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.

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

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.

Ambient air pollution is one of eight global risk factors for deaths and accounts for 38.44 all causes death rates attributable to ambient PM pollution, while in Bosnia and Herzegovina, it is 58.37. We have estimated health endpoints and possible gains if two policy scenarios were implemented and air pollution reduction achieved. Real-world health and recorded PM pollution data for 2018 were used for assessing the health impacts and possible gains. Calculations were performed with WHO AirQ+ software against two scenarios with cut-off levels at country-legal values and WHO air quality recommendations. Ambient PM2.5 pollution is responsible for 16.20% and 22.77% of all-cause mortality among adults in Tuzla and Lukavac, respectively. Our data show that life expectancy could increase by 2.1 and 2.4 years for those cities. In the pollution hotspots, in reality, there is a wide gap in what is observed and the implementation of the legally binding air quality limit values and, thus, adverse health effects. Considerable health gains and life expectancy are possible if legal or health scenarios in polluted cities were achieved. This estimate might be useful in providing additional health burden evidence as a key component for a clean air policy and action plans.

Aim The damage caused by the COVID-19 pandemic has made the prevention of its further spread at the top of the list of priorities of many governments and state institutions responsible for health and civil protection around the world. This prevention implies an effective system of epidemiological surveillance and the application of timely and effective control measures. This research focuses on the application of techniques for modelling and geovisualization of epidemic data with the aim of simple and fast communication of analytical results via geoportal. Methods The paper describes the approach applied through the project of establishing the epidemiological location-intelligence system for monitoring the effectiveness of control measures in preventing the spread of COVID-19 in Bosnia and Herzegovina. Results Epidemic data were processed and the results related to spatio-temporal analysis of the infection spread were presented by compartmental epidemic model, reproduction number R, epi-curve diagrams as well as choropleth maps for different levels of administrative units. Geovisualization of epidemic data enabled the release of numerous information from described models and indicators, providing easier visual communication of the spread of the disease and better recognition of its trend. Conclusion The approach involves the simultaneous application of epidemic models and epidemic data geovisualization, which allows a simple and rapid evaluation of the epidemic situation and the effects of control measures. This contributes to more informative decision-making related to control measures by suggesting their selective application at the local level.

Caries is the most widespread oral desease of all age groups, the main oral-health problem as well as the leading cause of teeth loss. Bosnia and Herzegovina has a huge prevalence of caries patients in comparison with a significant decline in developed countries. Postwar state period, inadequate nutrition and neglected care of oral health have reflected on oral health of children in Tuzla City. Aim: to determine prevalence of oral health of children of different age groups in the area of Tuzla City. Methods : physical checkup and education have encompassed 5452 children of different age groups in the period from 2011 to 2017 (5098 of six- year- olds, 114 twelve-year-olds, 120 fifteen-year-olds and 120 eighteen-year-olds). Physical checkups were done in dental practices of Public Health Scientific Institution (hereinafter PHSI) Medical Center Tuzla, children's department, with a dental probe and mirror. CES (caries, extraction, sealed teeth- permanent) and CES (caries, extraction, sealed teeth- dairy) were calculated on the basis of 100 checkups. During the same period there were educations for pregnant women in the first and last quarter of pregnancy organized within the school for pregnant women of the Women Dispensary of PHSI Medical Center Tuzla. Outcomes : the research determined the value of CES index of diary teeth for six-year-olds (6,41) in 2011 that was decreased in 2017 (5,19) what indicates a good effect of educative lectures. CES index of tvelwe-year-olds in 2017 was 3,2. The research proved that high school children (15-year-olds) have a high CES index (8,3) in year 2013/14 and the same group of examinees as graduates (18-year-olds) in 2016/17 had CES index of 7,73. Conclusion: CES of the examinees had very high values, far from the aim of the World Health Organization (1,5). Programs and activities of oral health promotion of the Dental Service of PHSI Medical Center Tuzla have made changes, warned of the importance of preventive action as well as triggered revitalization of preventive detal protection for preschool and school population of Tuzla City.

Introduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators leads to reduced working capacity of health-care professionals. Methods: Assessing the working conditions of 100 health-care professionals regarding stress impact on empathy and workability were the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability. Results: In the research group, “intensive care units” significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research group named “other departments.” Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of health-care professionals.

Introduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators results in the reduced working capacity of healthcare professionals. Material and methods: Assessing working conditions of 100 healthcare professionals regarding stress impact on empathy and workability was the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability. Results: In the research group “intensive care units”, significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research groups named “other departments”. Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of healthcare professionals. 

Introduction: Malignant breast cancer is the most common malignancy in women between 40 and 55 years of age. Dermatoglyphs are polygenetically determined properties, whose appearance and number are determined by a specific gene. They represent the skin reefs that are created by epidermis on the fingers or toes, palms and soles. Palmar dermatoglyphs have been used to estimate the hereditary basis of many diseases. Aim: The aim of the paper is to determine whether there is a statistically significant difference between the observed qualitative and quantitative parameters of both palms between the experimental and the control group. Material and Methods: A survey of the qualitative and quantitative properties of the palmar complex was carried out on a total of 100 female respondents. The first group included 50 women with breast cancer. Comparative data were used for the analysis of palmar dermatoglyphs in the second group of respondents, or 50 phenotypic healthy female subjects. The imprints of the palmar complex were taken using the printake ribbons, analyzed, and the data was then statistically processed and displayed in charts. An analysis of the number of reefs between two digital triradius was performed, followed by the determination of the axially triad position, as well as the ATD angle measurement. Results: Quantitative analysis of ATD-angle showed statistically significant difference between the left and right palms of the analyzed groups. However, the analysis of the number of reefs between triradius A-B, B-C, C-D did not show statistically significant results for both the left and right hand between the analyzed groups. Conclusion: These results indicate that the quantitative palmar parameter, ATD-angle, can play a role in identifying women with increased risk of breast cancer.

Introduction: The aim of this study was to assess the level of burnout syndrome among primary healthcare professionals in Canton Sarajevo and whether there is a link between the levels of burnout syndrome and sociodemographic parameters. Methods: We included a total of 300 primary healthcare professionals. The burnout syndrome level was measured by Maslach Burnout Inventory, consisting of 22 particles (3 subscales) measuring the level of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). We analyzed the correlation and difference between the level of burnout and sociodemographic parameters. Results: The study revealed that in Canton Sarajevo 25.3% of healthcare professionals experience a high level of EE, 17.7% experience DP, and 19.0% experience a low level of PA. The subjects under 40 years experienced a higher level of EE than older subjects (p=0.000). There were significant differences in PA subscale between men and women (p=0.033), women having lower level of PA than males. Respondents who worked in shifts and respondents with indefinite period employment experience significantly a high level of EE. Subjects who drink alcohol had a higher level of DP. Conclusion: Healthcare professionals are at increased risk of burnout. Factors which increase the burnout syndrome risk in health professionals in Sarajevo Canton were: age under 40 years old, female, working in shifts and drinking alcohol.

Introduction: Family is a strong communicative base of adolescent development, even though environment has its own influence as well. The study links the risks and substance use (tobacco, alcohol, and drugs) among adolescents to their perception about the functioning of family. Hence, a model of functional communication has been established aimed at preventing the defined problem. Methods: A random, voluntary, and anonymous survey was conducted that included a non-clinical sample of 1.018 adolescents in the Tuzla Canton. In a prospective method, the Youth Risk Behavior Surveillance System of the World Health Organization (WHO) was used, modified for this study. Results: The average prevalence of substance use is 81.2% and is significant for male adolescents. Some 33% of the respondents smoke tobacco, 25.4% drinks alcohol, while 12% of the surveyed adolescents use drugs. There is a significant correlation between a complete and broader family and tobacco and alcohol use, while incomplete family and household without family members are linked to tobacco use only. The risk of alcohol use is significantly related to father’s higher level of education while mother’s high school education is significantly related to tobacco and alcohol use. As perceived by adolescents, parents have negative attitudes about substance use (75%), they are more strict in setting the rules of behavior at home (45.5%) than outside, and control where more than with whom adolescents spend their free time (F=14.14, df [2.6], p<0.05). Conclusion: The functioning of a family (family structure, parents’ education, and the quality of communication in a family) is a significant factor in the context of tobacco, alcohol, and drug use.