Browsing by Author "Todorovic, Jovana (7003376825)"

Secondary metastatic deposits in the heart are generally rarely diagnosed antemortem. Malignant tumors of gynecologic origin commonly spread to the bones, lungs, local cervical region and the supra-clavicular lymph nodes, while gynecologic metastases to the thoracic region are rarely seen in clinical practice. We present a case of squamous cervical carcinoma that metastasized to the heart in 35-year old patient. The patient was admitted to cardiology department with complaints of retrosternal pain, dyspnea, fatigue, and cough. She informed the physicians that she had bilateral adnexectomy three years prior to admission. On physical examination patient was pale, febrile (38 °C), adynamic, with diminished breath sounds. Trans-thoracic echocardiogram showed aforeign mass of 42x64 mm extracardially proximal to the right atrium. Biopsy showed characteristics of metastatic deposits of squamous differentiation. These were the only metastases in this case. © 2018 EDIZIONI MINERVA MEDICA.

In this study we aimed to explore how managers in primary health care (PHC) organizations assess their managerial knowledge and skills, as well as the importance of these competencies for their job, and to identify whether there is an alignment between these two perceptions; therefore, whether there is a need for management competency improvement. With this study, we tried to address a high demand for information about health managers, especially in health systems in low-and middle-income countries. In a sample of 58 primary health care centers (n = 106 managers) in Serbia, we used a basic managerial competency matrix consisting of the following six competencies—communication, team-building, planning and priority-setting, performance assessment, problem-solving, and leading. Managerial perception of the importance of their job tasks differs by educational level and managerial position. The best alignment between the importance of knowledge and skills was for communication and leading. The study pointed out that managers were aware of the necessity to improve their level of managerial competencies, particularly in the domains of planning and priority-setting, performance assessment, and problem solving. The study highlights the need for formal managerial education for managers in PHC settings and commitment to continuously evaluate and improve management competencies in order to better manage PHC. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

In this study we aimed to explore how managers in primary health care (PHC) organizations assess their managerial knowledge and skills, as well as the importance of these competencies for their job, and to identify whether there is an alignment between these two perceptions; therefore, whether there is a need for management competency improvement. With this study, we tried to address a high demand for information about health managers, especially in health systems in low-and middle-income countries. In a sample of 58 primary health care centers (n = 106 managers) in Serbia, we used a basic managerial competency matrix consisting of the following six competencies—communication, team-building, planning and priority-setting, performance assessment, problem-solving, and leading. Managerial perception of the importance of their job tasks differs by educational level and managerial position. The best alignment between the importance of knowledge and skills was for communication and leading. The study pointed out that managers were aware of the necessity to improve their level of managerial competencies, particularly in the domains of planning and priority-setting, performance assessment, and problem solving. The study highlights the need for formal managerial education for managers in PHC settings and commitment to continuously evaluate and improve management competencies in order to better manage PHC. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Background: Frequent use of Facebook and other social networks is thought to be associated with certain behavioral changes, and some authors have expressed concerns about its possible detrimental effect on mental health. In this work, we investigated the relationship between social networking and depression indicators in adolescent population. Subjects and methods: Total of 160 high school students were interviewed using an anonymous, structured questionnaire and Back Depression Inventory - second edition (BDI-II-II). Apart from BDI-II-II, students were asked to provide the data for height and weight, gender, average daily time spent on social networking sites, average time spent watching TV, and sleep duration in a 24- hour period. Results: Average BDI-II-II score was 8.19 (SD=5.86). Average daily time spent on social networking was 1.86h (SD=2.08h), and average time spent watching TV was 2.44 h (SD=1.74h). Average body mass index of participants was 21.84 (SD=3.55) and average sleep duration was 7.37 (SD=1.82). BDI-II-II score indicated minimal depression in 104 students, mild depression in 46 students, and moderate depression in 10 students. Statistically significant positive correlation (p<0.05, R=0.15) was found between BDI-II-II score and the time spent on social networking. Conclusions: Our results indicate that online social networking is related to depression. Additional research is required to determine the possible causal nature of this relationship. © Medicinska naklada.

