Politički odgovor na demografske izazove

Populacioni izazovi su visoko rangirani na političkim agendama u XXI veku. Otuda postoji posebna potreba da se proučavaju karakteristike, determinišući faktori, posledice, zakonitosti u kretanju i očekivane promene u budućnosti svakog od izdvojenih populacionih izazova. To je zadatak demografa. Istovremeno se od istraživača nauke o stanovništvu očekuje da pomognu u pronalaženju odgovora na aktuelne dileme sa kojima se vlade suočavaju. To pretpostavlja postojanje dijaloga između demografa i donosilaca odluka. Ova vrsta dijaloga nije tako česta u Srbiji. Ona je bitna da bi populaciona politika bila zasnovana na činjenicama. No, zajedničko razmišljanje demografa i donosilaca odluka o odgovoru na demografske izazove izneto u radu je još značajniji korak od uspostavljanja dijaloga u ovoj sferi. Fokus u radu je na političkom odgovoru Srbije na nizak nivo rađanja, populaciono starenje i veće iseljavanje od useljavanja u zemlju. Pored ocene stanja političkog odgovora u ove tri sfere, iznesena su i očekivanja vezana za nadgradnju političkog odgovora Srbije na izdvojene demografske probleme, zasnovana na relevantnim teorijskim razmatranjima, rezultatima sprovedenih istraživanja, iskustvima drugih zemalja i preporukama međunarodnih organizacija

Predictive value of cerebrospinal fluid visinin-like protein-1 levels for Alzheimer's disease early detection and differential diagnosis in patients with mild cognitive impairment

Visinin-like protein 1 (VILIP-1) recently emerged as a potential biomarker of Alzheimer's disease (AD). This neuronal calcium sensor protein previously used as a marker of acute ischemic stroke is elevated in the cerebrospinal fluid (CSF) of AD patients. The goal of this study was to assess CSF VILIP-1 potential in early AD diagnosis and in differentiating mild cognitive impairment (MCI) patients with and without risk of AD. Additionally, we tested VILIP-1 ability to differentiate AD from other primary causes of dementia, and predict the progression of AD-related cognitive decline. VILIP-1 levels were compared with five CSF AD biomarkers (t-tau, Aβ1-42, p-tau181, p-tau199, and p-tau231). VILIP-1 successfully differentiated two MCI patient groups characterized by absence or presence of pathological levels of these CSF biomarkers, except for t-tau. VILIP-1/Aβ(1-42) and VILIP-1/p-tau181 ratios also differentiated MCI patients with pathological CSF biomarker levels. However, there was no difference in VILIP-1 levels between AD and MCI patients. VILIP-1/Aβ(1-42) and VILIP-1/p-tau231 ratios reached high sensitivities (above 70%) and very high specificities (above 85%) in differentiating AD patients from HC. Additionally, VILIP-1 differentiated AD from patients with Lewy body disease with 77.1% sensitivity and 100% specificity. VILIP-1 potential as a prognostic biomarker of cognitive decline in AD was also proved since VILIP-1/t-tau, VILIP-1/p-tau181, and VILIP-1/p-tau231 ratios correlated with MMSE scores. These data indicate that VILIP-1 alone or in combination with other AD CSF biomarkers represent a valuable marker for the early diagnosis of AD, recognition of MCI patients at higher risk to develop dementia, and in differentiating AD from LBD

Zuclopenthixol decanoate in pregnancy: Successful outcomes in two consecutive off springs of the same mother

