S Janković

University of Belgrade, Belgrade, SE, Serbia

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Publications (42)74.72 Total impact

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    ABSTRACT: See at www.seejph.eu
    South Eastern European Journal of Public Health. 10/2013; Vol. 1.
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    ABSTRACT: Reliable and comparable analysis of health risks is an important component of evidence-based and preventive programs. The aim of this study was to analyze the impact of the most relevant avoidable risk factors on the burden of the selected conditions in Serbia. Attributable fractions were calculated from the survey information on the prevalence of a risk factor and the relative risk of dying if exposed to a risk factor. The population-attributable risks were applied to deaths, years of life lost due to premature mortality (YLL), years of life with disability (YLD) and disability adjusted life years (DALY). More than 40% of all deaths and of the total YLL are attributable to cigarette smoking, overweight, physical inactivity, inadequate intake of fruit and vegetables, hypertension and high blood cholesterol. Alcohol consumption has in total a beneficial effect. According to the percent of DALY for the selected conditions attributable to the observed risk factors, their most harmful effects are as follows: alcohol consumption on road traffic accidents; cigarette smoking on lung cancer; physical inactivity on cerebrovascular disease (CVD), ischemic heart disease (IHD) and colorectal cancer; overweight on type 2 diabetes; hypertension on renal failure and CVD; inadequate intake of fruit and vegetables on IHD and CVD, and high blood cholesterol on IHD. This study shows that a high percentage of disease and injury burden in Serbia is attributable to avoidable risk factors, which emphasizes the need for improvement of relevant preventive strategies and programs at both individual and population levels. Social preferences should be determined for a comprehensive set of conditions and cost effectiveness analyses of potential interventions should be carried out. Furthermore, positive measures, derived from health, disability and quality of life surveys, should be included.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 05/2013; 70(5):445-51. · 0.21 Impact Factor
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    Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/2012; · 0.21 Impact Factor
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    BMC proceedings 01/2011; 5:1-1.
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    ABSTRACT: Aim: This manuscript deals with public health training, research and practice in order to identify the future perspectives and requirements of master’s programmes in public health sciences in Serbia. Methods: A wide array of documents and websites was analysed. The methods used for data collection were: (1) review of the existing written reports, the relevant legislation and other documents, and (2) Internet searches accessing the websites of the Ministries of Health, Education, Science and Technology of the Republic of Serbia as well as websites covering thematic areas in European and global education, research and development. Use has also been made of the results of the European Union projects done in the field of public health in Serbia, particularly the Tempus programme “Postgraduate Studies in Public Health Sciences”. Results: The most important role in the field of change in public health in Serbia is played by the School of Public Health (SPH) and the Institutes of Public Health (IPH). Although at the managerial level the need for change has been perceived, in general there is not a shared, clear vision of what the change should be and how this should happen. The reorganisation of the IPH in Serbia is greatly needed given their poor present performance and the expectations of the government to reach EU standards and to increase the health status of the Serbian population. The main obstacles are seen to be inappropriate legislation, lack of financial resources and insufficiently trained staff. Three areas with priority for future development have been identified: (1) doctoral programmes in public health and in health policy and management, (2) expansion of continuing and life-long learning in good governance and public health management, and (3) increasing the research base in public health and management. ConclusionThe need for a better trained workforce in the fields of public health, health management and health promotion is clearly recognised by public health professionals in Serbia. Therefore, the educational infrastructure should be amended by doctoral programmes and life-long learning schemes, based on intensified public health research. Keywords: Public health-Training-Research-Practice-Serbia
    Journal of Public Health 02/2010; 18(2):159-167. · 2.06 Impact Factor
