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The realm of the Orthodox Archbishopric of Karlovci in the Austrian Habsburg Empire was like no other founded on the concept of liminality. Established in 1690, the archbishopric was, from its outset, a highly peculiar space-in-between. This Orthodox domain in the Catholic Empire was never truly its own master and constantly threatened to be dissolved into the Catholic majority. The archbishopric had to perpetually re-invent itself and forge new legitimacies that were as ephemeral as its transient glory. Its liminal existence emerged saliently in ceremonial spaces, staged to celebrate the domain's fragile power. From liminal landscapes depicting forlorn glory, to processions staged upon its cities’ disowned spaces, the archbishopric's political propaganda was deeply marked by spatial ambiguities.
Keywords: The Archbishopric of Karlovci, ephemerality, fluidity, liminality, imaginary spaces
If any eighteenth-century realm was founded primarily on the concept of liminality, it was surely the Orthodox Archbishopric of Karlovci in the Austrian Habsburg Empire. Established in 1690 when the Serbian Orthodox populace fled the Ottoman Empire, from the outset, the archbishopric of Karlovci was a very peculiar space-in-between. An Orthodox domain in a Catholic Empire, whose space was never truly its own, and an ethnia constantly on the verge of assimilation into the Catholic majority, it had to perpetually re-invent its existence, and to forge new legitimacies that would prove as ephemeral as its transient glory.
The archbishopric was founded in the Austrian Habsburg Empire as a specific domain and populated by the Orthodox Serbs who, in their exodus in the face of Ottoman oppression, took refuge under Habsburg protection. After years of negotiations, Patriarch Arsenije III Čarnojević, the ecclesiastical leader of the Serbs under Ottoman rule, led one of the greatest exoduses of seventeenth-century Europe that together would re-draw it comprehensively. Such momentous movements of peoples were defining events of the age. This was the great age of movement, while Baroque man was often referred to as homo viator , a man in constant flux. Although situated at the very end of the seventeenth century, the exodus of Orthodox Serbs formed an inseparable part of other migrations that re-drew the map of early modern Europe.
Objective: To evaluate the effect of interaction with a robotic seal (PARO) for pain management in nursing home residents living with dementia.
Methods: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12618000082202), a pilot randomized controlled trial followed by semi-structured interviews were conducted between January 2018 and January 2019. Forty-three residents aged ?65 years living with dementia and chronic pain were recruited from three nursing homes in Australia. Participants were randomized to either a PARO group (individual, non-facilitated, 30-minute sessions, five days per week for six weeks) or a usual care group using a computer-generated random number. Observational pain behaviors were rated by researchers using the Pain Assessment in Advanced Dementia (PAINAD) scale and staff-rated pain levels were measured by the numeric rating scale. Medications regularly prescribed and as needed were quantified by the Medication Quantification Scale-III (MQS-III). Generalized estimating equation model and thematic analysis were used to analyze the data.
Results: Participants in the PARO group had significantly lowered level of observed pain (-0.514, 95% confidence interval [CI] -0.774 to -0.254, p<0.001) and used fewer PRN medications (-1.175, 95% CI - 2.205 to -0.145, p=0.025) than those in usual care after controlling for age, gender, cognitive function and medications at baseline. There were no significant differences in staff-rated pain levels and regularly scheduled medications between the two groups. Interviews also indicated that the PARO intervention may reduce the pain experience through distraction and reminiscence of previous positive memories. Limitations of weight, voice and characteristics of PARO were identified.
Conclusions and Implications: PARO shows promise in reducing pain and medications for nursing home residents living with dementia and chronic pain. This intervention might be incorporated into daily practice as an alternative to manage pain in people with dementia. Care staff need to balance the benefits and limitations of incorporating social robots into their clinical practice and residents’ individualized preferences need to be considered. Larger randomized controlled trials with longer time frames are warranted to further test the use of PARO in long-term care settings.
