15 research outputs found
Bullying Among School Children in Postwar Bosnia and Herzegovina: Cross-Sectional Study
Aim To compare the prevalence and characteristics of bullying between two towns in Bosnia and Herzegovina ā Stolac, which was exposed to firearm conflict during the 1992-1995 war in Bosnia and Herzegovina, and PosuÅ”je, which was outside of the active combat zone. Methods In this cross-sectional study, we included 484 primary school pupils attending 4th-8th grade of elementary school, 217 (44.8%) of them from Stolac and 267 (55.2%) from PosuÅ”je. The pupils were interviewed using a standardized questionnaire on the experience of bullying. Results Every sixth pupil (16.4%) experienced at least one form of bullying almost every day, while 34 (7.0%) pupils constantly bullied other children. Sixth-eighth graders were more often bullies than 4th-5th graders (P = 0.044). Girls were most often victims of bullying, while boys were most often bullies (P = 0.036). The expected difference in bullying between the two towns was not observed, except for older pupils in PosuÅ”je, who were more violent than their peers in Stolac (P = 0.044). Among the analyzed variables of sex, age, town, and school achievement, only male sex was significant predictor of bullying (P = 0.010), increasing the relative risk by 3.005 times. Conclusion Bullying among primary school pupils did not differ between areas that experienced war activities in 1992-1995. Our results could be useful in the introduction of specific prevention measures against bullying in postwar situation
THE ROLE OF FAMILY PHYSICIANS IN THE PREVENTION AND EARLY DETECTION OF CANCER IN HERZEGOVINA-NERETVA AND WEST-HERZEGOVINA CANTON
Background: This study aimed to investigate and analyze the role of general practitioners / family physicians (GPs/FPs) in
counseling and encouraging early cancer prevention, their perception of value systems towards health and disease (especially
malignant diseases), knowledge and experience with the national and local cancer early detection program.
Subjects and methods: A cross-sectional observational study included 38 GPs/FPs from nine municipalities in the Hercegovina-
Neretva and West Herzegovina canton. Data were collected by using an Individual questionnaire for all GPs/FPs which was
prepared according to the Questionnaire for family physicians on implementing the Cancer Control Program, which is used in
Croatia.
Results: Statistical analysis showed that most GPs/FPs carried out activities on primary cancer prevention (educating patients
about smoking, alcohol, diet, physical activity, cancer education, and screening). The majority of respondents stated that it was not
profitable to do screening for lung cancer and stomach cancer. Most GPs/FPs (73.7%) recommended mammography to women
individually, sporadically, according to individual risk assessment.
Conclusions: The scientific contribution and the results of this work can be applied in practice in local communities. Given its
position in the health system, ongoing contact with the population that elected it, and its impact on the local community in which it
operates, GP/FP plays an important role in the prevention of disease. Integration of preventive activities into the daily work of the
doctor plays the most important role in achieving excellent results. Family medicine is primarily focused on primary and secondary
prevention, which is carried out through a continuous approach and long-term management of patients
Influence of warning labels on daily salt consumption and arterial pressure
Prekomjerni unos kuhinjske soli je jedan od vodeÄih Äimbenika rizika krvožilnih bolesti. Cilj istraživanja je bio ispitati utjecaj naljepnica upozorenja, postavljenih na kuÄne spremnike soli, na dnevni unos soli u Mostaru (Bosna i Hercegovina). UkljuÄeno je 150 odraslih, lijeÄenih hipertoniÄara, nasumice podijeljenih u dvije skupine: kontrolna je dobila samo letak s upozorenjem o Å”tetnosti prekomjernog unosa soli, a interventna i naljepnice upozorenja. Mjerena je 24 satna natriurija (Na 24) i arterijski tlak, na poÄetku istraživanja, te jedan i dva mjeseca kasnije. Ishodni Na24 iznosio je 209,2Ā±78,3 mmol/dan ili 12,3 Ā± 4,6 g NaCl-a, bez razlika meÄu skupinama (P= 0,745). Nakon jedan i dva mjeseca u interventnoj skupini Na24 je pao na 183 Ā± 63 i 176 Ā± 55 mmol (P< 0,001), a u kontrolnoj na 203 Ā± 60 i 200 Ā± 58 (P= 0,147). Ukupno sniženje srednjeg arterijskog tlaka je u kontrolnoj skupini iznosilo prosjeÄno 0,7 mm Hg, a u interventnoj 3,6 mm Hg (P= 0,375).
