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Calvo‐Torres J, Rejas‐Gutiérrez J, Ramírez‐Mena M, Bradbury M, Del Pino M, González‐Granados C, Procas B, Coronado PJ. Population-based norms for the human papillomavirus-quality of life (HPV-QoL) questionnaire: A cross-sectional multicenter study. Acta Obstet Gynecol Scand 2024; 103:1584-1595. [PMID: 38872262 PMCID: PMC11266628 DOI: 10.1111/aogs.14877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/26/2024] [Accepted: 05/04/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) diagnosis has a considerable emotional and psychological impact on women. To evaluate the impairment this infection leads to regarding quality of life (QoL), several scales have been suggested, such as the human-papillomavirus-quality-of-life (HPV-QoL) questionnaire. This has been validated for the Spanish population and measures the impact of HPV on health-related-quality-of-life (HR-QoL). However, normative values are yet to be developed. Thus, the objective was to describe the population-based norms of the HPV-QoL for Spanish women aged 25-65 years and to test the questionnaire's construct validity. MATERIAL AND METHODS This was a cross-sectional nationwide multicenter study. Women from outpatient clinics in Spain aged 25-65 years, with a diagnosis of past or active HPV infection were recruited. The central tendency, dispersion, and percentiles were calculated for the total score and its dimensions for each age group. Construct validity was tested by analyzing age groups and their correlations with other related scales (12-Item General Health Questionnaire [GHQ-12], Female Sexual Function Index [FSFI], and Hospital Anxiety and Depression Scale [HADS]). RESULTS A total of 1352 women were included in the study. The norms showed moderate and significant coefficients of correlation with other related scales. Significant differences between age strata groups were found according to educational level, sexual dysfunction, sexual activity, mental deterioration, and severity of anxiety and depression symptoms (p < 0.001 in all cases). The total score differed significantly between the groups (p = 0.006). Significant differences in the contagiousness, health, and sexuality dimensions (p < 0.05) were found among the groups. It was seen that HPV infection impaired women's QoL. Dimensions within all test age groups (p < 0.001 in all cases) were significantly different, with the health dimension being the highest contributor to women's QoL impairment, whereas social well-being was the main determinant of QoL. CONCLUSIONS Population-based norms for the novel HPV-QoL questionnaire showed adequate validity and could be a useful tool for assessing the impact of QoL among women with HPV in Spain.
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Affiliation(s)
- Javier Calvo‐Torres
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
| | | | - Mar Ramírez‐Mena
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
| | - Melissa Bradbury
- Unit of Gynecologic Oncology, Service of Gynecology, Gynecology Oncology Department, Hospital Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Marta Del Pino
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital ClínicUniversitat de BarcelonaBarcelonaSpain
| | | | - Beatriz Procas
- Department of Obstetrics and GynecologyHospital General Universitario San JorgeHuescaSpain
| | - Pluvio J. Coronado
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
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Giovannetti O, Tomalty D, Adams MA. Sexual health and quality-of-life concerns of cervical dysplasia treatments: Review. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022. [DOI: 10.3138/cjhs.2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Thorough investigations have defined underlying disease mechanisms, determining effective cervical dysplasia (CD) treatments. Previous work has assessed the effects of different treatments on women’s sexual health. Recently however, several published studies have expanded the scope of findings, revealing the need for an updated examination and integration of knowledge to appropriately contextualize this clinical approach within sexual medicine and women’s healthcare. A review of relevant literature was completed. The findings indicate that treatments for CD may be correlated with sexual issues such as decreased interest and sexual functioning, and decreased QoL including psychosocial elements like anxiety. Methodological variations used to investigate different CD treatment outcomes were observed and should be streamlined to facilitate comparison in future studies. There is a need for additional research into alternative non-surgical CD treatments which could mitigate unintended outcomes, and consideration should be given to accessibility of these treatments across different regions in Canada.
