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  • 1
    Online Resource
    Online Resource
    Scientific Foundation SPIROSKI ; 2010
    In:  Macedonian Journal of Medical Sciences Vol. 3, No. 3 ( 2010-9-15), p. 251-256
    In: Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 3, No. 3 ( 2010-9-15), p. 251-256
    Type of Medium: Online Resource
    ISSN: 1857-5749 , 1857-5773
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2010
    detail.hit.zdb_id: 2552213-9
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  • 2
    In: British Journal of Health Psychology, Wiley, Vol. 19, No. 2 ( 2014-05), p. 425-441
    Abstract: During last two decades, within the process of transition, the socio‐economic reforms in Republic of Macedonia reflected on the national health care system. The objective of this article was to identify workplace stressors and factors that influence quality of care, from the perspective of health professionals ( HP s), and to understand how they were linked in the context of such social circumstances. Methods A qualitative research based on focus group ( FG ) methodology was conducted in a general teaching hospital. Two main topics were the subjects of discussion in FG s: workplace stressors and factors that influence quality of care, from the HP s perspective. Six FG s were conducted with a total of 56 HP s (doctors, nurses, interns, and residents) divided into two sets of three FG s for each topic separately. Two sets of data were processed with thematic analysis, and the obtained results were compared with each other. Results By processing the data, we identified themes relating to factors that generate stress among HP s and factors that influence quality of care, from HP s' perspective. By comparing the two sets of themes, we found that many of them were identical, which means factors that increase workplace stress at the same time reduce quality of care. Conclusions Implementation of specific organizational interventions in the hospital setting can lead to the prevention of work‐related stress and improvement in quality of care. Our research suggests that the prevention of work‐related stress will impact positively on the quality of care, which may contribute to establish criteria and recommendations for the improvement in organizational culture and climate in hospitals. Statement of contribution What is already known on this subject? Psychosocial stress at work among health professionals is often present and well studied, but relations between job stress and quality of care were rarely examined. Job demands‐resources model by Demerouti, Bakker, Nachreiner and Schaufeli (2001), for assessment of job stress includes job demands (working environment, work overload, time pressures, recipient contact, shift work) and job resources (feedback, rewards, job control, participation, job security, supervisor support) was applied in different studies. There is scientific evidence that burned‐out physicians have shown depersonalization from their patients, they have withdrawn from patients, demonstrated sub‐optimal care, and sometimes burnout has been related to serious mistakes and patient death. Different research has shown that some workplace factors contributed to the development of work‐related stress and burnout among HP s whereas others contributed protectively. What does this study add? Similar and overlapping workplace factors in hospital setting produce stress in health professionals and influence quality of care. Impact of specific socioeconomic environment in Macedonia as a country in transition and EU candidate country on job stress among health professionals and quality of care. Development of criteria and recommendations for the job stress prevention and improvement of the organizational culture and climate in hospital settings.
    Type of Medium: Online Resource
    ISSN: 1359-107X , 2044-8287
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2026500-1
    SSG: 5,2
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  • 3
    In: Occupational and Environmental Medicine, BMJ, Vol. 76, No. Suppl 1 ( 2019-04), p. A29.3-A30
    Abstract: Psychosocial context, characterized by the levels of job demands, shift/night work, burnout, and teamwork, as well as presence of certain somatic complaints (chronic respiratory, skin, and musculoskeletal symptoms) and health disorders could affect the work ability and job satisfaction of health professionals (HPs). The aim of this prospective cohort study will be to assess changes in self-reported psychosocial factors, work ability, and job satisfaction, as well as to evaluate the incidence of somatic complaints and health disorders in anaesthesia HPs. Additional objective of the study will be to evaluate associations between analysed variables. Cohort participants HPs working in a health institution for anaesthesia, reanimation and intensive care from Skopje will be included in the first phase of the study with a possibility to enrol other health institutions during the next phases of the research. The first phase will involve about 120 anaesthesia HPs (about 50 physicians and 70 nurses). Data collection phases At enrolment point, the participants will be invited to complete questionnaires and to attend a preventive medical examination by a specialist in occupational medicine (OM). The follow-up will include an annually self-administered questionnaire as well as periodic visits to an OM specialist. Main types of data collected Data collected for participants will include demographic and job characteristics; physical, organisational, emotional, and cognitive job demands; characteristics of shift/night work; burnout dimensions; teamwork; presence of chronic respiratory, skin, and musculoskeletal symptoms; work ability index; and job satisfaction factors (planning issues, general attitudes, performance issues, management issues, supervisory issues, training and salary issues, and benefits issues). Regarding medical examination by an OM specialist, a plenty of data on health status as well as work ability, will be collected at enrolment phase, and during follow-up.
    Type of Medium: Online Resource
    ISSN: 1351-0711 , 1470-7926
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2020276-3
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  • 4
    Online Resource
    Online Resource
    Open Access Pub ; 2021
    In:  Journal of Radiation and Nuclear Medicine Vol. 1, No. 2 ( 2021-1-17), p. 1-5
    In: Journal of Radiation and Nuclear Medicine, Open Access Pub, Vol. 1, No. 2 ( 2021-1-17), p. 1-5
    Abstract: The goal of this review is to assess the importance of various imaging modalities which can be used in assessing the viability and integrity of the bone allograft. As it is widely in use in majority of major and minor reconstructive procedures.
