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Background/Aim: Antibiotic use and resistance represent a growing public health issue, with a specific risk of uncontrolled use of antibiotics in children. The aim of the study was to examine differences in parental knowledge, attitudes and practices about antibiotic use in children between urban and rural areas of the Republic of Srpska. Methods: A cross-sectional study was conducted among 1459 parents of children under 6 years of age, out of which 1201 (82.3 %) lived in urban areas while 258 (17.7 %) lived in rural areas. The research is conducted among parents who brought their children to the selected primary healthcare centres and among parents of children in preschool institutions. Results: The majority of respondents (98.4 %) state that doctors are their main source of information. Only 61.2 % of respondents precisely know which drug is an antibiotic when offered different drugs and respondents from rural areas (54.3 %) more often (p = 0.012) gave more accurate answers when compared to respondents from urban areas (37.3 %). Among parents, 86 % agree with the statement that improper use of antibiotics reduces their effectiveness and leads to bacterial resistance, regardless of groups. More than a half of respondents (52.4 %) do not think that children with flu or common cold symptoms recover faster when they receive antibiotics, significantly more respondents from urban areas (p = 0.001). Respondents from rural areas significantly more often believe that antibiotics can produce harmful effects compared to respondents from urban areas (p = 0.049). Respondents from rural areas significantly more often think that antibiotic use can prevent complications caused by inflammation of the upper respiratory tract (p = 0.006). Parents from rural areas give their children antibiotics without a paediatrician's recommendation significantly more often (4.3 %) compared to respondents from urban areas (0.6 %) (p < 0.001). Conclusion: There are differences in parental knowledge, attitudes and practices regarding antibiotic use and antimicrobial resistance among parents in rural and urban areas. There is need for additional education of parents and for greater engagement of paediatricians in providing guidance and explanations regarding the use of antibiotics.

Djeca sa smetnjama u razvoju manifestuju teškoće u razvoju i ne dosežu zadovoljavajući nivo razvoja, naročito ako im se ne pruži podrška u vidu njege i obrazovanja. Viši nivoi empatije su značajan faktor koji može uticati na pojavu pozitivnijih stavova učenika prema vršnjacima sa smetnjama u razvoju. Cilj istraživanja je bio da se procjeni da li empatija ima uticaj na stavove učenika prema vršnjacima sa smetnjama u razvoju. Studija je obuhvatila 120 učenika 4. i 5. razreda osnovnih škola, oba pola, uzrasta 10 i 11 godina. Istraživanje je rađeno u Banjaluci tokom 2020.godine. Ispitanici su podijeljeni na dvije grupe, one koji su pohađali nastavu sa učenicima sa smetnjama u razvoju i one koji nisu. Za ispitivanje stavova učenika prema učenicima sa smetnjama u razvoju korištena je Čedok Mekmaster skala, dok je za procjenu empatije korišten Indeks međuljudskog reagovanja. Korelacionom analizom utvrđena je značajna (r=0,18; p

Summary Introduction. Cellulose nanocrystals (CNCs) as attractive natural materials, have numerous applications in the biomedical field. Their unique biomechanical characteristics, surface chemistry, low cost and sustainable nature make them an engaging alternative to conventional materials and potentiate their use as progressive material. Therefore, it is critical to evaluate the cytocompatibility and immunomodulatory properties of nCNCs, which have not been completely explored. The objective of this study was to examine a dose-dependent effect of native (n)CNCs on cytotoxicity and proliferative activity of human peripheral blood mononuclear cells (PBMNCs) in vitro. Methods. PBMNCs, obtained from the healthy blood donors, were cultivated with nCNCs. Cell viability was analyzed by flow cytometry assay, while proliferative activity was determined by MTT, [3H]-thymidine uptake assay and detection of IL-2 production. Results. The cytotoxicity results suggested that no concentration of nCNCs (50-400 μg/ml) affected necrosis of PBMNCs, whereas apoptosis was induced by the highest concentration of nCNCs compared to control (p

This study aimed to generate a linguistic equivalent of the COVID Stress Scales (CSS) in the Serbian language and examine its psychometric characteristics. Data were collected from September to December 2020 among the general population of three cities in Republic of Serbia and Republic of Srpska, countries where the Serbian language is spoken. Participants completed a socio-demographic questionnaire, followed by the CSS and Perceived Stress Scale (PSS). The CSS was validated using the standard methodology (i.e., forward and backward translations, pilot testing). The reliability of the Serbian CSS was assessed using Cronbach’s alpha and McDonald’s omega coefficients and convergent validity was evaluated by correlating the CSS with PSS. Confirmatory factor analysis was performed to examine the construct validity of the Serbian CSS. This study included 961 persons (52.8% males and 47.2% females). The Cronbach’s alpha coefficient of the Serbian CSS was 0.964 and McDonald’s omega was 0.964. The Serbian CSS with 36 items and a six-factorial structure showed a measurement model with a satisfactory fit for our population (CMIN/DF = 4.391; GFI = 0.991; RMSEA = 0.025). The CSS total and all domain scores significantly positively correlated with PSS total score. The Serbian version of the CSS is a valid and reliable questionnaire that can be used in assessing COVID-19-related distress experienced by Serbian speaking people during the COVID-19 pandemic as well as future epidemics and pandemics.

