Coping with Symptoms of Mental Health Disorders among University Students during the COVID-19 Pandemic in Relation to Their Lifestyle Habits.

Background and Objectives: The time of the pandemic brought great difficulties, both in state and interstate systems, industry, trade, and with individuals themselves. In addition, numerous studies have shown a drastic increase in mental disorders in people around the world. Therefore, the basic idea of our study was to investigate these disorders in university students in relation to their different lifestyles. Materials and Methods: The cross-sectional study was carried out at the University of Nis (Serbia) from December 2021 to February 2022. All of the participants were assessed by using appropriate questionnaires. The study included 1400 randomly selected students (692 females and 708 males). The statistical analysis of the data included the application of multiple regression analyses and correlation tests. Results: Statistical analysis indicates that extremely severe levels of depression symptoms were reported by 232 students (16.6%). Severe and extremely severe anxiety symptoms were reported by 480 students (34.3%). Multiple linear regression analysis found that for the increased depressive symptoms, the "most deserving" parameters were related to the consumption of alcoholic beverages and psychoactive substances (ß = 0.10, and 0.11, respectively), compared to the period before the COVID-19 pandemic. For anxiety symptoms, the main role was played by alcohol consumption (ß = 0.11) but also by the use of social networks as an adequate substitute for deprived content during the pandemic (ß = 0.13). Alcohol consumption was the most "responsible" for elevated stress levels compared to the period before the pandemic (ß = 0.19). Conclusions: Due to the COVID-19 pandemic, symptoms of depression, anxiety, and stress were drastically increased in the university students. There was significantly more frequent consumption of alcoholic beverages and psychoactive substances among them. That is why social support from a close environment is the most important strategy in coping with mental health issues during emergency situations.

A longitudinal study of the association between depression, anxiety and stress symptoms of university students in Serbia with excessive social media use before and during COVID-19 pandemic.

Background: Besides the well known good side of social media, it cannot be denied some of its negative effects. This two-phase study aimed to find out whether the usage of social media during the COVID-19 pandemic showed some significant association with depression and anxiety symptoms, and levels of stress. Methods: The study was based on the survey of 1,476 randomly selected students at the initial phase (December 2019 to February 2020), and 1,400 students of the same cohort at the follow up phase (December 2021-February 2022). The collected data included socio-demographics, social media usage aspects, and the ones concerning levels of depression, stress and anxiety symptoms. Standardized questionnaires - the Bergen Social Media Addiction Scale (BSMAS) was applied to measure the levels of social media addiction, and the Depression Anxiety Stress Scale (DASS 42) was administered to evaluate the symptoms of depression, anxiety and stress. Results: The comparison of responses regarding the six components of online social media addiction, which constitute the BSMAS, between the two phases of the study showed significant difference (p < 0.01) in favor of the follow up phase in the raised scores of all but one component. The probable severe or extremely severe symptoms of depression, anxiety, and stress were notably enhanced during the peak of pandemic, and all three of them were positively correlated with all 6 BSMAS components (p < 0.01). The results also indicate that students, who consumed alcohol beverages and psychoactive substances more frequently in the pandemic, exhibited more noticeable symptoms of depression (p < 0.01, for both associations). Higher levels of anxiety symptoms in students were found to be associated with longer sleep during the night (p < 0.01), increased alcoholic beverages consumption (p < 0.01). Stress levels had the strongest correlations with consuming alcoholic beverages during the pandemic (r = 0.16, p < 0.01). Conclusion: The comparison between two phases of this follow-up study revealed significant changes in the Internet usage characteristics, which may have had an essential influence on the investigated symptoms of depression, anxiety, and stress. However, other factors that may have influenced student's mental health during the COVID-19 pandemic should also be considered.

Head and neck cutaneous melanoma: 5-year survival analysis in a Serbian university center.

