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Arzija Pašalić

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Introduction: Medical biochemical laboratory professionals play a critical role in diagnostics, research, and patient care, performing complex tasks that require extensive knowledge, professional attitudes, and adherence to best practices. Understanding their knowledge, attitudes, and practices (KAP) is essential for improving laboratory performance, ensuring quality, and enhancing patient outcomes. Despite the importance of quality control systems and international standards, the existing literature reveals a lack of validated instruments to assess KAP among laboratory professionals. This study aimed to develop and validate a comprehensive questionnaire targeting key domains of laboratory practice, with the goal of identifying operational gaps and guiding future interventions. Methods: The questionnaire was developed through a four-phase process: Literature review, item construction, questionnaire distribution, and validation. Psychometric evaluation included internal consistency testing and factor analysis to ensure reliability and validity. Results: The final instrument, titled KAP of Laboratory Professionals on Standards and Work Quality Systems, comprised 73 items across six domains. The overall Cronbach’s alpha was 0.673, indicating moderate but acceptable internal consistency. The questionnaire effectively identifies gaps in KAP related to quality control in medical-biochemical laboratories. Its results can support laboratory managers in recognizing areas for improvement, ultimately enhancing service quality and patient outcomes. Conclusion: This descriptive and analytical study presents a validated and reliable tool for assessing KAP regarding standards and quality control systems in medical-biochemical laboratories. Its application can guide targeted interventions to address deficiencies and strengthen practices in laboratory medicine.

Mirela Lisičić Konaković, Sabina Šečić-Selimović, Arzija Pašalić, N. Fejzić, Irena Drmić Hofman, Amina Šeta, Ljerka Ostojić, Ivan Čavar, L. Sporišević et al.

Introduction: The impact of nutrition on human health has become a central topic in modern research. The Mediterranean diet, rich in fruits, vegetables, fish, whole grains, and olive oil, has been associated with a lower risk of cardiovascular diseases. However, the effects of non-Mediterranean diets, particularly among students, remain insufficiently explored. This study aimed to examine differences in the dietary habits of health sciences students in two cities in Bosnia and Herzegovina (Mostar and Sarajevo) and Split, Croatia. Methods: A cross-sectional descriptive study was conducted between February and November 2024, including 473 students (Mostar: 125, Sarajevo: 230, Split: 118). Dietary habits were assessed using a validated food frequency questionnaire and the Mediterranean Diet Adherence Screener. Statistical analysis included Pearson’s chi-square test, with significance set at p < 0.05. Results: Students from Split showed significantly higher adherence to Mediterranean dietary habits, including greater consumption of vegetables (p = 0.009), fish (p = 0.035), legumes (p = 0.036), and tomato sauce (p = 0.022). Students in Sarajevo reported the highest intake of sugary drinks (p < 0.01), while those in Split consumed the least margarine and cream-based fats (p = 0.003). No significant differences were found in fruit consumption. Conclusion: Given the importance of diet in preventing chronic diseases, targeted nutrition education programs are needed to promote healthier eating habits among students. Future research should explore the underlying causes of these dietary differences and their long-term health implications.

Mohammad Ardat, Naima Galijasevic, Lana Mulahasanovic, Djenana Saldo, Fahira Imamović, Arzija Pašalić, Vedran Djidzo

Background: Midwives are globally recognized as health professionals who specialize in the care of women in labor with a vital role in maternal and newborn health care. Midwives specialize in the care of women in labor and play a key role globally in managing normal vaginal birth, caring for pregnant women including supporting women and their families, providing consultations, managing normal birth for low-risk pregnant women and helping them maintain a healthy pregnancy. Despite the fact that the midwifery profession is an autonomous profession, in some countries there are many struggles to achieve recognition within its formal scope of work. The role of the midwife/midwife remains unclear in many countries due to poorly articulated policies and a lack of regulatory frameworks, which results in a lack of public clarity regarding the role of the midwife. Objective: The purpose of this expert report is to present the role of the midwife in protecting the health of mothers before, during and after childbirth, to clearly define their role and importance, and the need to improve midwifery as a profession in order to reduce the number of caesarean sections. Methods: This systematic review includes a comprehensive literature search of published scientific articles, in English, from 2020 to 2024, using electronic databases considered most relevant to the topics; CINAHL, EMBASE and PubMed. In this systematic review and meta-analysis, we included studies on the role of midwives in different countries, including Thailand, the United States, Australia, Canada, the UK, the Netherlands, Bosnia and Herzegovina, Slovenia, Croatia and Serbia, to arrive at results on what the role of midwives is in these countries. Citations without abstracts and/or full text, anonymous reports, editorials, case reports, case series and qualitative studies were excluded. Results: In the Law on Health Care of the FBiH, and the Law on Nursing and Midwifery of the FBiH, the role of the midwife is insufficiently defined and she is not given sufficient authority to work. For childbirth in BiH, in addition to midwives, a doctor must always be present. In European and foreign countries, the role of the midwife is put in the foreground during childbirth, so there are also hospitals where women give birth and are cared for by midwives. Midwife-led care, an approach that is already widely practiced in developed countries; however, it is a relatively new approach in lower-income countries. In midwife-led care, a midwife who is well known to the mother provides care for the low-risk pregnant woman during antenatal care, delivery and the postnatal period, rather than being cared for by different medical staff led by an obstetrician. The primary focus of care led by midwives is to support a healthy physiological pregnancy and birth and to empower women to give birth naturally with little or no regular intervention. Conclusion: It is very worrying for midwifery as a profession that there is currently a lack of visibility of midwives in practice within their scope of practice in Bosnia and Herzegovina. More research is needed on demonstrating the value of midwives as a primary role in the context of midwifery practice in Bosnia and Herzegovina.

