Uvod: Pandemija COVID-19 pokazala je nedostatke zdravstvenih sustava na globalnoj razini, a najveći utjecaj pandemije doživjeli su zdravstveni profesionalci koji rade u izravnom kontaktu s oboljelim pacijentima. Cilj: Cilj je rada ispitati stavove i mišljenja zdravstvenih profesionalaca koji rade u ruralnim i urbanim područjima Kantona Sarajevo o mjerama zaštite na radnom mjestu, zdravstvenom kadru i organizaciji rada tijekom pandemije COVID-19 od strane nadležnih institucija. Metode: Ispitani su zdravstveni profesionalci koji rade u urbanim i ruralnim područjima u Kantonu Sarajevo koristeći anonimne anketne upitnike čija je osnova bila check lista za provjeru spremnosti zdravstvenih ustanova za pandemiju COVID-19 koju je kreirala Svjetska zdravstvena organizacija. Kriterij za uključivanje u studiju bio je dobrovoljni pristanak ispitanika da sudjeluju u istraživanju. Rezultati: Analiza ustanove i spremnosti sustava na COVID-19 pandemiju ukazala je na mnoge nedostatke zdravstvenog sustava u Kantonu Sarajevo. Utvrđen je umjeren rizik kod odgovora zdravstvenog sustava primarne zdravstvene zaštite na području cijelog Kantona, s tim da je značajno veći rizik utvrđen u urbanim dijelovima Kantona. Utvrđena je značajna statistička razlika u ukupnom riziku (p < 0,001). Na skali od 8 do 40, ukupan rizik u urbanim sredinama iznosio je 21,95 (19 – 25), dok je u ruralnim sredinama iznosio 19,3 (16 – 23). Zaključak: Uvažavanje stavova i mišljenja zdravstvenih profesionalaca koji rade u izravnom kontaktu s pacijentima trebalo bi biti temelj za donošenje odluka u javnoj zdravstvenoj politici. U našoj se studiji, ali i ranije opisanim studijama, uočava pojam adaptabilnosti koji ukazuje na to da se, prema prijašnjim iskustvima, trebaju napraviti korektivne mjere kako bi zdravstveni sustav bio spreman za moguće epidemije i pandemije u budućnosti.

Introduction: Meningiomas are the most common benign tumor of the central nervous system, accounting for 53.3% and 37.6% of all central nervous system tumors (1). The World Health Organization (WHO) Grade I meningiomas account for 80.5% of all meningiomas and are considered benign meningiomas; the WHO Grade II meningiomas account for 17.7% of all meningiomas and exhibit more aggressive behavior. Methods: In the period 2015-2022, a retrospective single-center study at the clinic of neurosurgery at the Clinical Center University of Sarajevo was conducted, which included patients with a pathohistological finding of WHO Grade I or II meningioma. Depending on the pathohistological grade of the tumor, patients were divided into two groups: Grade I and Grade II patients. Patients were examined clinically and radiologically. Clinical data collected included in the study: Gender, age, number of symptoms before surgery, whether patients were symptomatic or asymptomatic, pre-operative Eastern Cooperative Oncology Group,and Karnopsky performance scale. Pre-operative contrast magnetic resonance imaging of the head measured tumor volume, temporal muscle thickness (TMT), sagittal midline shift, and surrounding cerebral edema. Results: A total of 80 patients were enrolled in the study, 68 with WHO Grade I and 12 with WHO Grade II meningiomas. We found that patients with Grade I meningioma were younger and that the mean thickness of the temporal muscle was statistically thicker than in patients with Grade II. Increasing TMT was significantly and positively associated with Grade I tumors and negatively associated with Grade II tumors (p = 0.032). Conclusion: This study demonstrates that TMT can serve as a radiologic pre-operative indicator of meningioma grade and provide valuable guidance to neurosurgeons in surgical planning. Further studies are needed to validate these results.

