Coronavirus disease 2019 (COVID 19) is a pandemic disease that is today a global public health problem caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). COVID-19 is a disease of middle and old age, but clinical expression may also be present in childhood. Asymptomatic and mild clinical forms are most often present in persons aged 0-19, but severe clinical forms such as, among others, acute respiratory distress syndrome and multisystem inflammatory syndrome may occur. In addition to presenting the epidemiology, clinical symptomatology of COVID-19, the authors consider certain specifics of COVID-19, that is, possible reasons for the lower incidence of the disease as well as unusual and rare clinical forms of the disease in children. The current activities of health professionals in the supervision of COVID-19 are mainly focused on early detection, isolation and treatment of patients, isolation of contacts, the regular and thorough practice of respiratory hygiene, hand hygiene, and physical distancing. Future efficient and safe vaccination will solve the biggest global medical challenge caused by the new coronavirus in the best possible manner.

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.

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world. From 1980 to 2018, the levels of total and non-high-density lipoprotein cholesterol increased in low- and middle-income countries, especially in east and southeast Asia, and decreased in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe.

Measles are a highly contagious and communicable viral disease which may be prevented by a sustained vaccination program. Due to missed vaccination, two major epidemics of measles (1997–1999 and 2014–2015) have been recorded after the war in Bosnia and Herzegovina (BH) with over 10,000 patients registered. According to the World Health Organization, BH is categorized as a country with endemic transmission of measles. The last measles epidemic was between 2014 and 2015, with 5,083 documented patients in the Federation of BH. In the first four months of 2019, more than 700 measles cases were registered in the same region. Significant transmission rate has been observed in Sarajevo Canton (SC) with 570 documented measles cases. Out of 570 measles cases in SC, 92.5% were unvaccinated. The most affected were children up to 6 years of age (62.8%), with one documented case of death (7-month old infant). In addition to this report, we discussed key stakeholders and possible circumstances responsible for the epidemic. The measles epidemic is still ongoing.

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3–6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. Contrary to the view that urbanization is a major driver of the global rise in obesity, the global increase in body-mass index is shown to be mostly due to increases in the body-mass indexes of rural populations.