    Type of Medium: Online Resource
    ISSN: 2766-8630
    Language: English
    Publisher: Open Access Pub
    Publication Date: 2021
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  • 5
    Online Resource
    Online Resource
    Scientific Foundation SPIROSKI ; 2017
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 5, No. 6 ( 2017-09-09), p. 724-729
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 5, No. 6 ( 2017-09-09), p. 724-729
    Abstract: AIM: To assess the mean serum C-reactive protein concentrations among farmers and office controls, and further examined its relation to exposure duration, smoking habit, as well as presence or absence of COPD.METHODS: A cross-sectional survey was performed including examined group (EG), composed of agricultural workers (87 crop - EG1 and 83 dairy farmers - EG2), and control group (CG) composed by 80 office workers. Evaluation of subjects included a questionnaire on chronic respiratory symptoms, lung function tests, COPD diagnostics, and measurement of CRP serum concentrations.RESULTS: Serum CRP concentrations were raised in stable COPD patients independent of smoking habit or exposure duration. The mean CRP serum concentrations were higher in the subjects of EG1 and EG2 compared with those in CG, but without statistical significance. This count for mean CRP serum concentrations in subjects of EG1 and EG2 exposed more than 20 years and for those in smokers in all three groups as well. The mean CRP serum concentrations were significantly higher in subjects with COPD within EG1 (P=0.049) and EG2 (P=0.040), while those in CG were not.CONCLUSION: Data obtained suggest that systemic inflammation is present in farmers with COPD and CRP is an important biomarker in COPD in means of reflecting disease severity and prognosis of exposed farmers.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2017
    detail.hit.zdb_id: 3032255-8
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  • 6
    Online Resource
    Online Resource
    Scientific Foundation SPIROSKI ; 2018
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 6, No. 11 ( 2018-11-07), p. 2017-2022
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 6, No. 11 ( 2018-11-07), p. 2017-2022
    Abstract: BACKGROUND: Bacterial infections are involved in more than a half of the exacerbations of chronic obstructive pulmonary disease (COPD). AIM: To evaluate the efficacy and safety of moxifloxacin in the outpatient treatment of moderate exacerbations of bacterial origin in the COPD patients. METHODS: We performed a prospective, observational study including 64 COPD patients with moderate exacerbation of bacterial origin empirically treated with moxifloxacin. In 31 of them, moxifloxacin was used as an initial antibiotic (Group 1), whereas in 33 of them moxifloxacin was used after treatment failure with another antibiotic (Group 2). All patients have treated 7 days with moxifloxacin 400 mg once daily per os, and they were followed up for 20 days, with an intermediate visit at 3, 5 and 7 days at which the duration of symptoms and the side effects of the drug were evaluated. RESULTS: We registered high clinical success rate, i.e. the complete resolution of the symptoms or their return to the baseline severity, similar in both groups (84.3% in all study subjects, 83.9% in the Group 1 and 84.8% in the Group 2). The mean time to complete resolution of the cardinal symptoms or their return to the baseline severity was 5.2 ± 1.1 days. Also, the mean time to complete resolution of the certain cardinal symptoms (increased dyspnea, increased sputum volume and increased sputum purulence) or their return to the baseline severity is given 4.9, 4.7 and 4.2 days, respectively. The incidence of adverse effects during the treatment with moxifloxacin in all study subjects was 10.9%, 9.6% in Group 1 and 12.1% in Group 2. There was no serious adverse effect that required discontinuation of the treatment. Relapse during a 20 days follow-up period was registered in 7.4% of the all study subjects with complete resolution of the cardinal symptoms or their return to the baseline severity, i.e. in two patients from both Group 1 and Group 2 (7.6% and 7.1%, respectively). CONCLUSION: Our findings suggest high efficacy and good tolerability of moxifloxacin in the treatment of moderate COPD exacerbations of bacterial origin.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2018
    detail.hit.zdb_id: 3032255-8
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  • 7
    Online Resource
    Online Resource
    Scientific Foundation SPIROSKI ; 2015
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 3, No. 1 ( 2015-02-13), p. 176-183
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 3, No. 1 ( 2015-02-13), p. 176-183
    Abstract: BACKGROUND: Few studies have examined teamwork as mediator and moderator of work demands-burnout and job engagement-job satisfaction relationships in healthcare workers (HCWs) in South-East Europe.AIM: To assess mediation and moderation effect of teamwork on the relationship between independent (work demands or job engagement) and dependent (burnout or job satisfaction) variables.METHODS: Work demands, burnout, job engagement, and job satisfaction were measured with Hospital Experience Scale, Maslach Burnout Inventory, Utrecht Work Engagement Scale, and Job Satisfaction Survey, respectively. Hospital Survey on Patient Safety Culture was used for assessment of teamwork. In order to examine role of teamwork as a mediating variable we fit series of regression models for burnout and job satisfaction. We also fit regression models predicting outcome (burnout or job satisfaction) from predictor (work demands or job engagement) and moderator (teamwork) variable.RESULTS: Teamwork was partial mediator of work demands-burnout relationship and full mediator of job engagement-job satisfaction relationship. We found that only job engagement-job satisfaction relationship was moderated by teamwork.CONCLUSIONS: Occupational health services should target detection of burnout in HCWs and implementation of organizational interventions in hospitals, taking into account findings that teamwork predicted reduced burnout and higher job satisfaction.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2015
