Novotni, Antoni

Preferred name

Novotni, Antoni

Official Name

Novotni, Antoni

Main Affiliation

prof.novotni2@gmail.com

Now showing 1 - 10 of 10

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Psychometric characteristics of the Macedonian version of Clinical Assessment Interview for Negative Symptoms (CAINS)
(Medicinska naklada, 2021-09)
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Markovska Simoska, Silvana
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Milutinovic, Miloš
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Novotni, Ljubiša
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What is in a name and what is in the brain? -clinicians’ dilemmas in the biomarker era
(Elsevier BV, 2025-05)
Novotni, Gabriela
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Karanfilska Plaseska, Dijana
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This viewpoint draws analogy from Shakespeare’s query, "What’s in a name?" and explores what defines neurodegenerative diseases such as Parkinson’s (PD) and Alzheimer’s (AD) and what clinicians understand by that name in relation to the underlying brain pathology and disease biology. The inspiration comes from the latest biological definitions of PD revealing significant similarities with the biological definition of AD.
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Evaluation of peripheral serotonin content and α2-adrenergic receptor function as potential markers for life-long recurrent depressive disorder by using methodological improvements
(Informa UK Limited, 2018-09)
Aleksovski, Boris
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Vujović, Viktorija
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We aimed to evaluate the role and the relations between peripheral platelet serotonin content, blood plasma serotonin concentration and the function of platelet α2-adrenergic receptors (α2-AR) as potential state or trait biomarkers for recurrent depressive disorder (RDD).
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SSRI-reduced platelet reactivity in non-responding patients with life-long Recurrent Depressive Disorder: Detection and involved mechanisms
(Elsevier BV, 2018-05)
Aleksovski, Boris
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Neceva, Violeta
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Vujović, Viktorija
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Adverse effects with bleeding disorders are often associated with the administration of SSRI in depression, although the exact mechanisms remain contradicting. This study is aimed at detecting and exploring the mechanisms of SSRI-induced changes in platelet reactivity in non-responding patients with Recurrent Depressive Disorder (RDD) and life-long exposure to antidepressants.
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Factor structure of the brief psychiatric rating scale-expanded among outpatients with psychotic disorders in five Southeast European countries: evidence for five factors
(2023)
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Russo, Manuela
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Repišti, Selman
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Maric P., Nadja
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Cross‐cultural Adaptation and Psychometric Evaluation of the Macedonian C‐DEMQOL: A Carer Quality of Life Measure using data from the NOMAD Trial
(Wiley, 2025-12)
Ivanovska, Andrea
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Taneska, Marija
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Farina, Nicolas
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Iloski, Svetlana
Background Caregivers of people with dementia face reduced quality of life, especially in Low‐ and Middle‐Income Countries, due to various systemic, social, and cultural challenges. Accurate measurement of their quality of life is essential for shaping policies and evaluating interventions. In North Macedonia, over 30,000 people with dementia rely mainly on family caregivers, who receive little to no support, resulting in significant stress and burden. However, no validated tools currently exist to measure caregivers’ quality of life. This study aimed to assess the psychometric properties of C‐DEMQOL, a reliable and valid tool for evaluating caregiver quality of life, in a North Macedonian context. Method The C‐DEMQOL was back‐translated, and three cognitive interviews with caregivers were conducted to confirm cultural relevance and face validity. Then it was administered to 120 dyads of individuals with dementia and their caregivers as part of the NOMAD (North Macedonia Interprofessional Dementia Care) trial. The internal consistency (Omega) was reported for the entire C‐DEMQOL measure and each subscale. Data were limited to baseline responses. Intraclass correlation was used to estimate the test‐retest reliability of control data by comparing baseline and follow‐up measurements. Convergent validity was assessed through correlations with the Patient Health Questionnaire (PHQ) and the Zarit Burden Inventory (ZBI), while discriminant validity was evaluated by examining correlations with the age and gender of the person with dementia. Result C‐DEMQOL demonstrated excellent internal consistency, with four of the five subdomains showing acceptable to excellent internal consistency. The total C‐DEMQOL score also demonstrated good test‐retest reliability, and most subdomains reached acceptable levels. Only the “Feeling supported” subdomain showed weaker internal consistency and test‐retest reliability. Convergent validity was indicated by moderate to large negative correlations with the PHQ and ZBI, while near‐zero correlations with the person with dementia's age and gender supported discriminant validity. Conclusion The Macedonian C‐DEMQOL is the first caregiver quality‐of‐life measure in Macedonian to demonstrate satisfactory validity and reliability. Further qualitative and quantitative analyses could help enhance the psychometric properties and optimize the final measure. Validating the C‐DEMQOL paves the way for accurately assessing the effectiveness of initiatives aimed at improving caregivers' quality of life.