BACKGROUND: Head and neck melanoma (HNM) is specific from the anatomical and etiopathogenetic aspects. In addition to morphopathological parameters, rich vascularization and lymphatic drainage of the head and neck affect the occurrence of lymphogenic and hematogenous metastases, as well as the metastases on both sides of the neck. METHODS: A retrospective cross-sectional study included cutaneous melanoma patients who underwent surgery at a clinical center over a 10-year period. The clinical follow-up was at least 60 months. The Kaplan-Meier method was used for the survival analysis. The predictor effect of certain independent variables on a given dichotomous dependent variable (survival) was measured by the Cox regression analysis. RESULTS: The analysis of demographic and clinical characteristics of 116 patients with HNM revealed that there was no statistically significant difference in age and gender in the total sample. Thirty-three (28.45%) patients were already in stage III or IV of the disease at the first examination, which affected the overall survival rate. The overall 5-year survival was 30.2%. No statistically significant difference in 5-year survival was found in relation to age and location. The period without melanoma progression decreased progressively in the advanced stage. Forty-nine patients (42%) underwent surgery for lymphogenic metastases in the parotid region and/or neck during the follow-up. CONCLUSIONS: Patients with HNM included in this study frequently presented an advanced stage of the disease at the first examination, which is reflected in a low rate of 5-year survival. Early diagnosis and adequate primary treatment can ensure longer survival.

Quality of Life Indicators in Patients Operated on for Breast Cancer in Relation to the Type of Surgery-A Retrospective Cohort Study of Women in Serbia.

Background and objectives: Quality of life (QoL) after breast cancer surgery is an important public health issue. The aim of this study was to determine the relationship between the levels of perceived quality of life in patients operated on for breast cancer in relation to the type of surgery, using the standardized questionnaires. Materials and Methods: We assessed 425 women after surgery for breast cancer. The assessment included the application of the WHOQOL-bref (The World Health Organization Quality of Life-Bref), and FACT-B (Functional Assessment of Cancer Therapy-Breast) questionnaires. The statistical analysis of the data included multiple linear regression and correlation tests. Results: Multiple linear regression analysis found that education, existence of comorbidities, time elapsed since surgery, and type of surgery were significant predictors of overall quality of life. Women's overall quality of life and general health has increased by 0.16 times for each subsequent year of surgery, and by 0.34 times for each subsequent higher education level. Breast-conserving surgery or mastectomy with breast reconstruction were statistically significant (ß = 0.18) compared to total mastectomy. Conclusions: There is a significant difference in the quality of life perceived by patients in whom the breast has been preserved or reconstructed in relation to patients in whom total mastectomy has been performed.

Mobbing and Violence at Work as Hidden Stressors and Work Ability Among Emergency Medical Doctors in Serbia.

Background and Objectives: People employed in emergency medical services represent a professional group which encounters events beyond ordinary human experience, great work demands, the risk of professional disputes, and stressful situations. The goal of this study is to examine the presence of mobbing and violence at work, as well as their influence on work ability of emergency medical doctors. Materials and Methods: The survey is conducted in Emergency Medical Service (EMS) in Nis in the period between December 2017 and January 2018. Using standardized questionnaires on psychosocial conditions in work environment (COPSOQ II) and work ability index (WAI) this study encompasses 79 doctors. For estimation of the examined factors' influence on WAI linear regression analysis was used. Results: EMS doctors were exposed to abuse in 30.4% of the cases. The decline in WAI is significantly related with exposure to violence by patients (ß = 0.727), exposure to physical violence (ß = 0.896), exposure to abuse several times (ß = 0.691) and exposure to ill-treatment by patients (ß = 0.750). Conclusion: The results indicate that in the examined doctors mobbing and workplace violence are very much present and have a negative impact on their work, and therefore on the quality of health care.

Relationship between the Manner of Mobile Phone Use and Depression, Anxiety, and Stress in University Students.

