Response and innovations of advanced practice nurses during the COVID-19 pandemic: A scoping review.

AIM: Identify and map international evidence regarding innovations led by or involving advanced practice nurses in response to COVID-19. BACKGROUND: COVID-19 necessitated unprecedented innovation in the organization and delivery of healthcare. Although advanced practice nurses have played a pivotal role during the pandemic, evidence of their contributions to innovations has not been synthesized. Evidence is needed to inform policies, practices, and research about the optimal use of advanced practice nurses. METHODS: A scoping review was conducted and reported using the PRISMA-ScR checklist. Electronic databases were searched for peer-reviewed articles published between January 2020 and December 2021. Papers were included that focused on innovations emerging in response to COVID-19 and involved advanced practice nurses. RESULTS: Fifty-one articles were included. Four themes were identified including telehealth, supporting and transforming care, multifaceted approaches, and provider education. Half of the articles used brief and mostly noncomparative approaches to evaluate innovations. CONCLUSION: This is the first synthesis of international evidence examining the contributions of advanced practice nurses during the pandemic. Advanced practice nurses provided leadership for the innovation needed to rapidly respond to healthcare needs resulting from COVID-19. Innovations challenged legislative restrictions on practice, enabled implementation of telehealth and new models of care, and promoted evidence-informed and patient-centered care. IMPLICATIONS FOR PRACTICE: Advanced practice nurses led, designed, implemented, and evaluated innovations in response to COVID-19. They facilitated the use of telehealth, supported or transformed models of care, and enabled health providers through education, mentorship, and mental health support. IMPLICATION FOR POLICY: Advanced practice nurses are a critical resource for innovation and health system improvement. Permanent removal of legislative and regulatory barriers to their full scope of practice is needed.

PERCEPTION OF FIRST-YEAR VERSUS SIXTH-YEAR MEDICAL STUDENTS IN SERBIA ON STUDYING MEDICINE AND POSTGRADUATE CAREER.

Self-perceived stress during undergraduate medical training could influence forthcoming career choices. The aim of this study was to explore the attitudes and potential differences between 1st and 6th year students regarding aspects of medical training and career plans. As many as 570 students in 1st and 400 in 6th year of studies at the Faculty of Medicine, University of Belgrade, were recruited on December 2-9, 2013. Data were acquired through a self-administered questionnaire. Students in both years rated "Helping other people" as the most important reason to study medicine. Freshmen rated statistically significantly higher 'good incomes' and 'social status' as reasons to study medicine (p=0.003 and p=0.037, respectively). The most desirable fields of specialization were surgery and internal medicine (36.4% and 18.7% for 1st year, and 26.3% and 36.6% for 6th year, respectively). Significantly more freshmen would prefer working abroad (χ2=3.891, p=0.029). In terms of careers abroad, students in both years expressed the highest interest in working in western and northern Europe. Desires for specialty training among medical students follow the pattern of the most frequent disciplines in the Serbian physician population, with gender differences comparable to other populations. A certain percentage of students would likely emigrate.

Flu vaccination among older persons: study of knowledge and practices.

BACKGROUND: Surveys of older adults' knowledge relative to flu immunization have highlighted its relevance in the improvement of vaccination coverage. The purpose of this study was to estimate the proportion of older persons who have ever been immunized against seasonal flu in the municipality of Vracar (Belgrade, Serbia), assess their knowledge related to flu and flu vaccination, and to determine factors associated with flu immunization. METHODS: In the period November 2012-January 2013, 480 persons aged above 65 years were recruited at the Community Health Center, of which 354 persons were finally included in the study. Data were collected using a questionnaire. To assess the level of knowledge, correct answers were awarded 1 point. The total knowledge score ranged from 0 to 17 and was divided into three levels: poor (0-4 points), moderate (5-8 points), good (9-13 points), and excellent (14-17 points). RESULTS: The proportion of ever vaccinated older persons was 47.7%. Of those, one third (29.1%) had been immunized regularly. Most seniors (61.9%) demonstrated good, whereas one third (29.8%) demonstrated excellent level of knowledge. In terms of reasons for non-compliance, the highest proportion of older persons declined vaccination because "they were in good health" (33.5%) and because "they did not believe that vaccine protects from flu" (31.5%). Independent predictors of being ever immunized against seasonal flu were having higher level of education, being more knowledgeable relative to flu vaccination, and taking more medications. CONCLUSIONS: Our results indicate that health care sector requires well-coordinated promotion campaigns to enhance acceptance of flu vaccination. Organized immunization counseling could provide accurate, evidence-based information in order to transform misbeliefs, prejudice, and negative attitude towards vaccination.

