Lazar Tenjovic

The European Early Promotion Project: Description of the Service and Evaluation Study

This chapter describes an innovative cross-cultural method of working with families to promote the psychosocial well-being of children and to prevent the development of psychological and social problems. It also presents a study designed to evaluate the effects of the service. Primary health care workers in five countries from Northern, Central and Southern Europe were trained to conduct promotional interviews with all prospective mothers in their area one month before and one month after birth. They were also taught to work with mothers identified as in need of support as a parent, by using a specific counselling model to try to prevent the onset of child mental health difficulties. Effects of the intervention on childrens psychological development and family adaptation were evaluated at two years of age in comparison with matched groups not receiving the intervention, using a set of questionnaires, interviews and observation methods. The total sample of the study at the initial assessment was 824 families, of which 705 (85.6%) were retained for the outcome assessment.

Cold Stress Dynamic Thermography for Evaluation of Vascular Disorders in Hand- Arm Vibration Syndrome

Exposure to hand-transmitted vibration can cause a variety of disorders collectively known as the Hand-Arm Vibration Syndrome (HAVS). Its neurovascular component is Vibration-induced White Finger (VWF), a type of secondary Raynaud’s phenomenon (RP), which manifests itself as episodic blanching of the fingers in response to cold. Due to the episodic nature of this condition, an occupational health physician rarely observes the blanching; thus, VWF has often been diagnosed based only on patient’s history together with a history of occupational exposure to vibration and the exclusion of other known causes of RP . For the assessment of VWF, measurements of finger skin temperature (FST) and finger systolic pressure (FSP) in response to cold stress are most widely used . The FST-based assessment relies on the principle that the pattern of FST following cooling reflects the degree of cold-induced vasoconstriction in the digital blood vessels. The rise in FST during recovery reflects the increase in blood flow in the investigated skin area. Abnormal rewarming times indicate different patterns of vascular dilatation following vasomotor responses to cooling. A lower FST is expected to reflect a persistent abnormality of blood flow in patients with HAVS 2, . Merla et al. described a technique that used infrared imaging to record the thermal recovery and produced images which visualized the τ times of individual pixels, assuming an exponential rewarming process ( τ being the time needed for rewarming to 63% of the total temperature change). The damaged areas exhibited a slower recovery and longer τ time. This was a novel approach in that it used dynamic parameter (Tau) imaging, but the parameter was derived as a cutoff-value, not from all the available rewarming data. Using a non-imaging infrared-based device, Foerster et al. also reported that a rewarming pattern could be described using the τ value. According to Darton and Black , thermographic images of the hands and rewarming curves after cold provocation show characteristic differences among patients with primary and secondary RP, and normal subjects. We propose a novel method of dynamic infrared thermography for assessing the dynamic response of the microcirculation during rewarming.

Personality Characteristics of Psychiatric Trainees

Personality Characteristics of Psychiatric Trainees Dusica Lecic-Tosevski a, Milica Pejovic-Milovancevic a, Lazar Tenjovicb, Saveta Draganic-Gajic a, George N. Christodoulou c a Institute of Mental Health, School of Medicine and bDepartment of Psychology, School of Philosophy, University of Belgrade, Belgrade, Serbia & Montenegro; c Department of Psychiatry, Eginition Hospital, University of Athens, Athens, Greece

Attitudes of psychiatry residents toward mental illness

INTRODUCTION Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. MATERIAL AND METHODS The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI) and personality traits were examined using the Eysenck Personality Questionnaire (EPQ). RESULTS Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. DISCUSSION The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill.

Assessment of coarse and fine hand motor performance in asymptomatic subjects exposed to hand-arm vibration

Summary A frequently encountered exposure profile for hand-arm vibration in contemporary occupational setting comprises workers with a long history of intermittent exposure but without detectable signs of hand-arm vibration syndrome (HAVS). Yet, most of the published studies deal with developed HAVS cases, rarely discussing the biological processes that may be involved in degradation of manual dexterity and grip strength when it can be most beneficial - during the asymptomatic stage. In the present paper, a group of 31 male asymptomatic vibration-exposed workers (according to the Stockholm Workshop Scale) were compared against 30 male controls. They were tested using dynamometry and dexterimetry (modelling coarse and fine manual performance respectively) and cold provocation was done to detect possible differences in manual performance drop on these tests. The results showed reduced manual dexterity but no significant degradation in hand grip strength in the exposed subjects. This suggests that intermittent exposure profile and small cumulative vibration dose could only lead to a measurable deficit in manual dexterity but not hand grip strength even at non-negligible A(8) levels and long term exposures. Sažetak U suvremenim uvjetima profesionalne izloženosti vibracijama koje se prenose preko ruke i šake, često se mogu vidjeti radnici koji su, i pored dugotrajne povremene izloženosti, i dalje bez uočljivih simptoma vibracijske bolesti. U većini dosadašnjih istraživanja analizirani su ispitanici s razvijenom kliničkom slikom vibracijske bolesti, uz rijetka razmatranja bioloških procesa koji mogu biti uključeni u degradaciju ručne spretnosti i snage stiska šake, osobito u asimptomatskoj fazi, kada bi to bilo od najveće koristi. U ovom su istraživanju uspoređene dvije skupine ispitanika: izložena skupina - 31 radnik izložen lokalnim vibracijama koji prema Stockholmskoj klasifikaciji nema simptome vibracijske bolesti, i kontrolna skupina - 30 radnika koji nisu izloženi lokalnim vibracijama. Svaki je ispitanik bio podvrgnut dinamometrijskom i deksterimetrijskom testiranju (model za grubu i finu motoričku funkciju šake) te testu provokacije hladnoćom radi usporedbe pada motoričkih funkcija šake. U izloženoj skupini zabilježen je pad fine motoričke funkcije, ali ne i snage stiska šake. Rezultati upozoravaju na mjerljiv deficit grube ali ne i fine motoričke funkcije šake kod povremene izloženosti s malim kumulativnim dozama, čak i kada se radi o dugotrajnoj izloženosti nezanemarivim razinama A(8). Vibracijama inducirane lezije živčanih vlakana i/ ili mehanoreceptora, koji osiguravaju senzornu povratnu vezu za signale pokreta - čime kontroliraju zadatke koji iziskuju precizno kretanje prstiju - mogle bi biti odgovorne za uočeno smanjenje ručne spretnosti. Taj mehanizam, međutim, nije potreban za kontrolu grube sile stiska.