    detail.hit.zdb_id: 3032255-8
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  • 8
    Online Resource
    Online Resource
    Scientific Foundation SPIROSKI ; 2020
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 8, No. T1 ( 2020-12-25), p. 634-641
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 8, No. T1 ( 2020-12-25), p. 634-641
    Abstract: BACKGROUND: Coronavirus (CoV) disease (COVID)-19 pandemic has put immense pressure on the healthcare systems worldwide. AIM: The aim of the actual study was to assess the availability of personal protective equipment (PPE) in health workers (HWs) during an outbreak. METHODS: The study was conducted in April-May 2020 using an on-line questionnaire. Completed surveys were returned by 560 HWs (297 physicians, 79 nurses/technicians, 78 dentists, 9 pharmacists, and 97 other HWs). RESULTS: High proportion of HWs was using one surgery mask for two or more times or not using it at all when contacting patients who were self-isolated (35.3%) or severe acute respiratory syndrome CoV (SARS-CoV)-2 positive (19.3%). More than 90% of participants were using surgery masks and gloves every time or almost every time while working with patients who were self-isolated or SARS-CoV-2 positive. High frequency of participants reported: No isolation zones at the workplace (61.2%), no triage of patients at the entrance (33.4%), and not attended a training course about the correct usage of PPE (72%). CONCLUSION: The data obtained can be used in the creation of specific interventions in healthcare settings aimed at providing high-quality PPE through the development of a national healthcare strategy that can lead to the prevention of COVID-19 in HWs.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2020
    detail.hit.zdb_id: 3032255-8
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  • 9
    Online Resource
    Online Resource
    Scientific Foundation SPIROSKI ; 2022
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 10, No. E ( 2022-10-13), p. 1652-1660
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 10, No. E ( 2022-10-13), p. 1652-1660
    Abstract: Objective: To assess the prevalence and characteristics of chronic obstructive pulmonary disease (COPD) in dairy farmers, and evaluate the role of job exposure and smoking as predictors for respiratory health impairment. Methods: A cross-sectional study was performed, including 83 dairy farmers (mean age: 52.6±8.7 years; mean exposure duration: 23.7±7.6 years) and 80 office workers as a control group (mean age: 52.7±8.2 years) matched for age, smoking habits, and socioeconomic status. Methods for evaluation of study participants included a questionnaire on respiratory symptoms in the last 12 months, baseline spirometry and bronchodilator reversibility testing, and diagnostic criteria for COPD. Results: The mean post-bronchodilator values of spirometric parameters are significantly lower in subjects among EG with negative bronchodilator test compared to those in CG, while the mean post-bronchodilator values of spirometric parameters are lower in dairy farmers with negative BD tests exposed more than 20 years compared to those with exposure less than 20 years, being statistically significant for FEV1/FVC%, MEF25, MEF50 and MEF75. The COPD prevalence is non-significantly higher in dairy farmers compared to controls, and is significantly associated with age over 40 years in dairy farmers (P=0.035). The risk for COPD development in dairy farmers is about 36 fold higher in subjects exposed more than 20 years (OR = 36.00 (1.21-37.77) CI 95%) compared to those with exposure duration less than 20 years, and is about 6 fold higher in dairy farmers who are current smokers (OR = 6.12 (0.95-37.77) CI 95%). COPD is significantly associated with smoking duration among smokers in both groups, while combined effect of smoking, smoking duration, and number of cigarettes smoked daily has a significant impact on COPD development in dairy farmers. According to the GOLD classification, depending on the degree of airflow limitation, mild and moderate types of COPD are detected in dairy farmers, and only mild type in controls, showing no significant difference between the two groups. Conclusion: The study findings recognized the role of farming exposure, and smoking as well, as predictors for respiratory health impairment, and furthermore confirmed their potential to be a predictive factor in the COPD development. These facts should be helpful in detection of critical points for action, indicate the need of adverse occupational exposures reduction through adequate preventive measures and regular health examinations, implementation of relevant engineering controls, smoking cessation programs, and complete and efficient respiratory health assessment.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2022
    detail.hit.zdb_id: 3032255-8
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  • 10
    In: Allergy, Wiley, Vol. 77, No. 6 ( 2022-06), p. 1736-1750
    Abstract: Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life‐threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Conclusion Based on the literature studied for this review, it can be stated that cross‐contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement “this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product” for a voluntary declaration on processed food packages. This level of avoidance of cross‐contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
    Type of Medium: Online Resource
    ISSN: 0105-4538 , 1398-9995
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2003114-2
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