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Affiliation(s)
- Olivia Giovannetti
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Diane Tomalty
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Michael A. Adams
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
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Sparić R, Bukumirić Z, Stefanović R, Tinelli A, Kostov S, Watrowski R. Long-term quality of life assessment after excisional treatment for cervical dysplasia. J OBSTET GYNAECOL 2022; 42:3061-3066. [PMID: 35695230 DOI: 10.1080/01443615.2022.2083486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We evaluated factors influencing long-term health-related quality of life (HRQoL) after excisional treatments of low- and high grade squamous intraepithelial cervical lesions (SIL) in three groups of women (n = 160): nulliparas interested in reproduction (A), parous women interested in reproduction (B) and women without pregnancy desire (C). The HRQoL was assessed using the disease-specific FACIT-CD and the generic SF36v2 questionnaires. Anxiety and depression were evaluated by Beck's inventories. After median follow-up of 5 (2-18) years, FACIT-CD total score and the score for Emotional Well-Being (EWB) were significantly lower in group A. The total, EWB and REL (Relationships) scores of FACIT-CD were the highest in group B. Women operated for HSIL demonstrated lower REL quality in comparison to those with LSIL. Neither SF36v2 nor FACIT-CD total scores differed in relation to SIL grade or type of excision. 'SF36v2 Mental Component Summary Score' and 'being parous and interested in fertility' were independent predictors of disease-specific FACIT-CD score.Impact StatementWhat is already known on this subject? Long-term consequences of excisional treatments for cervical dysplasia on health-related quality of life (HRQoL) are not well reported.What do the results of this study add? Our study provides data on HRQoL in women treated with large loop excision of the transformation zone (LLETZ) or cold knife conization (CKC) obtained during the longest (median 5 years) follow-up as reported to date. We were able to show that having children and planning further pregnancies positively influenced HRQoL in these patients. In addition, we identified nulliparas with pregnancy desire as psychologically the most vulnerable group within the studied cohort.What are the implications of these findings for clinical practice and/or further research? Even several years after LLETZ or CKC, women may suffer from impaired Emotional Well-Being and reduced HRQoL. Awareness and assessment of these long-term consequences should be part of surveillance after excisional treatments for cervical dysplasia.
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Affiliation(s)
- Radmila Sparić
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic of Gynecology and Obstetrics, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Zoran Bukumirić
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Institute of Medical Statistics and Informatics, Belgrade, Serbia
| | - Radomir Stefanović
- Department of Histopathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Andrea Tinelli
- Department of Obstetrics and Gynaecology, "Ignazio Veris Delli Ponti" Hospital Ringgold Standard Institution, Scorrano, Italy
| | - Stoyan Kostov
- Department of Gynecology, University Hospital "Saint Anna", Medical University of Varna, Varna, Bulgaria
| | - Rafał Watrowski
- Scientific Associate of Medical Faculty, University of Freiburg, Freiburg im Breisgau, Germany
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Buck S, Sandqvist J, Nilsing Strid E, Knibbe HJJ, Enthoven P, Wåhlin C. Translation and cross-cultural adaptation of the risk assessment instrument TilThermometer for a Swedish version – patient handling in the healthcare sector. BMC Musculoskelet Disord 2022; 23:531. [PMID: 35658927 PMCID: PMC9164361 DOI: 10.1186/s12891-022-05474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Work-related musculoskeletal disorders are common in the healthcare sector due to exposure of physical demanding work tasks. Risk assessment is necessary to prevent injuries and promote a safety culture. The TilThermometer has proved to be useful in the Netherlands for assessing healthcare workers’ physical exposure to patient handling. The aim of this study was to translate the risk assessment instrument TilThermometer from Dutch to Swedish, perform cross-cultural adaptation, and evaluate its linguistic validity to a Swedish healthcare context.
Methods
Translation and validation process was performed according to following eight steps: 1) Translation (two translators), 2) Synthesis, 3) Back-translation (two back-translators), 4) Synthesis, 5) Linguistic review (one bilingual reviewer), 6) fifteen experts in a panel review according to Delphi-method, 7) Semi-structured interviewing eleven informants, analyzed using qualitative content analysis and step 8) discussion and input from creators of the instrument.
Results
A new Swedish version, the TilThermometer, was provided through the translation process (steps 1–5). The linguistic validity and usefulness were confirmed thru step 6 and 7. Consensus was reached in the expert review after two rounds, comments were analyzed and grouped into five groups. The qualitative content analyses of the interviews emerged in to three categories: 1) “User-friendly and understandable instrument”, 2) “Further development”, and 3) “Important part of the systematic work-environment management”.
Conclusion
In this study, the cross-cultural adaption and translation performed of the Swedish version of TilThermometer assured linguistic validity. This is this first phase before further testing the psychometrics aspects, inter-rater reliability and feasibility of TilThermometer. In the second phase TilThermometer will be implemented and evaluated together with other measures in the Swedish healthcare sector.
