Analysis of the Professional Aspects of Medical Drugs Industry in the Republic of Serbia in Times of COVID-19 Pandemic

The research subject of this paper is the analysis of the attitudes of employees in pharmaceutical companies towards the business aspects of the pharmaceutical industry during and after the end of the pandemic in the Republic of Serbia. The aim is to examine the differences in the attitudes of employees, as well as to determine which variables predict the situations of endangering the professional reputation of pharmaceutical companies during the COVID-19 pandemic. The research was conducted by means of a survey during 2021 on a sample of 27 innovative and generic pharmaceutical companies. We used the SPSS program for descriptive statistics analysis, chi square test and binary logistic regression models. The findings show that there is a statistically significant difference in the expressed attitudes of employees in innovative and generic pharmaceutical companies in terms of coming to the office during the pandemic; the lack of medicines and medical devices used in the treatment of COVID-19 infections; the patient access to a chosen doctor; the expectations of the employees to continue working from home after the outbreak of the COVID-19 pandemic. The findings of the binary regression models show the slowdown in the supply chain, the access to doctors and working from the home office have not been perceived as creating situations of endangering professional reputations, that is, they contribute to the sustainable economic success. On the other hand, the introduction of digital technologies decreases the occurrence of conditions in which their professional reputation has been threatened

The Instruments Used to Assess Health Literacy and Pharmacotherapy Literacy of Diabetes Mellitus Type 2 Patients: A Scoping Review

Background: Patients with chronic diseases, like diabetes need to continuously perform tasks associated with self-management especially with medications they use. It is shown that the patients with diabetes with limited HL and PTHL cannot read medication labels correctly, may misuse their medications, spend much more on therapy and generally have difficulties in understanding printed care instructions and perceiving health advice and warnings. There has been an increasing demand for valid and reliable instruments for HL and PTHL assessment in this population. This review aims to search and critically discuss instruments used to assess HL and PTHL in people with type 2 diabetes and propose their use in different settings. Methods: Authors conducted a comprehensive, electronic search of original studies using a structured approach of the Scopus and PubMed databases, during November and the first 2 weeks of December 2020 to find relevant papers. The review was conducted in accordance with the Cochrane guidelines and the reporting was based on the PRISMA-ScR. The comparison of instruments was made by utilizing a comparison model related to their structure, measurement scope, range, psychometric properties, validation, strengths, and limitations. Results: The final number of included studies was 24, extracting the following identified instruments: Korean Functional Test HL, NVS, FCCHL, HLS-EU-47, TOFLHA, S-TOFHLA, REALM-R, 3-brief SQ, REALM, HLQ and DNT-15. In all, FCCHL and 3-brief SQ are shown with the broadest measurement scopes. They are quick, easy, and inexpensive for administration. FCCHL can be considered the most useful and comprehensive instrument to screen for inadequate HL. The limitation is that the English version is not validated. Three-brief SQ has many advantages in comparison to other instruments, including that it is less likely to cause anxiety and shame. These instruments can be considered the best for measuring functional HL in patients with diabetes mellitus type 2 and other chronic diseases. PTHL instruments (REALM and DNT-15) did not find the best application in this population. Conclusions: The future research should be directed in validation of the FCCHL in English and establishing of the structural validity of this questionnaire. Developing a specific PTHL questionnaire for this population will be of great help in management of their disease

TGFB1 Gene Promoter Polymorphisms in Serbian Asthmatics

Background. Asthma is a chronic respiratory disease caused by a combination of genetic and environmental factors. Transforming growth factor beta 1 (TGFB1) is a multifunctional cytokine that plays an important role in airway remodeling in asthma. Objectives. The aim of this study was to analyze common TGFB1 gene promoter polymorphisms C-509T and G-800A in Serbian asthmatics and to investigate their association with exacerbations. Material and Methods. The study involved 102 asthmatics and 58 healthy individuals from Serbia, age and gender matched. An analysis of the TGFB1 promoter was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results. For polymorphism C-509T a significant difference in the allele frequency was observed between the patients and the controls (p = 0.011), while the genotype distribution was similar in the analyzed groups, with statistical significance near the borderline (p = 0.061). For the polymorphism G-800A no difference was observed between the groups. The frequency of the -509TT genotype was higher in patients with exacerbations compared to patients without exacerbations (36.4% vs. 17.0%), with statistical significance near the borderline (p = 0.080). Conclusions. The results suggest that polymorphism C-509T may be associated with asthma and disease exacerbations, while G-800A is not significant for the etiology and clinical course of the disease. These findings should be confirmed in a larger study group, and since the TGFB1 promoter is highly complex and very responsive to environmental factors, future studies should also take other genetic and non-genetic factors into consideration

