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: Social support is not a one-way relationship but is based on the connections people have with other people, groups, and the wider community. This study aimed to assess the perception of social support by people in the third age and to investigate the correlation of social support with the sociodemographic characteristics of the respondents. Methods: A quantitative cross-sectional study was conducted with 147 elderly people who actively use the services of the Center for Health Promotion and Improvement “Generacija” in Sarajevo. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess social perceptions. Results: The results show a weak negative relationship between age and the total scale (r = −0.199, p = 0.05), with older people having lower scores on the total scale. A significant relationship was found between the subscale other factors and age (r = −0.202, p = 0.05). The evaluation of the performance of daily activities correlates weakly with the evaluation of the friend’s subscale (r = 0.186, p = 0.05). The friend’s subscale correlates significantly with the quality of social life (r = 0.227, p = 0.05). The subjective assessment of the quality of social life after arriving at the center showed a correlation with the overall scale score (r = 0.182, p = 0.05) and especially with the friend subscale (r = 0.219, p = 0.05), with the increase in social life and the subscales examined in both cases. Conclusion: Users of the “Generacija” center rate social support on the MSPSS with high scores, with users receiving the most support from family. The sociodemographic characteristics of the respondents have an impact on the perception of social support by the users of the Center for Health Promotion and Improvement “Generacija,” more specifically; they were statistically significantly influenced by age, the way of performing daily activities, the quality of social life and the quality of social life after arrival at the Center.

Communication is the foundation of every interpersonal relationship. Good communication leads to better relationships and trust, fosters improved interactions with colleagues, and has a positive impact on the workplace atmosphere. The aim of this study is to determine how the communication skills of management staff influence work processes. The primary task of this study is to examine the communication styles of responsible individuals in the healthcare process and their relationships with subordinates or executors in the healthcare process. The study is descriptive and comparative. An author-designed questionnaire, created based on a review of professional and scientific literature and experiences from everyday clinical practice, was used as the research instrument.The results showed that out of the total number of respondents, 33.3% reported being completely satisfied with interpersonal communication, 57.0% partially satisfied, and only 24 or 9.6% were not satisfied. It can be concluded that the good communication skills of managers positively impact staff productivity.

Introduction: The health system is one of the most complex systems in any country. According to the definition of the World Health Organization, the health caresystem includes health infrastructure that provides a spectrum of programs and services and provides health care to individuals, families and the community. A basichuman right is the right to health care, which includes health activities such as preventive, curative and palliative treatment. The organization of palliative medicineis necessary at all levels of health care.Aims: Situational analysis of the organization of palliative care in the Clinical Center of the University of Sarajevo. Examining the knowledge and approach of healthcareworkers in the process of providing palliative care at the Clinical Center of the University of Sarajevo. To examine the attitude of healthcare workers towards theAwareness and attitudes of nurses of the Clinical center of the University ofSarajevo (ccus) towards the organization of palliative care way palliative care is organized in the Clinical Center of the University of Sarajevo.Material and methods: 141 subjects employed at the Clinical Center of the University of Sarajevo (CCUS) participated in the research. The research is descriptiveand analytical. The results are presented in tables and graphs, chi-square and Fisher’s exact test were used for testing the significance of differences.Results: It was found that there are different knowledge, attitudes and approaches of the respondents regarding the way palliative care is organized, the provision ofservices and treatment in the hospital. The majority of respondents (64%) believe that palliative care should be organized in institutions for palliative care that meetthe conditions of the prescribed standards and criteria for palliative care.Conclusion: Significant differences were found in the knowledge, practice and attitudes of health workers about palliative care.