Climacteric women at work: What lurks behind poor occupational quality of life?

Physical and psychological changes during menopausal transition may affect various aspects of everyday functioning including women's work ability and work productivity. Presence of menopausal symptoms has been well-acknowledged to negatively affect quality of life (QOL). However, data on factors associated with occupational QOL among women at this period of life are lacking. The authors' purpose in this study was to evaluate factors affecting occupational QOL in a sample of employed mid-life women who are experiencing menopause. The authors performed a cross-sectional study among 335 employed women aged 40 to 65 years from Serbia. Socio-demographic questionnaire, Utian's Quality of Life Scale, and Beck's Depression Inventory were used in data collection. Women's average monthly household income and educational level were positively correlated, while having uterine prolapse was negatively associated with occupational QOL. Significant regression models assessing impact of gynecological illnesses and menopause-specific symptoms on occupational QOL (direct value and categories-below vs. above mean) showed that having insomnia, uterine prolapse, and genital inflammations may differentiate "good" from "poor" occupational QOL. Uterine prolapse, genital inflammation, and insomnia were associated with worse occupational QOL among working women in menopausal transition.

Factors associated with general and health-related quality of life in menopausal transition among women from Serbia.

This study assessed factors associated with quality of life (QOL) among Serbian peri- and postmenopausal women using two menopause-specific scales. This cross-sectional study included 500 women aged 40-65 years who had a gynecologic check-up in one of two Community Health Centers in Belgrade during February 2014 to January 2015. Women completed: a questionnaire about socio-demographics, habits, and health status; a menopause-specific questionnaire, Utian's Quality of Life Scale (UQOL); and a Women's Health Questionnaire (WHQ) and Beck's Depression Inventory (BDI). Higher education was associated with better occupational UQOL and memory/concentration, but with lower emotional UQOL and more anxiety/fears. City center residency was associated with better occupational and sexual UQOL. Being employed was associated with better occupational UQOL and lower anxiety/fears. Higher income was associated with better emotional UQOL. Not having uterine prolapse, insomnia, or tachycardia was associated with better occupational UQOL and fewer sleep problems. Higher parity was associated with better sexual UQOL. Having regular recreation was associated with better health and sexual UQOL but with more frequent vasomotor symptoms. Leaner women felt more attractive. QOL during the menopausal transition does not entail only somatic symptoms and therefore requires a more comprehensive approach that includes psychosocial underpinnings.

Factors associated with sexual quality of life among midlife women in Serbia.

PURPOSE: To assess factors associated with better sexual quality of life (QOL) in midlife period among women who are and are not sexually active. METHODS: Participants were 500 women aged 40-65 years from Belgrade, Serbia. Data were collected through general questionnaire (regarding socio-demographic characteristics, lifestyle habits, general medical, and gynecological history) in which one item investigated having partnered sexual activity (heterosexual intercourses). The sexual domain of the Utian Quality of Life Scale was used to assess the sexual QOL. The sexual QOL consisted of reflections on the satisfaction with frequency of sexual interactions, as well as sexual and romantic life in general. Higher scores indicated better sexual QOL. RESULTS: Most women were sexually active in midlife (81.6%). The mean sexual QOL score for the overall sample was 9.99 (range 3-15). The level of sexual QOL did not differ between sexually active and non-active women. Factors associated with better sexual QOL in sexually active menopausal women were being married or coupled, being physically active, having more children, having hot flushes, and not having tachycardia. Factors associated with better sexual QOL in sexually inactive menopausal women were drinking alcohol, being physically active, not having insomnia or skin rash. CONCLUSIONS: Sexual QOL among Serbian urban midlife women was good and did not differ between women who were sexually active and those who were not. Further studies are needed to determine in what manner women who are not sexually active in midlife achieve high level of satisfaction with their sexual QOL.

Menopausal transition in Southern Europe: comparative study of women in Serbia and Portugal.