Introduction. The rising need for quality health care, increased workload, accountability and healthcare reforms, are factors that resulted in growing requirements for recognition of the nursing profession, which are clearly defined in the Munich Declaration (2000). Unfortunately, in the current health care system in most of the transition countries of the Region of the South East Europe, nursing is still not adequately validated as a special profession. Aim. Presentation of legal solutions related to nursing profession in Bosnia and Herzegovina (B&H) from the aspect of definition of nursing activities, education standards, licensing and labor mobility. Methods. Desktop analysis as a method of quality research of legislative and strategic documents related to nursing in B&H. Analysis of the directive and legislation in the countries of the region and the EU. Comparison with the legislation of B&H. According to the constitutional solutions, within the competence of the Entities (Republic of Srpska), the area of health care in B&H is divided by the competencies of the entities and cantons (the Federation of B&H), that is, within the competence of the Brčko District of B&H, therefore, there is also a separate entity legislation. In 2013, the Government of the Federation of B&H adopted the Law on Nursing and Midwifery and secretly defined the nursing domains in accordance with the EU directives. In the Republic of Srpska and the Brčko District, this is partly defined in the systemic health care laws (amended in 2015). Conclusions. In all the legal acts reviewed, there are still shortcomings in the defined domains for the nursing profession. By addressing these issues, the progress of nursing development would speed up, strengthen and modernize the health system, which would undoubtedly increase the quality of health care to a higher level. The Ways of Development of Nursing as a Separate Health Profession: a Comparative Analysis of Legislative in the Nursing Profession in Bosnia and Herzegovina and Countries in the Region Croat Nurs J. 2018; 2(2): 141-148 142 Zelić S. et al. The Ways of Development of Nursing as a Separate Health Profession... Croat Nurs J. 2018; 2(2): 141-148 profession, increasing the mobility of nursing workforce, and improving the health care system in which nurses are an essential part, both as participants and as policymakers. The health of the population is undergoing significant changes in the current conditions of altered socio-environmental factors, the increasing challenges and risk factors in the environment, the new pathology, the need to strengthen health promotion and disease prevention, and bring new therapeutic approaches (4). Continuous monitoring and strengthening of health care is necessary. Consequently, the role of a nurse as a health care manager, from the planning, organization, management and control process is immeasurable in the health system of each country. There is not a single healthcare profession that treats individuals of all ages, families, groups and communities in a more comprehensive way, sick or healthy in all environments, such as nursing. Nursing involves health promotion, disease prevention, and care for sick, disabled and dying people. In addition, the key roles of nursing are the promotion of a healthy environment, research, participation in shaping health policy and managing hospital and health systems as well as education. Therefore, strengthening the profession of nursing is also a necessity and a need for the improvement of health systems in all countries of the world. Starting from the premise that health systems in countries all around the world are part of a global international health system, the EU, as an intergovernmental and transnational community of European states, emerged through the process of cooperation and integration, continuously implements the process of adapting health systems of all EU member states to the global health system and strives to achieve a recognizable quality of health education. Introduction The rising need for quality health care, increased workload and accountability, are factors that resulted in growing requirements for recognition of nursing and consequent health care reform. Relating to medicine as a science and profession, nursing must be defined as a specific branch of medical science, which has its own and completed framework of knowledge, methods, procedures and skills, as a part of the entire medical science. As a logical sequence of these demands, the Vienna Nursing Conference, 1988 and the Munich Conference, which further strengthened the status of nursing profession, were held. At the Munich Conference, the Munich Declaration 2000 was also adopted (1). Conclusions from these conferences became a guide to the legislative authorities of transition countries, such as the Southeastern European countries, which, through strong socio-economic reform processes, have begun to work on the development and advancement of nursing legislation and the advancement of nurses’ position in Europe, as independent and interdependent professionals. Furthermore, the European Union (EU) has defined the processes and norms of nursing education. The health systems of all EU Member States should be adapted to the global health system of the EU and achieve the prescribed and recognizable quality of health education. Implementation of those reforms requires the fulfilment of the Guidelines of the World Health Organization Regional Office for Europe, European Union Directives (2005/36/EC and 2013/55/ EC), and the Guidelines on the recognition of professional qualifications (2, 3). Unfortunately, in the current health care system in most of the transition countries of Southeastern Europe and the Western Balkans countries, nursing is still not adequately validated as a special profession. The aim of the paper is to analyze the legal and strategic solutions related to nursing and offered through legislation in Bosnia and Herzegovina (B&H) from the aspect of definition of nursing activities, education standards, licensing and labor mobility. By harmonizing these domains with EU standards, it can contribute to further strengthening the nursing Zelić S. et al. The Ways of Development of Nursing as a Separate Health Profession... Croat Nurs J. 2018; 2(2): 141-148 143 According to the constitutional solutions, within the competence of the Entities (Republic of Srpska), the area of health care in B&H is divided by the competence of the entities and cantons (the Federation of B&H), that is, within the competence of the Brčko District of B&H, and therefore there is a special entity legislation (6,7,8) complicated state system, poor coordination of competent sectors and many other problems, the process of harmonization of health laws will have to take place in those phases. The best example of this phase approach to solving the harmonization problem is the adoption of the special Law on Nursing and Midwifery of the Federation of B&H (Official Journal of the FB&H 43/13) (9). The basic goal of this law is to regulate the profession, i.e. define the activities, competencies, standards of education, licenses and other domains in order to place this profession in B&H at the same level with other regulated professions in health care. This would make nurses equal in rights and obligations with their counterparts in the EU, which would also enable the mobility of the personnel and the basis of this profession, the satisfaction of the end user or the patient. The law is mutually beneficial, both for nursing and for patients, and this is reflected in the following: • providing professional, efficient and effective nursing services for patients, • informing the patient about the possibilities of choosing services, • guarantee of quality of services, • encouraging the development of the profession, • recognition of the expertise, identity and social position of nurses. Through the Law, the nursing domains are clearly defined in accordance with EU Directives. Although not fully harmonized with European legislation, the part that could be harmonized is harmonized, and the part that is not harmonized due to existing obstacles will wait for the solution of these problems. In the Republic of Srpska and the Brčko District, this is partly defined in the systemic health protection laws (7, 8). Also, Directives 2005/36/EC and 2013/55/EC (2,3) provide the basis for mobility in the European labor market for sectoral professions, including nurses. Labor market mobility requires university education of Methods • Desktop analysis* as a method of quality research of legislative and strategic documents related to nursing profession in B&H • Analysis of directives and legislation in the countries in the region and the EU • Comparison with B&H legislation Directive 2005/36/EC of the European Parliament and of the Council on the Recognition of Professional Qualifications (2), (Directive 2005/36/EC) and its upgrading the Directive, Directive 2013/55/EC are two key EU Directives on Independent Professionals Of the European Parliament and of the Council on the Recognition of Professional Qualifications amending Directive 2005/36/EC on the recognition of professional qualifications and Decision (EU) no. 1024/2012 on administrative cooperation through the Internal Market Information System (3) (Directive 2013/55/ EC). These Directives contain standards that are the basis for the adoption of various legal acts in the field of nursing. In addition, the Bologna Declaration of June 1999 launched a series of reforms needed to make higher education in Europe more compatible and more comparable, more competitive and more attractive to its citizens and to citizens and scientists from other continents. Among the main objectives are the development of a progressive convergence of the overall framework of educational titles and cycles in the open European Higher Education Area, as a develo