Introduction:The diagnosis of acute kidney injury (AKI) in preterm newborns with perinatal asphyxia based on increased serum creatinine (sCr) value and oliguria/anuria is usually delayed. The Aim of this paper is to evaluate serum cystatin C as an early predictor of AKI. Materials and methods:The study included 42 preterm newborns (24-37 weeks) with perinatal asphyxia (Apgar score (AS) ≤ 3 at 5 minutes of life or blood pH on admission ≤ 7.00). The sCr and sCysC levels were measured on the 1st, 3rd, and 7th day of life. According to KDIGO criteria, the newborns were classified into groups, and sCr and sCys-C values were compared. Results:The mean gestational age was 29.9 ± 3.0 weeks. AKI was diagnosed in 62.8 % of patients. Of these patients, 81.5% belonged to AKI 1 group, and 18.5 % to AKI 2 group.No newborns had the criteria for AKI 3. On day 7 the mean sCr values were significantly higher in AKI (65.4± 21.8) compared with the non-AKI group (168.4±38.2) (p<0.001), but not on day 1 and 3 (p = 0.322, 0.012, respectively). The sCys-C values were significantly higher in the AKI group on day 3 ( AKI vs. non-AKI group, 0.69 ±0.22 vs. 1.22 ±0.20; p <0.001) and day 7 (AKI vs. non-AKI group, 0.62 ±0.41 vs. 1.68 ±0.20; p <0.001). The sCys-C was also an earlier marker of a more severe stage of AKI than sCr. Conclusion:The sCys-C was elevated earlier than sCr, making it a valuable diagnostic tool for AKI in preterm newborns.

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.

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.

Aim To determine a prognostic value of cerebral blood flow parameters for the development of neurological sequelae in term neonates with hypoxic ischaemic encephalopathy (HIE). Methods We reviewed medical records of 47 term neonates with HIE who survived until the age of 12 months of life. According to the Sarnat and Sarnat clinical score, neonates were divided into 3 groups: mild HIE, moderate HIE and severe HIE. All included neonates had the colour Doppler brain sonography performed in the first 24 hours of life. The neurological assessment was done at the age of 12 months of life by using the Denver Developmental Screening Test (DDST). Logic regression analysis was performed using the colour doppler brain sonography parameters with the development of neurological impairment as the primary outcome. Results Out of 47 neonates, 19 (40.4%) were with mild, 17 (36.2%) with moderate and 11 (23.4%) with severe HIE. The values of cerebral blood flow parameters and resistance index (RI) significantly correlated with the neurological impairment at the age of 12 months of life (p<0.001). The limit value of RI indicating the poor neurodevelopmental outcome was 0.81, sensitivity 80%, specificity 85.3%, positive predictive value 52.2% and negative predictive value 95.2%. Conclusion The cerebral blood flow parameters measured with colour doppler brain sonography are good indicators of the severity of HIE and later neurodevelopmetal outcome.

Introduction: Newborn screening (NBS) is a system of organized search in the entire neonatal population for specific diseases. In Bosnia and Herzegovina, two diseases are included in NBS, congenital hypothyroidism (CH), and phenylketonuria. The screening for CH is based on determination of thyroid stimulating hormone (TSH) levels in blood obtained by heel prick method. The aim of this study is to evaluate the effectiveness of NBS program for CH based on TSH and establish the mean age of diagnosis of CH.Methods: TSH was measured by time-resolved fluoroimmunoassay (DELFIA Neonatal hTSH kit). The TSH cutoff value was 9 μU/mL. Neonates with TSH < 9 μU/mL had a negative NBS result. Neonates with TSH ≥ 9 μU/mL were recalled for a confirmation test and thyroid hormones were determined from venous blood to establish diagnosis of CH.Results: A total of 24,351 neonates were subjected to NBS in our institution. A total of 164 newborns with TSH ≥ 9 μU/ml were sent to additional testing (mean recall rate of 0.68%) at a mean age of 11.4 ± 0.5 days of life. In this group, diagnosis of CH was confirmed in 22 neonates (13.41%). The mean rate of false positive results of NBS was 0.59%. The incidence of CH in Sarajevo Canton ranged from 1/2477 in 2018 to 1/641 in 2020. The mean incidence of CH over a 5-year period was 1/1085, while the mean age at the time of diagnosis was 16.5 ± 1.2 days.Conclusion: The analysis of NBS on congenital hypothyroidism data showed the satisfactory recall and false positive rate and indicated well selected TSH cutoff value. The mean age at the time of diagnosis assures early treatment and good neurological outcome in neonates with CH.

