Spinal injuries represent a significant public health concern, causing severe impairments in bodily functions, including disrupted postural control and the loss of the ability to maintain an upright position. These functional difficulties substantially affect patients' quality of life and their engagement in daily activities. Traditional rehabilitation approaches often demonstrate limited effectiveness in achieving functional recovery. Consequently, recent years have witnessed rapid advancements in technological innovations within the rehabilitation process for spinal injuries. The integration of robotic systems, wearable technologies, and neurostimulation, presents new opportunities for improved therapeutic outcomes. These innovations not only enhance the precision of therapy but also enable personalized approaches tailored to the specific needs of each patient. Particular emphasis is placed on technological advancements that facilitate verticalization and improve postural control, as these functions are crucial for maintaining balance and participating in everyday activities. This paper aims to present and analyze some of the technological innovations in the rehabilitation of individuals with spinal injuries, with a particular focus on verticalization and postural control. Future research should concentrate on optimizing technological solutions, developing personalized therapeutic approaches, and ensuring accessibility to maximize functional benefits for individuals with spinal injuries. Keywords: technological innovations, verticalization, postural control, spinal cord injury

This study aimed to determine the demographic and substance use trends among heroin addicts in Herzegovina.Methods: Data were analyzed regarding gender, age, educational attainment, types of psychoactive substances they use, reasons for initiating substance use, transition methods between substances, type of substitution therapy, and achieving abstinence with the use of substitution therapy. The sample consisted of 127 participants.Main findings: Most treated individuals were men, typically initiating psychoactive substance use in adolescence. Heroin was the primary drug of addiction, while tetrahydrocannabinol (THC) was commonly reported as a secondary substance. Intravenous use was frequent and often associated with equipment sharing. Hepatitis C was prevalent among users, with limited vaccination against hepatitis B. Methadone was the predominant substitution therapy. Among those with available outcome data, roughly three quarters achieved abstinence during treatment.Principal conclusion: Individuals treated for heroin addiction in Herzegovina are predominantly male with adolescent-onset substance use, frequent intravenous administration, and substantial infectious-disease burden. Comprehensive strategies—prevention in early adolescence, robust harm reduction, and sustained substitution therapy with psychosocial support—are essential to improve outcomes. Key words: sociodemographic characteristics, substance use, heroin addiction, Herzegovina

Introduction: Post-traumatic embitterment syndrome is a pathological reaction to drastic life events and doesnot have the tendency to end. This syndrome also occurs relatively frequently in patients with post-traumatic stress disorder (PTSD).Aim: To investigate post-traumatic embitterment syndrome in patients with post-traumatic stress disorder.Subjects and methods: A cross-sectional study was conducted on a sample of 200 subjects who were participants in the past war. The research group consists of 100 subjects who participated in the war and have a diagnosis of PTSD, and the control group consists of 100 healthy volunteers who were in the war but were not previously diagnosed with PTSD.The study used a sociodemographic questionnaire, a self-assessment questionnaire for post-traumatic embitterment syndrome, and a clinical questionnaire for post-traumatic stress disorder.Results: Subjects with PTSD show a statistically significantly higher level of post-traumatic embitterment syndrome compared to subjects without PTSD. There were no statistically significant differences between the groups that actively and passively participated in the war, between genders, and between the groups with current PTSD and lifetime PTSD.Conclusion: Subjects with PTSD show a statistically significantly higher level of post-traumatic embitterment syndrome compared to subjects without PTSD.

Introduction: Adults over 65 years of age have the highest mortality rate from lower respiratory tract infections caused by influenza. People who live with or care for patients in risk groups, such as healthcare workers, should be vaccinated. Low influenza vaccination rates among certain at-risk groups contribute to the burden of disease and remain a major public health challenge. The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on seasonal influenza. Aim: Investigate the coverage of influenza vaccination among adults at the Health Center of the Split-Dalmatia County in Vrgorac. Materials and methods: A retrospective analysis was conducted. Data on influenza vaccinations from January 01, 2019 to December 31, 2024 at the Health Center of the Split-Dalmatia County in Vrgorac were analyzed from the electronic immunization database. The following variables were included in the analysis: vaccination coverage by year, subject category (older than 65, chronically ill, healthcare worker, other), and subject gender. Results: A total of 2090 doses of influenza vaccine for adults were consumed. The most vaccine doses were consumed in 2020, 512 doses, and the fewest vaccine doses were consumed in the last two years, 257 and 296, respectively (p<0.05). The largest number of patients was over 65 years old, 1214, 833 were chronic patients, while 26 were healthcare workers (p<0.05). Conclusion: A statistically significantly lower consumption of vaccine doses was found during and after the end of the COVID-19 pandemic compared to the time before the pandemic. Healthcare workers were statistically significantly less vaccinated against influenza compared to other groups. Keywords: Influenza, human flu, vaccination, immunization, vaccines

