<p>Health workers, doctors and nurses and other health staff, due to their occupation and daily exposure to stressful situations, are the most exposed to professional burnout and the dangers of numerous mental disorders. The aim of this review was to point out, based on data from recent literature, the importance and level of mental health of doctors and nurses during the COVID-19 pandemic. Mental health is influenced by various factors, from social changes and circumstances to personal experiences in society. Extended working hours, night work, shift work, responsibility when making decisions, contact with the sick, contact and care for patients in the terminal phase of the disease, care for their families, and also the professional burnout of health workers have increased the morbidity of numerous psychological disorders and psychosomatic diseases in health workers, especially during viral epidemics and pandemics. The World Health Organization advocates the thesis that the feeling of pressure in the current situation associated with the COVID-19 pandemic is normal, and that taking care of mental health is just as important as taking care of physical health.</p>

Introduction: Dementia prevention trials have so far shown little benefit of multidomain interventions against cognitive decline. Recruitment strategies in these trials often centre around dementia risk or cardiovascular risk profile, but it is uncertain whether this leads to inclusion of individuals who may benefit most from the intervention. We determined the effects of eligibility criteria on the recruitment of potential trial participants in the general population. Methods: In a systematic search until January 1, 2022, we identified all published and ongoing large (≥500 participants), phase-3 multidomain trials for the prevention of cognitive decline or dementia. We applied trial eligibility criteria to 5,381 participants of the population-based Rotterdam Study (mean age: 72 years, 58% women), to compare participant characteristics, predicted risk of cardiovascular disease, and dementia risk, between trial eligible and ineligible persons. Results: We identified 10 trials, of which 5 had been published (DR’s EXTRA, FINGER, preDIVA, MAPT, and HATICE) and 5 are ongoing (US-POINTER, MIND-CHINA, MYB, AgeWell.de, and J-Mint). Among all Rotterdam Study participants, eligibility across published trials ranged from 48% for MAPT to 87% for preDIVA, in line with original trial reports. Variability in eligibility was wider for ongoing trials, from 1% for US-POINTER to over 94% for MYB trial. Over 70% of trial eligible individuals are recommended preventive intervention in routine care based on their cardiovascular risk, similar for lipid-lowering (71%) and blood pressure-lowering treatment (73%). Ten-year risks of dementia were similar for eligible compared to ineligible individuals (12 vs. 11%). Conclusion: Multidomain dementia prevention trials fail to preferentially include those at the highest risk of dementia and mostly include individuals who qualify for interventions already on the basis of cardiovascular prevention guidelines. These findings call for better targeted enrolment of individuals for whom trial results can improve clinical decision-making.

Introduction. A specific characteristic of the elderly is brittleness or fragility, and due to its prevalence, fragility needs to be understood as a public health priority. The aim of the study was to examine the association of functional and anthropometric parameters with fragility in persons over 65 years of age. Method. The study was designed as a cross-sectional study and included 446 elderly people. As research instruments, a general questionnaire was used to assess the functional status of the Tinetti test and, of anthropometric parameters, the circumference of the upper arm and the circumference of the middle part of the lower leg. We used the ch2 test and Pearson's correlation analysis as statistical tests. Results. Females had poorer functional status, walking, and balance compared to males (ch2 = 4.125; p <0.127). It was observed males subjects had higher values of upper arm circumference (26.96 ± 3.44) compared to females, while females had higher values of the middle circumference of the lower leg (32.66 ± 6.29). Analyzing the correlation of anthropometric measurements with the total score of the Tinetti test and in relation to subjects' gender, it was noticed there is a correlation analysis between the parameters. Conclusion. A high percentage of people over the age of 65 have poor functional status, as well as lower values of anthropometric markers, suggesting that they may be potential risk factors for the fragility in the elderly.

Emotional intelligence and health care are closely linked. Empathy is regarded as one of key dimensions of emotional intelligence. The nursing profession has numerous general, but also generic, competencies which requires not only technical knowledge, but also psychological support in everyday work. The aim of this review paper is to point out the importance of assessing the emotional intelligence of nurses on the basis of recent data from the literature. There are many challenges and various sufferings that many health workers are exposed to, especially nurses, which clearly indicates the necessary fact, ie. requires a high degree of emotional skills and competence, because the more complex the job, the more important emotional intelligence. High self-awareness, self-control, the ability to cope with feelings are just some of the competencies that nurses/ technicians should possess. All these characteristics are important factors of emotional intelligence and a basic prerequisite for providing empathy. There are numerous tests and instruments used to assess emotional intelligence.

