Recognition of COVID-19 with occupational origin: a comparison between European countries.

OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

Children's Eating Behaviour Questionnaire: association with BMI in children aged 3-10 years from Bosnia and Herzegovina.

OBJECTIVE: To evaluate differences in children's eating behaviour in relation to their weight status. DESIGN: Prospective, cross-sectional study. Anthropometric measures were taken and age- and sex-adjusted BMI percentiles and Z-scores were calculated according to the Centers for Disease Control and Prevention recommendations to assess weight status. Parents completed a questionnaire which included demographic data and the Children's Eating Behaviour Questionnaire (CEBQ) to assess eating behaviour. SETTING: Tuzla Canton, Bosnia and Herzegovina (September 2016-September 2017). PARTICIPANTS: Male and female children aged 3-10 years and one of their parents. RESULTS: The study sample comprised 2500 children; 6·8 % of them were underweight and 14·4 % were overweight, while there were 14·8 % obese children and 64·0 % had normal weight. The factor analysis of CEBQ revealed an eight-factor solution. Significant differences in CEBQ subscale scores were found within BMI categories for all CEBQ subscales except Food Fussiness. On the other hand, child BMI Z-scores showed a linear increase with the 'food approach' subscales of the CEBQ, except the Desire to Drink subscale which was excluded from analysis, and a decrease with 'food avoidant' subscales. CONCLUSIONS: The present study suggests that the CEBQ is valuable for identifying specific eating styles that are associated with weight status and can be seen as important and modifiable determinants implicated in the development and maintenance of overweight/obesity as well as underweight.

[LOW BACK PAIN AT NEW WORKING AMBIENT IN ERA OF NEW ECONOMY: A SYSTEMATIC REVIEW ABOUT OCCUPATIONAL RISK FACTORS]. / LUMBALNI BOLNI SINDROM U NOVOM RADNOM OKRUZJU U ERI NOVE EKONOMIJE: PROFESIONALNI CIMBENICI RIZIKA.

Low back pain is the second most common symptom-related reason for physician visits and the first reason of working disability. Low back pain is a ubiquitous complaint, with particularly high prevalence among people in their working years (67%). For many individuals, episodes of back pain are self-limited and resolve without specific therapy. For others, however, back pain is recurrent or chronic, causing significant pain that interferes with employment and quality of life. Many occupations have been anecdotally linked to certain low back pain syndrome. However, the relationship between the work environment and the patient's symptoms, though clearly perceived by the patient to be causative, may be less certain. The injury model of an occupational disorder proposes that specific work activities are the cause of the patient's pain. The injury model for low back pain; implicating a causal connection with specific work activities, is complex and controversial. Determining whether a patient's low back pain is a consequence of his or her occupational activity, and how best to treat symptoms to maximize functionality and potential for a return to full employment capacity, can be challenging. In this systematic review which included patients/employees with low back pain, the following databases were searched: Pub Med, Embase, Medline and Web of science. The role of occupational mechanical exposure e.g. lifting as a risk factors for low back surgery has been debated for several decades. Diagnostic uncertainty exists even for those with back symptoms and well-described findings on scan, as these findings are common even in subjects without back pain, and may be unrelated to the symptoms. As an example, herniated disks can be identified in significant numbers of CT or MRI low back studies in subjects with no back pain. In further analysis, lifestyle factors and occupational psychosocial exposures will be addressed. Many physicians, including those practicing in primary care settings where back pain is most often seen, lack training and confidence in addressing workplace issues. Occupational factors that have a significant influence on the development of low back pain disorders are not only mechanical and postural order but also organisational, social and psychological. Organisational changes and physical and psychological job demands should not be overestimated as causal factors. In the early phase of a work disability more emphasis should be laid however on appropriate information and medication and, in case of persistant impairment, active treatment (after 3 weeks or relapse). There is some evidence that catastrophizing as a stress coping strategy might lead to delayed recovery. Long-term work (sick) absence can be estimated through evaluation and observation of LBP risks and characteristics of the each individual case. An early return at workplace and to activities of daily life is urgent. To reduce LBS and its consequences, employers need to adopt a multifaced approach: concentrate on improving physical conditions as well as the psychosocial and environmental aspects of working environment. In cases at risk for chronification and/or with obstacles to reintegration at work an interdisciplinary work-oriented rehabilitation and occupational rehabilitation interventions (occupational reintegration) should be provided.

