed to determine to which degree the European SPH offer modules on Disease Prevention and Health Promotion in their postgraduate programs, but also the delay in full implementation for the target year 2030 that has been set at 100% for all SPHs. Methods: The Association of Schools of Public Health in the European Region (ASPHER) con-ducted two surveys on the activities of its members in 2011 and 2015/16. A group of 48 SPH responded in both surveys. Questions were related to the content offered by SPHs, the types of teaching methods that are in use and presentations of the modules at social networks. Results: For both modules, the 2nd survey in 2015/16 shows slightly less positive results as compared to the 1st Survey in 2011 (72.9% vs. 77.1% and 81.3% v. 87.5%). The only exception is the use of social media which increased for disease prevention from 20.8% to 37.5% of all SPH and for health promotion from 22.9% to 39.6%. Referring to the set target of 100%, delays between 4 and 13.5 years accumulate for the target year 2030. Conclusion: With the exception of the use of social media, progress towards 2030 is slow or even negative. Serious efforts have to be made by ASPHER to revert this process. © 2021 Stamenkovic;.

Objectives: The aim of this study was to assess the validity and reliability of the Serbian versions of the Copenhagen Burnout Inventory (CBI) and the Study Burnout Inventory (SBI) among fifth-year medical students at 5 universities in Serbia. Material and Methods: The study included 573 fifth-year medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis. Results: Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors. Conclusions: This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population. © 2021 Nofer Institute of Occupational Medicine. All rights reserved.