Introduction: Anterior cruciate ligament injury is an injury that occurs in both sexes and in the population of all ages. The anterior cruciate ligament (ACL) is a very strong internal ligament of the knee, whose injuries occur frequently in athletes (professional and recreational) and after which the recovery is very long and complicated. The aim of this study is to determine the effectiveness of a standardized rehabilitation program after anterior cruciate ligament reconstruction based on the time required for rehabilitation in athletes and recreational athletes. Methods: Research is designed as prospective study. The research was conducted in Polyclinic FM Sarajevo over a period of 10 months, starting in June 2018 and ending in March 2019. The collection of data required for the study was carried out using a form prepared for the analysis of patients included in the study. Results: Thirty-six people participated in the study, divided into two groups. In the first group, 52.8% belonged to recreational athletes, while in the second group, 47.2% belonged to athletes. At the end of the study, the flexion value in both studied groups was 120º. At the end of the study, the percentage of subjects with correct extension of the injured limb was 94.7% of recreational athletes and 64.7% of athletes. Of the total number of respondents included in this study, 33% were soccer players, 14% were basketball players, and 53% were recreational athletes. Conclusion: Based on the research results, it was confirmed that early rehabilitation after the established rehabilitation treatment program is shorter in recreational athletes than in professional athletes.

Background: Although stoma is a crucial surgical procedure, this operation has a physical and psychosocial impact on the patient, their habits and quality of life, which they should be properly educated on. Objectives: The purpose of the work is to analyze the impact of health care, key factors and problems that affect the final outcome of treatment in patients with a stoma, as well as suggestions and guidelines for improvement. Material and Methods: The results of 10 studies were reviewed including clinical trials, randomized prospective and retrospective studies published between 2011 and 2021. Results: Education of patients, their families, and medical staff is crucial in improving the quality of life of patients with stoma but also in reducing potential complications of stoma, along with stoma marking. It is also necessary to pay special attention to psychosocial problems in patients, as well as stoma problems in Bosnia and Herzegovina. Conclusion: More needs to be invested in educating staff, patients and their families about stoma, and integrating stoma patients into society in order to improve their life quality.

Introduction: The use of the Internet is becoming increasingly important in enabling children and adults to fully participate in society, whether it is learning new skills or connecting with friends and family. Consequently, children's opportunities are increasingly dependent on the Internet. The advance of technological innovations has resulted in more and more ICT devices being available to children, contributing to the deterioration of children and adolescents' health. Methods: The study was designed as an epidemiological, cross-sectional, descriptive-analytical, comparative study. The study was conducted from October 18, 2021, to January 16, 2022, using an online questionnaire accessible through the Microsoft Forms platform. Respondents were able to access the questionnaire via a link or QR code located on the child's consent form for participation in the study, which was previously signed by a parent/guardian. Results: The results of the study showed that school-age children were the most frequent users of smartphones and watches TV, with male respondents spending more time using almost all ICT devices, with the exception of tablets, which were used more frequently by female respondents. The analysis of pain intensity in the use of information and communication technologies revealed that respondents most frequently experienced mild pain, especially in the neck/shoulders and lower extremities. The frequency of eye problems after using ICT devices was found to be occasional, with the most pronounced symptoms being fatigue, tearing, and eyestrain, as well as headaches in one in five respondents. Conclusion: Increasing frequency of ICT device use was associated with higher pain intensity in all anatomic regions. A 1-hour increase in weekly ICT device use also increased the likelihood of pain intensity in all anatomic regions, including eye symptoms and headaches. High exposure to ICT is of concern because it leads to adverse health outcomes for children.

