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Background / Aim: COVID-19 is acute virus disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It was proclaimed as pandemic starting from March 2020 and is still ongoing. COVID-19 pandemic forced all segments of the society, particularly the health sector, to function in changed and aggravating circumstances and because of the transmission and new strains of the virus it resulted in the change of the number of infected people with peaks and oscillations. Aim of this study was to make analysis of the data related to COVID-19 positive/suspect patients examined in the Primary Healthcare Centre Banja Luka in the period 15 March 2020 - 15 March 2021, which refers to the incidence of the infected persons, sex and age representation, laboratory diagnostics and clinical parameters, applied therapy, as well as the number of patients sent for the hospital treatment. Methods: Data for the analysis were obtained by the retrospective analysis of the statistical data from the electronic medical record of the examined COVID-19 positive/suspect patients in the Outpatient Clinic for Acute Respiratory Infections (ARI) and in the field. Pearson's ch2 test of contingency was used for the comparison of differences of the observed characteristics of the examined groups. Results: Personnel of the Emergency Department (ED) of the Primary Healthcare Centre Banja Luka, in the period 15 March 2020 - 15 March 2021, examined the total of 3,937 COVID-19 positive patients and patients suspect of COVID-19. Out of that number, 3,601 patients were examined in the ED - ARI and 336 patients were examined in the field. The biggest number of patients was registered in November 2020 (768). Male sex prevailed (55.50 %) and patients of 20-50 years of age were most represented. There were 3.10 % of those highly febrile patients and 2.5 % of those with low SpO2 of under 90 %. 14.90 % of patients had higher values of troponin T and 45.50 % of them had higher values of D-dimer. In the field, 69.60 % of patients had pathological changes on lungs and 33.30 % had pathological ECG report. The number of patients sent from the ARI for further diagnostic procedure or hospitalisation to the Clinic for Infectious Diseases of the University Clinical Centre of Banja Luka was 1,191 and 258 patients were sent from the field. Conclusion: For the purpose of preventing the spread of epidemics, the ED reorganised the existing space by introducing temporary clinics - containers for the patients with acute respiratory infections and febrile status, COVID-19 suspects. Clinical parameters changed depending on the new virus strains, as well as on age distribution and infection complications.

Introduction/Objective. Growth, development and maturation are periods marked with individual physical characteristics, which provide the insight into the health status together with anthropometric indicators and physical appearance of an individual. The aim was to determine body height and body weight of a representative sample of schoolchildren from Novi Sad, to make a comparative analysis in relation to age and gender, and to determine the beginning of accelerated growth. Methods. Sample included 11,676 pupils aged 6–15 years, from Novi Sad, Serbia. The basic anthropometric measurements (body height and body weight) were performed according to recommended methodology. Results. The average values of boys’ body height ranged from 125.39 cm in those aged up to six years, to 175.09 cm for boys aged 15, and in girls from 124.07 cm at the age of six, to 165.77 cm for the oldest examined girls. The average values of boys’ body weight ranged from 25.58 kg at the age of six to 61.38 kg at the age of 15, and in girls from 23.94 kg in youngest to 54.46 kg, at the age of 15. The analysis of body weight and body height relation in the sample of boys and girls showed significant differences in all age groups, being most significant in boys aged from 11 to 13 years and in girls aged from nine to 12 years, marking the beginning of the rapid growth period. Conclusion. Having analyzed two basic anthropometric characteristics, i.e. body height and body weight, the authors found significant differences in the increase of these characteristics among the age groups of the study sample. In addition, the results of this research are in accordance with those reported in literature, which suggest that a sudden ponderal and statural growth starts earlier in girls than in boys.