Unos soli je neprihvatljivo visok, Äak i u lijeÄenih hipertoniÄara. Primjenom naljepnica upozorenja taj se unos može bitno smanjiti, no postignuti uspjeh je ipak nedostatan, a dugoroÄni ishodi nepoznati.Excessive salt intake is a major cardiovascular risk factor. Examined was the impact of enhanced warning on daily salt intake in Mostar (Bosnia and Herzegovina). A sample of 150 treated hypertensives was
randomized in a group receiving a leaflet about the harmful effects of excessive salt, and a group receiving in addition warning stickers for household salt containers. Blood pressure (BP) and 24 h urinary sodium excretion (Na24) were measured at the start of the trial, and one and two months later. The average starting Na24 was 209,2 Ā± 78.3 mmol,
equivalent to 12.3 Ā± 4.6 g NaCl, and similar inboth subgroups (P= 0.745). One month and two months later a significant decrease was observed in the intervention group (to 183 Ā± 63 and 176 Ā± 55 mmol; P<0.001) but not in the control group (to 203 Ā± 60 and 200Ā± 58 mmol; P= 0.147). A noticeable decrease in BP (by some 3.6 mm Hg in mean BP; P= 0.375) was observed in the intervention group
only. Salt intake is unacceptably high, even among treated hypertensive subjects. Enhanced warning achieved a marked reduction in Na24 and BP. However, these results are still insufficient and the
long-term effects are unknown
PSYCHIATRIC AND HEALTH IMPACT OF PRIMARY AND SECONDARY TRAUMATIZATION IN WIVES OF VETERANS WITH POSTTRAUMATIC STRESS DISORDER
Background: Along with primary traumatization, wives of PTSD-diagnosed war veterans often become victims of the altered and
dysfunctional state of their partners, which adds to the severity of symptoms of primary traumatization and furthers the development
of other mental disorders. The aim of this study was to compare the effects of primary and secondary traumatization in wives of
PTSD-diagnosed war veterans and wives of war veterans without PTSD.
Subjects and methods: The experimental group consisted of 154 wives whose veteran husbands had been treated in Mostar
Clinical Hospital for psychotrauma-induced PTSD. The control group was formed of 77 wives of war veterans who do not suffer
from PTSD. The research used a general demographic questionnaire, the Harvard Trauma Questionnaire (HTQ) and the MINI
International Neuropsychiatric Interview.
Results: Wives of veterans with chronic PTSD experienced a significantly greater number of traumatic events (t=2.66; p=0.008)
and had higher scores of PTSD symptoms (t=8.93; p<0.001). A significantly larger number of these women reported chronic somatic
diseases (ĻĀ²=4.553; p=0.033). Furthermore, wives of PTSD-affected veterans significantly more frequently met criteria for current
depression episode (ĻĀ²=20.65; p<0.001), past depression episode (ĻĀ²=24.40; p<0.001), depression with melancholic features
(ĻĀ²=19.20; p<0.001), dysthymia (ĻĀ²=7.15; p=0.007), panic disorder with agoraphobia (ĻĀ²=5.28; p=0.022), PTSD (ĻĀ²=18.39; ss=1;
p<0.001) and generalized anxiety disorder (ĻĀ²=19.58; p<0.001). This group also showed a higher level of suicidality (ĻĀ²=8.95;
p=0.003).
Conclusion: The findings of this research show how mental difficulties experienced by wives of PTSD-diagnosed war veterans
affect the interrelationship of their primary and secondary traumatization
Caregiver Burden and Burnout in Partners of War Veterans with Post-traumatic Stress Disorder
War veterans diagnosed with chronic post-traumatic stress disorder (PTSD) experience serious difficulties in social, professional and family life. Consequently, their wives often become indirect victims of their husbandsā dysfunction. The purpose of this study was to assess the caregiver burden and burnout level in partners of veterans suffering from PTSD, especially in cases where partners suffer from their own PTSD symptoms. The experimental group consisted of 154 wives or partners of war veterans treated for PTSD caused by the war trauma in University Hospital Mostar. The control group was made of 77 wives or partners of war veterans without PTSD. The study was based on the General Demographic Questionnaire, the Harvard Trauma Questionnaire, Bosnia-Herzegovina version, Caregiving and the Experience of Subjective and Objective Burden and the Maslach Burnout Inventory. The wives of PTSD affected veterans scored significantly higher in all subscales of the Caregiver Burden Questionnaire and the Burnout Inventory. The results indicated that subjective demand burden, subjective stress and burnout were significantly higher in relationships in which both partners suffer from PTSD compared to couples in which only the veteran suffers from PTSD and couples in which none of the partners has PTSD. Living with a veteran diagnosed with PTSD places a heavy burden on the wife and poses a serious risk of burnout, which has to be taken into account in treatment planning