Screening for depression patients in family medicine.

GOAL: The aims are to establish the prevalence of newfound, unidentified cases of depressive disorder by screening with the Becks Depression scale; To establish a comparative relationship with self-identified cases of depression in the patients in the family medicine; To assess the significance of the BDI in screening practice of family medicine. PATIENTS AND METHODS: A prospective study was conducted anonymously by Beck's Depression scale (Beck Depression Questionnaire org.-BDI) and specially created short questionnaire. The study included 250 randomly selected patients (20-60 years), users of services in family medicine in "Dom Zdravlja" Zenica, and the final number of respondents with included in the study was 126 (51 male, 75 female; response or response rate 50.4%). Exclusion factor was previously diagnosed and treated mental disorder. Participation was voluntary and respondents acknowledge the validity of completing the questionnaire. BDI consists of 21 items. Answers to questions about symptoms were ranked according to the Likert type scale responses from 0-4 (from irrelevant to very much). Respondents expressed themselves on personal perception of depression, whether are or not depressed. RESULTS: Depression was observed in 48% of patients compared to 31% in self estimate depression analyzed the questionnaires. The negative trend in the misrecognition of depression is -17% (48:31). Depression was significantly more frequent in unemployed compared to employed respondents (p = 0.001). The leading symptom in both sexes is the perception of lost hope (59% of cases). CONCLUSION: All respondents in family medicine care in Zenica showed a high percentage of newly detected (17%) patients with previously unrecognized depression. BDI is a really simple and effective screening tool for the detection and identification of persons with symptoms of depression.

The Relationship Between Work-Related Stress and Depression: A Scoping Review.

Objectives: Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge. Methods: We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria. Results: Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified. Conclusion: The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

The influence of the use of benzodiazepines in the frequency falls in the elderly.

INTRODUCTION: 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. MATERIAL AND METHODS: 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. RESULTS: 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.

Disability Weights and Years Lived with Disability of Depression with and Without Suicidality.

Background: Globally, depression is a silent epidemic, and more than 350 million people suffer from depression. For a long time, the belief prevailed that children and young people cannot suffer from depressive disorders, and depression is slowly becoming one of the leading health problems among the young population. Objective: This research aims to determine the mental health disorders burden attributed to depression, anxiousness, and fear with and without suicidal ideation among youth in Bosnia and Herzegovina. Methods: A prospective cross-sectional study was performed as screening of depression by Hamilton standardized screening instrument from May 3, 2018, to April 4, 2019, among young people, students in secondary schools, and the Faculty of Pharmacy and Medical Faculty of the University of Tuzla in the most populous Tuzla Canton in the Federation of Bosnia and Herzegovina. In achieving the research goals, we expressed the burden attributed to depression with and without suicidality, anxiousness, and fear as Disability Weight (DW) and Years Lived with Disability (YLD). For the population level, YLD was calculated by multiplying DW by the prevalence rate of depression, anxiousness, and fear per thousand of the population (YLD= DW x prevalence/1000), and DW was adjusted for suicidality. Results: The participants' ages ranged from 16 to 24 years, with a mean of 20,6 ± 1,9 years. The Body mass index (BMI) of 21,9 ± 2,7 is the recommended reference value of 18.5-24.9 kg/m2. The depression score of all participants ranged from 0 to 32 with a mean of 7.4± 6.3, which for our population of respondents at the sample level implies entry into the zone of presence of depressive symptoms. Descriptive statistics and differences per gender in sociodemographic variables (age, education state, and secure monthly existence); and modified factors attributed to satisfaction needs (life satisfaction, hope for the future, support from person of influence). Most participants belong to the age group 19-21 years, 71,44% (n=180), and the same 14,28% (n=36) other age groups (16-18 and 22-24 years), and sixty-two percent of participants are university students, and twenty percent are university failures. Conclusion: Based on our findings, the very high burden of depression in Bosnia and Herzegovina was found greatly not recognized and unsolved problem among the young population aged 16-24 years. Recognizing and screening depression in young people is the first step to prevention.

Association between shift work and extended working hours with burnout and presenteeism among health care workers from Family Medicine Centres.

Aim To investigate the influence of irregular shifts on increased emotional, physical, and cognitive exhaustion and decreased working performance expressed by the phenomenon of presenteeism. Methods The study sample of 405 healthcare workers from Family medicine centres completed questionnaires in two measurement time points, in 2014 (TP1) and repeated in 2019 (TP2), when 301 respondents remained in the study. Healthcare workers completed questionnaires assessing demographics, work schedules, job burnout, and presenteeism. Results Repeated long-term exposure to rotating day-evening shifts was a significant risk for increased presenteeism (OR=1.689, 95%CI 1.042-2.739; p=0.001) and burnout (OR=1.705, 95%CI 1.237-2.352; p=0.001). Extended working hours are a predictor of presenteeism (OR=1.989, 95%CI 1.042-2.739; p=0.008). Conclusion The adverse effects of rotating day-evening shifts on burnout and presenteeism among healthcare workers in a family medicine centre was little researched, particularly the issue of managing the risks of exposure to rotating day-evening shifts and extended working hours. This study reflects a situation of uncertainty, in which the logic of precaution is imposed on mental health, and keeps working engagements in health care workers. Appropriate management of shift work and better organization of work schedules in the primary healthcare sector protects the wellbeing of healthcare workers and patients, efficient work, and quality of health care, and invites for future research on better working schedules and introducing preventive interventions with available flexibility of working times.

Associations of burnout with job demands/resources during the pandemic in health workers from Southeast European countries.

Introduction: Despite several studies assessing job demands and burnout in countries from the Southeast European (SEE) region, there is still a lack of data about the psychological impact of the pandemic on health workers (HWs). Aims: The present study aimed to demonstrate and compare levels of burnout dimensions in HWs from SEE countries and to reveal the burnout-job demands/resources relationships in these workers during the pandemic. Materials and methods: During the autumn of 2020, this online multicentric cross-sectional survey studied a large group (N = 4.621) of HWs working in SEE countries. The Maslach Burnout Inventory was used for the measurement of burnout dimensions. We analyzed the job demands by using the Hospital Experience Scale. Remuneration and relationships with superiors were measured using the Questionnaire sur les Ressources et Contraintes Professionnelles (English version). Results: A series of ANOVA comparisons of means revealed the countries in which respondents showed higher mean values of emotional exhaustion (Bosnia and Herzegovina, Bulgaria, Croatia, Moldova, Montenegro, and North Macedonia) and the countries in which respondents showed lower mean values of this burnout dimension (Israel and Romania) (Welch F = 17.98, p < 0.001). We also found differences among HWs from different countries in job demands and job resources. The testing of hierarchical regression models, which have been controlled for certain confounding factors, clearly revealed that emotional exhaustion was predicted by job demands (R2 = 0.37) and job resources (R2 = 0.16). Conclusion: Preventive measures for the improvement of mental health in HWs during the pandemic and beyond have to take into account the differences between countries regarding the country context and current scientific knowledge. A modified stress test should be implemented in hospitals regarding future shocks that might include new pandemics, terrorism, catastrophes, or border conflicts.

Is adrenal exhaustion synonym of syndrome burnout at workplace?

UNLABELLED: The objective of this study is the assessment of the association of burnout syndrome with adrenal exhaustion specific symptoms and signs among 116 patients who were exposed to violence or mobbing at workplace and who were treated during 2005 to 2008 in Department of Occupational Pathology and Toxicology Tuzla; to detect symptoms and signs of adrenal exhaustion differences between patients who were exposed to act of violence as acute catastrophic event and patients who were long-term exposed to mobbing or chronic distress at workplace. MATERIAL AND METHODS: Data of 86 employees who were exposed to mobbing > 1 years (chronic distress syndrome) and data of 30 employees who were exposed to act of violence as acute traumatic crisis situation (evaluation in first week after acute stress situation and post control observation 6 months later). TOOLS FOR ASSESSMENT WERE CLINICAL EXAMINATION AND QUESTIONNAIRES: Occupational stress questionnaire (OSQ short version), self-constructed Questionnaire about symptoms and signs of Adrenal exhaustion; self-constructed mobbing questionnaire; and Maslach--Burnout Inventory. RESULTS: The patients expressed their traumatic experiences during exposure to stress more than 1 year (long-term exposure) which were compared with acute stress experiences (mostly high level of stress intensity. CONCLUSION: when workers constant expose to repeat mobbing behavior or have perception of extended distress reaction after act of violence at workplace they are suffering of Syndrome burnout and clinical picture of adrenal fatigue.