Introduction: Unhealthy behavior such as neglecting to brush and floss, using tobacco and alcohol, and inadequate nutrition can adversely affect dental health. The frequency of dental visits is also of great importance in the early detection of different oral disorders. Our aim was to assess oral health behavior and attitudes among students of the 1st year of  two health and non-health oriented studies of University of Sarajevo. Methods: We included 119 students of the 1st year of Faculty of Health Studies and 108 students of the 1st year of Faculty of Architecture of the University of Sarajevo. A self-administered questionnaire was used, comprising demographic data, data on oral hygiene habits, dental attendance pattern, a number of extracted teeth as well as problems with the appearance, comfort, and social life due to teeth problems. Results: Faculty of Architecture students significantly more often visit their dentist (χ2 = 24.174, df = 5, p = 0.00). Faculty of Health Studies students have significantly more extracted teeth (χ2 = 35.54, df = 4, p = 0.001). Dental health habits were significantly better at the students Faculty of Architecture (χ2 = 16.391, df = 2, p = 0.001). No significant difference between the groups about about avoiding encounters due to teeth and dentures problems. Conclusion: Oral health related attitudes may be better in students of non-health oriented studies, however, these results have to be confirmed by more investigations and larger studies.

Abstract Background Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.

Introduction: A number of people with facial injuries after surgical treatment one knee time comes and a violation of the opposite knee. These injuries have a major impact on quality of life if they are not treated properly, but also have consequences and after surgery. The aim of this paper is to analyze the questionnaires used to assess the quality of life after mutual ruptured anterior cruciate ligament, and to make recommendations for optimal use of the same. Our goal is to establish a correlation between the results obtained from questionnaires used descriptive answers to questions descriptive questions about aspects of everyday life, aspects of physical activity as well as aspects of personal perception of the current health and satisfaction with it. Methods: We analyzed questionnaires used to evaluate the quality of life after a bilateral rupture of the anterior cruciate ligament, which are listed in the attached work. In accordance with the subject of research, in this paper were used the following scientific research methods: a method of deduction, analysis, classification, comparison, analysis methods of written documents. Results: By searching the PubMed database for the purpose of this master's thesis under the terms "unilateral rupture ACL" we came across a 2792 articles, while the term "bilateral rupture of the ACL," retrieved only 73 articles, "contralateral ACL rupture" 192 articles, "Quality of life ACL "  41 articles. The most important dates in our study are certainly "Quality of life after bilateral rupture of the anterior cruciate ligament," where we all find only two articles on this topic. Conclusion: The most commonly used questionnaires to be used in assessing the success of treatment and quality of life after a bilateral rupture of the anterior cruciate ligament are: QOL, IKDC, KOOS, HSS, ADL, SF-36, WOMAC. IKDC proved to be most suitable for patients with ACL rupture in this study.