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    ABSTRACT: BackgroundEvaluation is a systematic process that facilitates measurement of the extent to which a student has attained the educational objective. ObjectivesThe article objectives were to describe the teaching evaluation approach of the Master of Health Policy and Management program developed at Centre School of Public Health, the School of Medicine, Belgrade University. MethodsThe evaluation strategy for the Master of Health Policy and Management program (which has not been completed yet) for four obligatory courses involves two simple components: evaluation of student performance and student evaluation of the teaching process. The teaching evaluation was based on a questionnaire with a total of 11 questions. External evaluation was conducted by an individual expert who visited one course. ResultsThe average final score for four courses was very high, somewhat higher than 86 points (of a maximum of 100) with a standard deviation of 9.76 points. However, the average final score per course differed significantly (F = 6.46, p = 0.001). Overall the average student's rating by questionnaire of all courses was 4.38 (of a maximum of 5), whereas the average marks for assessment of the specific characteristics of the course ranged from 3.65 (understandable teaching material and handouts) to 4.68 (the level of preparation by lecturers/instructors). Specific courses differed significantly in the overall rating (F = 10.81, p = 0.000). ConclusionThe average rating of teachers and instructors was high, as was the average final score of students. However, students rated teaching slightly better than teachers evaluated their knowledge and skills. KeywordsTeaching evaluation-Master's program-Tempus project
    Journal of Public Health 02/2010; 18(3):289-296. · 2.06 Impact Factor
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    ABSTRACT: BackgroundThe most important instrument of EU support for the reforms of higher education in the European countries with the final goal of joining the European Higher Education (HE) Area by the year 2010 is TEMPUS (Trans-European Mobility Programme for University Studies). So far, Tempus is the only EU programme providing support for the reform of HE in the Western Balkans. AimThe purpose of this paper is to present the new curriculum of the Master of Health Policy and Management programme, which will provide students in Serbia with the up-to-date knowledge and necessary skills to analyse options, define strategies, formulate and implement health policies, and manage solutions for the effective delivery of health services. MethodsWith financial support from the European Union’s Tempus project, the “Postgraduate Study in Public Health Sciences” core project team from the Centre School of Public Health (C-SPH) School of Medicine (SoM) in Belgrade, supported by European project partners from Dresden, Rome and Krakow, developed a new curriculum—the Master of Health Policy and Management (MHPM) programme. Project activities (courses, workshops and visits to partner institutions) took place in Belgrade, Dresden, Rome and Krakow throughout 2006–2009. ResultsThe MHPM programme, based on modular principles and a European Credit Transfer System (ECTS) approach (60 ECTSs), was established at the C-SPH SoM and approved by the University of Belgrade. The MHPM programme consists of two tracks: one for health-care services management and the other for public health management. The first generation of MHPM students enrolled at the C-SPH SoM, Belgrade, in September 2008. They successfully passed all obligatory courses. It is envisaged that the first MHPM students will graduate in autumn/winter 2009. ConclusionWe believe that the project will continue to deliver benefits to the project beneficiaries after the Commission’s financial assistance has been terminated. The MHPM programme will facilitate health-care administration reform, contribute to strengthening civil society and accelerate the development of democracy and the rule of law through good governance in Serbia. KeywordsHealth management-Health policy-Higher education-Tempus project-Serbia
    Journal of Public Health 02/2010; 18(2):153-158. · 2.06 Impact Factor
  • Jankovic S, Laaser U, Bjegovic V, et al
    01/2010: pages 7-34;
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    ABSTRACT: Background: In the last decade of the 20th century, a considerable effort has been put into the development of summary measures of population health that combine information on mortality and non-fatal health outcomes. We used the DALYs (Disability adjusted life years) method to assess the burden of disease and injury in the population of Serbia. Methods: Our study, largely based on the methods developed for the Global burden of disease study, was conducted between October 2002 and September 2003. DALYs, stratified by gender and age, were calculated for 18 selected health conditions for the population of Serbia, Serbia and Montenegro for 2000. Years of life lost (YLL) were calculated using country mortality statistics, while years lived with disability (YLD) were calculated using different sources of information. Also, the YLD/YYL ratio and age-adjusted rates of DALYs were calculated. Results: Ischaemic heart disease, cerebrovascular diseases, lung cancer, unipolar depressive disorders, and diabetes mellitus were responsible for almost two-thirds (70%) of the total burden of 18 selected disorders in Serbia 2000. The leading five causes for males were ischaemic heart disease (26.DALY per 1000), stroke (17.9), lung cancer (12.7), road traffic accidents (6.5), and self-inflicted injuries (5.5). For females, the leading five causes were stroke (18.DALY per 1000), ischaemic heart disease (14.1), depression (8.7), breast cancer (6.1), and diabetes mellitus (5.2). Conclusions: The final results of the study have shown that the national health priority areas should cover cardiovascular diseases, cancers, and mental health.