Objectives: Inflammatory cytokines like tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 can cause brain injury, slow recovery, and adverse effects (ADEs) in ischemic stroke (IS) patients treated with recombinant tissue plasminogen activator (rtPA). We explored the relationship between selected polymorphisms within TNF-α, IL-1β and IL-6 genes, and post-IS outcome and ADEs in patients treated with rtPA. Methods: One hundred and sixty-six patients with IS treated with rtPA were included in this study. The modified Rankin Scale (mRS) was used to assess functional recovery 3 months after IS likewise thrombolytic therapy efficacy. Patients were classified into groups with favorable (0–1) or poor recovery based on their mRS score at the ninetieth day post-IS. During hospitalization, ADEs following rtPA were monitored. TNF-α-308 G/A (rs1800629), IL-1β-511 G/A (rs16944), and IL-6-174 G/C (rs1800795) polymorphisms were genotyped using Real-Time PCR. SPSS software version 22.0 was used for statistical analyses. Results: Patients with the TNF-α-308 G/A GG genotype had a higher mean NIHSS value at admission (12.75 ± 5.176) than those carrying A-allele (10.56 ± 3.979;p = 0.016). Individuals with the CC genotype of the IL-6-174 G/C polymorphism had significantly lower NIHSS scores (8.79 ± 5.053) than those with G-allele (12.06 ± 6.562) 24 hours after rtPA (p = 0.050). Patients with the GG genotype of the IL-6-174 G/C polymorphism had a significantly poorer outcome (p = 0.024; OR = 2.339; 95%CI 1.121–4.880), while patients who were G-allele carriers of the Il-6–174 G/C polymorphism and had the AA genotype of the IL-1β-511 G/A polymorphism were statistically significantly more likely to experience hemorrhagic transformation (p = 0.046; OR = 2.7273; 95%CI 1.0414–7.1426). Conclusion: GG genotype of the IL-6-174G/C polymorphism is associated with poor recovery after IS treated with rtPA therapy. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Objectives: Inflammatory cytokines like tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 can cause brain injury, slow recovery, and adverse effects (ADEs) in ischemic stroke (IS) patients treated with recombinant tissue plasminogen activator (rtPA). We explored the relationship between selected polymorphisms within TNF-α, IL-1β and IL-6 genes, and post-IS outcome and ADEs in patients treated with rtPA. Methods: One hundred and sixty-six patients with IS treated with rtPA were included in this study. The modified Rankin Scale (mRS) was used to assess functional recovery 3 months after IS likewise thrombolytic therapy efficacy. Patients were classified into groups with favorable (0–1) or poor recovery based on their mRS score at the ninetieth day post-IS. During hospitalization, ADEs following rtPA were monitored. TNF-α-308 G/A (rs1800629), IL-1β-511 G/A (rs16944), and IL-6-174 G/C (rs1800795) polymorphisms were genotyped using Real-Time PCR. SPSS software version 22.0 was used for statistical analyses. Results: Patients with the TNF-α-308 G/A GG genotype had a higher mean NIHSS value at admission (12.75 ± 5.176) than those carrying A-allele (10.56 ± 3.979;p = 0.016). Individuals with the CC genotype of the IL-6-174 G/C polymorphism had significantly lower NIHSS scores (8.79 ± 5.053) than those with G-allele (12.06 ± 6.562) 24 hours after rtPA (p = 0.050). Patients with the GG genotype of the IL-6-174 G/C polymorphism had a significantly poorer outcome (p = 0.024; OR = 2.339; 95%CI 1.121–4.880), while patients who were G-allele carriers of the Il-6–174 G/C polymorphism and had the AA genotype of the IL-1β-511 G/A polymorphism were statistically significantly more likely to experience hemorrhagic transformation (p = 0.046; OR = 2.7273; 95%CI 1.0414–7.1426). Conclusion: GG genotype of the IL-6-174G/C polymorphism is associated with poor recovery after IS treated with rtPA therapy. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Purpose: Understanding target groups' awareness and knowledge regarding the human papillomavirus (HPV) and the HPV vaccine is essential for planning the screening and vaccination programs and attaining adequate vaccination coverage. The aim of this study was to estimate awareness and knowledge about HPV infection and the HPV vaccine and to assess factors associated with HPV awareness, HPV vaccine awareness and high HPV-related knowledge among women undergoing cervical cancer screening in Serbia. Methods: A cross-sectional study was conducted between January and June 2013 at the Obstetrics and Gynecology Clinic “Narodni Front” in Belgrade, Serbia. HPV awareness, HPV vaccine awareness, and HPV-related knowledge of women undergoing cervical cancer screening were estimated by the means of structured, self-administered questionnaire. Results: The median age of respondents was 36.0 years (range 18-65). Of 324 women participating in the study, 196 (60.5%) had heard of HPV while 95 (29.3%) had heard of the HPV vaccine. The median HPV-related knowledge score was 7 (interquartile range 4.8). Type of occupation and having an increasing number of lifetime sexual partners were associated with HPV awareness, while having no children was associated with HPV vaccine awareness. High HPV knowledge score was associated with younger age and type of occupation. Conclusions: Women undergoing cervical cancer screening in Serbia have moderate awareness of HPV infection and low awareness of HPV vaccine. However, it is promising that those who heard of HPV have high knowledge about it. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.

