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Dušanka M. Krajnović, J. Arsić, A. M. Georgiev, J. Manojlović

Health conditions in Vranje during the Ottoman rule were similar to the situation in the rest of Serbia at that time with poor organized health services. People asked for help for the treatment of "hakims", barbers, doctors and selfeducated folk healers. In the stores that were out of control, in addition to other goods, many medicines, raw materials for making medicines and poisons could be procured from Greece and Turkey. In the 20th century people could still remember various balms, splash, teas, syrups and "madzun" that could be bought in the shops of that time. At the beginning of the 19th century in Vranje, as well as in Serbia, the only help for the sick was provided by Greek self-taught healers, "kaloijatri". There was a self-taught folk healer Mika Stosi who became known in Vranje as "hakim"Mika. "Hakim" Mika died in Constantinople in 1854, where he had gone in order to solve the national status for the Municipality of Vranje . He conveyed his knowledge to his sons Zafir and Dimitrije. Dimitrije was successfully practicing medicine for ten years after his father's death, until a prominent Turk child who was treated by Dimitrije died. Fearing that he would be blamed for the child’s death, "hakim Dimitra " as he was called, committed suicide . A Turkish medical assistant Naum Markovi , who graduated from Medical School in Constantinople, came to Vranje in 1862 . Being a medical assistant (at that time a Turkish title "felcer" was used for this educational degree), he had the right to examine and treat patients and to prepare and sell medicines. In his twofloor house he opened an outpatient department and a pharmacy store where he prepared various preparations in the form of decocts and infusions and many others. Felcer Naum regularly went to Thessaloniki and Constantinople in order to supply his shop with the necessary materials and drugs of herbal, animal and mineral origin. The aim of this paper was to present the historical development of the first community pharmacy in Vranje with the focus on its personnel, legal conditions and pharmacy regulations from the second half of the 19th and the first half of the 20th century. The method of historical analysis was employed. Manual documentary analysis of original sources and desk research analysis from the secondary sources were conducted.

J. Brkic, L. Tasić, Dušanka M. Krajnović

Pharmacists as the most accessible health care professionals in outpatient settings can improve palliative patient care. The aim of this review was to assess utility of pharmacists (the effectiveness of pharmacists' interventions) on clinical outcomes of patients in palliative care at all levels of health care and in home care. Two electronic databases were searched: PubMed and SCOPUS (last searched August 2014). Primary studies, of any type of research design, in English, related to clinical outcomes of patients in palliative care and pharmacists' interventions were eligible. Studies that used surrogate outcome measures, such as number of pharmacists' recommendations were excluded. A total of 764 reports were found, and only three of them met our inclusion criteria. All of them assessed effects of pharmacists' interventions in outpatient settings and were case series. Symptoms improvement and stabilization of patients' conditions has been the main utility of pharmacists' interventions. Assessed quality of two studies was moderate, and one study had low quality. As number of studies and quality of the evidence were limited, and results of reviewed studies indicate that pharmacists' interventions potentially could improve clinical outcomes of patients in palliative care, more research is needed to provide evidences in this field .

S. Miljković, Djordje Baljozovic, Dušanka M. Krajnović, L. Tasić, G. Sbutega-Milošević

INTRODUCTION In Serbia, there have been no broad campaigns or educational programs focused on adolescents' sun protection. OBJECTIVE The aim of the study was to assess whether an educational program would have impact on changes of attitudes and sun-protective behaviors of high school students. More specific aim was to examine whether sex and age differences in sun behavior exists. METHODS Educational program was designed to provoke changes in attitudes towards sun protection and sun behavior. The investigation was carried out in Belgrade, Serbia in two educational cycles, during spring 2007 and 2008. Sixteen- and 17-year old high schools students were targeted and assessed before and after the educational intervention by means of self-report questionnaire designed for this study (about skin types and sun behavior). The students' attitudes towards sun protection and sun behavior before and after the educational intervention were compared and analyzed by the Pearson's chi-square test and logistic regression analyses. In the second educational cycle (2008) age and gender differences in sun behavior were analyzed. RESULTS Overall 3205 students in 2007, and 2155 students in 2008 year from 11 high schools participated. A statistically significant behavior change was observed for the use of sunglasses in 2007--the number of students using them increased from 41.6% to 45.6% (p < 0.05). There were no significant changes in other ways of protection i.e. sunscreen use, protective clothes or staying in shade. CONCLUSION Educational program had an impact, but broader activities involving schools, local communities and media are needed for significant changes in sun behavior and attitude.

