Psychometric properties of the Child Oral Impacts on Daily Performances (C-OIDP) index: a cross-sectional and an intervention study of adolescents in Bosnia and Herzegovina.

BACKGROUND: The clinical measures are not sufficient to assess oral health because they don't tell us anything about functional and psychosocial aspects of oral health and do not reflect person's concerns and subjectively perceived symptoms. This study aimed to investigate the validity, reliability and responsiveness of the child Oral Impacts on Daily Performances (C-OIDP) index among Bosnian 12-14 years old schoolchildren. METHODS: The study population comprised 203 primary schoolchildren aged 12-14 years attending three schools in the eastern part of Bosnia and Herzegovina. Data were collected through: a clinical oral examination, oral health questionnaire and C-OIDP questionnaire. The validity and reliability of the C-OIDP were tested on a sample of 203 school-going children while responsiveness of the C-OIDP was assessed on 42 randomly chosen participants requiring a dental treatment. RESULTS: In terms of reliability, Cronbach's alpha coefficient and the intraclass correlation coefficient were 0.86 and 0.85, respectively. Regarding the testing of construct validity, the C-OIDP score was increased as children's self-reported oral health changed from excellent to very bad and from very satisfied to dissatisfied. There was a significant improvement in C-OIDP post-treatment score compared with C-OIDP pre-treatment score. Overall, 63.4% of participants reported at least one oral impact in the last 3 months. The most affected performances were "eating" (38.4%) and "speaking" (25.1%). CONCLUSION: The Bosnian version of the C-OIDP showed satisfactory validity, reliability and responsiveness and can be used as an appropriate OHRQoL measure for further epidemiological researches.

An Insight into the Biology of the Rare and Peculiar Moss Pterygoneurum sibiricum (Pottiaceae): A Conservation Physiology Approach.

The biological features of the recently described peculiar and rare pottioid moss species Pterygoneurum sibiricum have been studied. A conservation physiology approach through in vitro axenic establishment and laboratory-controlled tests was applied to learn more about its development, physiology, and ecology. Additionally, ex situ collection for this species was established, and a micropropagation methodology was developed. The results obtained clearly document its reaction to salt stress in contrast to its sibling bryo-halophyte species P. kozlovii. The reaction to exogenously applied plant growth regulators, auxin and cytokinin, can be used in the different moss propagation phases of this species or for target structure production and development. Inference to the poorly known ecology of this species should also help in recent species records, and thus improve knowledge about its distribution and conservation.

Possible Effects of Climate Change on the Occurrence and Distribution of the Rare Moss Buxbaumia viridis in Serbia (SE Europe).

The distribution range and occurrence of the rare and threatened epixylic moss Buxbaumia viridis have been reviewed in Serbia. Climatic conditions of its recent distribution in Serbia were involved in species distribution modeling and analyzed with the aim of obtaining a projection of unknown potential sites and future scenarios of its distribution dynamics. The results achieved suggest potential distribution range of the species will be significantly reduced. According to the climate change models, the habitat changes including the range loss of this species are predicted to be drastic, i.e., between 93% and 97% by the year 2050, and between 98% and 99.9% by the year 2070, affecting primarily lower elevations of its current range in Serbia. A major reason for the projected decline of the species is climate change combined with continued poor forest management.

Effects of Cesium on Physiological Traits of the Catherine's Moss Atrichum undulatum Hedw.

Mosses are proven bioindicators of living environments. It is known that mosses accumulate pollutants from precipitates and, to some lesser extent, from the substrate. In this study, the effects of cesium (Cs) on the physiological traits of acrocarp polytrichaceous Catherine's moss (Atrichum undulatum Hedw.) were studied under controlled, in vitro conditions. Cesium can be found in the environment in a stable form (133Cs) and as a radioactive isotope (134Cs and 137Cs). Belonging to the same group of elements, Cs and potassium (K) share various similarities, due to which Cs can interfere with this essential element and thus possibly alter the plant's metabolism. Results have shown that Cs affects the measured physiological characteristics of A. undulatum, although the changes to antioxidative enzyme activities were not drastic following Cs treatments. Therefore, the activities of antioxidative enzymes at lower pH values are more the consequence of pH effects on enzymatic conformation than simply the harmful effects of Cs. Moreover, Cs did not affect the survival of plants grown on the solid substrate nor plants grown in conditions of light and heavy rain simulation using Cs with variable pH, indicating that Cs is not harmful in this form for the studied species A. undulatum.

