INTRODUCTION Good knowledge of diabetic patients about their disease is often not related with good glycemic control. The aim of this study was to determine the level of application of acquired knowledge about diabetes in recognizing and resolving hypoglycemic and hyperglycemic conditions in patients who did or did not do blood glucose self-monitoring as well as the impact of self-monitoring on HbA1c during education of patients with diabetes type 2. MATERIAL AND METHODS There were 91 patients with the type 2 diabetes who completed six months education about their disease in four family medicine practices in Tuzla Canton during the period from March to September 2005. The patients who did or did not do self-monitoring with glucometer were interviewed on knowledge about recognizing and resolving hypoglycemia and hyperglycemia by family physician and HbA1c was assessed at the beginning of the education, 3 months after reading the brochure (passive education) and additional 3 months of group (intensive) education. RESULTS Out of 91 interviewed patients, there were 29 who did self-monitoring by glucometer at the beginning of the education, 30 patients during the passive education and 34 after the intensive education. At the beginning of education, regardless of doing self-monitoring, the patients were less able to recognize and resolve hypoglycemia and even less hyperglycemia. At the end of education, their knowledge was better at both recognizing and resolving hypoglycemia (P=0.01) as well as at recognizing (P=0.01) and resolving hyperglycemia (P=0.001). In the patients who did self-monitoring the average value of the HbA1c did not improve significantly (P=0.44) compared to those who did not practice self-monitoring (P=0.10) during education. CONCLUSION Only one third of patients with type 2 diabetes had done self monitoring with glucometer and although their knowledge about hypoglycemia and hyperglycemia was improved during education, these patients did not have improved significant values of the HbA1c compared to patients who had not done self-monitoring.

1 Kljucne rijeci: stres, mobing, žrtve mobinga, privremena sprijecenost za rad SAŽETAK: Mobing ili psiholosko zlostavljanje usmjereno je prema jednom pojedincu koji je stavljen u poziciju u kojoj je bespomocan i u nemogucnosti da se zastiti od stalnih maltretirajucih aktivnosti. Mobing ima negativne posljedice na zdravlje zaposlenih, sto povecava stopu izostanka s posla zbog bolovanja. Cilj rada je procijeniti ucinke mobinga na privremenu sprijecenost za rad (apsentizam) u medicinskih tehnicara. Prospektivnom studijom poprecnog presjeka analizirali smo stopu prevalencije mobinga i njegove ucinke na apsentizam u medicinskih tehnicara u primarnoj njezi. U istraživanju smo se koristili validnim upitnikom samoodgovorom među 274 (239 žena i 35 muskaraca) medicinskih tehnicara. Za analizu rezultata primjenjivao se standardni Statisticki paket za drustvena istraživanja (SPSS) verzija 10.0. Statisticke hipoteze testirane su na razini od α = 0.05. Među ispitanicima 87% bile su žene. Oko 54% ispitanika imalo je iskustvo mobinga u prethodnoj godini, a 24% (36/147) bilo je perzistentno izloženo mobing ponasanju (žrtve mobinga). Ispitanici s iskustvom mobinga statisticki cesce su imali sve simptome vezane za stres i mobing, izuzev depresije i nesanice. Oko 22% ispitanika se izjasnilo da se koristilo privremenom sprijecenoscu za rad (bolovanjem). Srednja vrijednost izgubljenih radnih dana po ispitaniku je M±SD= 6,76±22,00 (rang: 1-180) dana. Bolovanje kao i dužina bolovanja su statisticki znacajno udruženi s ocjenom trenutne radne sposobnosti, ocjenom odnosa zdravlja i radnih zadataka (WAI) i mobingom (P=0,001). Mobing je rasirena pojava među zdravstvenim radnicima. Vise od pola medicinskih sestaratehnicara je bilo izloženo mobingu u prethodnoj godini. Osobe koje su prijavile mobing dva su puta cesce bile na bolovanju.

BACKGROUND The traumatic events experienced in Bosnia and Herzegovina during the 1992-1995 conflict may have a lasting effect on the mental health of the citizens, characterized by high rates of post-traumatic stress disorder (PTSD), depression, and anxiety. A diagnosis of PTSD, depression, and anxiety among family physician residents could affect their ability to diagnose and treat patients for depression, anxiety and PTSD. OBJECTIVES To assess PTSD, depression and anxiety symptoms and prevalence amongst family medicine residents (FMR) who were general practitioners (GP) in different war engagements and compare them with FMR who were medical students, 9 years after the 1992-1995 war in Bosnia-Herzegovina (BH). SUBJECTS AND METHODS We applied the Bosnia-Herzegovina versions of both the Harvard Trauma Questionnaire (HTQ) for PTSD symptoms, and Hopkins Symptom Checklist - 25 (HSCL-25) for anxiety and depression symptoms to 78 residents (age 30-45 years, 84.6% females), who lived in BH during the conflict years. RESULTS PTSD prevalence of 10.3% and depression and anxiety prevalence of 21.8%, was found. The anxiety symptoms score was significantly higher amongst FMR who were GPs (1.69+/-0.66) than medical students (1.40+/-0.41, t-test=2.219, P=0.029) during the war.