Introduction: Diabetes mellitus (DM) is a global public health problem. It is a complex illness which affects on the medical, psychological and social aspects of life. The aims of this research were to determine the subjective sense quality of life of patients with diabetes mellitus, to determine whether or not there are differences in the quality of life of patients with diabetes mellitus compared to sex, age and place of residence, as well as to determine factors the quality of life of patients with DM. Material and methods: The study was conducted as a crosssectional study of the population of persons with (DM). The sample consisted of 100 respondents, who in the observed period were treated at the Department of Internal Medicine of the University Hospital in Foča. A combined questionnaire consisting of 40 questions was used. The questions in the questionnaire were related to socio-demographic characteristics, hobbies, support of family and friends of patients, eating habits, as well as the presence of comorbidities. The HolmesRahe Stress Scale and the Subjective Assessment of Well-Being Scale (SVB Life Satisfaction Scale) were also included in the questionnaire. Results: Among the respondents there were 48 (48%) men and 52 (52%) women. Respondents rated their satisfaction with the quality of life, with an average score of 6.68 ± 1.72. Younger respondents have significantly better quality of life (7.09 ± 1.91) compared to the older group of subjects 6.35 ± 1.50. Also, respondents who living in the city are significantly satisfied with their quality of life (6.95 ± 1.80) compared to respondents who lives in the countryside (6.14 ± 1.45). Respondents with secondary education (30%) are significantly satisfied with their quality of life compared to respondents without primary school (13%), with elementary school (3%) or with higher education (12%). Conclusion: People with diabetes their own quality of life estimates with satisfactory grades.

Introduction/Aim: The problems facing the health sector in the Balkans, but also in most European Union countries (especially highly developed countries) is the lack of university-educated nurses in the labor market. The aim of the paper was to examine the attitudes of health professionals about the importance and possibilities of academic education of nurses. Methods: The cross-sectional study was conducted on 233 health workers in the period from July 10, 2019 to August 31, 2019 in the Public Health Institution (PHI) Health Center Zvornik, PHI Health Center Foca, PHI General Hospital Zvornik, PHI University Hospital Foca. All respondents filled out a questionnaire, which was previously culturally adapted. ch2 was used in the statistical analysis of the data. Results: The majority of health workers (73.8%) were women. There were slightly more women under the age of 50, and men over the age of 50. There were 41.3% of doctors/specialists, 42.2% of nurses with secondary education, and 16.4% of nurses with post-secondary and higher education. The largest percentage of health workers (91.4%) state that they are familiar with the possibilities of nursing education, while 69.5% are of the opinion that thorough secondary education and specialization is enough for nurses. About half of health workers (50.2%), regardless of the level of education, states that there is no need for the education of nurses at the level of doctoral studies, and ¼ abstained on this issue. Doctors of medicine and specialist doctors and nurses with secondary education were statistically significantly more likely (ch2 = 10,151; p = 0.038) to consider that there is no need for education of nurses at the level of doctoral studies than nurses with post-secondary and higher education. The largest percentage of health workers (66.6%) have the opinion that the nurse has the same authority as other team members, 86.3% agree with the statement that the development of the nursing profession will affect the quality of health care, and 55.8% believe that nurses have the professional capacity, knowledge and experience to innovate solutions and manage the inevitable changes on the pathway to modern nursing. Conclusion: In order to raise the reputation of the nursing profession, it is necessary to define the scope of work and set clear boundaries between the competencies of nurses of different levels of education at the level of the whole of Bosnia and Herzegovina. In order to further develop the nursing profession, better promotion of new postgraduate programs is necessary.

Various trials have investigated the effects of multidomain lifestyle interventions on cognitive decline, but with limited clinical benefit. This could be due to these trials targeting older individuals with elevated cardiovascular risk factors, who often already qualify for preventive intervention. We aimed to determine clinical implications of trials by application of trial eligibility criteria and prognosis to the general population.

