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Slobodan M Janković

Publications and source records attributed to Slobodan M Janković.

8 recordsLinked to original sources
PubMed2006

Characteristics of decision-making process during prescribing in general practice.

BACKGROUND/AIM: The process of precribing decision-making by general practitioners requires numerous consultations in order to obtain maximal effects, minimal risks, and cost-effectiveness with the full appreciation of a patient's right to choose. The aim of our study was to describe the process of decision-making by general practitioners who decide on the treatment for an individual patient, and to relate the scope and nature of this process to the quality of the outcome of the decision. METHODS: The study involved 53 general practitioners who worked in the Health Center, Kragujevac at the time of investigation (September-December 2002.). General practitioners made prescribing decisions, thinking aloud, for five patients with urinary tract infections (n = 2), or stomach complaints (n = 3). The resulting 265 transcripts were analyzed to determine the scope and nature of the decision-making processes. Differences in prescribing were related to the case or the practitioners' working experience, and to their educational background. RESULTS: Our results showed that the more years of practice the practitioners had the less treatments they prescribed, and the less additional aspects before prescribing they considered. The doctors with less experience, in most of the cases, considered the core aspects, while those with more experience more often considered the contextual and habitual aspects. Educational background of the general practitioners, and the type of a considered disease, had an influence on the decision-making process. The most optimal method for decision-making (marked as type F) was mostly used by the practitioners with the least experience, while the those with more experience mainly made their decisions in the ways considered the least acceptable. The optimal method for decision-making process does not necessarily provide the optimal therapy, so the least acceptable decision-making might not result in an inappropriate treatment. CONCLUSIONS: The observed prescribing decisions were mostly in disagreement with the Good Clinical Practice. Our study pointed out the need for the obligatory continuation of medical education of general practitioners in decision-making process during prescribing.

Adult↗
PubMed2003

[Controversies with aspartame].

INTRODUCTION: Artificial sweeteners are nowadays inevitable food additives, since they provide necessary food diversity to people suffering from diabetes. Aspartame is the most frequently used artificial sweetener ever and its safety profile is much better than that of saccharin or cyclamate. It received marketing approval in 1973, but only 3 months later aspartame was withdrawn because of allegations based on improperly designed experimental studies dealing with its carcinogen effects on rodent brain. However, extensive studies using the same model did not confirm such suspicions, and aspartame received a second marketing approval. EPIDEMIOLOGICAL STUDIES: Almost two decades later an epidemiological study found a relationship between aspartame and an increased frequency of brain tumors in humans. However, this study included a short time span of observation, and it did not estimate actual intake of aspartame, which led to loss of validity. Later on no epidemiological studies found correlation between aspartame use and incidence of brain tumors in humans. Up to now the only safety concern about aspartame, which received valid scientific proofs, is pro-seizure action of its excessive intake. In patients with epilepsy, excessive intake of aspartame can decrease the threshold for seizures or prolong them once they appear. However, if the intake is not above the recommended level of 40 mg/kg b.w./day, aspartame is well tolerated even in this subpopulation. CONCLUSION: Based on detailed analysis of published studies on safety of aspartame, it should not be restricted, but used in recommended amounts.

Animals↗
PubMed2002

Paying tuition and academic performance of students at Kragujevac University School of Medicine.

AIM: To assess whether the prospect of waiving tuition fees influenced the academic performance of students with the lowest admission test scores and consequent mandatory tuition. METHODS: We compared academic performance of 75 tuition-paying students with the students who did not have to pay tuition because they scored well on the 1996-1998 admission tests to the Kragujevac School of Medicine. We formed 3 control groups (high-, medium- and low-ranked students on the admission test), each with the similar number of students as the group of tuition-paying students. Students performance was assessed after the first two academic years on the basis of their average grades, number of tries to pass the same examination, the time needed to pass an examination after a course, and the number of repeated years. RESULTS: Of 75 tuition-paying students admitted to the School in the 1996-1998 period, 11 had their tuition permanently waived and were therefore excluded from the analysis after the first year. Tuition-paying students had the average grade of 6.8 +/- 3.2 (grade range 6-10), took each exam twice before passing it, needed more than four months of studying to pass an exam, and repeated 0.1 years per student. Their performance was statistically worse than the performance of the low-ranked group of control students in all parameters, except in the number of repeated years. The high-, medium-, and low-ranked student groups did not differ significantly in their performance, but all performed significantly better than the tuition-paying group in three following parameters: average grade (high-ranked group: 8.2 +/- 1.3), average number of tries to pass an exam (high-ranked group: 1.8 +/- 0.8), and average time of studying needed to pass an exam (high-ranked group: 119.6 +/- 65.9 days). CONCLUSION: The prospect of waiving tuition fees has no influence on students performance. The students rank on the admission test is a major predictor of their subsequent academic performance.

Education, Medical↗