Objectives: There is insufficient evidence regarding the potential risk of mobile phone use on mental health. Therefore, the aim of this research was to examine the relationship between mobile phone use and mental health by measuring the levels of depression, anxiety, and stress among university students in Serbia and Italy. Methods: This cross-sectional study was carried out at two distinguished universities in Serbia and Italy from March to May of the 2015/2016 academic year and included 785 students of both genders. The questionnaire was compiled and developed from different published sources regarding the manner and intensity of mobile phone use, along with the Depression Anxiety Stress Scale (DASS 42) for measuring psychological health. The statistical analysis of the data included the application of binary logistic regression and correlation tests. Results: Statistical analysis indicates that anxiety symptoms are somewhat more present in younger students (odds ratio (OR) = 0.86, 95% confidence interval (CI): 0.76-0.96), in those who send more text messages SMSs (OR = 1.15, 95% CI: 1.11-1.31), and in those who browse the internet less frequently (OR = 0.84, 95% CI: 0.73-0.95). Stress is more common in students who make fewer calls a day (OR = 0.79, 95% CI: 0.64-0.97), as well in those who spend more time talking on the mobile phone per day (OR = 1.28, 95% CI: 1.12-1.56). The strongest predictor of high stress levels was keeping the mobile phone less than 1 m away during sleeping (OR = 1.48, 95% CI: 1.12-2.08). Conclusions: The results indicated that the intensity and modality of mobile phone use could be a factor that can influence causal pathways leading to mental health problems in the university student population.

Knowledge, Attitudes Toward, and Acceptability of Genetic Modification among Western Balkan University Students of Life Sciences (AGREE Study).

BACKGROUND: There are still no data on the attitudes and acceptance of genetic modification (GM) food in European developing countries, such as the Western Balkan countries. The aim of the study was to assess the knowledge, attitudes, and acceptance of GM but also to shed light on the multifactorial process leading to acceptance of genetic modifications among Western Balkan students of life sciences. METHODS: In this cross-sectional study, the final study population sample was composed of 1251 university students. The instrument for data collection was a questionnaire consisting of 49 items composed of 5 sections taken from the literature. Attitudes toward GM were analyzed by using Q-mode factor analysis and principal component analysis was run for the assessment of perception of personal health risks. The acceptability of GM was analyzed in binary probit models assessing the acceptability of GM products in different areas of application with Q models, sociodemographic variables, perception of personal health risks factors, respondents' knowledge about biotechnology, gender, and age as explanatory variables. RESULTS: This study demonstrated that students of life sciences supported the implementation of GM in industry and medicine production but not in food production. Their acceptance was most influenced by 3 out of 5 attitude models that were identified (p < 0.0001). Regarding the perception of personal health risks, the factor "credence risks" was seen as a negative predictor of acceptance of GM in industry and food production (p < 0.05). The main knowledge predictor of rejecting GM was misconception, whereas real knowledge had no impact (p < 0.0001). CONCLUSION: The AGREE study provided the first rough picture of the knowledge, attitudes, and acceptance of GM in this area. Given the target population, it could be expected that the general population's acceptance of all observed elements, especially knowledge, would be lower.

Alcohol Consumption among Students--A Cross-Sectional Study at Three Largest Universities in Serbia.

INTRODUCTION: The prevalence of unhealthy alcohol use among university students is increasing in many countries. OBJECTIVE: The aim of the study was to investigate alcohol consumption and alcohol-related knowledge, attitudes and risky behaviors among Serbian university students. METHODS: The cross-sectional study was carried out at the three state universities from January to June in the academic year 2009/2010 and included 2,285 students of both genders. The students filled out a questionnaire consisting of 70 questions with respect to demographic and socioeconomic characteristics, their lifestyle habits, styles and attitudes, health assessment, as well as exposure to different risk factors. RESULTS: It was found that 77.7% of students drank alcohol occasionally, 4.6% of them consumed it on a daily basis. Friedman's test (p < 0.001) showed that students prefer drinking beer to all other alcoholic beverages. Students in Belgrade and students of Technical faculties are undisputed champions when it comes to how often they drink six or more drinks on a single occasion. Older students in Serbia drink more and get drunk more frequently. CONCLUSION: A high percentage of Serbian students consume alcohol, and even though they have their first drink at an early age, they generally drink less than students in many other countries.

Organizational commitment and job satisfaction among nurses in Serbia: a factor analysis.

BACKGROUND: One of the basic prerequisites of efficient organizational management in health institutions is certainly monitoring and measuring satisfaction of employees and their commitment to the health institution in which they work. The aim of this article was to identify and test factors that may have a predictive effect on job satisfaction and organizational commitment. METHODS: We conducted a cross-sectional study that included 1,337 nurses from Serbia. Data were analyzed by using exploratory factor analysis, multivariate regressions, and descriptive statistics. RESULTS: The study identified three major factors of organizational commitment: affective commitment, disloyalty, and continuance commitment. The most important predictors of these factors were positive professional identification, extrinsic job satisfaction, and intrinsic job satisfaction (p < .0001). Predictors significantly affecting both job satisfaction and organizational commitment were identified as well; the most important of which was positive professional identification (p < .0001). CONCLUSIONS: This study identified the main factors affecting job satisfaction and organizational commitment of nurses, which formed a good basis for the creation of organizational management policy and human resource management policy in health institutions in Serbia.

