Background. The management of breast cancer treatments within the limitations of family, social, and professional life is emotionally burdening and negatively affects physical, psychological, and social well-being, reducing the overall quality of life of patients and their families. Methods: This cross-sectional descriptive–analytical study was conducted from March to August 2023 at the “Dr. Radivoj Simonović” General Hospital in Sombor. A total of 236 breast cancer patients participated in this study. The research was conducted using the following instruments: a questionnaire on sociodemographic and clinical characteristics of patients, the Berlin Social-Support Scales—for assessing social support—and the Connor–Davidson Resilience Scale—for assessing resilience. This study aimed to determine the predictors and levels of social support and resilience of breast cancer patients. We also wanted to examine whether resilience is a mediator between patients’ sociodemographic and clinical characteristics and levels of social support. Results: The total average value of social support was 3.51 ± 0.63, while on the resilience scale, the respondents achieved a total average score of 52.2 ± 9.63. Perceived and actually received social support of breast cancer patients were positively correlated with resilience [p < 0.01], while no statistically significant correlations were found for the need for support and satisfaction. The sets of predictors can significantly predict their effects on all types of perceived social support (emotional social support: 9%; perceived instrumental social support: 9%) and all types of received social support (actually received emotional social support: 8%; actually received instrumental social support: 7%; actually received informational social support: 8%). There is a potential mediating role of resilience in relation to sociodemographic factors, clinical characteristics, and the need for support. Conclusion: This study confirms that a strong connection exists between social support and resilience. However, the analysis did not confirm the mediating role of resilience between the sociodemographic and clinical characteristics on the one hand and social support on the other.

Aim This is the first research in Bosnia and Herzegovina presenting minimally invasive coronary artery bypass grafting surgery (MICS CABG) experience, advantages, and outcomes as compared to conventional surgery (OPEN CABG). Methods This retrospective cross-sectional study was conducted between January 2019 and November 2022 and included patients with indication for surgical revascularization. Results Among 237 patients, males predominated, 182 (76.7%), with a mean body mass index (BMI) of 28.4±3.9, median The Society of Thoracic Surgery Risk (STS) score of 1.55 (0.8, 4.0), short term STS score of 11.2 (6.8, 23.7), mean age of 64.8±8.7 (ranging 41-83) years, 122 (51.4%) underwent OPEN CABG and 115 (48.6%) MICS CABG. MICS CABG took less time (p<0.001; OPEN 3.5±0.8h; MICS 2.8±0.8h) and needed less mechanical ventilation (p<0.001, OPEN 17.3±11.9h; MICS 13.0±12.5h) than OPEN CABG. Even though there was no difference in hospitalization length between groups (OPEN (7.5±3.2), MICS (7.1±4.0)), patients receiving MICS (2.9±1.5) spent less time in the ICU (p=0.0013) than OPEN CABG (3.6±2.8). OPEN CABG used also more blood derivatives, red blood cells (OPEN 292 vs MICS 55), plasma (OPEN 270 vs MICS 86) and platelets (OPEN 71 vs MICS 28). Conclusion Patients undergoing MICS CABG in Bosnia and Herzegovina had less mechanical ventilation hours and less ICU duration compared to OPEN CABG even though the hospitalization duration was very similar. MICS CABG takes less time to be conducted, has fewer CPRs postoperatively, uses less blood derivatives including red blood cells, plasma and platelets.