Introduction. Human monocytes are heterogeneous and plastic cell population with the ability to undergo phenotypic and functional changes as a response to a stimulus from a local microenvironment. Our aim was to determine the potential of human monocytes to differentiate into different cell populations depending on two different cytokines (IL-4 and IL-6) added to cultures as well as to compare their phenotypical and functional characteristics. Methods. Peripheral blood mononuclear cells (PBMNC) were isolated from buffy coats of healthy donors. Monocytes, which were separated from PBMNC by plastic adherence, had been cultivated in Dendritic cell (DC), serum free medium for 5 days, either with granulocyte/macrophage colony-stimulating factor (GM-CSF) alone or with GM-CSF, with addition of interleukin 4 (IL-4) or interleukin 6 (IL-6), respectively. After cultivation, phenotypic characteristics of these cells were analyzed by flow cytometry, whereas the levels of produced cytokines in culture supernatants were quantified by ELISA. The potential of differentiated cells to modulate the proliferation of allogeneic T cells was examined by co-cultivation of these cells with PBMNC. Results. GM-CSF differentiated monocytes into M0/M1 macrophages (MØ). The combination of GM-CSF and IL-4 favoured differentiation of immature DC, whereas GM-CSF and IL-6 transformed monocytes into monocytic myeloid derived suppressor cells (M-MDSC). All cell populations expressed typical monocyte/macrophage markers such as CD14, CD11b, CD16 and CD33, HLA-DR, CD209 and CD86, a co-stimulatory marker. DC and M-MDSC expressed CD1a and CD11c, in contrast to M0/M1 MØ. The expression of HLA-DR, CD1a, CD209 and CD86 was highest on DC. The expression of CD33 and CD16 was highest on M-MDSC, followed by lowest expression of HLA-DR. The potential of promoting T-cell proliferation was highest in cultures of PBMNC with DC, whereas M-MDSC had the opposite, suppressive, effect. These differences correlated with highest production of immunosuppressive cytokines such as IL-10, IL-27 and TGF-b by M-MDSC. Conclusion. This study confirmed the differentiation plasticity of human monocytes, which are influenced by cytokines added in cultures. Phenotypic characteristics of these cells correlated with the production of cytokines involved in modulation of T-cell proliferation.

Progress in diagnosis and treatment has led to a significant improvement in the fate of children born with tetralogy of Fallot, with the perioperative mortality of 2-3% and a 30-year survival rate of 90%. However, the majority of these patients have residual postoperative morphological and hemodynamic disorders, as well as heart rhythm disorders, primarily due to the volume loading of the right ventricle caused by chronic pulmonary regurgitation. Improved surgical techniques have reduced early mortality to less than 3%, but the annual mortality rate has increased 20-30 years after initial surgical remediation, mainly due to unwanted cardiac events. In longitudinal monitoring of patients after repair of tetralogy of Fallot, early detection of morphological and hemodynamic residual disorders both in asymptomatic and symptomatic patients is of great importance. The purpose of this is a timely identification of new therapeutic measures (e.g. pulmonary valve replacement) in order to improve the course and outcome of treatment. Cardiovascular magnetic resonance imaging is a diagnostic method that provides the most precise and accurate estimation of individual parameters of cardiac dysfunction and poor outcomes. Furthermore, it plays a significant role in defining the predictive ability of individual parameters. Previous research has shown that the increase in mortality risk coincides with progressive dilation and right ventricular dysfunction, by means of ventriculo-ventricular interaction and left ventricular dysfunction. Identification of parameters that can predict the high-risk patients for future unwanted cardiac events such as ventricular tachycardia and cardiac insufficiency can assist the customization of a therapeutic approach leading to improvement in quality of life and patient's survival rate.

