EMDR is a psychotherapeutic intervention that is based on the reprocessing and desensitization of symptoms related to traumatic stress experiences during bilateral stimulation (Shapiro 1995). According to Carrere (2013), approximately 150 000 clinicians have been trained in EMDR within the worldwide since 1995. EMDR training as a practitioner is traditionally organized in a two-level model, which consists of basic training completed in few days of training and supervision training with a minimum period of 20 hours after completion of basic EMDR training (Shapiro 1995). The two components of training do not overlap and there should be a minimum period of 1 year after completing basic training and supervision before seeking EMDR accreditation as a practitioner. This process enables the practitioner to incorporate the theoretical basis of EMDR and use EMDR as a part of comprehensive therapy intervention (Farrell & Keenan 2013). In reality, we see that a variety of internal and external circumstances in the life of practitioners influence the training process which is reflected in shorter or longer pauses during the training. It might be more precise to talk about many individual factors of practitioners that do have significant influence in a formal qualification. In this article, we will present the experiences of practitioners from basic and supervision EMDR at the humanitarian non-governmental organization Trauma Aid UK in Bosnia and Herzegovina (BH) (Hasanovi et al. 2018, 2021).
Abstract Nanoparticle materials have become a promising candidate for a new kind of storage media based on thermally induced memory effects due to the possibility to tailor their magnetic properties and behaviour. In this study, we have investigated whether the magnetic memory effects could appear at high, industry accessible temperatures including the possibility of thermal data inscription. Investigated iron oxide nanoparticles were synthesized by poliol method, which has been modified in order to allow control of particle agglomeration and consequently magnetic properties. Structure, morphology and the degree of nanoparticle agglomeration were studied by X-Ray diffraction, Transmission Electron Microscopy and Dynamic Light Scattering techniques, while magnetic properties as well as memory effects were measured on a commercial SQUID-based magnetometer. Results of the study confirmed that in super spin glass magnetite nanoparticles, magnetic memory effects can be observed up to 200 K which represents much higher temperatures in comparison to those achieved in spin glasses and other glassy materials. Procedures of writing and reading (inscribing and retrieving) of digital information in such a material were demonstrated and discussed in details.
Hip osteoarthritis (HOA) is characterized by degradation of the cartilage and synovitis. However, the pathohistological effects of synovial tissue inflammation on HOA are not clear. The aim of this study was to evaluate the expression of iNOS, BCL-2 and MMP-9 markers in different synovial cell populations. A total of 32 patients were evaluated retrospectively. Age, sex, height, weight, body mass index were recorded and lymphocyte, fibrocytes and macrophages were analysed in tissue sections. Osteoarthritis cartilage histopathology assessment system (OARSI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Krenn score, Harris Hip Score (HHS) and Kellgren–Lawrence (K-L) grading of the hip joints were performed. Total hip arthroplasty was performed on 32 patients and controls. Patients were divided into two groups according to their disease severity. The tissues were immunohistochemically analysed. K-L grade and Krenn score differ between all three groups, but also between moderate and severe OA. Synovial lining cell layer, resident cells in stroma and especially inflammatory infiltration were increasing with severity of OA. iNOS expression in both intima and subintima was positively correlated with Krenn score in moderate and severe osteoarthritis (OA) groups. Expression of BCL-2 in intima of severe OA patients was positively correlated with Krenn score. In conclusion, iNOS, BCL-2 and MMP-9 are involved in the regulation of HOA. Our study indicates a relationship between the pathohistological features, the synovial inflammation and the cartilage condition at the time of hip replacement due to OA or femoral neck fracture.
The presence of a high-density material object such as the vascular access port made of titanium, can affect the homogeneity of dose distribution in underlying tissues. This influence depends on numerous factors but in the first place on the composition material of such an object and its geometry. In this work an influence of the various titanium-made vascular ports, placed in the 6 MV photon field, have been analyzed. The vascular ports of various sizes were placed on the top of thepolymethyl-methacrylate (PMMA) phantom which is then scanned on a computed tomography (CT) simulator to generate the digitized 3-dimensional images for the purpose of treatment planning. The treatment plans were prepared in matRad treatment planning toolkit. The beam profiles and the percentage depth doses have been analyzed. The observed maximum dose values, for ports A, B, C and D, relatively to the maximum dose value in PMMA phantom alone, were 102.25%, 100.62%, 101.78% and 102.48%, respectively. The titanium edges of the ports reduce the dose below them in amount of 8.52%, 8.64%, 10.01% and 10.04% observed for ports A, B, C and D, respectively, in comparison to the central axis dose value obtained in PMMA phantom for the port-free case. The established changes in PDD curves and beam profiles depend on the vascular access port dimensions, reservoir volumes as well as of the amount of titanium content.
