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Allchar (North Macedonia) mining area is known for anomalous background Tl concentrations. In this study, we combine accurate detection of Tl stable isotope ratios with data on mineralogy/speciation and chemical extraction of Tl in Tl-contaminated Technosol profiles. We demonstrate that Tl in the studied soils varies significantly in both concentration (500 mg/kg-18 g/kg) and isotopic composition (-1.6 and +3.2 of ε 205 Tl, a ∼0.5‰ spread), which is due to changes in the phase chemistry and/or mineralogy of Tl. Moreover, the observed 205 Tl/ 203 Tl ratios do not reflect the extent to which individual soils undergo Tl isotopic fractionation during mineral weathering and soil formation. Clearly, they reflect the initial isotopic signal(s) of the primary ore or ore minerals, and thus, the general history or type of their genesis. As the Tl carriers, various types of Tl-Me-arsenates, mixtures of jarosite and dorallcharite and minor Mn-oxides predominated. We revealed intense adsorption of Tl by the identified Mn-oxides (≤6.7 at.%). It is hypothesized that these phases are of key importance in the fractionation of Tl isotopes, meaning at this type of secondary oxide-soil solution interface. However, model studies involving primary/secondary components (sulfides, sulfates, oxides and arsenates) are required to understand the mechanisms that may lead to post-depositional Tl isotopic redistribution in soils, as well as Tl isotope systematics in mining wastes in general., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: The Balkan Peninsula, acting as a crossroad between central Europe and the Middle East, presents diverse ecosystems supporting various tick species capable of transmitting TBDs. This study focuses on Serbia and North Macedonia, both endemic for TBDs, aiming to investigate human-biting ticks' prevalence, TBD prevalence, and major TBPs in blood samples., Patients and Methods: This prospective observational study was conducted in 2022 at two medical centers, involving 45 patients from Novi Sad, Serbia, and 17 patients from Skopje, North Macedonia. All participants had either a tick still attached or had had one removed within the preceding 48 h. The study consisted in clinical evaluations of patients and testing of patient samples and ticks for tick-borne pathogens using a High-Throughput pathogen detection system based on microfluidic real-time PCR. In addition, the study assessed the genetic diversity of the identified pathogens., Results: Ixodes ricinus was the most prevalent tick species, with varying infestation rates across various body parts. Tick species and feeding times differed between Novi Sad and Skopje. TBPs were prevalent, with Rickettsia spp. dominant in Skopje and a mix including Rickettsia aeschlimannii, Rickettsia monacensis, Anaplasma phagocytophilum, and Borrelia afzelii in Novi Sad. Subclinical bacteremia occurred in 8.06% of cases, mostly involving Anaplasma spp. Clinical manifestations, primarily local hypersensitivity reactions, were observed in six patients. Phylogenetic analysis confirmed R. aeschlimannii and R. monacensis identity, highlighting genetic differences in gltA gene sequences., Conclusions: This study sheds light on the prevalence and diversity of TBPs in tick-infested individuals from Serbia and North Macedonia, contributing valuable insights into the epidemiology of TBDs in the Balkan region., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Subjective quality of life could be considered one of the indicators of health behavior and wellbeing of women in the perinatal period. Accordingly, the aim of this paper was to examine how women in perinatal period perceive quality of life in various domains. Its relationship to age, number of pregnancies, course of pregnancies, and method of delivery and experience with Covid-19 pandemic was investigated, as well. Our sample consisted of 366 pregnant women in any period of pregnancy who came in for regular outpatient examinations and control, those who were hospitalized due to pathological pregnancy or due to the need for intensive care, as well as women in their postnatal period, one year after delivery, who were seeking professional advice from a gynecologist. The majority were aged 20 to 30 years (53.8%). The findings showed that assessed domains of subjective quality of life were related to a variety of experiences with the Covid-19 pandemic. The results are presented and discussed in detail. Implications and limitations are given, as well., (© 2023 Stojan Bajraktarov et al., published by Sciendo.)

Over the last decades, the epidemiology of human brucellosis globally has been subjected to significant changes, with the eradication of many existing endemic hot spots. This paper describes three cases with initial misdiagnosis of brucellosis that were managed during 2011-2017 in Republic of North Macedonia, country that until recently has been declared as endemic region. In spite of the fever, constitutional symptoms, focal disease (spondylitis, pneumonia and orchitis) and previous contact with domestic animals, brucellosis was not initially recognized, and patients were inadequately managed. Brucellosis should be part of differential diagnostic considerations in patients exposed to contacts with animals, with osteoarticular symptoms and signs, constitutional manifestations and different organ involvements in endemic regions where its incidence is diminishing.

This paper presents a brief history of Yugoslav psychology and a review of the current state of psychological research and practice in the former Yugoslav countries. Bibliometric mapping was used to explore the knowledge domain and international visibility of psychological research in Bosnia and Herzegovina, Croatia, North Macedonia, Montenegro, Serbia, and Slovenia. Judging by the number of papers visible in Scopus, psychological research activity in these countries is similar to the other former communist countries. In a relative sense, it is even higher in Slovenia and Croatia. However, psychologists still rely heavily on national journals indexed in Scopus when publishing their papers. Regarding psychological practice, former Yugoslav countries are facing challenges that are more or less typical for all small countries in the global scientific and economic market. Keeping in mind all the obstacles and traumas in the past decades, it should be considered a success that psychology in the former Yugoslav countries is now a fully established profession and a recognized scientific discipline., (© 2022 Wiley Periodicals LLC.)

Background: Congenital hypothyroidism (CH) is a common endocrine disorder that can be treated if timely detected by newborn screening, optimizing the developmental outcome in affected children. In the present study, we analyze the data of the national newborn thyroid screening program in North Macedonia collected over twenty years, including the CH prevalence as well as its geographical and ethnic variations., Methods: The thyroid-stimulating hormone (TSH) was measured on a filter paper blood spot sample using the DELFIA fluoroimmunometric assay. A TSH value of 15 mIU/L whole blood was used as the cutoff point until 2010 and 10 mIU/L thereafter., Results: Out of 377,508 screened live births, a total of 226 newborns with primary CH were detected, providing an overall prevalence of 6.0 per 10,000. Lowering the TSH cutoff led to an apparently increased prevalence of the transient CH, from 0.2 to 2.4 per 10,000 live births (p < 0.0001) with an impact on the overall prevalence of primary CH (from 4.0 to 7.1 per 10,000, p=0.0001). Taking ethnicity into account, the significantly highest primary CH prevalence of 11.3 per 10,000 live births was observed among the Roma neonates, with a predominance of permanent CH (75.5%). There were also regional differences in the prevalence of primary CH. The highest primary CH prevalence of 11.7 per 10,000 live births was observed in the Vardar region, together with the highest regional prevalence of the transient CH (3.2 per 10,000). The highest prevalence of permanent CH was observed in the Pelagonia region (6.6 per 10,000) where the largest percentage of the Roma population lives., Conclusions: The overall CH prevalence is high in North Macedonia, with substantial ethnic and geographical variations. Further analysis to elucidate the causes for the significant variations in the CH prevalence including environmental factors is warranted.

Citizens and scientists can work together to improve the collective well-being, if citizens are inspired to help the advancement of science, and researchers motivated to listen to the voices of citizens. The benefits of such collaboration are increasingly recognized by both citizens and scientists, as reflected in the growing number of related publications and initiatives. This is especially relevant for emerging areas of research, where early involvement of citizens could help to envision, prioritize, and plan prospective studies. The Problematic Usage of the Internet (PUI) is one such area, which is fast becoming a public mental health concern. However, there remains a lack of clarity regarding the practical guidelines and ethical requirements for citizen involvement at the earliest stages of PUI. In our paper, we propose a conceptual framework and a template for initial involvement of citizens in PUI. They are derived from our community case studies, conducted in six European countries (Georgia, Greece, Malta, North Macedonia, Portugal, and Spain) and consisting of consultation with diverse groups of interested citizens (students, parents, teachers, and health professionals). Informed by our consultation exercises, we also highlight four ethical aspects for citizen involvement in the research on PUI or novel disciplines in general. They follow simple guiding principles to ensure that scientists will: enable a long-term commitment and inclusive opportunities for citizens, challenge established power hierarchies, and support collaboration, co-production and co-authorship with citizens. We believe that the proposed practical guidelines and ethical considerations, provide a valuable foundation on which to advance our understanding and generate international strategies for citizen involvement in PUI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gjoneska, Jones, Vella, Bonanno, Flora, Fontalba-Navas, Hall, Ignjatova, Kirtava, Moreno Sanjuán, Vaz-Rebelo and Sales.)

