COVID-19-related stress response among adult females: Relevance of sociodemographics, health-related behaviors and COVID-19 contact.

Women were more affected than men during the COVID-19 pandemic. This study aimed to investigate COVID-19-related stress response in adult women and its association with the relevant socioeconomic, lifestyle and COVID-19-related factors. This research was carried out in eight randomly chosen cities from September 2020 to October 2021. To examine stress, we distributed the COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Women also fulfilled a general socio-epidemiologic questionnaire. The study included 1,264 women. Most women were healthy, highly educated, employed, married, nonsmokers who consumed alcohol. The average total CSS score suggested a relatively low COVID-19 related stress), while 1.7% of women had CSS ≥ 100. The mean PSS was around the mid-point value of the scale. Older women, who were not in a relationship, didn't smoke, didn't drink alcohol, but used immune boosters, had chronic illnesses and reported losing money during the pandemic had higher CSS scores. A higher level of stress was also experienced by women exposed to the intense reporting about COVID-19, had contact with COVID-19 positive people or took care of COVID-19 positive family members. In this sample of predominantly highly educated women few women experienced very high stress level, probably due to the study timing (after the initial wave) when the pandemic saw attenuated stress levels. To relieve women from stress, structural organization and planning in terms of health care delivery, offsetting economic losses, controlled information dissemination and psychological support for women are needed.

Relationship between socio-descriptive characteristics, burnout syndrome, and quality of life of employees.

Introduction: Burnout syndrome develops as a consequence of chronic stress among employees. The study objective was to examine what socio-descriptive characteristics of employees might be associated with the appearance of the occupational burnout and to evaluate the relationship between job burnout and the quality of life among security employees of the professional private security sector in Central Serbia. Methods: A multicenter cross-sectional questionnaire-based study was performed. A multivariate logistic regression analysis and ANOVA post choc test was applied. Results: A total of 353 respondents (330 male and 23 female) participated in the study. Female sex and older age were associated with a higher risk of total burnout and the development of emotional exhaustion while male sex, higher education, and managerial position were associated with higher personal achievement and lower risk of total burnout. Male sex, marital union, two or more children, and direct contact with clients were significantly associated with a lower quality of life of employees. A significant negative correlation was found between total burnout and the Physical Health Composite Score (PHC) score with a correlation coefficient (rs) of -0.265 (95%CI from -0.361 to -0.163); between total burnout and the and Mental Health Composite Score (MHC) score with a rs of -0.391 (95%CI from -0.480 to -0.301); and between total burnout and TQL score with a rs of -0.351 (95%CI from -0.445 to -0.258). Conclusion: Female sex and older age were associated with a higher risk of total burnout and the development of EE while a managerial position and higher education were protective factors in relation to the development of burnout. Male sex, marital union, two or more children, and direct contact with clients were significantly associated with a lower quality of life of the employees. Shift work significantly reduced the total quality of life, while managerial positions increased the quality of life.

The measles epidemic in northern Kosovo and Metohija, Serbia, October 2017-August 2019.

INTRODUCTION: Measles is among the most contagious and vaccine-preventable respiratory diseases. The aim of this research was to describe the socio-demographic profile, clinical manifestations and laboratory parameters of measles patients hospitalized at Kosovska Mitrovica Clinical Centre during the 2017-2019 outbreak. METHODOLOGY: The prospective study included all patients that had contracted measles (107) who were hospitalized at Kosovska Mitrovica Clinical Centre during the outbreak. All complications that led to hospitalization were analyzed and the frequencies of complications with respect to patient age and vaccination status were recorded. RESULTS: More than half (51%) of the patients were unvaccinated. Patients' age varied statistically significantly with respect to vaccination status. Pneumonia was noted in 65% of the patients from the younger age group, compared to 32% of adults, and this difference was statistically significant. Hepatitis was a significantly more frequent complication in adults, affecting 36% of measles patients in this age group, compared to only 7% of those aged below 18 years. In the unvaccinated group, 71% pneumonia frequency was noted, compared to 11% and 35% in the vaccinated and unknown vaccination status groups, respectively. The differences in frequencies based on vaccination status were statistically significant. CONCLUSIONS: Most hospitalized patients were unvaccinated. Complications showed a significant difference with respect to the age and vaccination status of patients. Therefore, it is necessary to carry out continuous health promotion activities to raise awareness among the entire population of the importance and need for vaccination of children against measles, but also adults who have not been previously vaccinated.

