Introduction: Lumbar pain syndrome is one of the most common conditions in clinical practice, more common than 290 other pathological conditions, which affect up to 84% of adults in a certain period of their life. The origin of the lower back pain can be classified as mechanical, neuropathic and secondary due to another illness. Patient education and information, muscle strengthening exercises, maintenance of routine daily physical activity and pain therapy are the basis of acute non-specific pain syndrome therapy. Aim: To determine the success of the motion therapy procedure in the prevention of lumbar pain syndrome relapse. Material and methods: The research is prospective, longitudinal, manipulative and controllable. It was conducted in the private practice “Praxis - dr. Pecar” in the period from June 20, 2014 to June 1, 2016, and included 200 respondents with symptoms of lumbar pain syndromes divided into the experimental (n=100) and control (n=100) groups. The presence of lumbar pain syndrome relapse in respondents experimental and control group was recorded in the second and third clinical examination. Results: In the second examination, 4 (4%) of the respondents from experimental group and 37 (37%) of the control group responded had LBS relapse. In the third examination, the number of respondents with recurrent LBS in the experimental group was 4 (4%), while in the control group was 17 (17%). After the study, no statistically significant difference was observed in the mean age of respondents who had LBS relapse compared to respondents without LBS relapse, as well as significant influence of sex structure on relapse in the experimental and control group during the second and third examination. Conclusion: After the second examination, the relapse rate in the experimental group was statistically significantly higher in the respondents withstanding jobs, while there was no statistically significant difference in the control group and both groups after the third examination.
Introduction: Time management is an important aspect of successful leadership and involves mastering your own work and time instead of allowing them to master you. Time management is a daily process that is applied in order to rationally use time, work schedules, lists of tasks, delegation of responsibilities and everything else that helps to efficiently use time. Material and methods: This research was prospective, descriptive, analytical and controlled. There was 100 medical worker involved, who have managing jobs of different levels and 100 medical workers who do not have managing jobs, who represented the control group. The questionnaire on „time stealers“ according to Sewert. Demographic data was gathered according to the questionnaire on self construction. Results and Conclusions: Based on conducted research, it was established that there were differences in frequencies of certain „time stealers“ in managers of different levels of University Clinical Center Tuzla; the „time stealers“ are more frequent among these with shorter length of service; These differences are significantly more frequent (p<0.05) for some questions e.g. being distracted by phone calls, meetings that are held just for the sake of having a meetings, insufficient, one-way or bad communication with superiors, and have negative effects on management of business hours.
Abstract Introduction: Charles Darwin recognised the importance of emotions and of the ability to control one's own emotions. Nowadays, the fact that the most influential and successful individuals attribute their personal development and success to not their intellectual ability but to emotional intelligence speaks for itself about the importance of this term. Emotional intelligence, when observed as a characteristic or a personality trait, is closely tied with emotional maturity and stability. Health professionals ought to be active members when it comes to treatment and rehabilitation and thus they need to participate in the change of communication, whether by following or influencing the change themselves. Objectives: Examine the characteristics, emotional competence distribution frequency as a factor affecting communication in the field of health care. Respondents and methods: The survey covered a sample of 64 respondents working as head nurses/technicians and/or charge nurses/technicians in the primary healthcare, i.e. community health centres in Sarajevo Canton. Survey and Theoretical Analysis methods were used. Results: Examination of frequency distribution in the Emotional Competence Scale, as a factor affecting communication in the field of health care, includes the presentation and analysis of the results achieved for each of the 14 items on this scale with the structure of responses and total score of the employees of the Community Health Care Centres in Sarajevo Canton, along with ranks for each of the items based on the total number of points as the scalar value of the item. Conclusion: Upon examination of the statistical analysis of the results of the Emotional Competence Scale, it can be concluded there are statistically significant differences in the average level of emotional competence as a factor affecting communication in the field of health care among the respondents based on their work place. Key words : emotional competence, communication, nurse/technician.
Modern forms of life marked by the sedentary habits and fast food, and with an extended life of humanity have led to the increasing occurrence of people with osteoporosis at a younger age. Osteoporosis is a devastating disease of the skeletal system characterized by low bone mass and changes in bone micro-architecture structure itself (1). It is characterized by reduced weight per unit volume normally mineralized bone, corresponding to body size, age, sex and racial affiliation. Such changes in the structure of bones lead to an increased risk of breaking bones (2). Osteoporosis as a disease is a silent epidemic because bone loss may be present dozens of years before the appearance of the symptoms. As a disease, it is usually diffusely distributed, and specific localization of fracture is the wrist, spine and neck of the femur. Often it is called the "silent epidemic" because of the lack of signs and symptoms until the first fracture. Fractures lead to reduced quality of life, prolongation of hospitalization until the long-term institutionalization and death (3). The World Health Organization (WHO) has defined osteoporosis as a reduction in bone mineral density of more than 2.5 standard deviations compared to healthy young population, and is determined by densitometry as the only method for diagnosing the disease and monitoring the flow treatment. Today, osteoporosis has epidemiological proportions in the world, and although it is difficult to define the size of the problem, because of the way the formation and detection of the disease, the data shows that there are 25 million women and 12 million men in the world suffering from this disease. Osteoporosis as a disease is a major medical, social and economic problem (4). In Croatia, there is no registry of patients with osteoporosis, nor a fracture register in people diagnosed with osteoporosis. However, in a study that dealt with 6,000 people aged 20-70 years respondents from Croatia participated along with respondents from 13 countries. What was discovered is that respondents from Croatia have similar bone mass as well as subjects of European countries. It is estimated that in Croatia, 90,000 men and 77,000 women has a fracture of the spine after 55 years of age (5). The most effective way to treat osteoporosis is actually working on the prevention of early youth. Numerous studies have shown if people exercise and consume diet enriched with calcium, they have significantly reduced risk of osteoporosis and fractures, which is considered the most effective method of prevention (6). The number of patients is growing daily and in 2010 the number of patients in the United States at the age of 50 years was 99 million (6); therefore the World Health Organization (WHO) in the decade of combat with osteoporosis have confided world experts to find "tools" for the prevention and "fight" against the disease. Because of the wide extent of the problem, WHO in the decade from 2000 to 2010, in which it dedicated to "fight" against osteoporosis, has accepted FRAX score as a possibility and the way in which patients can calculate the ten-year risk of fracture, and thus help prevent and reduce the number of people with osteoporosis (7). In that period it was confirmed that the safest diagnostic test for the registration and monitoring the course of treatment is densitometry which was set by the World Health Organization (WHO) as a guideline for diagnosing osteoporosis. However, in this period, in order to assist in the prevention and assessment of possible risks of fractures was placed the Fracture Risk Assessment Tool (FRAX score) computerized calculator.
