Veroslava Stanković

This study examined associations between self-rated health (SRH) and burnout dimensions among prehospital emergency physicians. This cross-sectional study included a convenience sample of 151 physicians from one emergency medical service in Belgrade, Serbia. Burnout was assessed using the Maslach Burnout Inventory–Human Services Survey and SRH using a single SF-36 general-health item. Ordinal models examined three ordered SRH categories (excellent/very good, good, and fair/poor), with burnout dimensions entered separately and jointly, adjusting for age, sex, professional qualification, and chronic disease. Binary sensitivity analyses compared fair/poor with excellent/very good/good health. Higher emotional exhaustion was associated with less favourable SRH in the separate adjusted ordinal model (OR per 10-point increase: 1.31; 95% CI 1.04–1.64). After mutual adjustment for burnout dimensions, the estimate remained similar but was less precise (OR 1.30; 95% CI 0.96–1.75). Evidence was also inconclusive in the adjusted binary analysis. Depersonalisation and reduced personal accomplishment showed no clear adjusted associations with SRH. Unadjusted associations of shift work and daily working hours with SRH were inconclusive. Emotional exhaustion may be associated with physicians’ perceived health, although the evidence varied across models. The cross-sectional design precludes conclusions about direction or causality; longitudinal studies are needed.

Background/Objectives: Previous studies have linked chronic conditions and multimorbidity to lower physical activity, but evidence across individual movement behaviours remains limited. We examined associations between the number of self-reported chronic diseases and conditions and transport-related walking, leisure time physical activity, muscle-strengthening activity and sedentary behaviour among people aged ≥15 years in Serbia. Methods: Nationally representative 2019 Serbian National Health Survey data were analysed (n = 13,076 with complete information on 17 conditions). Complex sample logistic regression models were sequentially adjusted for sociodemographic characteristics, body mass index, functional mobility and self-rated health. Additional analyses assessed linear trends and departures from linearity using all covariates except self-rated health. Results: Overall, 51.4% reported no condition, 18.0% one and 30.6% two or more. All outcomes were associated with condition status before adjustment, but most associations were attenuated after including functional mobility. After full adjustment, an overall association remained only for muscle-strengthening activity on p = 0.006). Compared with no condition, one condition was associated with higher odds (aOR 1.60, 95% CI 1.18–2.16), but two or more were not. Each additional condition was associated with 4.5% higher odds of sitting or reclining for ≥6 h/day (aOR 1.045, 95% CI 1.006–1.087; p = 0.025). No other linear trends were identified; muscle-strengthening activity showed a departure from linearity (p < 0.001). Conclusions: Associations differed across movement behaviour domains and were attenuated particularly after including functional mobility. The number of conditions alone only partially accounted for observed differences in movement behaviours.

Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder increasingly discussed within the microbiota-gut–brain axis. This narrative review synthesizes evidence on bacterial and fungal dysbiosis in ADHD, with emphasis on Candida spp., diet, probiotics, synbiotics, and health-related quality of life. A structured narrative search of PubMed/MEDLINE, Scopus, and KoBSON-accessible sources was performed for studies addressing ADHD, gut microbiota, mycobiome, Candida, nutrition, microbiome-targeted interventions, and quality of life. Evidence was synthesized thematically because of methodological heterogeneity. Available studies suggest that ADHD may be associated with altered gut microbial diversity, changes in taxa such as Faecalibacterium, Blautia, Odoribacter, and Enterococcus, and immune–metabolic alterations. However, findings are heterogeneous and do not support a single ADHD-specific microbial signature. The fungal component remains insufficiently investigated, although evidence indicates increased Candida, particularly Candida albicans, in children with ADHD and a possible link with intestinal permeability. Dietary quality, micronutrient status, probiotics, and synbiotics may modulate microbiota–gut–brain pathways, but should be considered complementary and individualized, particularly in patients with gastrointestinal, dietary, immune, or metabolic vulnerability. Bacterial and fungal dysbiosis may represent biologically plausible, primarily associative components of ADHD-related pathophysiology. Evidence remains preliminary, exploratory, non-causal, and requires cautious interpretation in future research and clinical settings.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder shaped by both genetic and environmental factors. The gut microbiome and diet have attracted particular interest as potentially modifiable components of the microbiota-gut-brain axis. Objective: This review aimed to critically evaluate the evidence on the role of the gut microbiome in ADHD, the potential mechanisms involved, and the influence of dietary patterns and nutritional interventions. Methodology: We searched PubMed/MEDLINE, Scopus, and Web of Science for studies published up to 31 July 2026. Given the heterogeneity of the available evidence, we synthesised the findings thematically. Results: Studies to date have reported differences in gut microbial diversity, the abundance of specific bacterial and fungal taxa, and short-chain fatty acid concentrations. However, no consistent microbiome profile associated with ADHD has yet been identified. Proposed mechanisms linking the gut microbiome to ADHD include altered intestinal barrier permeability, immune and metabolic signalling, vagal pathways, and the metabolism of neurotransmitter precursors. Diets high in processed foods have been associated with more pronounced ADHD symptoms and a less favourable gut microbiota composition. Evidence for the potential benefits of the Mediterranean dietary pattern, however, comes largely from observational studies. A few-foods diet may benefit some children when implemented under professional supervision. Findings on probiotics, kefir, omega-3 fatty acids, and micronutrient supplementation remain inconsistent. Conclusion: The microbiome and diet are biologically plausible but, as yet, insufficiently established components of the heterogeneous pathophysiology of ADHD. Nutritional interventions should be individualised and used alongside standard treatment, with appropriate monitoring of nutritional status and safety.