Purpose: Understanding target groups' awareness and knowledge regarding the human papillomavirus (HPV) and the HPV vaccine is essential for planning the screening and vaccination programs and attaining adequate vaccination coverage. The aim of this study was to estimate awareness and knowledge about HPV infection and the HPV vaccine and to assess factors associated with HPV awareness, HPV vaccine awareness and high HPV-related knowledge among women undergoing cervical cancer screening in Serbia. Methods: A cross-sectional study was conducted between January and June 2013 at the Obstetrics and Gynecology Clinic “Narodni Front” in Belgrade, Serbia. HPV awareness, HPV vaccine awareness, and HPV-related knowledge of women undergoing cervical cancer screening were estimated by the means of structured, self-administered questionnaire. Results: The median age of respondents was 36.0 years (range 18-65). Of 324 women participating in the study, 196 (60.5%) had heard of HPV while 95 (29.3%) had heard of the HPV vaccine. The median HPV-related knowledge score was 7 (interquartile range 4.8). Type of occupation and having an increasing number of lifetime sexual partners were associated with HPV awareness, while having no children was associated with HPV vaccine awareness. High HPV knowledge score was associated with younger age and type of occupation. Conclusions: Women undergoing cervical cancer screening in Serbia have moderate awareness of HPV infection and low awareness of HPV vaccine. However, it is promising that those who heard of HPV have high knowledge about it. © This work by JBUON is licensed under a Creative Commons Attribution 4.0 International License.

Chronic kidney disease (CKD) is an important factor that contributes to the increase of all-cause morbidity and mortality in the group of non-communicable diseases, and it is also recognized as a strong and independent risk factor that contributes to cardiovascular disease (CVD). CVDs are a consequence of the action of a large number of risk factors among which are traditional and non-traditional. These risk factors have been the subject of a large number of studies which partially explained the unfavorable cardiovascular (CV) outcome of CKD patients. Therefore, valid studies about clinical and biohumoral predictors are of particular importance, especially in the early stages of renal disease, that is, in patients with creatinine clearance below 60 ml/min/1.73 m2 when preventive measures are most effective. Among potential predictors of adverse CV outcome are biomarkers of inflammation (Interleukin-18—IL-18), oxidative stress (ischemia-modified albumin—IMA; superoxide dismutase—SOD), acute kidney injury (kidney injury molecule-1—KIM-1; neutrophil gelatinase–associated lipocalin—NGAL), and microribonucleic acids (specific microRNA-133a). In this review, we tried to confirm the relationship between risk factors of CKD and CVD and newer, less frequently examined biomarkers with the occurrence of incidental CV events in renal patients. © The Author(s) 2022.

