Diagnosis and treatment of adult asthma patients in Serbia: a 2022 experts group position statement.

INTRODUCTION: :Asthma is the most common non-communicable chronic lung condition in all age groups. Epidemiological data indicate that many asthma patients in Serbia remain undiagnosed and untreated. The implementation of recent global advances in asthma management is limited due to the lack of a systematic approach, drug availability, costs and regulatory affairs. In addition, the 2019-2022 global coronavirus disease pandemic has posed a significant challenge, particularly in resource-limited settings. AREAS COVERED: In this paper, we propose an algorithm for treating adult asthma patients in Serbia based on national expert opinions. We performed PubMed database search on published asthma clinical trials and guidelines from January 1st, 2015 to March 10th,2020.The consensus process incorporated a modified Delphi method that included two rounds of email questionnaires and three rounds of national asthma expert meetings. We focus on: 1) objective diagnosis of asthma, 2) the implementation of up-to-date therapeutic options and 3) the identification and referral of severe asthma patients to newly established severe asthma centres. EXPERT OPINION: Regional specificities and variations in healthcare systems require the adaptation of evidence-based knowledge. Practical, clinically oriented algorithms designed to overcome local barriers in health care delivery may facilitate timely and adequate asthma diagnosis and the local implementation of current advances in asthma management.

The effect of the COVID-19 pandemic on severe asthma care in Europe: will care change for good?

Background: The coronavirus disease 2019 (COVID-19) pandemic has put pressure on healthcare services, forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care. Methods: In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021. Results: 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions: Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.

The effect of the COVID-19 pandemic on severe asthma care in Europe - will care change for good?

Background The COVID-19 pandemic has put pressure on health-care services forcing the reorganisation of traditional care pathways. We investigated how physicians taking care of severe asthma patients in Europe reorganised care, and how these changes affected patient satisfaction, asthma control and future care. Methods In this European-wide cross-sectional study, patient surveys were sent to patients with a physician-diagnosis of severe asthma, and physician surveys to severe asthma specialists between November 2020 and May 2021. Results 1101 patients and 268 physicians from 16 European countries contributed to the study. Common physician-reported changes in severe asthma care included use of video/phone consultations (46%), reduced availability of physicians (43%) and change to home-administered biologics (38%). Change to phone/video consultations was reported in 45% of patients, of whom 79% were satisfied or very satisfied with this change. Of 709 patients on biologics, 24% experienced changes in biologic care, of whom 92% were changed to home-administered biologics and of these 62% were satisfied or very satisfied with this change. Only 2% reported worsening asthma symptoms associated with changes in biologic care. Many physicians expect continued implementation of video/phone consultations (41%) and home administration of biologics (52%). Conclusions Change to video/phone consultations and home administration of biologics was common in severe asthma care during the COVID-19 pandemic, and was associated with high satisfaction levels in most but not all cases. Many physicians expect these changes to continue in future severe asthma care, though satisfaction levels may change after the pandemic.

Factors Associated with Death of Covid-19 Patients: Case Series

This aim of this study was to identify potential factors associated with survival in patients with coronavirus disease 2019 (COVID- 19). This study was designed as a case series. It included patients hospitalized in Clinical Centre Kragujevac between March 10, 2020, and June 15, 2020, due to COVID-19. Variables with significant influence on the cure of patients were identified by multivariate logistic regression. A total of 234 patients were included. The average age of the patients was 57.2 ± 15.8 years. Thirty-five patients died (15.0%) and 199 (85.0%) were discharged as completely cured and with the sustained virological response.The study variables with significant influence (expressed as odds ratio – OR) on cure of COVID-19 patients after adjustment for effects of other variables were: stay in an intensive care unit – ICU (OR = 0.007;95% confidence interval – CI 0.001 – 0.086;p = 0.000), previous hospitalization (OR = 7.802;95% CI 1.198 – 50.924;p = 0.032), increased body temperature on admission (OR = 0.004;95% CI 0.000 – 0.771;p = 0.040), higher score of the Charlson Comorbidity Index (OR = 0.428;95% CI 0.235 – 0.780;p = 0.006), and increased values of C-reactive protein (CRP) serum level (OR = 0.978;95% CI 0.966 – 0.990;p = 0.000). In conclusion, clinicians should pay attention to patients with high body temperature at admission, presence of multiple comorbidities, high CRP, and patients who stay in an ICU, considering that they could be at risk for fatal outcome. [ FROM AUTHOR] Copyright of Serbian Journal of Experimental & Clinical Research is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Improvement of Quality of Higher Education Institutions as a Basis for Improvement of Quality of Life

This paper aims to propose a quality assessment model for higher education institutions in the technical–technological field and a system for decision support and optimal management strategies for quality improvement. Obtaining research results is based on surveying stakeholders in higher education and obtaining quantitative data regarding key performance indices. Quantitative data and the genetic algorithm method are applied to determine optimal management strategies for quality improvement. Quality in the higher education sector is among the current issues in the academic community. By monitoring and researching the higher education field and analysing the literature and the current situation in the system of higher education in developing countries, it can be concluded that there is no single way to assess the quality of higher education institutions. This knowledge was a good starting point for the research presented in this paper. Accordingly, the findings include developing a system for quality assessment and the ranking of higher education institutions. Additionally, evaluating the relevance of key performance indicators of higher education institutions differs from different stakeholder perspectives. However, it is possible to develop a system for decision support and the selection of the optimal strategy for improving the performance of study programs and higher education institutions with regard to quality. The practical implications include defining a decision support system that enables the adoption of optimal decisions by the management teams of higher education institutions to improve study programs and the performance of the higher education institutions. The presented system may enable the benchmarking, simulation, and verification of different scenarios for improving the quality and performance of higher education institutions. In this paper, the authors analysed the characteristics, benefits, and drawbacks of different ranking systems to develop and introduce a novel ranking system that suggests weights for the ranking criteria and different perspectives regarding new digital age requirements. The model was tested, and the results are presented to demonstrate the advantages of the developed model. The originality of the research lies in the presented novel model that can be made available to government institutions and serve as a basis for the overall ranking and evaluation of higher education institutions, with the possibility of developing a performance-based funding system. Additionally, other stakeholders can gain an insight into the performance of an institution in relation to their needs and goals.