Occasionally, Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) share similar nuclear features. The current study aims to quantify the differences between the investigated specimens of HT-associated PTC versus the HT alone, to reduce the subjective experience of an observer, by the use of fractal parameters as well as gray-level co-occurrence matrix (GLCM) textural parameters. We have analyzed 250 segmented nuclei per group (nn = 25 per patient and np = 10 patients per group) using the ImageJ software (NIH, Bethesda, MD, USA) as well as an in-house written code for the GLCM analysis. The mean values of parameters were calculated for each patient. The results demonstrated that the malignant cells from the HT-associated PTC specimens showed lower chromatin fractal dimension (p = 0.0321) and higher lacunarity (p = 0.0038) compared with the corresponding cells from the HT specimens. Also, there was a statistically significant difference between the investigated specimens, in the contrast, correlation, angular second moment, and homogeneity, of the GLCM corresponding to the visual texture of follicular cell chromatin. The differences in chromatin fractal and GLCM parameters could be integrated with other diagnostic methods for the improved evaluation of distinctive features of the HT-associated PTC versus the HT in cytology and surgical pathology specimens.
In this research paper we describe the technological properties of beneficial lactic acid bacteria (LAB) obtained from a dairy production chain and the development of a fermented milk produced with Lactobacillus casei MRUV6. Fifteen LAB isolates (Lactobacillus sp., Pediococcus sp. and Weissela sp.) presented acidifying abilities (pH ranges from 0.73 to 2.11), were able to produce diacetyl (except by 5 isolates) and exopolysaccharides, and two were proteolytic. L. casei MRUV6 was selected for producing a fermented milk, stored up to 35 d at 4 and 10°C. Counts on MRS agar with added vancomycin (10 mg/l) and MRS agar with added bile salts (1.5% w/v) ranged from 9.7 to 9.9 log CFU/g, independently of the tested conditions, indicating stability and intestinal resistance of L. casei MRUV6, despite some significant differences (P < 0.05). The study demonstrated the technological potential of a potential probiotic candidate strain, L. casei MRUV6, to be used as a starter culture in the dairy industry.
High prevalence of benzodiazepine use among citizens of Serbia has been described previously. The fourth year medical students are supposed to have sufficient knowledge on benzodiazepines, but it is also clear that medical students are not immune to substance use and abuse.
This study was conducted to assess the perceptions of a Serbian medical students (fourth year), regarding benzodiazepines utilization.
The study was conducted as cross-sectional, using structured questionnaire with 4 multiple-choice questions. The participation was voluntary and anonymous, 112 students participated and the response rate was 87%.
Results showed that slightly above half of the students (n=64; 57.1%) classified benzodiazepines correctly as anxiolytics/hypnotics (sedatives), while the others (n=48; 42.9%) non-specifically classified benzodiazepines as drugs acting on central nervous system. The majority of students stated that they never use benzodiazepines (n=72; 64.3%). Among benzodiazepines users (n=40; 35.7%), 100% were occasional users (less than once a week). The main reason for benzodiazepines use was insomnia (n=16; 40.0%), anxiety (n=12; 30.0%) and other reasons, such as tremor, muscle spasms etc. (n=12; 30.0%). The majority of benzodiazepines users (n=28; 70.0%) stated that benzodiazepines did not impair their concentration and studying, while the rest (n=12; 30.0%) noticed mild impairment.
Serbian fourth year medical students showed mildly disappointing knowledge on benzodiazepines regarding the classification. However, low rate of benzodiazepines use among students and the lack of recreational use indicate awareness of the risk of drugs misuse in this population.
Withdrawal syndrome and post-detoxication period in opiate addicts is characterized by different psychopathologic phenomena including the depressive syndrome.
The aim was to determine the response of the depressive symptoms in opiate post-detoxication syndrome to antidepressants.
Within the sample of 54 heroin addicts detoxified in the period June 2008 to December 2008, 33% were diagnosed as depression requiring treatment with antidepressants.