Chronic kidney disease (CKD) is an important factor that contributes to the increase of all-cause morbidity and mortality in the group of non-communicable diseases, and it is also recognized as a strong and independent risk factor that contributes to cardiovascular disease (CVD). CVDs are a consequence of the action of a large number of risk factors among which are traditional and non-traditional. These risk factors have been the subject of a large number of studies which partially explained the unfavorable cardiovascular (CV) outcome of CKD patients. Therefore, valid studies about clinical and biohumoral predictors are of particular importance, especially in the early stages of renal disease, that is, in patients with creatinine clearance below 60 ml/min/1.73 m2 when preventive measures are most effective. Among potential predictors of adverse CV outcome are biomarkers of inflammation (Interleukin-18—IL-18), oxidative stress (ischemia-modified albumin—IMA; superoxide dismutase—SOD), acute kidney injury (kidney injury molecule-1—KIM-1; neutrophil gelatinase–associated lipocalin—NGAL), and microribonucleic acids (specific microRNA-133a). In this review, we tried to confirm the relationship between risk factors of CKD and CVD and newer, less frequently examined biomarkers with the occurrence of incidental CV events in renal patients. © The Author(s) 2022.

Transforming growth factor beta (TGF-β), which has a role as a regulatory cytokine, has not been widely investigated in patients with major depressive disorder (MDD) who experienced childhood trauma. The aim of our study was to investigate the differences in circulating TGF-β levels between the patients with major depressive disorder (MDD) with and without child maltreatment (CM) history, and to compare them to the corresponding control subjects’ groups (with or without CM). Blood samples were obtained from 55 patients, fulfilling DSM-IV-R criteria for a current MDD episode without psychotic symptoms, and 45 healthy controls, matched for age and gender. Participants were administered the Childhood Trauma Questionnaire (CTQ). Serum TGF-β concentration was determined by enzyme-linked immunosorbent assay. The concentration of TGF-β was significantly higher in patients with MDD with CM history, compared to MDD patients with no CM, as well as both control groups. Furthermore, we have shown that the combined effect of CM history and MDD affected TGF-β levels in adulthood, which was not observed in the control group with CM. These results indicate that MDD patients with the experience of CM have altered immune-regulatory response, and they may constitute a specific subtype within this heterogenic disorder (ecophenotype). © 2021

Transforming growth factor beta (TGF-β), which has a role as a regulatory cytokine, has not been widely investigated in patients with major depressive disorder (MDD) who experienced childhood trauma. The aim of our study was to investigate the differences in circulating TGF-β levels between the patients with major depressive disorder (MDD) with and without child maltreatment (CM) history, and to compare them to the corresponding control subjects’ groups (with or without CM). Blood samples were obtained from 55 patients, fulfilling DSM-IV-R criteria for a current MDD episode without psychotic symptoms, and 45 healthy controls, matched for age and gender. Participants were administered the Childhood Trauma Questionnaire (CTQ). Serum TGF-β concentration was determined by enzyme-linked immunosorbent assay. The concentration of TGF-β was significantly higher in patients with MDD with CM history, compared to MDD patients with no CM, as well as both control groups. Furthermore, we have shown that the combined effect of CM history and MDD affected TGF-β levels in adulthood, which was not observed in the control group with CM. These results indicate that MDD patients with the experience of CM have altered immune-regulatory response, and they may constitute a specific subtype within this heterogenic disorder (ecophenotype). © 2021