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North Macedonia interprofessional dementia care (NOMAD) – personalized care plans for people with dementia and caregiver psychoeducation delivered at home by interprofessional teams
(Frontiers Media SA, 2024-04-10)
Novotni, Gabriela
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Taneska, Marija
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Fischer, Julia
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Iloski, Svetlana
Introduction The increasing number of people living with dementia and its burden on families and systems particularly in low- and middle-income countries require comprehensive and efficient post-diagnostic management. This study aimed to explore the acceptability and efficacy of a multi-professional case management and psychoeducation model (North Macedonia Interprofessional Dementia Care, or NOMAD) delivered by mobile teams for people with dementia and their caregivers in North Macedonia. Method We conducted a two-arm randomized controlled trial comparing the intervention with treatment as usual. Participants were recruited from 12 general practitioner (GP) offices in the Skopje region. The NOMAD intervention included the delivery of a personalized care plan over four home visits to dyads of people with dementia and their caregivers by a team including a dementia nurse and a social worker, in collaboration with GPs and dementia experts, and the introduction of a caregiver manual. We assessed caregivers' depressive symptoms, burden, and quality of life and the neuropsychiatric symptoms, daily living activities, and service utilization of people with dementia at baseline and follow-up; we also assessed the acceptability of the intervention by analyzing case notes and attendance rates. Results One hundred and twenty dyads were recruited and randomized to either the control (n = 60) or the intervention group (n = 60). At follow-up, caregivers in the intervention group had, on average, scores that were 2.69 lower for depressive symptoms (95% CI [−4.75, −0.62], p = 0.012), and people with dementia had, on average, 11.32 fewer neuropsychiatric symptoms (95% CI [−19.74, −2.90], p = 0.009) and used, on average, 1.81 fewer healthcare services (95% CI [−2.61, −1.00], p < 0.001) compared to the control group. The completion of the home visits was 100%, but the intervention's acceptability was underpinned by relationship building, GP competencies, and resources to support families with dementia. There were no differences in the caregivers' quality of life and burden levels or daily living activities in people with dementia. NOMAD is the first case management, non-pharmacological, and multi-professional intervention tested in North Macedonia. Discussion The trial showed that it is effective in reducing caregivers' depressive symptoms and neuropsychiatric symptoms in people with dementia and the burden on health and social care services, and it is acceptable for families. Implementing NOMAD in practice will require building primary care capacity and recognizing dementia as a national priority.
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On dementia, duties, and daughters. An ethical analysis of healthcare professionals being confronted with conflicts regarding filial duties in informal dementia care
(Frontiers Media SA, 2024-10-01)
Dogan, Vildan
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Taneska, Marija
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Novotni, Gabriela
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Iloski, Svetlana
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Background Existing literature on moral conflicts that healthcare professionals encounter in dementia care has explored, amongst others, issues related to autonomy, decision-making capacity, privacy, and more. Notably, conflicts related to healthcare professionals who support informal dementia caregiving and who are confronted with family members being overburdened with their care responsibly remains an underexplored topic in the current literature, particularly in the context of Low-and Middle-Income Countries. The present paper introduces such an encounter, presenting an ethical case analysis of a conflict that occurred during a larger research project conducted in North Macedonia. Case to be studied Due to the absence of formal care services that could have relieved an overburdened family caregiver, healthcare professionals felt compelled to reach out to the uninvolved adult daughters, requesting them to participate in their parents’ care. Wondering about whether their reaching out to the daughters might count as an attempt of pressure and undue interference, professionals conflicted over the appropriateness of their action. This paper follows up on their concern, ethically assessing the professionals’ action. To answer the question on whether the healthcare professionals acted appropriately or not, and to what extent, theories of filial duties are applied, embedding their action in the larger context of dementia care in North Macedonia. Results and conclusion It is argued that the lack of formal care services in North Macedonia is of utmost relevance to the conflict. Thus, the conclusion is that the ethical inappropriateness of the case is to be located not so much with the action of the healthcare professionals but with the state because of its failure to provide professional care services that allow healthcare professionals to take ethically sound actions to counteract overarching burdens that family members face when providing informal dementia care