Introduction: Conflicts are a social phenomenon and occur in all organizations where people work. So, they are inevitable even among nurses, because the work they do is very responsible and stressful. Conflicts of a personal nature are not uncommon, and they are produced by intimacy in the workplace.Methodology: The study was conducted among 146 nurses employed at the Clinical Center of the University of Sarajevo. The study is descriptive, analytical andcomparative. The original author’s questionnaire created on the basis of professional and scientific literature was used as a study instrument. The goal of thestudyisto determine if the conflict situations in nursing clinical practice are related to the dissatisfaction of nurses with working conditions, lack of motivational techniques, poor communication in the team and superior-subordinate relations.Results: Most respondents state that conflict situations are short-lived and do not affect work. Respondents pointed out that the most commoncauses of conflict are poorcommunicationand personal contempt of colleagues (71 or 48.6%), violations of labor regulations and non-performance of work obligations (68 or 46.6%), differences in education (39 or 26.7%), etc. The most common manner that nurses use to resolve conflicts is to exchange information in order to reach a joint decision, to negotiate and seek compromises.Conclusions: Conflicts are manifested in the form of negative emotions, so in this regard, they can have significant negative consequences, and contribute less toimprovement or have a positive effect on the work environment. Communication conflicts between nurses are detrimental to teamwork - negative confrontation between two sides, often revealing anger, not talking for a longer period, or personally standing out at the expense of the other side.

Background: MRI techniques of the lumbar spine have not provided data on the effect of gravity on the spine and on the relationship of anatomic structures during its action. Because conventional MRI examinations of the spine are usually performed in the supine position these are often exacerbated by standing upright and are not evident in the supine position the loading conditions differ from those known to cause symptoms in patients with lumbar instability. Axial loading imaging may improve diagnostics in the clinical management of LBP and lead to appropriate treatment decisions. Objective: The aim of this study is to determine the significance of alMRI in detecting the morphologic changes of the lumbar spine caused by axial loading and to compare it with conventional MRI images of the lumbar spine without loading. Methods: The study was conducted as a prospective, descriptive clinical trial. Imaging was performed with a MRI 1.5 T in the head-first supine position. Imaging was performed in two acts: without load and under load. Loading for alMRI was performed with the DynaWell L-Spine device. The onset of loading was 10 minutes before the start of alMRI. The loading continued throughout the imaging procedure. The height of the IV, AP and LL diameters of IV, IV disk surface area, DSCA and width of the IV foraminas before and under load was measured. Results: After evaluating the changes in the height and size of the lumbar disks, the size of the DSCA, and the narrowing of the intervertebral foramina significant differences were found between the images before and after axial loading. Conclusion: alMRI provides information on morphological changes of all segments of the lumbar spine. This data represents significant information that can lead to more accurate and effective treatment of LBP.

Introduction: Patient safety depends on a number of factors such as teamwork, working climate, employee satisfaction, work environment, stress awareness, management perception, and attitude. Nurses have a key role to play in protecting and supporting patients, and their assessment serves as a reliable predictor of overall hospital safety. A positive attitude toward patient safety is associated with a significant reduction in complications. The aim of the study was to analyze the perception of nurses about all aspects of patient safety in relation to the workplace and length of service. Methods: The research included 647 nurses employed in health care institutions at the primary, secondary, and tertiary levels of health care. A descriptive and cross-sectional study included nurses from the Federation of Bosnia and Herzegovina. It was conducted in the period from November to December 2021, during the COVID pandemic. A standardized questionnaire on the perception of patient safety was used – Safety Attitudes Questionnaire – SAQ. Results: The analysis of the examined factors in relation to the workplace of the respondents revealed a statistically significant difference in job satisfaction (p < 0.001), as well as in the safety climate at work in relation to the workplace (p = 0.005), working conditions (p < 0.001), and management perception (p < 0.001). Stress levels showed significant differences regarding working position (p = 0.017), but also through the years of service (p = 0.012). Stress was significantly correlated with teamwork (r = 0.124; p = 0.003), showing that better teamwork will help with stress. Conclusion: The synthesis of concepts that includes patient safety and orientation toward patients should be implemented as a strategic quality orientation and set as a priority of every health care system.

