To assess the frequency of reported mobbing and the association among mobbing, working environment factors, stress, health outcome, personality type, and work ability index in a sample of physicians ...in Bosnia and Herzegovina.
We conducted a questionnaire survey using a validated self-reported questionnaire among 511 physicians in national health sector of Bosnia and Herzegovina. The questions covered five major categories of mobbing behavior. Characteristics of the work, perceived work environment and its effects, stress, health, and satisfaction with work and life were assessed by the standardized abridged form of Occupational Stress Questionnaire (OSQ). A standardized questionnaire Work Ability Index (WAI) was used to determine the relation between mobbing and work ability.
Of 511 surveyed physicians, 387 (76%) physicians self-reported mobbing behavior in the working environment and 136 (26%) was exposed to persistent mobbing. More than a half of the physicians experienced threats to their professional status and almost a half felt isolated. Logistic regression analysis showed that lack of motivation, loss of self-esteem, loss of confidence, fatigue, and depressiveness were significantly associated with lack of support from colleagues. Intention to leave work was associated with lack of support from colleagues (OR 2.3, 95% CI, 1.065-3.535; t =4.296, P =0.003) and lack of support from superiors (OR 1.526, 95% CI, 0.976-2.076; t =5.753; P =0.001). Isolation or exclusion and threats to professional status were predictors for mental health symptoms. Persistent mobbing experience was a significant predictor for sick leave.
Exposure to persistent threat to professional status and isolation or exclusion as forms of mobbing are associated with mental health disturbances and lack of self-esteem and confidence. Setting up a system of support for physicians exposed to mobbing may have important benefits.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction: Factors of cardiovascular risk (CVR) are often grouped in cases with diabetes mellitus (DM) with significant increasment of risk for CV disease . The aim of this research is to ...determine the frequency of CVR and and total CVR in cases with DM and to investigate connection of CRP of other factors of CVR in total cardiovascular risks. Material and methods: In 92 cases with DM weist values were taken as well as body mass index (BMI), blood pressure, sugar in blood, cholesterol, triglycerides, C reactive protein (CRP) and according to SCORE system the 10 year period of CVR were determined. Results: Out of 92 tested cases with age 55,22± 8,3 years, 63,05% were males and 36,95% were women, 81,5% were with values of sugar in blood >7mmol/l, 44,6% were with values of HbA1C>7% and 63,0% >6,5%. The value of cholesterol were >4,5mmol/l in 87%, triglycerides >1,7mmol/l in 78.3% of tested cases. 81,5% of tested cases were overweight and 49% with larger weight values. Average cardiovascular factor according to SCORE system was 3, 92± 3,7% with significant difference among sexes (M-4,86; W-2,32, p<o,05). According to height value CRP (>3mg/l) 52% of tested cases were with high cardiovascular risk. There is significant positive correlation between CRP and cholesterol level (p<0, 01), triglycerides, blood in sugar, HbA1c and upper values of blood pressure (p<0, 05). Significant correlation between CRP and total cardiovascular risk (p=0, 63) was not evident. Conclusion: Cases with diabetes mellitus have high level of non regulated cardiovascular risk factors. Even though there is significant correlation between CRP and and pressure values, sugar in blood, HbA1c, cholesterol, triglycerides, significant correlation between CRP and total cardiovascular risk in cases with diabetes mellitus is not evident.
Significant increase in mortality from coronary heart disease (CHD) has been seen in Bosnia and Herzegovina in the past decade. Little is known about current secondary preventive practices and ...treatments among patients with CHD in primary health care. The aims of this study were to evaluate the components of secondary prevention for CHD and to detect possible gender differences. This trial included 70 patients, aged 40-70 years, with established CHD from Family Medicine Teaching Center Tuzla. We evaluated components of secondary prevention (serum total cholesterol and blood pressure levels, smoking habits, body mass index, using aspirin, ACE inhibitors and lipid lowering drugs) in all participants. Results showed that significantly more men than women had diagnosis of CHD. 26/70 (37.14%) patients had myocardial infarction, with significantly higher number of men than women, but more women had angina only. Mean systolic blood pressure was 148.09+/-20.22 and diastolic 91.62+/-10.17 mmHg; mean total cholesterol level was 6.23+/-1.33 mmol/l; mean BMI was 27.9+/-3.32 kg/m(2). Blood pressure was managed according to guidelines in 19 (27.14%), and lipid concentrations in 11 (15.71%) patients. 55/70 (78.71%) patients took aspirin, only 18/70 (25.71%) patients took lipid lowering therapy, and 20/23 (86.96%) patients with heart failure took ACE inhibitors. 16/70 (22.86%) patients were current smokers, only 19/70 (27.14%) patients had healthy body mass index, while 21/70 (30%) patients were obese. Results of this study show a suboptimal secondary prevention in primary health care, which indicate more effective public health messages and changes in the healthcare system that promotes preventive strategies.
