CYBERBULLYING AMONG ADOLESCENTS AND ONLINE INFORMATION SEEKING ABOUT MENTAL HEALTH

Background: Cyberbullying is a serious problem among adolescents and has an impact on mental health. The purpose of this study was to: 1) translate and validate the Cyberbullying and Online Aggression Survey in the Serbian language; 2) explore factors associated with more intense cyber victimization and cyber offending and 3) examine whether more intense cyber victimization and cyber offending are associated with a higher likelihood of online search for topics on mental health in a sample of high school students. Subjects and Methods: A total of 702 students from 4 public high schools participated in this cross-sectional study. Data were collected using a general questionnaire and the Cyberbullying and Online Aggression Survey. Internal consistency of the questionnaire was examined and confirmatory factor analysis was conducted to assess construct validity. The multiple linear regression model examined factors associated with higher levels of cyber offending and cyber victimization. The multiple logistic regression models examined whether cyber offending and cyber victimizations were associated with searching for mental health topics on the Internet. Results: Cronbach’s alpha for the Cyberbullying Victimization Scale was 0.813 and for the Cyberbullying Offending Scale was 0.789. Both scales had a one-factorial structure and parameters on the confirmatory factor analysis were appropriate. More than one-half of students (56.2%) reported ever being cyber victimized and 39.9% of students reported ever being cyber offenders. Having lower grades, being younger at first Internet use and more frequent use of the internet were associated with both higher Cyberbullying Victimization and Offending scores. Having higher scores on both Cyberbullying Victimization and Offending scales was associated with higher odds of searching for mental health topics online. Conclusion: It is necessary to address cyberbullying in schools to help recognize and modify the behavior of cyber offenders and provide means of support and empowerment to cyber victims

Frequency, risk factors and outcomes of falls in patients with Parkinson's disease

