According to the World Health Organization, quality communication is one of the five skills that individuals need for a healthy and happy life, and the knowledge and skills of quality communication are a prerequisite for quality action for many professions. In order for healthcare professionals to tailor health communication to each patient individually and to provide high quality healthcare, it is essential that they have an insight into the health literacy status of their users. Given the large percentage of the illiterate population around the world, it is necessary to conduct health literacy research in some of our adapted measuring instruments in our country as well.

INTRODUCTION: Internet addiction is a topic that is widely debated in scientific circles and the media. Students spend a lot of time in content-related activities online, neglecting common activities such as socializing, business obligations, learning, home affairs, etc., and have difficulty interrupting internet activities, even when they themselves recognize it is time for it. AIM: The aim of this research was to investigate Internet addiction among students of the Medical Care, Faculty of Medicine in Foca. MATERIAL AND METHODS: The research was conducted at the Medical Faculty in Foca in the period from 07.11. until 09.11.2016. year with health care students. The selected study design is a cross section study. The study covered 60 students, the first, second and third year of studies that were present on the days of the study and volunteered to participate in the research. RESULTS: The survey involved 60 respondents, of whom 21 are men (35%) and 39 women (65%), ages 18 to 24 years old. All of our respondents are Internet users. The largest percentage of respondents (66.7%) use the internet for 2 to 4 hours. The largest number of respondents first accessed the Internet at the age of 13 (21.7%). Most respondents use Facebook as a social network 56 (93.3%), while the least number of Twitter users. CONCLUSION: All of our respondents are Internet users, and the largest percentage of respondents (66.7%) use the internet for 2 to 4 hours. The largest number of respondents first accessed the Internet at the age of 13 (21.7%).

Aim To synthesize evidence about the influence of individual antimicrobial stewardship programs (ASP) related to the prevention of Clostridium difficile (C. difficile) infection on primary and secondary outcomes. Methods Relevant databases such as Medline, PUBMED, COCHRANE library and EBSCO were searched from 1 April to 27 April 2017. Additional studies were reached by the manual search for original articles in relevant journals. We included all randomized controlled, quasi-experimental and observational studies, published in the English language from 2007 onward, that evaluated effectiveness of ASP in preventing and controlling C. difficile associated disease (CDAD) among adult inpatients. Results Implementation of ASP interventions was associated with CDAD incidence reduction in 62.5% studies, but no significant differences were reported for the duration of hospitalization, readmission and mortality rate. Improvements in prescribing patterns (decreased antimicrobial use or increased rational use) and microbial outcomes (decreased rates of selected antimicrobial-resistant bacteria) were reported. Evidence on the effects of ASP is mainly limited to the results of studies low in methodological quality with great heterogeneity of outcomes, interventions, and units in which CDAD incidence data were reported. Conclusion Despite the low strength of evidence of reviewed studies, consistency of findings suggest the positive impact of antimicrobial stewardship programs on the prevention and control of nosocomial CDAD. The significance of this problem imposes randomized control trial use as the best instrument to provide highquality evidence. Further studies need to systematically analyse changes in all antibiotic use and its outcomes.

OBJECTIVES Interprofessional teamwork is best attained through education that promotes mutual trust and effective communication. The primary aim of the study was to evaluate the impact of interprofessional learning on knowledge about diabetes. METHODS The cross-sectional study included students of medicine, dentistry and nursing at the Faculty of Medicine Foča, Bosnia and Herzegovina. The students were randomly allocated into one of two groups. Group 1 attended an interprofessional course on diabetes while group 2 was divided into three subgroups and each of the subgroups attended an uniprofessional diabetes course. The measuring instrument used in the course in order to assess the participants' knowledge about diabetic care was a test containing multiple-choice questions about diabetes. The Interprofessional Questionnaire was used to explore the attitudes, views, values and beliefs of students regarding interprofessional education (IPE). RESULTS No statistically significant difference in total score on the test was found between the groups at baseline, but at follow-up the difference was highly statistically significant (F=10.87; p=0.002). The students from Group 1 had better results (21.82 points), compared to Group 2 (18.77 points). The statistically significant difference was observed in mean values (t=-3.997; p=0.001), between Groups 1 and 2; the students from Group 1 obtained 20.42 points, which is considered to indicate a respectively positive self-assessment of communication and teamwork skills. However, Group 2 indicated a negative self-assessment of communication and teamwork skills. CONCLUSION The findings suggest that IPE activities may provide health profession students with valuable collaborative learning opportunities.