    The European Journal of Public Health 02/2007; 17(1):80-85. · 2.52 Impact Factor
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    ABSTRACT: The science and practice of the New Public Health have a key role in the promotion of people’s health and in the reform of the health system. Serbia experienced many social and economic threats to public health during the 1990s when the health infrastructure both for curative and preventive services gradually deteriorated. Existing skills and knowledge of public health professionals are insufficient in virtually all fields of public health activities. The foundation of the Centre – School of Public Health, within the Medical School of Belgrade University has been a precondition for the improvement of professional training in public health. The objectives are described as (1) education of capable experts in the field of public health, (2) improvement of knowledge in the health sciences, (3) health promotion in cooperation with local communities, (4) training of competent researchers in the field of public health and (5) improvement of the process of decision making and policy formulation. The training programme covers five key areas of education in the domain of public health: (1) public health in Europe, (2) epidemiology and biostatistics, (3) health policy and management, (4) health promotion, health education and social sciences and (5) environment and health. In the first year, 27 students were admitted for the Master of Public Health programme and more than 350 participants attended various short courses for continuing education in public health and health management based on applied learning approach. The next developmental steps focus on sustainability of the programmes for continuing education and research and a wider national and international partnership.
    Journal of Public Health 01/2006; 14(4):208-216. · 2.06 Impact Factor
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    ABSTRACT: The aim of this paper is to show influence of different foods on bladder cancer appearance, as well as possible consequent ways of prevention. Consuption of food rich in animal fat and cholesterol, fried foods, especially several times used cookin oil for frying, processed meat with additives (nitrates, nitrites, azo-colourrs) can influence bladder cancer occurrence. Regularly, continous consumption of fermented milk products, which contains come types of milky--acids bacterias, is considered as protective factor in developing bladder cancer. Reports that fruit and vegetable are protective food items are pretty consistent. Data about mineral intake and bladder cancer are obscure.
    Acta chirurgica iugoslavica 02/2005; 52(3):77-82.
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    ABSTRACT: To investigate possible relationships between diet and risk for bladder cancer in Serbia, the hospital-based case-control study was carried out. This study included 130 newly diagnosed bladder cancer patients and the same number of controls matched by sex, age (%+/-%2 years) and type of residence (rural or urban). Dietary information was obtained by using a food frequency questionnaire. Initial case-control comparisons were based on tertiles of average daily intake of control group. The odds ratios (ORs) were computed for each tertile, with the lowest tertile defined as the referent category. All variables (food items) significantly related to bladder cancer were included in multivariable logistic regression analysis. According to this analysis, risk factors for bladder cancer appeared to be consumption of liver (OR=6.60, 95%CI=1.89-23.03), eggs (OR=3.12, 95%CI=1.10-8.80), pork (OR=2.99, 95%CI=1.16-7.72), and pickled vegetable (OR=3.25, 95%CI=1.36-7.71). A protective effect was found for dietary intake of kale (OR=0.21, 95%CI=0.06-0.73), cereals (OR=0.19, 95%CI=0.06-0.62), tangerines (OR=0.21, 95%CI=0.07-0.68), cabbage (OR=0.27, 95% CI=0.11-0.68), and carrots (OR=0.15, 95%CI=0.05-0.41). The study indicated a potentially important role for dietary fat and pickled vegetables in bladder carcinogenesis. An inverse association was recorded between consumption of fruits, vegetables and cereals, and the development of bladder cancer.
