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Almedina Hajrović, Arzija Pašalić, Aldina Alibegović, Adela Vranesic, A. Hadžiomerović, Amila Jaganjac

Introduction: Laboratory and anthropometric parameters for assessing lipid metabolism disorders are important for atherogenesis and the occurrence of cardiovascular disease. Material and Methods: The study was designed as a prospective longitudinal study, meant to assess the risk of cardiovascular disease, which included initial measurement of lipid status, CRP, and BMI, and repeated measurement after DASH diet and exercise. It was conducted on a sample of 60 female respondents. Results: Following the WHO categorization of BMI, the study found that 62% of respondents were overweight, 26% were obese, and only 12% of respondents were at ideal body weight. After the DASH diet and exercise program, the average value of BMI M = 27.02 was established. Analyzing the values of the CASTELLI 1 index in 95.9% of respondents, high values of M = 5.3 were observed, which indicates a high risk of CVD. The study results indicate that the average value of cholesterol, triglycerides, LDL-C significantly reduced after two months of adherence to the DASH diet and exercise. With the help of Spearman’s rank, the correlation coefficient indicated the existence of a positive relationship between the CASTELLI 1 index and total cholesterol, triglycerides and HDL-C. In the initial analysis, CRP had a high value (M = 10 mg/L). In contrast, after the program, the CRP value decreased to (M = 4 mg/L), and a significant negative correlation (p <0.01) was observed between CRP and HDL-C, indicating that HDL-C value as a protective lipoprotein for blood vessels increased. CRP decreased after two months of DASH diet and exercise. Conclusion: With this research, we aim to draw attention to the importance of promoting healthy lifestyles and creating adequate risk assessment models with a well-developed strategy that will include anthropometric, laboratory and other multidisciplinary aspects to combat cardiovascular

Amina Lučkin, Arzija Pašalić, Almedina Alihodžić, Elmedina Mrkulić, Alma Mizdrak, Sadžida Delić, Zineta Mulaosmanović, Nino Alić

Introduction/Objective Patient safety is defined as the prevention of errors and adverse effects aimed at patients and associated with health care. Patient safety culture (PSC) is "the product of individual and group values, attitudes, perceptions, competencies and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organization's health and safety management." Improving the perception of the PSC within the healthcare sector plays a key role in improving its overall quality, efficacy and productivity. This article aims to point out the importance of the inexhaustible and very interesting topic of safety culture as a basis for further research and strategy creation. Methods This is a qualitative research paper, based on a scientific review of the literature. Relevant articles for this review have been identified by searching digital databases: PubMed, Medline and Google Scholar. The research was retrospective and covered a timeframe of five years. Articles were selected by introducing keywords relevant to the subject. Results The results are based on the analysis and review of 12 published scientific articles from 2017 to 2021. Conclusion Patient safety must be the priority of the healthcare provider. Theoretical foundations should be combined with educational experiences following the development of knowledge, skills and attitudes for effective patient safety. Adverse event reporting should include learning from mistakes, supporting an environment that encourages reporting without blame or fear of punishment. The healthcare system needs to be made as safe as possible for both the patients and all those providing healthcare. Improving and developing the quality of healthcare requires knowledge, selection and application of specific methods and tools tailored to the capabilities of individual healthcare institutions.