Introduction: The education system of Federation of Bosnia and Herzegovina includes 60% of people with cerebral palsy (CP), hearing impairment and other associated difficulties, of which 37.50% in regular schools and 22.50% in special schools. From the total number of students, 44.44% attending schools according to the regular curriculum, and 55.56% according to the adjusted curriculum (1). Methods: The study is retrospective and analytical-descriptive. The study was conducted on a sample of 120 respondents from four cantons of the Federation of Bosnia and Herzegovina. Each Canton was used as one subsample of respondents. The data are presented in tabular form using classical descriptive statistics methods. The parametric statistics, analysis of variance (ANOVA) at the level of statistical significance of 0.05 was used to examine the statistical significance of differences between the sub-samples of the respondents. Results: The results of the study showed that persons with cerebral palsy, hearing impairment and other associated difficulties do not have adequate support in educational inclusion. Defectological support at school is provided for 17.50% of persons with cerebral palsy, hearing impairment and other associated difficulties, and only 6.66% of persons have the support of a teaching assistant. Conclusion: Persons with cerebral palsy, hearing impairment and other associated difficulties do not have adequate support in educational inclusion. There is no statistically significant difference between the subsamples of respondents when it comes to special education support and assistant support in the educational inclusion.

Background: Carbohydrates are mainly substrates for energy metabolism and can affect satiety, blood glucose levels, insulin secretion, and fat metabolism. Their amount and type in the diet affect metabolic responses. High-carbohydrate diets, particularly high sugar consumption, are considered particularly harmful because of their specific characteristics related to postprandial metabolism, effects on hunger and satiety, and thus on caloric intake and energy balance. The European Food Safety Authority has suggested that the reference intake for carbohydrates should be between 45 and 60% of total energy requirements and less than 10% should be added sugars, especially for children. Objective: Investigate the proportion and type of carbohydrates in the diets of children in early adolescence in two territorially distinct areas, the continental and the Mediterranean. Methods: The study was conducted as part of a longitudinal cohort study. The survey was conducted in elementary schools in two regions: continental and Mediterranean. The School Physical Activity and Nutrition Survey was used for research purposes. Descriptive and inferential statistical tests were applied for data analysis. Results: A total of 1,411 respondents of both sexes aged 12-15 years, 729 boys and 678 girls, participated in the study. The intake of carbohydrates in the total sample is represented in the daily intake of 59%. The proportion of natural sugar in the diet of boys is statistically significantly higher in the continental compared to the Mediterranean region at the age of 12-13 years (p = 0.002), 13-14 years (p = 0.049), and 14-15 years (p = 0.002). Added sugars in total carbohydrate intake are statistically significantly higher in girls in the Mediterranean region compared to the continental region at ages 12-13 years (p = 0.048), 13-14 years (p = 0.001), and 14-15 years (p = 0.001). Conclusion: The high intake of added sugars in children in the Mediterranean region is of concern, although the intake in the continental area is well above current recommendations. Therefore, one of the public health goals is to promote proper nutrition as well as the availability of healthy foods in schools, especially during early adolescence when proper eating habits are adopted.

Introduction: People over the age of 50 begin to show manifestations of reduced balance and instability, and as a result, simple activities such as standing or getting up from a chair may become limited or impossible. Therapeutic strengthening exercises can increase muscle strength and improve mobility, as well as the physical functioning of the elderly. The aim of this study was to evaluate therapeutic exercise on balance and gait in elderly. Methods: The prospective study included two groups of 130 respondents over the age of 65 who had come to the “Center for Healthy Aging Novo Sarajevo.” Using the Performance-Oriented Mobility Assessment (POMA) test, we assessed mobility performance. We tested the respondents at the beginning, in the middle and in the end of the research, which lasted 6 months. Results: In the control group, the required time increased by 2.04%. The largest improvement within POMA B was recorded in the examined Group B and it was 12.67 %, while in the examined Group A, the improvement was only 5.07%. Within POMA G, the largest improvement was also recorded in the examined Group B and it was 6.82%, while in the examined Group B, this improvement was 4.14%. Conclusion: Both strengthening and antigravity therapeutic exercises improve the level of physical fitness in older adults, although therapeutic antigravity exercises had a better impact on the level of physical activity.