Factors influencing health profession students' willingness to practice in rural regions of Bosnia and Herzegovina: a cross-sectional study.

INTRODUCTION: The literature indicates different factors influencing recruitment of health professional students to work in rural areas. The purpose of this study is to explore the willingness of health profession students in the Faculty of Medicine Foca, University of East Sarajevo, Bosnia and Herzegovina to work in a rural area following graduation and the factors influencing incentives to pursue a rural career. METHODS: The cross-sectional study included first-year through sixth-year students aged 18 years or older and enrolled in one of three study programs at the Faculty of Medicine: medicine, dentistry and nursing. The questionnaire was distributed at the beginning of the winter semester during the first required lecture for each year and study program class. Data was analyzed using student t-test, analysis of variance when appropriate, Kruskal-Wallis test and multivariate logistic regression analysis. RESULTS: A total of 519 students participated, an 88.3% response rate. Three hundred and ninety-nine (77%) participants responded positively to the question 'When you complete your studies, would you be inclined to accept a job in a rural region?' Factors associated with willingness to practise in rural areas included being female (p=0.027) and having a rural upbringing (p=0.037). Significant differences between medicine, nursing and dentistry students were found in their opinion that willingness to work in rural practice depends greatly on the possibility to get residency more easily (p=0.001). Compared to their peers, nursing students had better opportunities to attend national courses cost-free (p=0.027) and to be involved in the education of new generations of health profession students (p=0.001). Getting a post in an urban area after a work period in a rural area was most valued as an incentive by dentistry students (p=0.037). The multivariate logistic regression model was used to analyze predictors of willingness to practise in rural areas. Students who had been raised in a rural community (p=0.042) as well as female students (p=0.016) were more likely to accept rural practice. Statistical significance at an alpha level of 0.05 was not reached for study program and year of study. CONCLUSIONS: The results of the study showed a high willingness of medicine, dentistry and nursing students to work in rural areas following graduation. Female students and students who were raised in a rural community were more likely to choose a rural career. Stakeholders should be committed to strengthening the rural deployment of health professionals by creating a more attractive, rural environment.

Prevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina.

INTRODUCTION: As non-carious cervical lesions (NCCLs) may compromise aesthetics and function, knowledge of their aetiological covariables enhances management of clinical complaints and success of restorative treatments. AIMS: The primary aim of this study was to assess the presence of NCCLs among the general population of the Republic of Srpska, Bosnia and Herzegovina and the potential association with patient-related risk factors. METHODS: A prevalence study of NCCLs included 738 respondents from eight towns/municipalities. Two dental practitioners examined all respondents. NCCLs were diagnosed according to the Smith and Knight tooth wear index, measured using a Williams periodontal probe. Data regarding risk factors were obtained through a structured questionnaire. Multivariate logistic regression was used to analyse the association of risk factors and the occurrence of NCCLs. RESULTS: Non-carious cervical lesions were diagnosed in 384 (52%) respondents. Multivariate regression analysis showed that several variables were independently associated with the risk of developing NCCLs, including frequent consumption of acid food (P = 0.001), frequent consumption of acid drinks (P = 0.001), retaining drink in the mouth (P = 0.001), alcohol consumption (P = 0.030), bruxism (P = 0.018) and gastro-oesophageal reflux (P = 0.023). First mandibular premolars were the most affected teeth (left: 46.0%; right: 44.0%), followed by the second right maxillary premolars (37.3%), second left maxillary premolars (33.6%) and finally by the first right maxillary premolars (34.0%). CONCLUSION: The results of the current study suggest that NCCLs occur frequently and have a multifactorial aetiology. The lowest prevalence was recorded among individuals younger than 20 years of age. As the majority of risk factors are modifiable, regular dental care could lead to the early detection of NCCLs.