Urinary tract infection (UTI) is defined as a presence of significant bacteriuria in a properly collected urine sample, followed by various clinical manifestations - from asymptomatic bacteriuria to acute pyelonephritis. It is most common in infancy and particularly in females. There is a higher risk of UTI in children with underlying urological anomalies, voiding dysfunction and constipation. The subsequent long-term complications such as hypertension and chronic renal insufficiency might arise in children with recurrent pyelonephritis due to renal scarring. The early and proper diagnosis of UTI needs to be based on the recognition of clinical signs and symptoms of UTI, microscopic examination of urine sediment, urine culture and radiological findings. The objective of various medical imaging studies, including kidney and bladder ultrasound, voiding cystourethrography and technetium-99m-dimercaptosuccinic acid renal scintigraphy, is to identify urinary tract abnormalities, as well as risk factors for recurrent infections. The UTI that has been diagnosed requires a 7-14-day course of antimicrobial therapy in symptomatic and especially febrile children. In most children, the early diagnosis and treatment of recurrent UTI is of utmost importance. In this way the development of permanent kidney damage, as well as permanent consequences will be prevented.

The purpose of the present study was to examine self-perceived stress of health professions students at the Faculty of Medicine Foča, and to explore its association with anxiety, depression and health-related quality of life.The cross-sectional study enrolled 451 students at the Faculty of Medicine (medicine, dentistry, nursing and speech therapy). Survey instruments were distributed at the conclusion of the spring semester during the last required lecture for each year and study programme class. Perceived stress was assessed using the 14-item Perceived Stress Scale. The students were evaluated for symptoms of depression and anxiety, using Zung's self-assessment inventory for depression and the Spielberger State-Trait Anxiety Inventory (STAI). European Quality of Life-5 dimensions were used for describing and evaluating health. Multivariate analyses were carried out using logistic regression to examine the relationship between the outcome variable and selected determinant factors.A high degree of stress was reported by 1.6% of students, while the majority of students had either moderate (70.6%) or low degree (27.5%) of stress. The significant independent factors associated with perceived stress were anxiety score (OR, 0.339; CI 95%, 0.276-0.403) and EQ-5D score (OR, 0.044; CI 95%, 0.033-0.085). A high degree of perceived stress (OR, 0.624; CI 95%, 0.507-0.704), the presence of depression (OR, 0.800; CI 95%, 0.513-1.087), and low quality of life were associated with anxiety (OR, 0.073; CI 95%, 0.018-0.128).Higher levels of perceived stress predispose health professions students for anxiety and lower quality of life. The study programme was not a significant determinant of perceived stress sore.Namen študije je bil preučiti samo-zaznan stres študentov zdravstvenih ved na Medicinski fakulteti Foča in raziskati njegovo povezavo z anksioznostjo, depresijo in z zdravjem povezano kakovostjo življenja.Presečna študija je vključevala 451 študentov Medicinske fakultete (medicina, zobozdravstvo, zdravstvena nega in govorna terapija). Raziskovalna orodja so bila razdeljena ob koncu spomladanskega semestra med zadnjimi obveznimi predavanji za vsak letnik in študijski program. Zaznan stres je bil ocenjen z uporabo 14-stopenjske lestvice za zaznavanje stresa. Med študenti smo ocenili simptome depresije in aksioznosti z uporabo Zungovega vprašalnika za samooceno depresije in orodja Spielbergerjevega vprašalnika za oceno anksioznosti (STAI). Za opis in vrednotenje zdravja so bili uporabljeni vprašalniki o kakovosti življenja EQ-5D. Za proučevanje povezav med spremenljivko izidov in izbranimi determinantami so bile izvedene multivariatne analize z uporabo logistične represije.O visoki stopnji stresa je poročalo 1,6% študentov, medtem ko je večina študentov poročala o srednji (70,6%) ali nizki (27,5%) stopnji stresa. Pomembni neodvisni dejavniki, ki so bili povezani z zaznavanjem stresa, so bili rezultati vprašalnika o anksioznosti (OR 0,339; CI 95%, 0,276-0,403) in rezultati vprašalnika EQ-5D (OR 0,044; CI 95%, 0,033-0,085). Visoke stopnje zaznanega stresa (OR 0,624; CI 95%, 0,507-0,704), prisotnost depresije (OR 0,800; CI 95%, 0,513-1,087) in slaba kakovost življenja so bili povezani z anksioznostjo (OR 0,073; CI 95%, 0,018-0,128).Višje stopnje zaznanega stresa so predispozicija za anksioznost in nižjo kakovost življenja študentov zdravstvenih ved. Študijski program ni bil bistvena determinanta za zaznavanje stopnje stresa.