Burnout Among Private Security Staff in Serbia: A Multicentic Cross-Sectional Study.

Background: Burnout is a special a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. Objectives: To evaluate the predictors of burnout among work staff in the seven private agencies for support and defense of persons and their property. Material and Method: We performed a multicentric cross-sectional study that involved representative sample of working staff from Agencies of Private Security in Central Serbia. Burnout was assessed using Maslach Burnout Inventory- (MBI)-Human Services Survey. Results: A total number of participants were 353 (330 men and 23 women). Measured level of burnout as assessed by high emotional exhaustion, high depersonalization, and low personal accomplishment was 66.3, 82.4, and 13.4%, respectively. We identified that female gender, younger age, shorter work experience, working in shifts, working 12 h a day and more than 8-12 h a day as well as dissatisfaction with working conditions. Work in shifts, working 12 h a day and more than 8-12 h a day and dissatisfied with dissatisfaction with working conditions significantly increase the risk of total burnout. Conclusion: Our results showed that significant predictors for the development of burnout syndrome were female gender, younger age, shorter work experience, working in shifts, as well as dissatisfaction with working conditions.

Validation of the Study Burnout Inventory and the Copenhagen Burnout Inventory for the use among medical students.

OBJECTIVES: The aim of this study was to assess the validity and reliability of the Serbian versions of the Copenhagen Burnout Inventory (CBI) and the Study Burnout Inventory (SBI) among fifth-year medical students at 5 universities in Serbia. MATERIAL AND METHODS: The study included 573 fifthyear medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis. RESULTS: Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors. CONCLUSIONS: This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population. Int J Occup Med Environ Health. 2021;34(6):737-45.

The Burnout Syndrome in Medical Academia: Psychometric Properties of the Serbian Version of the Maslach Burnout Inventory-Educators Survey.

The aim of this study was to assess the psychometric properties of the Maslach Burnout Inventory-Educators Survey (MBI-ES). The presence of burnout syndrome, its relationship with personality traits, intention to change career and work abroad were assessed in a cross-sectional multi-center trial conducted among educators at three medical faculties in the Western Balkans during 2019. Translation and cultural adaptation were made based on internationally accepted principles. Personality traits were assessed by the Big Five Plus Two questionnaire. In total, 246 medical faculty members, predominantly females (61%), were enrolled. The three-factor structure of the MBI-ES questionnaire (exhaustion, cynicism, and professional efficacy) was validated. Analysis of internal consistency yielded a Cronbach's alpha of 0.785, indicating scale reliability. The majority of respondents (85.6%) reported moderate level of burnout. Aggressiveness, neuroticism, and negative valence were associated with emotional exhaustion and depersonalization, while extraversion, conscientiousness, openness, and positive valence correlated with personal accomplishment. Emotional exhaustion and depersonalization in a multivariate regression model were significantly associated with intentions to change career and work abroad (p < 0.05). The present study provided evidence for the appropriate metric properties of the Serbian version of MBI-ES. Presence of burnout syndrome, which was identified as a common problem in medical academia, and directly linked to personality traits, affected intention to career change and work abroad.

The Impact of Changes in Psoriasis Area and Severity Index by Body Region on Quality of Life in Patients with Psoriasis.

Psoriasis severity varies by body region, with each affected region having a different impact on patient quality of life (QoL). The aim of this study was to assess the impact of changes in the Psoriasis Area and Severity Index (PASI) scores by body region on QoL in patients with psoriasis after treatment. A total of 100 patients with psoriasis were recruited to the study. All patients completed the generic EuroQol-5D instrument and two specific QoL measures, Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI) at the beginning of the study, and 50 patients successfully completed the same questionnaires four weeks after the end of the treatment. Clinical severity was assessed using PASI total score and PASI body region (head, trunk, arms, and legs) scores. QoL improved after treatment, and PASI improvements on visible body regions (head, legs, and arms) showed significant correlation with the most sub-areas of the Visual Analog Scale (EQ VAS), DLQI, and PDI. Multiple linear regression analysis revealed that PASI improvement (particularly on the head), sex, age, and disease duration were predictors of QoL score changes for most domains of the three instruments. Improvement of psoriasis in visible body regions has an appreciable influence on QoL improvement, and may positively affect treatment success in patients with psoriasis.