Cervical cancer is a significant global health concern affecting young women, with over 500,000 new cases reported annually. This questionnaire-based study aimed to evaluate the knowledge of cervical cancer prevention among female students at the University of Novi Sad during the COVID-19 pandemic using the Cervical Cancer Knowledge Prevention-64 (CCKP-64) tool. The study sample consisted of 402 predominantly 20–22-year-old female students from either social or technical science faculties in urban environments. Results revealed that out of the 402 female students involved in the study, most had a good general knowledge of primary prevention of cervical cancer, with a correct answer rate ranging from 29.9 to 80.6%. On the contrary, only 63.4% of female students have heard about the vaccine against cervical cancer; 52.0% know that the vaccine exists in Serbia; and 31.8% know where to get vaccinated. Only a small proportion of students (9.7%) have encountered cervical cancer among their relatives/friends and think that the disease could affect them in the future (25.4%). Older students (>26 years) generally (p < 0.05) had better knowledge regarding distressing symptoms of cervical cancer, cytological examination and secondary prevention; however, it was also noted that a significant percentage of this age group reported not having received vaccinations (53.0%, p = 0.001). This study underscores the need for increased awareness and education about the HPV vaccine and secondary prevention among young women in Serbia. Future research should investigate knowledge and attitudes toward cervical cancer prevention in diverse populations to develop effective interventions and strategies. These findings have implications for public health policies in Serbia to promote cervical cancer prevention among young women.

The COVID-19 pandemic has had a significant impact on mental health, particularly among students, due to COVID-19-related fear and also the transition from traditional to online lectures. In this questionnaire-based study, the COVID-19 Stress Scales (CSS), the Fear of COVID-19 Scale (FCV-19S), and the Online Teaching Satisfaction Scale were used to assess COVID-19-related fear, stress, and overall satisfaction with online teaching during the COVID-19 pandemic among nursing students in Serbia. A total of 167 students participated in the study, whose mean age was 21.3 ± 5.3, and the majority of whom were female and first-year students. Overall, most students experienced moderate to extremely high COVID-19-related stress levels. Overall, first-year and fourth-year students scored significantly lower regarding the Xenophobia and Traumatic stress subscales than second-year and third-year students, whereas first-year students also scored significantly lower on the Danger and Contamination subscales. First-year students experienced less COVID-19-related fear compared to senior students. Students were reasonably satisfied with online teaching. A stratified program is needed to prevent further decline of students’ mental health and to improve their adaptation through public, health, and educational changes.

Aim To compare outcomes of two different surgical techniques of coronary artery bypass grafting (CABG) for treating isolated left anterior descending (LAD) coronary artery disease by full median sternotomy technique vs. minimally invasive approach via left anterior mini-thoracotomy. Methods This retrospective, observational study, which included 61 elective patients, was conducted at the Clinic for Cardiovascular Surgery of the Clinical Centre of the University of Sarajevo in the period from June 2019 to January 2022. Patients were divided in two groups according to the operative technique used, the sternotomy CABG group of 30 patients where the access considered full median sternotomy, and the minimally invasive CABG group where left anterior mini-thoracotomy was performed. The groups were compared by previously defined primary and secondary clinical postoperative outcomes. Results Out of 61 patients, the majority was males, 50 (82%). The analysis of the outcomes of the minimally invasive CABG surgery showed significantly shorter operative times (p=0.001), less postoperative drainage (p=0.001) and transfusion requirements, shorter mechanical ventilation duration (p=0.0001), low major adverse cardiac and cerebrovascular events rates, as well as shorter Intensive Care Unit stay days with mean of 3.3±1.442 days (p=0.025), but no total hospital stay days with mean of 6.7±1.832 days (p=0.075) compared to sternotomy CABG group. Conclusion Minimally invasive approach for CABG surgery in treating isolated single vessel LAD disease, together with the fasttrack protocol, offers a reasonable alternative to full median sternotomy, leading to faster patients' overall recovery and improving the quality of life.