OBJECTIVE: The aim of this study was to assess and compare general menopausal quality of life in Serbia and Portugal. METHODS: In all, 1,503 women aged between 40 and 65 years from Belgrade, Serbia, and Lisbon, Portugal, were included in the study. A sociodemographic questionnaire and the Utian Quality of Life (UQOL) scale were used in data collection. RESULTS: The average age of women was 50 (SD = 5.61) years. Serbian and Portuguese women differed in all sociodemographic characteristics except for body mass index (BMI) and relationship status. There were no significant differences in UQOL total score (P = 0.629) or UQOL sexual score (P = 0.396) between Serbian and Portuguese women. However, occupational (P < 0.001) and health (P = 0.003) scores were significantly higher in the Serbian sample, whereas Portuguese women had higher emotional scores (P < 0.001). Based on the total study sample, women with an average UQOL score were more highly educated, employed, non-smokers, and physically active, and more likely to obtain medical assistance for climacteric symptoms compared with women who reported lower UQOL score. In addition to these characteristics, women with a higher UQOL score had higher annual income, no recent illnesses, and optimal BMI compared with women who reported a lower UQOL score. CONCLUSIONS: This study showed that diverse populations of midlife women can have similar perceptions of quality of life as it encompasses broad dimensions of menopausal somatic and psychosocial symptoms, as well as habits and lifestyle. Further comparative studies using the UQOL scale are warranted to offer more information on the delicate factors influencing well-being in climacteric women worldwide.

Falls, risk factors and fear of falling among persons older than 65 years of age.

AIM: Falling represents a major public health problem among older persons because it leads to premature mortality, loss of independence, and placement in assisted-living facilities. The purpose of this study was to assess the main features and risks for falls among persons older than 65 years of age as well as to quantify their fear of falling. METHODS: A total of 354 persons older than 65 years of age were recruited at a community health centre. Characteristics of the most recent fall were obtained through detailed interviews with study participants. The Falls Efficacy Scale was used to quantify fear of falling. RESULTS: Frequency of falling was 15.8%. Falls occurred most often while walking (49%). One-half of fallers (49.1%) sustained an injury. Head haematomas and soft tissues contusions were the most common consequences of falls. The average Falls Efficacy Scale score was significantly higher in fallers ( P = 0.001). Multiple logistic regression analysis showed that having a fear of falling (odds ratio = 4.14, 95% confidence interval: 1.22-14.08, P = 0.02) and being a woman (odds ratio = 2.10, 95% confidence interval: 0.97-4.53, P = 0.05) were independent risk factors for falling among older persons. CONCLUSION: The frequency of falls among older people was similar to those in other populations. These results could be used to help select older persons who should be enrolled in fall prevention programmes.

Computer and online health information literacy among Belgrade citizens aged 66-89 years.

Computer users over 65 years of age in Serbia are rare. The purpose of this study was to (i) describe main demographic characteristics of computer users older than 65; (ii) evaluate their online health information literacy and (iii) assess factors associated with computer use in this population. Persons above 65 years of age were recruited at the Community Health Center 'Vracar' in Belgrade from November 2012 to January 2013. Data were collected after medical checkups using a questionnaire. Of 480 persons who were invited to participate 354 (73.7%) agreed to participate, while 346 filled in the questionnaire (72.1%). A total of 70 (20.2%) older persons were computer users (23.4% males vs. 17.7% females). Of those, 23.7% explored health-related web sites. The majority of older persons who do not use computers reported that they do not have a reason to use a computer (76.5%), while every third senior (30.4%) did not own a computer. Predictors of computer use were being younger [odds ratio (OR) = 2.14, 95% confidence interval (CI) 1.30-4.04; p = 0.019], having less members of household (OR = 2.97, 95% CI 1.45-6.08; p = 0.003), being more educated (OR = 3.53, 95% CI 1.88-6.63; p = 0.001), having higher income (OR = 2.31, 95% CI 1.17-4.58; p = 0.016) as well as fewer comorbidities (OR = 0.42, 95% CI 0.23-0.79; p = 0.007). Being male was independent predictor of online health information use at the level of marginal significance (OR = 4.43, 95% CI 1.93-21.00; p = 0.061). Frequency of computer and Internet use among older adults in Belgrade is similar to other populations. Patterns of Internet use as well as non-use demonstrate particular socio-cultural characteristics.

Molecular and functional characterization of goldfish (Carassius auratus L.) Serum Amyloid A.