A. Radovic, Sanela Hajro, A. Durmisevic, Melina Drljo, Aldina Alibegović, Selma Klepo, Adela Vranesic, Amna Vefic, Dženan Pleho et al.

Background: Cardiometabolic risk (CMR), encompassing metabolic syndrome, type 2 diabetes mellitus, hypertension, and dyslipidemia, represents a major public health challenge in Bosnia and Herzegovina, where overweight and obesity prevalence is high. Objective: The study aimed to: a) examine the prevalence of three or more metabolic risk factors in relation to age; b) analyze biochemical parameters, lipid indices, and body composition indices in association with cardiometabolic risk (QRISK3); and c) identify age-specific thresholds for elevated risk. Methods: A cross-sectional, observational, descriptive–analytical study included 203 working-age participants (≤49, 50–54, 55–59, ≥60 years). The research instruments included: laboratory analysis, anthropometric and body composition parameters, and the Q3 risk calculator. Results: The prevalence of three or more metabolic risk factors increased with age, from <49 years to ≥60 years. Younger participants exhibited lower HDL and higher visceral fat, whereas older groups showed elevated glucose, ALT, and AST (p<0.05). The Q3 risk score increased significantly across age groups (median 8.15 to 24.80; p<0.001). Visceral fat, BMI, and body fat percentage emerged as strong predictors of risk in younger and middle-aged adults. Conclusion: Cardiometabolic risk develops already in early adulthood. Age-specific thresholds for visceral fat and biochemical markers may improve risk stratification, highlighting the importance of early screening and preventive interventions.

Daniel Maestro, Arzija Pašalić, Aida Ramić-Čatak, Z. Obradović

Introduction: Most foodborne illnesses can be prevented by proper food preparation. The estimated prevalence of these diseases is 300-350 times higher than the data available today, which represents only the “tip of the iceberg.” Although restaurants are cited as the most common sites for food poisoning, these cases are three times more likely to occur in households. Therefore, assessing food consumer knowledge and practices provides a basis for formulating and designing programs to promote food safety in households. Methods: Representatives of 384 households in six urban and rural municipalities in Sarajevo Canton participated in the survey. A previously designed and validated household food safety questionnaire was used to explore the knowledge and practices of the population regarding household food safety. Respondents’ knowledge and practices were assessed by the score they achieved, with one point awarded for each correct answer. The range of scores for knowledge and practices was divided into quartiles. The Chi-square test was used to examine whether there was a difference between expected and observed scores in one or more categories in contingency tables. Results: In the assessment of food safety knowledge, 62% of the respondents had good knowledge, 33.1% had average knowledge, and 4.9% had poor knowledge. The results showed that 59.4% of the respondents had average practices and 22.4% had poor practices regarding food safety in their households. It was confirmed that various socioeconomic factors had a significant influence on consumers’ knowledge and practice regarding food safety in their households (p < 0.05). Conclusions: Nowadays, the topic of food safety is rarely discussed in households, and the public is not aware of the risks they face. Urgent action should be taken to raise collective awareness of the importance of household food safety to public health.

Introduction: Work-related musculoskeletal disorders (WRMSDs) are the most common work-related disorders and describe a wide range of degenerative and inflammatory states that affect blood vessels, peripheral nerves, bones, joints, ligaments, tendons, and muscles. Healthcare as a special sector has almost the highest prevalence of WRMSDs in the world, far ahead of construction, mining, and manufacturing. Studies conducted in the EU and the USA indicate that health-care professionals most often have a problem with the lower back between 50% and 57% of cases, resulting in an average loss of more than 7 working days during 1 year. Methods: This study included 177 health professionals of both genders who are actively involved in the provision of health-care services. The study was conducted in the Public Health Center of Sarajevo Canton, which provides primary and specialist consultative healthcare services. The study was designed as a prospective, longitudinal, interventional, and descriptive-analytical that included all respondents who met the inclusion criteria. The instruments used in the study are the standardized Dutch Musculoskeletal Discomfort Questionnaire, modified according to our study, the standardized work ability index, and the ergonomic intervention program (EIP). Results: The highest frequency of work-related MKDs in health-care professionals before and after implementation of the EIP was in the neck area (83.1% before, 64.9% after), in the upper back region (71.8% before, 56.5 % after) and in the lower back region (68.4% before, 55.9% after). The average score of the working ability index before the introduction of the EIP was 35.44 ± 8.59, while after the implementation of the EIP it increased statistically significantly and amounted to 38.40 ± 7.30. Conclusion: The EIP influenced the reduction of the MKDs frequency caused by work, and increased the working capacity of health-care professionals.