Background: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model toestimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (–0·01 kg/m² per decade; 95% credible interval –0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m² per decade (0·69–1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m² per decade (0·64–1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m² per decade (–0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m² per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation: The rising trends in children’s and adolescents’ BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

Introduction: Currently, there is a growing interest in alcoholism-related studies among healthcare community. Cigarette smoking is five times more prevalent among adult men compared to women but these gender differences have been decreasing among young people. In developed countries, harmful effects of sedentary lifestyle and physical inactivity have led to increased rates of obesity in young population. The main aim of this study was to explore the lifestyles of students at the University of Sarajevo. We investigated the prevalence of cigarette smoking and alcohol consumption, eating habits, and physical activity in this student population. Methods: Students from Faculty of Health Sciences [FHS], Faculty of Political Science [FPS], and Faculty of Traffic Engineering and Communications [FTEC]) voluntarily participated in this questionnaire-based study. We surveyed a total of 410 students. Results: On average, 21.8% of participants consumed cigarettes (a significantly higher number of those who smoked cigarettes was in FPS group). The highest number of students who reported physical activity (recreational or active sport) was in FTEC group (66.5%), and the difference was statistically significant compared to FHS (48.2%) and FPS (51.9%) groups. Over 60% of participants in all three groups experienced stress occasionally. The majority of students in three groups consumed fast food while at campus. The highest number of students in all three groups reported to drink water compared to other drinks. Conclusions: Our results indicate that the lifestyles of university students in Sarajevo are subject to concern. Frequent alcohol consumption and cigarette smoking are typical examples of behaviour that should be reduced through educative programs and workshops.

Introduction: Managing organizational culture has been increasingly viewed as a lever for health care improvement. The aim of this study was to investigate the correlation between the type of organizational culture and patient satisfaction in the selected health care centers in the Federation of Bosnia and Herzegovina (FBIH). Methods: We conducted a cross-sectional survey in two municipal primary health care (PHC) centers in the FBIH, referred as Primary health care (PHC) center A and Primary health care (PHC) center B. A validated questionnaire, known as the Organizational Culture Assessment Instrument (OCAI), was used for the assessment of organizational culture. The questionnaire was distributed among the family health care teams at the two PHCs. Simultaneously, we carried out a survey about patient satisfaction among patients during their visits to the family health care teams. Results: We observed the differences in the type of the organizational culture between the health care centers. The hierarchical culture was found the dominant culture in PHC center A, whereas the market culture was the dominant culture in PHC center B. Also, the statistical significance (t test) was recorded in the overall patient satisfaction in the health care center with the dominated hierarchical culture followed by the clan culture (PHC center A). Conclusions: Considering the lack of similar surveys in Bosnia and Herzegovina, we believe that this study might be a good starting point for education of human resource managers in health care.

Objective – The aim of the paper is to describe the complexity of pertussis-like syndrome in primary health care practice, and to highlight consequences of vaccine hesitancy. Case reports – We described five cases of pertussis-like syndrome in pediatric practice. Patients were unvaccinated or not fully vaccinated against pertussis due to parental refusal. There was intrafamilial and interfamilial spread of infection. Conclusion – Evaluation and treatment of pertussis-like syndrome remain challenging in primary health care practice. Dealing with vaccine hesitancy requires an adequate understanding and answer. Vaccine refusal increases the individual risk of disease but also increases the risk for outbreaks of vaccine-preventable diseases.