Introduction. Almost all individual antipsychotics are classified into the intermediate pregnancy risk category as no or limited data exist about human pregnancy outcomes. We presented the case of zuclopenthixol decanoate using in two successive pregnancies of the same woman, which had not been published in the available peer-reviewed literature. Case report. A middle-age female subject who suffered from schizophrenia received zuclopenthixol decanoate injection during her two consecutive pregnancies. About four and a half months before diagnosis of the first pregnancy (~3.5 years after psychosis emergence), zuclopenthixol decanoate (400 mg every other week, im injection) was introduced to the treatment protocol (due to previous non-compliance with halo-peridol and risperidone). A significant clinical improvement was achieved and the dose during pregnancy was reduced to 200 mg once monthly and maintained to date. In both pregnancies the women gave birth to healthy girls who have been developing normally until now, at their ages of 6 months and of 3.5 years. During pregnancy and after giving birth to children the mothers' psychiatric status and her social functioning were significantly improved and are still stable. Close monitoring of the mother's health, a multidisciplinary approach to both her treatment and the monitoring of pregnancies as well as the complete compliance with the prescribed drug protocol were likely to be crucial for the therapeutic success. Conclusion. A favorable outcome of the present case suggests that the zuclopenthixol decanoate is a rational therapeutic option for pregnant women suffering from psychosis when the expected benefit exceed the potential risk, but a definitive evidence for its safety requires large, controlled studies

Healthcare Professionals’ Knowledge and Behaviors Regarding Drug–Dietary Supplement and Drug–Herbal Product Interactions

Given the widespread use of dietary supplements (DS) and herbal products (HP), healthcare professionals (HCPs) will increasingly encounter patients who use these preparations with conventional drugs and who need their services to reduce the consequences of adverse therapeutic outcomes. The aim of our survey was to assess the knowledge and behaviors of HCPs regarding the risk of potential drug–dietary supplement (DDSIs) and drug–herbal product (DHPIs) interactions. This cross-sectional survey collected data via on paper-based questionnaire among general practitioners (GPs) (n = 105), specialty doctors (n = 87) and nurses (n = 154). The HCPs were mostly familiar with the interaction of doxycycline with magnesium (83%) and were least familiar with interaction of warfarin with glucosamine (14%). The results on DDSIs and DHPIs knowledge showed that GPs scored significantly higher than nurses (p < 0.001 and p = 0.003, respectively), while specialty doctors scored significantly higher than nurses only on DDSIs knowledge (p < 0.001). Only 28% of respondents reported that they often or always ask patients on drug therapy about the use of DS or HP, and 25% of respondents record such data in the medical documentation of patients. Our results showed that HCPs have sufficient knowledge about most major DDSIs and DHPIs, but insufficient knowledge about most moderate interactions. However, their overall knowledge and behavior regarding the risk of these interactions indicate the need for further continuing education and trainin

PyFlies: A Domain-Specific Language for Designing Experiments in Psychology

The majority of studies in psychology are nowadays performed using computers. In the past, access to good quality software was limited, but in the last two decades things have changed and today we have an array of good and easily accessible open-source software to choose from. However, experiment builders are either GUI-centric or based on general-purpose programming languages which require programming skills. In this paper, we investigate an approach based on domain-specific languages which enables a text-based experiment development using domain-specific concepts, enabling practitioners with limited or no programming skills to develop psychology tests. To investigate our approach, we created PyFlies, a domain-specific language for designing experiments in psychology, which we present in this paper. The language is tailored for the domain of psychological studies. The aim is to capture the essence of the experiment design in a concise and highly readable textual form. The editor for the language is built as an extension for Visual Studio Code, one of the most popular programming editors today. From the experiment description, various targets can be automatically produced. In this version, we provide a code generator for the PsychoPy library while generators for other target platforms are planned. We discuss the language, its concepts, syntax, some current limitations, and development directions. We investigate the language using a case study of the implementation of the Eriksen flanker task

Preeclampsia and level of oxidative stress in the first trimester of pregnancy

Background/Aim. Preeclampsia (PE) is a multisystemic syndrome that complicates 5–8% of all pregnancies. The aim of this study was to evaluate the biochemical parameters of oxidative stress in the first trimester of pregnancy in patients with preeclampsia, with the purpose of comparing the level of oxidative stress with normal pregnancy. Methods. The study was conducted as a prospective study. It included totally 107 pregnant women divided into two groups. In the study group (n = 33) there were women who developed preeclampsia in the current pregnancy. The control group (n = 74) included healthy pregnant women. Blood samples were taken between 11th and 14th weeks of gestation, and the values of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and total antioxidant status (TAS) were determined in serum by enzymatic colorimetric methods. Results. The values of SOD and GHS-Px were statistically higher in the study group, while the values of TAS were statistically higher in the control group. The level of TAS inversely correlated with GSH-Px and SOD, but there is no statistically significant correlation between GSHPx and SOD in the study group. Conclusion. The results of this study suggest a higher level of oxidative stress in the first trimester of pregnancy with preeclampsia, which may indicate that the initiation and development of pathophysiological processes underlying preeclampsia start much earlier than the clinical syndrome exhibit. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 174019

