The aim of the study was to examine the level of knowledge and awareness of healthcare professionals regarding feeding, sucking, and swallowing disorders, as well as their understanding of the role of speech and language therapists in the diagnosis and treatment of these disorders. The study was conducted on a sample of 51 healthcare professionals from public and private healthcare institutions in the Una-Sana Canton, using a questionnaire specifically designed for the purposes of this research.According to the results, 56.9% of respondents had received formal education on dysphagia, while only 27.5% had undergone training in the field of pediatric feeding disorders. Clinical experience with dysphagia was reported by 64.7% of respondents, whereas experiencewith pediatric feeding disorders was reported by 25.5%. Although 68.6% of respondents reported being familiar with the distinction between the terms “dysphagia” and “feeding disorders,” only 29.4% demonstrated a professionally grounded understanding of these concepts.Participation in diagnostic procedures related to pediatric feeding disorders was reported by 9.8% of respondents, while 7.8% reported participation in therapeutic interventions. In cases of dysphagia, 35.3% of respondents reported involvement in diagnostic procedures, whereas 17.6% participated in therapeutic treatment. Only 7.8% of respondents identified the speech and language therapist as a key member of the multidisciplinary team.Respondents also assessed the strengthening of knowledge on pediatric feeding disorders and dysphagia as being of high professional importance. The results indicate significant gaps in knowledge, education, and clinical involvement among healthcare professionals, particularly regarding the recognition of the roleof speech and language therapists, while respondents simultaneously express a high level of readiness for further professional development. These findings highlight the need for continuous and systematic education, as well as for strengthening interprofessional collaboration.Keywords: dysphagia; pediatric feeding disorders; healthcare professionals’ knowledge and competencies; speech-language pathology; multidisciplinary team

Vocal fold nodules (VFNs) are the main cause of paediatricdysphonia. Voice therapy is regarded as the preferred treatment approach for VFNs in children. The aim of this study was to evaluate voice characteristics before and after voice therapy using acoustic analysis. Thirty female patients with VFNs were enrolled in this study. Each patient underwent voice therapy conducted by an experienced voice therapist twice a week. Acoustic voice assessments were performed before and after the therapeutic intervention. Acoustic analyses were performed using computerized acoustic voice analysis. Post-therapy findings demonstrated a consistent and statistically significant improvement across multiple acoustic parameters. Significant reductions were observed in jitter and shimmer measures, as well as in noise-related acoustic parameters such as the noise-to-harmonics ratio, suggesting improved stability and efficiency of vocal fold vibration. Fundamental frequency showed a slight decrease following therapy. Overall, these findings indicate a more stable, less perturbed, and acoustically improved voice signal after intervention. The findings of this study suggest the effectiveness of voice therapy in improving acoustic voice parameters in children with VFNs. The observed improvements highlight the importance of early and structured behavioral intervention in pediatric dysphonia and reinforce the role of acoustic analysis as a valuable tool for objective assessment of therapeutic outcomes. Keywords: vocal fold nodules, dysphonia, voice therapy, acoustic analysis.

Abstract Heterobranch sea slugs represent one of the most diverse groups of marine gastropods in the Mediterranean Sea; however, their diversity and distribution along the short coastline of Bosnia and Herzegovina remain insufficiently documented. In this study, we report the first confirmed record of the sacoglossan nudibranch Elysia gordanae T. E. Thompson & Jaklin, 1988 from the marine waters of Bosnia and Herzegovina. A single specimen was observed and collected in the intertidal zone of Neum Bay during field surveys conducted in August 2023. Morphological characteristics correspond well with published descriptions of the species. This finding represents the easternmost confirmed record of E. gordanae in the Adriatic Sea to date and contributes to the growing knowledge of heterobranch diversity in Bosnia and Herzegovina, highlighting the need for continued systematic surveys of its poorly explored marine habitats.