Introduction: Hepatitis B is a viral infection of the liver that can present as both an acute and chronic disease, caused by the hepatitis B virus (HBV). Despite the availability of an effective vaccine and antiviral therapies capable of suppressing viral replication , hepatitis B remains a significant public health concern. The aim of the study is to collect, statistically analyze, and compare data on age, gender, and the number of hepatitis B cases in the Herzegovina-Neretva (HNC) and Split-Dalmatia (SDC) Counties. Participants and methods: In this retrospective study, data were collected on the number of inhabitants and the number of registered patients with hepatitis B in the areas of these two counties, as well as demographic data of patients (age, gender) for the period from January 1, 2014, to December 31, 2024. Results: In HNC region, 11 individuals with hepatitis B were registered during the study period, with nearly equal numbers of women and men. The affected men were significantly younger than the women (p<0.05). In the SDC, 55 individuals with hepatitis B infection were registered during the same period, with significantly more men than women (p<0.05), while there was no statistically significant difference in the age of the patients (p>0.05). The average annual rate of reported hepatitis B infections in the observed period in the HNC was 0.42 %000, while in the SDC, it was 0.96 %000,. The overall notification rate of cases in the SDC was 12.21 %000,, significantly higher than in the HNC, where it was 4,66 %000, (p<0.05). Conclusion: It was determined that both counties have a low incidence rate of hepatitis B. The epidemiological data on hepatitis B obtained in this study are important for guiding prevention and treatment of the disease in the areas studied and contribute to one of the World Health Organization (WHO) goals, which is the elimination of hepatitis worldwide by 2030. Keywords: hepatitis B, incidence, elimination, Split-Dalmatia County, Herzegovina-Neretva County.

Endothelial progenitor cells (EPCs) play a crucial role in vascular repair, and their depletion has been involved in coronary artery disease (CAD) severity. This study examines the relationship between circulating EPC levels and CAD complexity, as quantified by the Syntax Score I. A total of 85 patients undergoing coronary angiography were enrolled, with EPCs quantified using flow cytometry. EPC proportion showed a significant inverse relationship with CAD severity, measured by Syntax Score I. Additionally, we investigated EPC levels in patients presenting with acute coronary syndrome (ACS) and found that EPC depletion was more pronounced in this group compared to non-ACS patients (median EPC count: 0.35 vs. 0.61, p = 0.027). These findings suggest that lower EPC levels are indicative of more severe CAD and ACS, reinforcing their potential as biomarkers for cardiovascular risk stratification, monitoring disease advancement, and identifying patients at risk of adverse events.

SUMMARY – The aim of this research was to investigate the impact of COVID-19 on the mental health of primary health care workers. This prospective research included 107 medical (51.5%) and non-medical (48.5%) employees of Health Center (HC) Mostar. Data were gathered using a questionnaire that contained the depression, anxiety and stress scale (DASS-21) and a validated short questionnaire of human mental health (MHI-5) during the COVID-19 pandemic. Most respondents were < 45 years of age. There was no statistically significant difference between medical and non-medical staff on both the DASS-21 and MHI-5 scales. Also, no statistically significant difference was found in the subcategorization of medical staff. The prevalence of stress in the subjects was 30%, anxiety 54% and depression 31%. A multivariate logistic regression model found that age > 45 years (OR = 0.509; P = 0.016) and opiate use (OR = 0.203; P = 0.023) were positively associated with depression ( P = 0.042). The overall crisis related to the COVID-19 pandemic has led to various psychological difficulties in the general population, but also in a significant percentage of healthcare workers at all levels of healthcare. Therefore, new approaches are necessary in the treatment of the mentioned mental health problems.

