Introduction: The basic postulate of the lean concept is that greater efficiency of the work process can be achieved through a process of continuous improvement,which aims to eliminate waste and maximize activities that add value.The Netherlands, Great Britain, Italy and the United States were examples of healthcare systems that implemented the lean concept.Aim: To examine the opinion of health workers of a public hospital in the Sarajevo area about the possibilities of improving business processes by implementing thelean concept.Method: The cross-sectional study was conducted using a questionnaire. The questionnaire was sent to the e-mail addresses of health workers of public health organizations. 91 respondents of both sexes (doctors ofmedicine, residents, registered nurses, nurses and administrative staff) were included.Results: A positive correlation was establishedin the attitude toward the effectiveness and efficiency of business processes. According to the participant’s opinion, the greater effectiveness of business processes contributes to greater efficiency (r=0.846; p<0,05). Spearman’s coefficient rs=0.81 shows a strong connection between the effectiveness and efficiency of business processes.Conclusion: The study showed that there is a positive attitude towards the impact of the lean concept on improving the efficiency of business processes. The reducexpected positive effects of the implementation of the lean concept are manifested through faster provision of services to patients, reduction of service waiting times and general improvement of business processes.

Introduction: The health system is one of the most complex systems in any country. According to the definition of the World Health Organization, the health caresystem includes health infrastructure that provides a spectrum of programs and services and provides health care to individuals, families and the community. A basichuman right is the right to health care, which includes health activities such as preventive, curative and palliative treatment. The organization of palliative medicineis necessary at all levels of health care.Aims: Situational analysis of the organization of palliative care in the Clinical Center of the University of Sarajevo. Examining the knowledge and approach of healthcareworkers in the process of providing palliative care at the Clinical Center of the University of Sarajevo. To examine the attitude of healthcare workers towards theAwareness and attitudes of nurses of the Clinical center of the University ofSarajevo (ccus) towards the organization of palliative care way palliative care is organized in the Clinical Center of the University of Sarajevo.Material and methods: 141 subjects employed at the Clinical Center of the University of Sarajevo (CCUS) participated in the research. The research is descriptiveand analytical. The results are presented in tables and graphs, chi-square and Fisher’s exact test were used for testing the significance of differences.Results: It was found that there are different knowledge, attitudes and approaches of the respondents regarding the way palliative care is organized, the provision ofservices and treatment in the hospital. The majority of respondents (64%) believe that palliative care should be organized in institutions for palliative care that meetthe conditions of the prescribed standards and criteria for palliative care.Conclusion: Significant differences were found in the knowledge, practice and attitudes of health workers about palliative care.

Introduction: Conflicts are a social phenomenon and occur in all organizations where people work. So, they are inevitable even among nurses, because the work they do is very responsible and stressful. Conflicts of a personal nature are not uncommon, and they are produced by intimacy in the workplace.Methodology: The study was conducted among 146 nurses employed at the Clinical Center of the University of Sarajevo. The study is descriptive, analytical andcomparative. The original author’s questionnaire created on the basis of professional and scientific literature was used as a study instrument. The goal of thestudyisto determine if the conflict situations in nursing clinical practice are related to the dissatisfaction of nurses with working conditions, lack of motivational techniques, poor communication in the team and superior-subordinate relations.Results: Most respondents state that conflict situations are short-lived and do not affect work. Respondents pointed out that the most commoncauses of conflict are poorcommunicationand personal contempt of colleagues (71 or 48.6%), violations of labor regulations and non-performance of work obligations (68 or 46.6%), differences in education (39 or 26.7%), etc. The most common manner that nurses use to resolve conflicts is to exchange information in order to reach a joint decision, to negotiate and seek compromises.Conclusions: Conflicts are manifested in the form of negative emotions, so in this regard, they can have significant negative consequences, and contribute less toimprovement or have a positive effect on the work environment. Communication conflicts between nurses are detrimental to teamwork - negative confrontation between two sides, often revealing anger, not talking for a longer period, or personally standing out at the expense of the other side.

In this paper, we observed the ordinary differential equation (ODE) system and determined the equilibrium points. To characterize them, we used the existing theory developed to visualize the behavior of the system. We describe the bifurcation that appears, which is characteristic of higher-dimensional systems, that is when a fixed point loses its stability without colliding with other points. Although it is difficult to determine the whole series of bifurcations that lead to chaos, we can say that it is a common opinion that it is precisely the Hopf bifurcation that leads to chaos when it comes to situations that occur in applications. Here, subcritical and supercritical bifurcation occurs, and we can say that subcritical bifurcation represents a much more dramatic situation and is potentially more dangerous than supercritical bifurcation, technically speaking. Namely, bifurcations or trajectories jump to a distant attractor, which can be a fixed point, limit cycle, infinity, or in spaces with three or more dimensions, a foreign attractor.

