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: Falls in the elderly population are one of the main geriatric syndromes and a clear indicator of the fragility of the elderly population. Falls are a leading cause of death and injury in the elderly, resulting in disability and immobility requiring ongoing medical care and high treatment costs. Difficulties in performing daily life activities increase with age due to decline in physical and cognitive functioning. Research objectives: To assess the ability to perform daily life activities, to analyze the risks of falling in elderly people. Methods: 100 people over the age of 65 participated in the research. The research instruments were a questionnaire for the assessment of daily life activities - Barthel Scale / Index (BI) and a questionnaire on screening assessments for the evaluation of falls. Results: The Barthel index shows that the majority of respondents perform daily life activities without problems. Intrinsic factors prove that the median score was 12 with an interquartile range of 7 to 15, which represents the risk of falls in people of the third age. Extrinsic risk factors for falls in people of the third age indicate a median of 4 with an interquartile range of 2 to 5, which represents the risk for falls in older people. The most influential risk factors for falling in our survey are difficulty walking upstairs, incorrect or insufficient use of orthopedic aids, feeling of instability when standing up for the first time, complaining of weakness or reduced sensation in one or the other leg, feeling of low self-confidence, instability when walking and fear from falling. Conclusion: Analyzing the risk factors for a fall, we obtained the result that there is an evident risk for a fall. Based on the estimated risk of falling, the most influential risk factors that affect the performance of daily life activities of elderly people were singled out.

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: Aging is a natural physiological process based on disturbances of homeostatic mechanisms and loss of adaptability that significantly affects life activities over time. The activities of daily living (ADL) in old age represent the relationship between the subjective characteristics of each individual, supplemented by previous life experiences, and objective socioeconomic factors that create a desirable living framework for people in the third age. The objectives of this research are to analyze the sociodemographic characteristics of third-age people, to study the daily activities of third-age people, and to compare the daily life activities of third-age people living in a rural setting with those of third-age people living in an urban setting. Methods: The research was conducted in the area of urban and rural environment of Travnik municipality. One hundred elderly people (50 from urban and 50 from rural areas) were included in the research using the snowball method. The instrument used in our research is a standardized questionnaire on instrumental ADL (IADL) according to Lawton-Brody. The study was conducted during the period from the end of March to the end of May 2022. Results: There is a statistically significant difference in ADL in all eight domains. The mean IADL score in the total sample (n = 100) was 6.36 ± 1.78 and ranged from 1 to 8. The largest number of respondents had the highest IADL score of 8 in 41% of cases, while only one respondent had an IADL score of 1. Conclusion: The obtained results prove that the score of ADL is lower in people of third-age living in rural areas.

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: 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.

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.

Sensory integration is the organization of the sense for their use. It is a neuro-biological activity that allows the reception and processing of sensory information, which in large quantity arrive to the brain, at all times. The brain's ability to successfully process tactile information allows the child to feel safe and develop a connection with those around they. Children with Down syndrome may have difficulties of sensory integration. Decreased awareness and attention to tactile stimulation is possible, which leads to a reduction in tactile discrimination and difficult manipulation of objects, or to an increased response to sensory stimuli in the form of tactile defense. The aim of the study is to examine the prevalence of sensory integration of the tactile sensory system of children with Down syndrome, and to determine the statistical significance of differences in relation to children without developmental disabilities. The total sample of respondents (N=30) consisted of two subsamples. The first subsample of respondents (N=15) consisted of children with Down syndrome, and the second subsample of respondents (N=15) consisted of children without developmental disabilities. The measurement instrument „Questionnaire for testing tactile sensory sensitivity“ with 11 variables and offered answers of possible sensory response was applied. The Mann-Whitney U test and the Wilcoxon W test at the level of statistical significance of p<0.05 were used to test the statistical significance of the differences between the subsamples of the respondents. The results of the study showed that 66.67% of children with Down syndrome have difficulties with sensory integration of the tactile sensory system. 26.67% of children are hypersensitive and 6.67% are hyposensitive. 33.33% of children with Down syndrome have a mixed type of tactile sensory response. Children with Down syndrome compared to children without developmental disabilities show better results of sensory integration of the tactile sensory system on two variables; „Walking barefoot“ and „Certain types of fabric, seams, labels, belts, cuffs, etc.“. There is a statistically significant difference at the level of p<0.05 between children with Down syndrome and children without developmental disabilities on 5 variables.

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.

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

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.

Introduction: Although sense of security in mothers is not clearly specified in literature, most important factors that make it up in women that do not have issues in pregnancy are social support, prenatal health care and partner’s support. Psychological factors play a key role in recognizing fear of childbirth, distinguishing anxiety from clinical depression. Recognizing risk factors and adequate intervention support would significantly reduce fear. Aim: to analyze development of mother’s sense of security during the postnatal period and establish the differences between two study groups. Methods: The Cross section study was conducted in 2017 in the Public Institute for Health care Protection of Women and Maternity in Canton Sarajevo. Using random method in the study were included 395 mothers. The research instrument was PPSS-instrument and modified questionnaire. Results: Postnatal sense of security in n=395 of the mothers on average was 49, 61±7, 6. Mothers’ sense of security during the first week after their child’s birth differed significantly (p=0.004) between mothers whose husband actively participated in psychophysical preparation for childbirth. Development of parents sense of security is in direct connection with psycho-physical preparations of pregnant women for labor only when both partners took active part in preparations for labor. Conclusion: Postnatal sense of security in parents is a term that has not been researched enough and it requires further studies. Bachelor degree in health care/graduated nurse/midwife, especially in primary health care field, according to her competencies would be able to independently create and work on promoting prevention programs through holistic approach with individuals and families.