Cross sectional study on attitudes of Serbian mothers with preschool children: should a HIV-positive female teacher be allowed to continue teaching in school?

BACKGROUND: HIV/AIDS continues to be a serious challenge to public health and human rights in the new millennium. The objective of this survey was to identify the correlation between socio-demographic characteristics and knowledge, attitudes and practices of mothers with preschool children, and their attitude towards whether a HIV-positive female teacher should be allowed to continue teaching in school. METHOD: This survey was additional study analysis of the Multiple Indicator Cluster Survey (MICS) in the Republic of Serbia conducted in the period November-December 2010 following the UNICEF methodology. Women deemed eligible for the survey were those who had children under five, had never lost a child, were not pregnant at the time of inquiry and who had a clear attitude ("yes" or "no") towards whether a HIV-positive female teacher should be allowed to continue teaching in school. The criteria were met by 2309 out of 2992 interviewed women. Pearson chi-square and t-test were used to analyse the differences in respondents' attitude towards whether a HIV-positive female teacher should be allowed to continue teaching in school. Variables that were significantly associated with the dependent variable (p < 0.05) were entered into a multiple logistic regression model. RESULTS: The respondents who were more likely to think that a HIV positive teacher should not be allowed to teach in school were those: who did not know that a healthy-looking person can be HIV-positive (OR = 1.84; 95% CI = 1.19-2.83), who would not buy (OR = 29.90; 95% CI = 22.52-39.71) or did not know/were not sure (OR = 2.21; 95% CI = 1.46-3.33) whether they would buy vegetables from a HIV-positive vendor and women who did not know/were not sure (OR = 2.97; 95% CI = 1.64-5.39) whether they would take care of a family member sick with AIDS in their own home. CONCLUSION: Misconceptions about HIV transmission represent a major barrier to combating HIV/AIDS epidemic and HIV/AIDS-related stigma. It is, therefore, necessary to continue education and raising awareness of human rights both among the population living with HIV and the general population.

Predictors of Depression Problems of Adults Who Live in the Security Endangered Territory.

INTRODUCTION: By the year 2020, if current trends for demographic and epidemiological transition continue, the burden of depression will have increased to 5.7% of the total burden of disease, thus becoming the second leading cause of disability-adjusted life year (DALY) lost. Early detection of people at risk of developing any mental disorder is extremely important in the prevention of all mental disorders. OBJECTIVE: The objective of the study was to determine depression predictors among adult residents in four Kosovo and Metohia municipalities predominantly inhabited by Serbian population. METHODS: This cross-sectional study included the representative sample of adults in Leposavic, North Kosovska Mitrovica, Gnjilane and Pristina and was performed in October/November of 2009. The sample was selected from the list of citizens older than 18, received in the above mentioned municipalities. The Goldberg General Health Questionnaire (GHQ-28) was used as a research instrument. The methods of statistical analysis included descriptive statistics, simple and multiple logistic regression analysis, and analysis of variance, with a significance level of 0.05. RESULTS: Problems with depression have been significantly associated with female sex (OR=2.24), older age (OR=1.01), lower levels of education (OR=0.50), unemployment (OR=1.09), poor financial situation (OR=0.45), abuse (OR=0.08) and assessment of the future political and security situation as a highly risky one (OR=3.01). CONCLUSION: To determine risk groups being in greater risk to suffer from depression is important for planning, enhancing, promoting and implementing the prevention strategies for this disease.

Assessment of mental health in adults of the northern part of the city of Kosovska Mitrovica.