The Macedonian Society for Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) was established on September 1, 1992 in order to stimulate the development of nephrology and to unite experts from all professions interested in the research and treatment of kidney patients. Momir H. Polenakovic was elected President of MSNDTAO.The First congress of MSNTAO was held in Ohrid from October, 7 to 10, 1993 in hotel "Desaret" under the auspices of the first President of R. Macedonia, Kiro Gligorov. During the Congress, the Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO) was formed on October 9, 1993. The idea of cooperation with the Department of Nephrology from the Ege University, Izmir, R. Turkey was promoted. Some of the presented papers were published in the Proceedings "Nephrology '93" as a supplement to the Macedonian medical review. The "Doctrine for performing nephrological activity in the Republic of Macedonia" was also promoted.The Second congress of MSNDTAO was held in Struga, R. Macedonia from September, 6 to 10, 1997 together with the Second BANTAO Congress. Selected papers were printed in the Macedonian Medical Review.The Third congress of MSNDTAO was held from May, 30 to June 2, 2001 in Skopje, at the Macedonian Academy of Sciences and Arts (MASA). Proceedings of papers was also published.In 2011 M. H. Polenakovic was elected Honorary President of MSNDTAO for life, and Goce Spasovski was elected the current President of MSNDTAO.The Fourth congress of MSNDTAO was held in Ohrid from June, 21 to 24, 2012 together with the Fourth Meeting of the South-Eastern European Pediatric Nephrology Working Group (SEEPNWG).The Fifth congress of MSNDTAO was held from June, 9 to 12, 2016 in Skopje, at MASA together with the 6th Southeastern European Pediatric Nephrology Working Group (SEPNWG) Meeting and IPNA (International Pediatric Nephrology Association) Teaching Course. The VIII Macedonian-Croatian Nephrology Days were also held during the Congress.The Sixth congress of MSNDTAO was held from September, 26 to 29, 2019 along with the 15th BANTAO Congress, in Skopje, at MASA. The Congress also marked the 80th anniversary of the birth of M. H. Polenakovic.Apart from the participants from R. Macedonia, the congress was attended by renowned nephrologists from Europe and the world.A novelty of the last congresses was the organization of 9 CME (Continuing Medical Education) courses with famous lecturers. CME courses supported by the ERA-EDTA and / or the ISN were as follows: 2005 - Ohrid (BANTAO), 2006 - Skopje (MSNDTAO), 2009 - Skopje (MSNDTAO), 2010 - Skopje (ERA-EDTA - ESAO), 2011 Skopje (ERA-EDTA - EUTox group), 2012 - Ohrid (MSNDTAO), 2014 -Skopje (MSNDTAO), 2016 - Skopje (MSNDTAO), 2018 - Skopje (MSNDTAO - ERA-EDTA & ISN), 2019 - Skopje (BANTAO - ISN & ERA-EDTA).In addition to the congresses, MSNDTAO has held meetings with nephrological associations from the neighboring countries as Croatia, Serbia, Albania and Kosovo.The congresses of MSNDTAO contributed to the introduction and education of doctors in the diagnosis and treatment of kidney patients. They were a strong stimulus for the development of nephrology in R. Macedonia and beyond.

Prof. Dr. Dimitar T. Hrisoho was born on June 11, 1924 in Bitola, R. Macedonia. He died in Struga on September 22, 1986, and was buried in Skopje. He completed primary and secondary education in Bitola. He graduated from the Medical Faculty in Belgrade in 1951 as one of the best students of his generation (average grade of 9.75). In 1953 he was employed at the Internal Clinic of the Medical Faculty in Skopje, where in 1955 he passed the specialist exam in internal medicine. He successfully defended his habilitation "Polyarthritis chronica evolutiva" and his doctoral dissertation "Clinical features of Vitina nephropathy". The doctoral dissertation indicates that Vitina nephropathy is a new site of the Balkan Endemic Nephropathy entity and that more genetic testing of patients were needed. Based on numerous clinical and scientific researches published in over 200 papers, he was elected a Full Professor of internal medicine at the Medical Faculty of the Ss. Cyril and Methodius University in Skopje in 1971. In 1970, he formed the nephrology section of the Macedonian Medical Association (MMA), which grew into the nephrology Association of MMA. Through the Association, the education of the medical staff from the field of nephrology was performed. He also set up a bio-cybernetics association. He achieved his vision and desire to transfer and apply the achievements of modern nephrology in the diagnosis and treatment of kidney patients in Macedonia at the Clinic of Nephrology of the Medical Faculty in Skopje, which was the first specialized institution established for examination and treatment of kidney patients in the former Yugoslavia and the Balkans. The Clinic educated nephrological staff and examined and treated kidney patients with new methods and drugs that positively affected the development of nephrology as a subspecialty of the internal medicine. D. Hrisoho was actively involved in the introduction of new methods for examination of kidney patients, as well as in the treatment of patients with acute and chronic renal insufficiency with dialysis since 1965. He also participated in the first two kidney transplantations from living donors performed in 1977. He wrote a chapter on "kidney examination", printed in the book of Prof. A. J. Ignjatovski "Fundamentals of Internal Propedeutics" Part III, published by "Prosvetno delo", 1963, in Skopje. This is the first text to investigate a patient with kidney disease published in a textbook in R. Macedonia. In 1984 he published the textbook "Clinical Nephrology" printed by the University of the Ss. Cyril and Methodius University in Skopje. Prof. D. Hrisoho organized the First Scientific Meeting of Yugoslav Nephrologists with international participation, from 26 to 28 September 1977, in Struga, R. Macedonia. The meeting was attended by prominent nephrologists from the former Yugoslavia, the Balkans, Europe and the United States, among them: J.S. Cameron from UK, J.L. Funck-Brentano from France, M. Burg and P. Ivanovich from the USA, R. Kluthe from Germany and A. Puchlev from Bulgaria. The scientific meeting was the largest nephrology event until then organized in the former Yugoslavia. The meeting provided an exchange of experiences with world-renowned nephrologists. D. Hrisoho presented the paper Artificial intelligence in nephrology. The author tried to apply bio-cybernetics in nephrology. Prof. D. Hrisoho was Vice Dean of the Medical Faculty in Skopje in the period 1963-1965 and Vice Rector of the University of the Ss. Cyril and Methodius University in Skopje in the period 1974-1975. Prof. Hrisoho was also active in socio-political organizations. For his medical, educational and scientific activities he received several awards and recognitions in the country and abroad. Thus, the work of Prof. D. Hrisoho was permanently embedded in the nephrology of R. Macedonia.

The first epidemics of lumpy skin disease (LSD) reported in Europe in 2015 severely affected the cattle farming sector in several Balkan countries. After the first incursion into Greece in 2015, the disease quickly spread across the Balkan region with over 7000 outbreaks reported by the end of 2016. Thanks to a coordinated regional control and eradication policy, the spread of the disease was halted by the end of 2017. Regional large-scale vaccination campaign with effective homologous vaccines and high vaccination coverage revealed to be essential for the successful control the disease, supported by other measures such as early detection of outbreaks, total or partial stamping out and restrictions on cattle movements. The aim of this paper is to discuss the field observations, challenges and lessons learnt while dealing with the first LSD epidemics in Europe. The cross-border collaboration by the veterinary authorities of all affected countries, coordinated by the European Commission and the technical support provided by many other international organizations played a fundamental role in stopping the spread of a disease that otherwise could have expanded further to the European territory causing a large damage to the whole European cattle farming industry. The experience obtained during the control of LSD epidemics indicates that in the future LSD spread can be effectively halted, provided that appropriate surveillance plans and vigilance remains in place in the areas at risk of re-incursion, especially those bordering endemic countries., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This paper presents 58 new records of the family Dolichopodidae for Bulgaria, Montenegro, North Macedonia and European part of Turkey, collected from 37 localities. Seventeen species are recorded for the first time from Bulgaria, six of which are new to the Balkan Peninsula, 23 species for European Turkey, three of which are new to the entire territory of Turkey, seven species for Montenegro and 11 species for North Macedonia. A checklist of the Dolichopodidae of the Balkan Peninsula is provided. The total number of dolichopodids of the Balkan Peninsula is currently raised to 288 species.

The Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO) was established in Ohrid, Republic of Macedonia on October 9, 1993 during the First Congress of the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO). The idea of the founders was that such Society would have a clear impact on several aspects of practice and research in nephrology and artificial organs in the Balkans, firstly, by increasing its international visibility and potential collaborative work, and recognition by international organizations. Secondly, such a society would facilitate the exchange of experience and knowledge between experts in our area. In addition, it would be a very positive symbolic act showing that collaborative work for the betterment of life is possible and desirable in our area and that coming together will bear better fruits at the human and cultural levels. It will also send a very clear signal to the outside world that the Balkans can be a place of collaboration and mutual understanding. Several international bodies such as the International Society of Artificial Organs and the International Faculty of Artificial Organs have signaled their interest in and support for the creation of such a society. Despite the turbulent times in the Balkan Peninsula, the First BANTAO Congress was held in Varna from September 22 to 24, 1995, which was an impressive event. F. Valderrabano, Chairman of the EDTA-ERA registry reported on that event with a lot of sympathy in the paper entitled "Nephrologists of the Balkan countries meet across political frontiers and war fronts - an example to politicians. The foundation of and the Second Congress of BANTAO were also well accepted by the colleagues nephrologists from Russia. The Second Congress was held on September 6-10, 1997 in Struga, the Third BANTAO Congress was held on September 18-20, 1998 in Belgrade, the Fourth Congress of BANTAO was held in Izmir on November 14-16, 1999, the Fifth Congress of BANTAO was held in Thessaloniki on September 30 - October 3, 2001, the 6th BANTAO Congress was held in Varna, on October 6-9, 2003, the 7th BANTAO Congress was held in Ohrid, on September 8-11, 2005, the 8th BANTAO Congress was held in Belgrade, on September 16-19, 2007, the 9th BANTAO Congress was held in Antalya, November 18-22, 2009, the 10th BANTAO Congress was held in Chalkidiki, October 13-15, 2011, the 11th BANTAO Congress was held from 26 to 29 September 2013 in Timisoara on the 20th Anniversary of the foundation of BANTAO, the 12th BANTAO Congress was held on October 15-18, 2015 in Opatija, the 13th BANTAO Congress was held on 4-8 October, 2017 in Sarajevo, the 14th BANTAO Congress was held on September 20-23, 2018, in Budva and the 15th BANTAO Congress was held in Skopje, 26-29 September 2019. Another milestone in the life of BANTAO was the appearance of the BANTAO journal in 2003, which has been published biannually since then. In the past 17 years there have been 33 editions of the journal and seven supplements reporting BANTAO congresses. The editors of the journal past and present are: 2003-2005 (Dimitar Nenov); 2005-2009 (Ali Basci); 2009-(Goce Spasovski). Up to date, more than 400 papers have been published. The BANTAO journal is registered on EBSCO, DOAJ, SCOPUS, and has become a strong 'glue' among nephrologists from the Balkan cities. The BANTAO congresses and the BANTAO journal have succeeded in elevating nephrology knowledge and thus increased the standards of nephrology patient care throughout the Balkans. Standing above the divisive forces of politics, language and war, BANTAO gives a living example that collaboration and humility are feasible in times of maddening destruction, and are transformative.

Aleksandar J. Ignjatovski was born in the Smolensk Region, Russia, on 18.03.1875. He graduated from the Faculty of Medicine in St. Petersburg in 1899 where he started specialization in internal medicine and continued in Berlin, Heidelberg, Munich and Paris. In 1905 he was elected assistant professor in St. Petersburg, continued as an associate professor in Odessa in 1908 and a full-time professor in 1912 in Warsaw. During the October Revolution, he was the Head of the Internal Clinic in Rostov, and in 1920 he emigrated to Belgrade. In 1922 he was appointed full professor and Director of the First Internal Clinic at the Faculty of Medicine in Belgrade, which he established, developed and managed until his retirement in 1946. In 1948 he moved to Skopje as a full professor and first Director of the Internal Clinic at the Faculty of Medicine in Skopje. He studied the pathogenesis of arteriosclerosis and first proved it experimentally, and published a paper in 1908, indicating that it was associated with higher blood cholesterol level. He also dealt with immunobiology and infectious diseases, in particular tuberculosis and tetanus. Prof. A. Ignjatovski was an excellent clinician, teacher and scientist, who published over 80 papers. His most important textbooks are "Clinical Semiotics and Symptomatic Therapy", in two editions, in Russian (1919) and in Serbian (1929-37), and "The Basics of Internal Propedeutics" in three volumes, published in Skopje in 1952, 1954 and 1963. The work of Prof. A. Ignjatovski, as a leading clinician and a great teacher and scientist, is embedded in the development of internal medicine, and medicine in general, in Russia, Serbia and Macedonia. The bright memorial of the founder and first director of the Internal Medicine Clinic and the first Head of the Department of Internal Medicine at the Faculty of Medicine in Skopje has been permanently incorporated in the history of medicine in R. Macedonia. Prof. A. Ignjatovski died on 18.08.1955.

Introduction: Multiple factors can cause infection and other pathological conditions in mothers during childbirth. These risk factors and diseases/complications can be prevented or timely detected through the implementation of special protocols/procedures. The aim of this paper is to identify the implementation of procedures/measures for the prevention and detection of infections and risk factors for morbidity and mortality in four hospitals in the Republic of Macedonia, before and during childbirth., Material and Methods: A retrospective study was conducted in four hospitals in R. Macedonia, in December 2016, on certain days according to the same principle of selection in all institutions. The questionnaire used contained relevant and specific questions related to the application of procedures and protocols at the maternity clinic at the time of admission to the birthplace and immediately prior to delivery., Results: The study analyzes the performed procedures from 137 obstetric histories. Cardiotocograph was taken after the admission in a hospital in 86% of the mothers; a temperature was measured at only 47.5%, and arterial tension at 89.8%. Immediately before delivery, the color and odor of the vaginal discharge in 98.5% of the mothers was checked, urine was analyzed only in 8% of the mothers, and the analysis of the time of rupture of the mammalian sheaths in 98.6% of the mothers., Conclusion: The study showed that part of the analyzed procedures was not sufficiently implemented, and the percentage distribution varied between hospitals. There is a need for introduction of organized programs with standard procedures in maternity wards in order to protect against infections and other pathological conditions during childbirth.

The purpose of this study was to explore the effects of Brain Break ® activities on interest and motivation for physical activity among schoolchildren and the contribution of such activities on learning for health and holistic development. The study sample was comprised of 283 participants, primary school students from 3rd to 5th grades from two public schools in the Republic of Macedonia. Six experimental and six control groups were included in the study. Interventions in classroom settings-based Brain Break ® video exercises were introduced in the experimental group during a period of three months. Students' attitudes toward physical activity were tested using a self-report survey instrument entitled "Attitudes toward Physical Activity Scale (APAS)" before and after intervention. Applied factor analyses were completed and the results of these analysis support APAS validity and the successful use of this application in the measurement of the learning experience, self-awareness, self-efficacy, and self-confidence in developing physical fitness. Learning was enhanced by using video exercises. Information presented in this paper is meaningful for the promotion of better exercise habits and the holistic approach to better health by using personal motivation and motivation provided by others. The results from repeated ANCOVA suggest positive effects of the applied Brain Break ® video exercises as an interventional program. The study confirms the effect of application of Brain Break ® video exercises on children's attitudes for physical activity, motivation for PA, internalization of movement habits as personal good., Competing Interests: The authors declare no conflict of interest.

Objectives: As many studies have shown, one of the most important tendencies of employees nowadays is to achieve work- life balance. Organizations should develop various activities and create supportive climate, within the framework of which employees will have opportunities to realize aforementioned goals which in turn would increase work productivity and work motivation. The aim of this paper was to examine how subjective well-being (life satisfaction and exhaustion) is associated with commitment to work and family roles under the conditions of strongly and weakly perceived organizational support for family life among health care professionals, teachers and bankers in Macedonia. Marriage duration and the number of children were introduced as control variables., Material and Methods: This cross-sectional study was conducted on a sample of 198 full-time employed doctors, nurses, teachers and bankers. Research variables were assessed using self-reported measures/ questionnaires. Hierarchical multiple linear regression was performed for data analysis., Results: It was revealed that occupational role commitment contributed to highly expressed life satisfaction, while exhaustion was predicted by marital role commitment. These relationships were stronger among surveyed employees who reported positive family-supportive organization perception, but tested moderation effect of this variable was not statistically significant. Findings demonstrated that family-supportive organization perception moderated association of the number of children with life satisfaction, that is, participants who perceived an organization as family-supportive and had more children were more satisfied with their life in general., Conclusions: Results highlighted the importance of organizational orientation toward employees, their commitment to work and family roles, and their subjective well-being, as characteristics that might contribute to higher work engagement, success and family satisfaction. Int J Occup Med Environ Health 2018;31(3):281-291., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Papers on medical subjects have been published since the first issue of the journal Prilozi in 1969, totalling a number of of 957 (nine hundred and fifty seven) papers have been published in Prilozi. Two hundred and twenty nine cover subjects on natural sciences and mathematics, and 728 (seven hundred and twenty eight) subjects on medical sciences. So far, 2017 No. XXXVIII-2, 622 (six hundred and twenty two) papers published in Prilozi are in Pubmed. Prilozi is published three times a year and it is covered by the following services: Baidu Scholar, Case, Celdes, CNKI Scholar (China National Knowledge Infrastructure), CNPIEC, DOAJ (Directory of Open Access Journals), EBSCO (relevant databases), EBSCO Discovery Service, Elsevier - SCOPUS, Google Scholar, J-Gate, JournalTOCs, KESLI-NDSL (Korean National Discovery for Science Leaders), Naviga (Softweco), Primo Central (ExLibris), Publons, PubMed, ReadCube, ResearchGate, SCImago (SJR), Summon (Serials Solutions/ProQuest), TDNet, Ulrich's Periodicals Directory/ulrichsweb WanFang Data, WorldCat (OCLC).