    International Urology and Nephrology 02/2005; 37(2):283-9. · 1.33 Impact Factor
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    ABSTRACT: To examine the relation of the total intake of fluids and the types of beverages to the risk of bladder cancer, we conducted a hospital based case-control study with 130 newly diagnosed bladder cancer patients and the same number of matched controls. Information of total fluid intake was derived from the reported frequency of consumption of the different types of beverages on the food frequency questionnaire. Univariate and multivariate logistic regression analyses were performed in statistical analysis. There was no statistically significant difference between the cases and the controls in total daily fluid intake. Multivariate logistic regression model showed consumption of: soda (OR=8.32; 95%CI=3.18-21.76), coffee (OR=1.46; 95%CI=1.05-2.01) and spirits (OR=1.15; 95%CI=1.04-1.28) as statistically significant risk factors, while mineral water (OR=0.52; 95%CI=0.34-0.79), skim milk (OR=0.38; 95%CI=0.16-0.91), yogurt (OR=0.34; 95%CI=0.12-0.97) and frequency of daily urination (OR=0.27; 95%CI=0.18-0.41) were statistically significant protective variables. In our study no statistically significant association was observed for total fluid intake. The findings suggest consumption of soda, coffee and spirits were indicated as a risk factors for bladder cancer, while mineral water, skim milk, yogurt and frequency of urination as protective factors for bladder cancer.
    Neoplasma 02/2003; 50(3):234-8. · 1.57 Impact Factor
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    ABSTRACT: The retrospective cohort study comprised 97 Balkan endemic nephropathy (BEN) and BEN-suspected patients discovered in 1971 in the field examination in the village of Sopić, one of the regions most frequently affected by the disease. Our aim was to determine the outcome of the disease in patients and to compare the survival of BEN-suspected and BEN-manifested patients and the survival of their kidneys. The mean survival time was 16.4 years for all patients (95% CI 14.51-18.21) and 23.1 years for suspected and 13.3 years for manifested patients (log-rank = 19.46; d.f. = 1; p < 0.001). According to our results, it can be concluded that BEN is characterized by slow course and prolonged evolution and that the prognosis was consistently better for BEN-suspected than for BEN-manifested patients.
    Nephron 12/2000; 86(4):463-6. · 13.26 Impact Factor
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    ABSTRACT: Although there is permanent increase in incidence of malignant upper urothelial tumours [1, 2], these malignancies are rare neoplasms in relation to both all malignant tumours and urotract tumours. Upper urothelial tumours, i.e. tumours of the renal pelvis and ureter are more frequent in the regions affected by endemic nephropathy [3-5]. The aim of this paper was to describe the main epidemiological characteristics in patients with upper urothelial tumours (UUT) in endemic nephropathic (EN) foci in Lazarevac. We analyzed 73 patients treated at the Institute of Endemic Nephropathy, Lazarevac and the Institute of Urology and Nephrology, Belgrade, from January 1, 1992 to December 31, 1994. The descriptive-epidemiological methods was used. The characteristics in patients with histopathologically confirmed upper urothelial tumours were examined. The diagnosis was made on the basis of the clinical picture, echo-sonographic and radioscopic examinations, intravenous and infusion urography and retrograde pielography. With genealogic analysis, a genealogical tree as far as the fourth degree of kinship for each patient, was made both for urothelial tumours and endemic nephropathy. The average age of the patients at the time of diagnosis was 64.2 years, and the majority of the patients (59%) was in the seventh decade of life (Figure 1). Our results are in accordance with the results of other authors who examined the patients with upper urothelial tumours in the regions with endemic nephropathy and out of them [7, 8, 12, 14]. Females were more affected than males (1.4:1). These results are in accordance with the results of other authors who studied the endemic regions [7, 11, 13]. Foreign authors found that males were more affected by upper urothelial tumours [9, 10]. In view of anatomic localization of tumours (Table 2) our results are in accordance with results of the studies carried out in endemic [11, 12, 15, 19] and non-endemic regions [8]. The majority of patients were rural population and lived in villages known as endemic foci (89%) (Table 1). Agriculture was their main or additional occupation. A large number of UUT patients (67%) had endemic nephropathy as well. The other authors from our country found that farmers were most affected [17, 18]. In foreign studies, there are no data on the fact that farming is risk for the appearance of upper urothelial tumours. The family agglomeration of UUT and EN in UUT patients has been observed in all degrees of relation, especially in the second and third generations (Table 3). The obtained results are comparable with hypotheses on a possible mutual or the same aetiological factor for both diseases, which is in accordance with the results of other authors who studied the endemic regions [6, 7, 12, 13].