Objective: Romania began its COVID-19 immunization programme with approved vaccinations in three stages, as follows: The first step of vaccination is for health and social professionals, the second stage is for high-risk persons and the third stage is for the remainder of the general public. This study aims at assessment of knowledge, attitude and practice towards COVID-19 and vaccination against COVID-19 in the Romanian population during the third wave of the pandemic. Methods: This cross-sectional study was based on a Bosnian and Herzegovinian study on COVID-19 vaccination during the country’s third wave of COVID-19 pandemic. Results: Our study sample, dominantly female (629; 61.0%), with a bachelor’s degree (734; 71.2%), either single (539; 52.3%) or in a relationship (363; 35.2%), engaged in intellectual labour (910; 88.3%) and living in an urban environment (874; 84.8%) with a mean age of 25.07 ± 8.21 years, 294 (28.5%) people with COVID-19 symptoms and 86 (8.3%) were tested COVID-19 positive, had a mean knowledge score of 16.38 ± 4.0 with correct answer rates on questions ranging from 30.1% to 88.2%. Being single (odds ratio = 3.92, p = 0.029) or in a relationship (odds ratio = 3.79, p = 0.034), having a bachelor’s degree and higher (odds ratio = 1.61, p = 0.006) and being COVID-19 tested (odds ratio = 1.82, p < 0.001) were associated with higher knowledge test scores. Our sample had relatively optimistic attitudes towards final COVID-19 disease containment (712; 69.1%) and vaccination programmes (679; 65.9%). The majority of the sample followed socio-epidemiological measures and did not visit places of mass social gatherings (666; 64.1%) and wore masks (992; 95.7%) while being outside their home. In terms of vaccination rates, 382 (37.0%) of the individuals were presently immunized against COVID-19. Higher knowledge test scores (>15 points) (odds ratio = 1.66, p = 0.002) and positive attitudes of this study (odds ratio = 1.59, p = 0.001, odds ratio = 4.16, p < 0.001) were identified as independent predictors for vaccinating against COVID-19. Conclusion: Romanian citizens have had good knowledge, optimistic attitudes and appropriate practices towards COVID-19 vaccination during the third wave of COVID-19 outbreak in the country. Higher knowledge regarding the disease and vaccination against it not only increased attitudes towards the end of the pandemic, but also increased the willingness to be vaccinated and to avoid infection risk factors.

Objectives To evaluate the sleep patterns among young West Balkan adults during the third wave of the COVID-19 pandemic. Design and setting Cross-sectional study conducted using an anonymous online questionnaire based on established sleep questionnaires Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) (February–August 2021). Participants Young adults of Bosnia and Herzegovina, Croatia and Serbia. Results Of 1058 subjects, mean age was 28.19±9.29 years; majority were women (81.4%) and students (61.9%). Compared with before the pandemic, 528 subjects (49.9%) reported a change in sleeping patterns during the pandemic, with 47.3% subjects reporting sleeping less. Mean sleeping duration during the COVID-19 pandemic was 7.71±2.14 hours with median sleep latency of 20 (10.0–30.0) min. Only 91 (8.6%) subjects reported consuming sleeping medications. Of all, 574 (54.2%) subjects had ISI score >7, with majority (71.2%) having subthreshold insomnia, and 618 (58.4%) PSQI score ≥5, thus indicating poor sleep quality. Of 656 (62.0%) tested subjects, 464 (43.9%) were COVID-19 positive (both symptomatic and asymptomatic) who were 48.8%, next to women (70%), more likely to have insomnia symptoms; and 66.9% were more likely to have poor sleep quality. Subjects using sleep medication were 44 times, and subjects being positive to ISI 15.36 times more likely to have poor sleep quality. In contrast, being a student was a negative independent predictor for both insomnia symptoms and poor sleep quality, and mental labour and not working were negative independent predictors for insomnia symptoms. Conclusions During the third wave of the pandemic, sleep patterns were impaired in about half of young West Balkan adults, with COVID-19-positive subjects and being women as positive independent predictors and being a student as negative independent predictor of impaired sleep pattern. Due to its importance in long-term health outcomes, sleep quality in young adults, especially COVID-19-positive ones, should be thoroughly assessed.