Abstract In contemporary Bosnia and Herzegovina, rural poverty is an unresolved issue, despite farming having been a poverty coping strategy for many rural dwellers, especially after the end of the Balkan war. Eradicating poverty is among the priorities of the national government that aims at EU candidacy and accession. Being the most dynamic among agricultural sectors, berry farming is a key agricultural activity at the national level and had been the subject of rural development interventions, including the establishment of agricultural cooperatives. This article provides evidence from the largest agricultural cooperative in Bosnia and Herzegovina, to inform decision making and policy planning. The article aims at describing and analyzing the status and dynamics of poverty at the farm household level while highlighting their contributing factors, as well as at proposing possible development strategies based on the voice of local actors. Given the complexity and multifaceted features of the investigated issues, the methodological approach of this study relies on a mixed-methods research design, where the quantitative findings from the analysis of poverty status and dynamics and their contributing factors are complemented by qualitative findings from participatory activities. The results of the study pinpoint the successful contribution of the cooperative to the improvement of farmers' working conditions and market access and suggest that supporting collective action among berry farmers can be an effective rural development intervention to alleviate rural poverty and prevent poverty fallouts. To date, structural characteristics of farm holdings and households and climate and market-related conditions have significantly contributed to the farmers' poverty as well as to farmers’ exposure to poverty. Furthermore, bridging the gender gap is still a challenge in Bosnia and Herzegovina which should be addressed urgently to mitigate the problem of social exclusion and to promote bottom-up innovation.
Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Systematic review registration PROSPERO CRD42020196301
Background: Cardiac myxoma is the most common benign tumor of the heart. It presents with a variety of clinical signs and symptomatology making diagnosis frequently quite a challenge. Objective: The aim of this article is to present a case report of giant right atrial myxoma with symptoms of right heart failure in adult patient. Case report: We present a case of large right atrial myxoma which is an uncommon location for this type of heart neoplasms, discovered incidentally in a female patient 77-year-old who came to our polyclinic for cardiological exam with hypertension last 11 years and obesity. Results and Discussion: Various clinical signs and symptoms produced by cardiac myxomas have been reported in the literature. Depending on location and morphology, cardiac tumors can produce four types of clinical manifestations: systemic-constitutional, embolic, cardiac, and secondary metastatic manifestation. Echocardiography as non-invasive imaging method and Transesophageal echocardiography has superior role for precise evaluation of cardiac tumors. Transesophageal echocardiography has superior role for accurate diagnostic evaluation of cardiac mass. Surgical excision of cardiac myxoma carries a low-operative risk and gives excellent short- and long-term results. Conclusion: Myxoma is the most prevalent primary heart tumor. It is rare to find a myxoma in the right atrium, occurring only in 15-20% of myxoma cases. Clinical manifestations of myxomas consist in a triad: constitutional symptoms, embolization and intracardiac obstruction. Transesophageal echocardiography has superior role for precise evaluation of cardiac tumors. Currently, there is no effective medical treatment, and surgical excision of the tumor is necessary.
In the present study, we try to establish whether specific disciplines in women’s artisticgymnastics are equal and should the applicable Code of Points (COP) be revised in terms ofpoint standardization on apparatus. Our sample included all-around senior female gymnastswho participated in the qualification (C-I) competitions from 2009 to 2019. The aim of ourresearch was to determine the impact of individual apparatus D and E score in women'sartistic gymnastic in relation to the final result of all-around event. The age among seniorsrise from 2009 to 2019 for 1.88 years. In our analysis, we have found that the results achievedon each apparatus were significantly different. The average final scores on vault weresignificantly higher than on all other apparatus. Significant predictors of all-around successseem to be uneven bars D and E scores and balance beam E score. It was interesting toobserve that the vault, balance beam and floor D scores were not significant predictors.Coaches can use the results from this research in their planning of preparation tactics forgymnasts in all-around, team and apparatus competitions.
Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.
Aim To investigate the impact of pre-treatment serum total prostate-specific antigen (PSA) level on prevalence of prostate carcinoma detection in prostate core needle biopsy, and its correlation with established prognostic factors. Methods Prostate needle biopsy samples of 115 patients with available pre-treatment serum total PSA (tPSA) level were analysed. For all cases where morphology alone was insufficient, immunohistochemistry was performed using p63, CKHMW and AMACR antibody panel in order to confirm or exclude the existence of prostate carcinoma. Results Statistically significant positive correlation between serum total PSA values and prevalence of finding prostate carcinoma in needle biopsy specimens was found (p=0.011), as well as in the case when the patients were classified into groups according to tPSA levels (p=0.028). Serum total PSA values and levels (level groups) showed significant positive correlation with Gleason score (p=0.029 and p=0.036, respectively) and Grade Group of prostate carcinomas (p=0.044 and p=0.046, respectively). Sensitivity of the screening test by using 4 ng/mL as cut off value for tPSA was 94.12% (CI: 80.32-99.28%), specificity 8.64% (CI: 3.55-17.00%), positive predictive value 30.19% (CI: 21.65-39.87%) and negative predictive value 77.78% (CI: 39.99-97.19%). Conclusion The increase of serum tPSA value increases the likelihood of finding prostate cancer on needle biopsy specimens. Due to such findings and its positive correlation with a grade of prostate cancer, our study indicates that tPSA can still be considered as a useful tool both in detecting and predicting aggressiveness of prostate cancer.
