Introduction: The impact of nutrition on human health has become a central topic in modern research. The Mediterranean diet, rich in fruits, vegetables, fish, whole grains, and olive oil, has been associated with a lower risk of cardiovascular diseases. However, the effects of non-Mediterranean diets, particularly among students, remain insufficiently explored. This study aimed to examine differences in the dietary habits of health sciences students in two cities in Bosnia and Herzegovina (Mostar and Sarajevo) and Split, Croatia. Methods: A cross-sectional descriptive study was conducted between February and November 2024, including 473 students (Mostar: 125, Sarajevo: 230, Split: 118). Dietary habits were assessed using a validated food frequency questionnaire and the Mediterranean Diet Adherence Screener. Statistical analysis included Pearson’s chi-square test, with significance set at p < 0.05. Results: Students from Split showed significantly higher adherence to Mediterranean dietary habits, including greater consumption of vegetables (p = 0.009), fish (p = 0.035), legumes (p = 0.036), and tomato sauce (p = 0.022). Students in Sarajevo reported the highest intake of sugary drinks (p < 0.01), while those in Split consumed the least margarine and cream-based fats (p = 0.003). No significant differences were found in fruit consumption. Conclusion: Given the importance of diet in preventing chronic diseases, targeted nutrition education programs are needed to promote healthier eating habits among students. Future research should explore the underlying causes of these dietary differences and their long-term health implications.
Background: Midwives are globally recognized as health professionals who specialize in the care of women in labor with a vital role in maternal and newborn health care. Midwives specialize in the care of women in labor and play a key role globally in managing normal vaginal birth, caring for pregnant women including supporting women and their families, providing consultations, managing normal birth for low-risk pregnant women and helping them maintain a healthy pregnancy. Despite the fact that the midwifery profession is an autonomous profession, in some countries there are many struggles to achieve recognition within its formal scope of work. The role of the midwife/midwife remains unclear in many countries due to poorly articulated policies and a lack of regulatory frameworks, which results in a lack of public clarity regarding the role of the midwife. Objective: The purpose of this expert report is to present the role of the midwife in protecting the health of mothers before, during and after childbirth, to clearly define their role and importance, and the need to improve midwifery as a profession in order to reduce the number of caesarean sections. Methods: This systematic review includes a comprehensive literature search of published scientific articles, in English, from 2020 to 2024, using electronic databases considered most relevant to the topics; CINAHL, EMBASE and PubMed. In this systematic review and meta-analysis, we included studies on the role of midwives in different countries, including Thailand, the United States, Australia, Canada, the UK, the Netherlands, Bosnia and Herzegovina, Slovenia, Croatia and Serbia, to arrive at results on what the role of midwives is in these countries. Citations without abstracts and/or full text, anonymous reports, editorials, case reports, case series and qualitative studies were excluded. Results: In the Law on Health Care of the FBiH, and the Law on Nursing and Midwifery of the FBiH, the role of the midwife is insufficiently defined and she is not given sufficient authority to work. For childbirth in BiH, in addition to midwives, a doctor must always be present. In European and foreign countries, the role of the midwife is put in the foreground during childbirth, so there are also hospitals where women give birth and are cared for by midwives. Midwife-led care, an approach that is already widely practiced in developed countries; however, it is a relatively new approach in lower-income countries. In midwife-led care, a midwife who is well known to the mother provides care for the low-risk pregnant woman during antenatal care, delivery and the postnatal period, rather than being cared for by different medical staff led by an obstetrician. The primary focus of care led by midwives is to support a healthy physiological pregnancy and birth and to empower women to give birth naturally with little or no regular intervention. Conclusion: It is very worrying for midwifery as a profession that there is currently a lack of visibility of midwives in practice within their scope of practice in Bosnia and Herzegovina. More research is needed on demonstrating the value of midwives as a primary role in the context of midwifery practice in Bosnia and Herzegovina.