Self-concept is defined as a sum of perception, thoughts, feelings, evaluation and prediction about oneself as an experienced object, as a participant in the interaction with physical and social environment. As such, this topic is often encountered in working with children, young people and adults with intellectual disabilities (PWID). However, self-concept of PWID has been investigated mainly through psychometric paradigm, using different types of questionnaires for assessment. This did not provide either enough possibilities for active participation of people with ID in the research process, or the possibilities to reach adequate initial information about self-concept of PWID, which may serve as a baseline for development of support programs for self-determination of PWID. Therefore, this study aimed to examine self-concept of PWID in various domains of interest for PWID: global self-image, personality traits, competencies, difficulties in everyday life, awareness of one's own (intellectual) disabilities. The research was conducted through a series of five focus groups, with active participation of PWID, through combined workshop activities and discussions in small groups. Focus groups were conducted once a week and 16 participants were divided into two groups, of different ages (22 to 53 years), sex, type and degree of difficulties. All participants spent most of their lives in institutions. Since 2004, they have been living at supported housing for people with disabilities. Based on the analysis of the participants' testimony, there were three global issues with regard to general self-concept: competences and interests, physical appearance, and social roles. With regard to personality traits, attributes such as 'good', 'obedient', 'valuable' occur most frequently. With regard to their competencies and difficulties, those which are most important for full daily life in supported housing have been cited most often. While they recognize their cognitive difficulties, they often refuse to talk about them, and highlight their awareness of the devaluative implications of terms which are used for their categorization. The analysis showed that the self-concept of PWID is relatively poor with attributes, that it is acquired and learned, and comes as a product of relatively restrictive living conditions, such as living in an institution. However, it can be assumed that current living conditions have stimulating effect on the formation of self-concept of PWID. This article points out the possible implications of the basic results of practical work to improve self-concept and capacity for self-determination of people with intellectual disabilities.

Adoption of eating habits starts early in life, through interaction with family members and alongside preschool settings that offer context for developing healthy lifestyles among children. The aim of this study was to explore the perceptions and practices of teachers and parents related to the development of healthy eating habits among preschool children. Focus groups were conducted with a total sample of 48 parents and teachers (three focus groups among parents and three among teachers) from 15 kindergartens in the Republic of Srpska, Bosnia, and Herzegovina. All of the mentioned kindergartens are part of the "Nutrition friendly preschool/school initiative", a program aimed at creating and developing settings that support and improve children's health. Focus groups were audiotaped, transcribed verbatim, and analyzed according to the Framework Method. Teachers emphasized that good communication and support from parents are important factors for the development of healthy eating habits. During COVID-19, direct communication with parents was restricted, and mutual activities among teachers, children, and parents were reduced. Lack of knowledge, finance, and time are perceived by parents as main obstacles to the improvement of children's healthy eating habits. All participants in the focus groups agreed that more education and informative material are needed so their skills related to good nutrition can be improved and adopted in a culture-sensitive way. Mutual support, education, and dissemination of informative materials are imposed as particularly important needs by all actors involved in the upbringing of children in order to support the development of children's healthy eating habits., Competing Interests: D.S. is the coordinator of the “Nutrition friendly preschool initiative” in the Republic of Srpska. S.S., J.N., and D.M. are members of the team for the implementation of the “Nutrition friendly preschool/school initiative” in the Republic of Srpska. B.DJ. is an external consultant for qualitative research methodology., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses., (© 2021 World Obesity Federation. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.)

Background: Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits., Methods: The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status., Results: Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet., Conclusion: Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets., (© 2021 The World Health Organization. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities., (© 2021 World Obesity Federation. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.)

In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6-9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region., (© 2021 World Obesity Federation. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.)

Background: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing., Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI)., Method: The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration., Results: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night., Conclusions: The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