Aim To evaluate the relationship between numerical and categorical immunohistochemical score of Ki-67 and human epidermal growth factor of receptor 2 (HER2) with clinicopathological parameters of breast cancer (BC). Methods The study included 311 patients with invasive BC diagnosed at the Department of Pathology, School of Medicine in Sarajevo, Bosnia and Herzegovina, during the period 2015-2019. The expression level of Ki-67 and HER2 was detected by immunohistochemical analysis. Results The expression of Ki-67, as a numerical variable correlated significantly with tumour grade (p=0.025), progesterone receptor (PR) (p=0.034) and categorical score of HER2 (p=0.028). When Ki-67 was categorized into high (>14%) and low (≤14%) level groups, a statistically significant association was found between Ki-67 level groups and HER2 status (categorical and numerical) (p=0.001 and p=0.043, respectively), as well as significant negative linear correlation with PR (p=0.037). The expression of HER2, as a numerical variable, showed a statistically significant correlation with tumour grade (p=0.038), PR (p=0.025) and categorical Ki-67 (p=0.043). Categorical score of HER2 correlated significantly with age (p=0.025), histologic type (p=0.039), tumour grade (p=0.016), estrogen receptor (ER), (p=0.002) progesterone receptor (PR) (p=0.0001), and categorical and numerical value of Ki-67 (p=0.0001 and p=0.0001, respectively). Conclusion The results demonstrated that the categorical immunohistochemical score of HER2 provided a greater association with clinicopathological parameters than numerical score of BC. Furthermore, a slightly better correlation with clinicopathological parameters was shown by the numerical value than by the categorical score of Ki-67 by applying a cut-off value of 14%.
This paper presents the research results of a melt-spun Cu47Zr43Al6Y4 metallic glass. Examinations of its surface, chemical composition and electric resistance had previously been performed and published. Characterization was continued by an x-ray diffraction (XRD) analysis, differential scanning calorimetry (DSC) and microhardness measurements. XRD analysis has unambiguously confirmed that the sample is completely amorphous. DSC measurements were performed with different heating rates which made it possible not only to calculate activation energies, but also to analyse the crystallization process itself. Microhardness measurements have been performed on both sides of the sample.
Aim To present haemoglobin and ferritin parameters in donors to highlight the importance of serum ferritin testing for the purpose of evaluating iron depots in order to make recommendations for preserving a population of blood donors. Method A prospective study was conducted on 80 blood donors divided in two groups: group I (regular donors, n =40) and group II (irregular donors, n=40). Haemoglobin and ferritin were measured twice every 45 days, before two consecutive blood donations. Results By measuring haemoglobin and ferritin values before donation in both groups, a decrease of initial ferritin value in Group I relative to Group II was observed (without statistical significance). A significant decrease was found between repeated measurements for both parameters in both groups, indicating equal intensity of the decline in value regardless of a donor status. Measurement of ferritin before and after donation revealed statistically significant loss of ferritin in all examinees (p=0.011). The decline in haemoglobin after donation, although significant, did not fall below the reference value for donation in either women or men. Conclusion Results indicate the need for periodic monitoring of the plasma value of ferritin in voluntary donors who donate blood more than twice a year and the possible oral supplementation with iron.
Aim To characterize methicillin-resistant S. aureus (MRSA) strains phenotypically and genotypically and to determine their clonal affiliation, representation and antibiotic resistance profile. Methods A total of 62 randomly selected MRSA isolates of different clinical samples collected from 2009 to 2017 were phenotypically and genotypically analysed. Phenotypic analyses were performed by standard microbiological procedures, and using VITEK 2/AES instrument as well as MALDI-TOF (matrix-assisted laser desorption/ionization) technology. Genotypic characterization included spa, MLST (multilocus sequence typing) and SCCmec typing, and detection of the Panton-Valentine leukocidin (PVL) and other enterotoxin encoding genes. Results The largest number of isolates, 21 (33.87%) belonged to ST228-MRSA-I, spa type t041, t1003 and t001. Other major clones were: ST239-MRSA-III, spa type t037 and t030 (27.41%); ST8-MRSA-IV, spa type t008 and t121 (12.9%); ST247-MRSA-I, spa type t051 (4.83%). PVL was detected in 10 isolates (SCCmec IV/V). During 2009 and 2010 the most frequent MRSA strain was South German clone, ST228-MRSA-I (80% and 90%, respectively), while in later years it was replaced with Brazilian-Hungarian clone ST239-MRSA-III (75% in 2015 and 2016). The South German clone, spa type t041 in 90.48% of cases was resistant to clindamycin, ciprofloxacin, erythromycin, cefoxitin, gentamicin, kanamycin, tobramycin and penicillin, while 70.58% samples of the Brazilian-Hungarian clone spa type t037 were additionally resistant to tetracycline and rifampicin. Conclusion This research can supplement the existing knowledge about the clonal distribution of MRSA in Bosnia and Herzegovina and their sensitivity to antibiotics in order to improve the national control of these infections.
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