BACKGROUND Autistic spectrum disorders (ASD) are neurodevelopmental disorders that most often have profound impact on a person itself, as well as on parents, caretakers, and family life in whole. Parents of a child with ASD often have higher levels of stress and psychological distress. Aim of this study was to examine the stress sources, its frequency and predictability in parents of children with ASD, in relation to the communication and language skills of their children. SUBJECTS AND METHODS The sample consisted of 80 participants who are parents of children with ASD. The study was conducted using a questionnaire made for this research. Three groups of variables were analyzed: parental stress; child's communication; and child's language variables. Statistical analysis was performed by SPSS and included basic statistical parameters and multiple regression analysis. RESULTS The most common sources of parental stress are caring for the child's future; difficulties of the child with speech, language and communication; difficulties of the child in establishing contact with peers and other persons; and inappropriate behavior of the child (anger, aggression, stereotypical behaviors…). Multiple regression analyses used to determine whether a child's communication and language skills were valid predictors of parental stress showed significance. CONCLUSIONS ASD child's skills like showing gestures; looking, answering, and turning when called by name; making it known when he/she needs help or wants an object; answering simple 'Yes/No' questions; and establishing contact with peers, are valid predictors of some stress sources of the parents. Proper involvement in the development of a child's communication and language skills has numerous benefits, not only for the child, but also for the parental stress recognition and its potential frequency decrease.

Background: Vitamin D3 complexed to deglycosylated vitamin D binding protein (VitD-dgVDBP) is a water-soluble vitamin D dimeric compound (VitD-dgVDBP). It is not clear how VitD-dgVDBP affects circulating monocytes, macrophages, other immune cell systems, including phagocytosis and apoptosis, and the generation of reactive oxygen species (ROS) compared to dgVDBP. Methods: Flow cytometry was used to measure superoxide anion radical (O2*−) levels and macrophage activity in the presence of VitD-dgVDBP or dgVDBP. VitD-dgVDBP was incubated with normal human lymphocytes (nPBMCs), and several clusters of determination (CDs) were estimated. dgVDBP and VitD-dgVDBP apoptosis was estimated on malignant prostatic cells. Results: The macrophage activity was 2.8-fold higher using VitD-dgVDBP (19.8·106 counts) compared to dgVDBP (7.0·106 counts), but O2*− production was 1.8-fold lower in favor of VitD-dgVDBP (355·103 counts) compared to dgVDBP (630·106 counts). The calculated ratio of the radical/macrophage activity was 5-fold lower compared to that of dgVDBP. Only VitD-dgVDBP activated caspase-3 (8%), caspase-9 (13%), and cytochrome-C (11%) on prostatic cancer cells. PE-Cy7-labeled VitD-dgVDBP was found to bind to cytotoxic suppressor cells, monocytes/macrophages, dendritic and natural killer cells (CD8+), and helper cells (CD4+). After 12 h of co-incubation of nPBMCs with VitD-dgVDBP, significant activation and expression were measured for CD16++/CD16 (0.6 ± 0.1% vs. 0.4 ± 0.1%, p < 0.05), CD45k+ (96.0 ± 6.0% vs. 84.7 ± 9.5%, p < 0.05), CD85k+ (24.3 ± 13.2% vs. 3.8 ± 3.2%, p < 0.05), and CD85k+/CD123+ (46.8 ± 8.1% vs. 3.5 ± 3.7%, p < 0.001) compared to the control experiment. No significant difference was found using CD3+, CD4+, CD8+, CD4/CD8, CD4/CD8, CD16+, CD16++, CD14+, or CD123+. A significant decline in CD14+/CD16+ was obtained in the presence of VitD-dgVDBP (0.7 ± 0.2% vs. 3.1 ± 1.7%; p < 0.01). Conclusion: The newly developed water-soluble VitD3 form VitD-dgVDBP affected cytotoxic suppressor cells by activating the low radical-dependent CD16 pathway and seemed to induce apoptosis in malignant prostatic cells.