Background and Objectives: The aim of this study was to assess the differences in Doppler indices of the uterine (Ut), umbilical (UA), and middle cerebral artery (MCA) in diabetic versus non-diabetic pregnancies by conducting a comprehensive systematic review of the literature with a meta-analysis. Materials and Methods: PubMed, Web of Science, and SCOPUS were searched for studies that measured the pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio index (S/D ratio) of the umbilical artery, middle cerebral artery, and uterine artery in diabetic versus non-diabetic pregnancies. Two reviewers independently evaluated the eligibility of studies, abstracted data, and performed quality assessments according to standardized protocols. The standardized mean difference (SMD) was used as a measure of effect size. Heterogeneity was assessed using the I2 statistic. Publication bias was evaluated by means of funnel plots. Results: A total of 62 publications were included in the qualitative and 43 in quantitative analysis. The UA-RI, UtA-PI, and UtA-S/D ratios were increased in diabetic compared with non-diabetic pregnancies. Subgroup analysis showed that levels of UtA-PI were significantly higher during the third, but not during the first trimester of pregnancy in diabetic versus non-diabetic pregnancies. No differences were found for the UA-PI, UA-S/D ratio, MCA-PI, MCA-RI, MCA-S/D ratio, or UtA-RI between diabetic and non-diabetic pregnancies. Conclusions: This meta-analysis revealed the presence of hemodynamic changes in uterine and umbilical arteries, but not in the middle cerebral artery in pregnancies complicated by diabetes. © 2023 by the authors.

[No abstract available]

Objective: The novel coronavirus (SARS-CoV-2) has had an influence on almost the entire world and has become a major public health problem. Many countries have introduced measures that restrict the movement of the population and that may negatively influence the physical activity (PA) levels. The aim of this study was to examine the factors associated with changes in PA in Serbia during the COVID-19 outbreak. Methods: The cross-sectional study was conducted from the 9th through the 13th of April 2020. A total of 340 people, all contacted using Viber, were invited to participate in the study. The study instrument was a questionnaire that gathered information regarding social characteristics, PA during the outbreak, PA before the outbreak, and fear of COVID-19. Results: A total of 50 participants (14.7%) had low levels of PA in the 7 days prior to the study, while 133 (39.1%) had moderate and 106 (31.2%) had high levels of PA. The participants with high levels of PA had significantly higher energy expenditures before than after the COVID-19 outbreak (P <.001). There were no significant differences between the participants with different levels of PA in the scores on the Fear of COVID-19 scale (low: 13.4 ± 5.2; moderate: 12.6 ± 4.4; high: 13.8 ± 5.5; P =.204). Conclusion: One-sixth of the participants had low PA levels, and as restrictive measures are still in place in many countries, the lack of PA in high proportions of the general population may cause significant public health concerns. [P R Health Sci J 2022;41(2):63-67]. © 2022, University of Puerto Rico. All rights reserved.