Successful speech communication in multi-talker scenarios requires a skillful combination of sustained attention and rapid attention switching. While the neurophysiology literature offers detailed insights into the neural underpinnings of sustained attention, there remains considerable uncertainty on how attention switching takes place. In this study, using EEG recordings from normal-hearing adults in an immersive multi-talker environment, we measured the neural encoding of two competing speech streams amid background babble. Participants were cued to switch attention between streams every 15–30 s. Neural tracking was assessed via Temporal Response Functions (TRF), confirming reliable decoding of attentional focus. Our results indicate asymmetric disengagement and engagement processes during attention switches, where the neural tracking of the new target stream emerges before disengaging from the previous target, revealing a transient simultaneous encoding of two speech streams. That transition was closely mirrored by a reduction in EEG alpha power, informing on the cognitive effort during different phases of the attention switch. We then isolated cortical activity reflecting lexical prediction mechanisms to determine how lexical context is updated after an attention switch, comparing four context-accumulation strategies that were constructed using Large Language Models. Our findings elucidate both the temporal and contextual mechanisms underlying auditory attention shifts, pointing to the possibility that listeners carry out a reset in lexical context after switching attention. By focusing on dynamic attentional reallocation, this study offers insights into the brain’s capacity for flexible speech processing in complex listening environments.

Background/Objectives: Antipsychotic drug utilization has changed substantially over recent decades, reflecting evolving prescribing practices, drug availability, and treatment guidelines. Methods: This study analyzed national antipsychotic consumption in Serbia from 2006 to 2024 using official data from the Medicines and Medical Devices Agency of Serbia. Utilization was expressed as defined daily doses per 1000 inhabitants per day, and trends were assessed using linear and joinpoint regression analyses. Results: Total antipsychotic utilization increased from 4.35 to 14.42 DDD/1000 inhabitants/day, representing a 231.5% increase. This growth was predominantly driven by atypical antipsychotics, whose utilization increased from 1.16 to 10.91 DDD/1000 inhabitants/day (+840.2%). In contrast, typical antipsychotic utilization remained relatively stable in absolute terms. The share of atypical antipsychotics increased from 26.7% in 2006 to 75.6% in 2024, while the atypical: typical utilization ratio increased from 0.36 to 3.10. Atypical antipsychotics surpassed typical agents in 2013. Marked increases were observed for olanzapine, quetiapine, aripiprazole, paliperidone, risperidone, and clozapine, while chlorpromazine and fluphenazine declined. Conclusions: These findings demonstrate a substantial increase in overall antipsychotic utilization in Serbia and a pronounced structural shift toward atypical agents, highlighting the need for continued monitoring of prescribing trends, safety outcomes, and population-level treatment patterns.

Background: The Health in All Policies (HiAP) approach promotes the systematic integration of health considerations into policymaking across non-health sectors to address social determinants of health and improve population health outcomes. Although increasingly recognized internationally, the extent of its legislative implementation in the Republic of Srpska remains unclear. Objective: To assess the extent to which HiAP principles are embedded in sectoral legislation in the Republic of Srpska and to identify strengths and gaps in current legal frameworks. Methods: A structured content analysis of the text of laws was conducted across ten priority sectors. Twenty-two laws were reviewed using an analytical framework based on five core HiAP components: health outcomes, intersectoral governance, health equity, evidence-informed policymaking, and monitoring and accountability. The presence and distribution of these components were systematically examined across sectors. Results: Health considerations were frequently reflected in the text of the analysed legislation. Explicit references to health outcomes and intersectoral governance were identified in more than 60% of laws. However, integration was uneven across sectors. Health equity principles were inconsistently incorporated, while monitoring, evaluation, and accountability mechanisms were insufficiently developed, with explicit provisions found in fewer than half of the laws. No analysed law formally mandated Health Impact Assessment as a policy instrument. Conclusions: The Republic of Srpska has an existing legislative basis for advancing HiAP, but implementation remains fragmented rather than systematic. Addressing identified gaps—particularly in health equity, Health Impact Assessment, and health-oriented monitoring mechanisms—through targeted legislative reforms could improve policy coherence, accountability, and long-term sustainability. To our knowledge, this is the first systematic content analysis of HiAP integration in the sectoral legislation of the Republic of Srpska; it applies a replicable analytical framework derived from the WHO HiAP Framework for Country Action that is transferable to other decentralised and transitional governance settings.