Across Europe, Roma face exclusion and obstacles in access to health services, resulting in poorer health. While there are legal and policy frameworks for Roma inclusion, implementation often lags behind. Increasing the grassroots capacity of Roma to advocate for accountability in health care and against systemic impediments has been a central focus of Open Society Foundations (OSF) support. This analysis discusses the impact of an OSF-supported legal advocacy project on Roma health rights in Macedonia. The paper uses qualitative indicators to measure the capacity of nongovernmental organizations, accountability for violations, changes in law and practice, and impact on communities. The methodology for assessing the impact of legal advocacy was developed over the course of OSF's legal advocacy project and used to calculate the baseline and conduct the follow-up assessment to track progress across four strategies: legal empowerment, documentation and advocacy, media advocacy, and strategic litigation. Results show that legal advocacy has led to a notable increase in Roma awareness of their health rights. The number of lawsuits has risen dramatically, and cases are increasingly more sophisticated. Although accountability in health care is still the exception rather than the rule, blatant violations have been reduced. Some structural barriers have also been tackled. At the same time, new challenges require continuous and adaptable legal advocacy., Competing Interests: Competing interests: None declared.

Academician Prof. Dr. Isak Tadzer was born a hundred years ago on December 24, 1916 in Sofia. He completed the primary and secondary education at the German College in Sofia. In 1935 he began his studies at the Medical Faculty in Vienna, which he had to stop because of the annexation of Austria to Germany in 1938. He returned to Bulgaria where he continued his studies and graduated from the Medical Faculty in Sofia in 1941. During the War, 1941-1944, he was forcedly mobilized and he worked as a doctor in several villages. He was twice interned in camps in Bulgaria. In 1944 he joined the National Liberation Army and the Partisan Groups of Yugoslavia. After the liberation in 1945 he started specialization in internal medicine at the famous clinic of Prof. Chilov in Sofia. In 1946 he applied to the call by the Yugoslav government to the doctors in Bulgaria to come in aid of temporary work in our country. On the advice of the current Federal Minister of Public Health Dr. Dimitar Nestorov, Dr. Tadzer came to Skopje and was assigned to work in the Country hospital. He started specialization in internal medicine at the famous professor Ignjatovski, he established a family and decided to stay in Skopje. In 1949 Prof. Tadzer ended his specialization and he was elected an Assistant at the Department of Internal Medicine. In 1951 he left the Internal Clinic and he was elected an Assistant, and in 1952 he was elected a Docent in the subject of Pathological Physiology. In 1959 he was elected, and in 1964 he was re-elected as an Associate Professor, and in 1967 he was elected a Professor of pathophysiology at the Medical Faculty in Skopje. In the period from 1952 to 1978 he was Head of the Department and Director of the Institute of Pathophysiology. He was elected a Corresponding Member of the Macedonian Academy of Sciences and Arts in 1969, and a Full Member in 1974. In the period from 1984 to 1988 he was a Secretary of the Department of Medicine and Biology of the Academy. Prof. Tadzer has published over 300 scientific papers in the field of clinical medicine and pathological physiology, of which about 200 in journals in English, French, German and Serbo-Croatian, as well as 15 books, which include him among the most prolific pathophysiologists on the territory of former Yugoslavia and beyond. In the period from 1950 to 1966 several times he was on a vocational training in similar institutions and centers in Europe, and in 1972 he was on a study stay at many nuclear and medical laboratories in the USA. In addition to his great research activities his contribution as a teacher was of substantial influence and importance to the faculty. He was one of the greatest lectures at the Medical Faculty, the Faculty of Stomatology and the Pharmaceutical Faculty. Prof. Tadzer co-authored in most of the textbooks on pathophysiology for students of medicine, stomatology and pharmacy. He was an extraordinary physician, one of the pillars of the Macedonian medicine, he possessed universal, encyclopedic knowledge and is one of the most renowned medical workers in the second half of the 20th century in Macedonia. In addition to the scientific, medical and educational work Prof. Tadzer has especially rich social activity. He was President of the Faculty Council in 1975-76, he was Vice Dean of the Medical Faculty in 1958-60, Dean of the Faculty from 1963 to 1965, Dean of the Pharmaceutical Faculty and Vice Rector of the University from 1965 to 1967. Especially it should be noted his long-lasting activity at the Macedonian Medical Association of more than 50 years. Also, significant is his creative work within the Editorial board of the journal "Macedonian Medical Review", where for more than 15 years he was Editor in Chief or member of the Editorial board. For his complete activity Prof. Tadzer has won numerous diplomas, plaques and awards, and among them the following are emphasized: National Award of October 11, Order of Labor of Second Degree, the Award of the City of Skopje - November 13, the Charter of Dr. Trifun Panovski and the Certificate of Acknowledgement awarded by the Macedonian Medical Association for the outstanding results in advancing the medical science, practice and development of the health care and the long-term contribution and promotion of the MMA.

Introduction: Prematurely fused metopic suture results in developmental anomaly named trigonocephaly. The treatment of trigonocephaly is a surgical reconstruction, starting from the simple suturectomy toward the complicated cranial vault reconstructions with aim to obtain enough endocranial space for normal development of the brain and aesthetic correction as well., The Aim: The aim of our paper is to present our experience on this pathology in the Republic of Macedonia, stressing the trigonocephaly as one of the rare forms of craniosynostosis. Our material: During a period of 20 years (from 1996 to 2015) at the Pediatric department of the Clinic for Neurosurgery in Skopje, we observed 18 babies with trigonocephaly, including one with Carpenter syndrome and trigonocephaly, 14 males and 4 females. All children had simple trigonocephaly, one had syndromic trigonocephaly (Carpenter's syndrome). According to Oi and Matsumoto classification done in 19865 severe trigonocephaly is observed in 11 cases and, moderate trigonocephaly in 7 cases. Our method: Our treatment consisted of slightly modified Di Rocco's3 surgical procedure named "shell" operation, adding transposition of the "bone flap"., Results: The postoperative period was uneventful except for the expected forehead swelling. The babies were discharged from the hospital on average at the 8th postoperative day. At the three months control after the surgery, the head had excellent aesthetic appearance, with regular psychomotor development according to the age of the patient (Fig 3а and 3b). We had no serious complications except the expected postoperative swelling of the forehead. All operated children had excellent "long term" aesthetic effect and normal psychomotor development., Conclusion: The early recognition of these anomalies including all craniosynostoses, the deformities of the newborn and infant's head and the preventive operative reconstruction would prevent abnormal disturbance of the psychomotor development during the child's growth. The multidisciplinary approach can prevent new disabled individuals in the society. Our technique allows shortening the entire surgical procedure, especially in the departments where blood saving devices are not available.

Background: Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period., Methods: After ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5) and the evolution of the city population in two future time periods: 2026-2045 and 2081-2100, and in a past time period (1986-2005) to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact., Results: Our estimates suggest that, compared to the baseline period (1986-2005), heat-related mortality in Skopje would more than double in 2026-2045, and more than quadruple in 2081-2100. When considering the impact in 2081-2100, sampling variability around the heat-mortality relationship and climate model explained 40.3 and 46.6 % of total variability., Conclusion: These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.

The paper focusses its attention to the medical work of the British Military hospitals stationed in Macedonia during the First World War, the surgical work carried out under very heavy conditions in improvised operating theatres as well as the treatment of the wounded and sick solders brought from the battlefields on the Macedonian Front.

Background: There are only few assays available for the detection of Crimean-Congo Hemorrhagic Fever Virus (CCHFV)-specific antibodies in animals, and data about diagnostic sensitivity and specificity are incompletely documented for most of these tests. This is unfortunate since CCHFV antibodies in animals can be used as indicator for virus circulation in a geographic area and therewith potential risk of human exposure. This paper therefore reports on a novel ELISA for the detection of CCHFV-specific antibodies in cattle and on its application for testing ruminant sera from the Former Yugoslav Republic of Macedonia., Principal Findings: A highly sensitive and specific ELISA was developed to detect CCHFV-specific IgG antibodies in cattle. The assay was validated by using 503 negative serum samples from a country where CCHFV has never been detected until now, and by using 54 positive serum samples. The positive sera were verified by using two commercially available assays (for testing human serum) which we have adapted for use in animals. The sensitivity of the novel ELISA was 98% and its specificity 99%. The presence of Hyalomma ticks was demonstrated in the Former Yugoslav Republic of Macedonia and depending on the region antibody prevalence rates up to 80% were detected in the cattle population., Conclusion: This article describes a fully validated, highly sensitive and specific ELISA for the detection of CCHFV-specific IgG antibodies in cattle. Using this assay, CCHFV-specific antibodies were detected for the first time in cattle in the Former Yugoslav Republic of Macedonia, giving evidence for an active circulation of this virus in the country. Supporting this conclusion, the occurrence of the main vector of CCHFV was demonstrated in the present work for the first time in Former Yugoslav Republic of Macedonia.