Quantitative expression analysis of goldfish SAA revealed the highest mRNA levels in the kidney, spleen and intestine with lower mRNA levels in muscle and liver. Goldfish SAA was differentially expressed in goldfish immune cells with highest mRNA levels observed in neutrophils. To functionally assess goldfish SAA, recombinant protein (rgSAA) was generated by prokaryotic expression and functionally characterized. Monocytes and macrophages treated with rgSAA exhibited differential gene expression of pro-inflammatory and anti-inflammatory cytokines. rgSAA induced gene expression of both pro-inflammatory (TNFα1, TNFα2) and anti-inflammatory cytokines (IL-10, TGFß) in monocytes. rgSAA induced IL-1ß1 and SAA gene expression in macrophages. rgSAA was chemotactic to macrophages and neutrophils, but not monocytes. rgSAA did not affect respiratory burst induced by heat-killed Aeromonas salmonicida. rgSAA treatment of macrophages down-regulated their production of nitric oxide. rgSAA exhibited antibacterial properties against Escherichia coli in a concentration dependent manner.

Ready to work or not quite? Self-perception of practical skills among medical students from Serbia ahead of graduation.

AIM: To assess final year medical students' self-perception of their practical skills. METHODS: The study was conducted at the Faculty of Medicine in Belgrade during compulsory practical sessions in the period December 2-9, 2013 and 390 students agreed to participate (response rate 77.8%). The questionnaire included questions on demographic characteristics, 21 questions on students' self-perception of their practical skills, and 1 question on students' self-perceived readiness to start working with patients. RESULTS: Cronbach's α for the entire scale was 0.891. Students felt most confident about measuring arterial pulse and blood pressure and taking patients' history (average score 10 for all three skills) and least confident about placing a urinary catheter (average score 1) and suturing a wound (average score 2). They rated their readiness to work with patients with 5.0 out of 10.0 points. The total score did not correlate with students' average mark (Spearman's ρ=0.039; P=0.460) and the average mark did not correlate with the self-perceived readiness to work with patients (Spearman's ρ=-0.048; P=0.365). CONCLUSION: Our study suggests that medical students lack confidence to perform various clinical procedures, particularly those related to surgical interventions. To improve students' confidence, clinical curriculum should include either more hours of practical work or ensure closer supervision of practical training in wards.

Factors associated with positive attitude towards blood donation among medical students.

The aim of this study was to assess attitudes and practice of blood donation among medical students. Medical students were recruited at Medical Faculty, University of Belgrade, Serbia. Of 973 students, 38.4% of freshmen and 41.4% of final year students have donated blood (χ(2) = 0.918, p = 0.186). Blood donors had significantly more positive attitude towards some aspects of blood donation. Being female, residing in a city other than the capital and previous blood donation experience were independent predictors of positive attitude towards being a blood donor to an unknown person. Efforts are required to augment blood donor pool among future physicians.

The analysis of the acute phase response during the course of Trypanosoma carassii infection in the goldfish (Carassius auratus L.).

The expression of genes encoding the acute phase proteins (APP) during the course of Trypanasoma carassii infection in the goldfish was determined using quantitative PCR. Significant changes in the mRNA levels of ceruloplasmin (Cp), C-reactive protein (CRP), transferrin (Tf), hemopexin (Hx) and serum amyloid A (SAA) were observed in the kidney, liver and spleen at various days post infection (dpi). Of the five acute phase protein genes examined, CRP and SAA exhibited the highest expression in the tissues during the acute infection. Cp and Tf were up-regulated throughout the acute course of infection in the liver. During the chronic phase of the infection, APP expression in the liver was similar to that in the non-infected control fish. At 7 dpi, Cp, Tf and Hx were down-regulated in the spleen, and Cp and Tf kidney, but their mRNA levels gradually returned to those of control non-infected fish. In contrast, during the chronic phase of the infection, there was an up-regulation of Cp, Hx and Tf in the spleen, and Tf and SAA in the kidney. The goldfish CRP was cloned and functionally characterized. CRP was differentially expressed in normal goldfish immune cells, with highest expression in monocytes and lowest expression in mature macrophages. A recombinant goldfish CRP (rgfCRP) was generated using prokaryotic expression. rgfCRP enhanced complement-mediated killing of trypanosomes in vitro, and the lysis increased after addition of immune serum. rgfCRP did not affect the production of reactive oxygen and nitrogen intermediates by monocytes and macrophages, respectively.

Validation of the Menopause Rating Scale in Serbian language.