Cognitive functions of patients with epilepsy treated by topiramate

Topiramate is a newer drug with a strong antiepileptic potential, but also with adverse effects, especially on cognitive functions. This review deals with the study covering the impact of topiramate on cognition in patients with epilepsy. The most common side effects are included somnolence, psychomotor slowing, difficulty in memory, concentration and attention disorder and problems with speaking. Most studies have shown that a high initial dose, rapid titration and application in polytherapy increase the risk of cognitive impairment after-introduction of topiramate. In addition, depression and early onset of the disease can also contribute to cognitive adverse effects, even at low doses of the drug. Although topiramate indisputably linked to the risk of interference cognitive impairments, some studies suggest their reversibility. This, together with high efficiency antiepileptic obliges researchers to continue searching for the risk factors and mechanisms of cognitive side effects in order to define the profile of patients who would be of maximum benefit of the drug in controlling seizures with absent or acceptable side effects

The effects of topiramate on cognitive functions of patients with focal epilepsy - a follow-up study in a Serbian sample

Introduction/Objective. The aim of this follow-up study was to determine the effects of topiramate therapy on cognitive functions in patients with pharmacoresistant focal epilepsy. Methods. The study sample comprised of 40 topiramate naive patients. The topiramate starting dose was 25 mg, with a fortnightly titration schedule of 25 mg. A wide range of cognitive functions was evaluated through extensive neuropsychological testing at baseline and six months after reaching the target dose (200 mg/day). Results. The most common side effects following the introduction of topiramate were cognitive impairments, reported by 45% of the participants. The neuropsychological scores on attention, executive function, verbal content recall, improved cognitive flexibility, as well as visuospatial ability and speech, obtained at six-month follow-up were significantly lower than at baseline. However, statistically significant correlation between neuropsychological scores and the number of antiepileptic drugs taken alongside topiramate could not be established. Similarly, no statistically significant differences were noted between the percentage of reduced neuropsychological scores at follow-up pertaining to patients with lower and higher baseline cognitive performance. Moreover, regression analysis indicates that the percentage change in the majority of cognitive scores is unrelated to the age at the epilepsy onset, epilepsy duration, presence of brain pathology on magnetic resonance imaging and percentage change in the depression scale score. Conclusion. Despite slow introduction and administration of a relatively small dose, topiramate exhibits adverse effects on a wide range of cognitive functions, which appear unrelated to the number of additional antiepileptic drugs, baseline cognitive functioning, age at the onset of epilepsy and its duration, presence of brain pathology and the extent of depressive symptoms

The importance of functional hemispheric asymmetry in the assessment of cognitive evoked potentials and reaction time

The aim of this study was to determine whether there is a correlation of latency and amplitude of P300 cognitive potential and the degree of lateralization of brain hemispheres. The study included 60 subjects whose age was between 45 and 56 years. Bioelectric brain activity was recorded using argentum chloride (AgCl) electrodes that were placed at central line of the scalp (over Fz and Cz regions) according to the international 10-20 standard. P300 was generated using 'oddball' paradigm with randomized stimuli: A frequent 1000 Hz tone with an occurrence of 80 % and a 2000 Hz tone (target) with a 20 % occurrence. The measurement is done with the right hand (first recording) and left hand (second recording). All subjects in this study were tested for usage lateralization and showed that they are right-handed. Based on the results of gestural lateralization subjects are divided in three groups. In the group with high degree of lateralization latencies of P300 were significantly lower when dominant hand was used in comparison to non-dominant hand, on Fz electrode (t = 4,162, p0.05) for latencies and amplitudes of P300 between dominant and non-dominant hand for the group of subjects with weak and average degree of lateralization. In both subject groups, significantly faster RT was measured when dominant hand was used. The P300 cognitive potential and reaction time can contribute to the study of indicators of the functional hemispheric asymmetry of the brain