Falls are an important factor of morbidity and mortality in the elderly. Every year falls between 30% and 40% of people over 65 years, and the consequences of injuries in this age are much severe ...than in the younger age groups. Most of these falls resulting from complex interactions between the external and internal factors. The causes of falls of elderly patients are most frequently accidental, limb weakness, difficulty walking and taking medication.
Cross-sectional study, the control type, we analyzed the frequency of falls and individual risk factors for falls in the elderly (> or = 65 years). The dependent variable was the decline and potential risk factors were used: age, sex, use of benzodiazepines.
Out of 376 respondents were significantly more women 242 (64%) compared to 134 men (46%), the decline has been seen 128 (34%) were taking benzodiazepine 216 (57%) of the respondents, the most commonly used benzodiazepine is bromazepam and a positive correlation was found between the use of benzodiazepines and frequency of falls.
To examine the relationship between quality of life, self-rated health, and well-being and to establish the relationship between discontent with familial financial situation and health in adolescents ...living in the Tuzla Canton.
The study comprised a random sample of 356 high school students aged 16, coming from 15 different classes of 16 high schools in the Tuzla municipality. Data were obtained using a validated self-reporting questionnaire on demographic and socioeconomic background, structure, and dynamics of the adolescent's family, life-style, perception, and satisfaction with the financial situation and current health status, as well as social relationships and health care provided in school settings.
In 11% (n=40) of students' households several poverty indicators were present. Twenty three percent (n=82) of the examinees were dissatisfied with the financial situation in their families, and 73% of them came from local, non-refugee families. They presented with progressive symptoms of unhappiness and expressed discontent with their health condition, and even self-hate in comparison with adolescents who were satisfied with the financial situation in their families (chi(2)=21.5; P=0.001). The prevalence of self-rated mental symptoms was significantly lower among adolescents who were satisfied with their financial situation than in those who were dissatisfied (symptoms of depression 57/274 vs 40/82, P=0.001; sadness 73/274 vs 45/82, P=0.001; moroseness 34/274 vs 19/82, P=0.001; under-sedation 29/274 vs 18/82, P=0.001; bad marks and school failures 31/274 vs 20/82, P=0.001; suicidal attempts 11/274 vs 7/82, P=0.001, respectively). Using linear regression analysis we found that adolescents' satisfaction with the financial situation was a major factor predicting depression (OR, 1.57; 95% CI, 1.158-1.855), loss of appetite (OR, 0.82; 95% CI, 0.561-1.235), distraction (OR, 1.19; 95% CI, 0.837-1.154), unhappiness (OR, 1.05; 95% CI, 0.686-1.405), and inability to perform at school as expected (OR, 1.24; 95% CI, 0.903-1.581).
Discontent with the financial situation significantly reduces the quality of mental health, leads to inappropriate patterns of behavior, and endangers future perspectives and well-being of adolescents.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A broad definition of school bullying is when one or more pupils repeatedly disturb, attack or hurt other students. It could be direct and indirect, verbal and physical. Physical and psychical ...symptoms are found more frequently among school bullying victims. The aim of this study is to find out what are the types of bullying according to age, gender and town of study, and sense of safety in different school premises. This cross-sectional study enrolled 484 fourth to eight graders in two primary schools. Results of the study show that the most frequently reported type of victimization is verbal (59%) and the rarest one is sexual (2.24%). The boys are more frequently engaged in physical bullying than the girls, while the girls used verbal type of bullying more frequently. Pupil's sense of safety was highest in the classroom, and lowest in the toilette. In terms of safety in different school premises there are no differences between the towns, except concerning school playground: pupils from Stolac were more unsafe at the playground (31 or 14.3%) than their peers in Posušje (10 or 3.7%).