Introduction: Assessment of quality of life is an important subject of research in various disciplines and today it is an integral part of the evaluation of rehabilitation and therapeutic procedures. The aim of the study was to assess the quality of life and to assess the impact of depression on the quality of life in patients with breast cancer and lung cancer. Material and methods : The study included 60 people, of whom 30 were diagnosed with lung cancer and 30 with breast cancer. The questionnaire was constructed by researchers for this research. Quality of Life Assessment Questionnaire SF-36 and assessment of depression, Beck Depression Scale. Results: The presence of complications is a statistically significant source of differences in the domain of the total physical score, and is not a statistically significant source of differences in other domains from the SF36 questionnaire. Based on the data from the previous table, we can see that the values on the Beck Depression Inventory range from 23 to 35, with AS = 30.00 and SD = 2.584. Conclusion: Respondents who have a higher score on the Beck Depression Inventory also have a higher score on the dimension of physical functioning.

Objective. Proper nutrition means satisfying organism's needs for daily intake of energy and adequate amount of nutritional and protective substances which are essential for maintenance of physiological functions of organism and health. The aim of this study was to determine eating habits and nutritional status of school children. Methods. The research was designed as a cross-section study. It was carried out in primary school "Sveti Sava'' in Foča and primary school "Sveti Sava'' in Gacko, branch in Avtovac. The study included 110 pupils aged from 10 to 14 years. As a measuring instrument, anthropometric measurements (height and weight) were used as well as a questionnaire. Results. The questionnaire included primary school pupils of different gender and age. Among the respondents, there were 66 (60%) boys and 44 (40%) girls. Most of the pupils (80,9%) had normal body weight, 48 (43,6%) boys and 41 (37,3%) girls. Among overweight pupils, there was statistically significant larger number of male pupils who were overweight in comparison with female pupils (=8,490; p=0,037). Also, there was statistically significant larger number of overweight pupils from urban environment in comparison with pupils from the rural one (ch2=8,614; p=0,035). Most of the pupils regularly have breakfast (50,9%). There is statistical significance in that larger number of children from urban environment consume fast food daily in comparison with children from rural environments (ch2=10,187; p=0,006). Conclusion. Eating habits of the elementary school children are not satisfying, being reflected in frequent skipping of breakfast, overconsumption of sandwiches, snacks and candies, while healthy foods, such as fish and vegetables are deficient in nutrition.

Abstract Background The aim of the study was to determine the ability of ferritin, haemoglobin, albumin and total cholesterol to identify nutritional risk and malnutrition among elderly primary care patients. Methods The cross-sectional study included 446 elderly adults over 65 years of age from four areas of Bosnia and Herzegovina. In addition to anthropometric, functional, cognitive and biochemical indicators, nutritional status was evaluated using 24-hour recall of meals, the Mini Nutritional Assessment (MNA), and Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II (SCREEN II). Results Malnourished/at-risk study respondents had lower mean levels of haemoglobin (P=0.001) and total cholesterol (P<0.001), compared to those with normal nutritional status. Albumin levels significantly differed regarding nutritional status (P=0.004), but not nutritional risk level (P=0.521). Significant differences in serum ferritin levels were not found between malnourished and normally nourished study respondents (P=0.779) Determinants of albumin level were eating more than three meals a day (P<0.001), fewer than two portions of fruit and vegetables a day (P=0.024), drinking one glass of wine (P<0.001) and reporting functional independence (P=0.011). The AUC curves for serum ferritin, albumin and total cholesterol levels in men and women, as well as for haemoglobin levels in women, were poor to fair (AUC<0.800). Conclusion Although ferritin, haemoglobin, albumin and total cholesterol may be useful biomarkers of nutritional status, their accuracy in diagnosing malnutrition and nutritional risk among elderly primary health care patients is limited.

