Introduction: Legionella spp. is opportunistic pathogenic bacteria that cause two forms of the disease: more severe, more frequently diagnosed - Legionnaires' disease, and milder, less frequently diagnosed Pontiac fever. Research objectives: The primary objective of the study was to examine the presence of Legionella spp. in the air conditioning systems of the studied facilities. Methods: The study was conducted in the Sarajevo Canton, Federation of Bosnia and Herzegovina. The research included air conditioning systems in public facilities. Sampling was carried out over a two-year period. Water samples and samples collected using the wet swab method were obtained. The samples were laboratory analyzed for the presence of Legionella spp. in accordance with a standard method. During the period of sample analysis, the laboratory was undergoing accreditation in accordance with the relevant standard. A survey was also conducted in the included facilities. Results: Legionella spp. was detected in air conditioning devices of 8 (21%) facilities. No relation was established between knowledge, external education and management with bacterial colonization. Internal training of employees is carried out in three (37.5%) facilities compared to eight facilities in which bacteria were detected (p<0.05). Also, bacteria detected in 4 (40%) facilities where employee absenteeism was associated with respiratory diseases (p<0.05). Conclusion: The results emphasize the need for a systemic approach to risk management and the improvement of practices that contribute to safer stay of users and employees in the air-conditioned spaces of public facilities in the Sarajevo Canton. Keywords: Legionella, Bacterial Colonization, Education, Risk Factors, Facility Users

Because man strives to ensure the comfort in living and working spaces, there is a lot of air conditioning devices to achieve the desired temperature. Bacteria from the genus Legionella is a pathogenic bacterium that can cause the disease to occur in very severe form. It most often inhabits water systems created by human activity, among which are air conditioning devices, which is why there is a need to test factors that favors bacteria colonization. The study included 79 facilities from the territory of the Federation of Bosnia and Herzegovina, of which 42 or 53.2% facilities with centralized, and 37 or 46.8% facilities with individual air conditioning devices. Data were collected using a survey and laboratory analysis of samples. The analysis was performed individually, taking into account the different requirements and complexity of the two types of air conditioning devices. The objectives were related to the correlation between the age, distribution installation material, project, the maintenance dynamics and the need to use the air conditioner with Legionella spp. colonization. The results indicate a positive influence of the air conditioner age and steel distribution installation on the Legionella spp. colonization. Significant correlation was not observed between the collected survey responses (project, maintenance and the air conditioner use frequency) and the Legionella spp. colonization. The identification of factors that positively correlate with the presence of Legionella spp. in air conditioning devices has significant public health and technical contribution, especially in the context of legionellosis prevention, the implementation of adequate monitoring and maintenance.

Introduction: Scoliosis is a spinal deformity that affects school-age children and adolescents the most. Excessive body weight, heavy school bags, improper sitting at school desks, and reduced physical activity are significant risk factors for the development of scoliosis in children. To prevent the occurrence of scoliosis of the spinal column, the focus of attention must be on early identification and education about scoliosis. The research aims to determine the presence of risk factors for scoliosis in sixth-grade elementary school students, assess knowledge about scoliosis of the spine, and determine whether the health system can respond. Research Method: From a total of 3.600 sixth-grade elementary school students in the Tuzla canton a cross-sectional study was conducted among 350 students using anthropometric measurements, full and empty school bag measurements, and the Nordic Musculoskeletal Questionnaire (NMQ). Data on the health system was collected using a retrospective method. Discussion: Obesity was recorded in 21.14% of the respondents. Based on the results obtained, in 39.43% of the respondents, the ratio of the weight of a full school bag to body weight was equal to or greater than 10%. Almost one-third of the respondents felt pain/discomfort when carrying a school bag, which indicates that only 38.57% of children carry the bag correctly. 42.86% of the respondents have the wrong posture when sitting. Based on the results collected, 52.86% of the respondents do not play sports. The results show insufficient knowledge about scoliosis among both school-age children and parents/guardians. The health system of the Tuzla Canton can respond to the presence of the risk of spinal deformity with the available resources. Conclusion: The results of the study have shown the presence of risk factors for the development of scoliosis, a low level of knowledge about scoliosis, and the unwillingness of the health system to provide treatment and prevention services. Mandatory screening examinations and education of students, parents, and teachers are necessary.