Introduction: Work-related musculoskeletal disorders (WRMSDs) are the most common work-related disorders and describe a wide range of degenerative and inflammatory states that affect blood vessels, peripheral nerves, bones, joints, ligaments, tendons, and muscles. Healthcare as a special sector has almost the highest prevalence of WRMSDs in the world, far ahead of construction, mining, and manufacturing. Studies conducted in the EU and the USA indicate that health-care professionals most often have a problem with the lower back between 50% and 57% of cases, resulting in an average loss of more than 7 working days during 1 year. Methods: This study included 177 health professionals of both genders who are actively involved in the provision of health-care services. The study was conducted in the Public Health Center of Sarajevo Canton, which provides primary and specialist consultative healthcare services. The study was designed as a prospective, longitudinal, interventional, and descriptive-analytical that included all respondents who met the inclusion criteria. The instruments used in the study are the standardized Dutch Musculoskeletal Discomfort Questionnaire, modified according to our study, the standardized work ability index, and the ergonomic intervention program (EIP). Results: The highest frequency of work-related MKDs in health-care professionals before and after implementation of the EIP was in the neck area (83.1% before, 64.9% after), in the upper back region (71.8% before, 56.5 % after) and in the lower back region (68.4% before, 55.9% after). The average score of the working ability index before the introduction of the EIP was 35.44 ± 8.59, while after the implementation of the EIP it increased statistically significantly and amounted to 38.40 ± 7.30. Conclusion: The EIP influenced the reduction of the MKDs frequency caused by work, and increased the working capacity of health-care professionals.
Communication is the foundation of every interpersonal relationship. Good communication leads to better relationships and trust, fosters improved interactions with colleagues, and has a positive impact on the workplace atmosphere. The aim of this study is to determine how the communication skills of management staff influence work processes. The primary task of this study is to examine the communication styles of responsible individuals in the healthcare process and their relationships with subordinates or executors in the healthcare process. The study is descriptive and comparative. An author-designed questionnaire, created based on a review of professional and scientific literature and experiences from everyday clinical practice, was used as the research instrument.The results showed that out of the total number of respondents, 33.3% reported being completely satisfied with interpersonal communication, 57.0% partially satisfied, and only 24 or 9.6% were not satisfied. It can be concluded that the good communication skills of managers positively impact staff productivity.
Kultura sigurnosti je set vrijednosti, znanja, vještina, stavova i prakse na individualnom i institucionalnom nivou organizacije radioterapijskog procesa koji uspostavlja način rada u kojem sigurnost i zaštita zdravlja predstavljaju prioritet prilikom obavljanja radnih zadataka. Razvoj kulture sigurnosti na individualnom i institucionalnom nivou postalo je jedno od ključnih sigurnosnih pitanja u savremenoj radioterapiji. Cilj ovog istraživanja je procijeniti mogućnost upotrebe elektronskog sistema za prijavljivanje incidenata u razvoju kulture sigurnosti kod zdravstvenih profesionalaca u radioterapiji i mogućnost izgradnje sistemske primjene seta vrijednosti koji omogućava obavljanje svih radnih zadataka u radioterapiji uz davanje maksimalnog priorieta sigurnosti. Kao instrument istraživanja korišten je elektronski sistem za prijavljivanje incidentata u formi strukturiranog kompjuterskog intervjua prema ROSEIS metodologiji. Na osnovu informacija prikupljenih pomoću sistema napravljena je procjena razvijenosti različitih segmenata kulture sigurnosti, predložene mjere na njenom razvoju i poboljšanju, te data pocjena njihove efikasnosti u unaprijeđenju sigurnosti u radioteapiji. Razvijena kultura sigurnosti u radioterapijskom radnom okruženju može značajno unaprijediti kvalitet radioterapijskog tretmana, reducirati pojavu incidenata, poboljšati efikasnost i efektivnost radioterapijskog tretmana. Razvoj kulture sigurnosti ne podrazumijeva samo uspostavu standardnog seta pravila, nego i promjenu stavova, ponašanja i profesionalne prakse na individualnom i institucionalnom nivou.