The assessment of depression performed 21 day after the last use of opiate by means of CGI-S scale and the improvement during the treatment by CGI-I scale. Duration of the treatment lasted 4 months on average.
The results show reduction in depressive symptoms registered in 83% of patients for at least one point on the CGI-I scale, also patients were kept in the treatment programme approximately 2 mounths longer than average.
Opiate post-detoxication syndrome with depressive symptoms indicates antidepressant use and resulted in remission or recovery of symptoms and improves possibilities to keep patients in integrative treatment program
Elder abuse is a serious problem-each year hundreds of thousands of seniors are abused. Although the problem is described, defined and legislatures exist in many countries elder abuse is not still recognized as public health problem. Red Cross of Serbia has organized education of volunteers in Elder Abuse and Discrimination topic which is very important in sensibilisation among community-dwelling. Volunteers (N=226) were informed with generally accepted definitions, research in the field and legislature in Serbia concerning this issue and proposed network for prevention of elder abuse. Interactive workshops gave us data: distribution and types of elder abuse in their local communities and obstacles in referring and positive examples from practice as problem solving models.
Abuse of older people is a single or a repeated act or a failure to act happening in a relationship between two persons based on trust that causes pain or disturbance on the part of the older person. Red Cross of Serbia is the initiator and the founding member of Humanas (the network of 15 civil society organisations dealing with the issues of older people) and is spearheading a campaign of sensitisation of the public in relation to discrimination, neglect and abuse of older people.
Humanas has educated volunteers in Elder Abuse and Discrimination prevention.
A survey has been done in 8 cities in Serbia polling 250 older people of both sexes, age 65 or above. The survey results demonstrate that 44% of all the polled people are familiar with the existence of abuse. Alarmingly, as high as 32% of older people have been exposed to some form of abuse, with the most frequent form being verbal abuse (11.2%) The polled older people have stressed that they hate being called names, made fun of and called stupid or illiterate, within their families as well as in the general community. As for prevention, 52% of the polled older people think that ‘everybody’, meaning both public and civil sector should play a role in prevention.
The problem of abuse of older people has to be approached from a multi-sector and multi-disciplinary perspective. The emphasis should be on new, deeper surveys, education of professionals, family members and other care takers.
During the last 10 years a large volume of circumstantial evidence for an autoimmune aethiology of at least some cases of schizophrenia (SCH) has been collected.
We present the female patient (S.M.), now 41 years old, with four autoimmune diseases and psychosis schizoaffectiva.
Until the age of 2 S.M. had lactae crustae in extremely severe form. From the age of 3-6 she suffered of asthma bronchiale. At the age of 34 she developed the clinical picture of Myasthenia gravis (MG). One year later she got a new relapse of MG. During the diagnostic procedures for MG, just by mistake, an MRI of the brain has been made instead of the MRI of anterior mediastinum, which revealed a huge amount of the demyelinated plaques without any clinical symptoms of Multiple sclerosis (MS). Immunologic examination of the cerebrospinal fluid and evoked potentials examination confirmed the diagnosis of MS. At the age of 40 she got her only up till now clinical relapse of MS.
At the age of 22 S.M. got the first relapse of psychosis compatible with the diagnosis of Psychosis schizoaffectiva. Her psychosis has relapsing course and over the years disabled her in emotional, professional and social capacity.
This case is one more among many cases presented in the literature to contribute to the hypothesis that at least some forms of SCH have the autoimmune origin, which could suggest that immunotherapy might be benefitial to such patients.
In this study, we made an attempt to identify the physician-related factors that determine the choice of drugs in Serbian psychiatric practice.
The study was conducted at two major teaching psychiatric hospitals in Serbia. The structured questionnaire was used, and 41 psychiatrists were interwieved.