Introduction: Pedobarography as a new diagnostic tool enables measuring the pressure between the foot and the floor during dynamic loading. Dynamic analysis of the foot shows advantage over static analysis due to its capabilities for detecting high load points in certain diseases and in certain phases of walking. Pedobarography as a new method in the context of rehabilitation include wide range of clinical entities. Goal: To show the advantages of pedobarography as new diagnostic and rehabilitation method in prevention programs. Material and methods: A prospective study included 100 patients with diabetes mellitus type 2. Research was conducted in the Primary Health Care Center of the Sarajevo Canton and the Center for Physical Medicine and Rehabilitation. The test parameters were: Test of balance–symmetric load for the test, the number of comorbidity, clinical examination of foot deformity, test with 10 g monofilament, HbA1c. From the total sample 45 patients (Group I) were selected, aged 50-65 years, which underwent pedobarography (on the appliance Novel Inc., Munich with EMED™ platform) and robotic fabrication of individual orthopedic insoles, followed by control pedobarography. Plantar pressure was determined using standard pedobarography, computer recorded parameters: peak pressure (kPa), force (Ns), area (cm). Results: The average age of the respondents was 59.4±11.38 years; altered results on the balance test were present in 34% of patients; 61% of respondents have ≤2 comorbidity. In the total sample, the average number of foot deformity was 2.84. Flat feet have 66% of respondents, and valgus position 57%. The average HbA1c values were 7.783±1.58% (min.5–max.15.0). All subjects (45) after the first, and after the second measurement of peak pressure, have values above 200 kPa, or are in the designated zone of peak pressure that needs to be corrected. In a study was determined the correlation between the number of deformities and peak pressure, the number of deformities and the area upon which plantar pressure act, test with 10g monofilament and peak pressure. Conclusion: Within the framework of prevention programs early diagnosis, detection of sensitivity disorders, adequate treatment and taking load from the feet with the help of pedobarography, are of great importance for the patient suffering from diabetes
Introduction: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. Material and methods: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. Results: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). Conclusion: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.
Goals: The goal of this study was to determine the effectiveness of the organization and coordination of multidisciplinary team consisted of health and kinesiology professionals at the correction of posture among girls in the period of the second phase of intense growth and development. Material and methods: Testing was conducted on a sample of 70 girls, aged 11.9±2.3 years, in which by the expert evaluation is recorded weakness of individual muscle groups, but also of the whole musculature. For the assessment of posture we applied the method of Napoleon Wolanski. Used are 9 variables that included the observed region of the body and an overall assessment of posture. The subjects were included in the program of kinesiology treatment with duration of 28 weeks. For all the parameters have been applied statistical procedures at univariate and multivariate level. Results: Data on subjects were obtained by measuring the same variables at two time points, i.e. before and after the application of kinesiology treatments. Analyses of differences arithmetic mean and mean values were done with the t-test for paired samples. In order to determine global quantitative differences of tested variables tested discriminant analysis was applied. The results showed that the models which complement the experience and practical application of expert health professionals and kinesiology knowledge is a very effective tool for improving posture of girls in the second phase of intensive growth and development. In this way can be prevented health problems that might arise later in life.
Introduction: A person’s response and functioning under condition of stress and confl ict is fundamentally different from its usual behavior. Aim: To point out what type of attitude toward the management of healthcare institutions is worth developing as well as to determine which psychological dimensions of employed the best refl ect the efficacy of the management.Methods: The study included a sample of 52 subjects employed at the Clinical center at University of Sarajevo and 64 subjects employed in Healthcare clinic in Sarajevo Canton. Survey method and a method of a theoretical analysis were used in the data collection and processing.Results: The study concluded that there is no statistically significant gender difference in attitude about the value of talent development at managerial level as a factor in development of attitude toward communicationin healthcare. We find t-value of 2,213 for the Clinical center at University of Sarajevo and 2,210 for Healthcare clinic in Sarajevo Canton.Conclusion: No statistically significant results have been found for any of the factors considered in the study with respect to the gender differences.
The accessory deep peroneal (ADPN) nerve has been regarded as an anomalous nerve derived from the superficial peroneal nerve or its branch and supplies motor innervations for extensor digitorum brevis (EDB) and sensory innervations for the lateral part of the ankle and foot regions. The EDB is usually innervated exclusively by the deep peroneal nerve, a major branch of the the common peroneal nerve, however, in as many as 28% of patients (with same male/female frequency), one or both of the EDB muscles are (partially or exclusively) innervated by the ADPN nerve. This anomaly appears to be inherited in autosomal dominant fashion with incomplete gene penetrance. ADPN existence is of great clinical and surgical importance, and the aim of this study is to describe a very rare case of coexistence ADPN and anterior tarsal tunnel syndrome.
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