Treatment of open tibial fracture with bone defect caused by high velocity missiles: a case report.

INTRODUCTION: Tibia fracture caused by high velocity missiles is mostly comminuted and followed by bone defect which makes their healing process extremely difficult and prone to numerous complications. CASE OUTLINE: A 34-year-old male was wounded at close range by a semi-automatic gun missile. He was wounded in the distal area of the left tibia and suffered a massive defect of the bone and soft tissue. After the primary treatment of the wound, the fracture was stabilized with an external fixator type Mitkovic, with convergent orientation of the pins. The wound in the medial region of the tibia was closed with the secondary stitch, whereas the wound in the lateral area was closed with the skin transplant after Thiersch. Due to massive bone defect in the area of the rifle-missile wound six months after injury, a medical team placed a reconstructive external skeletal fixator type Mitkovic and performed corticotomy in the proximal metaphyseal area of the tibia. By the method of bone transport (distractive osteogenesis), the bone defect of the tibia was replaced. After the fracture healing seven months from the secondary surgery, the fixator was removed and the patient was referred to physical therapy. CONCLUSION: Surgical treatment of wounds, external fixation, performing necessary debridement, adequate antibiotic treatment and soft and bone tissue reconstruction are essential in achieving good results in patients with the open tibial fracture with bone defect caused by high velocity missiles. Reconstruction of bone defect can be successfully treated by reconstructive external fixator Mitkovic.

Smoking habits, knowledge about and attitudes toward smoking among employees in health institutions in Serbia.

BACKGROUND/AIM: According to the number of active smokers, Serbia occupies a high position in Europe, as well as worldwide. More than 47% of adults are smokers according to WHO data, and 33.6% according to the National Health Survey Serbia in 2006. Smoking physicians are setting a bad example to patients, they are uncritical to this habit, rarely ask patients whether they smoke and rarely advise them not to smoke. These facts contribute to the battle for reducing the number of medical workers who smoke, as well as the number of smokers among general population. The aim of the study was to determine the smoking behavior, knowledge and attitudes and cessation advice given to patients by healthcare professionals in Serbia. METHODS: A stratified random cluster sample of 1,383 participants included all types of health institutions in Serbia excluding Kosovo. The self administrated questionnaire was used to collect data about smoking habits, knowledge, attitudes and cessation advice to patients given by health professionals in Serbia. RESULTS: Out of 1,383 participants, 45.60% were smokers, of whom 34.13% were physicians and 51.87% nurses. There were 46.4% male and 45.4% female smokers. The differences in agreement with the statements related to the responsibilities of health care professionals and smoking policy are significant between the "ever" and "never" smokers, and also between physicians and nurses. Twenty-five percent of nurses and 22% of doctors claimed they had received formal training. However, only 35.7% of the healthcare professionals felt very prepared to counsel patients, while 52.7% felt somewhat prepared and 11.6% were not prepared at all. CONCLUSIONS: According to the result of this survey, there are needs for more aggressive nationwide non-smoking campaigns for physicians and medical students. Experiences from countries where physicians smoke less and more effectively carry out smoking cessation practices need to be shared with Serbian physicians in order to improve their smoking behavior and smoking cessation practices.

A preview of the efficiency of systemic family therapy in treatment of children with posttraumatic stress disorder developed after car accident.