Background and Purpose: There are only a few published studies on the relationship between cardiovascular health (CVH) status as proposed by the American Heart Association and the metabolic syndrome (MetS) in persons with cardiovascular disease (CVD). The aim of this study was to assess the prevalence of CVH and MetS and their correlation in the adult population of the Republic of Srpska, Bosnia and Herzegovina, in order to evaluate which set of cardiovascular risk factors (low or medium CVH status and MetS), or the combination of both, is a better predictor for the occurrence of CVD., Methods: We included 3601 adults (aged ≥25 years) from the Republic of Srpska National Health Survey 2010. CVH status was evaluated according to the American Heart Association criteria, whereas MetS was defined using the criteria of the National Cholesterol Education Program's Adult Treatment Panel III., Results: The prevalence of low or medium CVH status and MetS is significantly higher in participants who had experienced CVD than in those free of CVD. Our study showed that predictors for CVD occurrence were presence of MetS (odds ratio 3.61, 95% confidence intervals 2.14-6.07) and presence of both sets of cardiovascular risk factors in the same person (odds ratio 4.23, 95% confidence intervals 1.50-11.93)., Conclusion: Our results suggest that presence of both sets of cardiovascular risk factors (low or medium CVH status and MetS) is the strongest predictor of CVD. Identification of individuals with cardiovascular risk factors may provide opportunities to intervene earlier and can help reduce the risk of developing CVD., (Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Background: The aim of this study was to determine sex differences in the prevalence of cardiovascular health (CVH) metrics according to the CVH status., Methods: The cross-sectional, population-based study involved 2250 women and 1920 men aged ≥18 years that participated in the 2010 National Health Survey in the Republic of Srpska, Bosnia and Herzegovina. Prevalence of CVH behaviours (smoking, body mass index, physical activity, diet), CVH factors (cholesterol, fasting blood glucose and blood pressure, plus smoking) and ideal CVH were estimated according to the American Heart Association criteria for ideal, intermediate and poor levels. Association between sex and ideal CVH categories was analyzed with multivariable logistic regression analysis across three age stratums., Results: A higher prevalence of ideal CVH metrics was seen in women for smoking status, body mass index, healthy diet score and blood pressure, and in men for physical activity and total cholesterol. Women from all age groups had better CVH behaviours (odds ratio [OR] = 1.40 for the youngest; OR = 2.05 for middle-aged; and OR = 2.03 for older-aged women), while only women from the youngest age group had better CVH factors (OR = 5.09). In line with this, ideal overall CVH prevailed in younger and middle-aged women in comparison to men of the same ages (OR = 3.01 and OR = 2.25, respectively), while disappeared in older ones., Conclusions: Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention., (© The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: A relatively consistent body of literature, mainly from high-income countries, supports an inverse association between socio-economic status (SES) and risk of cardiovascular disease (CVD). Data from low- and middle-income countries are scarce. This study explores SES differences in cardiovascular health (CVH) in the Republic of Srpska (RS), Bosnia and Herzegovina, a middle-income country., Methods: We collected information on SES (education, employment status and household's relative economic status, i.e. household wealth) and the 7 ideal CVH components (smoking status, body mass index, physical activity, diet, blood pressure, total cholesterol, and fasting blood glucose) among 3601 participants 25 years of age and older, from the 2010 National Health Survey in the RS. Based on the sum of all 7 CVH components an overall CVH score (CVHS) was calculated ranging from 0 (all CVH components at poor levels) to 14 (all CVH components at ideal levels). To assess the differences between groups the chi-square test, t-test and ANOVA were used where appropriate. The association between SES and CVHS was analysed with multivariate linear regression analyses. The dependent variable was CVHS, while independent variables were educational level, employment status and wealth index., Results: According to multiple linear regression analysis CVHS was independently associated with education attainment and employment status. Participants with higher educational attainment and those economically active had higher CVHS (b = 0.57; CI = 0.29-0.85 and b = 0.27; CI = 0.10-0.44 respectively) after adjustment for sex, age group, type of settlement, and marital status. We failed to find any statistically significant difference between the wealth index and CVHS., Conclusion: This study presents the novel information, since CVHS generated from the individual CVH components was not compared by socio-economic status till now. Our finding that the higher overall CVHS was independently associated with a higher education attainment and those economically active supports the importance of reducing socio-economic inequalities in CVH in RS.

Objectives: Our aim was to assess the prevalence of ideal cardiovascular health (CVH) in the adult population of Republic of Srpska (RS), Bosnia and Herzegovina, and its relationship with socio-demographic characteristics of participants., Methods: We included 4,170 adults (mean age 50.2 years; 54 % women) from the National Health Survey performed from September to November 2010 in RS. Population prevalence of CVH health metrics (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose) were estimated according to the American Heart Association criteria for "ideal", "intermediate", and "poor" levels., Results: Only 0.02 % participants had ideal (all 7 health metrics at ideal levels), 7.6 % intermediate, and 92.4 % poor (at least one metric at poor level) CVH. The fasting glucose was the most prevalent (75.9 %), whereas the healthy diet was the least prevalent (4.4 %) ideal CVH metric., Conclusions: Our study indicates extremely low prevalence of ideal and high prevalence of poor CVH in the adult RS population. Such alarming results require urgent action. Comprehensive public health strategies and interventions must be developed to assist individuals and population in improving their CVH.

Objective: Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS)., Design: Population-based cross-sectional study., Setting: RS, Bosnia and Herzegovina., Participants: The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS., Study Variables: Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m(2), physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status., Results: Participants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively)., Conclusions: Our findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed at improving CVH in RS, targeting primarily low educational groups., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)