Relationship Between Symptoms of Temporomandibular Disorders and Estrogen Levels in Women With Different Menstrual Status.

AIMS: To evaluate whether serum estrogen level is associated with chronic pain, masticatory dysfunction, and depressive symptoms and/or somatization in women with temporomandibular disorders (TMD) and different menstrual cycle status. METHODS: A total of 64 women were allocated into one of three groups: one composed of women with normal menstrual cycles (Group 1), one composed of pregnant women (Group 2), and one composed of women in surgical menopause (Group 3). All respondents underwent a standardized clinical examination with the Research Diagnostic Criteria for TMD (RDC/TMD). Diagnoses were generated according to Axis I, and grades of chronic pain, depressive symptoms, and somatization were evaluated according to Axis II. The level of serum estradiol was measured by using the immunofluorescent method. Analysis of variance, Kruskal-Wallis test with post hoc comparisons via series of Mann-Whitney U tests, and Spearman correlation coefficient were used for comparisons between study participants. RESULTS: Reported pain was decreased with the progress of pregnancy among the women from Group 2 and was the lowest at the 36th week of pregnancy. Women in surgical menopause reported higher pain intensity as well as more difficulties with chewing and eating hard and soft food compared to the other subjects. Depressive symptoms and somatization were lowest among the women with advanced pregnancy and the highest among menopausal women. CONCLUSION: TMD-related chronic pain grade, masticatory dysfunction, and depressive symptoms and somatization are the highest when the estrogen level is the lowest.

Quality of diabetes care in family medicine practices in eastern Bosnia and Herzegovina.

OBJECTIVES: In the present study, the audit of medical files of patients with diabetes, followed in family medicine practices in the eastern region of Bosnia and Herzegovina (BiH), was carried out in order to investigate the frequency of the use of screening tests for early diagnosis of diabetes complications. METHODS: The audit was conducted in 32 family medicine practices from 12 primary health care centers in the eastern part of BiH over one-year period (March 2010 to March 2011). A specially established audit team randomly selected medical files of 20 patients with diabetes from the Diabetes Registry administered by each family medicine team database. Screening tests assessed are selected according to the ADA guidelines. RESULTS: Frequency of the individual screening test varied between 99%, found for at least one blood pressure measurement, and 3.8% for ABI measurement. When the frequency of optimal use of screening was analyzed, only 1% of patients received all recommended screening tests. CONCLUSION: The frequency of the use of screening tests for chronic diabetes complications was found to be low in the eastern part of Bosnia and Herzegovina. Multivariate linear regression analysis showed that longer duration of diabetes and a larger number of diabetics per practice were associated with a smaller number of screening tests, but specialists in family medicine provided a higher number of screening tests compared to other physicians.

Salivary cortisol levels as a biological marker of stress reaction.

AIM: To determine the validity and psychobiological significance of salivary cortisol as a biomarker of stress in the experiments. RESULTS: Stress is defined as a state in which homeostasis is jeopardized by the action of various external and internal stressors. The effect of cortisol is made through specific receptors located in the cytoplasm of the target cells. Determining blood cortisol levels, which has been the most widely used method, is characterized by certain shortcomings. The process of taking blood samples from the vein is accompanied by additional stress, which results in falsely positive results. Another flaw is found in the fact that cortisol taken and measured from serum or plasma represents total cortisol, not the free, biologically active one. Cortisol response lags behind ACTH by 5-20 minutes, with peak blood levels achieved in 10-30 min. The transfer of cortisol from blood to saliva takes place rather quickly, within no more than 2-3 min. CONCLUSION: Although, the studies on correlation between saliva cortisol concentrations and free levels of this hormone in blood samples are lacking, salivary cortisol offer a novel approach in research of stress biomarkers with its ease of collection and potentially wide scope for application.