Background/Objectives: Bipolar disorder (BD) is a complex and chronic mental health condition that poses significant challenges for both patients and healthcare providers. Traditional treatment methods, including medication and therapy, remain vital, but there is increasing interest in the application of artificial intelligence (AI) to enhance BD management. AI has the potential to improve mood episode prediction, personalize treatment plans, and provide real-time support, offering new opportunities for managing BD more effectively. Our primary objective was to explore the potential role of AI in transforming the management of BD, specifically in mood tracking, prediction, and personalized treatment regimens. Methods: To explore the potential role of AI in transforming BD management, we conducted a review of recent literature using key search terms. We included studies that discussed AI applications in mood tracking, prediction, and treatment personalization. The studies were selected based on their relevance to AI’s role in BD management, with attention to the PICO criteria: Population—individuals diagnosed with BD; Intervention—AI tools for mood prediction, treatment personalization, and real-time support; Comparison—traditional treatment methods (when available); Outcome—measures of mood episode prediction, treatment effectiveness, and improvements in patient care. Results: The findings from recent research reveal promising developments in the use of AI for BD management. Studies suggest that AI-powered tools can enable more proactive and personalized care, improving treatment outcomes and reducing the burden on healthcare professionals. AI’s ability to analyze data from wearable devices, smartphones, and even social media platforms provides valuable insights for early detection and more dynamic treatment adjustments. Conclusions: While AI’s application in BD management is still in its early stages, it presents transformative potential for improving patient care. However, further research and development are crucial to fully realize AI’s potential in supporting BD patients and optimizing treatment efficacy.

Background/Objectives: Our background comprises the previously identified consequences of bipolar disorder’s chronicity, which significantly affects not only the patients but also their caregivers, leading to challenges in caregivers’ physical, emotional, and financial well-being. This impact on caregivers’ quality of life (QOL) is often overlooked in the context of patient-centered care for bipolar disorder. Our objective was to explore how patient-centered care in bipolar disorder management affects caregivers, with a focus on improving both patient and caregiver outcomes. Methods: We performed a thematic qualitative synthesis of reviewed literature and case studies to explore the intersection of patient-centered care in bipolar disorder management and its impact on caregivers. This comprehensive review allowed us to identify key behavioral patterns and emotional fluctuations in patients that significantly affect caregiver well-being, with a focus on the challenges caregivers face due to the unpredictability of mood episodes and the lack of adequate support in current care models. Results: In the results, we identified that while patient-centered care enhances patient outcomes, it also exacerbates the strain on caregivers if their needs are not adequately addressed. Specific behavioral pathways and emotional fluctuations in bipolar disorder impact caregivers, such as the unpredictability of mood episodes, cognitive distortions during manic and depressive phases, and the emotional toll of managing crises. This article also emphasizes the role of patient-centered care, which places the patient at the core of treatment decisions, but often neglects the strain placed on caregivers. Conclusions: We conclude that a holistic approach to care, which includes caregiver support and resources, is essential for improving the QOL of both patients and caregivers. Future research is needed to develop strategies and interventions that better support caregivers and enhance their overall well-being, ensuring that patient care models are truly comprehensive.