Background: Autism spectrum disorder (ASD) is a developmental disability, which is a biologically based neurodevelopmental disorder that affects a child’s social interaction and communication skills. Core deficits are identified in two domains: social communication/interaction and restrictive, repetitive patterns of behavior. Children and youth with ASD have service needs in behavioral, educational, health, leisure, family support, and other areas. Autism is a set of heterogeneous neurodevelopmental conditions, characterized by inability to acquire social skills, repetitive behaviors and failure of speech and nonverbal communication development. Objective: To examine frequency, correlation and predictivity of communication and language skills of autistic spectrum disorders (ASD) children and their parents’ emotions. Methods: The sample consisted of 80 participants who are parents of children with ASD. The study was performed using a questionnaire made out for this research. Three groups of variables were analyzed: parental emotions variables; child’s communication variables, child’s language variables. Statistical analysis was performed by SPSS, and included basic statistical parameters and multiple regression analysis. Results: The most common ways of communicate for children with ASD are: Allowing to cuddle; Recognizes familiar faces; and Makes it known when he needs help or wants an item. The most common language forms of children ASD are: Following simple instructions; Understanding connected words/phrases; Pronouncing single words; and Looking at when called by name. Parents of children with ASD expressed the greatest agreement with the following statements: “My child is more demanding than most other children”; “It seems to me that my child is very sensitive and easily upset”; “My child can’t do much of what he’s expected to know to do”, and “I often lack energy.” Conclusion: Parents of children with ASD proved that their children have significant delays in communication and language. Developed communication and language skills of the child with ASD are valid predictors of parents’ emotions/attitudes. Speech and language therapy work focused on developing the ASD child’s communication and language skills can be expected to improve parents’ emotions/attitudes.

Objective This study investigated acoustic and perceptual characteristics of the voice of patients with thyroid gland disorders such as hypothyroidism and hyperthyroidism immediately after the diagnosis was made and six months later, after using drug therapy. Materials and Methods The study includes 20 female outpatients with hypothyroidism and 27 female outpatients with hyperthyroidism. The criterion for the selection of the patients was a thyroid gland disorder medical diagnosis, no history of voice disorders and absence of other possible causes of voice changes. Acoustic, perceptual and aerodynamic parameters were assessed. Acoustic analysis was performed by specific software. Experienced speech and language pathologists made perceptual voice assessment by using grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. Results Significant differences in patients with hypothyroidism were established on parameter amplitude perturbation, jitter and noise-to-harmonics ratio between pretreatment and posttreatment period, in which patients took drug therapy. In group of patients with hyperthyroidism significant difference was noted only on aerodynamic parameter maximum phonation time. There were a significant differences in all perceptual parameters in both groups of patients (p<0.05) in pre and posttreatment, except on grade and asthenia parameter in the group of patients with hypothyroidism and parameter grade was borderline insignificant in the group of patients with hyperthyroidism. Conclusion Voice quality is affected by thyroid disease. Thyroid gland disorders cause minor changes in acoustic voice parameters of patients with hypothyroidism and hyperthyroidism, but perceptual deviations in these patients are especially noticeable.

Received: 22 Jul. 2017 Accepted: 20 Oct. 2017

Introduction: Basic cognitive functions such as: alertness, working memory, long term memory and perception, as well as higher levels of cognitive functions like: speech and language, decision-making and executive functions are affected by aging processes. Relations between the receptive vocabulary and cognitive functioning, and the manifestation of differences between populations of elderly people based on the primary disease is in the focus of this study. Aim: To examine receptive vocabulary and cognition of elderly people with: verified stroke, dementia, verified stroke and dementia, and without the manifested brain disease. Material and Methods: The sample consisted of 120 participants older than 65 years, living in an institution. A total of 26 variables was analyzed and classified into three groups: case history/anamnestic, receptive vocabulary assessment, and cognitive assessments. The interview with social workers, nurses and caregivers, as well as medical files were used to determine the anamnestic data. A Montreal Cognitive Assessment Scale (MoCA) was used for the assessment of cognition. In order to estimate the receptive vocabulary, Peabody Picture Vocabulary Test was used. Results: Mean raw score of receptive vocabulary is 161.58 (+–21:58 points). The best results for cognitive assessment subjects achieved on subscales of orientation, naming, serial subtraction, and delayed recall. Discriminative analysis showed the significant difference in the development of receptive vocabulary and cognitive functioning in relation to the primary disease of elderly people. The biggest difference was between subjects without manifested brain disease (centroid = 1.900) and subjects with dementia (centroid = -1754). Conclusion: There is a significant difference between elderly with stroke; dementia; stroke and dementia, and elderly people without manifested disease of the brain in the domain of receptive vocabulary and cognitive functioning. Variables of serial subtraction, standardized test results of receptive vocabulary, delayed recall, abstraction, orientation and vigilance successfully discriminate studied groups.