PURPOSE: The study aim was to translate the Menopause Rating Scale (MRS) to Serbian language and assess its validity and reliability in the population of Serbian menopausal women. METHODS: The study included 200 peri- and postmenopausal women from two Community Health Centers (city center and outskirts) in the Serbian capital-Belgrade. Women filled out general questionnaire (socio-demographics, habits, medical history), the MRS, Short Form-36 questionnaire (SF-36) and Beck's Depression Inventory (BDI). The MRS was translated according to recommended methodology and its psychometric properties (internal consistency, factor analysis, discriminant, construct and criterion validity) were assessed. RESULTS: The Cronbach's alpha coefficient for the whole scale was 0.884 (psychological α = 0.902, somato-vegetative α = 0.761, urogenital α = 0.734). Values of the CI-TC coefficient for Serbian MRS were adequate for 10 items, proving their suitability in the scale. On factor analysis, we obtained the same 3 factors as in the original scale (73.1 % of variance). Communalities of all items were appropriate (>0.4). There was no common method bias. The MRS total score was correlated positively with BDI score (p = 0.001) and negatively with all SF-36 domains (p = 0.001) except General Health. Based on ROC analysis, MRS scores were more consistent for post- than perimenopausal Serbian women. Similar results of two raters (p > 0.05) implied on adequate translation and reliability of MRS. CONCLUSION: Serbian version of MRS demonstrated excellent reliability and validity. The MRS in Serbian language can be used in daily clinical work with menopausal women for assessing their symptoms and quality of life.

Translation and validation of the Utian Quality of Life Scale in Serbian peri- and postmenopausal women.

OBJECTIVE: This study aimed to translate the Utian Quality of Life Scale (UQOL) into the Serbian and to assess its validity and psychometric properties in Serbian peri- and postmenopausal women. METHODS: This survey included 200 perimenopausal and postmenopausal women. Women were approached after their regular gynecological checkup in two community health centers (city center and outskirts) in the capital city Belgrade. The following instruments were used: general questionnaire (sociodemographics, habits, and medical history), UQOL, Short Form-36, and Beck Depression Inventory. The UQOL was translated according to the recommended methodology for translating questionnaires, and its psychometric properties (internal consistency, factor analysis, discriminant validity, construct validity, and criterion validity) were tested. RESULTS: The mean (SD) UQOL total score was 80.5 (13.5). The Cronbach's α coefficient for the entire scale was 0.83 (Occupational, α = 0.76; Health-Related, α = 0.72; Emotional, α = 0.36; Sexual, α = 0.66). All corrected item-total correlation coefficients were greater than 0.40, confirming that all items were appropriate parts of the UQOL. On exploratory factor analysis, we obtained six factors (five items formed two new clusters: Physical Fitness and Professional Recognition) that explained 85.7% of the total variance. The UQOL total score was significantly negatively correlated with Beck Depression Inventory score (P = 0.001) and significantly positively correlated with all Short Form-36 domains (P = 0.001). In addition, significant intercorrelations of UQOL domains also indicated good criterion validity. CONCLUSIONS: The Serbian version of the UQOL demonstrates satisfactory reliability and validity in the assessment of quality of life among peri- and postmenopausal women. The Serbian version of the UQOL is an adequate quality-of-life instrument in the Serbian language that can be applied in the everyday clinical setting.

To be or not to be an organ donor: differences in attitudes between freshmen and senior medical students.

Despite a plethora of studies on overall attitudes related to organ donation in a health care setting, little is known as to whether or not medical students at various levels of undergraduate training have distinctive attitudes towards donation. The purpose of this study was to analyze attitudes of first- and sixth-year students towards organ donation. A total of 988 students in first (573) and the final, sixth, year (415) were recruited at the Faculty of Medicine, University of Belgrade (Serbia), in the period 2-9 December, 2013. Data were collected using an anonymous questionnaire. There were 3.0% of first-year and 3.9% of sixth-year students who were registered donors (p = 0.019). Sixth-year students felt statistically significantly more positive towards signing an organ donor card [odds ratio (OR) 1.45, 95% confidence interval (CI) 1.13-1.88]. Sixth-year students also considered that organ donation was sufficiently promoted, as well as that organ donation should be practiced unless there is a written notice of objection. In addition, sixth-year students had more confidence in local organ transplant institutions. In a multivariate logistic regression analysis significant predictor of positive attitude for signing organ donor card was being blood donor (OR 1.55, 95% CI 1.03-2.35). Undergraduate training and increase in overall medical knowledge seem to contribute in shaping positive attitudes towards being an organ donor. It would be beneficial that strategies for organ donation promotion target local centers for blood donor recruitment. Nevertheless, further promotion of organ donation is necessary to expand the total donor pool.

Identification and functional characterization of the goldfish (Carassius auratus L.) high mobility group box 1 (HMGB1) chromatin-binding protein.