Burnout syndrome represents a significant challenge in contemporary work environment, particularly within healthcare and helping professions characterized by high levels of emotional involvement, responsibility, and chronic exposure to stress. According to the World Health Organization, burnout is defined as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed and is manifested through emotional exhaustion, depersonalization, and a reduced sense of professional efficacy. Given the limitations of conventional preventive approaches alone, increasing attention has been directed toward integrative and complementary interventions targeting psychophysiological stress regulation. The aim of this review paper was to examine, based on an analysis of the available scientific literature, the role of Reiki as a complementary therapeutic method in the prevention of burnout syndrome among healthcare and helping professionals. The paper is based on a comprehensive review of relevant international and national studies published between 2000 and 2025, with a qualitative synthesis of theoretical models of burnout, the principles of Reiki practice, and empirical findings regarding its effects. The results of the literature review indicate that Reiki may contribute to reductions in perceived stress, emotional exhaustion, and anxiety, as well as improvements in subjective well-being and professional functioning. Several studies also report favourable changes in physiological stress markers, including heart rate variability, cortisol levels, and immune parameters. Although methodological limitations are present in the existing research, the consistency of findings suggests that Reiki may play a meaningful role as an adjunctive strategy within integrative programs aimed at preventing burnout syndrome.

Obesity is prevalent, complex chronic disease, which can lead to more than 200 diseases, including diabetes, cardiovascular and malignant diseases. Weight bias, stigmatization and discrimination are widespread and with serious consequences for people living with obesity. Approved methods for obesity treatment are: 1. Nutrition improvement; 2. Physical activity; 3. Psychotherapy; 4. Pharmacotherapy; and 5. Surgical therapy. Nutrition interventions and medical nutrition therapy are core treatment for obesity. Nutrition interventions that are safe, effective, nutritionally adequate, culturally acceptable and affordable for long-term adherence, should be considered for adults living with obesity. However, to date, no single best nutrition intervention has been shown to sustain weight loss long-term. Physical activity, psychotherapy, pharmacotherapy and surgical therapy can considerably improve results of treatment, but all together, treating of obesity is complex, expensive and with limited results. It has been suggested that primary prevention is the most cost-effective option for addressing obesity. Therefore, prevention of obesity and related health consequences should be a focus of every healthcare system.

Myo-inositol has attracted attention due to its potential as a therapeutic agent in the treatment of metabolic disorders, particularly diabetes mellitus (DM) and lipid profile disorders. This study investigates the role of myo-inositol in the regulation of glucose metabolism, insulin sensitivity, and lipid profile, with a special focus on its impact on type 2 diabetes and associated lipid disorders. Myo-inositol plays a key role in insulin signaling by regulating insulin action in target tissues, enhancing glucose uptake, and reducing insulin resistance. Clinical studies show that myo-inositol supplementation can lead to significant improvements in glycemic control, including reduced fasting glucose levels and HbAlc, and affects the lipid profile by lowering total cholesterol, LDL, and triglycerides, while increasing HDL levels. Furthermore, myo-inositol shows potential in addressing diabetes-related complications, including diabetic nephropathy and oxidative stress. These findings suggest potential of myo-inositol as an adjunctive therapy in the treatment of diabetes and lipid disorders. However, further clinical research with larger sample sizes is needed to fully understand the long-term effects and safety in patients with diabetes. This review highlights the need for further studies to optimize the therapeutic applications of myo-inositol in metabolic disorders.

Background: People living with obesity frequently experience weight bias, stigma and discrimination, from childhood through all their lives. Wight bias are negative weight-related attitudes, beliefs, assumptions and judgments in society, that are held about people with obesity. Weight stigma is characterized by prejudiced, stereotyped, and discriminatory views and actions towards people with obesity, often fuelled by inaccurate ideas about the causes of obesity. Weight bias, stigma and discrimination usually lead to several physical, psychological and psychosocial consequences. Some of the consequences of weigh bias and stigmatization include increased chronic stress, cortisol levels, oxidative stress, and increased risk for obesity, diabetes, avoidance of healthcare, greater cardiovascular risks, psychological distress, anxiety, body image disturbance and depression. Weight bias can also have social and economic consequences, such as fewer opportunities for education and employment for people living with obesity. A fundamental driver of weight bias is a lack of public understanding of the complex and multifactorial nature of obesity. Public health strategies that focus on obesity as an issue of unhealthy eating and physical inactivity, and ignore biological, genetic, environmental and social contributors of obesity, can contribute to the lack of public understanding of the disease and can lead to people experiencing weight bias and stigma. Public health campaigns that promote negative attitudes and stereotypes toward people with obesity, are not only ineffective in motivating behaviour change but also end up labelling and stigmatizing individuals further. Conclusions: In order to reduce weight bias and stigmatization, public health professionals should be aware of and concerned about weight stigma and its consequences, while all health workers need to be educated and trained in reducing weight stigmatization and discrimination. Instead of using stigmatizing language and images, public health policy makers should develop people-centred policies that move beyond personal responsibility, recognize the complexity of obesity and promote health, dignity and respect, regardless of body weight or shape.