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Jentschke M, Lehmann R, Drews N, Hansel A, Schmitz M, Hillemanns P. Psychological distress in cervical cancer screening: results from a German online survey. Arch Gynecol Obstet 2020; 302:699-705. [PMID: 32594298 PMCID: PMC7447652 DOI: 10.1007/s00404-020-05661-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022]
Abstract
Purpose The PODCAD study aimed at assessing the degree of psychological stress that women experience due to notification of an abnormal Papanicolaou (Pap) smear finding or a positive human papillomavirus (HPV) test result. Methods We designed a survey to address the question of psychological burden due to abnormal Pap smear results and/or positive HPV tests. In this online campaign approach, we aimed to reach > 2000 women all over Germany irrespective of kind and number of abnormal screening findings. We asked for different kinds of anxiety, distress and uncertainty regarding both, Pap and HPV status. Results A total of 3753 women completed the survey at least partially, and almost 2300 fully completed the survey. Of these, more than 50% were affected already since more than 1 year, and almost half of them had experienced at least three Pap smears in follow-up examinations. Almost 70% of the women were afraid of developing cancer. Intriguingly, almost half of the women with abnormal findings were not aware of their stage of the Pap smear. Furthermore, almost 30% of the women displayed signs of a post-traumatic stress disorder. Conclusion Abnormal results in cervical cancer screening have an impact on patients’ psychology, irrespective of the knowledge and severity of the findings. Better information concerning risks and benefits of cervical cancer screening and about the meaning of the outcome of its procedures are required to decrease this anxiety. Electronic supplementary material The online version of this article (10.1007/s00404-020-05661-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Jentschke
- Department of Gynaecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - R Lehmann
- DontBePatient Intelligence GmbH, c/o GCI Management, Brienner Str. 7, 80333, Munich, Germany
| | - N Drews
- DontBePatient Intelligence GmbH, c/o GCI Management, Brienner Str. 7, 80333, Munich, Germany
| | - A Hansel
- Oncgnostics GmbH, Winzerlaer Str. 2, 07745, Jena, Germany
| | - M Schmitz
- Oncgnostics GmbH, Winzerlaer Str. 2, 07745, Jena, Germany
| | - P Hillemanns
- Department of Gynaecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Khampanthip A, Kanlayanaphotporn R, Jensen MP, Janwantanakul P. Cross-cultural adaptation, test-retest reliability, and construct validity of the Thai version of the University of Washington Pain-Related Self-Efficacy Scale. Pain Rep 2019; 4:e787. [PMID: 31984292 PMCID: PMC6903351 DOI: 10.1097/pr9.0000000000000787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/08/2019] [Accepted: 08/01/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION One psychosocial factor in the biopsychosocial model is pain-related self-efficacy, which has been shown to be a strong predictor of response to pain treatment. OBJECTIVES To cross-culturally adapt the University of Washington Pain-Related Self-Efficacy Scale (UW-PRSE6) into Thai and evaluate its psychometric properties. METHODS The study was approved by the Chulalongkorn University Human Ethics Committee (COA No. 156/2018). The original UW-PRSE6 was cross-culturally adapted using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred forty-one individuals with chronic low back pain completed the Thai version of UW-PRSE6 (T-UW-PRSE6), Thai Fear Avoidance Beliefs Questionnaire (T-FABQ), and Thai Medical Outcome Study Short-Form 36 (T-SF-36). A subset of 152 participants completed the T-UW-PRSE6 again after a 7-day interval. Cronbach's alpha and intraclass correlation coefficients were calculated to estimate internal consistency and test-retest reliability, respectively. The construct validity of the T-UW-PRSE6 was evaluated by computing Spearman correlation coefficients between the T-UW-PRSE6 score and the measures of the validity criterion variables. RESULTS The T-UW-PRSE6 had good internal consistency (Cronbach's alpha = 0.85) and moderate test-retest reliability (intraclass correlation coefficient [2,1] = 0.72). The T-UW-PRSE6 was negatively correlated with the T-FABQ Work and Physical Activity subscales (rs = -0.34 and -0.34, respectively) and positively correlated with the General Health, Physical Functioning, Role Physical, Role Emotional, Social Functioning, Bodily Pain, Vitality, and Mental Health scales of the T-SF-36 (rs = 0.38, 0.42, 0.54, 0.51, 0.47, 0.54, 0.41, and 0.40, respectively). CONCLUSION The T-UW-PRSE6 demonstrated acceptable psychometric properties for assessing pain-related self-efficacy in individuals with chronic low back pain, making available a measure for facilitating future cross-cultural research on pain self-efficacy.