Selective serotonin reuptake inhibitors and risk for gastrointestinal bleeding
The most of the known effects of selective serotonin reuptake inhibitors, beneficial or harmful, are associated with the inhibitory action of the serotonin reuptake transporter. This mechanism is present not only in neurons, but also in other cells such as platelets. Serotoninergic mechanism seems to have an important role in hemostasis, which has long been underestimated. Abnormal activation may lead to a prothrombotic state in patients treated with selective serotonin reuptake inhibitors. On one hand there may be an increased risk of bleeding, and on the other hand reduction in thrombotic risk may be possible. Serotonin is critical to maintain a platelet haemostatic function, such as platelet aggregation. Evidences from the studies support the hypothesis that antidepressants with a relevant blockade of action of serotonin reuptake mechanism may increase the risk of bleeding, which can occur anywhere in the body. Epidemiological evidences are, however, the most robust for upper gastrointestinal bleeding. It is estimated that this bleeding can occur in 1 in 100 to 1 in 1.000 patient-years of exposure to the high-affinity selective serotonin reuptake inhibitors, with very old patients at the highest risk. The increased risk may be of particular relevance when selective serotonin reuptake inhibitors are taken simultaneously with nonsteroidal anti-inflammatory drugs, low dose of aspirin or warfarin
Formen der Gewalt bei Kindern und Sicherheitsfaktor an bosnisch-herzegowinischen Schulen
Prema Å”iroj definiciji, nasilje meÄu djecom podrazumijeva da
jedno dijete ili viŔe djece uzastopno i namjerno uznemiruje,
napada ili ozljeÄuje drugo dijete. Ono može biti fiziÄko,
verbalno, emocionalno, spolno ili ekonomsko. FiziÄki i
psihiÄki simptomi ÄeÅ”Äe su prisutni meÄu žrtvama Å”kolskoga
nasilja. Cilj je ove studije utvrditi vrste nasilja meÄu Å”kolskom
djecom u dva grada Bosne i Hercegovine i usporediti ih
prema dobi, spolu i gradu istraživanja te ispitati osjeÄaj
sigurnosti na pojedinim mjestima u Å”koli. Ovo popreÄno
istraživanje obuhvatilo je 484 uÄenika IV-VIII razreda
osnovne Ŕkole u gradovima Stolac i PosuŔje. Rezultati
istraživanja pokazuju da je najÄeÅ”Äi oblik nasilja u Å”koli
verbalno nasilje (59%), a najrjeÄi spolno nasilje (2,24%). U
poÄinjenom nasilju djeÄaci ÄeÅ”Äe provode fiziÄko, a
djevojÄice verbalno nasilje. OsjeÄaj sigurnosti uÄenika najveÄi
je u uÄionici, a najmanji u zahodu. U pogledu sigurnosti na
pojedinim mjestima u Å”koli nije naÄena razlika meÄu
ispitivanim gradovima, osim u Ŕkolskom dvoriŔtu. Tako se
uÄenici Stoca osjeÄaju nesigurnije na Å”kolskom dvoriÅ”tu (31
ili 14,3%) nego njihovi vrŔnjaci u PosuŔju (10 ili 3,7%).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\u27s 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 PosuŔje (10 or 3.7%).Kindergewalt im weiteren Sinne meint anhaltende und
absichtliche Beunruhigung oder Angriffe und
GewalttƤtigkeiten eines Kindes oder mehrerer Kinder gegen
einen oder mehrere Altersgenossen. Diese Attacken kƶnnen
physischer, verbaler, emotionaler und sexueller Natur sein
oder auf die Erpressung von Geld abzielen. Physische und
psychische Symptome sind bei Gewaltopfern an Schulen
hƤufiger festzustellen. Mit dieser Studie sollten verschiedene
Formen von Gewalt unter Schulkindern zweier bosnischherzegowinischer
StƤdte ermittelt und untereinander
verglichen werden; des Weiteren wollten die Autoren
herausfinden, an welchen Orten des SchulgelƤndes sich die
SchĆ¼ler sicher fĆ¼hlen. An der Untersuchung nahmen
insgesamt 484 GrundschĆ¼ler der Klassen 4ā8* aus Stolac
und PosuÅ”je teil. Die hƤufigste Form von Gewalt besteht
demnach in verbalen Attacken (59%), am seltensten kommt es zu sexuellen Ćbergriffen (2,24%). Physische
Gewaltanwendung ist meist Jungen zuzuschreiben, wƤhrend
MƤdchen eher auf verbaler Ebene gewalttƤtig werden. Am
sichersten fĆ¼hlen sich die SchĆ¼ler in den Klassenzimmern,
auf den Toiletten hingegen ist das GefĆ¼hl der Unsicherheit
am grƶĆten. DiesbezĆ¼glich besteht auch kein Unterschied
zwischen den StƤdten, in denen die Untersuchung
durchgefĆ¼hrt wurde, ausgenommen der Schulhof. Demnach
fĆ¼hlen sich die in Stolac befragten SchĆ¼ler auf ihrem
Schulhof weniger sicher (31 SchĆ¼ler bzw. 14,3%), ihre
Altersgenossen in PosuÅ”je hingegen schon eher (10 SchĆ¼ler
bzw. 3,7%)