Cross-Cultural Adaptation and Validation of the Functional, Communicative and Critical Health Literacy Instrument (FCCHL-SR) for Diabetic Patients in Serbia

Thoroughly validated instruments can provide a more accurate and reliable picture of how the instrument works and of the level of health literacy in people with type 2 diabetes mellitus (T2DM). The present work aimed at cross-cultural adaptation and validation of the Functional, Communicative and Critical Health Literacy Instrument (FCCHL) in patients with T2DM in Serbia. After translation and back-translation, views from an expert group, one cognitive interview study (n = 10) and one survey study (n = 130) were conducted among samples of diabetic patients. Item analysis, internal consistency, content validity, confirmatory factor analysis (CFA) and reliability testing were performed. When all 14 items were analyzed, loading factors were above 0.55, but without adequate model fit. After removing two items with the lowest loadings FHL1 and IHL2 the fit indexes indicated a reasonable normed χ2 (SB scaled χ2/df = 1.90). CFI was 0.916 with SRMR = 0.0676 and RMSEA = 0.0831. To determine internal consistency, Cronbach’s alpha coefficient was 0.796 for the whole FCCHL-SR12. With only minor modifications compared to the English version, the 12-item FCCHL instrument is valid and reliable and can be used to measure health literacy among Serbian diabetic patients. However, future research on a larger population in Serbia is necessary for measuring the levels of HL and their relationship with other determinants in this country

Ionizing irradiation affect extracellular nucleotide hydrolysis in brain of rats in different stages of development: i 15-day-old rats

Ionizing radiation affects plasma membrane functions mediated through transmembrane proteins including enzymes. Plasma membrane surface-located enzyme chain of ecto-nucleotide triphospho diphosphohydrolases (NTPDases) are involved in termination of cell purinergic signalization by hydrolysing extracellular adenosine tri- and di-phosphate (ATP and ADP). In the present study, effects of low (50 cGy) and therapeutic (2 Gy) dose of ionizing γ-irradiation on NTPDase activity in early postnatal rat brain neuronal cells were studied. Both low- and therapeutic doses significantly decreased hydrolyze of extracellular ATP (by 11% and 30%) and ADP (18% and 46%) in postnatal rats. These findings indicate that gammaradiation inhibits the enzyme activity in dose-dependent manner. This decreasing NTPDase activity 24h after whole body irradiation may lead to neuronal cell function disturbance, even cell death.Physical chemistry 2008 : 9th international conference on fundamental and applied aspects of physical chemistry; Belgrade (Serbia); 24-28 September 200

Investigating prevalence of beta-2 adrenergic receptors polymorphisms and correlation with therapeutic response in patients with bronchial asthma

Polimorfizmi gena za receptor beta2-adrenergičkih (ADRB2) su klinički relevantni iz nekoliko razloga, uključujući i kao faktor rizika za nastanak astme, stepen njene težine, kao i modulacije efikasnosti terapije beta2-agonista. Cilj ovog istraživanja bio je da se ispita povezanost između ADRB2 polimorfizama gena i astme u srpskoj populaciji, te da se proceni terapijski odgovor u odnosu na ADRB2 genotip. U istraživanju je učestvovalo 171 bolesnika s astmom i 101 zdravih osoba kao kontrolna grupa. Genotipizacija Arg16Gly i Gln27Glu polimorfizama je izvedena direktnim sekvenciranjem prozvoda lančane reakcije polimeraze (PCR). U srpskoj odrasloj populaciji, nosioci 27Gln alela i 27Gln / Gln genotipa su pokazali veći rizik od nastanka astme [(OR) 2.5, 95% interval poverenja (CI) 1,6- 3,8, a OR 3.00, 95% CI 1,7-5,3, odnosno], dok je nađeno da prisustvo 27Glu alela i 27Gln / Glu genotip imaju zaštitni efekat (OR 0.4; 95% CI 0,3-0,6, ili OR, 0.3, 95% CI 0.1-0.7, respektivno). Nadalje, utvrdili smo da prisustvo 27Gln alela u astmatičara mlađih od 50 godina dovodi do boljeg odgovora na terapiju s dugodelujućim beta2-agonistima (LABA) u kombinaciji sa niskim i umerenim dozama inhalacijskih kortikosteroida (ICS), za razliku od starijih gde nosioci 27Glu alela stariji od 50 godina imaju veću verovatnoću da će bolje odgovoriti na LABA + ICS terapiju. U zaključku, identifikovali smo da su u srpskoj odrasloj populaciji 27Gln alel i homozigotna kombinacija 27Gln faktori rizika za nastanak astme, što može biti od kliničkog interesa u prevenciji bolesti...Polymorphisms of beta2-adrenergic receptor gene (ADRB2) are clinically relevant for several reasons, including as a risk factor for asthma development/severity and prediction for the effectiveness of treatment with beta2-agonists in reducing asthma symptoms. The aim of this study was to examine the association between ADRB2 gene polymorphisms and asthma in Serbian population, and to evaluate the therapeutic response in relation to the ADRB2 genotype. The study included 171 patients with asthma and 101 healthy subjects as the control group. Genotyping of Arg16Gly and Gln27Glu polymorphisms was performed by direct sequencing of polymerase chain reaction (PCR) products. In Serbian adults, carriers of the 27Gln allele and 27Gln/Gln genotype were at higher risk of asthma [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.6-3.8, and OR 3.00, 95% CI 1.7-5.3, respectively], while the presence of the 27Glu allele and 27Gln/Glu genotype were found to be protective of asthma (OR 0.4, 95% CI 0.3-0.6, and OR 0.3, 95% CI 0.1-0.7, respectively). Furthermore, we found that the presence of the 27Gln allele in asthmatics younger than 50 years leads to a better response to therapy with long-acting beta2-agonists (LABA) in combination with prevailing low and moderate doses of inhaled corticosteroids (ICS), while carriers of the 27Glu allele over 50 years old are more likely to respond to LABA + ICS therapy. We identified that in Serbian adults the 27Gln allele and 27Gln homozygosity are risk factors for asthma, which may be of clinical interest in disease prevention..

Creative Ability of Students as a Precondition for the Successful Development of Children’s Musical Creativity in Teaching Music in Lower Grades of Primary School

The effectiveness of teaching music in lower grades of primary school depends on competences of pre-service and in-service teachers who have to teach the subject curriculum. During their formal education, student teachers at pedagogical faculties acquire elementary knowledge of the theory of music and didactic-methodical competencies, but the important factor of successful teaching has to be their musical-performing and creative abilities. In this paper we examine the musical and creative abilities of student teachers in the final year of their bachelor studies (N = 48), by analyzing their products within the course of the Methodological Practicum of Music Teaching. Descriptive method and procedure of qualitative analysis of obtained student teachers’ products in the field of music creation were used. The results show that student teachers’ musical and creative abilities and the quality of their creative products do not exceed the level of curriculum requirements for teaching music in the fourth grade of primary school. The aim of this paper is to determine the level of creativity aptitude of student teachers in order to improve it by adequate methodical procedures and training in order to achieve an optimal level sufficient for developing musical and creative activities in teaching young children in a regular school context. On the basis of the obtained results, it can be concluded that frequent neglect of work in the field of developing children’s musical creativity in music teaching practice is connected with teachers’ insecurity about their own creative abilities and competencies necessary for teaching music.Publishe

Globalization and methodology of researches in international trade

The intensive globalization of production at the end of the 20th and the beginning of the 21st century led to a significant distortion of statistical data of the volume of international trade. The usage of these data in quantitative research does not provide reliable information regarding the development potential of a particular export route (orientation) or products. The specific methodological procedure has been proposed in order to correct these data, prior to their application in known econometric models. It includes standard procedures for separation of inter-industry from intra-industry trade, and then the differentiation of horizontal and vertical form of intra-industry exchange. In the last step, the disputed value of exports is identified by marking unusual situation of higher export price of undeveloped economies to the developed ones. This is a result of the multiple crossing of the border of the same products. The obtained corrected value of statistical data can be successfully applied in existing econometric models. The methodological procedure was applied to the selected Serbian export groups of products and several of its key export partner countries. The results show that the statistical value of export is 10% to 40% higher than the real one

Farmakoekonomska evaluacija fakoemulzifikacije i ekstrakapsularne ekstrakcije u operaciji katarakte