Understanding how spirituality affects mental health can provide important insights into treatment and support methods for people with mental illness. In modern society, spirituality is increasingly recognized as an important aspect of human life. It signifies the deep values and life views that people want to live by. A higher level of spirituality aids personal growth and development, including an individual's mental health and emotional well-being. Providing spiritual health care is considered important for the prevention of depressive symptoms and includes activities such as listening to patients, offering peace, respect, comfort and hope. A holistic approach to treating patients is increasingly being recognized and applied throughout the world. A holistic approach to health recognizes the interconnectivity of the psychological, social, biological and spiritual aspects of a person, which is reflected in the application of various methods including medication, education, communication, self-help and alternative therapies. History shows that scientific research has long confirmed the connection between spirituality and improved health. Spirituality seems increasingly important in the context of increased life stress, and recent research suggests that spiritual practices can contribute to the reduction of depressive symptoms. Spiritual beliefs and practices can also provide comfort to people who are fearful or anxious, increasing their sense of control, security and confidence. The effects of spirituality on mental health are individual and depend on personal beliefs, life experiences and the context in which it is practiced. An individualized approach in the assessment and integration of spiritual and religious aspects in the treatment of mental disorders is key. This paper explores the connection between spirituality and mental illness, with the aim of illuminating how spirituality can be both a source of support and challenge for people struggling with mental disorders. Keywords: spirituality, mental diseases, mental health

ABSTRACT Background Cognitive emotional regulation refers to a conscious or unconscious process that affects an individual's emotions and the physical and mental health of the individual. The aim of this study was to detect strategies of cognitive emotional regulation used by physiotherapy students in stressful situations. Methods The study was conducted from January to March 2022 and enrolled 372 students. An announcement was posted electronically on the web page of each physiotherapy study in Croatia, inviting students to participate in the study. Each participant provided written informed consent. The Cognitive Emotion Regulation Questionnaire was used in the study for detecting cognitive emotional strategies that students use in stressful situations. Statistical analysis of data included descriptive statistics of data groups where values were expressed as mean and standard deviation. The Kolmogorov–Smirnov test was used to test the normality of the distribution. To test the differences between two independent groups, the Mann–Whitney U rank sum test was applied, while the non-parametric Kruskal–Wallis test was used to test the differences of several subgroups of variables. Categorical variables were tested with Fischer's exact test or chi-square test. Results The most frequently used emotional cognitive regulation strategies are acceptance and positive reappraisal. There is a statistically significant difference in the use of self-blame (p < .001), rumination (p < .001) and blaming others (p = 0.018) in relation to gender. Also, there is a statistically significant difference in the use of acceptance (p = 0.022), rumination (p < .001) and blaming others (p = 0.049) in relation to the year of study. Conclusion Education of physiotherapy students to the use of adaptive strategies could have a positive effect on the students’ learning quality, their decision–making abilities and the quality of physiotherapy provided to patients. Encouraging physiotherapy students to engage in cognitively adaptive ways of thinking can serve as a solid method to help students in an academic and professional environment.

Introduction: Vaccines for protection against 10 infectious diseases are available in the Program of Regular Immunization in the Federation of Bosnia and Herzegovina. These vaccines save the lives of up to 3 million people worldwide every year. The latest report of the Institute of Public Health of the Federation of Bosnia and Herzegovina on regular immunization carried out during 2020 shows that the rate of vaccination of children during the 2019 coronavirus disease (COVID-19) pandemic with regular vaccines has decreased compared to previous years. Such a situation in the health system leads to a potential risk of outbreaks of infectious diseases that are prevented by vaccination.Objective: To examine the impact of the COVID-19 pandemic on the regular immunization of children in the Mostar Health Center.Materials and methods: A retrospective cross-sectional epidemiological study was conducted. Data on regular immunization of children from theMostar Health Center, Herzegovina-Neretva County in the Federation of Bosnia and Herzegovina from 2017, 2018, 2021 and 2022 were used.Results: A statistically significant difference was obtained in vaccination against measles, mumps and rubella during a period of four years. Vaccination with the mentioned vaccines was significantly higher in 2017 and 2018 than in 2021 and 2022.Conclusion: It was shown that the COVID-19 pandemic affected the regular immunization of children in the Mostar Health Center.Keywords: regular immunization of children, COVID 19 pandemic, MMR vaccine, Mostar