We report on the identification and functional characterization of HMGB1 of the goldfish. Quantitative analysis indicated the highest expression of goldfish HMGB1 in the brain, with lower mRNA levels in spleen, intestine, kidney, gill and heart. HMGB1 was also differentially expressed in goldfish immune cell populations with highest mRNA levels present in splenocytes and neutrophils. We generated and functionally characterized the recombinant HMGB1 (rgHMGB1). The rgHMGB1 primed the respiratory burst response in monocytes and induced nitric oxide production of primary goldfish macrophages. Treatment of goldfish macrophages with heat-killed Mycobacterium marinum and Aeromonas salmonicida elevated the expression of HMGB1 and resulted in higher HMGB1 protein levels. The rgHMGB1 induced a dose-dependent production of TNFα-2 and IL-1ß1 of goldfish macrophages. Furthermore, the dual luciferase reporter assay revealed that goldfish HMGB1 induced the activation of the NF-κB signaling pathway. Our results indicate that goldfish HMGB1 is a critical regulatory cytokine of inflammatory and antimicrobial response of the goldfish.

Pharmacotherapy and over-the-counter drug use among elderly in Belgrade, Serbia.

From November 2012 to January 2013, 480 seniors were recruited at the Pubic Health Center in Belgrade, Serbia. The patients' records were validated by four independent investigators. Data on over-the-counter (OTC) drug use were collected through a questionnaire. Polypharmacy, an intake of ≥5 prescribed medications, reported in 10.4% of seniors, was associated with cardiovascular (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 1.12-8.39) and endocrine diseases (OR = 2.25; 95% CI = 1.05-4.84) as well as with the number of treated chronic conditions (OR = 2.45; 95% CI = 1.75-3.44). The most frequently used OTC drugs were analgesics (metamizole, diclofenac and acetaminophen) and vitamins (vitamin C and vitamin B complex). The number of treated chronic conditions was associated with use of OTC drugs (OR = 1.17; 95% CI = 1.01-1.36). Multiple chronic conditions correlated with multiple OTC drug use (ρ = 0.125, p = 0.019). Our analysis indicated that the prevalence of polypharmacy and OTC drug use in the elderly are comparable to those in industrialized countries.

Oral contraceptives usage patterns: study of knowledge, attitudes and experience in Belgrade female medical students.

PURPOSE: The purpose of this survey was to quantify oral contraceptive pill (OCP) use and to analyze attitudes and knowledge about the pill in a sample of female medical students. METHODS: A cross-sectional study, conducted between November 28 and December 20, 2011, included 464 female participants from the Faculty of Medicine, University of Belgrade. Data were collected before the start of compulsory practical sessions in the classrooms through a 37-item questionnaire and assessed statistically. RESULTS: Prevalence of OCP use was 11.3 %. Highest proportion of the pill use was in the third year (15.4 %). Approximately, 61 % used the pill as a therapy for dysmenorrhea. Difference in knowledge scores was observed between users and non-users (t = 3.596, p < 0.001). Advancing year at the faculty was highly statistically significantly associated with greater knowledge about health effects of the pill (ρ = 0.506, p < 0.001). There was no difference regarding attitude score among users and non-users (t = -0.9, p = 0.369). In the multivariate regression model the knowledge score was the only predictor of pill use. CONCLUSION: The results of our survey indicate that oral contraceptive pill requires further promotion and reproductive health education in a broader context.

What do male medical students know about the pill? study of knowledge and attitudes at the University of Belgrade.

BACKGROUND: Women have been traditionally more involved in birth control than men. The purpose of this survey is to analyze knowledge of and attitudes towards oral contraceptives (OC) use in a population of male medical students of the Faculty of Medicine, Belgrade, Serbia. METHODS: In November/December 2011, a total of 237 male medical students were recruited at the Faculty of Medicine before the start of compulsory practical sessions in their classrooms. Data were obtained through a 26-item questionnaire regarding knowledge of and attitude towards OC use. RESULTS: Less than a half (40.4%) had a partner and 3.2% did not know whether their partner used the pill. Approximately one fifth of the students (28.5%) did not inform themselves about the pill at all. The average knowledge score differed according to the relationship status (Z = -3.414, p = 0.001). The average attitude score did not statistically differ according to the relationship status (Z = -1.384, p = 0.166). An advanced study year was statistically associated with higher knowledge and attitude scores (ρ = 0.575, p < 0.001; ρ = 0.206, p = 0.002, respectively). CONCLUSION: Our students demonstrated a moderate level of comprehension. The results of our study indicate that the use of the OC pill needs further promotion to raise awareness of male involvement in health-related decisions of their partners.