Introduction: Aging, as an irrepressible biological process involves a series of physiological and pathological changes. The main aim of this study was to examine the correlation and predictability of receptive vocabulary and cognitive functioning of elderly people with anamnestic variables: chronological age, sex, level of formal education, marital status, years of work and retirement and years spent in an institution for the elderly. Material and Methods: The sample of participants consisted of 120 elderly people, average age was 78 years, placed in institutional care for elderly people in four cities in Bosnia and Herzegovina. It was three groups of variables: anamnestic, receptive vocabulary assessment, and cognitive assessments. A Montreal Cognitive Assessment Scale (MoCA) was used for the assessment of cognitive abilities. In order to estimate the receptive vocabulary Peabody Picture Vocabulary Test (PPVT-III-HR) was used. Results: Results of multiple regression analysis show that part of the variance of receptive language which is explained by the model (anamnestic variables) was 44.0% and of cognitive functioning was 33.7%. The biggest single contribution to explaining the development of receptive vocabulary was given by predictor variable of college education (β = 0.417) then variable university education (β = 0.293), while the smallest single contribution was given by variable secondary education (β = 0.167). The biggest single contribution to explaining the results of tests of cognitive function was given by predictor variable College education (β = 0.328) and variable unskilled (β = -0.229), which has a negative effect on the increase in recent cognitive functioning. Conclusion: Anamnestic variables were valid predictors of receptive vocabulary and cognitive functioning of elderly people. The highest individual contribution was given by variables describing the level of formal education of elderly.

The purpose of this study was to examine the syntactic and morphological skills of children who stutter and compare them with those of their fluent peers. Subjects were 58 children, chronological ages of 10 years and 58 of their fluent peers matched by age and gender. For testing of syntactic and morphological skills, we used questions from the informal test Expressive scale of Bosnian/Croatian/Serbian language, as in Bosnia and Herzegovina there is yet no standardized instrument for testing language skills. The results showed that the subjects were significantly different only in the use of gender of pronouns and their endings, and in the task of using different sentence structures, where the analysis showed that subjects who stutter use more simple sentence structures. On other tasks children who stutter showed slightly weaker syntactic and morphological skills. The results suggest that children who stutter at school age show slight linguistic delay in compare to their peers. We could say that there is a subgroup of children who stutter, whose language skills are within the normal range, but who are slightly behind their peers in certain linguistic domains.

Abstract The main purpose of this study was to examine the phonological skills among children with reading disabilities of the Bosnian/Croatian/Serbian language, where each phoneme is represented by a grapheme following a certain phonemic principle. The sample consists of 15 children with reading disabilities and 15 children without reading disabilities, where "The diagnostic set for examination of the speech, language, reading and writing abilities among children" was used for examination of their phonological capacity. Phonological skills in children are very important for reading and writing acquisition. The results of the study showed that children with reading disabilities achieved poorer results in all tasks examining the phonological skills, compared to children without reading difficulties. The results of our study comply with results of studies conducted for other languages. The study highlights the importance of the mentioned skills for acquiring reading skills in the Bosnian/Croatian/Serbian language and the significance of deficient phonological abilities for the etiology of reading disabilities. Based on the conducted study, it can be concluded that phonological skills are very important for acquiring reading and writing abilities. Key words: reading disabilities, phonological skills, phonemic synthesis and analysis 1. Introduction Phonology deals with the system of sounds that exist within a specific language, whereas phonetics deals with the physical reality of the speech sounds, independently of their meaning and function (1). Phonological skills involve the manipulation of phonological constituents of the spoken words in tasks such as blending, segmenting and rhyming. Different researchers reported that children who learn to read well can rhyme at the age of four and they can blend and segment orally presented words and sounds by the end of first grade (2). A number of longitudinal studies found that children who show poor phonological awareness before they have learned to read are at risk of developing a reading disability (3). Reading accuracy is well predicted by early phonological and language skills (4). The relationship between phonemic awareness and learning to read is a two-way process: phonemic awareness is a precondition for learning to read and learning to read facilitates further progress of phonemic awareness (5). Results of different studies showed that phonemic awareness does not develop itself spontaneously, but it partly depends on the literacy (6). When the child learns to read, he/she must be able to detect phonemes that make up spoken words in order to understand that these separate sound units can be represented by letters or group of letters, that is, graphemes in the written language. If the child has not mastered phoneme segmenting, it will be very difficult for him/her to achieve reading and writing fluency (7). In the past 15 years, it has been considered that deficient phonological processing represents the main cause of reading and writing difficulties (8). Most cases of reading disabilities arise because of difficulties in the process of word recognition. These difficulties occur due to deficiencies in the processes of phonological coding, where letter patterns are transformed into phonological codes (9). Dyslexia involves deficiency within the language system, especially at the level of a phonological module. Children with dyslexia need more time to retrieve appropriate phonemes and sometimes while speaking these children retrieve a phoneme that sounds similar to the one they intended to pronounce. The children with dyslexia lack phonemic awareness and they experience difficulty noticing basic sounds - phonemes that make up all spoken and written words (10). The majority of studies about phonological skills among children with dyslexia have been conducted in English speaking countries. The Bosnian language is characterized with a phonemic alphabet, where each letter conesponds to one sound. …