    Srpski arhiv za celokupno lekarstvo 01/1999; 127(11-12):371-5. · 0.23 Impact Factor
  • Z Radovanovic, Z Vukovic, S Jankovic
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    ABSTRACT: Rhinosporidiosis occurs extremely seldom in Europe. Until recently, the disease was unknown in Serbia (Yugoslavia). An outbreak that began in January 1992, affected 21 individuals. All of them had been exposed to the same source of stagnant water. The purpose of this study was to assess which control measures would be selected by epidemiologists potentially involved in the control of the disease. Most respondents (20 of 32 or 62.5%) opted only for an information release as the most appropriate control measure. The reasons listed by the epidemiologists to justify their choice of optimal control measures showed that the political and economic hardships, including an embargo imposed upon rump Yugoslavia, did not hamper their judgment. The turmoil associated with the disintegration of Yugoslavia, however, appears to have significantly affected the information level of the participants.
    European Journal of Epidemiology 03/1997; 13(2):157-60. · 5.12 Impact Factor
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    ABSTRACT: A case-control study of 130 patients with chronic lymphocytic leukemia (CLL) and 130 controls matched with respect to sex, age (2 years), type of residence (urban-rural) and area of residence (according to the national per capita income) was carried out. Conditional logistic regression analysis showed that, apart of four risk factors already described in the literature (work in a hazardous industry, hair dye use, family history of leukemia and exposure to electromagnetic radiation), brick mortar exposure was also significantly related to CLL.
    Neoplasma 02/1995; 42(2):79-81. · 1.57 Impact Factor
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    ABSTRACT: An anamnestic study encompassed 100 new patients with Graves-Basedow's disease and 100 controls matched according to sex, and age (+/-2 years) and place of living (rural/urban). The patients were treated in an out-patient clinic of the Clinical Center of the Medical Faculty, Clinical hospital center "Zvezdara" in Belgrade and in Special institution "Zlatibor" on Zlatibor in the period from May 1st, 1993 to November 1st, 1993. The aim of this study was to estimate the influence of family relationship and social support on the development of Graves-Basedow's disease. The diseased more often lived in an environment of family disharmony (McNemar's test = 3.76; relative risk (RR) = 3.25; 95% confidence limits CL = 1.01-10.68; probability (p) = 0.049) while the controls more often described themselves as nostalgic persons (McNemar's test = 4.96; RR = 0.38; CL (95%) = 0.16-0.89; p = 0.026). The possibility to discuss their personal problems with their relatives and friends (t = 2.29; DF = 99; p = 0.024), the relatives' and friends' interest for their problems and their readiness to help (t = 2.29; DF = 99; p = 0.004) and possibility of the patients to ask for help in case of financial problems (t = 2.78; DF = 99; p = 0.007) were more often present in persons from the control group.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/1995; 52(6):575-8. · 0.21 Impact Factor
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    ABSTRACT: A case-control study comprised 130 cases affected by chronic lymphocytic leukemia and the same number of individually matched controls, with accidental injuries as a cause of hospitalization. Matching criteria were: sex, age, type of settlement, and area of residence. Both leukemias and all cancers were more frequent among family members of cases, as compared to controls.
    European Journal of Epidemiology 05/1994; 10(2):211-3. · 5.12 Impact Factor
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    ABSTRACT: Hemoccult-test was performed in 3,000 inhabitants of Ruma aged 40-75 years. The response rate was 94%. Hemoccult was positive in 2% of cases. After detailed diagnostic procedures (rectosygmoidoscopy, colonoscopy or double-contrast irrigography) colerectal carcinoma was found in 3 and polyps in 6 subjects. Positive predicted value was 5.3% for colorectal cancer and 10.7% for polyps. Due to the used methodological approach our study failed to answer the question whether early detection of colorectal carcinoma by Hemoccult-test influenced the reduction of mortality rate in this malignoma, but it revealed the motivation of examined population for early detection of the colorectal cancer.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 01/1994; 51(3):220-3. · 0.21 Impact Factor