Sabrina Tantula, Amer Ovčina, Arzija Pašalić, S. Branković, Jasmina Mahmutović, Hamid Palalić

Communication is the foundation of every interpersonal relationship. Good communication leads to better relationships and trust, fosters improved interactions with colleagues, and has a positive impact on the workplace atmosphere. The aim of this study is to determine how the communication skills of management staff influence work processes. The primary task of this study is to examine the communication styles of responsible individuals in the healthcare process and their relationships with subordinates or executors in the healthcare process. The study is descriptive and comparative. An author-designed questionnaire, created based on a review of professional and scientific literature and experiences from everyday clinical practice, was used as the research instrument.The results showed that out of the total number of respondents, 33.3% reported being completely satisfied with interpersonal communication, 57.0% partially satisfied, and only 24 or 9.6% were not satisfied. It can be concluded that the good communication skills of managers positively impact staff productivity.

Daniel Maestro, Arzija Pašalić, Aida Ramić-Čatak, Zarema Obradović

Pravilnom pripremom hrane moguće je spriječiti većinu hranom prenosivih bolesti. Značajni napori uloženi u usaglašavanje legislative na širim geografskim područjima, rezultovali su formiranjem općeprihvaćenog stava da je većina kupljenih namirnica sigurna za konzumiranje. Međutim, neophodno je da potrošači nastave dobre prakse rukovanja, pripremanja i čuvanja namirnica u domaćinstvima. Ovo istraživanje je provedeno kao presječna, deskriptivno-analitička i eksperimentalna studija u periodu novembar 2020. – juli 2021. godine. Mikrobiološka analiza briseva je provedena u akreditovanoj laboratoriji Odjela za mikrobiološku analizu namirnica, voda i predmeta opšte upotrebe pri Zavodu za javno zdravstvo Federacije Bosne i Hercegovine. U domaćinstvima je uzorkovano po 7 briseva radnih površina i pribora u kuhinjama (n = 2681) u skladu sa smjernicama standardne metode BAS EN ISO 18593:2019 – Horizontalne metode za uzimanje uzoraka sa površine. U više od polovine domaćinstava (61,5%) izolovane su ciljane bakterije u vrijednostima iznad referentnih. Najveća odstupanja u bakteriološkoj ispravnosti utvrđena su na radnim površinama u kuhinjama (45,8%), daskama za rezanje (34,1%) i slavinama (34,1%). Staphylococcus aureus je izolovan u 153, Enterobacteriacea u 151, a aerobne bakterije u 286 domaćinstava. Prema kategorizaciji ukupnog rizika, 17% domaćinstava na području Kantona Sarajevo spada u kategoriju visokog rizika od hranom prenosivih bolesti u svojim domaćinstvima. Obzirom da javnost nije upoznata sa rizikom u kojem se nalazi, smatramo da je što hitnije potrebno poduzeti korake u podizanju kolektivne svijesti o javno-zdravstvenom značaju sigurnosti hrane u domaćinstvima.

Kultura sigurnosti je set vrijednosti, znanja, vještina, stavova i prakse na individualnom i institucionalnom nivou organizacije radioterapijskog procesa koji uspostavlja način rada u kojem sigurnost i zaštita zdravlja predstavljaju prioritet prilikom obavljanja radnih zadataka. Razvoj kulture sigurnosti na individualnom i institucionalnom nivou postalo je jedno od ključnih sigurnosnih pitanja u savremenoj radioterapiji. Cilj ovog istraživanja je procijeniti mogućnost upotrebe elektronskog sistema za prijavljivanje incidenata u razvoju kulture sigurnosti kod zdravstvenih profesionalaca u radioterapiji i mogućnost izgradnje sistemske primjene seta vrijednosti koji omogućava obavljanje svih radnih zadataka u radioterapiji uz davanje maksimalnog priorieta sigurnosti. Kao instrument istraživanja korišten je elektronski sistem za prijavljivanje incidentata u formi strukturiranog kompjuterskog intervjua prema ROSEIS metodologiji. Na osnovu informacija prikupljenih pomoću sistema napravljena je procjena razvijenosti različitih segmenata kulture sigurnosti, predložene mjere na njenom razvoju i poboljšanju, te data pocjena njihove efikasnosti u unaprijeđenju sigurnosti u radioteapiji. Razvijena kultura sigurnosti u radioterapijskom radnom okruženju može značajno unaprijediti kvalitet radioterapijskog tretmana, reducirati pojavu incidenata, poboljšati efikasnost i efektivnost radioterapijskog tretmana. Razvoj kulture sigurnosti ne podrazumijeva samo uspostavu standardnog seta pravila, nego i promjenu stavova, ponašanja i profesionalne prakse na individualnom i institucionalnom nivou.

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