Background: Individuals who suffer from multiple sclerosis, aside from other symptoms, usually have voice changes such as poor control of pitch, variations in voice intensity, altered voice quality and resonance disorders. Purpose: The purpose of this study was to determine voice acoustic characteristics in individuals with multiple sclerosis and to compare those results with control group. Methods: This study was conducted on 17 subjects, both males and females, of chronological age between 27 and 55 years. All subjects were diagnosed with multiple sclerosis by professional neurologist. Control group consisted of 17 subjects who matched with experimental group of the same age and sex. The study was conducted at the Clinic for Neurology, University Clinical Centre Tuzla. Sustained phonation of vowel /A/ was analyzed by computer programme for voice analysis MDVP (Multi Dimensional Voice Program). Results: Results of our study exhibited statistically significant differences between subjects with multiple sclerosis and control subjects in variables standard deviation of fundamental frequency and phonatory F0 range. We also found statistically significant differences between variable related to pitch perturbation (jitter) and peak-to-peak amplitude variation. Statistically significant differences were also determined between subjects with multiple sclerosis and control subjects in variables related to degree of irregular vocalization, noise to harmonic ratio and variable related to amplitude tremor intensity index. Conclusion: Results of this study showed that subjects with multiple sclerosis exhibited significant variation in voice acoustic characteristics compared to control group. MDVP can be a useful tool for further monitoring of voice characteristics alterations in patients with multiple sclerosis during diagnostic and treatment processes.

Introduction: The purpose of this research was to establish voice acoustic characteristics in stuttering children with mild and severe stuttering and relationship between degree of stuttering and characteristics of voice in children. Methods: Sample consisted of two subsamples of male subjects (subsample of subjects with mild stuttering and subsample of subjects with severe stuttering) aged 7 to 10,5. Control group of subjects consisted of 46 fluent speakers, matched by age and sex with experimenal group. This research was conducted in twenty primary schools in Tuzla Canton among children attending grades 1 to 4. Results: Results of this research showed that subjects with severe stuttering had more expressed short frequency variations and variations of amplitude in the vocal tone. Factor analysis revealed four significant factors: factor of frequency variation, phonation factor, factor of aerodynamic phonation characteristics and intensity variation factor. Results of one-way factor analysis of variance between examined groups in factors of voice acoustic characteristics showed that factor 4 contributed the most to differentiation of groups. This factor was created from variables describing variation of amplitude in the vocal tone. Examination of correlation between four factors revealed statistically significant correlation between factor of frequency variation and intensity variation factor. Results of canonic analysis showed that variables of stuttering intesity correlated significantly with variable intensity variation. Results of this study also showed that acoustic analysis of voice in stuttering children might be useful for indepth analyses of stuttering manifestations. Conclusions: Results of this study might serve as incentive for furthter studies of different aspects of acoustic and physiologic phonation characteristics in stuttering children.

Initial data about organized health work in Tuzla area comes from nineteenth century. Priest Ivan Kljaie, military physicians Muhidin-bey, Mehmed Said-effendi and Ignatius Gulielmus Petelenz are mentioned in it. In Tuzla, Mehmed Sami Serbić in year 1874, found first hospital named Hastahana. As a physician and humanist he leaves indelible trace. Three female physicians: Anna Bayerova, Teodora Krajewska, and Jadviga Olszewska, after the annexing of Bosnia and Herzegovina by Austria-Hungary monarchy, were engaged to work in Tuzla area. Each of them gave important contribution to development of health care in Tuzla area and broader. Physicians Josip Lymberski and Jozef Foglar worked in so called Miners Hospital. Due to cholera and malaria epidemics during the year 1893, two epidemiologists-bacteriologists came in Tuzla. Their names were Rudolf Fisher and Jozef Katz. We believe, that this work contributes to saving the memory of the work of the physicians from the Tuzla area in nineteenth century.