Ciljevi ove studije bili su procena učestalosti padova, faktora rizika i procena ishoda padova kod bolesnika sa Parkinsonovom bolešću (PB). Osim toga, ispitivane su karakteristike padova među svim regrutovanim bolesnicima i među onima koji su bili praćeni godinu dana. Takođe, ispitivane su kliničke karakteristike pacijenata koji su doživeli pad i onih koji nisu, kao i njihov kvalitet života. Hibridna studija je obuhvatila 300 bolesnika koji su lečeni u ambulantama Odeljenja za poremećaje pokreta Klinike za neurologiju Kliničkog Centra Srbije. Studija je sprovedena u periodu od 2011. do 2013. godine. Kriterijumi za uključivanje su bili dijagnoza PB prema the British Brain Bank criteria, Mini Mental Test skor ≥24, mogućnost samostalnog hoda u dužini od 10 m, mogućnost stajanja tokom 90 sekundi i pismena saglasnost bolesnika. Kriterijumi za uključivanje u kohortu koja se prati: odsustvo padova u proteklih 6 meseci. Kriterijumi za isključivanje iz studije su bili prisustvo drugih neuroloških, psihijatrijskih, oftalmoloških, vestibularnih, auditivnih i ortopedskih poremećaja. Podaci su prikupljeni putem sledećih upitnika: opšti upitnik, upitnik o PB, skala za za procenu rizika od pada (FES), skala za samoprocenu onesposobljenosti (SADS), Hamiltonova skala za depresiju (HDRS), Hamiltonova skala za anksioznost (HARS), upitnik o kvalitetu života (SF-36), novi upitnik za procenu freezing-a (NFOG), skala za procenu stadijuma bolesti (HY), skala za procenu funkcionisanja u PB (UPDRS) i dnevnik padova. U statističkoj obradi podataka su korišćene metode deskriptivne statistike, χ2 test, Man-Vitnijev U test, analiza varijanse (ANOVA), korelaciona kao i univarijantna i multivarijantna regresiona analiza. Učestalost padova na nivou čitavog uzorka pacijenata je bila 60%, dok je u kohorti nakon jednogodišnjeg praćenja prevalencija bila 30,8%. Najčešći ishod pada je bila kontuzija mekih tkiva dok je najređa fraktura. U kohorti za praćenje stopa incidencije padova je iznosila 8,9/100 pacijenata-meseci praćenja. U pogledu pola, primećeno je da je stopa padova kod muškaraca bila skoro 2 puta veća u odnosu na žene. Svi klinički parametri su bili statistički značajno lošiji kod pacijenata koji su doživeli pad u periodu od 6 meseci pre testiranja u odnosu na one koji nisu pali. Svi domeni kvaliteta života, osim onesposobljenost zbog emocionalnih problema, kao i oba kompozitna i ukupni skor kvaliteta života su bili statistički značajno viši kod pacijenata koji nisu doživeli pad u odnosu na one koji su padali u periodu od 6 meseci pre testiranja...The aims of this study were assessment of frequency of falls, risk factors and outcomes of falls in patients with Parkinson's disease (PD). In addition, charachteristics of falls were analyzed in the total sample of patients as well as among those in follow-up cohort during the period of one year. Also, we assessed clinical parametars in patient who experienced falls 6 months prior to testing and in those who were non-fallers and estimated their health-related quality of life (HRQL). A hybrid study with 300 patients was conducted at the Department of Movement Disorders, Neurology Clinic, Clinical center of Serbia in Belgrade during their regular check-ups. The inclusion criteria were following: the PD diagnosis made in accordance with the UK PDS Brain Bank criteria, Mini Mental State Examination (MMSE) score of 24 and above, ability to walk independently for at least 10 m, ability to stand for at least 90 seconds and signed informed consent. The inclusion criteria for the folow-up cohort was absence of falls during 6 months prior to testing. The exclusion criteria included the presence of one or more neurologic, psychiatric, visual, audio-vestibular and orthopedic disturbances. Data was obtained through general questionanire, questionnare on PD, Falls Efficacy Scale (FES), Self-assesment Disability Scale (SADS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), SF-36 questionanire for assessment of HRQL, New Freezing of Gait Questionnaire (NFOG), Hoehn and Yahr PD staging scale (HY), Unified Parkinson's Disease Rating Scale (UPDRS) and falls diary. The statistical assessment comprised descriptive statistics, χ2-test, Mann-Whitney U test, analysis of variance (ANOVA), correlation as well as univariate and multivariate regression analysis. The frequency of falls in the total sample of patients was 60%, wheareas the prevalence in the follow-up cohort after one year was 30,8%. The most frequent outcome of falls was contusion of soft tissues, while the least frequent one was a fracture. The incidence of falls int he follow-up cohort was 8.9/100 patient-months. The incidence of falls was two times higher in men than in women. All clinical characteristics were statistically significantly worse in patients who experienced falls during 6 mnths before testing. All HRQL domains, except Role Emotional, both composite scores and the total score were statistically significantly higher in non-fallers..

Trends in HPV Vaccine Initiation and Completion among Girls in Texas: Behavioral Risk Factor Surveillance System Data, 2008–2010

Objective: The objective of this study was to evaluate the trend of HPV vaccine initiation and completion among girls in Texas from 2008 to 2010. Methods: Data were obtained from the Behavioral Risk Factors Surveillance System (BRFSS) over 3 years (2008–2010). The information regarding HPV vaccination was gathered from the parents of 9- to 17-year-old daughters (choosing only 1 per household) in randomly selected households in the sample area. Results: The highest prevalence of vaccine initiation and completion were detected in 2010 (20.9% and 9.7%, respectively). Over the study period, HPV vaccine initiation statistically significantly increased (2008, 14.9%; 2009, 20.7%; 2010, 24.3%; p = 0.002), corresponding to an annual increase in coverage of 33.5% (odds ratio [OR] = 1.33; 95% confidence interval [CI]: 1.11–1.60). Similarly, HPV vaccination completion increased (2008, 6.3%; 2009, 9.6%; 2010, 11.6%; p = 0.021), corresponding to an annual increase in coverage of 37.1% (OR = 1.37; 95% CI: 1.05–1.79). Increasing trends in HPV vaccination initiation and completion were observed in mothers, white, non- Hispanic parents, parents who had attended some college or were college graduates, parents who were married/partnered, and parents who lived in urban areas. Conclusion: Although HPV vaccination coverage in Texas is lower than recommended, there have been increases in the trends of vaccine initiation and completion. The campaigns promoting HPV vaccination should target specific population groups in which HPV immunization rates did not increase over time