SUMMARY The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association of exposure to arsenic in drinking water and bladder cancer (C67). This retrospective ten-year analysis included age-standardized incidence rates (ASRs) and age-specific incidence rates of C67 in the municipality of Bogatić and rural municipalities of Mačva District. The concentration of arsenic in drinking water was determined at Šabac Public Health Institute (PHI) laboratories in 2015. ASRs were estimated using data from regional cancer registries at Šabac PHI and compared by use of the Mann-Whitney U test. Control population was recruited from an area where there were no artesian wells or hydrogeological conditions that would indicate elevated concentrations of arsenic in drinking water. Arsenic levels in all artesian wells in Bogatić municipality were 1.4 to 41 times higher than the maximum permissible concentration (mean 120 µg/L±165). Female subjects from Bogatić municipality had higher ASRs of C67 compared with the populations in rural municipalities of Mačva District (p<0.01), while the incidence of bladder cancer was by 13% greater than that in central Serbia (standardized incidence ratio, 113; 95% CI 96.97-131.35). Male subjects from Bogatić municipality had higher ASRs of C67 but the difference was not statistically significant (p>0.05). Our analyses suggested that exposure to arsenic in drinking water could triple the risk of bladder cancer. These results support the conclusions of previous studies that there may be an association between higher concentrations of arsenic in drinking water and higher ASRs of bladder cancer in both male and female subjects.

Purpose: The incidence of sexually transmitted disease (STDs) is being increased in the Mačva district. The aim of this study is to investigate differences in sexual behaviors, knowledge and attitudes related to STDs among female students of health and non-medical studies.Materials and Methods: In the cross-sectional study, an anonymous questionnaire was used specifically designed for the purpose of this investigation, among female students of health and non-medical studies.Results: A total of 394 students of health and non-medical studies (120 and 274, respectively). The majority (94.3%) had heard of STDs, and 76.6% knew STDs could be present without symptoms (90% students of health and 62% non-medical studies; p=0.000). Among the sexually-active students (81.5%), 36.3% reported having used a condom. Most of students (71.9%) were aware that using condoms for STDs prevention was important. One fifth of students of health study were tested for STDs, while the percentage of tested non-medical students was three times lower (p=0.000). Previous education and faculty type were strongly associated with knowledge level and attitudes among students. The primary and secondary school teachers were the main source of information for one-third of students (51.7% medical and 25.2% non-medical).Conclusion: There is a need to revise the existing STD education curriculum in both schools and universities and implement targeted educational measures.Key words: sexually transmitted diseases, attitudes, female students, health education, condom

People consumed salt exclusively through food millions of years ago, which amounted to less than 0.5 g/day. Recent researches indicate that the average daily consumption of salt is more than 10 g/day. The general conclusion of studies investigating the relationship between dietary salt intake and blood pressure led to recommendations on reducing salt intake and limiting total intake to 5 g of salt per day by the World Health Organization and the European Safety Agency of Food. Increased salt intake causes suppression of the Renin-Angiotensin-Aldosterone system by reducing sodium renal excretion. Also, an increase in salt intake leads to an increase in the concentration of sodium in the blood, which causes high secretion of vasopressin and causes high blood pressure. Namely, bread is a basic food and is high in salt, but the salt parameter is not mandatory in accordance with the regulations. Today, almost every EU country has different strategies that include recommending salt reduction through food reformulation to reduce the salt content of food, including bread and bakery products. Achieving and maintaining the reduction of the population's salt intake will soon give a great benefit in terms of the prevention of cardiovascular events as the first cause of death globally, then great savings for the health system and an individual.

