An ergonomic analysis and computer simulations of nursing activities while raising the patients in hospitals and nursing homes

Background: The use of trolleys for transporting the patients and lifting and lowering them in the trolley is a repeated activity in the daily work of a nurse, and a very common cause of the load of the lumbosacral part of the spine and the consequent pathological deformity, and the onset of clinical symptomatology of painful lumbo-sacral syndrome. The high level of excessive biomechanical stress is associated with the established practice of using standard medical wheelchairs to move patients inside the hospital. The process itself depends on the characteristics of the patient, his or her weight, as well as his/her cooperativeness, but primarily depends on the nurse's mobility. Although nurses strive to be in a position that reduces the load on the lumbosacral part of the spine during practice, this is often impracticable due to the patient's inconsistency. Objective: To present the ergonomic analysis of the medical nurse's workplace while lifting the patient into the wheelchair and to display solution for improving working conditions and prevention of musculoskeletal disorders. Results: By ergonomic module of this software, we got results that present load on lumbosacral region of spine of medical nurses during their daily activities, especially in the position of lifting and lowering patients. It was concluded that maximal spinal loading decreases significantly and becomes less than critical (3,100 N) in the case of a wheelchair that has ability to automatically lift and lower patient. Conclusions: The use of hospital wheelchairs with an mechanism for the automatic lifting and lowering of patients and with a sliding seat will reduce the load on the lumbosacral region of the spine, prevent the onset of lumbosacral pain syndrome, facilitates work for the medical nurse and allows nurse to handle the patient on her own. The prevention of lumbosacral pain syndrome improves the quality of work of the nurse and extends the working life. Use of this type of wheelchair is justified in terms of cost-benefit analysis

THE INFLUENCE OF THE INDIVIDUAL EDUCATIONAL-REHABILITATION PROGRAM ON THE MOTOR COORDINATION OF STUDENTS WITH VISUAL IMPAIRMENT

The motor development of the child, especially motor coordination, is important for performing purposeful activities. The aim of this study was to determine the impact of individual educational and rehabilitation treatment on motor coordination in studentswith visual impairment. The sample included one student, male, aged 9 years, with a diagnosis of nystagmus, amblyopia and astigmatism. The initial and final assessment was done with the student, and the Beery-Buktenica developmental test of visual-motor integration (VMI) fifth edition was used for the same, which is intended for the assessment of visual-motor integration, visual perception and motor coordination. For the purposes of this research, the subtest Motor Coordinationwas used, which consists of 30 tasks. After the initial assessment, an individual educational-rehabilitation treatment lasting 2 months was conducted. Survey data was processed by frequency analysis. Based on the obtained results, it can be concluded that there has been an improvement in students in the field of motor coordination. The results of the research indicated the importance of recognizing students with motor coordination difficulties as early as possible, as well as the importance of conducting educational and rehabilitation treatment, with a positive effect on motor coordination

UTICAJ IZABRANOG LJEKARA NA OBUHVAT MMR VAKCINOM

U evropskom regionu Svetske zdravstvene organizacije u toku je proces eliminacije malih boginja (morbila) i rubele, odnosno kongenitalnog rubela sindroma – KRS. Da bi se sproveo proces eliminacije navedenih oboljenja, neophodno je postići obuhvat obveznika imunizacijom protiv malih boginja sa dvije doze i rubelom sa jednom dozom od najmanje 95%. Pretpostavka je da na procenat obuhvata primoimunizacije MMR-om može uticati to da li obveznik ima izabranog doktora. U toku jula i avgusta 2014. godine sprovedena je studija presjeka kojom su prikupljeni podaci o primoimunizaciji MMR vakcinom za sve obveznike vakcinacije rođene od 01. januara 2008. do 31. decembra 2012. godine. Istovremeno, prikupljeni su i podaci o tome da li obveznici imaju izabranog doktora ili ne. Obrađeno je 40938 djece rođene od 01. januara 2008. do 31. decembra 2012. godine koja se nalaze u registru obveznika za imunizaciju. Ukupan obuhvat za obveznike navedenog uzrasta u trenutku sprovođenja analize iznosio je 94,1%, pri čemu je za obveznike sa izabranim doktorom (39471) 96,3%, a obveznike bez izabranog doktora (1474) 34,1%, što predstavlja visoko statistički značajnu razliku. Trenutno, učešće obveznika bez izabranog doktora u ukupnom broju obveznika iz analiziranih kohorti na nivou države iznosi 3,6%, uz variranje na nivou pojedinih opština, koje se kreće u rasponu od 0,7% do 7,4%. Rezultati studije jasno ukazuju da su obveznici koji imaju izabrane doktore u značajno većom obimu primoimunizovani MMR vakcinom od obveznika koji nemaju izabranog doktora. Neophodno je sprovesti aktivnosti kako bi se broj lica, obveznika za imunizaciju, sveo na vrijednost ispod 1% od ukupnog broja obveznika, kao i dopunske aktivnosti, koje podrazumevaju pozivanja i vakcinaciju obveznika koji nemaju izabranog doktora

Mathemathical modelling and numerical simulations of COVID-19 spreading - example of Bosnia

Introduction: Mathematical modeling of coronavirus disease spread and computer simulations are currently one of the main tools in public health that can give important indicators for prevention planning. Based on mathematical projections and daily updates of information, the measures are either tightened or reduced, in order to protect the health of the population. Aim: The aim of this paper is to present a computer system based on an adequate mathematical model that allows frequent execution of various scenarios of spread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in any period in the future. Also, the aim of this article is to point out the importance of measures for the prevention of coronavirus disease 2019 (COVID-19) in Bosnia and Herzegovina through examples of computer simulation models. Methods: Software solution based on the USLIRD model (Unpopulated - Susceptible - Latent - Infectious - Recovered - Deceased) was developed, with a number of variable parameters ‘reproduction number, delay period, infectivity period, hospital capacity, characteristics of population). By setting these parameters in accordance with the existing and available data, the model is brought to an optimized state with the possibility of a realistic assessment of the course of the infection curve in any future period. Data from the beginning of the pandemic are collected at the Faculty of Mechanical Engineering, University of Sarajevo and updated several times a day. The set of measures is divided into two types. 'Intervention 1' is a measure to close institutions that are at high risk for pandemics, working from home, wearing face mask, enhanced hygiene when entering facilities with a larger number of people. 'Intervention 2' presents restrictive measures that has been introduced as mandatory in Bosnia and Herzegovina. The period 01.03.2020 to 01.09.2020 was observed. Results: Without epidemiological measures, Bosnia and Herzegovina's health system would quickly collapse. Restrictive measures reduce the intensity of the spread of the infection, save human lives and keep the health system functional, but with consequences on other aspects of society - reduction of economic activities, collapse of the service industry and companies and disorders in mental health status of the population. Four different scenarios of the situation were analyzed. Scenario number three is current condition with measures that are currently in Bosnia and Herzegovina. The reintroduction of restrictive measures leads to a decrease in the number of infected population and suppression of the spread of the pandemic, which is shown in scenario 4. Conclusion: Self-discipline, adherence to measures, while trying to avoid restrictive measures should be the way to fight the COVID-19 pandemic. Whatever the consequences, the initiation of restrictive measures to preserve the health of the population should be imperative

Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro

Introduction. Female sex workers (FSWs) are a group at increased risk for human immunodeficiency virus (HIV) infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0%) of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR) = 22.7, 95% confidence interval (CI) = 2.3-228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4-118.9) towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0), and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5). Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs