Gender-specific characteristics of the population aging in the Republic of Serbia

Uvod: Starenje stanovništva jedan je od najvećih izazova sa kojim se svet susreće u XXI veku. Nezaustavljiv proces starenja stanovništva ima duboke posledice na ekonomsku, zdravstvenu, socijalnu i političku sferu društva zbog specifičnih i raznovrsnih potreba starog stanovništva. Specifičnosti rodnih modela starenja pre svega su posledica uticaja niza faktora koji deluju u određenim društvenim okolnostima i konkretnom društvenom okruženju. Rodne razlike u pogledu bračnih, obrazovnih i ekonomskih karakteristika su posledica preovlađujućeg modela rodnih uloga u porodici i u društvu, ali su i posledica relevantnog ponašanja žena i muškaraca. Njihova individualna životna iskustva jesu pod uticajem ovih društveno konstruisanih razlika, a to se odražava i na njihovo zdravstveno stanje. Stoga se rod smatra važnom determinantom zdravlja, koja dodatno oblikuje obrasce izloženosti faktorima rizika po zdravlje i obolevanje, pristup zdravstvenoj zaštiti, kao i dostupnost lečenja. Cilj: Studija se bavi ispitivanjem rodno specifičnih obrazaca starenja, sa posebnim osvrtom na karakteristike zdravstvenog stanja, zdravstvenih potreba i korišćenja zdravstvenih usluga u populaciji starih osoba u Srbiji. Materijal i metod: Istraživanje predstavlja deo Istraživanja zdravlja stanovništva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije, kao studija preseka na reprezentativnom stratifikovanom dvoetapnom uzorku. Istraživanjem je obuhvaćeno 3540 osoba starosti 65 i više godina. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja.Background: The aging of the population is one of the biggest challenges that the world faces in the xxi century. the unstoppable aging process of the population has profound consequences on the economic, health, social and political spheres of society because of the specific and diverse needs of the older population. specifics of gender model of aging are primarily the result of the impact of a number of factors that act in certain social circumstances and in the specific social environment. gender differences in marital, educational and economic characteristics are the result of the prevailing model of gender roles in the family and in society, but they are also the result of the relevant behavior of women and men. their individual life experiences are influenced by these socially constructed differences, and this is reflected in their health status. therefore, the gender is considered an important determinant of health, which further shapes the patterns of exposure to health risk factors and morbidity, access to health care and access to treatment. Aim: The study examined gender-specific patterns of aging, with special emphasis on the characteristics of health status, health needs and utilization of health services in the population of the elderly in serbia. Methods: The study is part of the national health survey of serbia, a cross-sectional study conducted in year 2013 by the ministry of health of republic of serbia on a representative stratified two-stage sample. the study included 3540 participants aged 65 years and over. the instruments were questionnaires designed in line with the european health interview survey questionnaire

Health self-evaluation of complementary and alternative medicine users in Serbia: cross-sectional national study

The aim of the research was to examine the influence of the respondents' health status on the use of complementary and alternative medicine methods. This was a population-based, cross-sectional study. The sample consisted of 550 interviewed persons, from the third National health survey of the residents of Serbia in 2013, who had used complementary and alternative medicine (CAM) services in the preceding 12 months. Just over 2/3 of CAM users had chronic health disorders (p < 0.01), the most commonly diagnosed chronic health disorder among CAM users was hypertension (36.7%). Every seventh and partially every fourth CAM user had been seriously restricted as regards undertaking normal daily activities for the previous 6 months or longer. CAM users were more satisfied with the services they received in private practice (p < 0.01). The two out of three users of CAM services rated their health as good and/or average. CAM users were more satisfied with the services they received in private practice, the highest percentage of them rated their health as good. The analysis of the impact of respondents' health status, the analysis of the correlation between the respondents' self-health assessment and the use of alternative medicine methods, analysis of the impact of socio-demographic characteristics on the use of CAM, along with a comparative analysis of the use of health care services - would significantly contribute to better recognition of CAM by the Ministry of Health

The impact of somatic symptoms on depressive and anxiety symptoms among university students in central Serbia

Background/Aim. Depression and anxiety problems are a major public health concern due to their high prevalence rates, difficult treatment, and often chronic course. This study examined the impact of somatic symptoms on depressive and anxiety symptoms among university students in Serbia. Methods. A cross-sectional study was performed among 1,940 students using a questionnaire specially designed for this study which included presence of Somatic and Non-specific Mental Symptoms (SNMS), Beck Depression Inventory and Beck Anxiety Inventory. The presence of somatic and associated non-specific mental symptoms over the last six months served as the basis for creating a new variable called SNMS score. Results. Receiver operating characteristic (ROC) curve showed that the SNMS score might be a very good marker for the distinction of students with or without depressive symptoms (area = 0.754, p < 0.05). The threshold value was 8.50 (sensitivity 67.6%, specificity 69.4%). Binary logistic regression showed that Odds ratio was 1.052 [95% confidence interval (CI) 1.045–1.059], which means that an increase in the value of the SNMS score by 1 increases the risk of depressive symptoms by 5.2%. ROC curve showed that the SNMS score might be an excellent marker for the distinction of students with or without anxiety symptoms (area = 0.800, p < 0.05). Limit value (cut-off) was 7.50 (sensitivity 74.2%, specificity 71.6%). Binary logistic regression showed that odds ratio was 1.056 (95% CI 1.049–1.064), which means that increasing the value of SNMS score by 1 increases the risk of anxiety symptoms by 5.6%. Conclusion. The SNMS score might be a state marker for the screening and distinction of students with depressive symptoms, and excellent state marker for screening and making distinction between students with anxiety symptoms and the students who do not have these symptoms

