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.

Introduction. Inhalation of coal dust during blasting in brown coal mines has been shown to lead to a lung disease called pneumoconiosis. There is very little data in the literature on the direct impact of coal on the quality of life of people who work in coal mines as well as the body's immune response to the effects of coal dust. The aim was to examine the immune response to exposure to coal dust in miners in a brown coal mine and whether mine workers have poorer quality of life compared to those not exposed to coal dust. Methods. This is a cross-sectional study among 100 employees in the Brown Coal Mine in Ugljevik, of which 50 of them are exposed to coal dust on a daily basis. Blood samples were taken from all subjects to test for the presence of cytokines IL-2, 4, 5, 9, 10, 13, 17A, 17F, 21, 22, IFN-g and TNF-a. The quality of life of employees was measured using a questionnaire for self-assessment of physical and mental health (36-item Short-Form Health Survey, SF-36). Results. Group of miners had a significantly (p<0.05) higher concentrations of pro-inflammatory cytokines IL-6, IFN-g, IL-17A and IL-22 when compared to the control group. Subjects from the control group had significantly (p<0.05) higher concentrations of anti-inflammatory cytokines IL-4 and IL-10 when compared to the group of miners. The quality of life was significantly (p<0.05) better in the control group when compared to the group of miners. Conclusion. Physical functioning, general health, mental health and Physical component summary were significantly poorer in the group of miners. Exposition to coal dust led to a significant increase in the production of pro-inflammatory cytokines and a decrease in the production of anti-inflammatory cytokines.

Pneumoconiosis of workers in brown coal mines is an occupational disease, a global public health problem and a serious disease of the lung parenchyma. If it is not prevented, it leads to irreversible changes in the lungs with complications. The disorder occurs after prolonged exposure to coal dust containing high concentration of free crystalline silica. Data in literature regarding its health impact on people working in coal mines are relatively scarce. Recently, there has been an increase in miners’ pneumoconiosis, which requires a stricter policy to protect workers in the mines. There are two classical types of CWP: simple and complicated. The main diagnostic method of CWP is based on a specific X-ray finding, and the auxiliary method of choice is spirometry. The pathophysiological mechanism of CWP formation is not fully known, although it has been shown that damage to the lung parenchyma goes through three phases caused by effect of lung cells exposure to coal dust. Studies show that cytokines play an important role in inflammation and the immune response as mediators of toxic and pathogenic effects in CWP. A link between exposure to coal dust in brown coal mines and the development of CWP has also been demonstrated, with a consequent reduction in the physical and psychological quality of life of workers in the mines.

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.

U oblasti javnog zdravstva mnogo je nerazjasnjenih pitanja koja su cesto prouzrokovana kompleksnim, međusobno uslovljenim pojavama, sto namece potrebu za sve cescom primjenom kvalitativnih naucnih istraživanja. Ovakava istraživanja se, prije svega, fokusiraju na nacin na koji pojedinci ili grupe shvataju svijet oko sebe i omogucavaju formiranje njihovih stavova i prakse povodom određenih istraživackih pitanja. Kako je cilj kvalitativnih istraživanja razumijevanje nekog aspekta drustvenog života, ona se prevashodno bave analizom rijeci, umjesto brojeva, sto dobijene rezultate cini komplikovanijim za interpretaciju. Pružajuci osnovni uvid u nacin formulisanja istraživackog pitanja, odabir uzorka, prikupljanje i analizu dobijenih podataka, ovaj rad ce kroz nekoliko jednostavnih koraka omoguciti sagledavanje metoda kvalitativnih istraživanja.

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.

Introduction: Controlling the presence of contaminants or harmful substances in milk and dairy products provides early detection of risks since their presence, even in legally permitted concentration, increases the risk of damaging human health, especially children's health, such as allergic manifestations, and they can have potentially toxic, carcinogenic and genotoxic effects. Aim of the Study: The aim is to determine the frequency of the presence of contaminants in samples of milk and dairy products in the Republic of Srpska from 2010 to 2012 (metals, radionuclides, aflatoxins and residues of antibiotics and pesticides), and especially to point out their public health significance because of possible health risks. The aim of the paper is to emphasize the need for monitoring all the other contaminants in milk and dairy products specified in regulations. Material and Methods: The frequency of the presence of contaminants in the samples of milk and dairy products (n= 407) was determined on the basis of legally prescribed methodology of sampling, chemical analyses and preparation of expert opinion on food safety in accordance with current food regulations. Descriptive statistical indicators were used (a number of the samples, minimum and maximum concentrations). Chi square test (χ2) of contingency was used for testing the significance of differences in presence of contaminants and residues analyzed and recommended by regulations in samples of milk and dairy products. Results: The results of public health research of contaminants in samples of milk and dairy products indicate that no health defective food samples were determined at tested parameters - metals, radionuclides, aflatoxins, and residues of antibiotics and pesticides. A statistically significant number of samples examined on heavy metal content (83.29% or 339 samples) was determined comparing to the number of samples examined on the other contaminants and residues recommended by regulations in milk and dairy products (χ2=1000.776, p<0.001) Conclusion: The data obtained can serve as a basis for further analysis in the context of milk and dairy product sample monitoring. Although samples of milk and dairy products are safe, a long-term exposure to residues of harmful substances results in cumulative effect and damage health, meaning that each early detection of food risk found through continuous controls has a public health significance for preservation and promotion of population health in the Republic of Srpska.