Aim: To analyse current ranking (2013) of institutions, journals and researchers in the Republic of Macedonia., Material and Methods: the country rankings of R. Macedonia were analyzed with SCImago Country & Journal Rank (SJR) for subject area Medicine in the years 1996-2013, and ordered by H-index. SCImago Institutions Rankings for 2013 was used for the scientific impact of biomedical institutions in the Republic of Macedonia. Journal metrics from Elsevier for the Macedonian scholarly journals for the period 2009-2013 were performed. Source Normalized Impact per Paper (SNIP), the Impact per Publication (IPP), and SCImago Journal Rank (SJR) were analysed. Macedonian scholarly biomedical journals included in Google Scholar metrics (2013, 2012) were analysed with h5-index and h5-median (June 2014). A semantic analysis of the PubMed database was performed with GoPubMed on November 2, 2014 in order to identify published papers from the field of biomedical sciences affiliated with the country of Macedonia. Harzing's Publish or Perish software was used for author impact analysis and the calculation of the Hirsh-index based on Google Scholar query., Results: The rank of subject area Medicine of R. Macedonia according to the SCImago Journal & Country Rank (SJR) is 110th in the world and 17th in Eastern Europe. Of 20 universities in Macedonia, only Ss Cyril and Methodius University, Skopje, and the University St Clement of Ohrid, Bitola, are listed in the SCImago Institutions Rankings (SIR) for 2013. A very small number of Macedonian scholarly journals is included in Web of Sciences (2), PubMed (1), PubMed Central (1), SCOPUS (6), SCImago (6), and Google Scholar metrics (6). The rank of Hirsh index (h-index) was different from the rank of number of abstracts indexed in PubMed for the top 20 authors from R. Macedonia., Conclusion: The current biomedical scientific impact (2013) of institutions, academic journals and researchers in R. Macedonia is very low. There is an urgent need for organized measures to improve the quality and output of institutions, scholarly journals, and researchers in R. Macedonia in order to achieve higher international standards.

Even in as small a country as R. Macedonia with limited resources allocated for science, there are many journals trying to establish good editorial practices and policies in publishing the scientific work achieved. Among the currently existing medical journals Macedonian Medical Review (MMR), ISSN 0025-1097, deserves to be elaborated as the oldest journal with continuous publication since its first appearance as the journal of the Macedonian Medical Association (MMA). Since its first issue, published in 1946, there has been an opus of some 4500 peer-reviewed published papers in more than 210 issues and some 80 supplements from various congresses and meetings. In this regard, great respect should be paid not only to the editorial boards, but also to the collaborators who have contributed to its successful continuity in all previous years. In line with the needs for further development of the journal and possibilities for access to world databases, the Editorial Board of MMR has made every effort to improve and modernize its work as well as the technical quality of the journal. Hence, MMA has signed a contract with De Gruyter Open as leading publisher of Open Access academic content for further improvement and promotion of the journal and facilitation of the Medline application, so we do hope for the further success of the journal. BANTAO Journal is published on behalf of the Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO), ISSN 1312-2517. The first issue was published in 2003, ten years after BANTAO was born. Its appearance was an extremely important event in the existence of BANTAO. The first official editor of the journal was Dimitar Nenov, Varna (2003-2005), followed by Ali Basci (Izmir, Turkey) and Goce Spasovski (Skopje, Macedonia) as editor-in-chief since 2009. Over the years, the Journal has been included in the EBSCO, DOAJ and SCOPUS/SCIMAGO databases. The journal is published biannually. Until now, 345 papers have been published in the past 11 years, in 21 regular issues and 3 supplements. It may be said that the journal is the "glue" between the nephrologists from the Balkan cities, reflecting the high quality research and scientific potential of Balkan nephrologists. The entire process of submitting and reviewing the manuscripts is electronically done and after their acceptance they are freely available (open access journal) on the website of the association and the journal: www.bantao.org. In this regard, the current President of BANTAO has already signed a contract with De Gruyter Open as leading publisher of Open Access academic content for further improvement and promotion of the journal and Medline application for the further success of the journal.

The Balkan Journal of Medical Genetics (BJMG) is an international, open access journal that publishes scientific papers covering different aspects of medical genetics. It is published by the Macedonian Academy of Sciences and Arts twice a year in both printed and electronic versions. BJMG is covered by many abstracting and indexing databases, including PubMed Central and Thomson Reuters. Although there are many journals in the field of medical genetics, only a few come from regions outside Western Europe and North America. Being one of these few journals, BJMG aims to promote genetics and research on this topic in the Balkan countries and beyond. BJMG's ultimate goal is to raise the scientific quality and metrics of the journal and provide a better place for BJMG in the community of scientific journals.

Several biomedical journals in the Republic of Macedonia have succeeded in maintaining regular publication over the years, but only a few have a long-standing tradition. In this paper we present the basic characteristics of 18 biomedical journals that have been published without a break in the Republic of Macedonia. Of these, more details are given for 14 journals, a particular emphasis being on the journal Prilozi/Contributions of the Macedonian Academy of Sciences and Arts, Section of Medical Sciences as one of the journals with a long-term publishing tradition and one of the journals included in the Medline/PubMed database. A brief or broad description is given for the following journals: Macedonian Medical Review, Acta Morphologica, Physioacta, MJMS-Macedonian Journal of Medical Sciences, International Medical Journal Medicus, Archives of Public Health, Epilepsy, Macedonian Orthopaedics and Traumatology Journal, BANTAO Journal, Macedonian Dental Review, Macedonian Pharmaceutical Bulletin, Macedonian Veterinary Review, Journal of Special Education and Rehabilitation, Balkan Journal of Medical Genetics, Contributions of the Macedonian Scientific Society of Bitola, Vox Medici, Social Medicine: Professional Journal for Public Health, and Prilozi/Contributions of the Macedonian Academy of Sciences and Arts. Journals from Macedonia should aim to be published regularly, should comply with the Uniform requirements for manuscripts submitted to biomedical journals, and with the recommendations of reliable organizations working in the field of publishing and research. These are the key prerequisites which Macedonian journals have to accomplish in order to be included in renowned international bibliographic databases. Thus the results of biomedical science from the Republic of Macedonia will be presented to the international scientific arena.

Ten years ago the Association of Albanian Physicians in Macedonia undertook the very brave step of publishing a scientific medical journal, Medicus, as a platform for publishing biomedical research papers. Medical journal MEDICUS is an international peer-review journal of biomedical science. The first issue was published in 2004, starting with publishing two issues per year. From 2013, the journal delivered three issues per year, namely in January, May and September. Editor-in-Chief of the journal is Prof. Dr. Aziz Pollozhani. This year marks the tenth anniversary since publication of the first issue of Medicus, a fact that makes us proud and happy. The journal has its own official website (www.imjm.mk), where papers can be submitted and published in electronic form. In addition, the journal also comes out in print form to be distributed mainly in the region. Taking into account the specific socio-cultural characteristics of the region, the journal attempts to promote research activities in the region, while seeking to serve as an educational tool to promote scientific work in such a setting. As a result, Medicus accepts manuscripts for publication in English, Albanian and Macedonian, with a mandatory abstract in English for all papers. The journal Medicus represents a solid platform of biomedical sciences that will serve to advance scientific research and promote professional achievements in medicine.

Background: Since its formation after the breakup of Yugoslavia, Macedonia has made major strides in formulating a framework for protecting patient rights through extensive legal reform. The impact of this reform had not been assessed before the work of this project., Methods/objectives: Within the context of a larger project on improving human rights in patient care, this paper provides an overview of patients' rights legislation in Macedonia and uses research, case reports, and other empirical information to highlight the gaps in the implementation of patients' rights legislation on the ground., Results: The Law on the Protection of Patients' Rights (2008) and attendant legislation governing health care provision and other aspects of the social contract in Macedonia provide extensive protections for the rights of patients in such domains as the right to access health care, the right to information, and the right to remedy. This legislation also outlines several new procedural channels to enable patients to vindicate their rights within institutional and governmental structures on the local and national levels. Data from a number of studies and case file reviews suggest, however, that the implementation of many key provisions is lacking, both in terms of quality and presence of services or mechanisms contemplated by Macedonian law. Gaps in implementation disproportionately affect vulnerable and marginalized groups, including women, rural residents, and Roma., Discussion: Although the letter of Macedonian law generally complies with international best practices in patients' rights, these rights are not fully implemented and the mechanisms implied are not fully functional. Additional investment must be made in monitoring systems, education, and incentive mechanisms to ensure effective implementation, including the formation of a mandated commission for the protection of patients' rights., (Copyright © 2013 Alcheva, Gerovski, and Beletsky. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The aim of this paper was to present the strategic approach applied for improvement of quality in emergency medical services (EMS) in the Republic of Macedonia. This approach was accomplished through three stages: (I) assessment and recommendations for policies; (II) development of innovative evidence-based programmes; and (III) policy implementation. Strategic assessment of EMS was performed by applying WHO standard methodology. A survey was conducted in 2006/2007 on the national level in fifteen general hospitals, four university hospitals, and sixteen pre-hospital EMS. The overall evaluation was based on a hospital emergency department (ED) questionnaire, information on the general characteristics of the pre-hospital dispatch centre, review of ED medical records, and the patient questionnaire. The key findings of the assessment showed that EMS required extensive changes and improvements. Pre-hospital EMS was not well-developed and utilised. Hospital EDs were not organised as separate divisions ran by a head medical doctor. The diagnostic and treatment capacities were insufficient or outdated. Most of the surveyed hospitals were capable of providing essential diagnostic tests in 24 h or less. There was no follow-up of the EMS patients or an appropriate link between the hospital EDs and primary health care facilities. The main findings of the assessment, recommendations, and proposals for action served as the basis for new policies and integrated into Macedonia's official strategy for emergency medical services 2009-2017.

