Electronic On-line Incident Reporting System (IRS) as a Tool for Risk Assessment in Radiation Therapy.

Background: Radiotherapy is one of the primary treatment options in cancer management, together with surgery and chemotherapy. Radiation therapy is technologically complex discipline involving professionals with various specialties, and using high energy radiation in treatment of wide range of different cancer types. Technical complexity, increasing number of patients, large workload, and delivery of radiation therapy treatment with lack of human, technical and financial resources in low and middle income countries creates environment with great potential to develop incidents. Emerging need of modern radiation therapy is to develop preventive approach to risk management i to improve the patient safety. Objective: The objective of this research is to identify and assess risk associated with radiation therapy practice in Bosnia and Herzegovina. Methods: An anonymous, voluntary electronic on-line radiation therapy incident reporting system (IRS) was created. IRS consists of four sections containing questions about working environment, incident occurrence, root causes and contributing factors, and incident severity assessment. Data collected using IRS were used to create taxonomy of incidents in radiation therapy. Risk assessment was made using Risk Matrix method. Research was made using the data collected from first 60 incidents reported to IRS. Results: Based on probability and frequency of incident occurrence and severity of consequences, it was assessed that 41.7% of incidents had low risk level (L), 50% of incidents had moderate risk level (M), and 8.3% of incidents had high risk level (H). Radiation therapy risk profile based on risk assessment results clearly shows that incidents with low frequency, low occurrence probability, but high consequences severity level have highest level of risk. Conclusion: The results of this research confirm that the electronic on-line radiation therapy IRS allows the identification and classification of the most significant risk factors in radiotherapy and prevention of serious incidents occurrence.

Association Between Risk Factors and Prevalence of Musculoskeletal Disorders Among Laboratory Professionals-an European Perspective.

Background: Musculoskeletal disorders (MSDs) are a large group of diseases that severely affect work productivity and quality of life. Objective: To examine the differences in the prevalence of MSDs among laboratory professionals (LP) and to assess their association with individual, psychosocial, and occupational risk factors. Methods: In a multicenter, cross-sectional study, a questionnaire was distributed online through professional association networks. Participants were divided into two groups based on their territorial affiliation-European Union (EU) and non-EU member states. Descriptive and inferential statistics were included in the analysis, and statistical significance was set at ≤0.05. Results: A total of 640 LPs from 20 European countries participated in the study, predominantly females (78.4%) with university degree (59.4%) and mean age of 41.2 ± 10.1 years. Statistically significant differences between groups were confirmed for several variables studied: neck flexion > 15o (p = 0.008), hands at chest level (p = 0.000), longer screen time, and sitting (p = 0.000). One-third of participants reported wrist (35.6%), shoulder (32.7%), and elbow (31.6%) pain, while low back pain was more common (48.9%). A statistically significant association was confirmed between the incidence of MSDs and stress at work, repetitive movements, and prolonged standing (p = 0.000). Several variables showed significant correlations with MSDs in different body parts (p <0.05). Conclusion: Our results show a higher prevalence of MSDs in LPs and recommend the development of targeted prevention programs and additional measures to modify the work environment and organizational activities.

Effects of Physiotherapy on Rehabilitation and Quality of Life in Patients Hospitalized for COVID-19: A Review of Findings from Key Studies Published 2020-2022.

The estimated percentage of individuals with COVID-19 due to infection with SARS-CoV-2 in need of hospitalization mostly increases proportionally with age, reaching almost 10% for those older than 60 years. Among hospitalized patients, one-fifth require treatment in the intensive care unit (ICU) due to acute respiratory distress syndrome, multiorgan failure, or hypoxemic respiratory insufficiency. Patients with moderate and severe COVID-19 who were hospitalized during the early stages of the pandemic and who continue to be hospitalized report fatigue, muscle weakness, joint stiffness, reduced mobility, increased risk of falls, and impaired quality of life. Physiotherapy is recognized to be important in the rehabilitation of COVID-19 patients requiring hospitalization. The current physiotherapy guidelines and recommendations for individuals with COVID-19, which include treatment methods and outcome measures for evaluation of the effects on respiratory and physical function and quality of life, are those established from the pre-COVID-19 era. The available extant scientific literature mainly reported the effect of physiotherapy in patients with COVID-19 in the acute, hospitalization courses of the disease, while there is a lack of quality primary, experimental studies on the effects of physiotherapy in rehabilitation of post-COVID-19 patients after hospitalization. This review aims to present an update on the effects of physiotherapy on rehabilitation and quality of life in patients hospitalized for COVID-19 and the findings from key studies published between 2020 and 2022.

The Proportion and Type of Carbohydrates in the Diets of Children in Early Adolescence.