Metabolic syndrome (METS) represent a simultaneous presence of multiple metabolic disorders in one person. Prevalence is increasing worldwide, which is probably related to increased obesity and ...sedentary lifestyle. Non-alcoholic steatosis or "fatty liver" is a metabolic disease caused by fat dysfunction. It can be a sign of some other disease, and can often be found in patients with metabolic disorders. Ultrasound is an acceptable method for the identification of fatty steatosis. There is evidence that when turmeric is used as a herbal diet, with its active metabolite of curcumin, can repair fatty acidosis and thus prevent progression of fatty steatosis complications such as cirrhosis and liver cancer. Goal. The aim of the study was to determine the effects of 400 mg curcuminaddition to the nutrition on ultrasound morphological characteristics of the liver in METS patients.
A prospective cohort study was conducted on 100 subjects with METS, treated in the family medicine practice of the Tuzla Canton, aged 35-70 years. The therapeutic effects of 400 mg curcumin on ultrasound-morphological characteristics of the liver were followed, validated by ultrasound in 50 respondents of experimental groups with METS. The data were processed by the IBM SPSS Statistics 21 statistical analysis program using parametric techniques andStudent's t-test for paired samples.
There were 65% of women in the study. There were no statistically significant differences in the age of respondents within the analyzed groups. The use of 400 mg curcumin per day was statistically significantly improved ultrasound morphological characteristics of the liver in subjects with METS.
All respondents with METS who used curcumin had beneficial effects on the morphological characteristics of the liver. Curcumin had stronger effects on subjects with METS and DM type 2 than others.
Cardiovascular diseases (CVD) are the leading death cause in modern world and are the most public health problem. WHO program for CVD contains: prevention, command and follow up of CVD in global ...level.
Investigate CVD frequency in family medicine team in 2012.year (one year period of time) and qualitative management prevention and clinical services management quality of CVD together with recommended standards.
clinical revision of clinical standard practice patients with CVD was provided in Family medicine team in Public Health Centre Tuzla for the period of time from January 01 2012 - December 31 2012. For quality of realized services, AKAZ standards were based for: chapter 2. Health promotion and diseases prevention 2.5. preventive clinical services; chapter 3. Clinical services, standard 3.1. Coronary diseases and standard 3.2. TIA and Stroke. From CVD register next parameters had been used: age, gender, disease diagnose, therapy, blood pressure values, total cholesterol values, ß blockers therapy, anticoagulant therapy prescription, smoker status, stop smoking recommendation and influenza vaccination recommendation.
All results were taken in Excel program and statistically analyzed. Descriptive standard tests were taken with measurement of central tendency and dispersion. For significant differentials achieved with χ² chances relation was taken (Odds Ratio-OR) with 95% relevant security. All tests were leveled in statistical significant from 95% (p<0,05).
Considering total registered habitants number 1448 (males 624 females 824) total diseases of usually CVD in Team 1 family medicine 531 (36,67%). The most frequent disease was hypertension which was presented in 30,31% of registered patients but in total CVD illness was present in 82,67%. In relation with total patients number (531), female prevalence from CVD 345:186 males vs. 65%:35%; P=0,001 and was statistically significantly higher. Almost patients were in age from ≥65 years. Nearly all the standards for chapter 2. Health promotion and diseases prevention and chapter 3. Clinical services, standard 3.1. Coronary diseases and standard 3.2. TIA and Stroke are met in larger percentages than the minimum, however, bad quality signs we have found in total cholesterol control were values of total cholesterol were ≤ 5mmol/l achieved only in 27.58% patients with CVD. Stop smoking recommendation in smokers with TIA and Stroke (total 10 smokers) was registered in 20,00% patients. Indicator was not achieved,(min level 25%).
Role of family medicine team is extremely important in patient care who suffer from chronically noncontagious diseases such as CVD, as one of them. Considering that in our country preventive programs for CVD are at small level, results of this study are acceptable. Our plans for personal continuous educations and patient educations about healthy life style are pointed for higher or average of achieved standards and of course everything what have to be done should be written in personal dates of patients.
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