It is unclear to what extent the 2019 European Society of Cardiology (ESC), 2018 American College of Cardiology/ American Heart Association (ACC/AHA), 2016 US Preventive Services Task Force (USPSTF), and 2016 Canadian Cardiovascular Society (CCS) guidelines differ in assigning levels of evidence and classes of recommendations (LOE/class) to lipid-lowering treatment recommendations in primary prevention of cardiovascular disease (CVD). To compare LOE/class from four commonly used guidelines at population level. A total of 7262 participants, aged 45–75 years of age and without history of CVD, from the prospective population-based Rotterdam Study were included. Per guideline, proportions of the population recommended statin therapy by LOE/class, sensitivity and specificity, and numbers needed to treat at 10 years (NNT10y) were calculated. Mean age was 61.1 (SD 6.9) years, and 58.2% were women. ESC, ACC/AHA, USPSTF and CCS strongly recommended statin use for a respective 33.8%, 48.1%, and 40.2% and 73.0% of the eligible population based on high-quality evidence, while in an additional 55.3%, 7.1%, 8.4% and 9.2% of participants statins use could or should be considered based on varying LOE/class. The sensitivity for treatment recommendations supported with strong, high quality evidence was 61.6% for ESC (“IA”), 74.6% for ACC/AHA (“IA or IB”), 69.4% for USPSTF (“USPSTF-B”) and 92.5% for CCS (“strong”). Specificity was highest for the ACC/AHA at 46.8% and lowest for ESC at 11.4%. Estimated NNT10y for those with the strongest LOE/class were comparable across all guidelines, ranging from 18 to 26 for moderate-intensity statin use, and 11 to 16 for high-intensity statin use. NNT10y reflective of recommendations supported with moderate strength of LOE/class varied substantially among guidelines for both moderate-intensity and high-intensity statin use, ranging from 33 for ESC and USPSTF to 91 for CCS. Assigned LOE/class varied greatly among four clinical practice guidelines for primary prevention of CVD. Efforts for harmonized and comparable evidence grading system for clinical practice guidelines in primary prevention of CVD may reduce ambiguity, and reinforce updated evidence-based recommendations for appropriate treatment of populations for whom clear evidence for benefit of statin use is available. Type of funding source: None

BACKGROUND: Psychological support for patients and their families is of great importance at times when they go through shock, stress, and fear at moments when confronted with diagnosis and treatment. AIM: Aim to this study was to examine the influence of family attitudes on psychosocial adaptation and the effect of treatment of patients with malignancies to preserve the integrity of the diseased person in Bosnia and Herzegovina. METHODS: The cross-sectional study included 100 patients who were hospitalized at Foca University Hospital, Department of Oncology between September 2019 and December 2019. The survey used a sociodemographic questionnaire as well as a standardized questionnaire to evaluate communication with patients with malignant diseases for the patient and family (CCAT-PF). RESULTS: More than half of the respondents (69%) accepted the malignancy. When it comes to communication between health-care professionals and patients, 51% are satisfied with the communication and 49% are not satisfied. Most respondents (62%) hesitate to talk about side effects during treatment with health-care professionals, with a statistically significant difference observed between male and female respondents (χ2 = 6,014; p = 0.014). CONCLUSION: The time devoted to the subjects by the physicians as well as the willingness to listen to the patient is important aspects that influence the adaptation of the disease as well as the treatment.

Abstract Objective: The aim of the current study is to compare Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II (SCREEN II) and Mini Nutritional Assessment – Short Form (MNA-SF), where each is used to identify nutritional risk prevalence among community-dwelling people aged 65 years and above in Bosnia and Herzegovina. Design: A cross-sectional study. Nutritional risk assessed using the nutritionist’s risk rating, anthropometric measurements, functional indicators, cognitive parameters, SCREEN II and MNA-SF. Setting: The municipalities of Foca, East Sarajevo and Bijeljina, Bosnia and Herzegovina. Participants: Eight hundred twenty-one community-dwelling individuals aged ≥65 years. Results: The prevalence of high nutritional risk per nutritionist’s risk rating, SCREEN II and MNA-SF was 26, 60, and 7 %, respectively. With the nutritionist’s rating score ≥5 as the criterion, the MNA-SF cut-off point of ≤11 (indicating any possible risk) had poor sensitivity (55·7 %), specificity (46·6 %) and AUC (0·563; P = 0·024). When the criterion of >7 was applied, good sensitivity (95·3 %) and specificity (88·9 %) were obtained for the MNA-SF cut-off score of ≤7. AUC for this comparison was 0·742 (considered fair). Cut-off points of <54 (AUC = 0·816) and <50 (AUC = 0·881) for SCREEN II (indicating moderate to high risk) corresponded with good sensitivity (82·2 %; 80·9 %) and fair specificity (72·1 %; 75·0 %). Conclusion: MNA-SF may have a limited role in nutritional risk screening among community-dwelling seniors in Bosnia and Herzegovina. SCREEN II has promising results in regard to validity, but further studies are warranted.