CONFLICT OF INTEREST: NONE DECLARED Distance learning refers to use of technologies based on health care delivered on distance and covers areas such as electronic health, tele-health (e-health), telematics, telemedicine, tele-education, etc. For the need of e-health, telemedicine, tele-education and distance learning there are various technologies and communication systems from standard telephone lines to the system of transmission digitalized signals with modem, optical fiber, satellite links, wireless technologies, etc. Tele-education represents health education on distance, using Information Communication Technologies (ICT), as well as continuous education of a health system beneficiaries and use of electronic libraries, data bases or electronic data with data bases of knowledge. Distance learning (E-learning) as a part of tele-education has gained popularity in the past decade; however, its use is highly variable among medical schools and appears to be more common in basic medical science courses than in clinical education. Distance learning does not preclude traditional learning processes; frequently it is used in conjunction with in-person classroom or professional training procedures and practices. Tele-education has mostly been used in biomedical education as a blended learning method, which combines tele-education technology with traditional instructor-led training, where, for example, a lecture or demonstration is supplemented by an online tutorial. Distance learning is used for self-education, tests, services and for examinations in medicine i.e. in terms of self-education and individual examination services. The possibility of working in the exercise mode with image files and questions is an attractive way of self education. Automated tracking and reporting of learners’ activities lessen faculty administrative burden. Moreover, e-learning can be designed to include outcomes assessment to determine whether learning has occurred. This review article evaluates the current status and level of tele-education development in Bosnia and Herzegovina outlining its components, faculty development needs for implementation and the possibility of its integration as official learning standard in biomedical curricula in Bosnia and Herzegovina. Tele-education refers to the use of information and communication technologies (ICT) to enhance knowledge and performance. Tele-education in biomedical education is widely accepted in the medical education community where it is mostly integrated into biomedical curricula forming part of a blended learning strategy. There are many biomedical digital repositories of e-learning materials worldwide, some peer reviewed, where instructors or developers can submit materials for widespread use. First pilot project with the aim to introduce tele-education in biomedical curricula in Bosnia and Herzegovina was initiated by Department for Medical Informatics at Medical Faculty in Sarajevo in 2002 and has been developing since. Faculty member’s skills in creating tele-education differ from those needed for traditional teaching and faculty rewards must recognize this difference and reward the effort. Tele-education and use of computers will have an impact of future medical practice in a life long learning. Bologna process, which started last years in European countries, provide us to promote and introduce modern educational methods of education at biomedical faculties in Bosnia and Herzegovina. Cathedra of Medical informatics and Cathedra of Family medicine at Medical Faculty of University of Sarajevo started to use Web based education as common way of teaching of medical students. Satisfaction with this method of education within the students is good, but not yet suitable for most of medical disciplines at biomedical faculties in Bosnia and Herzegovina.

CONFLICT OF INTEREST: NONE DECLARED Neck pain syndrome is described as: Pain in the neck affects at least once in a lifetime every second person, and also 10 % of adult population suffers from chronic pain in this area. It is more often among women. A constant increase of incidence in the industrialized countries is noticed. It is also the leading cause of referral to physical rehabilitation. It is causing huge financial costs in the health care system. There is no consensus regarding Neck pain syndrome management, but many therapeutic modalities are applied: a) to isolate (or manage) rare, but potentially dangerous states that can cause neck pain; b) identify and treat each co morbid state and risk factors; c) provide resources and information’s, especially about regarding use computers in dayly practice. Physical and manual treatments can be: a) physical therapy can assist to achieve early mobilization and return to daily activities; b) active physical therapy , mobilization, manipulation and exercises can assure short time relief of neck pain; c) home based exercises, as shown by this research, can significantly prolong the pain free period, in case of patients with the chronic syndrome; d) Medications, combined with the exercise program and ergonomic improvements can be effective solution for the chronic or recurrent neck pain. Intensive treatments in Neck pain syndrome are: a) Surgical and other intensive treatment (rarely indicated); b) invasive treatments includes and percutaneous radiofrequent neurotomy and cervical epidural analgesis.