BACKGROUND/AIM: Traumatic stress refers to physical and emotional reactions caused by events which represent a life threat or a disturbance of physical and phychological integrity of a child, as well as their parents or gaerdians. Car accidents are the main cause of posttraumatic stress disorder (PTSD) in children. The aim of this study was to preview clinical efficiency of systemic family therapy (SFT) as therapy intervention in treatment of children with posttraumatic stress disorder (PTSD) traumatized in car accident under identical circumstances of exposure. We pointed out the importance of specific family factors (family cohesion and adaptability, emotional reaction of the parents) on PTSD clinical outcome. METHODS: The sample of this clinical observational study included 7-sixth grade pupiles--5 boys and 2 girls, aged 13. All of the pupils were involved in car accident with one death. Two groups were formed--one group included three children who were involved in 8 SFT sessions together with their families. The second group included 4 children who received an antidepressant sertraline in the period of three months. RESULTS: Two months after the car accident, before the beginning of the therapy, all of the children were the members of rigidly enmeshed family systems, considering the high average cohesion scores and the low average adaptability scores on the FACES III. Three months after the received therapy, having evaluated the results of the therapeutic approaches, we established that the adaptability scores of the families included in the SFT were higher than the scores of the families of the children who received pharmacotherapy with one boy still meeting the criteria for PTSD. CONCLUSION: Systemic family therapy was efficient in the treatment of children with PTSD, traumatized in car accident. Therapy efficiency was higher when both parents and children were included in SFT than in the case when they were not included in the family therapy. The change in the functioning of the family systems was not accidental or simply time-dependant, but it depended on the therapy which was applied and the increased level of family adaptability as the main risk factor of retraumatization.

[Surgical treatment of tibial nonunion after wounding by high velocity missile and external fixators: a case report].

INTRODUCTION: The missiles of modern firearms can cause severe fractures of the extremity. High velocity missile fractures of the tibia are characterized by massive tissue destruction and primary contamination with polymorphic bacteria. Treatment of these fractures is often complicated by delayed healing, poor position healing, nonhealing and bone tissue infection. CASE OUTLINE: We present the management of tibial nonunion after wounding by high velocity missile and primary treatment by external fixation in a 25-year-old patient. The patient was primarily treated with external fixation and reconstructive operations of the soft tissue without union of the fracture. Seven months after injury we placed a compression-distraction external fixator type Mitkovic and started with compression and distraction in the fracture focus after osteotomy of the fibula and autospongioplasty. We recorded satisfactory fracture healing and good functional outcome. CONCLUSION: Contamination and devitalization of the soft-tissue envelope increase the risk of infection and nonunion in fractures after wounding by high velocity missile. The use of the compression-distraction external fixator type Mitkovic may be an effective method in nonunions of the tibia after this kind of injury.

[Characteristics of reproductive health of women in their generative age].

INTRODUCTION: Any research of reproductive health has to encompass the relevant connotations of this complex term. In order to establish relevant multidimensional characteristics, it is necessary to assess intercorrelations of the characteristics most commonly used to describe it. OBJECTIVE: Our aim was to describe the characteristics of reproductive health and to establish their significance in describing this term. METHODS: Within the study of health of adult inhabitants of Serbia, on the sample of 2,817 women aged 20-49 years, the data on different reproductive health characteristics were collected by way of a structured questionnaire. By way of factorial analysis (principal components method, Kaisser Varimax criterion), representative characteristics (factors) were selected out of a large number of characteristics, describing reproductive health of women in a multidimensional way, interrelationships of the factors were explained, and carriers--the most important individual characteristics--were selected for further analysis. RESULTS: The characteristics of female reproductive health in Serbia are poor, both from the health policy standpoint and in comparison with other countries. Reproductive health describes 7 relevant factors and their carriers (characteristics which best reflect the variability of characteristics involved in a factor). These involve sexual behaviour (self-assessed HIV infection risk), contraception (use of contraceptive devices on one's own initiative), adequate protection of reproductive health (usage of gynaecological services even when healthy), abortions (pregnancy outcome), HIV control (HIV testing usage), postpartal protection (visits of field nurses after being discharged from maternity ward) and reproductive period (doctor visits after being discharged from maternity ward). CONCLUSION: All the characteristics of reproductive health used in various studies are not equally important in the description of this complex phenomenon. Factorial analysis can explain intercorrelations of the studied characteristics and make possible the selection of those most representative.

Treatment of open tibial shaft fracture with soft tissue and bone defect caused by aircraft bomb--case report.