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Affiliation(s)
- Angkana Khampanthip
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Swedish women’s awareness of human papillomavirus, and health-related quality of life, anxiety, and depression after a notification of an abnormal Pap smear result: a cross-sectional study. Eur J Cancer Prev 2019; 28:96-101. [DOI: 10.1097/cej.0000000000000430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rask M, Swahnberg K, Oscarsson M. Notification of an abnormal Pap smear result: An intervention study. Eur J Cancer Care (Engl) 2018; 28:e12969. [PMID: 30457186 DOI: 10.1111/ecc.12969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/18/2018] [Accepted: 10/26/2018] [Indexed: 01/08/2023]
Abstract
This study aims to assess whether notification of an abnormal Pap smear result via a phone call, delivered by a trained healthcare provider, has an effect on women's HRQoL, coping and awareness of HPV. For this intervention study, women were consecutively recruited from a women's health clinic in Sweden. Women in the intervention group (n = 113) were notified of their Pap smear result via a phone call by a trained healthcare provider, while those in the comparison group (n = 122) were notified via a standard letter. A questionnaire was used to collect data. The results found no significant differences between the groups for HRQoL. However, 42.5% of women in the intervention group versus 48.3% in the comparison group reported anxiety. Women in the intervention group were more satisfied with the manner in which they were notified of their abnormal result than those in the comparison group (92.0% vs. 67.2%; p < 0.001), more aware of HPV (71% vs. 50%; p = 0.001), and called healthcare services less often (10.6% vs. 18.0%; p = 0.113), no significance. In conclusion, notification of an abnormal Pap smear result via a phone call does not increase women's HRQoL or reduce their anxiety.
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Affiliation(s)
- Marie Rask
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.,Department of Health Science I, Kristianstad University, Kristianstad, Sweden
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Marie Oscarsson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
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Kesić V, Sparić R, Watrowski R, Dotlić J, Stefanović R, Marić G, Pekmezović T. Cross-cultural adaptation and validation of the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) questionnaire for Serbian women. Eur J Obstet Gynecol Reprod Biol 2018; 226:7-14. [PMID: 29777860 DOI: 10.1016/j.ejogrb.2018.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES The FACIT-CD (Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia) questionnaire is a disease-specific instrument for assessing the health-related quality of life (HRQoL) in women with cervical dysplasia. Our aim was to perform a cross-cultural adaptation and psychometric evaluation of the FACIT-CD scale in Serbian women with cervical squamous intraepithelial lesions (SIL). STUDY DESIGN Our study included women of reproductive age diagnosed with SIL in a single university-affiliated hospital. A total of 160 participants with histologically confirmed low-grade (LSIL) or high-grade (HSIL) squamous intraepithelial lesions responded to the Serbian version of the FACIT-CD instrument, the Short Form-36v2 questionnaire (SF-36v2), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI). Women also participated in an interview regarding their socio-demographic data. We evaluated the validity and reliability of the Serbian version of FACIT-CD. RESULTS The Cronbach's alpha coefficient was 0.710 for the entire sample (0.702 for LSIL and 0.711 for HSIL). We found numerous correlations between the FACIT-CD scores and SF-36v2 scores, as well as between the BAI and BDI scores for both the total score and most of the domain scores. The mean FACIT-CD total score was high (114.47 ± 13.25 out of 136.00 which is the maximum score). There were no significant differences in the mean scores between the LSIL and HSIL groups. CONCLUSIONS Our study demonstrated that the Serbian FACIT-CD has overall good psychometric properties in women with both LSIL and HSIL. We propose the use of the FACIT-CD questionnaire as an indicator for HRQoL in women with cervical dysplasia.
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Affiliation(s)
- Vesna Kesić
- School of Medicine, University of Belgrade, Doktora Subotića 8, 11000, Belgrade, Serbia; Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovića 26, 11000, Belgrade, Serbia
| | - Radmila Sparić
- School of Medicine, University of Belgrade, Doktora Subotića 8, 11000, Belgrade, Serbia; Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovića 26, 11000, Belgrade, Serbia.
| | - Rafal Watrowski
- Department of Gynecology and Obstetrics, St. Josefskrankenhaus, Teaching Hospital of the University of Freiburg, Sautierstr.1, 79104, Freiburg, Germany
| | - Jelena Dotlić
- School of Medicine, University of Belgrade, Doktora Subotića 8, 11000, Belgrade, Serbia; Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Dr Koste Todorovića 26, 11000, Belgrade, Serbia
| | - Radomir Stefanović
- Department for Histopathology, Clinical Center of Serbia, Dr Koste Todorovića 6, 11000, Belgrade, Serbia
| | - Gorica Marić
- School of Medicine, University of Belgrade, Doktora Subotića 8, 11000, Belgrade, Serbia; Institute for Epidemiology, Dr Koste Todorovića 26A, 11000, Belgrade, Serbia
| | - Tatjana Pekmezović
- School of Medicine, University of Belgrade, Doktora Subotića 8, 11000, Belgrade, Serbia; Institute for Epidemiology, Dr Koste Todorovića 26A, 11000, Belgrade, Serbia
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