Introduction: Hospital-acquired infections (HAI) and surgical site infections (SSI) are a global public health problem. The aim of the study was to determine the incidence of SSIs at the Surgical Clinics of the University Clinical Centre Banja Luka and to identify risk factors for the development of SSIs. Methods: In order to determine the frequency of SSIs through the incidence compared to the patients operated at the Surgical Clinics of the University Clinical Centre Banja Luka, we conducted a prospective cohort study which encompassed 11.216 operated patients, in the period from November 11th, 2014 to September 30th, 2015. In order to identify risk factors for the development of SSIs, a nested case-control study of risk factors for SSIs was conducted. The study group consisted of patients who were diagnosed with SSIs in the period of monitoring, while the control group was consisted of patients without SSIs who corresponded with the study group in age and sex. Results: The highest values of incidence of SSIs were observed at the Department of Anesthesia and Intensive Care (2.65%), Department of Orthopaedic Surgery (2.48%) and the Department of Vascular Surgery (2.15%), and the lowest ones at the Department of Urology (0.59%). Among the cases of SSIs, deep infections of the surgical site were the most represented (82.7%). Multivariate logistic regression was used to identify the following independent risk factors: length of pore-operative stay in hospital (p=0.000; OR=1.062; 95% CI=1.037-1.087), reintervention (p=0.000; OR=22.409; 95% CI=6.361-79.071) and cotrticosteroids (p=0.023; OR=4.141; 95%CI=1.221-14.047). Conclusion: The incidence of SSIs at the Surgical Clinics of the University Clinical Centre Banja Luka is at the level of hospitals in developed countries. There are a number of risk factors for SSIs, which may be prevented.

BACKGROUND/AIM Active surveillance is an important component of surgical site infection (SSI) reduction strategy. The aim of this study was to analyze and compare SSI surveillance data in orthopedic patients in the Military Medical Academy (MMA), Belgrade. METHODS A 4-year prospective cohort study was performed to identify the incidence rate and risk factors for SSI in orthopedic patients in the MMA, Belgrade. We collected data regarding patients characteristics, health care and micro-organisms isolated in SSI. The National Nosocomial Infection Surveillance (NNIS) risk index was subsequently calculated for each patient. The Centers for Disease Control and Prevention criteria were used for the diagnosis of SSI. RESULTS Assessment of 3,867 patients after different orthopedic operations revealed SSI in 109 patients. The overall incidence rate of SSI was 2.8% with the decrease from 4.6% in 2007 to 1.6% in 2010. Using NNIS risk index for surgical procedures there were: 53.7% (2,077) patients with risk 0--the incidence rate of 1.4%; 38.9% (1,506) patients with risk 1--the incidence rate of 3.1%; 7.3% (281) patients with risk 2--the incidence rate of 11.7%; 0.1% (3) patients with risk 3--without infection within the risk. Multivariate logistic regression analysis identified 6 independent risk factors associated with SSI: contaninated or dirty wounds, smoking, preoperative infection, NNIS risk index, body mass index and the length of hospital stay. CONCLUSION The results of our study are valuable confirmation of relations between risk factors and SSI in orthopedic patients. A decreasing incidence rate of SSI (from 4.6% to 1.6%) during a 4-year active surveillance approved its implementation as an important component of SSI reduction strategy.

Introduction: Mumps is a systemic viral infection characterized by swelling of salivary glands, especially the parotid ones. Gonads, meninges, pancreas and other organs may also be affected. Aims of the study: The aim of this study was to analyze the epidemiological characteristics of mumps meningitis in the last epidemic of mumps in the Republic of Srpska, and to analyze the frequency of mumps meningitis and vaccination status in patients who were supposed to be vaccinated against mumps in the war and early post-war period, and also in those patients who were supposed to be vaccinated before or after this period. Patients and Methods: The study included 175 patients divided in the experimental group (140 patients with mumps meningitis) and the control group (35 patients with serous meningitis of other etiology, probably enteroviral). We compared epidemiological characteristics of these patients and additionally we analyzed the differences in these characteristics in patients with different vaccination status. Results: The mean age of patients in the experimental group was 20.0 years (18.0-24.5; IQ), and in the control group 7.0 years (5.0-14.0; IQ) (p <0.001). Patients born between 1985 and 1996 more frequently suffered from meningitis (p <0.001) caused with mumps virus than other patients in the experimental group. There was no statistically significant difference in sex distribution between patients in the experimental and control group (p = 0.746), nor between patients in the experimental group with previously different vaccination status (p = 0.371). Most patients in the experimental group didn’t have data of their immunization status. The subsequent are those patients who received only one dose of vaccine, followed by unvaccinated patients and those who were vaccinated correctly. Conclusion: The epidemic of mumps during 2011 and 2012 is a consequence of maintaining the virus in non-vaccinated population (mainly because of the omissions made during the war and early post-war period) and insufficient duration of protection after vaccination, especially in vaccination with one dose of vaccine.

BACKGROUND/AIM Acne is well recognized condition that adversely affects quality of life (QoL) of the patients. The aim of this study was to determine the self-reported prevalence of acne and its main characteristics in high school pupils, and to assess their QoL. METHODS The cross-sectional study conducted in May 2011 comprised 440 pupils from Serbia (281 from Belgrade and 159 from Uzice). Participation in the study was voluntary and anonymous. Two questionnaires were administered: a short demographic questionnaire, and Children's Dermatology Life Quality Index (CDLQI). Internal consistency was assessed using the Cronbach's alpha while item-total score correlations were assessed using Spearman's correlation analysis. RESULTS The majority of the study population (84.3%) were girls, and 15.7% were boys. The total mean age of the pupils was 16.48 +/- 0.55 years. A total of 228 (51.8%) pupils self-reported their acne with significantly higher prevalence in Uzice (73.6%) than in Belgrade (39.5%). The mean CDLQI score was 3.55 with the similar quality of life impairment in adolescents from the two cities. The mean Cronbach's alpha was 0.83. There was a statistically significant positive correlation between the mean overall CDLQI score and CDLQI subscale scores that ranged from 0.401 to 0.841. CONCLUSION Our study confirmed that acne is associated with impairment in QoL that is in accordance with previous studies performed on teenagers. The CDLQI is a reliable and valid measure, and can be used as a practical tool for measuring the impact of acne on patients' QoL.

BACKGROUND/AIM Acne is a common problem in adolescent children with considerable emotional and psychological effects. The aim of this study was to determine the self-reported prevalence of acne and to assess its impact on the quality of life in high school pupils in Serbia. METHODS The cross-sectional study was conducted in May 2011 in two medical high schools in Serbia. Only pupils who gave a written informed consent to participate in the study (n = 440) were asked to fill in two questionnaires: short demographic questionnaire and Cardiff Acne Disability Index (CADI), a disease-specific questionnaire measuring disability induced by acne. Internal consistency (tested by Cronbach's alpha) and item-total score correlations (Spearman's correlation analysis) were used for reliability analyses. RESULTS The study population consisted of 440 pupils, 281 from Belgrade and 159 from Uzice. Among them 371 (84.3%) were girls and 69 (15.7%) boys, with similar sex distribution in Belgrade and Uzice. The total mean age of pupils was 16.48 years (SD = 0.55). Out of 440 pupils 228 (51.8%) self-reported their acne. The acne prevalence was significantly higher in pupils from Uzice (73.6%) than in those from Belgrade (39.6%). The overall mean CADI score for the whole sample was 2.87 +/- 2.74, with the similar quality of life impairment in adolescents from Belgrade and from Uzice. The mean Cronbach's alpha was 0.82. CONCLUSION This study shows that the quality of life impairment due to acne is mild for the majority of the affected pupils. The Serbian version of the CADI is a reliable, valid, and valuable tool for assessing the impact of acne on the quality of life.

INTRODUCTION Among the most important causes of diarrhea in modern hospitals is Clostridium difficile (C. difficile). A wide spectrum of diseases caused by this bacterium is now known as C. difficile associated disease (CDAD). The development of CDAD is usually preceded by the administration of antimicrobial therapy and fecal-oral infections with C. difficile. Over the last years epidemiology of CDAD has significantly changed. Recently, a hypervirulent BI/NAP1/027 strain, the cause of severe epidemics in North America and Western Europe, has been identified. OBJECTIVE The aim of this study was to identify risk factors for CDAD in patients operated on at the Military Medical Academy (MMA). METHODS The study included all patients who underwent surgery at the MMA during 2010. Nested case-control study design was used. The subjects were divided into groups of operated patients with and without CDAD. The patients were under prospective follow-up, while their data were collected using a questionnaire during a routine epidemiological control. RESULTS During 2010 the incidence rate of CDAD was 3.3 per 10,000 hospital days. Univariate regression analysis showed that the length of administration of one or two antibiotics, as well as concurrent administration of two antibiotics, were far more frequently observed in the patients with than in the patients without CDAD. Independent risk factor for the development of CDAD was the length of the administration of one antibiotic. CONCLUSION Reduction in the incidence rate of CDAD can be achieved by using reliable measures of prevention and control; the rational use of antibiotics, early diagnosis and therapy of infected patients, contact isolation of infected persons, proper disinfection, and continued education of medical and nonmedical personnel.