Background/Aim. Cataract surgery is one of the most often performed surgical interventions. The predominant method in Western countries is phacoemulsification, while in developing countries, the extracapsular cataract extraction (ECCE) method remains popular. The aim of the study was to evaluate the cost- effectiveness of these two cataract surgery techniques from the provider’s perspective if operation complications were the out- come of the interest. Methods. The data were obtained from the Department of Ophthalmology of the General Hospital Kruševac during a one-year period. A total of 1,179 surgeries by five surgeons were performed. The cost-effectiveness was evaluated using the decision tree. All probabilities were calcu- lated based on the likelihood of the occurrence during the study period. Only direct costs were considered, and values were taken from the documentation at the hospital and the of- ficial price list of health services. One- and two-way sensitivity analyses were performed. Results. The total cost per patient in the phacoemulsification group was 71,008.70 Serbian dinars (RSD), while the total cost in the ECCE group was 74,340.36 RSD. At the same time, phacoemulsification shows higher ef- fectiveness than the ECCE method, with 87% and 57% of pa- tients without complications, respectively. With these results, phacoemulsification was the dominant strategy compared to ECCE. The sensitivity analysis revealed that the results are sen- sitive to the number of performed operations per year. Con- clusion. The phacoemulsification technique seems to be the preferred technique for cataract surgery. All the investment in phacoemulsification equipment and consumables is justified if the number of surgeries per year exceeds 350.Uvod/Cilj. Operacija katarakte predstavlja jednu od najčešće primenjivanih hirurških intervencija. U zapadnim zemljama, dominantna tehnika je fakoemulzifikacija, dok je u zemljama u razvoju najzastupljenija tehnika ekstrakapsularne ekstrakcije (ECCE). Cilj rada bio je da se proceni ekonomska isplativost te dve tehnike operacije katarakte iz perspektive pružaoca usluge, ukoliko se kao ishod posmatraju komplikacije. Metode. Podaci su dobijeni sa Očnog odeljenja Opšte bolnice Kruševac tokom jednogodišnjeg perioda. Ukupno je izvedeno 1 179 operacija od strane pet hirurga. Ekonomska isplativost je procenjena primenom „drveta odlučivanja“. Verovatnoće za događaje su izračunate na osnovu verovatnoće pojavljivanja tokom navedenog perioda. U analizi su razmatrani samo direktni troškovi, a vrednosti su preuzete iz prateće dokumentacije i zvaničnog cenovnika zdravstvenih usluga. Sprovedena je jednosmerna i dvosmerna analiza osetljivosti. Rezultati.Ukupni troškovi u grupi koja je bila podvrgnuta fakoemulzifikaciji iznosili su 71 008.70 srpskih dinara (RSD), dok su u ECC E grupi oni iznosili 74 340.36 RSD. Istovremeno, fakoemulzifikacija je pokazala višu efikasnost u odnosu na ECCE, 87% i 57% bolesnika bez komplikacija, redom. Na osnovu dobijenih rezultata, fakoemulzifikacija je bila dominantna strategija u poređenju sa ECCE. Analiza osetljivosti pokazala je da su rezultati osetljivi na broj izvršenih intervencija na godišnjem nivou. Zaključak. Fakoemulzifikacija je ekonomski isplativija tehnika operacije katarakte u odnosu na ECCE. Sva ulaganje u opremu i potrošni materijal za fakoemulzifikaciju opravdani su ukoliko je broj izvedenih operacija na godišnjem nivou preko 350

Ionizing irradiation affect extracellular nucleotide hydrolysis in brain of rats in different stages of development: ii 30-day-old rats

The effect of acute gamma irradiation (IR) on enzyme activity of rat brain Ecto-Nucleotide Diphosphohydrolase (E-NTPDase), in presence of adenosine triand diphophashates (ATP and ADP) and divalent cations (Ca2+ and Mg2+), has been investigated. The aim of research was to study the influence of low (50 cGy) and therapeutic (2Gy) doses of whole-body irradiation on rat brain E-NTPDase enzyme activity 24h after treatment in prepubertal and adult rats. Our results suggest that whole-body irradiation could induce modulation of neural activity in rat brain, especially in young rats.Physical chemistry 2008 : 9th international conference on fundamental and applied aspects of physical chemistry; Belgrade (Serbia); 24-28 September 200