Idiosyncratic adverse reactions of most frequent drug combinations longterm use among hospitalized patients with polypharmacy.

GOAL: Inappropriate prescribing of a multiple therapeutic agents to patients with chronic conditions is very common in everyday practice. Adverse drug reactions (ADRs) are still considered as one of the main problems of drug therapy. We investigated idiosyncratic symptoms and signs of adverse drug reactions (ADRs) of the most frequent used combination of drugs among hospitalized patients prescribed polypharmacy. METHODOLOGY: A cross sectional study (design) was performed in Pharmacies "Eufarm Edal" in Tuzla from 2010 to 2011. Polypharmacy was defined as using > or =4 drugs. The total study sample of 166 examiners was interviewed with a questionnaire about ADRs which was developed special for study. Linear regression analyses was used to evaluate predictors of idiosyncratic signs of adverse drug reactions of the most prevalent drug combinations; using length of drugs in cases polypharmacy more than 6 months as independent variable. Age, sex, index of cumulative morbidity, drug number in polypharmacy, type of drug combination related pharmacological effects, type of hospital clinics were used as possible confounders. RESULTS: The most common exposures to various drug combinations were: medication for high blood pressure and heart (62%), psychotropic drugs (59%), antacids (47%) and antibiotics (46%) among hospitalized patients with polypharmacy. Our results indicated that from 9.6% to 90.4% of hospitalized patients with polypharmacy had at least one suspicious long-term idiosyncratic drug combination use symptoms. The ADRs prevalence often used psychotropic drug combination was initiated suspected idiosyncratic adverse reactions: confusion, depression, anxiety, decreased libido and insomnia. Linear regression analyses also showed that it remains a very strange, and negative idiosyncratic and lacking therapeutic effects of use of antacids in conditions of polypharmacy. CONCLUSION: The toxicity of some drug combinations may sometimes be synergistic and be greater than the sum of the risks of toxicity of either agent used alone. In order to recognize and to prevent ADRs (including drug interactions), good communication between pharmacist and patient and/or physicians and patient is crucial, and prescribers should develop an effective therapeutic partnership with the patient and with fellow health professionals.

Female breast cancer in relation to exposure to medical iatrogenic diagnostic radiation during life.

AIM OF THE STUDY: Exposure to radiation and aging are the leading causes of breast cancer among female patients. We aimed to investigate and assess the relationship between exposure to medical, diagnostic and iatrogenic radiation and breast cancer using a questionnaire among 100 newly diagnosed female breast cancer patients and 100 control female subjects without cancer. MATERIAL AND METHODS: A case control study using a family ambulatory based survey was conducted among 200 female patients from all municipalities of Zenica-Doboj Canton. New cases of breast cancer among subjects of experimental groups (n = 100) were diagnosed between 1 January 2003 and 31 December 2007 using the institutional clinical procedure for breast cancer diagnosis. Data were obtained using a self-rated questionnaire on radiation as a breast carcinogen. Data analysis was performed using SPSS version 19.0. RESULTS: There were no significant differences between the two groups and their subgroups for individual data and demographics except for prevalence of decreased family financial situation (practical poverty) among subjects with breast cancer in relation to control subjects (31%: 17% among control subjects; p = 0.001). Female patients who are exposed to iatrogenic radiation before the 3(rd) year of life (OR = 1.29; 95% CI: 0.839-1.985) and those who are exposed to CT more than twice per year are more than twice as likely to have breast carcinoma (OR = 2.02; 95% CI: 1.254-3.261) compared to control subjects. Poverty and low family income are vulnerability factors associated with elevated levels of breast carcinoma. This result is not in accordance with prior study results. CONCLUSIONS: It is necessary to develop an adequate registration system of iatrogenic exposure to radiation for each patient of any age, particularly for children aged < 3 years and for CT iatrogenic exposure.

Epidemiological study on the incidence of haemorrhagic fever with renal syndrome in five Western Balkan countries for a 10-year period: 2006-2015.