Background: Western Balkan countries (WBCs) have a long-standing culinary tradition. The promotion of traditional foods may be a tool for coping with modernisation trends in such transition economies. This paper explores consumer preferences toward food in this region, focusing on a traditional fresh cow cheese locally called 'Mladi Sir'. This product was quoted in all the preliminary focus groups as a common traditional product present in the six WBCs studied: Bosnia-Herzegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia., Results: After a literature review investigating the concept of traditional food in WBCs and the implementation of focus groups, a survey including a conjoint analysis on preferences for fresh cow cheese was carried out in 2011 to collect data from 1200 respondents. Four clusters of consumers were identified: one focused more on the local origin; one oriented more toward the scale of production (on-farm and small dairy); the third favouring low prices and the fourth preferring high prices and industrial products., Conclusion: Policy makers and the supply chain could take these differences in consumer preferences regarding traditional food products into account in order to develop specific strategies., (© 2013 Society of Chemical Industry.)

This paper gives an overview of the development of health insurance and some aspects of the oral health care in the Republic of Macedonia since it became independent in 1991. First, it describes the provision of oral health care and treatments funded by the public health care system. The dental educational system and available epidemiological data are then described. Generally, few data are available about the dental workforce in recent years, especially regarding dental epidemiology. There are various specialisations in dentistry recognised in Macedonia, as well as three subspecialisations: implantology, maxillofacial and reconstructive prosthodontics, and prosthodontics for children. One aspect of particular interest is that there are many dental faculties in Macedonia and many dentists, relative to the population and the country's requirements.

In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original scientific papers published in indexed medical journals.

The University Clinic of Toxicology (UCT) in Skopje was founded as the Clinic for Toxicology and Emergency Internal Medicine on January 15th 1976. Today UCT has a modern building with office space of 1,300 m2 on 4 floors, 40 hospital beds and 72 employees including 18 doctors. UCT works in accordance with the public healthcare services in the Republic of Macedonia through the use of specialist/consultative and hospital healthcare for people over the age of 14 years. The Clinic also provides services in the field of emergency internal medicine, acute poisoning with medications, pesticides, corrosives, poisonous gases and mushrooms, heavy metals and other chemicals. The Clinic takes an active part in the detoxification programme for users of opiates and psychotropic substances, protocols for enteral and parenteral nutrition and guides for home treatment. Yearly there are more than 14,000 ambulance admissions, over 1,400 hospitalized patients, over 4,000 urgent EHO checks, more than 1,000 urgent upper endoscopies and over 700 other toxicological analyses and other interventions. The educational services and activities are realized through the chair for internal medicine. The Clinic offers undergraduate and graduate level education for medical students and dentists, for medical nurses, radiology technicians, speech therapists and physiotherapists. Over 300 papers and reports have been published to date by the medical staff at the UCT in the form of abstracts and integrated projects in the Republic of Macedonia and aboard. 8 doctorates have been successfully completed by employees from the Clinic as well as 4 master's theses and 1 in-depth project. UCT employees are the authors of some textbooks and monographs. UCT have undertaken some scientific projects. Employees from the Clinic of Toxicology are members taking an active part in many domestic and international associations.

In January 1975, de facto, the Nephrology Department was founded at the Medical Faculty in Skopje as the first institution of such a type in former Yugoslavia. The Nephrology Department was the driving force for the further development of nephrology in the Republic of Macedonia. D. Hrisoho was the first Director of the Department, and its subsequent Directors were G. Masin, M. Polenakovic, K. Zafirovska and currently A. Sikole. Prior to the establishment of the Nephrology Clinic there had been considerable experience in the diagnosis and treatment of renal patients. The first haemodialysis (HD) in the Republic of Macedonia (RM) was performed in 1959 on a patient with acute renal failure (ARF) using a Kolff-Brigham rotating drum artificial kidney at the Blood Transfusion Institute in Skopje. In 1965 the Renal Unit at the Department of Medicine, Medical Faculty, Skopje obtained a new, modern "Websinger" artificial kidney with a sigma motor pump and possibilities for the use of a disposable Kolff "twin coil" dialyser. Between 1959 and 1971, HD was performed only on patients with ARF. In May 1971, a Unit for Chronic HD was founded at the Renal Unit and the programme of maintenance haemodialysis (MHD) was started with five Stuttgart Fresenius machines and 12 patients dialysed on twin coil dialysers. That was a great incentive for the development of HD in the Republic of Macedonia enforced by the great number of patients with end stage renal disease. Thus in 2007 we have 18 HD centres in the Republic of Macedonia, with 1183 patients. Treatment of the patients with MHD is the greatest success achieved in the Republic of Macedonia in nephrology concerning patients with end stage renal disease. Prior to the treatment with MHD patients were destined to die, whereas now, with this type of treatment, they have a normal life and families. Patients with kidney diseases are examined in outpatients clinics as well as treated in the wards of the Department. All types of vascular accesses, renal biopsies, bone biopsies, kidney ultrasound, plasmapheresis and other investigations are performed every day at the Nephrology Department of the Medical Faculty. On the basis of the results of renal biopsy, a classification of parenchymal renal diseases has been established, as well as appropriate immunosuppressive and other treatments. The nephrology doctrine for primary, secondary and tertiary healthcare has been prepared and has been distributed to all medical centres in the Republic of Macedonia. The first (living donor) renal transplantation was performed in July 1977. Later, living and cadaver donor transplantations were performed, so the Department of Nephrology was complete concerning dialysis and renal transplantation, and it became part of the European centres for diagnosis and therapy of kidney disease. Doctors from the Nephrology Department are among the most productive scientific workers in the Republic of Macedonia and their papers can be found on the internet Pub Med. The Department of Nephrology, together with the Nephrology Association, was the source of knowledge in the area of nephrology and the transfer of knowledge from abroad into Macedonia and vice versa. The Nephrology Association has made a great contribution in the development of nephrology in our country. The most famous European and world nephrologists have participated in the work of our association and have contributed to the development of nephrology not only in Macedonia, but on the Balkans as well.

Dimitar Arsov was born in Kriva Palanka on September 28, 1908 and died on July 2, 1974 in Skopje; he had finished elementary education in Kriva Palanka, high school (1922-1926) in Kumanovo, Macedonia and Col-lege of Medicine (1926-1932), Ph. D. University of Paris, Sorbone, France, 1936. He returned to Macedonia in 1937. In 1947 he was elected and Assistant Professor and in 1950 a Docent at the Faculty of Medicine in Skopje. He was appointed Director of the Clinic of Medicine and Head of the Chair of Internal Medicine, who served at those positions in the period 1952-74. In 1958 he was elected Professor of Internal Medicine. The first habilitation of the Medical Faculty in Skopje was defended by D. Arsov in 1954, titled: "The Effects of the Intravenous Epinephrine on the Hypersplenism of Malaria and Cala-Azar". On August 18, 1967, D. Arsov was elected Full Member and also the first member in the field of medicine of the Macedonian Academy of Sciences and Arts. The excellent experience in the work with the patients, precise observation of the symptoms and syndromes of the diseases in each patient, knowing the most advanced therapy at that time enabled D. Arsov to make conclusion for possibility of new therapy and gave him the material for writing scientific papers. In the first half of the 50s, during his regular work, Arsov discovers a new, internationally recognized therapy for rheumatism. Patients of both Cala-Azar and inflammatory rheumatism were treated with small doses of adrenaline therapy and they felt drastic decrease in rheumatism inflammation within one week. This therapy was used a couple of years in several countries around the world. He participated in the undergraduate and graduate studies. He contributed to the development of 2,240 graduated doctors and under his management over 300 doctors specialized in internal medicine and became specialists internists. Under his management, numerous habilitations and dissertations in internal medicine were finished. He contributed also to the development of 25 assistants, 5 docents, 5 full-time professors in internal medicine at the Medical Faculty in Skopje. He has published more than 200 papers from different areas of internal medicine, of which 36 are on the PubMed. He has published 5 books on internal medicine for students and doctors. He was a President and member of several Macedonian medical associations, as well as of medical associations of former Yugoslavia. He was awarded with the highest awards of former Yugoslavia and Macedonia. He was also awarded with international awards, such as: Doctor Honoris Causa by the University in Besancon and Honor and Medal from the City Assembly of Besancon (France). During his management of the Internal clinic the University Internal clinic developed eight different sub-specialist departments: Cardiology, Pneumology, Rheumatology, Nephrology, Hematology, Gastroenterology and Endocrinology with metabolism and Clinical biochemical laboratory. The fast development of subspecialties has led to development of separate clinics for each subspecialty in 1975, so only the Chair of Internal Medicine remained as a connection between the subspecialties for education and scientific research. He was a prolific scientist who after World War II wrote the first scientific and specialist papers and books in the field of internal medicine in Macedonia. He created a school of internal medicine. The scientific and uncompromised attitude towards the expert truth are weaved in the unforgettable face of the Academician Prof. D-r. Dimitar Arsov, scientist, teacher, and doctor. With his vast work in healing the sick and preventing the diseases in the Republic of Macedonia, he became the cornerstone of modern medicine in the Republic of Macedonia. Thus, he truly deserves to be the doyen of internal medicine, one of the leading, most important persons in medicine of the 20th century in our country. Today, his honorary name appears on: Clinic of Rheumatology at the Medical Faculty in Skopje, Medical Center in Kriva Palanka, Scientific Club of the student organization of the Medical Faculty in Skopje.