Introduction. Orthodontic treatment is a common dental procedure in developedcountries. Assessment of orthodontic treatment need is importantfor health services planning and population trends monitoring. The aim ofthis study was to assess the need for orthodontic treatment among childrenin Foča, Bosnia and Herzegovina.Methods. The study involved 81 students of two primary schools in themunicipality of Foča, aged 11-13 years. The subjects underwent clinicalexaminations, the dental impressions were taken, study models were madeand analyzed, and digital photographs of anterior dentition were taken too.Index of Complexity, Outcome and Need (ICON) was used to assess theneed for orthodontic treatment. The number of orthodontists, which wouldbe sufficient to meet the needs of this population of children, was estimated.Results. ICON index results showed that 56.8% of children needed orthodontictreatment. There was no statistical significance in the need for orthodontictreatment between the subjects of different gender and age. The study showedthat 22.2% of boys and 34.6% of girls needed orthodontic treatment. In relationto age, 21% of eleven- and 21% of twelve-year-olds needed orthodontictreatment and 14.8% of thirteen-year-olds. The incidence of crowding was80.2%. Crossbite was present in 23.5% of examined students, open bite in 2.5%,deep bite in 29.6% and irregular dental esthetics anterior teeth in 28.4%. ClassII/1 malocclusion was found in 39.5% of children, II/2 class in 9.9%, class I in38.3%, while class III malocclusion was found in 9.9% of examined children.Conclusion. The study shows that a large percentage of children in Foča needorthodontic treatment. Percentage of the need for orthodontic treatment ishigher in comparison to most of the countries in Europe and the world. Thedevelopment of prevention programs and early caries therapy can greatlyreduce the need for orthodontic treatment.

Introduction: Hepatitis C Virus (HCV) is the leading cause of chronic liver disease and is a serious global health problem. Hepatitis C infection is highly prevalent in patients with end stage renal disease (ESRD), due to frequent exposure to blood and blood products, nosocomial transmission of HCV, and prolong hemodialysis duration. The aim of the study was to evaluate the influence of IL-33/ST2 signaling pathway on severity of the liver disease in ESRD HCV+ patients. Methodology: Blood samples from patients with end stage renal disease (ESRD) and hepatitis C infection (HCV), 20 patients with HCV infection, 20 patients with ESRD and 20 healthy control donor patients were taken for the examination of biochemical parameters, for the determination of the serum cytokine concentration, and for the molecular diagnostics of HCV. Results: Systemic sST2 positively correlated with serum level of urea and creatinine, respectively. Serum sST2 was significantly increased in ESRD HCV+ patients in comparison to HCV+ group. sST2/IL-1, sST2/IL-4 and sST2/IL-23 ratios were significantly increased in serum of ESRD HCV+ patients in comparison to HCV+ patients. Significantly higher systemic level of sST2 and sST2/IL-1 and sST2/IL-4 ratios were measured in ESRD patients compared to non-ESRD patients. Conclusion: These results suggested that elevated level sST2, as the consequence of renal failure, causes less destruction of liver in HCV infection.

Uvod. Neformalni osuđenički sistem u maloletničkom zatvoru sadrži podgrupenastale na osnovu različitog statusa i moći. Takva podela implicira ipodelu po različitom stepenu viktimizacije za svaku od tri statusno različitepodgrupe neformalnog osuđeničkog sistema. Definisanje unutrašnje prirodeosuđeničke interakcije kroz njihovo delovanje u određenim neformalnimgrupama od suštinske je važnosti za sveobuhvatno razumevanje ovog socijalnogfenomena, kojem nije poklonjena pažnja u onoj meri koja je neophodna.Cilj istraživanja je utvrditi da li osuđenici u statusno različitim neformalnimgrupama imaju različit stepen viktimiziranostiMetode. Uzorak obuhvata 102 osuđena lica, koja se nalaze u zatvorenom tretmanuizdržavanja kazne zatvora u Kazneno-popravnom zavodu za maloletnikeu Valjevu. Metod istraživanja je empirijski, sistematski, neeksperimentalnimetod (survey), kao i metod teorijske analize. Osnovna istraživačka tehnikaupotrebljena u procesu prikupljanja podataka je anketiranje, koje nam jeobezbedilo jednoobraznost ispitivanja i anonimnost ispitanika.Rezultati. Dobijeni rezultat viktimiziranosti za sve tri osuđeničke podgrupedokazuje da osuđenička podgrupa “vođe”, koja je statusno najjača, ima najnižiprosečan procenat viktimiziranosti od 29%. Osuđenička podgrupa “kolektivci”,koja je statusno ispod članova podgrupe “vođe”, ima srednji prosečanprocenat viktimiziranosti od 53%. Osuđenička podgrupa “marginalci”, kojaje statusno najniža ima srednji prosečan procenat viktimiziranosti od 78%.Zaključak. Na osnovu testa viktimizacije primenjenog na uzorku osuđenikau zatvorenom tretmanu, koji su pripadnici neformalnog osuđeničkog sistema,utvrđeno je da u Kazneno-popravnom zavodu za maloletnike postoje razlike ustepenu viktimiziranosti između tri osuđeničke podgrupe: podgrupa „marginalci“ima najviši stepen viktimiziranosti, „kolektivci“ srednji, a „vođe“ najniži.