BACKGROUND: Large-scale epidemics of haemorrhagic fever with renal syndrome (HFRS) have been reported mostly in Asia and Europe, with around 100,000 people affected each year. In the Southeast Europe, Balkan region, HFRS is endemic disease with approximately 100 cases per year. Our aim was to describe epidemiological characteristics of HFRS in five Western Balkan (WB) countries and to describe correlation between HFRS incidence and major meteorological event that hit the area in May 2014. METHODS: National surveillance data of HFRS from Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia and Serbia obtained from 1 January 2006 to 31 December 2015 were collected and analysed. RESULTS: In a 10-year period, a total of 1,065 HFRS patients were reported in five WB countries. Cumulative incidence rate ranged from 0.05 to 15.80 per 100.000 inhabitants (in North Macedonia and Montenegro respectively). Increasing number of HFRS cases was reported with a peak incidence in three specific years (2008, 2012, and 2014). Average incidence for the entire area was higher in males than females (5.63 and 1.90 per 100.000 inhabitants respectively). Summer was the season with the highest number of cases and an average incidence rate of 1.74/100.000 inhabitants across 10-year period. Haemorrhagic fever with renal syndrome incidence was significantly increased (7.91/100.000 inhabitants) in 2014, when a few months earlier, severe floods affected several WB countries. A strong significant negative correlation (r = -.84, p < .01) between the monthly incidence of HFRS and the number of months after May's floods was demonstrated for the total area of WB. CONCLUSION: Our findings demonstrate that the HFRS incidence had similar distribution (general, age, sex and seasonality) across majority of the included countries. Summer was the season with the highest recorded incidence. Common epidemic years were detected in all observed countries as well as a negative correlation between the monthly incidence of HFRS and the number of months after May's cyclone.

Determinants of Burnout among Teachers: A Systematic Review of Longitudinal Studies.

We aimed to review the determinants of burnout onset in teachers. The study was conducted according to the PROSPERO protocol CRD42018105901, with a focus on teachers. We performed a literature search from 1990 to 2021 in three databases: MEDLINE, PsycINFO, and Embase. We included longitudinal studies assessing burnout as a dependent variable, with a sample of at least 50 teachers. We summarized studies by the types of determinant and used the MEVORECH tool for a risk of bias assessment (RBA). The quantitative synthesis focused on emotional exhaustion. We standardized the reported regression coefficients and their standard errors and plotted them using R software to distinguish between detrimental and protective determinants. A qualitative analysis of the included studies (n = 33) identified 61 burnout determinants. The RBA showed that most studies had external and internal validity issues. Most studies implemented two waves (W) of data collection with 6-12 months between W1 and W2. Four types of determinants were summarized quantitatively, namely support, conflict, organizational context, and individual characteristics, based on six studies. This systematic review identified detrimental determinants of teacher exhaustion, including job satisfaction, work climate or pressure, teacher self-efficacy, neuroticism, perceived collective exhaustion, and classroom disruption. We recommend that authors consider using harmonized methods and protocols such as those developed in OMEGA-NET and other research consortia.

Harmonized definition of occupational burnout: A systematic review, semantic analysis, and Delphi consensus in 29 countries.

Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.

80th Anniversary of the Publication of Endemic Syphilis in Bosnia: Survey by the School of Public Health in Zagreb.

Certain regions of Bosnia and Herzegovina were prominent European sites of endemic syphilis. In 1934 and 1935 the School of Public Health in Zagreb, later the Andrija Stampar School of Public Health, conducted two surveys on endemic syphilis in Bosnia and Herzegovina. The surveys were well-described in the monograph published in 1939 by the School, under the title Endemic Syphilis in Bosnia: Survey by the School of Public Health in Zagreb ("Endemski sifilis u Bosni anketa Skole narodnog zdravlja u Zagrebu"). This paper provides a description of the publication for the first time, presents the most important data from it, and explores its significance from the historical perspective.

[Medical error--professional liability for malpractice in Bosnia and Herzegovina]. / Medicinska pogreska--profesionalna odgovornost za stete u Bosni i Hercegovini.

Medical care is frequently compared to aviation, as many of the factors which lead to errors in both fields are similar. In this article we review the literature on such events and discuss the ethical, legal and practical aspects of civil liability in the case of medical error. Ethics, professional policy and the law, as well as the relevant empirical literature, suggest that timely and candid disclosure should be standard practice. In harmonization to ethical codex, the physician is obliged to inform the patient about the origin of medical error. Civil liability is one of the most important parts of law that regulates health care service. Medical chambers could be having a very important role in alternative methods of medical error disciplinary screening proceedings. Guidelines for disclosure of medical error to patients, and their families if necessary, are proposed.