INTRODUCTION: Aircraft bombs can cause severe orthopaedic injuries. Tibia shaft fractures caused by aircraft bombs are mostly comminuted and followed by bone defects, which makes the healing process extremely difficult and prone to numerous complications. The goal of this paper is to present the method of treatment and the end results of treatment of a serious open tibial fracture with soft and bone tissue defects resulting from aircraft bomb shrapnel wounds. CASE OUTLINE: A 26-year-old patient presented with a tibial fracture as the result of a cluster bomb shrapnel wound. He was treated applying the method of external bone fixation done two days after wounding, as well as of early coverage of the lower leg soft tissue defects done on the tenth day after the external fixation of the fracture. The external fixator was removed after five months, whereas the treatment was continued by means of functional plaster cast for another two months. The final functional result was good. CONCLUSION: Radical wound debridement, external bone fixation of the fracture, and early reconstruction of any soft tissue and bone defects are the main elements of the treatment of serious fractures.

[Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters].

INTRODUCTION: Injuries caused by aircraft bombs cause severe damages to the human body. They are characterized by massive destruction of injured tissues and organs, primary contamination by polymorph bacterial flora and modified reactivity of the body. Upon being wounded by aircraft bombs projectiles a victim simultaneously sustains severe damages of many organs and organ systems due to the fact that a large number of projectiles at the same time injure the chest, stomach, head and extremities. CASE REPORT: We presented a patient, 41 years of age, injured by aircraft bomb with hemo-pneumothorax and destruction of the bone and soft tissue structures of the foot, as well as the treatment result of such heavy injuries. After receiving thoracocentesis and short reanimation, the patient underwent surgical procedure. The team performed thoracotomy, primary treatment of the wound and atypical resection of the left lung. Thoracic drains were placed. The wounds on the lower leg and feet were treated primarily. Due to massive destruction of bone tissue of the right foot by cluster bomb splinters, and impossibility of reconstruction of the foot, guillotine amputation of the right lower leg was performed. Twelve days after the wounding caused by cluster bomb splinters, soft tissue of the left lower leg was covered by Tirsch free transplant and the defect in the area of the left foot was covered by dorsalis pedis flap. The transplant and flap were accepted and the donor sites were epithelized. Twenty-six days following the wounding reamputation was performed and amputation stump of the right lower leg was closed. The patient was given a lower leg prosthesis with which he could move. CONCLUSION: Upon being wounded by aircraft bomb splinters, the injured person sustains severe wounds of multiple organs and organ systems due to simultaneous injuries caused by a large number of projectiles. It is necessary to take care of the vital organs first because they directly threaten the life of the wounded patient. Despite adequate surgical treatment of war wounds of the feet, because of massive defect of bone and soft tissue, amputation may be the only rational solution of the treatment. The resection of the lung may be succesfull method for the severe destruction of the lung.

[Treatment of multiple fractures in a patient wounded by aircraft bombing].

INTRODUCTION: Aircraft cluster bombs can cause severe fractures characterized by extensive destruction of affected tissues and organs. CASE OUTLINE: We present the methods and results of treatment of multiple fractures (left supracondilar humeral fracture, comminuted fracture of the distal right tibia, fracture of right trochanter major without dislocation and fracture of the right second metacarpal bone) in a 24-year old soldier after multiple wounding by a cluster bomb. After short pre-operative preparation a surgical debridement of all wounds was done in general anaesthesia and the fractures of the humerus and tibia were stabilized with the Mitkovic-type external fixator after adequate reposition. For the reconstruction of bone defect of the tibia we used the method of bone transport using the Ilizarov external fixator. CONCLUSION: Radical wound debridement, abundant rinsing, leaving the wound open, administration of antibiotics and antitetanus immunization, external fixation and early reconstruction of soft tissue and bone defects are the basic elements of the treatment of serious fractures caused by war injuries and aimed at saving the extremities.

[Determinants of the most significant characteristics of reproductive health].