Flu vaccination among older persons: study of knowledge and practices

Background: Surveys of older adults\u2019 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 Vra\u10dar (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\u2013January 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\u20134 points), moderate (5\u20138 points), good (9\u201313 points) , and excellent (14\u201317 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 \u201cthey were in good health\u201d (33.5%) and because \u201cthey did not believe that vaccine protects from flu\u201d (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

Stavovi studenata prve godine u odnosu na šestu godinu medicine u Srbiji prema studiju i poslijediplomskoj karijeri

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.Stres tijekom studija medicine mogao bi utjecati na predstojeće izbore u karijeri. Svrha ovog rada bila je istražiti stavove i potencijalne razlike između studenata prve i šeste godine medicine u vezi studija i daljnjih planova u karijeri. Ukupno 570 studenata prve i 400 studenata šeste godine studija na Medicinskom fakultetu Sveučilišta u Beogradu bili su regrutirani za studiju u razdoblju od 2. do 9. prosinca 2013. godine. Podaci su dobiveni putem anonimnog upitnika. Studenti u obje godine ocijenili su “Pomaganje drugim ljudima” kao najvažniji razlog za studij medicine. Brucoši su statistički značajno više ocijenili razloge “dobri prihodi” i “ socijalni status” za studij medicine (p=0,003 odnosno p=0,037). Najpoželjnije specijalizacije bile su kirurgija i interna medicina (36,4% odnosno 18,7% za prvu godinu i 26,3% odnosno 36,6% za šestu godinu). Statistički značajno više brucoša radije bi radili u inozemstvu (χ2=3,891, p=0,029). Studenti koji bi radili u inozemstvu izrazili su najveći interes za rad u zapadnoj i sjevernoj Europi. Želje za specijalizacijom među studentima medicine slijede obrazac najčešćih disciplina među srpskim liječnicima, s rodnim razlikama kakve su prisutne i u drugim populacijama. Određeni postotak studenata vjerojatno će emigrirati

Eating Habits and Body-weights of Students of the University of Belgrade, Serbia: A Cross-sectional Study

The purpose of this survey was to quantify the prevalence of overweight and obesity among a sample of students in Belgrade University, Serbia and to describe their main eating habits. A total of 1,624 questionnaire responses were analyzed (response rate 97.3%). The students were recruited during mandatory annual check-ups in April-June 2009. All subjects completed the questionnaire; height (in cm) and weight (in km) were measured by two physicians. Results were assessed statistically. Almost every fourth male student was overweight. Strikingly, 15% of female students were underweight. Highly-significant difference was found between average body mass index (BMI) of male and female students (F=317.8, p=0.001). Students\u2019 BMI did not correlate with average family income or with the frequency of taking breakfast (p=-0.064, p=0.152 for males and \u3c1=0.034, p=0.282 for females respectively). There is a growing demand for global health strategies which would encourage healthy body-image and figure; thus, these initiatives should mobilize the society on a national and international level