CONFLICT OF INTEREST: NONE DECLARED In Bosnia and Herzegovina, Medical informatics has been a separate subject for the last 15 years with regard to Medical curriculum at the biomedical faculties in the country (1,2). Education in the field of Medical informatics is based on the concept which is used in developed countries, according to the recommendations of the working groups EDU – Education of Medical Informatics, of the European Federation for Medical Informatics (EFMI) and International Medical Informatics Association (IMIA). Theoretical and practical teaching and training performance as a whole is performed by use of the computer equipment, and the final knowledge check of the students is also performed using the Data Base Management System MS Access specifically designed to cover full teaching and training material by using question sets in the data base which encircled nearly 1500 question combinations. The distance learning is logical step that can further improve this method of education. In this paper, authors present 15 years of experience of Medical informatics education at biomedical faculties in Bosnia and Herzegovina. Medical Informatics, as an obligatory subject, was introduced to the biomedical faculties in Sarajevo (medical, dental and pharmaceutical as well as the High medical school) in 1992 and 1993. Students have practical computer exercises for a period of 7 weeks. Students had training in Excel, Word etc. During the semester, the students perform specific operation such as creation of data carrier for manipulation with medical information. The information was analyzed by statistical program such as Excel. From 2002 years Medical Informatics is divided in two parts in order to facilitate data processing and other procedure that are necessary to perform at time when student’s knowledge of medicine is sufficient for practicing specific tasks that include management the data about patient, anamnesis and similar parameters cause we noticed that students without such knowledge cannot figure out the whole picture without difficulties. The Theoretical part of examination is done using the multiple choice answer form provided by special software with randomly selected questions for each student. Such way of practical and theoretical path of final exam make possible to perform such procedures such as electronic registration for exam and distance testing. Possibilities of introduction of distance learning in medical curriculum are the title of project which has been realizing at Cathedra for medical Informatics, Medical faculty since year 2002. Our undergraduate and postgraduate students are satisfied with contents and organization of the teaching process.

There is no such science as medicine where half life is 7 years, what means that in 3-4 years 50% of current knowledge will be wrong. If doctors use old techniques and methods then they will cure patients wrongly. Very fast and rapid increase of biomedical sciences and medical information in certain way force medical professionals to continuity learning in order to stay update. In this project a quantitative method of examination has been used. For the purposes of the research a survey questionnaires were created consisted of 28, 35 and 18 questions for all three groups of examinees. Beside general characteristics (sex, age, faculty, and year of studies) the questionnaire included questions referring to the variables of structure, process and results in the system of education. Authors used Lickert five degree scale for the evaluation. Total of 521 students of the faculties of biomedical science in Sarajevo were surveyed; students of the Faculty of Medicine, Faculty of Dental Medicine (Stomatology), Faculty of Pharmacy, Nursing College, students of final year and postgraduate students from Faculty of Medicine, University of Sarajevo. On the basis of survey results authors concluded that the following should be done: The reform needs to be carried out in accordance with possibilities and needs, general faculty rules should include regulations that refer to insuring the quality of education, a continuous quality of studying needs to be insured - internal and external evaluation of the quality of work of respective education institution needs to be carried out, education standards need to be set, i.e. minimum knowledge and skills which a student needs to gain during studies is to be set, curriculums and programs need to be harmonized with countries in the region and Western Europe, Regular evaluation of lecturers needs to be done, Increase of size and content of the practical part of teaching needs to be encouraged as well as distance learning organized on Cathedra for Medical Informatics and Family Medicine at Faculty of Medicine in Sarajevo, increase of international and regional mobility of students needs to be encouraged, students need to be included in the faculty reform, panel discussions need to be organized where students will be informed on the reform progress, where students can talk about their problems, give suggestions and solutions to certain situations. Students are motivated to study further when their ideas are accepted, the number of books in libraries needs to increase in accordance with financial possibilities and audio/visual and electronic aids need to be purchased and in place. Concept of quality incorporates at least three dimensions and has three different meanings. Those are: - Comparative meaning in terms of the level of perfectionist, - Quantitative meaning in terms of the level accessed and - Appropriateness for certain purpose. Objective of this study is to begin process of improvement of educational process at biomedical faculties at University of Sarajevo, but ultimate goal of all involved in medical education should be large number of health professionals who will be able to work independently and cure patients in best manner in 21st century.