INTRODUCTION: Reproductive health of women is determined by females' demographic and socio-economic characteristics, their behaviour, and the complex of environmental factors. OBJECTIVE: The paper examines the predictive impact of personal and environmental characteristics, health and healthcare characteristics regarding the most important aspects of reproductive health. METHODS: From a sample of 2,718 women, aged 20-49 years, we collected information on various characteristics using a structured questionnaire. Based on factorial analysis (principal components method, Kaisser Varimax criterion) we selected representative variables (factors), describing personal (demographic and socio-economic) characteristics of women, their environment (family, household, community), health (attitudes towards health, life-style, health status), healthcare (independent) and the characteristics of reproductive health (dependent variables). The predictors were analyzed by multiple regression and correlation. RESULTS: Sexual behaviour was determined by socio-economic status, personal tidiness, rest, presence of risk factor(s), health evaluation and attitude toward personal responsibility, trust in physicians etc. The predictors of contraception involved satisfaction with one's own health, serious health problems, health evaluation. The presence and number of abortions were determined by personal psychological maturity, rest, risk factors, life-style, health evaluation and its manifestations, and the continuity and timely healthcare.The predictors of adequate protection of reproductive health involved the cultural level of the community, financial standing of the household, satisfaction with one's own life, tidiness and rest, presence of risk factors, health evaluation, attitude towards personal responsibility, and trust in physicians. HIV control was determined by satisfaction with one's own life, physical activity of women, presence of serious health problems, and the content of primary healthcare. Postpartal protection was determined by the cultural level of the community, reasons for dissatisfaction with one's own life, presence of risk factors and deficiencies, and timely contraception. The predictors of reproductive period duration are availability of health care in a community and personal tidiness of women. CONCLUSION: The study confirmed predictive impact of most of the studied characteristics.

General characteristics of adolescent sexual behaviour: national survey.

INTRODUCTION: Investigation of adolescent sexual behaviour carried out on a large sample is primarily motivated by health and social problems which can occur when young people practice sex without protection and necessary information. There is no data that the national study on adolescent sexual behaviour has been conducted in the Serbian speaking area. OBJECTIVE: Monitoring and follow-up of trends in adolescent sexual behaviour. METHODS: The investigation sample comprised 1101 adolescents (472 male and 629 female), aged 13-25 years. As an instrument of polling, the questionnaire "Sexual Behaviour" was used specifically designed for the purpose of this investigation. RESULTS: Eighty-four percent of males and 65% of females reported having sexual experience. The age of the first sexual experience, total number of partners, number of sexual partners in the last year and the last month were investigated, and the number of loved and sexual partner compared. In addition, the length of foreplay, frequency of sexual activity, masturbation, sexual dreams and sexual daydreams and engagement into alternative sexual activities (oral sex, anal sex, group sex, exchange of partners) were estimated, as well as the reasons for their practicing. Sexual desire and its correlation with personality dimensions, the frequency of sexual disorders (erectile and ejaculation problems, anorgasmia), abortion, rape and identification of the rapist, the use of condoms and other methods of contraception were assessed. CONCLUSION: It could be postulated that biological influence on sexual behaviour is powerful and resistant to the influence of time and place, as well as socio-cultural religious influences. A high rate of premarital sexual activity with a number of sexual partners, a relatively low rate of condom use and the fact that 4% of the female adolescents in this sample had an induced abortion suggest that there are gaps in the education provided to adolescents about sexual and reproductive risks within the Serbian speaking territory. An alarming statistic is that 5% of the female adolescents in this sample reported that they had been raped, or forced to participate in non-consensual sex within an ongoing relationship with a regular partner. There is a need for systemic changes within the field of sexual education and protection from sexually risky behaviour among young adults.

Sentinel node biopsy for skin melanoma.

BACKGROUND/AIM: Skin melanoma is one of the most malignant diseases with increasing incidence rate. Sentinel node biopsy (SNB) is very important for early detection of metastatic spread. The aim of the study was to analyze the first 40 patients with skin melanoma of 1 to 4 mm Breslow thickness when SNB was indicated. METHODS: The patient characteristics, localization of the primary melanoma as well as histology grade were analyzed. SNB with intraoperative radiocolloid and methylene blue dye detection was performed. RESULTS: Complication rate after SNB was analyzed and seroma was found in 5% of the patients. The therapeutic node dissection was performed in 10 patients with positive sentinel biopsy. The follow-up lasted two years. In five patients the false negative SNB was defined after the mean time of 11 months and the therapeutic dissection was performed. CONCLUSION: SNB in melanoma patients is a useful diagnostic procedure. It is advised for melanoma of 1 to 4 mm Breslow thickness.