Despite considerable efforts to promote and support clinical practice guidelines (CPGs) use, adherence has often been suboptimal universally.The aim of this study was to assess to which extent family physicians (FPs) in Republic of Srpska (RS), Bosnia and Herzegovina (BiH) accept or reject the concept and practice of CPGs and evidence-based medicine (EBM).A cross-sectional survey was conducted among FPs from the RS, BiH in the period between January and March 2014. Recruitment of FPs was performed combining two different strategies, in-person recruitment at family medicine conferences and mailed invitations. The Questionnaire included19 questions from the existing Healthcare Monitor Questionnaire, divided into four thematic blocks and 11 self-designed questions.Seventy-seven per cent of 131 interviewed physicians reported already using guidelines in the treatment of patients, while 22.9% of them are undecided or disagree. As the reason for rejecting guidelines, 13.0% of the physicians stated they did not support their content, 12.2% found that limited knowledge about guidelines prevented their application, and another 12.2% reported that the current guidelines were not practical enough. All groups would rather not use guidelines developed by a governmental institution.Most physicians in the RS, BiH accept and declare application of CPG. However, a substantial percentage remains sceptical, using CPGs only as an exception, or rejecting them due to their content or impracticability. [Box: see text].

In 2012, alcohol liver disease resulted in 3.3 million—5.9% of global deaths. This study introduced whey protection capacity against chronic alcohol-induced liver injury. Rats were orally administered to 12% ethanol solution in water (ad libitum, average 8.14 g of ethanol/kg body weight (b.w.)/day) alone or combined with whey (per os, 2 g/kg b.w./day). After 6-week treatment, chronic ethanol consumption induced significant histopathological liver changes: congestion, central vein dilation, hepatic portal vein branch dilation, Kupffer cells hyperplasia, fatty liver changes, and hepatocytes focal necrosis. Ethanol significantly increased liver catalase activity and glutathione reductase protein expression without significant effects on antioxidative enzymes: glutathione peroxidase (GPx), copper–zinc-containing superoxide dismutase (CuZnSOD) and manganese-containing superoxide dismutase (MnSOD). Co-treatment with whey significantly attenuated pathohistological changes induced by ethanol ingestion and increased GSH-Px and nuclear factor kappa B (NF-κB) protein expression. Our results showed positive effects of whey on liver chronically exposed to ethanol, which seem to be associated with NF-κB-GPx signaling. © The Author(s) 2019.

Aims. The aim of this study was to examine self-perceived compassion fatigue and compassion satisfaction among family physicians in Bosnia and Herzegovina and describe potential contributing factor...

Paper description: Ethanol in alcoholic drinks causes liver injury. Cow whey and pumpkin seed oil have shown hepatoprotective effects in many studies. The effects of whey and pumpkin oil supplementation on the blood biochemical parameters of liver function in male Wistar rats subjected to chronic daily intake of 12% ethanol ad libitum were examined. Ethanol consummation in small doses for 6 weeks changed lipid metabolism, but did not induce extensive liver damage. Both whey and pumpkin seed oil showed some protective potential, but pumpkin seed oil and whey together with ethanol elevated lactate dehydrogenase. Abstract: We studied the effects of whey and pumpkin seed oil supplementation on the biochemical parameters in blood serum of male rats after chronic ad libitum alcohol consumption. The levels of AST, ALT, total bilirubin, ALP, LDH, triglycerides, total cholesterol, HDL, LDL, VLDL, triglyceride/HDL ratio, total cholesterol/HDL ratio (cholesterol ratio) and LDL/HDL ratio (index of atherosclerosis) were determined in rats after six weeks of treatment with: (i) ethanol (12% ethanol, ad libitum ), (ii) whey (2 g/kg per day), (iii) pumpkin seed oil (2 mL/kg per day), (iv) both ethanol and whey, and (v) both ethanol and pumpkin seed oil. The results showed no changes in the levels of AST, ALT, total bilirubin, ALP, total cholesterol, HDL and VLDL in alcoholic rats when compared to the controls (fed with a standard laboratory diet ad libitum ) and rats supplemented with whey and pumpkin seed oil. Our results suggest that alcohol consumption in small doses for 6 weeks changes lipid metabolism and significantly elevates the LDL/HDL ratio (index of atherosclerosis) but does not induce extensive liver damage. Ethanol consumption in our experimental conditions lowered the triglyceride level as well as the triglyceride/HDL ratio, suggesting lipid redistribution and the induction of some cardio-protective effect. However, ethanol induced a higher index of atherosclerosis. Pumpkin seed oil showed some protective potential in alcoholic rats by lowering the total cholesterol/HDL ratio, but it elevated the LDH. Whey consumption prevented elevation of the atherosclerosis index, pointing to its protective role, probably through the redistribution of lipids. However, whey in combination with ethanol elevated LDH. https://doi.org/10.2298/ABS180320014R Received: March 20, 2018; Revised: March 30, 2018; Accepted: March 30, 2018; Published online: April 17, 2018 How to cite this article: Radic I, Nestorovic V, Mijovic M, Tatalovic N, Joksimovic B, Lukic V, Mitic M, Adžic M, Blagojevic D, Velickovic S, Bulajic S, Đerkovic B, Miric M, Janicijevic-Hudomal S. The effects of whey and pumpkin seed oil on blood biochemical parameters of liver function and lipid profile in rats chronically drinking low concentrations of ethanol. Arch Biol Sci. 2017;70(3):…

