This cross-sectional study aimed to investigate the association between psychosocial school factors and life satisfaction, symptoms of depression and psychosomatic health complaints among first grade secondary school students in Serbia. We analysed data from the 2018 Health Behaviour in School-aged Children (HBSC) study in the Republic of Serbia. Analyzed psychosocial school factors included satisfaction with school, schoolwork pressure, teacher support, classmate support and being bullied at school. Life satisfaction was assessed by the 11-step Cantril’s ladder (cutoff >5). Symptoms of depression were measured by the Center for Epidemiologic Studies Depression Scale (CESD-10) and psychosomatic health complaints by using the HBSC symptom checklist. Univariable and multivariable binary logistic regression was used to determine independent predictors of students’ life satisfaction, symptoms of depression and psychosomatic health complaints in the school environment, while also considering their socio-demographic characteristics and perceived family and friend support. The study included 1605 students (average age 15.26 ±0.44 years), of whom 50.3% were females. Results from the binary logistic regression analyses showed that life satisfaction was positively related to school satisfaction and classmate support, and negatively to being bullied at school. Symptoms of depression were positively associated with schoolwork pressure and being bullied at school, and negatively with teacher and classmate support. All analyzed factors of the school environment were significantly related to psychosomatic health complaints, whereby schoolwork pressure and being bullied at school were positively associated, while teacher and classmate support and satisfaction with school were negatively associated. Given the established association of psychosocial school factors with mental health, there is a need for targeted measures both at school and community level with the aim of improving social support in the school environment, reducing schoolwork burden and preventing bullying at school, potentially resulting in the overall improvement of mental health of the first grade secondary school students.

Medical waste (MW) is all waste generated in healthcare institutions during the provision of healthcare services, conducting scientific research and experiments in the field of medicine, regardless of its composition and origin, i.e.. a heterogeneous mixture of classic municipal waste and hazardous MW. Medical systems including hospitals, clinical centers, and places where diagnosis and treatment are conducted generate waste that are highly hazardous and put people under risk of fatal diseases. In general, MW does not take up much of the environmental pollution, but its specific characteristics are potentially among the most dangerous types of waste. Inadequate care can affect the health of the medical workers, the population, and the surrounding areas in which the waste is stored, but also lead to outbreaks of global infection and poisoning. However, extra caution is required to avoid the risk of injury, cross-contamination, and infection; thus, healthcare workers and individuals responsible for waste management must follow the mandatory safety procedures. In this review, a classification of the various types and categories of MW and its treatment methods are discussed. Since MW can be contaminated and hazardous, it must be managed and processed using complex steps and procedures. The meaning of MW, the risks of exposure, MW management regulatory acts, MW management procedures and control techniques are presented.

Introduction/Objective. Problematic internet use has been associated with various mental health problems. The objective of this study was to investigate the internet use and its relationship with depressive symptoms among high school students. Methods. This cross-sectional observational study included 620 students from the first to the fourth grade of four high schools in Pozarevac, Serbia. The research data were obtained from an ad hoc designed questionnaire on socio-demographic data, health habits, and the internet use, Internet Addiction Test (IAT) and Center for Epidemiological Studies Depression Scale for Children (CES-DC). Results. Out of 620 students (66.9% girls) there were 389 respondents (62.7%) who reported normal (n = 40), or average internet use (n = 349) with a mild level of addiction, while 226 (36.5%) subjects belonged to problematic internet use group, and five students (0.8%) showed a high level of internet addiction. A CES-DC score ? 15, considered indicative of clinically significant depressive symptoms, was found significantly more frequent among internet addicts compared to internet normal users (78.4% vs. 46.5%, respectively). Among internet addicts there was a significantly higher percentage of those who used psychologist/psychotherapist help compared to internet normal users (29.4% vs. 12.1%, respectively). The logistic regression analysis showed that internet addiction (IAT score ? 50) was the strongest independent predictor of clinically significant depressive symptoms (OR = 3.32; 95% CI = 2.24?4.91), after adjusting for confounders (female gender, urban living, Tik Tok and Twitter use, sports activities, and the use of the internet for learning or for aimless ?surfing?). Conclusion. We show that internet addiction is positively related to clinically significant depressive symptoms among high school students. Health education focused on the proper use of the internet may be regarded as mental health promotion.

The presence of anxiety in individuals with epilepsy significantly influences their medical treatment and quality of life and often goes unrecognized or untreated, posing a challenge to differential diagnosis. The study aimed to investigate the influence of epilepsy characteristics on anxiety. The research involved 155 patients with generalized and focal drug-sensitive [DSE] and drug-resistant [DRE] epilepsy. Hamilton anxiety rating scale [HAS] was used to assess the symptoms of anxiety at three time points [baseline, 12, and 18 months]. DSE patients exhibited significantly lower HAM-A scores than patients with DRE at the initial visit [p = 0.000] after 12 [p = 0.000] and 18-month follow-up [p = 0.000]. Focal DRE patients presented higher HAM-A scores than focal DSE patients in the initial visit [p = 0.000] after 12 [p = 0.000] and 18 months [p = 0.000]. Medication responsiveness, seizure type, and illness duration emerged as significant anxiety predictors [p = 0.000]. After 18 months of follow-up, significant contributors to anxiety were drug responsivity and illness duration [p = 0.000]. The occurrence of anxiety in epilepsy patients is most significantly influenced by well-controlled epilepsy and a positive response to medication.

Background and Objectives: Although carotid endarterectomy (CEA) is the gold standard in the treatment of carotid disease, a higher frequency of adverse outcomes can reduce its benefit. The aim of the present study is to identify factors related to myocardial infarction, stroke, death and restenosis as the late adverse outcomes of CEA. Materials and Methods: The retrospective cohort study included 1597 CEAs that were performed in 1533 consecutive patients at the Vascular Surgery Clinic in Belgrade from 2012 to 2017. Late adverse outcomes within 4 years after CEA were available for the majority of them. Data for myocardial infarction and stroke were available for 1223 CEAs, data for death for 1305 CEAs, and data for restenosis for 1162 CEAs. The association between possible risk factors and late adverse outcomes of CEA was analyzed using univariate and multivariate Cox and logistic regression analyses. Results: During follow-up, myocardial infarction occurred after 55, stroke after 68, death after 103 and restenosis after 121 CEAs. Two factors were the most frequent predictors of late adverse outcomes, i.e., the patient’s age and diabetes mellitus (DM). Age predicted all late adverse outcomes except restenosis, and DM predicted all of them. A predictor of myocardial infarction, besides age (HR 1.08, 95% CI 1.05–1.11) and DM (HR 1.60, 95% CI 1.11–2.29), was peripheral arterial disease (HR 1.81, 95% CI 1.17–2.78) in personal history. Predictors were only age (HR 1.04, 95% CI 1.01–1.08) and DM (HR 1.68, 95% CI 1.03–2.72) for stroke, as well as for death (HR 1.17, 95% CI 1.12–1.21 and HR 1.94, 95% CI 1.17–3.21, respectively). For restenosis, in addition to DM (HR 1.78, 95% CI 2.62), predictors were hyperlipidemia (HR 3.52, 95% CI 1.27–9.76) and urgent surgery (HR 3.51, 95% CI 1.06–11.65). Conclusions: CEA should be performed with special caution in the elderly and diabetic patients. Modification of other risk factors and precise medical therapy are necessary to reduce possible adverse outcomes.