Knowledge about cervical cancer, Pap test, and barriers to women's participation in screening in Belgrade, Serbia.

INTRODUCTION: Cervical cancer (CC) is a serious public health concern in Serbia, due to opportunistic screening still being in force, which led to twice higher than the average incidence rate of cervical cancer in Europe. Despite the fact that early detection and treatment services of CC are available at no additional cost, majority of women use inadequate screening services in Serbia. OBJECTIVE: This study aimed to examine the link between the knowledge about CC and Papanicolaou (Pap) test and perception of barriers to women's participation in CC screening. MATERIALS AND METHODS: The study included 300 women aged 21 to 69, with a place of residence in the city of Belgrade (Serbia), who were attending for their medical examination to the University Clinic of Gynecology and Obstetrics - "Narodni front", from June through December 2014. A survey instrument to collect data was an adapted questionnaire for the assessment of knowledge about and barriers to CC and Pap test. Patients were divided into three groups: a study group consisted of women attending irregularly (over three years), women who never participated in screening, and a control group that included women regularly participating in screening. RESULTS: Women regularly participating in screening (52.7%) had adequate knowledge about CC and Pap test, while women who irregularly (79.4%) or never participated (71.9%) did not have any adequate knowledge. There was a significant statistical difference between the CC and Pap test awareness in a group of respondents who regularly participated in comparison to respondents who irregularly or never participated in screening (x²= 27.772, p = 0.000). Regarding knowledge about human papillomavirus (HPV), 80% of women did not know that Pap test cannot be used for detection of HPV, as well as that abnormal Pap test result may be due to HPV (61.7%). Majority of women (93.7%) had poor knowledge about Pap test role in CC early detection and considered Pap test to be used to diagnose CC. The authors found a significant statistical correlation between participation of women in screening and barriers. Women who were irregular or never participated, had barriers such as: lack of time (F = 9.51; p = 0,000), difficult access to Healthcare facilities (F = 11.29; p = 0.000), lack of knowledge about the Pap test procedure (F = 21.27,p = 0.000), discomfort (F = 9.36; p = 0.000), and anxiety of Pap test results (F = 3.35; p = 0.036). Women who regularly participated did not have prejudice when choosing a gynecologist, unlike the other two groups that preferred a female gynecologist (F = 3.61; p = 0.028). CONCLUSION: This study showed that the level of knowledge about CC and Pap test in women is an important factor associated with regular participation in screening. It is necessary to take educational measures in order to raise awareness of women regarding risk factors, as well as to overcome fear and shame, with the ultimate aim to reduce frequency and mortality rate caused by CC in Serbia.

VITAMIN D STATUS IN PATIENTS WITH MENTAL DISORDERS: A CROSS-SECTIONAL ANALYSIS OF SINGLE COHORT FROM ROUTINE PRACTICE.

CONTEXT: Clinical research suggests that vitamin D deficiency correlates with mental illnesses. OBJECTIVE: The aim was to prove that the patients from the psychiatric health care service in Serbia had higher vitamin D deficiency than patients from general practice. DESIGN: The study had a cross-sectional design. METHODS: The study included 47 patients aged 19 - 76 of both sexes with different mental disorders. We performed sample size calculation on available data for vitamin D deficiency in patients in health care facilities compared with the general population. The concentrations of vitamin D in serums were measured by HPLC (high performance/pressure liquid chromatography). RESULTS: The mean value of vitamin D (standard deviation) in the whole group of study subjects was 16.27(10.62) ng/mL; 68.1% of the patients had a deficiency of vitamin D (25(OH)D<20 ng/mL). The difference is statistically significant from expected proportion of people with vitamin D deficiency in general practice (p=0.040). Serum concentrations of 25(OH)D were significantly correlated with serum concentrations of phosphorus (ϱ=0.336, p=0.024) and sodium (ϱ=0.304, p=0.038). CONCLUSIONS: The patients of psychiatry health care had significantly higher frequency of vitamin D deficiency than expected. There is a significant association between serum levels of vitamin D, and phosphate and sodium.

Risk factors associated with anemia among Serbian school-age children 7-14 years old: results of the first national health survey.

BACKGROUND: Anemia in school-age children is an important public health problem and available data of its prevalence and existing risk factors are essential for planning preventive strategies. The purpose of the current study was to assess the prevalence of and the risk factors associated with anemia among the school-age children 7-14 years years old in Serbia. METHODS: In the 2000 National Health Survey, a cross-sectional, multistage cluster survey, performed in 1688 private and refugee campuses households across the territory of Serbia a total of 525 cases were recruited. Socioeconomic, nutritional, physical activities and lifestyle data have been collected and hemoglobin levels were determined. RESULTS: The overall prevalence of anemia was 18% (94/525) [95% CI 15-21]. Age of 12-14 yrs (odds ratio 3.56 [95% CI 2.17-5.85], p=0.000), male gender (3.22 [1.92-5.42], p=0.000), refugee campuses residence (1.98 [1.22- 3.23], p=0.000), lunch skipping (3.43 [1.40-8.33], p=0.007), defective poultry intake (1.65 [1.01-2.62], p=0.047), lack of fish consumption (1.84 [1.07-3.18], p=0.028), disagreement that sport contributes protecting health (3.80 [2.02-6.95], p=0.000), absence of learning (1.80 [1.12-2.90], p=0.016) and defective book reading in free time (2.18 [1.03-4.61], p=0.04), were independent risk factors of anemia. The frequency of anemia was highest in schoolaged of male gender adolescent males 12-14 years old (46/105, 44%); in 12-14 years aged participants living in refugee campuses' households (22/63, 35%); in refugees of 7-14 yrs old male gender (32/101, 32%); in subjects with defective fish and poultry intake (35/118, 30%) and in participants who escaped reading and learning as lifestyle practices in free time (53/204, 26%). CONCLUSIONS: Socioeconomic, nutritional, physical and lifestyle risk factors could be considered by introducing preventive strategies of anemia in school-age children in Serbia.

Topology of plasma equilibria and the current closure condition.

A virtually complete description of the topology of stationary incompressible Euler flows and the magnetic field satisfying the magnetostatic equation is given by a theorem due to Arnol'd. We apply this theorem to describe the topology of stationary states of plasmas with significant fluid flow, obeying the Hall magnetohydrodynamics model equations. In the context of the integrability (nonchaotic topology) of the magnetic and velocity fields, we discuss the validity of conditions analogous to that of Greene and Johnson, which, in the case of magnetostatic equations, states that the line integral dl/B is the same for each closed magnetic field line on a given magnetic surface. We also show how this property follows from the existence of a continuous volume-preserving symmetry of the magnetic field.