Background: The benefits of physical activity during pregnancy include lower maternal weight gain, a lower likelihood of gestational diabetes, low back pain, preeclampsia, preterm delivery, caesarian delivery, and macrosomia. This study aimed to examine the factors associated with insufficient leisure-time physical activity (LTPA) during the first trimester. Methods: A cross-sectional study was conducted at the Clinic for Obstetrics and Gynecology of Clinical Center of Serbia, Belgrade, between January and June of 2018. The final analyses included 162/175 pregnant women. The questionnaire was used to obtain social characteristics, pregnancy, and lifestyle characteristics (Pregnancy Risk Assessment Monitoring System—PRAMS), pre-pregnancy LTPA (International Physical Activity Questionnaire—IPAQ), and LTPA during the first trimester (Pregnancy Physical Activity Questionnaire—PPAQ). Women were classified into two groups of sufficient and insufficient LTPA during the first trimester based on the recommendations of the World Health Organization. Multivariate logistic regression analysis was applied. Results: A total of 27.2% of the women had insufficient LTPA during pregnancy. Insufficient LTPA during pregnancy was associated with <12 years of education (OR: 2.3, 95% CI: 1.05–5.04), self-rated financial status as poor (OR: 0.34, 95% CI: 0.14–0.79), and hours spent walking before pregnancy (OR: 0.87, 95% CI: 0.77–0.99). Conclusions: Our results can help direct health care professionals advice for women who are planning pregnancy towards walking as it seems to be sustained during pregnancy. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Background: The benefits of physical activity during pregnancy include lower maternal weight gain, a lower likelihood of gestational diabetes, low back pain, preeclampsia, preterm delivery, caesarian delivery, and macrosomia. This study aimed to examine the factors associated with insufficient leisure-time physical activity (LTPA) during the first trimester. Methods: A cross-sectional study was conducted at the Clinic for Obstetrics and Gynecology of Clinical Center of Serbia, Belgrade, between January and June of 2018. The final analyses included 162/175 pregnant women. The questionnaire was used to obtain social characteristics, pregnancy, and lifestyle characteristics (Pregnancy Risk Assessment Monitoring System—PRAMS), pre-pregnancy LTPA (International Physical Activity Questionnaire—IPAQ), and LTPA during the first trimester (Pregnancy Physical Activity Questionnaire—PPAQ). Women were classified into two groups of sufficient and insufficient LTPA during the first trimester based on the recommendations of the World Health Organization. Multivariate logistic regression analysis was applied. Results: A total of 27.2% of the women had insufficient LTPA during pregnancy. Insufficient LTPA during pregnancy was associated with <12 years of education (OR: 2.3, 95% CI: 1.05–5.04), self-rated financial status as poor (OR: 0.34, 95% CI: 0.14–0.79), and hours spent walking before pregnancy (OR: 0.87, 95% CI: 0.77–0.99). Conclusions: Our results can help direct health care professionals advice for women who are planning pregnancy towards walking as it seems to be sustained during pregnancy. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

The aim was to explore the factors associated with the financial burden (FB) of medical care, dental care, and medicines among older-aged people in Slovenia, Serbia, and Croatia using EU-SILC 2017. The highest frequency of FB of medical care and medicines was in Croatia (50% and 69.1%, respectively) and of dental care in Slovenia (48.5%). The multivariate logistic regression analysis with FB as an outcome variable showed that the FB of medical care was associated with being married (OR: 1.54), reporting not severe (OR: 1.51) and severe limitations in daily activities (OR: 2.05), having higher education (OR: 2.03), and heavy burden of housing costs (OR: 0.51) in Slovenia, with very bad self-perceived health (OR: 5.23), having the slight (OR: 0.69) or heavy (OR: 0.47) burden of housing costs, making ends meet fairly easily or with some difficulty (OR: 3.58) or with difficulty or great difficulty (OR: 6.80) in Serbia, and with being married (OR: 1.43), having heavy burden of housing costs (OR: 0.62), and making ends meet fairly easily or with some difficulty (OR: 2.08) or with difficulty or great difficulty (OR: 2.52) in Croatia. The older-aged have the FB of healthcare, especially the poorest or those with health problems. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

The aim was to explore the factors associated with the financial burden (FB) of medical care, dental care, and medicines among older-aged people in Slovenia, Serbia, and Croatia using EU-SILC 2017. The highest frequency of FB of medical care and medicines was in Croatia (50% and 69.1%, respectively) and of dental care in Slovenia (48.5%). The multivariate logistic regression analysis with FB as an outcome variable showed that the FB of medical care was associated with being married (OR: 1.54), reporting not severe (OR: 1.51) and severe limitations in daily activities (OR: 2.05), having higher education (OR: 2.03), and heavy burden of housing costs (OR: 0.51) in Slovenia, with very bad self-perceived health (OR: 5.23), having the slight (OR: 0.69) or heavy (OR: 0.47) burden of housing costs, making ends meet fairly easily or with some difficulty (OR: 3.58) or with difficulty or great difficulty (OR: 6.80) in Serbia, and with being married (OR: 1.43), having heavy burden of housing costs (OR: 0.62), and making ends meet fairly easily or with some difficulty (OR: 2.08) or with difficulty or great difficulty (OR: 2.52) in Croatia. The older-aged have the FB of healthcare, especially the poorest or those with health problems. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

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.