Objectives. Interprofessional teamwork is best attained through education that promotes mutual trust and effective communication. The primary aim of the study was to evaluate the impact of interprofessional learning on knowledge about diabetes. Methods. The cross-sectional study included students of medicine, dentistry and nursing at the Faculty of Medicine Foča, Bosnia and Herzegovina. The students were randomly allocated into one of two groups. Group 1 attended an interprofessional course on diabetes while group 2 was divided into three subgroups and each of the subgroups attended an uniprofessional diabetes course. The measuring instrument used in the course in order to assess the participants’ knowledge about diabetic care was a test containing multiple-choice questions about diabetes. The Interprofessional Questionnaire was used to explore the attitudes, views, values and beliefs of students regarding interprofessional education (IPE). Results. No statistically significant difference in total score on the test was found between the groups at baseline, but at follow-up the difference was highly statistically significant (F=10.87; p=0.002). The students from Group 1 had better results (21.82 points), compared to Group 2 (18.77 points). The statistically significant difference was observed in mean values (t=-3.997; p=0.001), between Groups 1 and 2; the students from Group 1 obtained 20.42 points, which is considered to indicate a respectively positive self-assessment of communication and teamwork skills. However, Group 2 indicated a negative self-assessment of communication and teamwork skills. Conclusion. The findings suggest that IPE activities may provide health profession students with valuable collaborative learning opportunities.

Introduction: Alcoholism is the third most common psychiatric disorder among the elderly, yet it often goes undiagnosed in primary care setting. Objective: To estimate the prevalence of alcohol use disorders among elderly primary care patients in Bosnia and Herzegovina and to determine the presence of different health problems related to alcohol consumption. Method: The study was conducted in 10 family medicine practices. Family physicians randomly selected a group of 40 patients over 60 years of age registered with their practice. As a part of Comprehensive Geriatric Assessment, patients were asked to complete Alcohol Consumption Screening Questionnaire, Functional Status Questionnaire, Geriatric Depression Scale (GDS), Mini mental screening examination (MMSE), and Hamilton Anxiety Scale. Screening results were followed by additional clinical evaluation. To estimate the feasibility of Alcohol Consumption Screening Questionnaire, one family member or a caregiver of each patient was questioned about patient's habits and health problems. Results: Eighty-nine (22%) patients were current drinkers. Of those, 59% were harmful drinkers, 26% hazardous and 15% nonhazardous drinkers. Women accounted for 27% of current drinkers. MMSE revealed dementia symptoms in 37%, and symptoms of mild cognitive impairment (MCI) in 25% of current drinkers. Depression symptoms were found in 38% and anxiety symptoms in 6% of current drinkers. Functional status was decreased in hazardous and harmful drinkers. Conclusion: High percentage of older adults in Bosnia and Herzegovina is regular users of alcohol. Hazardous and harmful drinking is associated with significant morbidity. These findings demonstrate the usefulness and importance of the excess alcohol use screening in all primary care settings serving adults over age 60.