Background: Empathy is an indispensable part of health care. The outcome of empathic response is satisfaction on sides, patient and health professionals. But it also requires a great deal of healthcare staff’s engagement what is exhausting and burdening. Many variables in increasing or decreasing way affect empathy.Aim: Combining facial emotion recognition and personal affective traits, the focus was to determine which one is a better predictor of health professional’s empathy.Methods: Therefore, a total of 150 health professionals was assessed in the level of empathy, position on extraversion-introversion dimension and ability to accurately recognize facial expressions of emotion. Gender and working experience were controlling variables in predicting the health professional’s empathy.Results: Generally, results show that extraverted health professionals with high accuracy of facial expression recognition have also higher empathy scores. Both studied variables were good predictors of health professional’s empathy whit a stronger unique contribution of personality traits.Conclusion: Managing health professionals human resources based on their empathy could serve, in long term, to prevent individual level occurrences such as burnout syndrome and extended work absenteeism, and on an organizational level many legal issues and to enhance better treatment outcomes, trust in health professionals with mutual satisfaction. Further studies are required for application in clinical settings. Keywords: empathy, facial expression, affective personality traits

Background: The organization of health care system on Cantonal level with the coordination from Federal level represents a real situation with the possibility of decentralization of health care system according to the experiences of developed countries. Objective. To make an overview of the situation at the primary and hospital health care level with the aim of assessing the existing human resources and capacity of health care institutions in FB&H, with which we entered in COVID-19 pandemic. Methods. This retrospective study presents the efficiency of health care in FB&H measured by number of medical doctors, and other medical staff during the time period of five years. Data of the Institute for Public Health FB&H were used. The Institute for Public Health FB&H is authorised by the law to conduct and implement statistical research in the field of health care in line with relevant laws and by-laws. The Institute is obliged to report on organisational structure, human resources and medical equipment. Results. Presented data include the number of health care employees in medical institutions in FB&H in the period 2015-2019 per 100,000 inhabitants and their numbers in primary health care, family medicine, secondary and tertiary level of health care in 2019. The study also presents the number of doctors of medicine, specialists and medical residents in FB&H, the number of nurses of all profiles and levels of education as well as medical staff and other employees in the public health care system in FB&H in 2019. Conclusions. The COVID-19 pandemic in FB&H has confirmed the fact that human resources in health care are insufficient, especially in the field of public health and epidemiology. The availability of these health facilities and human resource is not uniform throughout the FB&H, which may affect the capacity of the health system in some parts of the FB&H to meet the needs of providing services during COVID-19 pandemic.

Cardiovascular diseases rank first on the mortality list globally or 31%. The basic measure of prevention in accordance with the recommendations of the World Health Organization is a change in risk lifestyle in terms of diet, physical activity, tobacco and alcohol consumption. Vitamin D was previously recognized as a regulator of calcium and phosphorus ratio, bone remodeling or the main controller of skeletal pathophysiology. However, vitamin D enjoys great interest in clinical and epidemiological research in terms of its possible impact on reducing the risk of cardiovascular diseases. Among other things, vitamin D deficiency is associated with an increased risk of endothelial dysfunction. Although the deficiency has been identified as a risk marker for cardiovascular diseases, the mechanism of action of vitamin D on the path from endothelial dysfunction to cardiovascular diseases has not been fully revealed. The findings in this segment of activity of vitamin D would be significant in terms of reducing morbidity and mortality from cardiovascular diseases.

Seila CiloviC-lagarija1, NiNo HaSaNiCa2,3, MilaN radojiCiC4, elMa SokiC-BegoviC5 , Maida MuliC6, BiljaNa MijoviC7 , aida Pilav8, doriS BardeHle9, SaNjiN MuSa1 1Institute for Public Health of FB&H, Sarajevo, Bosnia and Herzegovina 2Institute for Health and Food Safety Zenica, Institute for Public Health, Bosnia and Herzegovina 3Department of Healthcare, Faculty of Medicine, University of Zenica, Bosnia and Herzegovina 4Institute for Public Health of Herzegovina-Neretva Canton, Bosnia and Herzegovina 5Ministry of Health of Federation of Bosnia and Hercegovina 6Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina 7Faculty of Medicine, University of East Sarajevo, Bosnia and Herzegovina 8Institute for Public Health of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina 9Foundation of Men ́s Health Berlin; Germany