A Complex Relationship between Quality of Life, Anxiety, and Depression among General Population during Second Year of COVID-19 Pandemic: A Population-Based Study.

Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic's second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS-21 scale for depression, anxiety, and stress, along with the Brief COPE scale, Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative coping was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive coping had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.

Seroprevalence of SARS-CoV-2 antibodies among primary healthcare workers in the Republic of Srpska, Bosnia & Herzegovina: A cross-sectional study.

Healthcare workers (HCW) in primary healthcare centres in the Republic of Srpska, Bosnia and Herzegovina, are on the first combat line with COVID-19. This study aimed to assess the seroprevalence of SARS-CoV-2 among HCW at the primary healthcare centres and to analyse the risk exposure to COVID-19, clinical signs and vaccination status. A cross-sectional study was conducted among HCW at the selected primary healthcare centres between 19 March and 30 April 2021. Antibodies against the SARS-CoV-2 virus were detected by enzyme-linked immunosorbent assay (ELISA). A total of 1,023 HCW (mean age 45 years; 71% female) were included in the study. The anti-SARS-CoV-2 antibodies were detected in 69.5% of all participants. There was a significant difference in seropositivity among primary healthcare centres from different geographical regions. As many as 432 (42%) of all participants had confirmed COVID-19 symptoms before the study and, 84.8% of them were seropositive. This study showed that 702 primary HCW were vaccinated with any of these vaccines: Sputnik V, Sinopharm, Pfizer/Biontech. High titre of SARS-CoV-2 antibodies was found amongst those who received one (92.6%) or both (97.2%) doses of vaccines. In this study, we report high prevalence of SARS-CoV-2 antibody among HCW in primary healthcare in the Republic of Srpska, Bosnia and Herzegovina during the third pandemic wave.

Seroprevalence of SARS-CoV-2 antibodies and knowledge, attitude and practice toward COVID-19 in the Republic of Srpska-Bosnia & Herzegovina: A population-based study.

The aim of the study was to assess the seroprevalence of SARS-CoV-2 in the Republic of Srpska, Bosnia and Herzegovina, and to analyse the knowledge, attitudes and practices of the population toward COVID-19. This population-based study was conducted in a group of 1,855 randomly selected individuals from all municipalities from 1 December 2020 to 15 January 2021. All individuals were asked to sign a consent form and to fill in a questionnaire, following which a blood samples were collected. Total anti-SARS-CoV-2 antibodies were determined in serum specimens using the total Ab ELISA assay. The overall seroprevalence rate was 40.3%. Subjects aged <65 years were 2.06 times more likely to be seropositive than those aged ≥65, and 30% of seropositive individuals presented no COVID-19 symptoms. The household members of seropositive individuals were 2.24 times more likely to develop COVID-19 symptoms than the household members of seronegative individuals. More than 95% of respondents believe that preventive measures are very important to control the infection transmission. Majority of respondents wear the masks properly, maintain the required physical distance whenever possible and wash hands with soap. Nearly 50% of individuals were of the opinion that the vaccine could prevent the infection. This study showed that an overall SARS-CoV-2 seropositivity rate by the middle of January 2021 was very high. Attitudes and practices regarding the COVID-19 indicate that additional efforts should be taken in order to improve the health education with a focus on preventive measures and vaccination.

Effects of problem-based learning modules within blended learning courses in medical statistics - A randomized controlled pilot study.

Problem-based learning (PBL) allows students to learn medical statistics through problem solving experience. The aim of this study was to assess the efficiency of PBL modules implemented in the blended learning courses in medical statistics through knowledge outcomes and student satisfaction. The pilot study was designed as a randomized controlled trial that included 53 medical students who had completed all course activities. The students were randomized in two groups: the group with access to PBL modules within the blended learning course (hPBL group) and the group without access to PBL modules-only blended learning course (BL group). There were no significant differences between the groups concerning socio-demographic characteristics, previous academic success and modality of access to course materials. Students from hPBL group had a significantly higher problem solving score (p = 0.012; effect size 0.69) and the total medical statistics score (p = 0,046; effect size 0.57). Multivariate regression analysis with problem solving as an outcome variable showed that problem solving was associated with being in hPBL group (p = 0.010) and having higher grade point average (p = 0.037). Multivariate regression analysis with the medical statistics score as an outcome variable showed the association between a higher score on medical statistics with access to PBL modules (p = 0.045) and a higher grade point average (p = 0.021). All students in hPBL group (100.0%) considered PBL modules useful for learning medical statistics. PBL modules can be easily implemented in the existing courses within medical statistics using the Moodle platform, they have high applicability and can complement, but not replace other forms of teaching. These modules were shown to be efficient in learning, to be well accepted among students and to be a potential missing link between teaching and learning medical statistics. The authors of this study are planning to create PBL modules for advanced courses in medical statistics and to conduct this study on other universities with a more representative study sample, with the aim to overcome the limitations of the existing study and confirm its results.