Introduction. Nursing is by nature a profession that involves a high level of stress. Stress or stressful reaction is response to stressful situations. Health care workers are exposed to combustion and it is professional nature of their work, especially in clinical hospital practice. The aim of this study was to identify and analyze the stress factors and the level of stress in the workplace of nurses and technicians.Methods. Research was conducted in the service of internal medicine and neurological wards at Clinical Center Foča. A sample consisted of nurses and technicians employed in these services interviewed in the period from February to March 2012 by means of an anonymous survey.Results. All surveyed nurses and technicians have a secondary education. Most respondents were female, 100% in the internal ward and 80% in the neurological ward. 75% of health of a total number of surveyed nurses and technicians in the department of internal medicine, 80% of them believe that they are exposed to stress whereas 20% of them deny it. All health care workers in the internal ward and 95%in the neurological ward consider that the relationships in these services are satisfactory. Most healthcare workers in the internal ward (75%) and more than half of health workers in the neurological ward (55%) believe that the primary stressor of health care workers are the professional requirements. All surveyed health care workers are able to take regular holidays (100%). Most health care workers (70%)are exposed to the risk and hazards in both services.Conclusion. Our results suggest that exposure to stress in health care workers is present in high percent-age. All health workers are able to take their vacations regularly while a major source of stress is work and professional requirements overload.

Background: Benzodiazepines have a direct bronchodilatory effect. Methacholine is a non-selective muscarinic receptor agonist causing bronchoconstriction. Aim: To examine the effects of inhaled benzodiazepines, modulating bronchoconstriction induced by methacholine in patients with asthma. Patients and Methods: Twelve patients with well controlled asthma were studied. On the first day, after determining the initial values of pulmonary function, a dose response curve was carried out with progressive doses of methacholine. After the last dose, when at least a 20% drop of the initial forced expiratory volume in the first second (FEV1) was achieved, vital capacity (VC) and FEV1 were measured at 7, 15 and 30 minutes after provocation. On the second day a diazepam aerosol was inhaled by the patients prior to the same protocol with methacholine. Results: In the first day of testing, methacholine inhalation (6 mg/mL) led to a significant drop in FEV1 from 2.98 to 1.69 L. On the second day of study, in the same patients, previous inhalation with diazepam reduced the changes of FEV1 after inhalation of methacholine. This parameter decreased from 2.48 to 2.21 L. Conclusions: Inhalation of benzodiazepines reduce bronchoconstriction after a methacholine challenge in patients with asthma.

Uvod. Zloupotreba psihoaktivnih supstanci u populaciji adolescenata predstavljajedan od najvećih psihosocijalnih problema savremenog društva. Ciljovog istraživanja je utvrđivanje nivoa znanja i stavova učenika osnovne isrednje škole, uzrasta od 11 do 18 godina, o načinima dobijanja droga, štetnimefektima na ljudsko zdravlje, kao i posljedicama koje se mogu javiti usljedupotrebe droga.Metode. Anterospektivna deskriptivna studija je sprovedena u Osnovnojškoli i Srednjoškolskom centru u Gacku, u periodu septembar-oktobar 2011.godine. U istraživanju je korišten upitnik od 15 pitanja. Anketirani su učeniciviših razreda osnovne škole ( VI-IX razreda) i učenici I-IV razreda srednješkole. Anketiranje je bilo anonimno.Rezultati. U studiji je učestvovalo 367 učenika (80% od ukupnog brojaučenika) osnovne škole i 370 učenika (85% od ukupnog broja učenika) srednješkole.Učenici srednje škole su imali više tačnih odgovora (3281) od učenikaosnovne škole (3241).Učenici osnovne škole dali su najviše tačnih odgovorana pitanje broj 3 (76,69%), a najmanje na 10. pitanje (38.75%). Učenici srednjihškola dali su najviše tačnih odgovora na 3. pitanje (72,47%), a najmanje na 8.pitanje (45,23). Učenici srednje škole su imali više tačnih odgovora od učenikaosnovne škole na 13. pitanje (p