In patients with diabetes type 2, good knowledge about disease often doesn't follow appropriate behavior in their life. Therefore, we wanted to find out basic level of disease knowledge and glycemic control among type 2 diabetic patients, and after that impact of passive and intensive education on knowledge and glycemic control. Starting with 130 participants, 91 patients with type 2 diabetes, from four family medicine services in Tuzla Canton, completed six months education about their disease. Disease Knowledge Test of Michigan Diabetes Training and Research Center was used to evaluate knowledge about diabetes and glycaemic control was assessed by HbA1c. Participants were tested at the beginning of survey, after 3 months of passive education and additional 3 months of intensive one. Basic test showed good knowledge of participants (score 8,3 out of 15), improved knowledge after passive education (score 9,23) and intensive one (11,19) (P<0,0001). Demographic characteristics of patients (age, sex, living area, level of education, duration of disease and type of treatment) had no influence on disease knowledge and glycaemic control during education. Generally, patient education improved significantly glycaemic control by HbA1c reduction 0,45% (P=0,011) without significant differences between passive and intensive one. Education of patients improves both disease knowledge and glycaemic control among type 2 diabetic patients.

AIM to determine impact of passive and intensive education on values of HbA1c, blood pressure, total cholesterol, triglycerides, mass body index as well as on practicing of recommended physical activity and habit of smoking among patients with type 2 diabetes. METHOD From 130 patients with type 2 diabetes questioned, 91 completed cycles of 3 months of passive and 3 months of intensive education. It took place in 4 family practices on Tuzla Canton from December of 2004 to December of 2005. For this purpose the Michigan Diabetes Knowledge Test was used for assessment about disease knowledge. Disease control was also assessed at the same time of diabetes knowledge testing, at the beginning, after 3 months and after 6 months of education. RESULTS After a passive and intensive education there has been a significant improvement (P < 0.05) on the following parameters of disease control: HbA1c, systolic and diastolic blood pressure and total cholesterol, however the difference in triglycerides, body mass index, smoking habits and practicing of regular recommended physical exercise statistically was not significant after passive and intensive education. CONCLUSION The total effect of passive and intensive education of patients with type 2 diabetes in our research resulted in improved metabolic control of the disease.

UNLABELLED Obesity is one excess of body fat frequently resulting in a significant impairment of health. Lack of physical activity is one possible cause for obesity. GOAL To exam relation between obesity and physical activity. MATERIAL AND METHODS A sample with 154 randomized chosen patients make 48 (31.2%) men, and 106 (68.8%) women, 30-80 years old. Obesity is defined by bodymass index (BMI) over 30. Physical activity is defined by the modified scheme of Hanson and Ainsworth. RESULTS Obesity was presented with 106 patients (68.84%). Lack of physical activity was present with 134 patients (87.01%). Physical activity was presented with 20 patients (16.91%), with 5 patients (25%) who are obese, and 15 patients (75%) who are no obese. CONCLUSION Lack of physical activity plays role in creation of the obesity.

The subject of the family medicine on the medical faculties in Bosnia and Herzegovina existed from recently as a separate curiculum of the medical study. Until recently the contents of this discipline interpreted within the subject of the social medicine or the object of the primary healthcare protection, and programs of teaching were based mainly on Anglosaxon experiences. The fact is that some teachers of the medical faculty in Sarajevo had their own visions and programs of the family medicine which by years were tested in the units of the family healthcare protection in Sarajevo, Mostar, and Banja Luka, about what was published in our and foreign literature. New approach from the family medicine should be based on as follows: greater use of the standardized procedures for the improvement of the communication skills; revised educational procedure of all the participants 6 interdisciplinaryilly in the education of the family medicine; improvement of knowledge about methodlogy and the principles of the research; improvement of the techniques and knowledge about the maipulatin of the medical informations; development of the skills of the continued studying through the total working aga; to the development of the capability of the critical estimation of the own work important; by the defining of the important educational goals in the curriculum of the urgent medicine; to the development and use of the methods feed-back informations from the students; to the modernizing of the methods of the evaluation of the educational process-adopted knowledge and the attitudes and the carrying out of the practice of the patients, and the ethic values in that process. In this work the authors consider the stated experiences in the education from the subject family medicine at our faculties realting to the foreign, and suggest that new concept of the education on the basis of these experiences in the practice.