Introduction: Insulin resistance (IR) is a complex pathophysiological condition multifactorial etiology characterized by diminished responsiveness of insulin target tissues. Today, various diagnostic approaches involving different laboratory parameters are available, but simple and non-invasive indices based on mathematical models are increasingly used in practice. This study aims to assess the effectiveness of various clinical surrogate indices in predicting IR across a population with varying body weights. Methods: The matched case-control study was conducted between January 2021 and December 2022. Secondary data extracted from the medical records of 129 subjects was analyzed, including demographic characteristics (age and gender), anthropometric measures (height and weight), and biochemical laboratory test results. y further divided into two subgroups based on body mass index (BMI): overweight (BMI between 25 and 29.9 kg/m2) and obese (BMI of 30 kg/m2 or higher). Using laboratory data values for six widely used clinical surrogate markers were calculated: Homeostatic model assessment for IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), Mcauley index (MCAi), metabolic score for IR (METS-IR), Triglyceride to Glucose Index (TyG), and TyG to BMI (TyG-BMI). Results: Significant differences in HOMA-IR levels were observed between the groups (p < 0.001). A similar pattern was found for the TyG-BMI, with notable differences (p < 0.001). The obese participants had the highest mean levels for METS-IR and the TyG index while the control group had the highest mean values for the QUICKI and MCAi indices (p < 0.001). According to the analysis, three indices showed statistical significance in predicting IR independent of BMI (p < 0.05). Sensitivity and specificity were higher in the obese group (0.704 and 0.891) than in the overweight group (0.631 and 0.721). Conclusion: Given that IR is a multifactorial disease, using derived indices based on a combination of biochemical parameters and anthropometric indicators can significantly aid in predicting and mitigating numerous complications.
Introduction: Aging is a natural physiological process based on disturbances of homeostatic mechanisms and loss of adaptability that significantly affects life activities over time. The activities of daily living (ADL) in old age represent the relationship between the subjective characteristics of each individual, supplemented by previous life experiences, and objective socioeconomic factors that create a desirable living framework for people in the third age. The objectives of this research are to analyze the sociodemographic characteristics of third-age people, to study the daily activities of third-age people, and to compare the daily life activities of third-age people living in a rural setting with those of third-age people living in an urban setting. Methods: The research was conducted in the area of urban and rural environment of Travnik municipality. One hundred elderly people (50 from urban and 50 from rural areas) were included in the research using the snowball method. The instrument used in our research is a standardized questionnaire on instrumental ADL (IADL) according to Lawton-Brody. The study was conducted during the period from the end of March to the end of May 2022. Results: There is a statistically significant difference in ADL in all eight domains. The mean IADL score in the total sample (n = 100) was 6.36 ± 1.78 and ranged from 1 to 8. The largest number of respondents had the highest IADL score of 8 in 41% of cases, while only one respondent had an IADL score of 1. Conclusion: The obtained results prove that the score of ADL is lower in people of third-age living in rural areas.
Introduction: Physical activity has a positive effect on the regulation of diabetes mellitus and has been shown to have benefits in improving health. Aim: Examine the effects of physical activity on changes in glycemic parameters (glucose, HbA1C) and inflammatory parameters (leukocyte count (WBC), CRP) before and one month after the exercise program. Material and Methods: The study was designed as a prospective, analytical, and observational study. Results: T-test of paired samples assessed the impact of physical activity on glycemic and inflammatory parameters in subjects with confirmed Diabetes mellitus type 2 and in subjects without confirmed diabetes mellitus type 2. In subjects with confirmed diabetes the value of eta squared (ɳ2 - eta sqared) is 95%, which indicates a significant impact of physical activity on the change in glucose values and on the change of HbA1C value was indicated by the value of eta square of 93%. When it comes to inflammatory parameters, the impact of physical activity was found in the reduced number of WBC (ɳ2 = 88%), and in CRP (ɳ2 = 90%). In subjects without confirmed diabetes mellitus, a significant effect of physical activity on the change in glucose (ɳ2 = 94%) and HbA1C (ɳ2 = 77%). The influence of physical activity on the reduction of leukocyte count was proven by ɳ2 - eta sqared test (ɳ2 = 66%), as well as a decrease in CRP (ɳ2 = 30%). Conclusion: This study showed a significant impact of physical activity on the reduction of elevated glycemic and inflammatory parameters.
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