Evidence- based Management Options for Nonspecific Musculoskeletal Pain in Schoolchildren.

INTRODUCTION: Children of school age (8-15 years) have a significant prevalence of non-specific musculoskeletal pain (from 11 to 38%, in our country as much as 48%), which represents a neglected public health problem without adequate preventive interventions. Health workers have little empirical evidence to support their clinical practice in deciding on intervention measures and treating this pain. AIM: The aim of this review article is to expand knowledge of the management of nonspecific musculoskeletal pain in school children based on the evidence. MATERIAL AND METHODS: The systematic review of literature was carried out at Biomed Central, PubMed, Scopus and Web of Science databases in search of relevant evidence supporting the research goal. RESULTS: A total of 564 publications were reviewed and 523 were considered irrelevant. The remaining 47 publications were assessed as potentially relevant, and among them 39 did not meet the criteria for inclusion and exclusion. Therefore, 9 publications met the necessary criteria for further analysis. CONCLUSION: There is little evidence to create an integrative program of intervention measures and treatment of musculoskeletal pain in school children. Based on scarce number of proofs shown in this research, no conclusive solutions have been reached, necessitating a need for further research.

The Site of Musculoskeletal Pain in School Children with Excessive Body Weight and Obesity in Bosnia and Herzegovina.

INTRODUCTION: The number of school age children with excessive body weight and perception of musculoskeletal pain is on the rise. AIM: The aim of this study is to identify the most common sites of acute and chronic musculoskeletal pain in school children with excessive body weight and obesity. METHODS: A survey included 1315 children aged 9-14 years from September 2016 to January 2017 in the Primary schools of Canton Tuzla. The weight and height were measured for each subject based on which a body mass index was determined and two groups were categorized: a group of children with excessive BMI and obesity (N = 406), and the remaining respondents were part of the control group. The Nordic questionnaire was utilized to examine places of perception of musculoskeletal pain experienced by children in the preceding 7 days (acute) or preceding 1 year (chronic pain). RESULTS: Prevalence of overweight and obesity in school children is 31% (significantly higher in boys than in girls, 38%: 25%). The incidence of acute and chronic pain in children with normal BMI 49% is significantly higher than in excessive BMI 45% or in children with overweight 39.1%. Obesity and overweight are risk factors for the development of nonspecific musculoskeletal pain (OR = 1.161, 95% CI, 1.020-1.322). The most common places for chronic pain associated with overweight and obesity are neck (OR = 1.212, 95% CI, 0.893-1.644) and knee (OR = 1.103, 95% CI, 0.690-1.760). While the most common place of acute pain is knee (OR = 1.127 , 95% CI, 0.673-1.890). CONCLUSION: The relationship between excessive body weight and chronic musculoskeletal pain (MSP) in the neck and knees indicates the cumulative effect of exposure to excessive body weight and obesity in BiH school children.

Perceived Work Ability Index of Public Service Employees in Relation to Ageing and Gender: A Comparison in Three European Countries.

BACKGROUND: Increasing longevity raised the prospect of a workplace for ageing workers. Previous studies reveal that work ability decreases with age, even among the healthy, and decreased significantly with age among women. The aim of the study is to examine the perception of work ability of public sector employees aged 55 years and older and gender differences in three European countries. METHODS: A prospective longitudinal study design and standardized "Work Ability Index" (WAI) were used. This study analysed the relationship between ageing, gender, and perceived work ability among 1653 employees aged 45.06±10.90 years (562 men and 1091 women) from Spain, Bosnia and Herzegovina and Monte Negro. The research was conducted in 2018. RESULTS: Older employees had a better WAI than their younger colleagues (P<0.001). The lowest prevalence rate 20% of excellent WAI was between 35 and 44 years of age. The reduction of WAI in Bosnia and Herzegovina was huge 68%, compared with 30% in Monte Negro (more than 2 times) and 14% in Spain (almost 5 times more). CONCLUSION: Gender and age was not protector and predictor of excellent or reduced work ability. Work ability did not decrease with age among women and men, public sector employees. Work ability depends of health and safety, promotion and preventive activities at the workplace.