BACKGROUND/AIM: Mental health disorders lead to disorder of effective functioning of people and deterioration of quality of life. Early detection of individuals at risk of mental health disorders is extremely important from the aspect of mental health disorders prevention. The aim of the research was to determine the frequency of mental health problems among adult residents of northern Kosovska Mitrovica and to examine the association between frequency of mental health problems and socio-demographic and other characteristics of the population obtained by the questionnaire. METHODS: The cross-sectional study on the representative sample of adult residents of northern Kosovska Mitrovica was performed in October 2009. To obtain information about the characteristics of mental health the Goldberg's General Health Questionnaire (GHQ-28) was used. For performing survey at site the method of rapid epidemiological assessment was chosen. Statistical analysis included the methods of descriptive statistics, multivariate regression analysis and calculation of the Cronbach's alpha coefficient of internal consistency of the questionnaire. RESULTS: Mental health problems (total score) were present in almost half of the respondents (49.2%). Psychosomatic problems were present in more than half of the respondents (55.4%), while anxiety and insomnia were present in almost half of the respondents (49.2%). Social dysfunction had more than three fifths of the respondents (63.1%) and depression more than a quarter of the respondents (28.5%). More positive responses in the questionnaire were statistically significantly associated with older age, poor financial situation, abuse and assessing of the current political-security situation as high risk. The value of Cronbach's alpha coefficient was 0.705. CONCLUSIONS: Almost half of the respondents (49.2%) of North Kosovska Mitrovica had mental health problems. Mental health problems were associated with older age, poor financial situation, abuse and considering the current political-security situation as high-risk factor.

[Predictors of self-rated health of citizens on the territory of endangered political security].

INTRODUCTION: Self-rated health is generally accepted by researchers as a valid measure of health status. The aims of the study were to investigate how the adult inhabitants of northern Kosovska Mitrovica described their health and which variables were the predictors of self-rated health status among that population. METHOD: The research was done as a cross-sectional study on the representative sample of 318 adult inhabitants of northern Kosovska Mitrovica in 2006. The instrument of research was a questionnaire containing questions about self-rated health and demographic and socio-economic characteristics, mental health, social interaction, possibilities of performing everyday activities, health behaviour and habits, diseases and injuries, utilization of health care service. The independent variables were defined through the factor analysis taken from these groups of questions. The multivariate stepwise linear regression was done to determine the correlation between self-rated health and independent variables. RESULTS: More than half of the respondents (54.7%) assessed their health as good or very good. The predictors of self-rated health were gender, mood problems, myocardial infarction, chronic bronchitis, psychic and neurotic disorders, rheumatic arthritis, high blood sugar, utilization of private gynaecologist service and paying for diagnostic service. CONCLUSION: Most of the respondents from northern Kosovska Mitrovica assessed their own health as good or very good. Bad and very bad health was significantly associated with females, problems with mood, myocardial infarction, chronic bronchitis, psychic or neurotic disorders, rheumatoid arthritis and high blood sugar. Good and very good health was significantly associated with utilization of private gynaecologist service and paying for diagnostic service.

[Health state of the citizens of northern Kosovska Mitrovica].

INTRODUCTION: For health assessment, beside the data of routine health statistics, it is necessary to include and data obtained by a health survey of the citizens. OBJECTIVE: The aim of this study was to establish how northern Kosovska Mitrovica adults assess their health and which diseases are most common among the population, as well as to investigate differences in relation to demographic and socioeconomic characteristics, the characteristics of social interaction and health behaviour and habits. METHODS: The research was conducted as a cross-sectional study conducted on the representative sample of adult citizens in northern Kosovska Mitrovica in 2006. Two hundred-eighteen respondents were included in the survey. In the research we used a questionnaire identical to the Health Survey conducted in Serbia in 2006. The significance of differences in responses about self-rated health and chronic diseases in relation to the characteristics of respondents' responses were determined by chi2-test with the significance level of 0.05. RESULTS: Over half of the respondents (54.7%) assessed their health condition as good or very good. There was a significant difference in self-rated health in relation to the respondents' age (chi2 = 202.036; p = 0.000), education (chi2 = 72.412; p = 0.000), social support (chi2 = 12.416; p = 0.015), smoking (chi2 = 11.675; p = 0.020) and physical activity (chi2 = 61.842; p = 0.000). The leading health problems among the respondents were high blood pressure, rheumatologic diseases of joints, ulcer of the duodenal or gastric ulcer, gall bladder disease and high blood fat. CONCLUSION: Adult residents of northern Kosovska Mitrovica assessed their health as better than the residents of Serbia without Kosovo and Metohia. The diseases in which stress plays the major role among etiological factors are in the leading position. The obtained data on the population level of specific areas represent the basis in the planning of health education and health promotion activities.