Physicians cited approximately four (of eight offered) categories of factors that determine the choice of drugs. Most often, these categories were: safety (adverse effects) (78%), proven efficacy of the drug (73%), recommendations of the relevant guidelines (65%), and reimbursement of the treatment costs by the mandatory health insurance (46%). About 65% of psychiatrists stated that they adhere to the national, or (where there are not national), relevant international therapeutic guidelines. When asked to cite which international or foreign guidelines in particular they used, approximately 50% failed to do so. The other half cited mostly the American Psychiatric Association (APA) Guidelines or National Institute for Health Care and Clinical Excellence (NICE) Guidelines.
The majority of the Serbian psychiatrists rely on the efficacy and safety of the drugs as major determining factors in the choice of therapy. However, substantial percentage of psychiatrists obtain indicators on drugs’ efficacy and safety from their personal professional experience. It is doubtful whether these indicators are valid, or just represent unproven prescribers’ habits. The majority of psychiatrists are willing to accept the relevant guidelines, and the effort should be made on the national level to further develop those guidelines and implement them into everyday practice.
Five factor model of personality tends to measure basic personality structure. Some authors clam that this model is not enough to explain every psychological phenomenon and that sixth factor model is a better solution especially in prediction of psychopathology. The objective of this research is to investigate this hypothesis, whether is possible to explain psychotic symptoms in depression using the five factor model and which is a better option five or sixth model of personality in prediction depression with psychotic symptoms.
Sample consisted of 30 inpatients diagnosed depression with psychotic symptoms and 30 inpatients diagnosed depression without psychotic symptoms. Depression was assessed by ICD-X criteria and confirmed by Hamilton Rating Scale for Depression (21-item form) and by clinical scales from Milons Clinical Multiaxial Inventory (MCMI III). All the participants were administered Neo Pir (five factor model of personality-measures basic personality structure) and DELTA-9 (measures psychoticism proneness).
We found one statistically significant canonical function that discriminate two groups of depressed patients. This function shows that domains of sixth factor-psychoticisam better discriminate psychotic symptoms then dimensions from Neo Pir.
Our findings suggested that the five factor model is not enough to explain and predict psychotic features in depression and that using a new concept of psychoticisam or six factor model of personality could be a better solution in clinical setting.
Torture is considered as physical or mental harassment, torment, causing pain, injuries and humiliation of an innocent person occurring during the shorter or longer period of time.
Is human emotional behavior based on primary biological mechanism that human inherited not only from close animal predecessors, but also significantly more distant kinds on evolutionary ladder?
Results of researches indicate that aggressiveness is stable pattern of behavior in children and young people. Aggressive behavior of humans decreases over the years, although certain types of personalities preserve stability of aggressive behavior.
Psychological profile of torturer includes diagnostical category of antisocial personality disorder.
Mental consequences resulting from torture are depression, psychosomatic reactions, aggression, state of anxiety. The contribution of victimology is significant, particularly from aspect of “selecting” psychopathological reaction. It is also important whether the torturer is known to be victims or it is a stranger. It is understandable that consequences are much more severe with people who had unfortunate to be tortured by known person.
The most common psychopathological reactions are:
1. Fear lived during the torture.
2. Depressive reaction.
3. Aggression - which may not be demonstrated in adequate manner, may be shifted to other people, which may create interpersonal disputes, before all for the victim and represents one of physical consequences resulting from torture.
Torture prevention is problem of individuals, community and society as whole.
Degradation of authorities in one society leads to moral erosion, and on its part, to torture on all functioning levels.
Optimal management of schizophrenia in adolescents is limited by the lack of available therapies. The efficacy and tolerability of aripiprazole was investigated in this patient population.
This 6-week, randomized, double-blind, placebo controlled trial was conducted at 101 international centers, with a safety monitoring board. 13-17 year-olds with a DSM-IV diagnosis of schizophrenia were randomized to placebo, or a fixed dose of aripiprazole 10 mg or 30 mg reached after a 5 or 11 day titration, respectively. The primary endpoint was mean change from baseline on the PANSS Total score at week 6. Secondary endpoints included the PANSS Positive and Negative subscales, and CGI Improvement score. Tolerabilility assessements included frequency and severity of adverse events, as well as blood chemistries, metabolic parameters and weight gain.