Glaucoma Symptom Scale: Psychometric properties of the Serbian version

Purpose The study aim was to translate and validate the Glaucoma Symptom Scale (GSS) in Serbian language. Methods Clinical parameters and socio-demographic data were collected for each of the 177 enrolled glaucoma patients. Each eye was classified according to the Glaucoma staging system by Mills into 6 stages. Patients filled out the GSS and National Eye Institute Visual Function Questionnaire (NEI-VFQ 25). The GSS comprises 10 complaints common for glaucoma patients on a topical treatment, grouped into two subscales: SYMP-6 (non-visual) and FUNC-4 (visual problems). The GSS was translated following the customary methodology and its psychometric properties were assessed by using both Classical Test Theory (CTT) and Rasch analysis. Results The internal consistency of the Serbian GSS for the whole scale was very good (Cronbach's alpha = 0.81). On factor analysis items were clustered into 2 factors (48.92% of variance) which corresponded to the original scale. The total and subscale GSS scores correlated significantly with measures of disease severity and also with total score and analogous NEI-VFQ 25 subscale scores. In Rasch analysis we obtained adequate item reliability index (0.90). Almost all items had infit and outfit mean squares in the accepted range. However, measurement precision was poor (low person separation reliability) and targeting revealed a ceiling effect. Conclusion When analyzed with CTT the Serbian version of the GSS seems to be a valid instrument, but Rasch analysis revealed some serious measurement flaws, therefore it should not be used in its current format. Further studies to modify and improve GSS are needed prior to its application for Serbian glaucoma patients

Validation of the Glaucoma Quality of Life-15 Questionnaire in Serbian language

AIM: To translate the Glaucoma Quality of Life-15 (GQL-15) to Serbian language and asses its validity and reliability in the population of Serbian patients. METHODS: The study included 177 glaucoma patients. Clinical parameters (visual acuity, mean defect and square root of loss variance of visual field) and socio-demographic data were collected. Patients were stratified according to the Nelson's glaucoma staging system as mild, moderate and advanced glaucoma. All patients filled out the GQL-15 and National Eye Institute Visual Function Questionnaire (NEI-VFQ 25). The GQL-15 was translated following the internationally-accepted methodology, and its psychometric properties were assessed by using classical test theory and Rasch analysis. RESULTS: The mean total score for the GQL-15 was 20.68 +/- 7.31. The Cronbach's alpha coefficient for the whole scale was 0.89 (central and near vision, alpha=0.24; peripheral vision, alpha=0.85; glare and dark adaptation, alpha=0.83). Factor analysis established 4 factors (70.3% of variance): two corresponding to the original factors and two new factors specific for the Serbian population. The GQL-15 score correlated positively with almost all clinical parameters and NEI-VFQ 25 proving good criterion validity. Correlation of the GQL-15 total score on test-retest confirmed appropriate scale reproducibility (rho= 0.96, P lt 0.001). The GQL-15 discriminated well advanced from mild and moderate glaucoma. In Rasch analysis we obtained adequate item (0.95) reliability index. Almost all items had infit and outfit mean squares in the accepted range. CONCLUSION: Serbian version of the GQL-15 demonstrates adequate reliability and validity. This version of the GQL-15 is a valid instrument for evaluation of quality of life among Serbian speaking patients with glaucoma and can be applied in daily clinical work

Compliance and approach to voluntary HIV testing in a high-risk region for HIV transmission in Europe

Background: The Kosovo province is being considered as a high-risk region for the spread of HIV. Objective: To estimate the prevalence and factors associated with HIV testing in a sample of university students from the Serbian northern Kosovo province. Material and Methods: A questionnaire examining socio-demographic characteristics, HIV–related knowledge, attitudes towards people living with HIV (PLHIV) and HIV testing was used in data collection. A total of 1,017 students from the University of Priština temporarily seated in Kosovska Mitrovica completed the questionnaire. Results: Only 5.4% of students have previously been tested for HIV, even though the majority (70.9%) had a positive approach to HIV testing. Factors associated with having been tested for HIV were being male and younger, having interest in HIV testing and having previous contact with PLHIV. Being more knowledgeable about HIV and having stronger positive attitude towards PLHIV, being older, receiving information about HIV through friends and special educational programs, using condom at last sexual intercourse, having positive opinion on gays/lesbians and previous contact with PLHIV were associated with positive approach to HIV testing. Conclusion: Having a positive approach to HIV testing does not suggest that students would take the HIV test. However, students who have low HIV-related knowledge, negative approach or lack of interest in HIV testing (believing that there is no need to take it) would likely never take the HIV test. Increasing HIV-related knowledge, acceptance of PLHIV and access to testing facilities should be public health priorities to raise HIV testing rates. Keywords: HIV testing; attitude; knowledge; University students

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