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On dementia, duties, and daughters. An ethical analysis of healthcare professionals being confronted with conflicts regarding filial duties in informal dementia care
(Frontiers Media SA, 2024-10-01)
Dogan, Vildan
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Taneska, Marija
;
Novotni, Gabriela
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Iloski, Svetlana
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Background: Existing literature on moral conflicts that healthcare professionals encounter in dementia care has explored, amongst others, issues related to autonomy, decision-making capacity, privacy, and more. Notably, conflicts related to healthcare professionals who support informal dementia caregiving and who are confronted with family members being overburdened with their care responsibly remains an underexplored topic in the current literature, particularly in the context of Low-and Middle-Income Countries. The present paper introduces such an encounter, presenting an ethical case analysis of a conflict that occurred during a larger research project conducted in North Macedonia. Case to be studied: Due to the absence of formal care services that could have relieved an overburdened family caregiver, healthcare professionals felt compelled to reach out to the uninvolved adult daughters, requesting them to participate in their parents’ care. Wondering about whether their reaching out to the daughters might count as an attempt of pressure and undue interference, professionals conflicted over the appropriateness of their action. This paper follows up on their concern, ethically assessing the professionals’ action. To answer the question on whether the healthcare professionals acted appropriately or not, and to what extent, theories of filial duties are applied, embedding their action in the larger context of dementia care in North Macedonia. Results and conclusion: It is argued that the lack of formal care services in North Macedonia is of utmost relevance to the conflict. Thus, the conclusion is that the ethical inappropriateness of the case is to be located not so much with the action of the healthcare professionals but with the state because of its failure to provide professional care services that allow healthcare professionals to take ethically sound actions to counteract overarching burdens that family members face when providing informal dementia care.
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North Macedonia interprofessional dementia care (NOMAD)–personalized care plans for people with dementia and caregiver psychoeducation delivered at home by interprofessional teams
(Frontiers Media SA, 2024-04-10)
Novotni, Gabriela
;
Taneska, Marija
;
;
Fischer, Julia
;
Iloski, Svetlana
Introduction: The increasing number of people living with dementia and its burden on families and systems particularly in low- and middle-income countries require comprehensive and efficient post-diagnostic management. This study aimed to explore the acceptability and efficacy of a multi-professional case management and psychoeducation model (North Macedonia Interprofessional Dementia Care, or NOMAD) delivered by mobile teams for people with dementia and their caregivers in North Macedonia. Method: We conducted a two-arm randomized controlled trial comparing the intervention with treatment as usual. Participants were recruited from 12 general practitioner (GP) offices in the Skopje region. The NOMAD intervention included the delivery of a personalized care plan over four home visits to dyads of people with dementia and their caregivers by a team including a dementia nurse and a social worker, in collaboration with GPs and dementia experts, and the introduction of a caregiver manual. We assessed caregivers' depressive symptoms, burden, and quality of life and the neuropsychiatric symptoms, daily living activities, and service utilization of people with dementia at baseline and follow-up; we also assessed the acceptability of the intervention by analyzing case notes and attendance rates. Results: One hundred and twenty dyads were recruited and randomized to either the control (n = 60) or the intervention group (n = 60). At follow-up, caregivers in the intervention group had, on average, scores that were 2.69 lower for depressive symptoms (95% CI [−4.75, −0.62], p = 0.012), and people with dementia had, on average, 11.32 fewer neuropsychiatric symptoms (95% CI [−19.74, −2.90], p = 0.009) and used, on average, 1.81 fewer healthcare services (95% CI [−2.61, −1.00], p < 0.001) compared to the control group. The completion of the home visits was 100%, but the intervention's acceptability was underpinned by relationship building, GP competencies, and resources to support families with dementia. There were no differences in the caregivers' quality of life and burden levels or daily living activities in people with dementia. NOMAD is the first case management, non-pharmacological, and multi-professional intervention tested in North Macedonia. Discussion: The trial showed that it is effective in reducing caregivers' depressive symptoms and neuropsychiatric symptoms in people with dementia and the burden on health and social care services, and it is acceptable for families. Implementing NOMAD in practice will require building primary care capacity and recognizing dementia as a national priority.

Novotni, Antoni

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