Uvod: Do sad korištene tehnike magnetno rezonantnog oslikavanja lumbalne kičme nisu davale podatke o djelovanju sile gravitacije na kičmu, te o odnosu anatomskih struktura prilikom djelovanja iste. Budući da se konvencionalni MRI pregledi kičme obično izvodi u ležećem položaju, u funkcionalnom mirovanju, stanje opterećenja se razlikuje od stanja za koje se zna da izaziva simptome kod pacijenata pogođenih nestabilnošću lumbalne kičme, to se često pogoršava uspravnim stajanjem i nevidljivo je u ležećem položaj. alMRI može poboljšati kvalitet dijagnosticiranja patologije lumbalne kičme i dovesti do lakšeg odlučivanja o daljem tretmanu. Cilj ovog istraživanja je utvrditi značaj alMRI u otkrivanju morfoloških promjena lumbalnog dijela kičme uzrokovanih aksijalnim opterećenjem i uporediti ga sa konvencionalnim MRI snimcima lumbalne kičme bez opterećenja. Metode: Studija je provedena kao prospektivno, deskriptivno kliničko ispitivanje. Snimanje je izvedeno na MR aparatu 1,5 T u ležećem položaju. Snimanje je izvedeno u dva čina: bez opterećenja i pod opterećenjem. Opterećenje za alMRI obavljeno je DynaWell L-Spine uređajem. Početak opterećenja bio je 10 minuta prije početka snimanja alMRI, a opterećenje se nastavilo tokom čitave procedure snimanja. Izmjerena je visina inetrevtebralnih (IV) prostora, AP i LL prečnik IV diska, površina IV diska, površina duralne vreće i širina IV foramena prije opterećenja i pod opterećenjem. Rezultati: Nakon evaluacije promjena visine i veličine lumbalnih diskova, površine duralne vreće i širine intervertebralnih prostora utvrđene su značajne razlike između slika prije i pod aksijalnim opterećenjem. Zaključak: alMRI daje informacije o morfološkim promjenama svih segmenata lumbalnog dijela kičme. Ovi podaci predstavljaju značajnu informaciju koja može dovesti do preciznijeg i efikasnijeg liječenja LBP.

Aim To investigate the effect of intermittent traction therapy (ITT) on pain in patients with chronic low back pain (CLBP). Methods A total of 81 patients with CLBP were included: experimental group received ITT (n=40) and control group received conservative physical treatment (n=41) 10 times for two weeks. A visual analogue scale (VAS) was used for measuring low back pain. Results In the experimental group, 26 (out of 40; 65.0%) patients were females, in the control group 20 (out of 41; 48.8%) were females (p=0.141). In a within-group comparison, median of VAS value was significantly decreased in both groups after ITT. A comparison of pre-intervention and post-intervention VAS value showed no statistically significant difference. Females from the experimental group had a significantly greater decrease of VAS compared with females from the control group. Patients in the ITT group with L5/S1 level of hernia had lower estimated marginal mean of VAS scale compared to the control group, as well the patients with left side of leg pain. Conclusion: Intermittent traction therapy is an effective treatment for pain reduction in patients with chronic low back pain.

Introduction: Insufficient physical activity is one of the leading public health problems in the world, but also in Bosnia and Herzegovina. Modern civilization is characterized by a significant decrease in physical activity, and the number of people whose lifestyle can be called sedentary has never been higher, which is especially emphasised among children and adolescents. Aim of the study is to examine public health significance of physical activity on the occurrence and the degree of obesity in children and adolescents in primary and secondary schools and to determine the applicability of the Fels questionnaire on physical activity of children in rural areas of Bosnia and Herzegovina. Methods: We used a transversal research method of a cross-sectional study at a one-time point, and for obtaining results we used the Fels physical activity questionnaire for children and measurement protocol. Results: 276 primary and secondary school students in two cities participated in this survey. Respondents in Busovaca are more physically active than their peers in Sarajevo. One-third of the total number of respondents is overweight and obese, and respondents in Sarajevo are significantly more nourished than their peers in Busovaca. The Fels questionnaire is conditionally applicable, especially in rural areas. Conclusion: This study confirmed that the Fels questionnaire for assessing the level of physical activity for children and young people, which is the general instrument for research of physical activity in children, is too generalized because it is based on a homogeneous urban population.