BACKGROUND/AIM Studies on physicians and other health care professionals indicate that attitudes towards and beliefs in their work with patients, can affect the quality of health care, and patients' behaviour and compliance, thus an instrument is needed to survey pharmacists as healthcare providers. The aim of this study was to describe the development and psychometric validation of a survey instrument to assess attitudes and beliefs of pharmacists toward their work with patients (Pharmacists' Attitudes and Beliefs Scale, PABS). The aim of this research was to determine the reliability, validity and factor structure of a newly constructed instrument - PABS. METHODS The statements from the cognitive, affective, and behavioral areas were identified by literature review and selected to cover the behavior of pharmacists in providing pharmaceutical care at community settings. The initial 5-point Likert type scale of 30 items was constructed and after initial validation its revised form developed. The reliability, construct validity and factor structure of the scale were established. RESULTS The reliability of the scale was determined by the method of internal consistency, on a convenient sample of 123 community pharmacists. The Cronbach's alpha coefficient was 0.67. Factor analysis of principal components was performed and 7 factors with latent roots greater than 1 were extracted, explaining 64.92% of total variance, a single 30.84%, 8.20%, 6.55%, 5.63%00, 5.01%, 4.68% and 4.01%. Based on the results of factor analysis in the development of the scale, some items in the scale were excluded (totally 7), so that the revised form of the PABS contained a total of 23 items. CONCLUSION The initial PABS scale did not meet theoretical statistical criteria for reliability (Cronbach's alpha coefficient was < 0.7), but the findings indicated its potentially acceptable construct validity. The results support its use as a research tool to assess the behavior of pharmacists in daily practice, and provide its use as an indicator of quality in delivering pharmaceutical care.

J. Arsić, Dušanka M. Krajnović, Srboljub Arsić, A. Milošević Georgiev, V. Marinković

INTRODUCTION Healthcare enlightenment and healthcare culture in Vranje and its region were under Turkish influence until the liberation in 1878, when the organisation of education, schooling and healthcare were initiated in the Vranje region OBJECTIVE The aims of this study were to shed light on the beginning of the development of pharmaceutical personnel, and their contribution to healthcare culture development in Vranje and its region, with a focus on healthcare legislation and its impact on pharmaceutical service availability, and the analysis of pharmaceutical personnel development within the healthcare services. METHODS We used the methods of documentation analysis and the desk analysis of the secondary information. RESULTS At the beginning of the 19th century healthcare services in Vranje were still inexistent. After the liberation from the Turks, Naum's medical office with pharmacy was opened in Vranje. Although it did not comply with regulations, it presented the only formal source of supply of medications and sanitary material, and as such it gave its contribution to healthcare service at that time in Vranje. Mr ph. Stevan Varjacic, 1st class pharmacy assistant, worked at a temporary hospital from 1880 until January 1881, suppling with medications soldiers and residents of Vranje. The development of pharmaceutical schooling began in 1883, when a pharmacy was opened by the pharmacist Velimir Karic according to the Law on Healthcare Organisation and People's Healthcare Maintenance. By the end of the 1930s there were ten civilian healthcare institutions in Vranje, even three of which were pharmacies. By the end of 1948, they were nationalized, and were renamed the City National Pharmacy of Vranje. CONCLUSION By the end of the 10th century, passing of the legislation on the regulations of pharmaceutical industry within healthcare services had an impact on Vranje that resulted in opening pharmacies with educated pharmaceutical personnel. Pharmacy owners changed, and the quality and continuity of medical supplies was always secured.

S. Bekcic, Nenad Kelecevic, V. Marinković, L. Tasić, Dušanka M. Krajnović

This paper discusses how a system approach to management can be used for the development and implementation of an integrated management system (IMS) in a company producing medicinal products. It is argued in the paper that approaches to the solutions of how to integrate management systems all require two elements: a conceptual model and a supporting methodology. Although a large number of models has been developed that could provide the basis for integration, development of methodologies to achieve fully integrated systems is still stagnating. This paper presents the IMS model that can be used to integrate the requirements of existing and upcoming standards in the pharmaceutical industry, followed by a discussion on the issue of the IMS methodology.

I. Tadić, D. Lakić, M. Odalović, L. Tasić, N. Stupar, D. Stevanović, G. Petrova, Dušanka M. Krajnović

A. M. Georgiev, Dušanka M. Krajnović, S. Milovanović, S. Ignjatović, D. Djurić, V. Marinković

INTRODUCTION Every clinical trial has to meet all ethical criteria in addition to the scientific ones. The basic ethical principles in the clinical trials are the following: nonmaleficence, beneficence, respect for autonomy and the principle of justice. OBJECTIVE The aim of the study was to analyse clinical cases with the outcomes leading to the changes in regulatory-ethical framework related to the clinical trials, as well as the outcomes of key clinical trials that influenced the introduction of the ethical principles into clinical trials. METHODS This was a descriptive research (methods of analysis and documentation; desk analysis of the secondary data). RESULTS By analysing the cases from the secondary sources as well as clinical and ethical outcomes, it may be noticed that the codes, declarations and regulations have been often preceded by certain events that caused their adoption. Moral concern and public awareness of the ethical issues have initiated not only the development of numerous guidelines, codes, and declarations, but also their incorporation into the legislative acts. CONCLUSION It is desirable that ethical instruments become legally binding documents, because only in this way will be possible to control all phases of the clinical trials and prevent abuse of the respondents.

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