Uvod. Unapređenje kvaliteta rada zdravstvenih ustanova, kao i svakodnevnihaktivnosti svih zaposlenih u zdravstvu je kontinuirani proces čiji je cilj dostizanjevišeg nivoa efektivnosti u radu, kao i veće zadovoljstvo pacijenata.Ciljevi ovog istraživanja su bili da se ispitaju stavovi medicinskih sestara i nivonjihovog zadovoljstva kvalitetom rada u organizaciji sestrinske službe, da seuporedi sistem kvaliteta na svakom odjeljenju posebno, i da li se standardi ikriterijumi zdravstvene njege sprovode po sistemu kvaliteta.Metode. Studija je izvedena među 30 medicinskih sestara zaposlenih u službamapedijatrije, porodične medicine i hitne pomoći Doma zdravlja Foča, kojesu anketirane u periodu avgust – septembar 2011. godine putem anonimnogciljanog upitnika.Rezultati. Sve anketirane medicinske sestre imaju srednje obrazovanje. Većinaispitanika (27) je zadovoljna radnom opremom. Po pitanju međuljudskihodnosa u Domu zdravlja Foča u službi pedijatrije 7 ispitanika smatra da sumeđusobni odnosi odlični, a tri da su zadovoljavajući, dok u službi hitnepomoći tri ispitanika smatraju da su međuljudski odnosi u njihovoj službiodlični, dok 3 smatra da su loši. U službi porodične medicine svih 10 ispitanikasmatra da su međuljudski odnosi zadovoljavajući.Zaključak. Naši rezultati ukazuju da je obrazovni nivo sestara nezadovoljavajući.Radni prostor i oprema su zadovoljavajući, medicinske sestre nedovoljnopoštuju standarde u radu ali žele da unaprijede kvalitet svoga rada.

Uvod. Bolnička infekcija je svaka infekcija koja je nastala kod bolesnika,osoblja, učenika ili studenata u bolnici ili u nekoj drugoj zdravstvenoj ustanovi,a koja nije bila prisutna, niti je bolesnik bio u inkubaciji na prijemu. Bolničkainfekcija se može manifestovati u toku hospitalizacije, ili po njenom prestanku.Cilj rada je bio da se ispita znanje studenata Medicinskog fakulteta u Foči uodnosu na bolničke infekcije.Metode. Studija je izvedena među 52 studenta IV i 48 studenata VI godineMedicinskog fakulteta u Foči, koji su anketirani u periodu septembar - oktobar2008. godine putem anonimnog epidemiološkog upitnika.Rezultati. Svi ispitani studenti su znali da je bolnička infekcija ona koja jepostala evidentna nakon 48 časova ili kasnije poslije prijema bolesnika ubolnicu, a koja nije bila prisutna, niti je bolesnik bio u inkubaciji pri prijemu.Najveći broj studenata (83%) je znalo da 5-10% bolesnika dobije bolničkuinfekciju tokom boravka u bolnici. Čak 82% studenata je znalo da su bakterijenajčešći prouzrokovači bolničkih infekcija.Zaključak. Naši rezultati ukazuju da je znanje studenata medicine o bolničkiminfekcijama na visokom nivou.

Background:Tobacco smoking amongst the young is a matter of public health concern because of the immediate and long-term health consequences associated with tobacco use, such as asthma, cancers, and cardiovascular diseases. The purpose of this study was to identify the determinants of smoking initiation among a sample of high school students in Bosnia and Herzegovina.Methods:The study was conducted among 198 high school students in Zvornik, Bosnia and Herzegovina, during April 2013. A self-administered, pre-tested, structured, close-ended questionnaire was used for data collection.Results:Fourth grade students mainly initiated smoking in high school (45%), while the majority of third and second grade students initiated smoking in primary school. Among students who smoke, an average duration of the smoking habit was Conclusion:This study indicates that a high proportion of 15–18 year olds in the town of Zvornik are current smokers. Gender, age, and parent and peer influence were identified as important associations with smoking. Interventions should not only be confined to the secondary school environment but they should also extend to their places of residence so that influences in the home environment and social surroundings that contribute to tobacco use are also tackled.

Objective. The primary objective of this paper is to examine the impact of diabetes mellitus on the ability to work in patients with diabetes mellitus. The second objective of this paper is to examine the differences in the ability to work between patients with diabetes mellitus and patients with other chronic diseases, such as hypertension. Material and methods. A study was conducted in 10 family medicine practices from two primary health care centers, Pale and East Sarajevo, in the period between July 2009 and May 2010, utilising a retrospective medical records review and a cross sectional survey. The outcomes used to portray respondent’s health status included functional measures and ability to work. Functional measures were analyzed using SF-36 and a general questionnaire. Absenteeism and productivity loss were retrospectively analyzed for the past ten years from a regional sick-leave database and the administrative records of the Commission for the assessment of work capacity for the Pension and Disability Insurance Fund of the Republika Srpska respectively. Results. Out of the total number of patients with diabetes, 24.6% had some form of disability. A statistically significant difference was found between the two groups; patients with diabetes mellitus were much more likely to have problems meeting the required standards at the workplace due to emotional and physical health issues compared to hypertensive patients. Conclusion. Diabetes mellitus appears to reduce an individual’s ability to work in comparison to patients with hypertension. There is a need to set up a diabetes mellitus prevention program and to develop and implement effective targeted intervention to help workers to manage their disease better.