Background Tobacco products represent a major health risk factor and a potent way to help transmission of COVID-19. Current data regarding consumption of these products in the region are scarce. The aim of this study was to evaluate patterns of cigarette, hookah and other tobacco products consumption among undergraduate students from the University of Sarajevo before the COVID-19 outbreak in the country. Methods This cross-sectional study based on a National Youth Tobacco Survey (NYTS) was conducted among undergraduate students from the University of Sarajevo in Bosnia and Hercegovina via an online questionnaire from 22nd to 26th of January 2020. Results Out of 605 students involved in the study, most of them were female (N=429, 70.9%); 363 (60.0%) were enrolled in medical sciences; 159 (26.3%) were attending the 3rd year of their curriculum; 224 (37%) were original from Canton Sarajevo and 514 (84.9%) were living in urban environment. Two hundred thirty five students out of 605 (38.8%) were current smokers and 117 (19.3%) hookah smokers. Being female (OR=0.539, 95% CI 0.368-0.790, p=0.002), in the 1st or 2nd year of study (OR=0.805, 95% CI 0.667-0.972, p=0.024) and living in a rural environment (OR=0.335, 95% CI 0.191-0.585, p<0.001) were associated with reduced risk of cigarette consumption, while older age (22+ years) (OR=1.287, 95% CI 1.122-1.476, p<0.001) increased the same risk. On the other side, being female (OR=0.595, 95% CI 0.380-0.930, p=0.023), of younger age (18-21 years) (OR=0.832, 95% CI 0.743-0.932, p=0.001) and medical science student (OR=0.567, 95% CI 0.328-0.978, p=0.041) were associated with decreased risk of consuming hookah. Conclusions This study provides an insight in prevalence of smoking among students at the University of Sarajevo. More antismoking efforts are needed, especially in urban environments; and a follow-up study, to be planned in the near future, should determine whether COVID-19 pandemic (and all the modifications of lifestyles connected with it) have eventually changed tobacco consumption patterns among undergraduate students.

Study design A cross-sectional study conducted by an online questionnaire-based survey. Methods This study was conducted by an anonymous online questionnaire based on a Chinese study during the fifth week from the beginning of outbreak of COVID-19 in Bosnia and Herzegovina. Background In order to control the spread of COVID-19, prevent the crash of health care system and ensure well-being of its residents, Bosnia and Herzegovina has taken rigorous preventive epidemiological measures in the beginning of the pandemic. Currently the situation has dramatically changed. The aim of this study is to present knowledge, attitudes and practices at the beginning of the outbreak in Bosnia and Herzegovina when the spreading of COVID-19 was well controlled and provide useful information to policymakers at this challenging time. Results In total 1,201 respondents, predominantly female (943 or 78.5%), with a mean age 30.57±11.26, scored very high on the knowledge test with a mean score 9.13±1.90. Being male (β: -0.141, p<0.001) and aged >30 (β: -0.099, p=0.030) were associated with lower knowledge scores, while education level of bachelor's degree and above (β: 0.092, p=0.003), living in urban environment (β: 0.062, p=0.044) and being a student (β: 0.240, p<0.001) were associated with higher knowledge scores. Only 638 (53.1%) of the participants agreed that COVID-19 will be successfully controlled. The vast majority of the participants (1,092 or 90.9%) have not visited any crowded place and 1,043 (86.9%) wore masks when they were going out... Decreased exposure to crowded places [(OR=0.427, p<0.001);(OR=0.805, p<0.001)] and an increase of wearing a mask while leaving home [(OR=1.564, p=0.022);(OR=1.219, p<0.001)] were associated with female sex and higher knowledge scores, respectively. Age group 18-29 (OR=0.616, p=0.007) and living in rural environment (OR=0.600, p<0.025) were associated with not wearing a mask outside the home. Conclusions Our study suggests that residents of Bosnia and Herzegovina have had good knowledge, a relatively optimistic attitudes and appropriate practices towards COVID-19 during the first period of outbreak.