University Pulmology and Allergy Clinic was founded in 1975 when the Depertment of Internal Medicine, directed by Prof. Dr. Dimitar Arsov, later member of the Macedonian Academy of Sciencies and Arts, was divided into eight separate and independent clinics. The first head of the Pulmonology and Allergy Clinic was Prof. Dr. Ljubomir Kotevski. He had a very difficult goal: to establish and further develop the newly formed clinic. The Clinic flourished and became one of the leading Clinics in the Clinical Centre during the directorship of Prof. dr. Dejan Dokic.. He completely rebuilt and refurbished the Clinic, which became a modern Clinic providing excellent working conditions for the employees and, most importantly, provided a first class service to the patients. During his mandate he obtained a grant from the Japanese Government worth $1,000,000 which was used to obtain a new, modern and sophisticated medical equipment. Since the establishment of the clinic, many national and international scientific projects were carried out and many scientific papers were published as well as many monographs, and chapters in scientific books. As a result of continuous education, of the total number of 24 doctors there are 16 subspecialists in respiratory medicine and 4 specialists in internal medicine. There are 9 professors in internal medicine at the University of Pulmonology and Allergy Clinic lecturing at the Medical Faculty in Skopje. The University Pulmonology and Allergy Clinic has an international reputation due to many contacts with famous European Institutions. All these international interrelations have resulted in honouring 3 professors: Prof. Dr. Gert Kunkel from Berlin, Germany, Prof. Dr. Robert Loddenkemper from Berlin, Germany and Prof. Dr. Peter Howard from Southampton, UK.

Aim: The aim of the paper was to present the efficacy and indications for application of conventional surgical treatment of retinal detachment by using external implants, that is,application of encircling band and buckle., Material and Method: This study comprised patients from the University Eye Clinic in Skopje. A total of 33 patients were diagnosed and surgically treated in the period between May 2010 and August 2011. Conventional surgery was applied in smaller number of patients whose changes of the vitreous body were manifested by detachment of posterior hyaloid membrane, syneresis, with appearance of a small number of pigment cells in the vitreous body and synchysis, and the very retina was with fresh detachment without folds or epiretinal changes (that is, PVR A grade). There were a larger number of patients with more distinct proliferative changes of the vitreous body and of the retina, grades PVR B to C1-C2, and who also underwent the same surgical approach. Routine ophthalmologic examinations were performed, including: determination of visual acuity by Snellen's optotypes, determination of eye pressure with Schiotz's tonometer, examination of anterior segment on biomicroscopy, indirect biomicroscopy of posterior eye segment (vitreous body and retina) and examination on biomicroscopy with Goldmann prism, B scan echography of the eyes before and after surgical treatment. Conventional treatment was used by external application of buckle or application of buckle and encircling band. In case of one break, radial buckle was applied and in case of multiple breaks in one quadrant limbus parallel buckle was applied. Besides buckle, encircling band was applied in patients with total or subtotal retinal detachment with already present distinct changes in the vitreous body (PVR B or C1-C2) and degenerative changes in the vitreous body. Breaks were closed with cryopexy., Results: The results obtained have shown that male gender was predominant and that the disease was manifested in younger male adults. According to the present risk factor, high myopia was found in 5 patients, which has been emphasized to be a significant risk factor for onset of retinal detachment. Lattice degeneration was the most common peripheral degenerative change. The most frequently found was horseshoe retinal hole with vitreous traction and the break location was most common in the upper retinal quadrants. The most commonly applied type was limbus radial buckle with encircling band, depending on the pathological process in the eye. The retina was postoperatively attached in 31 eyes. In two cases, the retina was not attached; in one eye due to the inadequately inserted implant and in the other case due to the larger number of breaks (3) with more distinct PVR (C2), and postoperative inflammation and proliferative components were more intensified. In one patient who did not have a total detachment, but had a larger break placed posterior to the equator and PVR C1, redetachment appeared one month later due to a manifested fibroproliferative reaction, although the break was closed. Regarding visual acuity, the day following the surgery there was no improvement; moreover, there was a small decline of visual acuity due to exudates in the vitreous body and vitreous hemorrhage. After 3 months, there was a significant improvement in the largest number of eyes. Intraoperative complications included intravitreous hemorrhage, and postoperative more distinct proliferative component in the vitreous body was found in two patients., Conclusion: Timely diagnosis and intervention in retinal detachment by application of an adequate method and less invasive technique gives excellent results in postoperative morbidity rate and rehabilitation of the vision. The results of the conventional treatment of retinal detachment justify its application in the treatment of this disease.

This paper presents a GIS-based multi-criteria decision analysis approach for evaluating the suitability for landfill site selection in the Polog Region, Macedonia. The multi-criteria decision framework considers environmental and economic factors which are standardized by fuzzy membership functions and combined by integration of analytical hierarchy process (AHP) and ordered weighted average (OWA) techniques. The AHP is used for the elicitation of attribute weights while the OWA operator function is used to generate a wide range of decision alternatives for addressing uncertainty associated with interaction between multiple criteria. The usefulness of the approach is illustrated by different OWA scenarios that report landfill suitability on a scale between 0 and 1. The OWA scenarios are intended to quantify the level of risk taking (i.e., optimistic, pessimistic, and neutral) and to facilitate a better understanding of patterns that emerge from decision alternatives involved in the decision making process., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The first scientific meeting of nephrologists in Yugoslavia with international participation was held in Struga, Republic of Macedonia, on Lake Ohrid, 26 to 28 September 1977. During the Third Symposium on Endemic Nephropathy, which was held in Nis on 5 to 8 November 1975 at the Radon Hotel, representatives of the nephrology sections of the republics founded the Yugoslav Society of Nephrology. Academician Vojislav Danilovic from Belgrade was elected as the Association's first President. It was decided that the first scientific meeting of Yugoslav Nephrologists be held in Struga, Macedonia, 1977, and the first Nephrology Congress in Belgrade in 1979. It was also agreed that congresses be held every four years, and to organize scientific meetings between congresses. In this way, the Nephrology Association of Yugoslavia gained the opportunity for a lot of activities every two years. The Proceedings of the First Scientific Meeting of Yugoslav Nephrologists contained 6 plenary lectures and 84 papers presented during the three sections of the scientific meeting, 31 about hypertension and kidneys, 19 about immunology in nephrology and 34 about dialysis. The first scientific meeting of Yugoslav nephrologists with international participation was the first major review of the achievements of Nephrology in Yugoslavia, assessment of its results, work incentives and the creation of a vision for future development. The meeting strengthened the ties among the colleagues, new acquaintances were created, and new ideas for further cooperation appeared.

In 2008, Macedonia adopted the Law on the Protection of Patients' Rights. This was a big step forward in the field of health care and regulation of patients' rights and responsibilities, as well as the rights and responsibilities of the health care providers. The Law introduces some new patients' rights (for example, right to second expert opinion) and new mechanisms for protection of patients' rights (Councilors for protection of patients' rights, Commissions for promotion of patients' rights). As this paper shows, the implementation of this Law is lagging behind. This paper argues that, besides a good law and political will, a continuous promotion of patients' rights and lifelong training of health care professionals is key to achieving promotion and protection of patients' rights in practice. The paper presents the findings from the comparison of the provisions of the Law on the Protection of Patients' Rights and the relevant international documents.