Background/Objectives: Bilateral thoracoscopic sympathectomy (BTS) is the definitive treatment for primary focal hyperhidrosis, yet postoperative pain remains an undertreated consequence with no established analgesic consensus. This study compared three analgesic regimens on pain trajectory, opioid consumption, and functional recovery following BTS. Methods: In this prospective observational cohort study, 300 patients undergoing BTS were allocated in a non-randomized manner reflecting institutional practice to three parallel cohorts (n = 100 each): Group 1 received systemic opioids alone; Group 2 received opioids plus pre-emptive local anesthetic wound infiltration; and Group 3 received opioids plus thoracoscopic-guided intercostal nerve block (ICNB). Primary outcomes included pain intensity on the Numerical Rating Scale and total opioid consumption. Results: ICNB patients reported significantly lower mean peak pain scores (3.8 ± 1.7) versus local infiltration (4.6 ± 1.9) and opioid-only groups (5.2 ± 2.1; p < 0.001). Total opioid consumption was reduced by 38% in the ICNB group (12.4 ± 4.8 mg vs. 20.1 ± 6.3 mg; p < 0.001). Moderate-to-severe pain occurred in 42.0% of ICNB patients versus 74.0% of controls (p < 0.001). ICNB was independently associated with reduced moderate-to-severe pain (adjusted odds ratio (AOR) 0.31; 95% confidence interval (CI) 0.17–0.56; p < 0.001). ICNB patients returned to normal activities faster (median 3 vs. 5 days; p = 0.008) with higher satisfaction (91.0% vs. 78.0%; p = 0.044). Conclusions: In this observational cohort, ICNB was associated with significantly lower postoperative pain scores, reduced opioid consumption, and faster functional recovery following BTS. These findings suggest that ICNB may be an effective adjunct analgesic strategy for ambulatory BTS, pending confirmation in randomized controlled trials.

Background: Thyroid cancer (TC) is the most common endocrine malignancy and is generally associated with a favorable prognosis. Its incidence has increased worldwide, whereas epidemiological data from Bosnia and Herzegovina, particularly Tuzla Canton, remain limited. Aim: The aim of this study is to determine the incidence, five-year period prevalence, histological distribution, and basic demographic characteristics of TC in Tuzla Canton between 2020 and 2024. Study design: This is a retrospective descriptive observational study. Methods: Records of 483 patients evaluated by the Council for Benign and Malignant Thyroid Diseases at the University Clinical Center Tuzla between January 1, 2020, and December 31, 2024, were retrospectively reviewed. Patients were included if they had histopathologically confirmed TC, were aged ≥15 years, and resided in Tuzla Canton. Incidence and five-year period prevalence were calculated using the latest available population estimates. Results: Of the 483 evaluated patients, 142 met the inclusion criteria. The cohort included 108 women (76%) and 34 men (24%), corresponding to a female-to-male ratio of 3.18:1. The median age at diagnosis was 56 years. Papillary TC was the most common type (n=105; 74%), followed by follicular (n=18; 13%), medullary (n=15; 10%), and anaplastic (n=4; 3%). The age-standardized average annual incidence was 6.99 per 100,000 population, while the five-year period prevalence was 32.98 per 100,000. Incidence was higher among women than among men and increased during the study period. The highest age-specific incidence was observed among women aged ≥75 years and men aged 65-74 years. Three deaths occurred during follow-up, of which two were directly attributable to TC; both TC-related deaths occurred in patients with anaplastic carcinoma. Conclusion: TC incidence in Tuzla Canton was lower than reported global and European estimates but increased during the five-year study period. Papillary carcinoma predominated, particularly among women. Longer-term population-based studies and the establishment of a national thyroid cancer registry are needed to improve epidemiological surveillance in Bosnia and Herzegovina.