Introduction: Positive attitudes toward the nursing profession among nursing students improve the sustainability of the profession. Studying the attitudes of nursing students toward nursing is of great importance, as it can indicate their remaining in the profession. This study aimed to determine the attitudes of nursing students toward the nursing profession.Methods: This was a cross-sectional, descriptive, analytical study. The research was conducted at the Faculty of Health Studies at the University of Sarajevo from May to June 2019. The study involved a convenience sample of 107 currently enrolled Bachelor of Nursing students from the 1st to the 4th (and final) year of full-time study and part-time students in the Baccalaureate of Nursing Care program at the University of Sarajevo. The students voluntarily and anonymously completed a questionnaire consisting of demographic information and the Nursing Image Questionnaire.Results: Overall, 107 students participated in the research. Their mean age was 23 years old (standard deviation, 5 years). Spearman’s correlation factor shows a statistically significant correlation between the scores and the mode of studying (full-time or part-time) (rho = −0.200*, p = 0.039) and whether respondents working in the profession or not (rho = 0.249*, p = 0.010).Conclusion: The attitudes of future Bachelor of Nursing toward the nursing profession were very positive. Full-time students had more positive attitudes toward the profession, compared with part-time students, although the difference was not statistically significant.

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.

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.

Introduction: Aim of the study is to piloting nursing documentation to obtain comments based on the experience of nurses/medical technicians from the primary, secondary, and tertiary health care about the documentation before it is published and starts being used.Methods: A questionnaire was designed in the electronic form to be used for the evaluation and suggestions by nurses/medical technicians on the piloted form and content of nursing documentation for all levels of health care. A piloting sample was prepared to make 10% of nurses/medical technicians from health care institutions from the territory of the Federation of Bosnia and Herzegovina.Results: A total of 94.3% of examinees at the primary health care level and only 17.2% of the examinees in the secondary and tertiary health care fill out nursing documentation both manually and electronically. All examinees at all levels of health care understand the purpose and importance of nursing documentation. A total of 27.7% of the examinees at the primary and 40.9% of the examinees at the secondary and tertiary level of health care pointed out that filling out nursing documentation was too time-consuming.Conclusion: A total of 51.2% of the examinees at the primary and 64.2% at the secondary and tertiary level of health care agreed that submitted nursing documentation was adequate for use. It is suggested that after the adoption of nursing documentation at all levels of health care, piloting of its use should be conducted to evaluate the quality and quantity of all nursing documentation.

Introduction: The primary source of strength and support is the child’s family. A special role in caring for a child with developmental disabilities is played by his mother. The objective of this research is to find out the assessment of the quality of life (QOL) of disabled children mothers as well as to research the relation of sociodemographic variables of the respondents, as specified in this study and estimate the quality of their life and health.Methods: The cross-sectional study was performed by the use of the descriptive-analytical method. In a targeted association of families which have children and persons with difficulties was conducted this research on a sample of 100 registered mothers. The research instrument was the standardized questionnaire for QOL, the World Health Organization QOL-BREF and the users’ records of the mothers in the association.Results: The average age of the respondents was M = 48. 01 ± 11. 68. About 62% of the respondents are married, 54% have a high school diploma, 67% are not employed, 68% of the respondents did not declare to have health problems, and among those who declared to have health problems, the most common disease was diabetes mellitus. The average number of household members was M = 3. 44 members. The number of the household members was significantly and positively related to the domain of social interaction (rs = 0. 219; p < 0. 05), the domain of the environment (rs = 0. 220; p < 0. 05) and to the general QOL (rs = 0. 227; p < 0. 05). The age of the respondents was significantly and positivelyrelated only to the environmental domain (rs = 0. 205; p < 0. 05). The respondents who drive a car showed a significantly higher level of QOL in the field of mental health (p = 0. 042) and the environment (p = 0. 005). Concerning mothers with higher incomes rate, their QOL was better in the following domains: Physical health (p = 0. 030), mental health (p = 0. 002), environment (p = 0. 000001), and general QOL (p = 0. 0002).Conclusion: The respondents with a larger number of household members, those who have the support of family members, who were without health problems, and who independently use own car for transportation, consider their QOL as being better. Therefore, a promotional – preventive program for improving the life quality of mothers of children and persons with disabilities should include accessible life in the community and the ability to recognize the unique needs of the entire family of children and persons with disabilities.