The efficacy of moxifloxacin in patients with bacterial keratitis

Background/Aim. Keratitis is a sociomedical problem of moderately developed countries. including Serbia, too. The incidence of bacterial keratitis in the world is about 20% in relation to all keratitis, but its frequency in Serbia is still not known. Bearing in mind the complications in the front segment of the eye after bacterial keratitis (ulcer, neovascularization, fibrosis) and decline in visual acuity, it was necessary to assess the efficacy of local therapy by moxifloxacin which will shorten the healing time and reduce complications. The aim of the study was to analyze the efficiency of shortening the treatment of bacterial keratitis with moxifloxacin. Methods. The study was designed as prospective, randomized, double-blind study. The study included 30 patients with diagnosed keratitis and locally applied antibiotic moxifloxacin, and 60 patients in a control group, with locally applied artificial tears. All participants were subjected to complete clinical ophthalmologic analysis (2015/16), for a period of 1–15 days after the application of therapies (healing time of corneal pathology). The following was determined in all patients: degree of hyperemia, degree of epithelial defect, level of corneal sensitivity, level of tear secretion and tear quality, degree of conjunctival secretion, degree of neovascularisation and corneal scarring, degree of visual acuity, score of subjective symptomatology and correlation of ophthalmological findings and subjective symptoms. Results. There was a statistically significant difference in times of therapeutic efficacy/clinical response between the study group patients who received moxifloxacin and the control group patients who received arteficial tears. Conclusion. Local application of moxifloxacin had therapeutic effect (total benefit) both in terms of the effective shortening of the healing time and also the reduction of the complications of bacterial keratitis, without unwanted effects

Socioeconomic inequalities and non-communicable diseases in Serbia: National health survey

Background/Aim. Non-communicable diseases (NCDs) are a major public health challenge worldwide. Although they are preventable, NCDs are the major global causes of morbidity and mortality, absenteeism, disability and premature death. The aim of this study was to examine socioeconomic inequalities in the prevalence of non-communicable diseases in Serbia. Methods. Data from the 2013 National Health Survey of the population of Serbia was used in this study. There were 13,765 adults interviewed, aged ≥ 20 years. We used multivariate logistic regression analyses with demographic and socioeconomic determinants of health as independent variables and prevalence of non-communicable diseases as a dependent variable. The minimum level of significance was p < 0.05. Results. Hypertension was the most prevalent NCDs (36.1%). The prevalence of multimorbidity was 47.1%. Multivariate logistic regression analysis showed that gender, age, place of residence, employment status and education were associated with the presence of NCDs. The odds ratio (OR) for age was 1.074 [95% confidence interval (CI) : 1.070–1.077). Women were at a higher risk of NCDs by 58.9% when compared to men (OR = 1.589; 95% 95% CI : 1.467–1.726). Respondents who lived in the rural areas were at a higher risk for NCDs by 14.1% compared to those who lived in urban areas (OR = 1.141; 95% CI : 1.047– 1.244). Odds ratio for unemployment was 1.227 (95% CI: 1.118–1.346). Respondents with primary education were at a higher risk for chronic diseases by 47.1% (OR = 1.471; 95% CI : 1.281–1.687) while those with secondary school were at a higher risk by 27.7% (OR = 1.277; 95% CI : 1.142–1.428) compared to respondents who had higher education. When it comes to Wealth Index, univariate logistic regression analysis showed that respondents who belonged to the poor and middle classes were at a higher risk for NCDs (OR = 2.031; 95% CI : 1.819–2.267; OR = 1.473; 95% CI : 1.343– 1.615) compared to respondents who belonged to the rich class. Multivariate logistic regression analysis did not show statistically significant correlations between the Wealth index and NCDs. Conclusion. Socioeconomic inequalities in health status are the major challenge and should be a target of national health policy in Serbia, not only because they represent social injustice but also because solving the health problems of underprivileged groups of the population can influence improvement of health status of the population as a whole

The influence of sociodemographic factors on the use of antihypertensive drugs among adults in Serbia: Cross-sectional study

Background: Despite the knowledge that they have high blood pressure, which can be controlled with medicines, one portion of the patients still ignores doctor's advice. The aim of the research was to examine the impact of socio-demographic factors for treatment of hypertension among adults in Serbia. Subjects and methods: In the study, we used data from the National Health Survey of the Republic of Serbia in 2013. The sample consisted of respondents who had diagnosed hypertension, 5073 of them. The dependent variable in the study was binary (treatment, or no treatment of hypertension) and independent was socio-demographic characteristics of respondents. Logistic regression was used to determine sociodemographic predictors associated with blood pressure control. Results: From a total of 5073 diagnosed hypertensive patients, 91.3% of them cures high blood pressure. Women, older, medium rich patients, those who follow health topics on television and those who do not follow them on the Internet, who, in the past year, have been hospitalized or used the services of daily care significantly more often treat hypertension. The results of binary logistic regression in which the dependent variable is the treatment of high blood pressure, showed that a statistically significantly predictors are: age, gender, the wealth index and monitoring topics related to health through television and the Internet. In the treatment of hypertension, the strongest predictor was the index of well-being. Thus, people who are medium rich are almost three times more likely to treat high blood pressure compared to the richest (OR=2.94, 95%CI=1.54-5.59). A statistically significant difference in treatment is not recorded between the richest and the poorest (p> 0.05). Men are 1.5 times more likely to treat their tension as compared to women (OR=1.54, 95%CI=1.02-2.32). People following itopics related to the health via the internet are1.7 times more likely to treat hypertension in comparison to subjects who do not follow these topics via the Internet (OR=1.72, 95%CI=1.07-2.76). Conclusion: Analysis of the impact of sociodemographic characteristics on the awareness of patients about the importance of treatment of hypertension is an important step in defining the strategies for treatment of patients