An attempt was made to retrospectively examine the medical journals published in the Republic of Macedonia since the Second World War. An analysis was made of the basic data concerning the journals, most of which are deposited in the Central Library of the Medical Faculty at the Ss. Cyril and Methodius University in Skopje, and a few deposited in the National and the St. Clement of Ohrid University Library in Skopje. Some journal-related data were obtained by searching the electronic databases (mainly Medline/PubMed, Hinari, Ebsco) and the Internet as a global system of network of networks. After the Second World War several attempts at publishing biomedical journals have been made in the Republic of Macedonia. The number of journals has increased especially in the last ten years. Only a few of them have a long-term publishing tradition. In fact, the only journal to maintain continuity in publishing until today is the Macedonian Medical Review, that has been published regularly since 1946 until today. It is an official publication of the Macedonian Medical Society. The Annual of the Medical Faculty in Skopje was published from 1954 to 1997 under this name, and in 1997 it was renamed the Macedonian Journal of Medicine. There was an interruption in its publishing in 1999 and 2000 and it was regularly published until 2007, after which its publication ceased once more. In addition to these two journals, other medicine-related journals that have been published in the Republic of Macedonia (some of them, however, irregularly or they have ceased publication) are Acta Morphologica (since 2004); Physioacta (since 2007); Paediatrics Annual Review (since 1996); Epilepsy (since 1997); Acta Ortopedica et Traumatologica Macedonia (since 1999); MJMS-Macedonian Journal of Medical Sciences (since 2008); Prilozi Macedonian Academy of Arts and Sciences (since 1969); Macedonian Dental Review (since 1977); Dental Review (since 2007); Macedonian Pharmaceutical Bulletin (since 1964); Macedonian Veterinary Review (since 1972); Archives of Public Health (since 2009); Medicus (since 2004); Vox Medici (since 1992); Social Medicine--Professional Journal for Public Health (since 2009); Journal of Special Education and Rehabilitation (since 1997); Balkan Journal of Medical Genetics (since 1998); BANTAO Journal (since 2003); Public Health--Journal for Health Education (1952-1986); Acta Chirurgica Iugoslavica (since 1954); Acta Chirurgica Macedonica (2001-2004); We You and Healthcare (since 2006); Newsletter-Health, Kavadartsi (1999); Medical Review--Professional Journal of the Medical Workers in Shtip (2001); Medicus--Information Newsletter of Public Health, General Hospital Shtip (2006); Medical Bulletin of the Health Service of the Skopje Army Region (1957-1987); Medical Spectrum--Professional Journal of Alkaloid--Skopje (1972-1981); Healthcare Newsletter, Kumanovo (1990-1996); Healthcare, Shtip (1979-1994); Healthcare Platform, Bitola (1975-1984); Journal with papers of the Society of Science and Art, Prilep; Healthcare Newsletter of the Medical Center Prilep (1975-1986); Healthcare Newsletter, Strumica (1978-1988); Contributions, a Journal of the Society of Science and Arts from Bitola; Doctors' Newspaper--Informative and educational newspaper of the Macedonian Medical Association (2010). A number of medical journals appear and after a short period of time disappear. The papers are mainly written in the Macedonian language, and none of the journals are currently indexed in Pub/Med, except for the Prilozi/Contributions of the Macedonian Academy of Sciences and Arts. In our opinion, to improve the quality of the published papers in the Macedonian journals, several goals have to be accomplished: better equipment and facilities in the hospitals, institutes and research centres that would yield better basic research and clinical trials; better basic education on how to write and publish scholarly/scientific papers, which has to be conducted at both undergraduate and postgraduate levels, along with lifelong learning; better peer-review processes; better editorial policy of the journals; compliance with international standards/uniform requirements for manuscripts submitted to biomedical journals; fostering the goals of the World Association of Medical Editors and European Association of Science Editors, etc. If these tasks and goals are realized, then we can build a solid ground to better present our medical results to the world.

Introduction: Most epidemiological studies and reports have reached a consensus on the leading causes of traumatic brain injury (TBI). Despite the fact that the area of TBI is relatively well studied, reports on differences in severity and outcome of TBI with different causes are lacking., Goal: This paper analyses the differences in severity and in short- and long-term outcome of TBIs with different causes., Method: This study analysed data on 1109 patients with severe TBI by dividing them into three injury-cause groups: 'traffic-related', 'falls' and 'other causes'. Severity and outcome was evaluated using chosen direct and indirect indicators., Results: The most severe trauma occurred in the traffic-related group followed by falls and injuries with other causes. On the other hand, patients with traffic-related TBI had the best outcome. Age improves the outcome in the traffic-related group significantly. However, in the multivariate analysis after adjusting for age (and other important predictors including level of care) the odds for favourable long-term outcome stayed significantly higher in the traffic-related group., Conclusions: It is concluded that the causes of TBI should be considered by both clinicians and public health professionals as a lead in prognosis of outcome and policy planning.

The rural economy of the Former Yugoslav Republic of Macedonia has been adapting to new economic and political realities. Especially important for rural areas has been the breakdown of the socialist market structure in agriculture, which meant the demise of cooperative structures and farmers gaining access to new market outlets. The aim of this paper is to investigate the potential of dairy sheep farmers to enter into new contracts with buyers and to analyze why some farmers continue selling to traditional market outlets. Using survey data of dairy sheep farmers we studied the choice they make between 3 market outlets: (1) selling milk to a recently established large dairy processor, (2) selling milk to traditional small local processors, or (3) transforming milk on-farm into cheese and selling it at the farm gate or at local markets. The significance of determinants of choice for these markets were tested in a multinomial logit model, which showed that distance to the collection point of the large dairy processor was the most important determinant of whether farmers sold milk or made cheese, with those at a greater distance selling cheese. Furthermore, we analyzed the main sources of transaction costs in developing new market channels. Overcoming transport and transaction costs may contribute to higher income for the farmers and hence to improving their livelihoods., (Copyright (c) 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Unlabelled: The main objective of the study was to investigate the influence of peers on the main determinants of adolescents' sexual conduct in Macedonia, in order to identify both risk and protective factors., Methodology: Data were obtained through a quantitative cross-sectional survey using a standardized paper-and-pencil self-administered questionnaire prepared for the WHO "Health Behaviour in School-aged Children" study. The study was conducted among 1226 secondary school students aged 15 and 17 (1st and 3rd year) from 10 different secondary schools in Macedonia. Peer contact frequency and peer group activities were examined as independent explanatory variables, and prevalence of sexual activity, age of onset of sexual activity, number of sexual partners and use of contraception during the first and recent sexual intercourse as dependent variables., Results: Peer contact frequency has shown to be a protective factor with regard to the age of onset of sexual activity and use of contraception during the first and recent sexual intercourse, a risk factor with regard to the prevalence of sexual activity, whereas it has no influence on the number of sexual partners. Peer group activities have no influence on the prevalence of sexual activity and the use of contraception, but direct 'face to face' conversation is a protective factor regarding the age of onset of sexual activity and the number of different sexual partners. Chatting over the Internet has shown to be a risk factor regarding the number of sexual partners, while 'hanging out' has no impact on the determinants of sexual conduct., Conclusions: Friends may protect adolescents from risk activities and peer influence may be used in public health interventions aimed to improve adolescent sexual and reproductive health.

The author describes problems related to the implementation of electronic medical record in family medicine in Slovenia since 1992 when first personal computers have been delivered to family physicians' practices. The situation of health care informatization and implementation of electronic medical record in primary health care in new countries, other former Yugoslav republics, is described. There are rather big differences among countries and even among some regions of one country, but in the last year the situation improved, especially in Montenegro, Serbia and Slovenia. The main problem that is still unsolved is software offered by several companies which do not offer many functions, are non-standardized or user friendly enough and is not adapted to doctors' needs. Some important questions on medical records are discussed, e.g. what is in fact a medical record, what is its purpose, who uses it, which record is a good one, what should contain and confidentiality issue. The author describes what makes electronic medical record better than paper-based one (above all it is of better quality, efficiency and care-safe, easier in data retreival and does it offer the possibility of data exchange with other health care professionals) and what are the barriers to its wider implementation.

Unlabelled: (Full text is available at http://www.manu.edu.mk/prilozi). The aim of the study was to assess the gender influence on the main determinants of sexual behaviour of senior high-school students in Skopje, R. Macedonia (prevalence and age of onset of sexual activity, duration of the relationship before and the contraceptive method used during the first sexual intercourse, and number of lifetime sexual partners)., Methods: After ensuring privacy and confidentiality, a cross-sectional study was carried out in Skopje by enrolling 310 high-school students (49.7% males, 49% females, 1.3% unknown) from 5 randomly selected high-schools, from the 4th grade, using a 32-item paper-and-pencil self administered questionnaire., Results: The prevalence of sexual activity was higher among boys than girls (when reaching grade 4 of the study 62.7% of the boys and 26.7% of the girls are sexually active) (p < 0.01). In addition, a significant gender difference was found in the following: the mean age of onset of sexual activity is 16 years for boys and 17 years for girls; concerning the duration of the relationship before the first sexual intercourse 33% of the boys and 2.5% of the girls had experienced one-night stand relationship (p < 0.01); and concerning the number of partners, having four or more sexual partners was reported by 29.8% of the boys and 5% of the girls (p < 0.01). Of those sexually non-active, 62.5% of the boys and 15.5% of the girls did not start with sexual activity because they did not have a chance (p < 0.01); 17.9% of the boys and 79.1% of the girls felt unprepared (p < 0.01)., Conclusion: The data indicates substantial gender differences in sexual initiation patterns and sexual conduct. Boys and girls are vulnerable at different times in their development and hence need to be reached with different public health interventions for improving their sexual and reproductive health, adapted to local cultural and gender norms. Key words: Macedonia, high-school students, sexual behaviour, gender.