Aim: This paper presents a qualitative study of the experiences of parents raising children with autism, as reflected in the media. The study aimed to explore the lived experiences of parents of children with autism and the challenges they face in Bosnia and Herzegovina. Methods: A content analysis of 20 media articles featuring parents of autistic children was conducted. The articles were selected from a range of sources, including newspapers, magazines, and online news portals. Results: We identified four major themes: supports, education, spousal relationships, and future. It should be noted that these themes are often intertwined. Conclusion: The findings highlight the importance of providing support and resources to parents of children with autism, as well as the need for greater awareness and understanding of the challenges they face. The implications of these findings for policy and practice are discussed, and suggestions for future research are presented.

The present age is moving through Industry 4.0 with massive technological developments. Supply chains have become digital, keeping sync with consumer demands and preferences. The recent pandemic has reinforced the need of embracing digital technologies in managing supply chains effectively. Therefore, it is necessary that supply chains adopt 5G mobile technologies. In this regard, the present study aims to discern the critical issues for the successful adaptation of 5G technologies for supply chain management (SCM) in developing countries such as India. The success factors for the adaptation of 5G in Indian supply chains are derived from the discussions made in the related past work regarding the challenges of implementing 5G technology. Then, the listed factors are finalised through initial rounds of face-to-face discussions with a focus group of five experts. Then, a q-rung-orthopair-fuzzy (qROFS)-based rating scale is used to rate the success factors. A new qROF-weighted-neutrality-average (q-ROFWNA)-based full-consistency method (FUCOM) approach for multicriteria decision-making (MCDM) problems involving group decision making is utilised to find out the critical success factors. Based on the comparative analysis of 17 success factors (grouped into four main factors), the spectrum availability, awareness of technology and usage, the development of supporting technologies and smart cities, and skill development are found to be the top five critical factors for the successful adaptation and implementation of 5G technologies in SCM. We further carry out a sensitivity analysis and validation test and observe that our model provides a reliable and stable solution.

This paper describes the first record of the critically endangered gravid female Spiny butterfly ray, Gymnura altavela (Linnaeus, 1758), in the northern Mediterranean and simultaneously the only record of the species in this century for the Adriatic Sea. The female (173 cm disc width and 43.25 kg total weight) was captured at approximately 200 m, off Vlorë in the southern Adriatic Sea off Albania on 12th of May 2022. Upon necropsy, seven near-term fetuses (mean 328 ± 6.47 mm disc width and mean 355 ± 20.06 g in total weight) were transported for further in-vitro incubation. These results represent the deepest capture for the species, as well as the largest litter size and largest size at birth in the Mediterranean Sea which indicates the need for further research.

Introduction: Preoperative carbohydrate oral (CHO) drinks attenuate the surgical stress response; however, the effects of CHO supplementation on the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory and immunology-based predictor remain unclear. This study evaluated the effects of preoperative CHO loading on NLR values and complications following open colorectal surgery compared with a conventional fasting protocol. Methods: Sixty eligible participants having planned for routine and open colorectal cancer surgery from May 2020 to January 2022 were prospectively and randomly allocated to either the control (fasting) group, whose members discontinued oral intake beginning the midnight before surgery, or the intervention (CHO) group, whose members consumed a CHO solution the night before surgery and 2 h prior to anaesthesia. NLR was assessed at 06:00 h before surgery (baseline) and at 06:00 h on postoperative days 1, 3, and 5. The incidence and severity of postoperative complications were assessed by Clavien-Dindo Classification up to postoperative day 30. All data were analysed using descriptive statistics. Results: Postoperative NLR and delta NLR values were significantly higher in controls (p < 0.001; p < 0.001). Control group participants also demonstrated grade IV (n = 5; 16.7%, p < 0.01) and grade V (n = 1; 3.3%, p < 0.313) postoperative complications. There were no major postoperative complications in the CHO group. Conclusion: Preoperative CHO consumption reduced postoperative NLR values and the incidence and severity of postoperative complications following open colorectal surgery, compared with a preoperative fasting protocol. Preoperative carbohydrate loading may improve recovery following colorectal cancer surgery.