Background: Identifying risk factors for the occurrence of cardiovascular diseases (CVD) is the first step in developing a prevention strategy. Objective: The aim of the study is to investigate the presence of risk factors and assess the overall risk of developing cardiovascular disease. Methods:.This cross sectional and experimental study involved 203 respondents of both sexes from the working population group aged 40 to 65 years. Results: Hypertension was diagnosed in 154 (75,9%) respondents, hyperglycemia in 177 (87,19%) respondents, dyslipidemia in 182 (89,66%) respondents and Diabetes mellitus type 2 was diagnosed in 53 (26,1%) respondents. Excess body mass was observed in 84 (41,4%) respondents, while obesity was noted in 91 (44,8%) respondents, and smoking habit in 117 (57,6%) respondents. Analyzing the above data using Q3 risk assessment for cardiovascular disease occurrence, it was found that the overall Q3 risk was significantly higher in male respondents, 21,8 (12.4-30.6), while female respondents had a median value of 14,7 (14-22,5), with an apparent statistically significant difference of p=0,001. Conclusion: To establish a strategic prevention program to eliminate the existing risk factors can only be achieved through multidisciplinary planning and the involvement of a multidisciplinary team of experts that will help improve the lifestyle of the individual and the entire community. From this work, we can see that the Q3 risk tool is well suited for risk assessment because it incorporates multidisciplinary parameters, whereas lipid indices can only be useful in cardiovascular disease risk assessment by comparing all indices.

M. Topčagić, Fuad Julardžija, Arzija Pašalić, A. Šehić, Hasan Osmić, Enis Tinjak, Adnan Huskić

Uvod: Radioterapija je kompleksna disciplina koja uključuje širok spektarstanja izazvanih malignim oboljenjima, organizacionu kompleksnost i upotrebu naprednih tehnoloških rješenja u terapiji, te ima veliki potencijal za razvoj incidenata.Incidenti, u zavisnosti od stepena ozbiljnosti, mogu kompromitirati efekat radioterapije, dovesti do izostanka kontrole bolesti i njenog recidiva ili pojave ranih i kasnih komplikacija na zdravim organima u smislu radiotoksičnosti. Ozbiljni incidenti u radioterapiji su rijetki, ali kada se dese, njihove posljedice mogu biti značajno oštećenje zdravlja ili smrt. Incidenti nisu posljedica slučajnog toka događaja, niti koincidencije koja će se teško ponoviti. Pojava incidenata ima svoje zakonitosi i posljedica je sistemskih postavki, uslova i procesa. Cilj ovog istraživanja je procijeniti mogućnost upotrebe elektronskog sistema za prijavljivanje incidenata u upravljanju rizikom u radioterapiji. Metode: Za potrebe istraživanja razvijen je elektronski sistem za prijavljivanje incidentata u formi strukturiranog kompjuterskog intervjua prema ROSEIS metodologiji. Na osnovu informacija prikupljenih pomoću sistema napravljena je taksonomija incidenata prema: vrsti, mjestu i načinu nastanka, načinu detekcije, uzroku nastanka i faktorima doprinosa, dozimetrijskom i kliničkom značaju, te ozbiljnosti posljedica. Procjena rizika je napravljena upotrebom Risk Matrix metode. Rezultati: U rezultatima su prikazani najčešći uzroci nastanka i faktori promocije incidenata u radioterapiji, kao i njihova povezanost sa faktorima radnog okruženja, organizacije i upravljanja, finanasijskim i ljudskim resursima, radnim opterećenjem, radioterapijskim uređajima, softverom i tehnološkom kompleksnošću tretmana.Predložene su korektivne i preventivne mjere, te data procjena njihove efektivnosti na poboljšanje detekcije, redukciju vjerovatnoće pojave incidenata i redukciju njihove magnitude. Zaključci: Rezultati istraživanja pokazuju da su informacije prikupljene pomoću elektronskog sistema za prijavljivanje incidenata dobar prerekvizit za razvoj sistema upravljanja rizikom koji omogućava identifikaciju i klasifikaciju najznačajnijih faktora rizika u radioterapiji, kao i utvrđivanje specifičnih preventivnih i korektivnih akcija s ciljem prevencije pojave incidenata i redukciju ozbiljnosti njihovih neželjenih efekata.