Background: Carbohydrates are mainly substrates for energy metabolism and can affect satiety, blood glucose levels, insulin secretion, and fat metabolism. Their amount and type in the diet affect metabolic responses. High-carbohydrate diets, particularly high sugar consumption, are considered particularly harmful because of their specific characteristics related to postprandial metabolism, effects on hunger and satiety, and thus on caloric intake and energy balance. The European Food Safety Authority has suggested that the reference intake for carbohydrates should be between 45 and 60% of total energy requirements and less than 10% should be added sugars, especially for children. Objective: Investigate the proportion and type of carbohydrates in the diets of children in early adolescence in two territorially distinct areas, the continental and the Mediterranean. Methods: The study was conducted as part of a longitudinal cohort study. The survey was conducted in elementary schools in two regions: continental and Mediterranean. The School Physical Activity and Nutrition Survey was used for research purposes. Descriptive and inferential statistical tests were applied for data analysis. Results: A total of 1,411 respondents of both sexes aged 12-15 years, 729 boys and 678 girls, participated in the study. The intake of carbohydrates in the total sample is represented in the daily intake of 59%. The proportion of natural sugar in the diet of boys is statistically significantly higher in the continental compared to the Mediterranean region at the age of 12-13 years (p = 0.002), 13-14 years (p = 0.049), and 14-15 years (p = 0.002). Added sugars in total carbohydrate intake are statistically significantly higher in girls in the Mediterranean region compared to the continental region at ages 12-13 years (p = 0.048), 13-14 years (p = 0.001), and 14-15 years (p = 0.001). Conclusion: The high intake of added sugars in children in the Mediterranean region is of concern, although the intake in the continental area is well above current recommendations. Therefore, one of the public health goals is to promote proper nutrition as well as the availability of healthy foods in schools, especially during early adolescence when proper eating habits are adopted.

The Vitamine Source, Usual Food Intake at Students.

INTRODUCTION: Inadequate vitamin B 12, folate status and B6 are associated with an increased risk for chronic diseases that may have a negative impact on the health. AIM: The aim of our study was to investigate dietary intake of vitamin B12, B6 and folates from various foods among the university students. METHODS: Dietary intake of foods having vitamins B12, B6 and folate was assessed among the students of University of Sarajevo, 19-22 years old, from 2017 to 2018. The participants were interviewed to collect information regarding age, socioeconomic status, B12, folate, B6 vitamin, and usual food intake during one week. RESULTS: The main sources of vitamin B12 and B6 in the students' diet were chicken white meat (51.8-53.7 %), beef (45-63 %), cream (62.2 -72.1 %), sardines in oil (47.9-52.2 %), tuna (55.2 -60.4 %), cheese edamer (80.1%) and cheese feta (67.4%-73%). The foods with a high source of vitamin B12 and B6 but rarely consumed were fish, shellfish, salmon, roasted trout and mackerel. Sufficient folate intake was mainly achieved through dietary intake of beans (48.5-57.2%) and oatmeal (46.3-48.2%), while folate-insufficient diet resulted from intake of spinach (30.9-35 %), turkey (26.2-33.4 %), lentils (16.9-19.7 %) and soy (9.4-15.5%). CONCLUSION: Our results show that there is an important percentage of the students in Canton Sarajevo that do not meet the recommended intakes for vitamin B12 and B6 and folate. Additional research is needed to establish the best cost-effective public health approach to achieve sufficient intake of these vitamins.

Correlation Between Quality of Life and Depression Among Persons Suffering from Psoriasis.

INTRODUCTION: Chronic dermatitis is a major sociomedical issue still being marginalized due to generally accepted view that skin diseases are less of a health problem than is the case with diseases of other organs and organ systems for they are not life-threatening. Measurement of quality of life of persons suffering from psoriasis could become an important factor in assessing the success of treatment and modern aspect of integration of the diseased into the planning of therapeutic procedures, monitoring of their outcomes and improving the quality of treatment. AIM: To determine the quality of life and the degree of depression of persons with psoriasis, as well as to make a correlation between the two. PATIENTS AND METHODS: A descriptive and analytical study of cross-sectional character has been performed. The sample consisted of N = 56 respondents with medically verified diagnosis of psoriasis that was treated at the Clinic for Skin and Venereal Diseases of the Clinical Centre of the University of Sarajevo. Criteria for involvement of participants: respondents are to be over 18 years of age with verified medical diagnosis of psoriasis, and to voluntarily consent for inclusion in the research. The research instruments consisted of standardized questionnaires: the WHO-BREF Quality Questionnaire and the Beck Depression Inventory. RESULTS: Median value of scores relating to quality of life of persons with psoriasis from our sample was highest in the domain of social interaction and amounted to 72 (51.50-81.00); the domain of physical health was 63 (39.50-75.00); the psychological condition was 63 (44.00-75.00); and the environmental domain was 63 (44.00-73.50). Depression of persons with psoriasis showed correlation with domains of quality of life. The depression proved correlated with the respondents': physical health (rho = -0.793 p = 0.0001); psychological health (rho = -0.842 p = 0.0001); social interactions (rho = -0.598 p = 0.0001); as well as with attitude towards the environment (rho = -0.709 p = 0.0001). Gender, age, education, marital or employment status did not prove statistically significant for influencing occurrence of the depression. CONCLUSION: Given that median scores of all four domains of the quality of life of persons suffering from psoriasis were in the higher half of classification scale, the quality of their life can be considered as satisfactory. The degree of depression and the domain of quality of life are in negative correlation with psoriasis.