Uvod. Populacija muskaraca koji imaju seksualne odnose sa muskarcima (MSM) predstavlja posebno osjetljivu grupu za prenos HIV-a i drugih polno prenosivih infekcija.Vulnerabilnost se povecava usljed rizicnog ponasanja, marginalizovanja, stigmatizovanja kao i nedostupnosti zdravstveno-socijalne zastite. Cilj rada je bio da se procijeni prevalencija HIV-a i odabranih polno prenosivih infekcija te ispitaju znanje, stavovi i ponasanje u odnosu na HIV/ polno prenosive infekcije u MSM populaciji u Bosni i Hercegovini, kao i da se dobijeni rezultati uporede sa istraživanjima iz 2008. i 2010. godine. Metode. Istraživanje je provedeno kao bio-bihejvioralna studija prevalencije u MSM populaciji. Obuhvacena su ukupno 333 ispitanika, u sest gradova Bosne i Hercegovine. Istraživanje je sprovedeno u periodu septembar – decembar 2012. godine, kroz dobrovoljno, anonimno i povjerljivo anketiranje. Nakon informisanog pristanka i obavljenog savjetovanja, uzet je bioloski materijal za laboratorijsko testiranje na HIV, hepatitis B, hepatitis C i sifilis. Rezultati. Istraživanje je pokazalo prisutnost rizicnog ponasanja u MSM populaciji: multipli partneri (prosjecno tri razlicita slucajna partnera u proteklih mjesec dana), nezasticeni seksualni odnosi (samo 20% ispitanika redovno koristi kondom sa stalnim partnerom, 37% sa slucajnim partnerom, 4,6% pri oralnom odnosu), seksualni odnosi pod uticajem alkohola (69,6% ispitanika) i droga (26,7% ispitanika) u poslednjih sest mjeseci, seksualni odnosi i sa ženskim osobama (45,5% ). Uprkos prisutnosti rizicnog ponasanja, 14,8% ispitanika smatra da rizik od prenosenja HIV-a ne postoji, a 41,3% da je nizak. Seroloska ispitivanja pokazuju i dalje nizak nivo HIV/polno prenosivih infekcija u MSM populaciji u BiH. Zakljucak. Iako postoji porast zastitnog seksualnog ponasanja i ucestalije HIV testiranje u odnosu na ranije periode, to nije dovoljno za održavanje niskog nivoa infekcije HIV/polno prenosivih infekcija. Dobijeni podaci pružaju osnovne smjernice za buduca istraživanja i formiranje preventivnih programa.

Like many public healthcare facilities in South-Eastern Europe, the Public Health Institute of Republika Srpska (PHI RS) has recently faced the problem of irregular inflow of funds from the state budget and health insurance fund and had to seek for additional sources of funding. The objective of this paper is to assess the importance of projects for operation of the public health institutes in transitional countries where multiple donors are active, based on the PHI RS’s case. The RS PHI has recently assumed five different roles during projects. In the role of the final project beneficiary, the RS PHI was one of the target organizations who were to benefit from premises renovation, equipment delivery, strengthening of staff capacities, exchange of experience and practices through study visits, improvement of legal environment or advancing its position in the health system. As the project partner, the PHI RS has used its unique position in the health system to attract project funding. The PHI RS has as contractor provided its services under different projects. Occasionally, the PHI RS has been the resource center that provided experts needed for implementation of the projects. It promoted the PHI RS’s expertise and helped the PHI RS to retain and reward its most qualified staff. Potentially the most beneficial role for the PHI RS is the one of the main applicant for projects. All other roles have supported building of the PHI RS’s capacity to take the role of the lead applicant in different types of projects. In transitional countries where donors do not pool their funds, the public health institutes have a chance to exploit availability of multiple sources of financing and to benefit from parallel participation in different projects.