Over 85% of 302 patients completed this study. Both 10 mg and 30 mg doses were superior to placebo on the primary endpoint (PANSS total), with significant differences observed as early as Week 1 (30mg). Both doses showed significant improvement on the PANSS Positive and CGI-I scales; and the 10 mg dose group was superior on PANSS Negative score. Approximately 5% of aripiprazole patients discontinued due to AEs. Weight gain and changes in prolactin were minimal.
10mg and 30mg doses of aripiprazole were superior to placebo in the treatment of adolescents with schizophrenia. Aripiprazole was well tolerated, in general, with few discontinuations due to AEs. EPS was the most common AE. Change in body weight was similar to placebo.
High rate of prescribing of psychiatric drugs causes medical, social and economic consequences.
This research was performed by collecting and analysing all the papers published on this matter in Serbia.
In former Yugoslavia (of which Serbia was a constitutive republic), during the eighties, a study of benzodiazepines use showed a trend of the increase of their use (17,9 defined daily doses - DDDs in 1983 - 22,3 DDDs in 1988) (Macolic V et al. Benzodiazepines utilization in Yugoslavia 1983–1988. Pharmaca 1990;217–97). Similar trends continued in the nineties. In 1994 diazepam was at the first position on the list of most prescribed drugs (Miljković M. et al. Analysis of Drug Utilization in Serbia During the Years 1996 and 1997. Pharmacoepidemiol Drug Saf 2000;9:59–64.). The analysis of the trend of prescribing of psychiatric drugs in Serbia (2000–2004) shows the increase, with the emphasis on the use of benzodiazepines and antidepressants (Divac N. et al. Trends in consumption of psychiatric drugs in Serbia and Montenegro 2000–2004. Pharmacoepidemiol Drug Saf. 2006;15:835–8.). There are also positive, qualitative changes in the prescribing practice: the increase of the use of SSRI antidepressants and atypical antipsychotics. Specific prescribing habits were noticed: the common practice of polypharmacy in the treatment of psychoses (Divac N. et al. Antipsychotic polypharmacy at the University Psychiatric Hospital in Serbia. Pharmacoepidemiol Drug Saf. 2007;16:1250–1.).
Pharmacoepidemiologic methods have found its place in Serbian science. The methodology used in these studies is mostly up-to-date. Main limitation of these studies is the lack of databases.
Affective spectrum disorders include mood and anxiety disorders, while term functional somatic syndrome describes disorders with chronic pain as dominant symptom, without patognomonic tissue damage, such as fibromialgia, irritable bowel syndrome, headache. Hypothesis of central neuropathic pain explains possibility of descendent inhibitor mechanism of pain deficiency, including noradrenergic and serotonergic projections, or possibility that central suprasegmental sensitisation within the nociceptive pathway, triggered by emotional stressors can caused pain symptoms in both. Serotonergic and noradrenergic pathways and voltage sensitive channels are include in that mechanism. Modern psychopharmacology can improve treatment fot both. Therapeutic action of SSRI's, SNRI's and alfa 2 delta ligands succesfully can increase neurotransmission in malfunctioning CNS pathways and reduce symptoms.
Our clinical trial was conducted during 2013/2014. with 57 patient 32 female, 25 male, diagnosed as tension headache, without brain damage or disease, with depressive symptoms.
Aim of the trial was to explore usefulness of antidepressant treatment for one of the common functional somatic syndromes as headache. Diagnostic instruments used were HAM-D 17, CGI, personal diary with registered frequency of headache attakcs were sour documents also. Patient treated with fluoxetine 20 mg daily, during 6 month and instructed to use personal diaries to. Diagnostic instruments were used at base line and after the treatment, when diaries reviewed also. Results showed that iimprovement in scores at HAM-D and CGI's scales was remarkable and frequency of headache attacks lowered. Conclusion was that antidepressants can bee effective in an typical functional somatic syndrome and can improve therapeutic approaches for remarkable large group of patients.