Daniel Maestro, S. Šegalo, Dinko Remić, Arzija Pašalić, A. Jogunčić

Introduction: Worldwide, COVID-19 pandemic caused millions of infected people and thousands of deaths. Due to enormous pressure on health-care systems and its inadequate preparedness, utter collapse is expected. In the current epidemic response, healthcare workers’ (HCWs) knowledge and practice are crucial, while the impact on their mental health is still unknown.Methods: The cross-sectional study was conducted among HCWs redeployed to COVID points in the Public Institution Health Centre of Sarajevo Canton. According to guidelines and information provided by the World Health Organization and Ministries of Health, a questionnaire was developed. In addition, General Anxiety Disorder-7 as a screening tool for anxiety disorders was used.Results: Of 180 respondents, 26 (14.4%) were in direct contact with the sick patient. In total, 79 (43.9%) respondents consider their personal protective equipment is in accordance with the guidelines of the world health authorities. A total of 72 (39.7%) of respondents used the same mask for several days. In general, the danger from new coronavirus was considered minimal by 59 (32,6%) HCWs. Based on the achieved score for assessing the anxiety disorder, in 63 (35%) subjects, the presence of severe symptoms was detected.Conclusion: This study found that most HCWs do not have enough knowledge about the COVID-19 pandemic. We identified that there are differences in the sources of information and gap in perceptions of the native origin of the virus. Considering the frequency of anxiety symptoms among HCWs, interventions are necessary in order to preserve their mental health.

Š. Delibašić, Nedžla Đokić-Kahvedžić, Mirela Karić, Indina Keskin, Aldina Velispahić, J. Huremović, K. Herceg, A. Selimović et al.

Abstract The aim of this study was to assess contamination and potential human health risks of heavy metals in street dust from the Federation of Bosnia and Herzegovina (FB&H). In total, 117 street dust samples were analyzed for Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn by flame atomic absorption spectrometry (FAAS). Health risk assessment was applied to determine potential health risks, non-carcinogenic and carcinogenic risks, in children and adults. According to mass concentrations of studied trace metals, the dust samples were arranged as the following diminishing series: industrial zone > high traffic streets > streets with moderate traffic > parking place > parks, school yards, sports facilities, medical facilities. Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn mean concentrations are 3.18, 33.17, 30.01, 3150, 236, 73.00, 52.49 and 81.72 mg/kg, respectively. In order to identify possible metals sources correlation analysis was applied. Strong correlations between Cd-Mn, Fe-Mn, Ni-Cr, and Cr-Fe were obtained, suggesting a common dependence or source of these metals in street dust in FB&H. Contributor that most impact the carcinogenic and non-carcinogenic risk is the ingestion route for both, children and adults, followed by the dermal and inhalation pathways. The risk assessment shows that the population of FB&H is at increased lifetime risk of experiencing cancer because of exposure to Cr and Pb concentrations in street dust of FB&H.

S. Šegalo, E. Kiseljaković, Lejla Berhamović, Arzija Pašalić, S. M. Vranic, E. Berhamović, Daniel Maestro, A. Jogunčić et al.

Background: Immunization is a key step in preventing the occupational risk of acquiring hepatitis B infection for healthcare workers (HCWs). Objective: The aim of the study was determination the hepatitis B vaccine (HepB) coverage rate among HCWs and support staff and immune response 10 years after primary vaccination.Methods: A retrospective study was conducted in the Public Institution Health Centre of Sarajevo Canton in Bosnia and Herzegovina. Second-generation vaccines Euvax (Sanofi Pasteur, Thailand/LG Life Sciences Ltd, Korea) and Engerix B (GlaxoSmithKline, Belgium) were applied. A level of ≥ 10 IU/L anti-HBs was set as a cut-off value indicating the presence of protective immunity against new HBV infections and successful vaccination. Results: In total, 1541 (75.80%) were fully vaccinated, out of 1126 (73.07%) were females. The median age of participans was 50.5 ± 9.4 years. Control measurement of the anti-HBs level was performed for 409 (26.54%) HCWs. During the research, 37 booster doses were administered. Of the 23 retested participants, anti-HBs ≥10 IU/L were observed in 19 (82.16%). Three non-reactors subject were revealed.Conclusions: A satisfying HepB coverage rate and a high protective rate against hepatitis B infection among HCWs and support staff was achived. These results indicate the active engagement of the institution in the implementation of preventive measures and the high level of awareness regarding the significance of immunization. Our results demonstrated the effectiveness of booster doses. A low prevalence of non-reactors was revealed. Additional research with a focus on occupational risk factors in dental service is advised.

S. Šegalo, Daniel Maestro, Lejla Berhamović, E. Berhamović, Dinko Remić, Arzija Pašalić

Introduction: Needlestick injuries (NSIs) are one of the most frequent routes of the transmission of bloodborne pathogens in health care settings and the substantial source of occupationally acquired bloodborne infections. They remain a significant problem for developing countries that lack the ability to implement more reliable technologies and available guidance because of the economic situation. The objectives of the study were to determine the frequency of NSIs among healthcare workers (HCWs) and supporting staff in primary health care, to investigate the factors that caused these injuries and to evaluate a set of implemented guides. Methods: A retrospective study of the Department of infection control records of NSIs between January 2003 and January 2016 was conducted. Incidence proportion (rate of injury risk) was calculated for each profession with reported NSIs. Results: A total of 156 NSIs and sharp injuries were reported to the Department of infection control during the 12-year period. Among the group of HCWs, medical nurses/technicians (54.49%) were the most common injured workers, and the lowest numbers were reported by a physical therapist and dental technicians (0.64%). In a total number of cases, support staff accounted for 16.67%. The most incidents occurred during the use of needles, in 146 (90.6%) cases. Calculated incidence proportion for medical doctors is 0.24%, 5.33% for dentists, and 13.8% for medical and dental nurses/technicians and laboratory technicians. For support staff, the calculated rate is 6.04%. Conclusions: At the primary health care level, the NSIs frequency among all employee profiles is lower and it is suggesting the possibility of underreporting cases. Healthcare facility management should consider introducing new and more reliable technologies to reduce the number of NSIs especially among nurses/technicians, laboratory technicians, and cleaning staff. Additional training and preventive measures should be directed towards the proper disposal of medical waste. Management of the Institution presented engagement to prevent the occurrence of NSIs, and it is a positive example for all countries in transition.

The aim of the research is to determine the effects on the recognition and naming of certain sentence structures through a verbal and non-verbal approach, or through the use of a verbal and non-verbal communication channel. The study was conducted on a sample of 30 deaf pupils at age from 11 to 14 years. As a measurement instrument, a modified image description test was used. The test consisted of six complexes, illustrated sentences, in which the actions and subjects performing certain actions are shown in the picture sequence in a way that deaf children understand. The descriptive analysis method was used for data processing. Measures of central tendencies and variations have been made. Testing the difference between verbal and non-verbal approach was performed by t-test. The correlation between the chronological age and the recognition and naming of the spoken structures were verified through the non-verbal approach. The results of the research have shown that respondents have achieved better results in recognizing and naming spoken content using the non-verbal communication channel, that there is a statistically significant difference in the use of verbal and non-verbal communication approaches in recognizing and naming spoken content, and that there is a high correlation between the chronological age of respondents and recognizing and naming of spoken content through a non-verbal approach.

Alija Sadiković, Azra Kurtić, Olivera Sadiković, Maida Mulić, Amela Džubur- Alić, Munib Smajović, Arzija Pašalić

Introduction: Occupational stress is inevitable, but prolonged and intense can lead to serious health problems. Neglecting this significant aspect of work and inadequate treatment of the first indicators results in the reduced working capacity of healthcare professionals. Material and methods: Assessing working conditions of 100 healthcare professionals regarding stress impact on empathy and workability was the primary goal of this study. A survey was conducted to identify differences between work in intensive care units and other clinical departments all related to empathy, workability, and stress perceiving to determine what is a better predictor of workability. Results: In the research group “intensive care units”, significantly lower empathy quotients, poorer workability, and different stressors were registered compared to research groups named “other departments”. Conclusion: The main conclusion of the study states different dynamics in the working environment of intensive care units compared to other departments that could potentially harm the personal capacity of healthcare professionals. 

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